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"So, what is CCF?" "Congestive Cardiac Failure" "No. I'm not a heart man. I'm a brain man. Something related to neuro please.I'm heartless." - Dr. Pulli (Neurosurgeon, QE2) "Ermm" "Haiya. Carotid Cavernous Fistula" . God put us exactly where He can strengthen us. #Drwawa #electivepostingyear4 #neurosurgery

Harini, life Najwa :) Alhamdulillah. Kind of warna warni. Primary Health Care (PHC), term baru for my life :)  Theoretically , yeap. Memang lesu. Luls. Mungkin, most of it adalah tentang data. So, agak* la lesunya tu. Hehe. Tapi, prof yang baik dan positif adalah advantage nya :) Najwa suka.  . So, perkara yang menarik harini untuk di kongsi :) PENTING ya!  The 5 key elements of healthy lifestyle: 0 - 5 - 10 - 30 - 150 RULES 0 = 0 smoking 5 = 5 serving of fruits and vegetables (Try to put those in the menu) 10 = 10 min of relaxation and meditation 30 = 150 = 150 min exercise/week Yah!  . Potential benefits: 40% - 65% reduction in all-cause mortality 81-87% reduction in coronary heart disease events 67% reduction in all CVS disease 50% - 71% reduction in the risk of stroke 58-93% reduction risk developing type 2 DM 36%-60% reduction in cancer deaths SubhanAllah :) if we can actually adopt...

So what is the clinical features for Down syndrome patient? Erm. Erm.  That's how my friend react when that specialist asked her that type of question. Mungkin blur. Mungkin sudah lama tidak ulang kaji. That's life! Bukan semua benda mau ingat! luls. "Tapi doctor WAJIB ingat! Kesian kat patient hah!" BAIKLAH. . Ok. Bayangkan patient berikut datang pada anda. Apakah yang anda boleh describe based on your observation? So, based on what we learned, those clinical features might be there, 1. Hypotonia (80%) Muscle dia lemah-lemah ja. Tapi, ada ja yang cergas berlari-lari. Riang ria ceria lagi ya :) 2. Poor moro reflex (85%) Ha, boleh google apa itu moro reflex eh#youtube you. hehe 3.  Hyper-flexibility of the joint Cuba tarik your jari up right now. Dia leh bend until mana? At least 85 degree la or 90 degree la. But this kids, dia boleh buat 150-180 degree bend beb! Fuh! But as usual. Bukan semua. hee.  4. Excess skin on the b...

And seriously, that situation was pathetic and hard. It made my eyes slightly  accumulated with tears and deep down broken inside. That kid, an Indian boy. he screamed out loud until the whole ward can hear him. I was in the next room. Did a physical examination upon a 1 month age boy who was diagnosed with bronchiolitis. I ran to the next room! . That boy screamed almost like hell! This is painful!!! He had severe headache that started a few days back. I didn't clerk his case, so I can't figure out the specific history. But he looked severely irritated. He knocked and kicked anything and everything around him! "Stat the vancomycin now sister!" "Ok doctor" . "He might have radang otak . Stat for lumbar puncture and CSF analysis", said the MO.  . I left the room. As my eyes can't cope with the feeling that I felt. Sad. Kecik-kecik dah kena gitu. (*Hati tisu*) Jangan nangis. Jangan nangis. 'Mengong Dr Najwa neyh eh...

Berdenyut-denyut. Spread. From the back area of your neck to the parietal part of your skull. Mungkin, peredaran darah di bahagian circle of Willis kau ndak lancar. 'Cess! trip-trip MBBS' lol*  Tapi serious. Harini kau bangun dengan disease tu. Rosak pagi kau, maka rosaklah juga separuh hari kau. Separuh ja? "Ya, separuh ja. Sebab start 2 petang, kau enter clinic. Clinic paeds :)  * Patient came dengan kerusi roda. Hensem budaknya. Mak kata, can't stand properly. Can't walk properly . Apa yang inappropriate tu? 'Dia boleh berdiri. Tapi kaki dia flexed . Bengkok. Ndak boleh tegak. Cam something sekat dekat lutut dari dia tegak. 'Oh'. "Apakah itu?  Since aku belum posting ortho lagi. Aku pun  buntu. Mungkin kau boleh share dengan aku. Hee" * The other one. Anemic . Common case dekat clinic. Common case jugak dekat ward. Reference range for Hb concentration - Men- 14-17.5 g/dL Female - 12 - 15.3 g/dL Paeds...