dilemma

assalamualaikum w.b.t.

This entry is specially dedicated to a friend of mine who enlightened me with your call to share your worries and dilemma. No, I am not enlightened by the fact that you are now facing some sort of dilemma and uncertainty but because of being able to listen to you when I thought I am of no use to the people around me. Though, the truth may be that you got no one else to talk to and you have to talk to me. It does not sound that nice, but still, I am glad to be there when it happens:)

One day, you got an offer which is absolutely irresistible but... you keep on having that 'but' there, for you are not sure of your capability or whether you are prepared for it. To me, you deserve every right to grab that opportunity and prove yourself to the world. Most importantly, to yourself. Smash that doubt and go ahead! Don't tell yourself all sorts of "what if..." for all of that would be a hindrance though they are not totally impossible. It is okay to be worried as we always need to expect the worse, but remember, do so when you are hoping for the best. Those thoughts are to make yourself prepared for all possibilities, not to let you push aside all the possibilities by avoiding that path drawn before you. The opportunity is there! Right before your own eyes! There is nothing wrong about it. You are not doing something haram, you even got your parents' permission. All that is left is for you to trust yourself and do your best for the rest of it =) My prayers will always be with you:)

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Pil *Shad* *Ba* *Ra*

Assalamualaikum w.b.t.

faham x tajuk kt atas? tajuk tu ialah penawar bagi semua perkara. Mek slalu ckp, setiap sesuatu ad ubatnya. Apa dia? Pil *shad* *ba* *ra*~SABAR~ hehe, comel kan Mek ni? mudah utk lafazkan, tp tidaklah sesenang ungkapan bibir. Bila direnungkan, betul kn benda ni? bila marah, sedih, kecewa, pil ni tetap boleh diambil. No absolute contraindication:) betul x? Relative contraindication, mungkin marah tatkala melihat maksiat, atau marah yang perlu dalam mendidik? Ada lagi x?

Pesan seorang ustaz, bila ditimpa ujian, sentiasa sabar. Diuji lagi, sabar lagi. Diuji lagi, tetap sabar. Kenapa? sebab dengan ujian inilah Allah meningkatkan iman dan taqwa hamba2-Nya. ujian--> sabar--> naik pangkat--> ujian lagi--> sabar lagi--> naik lagi~ dan begitula seterusnya. Tidak ada hadnya.

Apakah manusia itu mengira bahwa mereka dibiarkan (saja) mengatakan: "Kami telah beriman", sedang mereka tidak diuji lagi? (al-Ankabut, 29:2)

Sebenarnya~ rasa penat da ni.

Rasa bersalah bila tanggungjawab yg diberi tak dapat dijalankan dengan baik--> walaupun tak tahu, tp tu bukan alasan kn?

Rasa sedih bila kene marah xpasal2 --> walaupun mungkin masa tu org yg marah tu tertekan, so dia xsengaja marah? mungkin~

Rasa xlarat da bila learning issues bertimbun --> Parkinson plus(pernah dengar x? first time dengar smlm), lateral medullary syndrome, tajuk ni, tajuk tu, buku ni, buku tu... tp still layan muka buku? salah sendiri~ *bertambah stress*

Rasa hina bila sume pun xleh wt --> surah hafazan?xmasuk2(cukup ke usaha aku ni?)... tarbiyah diri?setakat mana je...

Rasa tertekan bila cuba positifkan diri, tp pada masa yg sama diri ni ckp: "salah ko sndiri la xcukup usaha, mcm mana Allah nk tolong? T.T"

wahai diri, makanlah pil ni byk2...

Dan Kami telah menunjukkan kepadanya dua jalan, Tetapi dia tiada menempuh jalan yang mendaki lagi sukar. (al-Balad, 90:10-11)

Ya Allah, janganlah Engkau hamparkan padaku kesenangan yang dengannya membawaku jauh dari-Mu. Ya Allah yang membolak-balikkan hati, tetapkan hati kami dalam agama-Mu dan ketaatan kepada-Mu

*terasa dgn artikel ni*

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10 things and 10 years

Assalamualaikum~

Tajuk cm best kn? Mind you, it is 10 things and 10 years not 10 things in 10 years. Nape tetiba ckp pasal ni? sebab aritu ad orang tanya saya tentang dua perkara ni. Apa yang akan saya jadi dalam masa 10 tahun n senaraikan 10 perkara yg saya nk capai dalam tahun 2012. dan nyatakan langkah2 yg akan anda lakukan untuk merealisasikannya. Fuh~ mcm simple tp x langsung... Justeru, berikut merupakan jawapan saya:

InsyaAllah lagi 10 tahun saya akan jadi final year registrar(brani mati tul jwpn ni) n insyaAllah, berkeluarga...

