Down with Flu

Assalammualaikum wrt wbt.

18 more days. 18 more days for my final exam, the exam that is gonna test the knowledge I accumulated (and kept in an unknown area of my brain) throughout these 5 (5.5actually!) years of medical school.
I hate this kind of exam. Why can't they give us exam after each posting? Like a lot other med schools, the exams will be held after the posting hence we need to gobble up all the topics in that block only.
In this exam of mine, I need to revise every little thing from acute asthmatic attack to myocardial infarction (heart attacks), to premature birth, to soiling in children, to menopause, to intrapartum care (care of the pregnant lady in labour), to taking cervical smears and swabs to administering oxygen, performing ECG and prescribing medications!
Such a wholeee lot of things to revise! Thank God they won't be many questions of the basic biochemistry; Kreb's Cycle and all. I cant even remember them properly now.

And I've been down with flu since like, 3-4 days ago.
It started with simple sore throat which progressed to blocked nose, some sort of sinusitis and headache and stomach "dizziness" today.
Most of the people in my house are walking around with rhinorrhoea (read: running nose, and we have to catch them). One of them asked me, "Could it be because we did not take the flu jab this year? Did you take yours? I didn't"
And I can't help but to doubt that could be the contributing factor.
As someone who works in a hospital, my friends and I are always offered free flu jab as part of the occupational health "requirement". I've never taken one, for the past 3 years. I can't remember if I was down with flu as well last year. But another of my housemate, the only one who took the flu jab this year, is not walking around with nasal voice and blocked nose. She's studying happily comfortably. And I had to drink litressss of water to "flush everything out" of my system and of course, run to the toilet several times during the day.

I've been reading a lot of headlines on vaccines these days, with one of my teachers being one of the most influential anti-vaccine person in my life. Hence, I always doubt vaccine that's why I did not take them for the past 3 years. And to be honest, I haven't read in detail about how vaccines are dangerous to us, but I can understand the fact that they may not be that beneficial to us, the pharmaceutical company may be just making money out of us.
I did read however about the autism and MMR vaccine, and that the link was apparently made by a doctor who published a fraudulent paper in The Lancet. I had to read that article because I need to convince mothers that vaccines are very good for their children. It came out in my mock OSCE that day! I can imagine how much my teacher is gonna hate this kind of station; brainwashing future doctors to brainwash future parents and damaging future children.

Since I have not read any further about any other vaccine (because...I have so much other things to readddddd~ *facepalm*), I cant really say much. If vaccine is not that beneficial, why bother injecting something that is potentially dangerous in the kids' bodies? But why have they been telling us that the incidence of certain diseases have remarkably reduced after the introduction of vaccines? Haemophilus influenza B, the causative agent of acute epiglottitis being the most "sold" to us. Acute epiglottitis is a very dangerous condition where the child can lose his/her airway at any time but thanks to the Hib vaccine, we don't have them that much anymore now. Paediatricians sell that stories to us. "I've been working for 10-15yrs, I've only seen 1-2 cases of it"

Anyway, I gotta get back to my notes (and water) now.
Enough of rantings.
Bye!

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Two Weeks in Renal Medicine

Assalammualaikum.

Let me start with a bit of introduction on how year 5 in U.o.Manchester is structured.
First of all, we have 8 blocks altogether - each block is 4 weeks.
Blocks 1-4 is before the exempting exam while blocks 5-8 is obviously, after the exempting exam but before the final exam.

What's with these two exams?
Well, an exempting exam is in January and the final is in June.
If you pass the exempting exam in January, then as the name implies, you are exempted from sitting for the finals in June.
That means, if you pass the January exam, you are pretty much in your honeymoon months from Febuary onwards. If you don't, you bury yourself in books and stethoscope, sometimes with a tendon hammer or fundoscope and try to put everything into your brain, revengefully while the bulk of your friends enjoy their blocks 5-8.
Clear on the exam bit?

Now let's get to the blocks per se.
Blocks 1 - 4 are the blocks in which you will do ONE community block; that means you are gonna travel to a GP surgery (basically klinik kesihatan in Malaysia) and see patients on your own and try to make these poorly people well. The other two blocks are in the hospital and one more block is an OSS (and I can't remember what it stands for). Anyway, OSS block is the block where you revisit all the skills you've learnt for the past 5 years (wow) such as poking needles into patients, sticking a catheter up their urethras (that's where people pee from), perform blood cultures etc etc. On top of that, the OSS block is also your Oncology block (that is what the "O" in the OSS mean).
So juniors (if any of you ever read this), you'll know roughly what to expect.

After block 4, is the winter break (read: crazy last two weeks b4 finals). And then the Jan exam.

Blocks 5-8 are hopefully, my honeymoon months. I really hope I can pass this exempting exam (which will be in 58days time!)
So out of these 4 blocks, 2 will be elective blocks ie you can go anywhere in the world to help doctors save ppl or, you can do what I will be doing, go back to Malaysia and enjoy life as a medical student in a Malaysian hospital before coming back to work as a junior doctor.

One more block is a Student Assistantship, which basically mean you are gonna shadow a FY1 (the most junior doctor in the hospital) and help him/her with everything so that you can do his/her job when you start working. It doesn't really apply to me since I am not going to work here in the UK but I think it'll be a good exposure to know the system in and out. The other block could be another hospital or a community block, just like in blocks 1-4.

So for my fifth year, my blocks allocation are:
Block 1: Endocrinology (Hospital block) in Royal Blackburn Hospital
Block 2: Community (in Accrington. The bus fare cost me £51 per month and two hrs of journey everyday)
Block 3: Renal Medicine (which is the block I am in now)
Block 4: OSS

EXEMPTING EXAM!!!!

Block 5&6: Electives in Malaysia woohoooo!!
Block 7: Student Assistantship
Block 8: Hospital (cant remember what exactly)

Blocks 1-4 can be switched around, you may start with OSS and end with Community etc.
Same goes with blocks 5-8. That means you will nvr do electives before the exempting exam in January.

