Bismillah.....
Mimpi yang pelik... ini kali ke dua anin mimpi bertunang dgn dia... dulu pn mcmtu.. tp, masa tu mak dia dtg sorg je.. Rumah tu rumah kayu dua tingkat.. Bwh rumah batu.. Anin tak tau rumah siapa.. Yang pasti anin baru lepas di make up duduk atas kerusi mcm stool tinggi tu.. mak dia dtg sarung cincin kat anin.. mcmtu je?kat dapur plk tu.. hahahaha.. pelik plk kejadian tu.. nasib mimpi..
This time.. anin tulis ni sbb anin takut nnt lupa apa yg anin mimpi pelik2 ni... 'dia' juga jadi watak utama... tapi, anin masih xberckp dgn dia.... kami dlm satu rumah yg sama.. banglo double storey.. mcm homestay.. anin luar rumah nmpk dia kat belah atas.. family belah anin kat bawah.. rumah tu cantik plk tu... ada beranda.. ada mcm gondola atau wakaf kat luar.. Dengan banyak pokok hiasan kat luar... mcm rumah peranginan... masa anin siap tu... anin perhati je sorg2... semua beria2 siap.. pakai cantik2... Semua gelak ketawa.. Happy moment lah tu.. Event apa anin pn xsure.. anin plk pakai baju entah dr mana.. warna kuning diraja plk tu... penuh manik kat baju kurung kosong tu... mcm baju pengantin pn ada.. semua org tgh siap2 nk kuar... anin pun toleh lah kebelakang... today must be something special... AKU BERTUNANG/BERKAHWIN?!? Mcm org kahwin je... bila toleh tu... i saw him.. YES!! him... the one that i think about lately sbb ternampak gmbr dia dlm ig kwn dia.. tapi bkn dia sorg... satu family dia ada... dia tgh betulkan sampin... hahhaha.. aku ketawa kecik sambil pandang dia.. handsome jugak dia berbaju melayu kuning...bersampin & bersongkok.. merepek je baju warna kuningkan.. Pilih la warna purple ke.. Biru ke.. Hahaha
Kata bertunang tapi,knp... knp kami tak berckp?? Communicate pn x.... harapan je nk bagi isyarat pn tak.. call? Tak jugak... saya je yg pandang dia dr jauh... mcm real.. sbb reality pn kami xbersembang... nk menegur jauh skali.. bila masa aku setuju terima dia?? Bila kami berbincang?? Nasib mimpi je.. kalo real.. mmg nk kena sekeh kepala sendiri la jwbnya.. sbb bila masa kami berjanji ?? Berapa tahun dh lost contact... Ym! Sama sekali TIDAK!! =P
Itulah mimpi kan mainan tidur.. lainkali, nak tidur basuh kaki, baca doa.. ni sebab letih sangat tidur je.. at least kalo amik wudhu tu oklah.. until this time, tiada siapa pun yang anin kenal boleh dikatakan anon serius utk dijadikan pasangan hidup.. Bukan memilihlah.. Tapi, diri sendiri yg xberani nak buka hati utk lelaki baru kenal.. maybe i will walk alone until the end ke? Wallahualam.. yang pasti anin penah dengar 'nabi akan tunggu mana2 gadis yang belum berkahwin di dunia di pintu syurga kelak...' itulah menyebabkan anin tak risau psl jodoh... Pasal org nak mengata tu.. Kita tak blh nak amik port.. Sbb org mmg tak akan berhenti berkata kn.. Hehhehe.. inilah masanya untuk anin bermanja lebihkan dengan mak dan bapak.. tiada siapa didunia mampu tandingi kasih-sayang anin untuk mereka..
Bila mak kata uncle nak jodohkan anin dgn anak dia.. I be 'cousin?? Seriously mak setuju??.. Tak boleh la mak.. Anin xsuka sepupu.. Mcm takde org lain je..
mak pulak kata "Mak ok je.. Korg sekufu.. Sama2 doktor.. "
Back to the story about the dream i got..
I hope he will be alright.. mmg selama ni aku sll berdoa agar dia bahagia disamping yg tersayang.. aku tahu cerita dia dgn gadis bertudung itu.. Siap ada citer bertepuk tampar lagi dlm kelas.. tp, untuk kepastian aku xmahu amik risiko dh utk memastikan kesahihan berita tu.. patah hati plk nnt kn.. apa yg aku harap , biarlah aku saja yg tahu apa sebenarnya yg aku rasa.. lagipun,cinta bukan harus MEMILIKI.. lagipun siapa aku jika nk dibandingkan dgn dia.. dr dulu lg aku sebenarnya rasa terperangkap dgn perasaan sendiri.. biarlah kali ini takdir saja yg menentukan.. siapa yg dtg dlm keluarga ini.. in sya Allah aku terima dgn hati yg terbuka.. i need to know who is my future husband.. baru dua minggu yg sudah ada org bg no. Telefon utk aku contact.. tp, taulah aku ni keras kepala.. susah nk percaya org yg bru kenal mcm dia tu.. too bold.. berani sgt nk kenalkam diri depan mak dan bapak plk tu.. nama dia suffian.. lahir tahun 85 maknanya skrg umur dia 31.. jgn fikir sangatlah anin.. good looking jgk lah... (i don't like family arrange )-we deserve to choose our own future life..
Aku ni dh la xkerja lg... duit xpn xde kalo nk nak minang anak org kn...
Let spend time with mak,bapak,kak janna,kak nani, hakim,fatihah,jazlaan,kak nita, abg harun,abg jafrul,kak nur,ariff,fina dan hafidz..
They are my harta dunia akhirat..
Kalau ada jodoh xkemana.... *peace*- kita enjoy dgn cuti yg panjang ni... tulah mulut ni masin kata nak kerja lambat2.. kan dh jadi reality... oh!! My......
Monday, March 21, 2016
Venupucture tips from Dr onn
My top 10 tips on how to do venupuncture easily
Ambik darah adalah salah satu tugas yang agak mencabar and as a house officer, especially during medical posting, you need to poke about 20-30 patients during your oncall shift
Teknik ni sangat penting sebab pertama, anda tak membuang masa and yang kedua, patient xbenci anda sebab kalau anda try poke tapi xdapat2
1. Adequate lighting
- seringkali saya tengok sesetengah colleague saya bila nak buat venupuncture, diorang akan tutup semua langsir kat sekeliling patient. Well, kalau ada lampu yang terang dekat patient tu, should be ok. Kalau pesakit yang duduk di sebelah tingkap, xperlu rasanya untuk tarik tirai yang belah tingkap tu, so that bila cukup cahaya masuk, senang nak locate vein2 yang tersembunyi tu :-)
2. Squeeze technique
- Hmm, semua orang kata nak ambik darah patient nephro memang tersangat susah, why? because they're usually oedematous. So, lepas apply torniquet kat tangan patient, take your time untuk urut perlahan-lahan tangan patient or tekan kat bahagian yang ada vein, it works like you're examine pitting oedema, except kalau area tu ada vein,surrounding
dia akan tenggelam, but the vein akan timbul
3. Apply torniquet firmly
- xperlu apply too hard, but some of my friend apply it too loose. Takut patient sakit katanya, tapi which one is better? ikat tangan patient kuat, and single poke dapat darah or kesian kat patient takut sakit ikat torniquet kuat-kuat tapi poke 6 kali?
