goo goo

over omar series

acute appendicitis

http://www.authorstream.com/Presentation/jigardoc-264548-acute-pancreatitis-entertainment-ppt-powerpoint/

mind-boggling afterall

been searching for this kind long-long time ago. yippie!!

http://abc.go.com/shows/greys-anatomy/medical-case-file/ThemeGallery/621498

Můj šestý smysl (my 6th sense)

MISS, PAP SMEAR IS ON THE GO

It's O&G time !!

FRIDAY, FEBRUARY 25, 2011

Counsel for pap smear

Posted by medik-ukm on Friday, February 25, 2011

1. Introduction

2. Ask patient if she know what we will do

3. Explain indication

-screening tool for cervical Ca

-yearly for two years,if normal then three yearly

- age 20-65 / once sexually active

4. Explain procedure

- duration is about 5-10 minutes

-no analgesia/ LA/ sedation given

- patient will feel uncomfortable during the procedure

-this is sterile procedure, wash hand,do aseptic technique, wear sterile gloves

- in dorsal position with open leg

- clean the perineum first with sterile water

- do bimanual palpation to know the position of cervix

- insert the Cusco speculum

-visualize if there is any lesion or abnormality if vulva/vagina/cervix

-use Ayre’s spatula to take sample

- rotate the spatula 360⁰

-put the smear on the slide

-make sure the slide have name and RN

- fix the slide with cytofix/ alcohol

-send the slide to lab

-then remove the speculum

-the procedure is finish

5. Explain complication of procedure

-spotting

-if having heavy bleeding come to hospital ASAP

-infection

6. Result

- ready in 1-2 weeks

- if normal, we don’t call. But if abnormal,we will call

- futher management will be done if any abnormalities detected

7. Ask patient if any question

source: workshop and dr. nasir

hanisah A115275

Reference :http://persiapbba0611.blogspot.com/2011/02/counsel-for-pap-smear.html

My letter to my medical students

posted in - Education, - Guest, - Inspiring |

To all of you my medical students,

You are very important. The future of many lives and families depend on what doctors do and SAY. I hope this realisation will uplift us with a sense of our remarkable place in the world as doctors.
And that is also why I keep on harping that Doctors MUST not be Wallpapers!
Please remember that Doctors had always stood at the forefront of change in society… those of you training under me MUST not only be skilful in diagnosis and management but also in social skills and leadership. It is your heritage that you cannot deny!

But the practise of Medicine is in trouble. Blatant commercialisation, rampant blood tests done without any doctors ordering or supervising, scans and probes of all kinds, are being conducted by laboratories and some doctors misguilded by wants rather than needs.

Hope lies in every one of us doctors, present and future, for the sensible management of patients; YOU remain the hope for untold numbers of patients in the future. Sadly some doctors see patients not as patients but as a disease that needs treatment which provides our source of income. This is nothing new, physicians like Osler had repeatedly cautioned againstnot forgetting the man behind the disease, and medicine as a calling rather than a business.

“The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions and powders, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish”.

~ Sir William Osler

Many doctors are unhappy with their work or simply too busy to talk, console or listen. Many just treat the disease and completely ignore the person who has it. We hear endless tales carried by patients of doctors who grunt instead of talk, who are capable only of monosylable conversation and who zip patients in and out of the consultation room with a speed that will make Superman jealous.

The reasons are complex. But one reason may simply be that some of us doctors have forgotten why we became doctors in the first place, and the wonder of caring for fellow humans. Some may be a bit burnt out. We had in our careers, seen and taken care of more pain and misery than most people. We saw prostitudes, drug addicts, criminals and the worst of humanity.
We also treated decent human beings, doting grandmothers and innocent children. No doubt, the demands on our skills and the medical-legal complexities that accompany our practise would have made even the greatest of our medical ancestors shudder. Yes, we deserve some rest from our weariness. But let’s not let go of the calling. Rather than try to correct the system which is basically dictated by our political masters, a system undeniably sick, we need to repair ourselves. Yes the system only makes it more painful. Regulations as thick as a medical text. Pharmacies selling controlled medicines like sweets. To change that will require one of us to be the next Prof Virchow, plunging head on into politics to make a difference. For the vast majority of us struggling on as individuals practising medicine, we hopefully don’t need much repairing; but to recall why we first fell in love with medicine, and why we wanted to become doctors.

In school we rose above the hoard, we were thecream de la cream. We obtained results the envy of most and we strove with pride to enter medical school. We sacrificed parties and dates to study for those results, we read volumes. In medical school we worked like ants on a long march. We reeked of formalin, we stared at slides till we saw mitochondria in our dreams and memorised volumes of facts
and figures. We did tough postings, survived the strictest professors, rounded in the pre-dawn drudgery of crowded wards, worked till hypoglycaemic on medicine rounds, performed every procedure required in the book, and passed our exams reasonably well. We stayed late, studied hard and looked at X-rays until our eyes turned red.

We finally graduated and became houseofficers. Yes, that year made the second world war look like a walk in the park but we survived. A few years later, we picked a specialty, from paediatrics to surgery, family medicine to cardiology, internal medicine to radiology, and shuffled off to more clinics, rounds grand or otherwise, work and studies. And MORE EXAMs.
During post grad training, we had exposed ourselves to the dangers of infectious disease, exhaustion, depression and violence. Operative instruments became flying daggers that we dodged in OT when the surgeon grew frustrated. I still recall with trepidation managing the very first patient admitted to our hospital with AIDS. We knew very little but feared a lot. As registrar, it was my duty to examine him. But again we survived. And learned. Now at almost every bedside teaching, I see patients with HIV. Fear can be turned to compassion. We drained fluid filled tuberculous chests, placed central venous lines, resuscitated the dying. We obtained consent for a thousand procedures, pronounced people dead, wrote enough case summaries to make ‘War and Peace’ look like short fiction and was almost ‘form-ed’ to death by the endless forms the admin would have us fill.
Our youthful enthusiasm and dedication well deserved the applause of our patients, when there was any. Weren’t we incredible then, if only because we came back to the wards night after night, day after day for emergencies, calls, rounds or simply a ’tissued’ drip. “Bengkak” the nurse will phone and we leave our dinner to struggle with chemo wrecked veins for IV access.