As I've said earlier, I am in block 3 (already third week now!) and I am doing Renal Medicine.
Guess what, my first day in this block was in a Renal Clinic.
And within that one morning, I know for sure I do not want to do Renal Medicine for the rest of my life. It is definitely one specialty I am going to avoid specialising into. Last year, we were asked to rank the blocks we'd like to do for fifth year and I think I put Renal Medicine as my second choice. That was because my mother has diabetes and I know it inavariably affects the kidney so it WAS always the specialty I consider. But after that first clinic, the interest and consideration went down the line. There is nothing wrong with my supervisor, NO.
It is just the fact that a Renal Medicine specialist could not do much for the patients. Kidney is just so important that when it goes, we cant really do much anymore. But because our kidneys are very good, we can lose about 60% of the function before they pack up.

You see, chronic renal failure (that is the failure of the kidney that happens over a long period of time, most commonly caused by diabetes and hypertension) is divided into 5 stages according to the severity.

Stages 1 to 3 can be managed in the community, means any doctor can deal with it with the patient coming over yearly or 6-monthly for health review. But at the same time, optimise diabetic or blood pressure control to slow down the damage to the kidney. Most of the patients will not progress further.

When it reaches stage 4, the guideline in UK recommends referral to a Renal specialist. I don't know at what stage do the doctors in Malaysia refer a patient with chronic renal failure (CRF) to the specialist.
And what will the specialist do? Not much, apart from keeping the diabetes and the blood pressure in tighter check. Well, most commonly CRF is caused by these two culprits. If it caused by any other diseases, then it will be a diff story.
Since the patient is now in the specialist's renal patient list, any deterioration of the patient's condition can be acted upon faster. Ultimately, when the kidney fails, we will be looking at either dialysis or renal transplant.


Hence in the clinic, patients will come in with a creatinine level of 280 (the normal level is less than 100), and the doctor will not be surprised, because the patient has been having a creatinine level of 260 and 270 all these years (remember the renal failure is already stage 4 when the patient is referred). Hence, the doctor is going to do the usual examination of the abdomen and BP la and everything and really2 monitor the medications the patient is taking (since so many meds can effect the kidney) and stop/slow the kidney damage. Hence a specialist might see the same patient for many many many years monitoring his/her renal function all the way, without actually treating it because we can't cure diabetes or hypertension.

That idea of seeing the same patient for 10 years but not being able to actively do something for him/her apart from keeping an eye on his/her renal function two or three times a year does not appeal to me, at all.

As a dramatic and active person, I would love to see my patient get better and not just monitoring them waiting for the kidneys to pack up, on one bad day in the future.

They say Orthopaedic Surgeons are very proud of themselves because their patients come into the hospital having broken their bones in an car accident or something and under their care, the patients can then literally walk out of the hospital. So I think literally, the patients of an Orthopaedic Surgeon will have the greatest improvement in their physical appearance, from a bent, bleeding almost crushed leg to an almost perfect leg (in a lot of the cases).
But no, I am not going into Surgery :)

'til then,

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Electronic Devices and Final Year

Assalammualaikum.

Hands up for those people who agree that electronic devices e.g. handphones, laptops, mp3 players, cameras etc are not made to LAST as long as they should be.

Photo by Edward Cisneros on Unsplash

*both hands are in the air*

You see, they either break, simply do not work, get slower, hang all the time, the screen breaks, the connection loose, the battery weakens or more commonly, get out of date.

I really hope one day there is this service where you can try a device for a week or two before committing to buy it.
Since my first laptop in 2007 (the year I entered INTEC), I've had 3 more laptops.
That's 4 laptops in the course of 6 years!
The laptop in INTEC, an ACER (Oh God I forgot the model now, Diana might still remember. We had almost the same model) lasted me around 2.5yrs.
After one year in IMU, the laptop screen was gone, something was wrong with the processor or smthing inside there (I am terrible with hardwares, softwares are alright).
What happened? My brother charged it for hoursssss and it just shut down. Old computer (eh?)
I brought it for repair in Low Yat, charged RM200 for screen replacement. The man said it might last, it might not last.
True enough, within a month the screen went off again.
If I want to repair it again, it'll cost me a few more hundreds. AND.....by then I was very interested with the idea of having a netbook.

Netbook; small, compact, cute, and cheap! It's not powerful but hey I am not an architectural or engineering student who needs fancy designing softwares to work on. I need basic Microsoft Office, web browser and that's it.
And the beautiful Ms Hezlin, my biology lecturer in INTEC had it. It looked so good on her!

And I even wrote some tips on looking for a good netbook.

And so, my second laptop was a pink Toshiba netbook. I sold my ACER to the repair man. He said he cant sell it second hand but he can take my hardwares as spare parts. Whatever la uncle.
Which, I find annoying because it is very slow and takes forever to load.
It is very good in the sense that the battery consumption is very very little.
It can last for hours just on battery. At least 4 hours if I am not mistaken.
But to load a powerpoint of lecture slides especially if the slides are full of pictures and graphics, urgh!
So, by the time I got really really tired of this netbook, my brother is almost going into his foundation.
So.....I started searching for a new laptop, again!

This time, I told my brother that I will give (read sell) this laptop to him when he started his foundation program in college. So, I dragged him to look for the laptop that he want, the specs and everything. Even the design.
Our deal was that I am gonna use that laptop first, for abt 6 months or so before I buy a new laptop to bring to UK.
And he agreed. Boys are easy, aren't they? They are not fussy, at all.

So I gave (read sell for a very low price) my Toshiba netbook to my mum. Well actually, not sell. I gave it to her and she gave me some "compensation". Heheh..
And my third laptop was a HP G42. It was an i5 with 8Mb RAM with NVIDIA Graphic Card and some other things I could not remember. But I always go for the moderately powerful laptop.
I cant stand waiting for things to load.

By the end of my course in IMU, I started to take interest in macbooks.
They said macbooks dont hang, they said it's beautiful. Macbook owners are so proud and full of themselves they macbooks to everyone they know are in search of a laptop and even ridiculed Windows. But they are expensive!

But I received quite some money prior to departure to UK.
So....I got myself a macbook.
Was thinking to buy an iPhone too at that time but because I do not want to spend more money than I should, I refrained.
So, the HP G42, as promised went to my brother and I got my macbook about one week before I flew off.

