Showing posts with label medical. Show all posts
Showing posts with label medical. Show all posts

Saturday, August 8, 2009

Influenza A H1N1

Salam to all.









Its all over the world now. What started in Mexico then spread to USA has become a global pandemic. Like it or not Influenza A(H1N1) came here and created panic in the country.

Initially, everyone felt relax and tidak apa-apa. We only have 1 case and that was an imported one.Then another one.Another import.Then another and another and another.Oh...its okay for all were imported.

Then the famous Jalan Davidson school was closed for a week.And we have a local transmission case.Then another and another and another.More schools closed.


Mr and Mrs AHINI

In Melaka, almost everyone was cool and relaxed.No case in Melaka what! Suddenly UiTM Melaka closed.Then ALAM.Then came Kolej Yayasan Melaka and Politeknik Kota. Then...there was no stop to it. More schools and colleges closed.

Despite that, public events were still held out. The Youth meet in MITC with many coming all over the country.And don't forget college students and UiTM students 'requested' to attend. from then on Melaka faced clusters of attacks.

But...some people still thought its okay to hold courses and camps for students. One of it was at the Melaka Scout Camp in Bukit Katil. And an outbreak.

Then a young lady died.Then a 3 years old child.Then 3 more died. As of today 14 death reported in the country and 5 are from Melaka.

So, DO BE CAREFUL.Don't panic but don't take it lightly.
By comparision Dengue causes more death. H1N1's death rate is only 0.4%, but its still death.

Please take a few precautions during this tiring time.Its simple. Everyone can follow it IF they want to follow it.

1- Wash your hands regularly especially after handshaking someone.




2- Wear a facemask especially when in public places.Schools, shopping centres, public transportations,Cinemas. Pasar malams.

use a facemask especially in public places

3- Seek treatment early if your have fever, cold and cough.You might feel tired and experience body aching and headache.Some sorethroat.If the doctor give you medical leave make sure you stay AT HOME. Self quarantine.


feeling down under


a nasty throat


fever with malaise and bodyache


4-If within 24-48 hours, your condition worsens, go back for medical treatment. Your doctor will review and might refer you for a throat swab.

5- Highlight to your doctor if you have Asthma or Diabetes or Heart disease or if you are pregnant. Or if you are immunosuppressed. Bring your regular medications if possible for them to review.Or your medical records.

6- If you cough or sneeze, cover your mouth and nose with a disposable tissue paper and throw that away in a waste basket. Influenza(of any type and variants) gets spread very effectively by cough and sneezing.

cover up when coughing

Cover up when sneezing too


effective viral disseminator

Let's hope by end of September the vaccines for A(H1N1) will be out and let's pray that it will be available to all Malaysians.

ouch!!....it hurts

I have to repeat again: Avoid public places unless necessary.
Wear a fecemask(at least 3 ply) in public.
Wash your hands.
If you have fever,cold, cough,sorethroat and difficulty in
breathing GO FOR TREATMENT.

Sunday, June 29, 2008

Wednesday, April 30, 2008

Whats that swelling doc?

I always have these scenarios:

" Doc!! Saya berak berdarah le....."
"Kat bontot saya ada bengkak dan sakit doc"
"Lepas berak darah menitis-nitis doktor!"
"Saya kena buasir..."


A haemorrhoid
(piles) looks like a bulge or swelling of skin.It is a cushion of blood vessels and bowel lining tissue.Haemorrhoid can be internal(bulges into the rectum) or external(bulges around the anus).They can cause itchiness around the anus and they may also bleed or be painful especially when passing a bowel motion.

Haemorrhoid occur more commonly in people over 50 but people of any age can get them.And they are more common in males than females.( So cheer up ladies!)

What do the patient complaint(Sign and symptoms)?

1-Bulge of skin around the anus which may or may not be painful.
2-Itching or irritation around the anus.
3-Blood while or after passing motion. Might be dripping or noted while using a toilet roll.
4-Pain when passing motion.

What causes haemorrhoid?

Commonly due to straining to pass a bowel motion( meneran) which occurs when one is constipated.

