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

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

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

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

Dealing with cute beings..

Salam..



Hi. Finally I can relax a bit as my study week just started. The term ends with Paediatric posting. It's not just dealing with cute beings(children). We have to win their hearts and modified certain techniques in dealing with our small patients.



During this posting, i am officially an aunt as my nephew was born on August 18th...new member of the family : Umar Khalish (haven't meet him in person yet..busy playing with other children in Paediatric posting..huhu)



I was susprised that i am more mentally exhausted for this posting (I rather be exhausted due to physical stress).I was quite depressed towards the end of it as I had to faced the small practical exam called short-case and also other factors that is to private to be mentioned here. Its funny cause I think, I am more stress in this posting compared to Obs& Gyne. Lucky, it happen in Ramadhan,where we will find back the ease of mind during this holy month.

The most enjoyable part of this posting is playing with the small children and determine their age based on their performance. We call it Developmental Assessment! So, now i have the skill of guessing the age of small kids..yeay! We also have to be competent in neonatal screening where we check any abnormalities in babies less than 24 hour of life. Now i can hold babies less than one day without fear of breaking their delicate bodies.

Doctors in paediatrics are considered as those who wants to produce a perfect & safe doctors out of the students. Their intention is good! The process of making us realizing how we should work hard is quite eye-opening. Medicine is not just memorizing..it is more to understanding!

In paediatric, we have to understand the impact of the problem towards the social factor of the child. I encounter a lot of patinents under 'Orang Kurang Upaya' (OKU) and go to special class. It's a bonus for me as I did my elective posting there last semester.Moreover, the effect towards the family economical status is tremendous in chronically ill patients. Belive me, medical treatment& management is not cheap!



I also also discover that even a few months old child can have a lots of problem more or equal to patients we see in the adult medical ward. It is intresting to see how critically ill babies were managed with my posting at neonatal intensive care unit (NICU). Paediatrics and obstetric & gynecology(O&G) are siblings. I understand more about the hazards and risk for the babies that can effect their future. We are exposed to so many hazards and yet we are able to be normal...hehe.



Wasalam.

Our beloved teacher..

Salam,

Wow, Paediatric posting does have its impact on me. I have 'puasa' from updating my blog for a month. And yes Ramadhan is coming up starting 11/8..but that won't keep me from having small jogs by tasik in the evening or futsal next to rumah Mc D every Thursday(strictly..the court is ours on Thrursday.no men are allowed.sorry to disapointed you guys last week.hehe)

With PERSIAP 2010 COmmittee..goodbye MU..welcome Arsenal

No one can replace his dedication towards us the students. Not all teachers are the same. Some are garang(stirct..and even give you palpitation), some are very friendly(making you smile up to your ear) and there's even certain lecturers are sarcastic (making you Insaf for a certain period). There's even lecturer who ignores you that you have to make certain effort for them to aknowledge you (if you are proactive enough).

All the differences colors up our life as astudent. I could not agree more with Prof Norzi, another respectable lecturer from O&G. The diversity makes life intresting and NOT BORING. Therefore,its up to us students to take it positively or negatively.

I'm glad to know that if you did something wrong, all the anger and dissapointment won't be remembered(unless it is significant). So, its ok to make mistake, but improve not to make it next time. Don't make the bad scene affects you so much causing you traumatized when you see the lecturer.

From a story by one of our lecturer(cannot tell who),it happened to one of our senior during professional exam(for final years). She was sooo traumatized by this one lecturer causing her to faint during the exam..the power of FOBIA..hehe

Buddies United at Prof's house

Personal birthday gift..sorry for the 'bunyi sumbang'..haven't play my 2nd instrument for quite sometime..

So, lecturers. I am glad for your help and touched by your dedication. To Prof Madya Shahrir Mohammad: Thank you for everything. Happy Belated Birthday! Glad we did suprised you with the help of your beloved wife & daughters :) I'm glad to be apart of the 5th year suprised party plan

Wslm.

