IMU Research Day.

I was in a deep sleep in a chilling rainny afternoon. Suddenly the ringtone of sms woke me up. Still semiconsicous and delirious, I open up my inbox. It was sms from Nikram. He has 1 good news and 1 bad news for me.

From the sms:

Nikram : We got accepted, but he wants us to shorten the research, make it into point form.

Me: Accepted?? Meaning? We need to present on the IMU Research Day?

Nikram: Yup, when you coming back?

Me: Next week, so I gonna present...........?

Yes, the good news is our group got choosen as the best 5 ( I wonder how many groups participated?? Maybe only 5 groups?) and we are gonna present it next week in front of the judges.

The bad news is I am the one presenting....Tsk tsk tsk..........Nikram claims that he has stage fright and he will faint in front of everyone. Due to another 2 group members doing elective outside Malaysia currently, the chances either me and Nikram presenting is 50-50%, but now seems like 100% I will be doing it. Nvm, because I am now having clinic posting in Penang, Nikram is the one who do most of the things for this competition. (except the front page poster) Meeting Dr. Shane and Prof. Teng, come out with an abstract, printing out the research summary, working until very late every night, finding info about our research tool "MINI questionaire" I received a call from him today morning 3am to discuss about the summary. That means he still doing it this morning before passing up. So I think he has contributed a lot for this.

So yes~~~~~~~~~ I am going to present next week. I am going for guillotin next week. Need to discuss alot more with him before the presentation. Wish me luck.

The guillotine was a device used for carrying out executions by decapitation.The device is noted for long being the main method of execution in France and, more particularly, for its use during the French Revolution.

Research Designer

Phiew....~~

Have been sitting in front of my laptop in Coffee Beans since 1:15pm just now. 3 hours!!!!!!!!! trying to come out with a poster about my research project. Initially I promised Nikram I will send to him via mail before 2pm, I thought I can come out with something in less than 1 hour...sigh~~~ It is not as easy as I think........Without any "pro" or "semi pro" software system, NOT EVEN A PHOTOSHOP....I designed it using Microsoft Power Point.

My final product....
I know what you guys are thinking after seeing this..~~~~ JUST DONT ASK!!!

愛回來

Insomnia

Hates the feeling of insomnia. I went to bed at 12:50am but now is already 2:50am....I still cant fall asleep. I took some black coffee hours earlier but this shouldnt affects me, I thought I have immuned to the effect of caffeine.........sigh...you tend to think about many things when you are alone at night, or early in the morning......My jogging plan is still on, never ever skip jogging.

Tmr onwards I should be busy doing my research. "IMU Research Day"......my research tutor is interested in joining the competition, although all of our group members not very keen on joining the competition, who cares who is the winner.....but what to do....the tutor said yes, we must follow. Worst still, with 2 of our group members on selective and elective holiday, only me and Nikram doing the job. Anyway, I rather be busy all the time.....keeps my mind occupied, keeps other things aside. Tmr I probably will go jogging in the morning and doing my research and EBM the rest of the day. Thursday night I will be joining my friends for futsal at Billion. I went to my primary school gathering at sunset bistro in Batu Ferringhi yesterday, but all of us (guys only) will be going out again, most likely steamboat dinner (and guys talk) before I go back.

Another friendly football match on Sunday morning, and that's it....GP posting on the following week.

What else can I do at this time? 2:54am......

Finish!

Finally, I finished reading the book I supposed to finish it 3 weeks ago. Good book!!!! Bravo Bravo....This is the first book I read from the author. Richard Montanari, Italian author?? Alright, back to the shelf....what's next??

Owen-Simply the best

Owen to the rescue at 96th minutes. "Alex, you should reconsider about keeping Owen on the bench."


ago, you were one of the most dangerous strikers in the world. Being the youngest English player in the World Cup history and scoring a fantastic goal against Argentina. Since we started playing and watching football in primary school, we keep hearing the commentator yelling your name once you scored. The crowd keep singing your name while you were playing. People wearing jersey with your name everywhere. Even thought you were playing for our rival, and always score against us,but we still love you.

11 years now, you may not as fast as when you were 19 years old. You may not score as often as last time. We all know that you had a bad season in Madrid and Newcastle. We know that injuries keep you out of the field for long period of time. The football fans keep talking about Benzema, C.Ronaldo, Drogba or Torres nowadays, but we are still living in the world of Michael Owen.