Other things that may cause or worsen haemorrhoids are:-
1-Heavy lifting,vigorous work or activity( where your abdominal pressure is constantly increase)
2-Pregnancy
3-Straining at childbirth
4-Being overweight
5-Chronic couhging
6-Severe liver disease
7-Excesive coughing,sneezing or vomiting
8-Cancer of the rectum or pelvis area.

Treatment available:

1-Suppositories or creams which is inserted into the rectum( to treat internal haemorrhoids)
2-Creams applied for external piles( basically anaesthetic cream for pain and itchiness)
3-Injecting haemorrhoid with chemical which shrinks the pile, but this is just a temporary measure.
4-Banding-applying a tight elastic band around the haemorrhoid to shrink the pile.
5-Surgical operation which is called Haemorrhoidectomy.Done under general anaesthesia(GA) and need few days in hospital.

Self Care:
External haemorrhoid often go off within a week but may leave a skin tag hanging outside the anus( not a comfortable feeling).
If you think you have haemorrhoids you should:-
1-try not to strain when passing motion.
2-Slowly and consistently increase high fibre intake( eg cereals,fruits) until your turd softens.
3-Drink between 6-8 glasses of fluids everyday.
4-Regular light exercise eg walking. Avoid exertion like weight lifting.
5-When the pile is swollen you can relieve them by applying a cold compression to help shrink the blood vessels.
6-Wash your anal/perineum arae after passing motion( basuh berak le tu)
7-Use wet wipes if toilet paper irritates.
8-Soak in warm salt bath which might relief pain( you need a tub or jacuzi)

Other causes of rectal bleeding(fresh bleeding)
1- Cancer colon or rectum
2-Ukcerative Cilitis
3-Crohn's disease.

Important to see you doctor if:-
1-Per rectal bleeding(with or after bowel movement) that doesn't clear up in 2 days
2-Recurrent bleeding per rectal
3-Persistent chronic haemorrhoids.

Monday, August 13, 2007

Kantoi hanya kerana sebuah Kapchai....


Anda mungkin tak akan percaya. Tapi percaya lah. Percayalah 100%. Anda mungkin akan bertanya: Apa pasal kena percaya? Kerana ini kisah benar. Bukan aku reka bukan aku cipta. Bukan aku dapat ilham. Cuma tiba-tiba aku teringat dan bila teringat aku terfikir. Fikir bahawa ianya relevan dalam kehidupan kita. Kehidupan berkeluarga. Tak kiralah samada Melayu,Cina atau India.

Kisah ni berlaku pada tahun 1989. Ya. 1989. Ketika itu aku bertugas di Hospital Taiping. Bertugas di Medical ward. Waktu itu kebanyakan Hospital amat kekurangan doktor. jadi keraplah kena buat on-call. Apa lagi sebagai houseman(intern). Lagi lah kerap kena on-call. Kadang kala selang sehari(bila ada kawan bercuti). Kalau selang dua hari dah kira nikmat besar. Kalau kena on-call kami akan bermula seawal 7.00 am hingga ke 5.oopm keesokannya. Minimum 34 hours in a stretch! Dulu-dulu mana ada day-off selepas on-call. Masa dulu bila on-call kena jaga all the medical wards. 2 ward lelaki dan 2 ward wanita.

Paling melecehkan bila ada kematian. Semua kelamkabut. Nak kena pergi resuscitate dan buat report dan buat death cert, nak kena inform family members. Lagi leceh kalau ada 2-3 kematian in one night. Silap hari bulan doktor bertugas pun boleh mati.( aku pernah ada 3 deaths in one night. Rasa perit sangat sebab hari tu dari pagi sampai ke tengah malam teramat sibuk with lots of admissions. baru nak makan at 1 am( dinner!) tiba2 nurse panggil sebab ada patient collapse. Lepas tu berturut-turut sampai 6 am. Masa tu rasa nak quit sebab dah terlalu letih sangat).

Kisah ni ialah tentang bagaimana seorang remaja kantoi di sebabkan hanya sebuah kapchai.

