It is nice and feels great to be in academia. However, academia demands a high level of time, energy, dedication and passion. There is one thing that kills academia, and that is cheating.
In academic indulgence, scholarship, research, writing and publication, there is a lot of room for cheating. There are many ways in which university lecturers have used to cheat their way to the top. I have seen too many times and thus this warrants a write-up first-hand.
When lecturers first get research students at their door, the student is almost always in a self-pity state. It is derogatory to get a begging student, doesn't matter whether it is a male or female. I have often accepted them, but I find that these beggar students are not worth my hard work of toil looking and supervising them.
A sad and begging student is a falsehood of everything that academia needs. I should turned away all research students who come into this category. They may succeed in obtaining their postgraduate degree, but they are undeserving and often ungrateful souls. I don't ever want them back with me or working with me.
Why?
Here are some instances I can cite and you can judge how former students and lecturers cheat. Cheating is big time at university.
Scenario 1
A beggar student with a low CGPA comes to your door - begging to be your postgraduate student. He gets accepted for begging hard. He turns out to be aligned to other researchers with even bigger grants. So he is just registered under you, but actually works for somebody else on the faculty.
Scenario 2
A beggar student with a reasonably good CGPA comes to your door, begging to be your postgraduate student. She gets accepted for begging hard. She turns out to be inclined to make better friends with your head of department. After graduation, she continues her research with your head of department, while you are oblivious to their research. Somehow, technology shows their publication, which you found by surprise. Of course your name is not on any of their research while the research involves learning off your back.
Scenario 3
This is like from rags to riches. An average student barely makes through the grades and graduates. She become a research assistant. Then she found herself a lecturer job by befriending a head department whom she met earlier during her struggling days. She gets promoted and landed a job as a research director. Good job but a sick attitude. How in the world can one appreciate an almost dropout student to easily become a research director?
Scenario 4
A medical lecturer tired to overpower her subordinate and tries to take away his research to call it her own. He defends himself and refuses to give it all up for her. He transfers. She has another plan - to take up his residual research and make it big and as if her own. Since she is head, it is big time for her. She is acknowledged, but for what? People must be blind not to see how a medical lecturer with just an average pass in MMed can be a director of a specialised field of research that someone else did before her.
Scenario 5
This one is what I call a killing. You have a medical lecturer as your head of department. She only has an MRCP but no PhD. You have a PhD and lots of other skills that all tertiary academics should have. Of course and in due time, the head of department will make a sure kill - kill you in your sleep, kill you till you cannot claim your academic freedom, kill you and make sure you don't get your academic promotions.
Scenario 6
This one is an old man who refuses to quit. Yes, the retirement age has been increased to 60, so many lecturers stay on till bald and forgetful. However, they are meaner. They have a hand in every university affair and decision that you can't even have a breathing space. Sometimes you just wish that old man will wither and just die, so lecturers can live, wish and work well in the university.
There is so much madness in academia. It feels great to survive torture, but it feels even greater to win battles against such cheaters and nerds.
Monday, 13 March 2017
Friday, 2 September 2016
Friday, 12 August 2016
Pancreatic Cancer
English: Pancreatic cancer
Malay: Kanser pankreas
Indonesian: Kanker pankreas
Q1. What is pancreatic cancer?
Q2. Who gets pancreatic cancer?
Q3. Why does pancreatic cancer occur in some patients and not others? What causes pancreatic cancer?
Q4. How does pancreatic cancer develop?
Q5. What are the signs and symptoms of pancreatic cancer?
Q6. Pancreatic cancer investigations and diagnosis.
Q7. Conventional pancreatic cancer treatment:
Q8. What does the pancreatic cancer patient feel? Does the patient feel pain? Yes.
Q9. Are there cures for pancreatic cancer? Yes.
Q10. Are there effective cures for treating pancreatic cancer? Yes. You can read about some of these but be careful of what you decide:
Q11. Will pancreatic cancer go away for good? Yes and No.