And I've been using this macbook till now.
Who says macbooks don't hang?
Mine does, sometimes.
Who says macbooks wont give you trouble?
Mine gave deafening siren and the screen froze few times before.
Who says macbooks are the best?
It is heavy! And I feel so reluctant to bring it for travelling.

But the battery is wonderful. I can watch a whole 2 hour movie only on battery and I still have roughly 30% battery left.
And the design is beautiful. I mean the softwares, they look unique. Mine is a macbook pro so I am not proud of the outer design. I prefer macbook white but they dont make new macbook white i3, i5 and i7 series anymore.

And I intend to use this macbook till the day I graduate, at least (that'll be next July insyaAllah!). And if I am to buy a new laptop again, should I stick with macbook or revert to Windows? What say you?

And oh, I am in final year medical school now.
Time rockets, doesnt it?
And finals (THE REAL FINAL) is in 113 days!
Gaspsss!


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Travel:: Amsterdam, Brussels, Geneva and Paris with Mum

Assalammualaikum.

Final year is coming soon, one week left.
How time rockets.

Unlike last year, this year I did not come home to Malaysia for summer break. Instead, my mother came and spend the raya with me and my brother.
Together, the 3 of us travelled to Amsterdam, Brussels, Geneva and Paris *grin grin*
Our first Raya day was supposed to be in Paris, but it turns out I miscalculated the dates. Or rather, I misread the calendar. Hence, we spent our first Eid day in Geneva.

Amsterdam!

The Iconic I amsterdam :)

Surprisingly, Amsterdam has many Indonesian restaurants hence it was not hard for us to find halal restaurants to break fast.

Brussels

But Brussels has even more Muslims. I see Muslim women everywhere, with their scarves and robes (err, jubah?).
I can't recognise Muslim men, they all look the same!
It was harder though to find halal food in Brussels, this is because most of the halal restaurants were closed, I am not sure why. At last, we found one kebab restaurant and to my horror, all the menu was in French (or maybe it was Dutch)! I had to subscribe to travel mobile data to Google Translate the menu and with the help of the pictures, we get a somewhat clear view of what we are ordering. Wasil and the waitress were using sign languages. Fortunately, "Assalammualaikum", "Muslim" and "Halal" were conventional.
We will always start with "Assalammualaikum!" followed by "Muslim, halal?"
We spent only one night in Brussels.

In Brussels, we went to Mini Europe.
This is a place where all the landmarks of the EU countries are displayed. But they are only miniatures.
It is fun to be able to see all the landmarks within 2 hours of walking.
Mama enjoyed it very much, she said she felt as if she has just toured the whole of Europe.
We were given a booklet with brief information about the buildings and both of us walked around reading the booklet.
Wasil, being a man (read: boy) was more interested in the buildings than reading it.

Mini Europe, Brussels

Geneva, Switzerland

Our next destination was Geneva, Switzerland.
It is a very expensive city. Since we started traveling, we've been surviving on kebabs and kebabs till my mum got very sick of it hence we treated her to a Western restaurant. And it cost us approximately CHF 60 for 3 vegetarian pasta! *facepalm*
We converted CHF150 per person and indeed, we finished almost everything in the 2 days we were there. Of course, most of the money went to souvenirs for people rather than food.

The tallest water fountain in the world. Geneva, Switzerland. 

Paris, France

All these while I've been hearing bad stories about Paris. How my friends (or friends of friends) were pickpocket-ed (what a word), tied one hand to the other while the bad man rummaged through his pockets and many other scary stories. I have a friend in Paris who denied all that and insisted these stories were exaggerated. But still, I stepped into Paris feeling very cautious, and apprehensive.

Turns out I was right.
But we were not "bullied" by back street people but rather by the authority!
From Paris Gare de Lyon (the train station we arrived from Geneva), we took the metro and changed to tram in one of the station. We thought the same ticket we used on the metro can be used on this tram, since usually, the transportation tickets are valid for 1 hour.

As soon as the tram departs, ticket inspectors came and asked for our tickets. We gave them our tickets and they started making noises saying that our tickets were invalid and we are fined €30 per person.

Mum and Wasil tried to explain that we did not know and stuff but in no time 5 of them were already surrounding us and demanded money. We even missed our stop.
Some of them can speak English and kept asking us to pay or they'll bring us to the police etc etc. It was so chaotic.

Not long after, I took out my debit card and grudgingly handed it to one of the officers who was holding a card machine. He quickly inserted my card into the machine after I agreed to pay for all 3 of us while another officer started writing in his record book.
After paying €90, we stopped at the next stop and had to take the opposite direction tram to get back to our hotel.

I really felt like cursing all of them.
Such a bad experience within the first hour of arrival into Paris.
The situation turned sour and all of us weren't really speaking to each other since everyone was trying to calm our anger.

My God, even thinking of it now made me feel like kicking those gangsters as hard as I could.
How could they surround us and forced us to pay?
I should not have paid, should I?
I should have just let them bring us to the police station, if they really wanted to.
Maybe they were just threatening us.
If they wanted to send the summon back to our house, we could have given our Malaysian address. Let's see how they want to force us to pay.

Haih...
Anyway, we had our lunch after that and calmed ourselves down in the hotel room before going out again to visit Paris. This time, we made sure we validate our tickets every single time we board any transportation.

Eiffel Tower, Paris

After telling my friend about the incident, he said trams are different from any other public transportations.
Usually, our tickets will be valid for 1.5hour but that does not apply on trams.
Sigh...

Alright, let's stop here for now.
I have to tidy up my room, heh.

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Helping in Year 3 OSCE

Assalammualaikum!

A year ago, I had my end of year 3 OSCE and it was in my opinion, very terribly done. But I passed, Alhamdulillah.
I'm not sure if I wrote abt it here, let's check.

CHECKING......

CHECKING......

CHECKING......

CHECKING......

CHECKING......

Err, no.
I did not write about the exam itself. I wrote on how I felt before the exam.

Anyway, I splashed a good amount of IV fluids onto my (simulated) patient.

For this exam, I was the simulated patient for an Arterial Blood Gas station.