Ada satu hari ketika aku on-call. malam tu adalah antara malam=malam yang rare bagi kami.Malam yg tak sibuk. After 7.00 pm tak banyak admission. Kebanyakan admission waktu siang telah rakan-rakan lain clerk dan examine( temubual dan pemeriksaan fizikal). Jadi malam tu masa maghrib aku sempat balik ke kuarters dan mandi serta solat. Lebih kurang jam 8.30 malam nurse talipon ke bilik dan memberitahu ada satu new admission. Aku terus ke ward.

Bila sampai aku dengar ada suara mengerang di selang-seli suara meraung wanita. dalam kepala aku : Hah! Apahal pulak ni? Aku bila ada family members dok meraung-raung ni cukup tak gemar. Bukan apa, pesakit lain yang dah sedia ada jadi tension.

Aku ke kaunter jururawat dan staff nurse memberi pada aku case sheet pesakit baru tu. Seorang remaja India berusia 17 tahun dari kawasan Trong. Admitted kerana: Minum racun rumput rampai.

Patutlah dengar suara wanita meraung. Mak dan kakak remaja ni yang meraung.
Aku ke katil dan introduce diri aku kat remaja tu dan mak bapak dia. Aku minta ahli keluarga dia tunggu di koridor dan pesan supaya jgn bising sangat.

Budak tu nama dia Arumugam. 17 tahun. Berbadan kecil tapi tegap. Dia nampak mencungap. Nurse telah kenakan saluran oksigen ke hidung dia.
Aku mula bertanya soalan dan selepas itu buat pemeriksaan. Di wad kecemasan tadi dia telah di beri minum air tanah( Fuller's earth) untuk neutralize kan racun yang dia minum. Jika sedikit yang di minum, ada harapan. Kalau banyak memang sukar.

Dari apa yang aku gather dia minum setengah cawan Paraquat. MasyaALLAH! banyak nya. Aku pernah tengok yang satu sip pun bleh membawa maut. Aku tahu budak ni tak lama. Paling kuat 3 hari lagi dia akan mati. Pemeriksaan fizikal pun dah menunjukkan sistem pernafasan dia sudah di compromised. Aku mengambil sample darah untuk monitor sistem liver dan kidneys dia.

Dari temubual aku, dia minum Paraquat pada jam 6.00 petang tu. Alasan kerana frust bapak dia tak mahu beli motor kapchai baru utk dia. Ada kawan dia dapat kapchai baru jadi dia minta kat bapak dia. Bapak dia kata sekarang mana ada duit( bapak kerja estet). Jadi kata dia dia minum racun tu sebab nak acah bapak dengan mak dia saja. Dia tak tau boleh jadi macam ni.

Aku kemudian jumpa bapak dan mak dia. Aku panggil ke bilik dan temubual mereka.

TA: Uncle...Aunty....ini apahal Aru bikin ini macam? Bila tahu dia sudah minum itu racun?

Mak: Ayooyoo...dokter...itu saya punya anak ada boleh idup ka? Dokter kasi tolong sama dia jangan kasi mati. Ayoyo...kadivalle....

TA: Aunty...dengar sini. saya akan tolong anak Aunty okay. Tapi saya mau tanya aunty sikit ,boleh?

Mak: ( Mengangguk sambil masih menangis): Wokey dokter..boleh..tapi dokter kasi janji itu saya anak tak mau kasi mati...ayoyo...Aru...Aru....

TA: Aunty...kasi cerita sama saya apasal Aru boleh itu minum itu racun. Dia ada gaduh ka? Ada marah sama sapa ka?

Mak: Ayoyo...itu saya anak mau dia bapak beli motor baru la dokter...Sudah lama dia ada minta dia bapak bili. Itu dia kawan ada motor juga jadi Aru jugak mau motor. Dia bapa cakap dulu sama dia, kalau mau itu motor, dia misti mau tolong potong susu jugak. Kalau duit ada cukup boleh sendiri bili....Saya juga ada cakap sama Aru..kita miskin jugak. Dia adik lagi mahu sekolah ampat orang. Dia sendiri sekolah itu Form 3 juga dokter...Kadang2 ada tolong potong susu. Kadang2 ada kirja kontrak bikin jalan. Dia cakap mau itu motor sebab mau ikut kirja kontrak senang.