4. Lights/Pocket light/ Venoscope
- Well, saya bukan nak promote lampu energizer, but their keychain light is very2 useful especially nak locate vein in oedematous or paediatric patient. Kalau ada duit lebih
bolehla invest kat venoscope (50 USD). If patient tu oedematous, lampu tersebut akan menerangi seluruh bahagian tangan pesakit tu dan anda akan dapat locate vein pesakit easily. Rapatkan torch pada bahagian atas or belakang point yang anda nak poke. Well, the principle is like transillumination test in hydrocele, except kalau area tu ada vain, kita akan dapat detect dengan lebih mudah (cer try check link ni https://www.facebook.com/photo.php?fbid=1189741544387647&set=pb.100000554391883.-2207520000.1458497230.&type=3&size=629%2C456)
5. Take your time locating the vein
- Ok, anda dah apply torniquet firmly, tap on the patient's vein couple of times and kalau xconfident, jangan cucuk lagi. Cari alternative or kawasan yang veinnya sangat prominent. Xpe, ambik masa cari vein betul2, sambil2 tu sembang le dengan patient tu. Jangan cucuk je kerja, kesian kat patient
6. Ethyl Chloride spray/ EMLA cream
- kat government hospital payah nak jumpa menda ni, but you can easily find them at local pharmacy. Yup, spray ni sangat berguna (for me personally)sebab bila kita spray with adequate amount, patient usually takkan rasa sakit ila kita poke. Well, ada yang rasa pedih bila kita spray, but actually its because the spray was very2 cold that it creates a numbing effect kat atas skin patient. Kalau patient tak sakit, kan best untuk kita, then mesti dia cerita "doktor tu ambik darah xrasa pun...".
7. 30 degrees angle
- sesetengah orang saya tengok, angle bila nak cucuk jarum tu terlalu tinggi, making double puncture to the patient's vein, and some of them, the angle is too low, memang xkan dapat darah because you're in subcutaneous layer. 30 degrees angle adalah angle yang terbaik untuk kita cucuk, and if you done countless blood taking, you will feel a give away bila masuk dalam blood vessel
8. Stop after 3 times of fail attempt
- ok, biasanya kalau saya cucuk dah sampai 3 kali xdapat, and if I'm alone, I will get back to that patient later. Of course you need to apologize to the patient, but kalau ada colleague saya around, I will ask them to take it for me. Sometimes, memang kita tak boleh, n try not to take more than 3 times, kesian kat patient
9. Clean the skin adequately
- ok, jangan kedekut nak guna alcohol swab, clean area yang kita nak cucuk tu thoroughly, usually i will take 5 - 7 cm in circumference area tempat kita nak cucuk untuk diswab guna alcohol swab especially when you're inserting the brannula. And sometimes bila you wipe tangan patient, sampaikan alcohol swab tu jadi warna hitam, then, take and open another one, and swab it again until clear, this will minimize the risk of patient developing thrombophlebitis
10. Locate the veins merata-rata
- Don't just focus on the upper limbs, sometimes memang vein nya dah burn out ataupun terlalu halus dekat upper limbs, you can take it at the lower limbs as well (but clean the area properly). Cari sampai jumpa and kalau dah memang xde (eg in IVDU patient), alternative is triple lumen via subclavian vein, jugular vein ataupun femoral vein
Remember, venupuncture is 90% skill, 10% luck
Ambik darah adalah salah satu tugas yang agak mencabar and as a house officer, especially during medical posting, you need to poke about 20-30 patients during your oncall shift
Teknik ni sangat penting sebab pertama, anda tak membuang masa and yang kedua, patient xbenci anda sebab kalau anda try poke tapi xdapat2
1. Adequate lighting
- seringkali saya tengok sesetengah colleague saya bila nak buat venupuncture, diorang akan tutup semua langsir kat sekeliling patient. Well, kalau ada lampu yang terang dekat patient tu, should be ok. Kalau pesakit yang duduk di sebelah tingkap, xperlu rasanya untuk tarik tirai yang belah tingkap tu, so that bila cukup cahaya masuk, senang nak locate vein2 yang tersembunyi tu :-)
2. Squeeze technique
- Hmm, semua orang kata nak ambik darah patient nephro memang tersangat susah, why? because they're usually oedematous. So, lepas apply torniquet kat tangan patient, take your time untuk urut perlahan-lahan tangan patient or tekan kat bahagian yang ada vein, it works like you're examine pitting oedema, except kalau area tu ada vein,surrounding
dia akan tenggelam, but the vein akan timbul
3. Apply torniquet firmly
- xperlu apply too hard, but some of my friend apply it too loose. Takut patient sakit katanya, tapi which one is better? ikat tangan patient kuat, and single poke dapat darah or kesian kat patient takut sakit ikat torniquet kuat-kuat tapi poke 6 kali?
4. Lights/Pocket light/ Venoscope
- Well, saya bukan nak promote lampu energizer, but their keychain light is very2 useful especially nak locate vein in oedematous or paediatric patient. Kalau ada duit lebih
bolehla invest kat venoscope (50 USD). If patient tu oedematous, lampu tersebut akan menerangi seluruh bahagian tangan pesakit tu dan anda akan dapat locate vein pesakit easily. Rapatkan torch pada bahagian atas or belakang point yang anda nak poke. Well, the principle is like transillumination test in hydrocele, except kalau area tu ada vain, kita akan dapat detect dengan lebih mudah (cer try check link ni https://www.facebook.com/photo.php?fbid=1189741544387647&set=pb.100000554391883.-2207520000.1458497230.&type=3&size=629%2C456)
5. Take your time locating the vein
- Ok, anda dah apply torniquet firmly, tap on the patient's vein couple of times and kalau xconfident, jangan cucuk lagi. Cari alternative or kawasan yang veinnya sangat prominent. Xpe, ambik masa cari vein betul2, sambil2 tu sembang le dengan patient tu. Jangan cucuk je kerja, kesian kat patient
6. Ethyl Chloride spray/ EMLA cream
- kat government hospital payah nak jumpa menda ni, but you can easily find them at local pharmacy. Yup, spray ni sangat berguna (for me personally)sebab bila kita spray with adequate amount, patient usually takkan rasa sakit ila kita poke. Well, ada yang rasa pedih bila kita spray, but actually its because the spray was very2 cold that it creates a numbing effect kat atas skin patient. Kalau patient tak sakit, kan best untuk kita, then mesti dia cerita "doktor tu ambik darah xrasa pun...".