Q12. Will pancreatic cancer kill? Is it fatal? Yes and No.
Q13. Are there pancreatic cancer survivors? How long can they survive? Yes.
Q14. What will happen to pancreatic cancer in the future?
Q15. What is the prognosis of pancreatic cancer? Bad and Good.
Q16, Pancreatic cancer Q&A
Q17. Pancreatic cancer diary
Q18. Pancreatic cancer Patient's Guide.
Q19. Cancer Care therapy for pancreatic cancer
Q20. Eat the right food
Malay: Kanser pankreas
Indonesian: Kanker pankreas
Q1. What is pancreatic cancer?
Q2. Who gets pancreatic cancer?
- Some people are more prone than others to get pancreatic cancer.
- There are multiple risk factors associated with pancreatic cancer; it does not necessarily mean that if someone has any of these risk factors they will get pancreatic cancer. These risks factors have only a weak link to pancreatic cancer.
- Sometimes there are none of the risk factors in pancreatic cancer patients.
Q3. Why does pancreatic cancer occur in some patients and not others? What causes pancreatic cancer?
- Multiple risk factors are linked to pancreatic cancer.
- Genetics. Approximately 5% to 10% of pancreatic cancer patients have an immediate family member who also has pancreatic cancer. It should not mean that pancreatic cancer runs in families. Although genes have been associated with increased risk of pancreatic cancer, nevertheless, no pancreatic cancer gene has been identified.
- Diabetes. Pancreatic cancer is linked to diabetes, but not all diabetics have pancreatic cancer.
- Smoking. Smoking is linked to pancreatic cancer, but not all smokers have pancreatic cancer.
- Obesity. Pancreatic cancer patients are obese initially and lose weight constantly.
- Ethnicity. Over 80% of pancreatic cancers develop between the ages of 60 and 80 years, in African-American Black population.
- http://www.webmd.com/cancer/pancreatic-cancer/causes-pancreatic-cancer
Q4. How does pancreatic cancer develop?
- All cells contain DNA except mature red blood cells (mature erythrocytes).
- DNA can be damaged by constant exposure to radiation and by chemicals in the food we eat and the environment we live in.
- This damage is described as a mutation in the DNA.
- When the DNA has mutated, it produces certain proteins that can trigger new protein formation.
- These are abnormal proteins, which can trigger cells to proliferate.
- When cells proliferate at an uncontrollable rate, it can lead to a mass of cells that form a tumour.
- A tumour can be either benign or malignant.
- Tumours can spread (metastasize) via the lymphatic system (vessels that contain lymph) or the general circulatory system (vessels that contain blood).
- In this way, a single tumour cell can re-establish in another organ far away from the initial tumour site and start a new tumour growth.
- How fast or slow a tumour grows depends on what nutrients are supplied in the diet and what nutrients eventually reach the tumour.
- Tumours love loads of sugar in the food that we eat.
- Reducing sugar intake and making correct dietary adjustment to food intake can help in stopping tumour spread and get rid of the cancer itself.
- https://youtu.be/SM2VYx510y8
- https://youtu.be/6xLkhDJsDGo
Q5. What are the signs and symptoms of pancreatic cancer?
- https://youtu.be/-Ra6YrSsxB0
- https://youtu.be/TMNdb1XeeN8
- https://youtu.be/7qnJMt4q4Yk
- https://youtu.be/_DBPoiG_Prg
- https://youtu.be/0rvFETOftvY
Q6. Pancreatic cancer investigations and diagnosis.
Q7. Conventional pancreatic cancer treatment:
- surgery
- radiotherapy
- chemotherapy
- pancreatic cancer surgery: https://youtu.be/usGW6jp-MjA
- herbs are useful during radiotherapy and chemotherapy
- clinical trial of double-drug chemotherapy: https://youtu.be/EEcqWUEQlnE
Q8. What does the pancreatic cancer patient feel? Does the patient feel pain? Yes.
