kembara di bumi Melbourne

Year Zero - Before Melbourne Uni

2009-11-05T22:40:00.000+11:00

Back in 2003, when I graduated from Mara College Banting (MCB) with a diploma in International Baccalaureate(IB) , I have roughly about 7 months of holiday before going to Australia. The IB programme was initially designed for students who are going to universities in Ireland and United Kingdom (UK). Therefore the IB programme in MCB finished in the middle of the year and gave their students 2-3 months before starting their studies in UK or Ireland. Most if not all universities, at Ireland and UK start their intake on August/September.

At that time, there were only two Australian universities available to MCB graduates, namely University of Melbourne and University of Monash. I am among the first batch from MCB who are going to study at Melbourne Uni.

My friends who were going to study at University of Monash, Australia had their 3 months orientation programme starting from September that year. Their orientation programme is held at Melbourne, Australia. I guess at that time, I felt a bit disappointed to learn that my friends at Monash were having fun and getting allowance at the same time whereas I have an extra long holiday after finishing my study at MCB.

So, what did I do at that time? After few weeks discussing with our MCB principal, and confirming that I don't have any similar orientation programme similar to Monash Uni, thus began the era of me looking for various sorts of jobs.

I initially planned to work in a factory but the working condition and the low salary immediately turn me away from the job. Then, I thought of working as a cashier in a nearby petrol station but the position was not vacant at that time.

My mom suggested to me to work as a substitute teacher in her school. So, I took the opportunity and immediately got the job. I had to teach the entire Form Four in the school from the topmost class to the last class in the Form Four. It was an interesting yet challenging experience for me.

The last class in Form Four were filled by students who were not motivated to study or even came to the school. They had to come to school because their family forced them to come. They don't have any insight on the importance of having education for their own future. Compare this situation with the topmost class students who were quite motivated to study and willing to do lots of homework to improve their knowledge.

I had to be flexible in teaching these students and need to adjust the level of teaching according to their level of interest and knowledge. It was certainly an eye opener for me to learn the skills to teach students who are not motivated to study in the first place.

After two months of teaching, I retired from the job when the original teacher came back from her maternity leave. Thus, I was jobless again. I had to look for another job but what could I do then at that time? I had only SPM certificate and IB diploma, and hardly anyone knows what is IB programme anyway.

If I'm not mistaken, I retired as a teacher on middle of September and I had few months to go before I started my study at Melbourne Uni. Waiting for my flight to Melbourne was certainly a lesson in patience for me. Doing nothing during an extra long holiday is not something that suits me. I need to do something interesting. Otherwise I will be extremely bored killing all those free time.

After early retirement from teaching those students, I had to stay at home and look after my two younger sisters. My youngest sister was only 3 years old and her older sister was only 5 years old. Early in the morning, I had to sent them to a neighbour who will be looking after them and pick them up in the afternoon. Both of my parents are working and no one is at home to look after them. I'm not qualified enough to look after young children :)

It was during those days that I had the chance to learn how to cook. I never cooked any meals before. Hmm, looking back at those days, it was funny to see how I approach cooking. I always think cooking as a chemistry experiment where you add few of stuffs together and boil them in a frying pan. To get the taste right, you need the right amount of stuff and this ingredients need to be balanced. I constantly tried to find the right chemistry equation for different type of meals but I failed miserably in the end :) There are too many variables that need to be adjusted to get the right taste and it was certainly will take me ages if I were to write equations for all the meals. In the end, I had to use my own taste bud to adjust the ingredients.

This is an already long entry for Year Zero. I guess I will stop here and continue later whenever I have free time :)

Final Year

2009-10-26T22:29:00.000+11:00

It has been busy, but it is expected. My final year exam will be in another two weeks and yet there are lots that I haven't revised. Speaking of revision, I don't think it should be called as revision in the first place since I pretty much forgot everything that I've learned so far. Hopefully I won't be extremely anxious when the exam comes in the next fortnight.

Apart from studying, I'm also in the midst of selling my first car. It is not easy to sell an old car and it has been a bit stressful for me. The experience of selling a car certainly taught me a lot on how to deal with potential car buyers. I'm also looking for cheap courier service to bring my stuffs back to Malaysia. Maybe I would do that after the exam.

