DeSTRESSing Activity: Cameron Highland (>,<)V

After 2 postings in final year, i've found a group of posting mates that we can 'ngam & kamcheng' togather despite our differences. Circumstances had made us housemate for almost 2 weeks at Teluk Intan (during Internal Medicine) and immediately we fall in love with each other..haha. We even throw an Open House at Teluk Intan..

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..


Fresh salad.........grrr



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 (>,<)

Misi Jubah Merah 2012: 2nd posting-Internal Medicine

I've reached the end of my 2nd posting which is Internal Medicine. In 7 weeks we were devided into 3 groups and posted to HUKM, Hosp. Teluk Intan (HTI) and KL General Hospital in rotation of 2 weeks each. Every hospital has its own different approach & experience. So, a quick adaptation to the environment is important.

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 (>,<)

Best birthday gift ever!!!

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?

Raya & my holiday project in the kitchen (>,<)

Happy Eid to muslim bloggers!!

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!!

Unintentional Weight loss in elderly: Should we be worried?

Salam,

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.

Clinical scenario:

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.

Current problem:
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.

HOWEVER>>>>>>

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...

So,
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

Contact dermatitis...a suprising culprit , I've learned!

Salam & Hi,

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.

Clinical Scenario:


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.

Discussion:
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)

Final year at last...

Salam,

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

Travel to UK & Holland during Spring!!

Alhamdulillah, I was able to fulfill my dream to travel to UK. Decision was made 4 months earlier. I manage to get a cheap ticket to Manchester (RM3200 return). Off i go to Manchester, travelling from KLIA alone and get 12 hours transit at Doha (that's why the ticket is cheap...haha). Lucky the return flight only cause me 1 hour transit. Anyway, alhamdulillah, nothing bad happen while i'm travelling alone for the first time in >2hours flight journey.Total flight journey was 14 hours...total duration of trip=15days...

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..



sterling 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


Windmill!!


Clogs revolution...


Subahannallh, i can see a lot of amazing creation of Allah
Masyaallah,a very LOVELY experience,(",)

To my juniors : 3rd year books at UKM

Salam my dear Juniors TWP'08...

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.


Internal Medicine:

1. Oxford handbook of clinical medicine


2. X'press revision in short case, aids to undergraduate medicine,UM


3. sarawak emergency medicine



Surgery:

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.


http://www.medicalpblukm.blogspot.com/



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

FUTSAL...can't get enough of it :)

Yes.. that's right.. i was introduced to futsal during my 1st year at Bandung. My team was the underdog. the only game we won was when my left front teeth broke into half...haha..worth the damage. Lucky the minor recostructive procedure is covered under my medical insurance :) only tell my 2nd brother about it cause i know he won't freak out and prevent me from playing. Mama only knows about it months later..hehe

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

Good things keeps on coming...

Alhamdulillah.....

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

Palestine, tomorrow you'll be FREE!

Salam.


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

ALGEBRA..


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 (",)

TRIAD (ENT,OPthal,Anaesth) Posting!

Salam,



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.


Anaesthesiology
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).
Source of picture : http://mediconet.blogspot.com/2009_11_01_archive.html

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



Source of picture :
http://www.eardoc.info/news/swimmers-ear-overview/

An ear infected with Aspergillus Niger. Diagnosis : otomycosis



Source of picture:
http://lessons4medicos.blogspot.com/2008/07/inflammation-of-ear-canal.html


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

Ophtahlmology
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!)



Source of picture:
http://faculty.washington.edu/alexbert/MEDEX/Fall/HEENT_PE_Obj.htm

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

Sexually Healthy Youths!

Salam,

What happen if you talk about sexuality issues?? Variety of respond will come out.The respond will range from openly discuss about it to stigmatized the topic and refuse to discuss it. It is not only about sex.It is about the relationship between men and women,XY with XX,mars & venus (you get the picture).