That means, I sit there and pretend to be a lady who's suffering from pneumonia and needs ABG.
The students have to talk to me, explain the procedure, gain my consent and then proceed to take blood from a dummy wrist next to me.

There were 8 students altogether. Generally, they did well.

But there was one who did not know what he was doing! I felt so bad for him.
He looked like a nice boy, who studies a lot. But looks can be deceiving, can't it?

And an exam is always nerve-wracking anyway.

He did not clean his equipment, neither did he wash his hands with the alcohol gel.
He took a pair of gloves and then throw one away. He tore a packet of alcohol swab and left it there next to me. He really looked as if he did not what he was doing. And I felt so much for him. Haish...

Too bad, but not surprisingly though, the examiner failed him :(

In conclusion, the experience of becoming a volunteer in an exam gave me a whole new perspective. Being in an exam but on the side of it. Not as a student taking the examination but someone backstage. I saw how the skills centre staff busily set up the place for examination. How they gathered the simulated patients and what briefing they give.

After this I won't be afraid and scared of the patients anymore :D

They're just students like me. Haha

Apart from some who are real patients with real findings, the rest are normal people :)

-Because life is a test-
-AkMaR-

http://nur-akmar.blogspot.com

General Election 13 - PRU 13

Assalammualaikum!
Heyyya hey!

Hmm.. There were loads of things in my mind before the GE but I decided against writing about it.
Now that GE is over, I feel like writing about it but I've delayed it for so long I became lazy and became dry of ideas and desire.

It's been a month now that the GE has passed, and I have since lost interest in reading the news in The Malaysian Insider (TMI). It felt as if the news are not "news" news but rather opinions from someone from some party about something. If you know what I mean.
It felt like our politicians are talking more than they work hence we hear their opinions more than we see the advancement of something. Only today that I see "Section of Second Penang Bridge Collapse". The headlines have been "GE13 shows DAP’s ‘Chinese racism’ in bid to rule Malaysian politics, says Dr M" or "Khir Toyo says made scapegoat by Najib’s anti-graft fight" or "Dr M, Daim will decide debate on Najib’s future, says veteran newsman" which are actually nothing but opinions from certain people. I don't think they should be the headlines, I've not seen any news about the latest Turkish turmoil making the headline in TMI which explained why I know nuts about the chaos until I've seen some pictures being shared about Turkey in fb. Shame shame...

I've always (like I think most other people) not liked someone being oppressed and bullied. And PR has somehow managed to appeal to the public as the "oppressed parties". They don't get publicity, coverages as much as the government does in mainstream media. They claimed to be oppressed financially, Federal govt gives less funds to the states ruled by the PR than the ones under BN.

PR managed to appear as the "hero" and "hope" of the people, hence gathering a lot of support in the virtual world. I've not seen even one comment/posts in fb by my friends (which are unsurprisingly largely made up of Msian students studying/studied overseas) that slams the PR or support BN. It looked as if PR is going to win, by at least a 90% majority. And it got me really nervous, waiting for the day of the election. The losing party will not give up, for sure. Either way, the people will suffer.

And Anwar is freaking me out too.
If someone were to ask me who would I like to have as the PM, Anwar will not be in the top 5 list.
I am afraid his motivation is personal revenge rather than the good of the people. I can't prove it of course. It is just my gut feeling. His name is too tainted to be a Prime Minister.
His daughter and his wife have good reputations. So do Rafizi Ramli, Khairy Jamaluddin and Lim Guan Eng.

BN on the other hand was doing almost all possible wrong things they can do for a campaign.
The "One Vote for DAP means One Vote for PAS" adverts by MCA was so ridiculous and offensive to the point that it is almost laughable!
How could they harbour hatred and fear towards a party that is known nationwide to be bringing the values of a religion (Islam)? Be it the correct Islam or the false one, it was not their main concern. The advert's main point was to reject a party that is bringing up a religion. If the advert was saying something like "Islam has never said XXXX but PAS kept saying XXXX is correct hence we should reject PAS" then it will be a totally different matter!

And there were also many supposedly campaign posters by MCA candidates claiming the candidate is a champion in singing, cooking, beauty pageant etc. I've never shared all these in fb, because I do not know the authenticity of them. They could be photoshopped you know, or even designed by some irresponsible people. But if they were genuine, OMG, I can't possibly say how frustrated I am at the quality and qualification of our "future" politicians. Who needs someone who promotes herself of being a beauty pageant? We are not choosing a Bond girl now. I'm sorry I could not find ANY of the posters now. I've searched over and over, even stalked some of my hardcore PR friends, could not find those posters anymore. Oh I should have saved them in my computer!

I wished (and still am) these posters are fake, as much as I wish Rosmah Mansor did not actually answer "I saved money from my schooling years to buy the jewelries" to the newspaper when people questioned her financial sources. One of my friends pointed out that Rosmah has been very quiet during the GE campaigning period. And I think that was a very wise thing to do given how unpopular she is with the people from the virtual world.


Some of the supposedly "exposure" by PR supporters were also ridiculous.

Pictures I find most troubling are all the Bangladeshi pictures.
Banglas in uniform lining in the airport, supposedly just arrived in Malaysia to "help" vote for BN.
How true are these? How could these people be transported here but the pictures are all from the same angle? And don't tell me BN is such a thoughtless party that they will make all the Banglas wear the same uniform and make them form lines in the airport? Come on.
And, suppose they ARE being flown here to vote, who can prove that they were paid to vote for BN? They could also vote for PR, can't they?
And people start posting "Banglasia" as their fb status-es. Disgracing!

The authenticity of all these pictures are very questionable because not only are they too illogic but also too embarrassing if they are the truth.

I oppose strongly to the act of leaking "internal problems" outside. I value privacy a lot.
A household problem should never be sold outside.
Why would we tell everyone in class that our parents fight every day at home?

Or if our fathers are a drunk?

Or if our sisters got pregnant with her boyfriend before marriage?

Or if our husbands do not want to help with household chores after work, he prefers reading newspaper, watching television or football.

Or even as simple as our husbands has a scar on his forehead because he was chased by a chicken (read hen) when he was 15, fell down and knocked his head onto the stone outside his grandmother's house.