We as doctors must hold onto that commitment, that wonderful calling. Then we see another world – the realm of the business of medicine, where every disease is a “case” to be investigated.

A very senior Professor tells me she had seen doctors ordering investigations before even taking a history! Here is also the world of the grunting and monosylable doctor, the superman of 2 minute consultations and management. True, the superb rare genius of a diagnostitian may well have obtained all the data that he needed sub- 2 minutes, but the poor human called ‘the patient’ needed at least 6 minutes of compassionate conversation. (By the way, that is why your OSCE exam is 6 minutes long, or SHORT from your examinee viewpoint.. now you know how the patient will feel when the consultation is even shorter than this!). Recall that the only reason the woman in labour remembered us the attending medical student is because we held her hand while she screamed.
In the midst of all that we call Medicine, let us always remember the human behind the disease.

Let us recall that our work is a wonderful calling, a great gift. We are the descendents of Aescalapius, the inheriters of all that is noble in the Hippocratic oath. We may fail to change the ideas of many doctors however we may preach from some illusive high moral ground. But as individuals let us try not to lose our ideals.

Don’t let the system, colleagues or patients burn us out. Go for a holiday, trek lonely mountains, meditate, pray, sing, chant or simply relax. The sick is the reason for the practice of medicine, their care is why we became doctors! If we keep our mission clear, and our calling intact, we’ll care less about money and in all probability still make all that we need. By all means earn what is deservedly ours, but never forget the human who is paying. He is called the patient!

And in the process we can teach and inspire the next generation of doctors, ie you and all your friends. If we tell our students that the learning of medicine is through their apprenticeship to us their seniors, then we better be sure that we are good role models.

As medical students and future doctors, you all are the hope of the febrile, the breathless and the pregnant. And let us old froggies never forget the calling that we answered after decades of preparation from school to university to hospitals.

Do not let what you see in the misadventures of some doctors discourage you. Instead let them be teachers to you for you now know what you do NOT want to be like.

When a doctor have taken medicine to be a business or trade, he will ask what are his achievements — material success, cars, wealth, etc..
When a doctor has taken medicine to be a calling, he will ask what has he become — his character.

I hope we doctors can discern and reflect on what we have become in the practice of medicine, and teach all our young charges, delivering them safely through the long 5 years of protracted labour into a reasonably sane medical world.

Thank you

Your lo si,

Associate Professor Wong YO.

medicine.com.my

Acuostic neuroma

Acoustic Neuroma (Vestibular Schwanoma) Acoustic neuromas are benign tumors that arise from the cochleovestibular (hearing and balance) nerve. At least four thousand of these tumors are diagnosed in the United States per year. These tumors are slow growing and arise within the temporal bone which contains the nerves to the inner ear. As these tumors expand, they grow into the intracranial cavity and lead to compression of cranial nerves that regulate facial movement, facial sensation, hearing, balance, and speech and swallowing. In addition, the portion of the brain that regulates coordination and motion (the cerebellum) and the brainstem itself may be compressed by these tumors. Early in tumor growth the acoustic neuroma is limited to the internal auditory canal a structure that transmits the hearing and balance nerves from the inner ear to the brain, and that also transmits the facial nerve on its journey to the muscles of facial expression. Patients with a stage one or intracanalicular stage acoustic neuroma (confined entirely inside the internal auditory canal) often complain of difficulty with hearing in one ear, which may begin suddenly or insidiously. Hearing loss may be accompanied by noise inside the ear (tinnitus), dizziness and vertigo.  

Figure 1 is a view of the head from above. The posterior fossa with the intracranial contents of the cerebellum, brain stem and cranial nerves, as well as the temporal bone can be seen. The temporal bone is a part of the skull base. In the temporal bone is the internal auditory canal that allows the cochleovestibular (hearing and balance) nerve and the facial nerve to pass from their intracranial site of origin to either the cochlea (snail like hearing organ), vestibular apparatus (balance organ with the 3 semicircular canals), or the muscles that move the face. Acoustic neuromas most commonly arise in this canal. In Figure 1, a small intracanlicular tumor (colored brown in this illustration) can be seen. 

In Figure 2, a larger acoustic neuroma is present. This tumor has grown out of the internal auditory canal into the region known as the cerebellopontine angle, or CPA. The tumor has a characteristic shape, with a root like extension in the internal auditory canal and a globular portion in the intracranial cavity, just touching the brainstem, cerebellum and some of the cranial nerves. Patients may have the same symptoms as when the tumor is in the internal auditory canal or patients may have additional symptoms such as headache. 

The brainstem compressive stage can be seen in Figure 3. In this figure the brainstem, cerebellum and cranial nerves are being compressed by the tumor. Acoustic neuromas are almost universally benign (not cancer), so they do not erode into, or replace brain tissue. Rather acoustic neuromas cause damage by taking up space in the intracranial cavity where no extra space exists. Compression and attentuation of vital structures in this stage can lead to increased headaches and numbness of the face. 

The final stage of acoustic neuroma growth, seen in Figure 4, causes hydrocephalus or a blockage of drainage of the cerebrospinal fluid in the head that bathes the brain. This increased pressure and further compression of the brainstem, cerebellum and cranial nerves results in more severe symptoms such as double vision , difficulty with speech and swallowing, and even difficulty with breathing, and, if left untreated for an extended period, eventually death. 
The treatment of acoustic neuromas is complex and requires a sophisticated and well coordinated team. Our Consortium on Skull Base Tumors cares for patients with these and other complicated tumors in this region. The skull base surgery team is composed of a neurotologist-skull base surgeon and neurosurgeons who perform microsurgical resections of these lesions. During the microsurgery a third physician, a neurophysiologist, performs electrophysiologic monitoring of many of the nerves compressed by the tumor, so that these nerves can be both electrically and visually identified, in an effort to preserve function.