P/s : Glad that Prof 'tak jadi' transfer to USIM totally :)

Extra lesson at Operation Theater (OT)

Salam,

Entering Operation Theater(OT) room is our routine in certain postings. I had this experience in previous postings ( Surgery and O&G). However, today it is quite different with the rest of my experiences in OT room. We received tazkirah, philosopy insight and teaching by Mr Halim, an Ortho-Paediatric specialist of UKMMC. We cover a lot of topics today and as adult self directed learner, we had to revise Apley's(our ortho book) to learn more rather than spoon feed by our lecturers.

Extra things we learn besides orthopaedic are :

1. We get to use to mp3 player playing music in OT room to make working environment less intense. Sometimes they even put al-Quran recital which make the surrounding calm & soothing. I even encounter an OT room where the registrar from middle east recite alquran that he bought during a sugery of a muslim man during my surgical posting.

Mr Halim inform us that its better to play Al-Quran recital than other songs. It makes people talk less inside the OT (to respect the recital) and less tense. Besides, we don't frequently recite al-Quran therefore, why not we listen more.

2. He did mention about prayers that doctors usually always try to fullfill during their busy day. Never leave your prayers,he said.DUring Friday prayers, he advise us the girls to help the Muslim male doctors in covering them during the prayers. It is a win-win situation coz they have to cover female doctors during maternal leave. Have to agree with that!

3. It is also important for us students to be change our attitude and become adult learner. We all are given the freedom of choice in choosing how we want to learn and become the doctor who saves people. It is quite related to a forum done just a few days ago for our juniors during their orientation before entering clinical world.

Malaysian education system is so used to spoon-feeding in giving education since kindergaten and suddenly, during university they want us to be matured with self-directed learning. The adjustment have to be made and the mind set have to change into a better insight. We are already adults and given the freedom of choice on how to learn without being told. We have to be proactive in the sense of seeking knowledge.

We cannot wait the lecturers to give silver spoon-feeding or attach a ryles tube to channel the knowledge to us. Knowledge is at the tips of your finger. There are internet to be the source of knowledge if books is a burden for you. There are friends that we can form a group and study togather for better understanding.

4. Never talk or give information about something you are not sure. Rather say that you don't know rather than not sure about what you trying to convey. People tends to hold to what we say. For example when we give the possible diagnosis to a patient saying that the patient might has cancer but it can be possible an infection. The patient will prefer to hold to the better progosis one which is cancer as the diagnosis. We are humans. We do prefer the good things rather than the bad one. So, we might give them false hope(s)!

5. Our priority is as a STUDENT! Do not involve with things that can jeoparadise your study and future. Be a student who do his/her part as a student-study adequately and follow the flow. Adjustment to the situation is important!

Actually this is his comment on some issues faced by our medical students' society,PERSIAP(we are a NATURAL organization!!) being the blacksheep of the university family due to student's & university political issues..He gave his point of views base on his exprience as student leader during his time. From his concern of PERSIAP, I think he was probably one of PERSIAP committee...hehe

We have to seek knowledge, don't wait for it to come!

Tips in becoming surgeon...you have to have:

Eyes like an eagle,Heart like a lion, Hands like a lady,

Wasalam.

A Sunshine award to fellow bloggers (",)

Salam,

"The Sunshine Award is awarded to bloggers whose positivity and creativity inspire others in the blogging world."

This is something nice to do to other people telling how much I appreciate their blog. I was actually given the same award by a Twinning UKM-UNPAD junior(Asmayanti) I met less than an hour during her orientation at UKMMC before going to Bandung in 2009. Giving is rewarding :)

This is what she write about me:

7. LIFE: WONDERFUL AND MEANINGFUL. A blog of Kak Aishah. My super senior, the first generation of TWP UKM-UNPAD. First met her at PPUKM during the registration. A cheerful and cute girl I must say. Love to read her entries about experiences in clicinal year. Thanks akak, you make it sound so fun! Do accept this award from me. :)



I would like to award a few of my blogger friends that most of them I know outside the blogger life. This is not ordinal and hopefully it does makes your life shine as bright as the sun and motivates you to write more (",)

1. aku yang sedang belajar by Madziani aka Ani, my TWP UKM-UNPAD friend and my ex study group mate at UNPAD who always love to write intresting stories about her life. Some may sound sad but at the end you'll find the intresting part of it. Likes to write sajak.