All these are nothing to be proud of and as conservative (as some people might brand me after this) as I am, I truly believe these should not be told to the public UNLESS, something can come out of it (maybe some people do not see the scar as something shameful. That's alright. I don't either. But if he does, then we should not tell, should we?).

If we told these problems to a friend, even if she might not be able to directly help but if she can help ease the burden in our hearts, then that is alright.
If we told the police about the constant beating our mothers get from our fathers, she can be protected. Then do so.
But if it was simply to gain sympathy from the others, better not. Because not everyone gives unconditional sympathy.

Hence, I dislike PR's way of getting the attention of the international media.
What can the international media do? They can put pressure to the ruling government to give more/equal airtime in the mainstream for both opposition and the govt, yes. Or some other form of pressure for that matter. But doesn't that come with a price?
A price where all the common people pays for it.
An opportunity for the "internationals" to meddle with our internal affairs has been created.

All these nonsense campaigning gave me a truly mixed feeling; they were sick, shameful but funny at the same time.

Anyway, the GE is over.
And if I were to talk about what I feel and think during and after the GE itself, this post is gonna bore everyone (if anyone ever read it).


'til then,

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Dirty Handphones

Assalammualaikum!

About 1 year and 8 months ago, my housemates and I went to Warrington for the IKEA.
We have just moved into our "bungalow", and were in dire need of study tables and some other furnitures.
After much googling, we decided to be adventurous and head to IKEA in Warrington.

But that's not what I want to write about today.

I want to write about something I read on that day.

While on the train, there was an abandoned newspaper.
I flipped through the newspaper and read loads of petty, trivial news.
I can't remember what newspaper was it but I think it is the UK version of Harian Metro or Sinar Harian.

And there was this one article titled:

"More than 50% of the handphones are found to have traces of faeces"
(or somewhere along that line)

And I was like, yuck! Yuck yucky yuck!!
But I did not believe it.
I hate those articles in newspapers or the internet that begin with "Research says that......." .
Most of the time the sentences end with "Girls marrying older man are found to be happier" or "Yoghurt can increase life span up to 10 years" or "Coffee lovers perform better than tea lover".
I mean, who did these researches and how reliable are they?
Just because a bunch of Psychology students together with their tutor did a survey on 200 people within their community for the end-of-year project and found that people who eat yoghurt are generally older than 60y.o, that doesn't say yoghurt increases lifespan. Newspapers tend to "factualise" ANY research findings and gullible readers tend to absorb them like sponge.

But anyway, now I think the finding MIGHT actually be true.
That more than half of our handphones have traces of faeces on them.

You want to know why?
Be prepared...

It is simply because.....
There is no water hose/bidet in the toilet!

Imagine people only wiping instead of washing properly. You can't wipe your whole hands, or you'll start using half a roll of the toilet paper. I do not wish to explain further, although I can.

But my point is, while in Malaysia I have lots of water to use while in the toilet itself, to wash hands properly, that doesn't happen here. We can only wash our hands when we get to the sinks outside.
And for them who hold their handphones all the time, or worse (which I think is quite common), texting while in the toilet, they'll be holding their handphones with the unwashed hands!
How many people you see wash their handphones together with their hands?

Renung2kan! :p
Tu je la.

'til then

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

New Layout! and Project Options.....

Assalammualaikum!

Yeayy!! New layout at last!
I am so satisfied :D :D

It took me so long to get this layout. Not that it is too hard, but just because I can't find the few hours to concentrate only on the designing. Well actually, I didn't do much but whatever.

All year 4 medical students in UoM need to complete an 11-week project called "Project Options".
My my my...11 weeeeks? I'd prefer it if they take 2 weeks of this project and put the 2 weeks into my Neurology block.

But anyway, in this 11 weeks, we can choose to do any project we want; research or non-research. Non-research can be critical appraisal or an audit. I am doing an audit on bisphosphonate therapy in symptomatic multiple myeloma. Well yes, it does sound posh. But what I am actually doing is just looking through patient notes and fill in the proforma, analyse the data, and at the end, write a report and present it.

I really think anyone can do that.
I prefer doing a case study.
And I'm too timid to do a research. I didn't even know what to research on for just 11 weeks.

This is already the 3rd week of my 11 weeks. And guess what, I have just started doing it today.
This is because my consultant asked me to do another audit for the past 2 weeks, for his department. Aigoo..
Not that I have a lot to complain but I think it is almost an exploitation of my time.

But I promise myself not to take up any other audit suggested by him until my bisphosphonate audit is finished.

'til then!

-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Post GE-13, Pre Exam.

Assalammualaikum wrt wbt.

Oh well, the GE 13 has passed.
LOADS of things are in my mind re the GE, but let's keep it in there for now.

I've changed my layout again. This is not the end result.
I've just decided to republish previous posts because I feel bad for keeping my blog "Under Construction" for too long.

I have my Progress Test next Monday, I will continue working on this blog after that.

Dh la, jom study!
:D

-Because life is a test-




-AkMaR- http://nur-akmar.blogspot.com

Post Title

Trying test test test

This is a test post.
Test testing
Lalalala

-Akmar-

UNDER CONSTRUCTION

SORRY! THIS SITE IS UNDER CONSTRUCTION UNTIL I CAN SORT THE ANNOYING ADVERTISEMENT OUT AND MAKE A NEW DESIGN! :D


-Because life is a test-
-AkMaR- http://nur-akmar.blogspot.com

(Almost) The End of Year 4

Assalammualaikum!

Pergh, lama gler x tulis dlm blog ni dh.
Busy with other things (and kemalasan nk menaip panjang. Idea byk sgt, x smpat nk put them into words).

Anyway, I've just finished the last OSCE of my 4th year last Friday! And the results will be released exactly two weeks from today. *dupp dapp dupp dapp*
All the OSCE stations started with "You are the FY1......" (FYI, FY1 = Foundation Year 1 = first year houseman).
So I proudly introduced myself, "Hi, my name is Akmar, I am a junior doctor here. Can I confirm your name and DOB?".