Radiosurgery:
Gamma Knife and X Knife - LINAC Our team is also known for our expertise in treating with focused forms of radiation therapy including gamma knife radiosurgery and X knife Linac based radiation. Increasingly, these forms of radiotherapy are being used both in combination with surgical debulking for larger tumors, and as a form of primary therapy for selected smaller tumors, often in older patients.
If you would like to schedule an appointment, please contact:

http://www.nycornell.org/ent/acoustic.neuroma.html

Neuron Synapse

neuron synapse

http://www.youtube.com/watch?v=LT3VKAr4roo&feature=related

gout

http://knol.google.com/k/gout#

http://www.beatinggout.com/2009/04/how-to-stop-a-gout-attack/

Kenapa wanita tidak suka apabila disebut BIDADARI???

by Nisrin Insyirah on Saturday, August 28, 2010 at 4:50pm



“Ustaz, boleh tak kalau di syurga nanti, saya tak nak suami saya ada bidadari?”

Soalan ini pernah dikemukakan oleh seorang wanita (entah datin mana tah), sewaktu sesi soal jawab dalam satu kuliah (kalau aku tak silap, oleh Ustaz Dato Abu Hassan Din Al-Hafiz), pada sekitar awal 90-an.

Jawapannya nanti dulu. Aku nak bincang hal yang lebih penting. Haha..

Datin tersebut wajar diberi ucapan syabas kerana berani menyuarakan apa yang terbuku di kalbu ramai wanita. Tapi pasti kebanyakannya tak tergamak nak luahkan perasaan tu.

Mmm..nampaknya sampai begitu sekali kaum wanita ni meluat dengan bidadari syurga. Aku guna perkataan ‘meluat’ sebab aku rasa inilah istilah yang paling sopan. Mungkin ada yang sampai rasa benci bila mendengar perkataan ‘bidadari’, aku tak nafikan.

Apa puncanya sampai jadi macam tu?

Penjelasan yang paling mudah, sebab cemburu.

Penjelasan yang lebih mendalam; sebab wanita sebegitu menyangka bahawa suaminya adalah MILIK mutlak si isteri. Sebagaimana miliknya terhadap kereta Mercedesnya dan rumah banglonya. Tak mahu KONGSI dengan orang lain.

Aku pernah menghadiri majlis ilmu yang dianjurkan satu jemaah tabligh..ustaz yang sedang memberi amanat kepada bakal-bakal da`ie itu ada menyebut, “Jangan sekali-kali ceritakan mengenai bidadari apabila anda sedang membicarakan tentang nikmat syurga di khalayak yang ada wanita menghadirinya. Dikhuatiri jika anda tidak bersedia dengan ilmu yang cukup, majlis ilmu itu akan hanya menimbulkan rasa benci di kalangan wanita yang masih lemah imannya..”

Fuhh~! Sampai begitu sekali rupanya. Dahsyat..

Aku tak sangka sampai begitu sekali, hingga ‘pantang’ disebut tentang bidadari di depan wanita.

Tapi..Dalam Al-Qur’an kan bidadari disebut tanpa berselindung? Ohoho…mungkin tak apa la sebab kebanyakan wanita di luar sana tak faham pun bila mendengar atau membaca Qur’an.

Habis, nak biarkan macam tu je? Biarkan je wanita ‘bermusuh’ dengan bidadari? Tak ada cara nak ‘mendamaikan’ dua golongan ni ke?

Biar aku beritahu apakah jawapan ustaz yang awal tadi.

“Di syurga nanti, selagi puan tak berenggang dengan suami puan, suami puan seakan-akan tak nampak pun bidadari. Tak perlu lah puan risau sangat. Yang penting sekarang, usahakan agar puan bersama suami dapat menjadi ahli syurga. Kalau isteri terpaksa masuk neraka buat sementara, dan suami yang masuk syurga dulu, saya tak jamin la bidadari tak ganggu dia..” Padat dan bersahaja jawapan yang diberikan ustaz, disambut gelak ketawa hadirin. Si datin tunduk sambil tersenyum kelat.

Hmm..kenapa suami tak nampak bidadari bila isterinya ada? Sebab wanita ahli syurga kelak akan dijadikan oleh Allah sebagai ketua bidadari. Hebatnya kecantikan ketua bidadari ni, adalah ibarat cahaya bulan mengambang penuh di musim panas. Para bidadari yang lain pula ibarat bintang-bintang yang bertaburan di sekelilingnya. Hanya menyerlah tika bulan menyepi.



Maka apabila Ketua Bidadari itu hadir, si suami seolah-olah terpukau, dan bidadari yang lain seakan tak kelihatan, ataupun nampak kecil saja. Macam gadis jelita dikelilingi budak-budak tadika. Tentu saja fokus si suami takkan beralih dari melihat isterinya.

Hebat kan? Tapi macam mana kalau tiada bidadari langsung? Kan lagi bagus kalau tiada saingan?

Tidak juga.

Andai tiada bidadari, maka cantiknya Ketua Bidadari umpama bulan penuh di langit yang kosong. Kejelitaannya jadi kurang menyerlah kerana dia cantik sorang-sorang, tak ada siapa yang kurang dari dia, jadi pada siapa dia nak dibandingkan? Pada jiran di mahligai bersebelahan yang jaraknya sejauh mata memandang?

Wahai wanita penghuni syurga; anda sama cantik saja dengan Ketua Bidadari yang lain. Tak berapa seronoklah. Anda hanya paling cantik di mata suami anda. Begitu juga Ketua Bidadari yang menjadi jiran anda, tercantik di mata suaminya.

Satu perkara lagi, para bidadari syurga adalah penghuni asal yang telah Allah tempatkan di situ. Mereka penduduk asal syurga. Tak bolehlah nak halau mereka pula. Nanti mereka mengadu pada Allah. Mereka tidak pernah berbuat dosa, taraf mereka seakan malaikat yang sentiasa makbul doanya. Cuma mereka ini Allah kurniakan nafsu sebagaimana manusia. Tetapi nafsu mereka bersih (tidak takabbur terhadap Allah) dan tidak terhijab.

Dalil tentang mereka mempunyai nafsu, dalam surah Al-Waqi`ah ada ayat yang berbunyi `uruban atraaba, yang apabila diterjemahkan bermaksud: “sentiasa merindui (suami mereka yang berada di dunia) dan muda belia usia mereka”.