2. Secebis kehidupan by Nur Hanisah, my TWP UKM-UNPAD friend and also my ex study group mate at UNPAD who like to share info about medical,life and some motivation. Like to write sajak too!

3.Coffee-Talk by Lutfi Fadil, my TWP UKM-UNPAD junior(responsible in persuading him to take this program),ex-KMPK 2005/2006 mate(even though i when there for 1 half month)and my friend who never skip his coffee drink since school. Also coffee fanatic & addict(u can relate that to his blog title)haha.Anyway,his writing is intresting that makes you open your eyes and think. Maybe its the effect from the coffee..yeke?? Nice insight too!!

4. A little reminder by Jazli Aziz, my high-school (SMKBB) friend now a final year at UIA Kuantan that likes to write about Islamic views on various things that we youngsters ought to know. He had nice point of views and intresting topic on his post.

5. Ini Amad Pesan by Ahmad Fahmi aka Dr Amad, my batch mate at UNPAD Bandung who likes to share his views on a lot of matters relate to Islam that I consider as my online usrah..Always love the input that also fills with colors. Nice to read eventhough its long.Like to see intresting pictures inside it too!

6. Ana Solehah by Kak Aimi, my senior at UNPAD Bandung who like to write short(less wordy) but meaningful stories about her clinical life at UNPAD Bandung.It gives me some idea about how our seniors encounter clinical years (KOAS) at Bandung since I do my clinical at UKMMC. Anyway, I like her thoughts & pint of view of thins she sees in life.Thanks kak (",)

7. Penjejak FIhyatul Kahfi by Ahmad Zulfahmi, my batch mate at UNPAD Bandung and also my ex-bos when I was Exco of Student society at Bandung.He likes to share some ideas on things happening around us and also his life that have relation to Islamic views on it. Like his insight on his stories.Another online Usrah..hehe

8.Ain Musa by Ain Musa,my batch mate at UKM Malaysia. She is pettite',cute and funny. I will always find her post to be funny and cute. The writing is very creative and this girl really have the talent to make people laugh by reading her entries..keep it up girl (",)

9.Fadhli16288 by Mohd Fadhli, my UKM Malaysia senior, 'cikgu' and friend who helps me fit in into academic system and organisation field in UKM. He was the YDP of our Medical students' society and writes mostly about his opinion on our medical students' society, UKMMC, his life and also some public issues. Suprisingly i found it informative..hehe.

10.Dr Radzi's weblog by Radzi, my batch mate at UNPAD Bandung who likes to write about life and Islam..Indeed another online usrah!! He likes to share his opinions on things happens in life that we can reflect to ourselves and try to be better.

11. Hikmah Kembara by Nur Faiz, a blogger friend from Mut'ah, Jordan.She likes to fills her blog with 'pantun' that I found intresting and creative.

12. Medical PBL UKM by a group of final years (UKM Medical students batch 2006). It is a very informative and usefull blog created by students that is very benificial to us,especially to UKMMC medical students.Lecture notes, list of books, past year questions and informations on medical postings can be found in this blog. Manage to get the idea of clinical year postings of UKM from this blog.I learn about this blog before I winish my pre-clinical at UNPAD,Bandung. FOund it useful.Good job to the admin!


Actually, there are other blogs that I like to 'hop in' and be faithful silent reader. they all are in my blog list..

For these 12 bloggers, please claim your award and...


i. Nominate 12 more bloggers.
ii. Put the logo onto your sidebar or within a post.
iii. Link the nominees within your post.
iv. Let the nominees know they have received this award by commenting on their respective blogs.
v. Share the love and link to the person from whom you have received the award.