I am already at the end of my first week in "Children and Adolescent Psychiatry" posting.
This is not really a posting, this is a Student Selected Component (SSC), which I chose about two months ago?
Gler la, most of the budak2 / teens yg msuk sini are due to self harm. And their self harms usually stem from a family crisis, childhood abuse etc.

Apa lagi nk bgtau?
Oh! We can already feel the spring, the temperature started to get higher than 5° already, which means we can reduce the hours the heaters are switched on, significantly.
But, Syuruk is at 6.03am! Oh God..
I don't usually sleep after Subuh so I tend to wake up towards the end of Subuh, before Syuruk and start my day early.
But when Syuruk itself is 6.03am, I am facing a great great dilemma whether to sleep after Subuh or not when Syuruk started to be 5.30am later in the month. Aigoo.

And oh, I am now watching the korean drama, "Gentleman's Pride".
Cite tu sweet smpai rasa nk meletup.
Ok dh..
Get back to work.
It's 7.49am now :)

Haishh!! Camne nk hilangkan these annoying video ads on my blog?
Anyone know?

-Because life is a test-


-AkMaR-
http://nur-akmar.blogspot.com

Depression

One question I really would like to ask doctors/medical students/nurses in Malaysia; "How often do you see a patient coming in with depression as their presenting complaint"?

"Oh doctor, I can't stand it anymore. Everything is just not going the way it should be. I don't think I can take this any longer...."

I've seen that many times her in the UK, in the GP (GP is equivalent to Klinik Kesihatan in Malaysia).
And I feel like smacking the patient every time and tell her/him right on her/his face, "Life is not a bed of roses anyway, you gotta go through it like how people used to. Stop dwelling on your problem and sort it out yourself. Come on, pull yourself together!"

OK, maybe I won't smack the patient.
Maybe I'll just slam the desk.
Or maybe I'll just hit my forehead hard.
Or maybe I'll be nice and pat her hands and say everything in a nice, sweet and loving manner.

But the point is, I don't think Malaysia will have this much of depression cases.

It may be because our society does not acknowledge Depression as a medical illness. So our depressed people came in with somatic symptoms instead. "Oh doctor, my back kept aching. I don't know why. I've been putting ointments everyday"
"Oh doctor, my knee hurts"
"Oh doctor, my ankle hurts"

Maybe we do not have the "help seeking behaviour" as much as we are supposed to have.
So our depressed patients are left alone, not getting any help, left to commit suicide on their own.

Or may be, our society truly does not get depression as much.
Or may be, depression in this society has been overdiagnosed.
And in my honest opinion, I think the last two are the most likely.

I think depression is an illness of the modern society.
When expectations get too high, demands get ridiculously overwhelming, it is easy to be disappointed and frustrated. Not being able to cope with the failure or loss, or rough life, people sought for help.
I acknowledge it. But help does not come in the form of tablets and pills. Not in this case.

The society here KNOWS about antidepressants. They know antidepressants work.
Most Malaysians do not know that when you don't have energy to do anything; be it work, eat, or even getting out bed, tired all the time and you find no interest doing anything you used to enjoy or not finding the motivation to do anything, then you are suffering from "Depression".
Well, I didn't.
In fact, I only grasped this condition when I came here. I didn't even know much about it when I was in IMU. Or maybe I was dumb.
We may see that as lazy, unmotivated, sad or depressed but whatever that is, it is never a medical condition where you can get pills that will make you feel better in 3-4weeks time. So we deal with it. We started dealing with it even before it gets that bad.

And we still have good family support and religion, Alhamdulillah.

When someone in our family dies, we do bereave.
We do get sad.
I can imagine myself crying for days if something bad happened to my parents or siblings, or uncles or aunts or friends I'm close with, or anybody I'm close with for that matter.
But I know I'll still have other people who I can talk to and turn to. And if someone find themselves not having anyone to talk to, we can still talk to Him, the Almighty.

Rasulullah was sad too during the period where he lost his wife Khadijah and uncle, Abu Talib, the two beloved people of his life.
But Islam taught us to turn to Him in times of despair and joy, times of sadness and sorrow, times of rich and poor. And to accept loss and failure, joy or sorrow as not only a consequence to our actions but also as His destiny and test upon us.

So our society does not know about depression and antidepressants.
Hence we don't get hooked or dependent on it.

I know depression can get very bad.
People commit suicide from it.
They lost their personality, job and life because of it.
And that's why we'd want to catch them before it reaches that stage.
But that doesn't justify handing out antidepressants like candies to patients coming in feeling sad and low mood.
Isn't it better to prevent depression than treating it?
Isn't it better to hold family bonds stronger?
And I think one of the first steps is to stop sending elderly parents to care homes.
Take care of them in your own house, and you'll feel better. The children will see that their own parents are taking care of their grandparents and they'll take it as an obligation to take care of their parents.

Start having religion. Start having God.

And by the way, in my recent conversation with a Psychiatrist, he agreed that most "depressed" patients in GPs are not truly depressed. Antidepressants might have only a placebo effect on them.
And from this Psychiatry placement, I learnt that we can judge a patient's mood ourselves. We can use our own sense to decide whether or not this patient is really depressed. A patient coming in with full make up, blue eyelashes and green eyeshadows with flowery boots is most likely only mildly depressed, if at all. What more if the patient coming in looking bright.


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

Bumiputra and Scholarship Privileges

As the General Election gets nearer, more and more nasty and dirty issues being dug by both the Opposition and the Government. Nasty remarks and perhaps false accusations are thrown at each other, hoping some of the rakyat might just believe them without thinking much. This is dirty politic. Too bad the politics in Malaysia is not something I can be proud of but nevertheless, it is still much better than other 3rd world countries and I am grateful for it. We have violent remarks but not violent physical resistance. "Malay is a soft race", that's what my mother says.

