Monday, September 26, 2011
Ok, enough about the gushy-mushy feeling..So, we went to Cameron Highland for a 2 days and a night.I'm willing to sacrifice my Siemens 10 km run for this vacation. yeah..i need some de-Stressing activity. Cameron Highland's weather reminds me a LOT like BAndung and Jatinangor...oh how i miss dat place..hurmm. The food was superb..We go there and eat A LOT.. I hope i don't gain weight..hehe
A picture of us playing bubbles (thanks to Miss Nina Hoklai's influence) on a suspension bridge..oh ya da guys are addition to the Mag7. They are our Pak Supir+Sappam (driver+ guard in indo language)
Time tunnel museum is like a collectors display of things from before independence up till 90's. I just like the desk....
We also went to usual place at cameron like strawberry farm, bee farm,cactus valley and tea plantation. The strawberry + yougurt + honey just made my day more sweet & happy...nyum..nyum..
Boh tea plantation was superb. The road was tricky to. It was there since 1920's (some knowledge gain from the video at the museum). I just fell in love with the cafe which was built at the edge of the hill..Wish i have a villa there...haha. They fertilize the tea with aeorplane..so, u can imagine how bis is the place.
ok...so, now back to reality. After 4 hours journey.Thanks to our Pak Supir for his driving skill & effort. We went back home safely,alhamdulillah without injuries or accident. Will start surgical posting the next day...Hepato-billiary team here I come (>,<)
Sunday, September 25, 2011
My experience for IM:
1. Hospital UKM (HUKM/PPUKM)
since this is our prime hospital, we were expected to be ready & be the best. So, most of us are more 'rajin' here. I went to the ward morning, evening and night....with breaks in between. We are entrust with 6- 7 patients per person and expected to know the patients condition & daily management. We are expected to help the housemans doing minor procedures. Follow the rounds and present any new case (thats why we need to come every night to cover the beds).. However, it depends on the Medical officer or specialist. Not all of them expect or wants you to present.......
2. Hospital Teluk Intan (HTI)
Shall i say it as a vacation??? haha...I might after 2 weeks of so call 'hardship' at HUKM. We are send to Perak and stays at a terrace house with given a driver to pick us up. Acceptable accomodation & service given by UKM. HTI patients and medical staff are nice...I mean VERY nice. It is obvious especially the nurses if i compare it with PPUKM nurses. They are VERY nice. Now, I've said it twice. Better not to 'mengumpat' here, coz my life will be miserable in HUKM if i wrote it down. The patients respect you and very humble. However, i do notice some language difference. They are not city people. Therefore, the words we choose must not be too formal. Not all, but most of them...
3. General Hospital (HKL)
We were send here to do Dermatology for a week and general medicine for a week. HKL is a very busy hospital. And yes, the nurses are NICE too even they have twice more patients than HUKM....(ok tak nak mengumpat disini pasal nurse HUKM).The general ward gave me a lot of experience with HIV and intravenous drugs users (IVDU) patients. In HUKM i rarely seen them. In HKL they are admitted almost everyday.There are also a lot of TB patients.
Dermatology was also intresting...Get to see various type of psoriasis, Herpes Opthalmicus and Lepramatous Leprae. Others are contact dermatitis and venous stasis..
Thats all for Internal Med....Next stop is SURGERY...The list is out. I'll be in Hepatobilliary team..wish me all da best (>,<)
Tuesday, September 13, 2011
For my 23rd birthday, my 1st brother bought me ticket for YUNA's concert at Dewan Filharmonik Petronas (DFP). I was soooo thrilled about it. We LOVE music and we spend our teenage life playing trios together during our free time (saxaphone,violin & piano).It turn out to be our siblings night out since both of my brothers decided to come along. SO, their job description that night was driver,photographer,chaperone & bodyguard...hehe
My brothers: Anas, Azhar(excluding Adam cause he got UPSR the next day) and me...
Why I like Yuna?? Simply because of I fall in love with her songs:
1. I can relate with the songs cause some of it related to events in my life.
2. Her music got soul in it..
3. Definitely ORIGINAL!!
4. It is different than other Malaysian artist.
5. The music just suits me..a mixture of everything I like..Just nice.The EP in US is much more better.She has improve a lot.
