?

alhamdulillah, its finally over. i mean, the exam. about to write something, tp cam terbantut lak pasal tetibe cam sakit kepala. egypt tgh memancarkan kegarangan musim summer nye. aduhai.

sorry anas. :'(

al-Fatihah buat Anas Hakimi bin Wan Umar..

i have never thought that what i've been afraid of since the day Anas was moved to ICU, eventually turn into a reality one..for all those suffering moments u had in the previous attacks your ummi told me, sometimes I cant help thinking of the worse condition u might deal with..3-4months hospitalization u used to go tru is enough to tell how much u suffer, not to mention all those interventions made up through your body..and I know how much your ummi hurts seeing u that way

never thought that when I'm coming back home this coming september I'll never meet u again.. the moment ayah cik texted me, i just couldnt believe what my naked eyes were seeing..the worst thing that I would never wish to happen, and it even sickened me for couldnt be around together with everyone for u the last few days..i hate it.

doakan cikpah nak exam..cikpah akan doa byk2 utk anas..cikpah tahu Allah sayangkan Anas thats why Dia amek Anas balik not allowing u to suffer much more..i'm gonna miss u..cikpah sayang semua :'(

***

The Gorham-Stout syndrome (Gorham’s massive osteolysis)

Gorham’s disease is a rare disorder characterized by proliferation of vascular channels that results in destruction and resorption of osseous matrix. Since the initial description of the disease by Gorham and colleagues (1954) and by Gorham and Stout (1955), fifty years have elapsed but still the precise etiology of Gorham’s disease remains poorly understood and largely unknown. There is no evidence of a malignant, neuropathic, or infectious component involved in the causation of this disorder. The mechanism of bone resorption is unclear.

The clinical presentation of Gorham’s disease is variable and depends on the site of involvement. It often takes many months or years before the offending lesion is correctly diagnosed. A high index of clinical suspicion is needed to arrive at an early, accurate diagnosis. Patients with Gorham’s disease may complain of dull aching pain or insidious onset of progressive weakness. In some cases, pathologic fracture often leads to its discovery. Gorham’s disease is progressive in most patients; however, in some cases, the disease process is self-limiting. The clinical course is generally protracted but rarely fatal, with eventual stabilization of the affected bone being the most common sequelae. Chylous pericardial and pleural effusions may occur due to mediastinal extension of the disease process from the involved vertebra, scapula, rib or sternum, and can be life threatening. A high morbidity and mortality is seen in patients with spinal and/or visceral involvement.

Classification of idiopathic osteolysis according to Hardegger et al

1. Hereditary multicentric osteolysis with dominant transmission - Between the age of two and seven years, spontaneous pain and swelling begin in the hands and feet. Carpotarsal osteolysis occurs over the period of a few years. Progression ceases normally in adolescence.

2. Hereditary multicentric osteolysis with recessive transmission- Similar to type 1, but may be associated with severe generalised osteoporosis.

3. Non-hereditary multicentric osteolysis with nephropathy- Appears in childhood. There is a gradual disappearance of the carpus with the tarsal bones involved, but to a less degree, and an association with proteinuria. Death occurs usually due to renal failure and malignant hypertension.

4. Gorham's massive osteolysis (Gorham-Stout syndrome) - Monocentric occurrence in any part of the skeleton may start at any age. Normally ‘haemangiomatous tissue’ is found in the osteolytic region. It has neither a hereditary pattern nor an associated nephropathy. The disease is benign and the osteolysis usually stops after a few years.

5. Winchester syndrome Autosomal recessive transmission- Rare childhood carpotarsal osteolysis inassociation with contractures, shortness of stature, skin lesions, corneal clouding and osteoporosis without nephropathy.

sayu sebuah kehilangan

regarding this shocking news ,

kami menerima berita accident tersebut pada malam hari kejadian dan seriously sgt mengejutkan kami memandangkan kami sempat mengenali Allahyarham Ammar semasa mengikuti jaulah. orang nya baik pertuturan, tinggi budi bahasa.

sejurus menunaikan 2rakaat solat sunat dan membacakan Yaasin pada malam semalam, sebak rasanya bila sampai pada 2 ayat terakhir surah Yaasin. setinggi tasbih buatNya y memiliki segala alam ini, dan kepadaNya akan segalanya dikembalikan. dan Dia telah membuktikan bahawa segala kejadian adalah dibawah qudrat dan iradah Nya.. apabila dikehendaki sesuatu perkara utk berlaku, maka adalah terus terjadi sesuatu itu kerna kehendakNya.

semoga Allah memelihara 4 org lagi sahabat2 y terlibat dalam kemalangan tersebut, terutamanya buat saudara Saif yang khabarannya trauma teruk memandangkan die y memandu, & Allahyarham menghembuskan nafas terakhir di pangkuannya..dek kerna trauma Saif masih belum menjamah sebarang makanan semenjak kejadian., semoga mereka dapat menerima bahawa semua ini berlaku atas kehendaknya..

p/s: al-Fatihah buat Allahyarham Muhammad Ammar bin Zulkifli
sedikit penerangan about their current condition di sini

xreti pasang canula? xreti amek darah?

