Article : Is Competition Important in Medical School?

Came across the article : 'Is Competition Important in Medical School?' . I think it's a food for thought, especially in one of the most competitive fields in this world. Claimed by certain people, medical field has the most smart people. Before you gonna start scolding or backfiring me, i swear to god that i never said that in my whole life..Perhaps after reading the article, medical students or doctors out there would like to share few words about that?

Food hunting n last post

Today is the 1st day of my summer holidays...Since we are going to backpack in Europe for 11days, we went to Real (a hypermarket in Volgograd) to get food stuffs for our trip( after calculating how much we have spent for transportations and accommodations, we think it's wiser to buy food stuffs which are cheaper here n eat along the way, in order to save some money). I estimated that we have bought about 12kgs of stuffs ( biscuits, cakes, instant noddles, chocolate bars, tuna...) and i hope that would save us some money in countries which trade only in Euro ( 1 euro = rm5.13).. Wondering when the day which rm1=5.13euro will come? perhaps in my dream?haha... Our destinations will be Vienna (Austria), Prague (Czech Republic), Krakow(Poland), Amsterdam(Holland) and Cologne(Germany). We will depart from Moscow to Vienna on 7th July, and then fly back to Moscow again on 18th, and catch the flight home on 19th...Oh ya..i will go with 2 friends..Who they are? Wait till i update the photos when i come back k, then you all will know. Stay tune GUYS.(specifically, to the GUYS)
I guess this will be my last post, till i reach Malaysia on 20th...At the mean time, tiger will update this blog whenever she is free...All the best to you tiger, in your block 4 exam and uni. I will always pray for your health and success...

Histoplasmosis

I was asked by my dear what's the other name of histoplasmosis. Ok..i admit i am dumb, and before this, i jz knew histoplasmosis is a fungal infection which mostly affects the lungs,that's all. So i decided to find out more about it...(though i am having summer holidays now, my 'CME' still goes on ok.Haha!)

Histoplasmosis (Darling's disease)
Etiology : Histoplasma capsulatum

Epidemiology : throughout the world, and endemic in certain areas in the USA.

Transmission : It's contracted by inhalation of the spores from soil or guana. It isn't contagious!

Clinical picture : After exposure, the symptoms will appear in 3-17 days (average 12-14days).
Most patients show no apparent illnesses. The acute phase of histoplasmosis is
characterized by non-specific respiratory symptoms. Chronic histoplasmosis cases can resemble tuberculosis; disseminated histoplasmosis affects multiple organ systems and is fatal unless treated.
Severe infections can cause hepatosplenomegaly, lymphomegaly and adrenal
enlargement. These lesions tend to calcify as they heal.
Ocular histoplasmosis can result in loss of vision.

Diagnosis : Look for the fungus in the blood, sputum or infected organs. ELISA or PCR. It can also be diagnosed by a test for antibodies against Histoplasma in the blood. Histoplasma skin tests indicate whether a person has been exposed, but do not indicate whether they have the disea

Treatment : Antifungal medications are used to treat severe cases of acute histoplasmosis and all cases of chronic and disseminated disease. Typical treatment of severe disease first involves treatment with amphotericin B, followed by oral itraconazole.^[3] In many milder cases, simply itraconazole is sufficient. Asymptomatic disease is typically not treated. Past infection results in partial protection against ill effects if reinfected.

(Source : Wikipedia)

p/s : For those who laughing at my dumbness. Pls do it in private ok...Feel so bad now..Certainly have to study harder now...As my hsmate and i always say, 'have to turn into new leaves' next semester...But, after few semesters...i am still the same old leaf..Perhaps next sem?..Haha..

Pleural effusion : transudate vs exudate

Learnt about differentiating transudate and exudate based on Light's criteria.

Light's criteria :
1. Protein - pleural fluid : serum >0.5
2. LDH - plueral fluid: serum >0.6
3. LDH is more than 2/3 normal upper limit for serum

Twenty-five percent of patients with transudative pleural effusions are mistakenly identified as having exudative pleural effusions by Light's criteria. Therefore, additional testing is needed if a patient identified as having an exudative pleural effusion appears clinically to have a condition that produces a transudative effusion. In such cases albumin levels in blood and pleural fluid are measured. If the difference between the albumin levels in the blood and the pleural fluid is greater than 1.2 g/dL (12 g/L), it can be assumed that the patient has a transudative pleural effusion.

