tag:blogger.com,1999:blog-74786313451638956122024-03-14T12:09:03.992+05:30/\/\Y /\/@/\/\3 !$ $Y@UQ!\/\/3L[()/\/\3 t() /\/\Y \/\/()rLd!!!!!!X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.comBlogger80125tag:blogger.com,1999:blog-7478631345163895612.post-88428418262132574222014-08-03T11:30:00.001+05:302014-08-03T11:30:58.726+05:30Houseman in Sarawak General Hospital (SGH) Vs Hospital Seri Manjung (HSM)<p dir=ltr>5 things about SGH & another 5 about HSM</p>
<p dir=ltr>1. Working in SGH was super duper hectic and tiring. Never had a chance to watch an English Premier League Match nor Malaysian Super League. At that time I even didn't know at all that my favourite club Chelsea FC buying Demba Ba from Newcastle United.</p>
<p dir=ltr>2. Some if the MOs in SGH like a very BIG BIG BOSS. Even the specialist also were nicer compared to the 'some' MOs. Mind my word; some, not all!</p>
<p dir=ltr>3. In SGH,Off to work at 5.30am and reached home at 9 or 10 at night for almost everyday in a week!</p>
<p dir=ltr>4. Chances of extension was very high in SGH. O&G, Paeds come 1st, followed by Ortho, Surgical and medical. When I was in Paeds, most of my seniors get extended. Higher expectations perhaps. I was lucky enough to complete Paeds Posting without any extensions! </p>
<p dir=ltr>5. In a tertiary center like in SGH, I still can imagine how there was no printer to print all the investigations! Just imagine, I did my oncall alone, need to take blood, then I need to send myself the blood to thw lab, wait another 1 hour, then go back to the lab to trace the results. Sometimes the results still not ready. The Mos will asked this and that. If something happen during my time walking to send and tracing blood/results I would be the one getting the blame. Its somehow very unfair. Hopefully things change nowadays.</p>
<p dir=ltr>6. In HSM, though its not that hectic but the stayback shift makes me feel damne tired. But nevermind, still can go back home to see and sleep with my cuttie little daughter! Yeay!!!</p>
<p dir=ltr>7. MOs here treat the houseman like a colleague. Its because MOs are a senior colleague. Once we completed our HOship well become an MO too...</p>
<p dir=ltr>8. In HSM, went to work at 6.30 or 6.45 and get the chance coming back at 5 or 5.15 almost everyday. But u need to be super duper efficient, and good communication with your colleague. </p>
<p dir=ltr>9. There are still chances of getting extended. But the rate is not sky high. Among all Medical is the highest is HSM. Almost nil in O&G, surgery and ortho (during mr suresh era)</p>
<p dir=ltr>10. Though sometime the PPK quite lame in HSM, but the printer is available! Just need to call the respective lab number, then the results will be printed in front of you! </p>
<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com2tag:blogger.com,1999:blog-7478631345163895612.post-10087871553748557592014-08-02T08:45:00.001+05:302014-08-02T18:36:41.904+05:30Snipper~<p dir=ltr>Apart from the previous post, it has been almost a year I have  not blogging...</p>
<p dir=ltr>1. Im officially a papa on the 20 September 2013. Yeay!. Love u both..mama and dearie daughter</p>
<p dir=ltr>2. Did aqiqah for my daughter on the 6th of her birthday.</p>
<p dir=ltr>3. Attended almost all the vaccinations for my baby! Yippie. I wondered if I have time to attend it if Im in Kuching. With due respects to SGH, it is dam* unfair asking us to work almost everyday in 4 ******months!!!</p>
<p dir=ltr>4. I am a houseman in Hospital Seri Manjung. Started with ortho (3rd posting). Completed ortho posting uneventfully. Was seen as a regular in OT. Had a couple of  wound debridement done. Had once considered to do ortho as MO ship. We ll see how it goes.</p>
<p dir=ltr>5. O&G was my fourth posting. 2nd in HSM. People said that the most important thing is VE, which totally agreed! All went well except my End Of Posting leave. From 7 days cut down to 2. Missed my chance to went back to Kuching...argh!!!</p>
<p dir=ltr>6. Then my medical posting. Will share  regarding this posting later. Another 1 more week....</p>
<p dir=ltr>7. Although tentatively it is more chillexing from SGH, But the schedule are more packed here in Hospital Seri Manjung. Therevare lots of stayback shift  (6.30am to 10.30 or 11 pm)which require us to work more time in Hospital. Average of 75 hours per week!</p>
<p dir=ltr>8. Anesth vs Casualty. Im choosing anesth. hopefully I can enter anesth! </p>
<p dir=ltr>9. For the first me in my life fasting in ramadhan as a dad! Though my little cutie daughter also woke up, but her tok ayah really like her so much in the very early in the morning! !</p>
<p dir=ltr>10. Raya-ing as dad!!! Yahoo....Selamat hari raya!!!</p>
<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-63644611993079321642014-08-02T07:51:00.001+05:302014-08-02T07:51:39.774+05:30Selamat Hari Raya 2014!<p dir=ltr>Its been a long year since the last entry...huhu</p>
<p dir=ltr>1. 1st raya in Penang. Brought my wife and daughter to meet with their tok nek jah and tok nek wan.</p>
<p dir=ltr>2. Raya eve, 2nd and 3rd day of raya still working in Hosp Seri Manjung</p>
<p dir=ltr>3. Off to Kuching on the postcall day 3rd Hari Raya. </p>
<p dir=ltr>4. 1st time Hari Raya as a dad. Im very proud of it.</p>
<p dir=ltr>5. Again, people in Kuching wear baju melayu</p>
<p dir=ltr> until more than a week of raya! Raya sakan!. I like the spirit!!!!</p>
<p dir=ltr>6. Happy to see my daughter plays with her cousins- Aziz & Aishah ( little cuttie Aishah daa besar = ) )</p>
<p dir=ltr>7. Feel chillex as Im off from hospital for few days~ yeay...</p>
<p dir=ltr>8. I still vote ketupat palas is the best among all ketupats/lemangs</p>
<p dir=ltr>9. RAYA RAYA RAYA!</p>
<p dir=ltr>10. RAYA RAYA RAYA RAYA RAYA RAYA <br>
X 1000000000. HAHAHA......</p>
<div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEie2PfKr-wsG8W_vgv3pBabV7LAP6248tHeCmMr2FKca_Z0kltdqKOZK_WL7oMoodib8h5uRJAKDNMz35FXdqWm91Oo5TBPzqJOVSyBoOasZ_09IvWIl06-hCRBdCGENtov_YraM0flczk/s1600/IMG-20140801-WA0013.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEie2PfKr-wsG8W_vgv3pBabV7LAP6248tHeCmMr2FKca_Z0kltdqKOZK_WL7oMoodib8h5uRJAKDNMz35FXdqWm91Oo5TBPzqJOVSyBoOasZ_09IvWIl06-hCRBdCGENtov_YraM0flczk/s640/IMG-20140801-WA0013.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhMel4o__bu-xDnuL4rcmMOGlHhA0ekHxdKEUJcQfiFFqAEf81BWkjqbZlXmieoObWkLn3qwDmjbn-uoOrD2zA2Ctq1iyvS-HJoKkMalFeFkfrAcR247le7R_Bu5fl74hadPsfvmGqpS04/s1600/IMG-20140728-WA0029.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhMel4o__bu-xDnuL4rcmMOGlHhA0ekHxdKEUJcQfiFFqAEf81BWkjqbZlXmieoObWkLn3qwDmjbn-uoOrD2zA2Ctq1iyvS-HJoKkMalFeFkfrAcR247le7R_Bu5fl74hadPsfvmGqpS04/s640/IMG-20140728-WA0029.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDDW6PuqGzWrkgMYJtm_hPka1NzfeUMfGp_xR6CS2mJVXm0ffmwlDdMw4PgPTLW7GsD9aDVEG7I8WJSfHAU9heWrU4suTUk4ZgpxBT-2dYUvc2Z5NTJdB9LcIfgYwIBE-7bj72vh5Cz1s/s1600/IMG-20140728-WA0019.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDDW6PuqGzWrkgMYJtm_hPka1NzfeUMfGp_xR6CS2mJVXm0ffmwlDdMw4PgPTLW7GsD9aDVEG7I8WJSfHAU9heWrU4suTUk4ZgpxBT-2dYUvc2Z5NTJdB9LcIfgYwIBE-7bj72vh5Cz1s/s640/IMG-20140728-WA0019.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtc9wKk_O0_Vl9F4JbsTDz1bVKnKH-p7zaxtsgciomhJDFKtHz6p2LFgjbjLS-Z5VVe68QJHml6Q6txNAF5QwqkwdmPfNV228q9W5HDQ_gs_yE5kOWyCiPWQ1nUHzqspec2W8luxsSBKA/s1600/IMG-20140728-WA0025.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtc9wKk_O0_Vl9F4JbsTDz1bVKnKH-p7zaxtsgciomhJDFKtHz6p2LFgjbjLS-Z5VVe68QJHml6Q6txNAF5QwqkwdmPfNV228q9W5HDQ_gs_yE5kOWyCiPWQ1nUHzqspec2W8luxsSBKA/s640/IMG-20140728-WA0025.jpg"> </a> </div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkF1fynjEqW6S85AHCvgG1QY2IXeGlYOjPnQBzOHmE6ayUr-iGDyjTYDqJ3W4FcTWNhutjFgf8DSYiyBYwIH-_oLqyuTHBEgzCDATw6Yeg4IwHkoSRGr9KuuXDUo8tMxBfaZRBxWRsIJ0/s1600/20140731_174454.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkF1fynjEqW6S85AHCvgG1QY2IXeGlYOjPnQBzOHmE6ayUr-iGDyjTYDqJ3W4FcTWNhutjFgf8DSYiyBYwIH-_oLqyuTHBEgzCDATw6Yeg4IwHkoSRGr9KuuXDUo8tMxBfaZRBxWRsIJ0/s640/20140731_174454.jpg"> </a> </div><div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-22375047477452133692013-08-14T15:42:00.001+05:302013-08-14T15:42:42.081+05:30Saddest & Happiest Raya<p dir=ltr>1. I miss my wife, my queen, my soulmate, my munyi so much. Miss you honey.</p>