ini adalah sebuah msg drpd yahogroups perubatan_mesir. utk sama2 kita take note
utk ahli PERUBATAN y belum subscribe to the mailing list, please do so here

******

assalamualaikum w.b.t apa khabar sume? dah lama x tulis kat sini, cuma nak ingatkan beberapa perkara Sejak akhir tahun lepas dan awal tahun ni, setelah dinilai beberapa universiti berdasarkan merit Housemanship di Malaysia, MMC telah menghantar beberapa pekeliling ke beberapa university yang calon-calonnya gagal melepasi tahap minimum pencapaian. Pendek kata fail housemanship. Atas dasar ini, MMC telah, sedang, dan akan menilai balik system recognization medical schools around the world, even the JPA has recognized them before. Sebab-sebabnya tak boleh dinyatakan di sini sebab sumber bertulis tak ada, hanya hasil perbincangan mesyuarat antara pakar-pakar perubatan di Malaysia tentang reputasi segelintir calon housemanship yang gagal dan hasil perbincangan ni bocor ke pengetahuan saya dalam beberapa bulan ini. Alhamdulillah SETAKAT ini nama university-universi ty di Mesir(candidates cairo , azhar, alex dan ain shams university system pembelajaran arab) semua berjaya melepasi requirement tersebut. Masa depan tak tahu lagi. Saya nk mencadangkan di sini semua pelajar perubatan dari tahun satu sampai tahun enam yang berkelapangan cuti summer ini, sila isi jadual cuti anda dengan membuat attachment di Malaysia dan di Mesir.

prosedur:

1.sila buat syahadah dalam bahasa inggeris di university masing-masing yang menunjukkan kita pelajar perubatan di syuun tulab u masing-masing( syuun tulab ada syahadah bahasa inggeris, cuma perlu minta).

2.sila buka website hospital-hospital yang berminat untuk apply attachment atau elective, dan apply online , sertakan syahadah tadi yang telah discan, atau apply directly di bahagian pengurusan hospital berkenaan, ada hospital free ada hospital kenakan bayaran, tapi perlu apply cepat-cepat sebab kalau HUKL tu, berebut tempat ngan budak rusia, uk, bla bla bla untuk buat attachment, kalau ramai sangat dia tak terima. pastikan tahu nak buat attachment di department mana, dan berapa lama, rujuk bahagian pengurusan hospital berkenaan pelajar perubatan di malaysia memang telah dibiasakan buat kerja-kerja practikal , dan hospital di malaysia memang dah anggap kalau dah H.O tu maknanya dah tahu buat kerja, tetapi pelajar perubatan luar negara hampir kesemuanya practikal insufficiency , sebab tu sakit sikit waktu masuk H.O nanti, kalau tanya abg2 yang dah masuk H.0 sume kata relax je, kalau akak2 lak sume suruh belajar betul2 jangan insufficient macam diorang, hakikatnya akak2 dari mesir la yg paling famous kat hospital masing-masing, humble dan zuhud katakan , bagus tul

antara kes-kes yang menimbulkan kontroversi tentang system pendidikan di luar negara:

1. h..0 ambil darah pun tak reti, pasang canula pun x tau,kerja2 basic ni la

2. present history kat M.O pun tak tahu(memang ada negara yang history pun tak belajar cara nk present)
3.basic surgery skill tak ada e.g. suture
dan macam-macam lagi, ramai yang digagalkan h.O tahun nih dan terpaksa menambah tahun sebagai h.o

kita di mesir benda2 asas H.O ni belajar waktu clinical dan H.O di sini, tetapi sume pelajar medic balik malaysia lepas tahun 6(kecuali kak battah) maka kesemua skill H.O tu memang tak cukup. Maka atas daya usaha sendirilah untuk memenuhi knowledge and skill gap masing-masing. orang lain tak dapat nak tolong.

antara sillibus yang disarankan oleh MMC(sila salin)(sama jer ngan sillibus cairo U ngan ain syams, u lain tak tahu, sila rujuk)

1. Infection control

• a.blood borne pathogen and standar precaution
• b.hygenic hand washing
• c.surgical hand washing

2.basic practical skill

• IV injection and venous blood sampling
• IM and SC injection
• IV cannula
• Arterial Blood sampling
• Urinary catheterization
• Nasogastric tube
• Sangestaken- Blakemore tube
• Oropharyngeal tube
• Endotracheal tube

3.Basic Life support

• CPR(sequences, drugs, technique, equipments)

4.Fluid therapy and blood transfusion 5. Basic surgical technique

• instrument
• Local anasthesia L.A
• suture materials
• needles
• knot-tying principles
• skin edge eversion
• simple interrupted suture
• vertical mattress suture
• horizontal mattress suture
• halving technique
• running cutaneous suture
• runing subcutaneous suture
• running intradermal suture
• buried subcutaneous suture
• wound dresssing
• suture removal

