kimia sempurna

memohon dengan amat

God grant me the serenity. To accept the things I cannot change; Courage to change the things I can; And wisdom to know the difference. Living one day at a time; Enjoying one moment at a time; Accepting hardships as the pathway to peace; Taking, as He did, this sinful world. As it is, not as I would have it; Trusting that He will make all things right. If I surrender to His Will; So that I may be reasonably happy in this life. And supremely happy with Him. Forever and ever in the next.

Ahad, November 08, 2009

seorang dan ramai

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individualism. here

are you, or are you not ? i believe i still am.

sahabat yang seorang itu katanya kita mesti bergerak menjauh dari sifat individual ke arah lebih kolektif dengan niat untuk yang Satu. dan ya, aku setuju. kamu ?

tapi ada dia yang berkata, mana mungkin kita lakukan sesuatu bukan walau sekelumit atas sebab yang berbalik kepada kita sendiri. mungkin ?

-

klinikal - sedikit bosan dengan basma yang dah masuk minggu ke-3. naseb ada mereka mereka. terasa excited dan awesome bila dapat dengar murmur and such. oh, dapat tengok leukonychia pon dah excited (lol)

p.s. i feel more alive setelah ada dan dapat dos mingguan. i am about to have my withdrawal symptoms okay. dan aku tak online bukan kerana alam klinikal.

Jumaat, Oktober 09, 2009

sesuatu

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ye, belog dah serupa macam belog pengiklanan. tapi ni iklan kesihatan. jadi, okay lah.
it's not that i have nothing better to do besides meng-update belog ini, but this interest me, and i just thought that i should share.

quote of the day :
"I believe that everything happens for a reason. People change so that you can learn to let go. Things go wrong so that you appreciate them when they go right. You believe lies so you eventually learn to trust no one but yourself, and sometimes good things fall apart, so that better things can fall together." — Marilyn Monroe

Rabu, Oktober 07, 2009

which one are you ?

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Are you a carrot, an egg or a coffee bean?

A young woman went to her mother and told her about her life and how things were so hard for her. She did not know how she was going to make it and wanted to give up, She was tired of fighting and struggling. It seemed as one problem was solved, a new one arose.

Her mother took her to the kitchen. She filled three pots with water and placed each on a high fire. Soon the pots came to boil.. In the first she placed carrots, in the second she placed eggs, and in the last she placed ground coffee beans… She let them sit and boil; without saying a word.

In about twenty minutes she turned off the burners. She fished the carrots out and placed them in a bowl. She pulled the eggs out and placed them in a bowl. Then she ladled the coffee out and placed it in a bowl. Turning to her daughter, she asked, ’ Tell me what you see’

‘Carrots, eggs, and coffee,’ she replied…

Her mother brought her closer and asked her to feel the carrots. She did and noted that they were soft.. The mother then asked the daughter to take an egg and break it. After pulling off the shell, she observed the hard boiled egg.

Finally, the mother asked the daughter to sip the coffee. The daughter smiled as she tasted its rich aroma. The daughter then asked, ‘What does it mean, mother?’

Her mother explained that each of these objects had faced the same adversity: boiling water. Each reacted differently. The carrot went in strong, hard, and unrelenting.. However, after being subjected to the boiling water, it softened and became weak. The egg had been fragile. Its thin outer shell had protected its liquid interior, but after sitting through the boiling water, its inside became hardened. The ground coffee beans were unique, how ever. After they were in the boiling water, they had changed the water.

‘Which are you?’ she asked her daughter. ‘When adversity knocks on your door, how do you respond? Are you a carrot, an egg or a coffee bean?

Think of this: Which am I? Am I the carrot that seems strong, but with pain and adversity do I wilt and become soft and lose my strength?

Am I the egg that starts with a malleable heart, but changes with the heat? Did I have a fluid spirit, but after a death, a breakup, a financial hardship or some other trial, have I become hardened and stiff? Does my shell look the same, but on the inside am I bitter and tough with a stiff spirit and hardened heart?