If the fluid is definitively identified as exudative, additional testing is necessary to determine the local factors causing the exudate.

According to a meta-analysis, exudative pleural effusions must meet at least one of the following criterias.
1. Pleural fluid protein >2.9g/dl
2. Pleural fuild cholesterol . 1.16mmol/l
3. Pleural ADH more than 60% of upper limit for serum

(Source : Wikipedia- pleural effusion)

Graduates 2008

Dang dang! Let me present to you the future dentists :-D...Got 2 leng luis here....Look by yourself...

















The most precious moment awaited by every student :-)


















The graduate, Dr. Chu Wooi Cheat. (profession: going-to-be dentist, status : unknown), pls let me know if interested.:-D

For more photos , visit Peanut...Today my summer holidays started...Dunno wat to do now..haha

luckiest...

Recently things din go as smoothly as i wish.. dunno whether is because of exam stress...or unneccesary fear of uncertainties and sufferings in life...having a hard time esp these few days.. but god stil loves me a lot.. by sending him to me.. Luckily i have him who listened to me all the time whenever i got stressed up ... whenever i m sad.. whenever i got angry at myself for having nonsense thoughts... with all the patience..again and again he is there for me ...though at times i already got fed-up at myself ..thanks dear.. :-) I promised i wil help myself too.. my dear is studying now..so I help him updating the blog.. tml he will be having last paper internal disease then holiday starts...all the best to the mouse n his fellow frens...:-) nitez...

Mnemonics : Risk factors for IHD & Complications of MI

Came across these 2 mnemonics in the book , Pathology SECRETS 2nd edition, by Ivan Damjanov.

1. Risk factors of IHD - has lipids

• H Hereditary
• A Age
• S Sex (male)
• L Lipidemia
• I Increased weight (obesity)
• P Pressure (arterial)
• I Inactivity (sedentary lifestyle)
• D Diabetes
  
• S Smoking

2. Complications of MI - appearance

• A Arrhythmia
• P Pump failure
• P Pericarditis
  
• E Extension of the infarct
• A Asystole (Heart block or VF)
  
• R Rupture (free wall of the ventricle, septum, or papillary muscle)
• A Aneurysms of the ventricle
• N Nervousness (fear of reinfarction)
• C Coagulation problems (mural thrombosis)
• E Emboli
  

p/s : all the best to fellow friends who have internal diseases and obstetrics exam tomorrow.

New site for medical students

Spotted this new site : Medicine for medical students. For those who like quizzes and questions, certainly this is a site not to be missed. :-)

almost the end..

today officially end of lectures for all 3 main subjects for 2nd year..remaining is forensic medicine and few lab sessions and revision...tiring day... 10 more days to block 4 exam...nearer and nearer..count down starts..

p/s: today my dear very charming :-)

Just a thought - post-obs...

Came across this article by Anna Burkhead : The Scariest Med Student of All. It remains me of kiasuism ( Kiasu - being afraid to lose to others, in Hokkien dialect) among people nowadays. It just exists at all levels of life, from kindergarten to school, then to work, even after retirement. I wonder if kiasuism is the sole driving force for the betterment of this world? As for the article mentioned above, it's about how medical students try to supersede their fellow friends in front of their residents in the US. There was a time, and even now a debate on quality of medical graduates from countries like Russia, Ukraine going on. I don't deny there are black sheep among us, but there are bunch of people who study hard, work hard, to become better doctors in the future. Other than looking down at these students / graduates, i think the doctors (MOs, specialists, consultants) in Malaysia have better things to offer.To the doctors, by training these graduates into better doctors, so that they can fit into the local health system, so that they can practice medicine safely and independently in the future. By sharing what you know, your experience, so the younger generations can benefit from it. After all, in the future, we will just be in the same boat. The quality of health care in the country doesn't just depend on just a small bunch of doctors,but on all of them...We may have House-like physicians, world-class surgeons,but i doubt the number of these doctors will be sufficient to care for the health of 27 million people? Since absorbing them into the system is inevitable. Why not just accept them , train them, teach them? If really wanna make thing harder for these graduates, common qualifying exam, is the solution , though i am fear of it too...At least this will make students to strive even harder.
Arghh...post exam state, the longer i stay, the more nonsense i speak...good night everyone :-)

p/s : sorry ppl, for bringing up this old boring issue again...

