ROYO hospital limited

28/04/2026

Join us celebrate world asthma day

09/04/2026

She died on arrival.

A mother.Delivered at home.Started bleeding.

A Level 3 facility called for help.We sent the ambulance.

But when she reached us…she was already gone.

💔

This is what we call the 3 delays — and they cost lives:

1️⃣ Delay at home“Wacha tuone…” (let’s wait and see)“It’s just normal bleeding…”

But heavy bleeding after delivery is an emergency.It doesn’t wait.

2️⃣ Delay getting to a facilityDistance. No transport. Time lost.

By the time she reached the Level 3…she was already in danger.

3️⃣ Delay getting definitive careThe facility called for help.But referral takes time.

And sometimes… that time is too much.

⏳

By the time she arrived —her body had already shut down.

💔

This is why we keep saying:

Deliver in a health facility

Don’t ignore heavy bleeding

Act immediately

Because in maternal health…delay is deadly.

28/03/2026

The p***s has two large dorsal vessels: the artery - the blood is led along it, and the vein - according to it, blood is discharged from the p***s. The er****on is provided by the valves located in Dorsal Naya Vienna - it is they who overlap the blood flow and hold the blood in the p***s.

19/03/2026

Scientists Achieve Long-Sought Breakthrough Toward Oral Insulin Pills

By Kumamoto University March 17, 20262

Doctor With Stethoscope Holding White Pill Medicine
For decades, scientists have sought a reliable way to deliver insulin orally, but biological barriers in the digestive system have made this goal difficult to achieve. Researchers have now developed a peptide-based delivery platform that enables insulin to pass through the intestinal barrier and enter the bloodstream. Credit: Shutterstock
A new peptide-based drug-delivery strategy may bring scientists closer to an oral form of insulin.
For more than 100 years, scientists have pursued the idea of delivering insulin as a pill. This goal has remained difficult to achieve because insulin breaks down in the digestive system and the intestine lacks a natural transport pathway that allows the hormone to enter the bloodstream.

Because of these biological barriers, many people with diabetes still depend on daily insulin injections, which can place a significant burden on long-term treatment and quality of life.

Researchers at Kumamoto University, led by Associate Professor Shingo Ito, have now developed a promising drug delivery strategy designed to overcome these obstacles. Their approach uses a cyclic peptide that can pass through the small intestine. The molecule, called the DNP peptide, helps insulin move across the intestinal barrier and into the body after oral administration.

Two Complementary Strategies for Oral Delivery
The researchers established two effective approaches to facilitate the intestinal absorption of insulin:

Mixing method (interaction-based): In this approach, a modified “D-DNP-V peptide” was mixed with zinc-stabilized insulin hexamers. When given orally in several diabetes models, including chemically induced (STZ mice) and genetic (Kuma mice) models, the treatment quickly lowered blood glucose levels to the normal range. With once-daily dosing, stable glycemic control was maintained for three straight days.
Conjugation method (covalent-based): In the second approach, the team used click chemistry to directly attach the DNP peptide to insulin, creating a “DNP–insulin conjugate.” This version produced glucose-lowering effects similar to those seen with the mixing method, supporting the idea that the peptide actively drives intestinal transport of insulin.

Overcoming the Dose Barrier
One of the biggest challenges in developing oral insulin has been the need for very large doses, often more than ten times the amount used in an injection. In contrast, this platform reached a pharmacological bioavailability of about 33–41% compared with subcutaneous injection.

That finding suggests a major reduction in the amount of insulin required for oral use and represents an important step toward real-world clinical application.

DNP Peptide Based Delivery Platform May Support Future Oral Insulin Development
Engineered DNP peptides—either fused to insulin-binding peptides or covalently linked to insulin using click chemistry—directly enhanced insulin absorption in mice. These findings demonstrate that DNP peptides are versatile carriers for the oral delivery of macromolecular drugs, offering a practical way to convert injectable biopharmaceuticals into patient-friendly oral medicines. Credit: Chikamatsu et al.
Perspective
“Insulin injections remain a daily burden for many patients,” said Associate Professor Shingo Ito. “Our peptide-based platform offers a new route to deliver insulin orally and may be applicable to long-acting insulin formulations and other injectable biologics.”

The findings were published in the international journal Molecular Pharmaceutics.

The research team is now moving forward with translational studies. Planned work includes testing the system in large animal models and evaluating its performance in human intestinal systems.

Reference: “Small Intestine-Permeable Cyclic Peptide-Based Technology Enables Efficient Oral Delivery and Glycemic Efficacy of Zinc-Stabilized Insulin Hexamer and Its Analogs in Diabetic Mice” by Shoma Chikamatsu, Kosei Sakaguchi, Masataka Michigami, Kimi Araki, Shoen Kume, Midori Tokuyasu, Takeshi Masuda, Ikuo Fujii, Sumio Ohtsuki and Shingo Ito, 24 November 2025, Molecular Pharmaceutics.
DOI: 10.1021/acs.molpharmaceut.5c00902

10/03/2026

22/02/2026

Rironi–Naivasha–Nakuru–Ngata–Mau Summit corridor should be expanded the same way the Thika–Kenol–Sagana–Nyeri highway was expanded, without condemning hardworking citizens to 30 years of toll payments under Chinese-financed concessions on top fuel taxes and other huge taxations.

‎Tolling will inevitably raise fares and commodity prices while pushing the majority of road users onto longer, poorly maintained alternative routes. That is not development; it is economic punishment.

‎Good governance protects citizens - it does not tax them to exhaustion and then hand public infrastructure to private profiteers, local and foreign, through opaque deals. The Nairobi Expressway is a clear example: an exclusionary, elitist road private owner road serving a small minority of motorists at the expense of mass transit. It is not a model Kenya should replicate.