Di dalam bahasa Arab, kalimah `uruban juga bermaksud berahi berpanjangan. Dalam istilah yang agak kurang sopan (minta maaf), mereka ini sentiasa merindui jimak. Saya mohon maaf sekali lagi, tapi wanita dengan sifat sebeginilah yang diidamkan oleh hampir semua lelaki. (ah..aku rasa bukan HAMPIR semua, tapi memang SEMUA lelaki normal macam tu).

Baiklah. Anda dah nampak, cara untuk mengelakkan suami anda dari melayani bidadari, ialah dengan sentiasa ada di sisi suami. Senang saja bukan? Barulah bidadari lain tak ‘kacau daun’.

Betul?

Tapi adakah anda pasti?

Kita rujuk sebuah hadith yang menceritakan tentang keadaan penghuni syurga;

Para Sahabat bertanya, adakah penghuni syurga melakukan jimak, dan bagaimanakah keadaan mereka? Dijawab oleh Rasulullah, “Benar. Oh, sungguh hebat sekali. Tenaga dan kenikmatan mereka Allah gandakan kepada seratus, dan mereka sekali pun tidak akan merasa letih.” ~au kama qaal

Hmm. Maknanya, kalau Ketua Bidadari tak mahu berenggang dengan suami, maka alamatnya tak keluar dari bilik la. Layanlah sampai dia puas.

“Tak kisah, janji dia tak layan bidadari..” mungkin itu jawapan seorang wanita.

Saya beritahu lagi; Ahli syurga juga tidak tidur, kerana terdapat hadith yang menyatakan bahawa “tidur itu saudara mati, maka ahli syurga tidak memerlukan kepada tidur, tidak mengantuk, dan tidak letih, lapar, atau dahaga..”. (au kama qaal)

Jenuh la kali ni tak turun-turun dari katil. Sanggupkah anda? Berapa minggu anda sanggup? Berapa tahun? Berapa dekad? Berapa kurun?

Jika di hati anda terdetik rasa bosan, para bidadari di luar bilik akan mengetuk pintu sambil bertanya bilakah gilirannya akan sampai. “Ketua! Biar kami pula ambil alih!” ..mungkin itu yang mereka kata.



“Biarlah diorang menunggu kat luar..aku takkan tinggalkan suami aku!” Mungkin ada wanita yang berfikir begini.

Izinkan saya bertanya lagi; “Tak nak pergi shopping ke?” ; )

“Eh, shopping? Shopping apa? Kat mana?”

Mafhum daripada beberapa hadith yang mutawatir, Pada setiap Jumaat Allah adakan suatu ‘pasar’ di syurga. Di pasar inilah, ahli syurga diberi nikmat terbesar antara segala nikmat di syurga, iaitu diizinkan melihat kepadaNya. Tiada satu pun ciptaanNya yang mengatasi keindahan Sang Pencipta, Rabbul Jalil yang bersifat Al-Jamiil.

Dan di ‘pasar’ syurga inilah Allah sediakan segala pakaian, makanan, dan perhiasan (barang kemas dan aksesori) yang berbagai-bagai rupa, beraneka warna dan bentuk.

Ahli syurga cuma perlu melihat kepada contoh ‘produk’ yang dipamerkan, niatkan “Aku mahu yang ini!”; maka dengan serta-merta benda itu sudah dipakai di tubuhnya. Boleh juga meminta seperti itu apabila terlihat ada ahli syurga yang lain, memakai sesuatu yang menarik perhatiannya.

Kenapa perlu ada pasar? Kan boleh minta saja dari dalam bilik?

Perlunya ada pasar ini kerana ahli syurga ketika itu dah tak tahu apa lagi yang mahu diminta, kerana terlalu lama dan banyaknya nikmat yang diperolehi mereka.

Ibarat anda dah dapat semua file/software yang anda ingini, sampai anda tak tahu nak download software/file apa lagi di internet. Dah tak tahu nak ’search’ apa, sampai termenung di depan superkomputer yang terhebat dan terlaju di dunia, milik anda. Lebih kurang macam tu la ibaratnya.

Maka di ‘pasar’ syurga inilah terdapat pakaian dan barang kemas serta aksesori wanita (dan lelaki) dalam ‘rekabentuk terbaru’…’latest design’ kata sesetengah orang. Sebab itu ahli syurga tidak akan merasa jemu.

Dan apa yang paling hebat, semua yang ada di pasar ini adalah PERCUMA! Ibarat Ivana Trump pergi shopping di HyperMall milik ayahnya yang asyik pecat orang (”you’re fired!”). Tapi di syurga pastinya berjuta-juta-juta kali lebih mewah. Dan anda kekal muda selama-lamanya, tak macam minah saleh tu..

Di pasar syurga tu, semua benda yang menyenangkan hati anda boleh didapati. Niat saja nak pakaian baru, anda akan tiba di Department Pakaian Wanita.

“Handbag LV (Louis Vuitton) ada ke?” ..cheh. Ada sorang minah yang baca artikel ni boleh terfikir nak tanya camni..

Begini sajalah. Biar saya bacakan mafhum sebuah hadith lagi. “Jannah itu ialah satu kawasan yang tersangat luas. Terdapat lembah, sungai, pohon, dan bukit. Tanah di tengah-tengahnya yang paling tinggi, dan Al-Firdaus berada di tempat yang paling tengah dan paling tinggi”.



belum habis lagi..ada sambungan hadith ni;

“Keseluruhan syurga itu terdapat seratus tingkat. Pada tingkat yang terendah dan pertama, kesemua sudu senduknya, gelas pinggannya, kerusi mejanya diperbuat daripada perak. Tingkat yang kedua, semua sudu senduknya, gelas pinggannya, kerusi mejanya daripada emas; pada tingkat yang ketiga, sudu senduknya, gelas pinggannya, kerusi mejanya daripada yaqut, lu’lu’ dan zabarjad (batu-batu permata yang mahal), dan pada sembilan puluh tujuh tingkat lagi hanya Allah yang mengetahuinya. Jarak antara satu tingkat dengan tingkat yang lain adalah sejauh jarak langit dan bumi.”

Rasulullah hanya sempat meninjau tiga tingkat yang pertama sahaja sewaktu isra’ dan mi`raj.