7. 30 degrees angle
- sesetengah orang saya tengok, angle bila nak cucuk jarum tu terlalu tinggi, making double puncture to the patient's vein, and some of them, the angle is too low, memang xkan dapat darah because you're in subcutaneous layer. 30 degrees angle adalah angle yang terbaik untuk kita cucuk, and if you done countless blood taking, you will feel a give away bila masuk dalam blood vessel
8. Stop after 3 times of fail attempt
- ok, biasanya kalau saya cucuk dah sampai 3 kali xdapat, and if I'm alone, I will get back to that patient later. Of course you need to apologize to the patient, but kalau ada colleague saya around, I will ask them to take it for me. Sometimes, memang kita tak boleh, n try not to take more than 3 times, kesian kat patient
9. Clean the skin adequately
- ok, jangan kedekut nak guna alcohol swab, clean area yang kita nak cucuk tu thoroughly, usually i will take 5 - 7 cm in circumference area tempat kita nak cucuk untuk diswab guna alcohol swab especially when you're inserting the brannula. And sometimes bila you wipe tangan patient, sampaikan alcohol swab tu jadi warna hitam, then, take and open another one, and swab it again until clear, this will minimize the risk of patient developing thrombophlebitis
10. Locate the veins merata-rata
- Don't just focus on the upper limbs, sometimes memang vein nya dah burn out ataupun terlalu halus dekat upper limbs, you can take it at the lower limbs as well (but clean the area properly). Cari sampai jumpa and kalau dah memang xde (eg in IVDU patient), alternative is triple lumen via subclavian vein, jugular vein ataupun femoral vein
Remember, venupuncture is 90% skill, 10% luck
Wednesday, March 16, 2016
Interview SPA
Assalamualaikum......
Harini 17 mac 2016
Hari ni anin interview... yeah... yeah...
Ya Allah... hari yg dinanti sudah pn tiba...
Soalan yg bermain di minda... apa agaknya yg ditanya? Ada soalan medik x? Gcs? Zika? Cardiogenic shock? ACS?hypertension?dm?
Ok.. mak masak nasi lemak.. jam dah menunjukkan 7.20pagi.. mak siap2 tau.. anin nak sampai sana kul 8 pagi..
Nervous? Apa pasal aku tak rasa pape?? Risau? Takde plk.. sama mcm aku rasa PRO 3? Pn xde... Ya Allah... apa patut aku rasa skrg ni?? Makan pn relax.. masuk kereta pn relax.. ok check blk.. file semua dh msk beg smlm.. tab pn dh msk beg.. ada apa2 yg tertinggal? Ermmm.. xde kot.. smlm dh susun elok2.. oklah tu..
Mak dan bapak hntr sampai ke tempat temuduga SPA.. betullah ckp shela tu... atas restaurant simpang tiga.. masa nak naik lift tu ada sorg lelaki naik sama... org ni nk pegi yayasan bina upaya kot.. org tu pn masuk sekali.. dia yg tekan lift.. level 2 dan 5.. ek?? Mcm tau2 je yg anin nk g interview kat level 5. .. hehhehe (say tq2 je dlm hati)
Turun je lift kt level 5.. mcm ku kenal mereka ni... eh2.. meriahnya... syakirin, ainul farhana, dgn hema... dan sorg lg dari manipal fadhil.. so, anin org yg ke 5 lah.. ok.. encik yg kat kaunter tu suruh letak surat panggilan kat dlm kotak.. anin pn keluarkan lah... letak... dan disusuli yg lain.. hahhaa... nama anin di panggil.. JANNATUL ADNIN BT JINAN TAIB .." ohh... ni anak en jinan lah ni??" - aah.. saya.. anin pn bangunlah... " meh bagi semua salinan saya susun... " sy dh susun dh... ok.. bagi saya check... Encik mior amri (uru setia SPA) abah awak dulu kerja pejabat tanah ya?? Aah..... dulu SUK lepas tu kerja PTG.. (p/s: ada plk org kenal bapakku ni... hohoho.. ipoh kn...anin jgn nakal2.. :P)
Anin on tekanlah no.. dpt 0001 .. masa tgh tunggu kat kaunter.. "Assalamualaikum dato'" oowhh.. nimkot dato yg shela citer tu.. oklah sorg je penemuduga.. =)
Sekali Ainul ckp... encik kami nak masuk kesali boleh?? Jadi sy dan hema pn mengalahlah.. bagi ainul, syakirin dgn fadhil nk masuk dulu.. bagilah diaorg.. hema jadi no. 0004... dan saya 0005 (owhhh... my favourite no.. ) sbb diaorg nk g dulu kn... cantikk kn perancangan Allah.. sama mcm yg Shela ckp... kat Ipoh ni... by group..
My group... berkenalan dgn mereka
hema (0004), anin (0005), balakavitha (0006) rupanya dia ni my junior kat tcs from Monash university (siap dia tny kenal tak rachel,linot? Kenalll.... hehehhe dulu sama pengawas.. , dave (0007) otawwa university
masuk je bilik tu.. kami diminta letak file atas meja ikut susunan no. Anda.. sebelum kita mulakan saya mahu dengar anda bercakap.. kita sembang2 je.. kalau formal anda pn gemuruhkan.. kita sembang santai je.. (kami masing2 senyum je)
1st question : ceritakan pasal diri anda
2nd question : pengalaman yg tak boleh dilupakan sepanjang clinical attachment (gembira atau sedih)
3rd question : bincangkan satu isu semasa
1st question
All about me
(srk jln panglima bkt gantang)
(SMK Tarcisian convent, ipoh)
(Management and Science University )
2nd Q
Anin ceritakan psl pengalaman anin semasa intership dgn Dato razak mutallif (chest physician) semua department masuk termasuk ward tb, asthma... yang yg tak boleh dilupakan anin ikut sama ward round dan melihat Dr kendalikan patient yg resistant dgn apa2 ubat tb.. dari situ anin mula berminat nak sambung dlm mbbs lepas abis bms.. kalau tidak anin 50-50.. nak sambung master atau mbbs.. alhamdulillah saya sudah pn habis mbbs
3rd Q
Hema start dgn dengue... the aedes mosquito breed , incubation period dll.. memang agak sukar la.. kita bljr dlm english sekali nak ckp dlm bahasa malaysia... hahaha.. my part about sign &symptom.. fever, rash, sakit sendi?? Hahha... joint pain, periorbital pain, warning sign sakit perut, muntah, dll... kavitha plk tambah yg lain2.. dave ckp psl tourniquet test (hess test)
4th Q
In case patient nk discharge dengan dengue.. apa yg you all nk nasihat masa dia discharge?? Point yg dato tu nk dengar mcm shela ckp lah.... gotong--royong... masyarakat skrg banyak yang pentingkan diri sendiri... sampah luar dr kwsn rumah.. harapkan majlis perbandaran yg bersih kn... apa salahnya kalau kita tolong bersihkan dekat je dgn kwsn kita kn... jagalah kejiranan anda... nyamuk tu boleh terbang... sape saja dia boleh serang.. kalau kena ahli keluarga kita?? Baru nak sedar?