Islam is syumul(complete) that have guidelines in sexuality issues and on how we should behave among different genders. A sexually healty youth should feel safe with those who are known to be safe.

from An-Nur (24:30-31)
Tell the believing men to lower their gaze and be modest. That is purer for them. Lo! Allah is aware of what they do. (30)
And tell the believing women to lower their gaze and be modest, and to display of their adornment only that which is apparent, and to draw their veils over their bosoms, and not to reveal their adornment save to their own husbands or fathers or husbands' fathers, or their sons or their husbands' sons, or their brothers or their brothers' sons or sisters' sons, or their women, or their slaves, or male attendants who lack vigour, or children who know naught of women's nakedness. And let them not stamp their feet so as to reveal what they hide of their adornment. And turn unto Allah together, O believers, in order that ye may succeed. (31)

Who are the one who are known to be safe?? They are those who obeys these to verses in Al-Quran.. men who protect his and the womens' modesty..women who protects her modesty and cover her aurat (body)..Its all there in AL-quran the book of guidence for Muslims.

According to Mary Buxton,a certified sex therapist, A sexually healthy teen are those who appreciates their BODIES (even a non-muslim agrees on this). Appreciating your body in Islam is covering our body and also keep our modesty.

Sexually healthy teens are:

* those who take RESPONSIBILITY for their own BEHAVIOURS
-so,please be wise in any decision and do not blame others on your action because you are the one who is responsible for your own choice.
* COMMUNICATE effective and respectfully
-learn to say NO,protect and prevent yourself from being used.
* express love and intimacy in a way that is appropriate to their AGE
-choose SAVE sex instead of safe sex...SAVE it for the only one who already commit to you (husband/wife). Say NO to pre-marital sex!

remember this from An-Nur,24: 26...
Vile women are for vile men, and vile men for vile women. Good women are for good men, and good men for good women; such are innocent of that which people say: For them is pardon and a bountiful provision. (26)

Another issue related to medical profession...

you are a muslim doctor at a general private clinic. One day a Muslim colleage girl came and admit to you that she is sexually active and need you to prescribe her contraception pill. What will you do?

Some may say, I am a muslim doctor.so, I am against this behaviour and I want to refer her to a colleague who agrees to do it.

However...what if she neglects it and take some other harmful medication or methods for her contraception needs? Who will be responsible if anything goes wrong?

The best thing to do is...

First, make a good rapport with her. Explain the consequences and advice her to get back to the right path. After that, give her the contraception as ethically it may prevent harm and provide beneficience to the patient. Pray that one day she will realize her mistakes and seek forgiveness form HIM (taubah)

Note: This issue was dicussed by Prof Harlina during her talk on Let's become sexually healthy youths! I just share what I got from her intresting talk.May it benefit me and you..Ameen :)

Revised topic:Muslim Government Doctors Criteria

Salam...this is an entry written by a friend (also my batch mate) as a feedback on Malaysian GOvernment Doctors Criteria. It is something we all medical students should read and think of!!

1. There is life outside medicine. Who said so you can't have life outside medicine. That's ridiculous. Think! There is doctor who is married with doctor in the same hospital. Also, there is doctor who is dating with staff in the hospital, including nurses! Well, that's what I call dating. Sport? Walking, running in the hospital isn't that call sport? Don't be "closed-minded" Think! There is doctor who joins the Fitness First. Clubbing? A muslim should avoid this. You know that. Think! Can't do chores for your parents? Of course you can’t if you are not living with them in the same house. But wait, praying Dua’ for your parents isn’t that one’s must do? That’s one simple chore you can do for your parents. Think! Even, there are doctors who become a member of NGO of Islamic Society eg. IKRAM, KARISMA, JIM, others as to dakwah. Think! The is life outside medicine. It’s just you who make your life in such a cocoon. Think!