6.basic and emergency obstetric

• history,gynecologic al and obstetric exam
• antenatal care
• drugs to be aboided in pregnancy and lactation
• emergency reception room
• diagnosis in obstetric
• cases of emergency room
• labour room
• management of labour(sume stages)
• episiotomy
• shoulder dystocia
• post partum hemorrhage
• cesarian section
• contraception
• infertility

7.neonatal resuscitation and examination 8.surgical emergency

• post concussion
• polytrauma
• acute abdomen

9.preoperative care

hampir kesemuanya dah belajar waktu clinical cuma sillibus2 yg kurang penting ajer yg x diajar, suruh belajar sendiri, tapi kebanyakan h.0 yg sillibus kurang penting tu la yg tak tau, mana nurse tak bengis kat hospital, sume nk suruh dia ajarkan

kalau kat mesir ni cara sunat(circumcicion) diajar convensional method, kalau kat malaysia guna smart clamp tuh, banyak lagi la clamp dia, sangat mudah, suma bila complicated baru guna cara convensional balik, so update ur skill, sunathon tu p buat ramai-ramai, ramai pelajar medic cairo university dan alex yang tahu sunat orang tahun lepas, so belajar ngan diorang,

tolong start elective ni sejak tahun SATU, jangan balik bercuti kat malaysia makan tidur ajer, by the end of 6 years sume sillibus dah tahu buat, cuma tajamkan skill jer buat dengan cepat dan tepat sume prosedur-prosedur tuh

untuk sesiapa yg tak balik malaysia, contact senior yang x balik, menempel kat hospital dengan diorang, lain u lain prosedur, kalau lebih berani lagi, redah ajer hospital tuh, introduce diri,tanya boleh belajar apa2 tak di wad nih, tanya dr yang boleh bantu, jaga sopan sikit, jangan kerek waktu elective, doctor sume busy, kalau kerek alamatnya kena marah ajerla, kita nk belajar, apa yg dimarah tuh ingat, sabar nk jangan putus asa untuk cuba dengan lebih baik, pelajar perempuan cairo u tolong tanya akak-akak,saya bertugas kat labor room ngan internal medicine cuti nih, tapi dh ramai adik2 lelaki yg nak menempel, so yg akhawat sila menempel ngan akak2 pulak yer,

tip1. jangan berharap ada kawan nk buat sama baru nk buat attachment, kalau mcm tuh, dh hbs tahun 6 pun belum tentu buat lagi, x caya p tanya senior2, nak belajar, buat cara belajar, kalau xde kawan nk ikut, p blajar sesorang, niat ikhlas dan betul, insyaallah allah tolong, sy dulu main redah jer hospital kat mesir ni, lagi la bahasa arab, allah bantu, ramai jer doctor excited nak ajar,alhamdulillah
tip 2. senyum sentiasa, lebih2 lagi dalam O.T sebab operation ni sume org stress so kalau senyum at least hilang stress dr yg ajar tuh, dan dia pun lebih bermurah hati nk terang apa yg dia tgh buat waktu surgery tuh
tip 3. serius dengan ilmu, kalau dah tgk cases ata surgery tu, balik rumah trus buka buku kalau ada, atau buka internet baca skit2, baru ingat sampai akhir hayat
tip 4. jangan limitkan ilmu i.e jangan letak barrier dalam ilmu pengetahuan, pendek kata, jangan sesekali cakap, ni sillibus tahun 6, tunggu tahun 6 baru belajar, ni salah, the more u know, the wiser u'll be, learn anything u can, kalau x paham sekarang at least masa akan dtg u all akan paham sebab dah ada general idea, there is no limit to knowledge, org yg letak limit kat knowledge ni org "berotak sempit" -ramai lak tuh
tip 5. bawa gula-gula ke, belon ke, snack ke, kalau p wad paediatric, sangat memudahkan kerja

harap info ni dapat membantu,
faizal azmi
cairo university

******

Bala, ujian, dugaan dan kekurangan itu terkadangnya adalah suatu ‘alarm’ untuk kita merenung kembali sejauh mana telah kite mensasarkan diri dari jalanNya, terlupa akan tanggungjawab kita terhadapNya, menunaikan hak2 Dia dari kita, dan kebergantungan kita terhadap Nya selaku pemberi rahmat.

Cuti summer makin menghampiri, dan seperti biasa akan timbul krisis2 harga rumah; harga rumah dinaikkan lantaran trend tuan2 rumah membanding2kan harga sewa antara mereka. “your rent is so and so, then I shud make mine equal to yours or plus minus about that price’. And our baba, eventhough claiming that he treated us in a fatherly way and yes we do agree but still that shudnt be a reason for him to rise the rent up.

The exam format for first year students in conventional system as being claimed is different from the previous years. No more MCQ isn’t it? I supposed that’s gonna be quite tough for them.

The juniors in MMMP are currently having their exam in these few days and most of the responses regardless from sem5, sem2, or else

"susah tp boleh jwb" “dun ask me further” “it’s quite hard” “ ’ “ :((‘ "mabuk la" etc

Dr said brief us about our impending exam on jun 28, telling that it’s gonna be quite tough. :|

“ Allahumma sahhil-lana abwaaba rahmatik “