<p dir=ltr>2. Many things happen in life. You can be happy the 1st day, then sad on yhe next day.</p>
<p dir=ltr>3. Its hard to take when the love one are taken or being away from you.</p>
<p dir=ltr>4. Really enjoy my raya there in Kuching. People there wear baju melayu for more than a week after raya.</p>
<p dir=ltr>5. Met a lot kinds of people while I am abroad. Most of them only cared about themselves only, only some will think about the others.</p>
<p dir=ltr>6. Soon I will became a pappa. Dear, I really love u so much. Please take care of yourself and our baby. Pappa loves both of you. I feel blessed.</p>
<p dir=ltr>7. Ya Allah, please give us strength in life.</p>
<p dir=ltr>8. All of us do have problems. Iys a matter of how we manage it.</p>
<p dir=ltr>9. Live is simple. Don't make it simpler. I like it.</p>
<p dir=ltr>10. Again, I love you dear, Nur Afiqah Binti Morshidi...<br></p>
<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-81691828744817867622013-08-05T03:30:00.001+05:302013-08-05T08:02:34.568+05:30Paediatric Posting in SGH/ Hospital Umum Sarawak<p dir=ltr>Paediatric is my second and last posting in Sarawak General Hospital. There are lots of ups and downs, but playing with kids somehow make me happy...</p>
<p dir=ltr>1. I am not sure elsewhere, but my tagging time started at 5pm till 11pm (actually it exceeded 11pm, once I went back home almost 1 am, and need to go to work as early ad 6 am the following day). Huh..</p>
<p dir=ltr>2. Houseman here tag for 10 days, which are 5 days in ward and 5 days in nursery. We have our own tagging sheet. Need to do alot of stuff such as clerking 10 general cases, 5 NNJs, 5 blood c&s, 5 participation in resuscitation, 5 interpretation of ABG, and clerking 10 cases in nursery.</p>
<p dir=ltr>3 Started my posting in Paediatric Oncology ward. There I met one of the Giant name in paediatric oncology in Malaysia, Dr Ong Gaik Bee. Struggled for the 1st few days but able to recover in time. </p>
<p dir=ltr>4. Then I went to paed isolation ward. 1st time I was shouted in a ward. The very 1st day. Here I learn a lot of AGE and HFMD cases. Able to met with Dr Ng Hoong Phak. Check his name in the Paediatric Protocol Cover</p>
<p dir=ltr>5. Next, Nursery. The hell among all. The 1st 3 week is very difficult and tough. For most every day I went at 4.30 to 5 am in the morning and went back aeound 8 to 9 pm  Managed to see the rotation of nurses all 3 shifts. Seriously having an OCD mo was very crazy. Once, I need to take full set of blood investigation for 4 babies and another 2 urine in and out cathether for 2 babies in the same SCN. This place really challenge d me to the limit.</p>
<p dir=ltr>6. General Paed 2B. Heaven. As simple as that.  </p>
<p dir=ltr>7. Paed ICU-PICU. Spent 3 weeks there. At this time, I was one of the senior poster already. Bosses and mo's seem to trust us more. So its quite hard hard to repay your bosses trust by not to do any stupid mistakes. I tried to maintain the standard of a senior poster which I could. Its been relaxing for the the entire 3 weeks there, but startedbto get hot on the very last day. Haha.</p>
<p dir=ltr>8. Paed 2B second spell. 4 more days left in paeds. As a senior  poster, I went to home visit to evaluate the condition of child with hime oxygen therapy with Paediatric  Intensivist Dr Chor Yek Kee. We started to go around 10am and we reach ed SGH around 6pm. It was a good experience for me and I learnt alot of stuff.</p>
<p dir=ltr>9. NRP. Neonatal Resuscitation Programme. Failed once but not twice. Haha. If I failed x2, I will be getting extended. 2 values need to remember, 100 & 60. Remeber the basic algorithm too.</p>
<p dir=ltr>10. PALS. Paediatric Advanced Life Support. Im not sure other hospital have it or not. But this tine I passed during my 1st attempt. </p>
<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0Petra Jaya, Petra Jaya1.596746 110.33386tag:blogger.com,1999:blog-7478631345163895612.post-47335238779852495572013-08-04T16:57:00.001+05:302013-08-04T16:57:15.795+05:30Its been a long time 2<p dir=ltr>1. Barisan Nasional won the election once again.</p>
<p dir=ltr>2. NAJIB is still th PM. Not ANWAR.</p>
<p dir=ltr>3. Manchester United yet again the champion of England. </p>
<p dir=ltr>4. Chelsea? Not bad for becoming Europa League champion.</p>
<p dir=ltr>5. John Cena is a champ once again.</p>
<p dir=ltr>6. ASB loan settled already. Next will be House, then car.</p>
<p dir=ltr>7. A good paediatric intensivist offered me to become his trainee. Hurm...</p>
<p dir=ltr>8. Currently on Cuti Tanpa Gaji.</p>
<p dir=ltr>9. My cargo will be on next Wednesday. </p>
<p dir=ltr>10. Just few more day..August 13...</p>
<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-3207246084030796902013-08-04T12:31:00.001+05:302013-08-04T12:31:23.514+05:30Its been a long long time<p dir=ltr>1. My last post was back in 2011???!!??</p>
<p dir=ltr>2. Thank God. Syukur. I passed my MBBS. Automatically I am a doctor now.</p>
<p dir=ltr>3. I am blessed that I married the one that I love. I am blessed too that I am awaiting my 1st child. Yahooooo..  </p>
<p dir=ltr>4. Working for almost everyday in 8 months time really challenging and take me to the limit. Housemanship in Sarawak is challenging but working for almost everyday is ridiculous.</p>
<p dir=ltr>5. Goverment or ministry of health need to look in depth how to ease the burden of houseman in SGH. I am serious. </p>
<p dir=ltr>6. This year I will be celebrating raya for the 1st time in Sarawak.</p>
<p dir=ltr>7. I had celebrate raya without my parents back in Manipal days. So this is not the 1st time.</p>
<p dir=ltr>8. I will be transferring to Hospital Seri Manjung as a 3rd poster with effective date of 19 August 2013</p>
<p dir=ltr>9. I really hope and pray so that my wife can cope or manage on her own during my absence. </p>
<p dir=ltr>10. May God bless us all.</p>
