Durians!

The season is now!

I had it 6 times so far.
And counting...
:)

*Update: It's 10 times as of 3/8/09!

The final count down

An outstanding doctor makes a dead ward alive! I am just inspired by the way he deals with patient. Sometimes it isn't by how knowledgeable you are, but how much knowledge you can convey to patient.

Give a person a fish and it sustains him a meal.
Teach him to fish and he will fish for his living.

Patients themselves are ultimately their own doctor if they are motivated enough to get well.

In the mean time of thanking God for bring me thus far as a medical student, I admit I did feel inferior at times of not knowing enough for what I should.

Give a final push my friends! We will graduate together!

Portfolio-phobic syndrome

NCM, 25/C/♀
Complained of left sided throbbing headache and nausea x 2 days.
A few similar episodes since 3 months ago.
Precipitated by portfolio completion.
In contact with friends with similar presentations.

Provisional diagnosis: Portfolio-phobic syndrome

Management:
Supportive therapy
KIV anti-emetic prophylaxis
TCA 5 weeks (In viewing symptoms will last till then)

P/S: Down with upper respiratory tract infection. The spell of Paediatrics seems unbroken.
Painful wisdom tooth is growing, again. Wonder why do we need so many teeth...

The angel smiles

He smiles, so wide and sun-shinny. A 9-year-old boy came tightly held by his mother in his broad based gait. I attempted rapport building. He spurted me saliva all over. He has Angelman syndrome with most of the following features:

Consistent (100%)

• Developmental delay, functionally severe
• Speech impairment, none or minimal use of words; receptive and non-verbal communication skills higher than verbal ones
• Movement or balance disorder, usually ataxia of gait and/or tremulous movement of limbs
• Behavioral uniqueness: any combination of frequent laughter/smiling; apparent happy demeanor; easily excitable personality, often with hand flapping movements; hypermotoric behavior; short attention span

Frequent (more than 80%)

• Delayed, disproportionate growth in head circumference, usually resulting in microcephaly (absolute or relative) by age 2
• Seizures, onset usually less than 3 years of age
  
• Abnormal EEG, characteristic pattern with large amplitude slow-spike waves

Associated (20 - 80%)

• Strabismus
  
• Hypopigmented skin and eyes
• Tongue thrusting; suck/swallowing disorders
• Hyperactive tendon reflexes
• Feeding problems during infancy
• Uplifted, flexed arms during walking
• Prominent mandible
• Increased sensitivity to heat
• Wide mouth, wide-spaced teeth
• Sleep disturbance
• Frequent drooling, protruding tongue
• Attraction to/fascination with water
• Excessive chewing/mouthing behaviors
• Flat back of head

Half way through history taking, again he spurted me saliva.

"Don't play with saliva." I said, not knowing earlier that impaired swallowing mechanism and saliva drooling are the features. Mother warned him by a gentle slap on his lips. He was still smiling. Happily and contented.

He is the only child. The diagnosis was certainly life changing to the family. To expect a child is joyous, but who would anticipate a needful kid? I saw his mother teaching him patiently. I noticed the mother's cross pendant. I saw motherly love.

They stepped out the clinic meeting his father. The touch his dad offered was tender. The whole family walked away with much laughter. Staring at their shadows, I am glad for such loving and supportive family. He remains the angel of the family despite being a little extraordinary.

His smile will stay with me vividly. It is indeed the happiest disease I have ever seen. Hope my ignorance was forgiven.

So smile back if somebody is smiling at you. It may be the only way he communicates.

Porty my love

Porty porty I love you!
I love portfolios!
I so love portfolios!

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Just tried hypnotizing myself. Obviously it failed.
Motivation's needed :(

Congratulations

Event: C206, B105 convocation

Date: 30th May 2009
Venue: IMU Bukit Jalil

The graduates-to-be

Dreamed a little, don't break my bubbles...

To Min Ran who deserves a joyous graduation after years of toils and turmoils: You did well, we are all proud of you.

Congrats to all graduates! Though it may be the beginning of a rough ride, I know you guys will pull through. God bless for your future undertaking.

I am looking forward mine!

♥ Never be afraid of giving up your best, God will give you His better ♥

I am fantasizing!

Just amazing!