HARI-HARI TERAKHIR DI SINI

hari-hari terakhir di sini, membuat aku rasa sedih dan berat hati...
kenangan bersama kawan-kawan...3 tahun bersama... macam-macam kita lalui bersama..
setiap kenangan yang kita coret akan sentiasa tergambar di minda....

RESULT EXAM....

result exam final dah kua...alhamdulillah... semua lulus...tapi pointer xtahu la brape....anyway, happy sangat.....

a st0ry 0f used vs l0ved..

While a man was polishing his new car,
his 4 yr old son picked up a stone
and scratched lines on the side of the car.
In anger, the man took the child ' s hand
and hit it many times not realizing
he was using a wrench.

At the hospital, the child lost all his fingers
due ...to multiple fractures.

When the child saw his father.....
with painful eyes he asked, ' Dad when will my fingers grow back? '
The man was so hurt and speechless;
he went back to his car and kicked it a lot of times.

Devastated by his own actions..... .
sitting in front of that car he looked at the scratches;
the child had written ' LOVE YOU DAD ' .

Anger and Love have no limits;
choose the latter to have a beautiful, lovely
life & remember this:
Things are to be used and people are to be loved.
The problem in today ' s world is
that people are used while things are loved.

Let ' s try always to keep this thought in mind:
Things are to be used,
People are to be loved.

Watch your thoughts; they become words..
Watch your words; they become actions.
Watch your actions; they become habits.
Watch your habits; they become character;
Watch your character; it becomes your destiny.

NOVEMBER

Banyak idea dalam perkara Sukar untuk dimengertikan atau difahami sikapnya Berfikiran kehadapan Berfikiran unik dan bijak Penuh dengan idea-idea baru yang luar biasa Pemikiran yang tajam Daya firasat yang sangat halus dan tinggi Bagus untuk jadi doktor Cermat dan teliti Personality dinamik Sifat yang berahsia, pandai mencungkil dan mencari rahsia Banyak berfikir, kurang bercakap tetapi mesra Berani, pemurah setia dan banyak kesabaran Terlalu degil dan keras hati apabila hendak. Diusahakan sehingga berjaya Tak suka marah kecuali digugat Mudah ambil berat terhadap orang lain Pandai muhasabah diri Cara berfikir lain dari orang lain Otak yang sangat tajam Pandai mendorong diri sendiri Tidak hargai pujian Kekuatan semangat dan daya juang yang sangat tinggi dan apabila hendak sesuatu cuba sampai berjaya Badan yang "tough" (sasa) Kasih sayang dan emosi yang sangat mendalam Romantik Tidak pasti dgn hubungan kasih sayang Suka duduk di rumah Sangat rajin dan berkemampuan tinggi Amanah, jujur, setia dan pandai berahsia Tidak berapa berjaya dalam mengawal emosi Bercita-cita tinggi Perangai tidak dapat diramal dan mudah berubah-ubah

UNDER WATER SEAL

Under Water Seal Drain & Chest Tube
A chest tube is a long hollow tube inserted between the ribs and into the pleural space. An underwater seal drain (UWSD) is the specialized drain, which is attached to the chest tube. Chest tubes are normally inserted under a local anaesthetic or under a general anaesthetic if the patient is undergoing chest surgery.
"The two common complications are the risk of infection and pain."
How does it work?
A chest tube is inserted to drain either extra air and / or fluid (including blood) from the pleural space. Once the chest tube is attached to the UWSD system the air or fluid ‘bubbles’ through the water seal inside the drain. This water seal acts as a one-way valve and prevents the air or fluid going back into the pleural space
Why or what is it used for?
The pleural space is the space between the two layers of pleural tissue (visceral and parietal), which line the inside of the chest cavity, and lungs. The two layers are held together by a small negative pressure or vacuum. This keeps the lungs inflated. The pleural space is normally empty except for a small amount of fluid. Air or fluid may accumulate in the space under a number of circumstances including during chest surgery, as a result of chest trauma, pneumonia or some intraabdominal conditions. A pneumothorax or air in the pleural space (sometimes referred to as a ‘collapsed lung’) can also occur spontaneously. The fluid or air can accumulate rapidly or slowly over a number of days. This air or fluid may lead to an increased difficulty in breathing for a patient. If both fluid and air need to be drained the patient may require 2 chest tubes.
A pleural effusion is a fluid collection in this space. A haemothorax is a collection of blood in this space. A haemopneumothorax is a combination of blood and air in this space.

How long will it be used for?
Chest drains normally remain in so long as the air or fluid remains in the pleural space. The patient will have regular chest x-rays to monitor the resolution of the problem.
Are there any complications?
All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. The two common complications are the risk of infection and pain. As with any drains inserted into the body there is a risk of infection so it is important that neither the patient nor relatives touch the drains, tubes or dressings covering the insertion site at the chest. Good hygiene practices including washing hands before contact with the patient will help to minimize the infection risk. There can be a degree of pain and pain relief is individualized according to different patient needs and should be discussed with the doctors and nurses caring for the patient.
Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.

URINALYSIS_normal value

URINALISIS – NILAI NORMAL
PHYSICAL EXAMINATION
i. ALBUMIN - NEGATIVE
ii. APPEARANCE - CLEAR
iii. BILIRUBIN - NEGATIVE
iv. COLOUR - COLOURLESS – DEEP YELLOW
v. GLUCOSE - NEGATIVE
vi. KETONES - NEGATIVE
vii. OCCULT BLOOD - NEGATIVE
viii. PH - 4.5 – 8.0
ix. ODOUR - FAIN
x. PROTEIN - NEGATIVE
xi. SPECIFIC GRAVITI - 1.003 – 1.030

MICROSCOPIC EXAMINATION
i. CASTS
 RBC - glomerulonephritis, vasculitis
 WBC - interstitial nephritis, pyelonephritis
 EPITHELIAL CELL – ac. tubular nephritis, glomerulonephritis, interstitial nephritis
 FATTY - proteinuria
ii. CELLS
 RBC - < 3 cells/HPF - UTI / inflammation
 WBC - < 4 cells/HPF - UTI / inflammation
 EPITHELIAL CELLS - < 10 cells/HPF - contaminants
iii. CRYSTALS - small amounts
 Uric acid
 Calcium phosphate
 Calcium oxalate
 Cystine
 Sulfur
iv. BACTERIA - NONE @ < 1000/ml
v. PARASITES - NONE

URINE COLOUR POSSIBLE CAUSES
1. Black Ferrous sulphate, melanin, urobilin, methemoglobin
2. Blue Methylene blue, nitro furans, certain diuretics
3. Brown Acid hematin, bile pigment, metronidazole, myoglobin
4. Dark Yellow (amber) Bilirubin, chloropromazine, food (carrots), riboflavin, urinobilinogen
5. Green Bacterial infection, biliveerdin, vit.
6. Light Diuresis – alcohol / diuretics
7. Orange Bile pigments, rifampin
8. Red Hemoglobin, porphyrius, rifampin

hari ni aku praktikal dekat wad30 HRPZ.. seminggu jer.. agak boring, tapi ok la....