Thursday, January 15, 2015

I update my tumblr more frequent than I update my blog. Sorry, I'm quite busy lately :(
Do follow my tumblr anyway, just click on the link below. 

Thursday, December 25, 2014

SUNATHON

Assalamualaikum warahmatullahi wabarakatuh.

When was my last post again?
About a month ago wow so berhabuk!

Before that, my deepest sympathy goes out to all flood victims out there especially in Kelantan, Terengganu, Perlis, Kedah, Perak and Pahang. May Allah comfort you and your family in this time of grief.
Stay strong!

And for those who aren't affected by flood, don't take this time as an opportunity to be "famous" in social media and this matter should not be politicised.
Why don't we, hand-to-hand, together helping them as much as we could do.
At least, pray for their safety and welfare.

Alright now let's move on to our main topic for today.
Sunathon is basically a combination of Sunat (Circumcision) and Marathon or in other words, mass circumcision.
IMU doesn't provide this kind of training so about 20+ of us (under IMU Muslim Society) paid a few amount and went to Cyberjaya University College of Medical Sciences last week to learn everything about circumcision.
This may be very useful in the future.

After we had breakfast, we were given few lectures on different topics about circumcision; General idea, Management of the program (If you wanna conduct Sunathon at your place), Procedure, Equipments, Sterilisation, Post Operation and Overall Flow.

There are 10 steps in the procedure that involve the patient.
Other few steps such as sterilisation etc only involve the team, not the patient.

FIRST STEP
As usual, build rapport first.
Explain the procedure to patient.

SECOND STEP
Give the patient Local Anaesthesia (LA) which consists 2ml of Lignocaine (short-acting LA) and 2ml of Marcaine (long-acting LA).
There are 3 places that have to be injected.

THIRD STEP
Clean and drape.
Clean the area and make a hole in the drape (which is given along in the dressing kit).

FOURTH STEP
Dissection.
Remove smegma (death cells) that's usually trapped.
Clean.

Smegma is actually a buildup of exfoliated (shed) epithelial cells, transudated skin oils, and moisture found between the foreskin and penis. When the head of the penis isn't regularly cleaned, this fluid accumulate and expel an unpleasent odor.

So to those yang dah bersunat, tiada lagi accumulation of spegma ni :)

FIFTH STEP
Dorsal slit.

SIXTH STEP
Haemostasis.

SEVENTH STEP
Suturing.

EIGHT STEP
Cleaning

NINTH STEP
Prescribing; Painkiller (Ponstan) and Antibiotic (Penicillin/Amoxycillin)

TENTH STEP
Post/Care and advices.
Observe 30 mins for bleeding.

We also had a session, explaining about the equipments and sterilisation process.
Apparatus and equipments that will be used were; artery forceps, needle holder, forceps (either with or without tooth), scissors, catgut, syringe, disposable gloves, saline, dressing set and Chloramphenicol (CMC).

Then we had a practical session with few stations! Weeeee

First station; Local Anaesthesia
We learned how to draw Lignocaine and Marcaine from their bottles.
We had to perform Intramuscular (IM) and Subcutaneous (SC) injections on a half-cut orange.
It was quite hard actually to perform it below than 1 minute!
And we had to make sure there's no bubble inside the syringe because it can cause air embolism.

Second station; Clean and Drape 
We were required to clean a so-called penis (bottle) using alcohol and then drape it with a newspaper.
This station was quite easy to be finished in less than a minute hehe.

Third station; Suture
At this station, we were being taught on how to suture a cloth.
We had to do 5 sutures in less than 5 minutes.
I always wonder whenever I look at doctor performs surgery, how can they suture very well!
Now I know.
If you know the technique, suturing is reallyyyy easy!
Fyi, you can look like a pro too ;) heee.

Fourth station; Dorsal slit and Suture
With a partner, we had to perform dorsal slit on a tyre and then suture it back!
Cutting (Dorsal slit) was quite easy but to suture it back is not that easy because the tyre was quite thick and the catgut wasn't easy to penetrate it.
We sutured the tyre by using the interrupted 6 sutures that had been taught.
It is called interrupted because 6 sutures are sewn separately, so that if one is accidentally opened or if an infection occurs at only one part, we don't have to open all the other sutures.

In the evening we had an exam for all stations and some written questions.
My best friend Diddy who studies in CUCMS spent some time, visiting Tiara and I weeee.

We went back to IMU by the same bus.
Unfortunately the bus couldn't go into Bukit Jalil area bcs at that time ada perlawanan akhir Piala Suzuki between Malaysia and Thailand in the Bukit Jalil National Stadium.
So we had to walk all the way from the highway to Vista haha.