And finally, I am also inviting you, the blog readers, to my home at the end of this year (to be exact 2nd January 2010) for a small ceremony :D I am getting married at the end of this year. The wedding preparation has kept me extremely busy and I still haven't finished printing all the wedding invitation cards. Hopefully it will be done by next few weeks and I will be able put up the scanned wedding cards here in this blog.

Last but not least, I have already booked my flight ticket home. This time, the flight ticket is paid by my sponsor :) I will be going home few days after the graduation ceremony.

p/s: After 6 years living in Melbourne, it is sad to see how things will end. After reading my friend's blog, I think I should reminisce about the past 6 years.

Anaesthesia

2009-10-09T22:44:00.002+11:00

Over the last five days, I have spend most of my time in theatre. As part of my surgical rotation, I need to do a week of anaesthetic.

Anaesthesia is defined as loss of bodily sensation with or without loss of conciousness. There are three main components of anaesthesia, namely hypnosis (being put to sleep), relaxing your muscles and sedation (this means that you lose your awareness of your surrounding).

As a specialty, anaesthetic is one of the toughest training program to get into. There are high level of competition for young doctors to participate in anaesthetic training. It is quite attractive to become an anaesthetist since there are wide range of skills being involved and in term of salary, it has one of the highest salary grade among specialist.

Over the last week, I had the opportunity to practice putting a laryngeal mask into few patients. I had the chance to sharpen my skills in performing intravenous cannulation.

A laryngeal mask is a tube that is inserted inside your throat during an operation. The picture below shows how to put the laryngeal mask inside your mouth.

Picture from Merck Manual.

Intravenous cannulation simply means of putting a needle inside your blood vessels. This link will describe in detail how you perform the procedure.

As a medical student, putting a cannula (needle) inside the blood vessel was initially a hard task to be performed. You have to overcome your anxiety of hurting the patient and develop a good technique to insert the needle into a blood vessel.

Anyway, back to my anaesthetic rotation, it was exciting to be at the other side of the theatre. I used to be helping surgeons with the operation and hardly have any chance to sit on the other side. The anaesthetist usually sit behind the curtain and will monitor the anaesthetist machine to ensure the patient is breathing appropriately and is comfortable throughout the operation.

It is interesting to see how the anaesthetist handle the emergency cases. I had several emergency operation throughout the week such as emergency caesarian and emergency laparotomy due to unknown abdominal bleeding. There was a patient who had laryngospasm at the start of the operation and the anaesthetist taught me how to handle this emergency. Laryngospasm is uncontrolled contraction of the muscles inside your vocal cord and will cause a person to stop breathing. This is certainly a dangerous situation since it will cause lots of damage to your organs especially your brain.

In summary, being anaesthetist is fun but at the same time, it is hard to get into their training program. My next four weeks will be in theatre assisting the surgeons with their operation. This will be my last four weeks in medical school.

p/s: I'm looking forward for graduation but at the same time, I've to study hard for the final year exam. Hopefully, I will get a good mark from the exam.

General Practice rotation

2009-10-03T22:20:00.003+10:00

It has been 5 weeks since the last time I blog. A lot has happened in the last 5 weeks. Alhamdulillah, I have finished my general practice (GP) rotation.

This rotation means that you are spending time with doctors at their own clinic and observing how the doctors managing their own patient. You will be given lots of opportunities to interview the patient on your own and then presenting your findings to the doctor. It is a good practice for my final year exam.

This rotation gives you an insight on what are the most common illnesses around the community. Sinusitis is more common than temporal arteritis. Otitis media is more common than croup. Pneumonia is quite common but it is not that severe to warrant the patient to be admitted to the hospital.

Having been spending few years in the hospital, it certainly give me a bias perception towards finding out what is the most likely diagnosis. If I were to see a patient in the hospital, I'm more inclined to think of rare or life-threatening conditions rather than to think of more safer illnesses.

I did my GP rotation in rural Victoria and there were several opportunities for procedural skills. I managed to excise a skin mole and suture the wound. After 6 years of studying medicine, I finally performed my first PR examination on a patient. It was an exciting experience to learn how normal and abnormal prostate gland feels like. I managed to deliver a baby in the hospital which is quite exciting considering that the last time I delivered a baby was almost 12 months ago.