Invitation card for graduation 2008

Got an invitation to the graduation ceremony tomorrow afternoon, from the dentistry senior, Dr.Choo aka the Mouse ( the genuine one in Volgograd city, while i am the fake one.lol). This year the graduates come from various countries, total 24 in number ( Msia, China, India, Vietnam, Kenya....), flags are shown, you name them all.. Will update this event after tomorrow.

1 more down, and 1 more to go

Today had my obstetrics exam. Huh...finally it is over...Others i makan baby, tidur baby, hidup baby. lol...Even when sleeping, my mind was jz full of women ( i meant the mothers) and babies... Next exam will be internal diseases which falls on 28th. After that, officially, my summer holidays start. ( and officially, my 4th year ends). Will go jalan-jalan, makan-makan and tengok-tengok in Europe before going back to Msia on 20th July.

Modified version of 4Ts

Modified version of 4Ts as suggeted by Darren :

1. Tone (75% of cases)
2. Tissue (15%)
3. Trauma (5-10%)
4. Takes too long to clot / coagulopathy.

Modifications include :
1. Causes are arranged from the commonest to the least.
2. Thrombosis is changed to Takes too long to clot / coagulopathy.

Thanks Darren for his suggestion :-)

4 Ts - for postpartum hemorrhage (PPH)

To remember causes of PPH, just gotta remember 4 Ts

1. T - trauma - e.g laceration of cervix, uterus
   
2. T - tissue - e.g retained placental tissue, placenta accreta
   
3. T - tone - e.g atonia / hypotonia of uterus
4. T - thrombosis - e.g coagulopathy

Any1 wish to add, jz leave a comment.
Any mistakes, jz correct me.

Sony PSP for sale

Sony PSP for sale (only in Volgograd)

- Condition : Good, less than 12months old
- Accessories : Original earphones, charger, carrying case, protective cover, 4GB memory card and 40 games.
-Price : 6000rubles (negotiable)

If interested, pls leave your contact.

Thermal burns - by Dr.Chew

A post on Thermal Burns , by Dr.Chew...Managed to revise how to estimate TBSA (Total Body Surface Area ) , on adults and children. Below are a few Q&A from that post which i would like to share with you :

Is there any other formula to use to calculate fluid requirement besides Parkland formula?
You can use the Galveston formula, which is based on BSA rather than body weight. Although many pediatric burn centers believe it is more accurate than the Parkland formula, it is more time-consuming to calculate.
URL: http://www.emedicine.com/emerg/TOPIC72.HTM

How about the use of Silver Sulphadiazine (SSD)?
When I was a house officer (HO), SSD was recommended for all types of burns especially for first aid measure in A&E and for daily dressing, as long as it was a burn case, the HO would order for SSD dressing daily and the staff nurse would apply the SSD every time a burn dressing was changed.

But increasingly there are published papers to say comparing SSD with other methods like using hydrocolloid dressing (Duoderm), and even honey and found that SSD has not been found to be superior; in fact, worse in terms of healing rate, repigmentation, etc. Click here to read a good review article comparing SSD with other agents.

Evidence exists that the use of SSD may place patients at increased a risk of
1. developing neutropenia
2. erythema multiforme
3. crystalluria, and
4. methemoglobinemia


For the complete post on Thermal Burns, please visit the following link.

favourite bookmark...

Friday night again...another week again coming to an end..anyway tml stil have lecture and lab to attend...

recently while choosing a present for a fren , a book mark in the gift shop attracted my attention..which give me a cheerful.. carefree feeling... love it so buy it and put on my study desk.. **SMILE ** :-)

While waiting...

In the middle of preparing for my obstetrics examination. While waiting for my dear to talk to me( she is now entertaining 10 friends at one time..Wonder what she is doing? haha), decided to write something abt the first delivery i observed.1st thought was : Terrifying! Remember the pain the mother going through, i felt she was experiencing the greatest pain in her life. After 20 minutes of fighting ( pushing ) hard, finally the new one came out. All of the sudden, the feeling changed.. Felt so great to share the happiness of the mother( imagine 9mths she carried the baby, now finally he is out), and the medical personnels around it. In Russia, usually the 1st thing they do after the baby was delivered, is to place on the baby on the mother's abdomen and let the baby suckling, 1stly is to stimulate oxytocin secretion (a hormone ) which stimulates uterine contraction, thus decreases blood loss, and 2ndly, is to bond the mother and the child. Wonder if the same is done in other countries, for the same reasons?
Be frank, i used to dislike obstetrics, as i thought it's a 'dirty job'...but as time passes on, i started to like it. Being able to deal with mothers and babies prenatally, perinatally and postnatally, i feel that it's a great job ( though it's also the field where doctors face most malpractice lawsuits.) . Ok..that's all for now ( haih....still wondering what they are doing ...)