One of the issues that have always been a hot topic for debate is the privileges Bumiputras get, and since the majority of the Bumiputras are Malays, it became "the privileges of the Malays". "Bumiputra" is actually a very vague term. How do we really define it? I don't even know. My father is not a Bumiputra because he wasn't born in Malaysia and his parents are not Malaysians, my mother, on the other hand, is a Bumiputra despite being a pure 100% Chinese. She reverted to Islam when she was in her teens and have been living in a Malay community since, adapting the Malay culture lifestyle and for that, she can apply for the ASB while my father's application was rejected. That left me in a huge identity crisis, am I a Bumiputra or am I not? I should be one actually because my mother is. But I dare not put my stake on it, which is why I dare not apply for MARA scholarship but chosen JPA instead.

At face value, I am a Malay. On paper, I am not. I can't be a Malay when neither of my parents is, can I?
"Bumiputra" status is not written anywhere on your birth certificate or IC details so no one can really say that I am for certain. But I'm sure I can buy an ASB.
But to everyone else, I am a Malay without a doubt.
And I received an overseas scholarship from a governmental body; the Public Service Department (JPA).
Somehow, people especially those who DOES NOT receive the scholarships tend to associate my "Malay Muslim" name with my scholarship, instead of the hard work I put during SPM.

During a Malaysian Study presentation in IMU, one of the private boys (in IMU, we are vaguely divided into JPA students and private students) pointed out that the Malays have been too spoilt with all the privileges they get that they have become incapable of achieving anything on their own. Even if they can't study well, there are lots of scholarships around being thrown at them, universities opening doors to them to complete the Bumiputra quota, and technic and vocational schools ever ready for these dependent Malays. And that got me so mad. He was indirectly implying that a Chinese or Indian who received a scholarship is more worth of acknowledgment than a Malay who received the same scholarship. He was practically dismissing my SPM results (I am not boasting neither trying to be arrogant about the result but at least, acknowledge it lah kan).

But he was talking too much at that time and time was really restricted that I didn't have the chance to refute his claim. He was stopped by our lecturer a few minutes after that remark. Not because of the remark but rather he was taking other group's time too much.

Today, I read an article on The Malaysian Insider by Erna Mahyuni titled "On being called an ‘ungrateful Malay’", and all the issues regarding Bumiputras and their(our?) privileges came back to me.

Should the Bumiputras receive the privileges? Yes, they should, when Dasar Ekonomi Baru was introduced way back in 1971 by our dear PM, Tun Razak.
Should the Bumiputras continue receiving those privileges? Now? No, they should not. At least not all of the privileges that were offered back then.

It has been 30 years since these privileges were given. A young man of his 20s receiving the loan to set up his own business at that time should have been in his 50s now and should have been able to support his own family enough. A young student who received a scholarship at that time should have finished studying by now and start contributing back to our country and improve our economy.
I'm pretty sure Tun Razak's vision was that of an improved, educated and richer Bumiputras, be it the Malays, Bajaus, Kadazans, Melanaus, or the Semai, Jakun and Temiar of the orang Asli.

But what do we see now?
The rich Malays getting richer, and the orang Asli are still left in the jungle. Good news, they have one hospital in Gombak only for them. And they have missionaries; Muslim and Christians alike going to save their soul.
There are more rich Malays now compared to 30 years ago, correct.
But isn't that a given? After 30 years, surely no one will expect a country to have the same number of poor people? Unless war erupted.
The lower class Malays? The very unfortunate young girls got pregnant and out of fear went through illegal abortions or worse, dump their newborns. The unfortunate young men got stuck with drugs and loitering. I am sure many of the young Malays received help through technic and vocational colleges but the numbers that were left behind is not insignificant.

Why is this happening?
Because the Malays (unfortunately), who did not deserve the privileges continued taking the privileges and did not have any intention to help the unfortunate ones. People became greedy. I know some friends who can afford for a (or a few) tours in Europe with the whole family and yet, received JPA scholarship. You think that's fair? Yes they secured 11As in their SPM but that does not justify the scholarship. Dr Musa, a Consultant Paediatrician I looked highly upon once mentioned in his talk when he came to IMU during our Palestine week about his daughter and education. He said he can afford his daughter's education and so he won't allow his daughter receive any scholarship. His daughter is now a practising doctor having graduated from CUCMS (I think I got this fact correct).

And now PERKASA came in, led by rich Malay men, determined to uphold the Ketuanan Melayu.
Oh come on, on one side the PM is screaming "1Malaysia 1Bangsa" and there you are screaming "Ketuanan Melayu".
I wonder why is he not charged with trying to put the races in Malaysia at loggerheads.
The not so fortunate Malays that are supporting PERKASA, in hope that their lives will be improved will soon have to face the bitter truth; they won't benefit from it.
PERKASA is not fighting for the mass of Malays, they are fighting for the rich Malays.

Some people might say, Akmar dh dh la tu... If there is no quota for Bumiputra, you might not be writing this post in Manchester. There is no way your parents can even afford to send you to a 5 year Medical course in a private Malaysian university.
Yes, true.
But if there is no quota (assuming the privileges have been scraped off) because more than 50% of the Malaysians have benefited from the privileges 50 yrs back and started contributing sincerely to Malaysia, won't Malaysia be a lot richer now and be able to fund even more students overseas?
The more bright youths a country have, the more prosperous and economically stable a country should be, given that they are working to make the country better.
But oh, that's only my ideal world.

Anyway, I should get back to my study and prove to everyone that I did not rely on my Malay Muslim name to secure this scholarship. A lot of my Malay friends don't.

I'll just end with a verse from the Quran.

For each one are successive [angels] before and behind him who protect him by the decree of Allah . Indeed, Allah will not change the condition of a people until they change what is in themselves. And when Allah intends for a people ill, there is no repelling it. And there is not for them besides Him any patron. [13:11]
Yes, He does not change your life until you change it yourself.
Privileged or not, you still have to put in your own effort :)


-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

And It Snowed!!

Assalammualaikum!

Ever since I know that people can study overseas, my dream has always been to study in a country where there is snow. I've never thought much which country it will be, or even what course will I study.
Then I came to UK, Preston specifically.

And it didn't snow during my first year here (2011), except for the one day that I was stuck in a ward round with Dr B in the Assessment Unit in Chorley Hospital :(

It was cold, it has always been cold but it didn't snow as I wanted it to be.

Then last year I went to Germany, hunting for snow. It didn't snow too.
There was snow on the ski mountain, yes. But it wasn't snowing!