I know it's a hassle, but wouldn't it be nice to share this and bring smile to others?

Wasalam (",)

Elective Posting with special kids (",)

Salam,

During end of year 3 holiday, I am required to do an elective posting that is preferably more to community work rather than anything to do with medical. It is a must for medical students of UKM to fulfill this requirement before graduate.

My mum prefers me to spend most of my holidays at home.Therefore, I choose a place near my house & only do a half day work.Therefore, I choose volunteering at Kelas khas(Special need class). In Malaysia, we have 'Kelas Khas' at normal government schools to let them be in the society and not feel left out. I'm fortunate to have Puan Azizah,Penolong Kanan 1 of SK Bukit Beruang,Melaka as my neighbour who kindly give me the ride to school every morning.

At first, Puan Aishah the coordinator(yes, we share the same name..hehe) doesn't know what kind of work to give me. They never receive medical student for an attacthment before. The pogram just entering it's 2nd year at the school. They only receives their first elective teacher a week earlier than my application. I did variety of things : entering students data,entertain them, decorating the class, teaching & managing the childrens(including make them wash their hands before they eat).

Bulliying the kids or being bullied by the kids..huhu..



decorating...

The 'Kelas Khas' consists of 20 children devided into 3 classes based on their IQ : Pintar(low), Bestari(moderate) and Arif(good). They have four teachers with one coordinator. They are having shortage of teachers since I was told that the teacher to student's ratio should be 1:4.

How the children was detected and advised to enter the school??
Some of them was detected by parents earlier who later seek advice from the doctor. However most of them gets recomendation from their teacher/school to do check up at the nearest Policlinic. They will be screened by the doctor that decides weather the child have learning disorder or not.If they have certain disorder, they will be advised for further management and registered under OKU (orang kurang upaya-disable people). These children will recives RM3OO per month(if i'm not mistaken) from government.

Not all children with learning difficulties are considered as OKU and send to 'Kelas khas'.Every primary school in Malaysia have to make sure that their students can fulfill 3M (Membaca,menulis,mengira-reading,writing,counting) by standard 3 (9 years old).Teachers who detect their students cannot read or count by that time will be send to 'Kelas Pemulihan' under qualified teachers.This program is under LINUS. Teachers at 'Kelas Pemulihan' will detect weather the child can be considered as OKU or not and make referal letter for check-up with the doctor.

I had a GREAT time there and the childrens are cute & adorale(naughty at the same time..hehe). I experienced variety of disorders: DOwn syndrome,autistic,mild conductive hearing loss with with isolated speech delay,slow learner. Most of them have Attention deficit hypertensive disorder(ADHD).

{DOwn syndrome:extra genetic material at chromosome 21 causing Trisomy 21 developemntal delays and abnormalities mentally & physically, Autism:neural development disorder that impaired social interaction & communication, COnductive hearing loss: hearing loss due to defect on conducting sound to the inner ear,Isolated speech delay: speech disorder limited to language expression or production,Slow learner a.k.a Lembam(in Malay language), ADHD: either attentional problem is greater than hyperactivity or vice versa or both in a child which is a neurobehavioral developmental disorder)

During my elective posting there,I am fortunate to have opportunity to join Hari OKU Peringkat Negeri Melaka 2010 as the 'Guru Pengiring' as the class sends some children for drawing contest.I also join their Bowling therapy (held once a month) and gardening with them to upgrade their class backyard. The school also receives a visit from Thailand teachers during my 2nd week of posting.

Hari OKU Peringkat Negeri Melaka 2010

Bowling therapy

Gardening day

Visit form Thailand teachers..



The best thing of all, i was adressed as CIKGU when i was there. The kids know me as their teacher .I used to have the ambition to become a teacher until I develop more passion towards medical world. Most of my families(mom,aunt,uncles & cousins) are teachers. Therefore, this opportunity fulfill a part of me. Indeed "Giving is Rewarding"

Thank you to all the teachers and supporting staff of Kelas Khas,SKBB including 2 practical teachers in the picture and 2 male teachers not in the picture..