Syurga tingkat pertama yang terendah adalah untuk ahlul fitrah, manusia yang tidak pernah beriman tetapi seruan tauhid tidak pernah sampai kepada mereka ketika hidup di dunia dahulu. Mereka diizinkan masuk ke syurga setelah selesai menjalani qisas di mahsyar, jika mereka ada menzalimi sesama mereka. Inilah tanda betapa Maha Pemurahnya Allah Yang Maha Adil, tidak menzalimi seorangpun hambaNya.

Tingkat pertama ini juga adalah untuk para muallaf yang hanya sempat mengucapkan syahadah tanpa satu pun amalan baik, dan tiada satu pun kalimah Allah yang sempat dipelajarinya.

Maka sekiranya kita umat Islam ini berjaya ke syurga, tempat kita adalah bermula dari tingkat yang kedua, atau lebih tinggi lagi. Tingkat kedua, barang-barang perkakas dapur serta perabutnya diperbuat daripada emas.

Saya tanya; Di dunia sekarang (di bumi) ini, adakah pakaian dan barang kemas kita diperbuat daripada bahan yang serupa dengan bahan membuat perabut dan peralatan dapur?

Anda tahu jawapannya ialah tidak. Bahan untuk pakaian dan perhiasan kita lazimnya mestilah lebih mahal daripada bahan membuat perabut dan perkakas dapur.

Ertinya, bila sudu dan meja pun diperbuat daripada emas, agaknya apakah bahan yang jadi pakaian dan barang kemas ahli syurga? Sudah tentu lebih mahal daripada emas!

Ya. Bahan dan unsur yang lebih mahal itulah yang dibuat pakaian ahli syurga..termasuk juga kasut tumit tinggi dan handbag (jika anda mahu, pasti ada!), termasuk juga barang kemas yang ada di Pasar Syurga tu.

Ketika itu jika anda ternampak handbag LV dari alam dunia, mungkin anda akan terasa jijik nak menyentuhnya macam tengok tahi ayam. Mana ada kelas! Emas pun setakat jadi jug air je..Gelas minuman pun dibuat daripada berlian (kalau anda menghuni syurga tingkat atas sikit).

Hm..Di pasar yang bagaikan real-life catalogue ini, semuanya lebih mahal dari perkakas dan pinggan mangkuk anda. Terlalu banyak pilihan. Shopping la sebanyak mana yang anda mahu. Tak perlu trolley. Kalau anda nak suruh bidadari bawakan barang yang anda shopping itu pun, mereka pasti gembira dapat membantu.

Janganlah lupa pula..para bidadari itu juga khadam anda yang sangat suka berkhidmat. Anda kan ketua mereka?



Ingat ni, kesemuanya anda tak perlu bayar! Bayarannya telah dilangsaikan dengan keringat, darah dan air mata anda ketika di dunia dahulu.

Tapi kalau nak dapatkan ‘design’ terbaru tu, kenalah keluar dari rumah (istana) dan tengok sendiri di pasar Jumaat. Di pasar ini juga ahli syurga akan bersosial, bertemu rakan lama dan saudara mara.

Berapa luas pasar tu? Jika anda terbang menaiki buraq selama sehari pun belum habis melihat keseluruhan bahagian ‘pasar’ itu. (kalau naik kenderaan yang lebih laju, anda tak nampak apa-apa sebab laju sangat, mengatasi kelajuan cahaya).

Dan sudah tentu suami anda pun nak pergi ke Pasar Jumaat itu juga untuk melihat Allah Rabbul Jalil. Ajaklah suami shopping sekali!

Setiap minggu, akan ada design terbaru yang boleh anda dapati. Setiap minggu juga anda boleh datang shopping di pasar ini. Sampai tahun depan, kurun hadapan, alaf hadapan…sampai bila-bila. Tiada had usia di syurga..

Soalan terakhir saya: Yang mana lebih menyeronokkan bagi anda; shopping dengan suami, atau pergi shopping bersama bekas teman-teman rapat, rakan sekolej (atau rakan serumah) anda dahulu? ..dan mungkin pada kurun hadapan, suami anda nak pergi memancing di sungai syurga bersama bekas rakan sekampungnya…atau mungkin dia cuma nak ‘berehat di rumah’ saja.. ;-j

P. S : Dah la..tak payah risau. Perasaan cemburu tu kerana disebabkan kejahilan tentang fitrah lelaki dan tak faham kehendak suami. Ahli syurga tidak ego dan cemburu buta. Di syurga tiada hasad dengki dan tiada sifat takabbur. Qaalu salaaman-salaama ~ 

pasted from

http://www.facebook.com/note.php?note_id=235791575089&id=1196086465

Crush syndrome vs DrHouse season6-Help Me

Crush Syndrome Protocol

Crush syndrome is a medical condition that occurs when significant portions of the body are subjected to crushing force for an extended period of time. Large numbers of crush syndrome cases are often seen after serious earthquakes, when people are trapped under falling rubble and sometimes have to wait several hours for rescue. The most serious complications of crush syndrome result from the death of large numbers of muscle cells and the release of the contents of these cells into the blood. Crush syndrome protocol is a set of treatments aimed largely at minimizing these complications.

Pathology of Crush Syndrome
1. While some muscle cells are ruptured by the actual pressure of the crushing trauma, the most destructive aspect of crush syndrome comes from the disruption of blood flow. When muscle cells are deprived of blood, they eventually die and release their contents to the surrounding tissue (rhabdomyolysis). The most dangerous muscle cell contents are the protein myoglobin and the mineral potassium. When circulation is restored to the surrounding tissue, the myoglobin and potassium spread throughout the blood stream and can cause serious problems.

Consequences of Crush Syndrome
2. The most dangerous aspect of crush syndrome is the increase in potassium in the blood (hyperkalemia). High levels of potassium can disrupt electrical conduction in the heart and potentially cause it to stop beating. The high levels of myoglobin in the blood can cause damage to the kidneys, since they are responsible for filtering excess proteins from the blood. The crush syndrome protocol is designed to minimize these dangers.