<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-78732923422697756422011-05-22T14:47:00.001+05:302011-05-22T14:49:30.581+05:30'3S'It's Sunday! but need to study for my sessionals, in between, I slept alot also~ huhu<br /><br />Sunday-Study-Sleep<br /><br />~~~<br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-35073241376795392822011-05-15T13:05:00.001+05:302011-05-15T13:08:13.864+05:30Obstetric MnemonicSince I am having a block test tomorrow, here a little bit of mneumonics to share with..p/s thanx to the one that create it!<br /><br /><br />Oral contraceptive complications: warning signs ACHES:<br />Abdominal pain<br />Chest pain<br />Headache (severe)<br />Eye (blurred vision)<br />Sharp leg pain<br /><br /><br />Abdominal pain: causes during pregnancy LARA CROFT:<br />Labour<br />Abruption of placenta<br />Rupture (eg. ectopic/ uterus)<br />Abortion<br />Cholestasis<br />Rectus sheath haematoma<br />Ovarian tumour<br />Fibroids<br />Torsion of uterus<br /><br /><br />Post-partum haemorrhage (PPH): causes 4 'T's:<br />Tissue (retained placenta)<br />Tone (uterine atony)<br />Trauma (traumatic delivery, episiotomy)<br />Thrombin (coagulation disorders, DIC)<br /><br /><br />Prenatal care questions ABCDE:<br />Amniotic fluid leakage?<br />Bleeding vaginally?<br />Contractions?<br />Dysuria?<br />Edema?<br />Fetal movement?<br /><br /><br />Asherman syndrome features ASHERMAN:<br />Acquired Anomaly<br />Secondary to Surgery<br />Hysterosalpingography confirms diagnosis<br />Endometrial damage/ Eugonadotropic<br />Repeated uterine trauma<br />Missed Menses<br />Adhesions<br />Normal estrogen and progesterone<br /><br /><br />Gestation period, oocytes, vaginal pH, menstrual cycle: normal numbers 4 is the normal pH of the vagina.<br />40 weeks is the normal gestation period.<br />400 oocytes released between menarche and menopause.<br />400,000 oocytes present at puberty.<br />28 days in a normal menstrual cycle.<br />280 days (from last normal menstrual period) in a normal gestation period.<br /><br /><br />CVS and amniocentesis: when performed "Chorionic" has 9 letters and Chorionic villus sampling performed at 9 weeks gestation.<br />"AlphaFetoProtein" has 16 letters and it's measured at 16 weeks gestation.<br /><br /><br />Alpha-fetoprotein: causes for increased maternal serum AFP during pregnancy "Increased Maternal Serum Alpha Feto Protein":<br />Intestinal obstruction<br />Multiple gestation/ Miscalculation of gestational age/ Myeloschisis<br />Spina bifida cystica<br />Anencephaly/ Abdominal wall defect<br />Fetal death<br />Placental abruption<br /><br /><br />Female pelvis: shapes GAP:<br />· In order from most to least common:<br />Gynecoid<br />Android /Anthropoid<br />Platypelloid<br /><br /><br />Pelvic Inflammatory Disease (PID): complications I FACE PID:<br />Infertility<br />Fitz-Hugh-Curitis syndrome<br />Abscesses<br />Chronic pelvic pain<br />Ectopic pregnancy<br />Peritonitis<br />Intestinal obstruction<br />Disseminated: sepsis, endocarditis, arthritis, meninigitis<br /><br /><br />B-agonist tocolytic (C/I or warning) ABCDE:<br />Angina (Heart disease)<br />BP high<br />Chorioamnionitis<br />Diabetes<br />Excessive bleeding<br /><br /><br />Secondary amenorrhea: causes SOAP:<br />Stress<br />OCP<br />Anorexia<br />Pregnancy<br /><br /><br />Preeclampsia: classic triad PREeclampsia:<br />Proteinuria<br />Rising blood pressure<br />Edema<br /><br /><br />Alpha-fetoprotein: some major causes for increased maternal serum AFP during pregnancy TOLD:<br />Testicular tumours<br />Obituary (fetal death)<br />Liver: hepatomas<br />Defects (neural tube defects)<br /><br /><br />Dysfunctional uterine bleeding (DUB): 3 major causes DUB:<br />Don't ovulate (anovulation: 90% of cases)<br />Unusual corpus leuteum activity (prolonged or insufficient)<br />Birth control pills (since increases progesterone-estrogen ratio)<br /><br /><br />IUGR: causes IUGR:<br />Inherited: chromosomal and genetic disorders<br />Uterus: placental insufficency<br />General: maternal malnutrition, smoking<br />Rubella and other congenital infecton<br /><br /><br />Early cord clamping: indications RAPID CS:<br />Rh incompatibility<br />Asphyxia<br />Premature delivery<br />Infections<br />Diabetic mother<br />CS (caesarian section) previously, so the funda is RAPID CS<br /><br /><br />Oral contraceptives: side effects CONTRACEPTIVES:<br />Cholestatic jaundice<br />Oedema (corneal)<br />Nasal congestion<br />Thyroid dysfunction<br />Raised BP<br />Acne/ Alopecia/ Anaemia<br />Cerebrovascular disease<br />Elevated blood sugar<br />Porphyria/ Pigmentation/ Pancreatitis<br />Thromboembolism<br />Intracranial hypertension<br />Vomiting (progesterone only)<br />Erythema nodosum/ Extrapyramidal effects<br />Sensitivity to light<br /><br /><br />Forceps: indications for delivery FORCEPS:<br />Foetus alive<br />Os dilated<br />Ruptured membrane<br />Cervix taken up<br />Engagement of head<br />Presentation suitable<br />Sagittal suture in AP diameter of inlet<br /><br /><br />Delivery: instrumental delivery prerequisites AABBCCDDEE:<br />Analgesia<br />Antisepsis<br />Bowel empty<br />Bladder empty<br />Cephalic presentation<br />Consent<br />Dilated cervix<br />Disproportion (no CPD)<br />Engaged<br />Episiotomy<br /><br /><br />APGAR score components SHIRT:<br />Skin color: blue or pink<br />Heart rate: below 100 or over 100<br />Irritability (response to stimulation): none, grimace or cry<br />Respirations: irregular or good<br />Tone (muscle): some flexion or active<br /><br /><br />Postpartum collapse: causes HEPARINS:<br />Hemorrhage<br />Eclampsia<br />Pulmonary embolism<br />Amniotic fluid embolism<br />Regional anaethetic complications<br />Infarction (MI)<br />Neurogenic shock<br />Septic shock<br /><br /><br />Multiple pregnancy complications HI, PAPA:<br />Hydramnios (Poly)<br />IUGR<br />Preterm labour<br />Antepartum haemorrhage<br />Pre-eclampsia<br />Abortion<br /><br /><br />IUD: side effects PAINS:<br />Period that is late<br />Abdominal cramps<br />Increase in body temperature<br />Noticeable vaginal discharge<br />Spotting<br /><br /><br />Labour: preterm labor causes DISEASE:<br />Dehydration<br />Infection<br />Sex<br />Exercise (strenuous)<br />Activities<br />Stress<br />Environmental factor (job, etc)<br /><br /><br />Miscarriage: recurrent miscarriage causes RIBCAGE:<br />Radiation<br />Immune reaction<br />Bugs (infection)<br />Cervical incompetence<br />Anatomical anomaly (uterine septum etc.)<br />Genetic (aneuploidy, balanced translocation etc.)<br />Endocrine<br /><br /><br />Shoulder dystocia: management HELPER:<br />Call for Help<br />Episiotomy<br />Legs up [McRoberts position]<br />Pressure subrapubically [not on fundus]<br />Enter vagina for shoulder rotation<br />Reach for posterior shoulder and deliver posterior shoulder/ Return head into vagina [Zavanelli maneuver] for C-section/ Rupture clavicle or pubic symphisis<br /><br /><br />Labour: factors which determine rate and outcome of labour 3 P's:<br />Power: stength of uterine contractions<br />Passage: size of the pelvic inlet and outlet<br />Passenger: the fetus--is it big, small, have anomalies, alive or dead<br /><br /><br />Post-partum examination simplified checklist BUBBLES:<br />Breast<br />Uterus<br />Bowel<br />Bladder<br />Lochia<br />Episotomy<br />Surgical site (for Cesarean section<br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-51511894251068375332011-05-15T11:53:00.002+05:302011-05-15T12:03:56.586+05:30'Big' day for Manchester!<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSh282VikDoy1qraXzuErJ1jV64_PF0yS2U0Si1TEuypB0IB0mgMX6OWlPd1xaFIVvzLdoIqagWL17GdKR5C3lJm0-VVgZoN8K7lgLtkivYIs8tZUlW4nndK0EwiORUmHSKt7uUh7J91k/s1600/Man+U.