Lower Risk of Heart Disease Death Among Coffee Drinkers

Spotted this article 'Coffee Drinkers Have Slightly Lower Death Rates, Study Finds' from Malaysian Medical Resources. Somehow the risk of heart disease death is lower among coffee drinkers (caffeinated and decaffeinated).
Perhaps i shall drink more now ? Hehe....

TRAP men after 60 ?

TRAP men after 60? Hehe...what do you people think it's? Just wanna share a mnemonics i thought of while studying Parkinson disease for my neuro exam.

Parkinson Disease is characterized by :

• Tremors
• Rigidity
• Akinesia / hypokinesia
• Postural instability
  
• and usually affects men after 60 y.o

That's why TRAP men after 60.

Books for sale

Good books at cheap price ! ( only for students in Volgograd )

1. Langman's Medical Embryology 9th edition

• Description: For students in 1st and 2nd year.
• Condition : 99% new and wrapped
  
• Price : 350 rubles

2. Harper's Illustrated Biochemstry(international edition)

• Description: Essential for students in 2nd year
• Condition : 90% new and wrapped
• Price : 300 rubles

3. PL Dhingra's Diseases of ENT 4th edition ( not shown here )

• Decription : Essential for 4th year students who will have ENT cycle and exam in 2nd sem
• Condition : 99% new and wrapped
• Price : 350 rubles
  

Why buy here ?
- Don't have to waste the luggage allowance to carry the same books from Malaysia
- The price quoted is very much cheaper compared to the original price
- Personal delivery

Any1 who is interested, pls leave me your contact number / contact me directly. And pls spread the words. Thanks :-)

-by mouse

Coming to the end...

Soon my 4th year of medical school is coming to the end (in less than 2 weeks time). Somehow i feel that i learnt nothing for the past 9 months here, or perhaps it's because too much to learn, that's why i feel that i learnt nothing? In 2 years time i will graduate and start working as a houseman in Malaysia. Hopefully in the next 2 years, i will strive harder to attain more knowledge and skills... No matter how tough is it, never give up. By constant acquiring of knowledge, skills ,experience and hardwork will always shape us to be better doctors, i believe. Anyone out there who want to share about this can always leave a comment after reading this post. Thanks

- a dedication to a friend :-)

huh..finally

Since last week, it has been raining nonstop here...hardly an hour without rain sometimes..once a year phenomenon...our beloved Dean always told us "enjoy the rain, u wont get the rain like this when u go back malaysia...Come we do rain clap!!( only batch 19 MMMC wil know this..heehe)" it is an indication for manipal-ians to start bringing umbrella/prob raincoat( useless anyway) anywhere u go..or else u gonna stuck somewhere for sure.. this sudden change of weather is really sickening..make ppl sick easily ...anyway, today got better dy..thanks my mouse for the recovery prayers ;-p
currently block 4 seems to be running at a tiring pace..today from9-4 classes with one SDL..all lecturers seem to be rushing to finish off syllabus so we have to join the marathon too..no choice..one week already over meaning 1/3 of the block is over.. ..the block 3 exam seems like just ending...but the whole cycle of new block begins again..lecs..PBL, SDL, tests..anyway deal with it!.. very soon block 4 wil come to an end...then few days study break..then block4 exam..then approx 3 weeks study break..then uni( the big monster which dreads every MMMCstudent..) It is the only monnster that can make even the laziest individual on earth to sit and study..otherwise u have to bear the consequesnces..meaning another 6 months here... ...time..money..etc. Now I just hope and pray that I m blessed with good health and clear peaceful mind all the tiem, so that i can study well and pass uni ( fingers crossed).. And, wanna wish my dear all the best for his neuroanat exam this thurs...will pray for u..kambate!

Congratulations !

Congrats to all the VSMU final year students who officially finished their final exams today. This year we have graduates from faculty of General Medicine ( 2nd batch) and faculty of Dentistry (1st batch). Here we wish you all the best and enjoy the path of healing...

