Saturday, November 27, 2010

TRIAD (ENT,OPthal,Anaesth) Posting!


Yesterday, I officially ended this three minor postings group all togather and called TRIAD posting. It was definitely tiring with so many things to catch up in such a little time. We also log book to fill in and case reports(case write up) to be made for each minor posting. Regardless all, it is indeed an intresting posting as I won't encounter it as houseman (HO) again.

We get 3 weeks for Ear, Nose & Throat (ENT) posting, 3 weeks for ophthalmology and 2 weeks for Anaesthesiology. So total duration like a major posting = 8 weeks !! oh ya, for this posting we need to have an otoscope and opthalmoscope that cost about RM600 altogather. The advantage is you can practice it at people anytime you want.

This is the last minor posting of triad which I am most intrested on. Anaesthetist are also known as perioperative doctor. They manage patient whenever a surgery is involved and will see the patient before. during and after surgery (during recovery). The triad of anesthesiology on the effect aimed during surgery is: anesthesia (unconscious), muscle relaxant and analgesia (no pain).

In this posting, knowledge about drugs & medication is vital. We need to know the types of drug, mechanism of action, effects, indication...all the pharmacology parts. I used to dislike memorizing pharmacology. However, since the posting teaches us the relation and importance of these drugs, it makes pharmacology interesting!

Anesthetist need to be skilled in inserting needles to patient and life saving procedures. We need to do 5 intravenous cannulation at Accident & emergency(OT)within 2 weeks for this posting and see general and regional anaesthesia procedures at Operation Theater(OT). We also took Basic Life course(BLS), learn about defibrillator and type of mask use during the last week(2nd week).
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Yup,maybe I want to be an anaesthetist...put people to sleep..and wake them up after the surgery..hehe :)

Ear,nose & throat (ENT)-Otolaryngology

From the name itself, you can guess which area it involves. It is the first minor posting frm TRIAD. SInce my supervisor is specialize in nose, i see a lot of cases related to nose. In this posting, we need to know how to use the otoscope to see the eardrum clearly. The most intresting thing I was able to see is the presence of Aspergillus Nigra inside the ear (looks like fungi at the bread). The doctor later clean it with the ear toilet (suction of the fungi out from the ear).

normal eardrum that can be viewed via otoscope

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An ear infected with Aspergillus Niger. Diagnosis : otomycosis

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Some common cases seen are allergic rhinitis. They have special clinic day called allergic clinic. Another intresting thing to see is the needle prick test. There will be about 20 antigens of common triggers of allergic like dust mite, prawn an nuts that will be tested. The staff will make a small pricked on the patient's forearm(palmar side) with a blunt pin without bleeding. It is painless. Although, it may cause anxiety to certain people...hehe

Your eyes do not see what your mind does not know!! It is all about eyes and everything related to it. So, the basic science of eyes needed to be revised. I am amzed to know that we can suspect a systemic disease by looking at the eyes. The eyes will effected in most systemic disease know especially diabetes mellitus. We have to learn to use opthalmoscope to see the retina (an area further behind, inside your eyeball) with the help of pupil dilator. We need to draw 20 significant findings of retinal disorder in our log book that needed doctor's sign.

It needs a lot of practice to get the skill of using a direct opthalmoscope. It can be tiring to us as we need to strain our eyes to see the area of retina and find if there's anye significant finding.

However, regardless all, i like the picture of retina..its' beautiful (subahanallah!)

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Next posting will be PSYCHIATRY(my LAST posting for year 4) and then I'll be a FINAL YEAR student after the final exam... (",)

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