- Pain is in the middle of the top segment of the abdomen.
- Patients take painkillers to cover pain and forgot that there is a cure for it.
- https://youtu.be/IBIhbqSZ51Y
Q9. Are there cures for pancreatic cancer? Yes.
- There are two options.
- There is conventional treatment (surgery, radiotherapy and chemotherapy).
- There is an alternative DIY therapy, a self-taught, more herbal routine that has worked for patients.
- You can try the techniques of these successful patients or DIY (do it yourself).
- There is no one cure that will heal pancreatic cancer.
- There is no one pancreatic cancer that will respond well to all known therapies.
- There is always room for innovation and improvement for pancreatic cancer.
- https://youtu.be/NZUUYARQonI
Q10. Are there effective cures for treating pancreatic cancer? Yes. You can read about some of these but be careful of what you decide:
- Controversy of 'vitamin B-17 laetrile' https://en.wikipedia.org/wiki/Amygdalin
- Controversy of dimethyl sulphoxide or dimethyl sulfoxide (DMSO) https://en.wikipedia.org/wiki/Dimethyl_sulfoxide
- Safety issues of high dose vitamin C http://www.mayoclinic.org/drugs-supplements/vitamin-c/safety/hrb-20060322
- Porcine pancreatic enzymes https://www.pancan.org/facing-pancreatic-cancer/diet-and-nutrition/pancreatic-enzymes/
- Apricots ... source of vitamin B-17
- http://www.chrisbeatcancer.com/how-felicity-healed-stage-4-pancreatic-cancer-in-2003/
- Gerson Therapy. Charlotte Gerson (80) d/o Dr Max Gerson speaks on Gerson Therapy https://youtu.be/quuvi6Gvvmc
Q11. Will pancreatic cancer go away for good? Yes and No.
- If you look after yourself well after curing cancer, the cancer will stay away from you.
- If you don't look after yourself after curing cancer, the cancer will return.
- Stay on a right diet, live peacefully and happily, stick to your faith and live a life of no worries.
Q12. Will pancreatic cancer kill? Is it fatal? Yes and No.
- Yes, if you do nothing about your pancreatic cancer. It will kill you because you did nothing and just ignored it and just took painkillers.
- No, if you did something to stop it and reverse it. You need to learn how to by understanding your cancer, how it happened, its symptoms etc. Then read about how others have successfully managed to heal their pancreatic cancer.
- Even an elderly 74-year-old lady knows how to cure her pancreatic cancer. You decide what you want to do.
- https://youtu.be/LL3WmXIRNKg
Q13. Are there pancreatic cancer survivors? How long can they survive? Yes.
- In 2000, she had stage 4 pancreatic cancer and refused conventional treatment. https://youtu.be/xh1pOB2h97U
- In 2003, an elderly 74-year-old lady created a record for herself. She cured herself of stage 4 pancreatic cancer with her own routine. She shares her experience and routines with other pancreatic cancer patients and the world. https://youtu.be/LHKaVd_twIE
- In 2012, she had stage 4 pancreatic cancer and survived chemotherapy. She had her own natural DIY cure https://youtu.be/hdWatSJEcbM
Q14. What will happen to pancreatic cancer in the future?
- The future of pancreatic cancer is now a living past.
- We already have cures for pancreatic cancer today.
- Conventional treatment cures 40% of pancreatic cancer cases. The remainder 60% of pancreatic cancer patients have can resort to alternative DIY routines as a form of therapy to cure themselves. DIY pancreatic cancer therapies will certainly need time, commitment and patience. Nothing comes easy. Perseverance usually gives the best results. As the Arabic saying goes: Haste makes waste. There is no cure if you are going to rush things.
Q15. What is the prognosis of pancreatic cancer? Bad and Good.
- Depends on how you look at it.
- Any cancer diagnosis comes with a negative cloud and frightens patients as if it is the end of their world. This must stop.