Once the match against Manchester City started yesternight, we were dissapointed again that they keep you on the bench again, we were hoping that you will play during the second half. Everytime M.C. score against us, we were very upset, frustrated and get impatient to see you back in the field. Trust me......If we were in the Old Trafford last night, we will run towards Alex Ferguson to beg him. Finally at 82nd minutes, we saw you taking down your jacket and walking down from the subsitution bench, that's it.....~~ we hope that you will score winning goal for M.U.

Sadly near the end of the match, MC players were holding the ball very well. Injury time approaching, but we still holding on with our wish..........We wish that you will score the winning goal, to prove to everyone that you are still a dangerous striker. Is just like a kid wish that he can play with the stars on the sky.....with the injury time approaching 5 minutes, we know that in reality it is quite impossible.

Out of sudden, we saw you standing at unmarked position and you were holding the ball...the next thing we saw was the ball is already in the net.. "Yes..~!!!!!!!!!!!!!!!!!!!!!!!! Woohoooooo~~~~!!!" you really score~~~ and is a winning goal......we were the loudest when you score...

People and the press may try to write you off nowadays, but we will still support you. Yesterday was one of the greatest MU match in my life. We all very happy because MU won the derby, but we even more happier because you are the one who make it happened. Owen, simply the best.

I want some distraction

Trying my best to keep myself busy....distraction distraction distraction.......................

2 hours in KK pharmacy.

I visited the Pharmacy in Klinik Kesihatan Ampangan last week, because that day only half of the group had Clinic session with the doctor, for those without clinic session we are required to visit either the pharmacy, lab, X ray room or treatment room. My friend and I decided to go to the pharmacy. It is important for us to learn about the medication commonly prescribed from the community clinic. The form (capsule or tablet), dosage and colour, because sometimes we need to make a good "guess" when the patient said:" I usually eat the love shape white tablet for my cholesterol". Not everyone will remember the name of the medication given by their doctor.

Tablet Metformin

Tabet Glibenclamide.
Tablet Amoxycillin

Tablet Ampicillin

Tablet Erythromycin

Tablet indometacin.

The "love" shape Lovastatin, Tablet Cephalexin, Tablet Atenolol.

My EBM report.

Spend most of my weekend doing Evidence Based Medicine commentary report. From what we have seen in the clinic, we need to come out with a learning issue, and try to find research paper regarding that topic and make a conclusion. Last time during semester 6 my topic was " Comparison between Cardiac troponin and CKMB as leading cardiac marker in detecting heart attack". This time, my topic was "How effective is antibiotic in treating sinusitis". Surprisingly, from the research paper I've found, antibiotic has no significant effect in treating sinusitis. Whether or not patient was given antibiotic, the duration of illness remains the same. After 2 weeks, 83% of patient and 77% of patient will eventually recover. So should we give antibiotic?

I love this song.

I used to love lots of song from the Hong Kong TVB drama, but this song is one of my all time favourite. Sad to say that I haven't watch this particular series yet, and I doubt I have the time to finihs watching it, heard is 40 smth episodes?? is that true?

09/09/09 Shall we make a wish?

09/09/09, make a wish?

My friend told me that if you make a wish at 12am at 09/09/09, your dream will definetely come true.

I dont have any wish right now, so I hope I can wish for other people in my life.


My 9-wish list:
1) I wish my parents in good health condition for many many years to come.
2) I wish my sister and my brother in-law a happy family with their daugther, son in the making.
3) I wish desiree and deslyn will healthy always and become a good girl in the future.
4) I wish those of my friends who are still single, will find someone soon.
5) I wish those of my friends who is in relationship right now, will happy and lasts forever.
6) I wish that he can recover from this tragedy and gets his feet up again and be strong again in life, free from financial problem.
7) I wish she can find somone she love and can take care of her forever.
8) I wish that he can be accepted by people in uni, no more hatress.
9) I wish Justin will become a famous consultant next time and start practicing 검무 every night ( this is the most simple I can think of , peng you.)




If only one wish is allowed, then I wish all living things in this world will have a good night sleep at least for tonight, free from suffering, free from hunger, free from danger.

Lesson in clinic

Today in the KK Ampangan.................