Everyday fills with colors of life and I learned to cope with it. Emotionally win the childs’ heart and trust is a reward for me. Receiving hug and kisses or able to make them fulfill small task is a huge success for me.

Wasalam

P/s: DO correct me if there is any correction one the facts of special class and special children.

L.O.V.E is....??

Salam,

Love is a state of feeling that can do tremendous things, either postive or negative. Because of love human can make the world a better place or destroy it.

There are two kinds of love: love between human and God(ALlah) and between human and god's creation(human,animals,nature,things)

We are blessed with 'unconditional love' that makes a family close to each other: Husband and wife tolerating each other, mothers' sacrifice for the child,father's hard work as breadwinner of the family, children obeying their parents.

Unconditional love is a love given without condition or wanting anything in return.It is a natural reaction of feeling that god creates for us humans to make a world a better place. For example, mothers are the best teacher of all since nothing can beat her influence of the child. Anything that she taught her children since young will be easily digested & followed.Isn't the reason behind this is the unconditional love??

I went to a talk organized by Malaysian Student's organization at Bandung on love between men & women(between Mars&Venus,two different creature sharing same genus & species-homo sapiens). What's the cronology of LOVE that brings two different hearts togather?
1.CRUSH
2.AMAZED-positive quality shown by the person that make you like him/her
3.FEARED-fearing of losing of having to share the special place in the person's heart.
4.ACCEPTANCE-accept the person's personality positve & negative
5.SACRIFICE-willing to do anything for that person
6.HOPE-hoping that the person will love you as much as you love him/her
7.LOYALTY-loyal to the person you love.

The best way to deal with it is by coupling reaction=MARRIAGE.Which is Nikah connecting people..NOT pre-marriage coupling reaction.

The world view premarriage couple as normal thing and chosing to only couple after marriage as a weird thing. I experienced that and I'm considered as one of the weird one. I choose to 'be weird' as I think premarriage coupling only brings more bad than good. Marriage means able to give commitment to another person, therefore no harm to wait for the right moment.


DOn't be like this cat who is trapped in love...

Today, during one of our common lecture, we learned about 'Dealing with uncertainties & death' for Personal & Professional Development (PPD) course . The doctor point out that besides the patient's condition, Love is a also another example of uncertainty...Doug Hubbard define Uncertainty as the lack of certainty, A state of having limited knowledge where it is impossibleto exactly describe existing state or future outcome, more than one possible outcome.

It is true love among humans, animals and all the creation of god is in a state of uncertainty. We always forget that there is a love that is 'certain' which is love to God (Allah). We experienced the love everyday and yet we always forget where the source comes from.The air we breathe,the delicious food that we eat, the beautiful creation of god that we able to appreciate are all the prove of love that god gives us.

No matter how much we adore,look up to or hope for a person there always be the uncertainty of the state of love.It might be 'crushed' anytime.The person or animal may died,the things that you like may destroyed or stollen.The Love of god is lasting,forever and never ends unless we choosen not to believe.

I think what i like to convey about ALlah's love is well written and sing in a song 'Open your eyes' by Maher ZAIn-which is another Maher Zain song i'll learn to play with my piano right after final exam as requested by my beloved twinning UKM-UNPAD friends.

May this post brings benefit to you and me (",)

Wasalam.

Unity & 1 Malaysia in Interfaith discussion..

Salam,

Yesterday, clinical medical students (especially 3rd years) were invited to attend an interfaith forum regarding medical proffesion. It was arranged by our Personal & Professional Develepment Modul Coordinator-Assctd Prof Harlina Siraj. It was very interesting, interactive and motivating.

SInce it was done on friday evening (where the mind of most of us towards weekends activities & going home), the attendence was between poor to satisfactory. Well, its everybody choice. ATTITUDE problem is one of the main reason. However, there are some who have teachings & long case(practical assessment) during that time.