Bapak: saya ini anak banyak keras kapla juga dokter. Dia sudah tau kita miskin juga lagi mahu motor juga. Saya sindri basikal jugak. Tapi ini muda orang susah. Itu basikal tarak standard juga ka? saya ada cakap, kita angkat motor second hand juga tapi dia tak mau. baru jugak mau. banyak keras kapla ini budak.

Mak: (Cakap Tamil macam marah-marah kat bapak Aru. Bapa dia balas balik dalam tamil. Aku rasa macam dok tengok wayang Tamil saja.)

TA: Uncle..Aunty...Sudah-sudah! Tak mau gaduh-gaduh okay. Anak sudah ini macam tarak baik. Pukul brapa tadi tau Aru minum racun.

Bapak: Sori dokter...ini dia punya mak kata saya punya pasal dia anak minum racun. Sebab saya tarak bili motor. Sekarang dia mahu saya bili baru punya motor kasi sama dia anak! Cit! Busuk punya pompuan! saya ada salah ka dokter?

TA: Sudah lah tu... Aunty..kita tengok dulu kalau Aru sudah okay baru beli motor okay. Sekarang sudah malam kedai pun tarak buka .

Mak: Wokey..wokey...tai saya mau dia bapa bili baru motor esok jugak. Ini Aru kita ingat , itu jam 4 .30 petang ada pirgi bola main. Tarak lama dia ada balik kasi bising2 mau itu motor baru jugak. Dia punya pak baru balik banyak penat...marah sama dia. Dia bapak cakap itu motor kasi tunggu ada duit dulu la...Aru bising2 kata dia bapak sama saya tarak sayang sama dia lagi. mau motor tarak mau kasi...Dia kawan ada dapat motor baru...Habis dia bapak cakap kalu Aru tarak diam dia bapak mau hantam sama kayu. Aru cakap ,tengok semua sudah tarak sayang sama dia. Dia ada keluar. tarak sampai 10 minit dia masuk bawak itu cawan ada racun Parakuat ...ayoyo....kita sudah tau ini tarak baik. terus dia bapak minta tolong ada orang Melayu ada kreta hantar hospital doktor....(Kemudian dia cakap tamil pada suami nya macam marah2)

Aku arahkan jururawat teruskan arahan aku.kalau apa-apa bagitau aku. Rupanya kes Arumugam adalah last kes yang masuk. Sampai ke subuh aku dapat tidur nyenyak kat bilik on-call. Nurse kejutkan aku dan lepas subuh, aku mula mengambil darah pesakit-pesakit serta memberi suntikan kepada yang perlu. By 7.00 am selesai dan aku balik sekejap utuk mandi. Aku lihat Aru masih macam tu tapi nafas makin dalam dan panjang.

Selesai mandi dan tukar pakaian, aku bergegas semula ke ward. Aku kena review pesakit di bahagian aku(termasuk Aru di bahagian aku) sebelum bos datang untuk ward rounds. Kebanyakkan pesakit aku stabil. Ada 2-3 orang yang aku nak discaj pagi tu tapi kena tunggu wardrounds dulu. Bila habis yang lain, aku review Aru. Bibirnya kering dan mengelupas kesan dari Paraquat. Dia sudah mula batuk-batuk dan paru-parunya sudah mula mempunyai tanda-tanda internal injuries.Ini yang kami risaukan. Bila aku raba dada Aru, terasa crepitus di bawah kulit. rasa seperti kita menggenggam kertas di tangan Ini bukan pertanda yang baik. kahak Aru sudah berdarah. Dia berbisik pada aku: Dokter...jangan kasi saya mati dokter...Dokter kasi tau sama bapa saya...itu motor saya tarak mau lagi...saya tak mau mati. Saya mau jadi anak baik dokter....Saya tarak tau itu minum sikit boleh jadi ini macam. Saya badan sakit nafas banyak susah dokter. Tolong sama saya dokter...tolong.....