Dato tu pn beri nasihat pada kami... nnt jadi Doktor.. jadilah Dr yg prihatin.. jgn lepas tangan suruh org lain yg buat kerja kaunseling patient.. kita sendiri pn boleh buat.. baik Dato..
Ada apa2 soalan lain? Bila agaknya penempatan kami? Itu kena tunggu KKM beritahu.. pasal keputusan temuduga SPA ni dlm 2-3 minggu nilah..
Harini 17 mac 2016
Hari ni anin interview... yeah... yeah...
Ya Allah... hari yg dinanti sudah pn tiba...
Soalan yg bermain di minda... apa agaknya yg ditanya? Ada soalan medik x? Gcs? Zika? Cardiogenic shock? ACS?hypertension?dm?
Ok.. mak masak nasi lemak.. jam dah menunjukkan 7.20pagi.. mak siap2 tau.. anin nak sampai sana kul 8 pagi..
Nervous? Apa pasal aku tak rasa pape?? Risau? Takde plk.. sama mcm aku rasa PRO 3? Pn xde... Ya Allah... apa patut aku rasa skrg ni?? Makan pn relax.. masuk kereta pn relax.. ok check blk.. file semua dh msk beg smlm.. tab pn dh msk beg.. ada apa2 yg tertinggal? Ermmm.. xde kot.. smlm dh susun elok2.. oklah tu..
Mak dan bapak hntr sampai ke tempat temuduga SPA.. betullah ckp shela tu... atas restaurant simpang tiga.. masa nak naik lift tu ada sorg lelaki naik sama... org ni nk pegi yayasan bina upaya kot.. org tu pn masuk sekali.. dia yg tekan lift.. level 2 dan 5.. ek?? Mcm tau2 je yg anin nk g interview kat level 5. .. hehhehe (say tq2 je dlm hati)
Turun je lift kt level 5.. mcm ku kenal mereka ni... eh2.. meriahnya... syakirin, ainul farhana, dgn hema... dan sorg lg dari manipal fadhil.. so, anin org yg ke 5 lah.. ok.. encik yg kat kaunter tu suruh letak surat panggilan kat dlm kotak.. anin pn keluarkan lah... letak... dan disusuli yg lain.. hahhaa... nama anin di panggil.. JANNATUL ADNIN BT JINAN TAIB .." ohh... ni anak en jinan lah ni??" - aah.. saya.. anin pn bangunlah... " meh bagi semua salinan saya susun... " sy dh susun dh... ok.. bagi saya check... Encik mior amri (uru setia SPA) abah awak dulu kerja pejabat tanah ya?? Aah..... dulu SUK lepas tu kerja PTG.. (p/s: ada plk org kenal bapakku ni... hohoho.. ipoh kn...anin jgn nakal2.. :P)
Anin on tekanlah no.. dpt 0001 .. masa tgh tunggu kat kaunter.. "Assalamualaikum dato'" oowhh.. nimkot dato yg shela citer tu.. oklah sorg je penemuduga.. =)
Sekali Ainul ckp... encik kami nak masuk kesali boleh?? Jadi sy dan hema pn mengalahlah.. bagi ainul, syakirin dgn fadhil nk masuk dulu.. bagilah diaorg.. hema jadi no. 0004... dan saya 0005 (owhhh... my favourite no.. ) sbb diaorg nk g dulu kn... cantikk kn perancangan Allah.. sama mcm yg Shela ckp... kat Ipoh ni... by group..
My group... berkenalan dgn mereka
hema (0004), anin (0005), balakavitha (0006) rupanya dia ni my junior kat tcs from Monash university (siap dia tny kenal tak rachel,linot? Kenalll.... hehehhe dulu sama pengawas.. , dave (0007) otawwa university
masuk je bilik tu.. kami diminta letak file atas meja ikut susunan no. Anda.. sebelum kita mulakan saya mahu dengar anda bercakap.. kita sembang2 je.. kalau formal anda pn gemuruhkan.. kita sembang santai je.. (kami masing2 senyum je)
1st question : ceritakan pasal diri anda
2nd question : pengalaman yg tak boleh dilupakan sepanjang clinical attachment (gembira atau sedih)
3rd question : bincangkan satu isu semasa
1st question
All about me
(srk jln panglima bkt gantang)
(SMK Tarcisian convent, ipoh)
(Management and Science University )
2nd Q
Anin ceritakan psl pengalaman anin semasa intership dgn Dato razak mutallif (chest physician) semua department masuk termasuk ward tb, asthma... yang yg tak boleh dilupakan anin ikut sama ward round dan melihat Dr kendalikan patient yg resistant dgn apa2 ubat tb.. dari situ anin mula berminat nak sambung dlm mbbs lepas abis bms.. kalau tidak anin 50-50.. nak sambung master atau mbbs.. alhamdulillah saya sudah pn habis mbbs
3rd Q
Hema start dgn dengue... the aedes mosquito breed , incubation period dll.. memang agak sukar la.. kita bljr dlm english sekali nak ckp dlm bahasa malaysia... hahaha.. my part about sign &symptom.. fever, rash, sakit sendi?? Hahha... joint pain, periorbital pain, warning sign sakit perut, muntah, dll... kavitha plk tambah yg lain2.. dave ckp psl tourniquet test (hess test)
4th Q
In case patient nk discharge dengan dengue.. apa yg you all nk nasihat masa dia discharge?? Point yg dato tu nk dengar mcm shela ckp lah.... gotong--royong... masyarakat skrg banyak yang pentingkan diri sendiri... sampah luar dr kwsn rumah.. harapkan majlis perbandaran yg bersih kn... apa salahnya kalau kita tolong bersihkan dekat je dgn kwsn kita kn... jagalah kejiranan anda... nyamuk tu boleh terbang... sape saja dia boleh serang.. kalau kena ahli keluarga kita?? Baru nak sedar?
Dato tu pn beri nasihat pada kami... nnt jadi Doktor.. jadilah Dr yg prihatin.. jgn lepas tangan suruh org lain yg buat kerja kaunseling patient.. kita sendiri pn boleh buat.. baik Dato..
Ada apa2 soalan lain? Bila agaknya penempatan kami? Itu kena tunggu KKM beritahu.. pasal keputusan temuduga SPA ni dlm 2-3 minggu nilah..