SO....about the concert. It was brilliant & awesome!! I sat about 10 meters from her.The whole 90 minutes gives me goosebumps.The band was wonderful too. Her music was presented 10 times nicer than the CD. And of course, i'll be biased and say her voice was PERFECT!!
I found out that the concert ticket was sold out and they make another concert the next day. But that additional concert ticket was sold out too...incredible response from her fans!
with some of Yuna's band members Effry(bass), Shafiq (2nd guitar) & Adam (keyboard)...they deserved some compliment too!!
my dream comes true....yeay!!
A 'syok sendiri' poem using some of Yuna song titles:
SHe's just a'GADIS SEMASA'
with 'GREEK GODDESS' aura
who says 'Raya oh Yeah'
and enjoys 'FIREWORK' 'AFTER MIDNIGHT'
She 'DECORATE' her lyrics with musics
they are 'RANDOM AWESOME'!!
'ROCKET' to fame,there she goes..
ain't she just a SUPER SOMETHING?
Saturday, September 10, 2011
FInally,After 4weeks of hectic life as medical student at Medical department, i get to be a mad scientist in the lab...(meaning the chef in the kitchen) haha...it was fun to try out the recipes and experiment on your own cook food.
This year i learned how to make 'ketupat daun palas'. I was suprised that they sell daun palas at Malacca. My mum told me the leave is also used by Malacca people to make desert (kueh)..We made it,Since this food rarely found in Malacca (origin from Kelantan-terengganu).
It takes me quite some time to master this triangle shape casing.
Another food i miss but hard to get in KL is Kerabu Mangga !! The kerabu mangga i found in KL does not have fish in it.Time to make one at home..yippeee
This year is the 3rd eid celebration at my new house in Malacca. This year decided to host a small feast (open house) for our neighbours and extended family around KL, Malacca & Muar. We also celebrate my 1st nephew 1 year old birthday. It was fun. Since our lawn is quite spacious the childrens love to play football and fireworks there.
Birthday boy with his cousin in his Bumblebee (A gift from Mama Tok)
Other projects are some biscuits and my very own bread pudding. Love the oven so much. I wish i can have one at college..with a set of my own kitchen..
Last but not least, I still get 'duit raya'..haha..Even 2 of my cousin (same age as me) who just started working,also gave me their very own duit raya..Oh, i just love being a student. This will be the last year.The privilage will expired & i have to started giving next year (>,<) Insyallah..Misi Jubah Merah 2012!!
Thursday, June 23, 2011
It my 2nd week of posting in Family Medicine & Society (FMS)....
Last week, I our weekly Clinical Pathology Conference (CPC) in UKM Medical Center was presented by FMS department. The main topic was about Isolated Unintentional Weight Loss in elderly.It is a diagnostic challenge for the doctors in primary care ( clinics/ general practitioner) since it can be either apart of aging process or pathological. The doctors cannot just simply refer to specialist.them without knowing the reason to do so.
A 71 years old Malay lady, married with 4 children with background history of chronic illness under medication & follow up
* hyertension for 30 years
* diabetes mellitus (DM) for 6 years
* hyperlipidemia for 6 years
There was a history of stroke in 2005 (6 years ago) that was treated.
She also had peptic ulcer disease.
She came to primary care (klinik kesihatan) with problem of loss of appetite and loss of weight for 2 months.
No fever or sign and symptoms pf Upper respiratory tract infection (URTI) and Urinary tract infection (UTI).
She was not depressed.
On physical examination: she is pale but no other abnormalities found. There is no lymphadenopathy.
Investigation on occult blood test: negative
Ultrasound of the abdomen does not reveal any abnormality.
Management at Primary care:
* come again to the clinic in a week.
* with-hold Oral hyperglycemic agent(OHA) since she is hypoglycemic
*continue hypertensive medication
*communicate with family members: bring patient to the nearest health care center if the patient is deteriorating.
A week later, her condition suddenly worsen and she deteriorates. She is jaundice. Immediately,she was admitted to the medical ward in the hospital..