Compartment Syndrome
3. Compartment syndrome is an extremely serious condition that can occur as part of crush syndrome. Compartment syndrome occurs when there is so much swelling within an enclosed compartment of a limb that blood can neither enter nor leave. Pressure rapidly builds up inside the compartment and widespread destruction of tissue occurs. Untreated compartment syndrome usually results in the need for limb amputation.

First Responder Protocol

4. First responder protocol for crush syndrome is in many ways similar to that for other types of trauma. The first priorities are still ensuring that there is adequate respiration and blood pressure. The crush syndrome protocol places extra emphasis on IV hydration to help lower the level of potassium in the blood and reduce the filtering work of the kidneys. Tourniquets are usually applied to affected limbs to reduce the risk of compartment syndrome. There is also increased monitoring for rhythm problems in the heart.
Hospital Protocol

5. The hospital protocol for crush syndrome is in some ways a continuation of the first responder protocol. Emphasis is placed on aggressive hydration to relieve the strain on the kidneys, and sodium bicarbonate may be used intravenously to help protect the kidneys. If the kidneys show signs of failing, it may be necessary to resort to dialysis to remove the myoglobin from the blood. Careful monitoring for compartment syndrome is essential, and surgery to relieve the pressure must be performed immediately if it develops


Read more: Crush Syndrome Protocol | eHow.com http://www.ehow.com/about_6453495_crush-syndrome-protocol.html#ixzz0ueKe9Qns
http://www.ehow.com/about_6453495_crush-syndrome-protocol.html

When truth beautifully said...

A thousand miles I'd run and walk,
A thousand times I'd slip and fall,
But for you I'd do it again,
A thousand times

DOA ANGIN AHMAR

Doa pelindung & penawar angin ahmar

Posted by nurjeehan in Doa & Zikir, Petua & Amalan. 52 Comments

PENYAKIT Angin Ahmar ialah penyakit mati sebahagian badan, yang biasanya datang dengan tiba-tiba dan sukar pula untuk diubati. Walau bagaimanapun, dengan rahmat dan belas kasihan Allah swt kepada hamba-hambaNya maka melalui Nabi Muhammad s.a.w., umat Islam dikurniakan doa yang sangat mustajab dan besar faedahnya bagi menjauhi penyakit tersebut disamping lain-lain penyakit berbahaya dan bala bencana.

Amalkanlah membaca doa ini selalu, paling kurang sekali seumur hidup. Dengan mematuhi kaedah dan adab-adab berdoa disamping berikhtiar, Insya Allah, mudah-mudahan doa kita dikabulkan dan kita terhindar dari penyakit yang berbahaya ini.

Maksudnya:

Dengan nama Allah Yang Maha Pemurah lagi Maha Penyayang; dan dengan-Nya kami memohon pertolongan; dan dengan Allah; dan dari Allah; dan kepada Allah; dan segala pujian tertentu bagi Allah; dan tiada Tuhan melainkan Allah; dan Allah Maha Besar, yang Maha Mulia dan Maha Agung; yang aku takut dan bimbang terhadap-Nya. Allah Maha Besar dengan segala kebesaran-Nya; segala pujian tertentu bagi Allah, sebanyak-banyak pujian. Dan Maha Suci Allah pagi-pagi dan petang-petang. Dengan nama Allah yang menyembuhkan, dengan nama Allah yang mencukupkan; dan dengan nama Allah yang menyihatkan; dengan nama Allah yang dengan nama-Nya tiada memberi mudharat sesuatu apa jua di bumi dan di atas langit, dan Dia Maha Mendengar lagi Maha Mengetahui. Dan Kami turunkan sesetengah dari Al-Quran yang menjadi penawar dan rahmat untuk orang-orang yang beriman.

Ya Allah, aku yang menjampi dan Engkau yang menyembuhkan. Aku berlindung dengan-Mu daripada kejahatan yang telah Engkau takdirkan. Allah Maha Besar, Allah Maha Besar, Allah Maha Besar. Aku berlindung dengan Allah, Tuhanku dan Penciptaku, Pembentukku dan Pencipta Rupabentukku dan Pemberi Rezeki sekalian manusia. Aku berlindung dengan Allah daripada sekalian kebinasaan, dan segala maksiat, bala bencana, penyakit dan segala kesakitan, kemalasan, kemunduran dan kebinasaan.

Ya Allah, lindungilah penanggung (pengguna) suratku ini dengan nama-Mu yang Maha Mulia dan Maha Agung; dan sifat-sifat-Mu yang sempurna, wahai Yang Mempunyai Kebesaran dan Kekayaan. Wahai Tuhan yang memiliki kerajaan dan alam malakut; wahai Tuhan yang memiliki keagungan dan kegagahan. Maha Suci Engkau, alangkah besarnya Engkau wahai pencipta segala langit dan bumi. Wahai Tuhan tempat berlindung mereka yang menyesal (akan dosa-dosa mereka); wahai Tuhan yang Maha Pengasih terhadap orang-orang miskin; wahai Tuhan pemilik kebesaran dan kekuasaan, wahai Tuhan yang mempunyai belas kasihan dan memberi kebajikan dan Ihsan; wahai Tuhan yang banyak kasih sayang, wahai Tuhan yang banyak memberi; wahai Tuhan yang Maha Gagah dan tiada sesiapapun yang mampu mengalahkan-Nya; wahai Yang Melindungi dan Dia tidak memerlukan perlindungan, aku berlindung dengan-Mu dari azab ke atas badan dan kesempitan; dan aku berlindung dengan-Mu dari penyakit Angin Ahmar dan penyakit yang besar yang menimpa ke atas diri dan roh, darah dan daging, tulang dan kulit, urat dan urat saraf.

Maha Suci Engkau; yang apabila Engkau menghendaki sesuatu maka Engkau hanya mengatakan “Jadilah! Maka jadilah ia”. Allah Maha Besar, Allah Maha Besar, Allah Maha Besar. Wahai Tuhan yang menjadikan; wahai Tuhan yang membuat kebajikan, wahai Tuhan yang memberi pertolongan, wahai Tuhan yang Maha Gagah, wahai Tuhan yang Maha Adil, wahai Tuhan yang Berdiri dengan Keadilan, wahai Tuhan yang mendengar tangisan orang-orang yang meminta pertolongan. Wahai Tuhan yang memulakan (dari tiada kepada ada), wahai Tuhan yang mengembalikan, wahai Tuhan yang menolak, wahai Tuhan yang Mencukupkan. Wahai Tuhan yang menyembuhkan, wahai Tuhan yang meng’afiatkan, wahai Tuhan yang memberi pertolongan terhadap orang yang memohon pertolongan.