nk komen skit kt jwpn sendiri... about the first statement, I have never thought I would have the gut to say so... cm xcaya pun ada, kdg2 rasa cm siyes di awangan impian tuh~ huhu... xpela, positif2.. bak kata ayah, azam tu mesti ada :D sayang ayah! yg penting, buat yg sehabis baik dlm segala sesuatu(sebenarnya, minggu ketiga ni baru la bersemangat skit dlm posting ni, kalau x mcm kayu yg hanyut je). Moga semangat ni berkekalan n smoga niat sentiasa untuk beroleh redha-Nya

n statement kedua tu... sape yg xnk kn? tmbhn pulak itu ialah salah satu sunnah Nabi Muhammad s.a.w. pernah baca, utk mndpt psgn yg baik, ada dua cara: pertama, mnjd yg baik kerana Allah menjanjikan org yg baik utk org yg baik dan sebaliknya. Kedua, mencari yg baik. Usaha untuk mencapainya, stkt ni, berusaha mnjd yg baik je la...utk cara yg kedua tu, xde lg ikhtiar yg sesuai buat saya=)

Papepun, andainya dikurniakan hayat n rezeki untuk mencapai semua ni, alhamdulillah... moga semuanya berlaku dalam naungan rahmat n barakah Allah

Jom g soalan kedua plak. 10 perkara yg saya mahu capai/dapatkan dalam tahun 2012:

err.. maafla, belum bersedia lg (=.=')

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~aku bukan parasit~ #003 Session with Prof 01

Assalamualaikum w.b.t.

Some recap on session with Prof, sorry for the limited info, hardly able to recall everything:

The case is about a HbE beta thalassemia complained of vomiting, etc.. (sori xingat, but in short, this pt is most like having food-poisoning with underlying anemia d/t thalassemia).

**HbE is a variant of abnormal Hb, a subset of beta-thalassemia since it is affecting the beta globin chain. please click here or here for more detailed information. Also, please note that HbE is the most common variant in Southeast Asia (epid medicine :D)

In anemia(pale/reduced Hb) case, it is important to ask about

• bleeding tendency
• relevant social hx [ i)diet hx- IDA, ii)hx of barefooting-percutaneous parasitic infx: hookworm(Necator americanus or Ancylostoma duodenale), iii) hygiene-feco-oral infx: most likely present with dysentery, caused by Trichuris trichiura), iv)auto-immune ds (SLE, RA)- auto-immune hemolysis]

Prof did touch a little bit on food-poisoning:

i) can the pt point out any food that s/he took that may be the culprit? is anyone else affected-if yes, does this person consume the same food?

ii) has the pt went out to eat? if yes, how is the hygiene of that place/restaurant/stall? its environment?

Investigation:

This pt has thalassemia, so the peripheral blood film would show hypochromic, microcytic, pencil-shaped erythrocytes[is this correct?-a little bit confused]. As for which investigation would you like to request: ask for electrophoresis first as beta-thalassemia is diagnosed by electrophoresis(since it is most common). If negative or not available, perhaps you may want to request for chromosomal analysis(alpha-thal)...

Other things:

• Prof asked about how many percent of myelocytes/myeloblast in peripheral blood film will be diagnosed as leukemia? @ >x% myelocytes/myeloblast=leukemia? - i couldn't find the answer, anyone knows?

• leukemoid reaction- there is leukocytosis with normal amount of myelocytes(may happen in severe infection/stress)

• Causes of macroglossia: B12 & folate def., Down Syndrome, acromegaly, amyloidosis, hypothyroidism.

• Collapsing vs bounding pulse... the term collapsing is used only when the etiology is of CVS problem, otherwise it is called bounding pulse... 5 causes of collapsing pulse: i) aortic regurgitation ii) Patent ductus arteriosus iii) arteriovenous malformation iv) arteriovenous fistula v)i forgot~ sorry!

• hypokalemia in ECG- i)prolonged QT interval ii)presence of U-wave(a camel hump effect next to T wave)- fusion of T and U wave cause QT interval to appear prolonged. Other features: ST-segment depression, reduced T-wave amplitude

• Comments on short case examination: i) Clinical is all about practise ii)During examination, you will be assessed on: speed, steps, smoothness, correlating signs and diagnosis... This shows that clinical skill is the major bulk of it, not your diagnosis... Most students are lacking in smoothness... You need to be systematic, confident and correct. Confidence but wrong is useless and so does vice versa.

• Recommendation from Prof: multiple short cases per day and all systems in each week. (to be honest, I am far from achieving this, please don't blame me if I don't achieve it, I am sharing this for your benefit:) *p/s: I don't want to be CaTakSeruKin...

Disclaimer: I am sorry if I posted the wrong info but at this point of time, I wrote only things that I know are correct(unless I mentioned otherwise). If any of you is able to point out the mistake/wrong info, please, please and please comment on it... you help is very much appreciated!

Mood: this posting is not easy but lots of nice things can happen too:)

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