It is certainly an interesting rotation and it certainly boosts my experience in managing the more common variety of medical illness.

p/s: Since I hardly been able to use the internet in the last 5 weeks, there are a lot that I need to catch up with. My google reader is already been filled with few thousands of unread items.

General Practice

2009-09-01T09:09:00.001+10:00

For the next 5 weeks, I will be spending time at General Practice (GP) clinic. This means that I will be having lots of opportunities to clerk patient individually and present the findings to the doctor. This will be the best time for me to get lots of procedural skills done.

During winter holiday, the medical school asked us to choose 10 places for our GP placement. Unfortunately, since many medical students choose city placements, not many were able to get their place of choice. In my case, my placement was not even in my list. I was given rural GP placement which is quite far and close to the border of Victoria. I might be celebrating Eid over there as well. There won't be any Muslims within 50-70km radius from my GP placement.Now, that is something that I would call as celebrating Eid'ul Fitr in a foreign land.

I don't think I would be able to get free internet access over there. Hence, no more blogging or even facebook-ing in the next 5 weeks. As this will be my last post before going to my GP placement, please forgive for all my wrongdoings and Happy fasting. Happy Eid in advance too.

Medical Rotation

2009-08-29T19:21:00.001+10:00

Alhamdulillah, I have finished my medical rotation. After 5 weeks of spending time following a general medical team, there has been lots of stuff that I've learned yet at the same time, I managed to find out the limit of my knowledge. Clearly, after studying medicine for 6 years, there are still a lot that I don't know.

6 years of studying medicine does not really teach you how to works as a doctor. There seems to be a big gap on how to put all your medical knowledge into practise. Doctors do lots of paper works and referral. Medical school won't teach you how to fill in those paper works. You are supposed to observe it from the interns during this semester and learned it by yourself.

Referring patients to the other specialty is not an easy task to do. Interns are supposed to refer any suitable patients to the specialist for further management. The most difficult part of this process is to answer questions from specialist on reason for referral. I've seen how interns were scared to death when referring to the specialist. If you are not able to answer the questions from the specialist, the referral won't be accepted and you have to tell this to your own consultant.

Many patients who are admitted to the hospital require lots of medical imaging such as chest X-ray, CT scan and MRI. Radiology department is always busy and it is not easy to get a slot for your own patient. Somehow, the young doctor has to plead or find convoluted ways to get permission from the radiologist. Asking for permission to do medical imaging for your patient will always be one of the most difficult tasks for an intern.

Drug chart is one of the most common tasks that every young doctor will do. Yet up to now, I have never been taught formally about all of the doses of the medication. The university asks us to learn it by doing online course.

In the last 5 weeks, I have learned more on how to do my future job more efficiently than learning anything on medical knowledge. Hopefully, my next two rotations will be interesting :)

2009-08-24T07:20:00.002+10:00

وَمَن يُشَاقِقِ الرَّسُولَ مِن بَعْدِ مَا تَبَيَّنَ لَهُ الْهُدَى
وَيَتَّبِعْ غَيْرَ سَبِيلِ الْمُؤْمِنِينَ نُوَلِّهِ مَا تَوَلَّى وَنُصْلِهِ
جَهَنَّمَ وَسَاءتْ مَصِيرًا (4:115)

If anyone contends with the Messenger even after guidance has been plainly conveyed to him, and follows a path other than that becoming to men of Faith, We shall leave him in the path he has chosen, and land him in Hell,- what an evil refuge!

[An-Nisa:115]

closer to the grave

2009-08-23T23:07:00.002+10:00

Alhamdulillah, I have been blessed to be given 26 years to live in this world.

Whenever I went to the ward, the average age of the patient would be around 75 years old. 26 years seems not a long period to me. I gained lots of reminder each time I met an elderly patient. Looking at their face and thinking of what sort of experience they have gained in the past, it helps me to re-orientate myself to the reality of this world.

Every time you reach an anniversary of your life, you are one step closer to the graveyard. It may seem far for now, yet sooner or later, you will meet the judgement day.