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 223px; height: 226px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSh282VikDoy1qraXzuErJ1jV64_PF0yS2U0Si1TEuypB0IB0mgMX6OWlPd1xaFIVvzLdoIqagWL17GdKR5C3lJm0-VVgZoN8K7lgLtkivYIs8tZUlW4nndK0EwiORUmHSKt7uUh7J91k/s400/Man+U.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5606826835845532866" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXqSHB8XyhSna-WFDM4NAGCDjysLqVi2q36jQuuIgELmU8oE5kelAAoxvtMdzBOHHkbtQ0riGo6W3lyC6nGUyDpuKV8nutCHrTdAWuEzqThXec0k9Do6DCKkQhMTJGTnWljEvk8-Z1iUs/s1600/man+City.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 225px; height: 225px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXqSHB8XyhSna-WFDM4NAGCDjysLqVi2q36jQuuIgELmU8oE5kelAAoxvtMdzBOHHkbtQ0riGo6W3lyC6nGUyDpuKV8nutCHrTdAWuEzqThXec0k9Do6DCKkQhMTJGTnWljEvk8-Z1iUs/s400/man+City.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5606826837855481186" /></a><br />Though I am a Chelsea fan, but today is absolutely a massive day for Manchester. Both Man U & Man City won the Premier League for 19th time and FA cup respectively~ <br />For Man U, they have surpassed the record held by Liverpool of 18th league title, and for Man City, their huge investment started to paid off! Well, we're looking forward for next season, as it getting tougher and tougher. Believe me! For Chelsea FC, its the 3rd season post-Abramovich era trophyLESS. <br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-33373006353079142212011-05-14T08:17:00.002+05:302011-05-14T08:24:24.107+05:30Surgery Posting Over~ ONG begins!!!~ After all the 'suspens' unofficially I managed to 'pass' my Surgery posting-The most 'challenging' 4th year posting in MMMC--> Alhamdulillah...currently in ONG posting, but the 1st week already finished...<br />Around 3.5 month to go before P2S1 exam...no other choice, study, study, study...<br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-53587562618721114252011-04-28T18:34:00.002+05:302011-04-28T18:37:23.371+05:30Almost over...My surgery posting almost over~ I think this is the thoughest posting ever...and it near to its end~...hopefully after this, i can continue my blogging activities~<br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-40703711090699712612011-03-22T19:14:00.002+05:302011-03-22T19:16:19.385+05:30Buzz, buzzing, buzy~Currently I am in the 2nd week of surgery posting. Seniors said that this is the most challenging posting from all. So, I think I might reduce my blogging activities.<br />Sorry for the inconvinience.<br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-32105447312323614472011-03-11T07:43:00.004+05:302011-03-15T04:03:40.754+05:30The Fantastic 2nd weekPeople say that the time pass so fast. In a blink of an eye my holiday almost over. Today is Friday. Just wanna freshen my mind of what I've been doing in my 2nd week of holiday;<br /><br />last Friday- cycle to Masjid with bicycle. I think the distance is more far as compared from my hostel in Melaka to Masjid al Azim-the mosque where I usually pray in Melaka. Then I packed some stuff to be brought back to Penang. As Ayah and Ibu returned back from KL, in the evening we went for an early dinner at Secret Recipe plus enjoying eating the cakes there too.<br /><br />Saturday- Went back to see my Tok and Wan (of my father's side). 'Tok' is meant for 'grandma' and 'Wan' is meant for 'grandpa'. The word nenek/ tok nek is usually meant for the 'great grandma'. As for the 'great grandpa' for this time being, just assume as KIV. I drove all the way from Manjung to Penang. Before we (me, ayah and ibu) arrived there we stopped by to buy Ikan Bawal for lunch. The meal was superb and also cheap. Nothing much has been done on the day itself after arriving there other than chatting with Tok, but at night we (+ Wan) went to Nasi Kandar Beratur. Fullamak, panjang giler orang beratur dekat situ~. The food was marvellous and I give it 9/10.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjOOMAzDNFhQ1P9ysB4GRispKMEs0qsP3Jzx5kQ_b_X9l8B_-f3y_Wqul8wVVScLy3FLkBvrg7w02s2cAAxH5U8U7XkfGYfcb7bc-R-4LNbGpvwVfvzKBSl9_kwp5l4qwwY3w771l-8Vw/s1600/05032011641%255B1%255D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhjOOMAzDNFhQ1P9ysB4GRispKMEs0qsP3Jzx5kQ_b_X9l8B_-f3y_Wqul8wVVScLy3FLkBvrg7w02s2cAAxH5U8U7XkfGYfcb7bc-R-4LNbGpvwVfvzKBSl9_kwp5l4qwwY3w771l-8Vw/s400/05032011641%255B1%255D.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583801779319498786" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2UI6A_2-B6ucA9tToH1kLga9uA0w2fznuFDdYlbCNi4yB3kiLjYaJG3gqe6GcjkyAL5xVkC3SPZ5dkzKnYiegoiePZ0uVnNM3ceNxt3sk53ZMgyINfWeHqCWvtWZfCAOry4fLAf_kAas/s1600/05032011634%255B1%255D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2UI6A_2-B6ucA9tToH1kLga9uA0w2fznuFDdYlbCNi4yB3kiLjYaJG3gqe6GcjkyAL5xVkC3SPZ5dkzKnYiegoiePZ0uVnNM3ceNxt3sk53ZMgyINfWeHqCWvtWZfCAOry4fLAf_kAas/s400/05032011634%255B1%255D.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583801777846761474" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgT3TVZ6BMbrZrRh5wWxX9gUbz5HRMyHoiH1mMR6n8TDUO0TjiNptaDMD2sh0I89zkJTH8MjZVS0N5ankGIVDG1S1ea8wabYX2csIJdVBqTpq5sbbG27F4yJSnOsNCcQmmJksMFajXl7Zs/s1600/05032011646%255B1%255D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgT3TVZ6BMbrZrRh5wWxX9gUbz5HRMyHoiH1mMR6n8TDUO0TjiNptaDMD2sh0I89zkJTH8MjZVS0N5ankGIVDG1S1ea8wabYX2csIJdVBqTpq5sbbG27F4yJSnOsNCcQmmJksMFajXl7Zs/s400/05032011646%255B1%255D.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583801799366325074" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYipJAPjZE4TZWARSSTbXhzr9eYkH5jDQhwOlmyfbeZdREIY4fx5fvf16krE1qKRCbSPUpvsYREgF4Lxs7ZCR9meIOEV4BPqizyQbjluAr-dDyPGbuP0gCA-su4mfti-f1CM-GkaO08DI/s1600/05032011645%255B1%255D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYipJAPjZE4TZWARSSTbXhzr9eYkH5jDQhwOlmyfbeZdREIY4fx5fvf16krE1qKRCbSPUpvsYREgF4Lxs7ZCR9meIOEV4BPqizyQbjluAr-dDyPGbuP0gCA-su4mfti-f1CM-GkaO08DI/s400/05032011645%255B1%255D.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583801793686153314" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLfTBlfQh1y_De_792LiTqKZTMpFHM1-qhrLDXXPQ1_RSabeGYx0zVRiVhwXoswIAYVGQk8dZEGFRpFzCpE88CG7vlFaCYudof9Id_0cBS3F-Qqs4OWEFd5JlyUdCEHi-tNMARFSgf3Fo/s1600/05032011644%255B1%255D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLfTBlfQh1y_De_792LiTqKZTMpFHM1-qhrLDXXPQ1_RSabeGYx0zVRiVhwXoswIAYVGQk8dZEGFRpFzCpE88CG7vlFaCYudof9Id_0cBS3F-Qqs4OWEFd5JlyUdCEHi-tNMARFSgf3Fo/s400/05032011644%255B1%255D.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583801782663411346" /></a><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFrry6MfGc4lBPMaGfRLAF5mnmZ3ac6a13y2y9RdKEXogF4fzuoHsA7BWgNHdgj2oY0plbBAhoq3r_G8UGP5Z5UObarC-ZG3EuhjyHiPp3uRhfF36gCR5GtSFoX54X4FAj7wEK4IvbPWs/s1600/05032011647.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFrry6MfGc4lBPMaGfRLAF5mnmZ3ac6a13y2y9RdKEXogF4fzuoHsA7BWgNHdgj2oY0plbBAhoq3r_G8UGP5Z5UObarC-ZG3EuhjyHiPp3uRhfF36gCR5GtSFoX54X4FAj7wEK4IvbPWs/s400/05032011647.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583901012113194514" /></a><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9aMRIzqqy1WXvGrzNUYPj7JGPHLxmo_9xyBEZZPgWM6wkY8YpSjnE-VhxLnOV1FWu1oez2qaonWBNJ_XqJ2Logg2eepdt25_JDgdOcTqEbQMtugkpKQuHnKEXuHmiQ_ClCqNgtXwgcmE/s1600/05032011651.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9aMRIzqqy1WXvGrzNUYPj7JGPHLxmo_9xyBEZZPgWM6wkY8YpSjnE-VhxLnOV1FWu1oez2qaonWBNJ_XqJ2Logg2eepdt25_JDgdOcTqEbQMtugkpKQuHnKEXuHmiQ_ClCqNgtXwgcmE/s400/05032011651.