A glance of OT experience

Patient’s History
Name: Tasneem
Age: 4 Years Old
Diagnose: Chronic Tonsillitis (Bilateral)
Operation: Tonsillectomy (perform by Dr.Ahmad)
Time: 12.30-1.45 pm, 30 Oct 2010


Patient’s been given general anesthesia. Usually there’re 4 technique performed, but the commonly used is dissection. The other 3 are Guillotine, Laser Dissection or cryptolysis and Cryosurgery.

Only three main things were done by Dr Ahmad and of course, the operation shouldn‘t take much time. But due to his generosity, we (3rd Group)stand for almost one and half our observing and questioning this and that, what and why, bla3… After the patient was fully unconscious (in supine position), the mouth was maintained open by Davis-Boyle mouth gag (seriously guys, this gag is scary! with rusty look, we do think it’s one of the instrument use in SAW movie~) Then the incision of the pillar which involve mucosa only and lastly, dissect the tonsils and ligate the blood vessels. This was when we saw Dr Ahmad was kind of struggling since the child’s mouth space was so narrow and the tonsils were quite deep. But he managed to do them well, though the MO-in-charged of anesthetic that day was pushing him to hurry and the Senior MO also kept telling that he was wasting time doing a small operation. Pressure!

What’s the most important were the complications that need to be handled after the surgery. Still remember the 6 things? Anesthesia, haemorrhage, trauma, infection, pulmonary and miscellaneous. But what’s the most important was hemostasis, stop the bleeding once the operation was finished. 3 types of haemorrhage might occur: primary, reactionary and secondary. Primary might occur during operation, due to any blood vessel injury but still can be managed by ligating it. The reactionary happened within 24hours, caused by the sudden elevation of the BP after recovery from anesthesia. And the secondary was the dangerous one. Why? Because it usually happened within week post-op, due to wound infection and the patient might need to be re-operated and other complication need to be monitored also.

The other one thing that made us felt a bit awkward was when the anesthetic tried to make the child woke up after the surgery. One of us do ask why the doctor was like using violence to the child? (she got ‘beaten’ at the chest, pinched on face and also the tonsil part where the surgery’s been made!) He answered that it’s a way of making painful stimulation so the patient woke up naturally, and the team can monitor her BP (which can cause reactionary haemorrhage), O2 saturation, or any cardiac manifestations that may persist post-op. And all of us then…OOoooooo~

Seriously, it’s fun playing in the OT! It really feels differ, when you read word by word in the book, compared to the situation when you get real experience from the doctor in the lecture or OT. When we were given chances that were not given before, why don’t we grab this chance, instead of let others go and watch all by themselves? Everybody deserve the same knowledge, be competitive, and share our experience together here!


*some of our colleague make advanced move,go to O&G, and experienced to see a normal and caeserian delivery. Care to share?=)



-ilmu didahulukan,pencapaian diutamakan-

VOTE FOR THE BEST!

Assalamualaikum wbt.. 

fuhh..election time has come again. do vote for your favorite leaders and keep in mind that every vote should be kept secret.

click to view 

"You who believe, be steadfast in your devotion to God and bear witness impartially: do not let hatred of others lead you away from justice, but adhere to justice, for that is closer to awareness of God. Be mindful of God. God is well aware of all that you do." (The Qur'an, Al-Maida, 5:8)

-ilmu didahulukan,pencapaian diutamakan-

interesting facts about wax or cerumen

Salam kawan2 sume ..just nak share balik ape yg kite dpt tadi kat kuliah..WAX..i think this is one of the most interesting knowledges I gain today..actually I heard this b4 from my father..he told me that..” mi,xyah korek telinga..telinga tue ade cleaning system die sendiri..” I just neglect what my father had told me and insist continued doing what everyone loves to do ..korek telinga! Haha.. (sambil bermonolog sendiri..”bapak aku mmg slalu gosip ngan kengkawan die kat kedai kopi”) TAK PERCAYA!

BUT TODAY EVERYTHING WAS REVEALED.n my father was right..salute to him! Okay..here we go..

This is the FACTS;

1.One should not clean his/her ears in the ext auditory canal by himself.

2.no sterile cleaner present in the market.n for your information..the medial third of the external ear is sterile.if u want to clean it ..just clean the external ear or auricle.it seems like..u wanna cleans n protect your ear but the fact is u make it worse..paradoxical ..simple!

3.wax is not a dirt.instead,this is the mechanism to defense our middle ear from infection.if u taste the wax..( I wish I can..but can’t..how can someone could??) the taste is a little bit bitter n sticky..this is how u rarely found alient/insect inside your ear..the wax will entrape the insect b4 its finally reach your middle ear which will predispose to infection..otitis externa

4.lastly.never remove hairs lining the external auditory canal on beauty purpose.its unlogic.AGREE!!

Okay..finish about wax..continue with some important collection I think..this is important for diagnose for certain dse as tumor..we should know it n remember it as u remember your names....sounds like familiar? :p

Lining of the ent lumens:

All epith lining the ENT cavity is ps.str.col.ciliated epith. EXCEPT;

a.area lined by neuroepithileum eg:cochlear,vestibular,tongue

b. area lined by st.sq.keratinized epith, which is area exposed to friction n solar rays(protection againts uv rays)..SUBHANALLAH..Allah is The Allmighty..this area includes 2:

-vestibule of the nose

-ext.auditory canal

c.area lined str.sq.non keratinized which is area expose to friction without sun exposure..consist of 3 areas;

-aerodigestive ( contact with food)

-larynx(speaking)
 --@ EDGE OF VOCAL CORD
 --@ inlet of the larynx n vestibule(for deglutation)
- All lining of the stomach.

