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 (",)

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 :)

Passion for sports :)

Salam,

It's already a year since I lft Bandung. Overthere,i have a routine of spending my evenings or weekend morning doing aerobic, light jog or swimming. Among of those three, I usually go for aerobic the most since the gym is just 15 minutes walk from where I stayed. I even entered the competition twice and attended the gym instructor's parties a few times for birthdays and her engagement. Through sports, I make friends with the local peoples(ibu-ibu), including students from other faculties.

When I came back to Malaysia, I have to find something to substitute my evening aerobics. The hospital is a very strategic place since the swimming pool and stadium is just in front of it. However, no ladies' day for the pool which keeping me from going...huhu. Another alternative is jogging by Taman tasik Permaisuri which something I can do alone when no one can accompany me.

I am not new in jogging. I did jogging since high school.However, I never consider it as something I enjoy the most(especially when u do it alone) until I enter the competition which I upgrade myself as a long distance runner. It feels good when you are able to finish the race. It is definitely a bonus when you are better than others. The next aim is 12.3km run..

It started about a year ago which i only manage to jog half round of the tasik and then gradually upgrading myself until I was able to finish 3 rounds straight without stopping. Later, I entered a 7km run organized by my fellow friends which open for public . I did training twice for it and manage to get 4th place in 43 minutes duration without injuries and to my suprise no tremendous exhaustion. I puasa sunat the next day and did my normal run on the other day. Therefore, i am eager for another run. I guess, I am now infected with running. :) Thus, i bought the Nike shoes specifically for long distance running at a bargain price.

Actually I was aiming for a futsal shoes for a long time. However, after a few considerations, I choose running shoes. Finally, we girls get one day (Thursday) for us to use the court at our 'kolej kediaman'. Thanks to our Jawatankuasa Kolej (JAKSA).However, I wonder will it last? This is because, not many girls are ehtusiastic enough to come down and play. Sooner or later, the guys will claim back the day..huhu.

Sports unites people no matter who they are and brings us closer :)

Wasalam (",)