Do not despair~

I am terribly sad today and this video had touched my heart..

Bird~

I missed writing. I wish that i can share anything here..

Sometimes i wonder what is happiness is all about..

I am sick with this world..

Sometimes i hope that i am not created..

I wish that i am a bird..

I eat the fruits..

I stand on the trees and not accountable to anybody nor indeed can anybody punish me...

I wish I was a tree by the road, and that a camel would come along and eat me.

I wish that I had been all that, rather than a human being..

It was so tiring to become a human being..

Death was painful..

Life is sucked..

O rabb, help me..

Ghuraba...

Sometimes you're doing the right thing...

But then the whole world is against you...

And you started to think..

Am i doing the right thing?

Am i crazy?

Living in this world and being so different...

When following Islam would be like carrying charcoal in the hand...

And then i remember the word that the Prophet said:

Fatuba lil ghuraba'

Glad tidings to the stranger~

Run...

I felt that i want to run..

Run as far as i can...

This place is not my home...

This place is so far away from my dream..

Ya Rabb, let me run..

Ya Rabb, let me go...

Ya Rabb, let me to your Jannah...

Spina bifida~

Spina bifida occulta ("hidden")

• mild form of spina bifida
• no opening on the back, but the outer part of some of the vertebrae are not completely closed split in the vertebrae is so small that the spinal cord does not protrude
• skin at the site of the lesion may be normal, or it may have some hairs growing from it
• there may be a dimple in the skin, or a birthmark
• may have incontinence, slight ambulatory problems, and slight loss of sensation

Spina bifida cystica (myelomeningocele)

• meningeal membranes that cover the spinal cord and part of the spinal cord protrude through a cleft, forming a sac or cyst, which are clearly visible on the skin
• opening is surgically repaired, shortly after birth
• sac or cyst not only contains tissue and cerebrospinal fluid but also nerves and part of the spinal cord
• spinal cord usually damaged at that level
• as a result, there is always some degree of paralysis and loss of sensation below the damaged vertebrae
• amount of disability depends very much on where the spina bifida is and the amount of nerve damage involved
• many children and adults with this condition experience problems with bowel and bladder control
• in approximately 90% of the people with myelomeningocele, hydrocephalus, extra fluid in the ventricles of the brain, will also occur
• lipomyelomeningoceles are more extensive lesions and represent a combination of a splayed spinal cord fused with a lipomatous mass, which in turn fuses with the subcutaneous adipose tissue

Meningocele

• the least common form
• outer part of some of the vertebrae are split and the meninges are damaged and pushed out through the opening, appearing as a sac or cyst, which contains both the meninges and cerebrospinal fluid
• nerves are not usually badly damaged and are able to function, therefore there is often little disability present
• there are usually no long-term problems, although problems can arise
• defect is usually surgically closed soon after birth

Diagnostic vaginal discharge~

Candida vaginitis

• organism: Candida albicans
• pH <>
• branching hyphae

Bacterial vaginosis

• clue cells
• amine odor

Trichomonas vaginitis

• organism: Trichomonas vaginalis
• unicellular flagellated organism
• flagellar motion on a saline wet smear

Chlamydia & Syphilis

• no diagnostic vaginal discharge

Aortic insufficiency~

• diastolic murmur
• Corrigan's pulse (water-hammer pulse)
• de Musset's sign (head bobbing)
• Traube's sign (pistol shot sound over the femoral artery)
• Duroziez's sign (to-and-fro murmur over the femoral artery)
• Quincke's pulse (capillary pulsation in the nail beds)
• Hill's sign (politeal artery pressure greatly increased over brachial pressure

Malignant Melanoma~

Remember ABCDE's:

• A- Asymmetric shape
• B- Borders irregular
• C -Color variation
• D- Diameter > 6 mm
• E- Enlargement & Evolution of lesion

Lichen Planus~

Remember 5 P's

• Purple
• Polygonal
• Pruritic
• Planar
• Papules

Erytema Infectiosum~

• also known as Fifth disease
• remember slapped cheek appearance!

Potter's sequence~

• bilateral renal agenesis
• causing mother to have oligohydramnios
• lung hypoplasia

Picture

Howell-Jolly bodies~

• small,spherical, nuclear remnants
• seen in the reticulocytes and rarely, erythrocytes of persons who have no spleen (because of congenital asplenia or splenectomy) or poorly functioning spleen (eg in hyposplenism a/w sickle cell disease)

Noonan's Syndrome~

It is a male version of Turner's Syndrome!