Saturday, March 12, 2016
Musim berganti
Bismillahhirahmanirahim........
Panas... panas... memang panas...
Skrg kalo minum air sehari 2liter pn xcukup nih... dari tidur xberkipas... skrg 24/7 pasang kipas... even kat dapur... nk baking sll kalo malam boleh tahan je oven tu panas.. skrg x... nk kena jugak pasang kipas... it's sooooooo hot.....
Nasiblah sebahagian rumah ni pakai batu marmar.. sejuk jugaklah lantai nya.. nk dibandingkan dgn lantai simen..
Semalam memanjat bumbung dgn bapak.. betulkan atap umah.. ada yg pecah... dh lama xpanjat survey kawasan... mula2 panjat masa form 2kot.... hahhahha... xingat lah.. tp,yg pasti salah pijak.. hampir jatuh lah... terkapai2 pegang tiang kayu.. sejak dr tu bapak xbg naik dh... daddy little princess actually sukakan cabaran... tapi, terbatas bila mummy ratu kebaya masuk campur.. girls don't do That!!!!! :(
Muhammad Jazlaan.... budak kecik yg mencuri tumpuan kami sekeluarga dlm rumah ni... ada aje telatah dia yg buat org ketawa... hari ni buat lg... baru blk dr jln2 dgn kak nani.. sampai rumah... "makkkk.... saya balik... " ehhh.... sape budak ni.... (sampuk aku ) dgn muka xbersalah.... "ni sayalah... MUHAMMAD JAZLAAN.... " (HAHHAHAH.... siap bagi nama penuh lg.... apa yg dihappykan sangat tu?) Dia msk... menghampiri maknya sambil menunjukkan mainan yg baru dibeli oleh aunty nani kesayangannya.... sedang aku menoleh ke phone... dia dtg menghampiri... "anin..... nah amik ni... " ?? Nk buat apa ni jazlaan?? Mainlah........
(hahhha.. bertuah betul bdk ni.... suka kongsi mainan... mmg diajar.. ingat lg masa kat kelantan.. dia lihat mainan warna-warni jual kat wakaf che yeh.... dia tengok... dia pegang... tapi, bila mak dia kata letak balik... xnk beli.... dia xmerenggek.. dia ltk balil.. dia just xckp... "kenapa xboleh mak??" -easiest way to teach children by telling the reason.... why can... why cannot... bdk2 blh berfikir ) panjang plk throwbacknya...
Thank sis for reading my blog... hahaha... emoticon xhidup plk kat sini.... :P
Anin interview 17/3/2016 ni..... uwaaaaa....... dlm grp mcm2 soalan kuar... hahhahaha mcm soalan PRO 3 pn ada...
Soalan harini..panel 8. 1 doctor 1 spa
Nama siapa
Dulu belajar dimana
Siapa datuk nor hisham-ak kata director general,director general tu ap,...krik2....
Akta siapa gubal
Parliment ad 2 dewan...dewan ap
-brape populasi msia
-brape doc-patient ratio
-kenapa kkm buat peringkat2 mcm ad tmpt ni ad KK je..ad tmpt ni ad 1msia klinik je,ad tmpt ni ad hospital besar
-nak jadi specialist ap
Soklan doc
-how many stage of labour
-how many phase of 1st stage labour
-when u call latent,when is active
-what is true labour
-stage 3 apa
-if 10minute stage 3..what u shud do
-what r sign of placnta separation
-since u said globular uterine during palpation,why it is globular
-what is the reason for sudden gush of blood
-what do u call when there is no sign n symptom of placnta separation
-cause retain placenta
-why fibroid cause placenta to retain or remain
-list what u can see on partogram
-normal fetal heart rate brape
-what is ctg
-what component u see on ctg
-on fetal component,what u need to see
-what is baseline
-what is deceleration
-when u call decel
-what is type 1 ,2 n 3 decel
-pathophysio each
Hahhaa.... kann... ni belum soalan terkumpul yg lain... simpan dulu lah.... buat seramm je rasa nk g interview... seminggu sblm ni relax lg ni... tinggal brp hari je... 3hari?? Ya Allah permudahkanlah hambaMu ini dan rakan2nya menghadapi hari temuduga nanti...
Gaya penduduk kampung semarah padi tenangkan diri...
1) tarik nafas.........
2)angkatkan kedua belah tangan... goyangkan...
3)sambil SENYUM.....
Haahaha... that's all... sayonara.... ;) :D
Panas... panas... memang panas...
Skrg kalo minum air sehari 2liter pn xcukup nih... dari tidur xberkipas... skrg 24/7 pasang kipas... even kat dapur... nk baking sll kalo malam boleh tahan je oven tu panas.. skrg x... nk kena jugak pasang kipas... it's sooooooo hot.....
Nasiblah sebahagian rumah ni pakai batu marmar.. sejuk jugaklah lantai nya.. nk dibandingkan dgn lantai simen..
Semalam memanjat bumbung dgn bapak.. betulkan atap umah.. ada yg pecah... dh lama xpanjat survey kawasan... mula2 panjat masa form 2kot.... hahhahha... xingat lah.. tp,yg pasti salah pijak.. hampir jatuh lah... terkapai2 pegang tiang kayu.. sejak dr tu bapak xbg naik dh... daddy little princess actually sukakan cabaran... tapi, terbatas bila mummy ratu kebaya masuk campur.. girls don't do That!!!!! :(
Muhammad Jazlaan.... budak kecik yg mencuri tumpuan kami sekeluarga dlm rumah ni... ada aje telatah dia yg buat org ketawa... hari ni buat lg... baru blk dr jln2 dgn kak nani.. sampai rumah... "makkkk.... saya balik... " ehhh.... sape budak ni.... (sampuk aku ) dgn muka xbersalah.... "ni sayalah... MUHAMMAD JAZLAAN.... " (HAHHAHAH.... siap bagi nama penuh lg.... apa yg dihappykan sangat tu?) Dia msk... menghampiri maknya sambil menunjukkan mainan yg baru dibeli oleh aunty nani kesayangannya.... sedang aku menoleh ke phone... dia dtg menghampiri... "anin..... nah amik ni... " ?? Nk buat apa ni jazlaan?? Mainlah........
(hahhha.. bertuah betul bdk ni.... suka kongsi mainan... mmg diajar.. ingat lg masa kat kelantan.. dia lihat mainan warna-warni jual kat wakaf che yeh.... dia tengok... dia pegang... tapi, bila mak dia kata letak balik... xnk beli.... dia xmerenggek.. dia ltk balil.. dia just xckp... "kenapa xboleh mak??" -easiest way to teach children by telling the reason.... why can... why cannot... bdk2 blh berfikir ) panjang plk throwbacknya...
Thank sis for reading my blog... hahaha... emoticon xhidup plk kat sini.... :P
Anin interview 17/3/2016 ni..... uwaaaaa....... dlm grp mcm2 soalan kuar... hahhahaha mcm soalan PRO 3 pn ada...