07/02/2026

Long-term or prolonged use of anticonvulsants (antiepileptic drugs or AEDs), particularly enzyme-inducing drugs like phenytoin, phenobarbital, and carbamazepine, is most commonly associated with Vitamin D deficiency.
Here are the key details regarding vitamin deficiencies associated with anticonvulsants:
Vitamin D Deficiency: Enzyme-inducing AEDs increase the hepatic metabolism (breakdown) of vitamin D into inactive forms, leading to reduced calcium absorption, hypocalcemia, and increased risk of osteoporosis or osteomalacia (softening of bones).
Folate (Vitamin B9) Deficiency: Prolonged use of anticonvulsants, especially phenytoin, primidone, and phenobarbitone, is strongly linked to folate deficiency, which can cause macrocytic/megaloblastic anemia and elevated homocysteine levels.
Vitamin B6 (Pyridoxine) Deficiency: Studies have shown a high prevalence of vitamin B6 deficiency (nearly 50%) in patients taking enzyme-inducing anticonvulsants.
Vitamin B12 and Biotin: Reduced serum levels of vitamin B12 and biotin have also been observed, contributing to further metabolic issues.
Recommendations: Regular screening of vitamin D levels and consideration of supplementation are often advised for patients on long-term anticonvulsant therapy.

24/11/2025

🚨 HOSPITAL IS NOT FIRST COME, FIRST SERVE , PLEASE READ!

Lately, there have been many complaints from the public saying nurses and doctors are “not being fair” because someone may wait for a long time, only for another person to come in and be attended to first. Some believe it’s because the patient is our relative or someone we personally know.

This is not true.

In hospitals, we use a system called TRIAGE.

Triage means putting the right patient, in the right place, to receive the right treatment, at the right time, by the right personnel.

In simple terms:
We attend to the patient whose condition is more serious not the one who arrived first. This is not favouritism; this is saving lives.

Examples:

Someone with a mild fever or headache may wait longer because they are stable.

Someone who is struggling to breathe, bleeding heavily, unconscious, or in critical danger will be seen immediately, even if they arrived later.

This is why you may see another patient being taken in before you.
It is not because we know them , it is because their life may be at risk.

Please also understand that sometimes we may already be with your patient, but if a sudden emergency comes in, we might need to pause and attend to the person whose condition is more critical.

We do this because our priority is to save lives

03/11/2025

Exploring anemia burden and treatment patterns in patients with chronic kidney disease and diabetes
by
Truveta Research

Text graphic with title and subhead Anemia among patients with chronic kidney disease and diabetes anemia burden and treatment research using EHR data
In patients with CKD and diabetes, anemia prevalence and severity increased from stage 1 to stage 5, with overall anemia rising from 46.4% to 85.0% and severe anemia from 2.5% to 11.8%
Erythropoiesis-stimulating agents (ESAs) and IV iron use rose as hemoglobin levels dropped, though with distinct stage-specific patterns and evidence of flexible application of guideline thresholds.
Anemia is a shortage of healthy, oxygen-carrying red blood cells, which leads to fatigue, weakness, and shortness of breath. It is a common complication of chronic kidney disease (CKD), particularly among those with diabetes (1, 2). is the leading cause of CKD and together they create a compounded risk for both the development and severity of anemia (3, 4). In CKD, the kidneys lose their ability to produce erythropoietin, a hormone essential for red blood cell production (1).

Anemia in patients with both CKD and diabetes significantly increases the risk of cardiovascular disease, accelerates the progression of kidney failure, and is associated with higher rates of hospitalization and mortality (7–9). Effective management is therefore essential, and current clinical practice recommendations are outlined in the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines (10).

According to the KDIGO guidelines, anemia in patients with CKD is diagnosed when hemoglobin levels fall below 13 g/dL in men or 12 g/dL in women (7, 10). If iron deficiency is present, oral or is the recommended first-line treatment. If anemia persists despite adequate iron stores and hemoglobin remains below 10 g/dL, erythropoiesis-stimulating agents (ESAs) may be initiated to support red blood cell production (10, 11).

In this report, we examined hemoglobin lab results from patients with CKD and type 1 or type 2 to describe the prevalence and severity of anemia across CKD stage, dialysis status, and patient characteristics. We further evaluated ESA and IV iron use following low hemoglobin values to assess how treatment patterns vary in relation to clinical guidelines and disease stage. The combination of the linked EHR and medical claims data can provide a detailed and more complete view of patient care.

Methods
We used a subset of Truveta Data to identify adults aged 18 years and older with evidence of CKD and type 1 or type 2 diabetes (henceforth referred to as diabetes) between January 2019 and August 2025. CKD and diabetes were defined by the presence of at least one diagnostic code for CKD or diabetes, identified from EHR or medical/pharmacy claims data, recorded prior to the hemoglobin lab. Patients were required to have at least one hemoglobin lab, with continuous medical and pharmacy enrollment for at least six months prior to the test and extending through 90 days afterward. To ensure continuous care, patients were also required to have at least one healthcare encounter in the year preceding the hemoglobin lab.

To ensure that anemia could be attributed to CKD, we excluded hemoglobin lab results if patients had a diagnosis of anemia due to acute blood loss or underwent surgery within 90 days before or 7 days after the test. In addition, patients with a diagnosis of cancer at any time, or who had a live birth recorded within 9 months of their hemoglobin lab were excluded.

Anemia severity classification
Anemia severity was categorized based on hemoglobin levels using s*x-specific thresholds (12):

Severe: 1 indicates higher odds of worse anemia compared with the reference group, while an OR < 1 indicates lower odds. When the confidence interval (grey bars in the image below) crosses 1, the association is not statistically significant.

Patients with COPD (OR = 1.08, p