Wahai Tuhan yang menerima kesyukuran, wahai Tuhan yang banyak memberi balasan atas kesyukuran. Wahai Tuhan yang Maha Kasih Sayang, wahai Tuhan yang Maha Belas Kasihan, wahai Tuhan yang memberi pertolongan, wahai Tuhan yang Maha Berkuasa, wahai Tuhan yang Maha Gagah, wahai yang Maha Berkuasa, wahai Tuhan yang Maha Agung, wahai Tuhan yang mendahulukan, wahai Tuhan yang mengkemudiankan. Wahai Tuhan yang hidup, wahai Tuhan yang berdiri dengan sendiri-Nya, yang membalas mereka yang jujur dengan balasan ke atas tiap-tiap diri dengan apa yang mereka usahakan. Wahai Tuhan yang memerintahku, wahai Tuhanku yang memiliki aku, wahai Tuhan yang memberi perlindungan.

Wahai yang Maha Mengetahui sesuatu yang kami sembunyikan dan kami dedahkan; wahai Hakim yang menjatuhkan hukuman, wahai Tuhan yang memerintah sekalian orang-orang yang beriman; wahai Tuhan pembantu orang-orang yang dhaif dan miskin; wahai Tuhan yang Mencukupi keperluan orang-orang yang bertawakkal.

Wahai Tuhan yang mendatangkan malam ke atas siang dan siang ke atas malam; wahai Tuhan yang Gagah (mengalahkan) setiap syaitan yang sangat durhaka, wahai Tuhan yang mengalahkan setiap orang yang sombong lagi degil; wahai Tuhan sebaik-baik Pemerintah; wahai Tuhan yang sebaik-baik memberi pertolongan, wahai Tuhan yang memberi rezeki kanak-kanak yang kecil, wahai Tuhan yang Maha Pengasih terhadap orang tuan (yang sangat tua), wahai Tuhan yang memerintah orang-orang yang beriman; wahai Tuhan bagi orang-orang yang dahulu dan orang-orang yang kemudian; wahai Tuhan yang pengasih kepada orang-orang yang bertaubat, wahai Tuhan yang Maha Pengasih dari kalangan yang mengasihi. Wahai Tuhan sebaik-baik pengampun dari yang mengampuni; wahai Tuhan sebaik-baik pewaris; wahai Tuhan sebaik-baik Pemberi Keputusan; wahai Tuhan yang memerintah pada Hari Pembalasan.

Ya Allah, hanya Engkaulah yang aku sembah dan hanya kepada Engkaulah aku memohon pertolongan. Dan kepada-Mu aku bertawakkal. Dan kepada-Mu aku gemar dengan apa yang ada di sisi-Mu. Kepada-Mu aku berharap dan hanya Engkau yang aku takuti. Ya Allah, peliharalah aku dari segala kepayahan hidup dan penyakit-penyakit dan segala kesakitaan dan kesusahan dan darah hitam.

Ya Allah, peliharalah aku dari penyakit yang merbahaya dan dari penyakit Angin Ahmar dan penyakit darah kuning, dan segala kebinasaan dan segala maksiat dan pengsan, dan kerungsingan dan kesedihan dan dukacita dan dari di penjara. Ya Allah, peliharalah aku dari kejahatan binatang buas, dan binatang yang melata, serta permusuhan (benci membenci) orang awam, dan dari kekalahan dan kejahatan syaitan; dan raja, kemarau, kemahalan barang keperluan, dan gempabumi, dan bala bencana, dan keruntuhan bangunan, dan serangan musuh. Ya Allah, peliharalah aku dari kejahatan orang-orang yang jahat dan tipudaya orang-orang yang melampau, dan dari sesuatu yang silih berganti atasnya oleh malam dan siang melainkan yang datang itu adalah dengan baik, wahai Tuhan yang Maha Pengasih lagi Maha Penyayang.

Aku berlindung dengan Engkau dari kejahatan setiap kejadian yang Engkaulah pemegang ubun-ubunnya; sesungguhnya Tuhanku di atas jalan yang tegak dan lurus. Engkau ialah Tuhanku dan di atas Engkau jua aku bertawakkal, dan Engkaulah yang Mencukupkan aku, dan sebaik-baik yang Mewakili, sebaik-baik Pemerintah dan sebaik-baik yang Memberi Pertolongan. Dan tiada daya upaya bagiku melainkan dengan Allah yang Maha Tinggi lagi Maha Agung.

Dan cukuplah kami oleh Allah, dan sebaik-baik yang mewakili sebagai Pemerintah dan Engkau sebaik-baik pemberi pertolongan. Allah yang mencukupkan, Allah yang menyembuhkan, Allah yang memberi a’fiat. Dan ucap selawat oleh Allah ke atas penghulu kami Nabi Muhammad dan ke atas keluarga dan sahabat-sahabatnya; selamat sejahtera; dan segala pujian bagi Allah Tuhan Pemerintah Seluruh Alam. Amin…

http://nurjeehan.wordpress.com

STROKE

How Is A Stroke Treated?

A stroke is a medical emergency, regardless of whether it is a major stroke or a short-lasting TIA. A person suffering a stroke should be taken immediately to a hospital emergency department.

The ability to pinpoint quickly the precise location of a stroke and determine the extent of damage is critically important in treatment decisions. A stroke caused by a blocked artery is treated in an entirely different way than a stroke caused by bleeding within the brain.

The key to survival and recovery is prompt medical treatment.

How-To Information:

If a stroke is caused by a blocked artery, medications are now available to reverse damage to the brain and significantly increase the odds of survival. However, these medications are effective only if they are given within a few hours of the time when the first stroke symptoms begin.

Tests That May Be Performed At The Hospital

Scans of the brain are performed to confirm a diagnosis of stroke and to determine the type of stroke. This is important since the treatment of different types of stroke differs.