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583909805266288418" /></a><br /><br /><br /><br />Sunday- Had breakfast at Acik Mus House and makan Bihun wit roti canai. After that, me ibu ayah wan and tok went to TAnjung Dawai and bought some ikan masin<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL4ReE25QCP8Sk5ZPFZb9Jc4-d-aa1UJCJYAkK3kaJLetKFJYZLP7HOAn6ecOLQM6uO6gaEM_9mZ7EBYBUGYXb2qZwtOi0PT3TlWvY_sMSUW0NEcsjSjAYQmKVS6W3VbL_iIbzlJfXQGo/s1600/06032011657.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL4ReE25QCP8Sk5ZPFZb9Jc4-d-aa1UJCJYAkK3kaJLetKFJYZLP7HOAn6ecOLQM6uO6gaEM_9mZ7EBYBUGYXb2qZwtOi0PT3TlWvY_sMSUW0NEcsjSjAYQmKVS6W3VbL_iIbzlJfXQGo/s400/06032011657.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583901030103758002" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNkBagmz55it1h8MNQEQx6H5Epb-eF46lJghqJuxrV0Pz59IE7Kvjz2hUoAC0BKkbTGksEK_5W8kqc0Lg-J0ktKj_R8VAhPr5iNK5CBG0RiSSaBYZ8DnqSd9t5g95vYrKhPYhsS_yaR0I/s1600/06032011654.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNkBagmz55it1h8MNQEQx6H5Epb-eF46lJghqJuxrV0Pz59IE7Kvjz2hUoAC0BKkbTGksEK_5W8kqc0Lg-J0ktKj_R8VAhPr5iNK5CBG0RiSSaBYZ8DnqSd9t5g95vYrKhPYhsS_yaR0I/s400/06032011654.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583901022854060514" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrtGqBHQCWsFyRIMetTo6wqPcuhyphenhyphenDbEyat8BWmeSjEAruVVxWEEoXqqylPUmdp8ndndGouYX2D-bu3NSkPYaOJfNtzvmuw-w9uEhQ68OGIPhjcUNfIpKaralrzDsh2nZGtdl7izYJQPeY/s1600/06032011652.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrtGqBHQCWsFyRIMetTo6wqPcuhyphenhyphenDbEyat8BWmeSjEAruVVxWEEoXqqylPUmdp8ndndGouYX2D-bu3NSkPYaOJfNtzvmuw-w9uEhQ68OGIPhjcUNfIpKaralrzDsh2nZGtdl7izYJQPeY/s400/06032011652.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583901020745887458" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV1UyLEXQpZh_OO6sJ4v6j2zy-NCbg2XmFyIqr-fiFxES6_aeNmCti6frD9q9e5zVhSw0O7Xbq3joX183NMdTuEHj-IEpSTtgU0PgGKGXI0_TwUbTnIm_eWOjBONr8SsFOrogmKwTP7dM/s1600/06032011660.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiV1UyLEXQpZh_OO6sJ4v6j2zy-NCbg2XmFyIqr-fiFxES6_aeNmCti6frD9q9e5zVhSw0O7Xbq3joX183NMdTuEHj-IEpSTtgU0PgGKGXI0_TwUbTnIm_eWOjBONr8SsFOrogmKwTP7dM/s400/06032011660.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583909838440858402" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzOys7m5XWmmAybuzcYPEDSAyFmXRHdcj2bmgS0Ay_FD57G2iDi2jxR2C3ABoplbXAoHBVObfoyc9bJxtg4if3ObXMOQ_924VkNa82omCgiwYAdHQIjN3Z4eepvRxIjFmcLn96BlKrep4/s1600/06032011655.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzOys7m5XWmmAybuzcYPEDSAyFmXRHdcj2bmgS0Ay_FD57G2iDi2jxR2C3ABoplbXAoHBVObfoyc9bJxtg4if3ObXMOQ_924VkNa82omCgiwYAdHQIjN3Z4eepvRxIjFmcLn96BlKrep4/s400/06032011655.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583909830462216034" /></a><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFPRfYdHMcIwJ2J4BY0mM_ek-FBCOMemgvH-3nwfOMGpUD-Sw1tpCacHlXvt1oX3To42xPTNzwtSiXUfodhfZi5ESLaj70HZPXlWww1j3qXaDdDLq1bf5u2SxzN93POW0hYNgwwlskbIk/s1600/06032011653.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiFPRfYdHMcIwJ2J4BY0mM_ek-FBCOMemgvH-3nwfOMGpUD-Sw1tpCacHlXvt1oX3To42xPTNzwtSiXUfodhfZi5ESLaj70HZPXlWww1j3qXaDdDLq1bf5u2SxzN93POW0hYNgwwlskbIk/s400/06032011653.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583909817476099378" /></a><br />~Returned back to Seri Manjung, and well managed to watch Liverpool vs Man U with Astro Beyond HD! Wow. The good news was Man U was defeated that night and that gave an advantage to Chelsea! Hooray!!!<br /><br />Monday, Tuesday, Wednesday, Thursday- Basically I enjoyed it by playing Mahjog with My mom- quite addicted playing it. Sometimes my mom won the game, but almost all the time, it was me! haha...At night I had the symptoms of hepatic encephalopathy- reversed sleep pattern just to watch the Uefa Champions League- Barcelona Vs Arsenal (Barca won 3-1) & Tottenham Vs Ac Milan-Spurs won via away goal rule.<br /><br />Friday- I helped my neighbour preparing what is necessary for the daughter's wedding. The Akad Nikah is today itself whereas the wedding ceremony will be tomorrow.<br /><br />Saturday- 12.30a.m I went to fetch Syahmi at Manjung Bus Station who was just arrived from Seremban. I made a mini birthday celebration for him as both ayah and ibu already asleep.<br />Today got kenduri kawen at rumah Jiran. Auntie Noor's daughter is married with a guy from Kedah. In the afternoon, me, syahmi, ibu and ayah went to Damansara Damai...<br /><br />Sunday- Sob2...a very sad day...my holiday is over already..huhu...Drove back all da way to Melaka with AEN 5454...<br /><br /><br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-3453866766056659922011-03-03T17:52:00.003+05:302011-03-14T10:42:29.024+05:30Home AloneHome Alone...<br />As usual, I began my day with a morning jog, followed by shopping some groceries at TESCO Seri Manjung. Nothing much happen during the day time, but the night was marvellous. I watched Perak Vs Harimau Muda via Astro Arena Channel 801 with both team held in a 1-1 draw match thanx to a last-minute free kick goal scored by the Perak left back. The Young Tiger played a very high tempo game, resulting Perak was shocked and outplayed in the 1st half. But the Perak game was much better in the 2d half.<br />After the game ended, I watched WWE until 12.30...<br /><br />Wednesday morning started as early as 3.30a.m to watch Chelsea vs Man U. The game was very interesting as Chelsea came from behind to win the match thanx to the equalizing goal scored by Chelsea new boy, David Luiz (although he might be sent off that night) and a penalty scored by (who else?) Frank Lampard. Man U scored a first half goal by Wayne Rooney-his 7th of the campaign. The most interesting part was, I watched it with Astro Beyond HD via 54' LED TV. That's superb!!! Its been a long time that I haven't enjoyed watching football. Yeah!! After performing the subuh prayers, I slept until 12noon. In the evening, I went for jogging and double the amount that I usually did ( because I didn't jog in the morning). At night I watched RED> Retired Extremely Dangerous casting Bruce Wills as the the main actor and it was a very good movie and worth watching.<br /><br />Thursday, began with -I cooked spaghetti for my breakfast. Initially it was not that good, but after a proper modification of the meal itself, it became marvellous. Yummy!!! Actually I wanna go for jogging but, it seem to be raining, so I cancelled my jogging. Later I watched the movie The Lost Future~ quite an average movie. Facebooking, watching TVs and checking the mails. Alhamdulillah, JPA has credited my allowances into my account. In the evening, I jogged for 10 rounds!!! Wowo...quite A LOT!!! I ate dinner with the spaghetti that I cooked in the morning and currently I am writing this blog..hehe...the holiday goes on and on~<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiajl9p8drr7uADYEBSj0ddOSne3Y2sCCP0lebipugo4uwwshIRe7U2zM0_5MFNJsJUzbPSMAkHQzDuyhyphenhyphenwJZTAtUzzrudtPE0H-y_VDOgThJRr1DQwqNfZuoKVmWSRHClzSJwePxKox4A/s1600/03032011631%255B1%255D.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 300px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiajl9p8drr7uADYEBSj0ddOSne3Y2sCCP0lebipugo4uwwshIRe7U2zM0_5MFNJsJUzbPSMAkHQzDuyhyphenhyphenwJZTAtUzzrudtPE0H-y_VDOgThJRr1DQwqNfZuoKVmWSRHClzSJwePxKox4A/s400/03032011631%255B1%255D.