Sometimes, I'm a bit hesitant to celebrate my own birthday. Maybe unconsciously, I'm afraid that I will realise that all this while, I have been wasting my time. I hope that in the past 26 years, I have done enough good deeds and repent for all my sins to Allah and for any wrongdoings to any human being that I have met in the past. Insha-Allah, I will try my best to be a better person and controlling all my negative attitudes.

I'm grateful for all the birthday wishes that I received. I hope that everyone will remain steadfast in Islam. Happy Ramadan.

5th Anniversary

2009-08-15T19:58:00.002+10:00

This blog as of today, will be 5 years old. A lot has happened in the past 5 years. Let me tell you a little bit about my blog.

This blog was started as a personal blog. A place for me to jot down all the ups and downs of my life as a medical student. The initial title of this blog was paradigmshift and the initial url was hafiz_238.blogspot.com. I chose paradigm shift to reflect my motivation to be a better person and to be brave to face all of the challenges in the future.

Later, I changed the blog title to 'kembara di bumi Melbourne'. I think I have to change the title of this blog at the end of this year since I won't be living at Melbourne. Not sure which title I should choose.

I used to be blogging frequently. However, in the last few years, especially when I started my clinical years, I haven't been able to blog as frequent as it used to be. Perhaps, life has been busy or I don't have any inspiration to put my mind into writing. Nevertheless, I hope that I would be able to maintain this blog for the next few years.

Pergi tak kembali

2009-08-13T21:31:00.002+10:00

Al-fatihah to Ustaz Asri. Read more.

Gen Med

2009-08-09T22:05:00.004+10:00

Tomorrow will be my third week of doing rotation in General Medicine. So far, alhamdulillah, it has been fulfilling. The consultant expects the medical student to participate in the ward round everyday and try to admit patient and presenting on the ward round. The ward round usually lasts between 4-5 hours everyday. It has been busy, but that will be my life starting from next year. So, I guess I shouldn't be the one complaining.

I usually arrived at the hospital around 8am and only came back to home around 10pm. I like to do my revision at hospital rather than studying at home since it can save me lots of electricity bills and prevent me from wasting my time doing unnecessary things.

There are lots of things that I need to revise for this semester. I am still trying to find time to revise my Obstetrics and Gynaecology and Paediatrics since those subjects will be part of my semester exam. Hopefully I can find time to blog and visit other blogs as much as possible in the next few months.

Ok, that's all for now.

Semester 12

2009-07-26T20:17:00.003+10:00

This will be my final semester at Melbourne. There will be three rotations during this semester (Medicine, General Practice and Surgery). Each rotation will be 5 weeks and at the end of 15 weeks, there will be 10 OSCE stations and 1 long case.

I am looking forward for this semester since it means that my 6 years of studying in Melbourne will end very soon. At the same time, I am feeling a bit anxious knowing that I will be working as a doctor in less than 6 months time. This will be my transition point from being a student to someone who will be looking after many sick people.

For GP rotation, we were instructed to choose 10 places that we would like to go and at least 3 of them have to be rural places. For this rotation, I was hoping to get somewhere close to home. Unfortunately, I got rural place for my GP rotation. It is so far that I don't think I would be able to return home every week. Hopefully, there will be internet access over there.

My first rotation will be medical rotation and it starts tomorrow. Despite being a final year student, I still believe that there are so many things that I didn't know and I am expecting a busy semester ahead. Hopefully I can survive this semester.

p/s: It is interesting to read what I have predicted 5 years ago. Read future predictions (In Malay)

Winter Holiday

2009-07-17T07:47:00.004+10:00

I haven't been updating this blog regularly. Perhaps I am having writer's block which is perpetuated by the cold temperature of winter season. This condition might be precipitated by not having much interesting activities to be written on the blog. However, I believe there are few protective factors that will protect me from giving up blogging.

p/s: The paragraph above was written in the format of formulating a psychiatry history. Usually, you need to mention 4P (Predisposing, Precipitating, Perpetuating and Protective factors) at the end of your presentation

Swine Flu (H1N1) in Melbourne

2009-07-04T22:17:00.002+10:00

In response to one of my commenters, I will try my best to illustrate what is happening in Melbourne regarding to the famous swine flu.