SO, in summary here are some of things that were discussed. I only point out things that i'm confident of to share with some addition of my opinion.

In Islam, The prophet reminded us to remember about 5 things before 5 things like in Surah Al-Asr(Time) :

1.Health before ill
2.youth before old
3.wealth before poor
4.free before busy
5.life before death

WHY?? Life for Muslim is the intermediate phase as we belive in afterlife. The 5 things are the motivation for us to amal ma'aruf, nahi mungkar(do good and leave the bad things)as the preparation for afterlife later. In life we receives challanges to strenghten our faith to Allah (god).One of the challange is ILLNESS. A good believer will accept his fate but never stop losing hope to cure him/herself. Therefore, it does not mean that if you are extremely ill, you can kill yourself.

The Speaker from Buddhism(Dr Phang, a Psyhciatrist from UPM) mentioned about Karma. Karma is a concept of action or deed that causing the cycle of causes and effects.It was originating in India and applied in Eastern religions : Hinduism, Jain, Sikh and Buddhist. Basically Karma relates more to the power of your mind control.

Quoted from Wikipedia :Buddhism links karma directly to the motives behind an action. Motivation usually makes the difference between "good" and "bad" actions, but included in the motivation is also the aspect of ignorance such that a well-intended action from an ignorant mind can subsequently be interpreted as a "bad" action in the sense that it creates unpleasant results for the "actor".

There are mental and physical health.The mind can effect the health and vice versa.In medical we call the condition psychosomatic when someone thinks that he is sick but actually nothing wrong with him (physically).However, eventually he will get the physical problems also, as his minds make hime thinks he is sick.

Speaker from Christianity, Dr Lopez(Oncology Specialist) focused his presentation on abortion and ethuanasia. In Malaysia, 50 million abortions done yearly. A suprising fact indeed because Malaysia population is about 22-25 millions. Only the minority of the whole are due to medical reasons. Sad fact isn't it?/

Euthanasia..Eu means good, Thanasia means death..GOOD DEATH??Is there such thing? Ethuanasia is a mercy killing; the delibrate ending of a life of a person suffering from an incurable disease(Dorland's dictionary).However, all religion against it. Dr Lopez mentioned that Christians believed that life is sacred and humans was given the right to lead the world. In Islam, life is a GIFT from Allah(god)that we have to accept and makes good things out of it.It is not our decision to take our own life,and not even others.So far, only Netherlands legally allowed euthanasia.

Sadly, I was half awake during the 4th & last presentation from Dr Bala, Hinduism representative due to lack of sleep for long case assesment preparation (I had my long case assessment earlier on that day). Therefore, I googled and found an intresting article about Hinduism & Medical care. The basic concepts in Hinduism are Ahimsa (non-violence) and Karma. Ahisma is cause no harm either by action, word or thought(one of the reason why Hidus are vegetarian).

Karma in Hinduism is quite similar to Budddhism about good and bad that helps balance the person's soul. The Karma lets their believer ACCEPT challenges in life (eg: illness,death,fate)by thinking of the positive things out of the bad things that happens. Can read more about it from here http://www.angelfire.com/az/ambersukumaran/medicine.html

In Islam we believed in 'Qada' & 'Qadar' which is fate & Allah's will that we have to learn to accept and go through because in everything that happens there's always the 'hikmah'(good & benificial things) behind it.Only those who make an effort to find it,will able to feel it.This is because humans created with 'fitrah'(human nature) of finding goodness in life no matter how bad he was before.

During the Question & Answer(Q&A) session, a friend ask about what if the patient wants something (eg : sperm donation) that against the doctors' religion??
ANswer: Assctd Prof Harlina says, according to International Federation of Gynecology & Obstetrics (FIGO)on FIGO committee for study of ehtical aspects of Human reproductive and Women's Health published November 2006: If a physician is either unable or unwilling to provide a desired medical service for nonmedical reasons, he or she should make every effort to achieve appopriate refferel.

in simple word: if you decided that what patient wants is against your religion, you should respect them and reffered to a colleague that share the patient's belief.