Treating Your Throat

What comes to your mind when you having sore throat? Something to relieve the symptoms? and the next will be Strepsils ? Just wanna share with you 'Treating Your Throat'- by Strepsils.com (http://www.strepsils.com/treating.php)
Publish Post



Treating Your Throat

If you have a sore throat already, to make yourself and your throat feel better there are some options:

• Drink plenty of warm liquids to keep your level of body fluids up
• Try to breathe through your nose. If your nose feels congested, inhaling the steam from a bowl of hot water will help it to clear or look for a lozenge which also offers a decongestant
• Try to avoid alcohol. The idea that alcohol 'disinfects' the throat is unfortunately a myth! In fact, drinking alcohol is much more likely to irritate than soothe a sore throat
• Swallow - it might hurt but its one of the best things you can do because saliva is a natural lubricant so it helps soothe a sore throat
• Sucking an effective medicated lozenge can help lubricate the lining of the throat further bringing real, noticeable relief. And if you choose one from the Strepsils range, rest assured that it can keep working, even after the lozenge has gone. Check out the Strepsils range to find a suitable remedy for you.

Europe backpack trip

The mouse will be away from 5th to 19th July, as he will travel to few European cities before going back to Msia for summer holidays. Stay tune for the update :-)

Get Well Soon :-)

Let's pray for tiger for her speedy recovery. Thanks :-)

Happy Father's Day

Dear pa,
Through this blog, we would like to wish you Happy Father's Day. May you always stay wealthy, healthy and happy...You are always a great dad to us :-)...

From,
The 3 sons of yours


p/s : pls remember to wish your beloved father k :-)

The best mate (and its effects) !

Coffee is always my best mate, especially when i gotta study alone for my exams during pre-exam nights... I am someone who is seriously addicted to coffee, especially when exams are just around the corner, i can easily drink 3/4 cups of coffee in a day... The tiger always tells the mouse not to drink so much coffee....yet i fail to listen to her...sorry ya tiger ;-).. But then recently she is also addicted to MochaChillo right? Hehe...
What am i gonna share here is the effects of coffee on health (from Wikipedia http://en.wikipedia.org/wiki/Coffee)

Scientific studies have examined the relationship between coffee consumption and an array of medical conditions. Findings are contradictory as to whether coffee has any specific health benefits, and results are similarly conflicting regarding negative effects of coffee consumption.
Coffee appears to reduce the risk of Alzheimer's disease, Parkinson's disease, heart disease, diabetes mellitus type 2, cirrhosis of the liver, and gout, but it increases the risk of acid reflux and associated diseases. Some health effects of coffee are due to its caffeine content, as the benefits are only observed in those who drink caffeinated coffee, while others appear to be due to other components. For example, the antioxidants in coffee prevent free radicals from causing cell damage.
Coffee's negative health effects are mostly due to its caffeine content. Research suggests that drinking caffeinated coffee can cause a temporary increase in the stiffening of arterial walls. Excess coffee consumption may lead to a magnesium deficiency or hypomagnesaemia, and may be a risk factor for coronary heart disease. Some studies suggest that it may have a mixed effect on short-term memory, by improving it when the information to be recalled is related to the current train of thought, but making it more difficult to recall unrelated information. About 10% of people with a moderate daily intake (235 mg per day) reported increased depression and anxiety when caffeine was withdrawn, and about 15% of the general population report having stopped caffeine use completely, citing concern about health and unpleasant side effects. Nevertheless, the mainstream view of medical experts is that drinking three 8-ounce (236 ml) cups of coffee per day (considered average or moderate consumption) does not have significant health risks for adults.
An American scientist Yaser Dorri has suggested that the smell of coffee can restore appetite and refresh olfactory receptors. He suggests that people can regain their appetite after cooking by smelling coffee beans, and that this method might also be used for research animals.

p/s : the pic above is for u tiger , it's mochachillo! hohoho...

1st blog

The idea of blogging was conceived 2 nights ago, when i was chatting with my dear( who is also the co-blogger of this blog). Having the thoughts of writing abt our life, our relationship would be fun, i decided to start this blog after my ENT exams. Be warned, this isnt just a blog about love and life...it's also partly a medical blog. haha...Enjoy it ;-)

Beginning...

I have never thought of blogging til 2 nights back, my dear told me he wanted to start a blog and even asked me to be a co-blogger *touched* :-) after considering it, why not give it a try rite...can use it as a tool to express and to share.. As for my friends and family miles away, i will keep updating bout my life now in manipal ...holidays sooooon...:-p