- Patients must come to know that there are conventional treatment and alternative DIY cures for pancreatic cancer.
- The prognosis of a metastatic pancreatic cancer 5-year survival rate is 2%.
- https://youtu.be/FmZqiBo8fPw
Q16, Pancreatic cancer Q&A
Q17. Pancreatic cancer diary
Q18. Pancreatic cancer Patient's Guide.
Q19. Cancer Care therapy for pancreatic cancer
- http://www.cacare.com/the-ca-care-therapy
- https://youtu.be/aU0U1xgPaUA
- https://youtu.be/pTjAcv1Zsow
- https://youtu.be/NkugbjMOUcQ
Q20. Eat the right food
Sunday, 7 August 2016
General Healthcare Products
Gingko Products
- Gingko products are made from Gingko leaves
- Gingko is a diuretic agent and produces a lot of urine
- remember to drink more water when taking Gingko products, to avoid dehydration
- do not take Gingko products for extended periods
Hovid Gingko 10 tablets per foil RM12, round yellow pills Medica Pharmacy
Standardized Gingko Biloba Extract 80mg
24% Flavone Glycosides & 6% Terpene Lactones
Shine Gincare Film coated tablet
Blackmores Gingko Forte 2000
Standardized ...
Traditional medicine
Traditionally used to improve blood circulation
30 tablets per bottle
Gingko Forte
https://www.standardprocess.com/Products/MediHerb/Ginkgo-Forte#.V6bjU9R97Gg
-----------------------------
Skincare
- some skin and skin types need more attention than others
- some skins are difficult to treat and finding the most successful treatment needs time, and healing itself will also need time
- sometimes the cause is unknown
- sometimes skin conditions are caused by the chemicals present in food (artificial food colourings, food additives etc)
- a severe skin condition may take years to manifest and many more years to make it go away
- olive oil and paraffin oil/mineral oil are best for the worst skin conditions
- sheep wax (lanolin) is best for cracked skin, including cracked nipples during breastfeeding
- argan oil, marula oil are Old World Oils but are re-purposed for multipurpose use
- certain oils have antiseptic, antibactericidal and antifungal properties
Marula Oil Body Scrub
Contains marula oil
- smooth cream, not oily, dries fast
- good for dry skin
- apply and let dry. Wash off when you take a bath.
Thursday Plantation Tea Tree Oil
Australia's 100% Pure Tea Tree Oil 10 ml / 25 ml bottles
Multipurpose liquid
- good for itchy skin, problem areas of the skin, foot fungus/athlete's foot
- good for in-grown toenails
- kills bugs, bacteria and fungus
------------------------------
Joint pain
- knee, ankle, sprain, falls, cold days, standing too long, sitting too long
- humans age and as we age, our bones become fragile as a result of wear and bone thinning (osteoporosis)
- falls will result in broken bones (fractures)
- joint pain, bone pain (osteomalacia), osteoporosis, arthritis cause excruciating pain in the elderly
Flanil Analgesic Cream
RM9.12 Farmasi Makmur Jaya
For relief of simple muscular discomforts and painful muscles following unaccustomed exercise or exertion.
Fastum Gel
Nonsteroidal anti-inflammatory agent
Ketoprofen 2.5%
Tube of 30 g
For external use only
Voren Plus Gel
RM10 Medica Pharmacy
Each gram contains 10 mg Sodium diclofenac.
Menthol added.
Anti-inflammatory and analgesic agent
For external use only
20g
Atroxene Flex
Emulgel 100 ml
Ozonized olive oil
Bought at Subang Airport
- good for painful knee
- no more knee pain after a few applications
-----------------------
Wound Management, Care and Healing
- wounds have to be seen to at the Emergency Department at any hospital
- only after x-ray, proper wound cleaning and placing an injured limb in a cast (if any) can the patient take care of his wounds
- most open wounds cannot touch water. Bathe briefly and do not soak open wounds
- dab and let open wounds air-dry
- perform Wudhu' on the injured limbs only if necessary and when safe to do so. Else the wounds will progress to become septic or gangrenous. If pus form, clean, air-dry or dry with hair-dryer/blow dryer, and apply Solcoseryl Jelly. Never let pus form in the first place.