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5583798974326721970" /></a><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com1tag:blogger.com,1999:blog-7478631345163895612.post-66196430284492606042011-02-28T20:48:00.003+05:302011-02-28T21:23:36.113+05:30Hola Holiday : )2 weeks of holiday meant alot to me...but for sure I will miss 'her' for 2 weeks also..sok sok..My holiday began cannot become any better than playing in a Futsal Tournament with my team dubbed the Coolblog FC. I wonder who gave the name to this team. Tourament held in Kolej Ibn Sina, University Malaya. Our team managed to win all the preliminary round group matches only to suffer heart break defeat at quarter final. After scoring 20 goals and conceding 8, we all went back in frustration.<br /><br />I stayed at Damansara Damai for a day.On Sunday my sis and me went to Saujana Putra to settle her 'housing' stuffs. Pity her that her Sony handphone was lost during the process. An indication for a brand new I-phone/ Blackberry. Later I went back to Seri Manjung with bus. My sis sent me to Hentian Duta, only to miss my yummy waffle at the very last minute as the bus ready to push off.<br /><br />I safely arrived at the Seri Manjung Bus Station with my parents already waited there. After performing the Asar prayers, we went to Pasar Malam for dinner. Me ate Maggie goreng and ayam percik~ Hehe...nyum2..<br /><br />Monday started with my mom waking me up at 7 a.m...Guess what? Its jogging time!! I managed 6 rounds this morning and then we went to KWSP together due to some banking stuff. We cooked lunch together and played Mahjong via I-Pad together! Me win a couples and lost a lot!!! Monday ends with me writing this blog and both my parents went to KL..Home Alone~ <br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com1tag:blogger.com,1999:blog-7478631345163895612.post-91401372101264631992011-02-24T09:30:00.003+05:302011-02-24T09:47:45.786+05:30Medicine End Posting Bedside ExaminationDate: Today (24/2/2011)<br />Examiner: Dr Anoop<br />Student: Me<br />Patient: A Bangladeshi guy (who Dr Anoop can speak fluent Hindi with)<br />Question: Do the General Physical Examination. ( which include examination of hand, pulse, eliciting collapsing pulse, peripheral pulses, anatomical landmark of dorsalis pedis artery, popliteal artery)<br />Homework: Anatomical landmark of popliteal artery (Exam also got homework ek?? Got...with Dr Anoop only)<br /><br /><span style="font-family:Arial, Helvetica;font-size:100%;color:#333333;"> The course of the upper part of the <b>popliteal artery</b> is indicated by a line from the lateral margin of Semimembranosus at the junction of the middle and lower thirds of the thigh, obliquely downward to the middle of the popliteal fossa; from this point it runs vertically downward for about 2.5 cm. or to the level of a line through the lower part of the tibial tuberosity</span><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxkfkxwyP7WnGY_9XV29iem0fdomATXsmWyCls_iFlIt4_BRTeAqGUhou1-9fWEq5JYKWO9aFU6OL0bI_k68E3UT8DUTits0kYiuFTJCeXWRygv6O7-MwnPdPzmmpe3C0w4QbmFN81E8w/s1600/image1247PA.gif"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 126px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgxkfkxwyP7WnGY_9XV29iem0fdomATXsmWyCls_iFlIt4_BRTeAqGUhou1-9fWEq5JYKWO9aFU6OL0bI_k68E3UT8DUTits0kYiuFTJCeXWRygv6O7-MwnPdPzmmpe3C0w4QbmFN81E8w/s400/image1247PA.gif" alt="" id="BLOGGER_PHOTO_ID_5577105007170890946" border="0" /></a><br /><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiieQfx6CxJCH1Ry0yhpoyzxbqZ7QRqzvoQ8Yj5eTcDsfZijPNhqVgouJ7tafHsA7nxBzHKbVXwbJ8RUpcSEZ0qSv2xmaGJZ9mNd_fgmacVUadB_blUNo33B8E6m9zEDaIK2uxhsdxYiKA/s1600/250px-Popliteal_artery.png"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 185px; height: 400px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiieQfx6CxJCH1Ry0yhpoyzxbqZ7QRqzvoQ8Yj5eTcDsfZijPNhqVgouJ7tafHsA7nxBzHKbVXwbJ8RUpcSEZ0qSv2xmaGJZ9mNd_fgmacVUadB_blUNo33B8E6m9zEDaIK2uxhsdxYiKA/s400/250px-Popliteal_artery.png" alt="" id="BLOGGER_PHOTO_ID_5577105012094538242" border="0" /></a><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com1tag:blogger.com,1999:blog-7478631345163895612.post-56893349056068618962011-02-22T15:31:00.004+05:302011-02-22T19:52:55.507+05:30Witnessing 'DEATH"Innalillah Wa Inna Ilaihi Raajiuun...<br /><br />Yesterday 21/2/2011 was the 1st time in my life I saw and experiencing a man who is dying.<br />B4 that, in the morning as usual I was clerking a patient who was beside his bed. That time I could see he was in an intolerable state of breathelessness. Though his wife was there with him, but the pain that he was suffering cannot be described with words. An immediate lesson that I gained that time was, breathlessness can range from very mild to the one that the pak cik was suffering.<br /><br />After having a Cardiovascular class with Dr Sushil under the topic of ACS-Acute Coronary Syndrome, as I was walking back (returning to hostel), I could saw the same Mak Cik (the wife of the suffering Pak Cik) crying. At that point of time, I didn't have the 'guts' to walk and go back from the hospital. There, inside an intensive room, I saw the MOs, HOs were struggling to resussitate the Pak Cik. Drugs such as Adrenaline, Dobutamine have been used.They countered the acidosis with Sodium Bicarbonate Infusion and CPR was also done. That time I was standing at a corner and felt so hopeless. Even the student nurse also was doing something to help that old man, and what is my contribution as a Medical Student? Nothing. I was a hopeless 'amoeba'. That old man was dying.<br /><br />Suddenly I heard the MO incharge shouted at me- "Hey Medical Student, wear your glove and mask, come here and do CPR! Hurry!" At that time, I was so surprised and cannot believe that something I could do and contribute. Quickly I rushed off and those things and jumped on the bed and performed the CPR. Slowly, I told the Pak Cik to recite the Holy Sermon " La Ilaha Illa Allah"<br /><br />Pupillary reflex was absent as I checked his eye. His BP continued to drop inspite the ionotropic agents that was given earlier. His pulse was irregularly irregular possibility of ventricular fibrillation. His extremities started to feel cold. The doctor sent a form to the Mak Cik to be signed. It indicated that 'the time' has came for the Pak Cik to meet his God, our God, The Empire of The Universe. I went and met the Mak Cik and told her to be brave, patience, stay strong and reminded her that all of us came from Allah al-Mighty, and to Him also, we shall return. I gave a kiss to the Pak Cik's forehead and walked out from the ward. I knew that, one day, we shall meet again, but for surely, in another world, World Of Justice.<br /><br />Life has to move on. But definitely there will be a time, that its our turn. Maybe now, next 2 minutes, next week or next year.An 'Alim' person had told me that the interval between life and death is as same as the duration between the Azan and Iqamah.<br /><br />Before I end, let us together recite the Ummul Kitab Al Fatihah, for those who have past away before us and all the Muslimin Muslimat, Mukminin Mukminat entirely.<br /><br />Al-Fatihah...