Further investigation was done and the rults as follows:
*Low Hemoglobin level
*Occult blood test positive
*Increase CA19-9 tumor marker
*Increase Liver function test (LFT)
Final diagnosis : Periampullary carcinoma metastasis to gastric mucosa with obstructive jaundice and impending gastric outlet obstruction...
(what an unexpected complicated diagnosis??....)
Prognosis: The patient had Whipples' Procedure surgery and biliary stenting via ERCP.
click here for the Source of photo
ISOLATED UNINTENTIONAL WEIGHT LOSS IN ELDERLY
Definition: Weight loss of >5% over 6 months (as high as 15-20% in >65 years old)
It's always present with other problems (in this patient: DM, Hypertension, hyperlipidemia). However, there is NO published guideline to manage it.
SO,(in primary care context) either (1) do nothing and accept it as aging process or (2) refer patient for further investigation and management.
What may be the cause???
(1) the most fearful one : MALIGNANCY
(2) should be worried but it is treatable if manage early : NON-MALIGNANCY (60% of the cases) eg: chronic disease(ie DM), Tuberculosis infection.
(3) PSYCHIATRIC ILNESS (10-20% of weight loss) eg: depression
(4) not to worry: ANOREXIA of AGING- physiological change due to decrease smell, taste, chewing and periodontal disease.criteria: 0.1-0.2kg per year.
(5) IDIOPATHIC (25%) unknown cause...
The risk factor for MALIGNANCY(cancer) are Male, increase weight loss, decrease hemoglobin, increase erythrocyte sedimentation rate(ESR), increase ALT,increase LDH
Tumor marker in not the initial investigation, but it it is useful (like in this case)
What can we do if a patient comes to you with unintentional weight loss??
(1) Full history taking
(2) physical examination
(3) investigation: Full blood count (FBC), Renal profile(RP), Liver function test (LFT), ESR/CRP, Chest X-ray, Stool occult blood test.(in there is suspicious/abnormal finding, refer the patient to respective specialist.However, if the findings are normal,observe the patient 3 months later)
Source: notes taken by writer during weekly Clinical Pathological Conference(CPC) on June 15th by Family Medicine & society (FMS) at Universiti Kebangsaan Malaysia Medical Center (UKMMC)
Sites for futher information:
(1) Evaluating and treating unintentional weight loss in Elderly patient-American Academy of Family Physician
(2) An approach to management of unintentional weight loss in elderly people-Canadian Medical Journal Association
Saturday, June 18, 2011
I've been to family medicine posting for just a week and there are a lot of common-everday problems I saw at the outpatient clinic. It is interesting because these problems usually does not need admission and requires simpler management.
Here I would like to share a case that is quite common due to misunderstanding and white lie given by the advertising company regarding the everyday soap for bathing or hand washing.
Source of picture:Wikimedia Commons
A 51 years old senior police officer came with first onset of generalised pruritus (itchiness) for a month. It is more severe at his limbs and abdominal area. It also cause him to have dry skin.
On further questioning on possible allergen contact he denied any allergy towards food,dust,aerosol, current detergent,animals etc. He did not engaged in recent outdoor activites like swimming, travelling or jungle tracking. Moreover, his occupation nature requires him to be inside an air-conditioned room. However he mentioned that he had changed his bathing soap to a antimicrobial soap recently ( I won't mention the brand here...but, it is the commonest anti-microbial being advertised nationwide)
He did seek medical help from private clinic and was given topical cream. His problem relieved by the appliance of the cream temporarily but the symptom persist afterwards.
Other medical illness: sinusitis under medication. There is no chronic illness
He does not smoke or consume alcohol.No fever, loss of appetite or weight. There is no other significance found on other history asked.
On examination of his skin : There skin looks dry with scratch marks.There is no abnormality of the skin indicting skin infection or atopy.
What could be the possible cause of his problem????
* from history, he is not allergic to any possible allergen
* there is no sign of infection
However, the answer is : THE ANTI-MICROBIAL BATHING SOAP!!!
Reason: Anti microbial bathing soap have strong anti microbial properties but LACK of MOISTURIZER. It may not cause problem to younger people since the skin can still produce some naturel moisturizer itself. However, in older people,it will cause dryness of skin and eventually DERMATITIS!!