Aku cuma mengangguk dan suruh dia jangan susah hati. Aku akan bantu dia.
Sebelum pakar masuk aku panggil mak Aru dan beri dia bercakap berdua. Aru bagitau maknya dia tidak mahu lagi motor itu. Mak dia menangis tak berhenti-henti hingga pakar masuk ke dalam ward.

Setelah ward rounds selesai aku ke klinik untuk pesakit rawatan susulan. Lebih kurang jam 1.30 pm baru kami selesai. Aku pergi ke kantin( masa tu tak dipanggil cafeteria lagi) dan had lunch. Lepas Zuhur ke klinik semula untuk kes-kes susulan yang tak selesai pagi tadi.

4.30 selepas klinik aku terus ke ward semula. nak tengok apa-apa kes baru yang di admit ke bahagian aku. Ada 2 orang. Kedua-dua kes asthma dan sudah di rawat oleh doktor yang on-call hari ni. Aku ke cubicle Aru. Aku lihat ramai saudara mara dan kawan2 dia di situ. Mak dan bapak dia serta dua tiga orang tua sedang menangis. Aru juga aku lihat ada air mata meleleh di pipi. tapi dia susah nak bercakap. Nafasnya pun sesak. Aku minta izin keluarga untuk examine Aru sekejap. Aku dapati crepitus semakin banyak keseluruh depan dada.

Selesai, mak dia beritahu aku: Dokter...kasi saya anak selamat...Dia punya bapak sudah bili baru motor tadi jigak. Itu motor bawah ada( ditempat parking sebelah ward)

Aku terkejut. Bapak dia beli motor? Mana dia dapat duit?
Aku tanya bapak dia dan dia kata dia pinjam duit tokey estate tempat dia menoreh. Dia kata dia dah beritahu Aru dia dah beli motor untuk Aru.

Bapa: Dokter....tolong kasi Aru tarak mati...tolong dokter....tolong lah...saya mau dia esok ka lusa ka...minggu depan ka...naik iti motor. saya mau dia tau kita sumua sayang sama dia...Kita tarak mau dia mati dokter......

TA:.....Uncle....kita boleh cuba saja. Tengok satu dua hari apa macam okey....Saya mahu balik dulu. nanti malam pukul 8 saya mari tengok Aru.

Aku ke kaunter dan beritahu jururawat yang aku akan datang review pesakit aku jam 8 nanti. Kalau apa-apa berlaku beritahu aku. Aku pulang ke bilik. Dah berjanji dengan kawan2 jam 9.30 nak pergi makan di stesen Keretapi Taiping(sambil nonton wrestling).

Jam 7.00 jururawat telifon ke bilik aku. Aru sudah meninggal dunia.


Kandungan posting mungkin ada kena mengena atau tidak dengan makhluk yang hidup atau yang telah tiada.Kalau sapa-sapa terasa nak buat macamana kan. Sapa makan cabai melaka dia pedaih laa

Tuesday, June 26, 2007

Ankle sprains- the do's and don'ts

He came in limping. His face showed he was in great pain. His weight of 100kg is taking its toll on him.He sat on the chair beside me and smiled.

TA: What happened to you Sri?

SRI: I played Futsal last night and I think I sprained my right ankle la doc.


TA: Alamak Sri...I told you last week not to play yet. You are overweight and not fit to play futsal.Even me, is not fit yet for futsal. You ni betul-betul degil laa.

SRI: Sorry doc. My friends keep on pestering me to play laa doc.


Sri is among the many who came to see me with an ankle sprain. Most are not fit for sports like futsal or football. Most haven't done any exercise for years. But with the Futsal craze everyone wants to give a try...with consequences.

PAIN & Ankle Sprains



Ankle joints and feet are the link between your body and the ground.If the ankle is twisted as the foot hits the ground,particularly during a fall,this may cause an injury called Sprain.

What is ankle Sprain?