These tests include:

* Computed tomography scan (CT scan) is generally the first diagnostic test done after a person suspected of having a stroke arrives in the emergency department. The test uses low-dose x-rays to take pictures of the inside of the brain.

For more information about CT Scan, go to Computed tomography scan (CT scan).

* Magnetic resonance imaging (MRI) is an advanced diagnostic tool that uses the principals of magnetism to view the inner body. An MRI of the brain can show small blood vessels that may be blocked or bleeding.

For more information about MRI, go to Magnetic resonance imaging (MRI).

* Transcranial doppler (TCD) is a new, noninvasive ultrasound procedure that uses a small probe placed against the skull to track the blood flow through the vessels in the brain.

* SPECT imaging uses low doses of a harmless radioactive substance injected into a vein in the arm, then uses a specialized camera to view the blood flow in the brain.

Medicines To Treat Stroke

If the stroke A type of cerebrovascular disease that is caused by a sudden interruption of blood flow to a part of the brain, which can kill or damage brain cells. A brain attack. is caused by a blockage:

* Drug therapy is a relatively recent approach to the treatment of stroke. If the stroke is caused by a blockage in an artery, medications called thrombolytic drugs can be used. The only drugs approved by the FDA for treatment of stroke are tissue plasminogen activators (TPA drugs). Popularly referred to as "clot-busting" drugs, these medications have been used for years to treat heart attacks.

Some studies have indicated that if TPA drugs are given to stroke patients within three hours of the onset of symptoms, more than half of them will make a full recovery in a matter of months.

Not all hospitals, however, have the ability to give TPA drugs to people having a stroke. Before these drugs can be given, doctors must be certain that the stroke is the result of a blockage in the artery and not due to bleeding from an artery. This is determined through imaging procedures such as computed tomography (CT) scans and magnetic resonance imaging (MRI). But not all hospitals have around-the-clock imaging services.

If a stroke is caused by bleeding:

* Medication can be given to reduce swelling of brain tissue.

Surgical Procedures

If the stroke is caused by a blockage:

A procedure called carotid endarterectomy The surgical removal of plaque that is blocking or reducing blood flow in a carotid artery. can be used to remove a buildup of plaque Fatty deposits that stick to the inside walls of blood vessels, causing the vessel to become narrow and, in some cases, blocked altogether. from inside the carotid artery The arteries on each side of the neck that carry blood from the heart to the brain., one of the major sources of blood to the head and neck. Carotid endarterectomy can be used to treat people who have had a stroke and also as a preventive measure for people at risk for stroke.

If the stroke is caused by bleeding:

* An artery within the brain sometimes can be "clipped" to prevent further bleeding.

* If the bleeding has occurred in the subarachnoid space, pooled blood (hematoma) can dangerously increase pressure on the brain and damage delicate tissue. If it is feasible, surgery may be necessary to drain blood from within the area of damaged brain tissue.

Other Procedures

Several types of interventional radiology also are available to treat stroke. These procedures have been in existence for some time, but they have been improved and refined in recent years. However, not all hospitals are equipped to offer interventional radiology.

Interventional radiology is performed by inserting a long, thin, flexible tube called a catheter into blood vessels. The insertion point is usually in the groin, and the incision is about the size of the tip of a pencil. The catheter is guided to various parts of the body while a computer tracks it and records images of the blood vessels. This procedure creates a precise road map of even the tiniest vessel in the body.

* The catheters can be guided to areas of bleeding and used to effectively close off the leaking vessels.

* The catheters can be used to widen areas of blood vessels that have become narrowed because of a buildup of plaque.

* The catheters can be used to place stents made of a fine, tubular wire mesh to hold a blood vessel open.

What To Expect During A Hospital Stay

After the initial tests to determine the type of stroke and the best treatment, other procedures may be necessary to find the cause of the stroke. These procedures may include tests of the heart or the arteries to the brain.

The length of the stay in the hospital and the type of treatment will depend on the severity of the stroke. Many people need some form of therapy to help their brain relearn skills lost because of the stroke.

Nice To Know:

Q: My father had all the signs of a stroke, but he waited more than six hours before getting to the hospital. Even though his stroke was caused by a blocked artery, doctors did not give him "clot-busting" medicines. Why not?

A: TPA drugs are powerful blood thinners that can help dissolve a clot and restore blood flow, but the FDA requires that they be given within three hours after stroke symptoms first begin. When TPA is given more than three hours after stroke A type of cerebrovascular disease that is caused by a sudden interruption of blood flow to a part of the brain, which can kill or damage brain cells. A brain attack. onset, there is a greater risk that it will cause uncontrollable bleeding. It is very important that this guideline is followed and that everyone is made aware of the critical importance of seeking help immediately if experiencing stroke symptoms.

can stroke be treated

For the best, most effective treatment of stroke, a person with a suspected stroke must be given immediate medical attention. It is during the critical first 3 to 6 hours following stroke that today's growing stroke therapy options have the highest curative potential. Doctors can now administer an injection of tissue plasminogen activator (TPA) to dissolve the clots that block blood flow to the brain. If the blockage can be removed with administration of TPA and sufficient blood flow is recovered within a three hour period following the stroke, the severity of permanent brain damage (neurological disability) is minimized or eliminated. However, medical imaging is a critical component in determining the course of stroke treatment.

Medical imaging is vital in the detection and treatment of stroke.

Important Note: Some of the methods of acute stroke diagnosis and treatment described herein are new and are still not widely available in the U.S. People who are at high risk of stroke should investigate which medical centers in their area have active stroke diagnosis and treatment capabilities. Those medical centers and hospitals with dedicated stroke treatment programs should have experience in the administration of tissue plasminogen activator (TPA) or other thrombolitic and neuro-protective agents, as well as dedicated specialists and imaging protocols for diagnosing stroke and mapping the best course of therapy. Particularly in rural areas, which may not have large medical centers with the needed neurology specialists and emergency room staffing, access to these new methods of stroke diagnosis and therapy may be limited for some time (some predict it may be five years before TPA treatment of stroke becomes routine).

Updated: January 14, 2008
http://www.imaginis.com/stroke/treatment.asp

hmmm..another one of my auntie got stroke..praying for the best of her

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