Soalan harini..panel 8. 1 doctor 1 spa
Nama siapa
Dulu belajar dimana
Siapa datuk nor hisham-ak kata director general,director general tu ap,...krik2....
Akta siapa gubal
Parliment ad 2 dewan...dewan ap
-brape populasi msia
-brape doc-patient ratio
-kenapa kkm buat peringkat2 mcm ad tmpt ni ad KK je..ad tmpt ni ad 1msia klinik je,ad tmpt ni ad hospital besar
-nak jadi specialist ap
Soklan doc
-how many stage of labour
-how many phase of 1st stage labour
-when u call latent,when is active
-what is true labour
-stage 3 apa
-if 10minute stage 3..what u shud do
-what r sign of placnta separation
-since u said globular uterine during palpation,why it is globular
-what is the reason for sudden gush of blood
-what do u call when there is no sign n symptom of placnta separation
-cause retain placenta
-why fibroid cause placenta to retain or remain
-list what u can see on partogram
-normal fetal heart rate brape
-what is ctg
-what component u see on ctg
-on fetal component,what u need to see
-what is baseline
-what is deceleration
-when u call decel
-what is type 1 ,2 n 3 decel
-pathophysio each
Hahhaa.... kann... ni belum soalan terkumpul yg lain... simpan dulu lah.... buat seramm je rasa nk g interview... seminggu sblm ni relax lg ni... tinggal brp hari je... 3hari?? Ya Allah permudahkanlah hambaMu ini dan rakan2nya menghadapi hari temuduga nanti...
Gaya penduduk kampung semarah padi tenangkan diri...
1) tarik nafas.........
2)angkatkan kedua belah tangan... goyangkan...
3)sambil SENYUM.....
Haahaha... that's all... sayonara.... ;) :D
Friday, February 5, 2016
what's going on??
assalamualaikum...
cutiiiii... oh cutiii.....
benda yg anin terokai semasa cuti ialah craft...
menarik betullah brooch keeper ni... sejak masuk grp "geng jahit beg" macm2 hasil seni yg diaorg hasilkan...
lagi anin cuti lagi mcm2 anin nk cuba... pasal masak malaslah nk citer SEMUA anin nk buat.. tapi kalo xpandai suh kakak lah buat kan... hehhehe ..
jahit beg ni mmg kena sabar sikit bagi org baru mcm anin ni...
step by step kena ikut.. kena kemas kalo tak kak janna rotan.. hehehe
satu lagi anin dh join kelab peminat rose jepun/japanese rose/moss rose/portulaca grandiflora
anin juga nk citer anin dh msk group "geng mak nenek" - dari last year lagi lah..
macam2 kitaorg sembang.. bkn takat tu.. bila kepala msk air ni.. byklah benda yg merepek2 dibincangkan... tapi, takdelah menyentuh sensitiviti sejagat.. cukuplah menceriakan hari anda..
anin kenal start dari twitter dgn sorg ni. nama shazwani.. panggil cik kiah /sha/wani...
dia yg mula add anin dlm whatsapp... dlm instagram.. dlm weechat.. dlm facebook..
orgnya happy go lucky.. suka mengusik org.. dia dulu kerja kat singapore.. skrg sambung architect balik.. stay kat melaka.. sll gak dia citer dia busy sangat skrg ni.. pandai main biola.. entah bila dia nk bt kelas utk kitaorg ni..dia berangan nk main biola lagu mohabbataein masa kenduri dia.. rare kn?? dia jugak ada bkk kedai Dpavillion (physical store) kat melaka gak.. anin lupa nama tempat tu..
anin simpan sikitlah citer kami geng mak nenek di sini dululah..
dlm grp tu ada Nadia,huda,fiqah dan wani.. yg lain2 anin xkenai sangat.. sbbnya diaorg pun kenalkan diri dgn anin... hurrrrmmmm.... jadi kami2 jelah yg byk berbicara..
oklah sambung later ek.. sbb nk g masak bahulu dgn donut.. nk MAKAN...
=)
cutiiiii... oh cutiii.....
benda yg anin terokai semasa cuti ialah craft...
menarik betullah brooch keeper ni... sejak masuk grp "geng jahit beg" macm2 hasil seni yg diaorg hasilkan...
lagi anin cuti lagi mcm2 anin nk cuba... pasal masak malaslah nk citer SEMUA anin nk buat.. tapi kalo xpandai suh kakak lah buat kan... hehhehe ..
jahit beg ni mmg kena sabar sikit bagi org baru mcm anin ni...
step by step kena ikut.. kena kemas kalo tak kak janna rotan.. hehehe
satu lagi anin dh join kelab peminat rose jepun/japanese rose/moss rose/portulaca grandiflora
anin juga nk citer anin dh msk group "geng mak nenek" - dari last year lagi lah..
macam2 kitaorg sembang.. bkn takat tu.. bila kepala msk air ni.. byklah benda yg merepek2 dibincangkan... tapi, takdelah menyentuh sensitiviti sejagat.. cukuplah menceriakan hari anda..
anin kenal start dari twitter dgn sorg ni. nama shazwani.. panggil cik kiah /sha/wani...
dia yg mula add anin dlm whatsapp... dlm instagram.. dlm weechat.. dlm facebook..
orgnya happy go lucky.. suka mengusik org.. dia dulu kerja kat singapore.. skrg sambung architect balik.. stay kat melaka.. sll gak dia citer dia busy sangat skrg ni.. pandai main biola.. entah bila dia nk bt kelas utk kitaorg ni..dia berangan nk main biola lagu mohabbataein masa kenduri dia.. rare kn?? dia jugak ada bkk kedai Dpavillion (physical store) kat melaka gak.. anin lupa nama tempat tu..
anin simpan sikitlah citer kami geng mak nenek di sini dululah..
dlm grp tu ada Nadia,huda,fiqah dan wani.. yg lain2 anin xkenai sangat.. sbbnya diaorg pun kenalkan diri dgn anin... hurrrrmmmm.... jadi kami2 jelah yg byk berbicara..
oklah sambung later ek.. sbb nk g masak bahulu dgn donut.. nk MAKAN...
=)
Thursday, January 28, 2016
jom belajar sama2..
CASE WRITE UP..
should be kena tulis by handwriting... but, disebabkan tulisan cantik sangat... anin nak kena taip lah dulu... later anin tulis ek... =P
Thank you for seeing this patient..(ayat yg anin selalu jmp time praktikal kt IPR dulu...)