<br /><br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-19553234429009893202011-02-21T09:00:00.004+05:302011-02-21T09:27:56.659+05:30MasyaAllah...Egyptians' Victory!!!I am pretty sure that all of us knew that Husni Mubarak's regime has been teared into pieces. But I'm not sure whether most of us knew that Syeikh Yusuf Qaradhawi has returned to his homeland for the 1st time in 30 years! What a massive reception for him! He lead the Friday(18/2/2011) prayers as well reciting the Friday sermon(khutbah)! Nearly 2 millions of Muslims were there at the Tahrir Square! MASYAALLAH!!! ALLAHUAKBAR!!!<br /><br /><br /><br /><iframe title="YouTube video player" src="http://www.youtube.com/embed/-wyqywuA03s" allowfullscreen="" width="480" frameborder="0" height="390"></iframe><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-39942971138895027932011-02-20T18:53:00.004+05:302011-02-20T19:24:58.525+05:30Perak FA & Hamburg SV<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPz95pW_eDlGzlIS7RdA_zRFapeBlQ_JphERV2HneO-3zNOsDmphKdC9qwKwDBADni3g-GHtBrJdrqDmXlBqP6ObCyPnIB_19UaRewMZTYR_nJfg36EdOs35-l2p2-pwsk_4BcBkVZAis/s1600/Perak+FA.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 215px; height: 235px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPz95pW_eDlGzlIS7RdA_zRFapeBlQ_JphERV2HneO-3zNOsDmphKdC9qwKwDBADni3g-GHtBrJdrqDmXlBqP6ObCyPnIB_19UaRewMZTYR_nJfg36EdOs35-l2p2-pwsk_4BcBkVZAis/s400/Perak+FA.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5575766223732912898" /></a><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRT0j9KetSb5L2A_S79F7EPYh94PBO3Fd_wsi-cKrTIKhjmVA2zMH__7Je6ll8vO3KJzgFA55DvIjBqNfomoBgwY_Qj26_52Ke_kzcJZE-P19u47FnDjm5mgYF0QeSFTvyxwoBRQXxCY8/s1600/Hamburg+SV.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 266px; height: 189px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRT0j9KetSb5L2A_S79F7EPYh94PBO3Fd_wsi-cKrTIKhjmVA2zMH__7Je6ll8vO3KJzgFA55DvIjBqNfomoBgwY_Qj26_52Ke_kzcJZE-P19u47FnDjm5mgYF0QeSFTvyxwoBRQXxCY8/s400/Hamburg+SV.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5575766227032537026" /></a><br /><br />As many people know that I am a fanatic fan of Perak FA, just wanna share something intresting here...Just now, as I was surfing the internet, I just realized that there is ONE similarity between these 2 clubs...BOTH OF THEM HAVE NEVER BEEN RELEGATED!!! <br />It means, since the inception of the Malaysia Football League-previously known as Liga Perdana Malaysia, now Liga Super Malaysia/Malaysia Super League, Perak FA has never been relegated! Congratz!!!<br />The same happen to Hamburg SV, there have never been relagated from the top-tier of the German Football- currently known as 'Bundesliga'. Credit to them also!<br />I wonder how top Giants teams like Bayern Munich, Werder Bremen, and Schalke 04 have 'tasted' relegation???<br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com1tag:blogger.com,1999:blog-7478631345163895612.post-47102607393794054582011-02-19T07:45:00.002+05:302011-02-19T07:57:46.574+05:30Aortic RegurgitationSometime, I use this 'fancy' word --> aortic 'regurge'<br /><br />Clinical signs include;<br /><br />* Hyperdynamic apical impulse displaced laterally and inferiorly may be associated with an ejection click.<br />* Decrescendo diastolic murmur is heard best while the patient is leaning forward on deep expiration.<br />* Apical middiastolic rumble<br />* Austin-Flint murmur<br />* Pulsus bisferiens; increased pulse pressure; visible, forceful, and bounding peripheral pulses (water hammer)<br />* Corrigan pulse - Quickly collapsing pulses <br />* Corrigan sign- dancing carotids,prominent carotid pulsation in the neck<br />* Musset sign - Bobbing/nodding of the head with each systolic pulsation<br />* Quincke sign - Capillary pulsations of the nail bed (alternate flushing and blanching of the nail bed)<br />* Hill sign - Systolic pressure in lower extremity greater than systolic pressure in upper extremity by at least 100 mm Hg<br />* Traube/ Pistol shot sign - Loud systolic sound over femoral arteries<br />* Duroziez sign - Systolic-diastolic murmur produced by compression of femoral artery with a stethoscope<br /><br />Usually all these sign can be appreciated in chronic cases.<br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-19057539901429370972011-02-19T07:22:00.003+05:302011-02-19T07:35:49.812+05:30Horner's Syndrome<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIRDE5s1uE9UuLJnrvhMgtNu1kKiuO84ieMJkbsMzsyrD3caHe4jgIZ-o4hI8RH8v40gnQRHyxybiTUmCrHoDU3j6NNEp4sqyJGihhLzufBU0ES-p_JbIujZkhKadmeDHAyiBSnSho2nE/s1600/230px-Miosis.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 230px; height: 173px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiIRDE5s1uE9UuLJnrvhMgtNu1kKiuO84ieMJkbsMzsyrD3caHe4jgIZ-o4hI8RH8v40gnQRHyxybiTUmCrHoDU3j6NNEp4sqyJGihhLzufBU0ES-p_JbIujZkhKadmeDHAyiBSnSho2nE/s400/230px-Miosis.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5575214549507574850" /></a><br />Horner's syndrome or Horner syndrome is a clinical syndrome caused by damage to the sympathetic nervous system.<br />A classiccal triad of;<br />1. miosis (ie, constricted pupil)<br />2. partial ptosis(which is drooping of the upper eyelid from loss of sympathetic innervation to the superior tarsal muscle, also known as Müller's muscle) and <br />3. loss of hemifacial sweating (anhidrosis)<br /><br />others->Enophthalmos (the impression that the eye is sunk in) loss of ciliospinal reflex and bloodshot conjunctiva may occur depending on the site of lesion<br /><br />The clinical features of Horner's syndrome can be remembered using the mnemonic, "Horny PAMELa" for Ptosis, Anhidrosis, Miosis, Enophthalmos and Loss of ciliospinal reflex.<br /><br />Usually examiner will ask, the relationship between Horner Syndrome & Bronchogenic Carcinomo of the apex of lung.<br />Bronchogenic Carcinomo of the apex of lung (aka Pancoast Tumor-mostly a non small cell cancer)-->Sympathetic Ganglion Compression in the cervical region--> Horner Syndrome<br /><br /><br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-64760269174747399232011-02-19T06:56:00.004+05:302011-02-19T07:16:53.807+05:30Jugular Venous Pressure ( JVP)<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA2kDKYAYlYJruEjI3ss44c13K2BxeUwpYkp_MdKZpmUiHE8ZqMKq6Xs3-4kv7ZIhPQRE5jlYr2_17LUr0aIiFpH1XqQLIvVVTtbtu-y6tNNBflGAobdgihighMCuKiRFxjXJDTlPC1C0/s1600/220px-Elevated_JVP.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 220px; height: 288px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA2kDKYAYlYJruEjI3ss44c13K2BxeUwpYkp_MdKZpmUiHE8ZqMKq6Xs3-4kv7ZIhPQRE5jlYr2_17LUr0aIiFpH1XqQLIvVVTtbtu-y6tNNBflGAobdgihighMCuKiRFxjXJDTlPC1C0/s400/220px-Elevated_JVP.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5575208228460116722" /></a><br /><br />The jugular venous pressure (JVP, sometimes referred to as jugular venous pulse) is the indirectly observed pressure over the venous system. It can be useful in the differentiation of different forms of heart and lung disease. Classically three upward deflections and two downward deflections have been described.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjfCJr3ziK2tuuSXV8LFHxANLFag8_z0BMNlBBG_-FRULseS2jzMMn5L4Fidl_pMTG5tR1p6ZH6maoQ-Ep_N3SFrz-NeytIzO0YUzmwgDHyaZ-Z7TDu1t72LWVRVloNSZtHpWI4tJf9BmQ/s1600/Jugular_venous_pulse_1.