Up to 2nd July 2009, there have been 1691 cases in Victoria out of a total of 4568 cases in the whole Australia. Melbourne has among the highest swine flu cases per capita in the world.

However, this does mean that there is a widespread panic among people living here. Despite there were many school closed down and intensive media coverage, there were not many deaths associated with swine flu.

You should know that swine flu is not a dangerous disease. It is known to be extremely contagious but it is less likely to kill you. The normal seasonal influenza kills more people than the current swine flu.

Right now, I'm glad that the media has shifted their attention from swine flu and focus more on the death of an artist .

A frustating OSCE

2009-07-01T15:30:00.004+10:00

I finished my exam yesterday. One of the main reasons I took a day to write about OSCE were that those OSCE were quite frustating.

There were 5 OSCE stations.

Take history from patient with symptoms of depression.
Take history from patient with bulimia nervosa. Describe the management.
Elderly women with Colles' fracture. Describe your findings in clinical examination and x-rays. Management of Colles' fracture.
Patient with advanced lung cancer, want to die at home. Has several issues. Medication, feeding, EPOA.
Elderly patient with side effects of medications (MS Contin and Naprosyn).

The first station I had, was the depressive patient. I had to exclude whether this patient has Major Depression. I almost forgot all the symptoms of depression due to anxiety. Fortunately, I'm able to remember few of the symptoms before the bell rang.

Bulimia nervosa again. This disorder has been featured in the previous written exams and I'm not sure why the medical faculty is so interested in asking medical students about eating disorders. During this station, I'm not sure what else to ask after eliciting all the DSM IV criteria for bulimia nervosa.

Colles' fracture. Hmm, I'm stumbled quite a lot in this station. When the examiner asked me to do physical examination of the wrist, I'm not sure how to neuro exam of the hand, so I quickly do a random examination of the hand. Hopefully, I can get enough points in this station to pass the ED station.

The last two OSCE stations were quite a puzzle. I'm not sure what else to say in patient with palliative care needs and not sure what are the side effects of those medication.

Overall , this semester which is made of RAPP (Rehabilitation, Aged Care, Palliative Care and Pyschiatry of Old Age), Rural rotation, Emergency Rotation and Psychiatry has been a frustating semester. Let us hope that all my friends and I could pass this semester exam.

p/s: Before the OSCE, we were given surveys for this semester to fill in. This was what I wrote for RAPP: The RAPP handbook is too painful to read.

Hopefully they will make significant improvement for RAPP :)

Benign Paroxysmal Positional Vertigo (BPPV)

2009-06-28T19:14:00.004+10:00

BPPV refers to a condition when you get dizziness on a certain position such as rolling in the bed or waking up from sleep.

While studying for this condition, I found out a nice claymation video showing Hallpike manouevre and Eppley's Manoeuvre.

Below is a nice diagram showing what is happening in the ear canal.

Credit to Merck Manual

SHR Written paper 2

2009-06-27T18:32:00.003+10:00

Six 5 marks questions

Side effects of haloperidol
Football player hit at head. GCS 3. Describe assessment, initial management and investigation
Key features of delirium
Key features of obsessive-compulsive disorder
Describe 3 risk factors of fall and give example for each factor.
Elderly men with recent cognitive impairment. Given diazepam to treat his ‘nerve’ problem. Give comment on his diazepam usage.

Six 15 marks questions

Elderly Italian lady with mental impairment. Lives in Shared Supported Accommodation. Unable to speak in English. Has diabetes, obesity and history of falls. List 5 issues in this lady. Describe your management.
Men with paracetamol overdose and found with empty whisky. Slightly intoxicated. Describe initial management, investigation. Mechanism of paracetamol toxicity. Tool to assess paracetamol toxicity. Management of paracetamol toxicity and route of administration. [Guidelines for the management of paracetamol poisoning]
Elderly women with advanced lung cancer. Want to die at home and family happy to support her. Describe your discharge planning.
Women present to GP with symptoms of 8 years history of binge eating and purging. Normal physical exam. Describe management of this patient.
40 year old women with MS. Work as a telephonist and need to access computer as part of her job. Describe clinical features of MS that may interfere with her job (4 marks). Describe your assessment on finding out what are available at work to overcome this issue (4 marks). Recommendations on how to cope with work difficulty due to her MS-related disability (7 marks).
Elderly men with long history of ischaemic heart disease and now presents with depressive symptoms. Describe the relationship between medical illness and depression.