KS: "Okie Pagi Puan, nama saya Kean Seng, pelajar doctor, saya akan tanya beberapa soalan boleh?"


Puan: "Boleh..."


KS:" Puan datang sebab sakit apa?"


Puan:" Saya ada migraine..."


KS:"Oh, sudah berapa lama? "


Puan:" sudah 3-4 tahun."


KS:" Dulu ada tengok doctor?"


Puan:" Ada....doctor swata"



KS:" Doctor bagi ubat apa?"


Puan:" Doctor bagi Ergometrine, Ponstan and nasal spray."
(Wow....Kean Seng is happy that she still know what medication she is taking, not taking it blindly)


KS:" Keluarga ada siapa ada sakit tak? biarpun migraine atau sakit lain."


Puan:" ibu bapa ada hypertension dan diabetes, adik ada asthma, saudara ada dua orang ada sakit, satu Lymphoma and satu renal problem....ARF"

(ARF.....?!!!!!! Lymphoma?!!!!!!! somemore use the word "renal" ????? Wait wait wait........this is not right man, normal people usually wont use the words renal and ARF......who is she actually)


KS:" Puan, kerja apa ya?"


Puan:" saya kerja di hospital.."


-_- no wondeR she knows about ergometrine, ponstan and uses the word renal rather than kidne and ARF........


Surprise but still remains calm.


KS:"Oh....hospital mana?"


Puan:" Hospital Tuanku Jaafar...staff nurse"



0_O HTJ ???? (Our teaching hospital!!!??!!)



well, nvm......

calm calm calm calm calm calm...............


KS:" Sebagai nurse?"


Puan:" Ya......"

I see.....nurseeeeeeeeeeeee...........my kakak (I used to call nurse kakak, they are like my sister and teaches me many things in the ward)


KS:" Oh........kat mana department?"


She smile and said....


Puan:" Surgical................." :)








KS....!!!!!! YOU NOOB!!!!!!!!!!!!!




Lesson of the day:" Must always ask the patient about their occupation, even before the ch ief complaint."



Later, during examination....Kean Seng has fine tremor and have difficulty in taking temperature, not because he was afraid of the nurse but this is the effect from the shock during clerking.

Recycle and Reuse

Yes, It has been quite some time (approximately 1 year) since we cleaned our house. The dirtiest part of the house was supposed to be the cleaniest place, the Kitchen, this is unacceptable...~!! However, no one should be blamed because most of us were quite busy during the weekdays(on call, seminar, TBL preparation, case presentation, IMS, research, case reports, case summaries and all that stuff....) and weekend was the only period of time for us to revise all the things that we learned during weekdays.

Besides cleaning the house, I recollect the empty soft drink bottles that were being left on the floor for the past 1 year, wash it with water and left it in 1 corner of the house. So that I can bring back to Penang for recycling. Recently I chose recycling as one of my hobbies, because I think it is something useful and do good to our earth.

The word "Recycle" came to my attention 2 year ago. I received a call from my lecturer in KDU, Mr Low. He is in his 40s, a very friendly guy who taught us Maths in A-Level. He is a vegetarian. During college time, we used to join him for lunch in a vegetarian shop nearby our college. Because of him, our college has this so called "vegetarian" day during the 1st day and the 15th day of the chinese month. The famous "tsu zhi/charity" located near our college (not that Penang is very big anyway, everything is so near). The tsu zhi will provide lunch catering during the 1st and the 15th day of the month, each lunch box costs RM3.50. All the money received from the food catering will be donated for charity. For example donation for old folks home, donation for dialysis centre maintanence, donation for victims during natural disaster. So we started this vegetarian lunch cater in our A-level class, I was being elected as treasurer to collect money from those who ordered. Initially only few people in the A level department order for the lunchbox, slowly everyone gets to know about this charity program and more and more people started to order. Later on others department in KDU (Engineering, IT, Business etc) also joined in the programe, even the mangement people also started to order a few lunch box every month. Everytime when the vegetarian day comes, a few of us will follow Mr Low in 1 car to the Tsu Zhi and collect the lunch box from them, we then help to distribute the lunch box to different department. I remember near the end of my A level before I left for IMU, the total record of order was 70 lunch box!!!! I went back to KDU last 2 weeks, the programe still going on but still the record still not broken yet. :)

Mr Low and our A-level class.