This patient 16 y/o Malay student with no know medical illness previously. she came to emergency department accompany by her parents due to chief complain of cough for 2 week associated with yellowish sputum. There is no Hx of pleuritic pain and no haemoptysis. She present of Hx of exertional dyspnea and palpitation. She also has fever for 1 week duration, on & off with chills and rigors. She does not have night sweat, loss of weight or loss of appetite. She has a hx of contact with her uncle with pulmonary tuberculosis but the contact was not prolonged and her uncle already completed his TB medication of 6 month. she does not have altered bowel habits and no family hx of malignancy.
on clinical examination, she was no tachypnea, BP 123/56 mmHg, Pulse rate 108 beat/min,regular,good volume, afebrile SpO2 97% under room air. Respiratory system revealed trachea deviated to left, stony dullness on percussion and reduce air entery on left lower zone. On auscultation, normal S2 and S2 heard without any murmur. Her abdomen was soft and non tender.
A pleural biopsy and pleural tap under aseptic technique was performed on day 2 of admission. Aspirate was around 100ml pus, foul smelling and not blood stained. Chest tube was inserted on left on day 6 of admission. Howerever, the was no drainage. The chest tube was subsequently removed.
She was treated as left lung empyema for further investigation. She was started on Augmentin 1.2g TDS for 5 day and complete T.Azithromycin 500mg OD for 3 days. She is currently on IV Rocephine 2g OD (5 days)and IV Flagy 500 mg TDS (5 day)
Radiology investigation
Chest radiography
left sided homogenous opacity
Ultrasound of left hemithorax
revealed marked elevates left hemidiaphragm with remarked displacement of spleen and left kidney suggestion of left lung collapse. No significant pleural effusion identified on ultrasound.
CT Thorax
was performed on day of admission and the CT scan showed reduced left volume with trachea and mediastinal shift to the left. Cystic bronchiectasis change of whole left lung. Thick wall collection in the anterior segment of upper hemithorax, measuring 4.5 (AP) X2.2 (W) X 4.9 (CC) cm with air fluid leve;. No calcification noted in the left hemithorax. The chest tube tip is in th epleural space at left middle thoracic region. the left superior mediastinal nodes are enlarged and matted. the largest measuring 2.0 X 2.3 with central necrosis. Nodes also seen in the carinal region. Subcentimeter nodes in both axillary region. No enlarged nodes in lower cervical and superclavicular region. Minimal left pleural effusion.
compensatory hyperinflation of upper and lower right lung. Cystic bronchiectasis of the right middle lobe, no right pleural effusion. The visualized upper abdominal angle appear normal. No upper abdominal lymphadenopathy.Vesicual bones are normal.
Impression:
the lung empyema with matted left superior mediastinal lymphadenopathy in the background of cystic bronchiectasis. Reactivation of PTB need to consider.
TRO Bronchigenic carcinoma associated obstructive pneumonia.
Biochemical Investigation:
FBC (19/10/2012) Hb : 11
WBC : 14.26 (on admission) , currently 8.12 (19/10/2012)
Hematocrit : 34.4
Platelet : 550
Renal profile : Urea: 4.8
(19/10) Sodium : 137
Potassium : 5.3
Chloride : 103
Creatinine : 55
Liver function test :
Total protein : 55
Albumin : 30
Globulin : 58
ALP : 103
ALT : 20
Total Bilirubin: 3.3
CRP 96.1
ESR 114
Ca125 55.6 (0-35)
Ca 19-9 11.1 (0-27)
CEA 1.2
Blood C&S No organic isolated
Mantoux negative
Sputum AFBX 3 negative
Pleural Fluid Investigation
Plaural fluid gram stain - Aspirate appeared pussy & no organism isolated
Pleural FEME >1000 cells/mm3, predominantly ,neutrophils
Pleural fluid for AFB negative
Plaural Biopsy no granuloma or malignancy
this patient is referred to seek your expert clinical evaluation and subsequently needful management.
on 23/10/20012
patient are alert, conscious, cooperative, to time,places and people.
B/P : 118/71
PR : 72 (rate/rhythm/volume)
T : 37'C
SpO2 : 100 % under room air
Plan :
1) continue respiratory plan
2) to ask patient to bring letter from Serdang Hospital (kept by mom)
24/10/2012
B/P: 109/91
PR : 71
T: 37'C
SpO2 : 100 % under room air
plan :
1) continue abx X 2/52
2) continue medication
3)SpO2 monitor
4)confirm empyema
5) Hypoplastic left lung secondary congenital
continue:
Azitromycin/ Augmentin
reduce IV Rocephine 2g OD
Hagly 500mg TDS
TROMAL 50mg 3OD
p/s: this is only a STORY about how doctor make the decision during ward round... and what they plan for the real patient... please don't make anything conclusion before you can really understand what the patient being going thru... kasihanlah pada mereka.. jika, kita berada dalam kedudukan mereka.. barulah kita benar2 faham apa erti nikmat kesihatan.. saat berserah diri pada Allah.. Allah uji lagi kita dengan perkara yang tak kita jangka... percayalah... Allah sangat-sangat-SANGAT menyayangi KAMU......
insya-allah...
cerita tentang kisah adik ini belum berakhir lagi.....
my CASE WRITE UP tak siap lagi.... hehhehehe...
handwritinglah kena check betul2.......................... bkn boleh edit... so, bila dah tenang nnati anin tulis balik ek... kat kertas... sekarang masanya untk makan daging korban....
Bismillahirammanirrahim.................................
should be kena tulis by handwriting... but, disebabkan tulisan cantik sangat... anin nak kena taip lah dulu... later anin tulis ek... =P
Thank you for seeing this patient..(ayat yg anin selalu jmp time praktikal kt IPR dulu...)
This patient 16 y/o Malay student with no know medical illness previously. she came to emergency department accompany by her parents due to chief complain of cough for 2 week associated with yellowish sputum. There is no Hx of pleuritic pain and no haemoptysis. She present of Hx of exertional dyspnea and palpitation. She also has fever for 1 week duration, on & off with chills and rigors. She does not have night sweat, loss of weight or loss of appetite. She has a hx of contact with her uncle with pulmonary tuberculosis but the contact was not prolonged and her uncle already completed his TB medication of 6 month. she does not have altered bowel habits and no family hx of malignancy.
on clinical examination, she was no tachypnea, BP 123/56 mmHg, Pulse rate 108 beat/min,regular,good volume, afebrile SpO2 97% under room air. Respiratory system revealed trachea deviated to left, stony dullness on percussion and reduce air entery on left lower zone. On auscultation, normal S2 and S2 heard without any murmur. Her abdomen was soft and non tender.
A pleural biopsy and pleural tap under aseptic technique was performed on day 2 of admission. Aspirate was around 100ml pus, foul smelling and not blood stained. Chest tube was inserted on left on day 6 of admission. Howerever, the was no drainage. The chest tube was subsequently removed.