Or am I like the coffee bean? The bean actually changes the hot water, the very circumstance that brings the pain. When the water gets hot, it releases the fragrance and flavor. If you are like the bean, when things are at their worst, you get better and change the situation around you. When the hour is the darkest and trials are their greatest do you elevate yourself to another level? How do you handle adversity? Are you a carrot, an egg or a coffee bean?

May you all be coffee beans :)

Selasa, Oktober 06, 2009

int med: 2nd day

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ascites [sumber]

aku mulakan alam klinikal dengan rounds internal medicine di princess basma teaching hospital. teringin nak rounds di KAUH but hey, maybe PBTH is better, who knows.

semalam, aku dah terlebih terkurang excited dengan seorang makcik yang memberi aku peluang untuk lihat dengan mata sendiri dan rasa dengan tangan sendiri ketumbuhan, dan everted umbilicus. selalu tengok kat buku je. ni live and it is sooo awesome.

(rasa bersalah sebab rasa sangat awesome dengan orang sakit tsk tsk T__T)

dr. odeh makes all of us (A7) wait for more than an hour but for me, personally it is all worth it. we did abdominal exam on a patient with ascites. from inspection you could see that the abdomen is distended and large with an everted umbilicus, some striae and dilated veins on the skin. patient looks ill and didn't talk very much. dr asked the patient to get up a little bit and a bulge of masses protude on the epigastric. (saya rasa memang amaze melihat hernia, i think it is an abdominal hernia)


during palpation, we started with superficial palpation. from right iliac fossa to the left iliac fossa. (sebab makcik itu ada gauze on her left iliac fossa) once you palpate the left hypochondrium, you could feel a mass (saya tak tau mass apa, tapi memang tak mungkin akan miss)

with deep palpation, we search for any abnormalities (abdominal mass/rigidity/tenderness) patient seems uncomfortable (taktau sebab kami atau sebab sakit) palpate to search for any organomegaly. palpate the spleen diagonally. (spleenomegaly normally is on the right illiac fossa) no palpable spleen noted. kidney : bimanual (use both hands)

percussion: note that resonance - air and dull - hollow organ. do liver span to identify if patient has hepatomegaly. on the mid axillary, normal liver span is 8-10cm. percuss from the 2nd coastal margin, untill you hear a dull sound; mark them. this is the upper margin. for the lower margin, percuss from the iliac fossa and go up till you hear any dull sound. mark them, this is the lower margin. measure upper to lower margin. patient's liver span is around 14cm = hepatomegaly. do the shifting dullness and fluid thrill. (fluid thrill : akan rasa seperti a wave hitting your hand)

auscultation: dr odeh tak dapat tunjukkan, he is a busy man. tp kalau nak buat, listen for any bruits on the renal artery. indicate stenosis.

secara kebiasaan : 1) inspection 2) palpation 3) percussion 4) auscultation. tapi sesetengah doktor suka buat 1) inspection 2) auscultation 3) palpation 4) percussion. sebab palpation before auscultation may stimulate bolus movement.

p.s. maaf bahasa campur-campur dan kalau kurang paham.

video reference yang aku rasa membantu : bates' physical examination

Rabu, September 23, 2009

titik kosong

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hari raya aku dah habis hari ini mungkin. ensha2llah. dah penat perut dan sistem pencernaan makanan proses segala macam makanan raya kali ni.

terjumpa iklan ni semasa nak cari iklan raya malaysia. usaha yang baik, bagi aku.
jangan menyesal di kemudian hari.
the thing you can change for a better future, make a change.

rokok merupakan psychostimulant yang digunakan secara meluas. jangan jadi hamba atau rakan karib kepada rokok.

p.s. doa supaya keturunan aku yang lepas lepas tak ada yang makanan kegemaran mereka rokok.