In conclusion of the forum, i would like to quote the points by Dr Munnawar Hatta,the Islamic speaker in encouraging us to learn more about other religions for better understanding and respect among each other.

We live in the world of diversity.DOn't make the interfaith discussion as a battlefield to damage the relationship among us. Isn't the reason why Allah creates us in diversity is for us to learn to accept,learn about each other and be friends??

Therefore:
1. lets join interfaith forum in future
2. Learn about the similarity and differences
3. Respect other's belief
4. Don't be afraid or have stigma in interfaith discussion if the purpose to find an agreement instead of argument.



May readers have benefit from this post.

1 MALAYSIA!!

Wasalam (",)

Music & lyrics works togather...

Salam,

Anugerah Juara Lagu fever just cured... I'm glad that all my favourite songs win the prizes.I love music...Maybe its the influence from my passion on playing instruments (piano & violin).

Whenever i hear a song i will concentrate on the music more and ignore the lyrics. Not until a couple years ago, a friend changed me to appreciate the lyrics also.

At the same time, the movie 'Music & lyric' came out played by Hugh Grant and Drew Barrymore. It makes me changed my perception on songs. To give a good impact to the listener, both music & lyrics have to be good. This is because, it have to be appreciated and understand altogather.

After i did that i realise that not all songs with good musics have nice lyrics. Some even have some bad and indecent meaning.

Last weekend during UKM Medical Student Society aka PERSIAP 35 years celebration Dinner, i played piano as a backup for my friend who sang solo. Eventhough its a nasyeed (islamic song), i think the song can be applied to anyone who's in sadness and feel loss. It is suitable for anyone who believes and put trust in god.

I was given the task a week earlier, within the day, i manage to play the whole song. It have a beautiful music & lyrics..

Insyaallah ( With god's willing)
by Maher ZAin

Everytime you feel like you cannot go on
You feel so lost
That your so alone
All you is see is night
And darkness all around
You feel so helpless
You can`t see which way to go
Don`t despair and never loose hope
Cause Allah is always by your side

Insya Allah3x
Insya Allah you`ll find your way

Everytime you can make one more mistake
You feel you can`t repent
And that its way too late
Your`re so confused,wrong decisions you have made
Haunt your mind and your heart is full of shame


Don`t despair and never loose hope
Cause Allah is always by your side
Insya Allah3x
Insya Allah you`ll find your way
Insya Allah3x
Insya Allah you`ll find your way

Turn to Allah
He`s never far away
Put your trust in Him
Raise your hands and pray
OOO Ya Allah
Guide my steps don`t let me go astray
You`re the only one that showed me the way,
Showed me the way 2x
Insya Allah3x
Insya Allah we`ll find the way



source: http://media.photobucket.com/image/hope/dramadiva_photo/My%20Favorites/Spritual/hope.jpg

Candid picture at dinner...



Another favourite song of my is a theme song of a box office Indonesian Movie, Laskar Pelangi. It's about someone trying to persue his dream with enthusiasm and high spirit believing that one day he /she will prevail.

At the same time, the song keep reminding the listener to appreciate life eventhough life is hard. Lif is indeed WONDERFUL & MEANINGFUL Isn't it a good motivational song??

LASKAR PELANGI (soldier of the rainbow)by Nidji (an indonesian band)

Mimpi adalah kunci
Untuk kita menaklukkan dunia
Berlarilah tanpa lelah
Sampai engkau meraihnya

Laskar pelangi
Takkan terikat waktu
Bebaskan mimpimu di angkasa
Warnai bintang di jiwa

Menarilah dan terus tertawa
Walau dunia tak seindah surga
Bersyukurlah pada yang kuasa
Cinta kita di dunia

Selamanya...