Pyloric Stenosis~

Pocture below shows string sign

After the string sign, there was something like a mushroom. It was called as mushroom sign = kirklin sign.
Always remember hypocloremic, hypokalemic metabolic alkalosis!

Rain...

Sometimes you already know the theory part of Islam. For example, you already knows that Allah won't see the product, but look at your effort. But then, when somebody does not appreciate your work, you became so sad.

You already knows that Allah only plan something that is best for you. But when things doesn't follow your desire, you felt so sad.

That's why you will be always facing test in life so that you became more stronger and open to challenges in life.

Have you ever seen the rains?

It is He Who sendeth the winds like heralds of glad tidings, going before His mercy: when they have carried the heavy-laden clouds, We drive them to a land that is dead, make rain to descend thereon, and produce every kind of harvest therewith: thus shall We raise up the dead: perchance ye may remember. (Surah Al Aa'raf: 57)

The verse was so beautiful right? There will be sunshine after every rain.

Why?

Wallahi it was the most painful thing that ever happen to me..

I already faced so many things in life, but that was the things that i regretted most...

Why all these things happened to me?

How lucky i was if i am not alive to see all these....

Ya rabb, please give me strength to face all these...

Hypertension~

5 risk factor for hypertension

1) Hypertension
2) Cigarette smoking
3) Physical inactivity
4) Diabetes Mellitus
5) Dyslipidaemia

5 fundoscopic changes in severe hypertension

1) Hemorrhages
2) Exudates
3) Papilloedema
4) Arteriolar narrowing
5) Swollen optic nerve

5 causes of secondary hypertension

1) Sleep apnoea
2) Acromegaly
3) Coarctation of aorta
4) Chronic kidney disease
5) Thyroid or parathyroid disease

5 classes of antihypertensive medication

1) ACE inhibitors
2) Angiotensin Receptor Blockers
3) Beta-blockers
4) Calcium Channel Blockers
5) Diuretics

5 features of malignant hypertension

1) Numbness of the arms, legs, face or other areas
2) Changes in mental status – confusion, decreased alertness
3) Seizure
4) Shortness of breath
5) Blurred vision

5 investigations in primary hypertension with reason

1) ECG – left ventricular hypertrophy ( target organ damage)
2) Fasting blood sugar – diabetes (risk factor)
3) Renal function test – chronic kidney disease ( target organ damage)
4) Lipid profile – Dyslipidaemia (risk factor)
5) Chest X ray – heart failure ( target organ damage)

List 2 medication that is preferred in

1) Hypertension + diabetes – ACEi & ARB
2) Hypertension + ischemic heart disease – ACEi & Beta-blockers
3) Hypertension + congestive heart failure – diuretic & ACEi
4) Hypertension + chronic renal failure – ACEi & ARB
5) Hypertension + hypertensive crisis – CCB & Beta-blockers

5 complications of hypertension

1) Left ventricular hypertrophy
2) Angina or myocardial infarction
3) Heart failure
4) Chronic kidney disease
5) Stroke/ transient ischemic attack

5 pathophysiological changes that increase blood pressure

5 advices to patient with hypertension on discharge

1) If you are overweight, try to lose weight
2) Reduce salt intake
3) Exercise regularly
4) Moderate alcohol intake
5) Stop smoking

5 common side effect of hypertension and which class it associated with

1) Diuretics – hypokalemia
2) Beta-blockers – erectile dysfunction
3) Calcium channel blocker – ankle oedema
4) ACEi - cough
5) Alpha-1-adrenergic blockers – postural hypotension

5 drugs to prevent recurrent stroke

1) ACEi
2) Diuretic
3) ARB
4) Warfarin
5) Aspirin

5 different types of cerebrovascular accident

1) Subarachnoid hemorrhage
2) Subdural hemorrhage
3) Intraparenchymal hemorrhage
4) Epidural hemorrhage
5) Ischemic stroke

5 signs of overdose antihypertensive

1) Bradycardia
2) Hypotension
3) Altered mental status
4) Seizures
5) Angioedema (ACEi)

Nursemaid's elbow~

• sudden traction
• radial head sublaxation
  

Osgood-Schlatter disease~

• tibial tubercle apophyseal traction injury
• rupture of the growth plate at the tibial tuberosity
• tibial tubercle hurt
• caused by overuse

Baker's cyst~

• popliteal cyst
• non-pulsatile swelling
• posterior aspect of the knee
• Ddx - lipoma, aneurysm, neuroma & rarely tumor