The ankle joint is made of 4 bones whose shapes help made the joint stable.Stability around the joint is increased by the ligaments,which are bands of strong connective tissues that prevent unwanted movement.
When the ankle twists,the ligament will prevent the joint from moving too much.
An ankle sprain occurs when one of the supporting ligaments is stretched too far or too quickly,causing the ligament's fibres to tear and bleed into the surrounding tissues.The bleeding causes pain and swelling.

What should I do after a sprain?

In the first 24 to 72 hours after injury, use the P.R.I.C.E. method:

** Protect : protect the affected part from further injuries

** Rest: Stop all activities which causes pain to the sprained area. take it easy but move within your limit of pain.

**Ice: Apply ice packs for 10-15 minutes every 2 hours. This helps control the pain,bleeding and swelling.

**Compression: Firmly bandage the entire ankle,foot and lower leg.This reduces swelling.

**Elevation: Have ypur ankle and leg supported as close to the level of your heart(higher is better).This reduces bleeding and swelling.


What to avoid?

Your chances of full recovery will also be helped if you avoid the H.A.R.M. factors in the first 48 hours after injury:

# Heat: heat will increase swelling and bleeding.( so jangan dab or tuam or demah dengan benda panas or tungku)

#Alcohol: increases swelling and bleeding.

#Running or Exercise: aggravates the injury

#Massage: increases the swelling and bleeding.( most
people will do this to avoid 'masuk angin'. Please do not do this first)



What will the doctor do?

Your doctor will examine to determine the extent of your injury. He/she will give medications to ease the pain and reduce the swelling apart from compression/bandaging.
He might order an X-ray too.
You will be given rest( medical leave) for several days before reviewing your ankle after a few days.
You might need a support to move around( crutches or walking stick).

How soon can I get to work or sport?

That will depend on how badly you have damaged the ankle ligament.Returning to work or sports too early can delay healing and prolonged recovery.
Bracing and taping may allow early return to sport but normal ankle ligament strenght and muscle control will take longer.

Can ankle sprains be prevented?

Yes,you may reduce the chance of ankle injury by:
** Warm up before your exercise.Warm down when you finish.

** Wear well-fitting shoes,boots or ankle braces that give good lateral ankle joint support

**Avoid activities on slippery, wet or uneven surfaces, or in areas with poor lighting.

**Maintain a good general fitness.

Sprain: also know locally as terseliuh, tergeliat,terkehel dan terkucil.Ada lagi ka??


Kandungan posting mungkin ada kena mengena atau tidak dengan makhluk yang hidup atau yang telah tiada.Kalau sapa-sapa terasa nak buat macamana kan. Sapa makan cabai melaka dia pedaih laa

Monday, June 25, 2007

Medical Terminology


Artery -- The study of paintings

Bacteria -- Back door of cafeteria




Bowel -- A letter like A.E.I.O.U


Caesarean section -- District in Rome




Cat scan -- Searching for kitty



Cauterize -- Made eye contact with her


Colic -- Sheep dog




Coma -- A punctuation mark


D&C -- Where Washington is



Diarrhea -- Journal of daily events




Dilate -- To live long



Enema -- Not a friend




Fester -- Quicker


Fibula -- A small lie




G.I. Series -- Soldiers' ball game




Hangnail -- Coathook



Impotent -- Distinguished, well known




Labor pain -- Got hurt at work






Medical staff -- Doctor's cane




Morbid -- Higher offer




Nitrate -- Cheaper than day rate




Outpatient -- Person who had fainted



Pelvis -- Cousin of Elvis



Post operative -- Letter carrier





Protein -- Favoring young people




Rectum -- It almost killed him




Recovery room -- Place to do upholstery




Secretion -- Hiding anything




Seizure -- Roman emperor



Serology -- Study of knighthood





Tablet -- Small table





Terminal illness -- Sickness at airport





Tibia -- Country in North Africa




Tumor -- An extra pair







Urine -- Opposite of you're out





Varicose -- Located nearby



tokasid:Hope you enjoyed it.

Kandungan posting mungkin ada kena mengena atau tidak dengan makhluk yang hidup atau yang telah tiada.Kalau sapa-sapa terasa nak buat macamana kan. Sapa makan cabai melaka dia pedaih laa