After I left KDU, he and a new batch of students formed a club called" GO GREEN CLUB" to in charge of recycling program in KDU. I received a call from him during my semester break and he invited me to join a seminar in one of the private hospital in Penang. What is so special about this private hospital is because everyone in ths hospital, including the management, doctors and nurses participate in recycling program. The hospital has won several awards on its achievement in saving the number of waste produced. They re-use some paper for paperwork, use disposable lunch box, recycle the medication boxes and many more. Every week they have roaster for staff nurse and doctor to volunteer in the recycling room to sort out the waste paper, bottles or boxes for recycle. Since Penang KDU is starting its own recycle program, the person in charge from the hospital agree to share the experience.

We actually produced 15,000 tons of rubbish everyday.Sooner or later, we are running out of space to dispose those rubbish. More and more trees being chopped down to produce paper and tissue. More and more plastics being produced and it takes thousand year to dispose them. Recycling actually reduce pollution and saves energy, because in order to make product we need raw materials therefore results in more pollution and usage of more energy. According to expert, a lanfill can last 10 years longer if malaysian recycled 50% of their garbage. Instead of throwing in the dust bin, why not throw it inside recycle bin for recycle, just a little more effort and you are doing something to protect the environment. :)

I brought back 2 boxes of empty bottle and waste paper to college for recycle during my last visit. I agree that it is time consuming to collect, wash and pack the waste before we can send for recycle, but when you think of your children and your grandchildren, in order for them to be able to continue enjoy the clean enviroment we used to have when we were small kid, it is worth doing it. Anyway the earth is our home, we should keep our home clean. :)

And...........

IKEA, you rockksss~!!

Anyone has anything to recycle please let me know, I will collect them from you. :)

Back to the ward.

Feels good to be back in the ward again. I went back to medical ward yesterday after being asked by my friends . I will be quite free and relaxing during this semester. Their emotion and facial expression reminded me during the time when I was semester 7. Those feelings when all of us feel lost and dont know what we will be facing in few months time. "This is just the begining......."this words keep flashing through my mind during that period of time.

Well, no harm for me to learn more. I agree to go back to the ward and try to elicit clinical signs from the patient with them. I was glad that I have group of seniors who taught me a lot since I came to clinical school. I believe that without them, I won't have passed the exam. I think this is the time I should help the others, those who will be sitting exam this semester. A part-time lecturer told us in the clinic :" In medicine, you must always have mentor or senior around during your clinical practise, it is impossible for you to know all and you should keep asking and most of the time you need help from others."

The wards still looked the same as last time when I was semester 6. The only thing different was the doctors and nurses. Now it is a compulsory from Ministry of Health for all the hospital staffs to wear surgical mask as long as they are in the hospital, because H1N1 is on the heat now, sometimes you wont realise that you just walk passed a H1N1 patient who is waiting for registration.

Since we were banned from entering hospital a week before exam, I've never been in the ward until yesterday. The feeling was kind of weird :" I am back....." all the doctors and nurses with familiar faces, busy working on the Friday night, I saw a group of doctors and nurses resuscitating a patient on the bed. Although they were all wearing mask, but I still can recognized some of them. I really miss this place man.....As a small kid 20 years back, I remember I always get excited to be in the hospital, whenever my parents went to hospital for health screening, I always wanted to follow. I like the smell of the hospital, I like to work in the hospital. Crazy guy.......lucikly I dont have Malingering or Maunchaussen syndrome.

I miss talking to the patients.

"Pak cik rasa macam mana sekarang?"

"Pak cik sudah masuk ward berapa lama?."

" Aunty, can I check your stomach for a while?"

" Pak cik tinggal mana, dengan siapa?"

" Oh pak cik dulu kerja Army kah?? Air force army!!!! Seronoknya...so sekarang pencen enjoy life lar...haha"

" Adik, awak ada rasa muka atau badan warna kuning kuning?"

" So uncle, how long have you stopped taking TB medicine?"

I saw an elderly patient with CML (Chronic Myeloid Leukemia) with skin metastasis, which I think is quite rare to find someone with skin metastasis. He looked confuse, his eyes can barely opened. He can hardly speak clearly which I think is because of the obstruction from lymph nodes around the neck. My friends and I examined him. He has massive hepatomegaly and massive splenomegaly. I never felt such a big spleen before in clinical school. Yesterday was the first time and also the first time I saw a skin metastasis. I dont know whether I will see this patient again or not, and I not sure how many time left for him, but for sure I will remember him.