Then 2013 came.
There was bits of snow last week, not much but there was.
I was so excited.
But other cities hv a loot more snow. Liverpool was covered with snow, people in Edinburgh are posting pictures of snowmen on facebook, even London snowed!
But the snow in Preston was very shy. It came out, vry lightly.

There was a football match yesterday, Man Utd vs Tottenham. They played in the snow! In London!
I looked outside my window, there was no snow.

Then this morning, I noticed the cars parked next to my house were covered in snow, and to my delight, it was still snowing!

Syahidah and I went for our GP placement in Leyland, and the snow was even heavier!
And we made our very own first snow man :D

I was still stingy.
Upon returning to Preston, the snow wasn't heavy and thick enough for me to build a snowman near our houses so Akmal and I went to Avenham Park and built another snowman! This time I was prepared. I brought a carrot and an extra scarf for our snowman!

After building two snowmen in a day, and witnessing the beauty of snow, I felt all the agony and sufferings I went through so far, surviving the coldness and darkness, with temperatures of lower than 0, have been redeemed. It is all worth it now, the coldness and shivers. For the beautiful snow :)


-Because life is a test-



-AkMaR-
http://nur-akmar.blogspot.com

Listen, Listen, Listen

Assalammualaikum.

I think by now everyone; young or old, working or not who spend enough time on facebook would have watched the much talked about 12min "Listen Listen Listen" video.

I'm sure you all have but to make it easier for me myself to re-watch in the future shd I need it, I'll just embed it here. This video hits about 200k views already.


Everyone





-Because life is a test- -AkMaR- http://nur-akmar.blogspot.com

Pruritic Fingers and Absent Mind

Because the exam is coming near.
Because I am stuck on my desk for most of the time, mugging up the notes.
Because there are too many things to revise, I do not know where to start from.

And I feel like scrolling down ebay or amazon and buying stuffs.

Anyway, I watched these two videos lately,

1) Yusuf Estes answering a Christian's question on what changed his mind from a Bible preacher to a Muslim preacher.
It's a bit long (32mins), yes. But the first 20-25mins was well worth it and interesting :) The end is a bit dramatic but hey, it's genuine! You can skip the last 10mins if you want to.




2) A totally different video, a sweet and entertaining wedding speech by a groom.




Ugh, I so want more time to revise but I also want this exam to be over, fast.

And anyone knows how to get rid of that annoying ads on this blog? The ads that come out either on the top left corner or the bottom right corner? The one that comes out on the top left corner can be closed (there's a small, almost invisible [close] below the ad that you can click) but the one that appears on right bottom corner is the more annoying, I can't close it.
They are ads about interesting videos.
I've no idea what I did that they turned up.
I did not put in any html on my blog, I might have put my url in some other websites allowing ads so that I can use their feature (and I cant remember what now).

Btw, pruritus is the posh (read: medical) word for itch so, pruritic means itchy.

p/s: At least I'm writing nonsense here in my blog, writing my disorganised thoughts than posting it as a status on facebook where everyone is forced to read it in their newsfeed. You're reading this bcos you chose to. The fact that you got this far down prove it.

Ok.bye.

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com

When the Exam is NEAR

I've always written my yearly summary (at least for 2010 and 2011), I wonder if I should wrap up my 2012 this time?

When the exam comes, I start to feel the burning desire to write.

-Because life is a test-

Akmar

Day 5 - Hamburg and Manchester

It took me 9 days to write this!
Usual excuse, class started.

So that morning on the 31st we took an ICE train to Hamburg, the journey was only about 2+ hrs and Wasil finished watching Gadoh on my iPad.

From Hamburg Hbf we went straight to (I can't remember the station now) the nearest S-bahn station to Miniatur Wunderland. And my my, we had a fantastic time in Miniatur Wunderland!
You know what? I'll write a specific post on that later, either after my progress test (which will be in 5 days time!) or before if I find myself unable to focus on studying (like now).

Right after Miniatur Wunderland we went looking for a halal restaurant to eat.

Alhamdulillah, for the past 4 days we have been able to find halal restaurants in all cities we've visited. Some of the times we shared a foot-long Tuna from Subway though bcos it's a lot cheaper!

Upon googling, there was this one restaurant called "Cita Rasa". Apparently it was an Indonesian restaurant! So we made our way there. Unfortunately the restaurant was closed until early Jan but the area that we were in was I think a Muslim area, an equivalent of Rusholme in Manchester. It was along a road called Steindamm. We saw lots of dark haired men and women with hijab and robes and also many halal restaurants along the way.

However, to our surprise, we also saw lots of sex shops (as written on their signboards)! I'm not sure what it means but one of them were called "Men's Paradise", I can't remember the names of the others. But all of them had a sexy woman picture in front of it with a large dark, closed doors. There was no censorship at all, no effort to make the shop "unobvious"at all! So it was all so confusing really. An area with many Muslims, many halal restaurants but also many indecent shops. I hope that area is not known as a Muslim area in Hamburg or it will be a very bad connotation!

We had lunch at Kabul Restaurant, an Afghan restaurant. It had an "All You Can Eat" buffet for €6+ if I'm not mistaken. The taste was so different from the Mamak, Malay, Thai or Pakistani curries I've tasted before. And that was also the first time I saw a restaurant serving a full plate of long, thin but furious looking cili api (bird's eye chilli) on the table.

And after lunch we headed straight to the Hbf (it means central rail station) and to the airport. And then, we were in Manchester.

I realised in Manchester, that I lost £40 *cry cry cry*
I am sure I took it out of my little pouch in the toilet in Kabul Restaurant and put it in my jeans pocket. And then, I completely forgotten about it. By the time I reached Manchester, it was gone. Come to think of it again, when the airport security officer did a full body search on me (the alarm went off as I walked pass the gate. I hate it when it happens), I can't remember taking out the notes from my pocket. It was already gone by then, I just did not notice.

And so, on top of all the things I spent on my 5-days-trip to Germany, I have to add a careless £40 "spend" in my budget report :(

-Because life is a test-

-AkMaR-
http://nur-akmar.blogspot.com