* Eventhough, Malaysia have high humidity index, our skin still need some moisturizer effect!
So, plan of management:
1. Stop using 'the soap'. Choose a normal soap with good moisturizer properties.
2. Give anti-histamine (Piritone)
3, Moisturizer aqueous to be applied to dry skin
4. Steroid(Hydrocortisone) cream to be applied at the MOST itchy part.
5. Do come back if the symptom persist after a week...(it may due to other cause)
Take home message:
* Choose your hygiene care product that suitable for your skin. If there is any signs of irritation i.e ithciness do change to another product.
* anti-microbial soap is not to be used regularly in people with dry skin type and elderly.
p/s: this case is quite common in primary health care due to lack of knowledge on this kind of matter.
other cause of contact dermatitis : sun light and specific allergens(metals, jewellery...etc)
Saturday, June 11, 2011
I just got back from 5days 3rd Professional & Personal Development (PPD)camp and BTN at Kem Bina Negara at Ulu Sepri, Rembau. I won't comment on the place or cetain issues as we are forbidden to do that. However, i would like to share about what I learned during PPD session.
First of all PPD is the only subject that is compulsory for medical students of UKM. They are starting to implement this program in other faculties in UKM. The 3rd PPD camp is made to prepare us for House officer(HO) life.
The reality of HO life is not short and sweet. I like to quote what was told by a houseman during the video session:" You choose to be a doctor, so do not complaint". She is totally right! We were told about the reality which is not pretty at all. We have to sacrifice a lot of things: missing family functions, no sports,lack of sleep & rest etc..this will continue for 2 years.
Photo of my group members for the LDK session with our facilitator..Thank you very much for sharing your experience with us.
A few lessons learned from my fasilitator who is a professor (peadiatric):
1. BE HUMBLE
*the most dangerous thing is yourself...(EGO)..
* doctors should realize that they are only the INSTRUMENT OF GOD...
* every success they made is from god...your effort contributes to it
* every mistake you make is from yourself because you don't try hard enough to be competent.
* therefore, do not be cocky, think yourself are great because you are the healer!
* treat your parents, siblings,relatives,colleagues, friends and patients right.
2. Be HONEST!!
* do not lie to yourself or others.
* be frank and tell the truth in a nice way. Do not give political correct answer.
3. Cry for HELP!
* being a doctor is not an easy job...ventilate your problems(without mentioning names) to your trusted person (spouse,family,friends)
4. AVOID using CREDIT CARD! * don't event use credit card because you will fall into the financial trap easily.
* our pay won't make us rich but it is adequate for a secure life if we manage it wisely.
5. Treat your patients like your own mother, father and siblings...
To all my batchmates. Hopefully 256 of us will graduate next year...MISI JUBAH MERAH 2012!! Just remember:that a HERO lies in (each of) you!-from our PPD theme song(HERO by Mariah Carey)...
P/S: I was included in mass celebration for people born in June. Thank you to all. It was very special as we get to celebrate it with the whole batch (>,<)V
Wednesday, April 20, 2011
Special credit to my cousins Nabila Yusoff, Azmir Hisham Ahmad and Zaid Hakim Iskandar & his fiancee' Jannah Radzif. Thank you for the good care and babysitting me while i'm there. Sorry for any inconvenience (",)
University of manchester
The Old Trafford stadium
Piccadily Train Station
at York (about 1 hour from manchester) day trip
Alton's Tower Theme Park at Staffordshire (2 hours from manchester train+bus) day trip. COooooooL rides :)
3DAYS TRIP TO EDINBURGH (colder than manchester,brilliant architecture,love the buildings,very-Harry Potter-like)
backpacking to edinburgh
The view from Edinburgh castle..
Firth Forth Bridge,end of our countryside trip at edinburgh ..
3NIGHTS 2 DAYS TRIP TO HOLLAND (Brezzy & cold!!,beautiful,cute buildings,canals-a little bit like venice,full with old bicycles,I LOVE TULIPS!)
Holland trip...amsterdam city
one of the buildings at Amsterdam city
Keukenhoff Lisse,the Tulip garden..Holland
Subahannallh, i can see a lot of amazing creation of Allah
Masyaallah,a very LOVELY experience,(",)
Monday, March 21, 2011
Congratulation in advanced for able to be back home. I am looking forward to meet you all at UKMMC.