Another case I saw was a patient which I guess has infective endocarditis. Yesterday was the first time I able to appreciate 2 different murmurs from same patient, and another patient diagnosed with Gonorrhea infection with Reactive arthritis aka Reiter Syndrome.

Helping juniors = helping myself. If not because that I followed them back to the ward, I wont be able to see the 3 cases above.

:) just back from futsal.

Just finish playing futsal with friends again. Haha..... Happi :)

Tuesday played futsal, Wednesday chill climbing and today played futsal again.

Damn, is almost 12am now and I havent really study anything yet. I should study about antibiotic now. Tommorow we having clinic session at Clinic Ampangan again, and later of the day we are having plenary regarding "care of the elderly." Then that's it! end of the week 1 of semester 8.

Healthy semester

Ever since after exam, I tried my best to make sure to be healthy. Few weeks before exam and especially during study break, that period was the time that I consumed all the high trans- fatty acid and cholesterol diet. (Mcdonald's, KFC, Mamak etc.), slept around 3-4am in the morning and woke up at between 8-9am, my sleeps were severely deprived, still yet to consider that I abused coffee 3-4 cups everyday. Mental and physical stress that triggers more corticosteroid hormone to release in my body. Therefore, after exam, I make sure that I sleep around 12-1am and woke up at 7-8am in the morning. Limit myself to 1-2 cup of coffee per day, less sugar, no more fastfood until next the next final exam. More fruits and vegetables. Must make sure that I exercise every week. I remembered back in Penang, I used to jog with my friends at least twice a week, 8 rounds in a size of a 8 football fields. We played football every Saturday morning, no doubt and there is no need to call people for football, all of us will eventually turn up every Saturday.

I was lucky that during the past 1 week of holiday I jogged for 3 times in Botanical Garden,alone. Because 2 of my friends who used to jog with me still studying in other states. One in KL and another one in Nilai. Yesterday I played futsal again with IMU friends, which was fun. It was not as tiring as I was when I played with my friends in Penang. After abstinence for some time, the first time I started palying futsal was with friends in Penang, crazy.......!! that was like hell, tiring as if I was going to collapse due to dehydration and exhaustion. :)

Semester 8 is going to be a HEALTHY semester. We have more free time, not as busy as semester 7 because no major exam, althought we still have minor posting exam. I hope we have more time playing futsal together, sometimes I can go jog around my house. At the end of the day, as a medical student and doctor in the future, I think we should set a good example of healthy diet and lifestyle before we can even tell patients to reduce their BMI.

Today I only got class at 2pm. I woke up at 8am this morning, had breakfast in Aukland. I ordered 2 oat meal breads and 2 half boiled eggs, together with Nescafe ice less sugar. Enjoy reading my book and breakfast at the same time. What a life man!!

A wet new start

Yes yes...I told myself early in the morning that today is a brand new start, a new semester. Very reluctant to get up from bed though. I should be sleeping comfortably on my bed in Penang right now.

My first posting is Family Medicine, basically it is similar to what's doctor doing in the clinic right now, so we dont have to go back to the hospital yet. Most of our time will be in clinic, I hope.

Today is quite a "cold" welcoming day for us who came back to Seremban from holiday, because its rain heavily today. The sky started to get dark from 930am with heavy clouds, and it started to rain from 10am, since then I dont know when the rain stopped. Too bad that we are required to go clinic even is only the first day. This time we were posted to Klinik Kesihatan Ampangan, 20 mins drive from the General hospital.

The main problem we heard from our lecturer about Klinik Kesihatan Ampangan was that the parking is always the main problem for those who works there or for those who seek medical care. Parking place is so limited there that we need to park our car up hill and walk down to the clinic, so....Raining is not a good sign....However we still managed to find parking near the clinic, we quickly ran out from the car. We still get wet....Today we only saw one patient, mostly because of the introduction of the new posting by coordinator. Other days we were expected to be there at 8am.

I still struggling to get back to study mood now. Somtimes my mind will start thinking about the things I did with my family, my girl friend and my friends back in Penang. I think it takes time to get back to normal. Is normal for anyone I guess....

I dont think I will study tonight.