She was treated as left lung empyema for further investigation. She was started on Augmentin 1.2g TDS for 5 day and complete T.Azithromycin 500mg OD for 3 days. She is currently on IV Rocephine 2g OD (5 days)and IV Flagy 500 mg TDS (5 day)
Radiology investigation
Chest radiography
left sided homogenous opacity
Ultrasound of left hemithorax
revealed marked elevates left hemidiaphragm with remarked displacement of spleen and left kidney suggestion of left lung collapse. No significant pleural effusion identified on ultrasound.
CT Thorax
was performed on day of admission and the CT scan showed reduced left volume with trachea and mediastinal shift to the left. Cystic bronchiectasis change of whole left lung. Thick wall collection in the anterior segment of upper hemithorax, measuring 4.5 (AP) X2.2 (W) X 4.9 (CC) cm with air fluid leve;. No calcification noted in the left hemithorax. The chest tube tip is in th epleural space at left middle thoracic region. the left superior mediastinal nodes are enlarged and matted. the largest measuring 2.0 X 2.3 with central necrosis. Nodes also seen in the carinal region. Subcentimeter nodes in both axillary region. No enlarged nodes in lower cervical and superclavicular region. Minimal left pleural effusion.
compensatory hyperinflation of upper and lower right lung. Cystic bronchiectasis of the right middle lobe, no right pleural effusion. The visualized upper abdominal angle appear normal. No upper abdominal lymphadenopathy.Vesicual bones are normal.
Impression:
the lung empyema with matted left superior mediastinal lymphadenopathy in the background of cystic bronchiectasis. Reactivation of PTB need to consider.
TRO Bronchigenic carcinoma associated obstructive pneumonia.
Biochemical Investigation:
FBC (19/10/2012) Hb : 11
WBC : 14.26 (on admission) , currently 8.12 (19/10/2012)
Hematocrit : 34.4
Platelet : 550
Renal profile : Urea: 4.8
(19/10) Sodium : 137
Potassium : 5.3
Chloride : 103
Creatinine : 55
Liver function test :
Total protein : 55
Albumin : 30
Globulin : 58
ALP : 103
ALT : 20
Total Bilirubin: 3.3
CRP 96.1
ESR 114
Ca125 55.6 (0-35)
Ca 19-9 11.1 (0-27)
CEA 1.2
Blood C&S No organic isolated
Mantoux negative
Sputum AFBX 3 negative
Pleural Fluid Investigation
Plaural fluid gram stain - Aspirate appeared pussy & no organism isolated
Pleural FEME >1000 cells/mm3, predominantly ,neutrophils
Pleural fluid for AFB negative
Plaural Biopsy no granuloma or malignancy
this patient is referred to seek your expert clinical evaluation and subsequently needful management.
on 23/10/20012
patient are alert, conscious, cooperative, to time,places and people.
B/P : 118/71
PR : 72 (rate/rhythm/volume)
T : 37'C
SpO2 : 100 % under room air
Plan :
1) continue respiratory plan
2) to ask patient to bring letter from Serdang Hospital (kept by mom)
24/10/2012
B/P: 109/91
PR : 71
T: 37'C
SpO2 : 100 % under room air
plan :
1) continue abx X 2/52
2) continue medication
3)SpO2 monitor
4)confirm empyema
5) Hypoplastic left lung secondary congenital
continue:
Azitromycin/ Augmentin
reduce IV Rocephine 2g OD
Hagly 500mg TDS
TROMAL 50mg 3OD
p/s: this is only a STORY about how doctor make the decision during ward round... and what they plan for the real patient... please don't make anything conclusion before you can really understand what the patient being going thru... kasihanlah pada mereka.. jika, kita berada dalam kedudukan mereka.. barulah kita benar2 faham apa erti nikmat kesihatan.. saat berserah diri pada Allah.. Allah uji lagi kita dengan perkara yang tak kita jangka... percayalah... Allah sangat-sangat-SANGAT menyayangi KAMU......
insya-allah...
cerita tentang kisah adik ini belum berakhir lagi.....
my CASE WRITE UP tak siap lagi.... hehhehehe...
handwritinglah kena check betul2.......................... bkn boleh edit... so, bila dah tenang nnati anin tulis balik ek... kat kertas... sekarang masanya untk makan daging korban....
Bismillahirammanirrahim.................................
emergency!!!!!!!!!!!!!
morning people....
yesterday recap
etopic pregnancy- send to ot after blood transfusion
alleged MVA- back bone rupture? 6 pack of FFB and plasma-cryp?
?femur fracture
tolong!! tolong !!! anin tak tau nak buat apa... then, dr aka BOSS for emergency department tu ask me??
1 scene :
"medical student from MSU??- why u late?? " -specialist
me?? hahhaha... (dlm hati- did anyone come here before this??) my opportunity to learn something....
"help me to take off the ECG lead.... - sambil tu amik la kesempatan tny patient what happen actually..
hyperthyroiodism suggested due to tachycardia-BP high-irregular menstrual.. mother also on medication..... but she don't know which one.. hypo or hyper....
2 scene:
pakcik.. saya nak masukkan tiub nanti.. nak intubate... so, pakcik banyak2kan mengucap ya....
perlu ke nak ckp mcm tu... "menakutkan anin je...... "
long day at A&E- from 4 pm till 11pm.... kalo masuk ot pn org dah balik dah...
arini klas kat MSU- dari kul 10..
kalo takde klas, boleh la msk OT uncle semalam..- kul 7.30 pagi tadi.. -ampullary carcinoma-under Dato Nordin -major surgeon...
hujan... hujan... balik tu lepas makan malam kat luar... hujan... - me alone
should i say........... thanks to whom they may concern....
yesterday recap
etopic pregnancy- send to ot after blood transfusion
alleged MVA- back bone rupture? 6 pack of FFB and plasma-cryp?
?femur fracture
tolong!! tolong !!! anin tak tau nak buat apa... then, dr aka BOSS for emergency department tu ask me??
1 scene :
"medical student from MSU??- why u late?? " -specialist
me?? hahhaha... (dlm hati- did anyone come here before this??) my opportunity to learn something....
"help me to take off the ECG lead.... - sambil tu amik la kesempatan tny patient what happen actually..
hyperthyroiodism suggested due to tachycardia-BP high-irregular menstrual.. mother also on medication..... but she don't know which one.. hypo or hyper....
2 scene:
pakcik.. saya nak masukkan tiub nanti.. nak intubate... so, pakcik banyak2kan mengucap ya....
perlu ke nak ckp mcm tu... "menakutkan anin je...... "
long day at A&E- from 4 pm till 11pm.... kalo masuk ot pn org dah balik dah...
arini klas kat MSU- dari kul 10..
kalo takde klas, boleh la msk OT uncle semalam..- kul 7.30 pagi tadi.. -ampullary carcinoma-under Dato Nordin -major surgeon...
hujan... hujan... balik tu lepas makan malam kat luar... hujan... - me alone
should i say........... thanks to whom they may concern....