Ok..about Year3 UKM books, you can buy it once you entered UKM. So, you can save your energy.There will be a book sale at our college by PERSIAP. They get the books from Kamal bookstore.
There are 4 postings and departments in year 3.therefore i list out the books based on that. However i recommend you to see the books first and also ask you other seniors' opinion about it.
1. Oxford handbook of clinical medicine
2. X'press revision in short case, aids to undergraduate medicine,UM
3. sarawak emergency medicine
1. Browse's Introduction to the symptoms and signs of surgical disease
2. principle & practice of surgery
3. In a page surgery-just photocopy this one
4. Churchill's pocketbook of surgery
Obstetric & gynecology:
1.labour room protocol HUKM-buy this at O&G department
2.obstetric UM- original version is cheaper than photocopy version
3.gynecology UM- original version is cheaper than photocopy version
Medicine & society:
It is UNPAD version of PHOP & CHOP...so, you can photocopy the lecture notes from your UKM friends. for this posting,you will have to stay at Tanjung karang for 7 weeks.
For more info, please visit this blog created by the current final year.
Let me five you some brief sharing of experience on what happen to me fro the past 2 years.Basically, being the first batch, I don't know what to expect from my new collegues and lecturers. My self esteem is slightly low than it was in UNPAD. I was involved with a LOT of activities and had a GREAT life at UNPAD. Being in UKM, i thought i had to say GOODBYE to all the student activities i enjoyed and focus on my study alone.
haha...NOT>..it is soo not true :)
We are well accepted in the community of UKM. However, there are certain things that never will be same. Just want to say DO NOT WORRY, rest assured...insyaallah you will have a great time here. However, BEAR IN MIND...please do not carried away with the activities and neglect your studies..try not to fail any of your postings (",)
as for student activities...you can join a lot of them and gain merit for you to stay in the college. There are 3 student bodies : JAKSA (manage all about our college-KTDI), PERSIAP (all about academics, management,schedule) and AMSA.
As for me, i think the student activities here are broader...I hold a position at PERSIAP for a term(2010), i join & handle a lot of student programmes inside UKM and outside UKM.
with PERSIAP 2010 committee members..during our outing..
with my nasyeed band..CIMOLEN(Cimol+molen..you can watch our performance in utube,posted by Izmeer..
For guys who LOVE Sports..there are 4 games that you can join each year
1. Sukan antara kolej UKM (SUKEM)
2. Intervarsity Sports Game by AMSA-an inter medic school game
3. Liga Antara Tahun by PERSIAP-an inter batch game among UKM medic
4. KTDI Sports day by JAKSA-our college sports day
there are also games organized by other universities that we sometimes received by invitation.
(yeay...i join them too...FUTSAL WOMEN's team )
for those who like long distance run or marathon...u can join KTDI runners club...hehe..speaking of 5km,10km,15km,20+ run.u can personally contact me for this :) there is tasik permaisuri in front of the hospital for you to jog every sunny morning or evening. Free public aerobic every sunday. For those who likes to swim, u can go to Pusat renang cheras (also in front of HUKM).personally, i never go there because there is no womens' day..huhu.
some of the medals gained during year 3 and 4...there are 3 others not included in the photo :)
Again BEAR in MIND..do not neglect your studies. you will find a lot of distrations here..my advice to you is form a study group, makes discussions. read the gudiebook and identified the important topics. learn how to answer the exam questions. Go to the library, there are a lot of books you can borrow (5 books for 2 weeks).
verily,along with every hardship is relief
verily,along with hardship is relief
so when you finished(your occupation),devote yorself to Allah's worship
and to you lord(alone) turn (all your) intentions and hopes
verses 5-8, Al-Inshirah
That's all for now... All the best my dear Juniors :) see ya at HUKM
Monday, February 28, 2011
then..I stop...because the team don't want to continue anymore...lack of players..etc...
when I came back to UKM..jeng..jeng jeng..I was shock..They actually have games for girls it FUTSAL. I was Thrilled...yeay. However, my batch(year 3) don't have a team. The year 4 seniors do play and have their own team. So, I start my search...gather some friends to form a team. The seniors was very encouraging. They let us play to represent our college and university. however, the team is still new, lacking of people and skills.