Credit to dr mahmud atiyya for his wonderful lecture..may Allah bless u..

"ITS IS ALLAH WHO CREATE YOU & WHO PROTECT YOU..PRAISE TO ALLAH..THE MOST RIGHTEOUS,THE MOST MERCIFUL"

Other collections include;

1.watery discharge tru ear n nose= CSF result from post traumatic or post surgery

2.mucoid ear discharge= drum perforation. bec the lining of the midd ear is goblet cell

3.virulent(100% pus,no mucous) ear discharge=EAC(furunculosis).ME( Aattic/antrum)

4.which is more profuse? Mucopurulent or purulent?= of course mucopurulent bec it's rapidly discharge,purulent usually scanty.

5.cholesteatoma(lined by flat/cubical)=scanty n purulent

6.lining of the hypo n meso tympani is ps.str.epith. with goblet cell= so discharge is mucoid,profuse n odourless

7.cause of offensive,profuse,mucopurulent ear discharge:

-myasis(dead fly or larvae)

-acute necrotizing otitis media

8.offensive ear discharge=cholesteatoma,myasis,acute necrotizing OM, mg tumor in EAC or ME,3^rd stage of syphillis

p/s;timing untuk round ent

clinic:

9am till 1 pm.if there is many patient maybe extend to 2.30pm.but after zuhr dr usually will just fulfill the report.checking the patient usually held on the morning.

Ward:

u can see the patient n talk to them..but it is advise to u .ask the dr 1^st which patient u should going trough.

OT/OR:

EVERYDAY EXCEPT THURSDAY.from 9am till 2pm.but most of the surgery will be held in the morning.the schedule given just to give the chance to every student to attend the OT/OR.feel free to go anytime..to gain more experience n to be good observer..

This is reminder from the vice precident of the class,kak amani.dont forget to introduce yourself,what year u are in , and what program u take..manchester or conventional...`BUDI BAHASA BUDAYA KITA :-)

Any info about round exam will be inform as soon as possible.

p/s..nama ”mi” diatas hanye nama samaran. :P

RAWATAN GIGI??? dan ianya PERCUMA!

-ilmu didahulukan,pencapaian diutamakan-

TOPUP ILMI

SALAM
Agak-agak kita duk Mesir nak masuk tahun ke-4 ni
Banyak mana je orang boleh kenal kita sebagai pelajar medik di Mesir ye?
Banyak mana je kita topup ilmu agama (which is wajib actually) selain ilmu perubatan?
Paling penting, banyak mana je kita boleh ajar petient pasal Islam?Basic things pun jadila...

Dengan kelapangan masa kita sekarang ni
Boleh kot kita sama-sama ambik ilmu-ilmu agama ni,buat bekal balik Malaysia karang
Dah timing ok,kelas agama pun depan mata,tinggal tunggu kita nak grab je
So, jomlah ramai2! Jemput ke Darul Rahmah (DR),setiap minggu,pada


1)RABU
7.00 -7.45 pagi
Sirah Nabawiyah
Ustaz Fadhil

2)KHAMIS
7.00-7.45 pagi
Tarbiyatul Awlad Fil Islam (Child Education in Islam)
Ustaz Nasir

3)JUMAAT
9.30 - 10.30 pagi
Fiqh Manhaji
Ustaz Firdaus
*sekarang tengah bab solat*

4) JUMAAT
1.30-2.30 PETANG
Kelas Bahasa Arab Amiyyah FREE
Ustaz Nuzulhakimi


Untuk makluman2 terbaru pasal Kelas Madrasah Imam Nawawi


ilmu didahulukan
pencapaian diutamakan
ISLAM kita tegakkkan!

 CONVENTIONAL MEDICAL STUDENTS OF 

4th year 2010/2011

CLASS PRESIDENT : 

DR. NUR ILAHI BIN RAMLI

CLASS VICE PRESIDENT : 

DR. AMANI BINTI TAHA

CLASS SECRETARY : 

DR. ABDUL RAHMAN BIN MOHAMAD SYUKOR

DR. JULIANA BINTI IHSAN

CLASS TREASURER : 

DR. ABDUL WAFI BIN ABD. KHALID

DR. NURUL HIDAYAH KAMAL NASHARUDDIN

SUBJECT LEADERS :    

i.       OTORHINOLARYNGOLOGY :

         DR. LINA EMELIA BINTI AHMAD ADNI  

   

ii.      COMMUNITY MEDICINE : 

         DR. HANISAH BINTI ABDUL RAHMAN 

iii.     OPTHALMOLOGY : 

         DR. AHMAD RASHIDI BIN ABDUL AZIZ

         DR. A'FIFAH BINTI ZAHARI  

iv.    FORENSIC MEDICINE : 

        DR. MUHAMMAD ZULHAKIMI BIN SAMSUDIN

        DR. NURUL HIDAYAH BINTI ABDUL WAHAB

      ~ ilmu didahulukan, pencapaian diutamakan ~