Solcoseryl Jelly 10%
20 g jelly
Composition: 1 g jelly contains:
4.15 mg protein-free haemodialysate of calves' blood, chemically and biologically standardised
Methyl parahydroxybenzoate (E218) 1.73 mg/g
Propyl parahydroxybenzoate (E216) 0.27 mg/g
Sodium carboxymethylcellulose, Propylene glycol, Calcium lactate, Water for injection.
Keep out of reach of children. Jauhi dari kanak-kanak.
- this product contains ingredient derived from animal origin (bovine)
- for weeping wounds and burns
- dries fast. Apply directly onto weeping wound and let dry in front of fan. Then apply Hansplast to avoid bleeding and sticking to clothing
- wash off before performing Wudhu'. Re-apply after prayers.
Hansaplast
Transparent almost invisible on skin
Strong adhesion
Tidak kelihatan pada kulit
Pelekat kuat
20 strips per box
Premier Cotton Buds RM2.80
200 tips per container
- use cotton buds to clean wound with antiseptic solution
- remove all traces of dried blood and fresh blood. Then apply Solcoseryl Jelly.
- Gingko products are made from Gingko leaves
- Gingko is a diuretic agent and produces a lot of urine
- remember to drink more water when taking Gingko products, to avoid dehydration
- do not take Gingko products for extended periods
Hovid Gingko 10 tablets per foil RM12, round yellow pills Medica Pharmacy
Standardized Gingko Biloba Extract 80mg
24% Flavone Glycosides & 6% Terpene Lactones
Shine Gincare Film coated tablet
Blackmores Gingko Forte 2000
Standardized ...
Traditional medicine
Traditionally used to improve blood circulation
30 tablets per bottle
Gingko Forte
https://www.standardprocess.com/Products/MediHerb/Ginkgo-Forte#.V6bjU9R97Gg
-----------------------------
Skincare
- some skin and skin types need more attention than others
- some skins are difficult to treat and finding the most successful treatment needs time, and healing itself will also need time
- sometimes the cause is unknown
- sometimes skin conditions are caused by the chemicals present in food (artificial food colourings, food additives etc)
- a severe skin condition may take years to manifest and many more years to make it go away
- olive oil and paraffin oil/mineral oil are best for the worst skin conditions
- sheep wax (lanolin) is best for cracked skin, including cracked nipples during breastfeeding
- argan oil, marula oil are Old World Oils but are re-purposed for multipurpose use
- certain oils have antiseptic, antibactericidal and antifungal properties
Marula Oil Body Scrub
Contains marula oil
- smooth cream, not oily, dries fast
- good for dry skin
- apply and let dry. Wash off when you take a bath.
Thursday Plantation Tea Tree Oil
Australia's 100% Pure Tea Tree Oil 10 ml / 25 ml bottles
Multipurpose liquid
- good for itchy skin, problem areas of the skin, foot fungus/athlete's foot
- good for in-grown toenails
- kills bugs, bacteria and fungus
------------------------------
Joint pain
- knee, ankle, sprain, falls, cold days, standing too long, sitting too long
- humans age and as we age, our bones become fragile as a result of wear and bone thinning (osteoporosis)
- falls will result in broken bones (fractures)
- joint pain, bone pain (osteomalacia), osteoporosis, arthritis cause excruciating pain in the elderly
Flanil Analgesic Cream
RM9.12 Farmasi Makmur Jaya
For relief of simple muscular discomforts and painful muscles following unaccustomed exercise or exertion.