In this paper, there were few questions asking on DSM IV criteria of several psychiatry disorders. DSM IV is the manual published by the American Psychiatric Association and covers all mental health disorders for both children and adults. It tells you how to diagnose any mental illness and describe the relevant differential diagnosis. Most, if not all, psychiatrist were able to recite the DSM IV criteria for any mental illness. So, it is necessary for medical students, to memorise the DSM IV criteria for major mental disorders.

I'm not sure how to answer the question on MS. It is asking for specific answers related to work-related issues. I randomly put anything that might be relevant in answering this question. Hopefully, I could gain at least several points from this question.

Overall, I'm glad that the written exam is over. Now, I could look forward for my OSCE and the short winter break after that

Update 27/9/2009: Thanks to Intan for telling me the other questions.

SHR Written paper 1

2009-06-27T15:49:00.001+10:00

Six 5 marks questions and six 15 marks questions.

5 marks questions

List symptoms faced by an elderly widow, few weeks after the death of her husband.
Describe the differences between vasovagal collapse and syncope.
Describe anorexia nervosa
5 causes of constipation in bed-bound cancer patient
5 components of CBT in managing major depressive disorder
A young boy falls on outstretched hand. Presents with pain in anatomical snuffbox. Normal plain X-ray. Diagnosis, management and complication.

15 marks questions

Differences between acute, chronic and cancer pain. Answer in table form
87 year old female, lives alone, presents with decline in function over the last 6 weeks. Has multiple co morbidities and lots of medications. Still driving. Has slightly reduced score in MMSE. Describe your management of this patient.
A young tourist poisoned by bright-coloured octopus. Presents to ED. Which organism (blue-ringed octopus), what type of toxin and mechanism of toxin. Initial assessment and management. Treatment and expected outcome
38 year old women, previously well, presents to ED with back pain. Normal neuro exam and MRI. Has relationship problem with her partner but has resolved. 3 differential diagnosis. How to assess the different diagnosis in Hx and MSE.
40 year old train driver, presents with history of frequent alcohol drinking. In the last few weeks, he had panic attacks while driving the train and this is alleviated by drinking alcohol. DDx (6 marks). How to assess him in hx and MSE (9 marks)
40 year old policeman, presents with delusion and hallucination. He needs to do something to protect himself. Describe a thorough risk assessment (11 marks). Ethical principles faces by GP in this patient (4 marks)

Few of the questions were a bit difficult to answer. Those questions test the capacity of your memory.

The question on octopus was in a way interesting. I knew the type of the octopus but I didn't know the toxin nor its mechanism of action. In fact, I wrongly guessed the management in this question. There goes my 15 marks.

15 days later

2009-06-26T20:00:00.003+10:00

The title refers the number of days this blog last updated. Lots of things has happened in the last two weeks.

Swine flu is now officially an epidemic. Malaysia currently has more 90 cases of swine flu and the reaction from the Malaysian newspapers has managed to over exaggerate the severity of the swine flu. In fact, many of my friends who are going back to Malaysia for winter holiday are quite worried that they will be under home quarantine too, since few cases of swine flu in Malaysia originate from here. Go read this; Swine flu's not that bad.
Riot in Iran. I wonder what will happen to Iran in the next few months. Hopefully, if there is any chaos in the future, it won't lead to lots of unnecessary killing among the citizens and disrupting the petroleum production. Petrol prices has already been increasing and we don't need another riot to push up the petrol price.
New operators for tram and train in Melbourne. Hopefully this will improve the quality of public transport in Melbourne in the future.
Exams. I have finished two written exams and will be sitting for OSCE next week. Will write more about those written exam later.
Firefox has released the third Firefox 3.5 release candidate. I am patiently waiting for the next version of Firefox . Read this; Firefox 3.5 memory usage, Top 10 features in Firefox 3.5

Update

2009-06-11T14:13:00.006+10:00

It has been more than a week since I last updated this blog. Currently, there are about two more weeks before my semester exam.