2. When you are in the working profession, you earn your own money. You have your own life. Still living with parents under one roof and being pampered by them? Of course not. And of course you can, if you want to. Well, not only doctors who are not living with their parents! Don't you think so? Think! Move out of the house ASAP because your parents wouldn’t understand your job? Please don’t follow this advice. Don’t run away from your parents. They wouldn’t understand your job? They’ve raised you up until you are able to stand on your own feet. They know you. They will know. They never come to hospital watching how a doctor working? I bet your mom had admitted to any Gynecology ward before this. Think!

3. Bila jodoh dah sampai seru dan berkemampuan, berkahwinlah. Sememangnya fitrah manusia ingin saling mencintai dan dikasihi. No need to wait until you have complete for the Govt compulsory services. There is medical student who married during study. There is houseman who married her registra. Think! There is life outside medicine.

4. Get baby as soon as possible after getting married. Well, depend on your luck. Rezeki Allah bg lain-lain. Fikir balik. Apekah tujuan berkahwin? Tak mau anak? Panjangkanlah zuriatmu yang baik-baik sementara nyawa masih ada. Think!

5. Follow the work protocols in your hospital. That what keeps you safe. Think!

6. 36 hours working non stop? Trust me, you can sleep in between. Yes, I’ve seen doctors doing it. Are you really sure non stop? Muslim has break for prayers. Isn’t that enough? How many doctors have died because of this? None. Think! Everybody can do it. Allah akan bagi ujian yang hanye setimpal dengan kemampuanmu.

7. Don’t drive if you know that you are drowsy or disoriented. Don’t be stupid. Get a taxi. Be smart, be safe. Think!

8. Coffee contain caffeine, and some how it can cause tolerance. If you are a coffee lover, of course you need constant supply of it. For coffee hater like me, better to avoid it. Find a better way to keep you fresh. Think!

9. Managing stress is very important. I’m sure you have had experienced any stressful event in your life. But yet, you managed to get over it. How? Nicotine patch? Definitely not. You are doctor. Don’t abuse drug. That’s why you learn psychiatry aren’t you? Think!

10. Don’t get over influenced by the media. That’s are all movies to be watched by the people all over the world. Of course the story line are all made up and making its much interesting. Don’t you think so? Do you think that the doctors’ life in the movies (House, Scrubs, Grey Anatomy) resembles its own doctors’ life in its country? Do you think so? Think! Do you think that you can get better life in other hospital than in Malaysia? How better is better? Think!

11. There are doctors who have gardens at their houses. Yes, they have maid. So?

12. Try to walk around with houseman in the hospital during your practical year. Don’t forget to smell them. Do they smelly? Never in my experience! They have time to take a break, and have bath. Think!

13. Fasting. Islam has trained you to stay empty stomach, right? Sacrificing yourself to save someone’s life isn’t that beautiful? Think!

14. Doctors do deserve MCs. Who says so that they’re not deserve to get one?! Remember, we are all human being and human gets sick when they get sick. Don’t you think so? Nobody is perfect. My supervisor had MC because she had sore throat. What?! Sore throat? Think!

15. Scolding, destructive criticism, racial bias, finger pointing from your supervisors are nothing. I am very sure you have trained to become resistant with all of these negative tortures during your practical years. Think! Why they do that? They love you. They want to make you a better doctor. They don’t want you to make mistakes. This profession involving lives. This is not a playground. Think! You want being pampered by them? Being nicely treated by them? This is not kindergarten anymore. Think! I love being scolded. That what keeps me moving on.

16. You think your life will be just confined to the hospital only? How many doctors having fun with families, travelling around the world, win noble prizes, etc, etc, etc………..? Think!

Never regret of what you are doing now, Medical Students…
Isn’t this your school-age AMBITION?Yer cikgu, saye nak jadi dokter. Saye nak bantu orang sakit.
Wasn’t that your kiddy answer?
Yes, you wanted to be here. Yes you are.Think! Think back.