Fastum Gel
Nonsteroidal anti-inflammatory agent
Ketoprofen 2.5%
Tube of 30 g
For external use only
Voren Plus Gel
RM10 Medica Pharmacy
Each gram contains 10 mg Sodium diclofenac.
Menthol added.
Anti-inflammatory and analgesic agent
For external use only
20g
Atroxene Flex
Emulgel 100 ml
Ozonized olive oil
Bought at Subang Airport
- good for painful knee
- no more knee pain after a few applications
-----------------------
Wound Management, Care and Healing
- wounds have to be seen to at the Emergency Department at any hospital
- only after x-ray, proper wound cleaning and placing an injured limb in a cast (if any) can the patient take care of his wounds
- most open wounds cannot touch water. Bathe briefly and do not soak open wounds
- dab and let open wounds air-dry
- perform Wudhu' on the injured limbs only if necessary and when safe to do so. Else the wounds will progress to become septic or gangrenous. If pus form, clean, air-dry or dry with hair-dryer/blow dryer, and apply Solcoseryl Jelly. Never let pus form in the first place.
Solcoseryl Jelly 10%
20 g jelly
Composition: 1 g jelly contains:
4.15 mg protein-free haemodialysate of calves' blood, chemically and biologically standardised
Methyl parahydroxybenzoate (E218) 1.73 mg/g
Propyl parahydroxybenzoate (E216) 0.27 mg/g
Sodium carboxymethylcellulose, Propylene glycol, Calcium lactate, Water for injection.
Keep out of reach of children. Jauhi dari kanak-kanak.
- this product contains ingredient derived from animal origin (bovine)
- for weeping wounds and burns
- dries fast. Apply directly onto weeping wound and let dry in front of fan. Then apply Hansplast to avoid bleeding and sticking to clothing
- wash off before performing Wudhu'. Re-apply after prayers.
Hansaplast
Transparent almost invisible on skin
Strong adhesion
Tidak kelihatan pada kulit
Pelekat kuat
20 strips per box
Premier Cotton Buds RM2.80
200 tips per container
- use cotton buds to clean wound with antiseptic solution
- remove all traces of dried blood and fresh blood. Then apply Solcoseryl Jelly.
Monday, 13 June 2016
Housemanship
Local graduates get posted soon after graduation. Overseas graduates have to wait about 8 months (September 2015 - May 2016 ) before they are called for an interview and then wait another month (29 May 2016) before they get a letter telling them where they have to undergo housemanship.
BTN for east coast graduates
The letter also specifies where they must do a BTN course (eg for east coast graduates, they have to report at BTN Besut). The BTN course is 5 days (Monday, 2 pm - Friday, 1 pm). Brothers are best to send and pick up for the BTN course as Monday is a work day and Friday is for Solat Jumaat. Can stop at any masjid along the way. Planning is necessary. Besut is 2 hours drive from P. Chepa airport. Going to BTN Besut is easy, but graduates may need to hitch a ride with friends from BTN Besut to the airport in P. Chepa.
------
Housemanship Guide 2016-2018
Housemanship is done immediately after graduation and lasts 2 years. It involves attachment to a few select hospitals which have vacancies for house officers (HO). Not all hospitals have the necessary expertise and facilities for housemanship training. Learning during this time is by tagging - follow other doctors and the team. The working hours are long, tiring and heart-wrenching.
A houseman has to try and meet set targets (eg handle 10 deliveries in 2 weeks at O&G).
A warning letter comes if targets are not met ... can either remedy or get kicked out for good.
This is roughly what daily life is like as a houseman:
Night before: charge handphone and powerbank.
5:00 am: Get up. Wash and have breakfast (instant oats) and drink something (eg Milo).
6:00 am: Pray solat Subuh. Bathe, iron clothes and get dressed. Pakai tudung and kasut.
6:30 am: Drive/chauffeured to hospital (fathers are best drivers at this early hour).
7: 00 am: Clock-in at O&G section (or whichever you are assigned to during prior orientation).