At this time of the year, many medical students are busy applying for the intern job in Victoria or interstates. Most of my groupmates were having lots of stress and worries since it is not an easy process to apply for a job here in Victoria. They have to sit for many interviews and few of the interviews will be during the exam period. They have to balance between revising for the exam and preparing for the interviews.

As the only person in the group who is not applying to get a job in Australia, my role for the last few weeks has been to calm them down and help them with possible interview questions. Interestingly, we are doing psychiatry rotation and it has been useful to put all of those relaxation techniques into practice. I hope that all of my groupmates and my friends will get a job in Victoria.

In term of psychiatry rotation, I don't think it has been a useful rotation for me. It was not properly taught and most of the students are not really interested in choosing psychiatry as their future career.

Swine flu in Victoria has been infected many people in the last few weeks, and of last night, there has been at least 1011 persons infected in this state and the total number of swine flu cases in Australia is 1260. If the number of cases in Australia especially Victoria keeps on increasing, WHO might have to declare the swine flu as a pandemic.

Iklan 1960an

2009-06-03T19:23:00.002+10:00

Sungguh klasik bahasa yang digunakan .

Disturbing radiology images

2009-05-31T14:14:00.004+10:00

Warning: Viewer discretion is advised.

From ABC News via [Kevin MD.]

Bizarre radiology images.

Part of being a medical student is the ability to be calm whenever facing a major trauma. Hence, we have been shown weird and traumatic images since first year. The ability to calm down is important since it can have a direct effect towards the patient.

Imagine your doctor being more anxious than you. How do you think that would affect the patient?

Swine Flu in Melbourne

2009-05-30T10:04:00.005+10:00

VICTORIA has passed the point where the spread of swine flu can be prevented and should immediately close every school in the state for a week to slow the progress of the virus, a federal government influenza adviser has warned.

There were last night 209 confirmed cases of swine flu nationally, with 138 cases in Victoria.

Tasmania also reported its first case.

Although seven Victorian schools have been closed in steps to contain the virus and a further 27 identified as "affected", governments and health authorities insist the scale of the outbreak does not warrant wholesale school closures or cancellations of major public events. But Raina MacIntyre, an infections diseases expert and a member of Australia's Pandemic Influenza Advisory Group, said yesterday the time had come to consider more drastic steps.

"We're at the stage now in Victoria where a blanket closure of all schools and pre-schools should be on the agenda and a decision needs to be made quickly," Professor MacIntyre told The Weekend Australian.

Federal Health Minister Nicola Roxon conceded yesterday that the focus of Australia's pandemic response would invariably shift from trying to contain the virus to treating it.

Read more

It is interesting to see the number of schools that have been closed down around Victoria for the past few weeks. I have managed to mark all the schools that has been closed down (in red) and the schools that has been affected by swine flu but does need to be closed down (in blue).

The hospital that I'm attached to is right in the middle of the epidemic area. I might add that there is one railway line that is passing through all of those schools.

p/s: Having said that, I don't think we should be panic with the increasing number of swine flu in Australia.

Trials and Tribulations

2009-05-30T08:16:00.001+10:00

Be sure we shall test you with something of fear and hunger, some loss in goods or lives or the fruits (of your toil), but give glad tidings to those who patiently persevere,

Who say, when afflicted with calamity: "To Allah We belong, and to Him is our return"

They are those on whom (Descend) blessings from Allah, and Mercy, and they are the ones that receive guidance.

[Al-Baqarah: 155-157]

Signs versus Symptoms

2009-05-28T11:18:00.003+10:00

This post is written to clarify the difference between symptoms and signs.

When a patient come to see a doctor, the patient will usually tell what is wrong with him/her such as having fever, short of breath or chest pain. These are what the health professionals called as symptoms. Symptoms are the observations made by the patient.

On the other hand, signs are the observations made by the health professionals. For example, a doctor might notice that there is an abnormal breath sound heard using stethoscope. The doctor might used various medical terms to describe the abnormal breath sound. This is a sign that may indicate that there is something wrong with the chest.

In summary,

Symptoms : any feature which is noticed by the patient
Signs : any feature that is observed by any health professionals (Doctors, nurses, allied health professionals).

p/s: Sometimes, signs and symptoms are used interchangeably .