Because of us, we girls get a turn to play at the only court available in the hospital (next to rumah McD). Every thursday is our day. Occasionally, we rent the futsal court at Challangerz. they have girls night discount..hehe. We usually play at night.
Our enthusiasm and chemistry started to built up.We learn the skills and tactic by ourselves and some help from the seniors and friends.Techically we don't have a coach. We only started to win...and win BIG during the 4 th game at SUKEM in 2010. We got 2nd place in UKM (if we got first we have the chance to represent UKM in MAKSUM-sukan antara universti). Then we got 3rd place during inter varsity game.
Our team had play against each other during futsal 3 by 3 match for our sport's day. My team get the 1st place. we got the big hamper :)
The last game was the BIGGEST win ever. we got GOLD...yeay!
I hope, we don't have to retire from the games in final year. we do give the opportunities to the juniors. however, there's always something that hold them from joining. Therefore,we will be GLAD to play if they can't play for any tournament this year :)
1. Sukan antara kolej UKM (SUKEM) 2009 at UKM,Bangi
2. AMSA Inter-varsity game-medical students 2009 at UKM, Bangi
3. SMMAMS' Inter-varsity game-medical students UPM 2010 at UPM Serdang.
4. Sukan antara kolej UKM (SUKEM) 2010 at UKM, Bangi
5. AMSA Intervarsity game-medical students 2010, at UKM, Bangi
6. Kolej Tun Dr Ismail (KTDI) Sports day 2011
6. Inter-medical varsity Debate & Sports 2011, at UM, Jln Pantai
AsSalam (peace be upon you).
Sorry, for a long holiday from blogging.
Updates about me:
1. end my year 4 with psychiatry department. It was very intresting and colourful. i like my supervisor a lot.
2. I PASS my final exam...alhamdulillah...that means 2 months holiday.
3. My futsal team get to win GOLD...yeayeahh :) more about it in the next post...EXCITED ('',)
4. I'm going to UK and Amsterdam....with my cousins :) Finallly my dream comes true
5. My 2nd bro is getting married in June.my cousin is getting married in July...THREE of my Twinning UKM-UNPAD family members are getting married this year(1 of them already married)
6. I'm officially an aunt last year when my nephew was born in september. Now, more babies keeps on coming from my cousins...yeay!! can't get enough with those cute babies
Sunday, January 2, 2011
I celebrate new year differently this year. The date 01.01.01 brings a significant meaning for me as I participate in supporting campaign to FREE Palestine by Konsert Amal Palestine.It is our college yearly program to collect donation fro Palestine.Last year we did a run.
We are able to get Algebra, NICE and Nowseeheart performing. My team, CIMOLEN(Cimol+Molen-indonesian snacks) also makes our first performance after we won the TAlentime English speaking ZOne,alhamdulillah.
Here are some sneak peak of the event. credits to Aisyah Zakaria, Nina Hoklai and Hanim Nawawi for some pictures in here.
CIMOLEN: frm left Izmeer(solo), Mudin(solo), Syahrul(percusionnist), Hanim (percusionnist) and me(pianist)
You can view CIMOLEN performances here:
1. Open your eyes, Maher Zain http://youtu.be/JWk_tqkqYCg
2. Palestine Tomorrow will be free,Maher zain http://youtu.be/q2rR-zdlGUU
NOWSEEHEART performing 3 songs: Damai yang hilang& KuHarap Cinta-lagu kenangan zaman sekolah rendah dulu-dulu..lagu terbaru: kerana doa
sila jangan jelous...hehe
with ALGEBRA & NICE
CIMOLEN with a fan...cewah..
InsyaAllah PAlestine will be FREE one day!! Allah never let us down, put our trust in HIM. ALlahhuakhbar(Allah is the GReatest)!!
p/s CIMOLEN next performance will be for college dinner at Putrajaya Convention Centre (PICC).We will try to perform song other than Maher Zain..hehe. Then we might enter inter college Nasyeed song in MArch. Pray for us (",)