Its not easy to get you here. Yes, here. How many years had you struggled to get you in this profession. You are now half-step distance to become a doctor. Never turn back.

I do believe that my life has been planned by Allah. Why am I here? Because Allah had planned for me to be here. Ouh, I need to find the hikmah behinds these. Allah knows what is the best for His servants.

Never let negative thought under estimate yourself, your capability. If other doctors who can do it, why not you? WHY NOT YOU? Of course there is NO SHORTCUT to be one. A consultant. You think it is easy to become one? They also had struggled through tough years to be one. Yes.

Every king was once a weak baby, and every awesome building was once just a drawing on a piece of paper. And you? THINK!

Jadi dokter, satu pekerjaan yang mulia. Yes, doctors playing God. But yet, everything happen dengan IzinNya. Saving lives, isn’t that mulia? Imagine you save someone’s life or making someone to have a better quality of life. And that person able to beribadat and do good things because you’ve helped that person. Don’t you think “saham pahala” gets to you? Allah knows.
What other profession yang the customer really trust the person? None can beat doctor profession. So, use this opportunity to dakwah as well.
THINK PLEASE!

Positive mind set will definitely deliver Positive attitude!

written by Muhd Izmeer

Dare to DREAM!!

Salam(peace be upon you),

WARNING:this entry is quite self centered cause i'm talking bout my achievements..hehe :)

October is the month of some of my dreams comes true. It all does not come easily. Practise makes perfect.I did encountered some failures in achieving them.Therefore, when I practise,spend some time & money in preparing myself for it. I was dare to DREAM.

However, the road is not easy and I never thought that god will answers my prayer so soon in giving everything in a month...alhmdulillah(praise Allah).

My dreams that are fulflilled:


1. PAss my Paediatric & Orthopaedic posting (core posting that people can easily get flunk). so far never fail any posting yet even though i'm busy with college activities & student societies..God forbid any of this from happening..Amin :)

2. Get 2nd for Futsal in inter-collage sports game at UKM (SUKEM 2010)-we are competing other non medical colleage in our Universiti Kebangsaan Malaysia so far our team never win any game.our greatest achievement was a tie..hehe.On that day we only loss to the winning team.My 'udang terbakar' (burned face) was worth it after all-still have it after 2 weeks. We played 5 games straight that day.

As the Captain, I can never do this alone.Thanks to the dedicated people in the team-Temoh, Farah, Fatin,Farhana,Christina,Afifah & Hanim for the constant practise this year...even during puasa :) also Nana and friends as our additional help! It all started last year but the team expanded middle of this year. Thanks to my futsal ball that become the pacemaker of our team..Just before SUKEM, my futsal shoes came along,and it is PINK!-the only thing I bought for raya :)



3. Get to sing and perform duet piano-guitar at my college during Hari Siswi :) last performance was last year..Me & Farah performed togather last year during our college dinner but we did not sing. This time we sing and we only practise togather the night before and the performance turn out to be just nice as everyone like it :)


4. Able to finish 10km run at get the finishing medal at UPM Wave Run 2010-This is my second attempt on 10km run. My first one was at Putrajaya.unable to get the finishing medal & was quite sad about it(maybe will try again next year). This time I am quite prepared. Thanks to Nadiah my runner buddy for the training togather, Mr KC Lee a.k.a coach for the guide and 'Nike+ band'..not feeling guilty to buy it coz I get it less 50%..hehe

(an insult to Mizuno because regardless the runner tee, I'm wearning Nike+band & Nike shoe with Addidas pants)SORRY!!

I was DARE to DREAM! and NOW i BELIEVE anything is POSSIBLE..insyallah(with Allah's will). Just need to believe and work on it.. everthing starts with the WILL to DO IT!

p/s it is normal to get down sometimes. I do feel it to. Just need to find the way to get your spirit up. What happen this month do lift up my spirit...however you never know what the future holds. May my spirit always lift up high (",)