Cinta kepada hidup
Memberikan senyuman abadi
Walau hidup kadang tak adil
Tapi cinta lengkapi kita

Laskar pelangi
Takkan terikat waktu
Jangan berhenti mewarnai
Jutaan mimpi di bumi

Menarilah dan terus tertawa
Walau dunia tak seindah surga
Bersyukurlah pada yang kuasa
Cinta kita di dunia

Menarilah dan terus tertawa
Walau dunia tak seindah surga
Bersukurlah pada yang kuasa
Cinta kita di dunia

Selamanya...

Selamanya...

Laskar pelangi
Takkan terikat waktu...



source: http://www.cartoonmotivators.com/MotivatorCartoons/images/Road2Success(b).jpg

Becoming a part of PERSIAP committee family..This picture was taken after the voting & announcement with the previous committee during the PERSIAP 35th Annual Grand Meeting.Thanks for the vote and trust on me. An extra task and responsibility that will be handle with effort and diligence(A promise to myself..hehe)




WAsalam (",)

Stigma is prejudism!!

Salam(peace),

What do you think when you see these pictures??

Down syndrome- they don't choose to be like this and it is not a transmitted disease!!


leprosy- it can be cured(if get early treatment),the picture on the right is after the treatment.


obesity-there are many reasons on why they become like this


mental illness and starvation-a boy that was locked in his house and doesn't get proper treatment.


dwarfism-they don't choose to be small, regardless their size,they are like normal people too


You might think of avoiding them...staring at them because they don't look normal or worse tease them.

DOn't you think it is inappopriate?? Aren't they human being too like us??
These people have stigmatized illness who usually gets stigma from the society.

What is stigma? Stigma is a negative impression or prejudism on a certain group of people who have stigmatized illness(eg: mental illness, skin diseases, HIV,Down syndrome).

They tends to get stigmatized and neglected by the society.

Moreover, they receives less social support. In addition to their own problem, they can get depress because of less support. Not many employeers want to employ them. Since they don't have income, the can't afford the medicine or treatment they need.
Due to their limitation, they need special public facilities or consideration that we tends to neglect.

Some of them may not have support by their own family members. The health care system also do have stigma on them.Sadly, some health care workers too doesn't understand their condition and have stigma on them

What we can do???
First, UNDERSTAND their condition and erase the myth you know about them
Next, ACCEPT them as who they are.Let them live with us without feeling inferior
Then, CHANGE and let others change wih you by educating them to UNDERSTAND & ACCEPT

To learn more about STIGMA and STIGMATIZED illness...you are invited to attend this forum under Hari KEsihatan Sedunia 2009.The theme this year is STIGMATIZED illness-To Understand, Accept & Change organized by AMSA UKM in conjunction with PERSIAP,PPK & JAKSA.As one of the high committee members, I'll be glad if many people willing to join us.

Title: ''Penyakit Stigma, Masyarakat boleh berubah''
Panels:
Prof Fuad Ismail- Jabatan Onkologi, PPUKM
Prof Madya Dr. Ruzanna Zamzam-Jab. Psikiatri, PPUKM
Dr Azmi Mohd Tamil-Jab. Kebajikan Masyarakat, PPUKM
Where?? Pusat Perubatan Universiti Kebangsaan Malaysia, PPUKM
When?? 18/07/2009(Saturday) from 2.00pm till 5.00pm
Fee?? FREE of charge

Contact person:Siti Juliana 017 370 2023, Noradila Salmi 017 953 9608

Publics can also join the blood donation, medical check-up and mini exhibition.
Where?? PPUKM
When?? 17-18/07/2009(friday and saturday) from 10.00am till 5.00pm

Hopefully our small effort will make the difference..by making people aware of the stigmatized illness.Hopefully many people will change and make world better place to live.

Poster of HAri kesihatan Dunia 2009-Peringkat PPUKM



Wasalam..(",)

P/s: Stigmatized illness patients can be pretty and live happily like them...so, CHANGE to make the world a better place for them to live.