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 140px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjfCJr3ziK2tuuSXV8LFHxANLFag8_z0BMNlBBG_-FRULseS2jzMMn5L4Fidl_pMTG5tR1p6ZH6maoQ-Ep_N3SFrz-NeytIzO0YUzmwgDHyaZ-Z7TDu1t72LWVRVloNSZtHpWI4tJf9BmQ/s400/Jugular_venous_pulse_1.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5575208239035600306" /></a><br /><br />The upward deflections are; <br />- "a" (atrial contraction)<br />- "c" (ventricular contraction and resulting bulging of tricuspid into the right atrium during isovolumic systole) and <br />-"v"= atrial venous filling<br /><br />The downward deflections of the wave are;<br />-"x"(the atrium relaxes and the tricuspid valve moves downward) during early right ventricular systole <br />-"y" descent (filling of ventricle after tricuspid opening)<br /><br />In Exam, all the above will be asked, as they are the basics that all medical student should now, and after succeding in answering them, this they (the examiner) might asked;<br /><br /># Large 'a' wave (increased atrial contraction pressure)<br /><br /> * tricuspid &/ pulmunory stenosis<br /> * Right heart failure/ Right vntricular hypertrophy<br /> * Pulmonary hypertension<br /><br /># Cannon 'a' wave (atria contracting against closed tricuspid valve)<br /><br /> * Atrial flutter<br /> * Premature atrial rhythm (or tachycardia)<br /> * third degree heart block<br /> * Ventricular ectopics<br /> * Ventricular tachycardia<br /><br /># Absent 'a' wave (no unifocal atrial depolarisation)<br /><br /> * atrial fibrillation<br /><br /># Large 'v' wave (c-v wave)<br /><br /> * Tricuspid regurgitation<br /><br /># Slow 'y' descent<br /><br /> * Tricuspid stenosis<br /><br /><br /><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6bngBf1aLBVu1sbtP6Ce1VtgPRIwzairUL3D6HuW_82Xl5f25FN49xKRDaFZZiaJRcmbVx53QLODfi4Ay_ZuaiNNLozYGJ9JtSQ8xT34cbSdABkE7lxYtvnyPSzJkJtWk23MnevufjCg/s1600/220px-Gray558.png"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 220px; height: 249px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6bngBf1aLBVu1sbtP6Ce1VtgPRIwzairUL3D6HuW_82Xl5f25FN49xKRDaFZZiaJRcmbVx53QLODfi4Ay_ZuaiNNLozYGJ9JtSQ8xT34cbSdABkE7lxYtvnyPSzJkJtWk23MnevufjCg/s400/220px-Gray558.png" border="0" alt=""id="BLOGGER_PHOTO_ID_5575208233836959794" /></a><br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-9590244350630160312011-02-18T14:22:00.004+05:302011-02-18T14:33:43.694+05:30Hooray!!! Its weekend again!!!HAha...its Friday! and the best part of it--> Its weekend!!!<br />The question right now will be, how should I manage my weekend? Just no my brother called me, asking whether I am interested in going to Paroi Stadium to watch Perak Fa VS PDRM...I don't think so, as I am having exam next week!<br />My plan are as below;<br />1.Study for End of Posting Examination<br />2.Exercises/ Work Out<br />3.Study for End of Posting Examination<br />4.Study for End of Posting Examination<br />5.Finish my Medicine logbook<br />6.Study for End of Posting Examination<br />7.Finish 2 Medicine Case Sheet<br />8.Try to go hospital for Study for End of Posting Examination<br />9.Study for End of Posting Examination<br />10.Study for End of Posting Examination<br /><br />Arrghhh!!!!!-->Study for End of Posting Examination<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEIdddGFgXjhdPpUwdege2d2jdLY29B8UI6db2i6Tpd89VhfnlnULTy5-irk5nzPOerFzbnTjgSXmLO2_IzxHuMphVUgECigYHmXWMJ7BiRXrWIYpl6m4Kw0ntKs4wPVQYvmzHZcsm64Y/s1600/exam.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 235px; height: 215px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEIdddGFgXjhdPpUwdege2d2jdLY29B8UI6db2i6Tpd89VhfnlnULTy5-irk5nzPOerFzbnTjgSXmLO2_IzxHuMphVUgECigYHmXWMJ7BiRXrWIYpl6m4Kw0ntKs4wPVQYvmzHZcsm64Y/s400/exam.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5574952165343349506" /></a><br /><br />Huhu..No more 'Hooray' =(<br /><br /><br /><br />X!0M@N!@[$ Prop.<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com0tag:blogger.com,1999:blog-7478631345163895612.post-67752444019861818542011-02-17T21:36:00.006+05:302011-02-17T22:06:52.580+05:30Dream Car ( As for now~)When I was playing futsal with my teammates (usually, there will be Arif, Abbas, Dinbo & the others- we usually play at Cheng Sport Planet) something that always attract me beside the talents that the futsal players already have in them (such as Arif~) is nothing but CARS (berlambak parking dekat futsal court)!...<br /><br />Logically thinking, people who play futsal usually fall under medial to upper class group in Malaysia. There I could see them using from 'Protons'(which include all models of Proton) & 'Produas'(mostly Kancil and MyV) to cars like Toyota Vios, Honda City, and if I am lucky enough; Toyota Corolla Altis & Honda Civic. Very hard to see Mercedes, BMW (old BMW ada laa), and all the upper class cars.<br /><br />Suppose I am working with 'sufficient' income, these are my preference;<br />1. Peugeot 308- The lowest price; RM 100k on the road!<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgK2wY4ZLQUDE1DYB8xAhNGDruzAirb-j6IY9E5_7LWdYio8QMsN6db3oeD1Pi9nChOD05o2OR2G4Ufa7Etzjnby-DNLjTosxFRgf2-btbKJ2yhqyLKCj1U9RNzVo6PyjCLAmMqrOdDwUA/s1600/car.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 290px; height: 174px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgK2wY4ZLQUDE1DYB8xAhNGDruzAirb-j6IY9E5_7LWdYio8QMsN6db3oeD1Pi9nChOD05o2OR2G4Ufa7Etzjnby-DNLjTosxFRgf2-btbKJ2yhqyLKCj1U9RNzVo6PyjCLAmMqrOdDwUA/s400/car.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5574694688549594370" /></a><br /><br />2. Mitsubishi Lancer- around RM120k OTR!<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ8WkGGFo0-dCoXCT-oOp_XpxAjKxkJ8VDYawrH5Wq2qaBKbOQkgikvv8l34kve5TlkpxbiNmOVzb3neT7r4NRQ0kPNnGXH06yzL6oNA_-tbu72_IMIaeNYUD2ClPfmkVRkQ9HWm127rg/s1600/car2.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 236px; height: 157px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJ8WkGGFo0-dCoXCT-oOp_XpxAjKxkJ8VDYawrH5Wq2qaBKbOQkgikvv8l34kve5TlkpxbiNmOVzb3neT7r4NRQ0kPNnGXH06yzL6oNA_-tbu72_IMIaeNYUD2ClPfmkVRkQ9HWm127rg/s400/car2.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5574695498629947186" /></a><br /><br />3. Toyota Vios the lowest price is around RM 72k OTR...(My last choice as it is the cheapest among the 3 and being manufactured by Toyota)<br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq729QPGUSpd-ivBEPodvCU3lp1mEUwQrArtoH3JUagYTBsB28qKcA2AzTtUObCxttMM5SDTdDLEGrsUpjQOjvLptUV99BfXWZzGpgKCvp2eIztGkOavhUTDPkVbbLXjXdYt78pjlWTTw/s1600/car3.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 269px; height: 187px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq729QPGUSpd-ivBEPodvCU3lp1mEUwQrArtoH3JUagYTBsB28qKcA2AzTtUObCxttMM5SDTdDLEGrsUpjQOjvLptUV99BfXWZzGpgKCvp2eIztGkOavhUTDPkVbbLXjXdYt78pjlWTTw/s400/car3.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5574696648695522770" /></a><br /><br />Actually I wanna opt for Lancer, but to mahallaa...Peugeot 308 kinda 'ok' with its price and performance...but still log way to go. By the time I start working, there will be plenty of new cars in the market. Really hope the price will not be so expensive in the future (Malaysia will 100% follow the AFTA)...<br />But as for now, its just angan2 Mat Jenin...<br /><br />X!0M@N!@[$ Prop..<div class="blogger-post-footer">X!0M@N!@[$ Prop.</div>X!0M@N!A($http://www.blogger.com/profile/00131792807523498973noreply@blogger.com1