Lbnl, tbh everything was great!
Time and money spent on this program were really worth it.
For those who plan to know about Sunathon and experience this by yourself, just give a call to CUCMS.

Alright I better go now.
Assalamualaikum! :)

Diddy and Meeee!
From left; Diddy, Me, Tiara
Participants & CUCMS students

Friday, November 28, 2014

HISTORY TAKING (VIDEO RECORDING)

Assalamualaikum warahmatullahi wabarakatuh.

Yeayyy done with my video recording session!
What's 'video recording'?
Video recording is actually another type on how we learn during the clinical skills session.
We will have to interview a simulated patient (history taking) according to the case that we get.
The duration for the interview is 5 minutes and another 1 minute is for the simulated patients (SP) to give feedback.
What we do will be recorded and on the following week we'll get feedback from our peers.

I was quite excited and a bit nervous.
Excited because this is the time to know where am I (at which level) and nervous because this is my very first time!
We were divided into few groups and guess what?
I was in group 1!
Each of us got a room and a case.
I was assigned to be in the room 29C.
My case for today's video recording was a patient with sore throat.

I just waited in the room until the patient came in.
Okay now I'm going to tell on what I supposed to do.
Then I will tell what I forgot to do haha.

The patient came in.

Hello and good morning. (Greet)
My name is Nurul Ardilla Noorezan, first year medical student from IMU. (Introduction and role)
Please, have a seat.
May I know your full name please? (Patient's full name)
Can I address you as Ms _____?
Okay Ms ____, I'm here on behalf of my consultant to gather some information from you.
Is that okay with you? (Ask for consent)
I will make sure that all informations will be kept confidential between me, you and my consultant. (Confidentiality)
So, can we proceed?

Ms _____, what seems to be the problem? (General open-ended question)
(She told me she was having sore throat).
Oh I can see it's hard for you to talk.
Do you need some water?
Do you feel comfortable?
Can you tell me more about your sore throat? (Open-ended question)
Is swallowing food painful?

(I tried to use SOCRATES in this case. Later I will explain what is it).
Do you have any idea on how you get this sore throat?
When did you get it?
How's the progress? Is it becoming better or worser?
How the sore throat feels like? Is it like sharp pain or burning?
Is there any other things (aka symptoms. I tried to minimise medical jargon as many as I could) that come along with this sore throat?
Does the sore throat follows any pattern? Is it constant or on off?
Did you take any medications or do anything to relieve the sore throat?
If I give you a scale from 1-10, what is the level of the pain that you feel?

Okay now I'm going to ask few questions about your current health. (Signposting)
Is that okay with you? (Consent)
Do you lose your weight?
Is your appetite okay?
Do you drink alcohol? Do you smoke?
Do your sleep cycle change?
Is your bowel motion okay?
Has there been any changes in the character of your bowel movement?
Is there any changes in colour or consistency of your stools?
Did you have any bleeding?

Now I'm going to ask about your family. Is that okay with you? (Signposting & consent)
Is there any of your family members who is affected too?
Do any of them has any diseases?

Ms _____, do you have any other medical problems?
Have you had any surgery in the past?
Do you take any medications?
What is the dosage?
How often do you take it?
Do you have any allergies to drugs and medications?

Okay Ms ______, now I would summarise a bit everything. (Summary)
(Use ICE)
Ideas, Concerns, Expectations (Patient's expectations).

Alright Ms ______.
Don't worry, you have come to the right place.
I will pass everything to my consultant and he will decide on what we should do.
Hopefully you will have a very speedy recovery.
Thank you Ms ______.

So the feedback that I got from the SP were;
I was neat. I maintained eye-contact.
Body posture and gestures were good.
My voice and tone were good.
Bla bla bla.
But.. (jeng jeng jeng)
I didn't show enough empathy wuaaaaa.
She told me that I looked too calm.
I just asked her if she wanted some water which was not really enough.
Sokay, I will improve myself next time InshaaAllah!

Oh and I'm not really sure is it right if I use SOCRATES in this case.
SOCRATES is usually used if the patient has pain (knee pain, arm pain etc).
SOCRATES stands for Site, Onset, Character, Radiation, Association, Time course, Exacerbating/Relieving factors and Severity.
You can google it if you wanna know more details.

As I mentioned we had to interview the SP for 5 minutes.
I had asked all questions 1 minute before the bell rang so I simply asked few more questions regarding urination and travel history, which I think were not necessary haha.
Travel history is usually taken from patient who's having fever.

This is just the basic thing that I learned.
I'm so sorry if there's any mistake.
And I know the flow may be quite bercelaru bcs we haven't learned the systems yet so we don't know what are the real questions that we should ask.
If there's anything that you want to correct me, just tell me okay.

With that, I thank you.
Assalamualaikum and good night! :)