8: 00 am: Start work by tagging other doctors and the team.
2:00 pm : Solat Zohor. Light lunch.
5:00 pm: End of day job. Clock-out. Solat Asar.
5:00 pm: Start of on-call job. Clock-in.
8:00 pm: Solat Maghrib.
11: 00 pm: End of on-call job. Clock-out. Go home before midnight.
11:00 pm: Pick up at O&G department (fathers are best to pick up their daughters at this hour).
11:30 pm: Reach home, bathe and have dinner/supper. Solat Isya'. Write short notes in logbook.
12:00 am: Sleep. Totally knocked-out.
------
-------
Are there problems with Housemanship?
Yes and No.
Some doctors think good of Housemanship, some think otherwise.
Many doctors give up on their Housemanship and move to other areas of work.
Many persevere and make it successfully through their Housemanship.
Many leave medical practice by doing a postgraduate degree (eg Master of Medicine, MMed) and enter teaching at the university.
Many still engage in surgery and run clinics at university hospitals.
-------
What is Housemanship?
The Housemanship is necessary after completing the undergraduate medical degree (MBBS/MD).
There is an interview to evaluate the students 8 months after graduation.
The graduate is asked where she/he wants to do Housemanship.
A letter is issued from the Ministry of Health, MoH (Kementerian Kesihatan Malaysia, KKM).
The Housemanship is for 2 years at an appointed hospital.
Can't switch hospitals unless for valid reasons - anak premature masuk NICU etc.
Can't take leave unless for valid reasons - anak sakit dan kena jaga di NICU/ICU, ibu sakit dan meninggal, urusan nak kahwin etc (2 weeks leave allowed at most).
Can only do Housemanship at appointed hospitals as not all hospitals have the necessary depts, expertise, and capacity to take in Houseman to train them for 2 years.
There are 6 postings at 6 depts, for 4 months each posting, plus 1 month extension if necessary.
There is viva/written exam at the end of each posting.
If pass can continue to next posting.
If fail, must repeat another 1 month of the failed posting, and then proceed if pass.
---------------
An example of Housemanship at HRPZ II in Kota Bharu, Kelantan:
1. Posting O&G, 6 June 2016 - 28 Sept 2016 (4 months)
2. Posting Surgery, 29 Sept 2016 - 28 Feb 2017 (4 + 1 months)
3. Posting Medicine, 1 March 2017 - June 2017
4. Posting July-Oct 2017
5. Posting Nov 2017 - Feb 2018
6. Posting March - June 2018
------------
Some issues:
The major issues before/during Housemanship for female doctors are:
1. Bila boleh kahwin? Preferably after successfully completing Housemanship.
2. Bila boleh beranak? Preferably after successfully completing Housemanship.
3. Bila boleh independent? After first pay, first month of Housemanship.
4. Bila mampu berdikari? After first pay, first month of Housemanship.
Since the Housemanship is a very trying period, the houseman can start live alone at nearby rented places or Houseman quarters at the appointed hospital.
For most unmarried women, the Housemanship is very trying and leaves no time and energy for a good life. It drains the person, and worse still is she has her menses. If in this poor unmanageable state, it is not advisable to live apart or alone, but to continue to live with one's family while highly dependent. Only decide to get married when things have stabilized and life is manageable. Otherwise family problems will crop in and the marriage will tend to fail.
Some ladies have managed to get married soon after arrival from overseas after their MBBS/MD or during their undergraduate days. However, they still have to depend o others to look after their babies or children - usually their aged mothers or childcare centres. Most mothers prefer to cook, send and care for their married daughters who are undergoing Housemanship. They also do babysitting.
Most unmarried ladies dread and cannot cope with Housemanship. Their personal problems, attitudes, mood swings and menses add to their difficulties. They cannot adjust to Housemanship life. They make life difficult for themselves and others around them. They threaten to give up and scare their parents and siblings.
A few unmarried ladies are wonderful and can manage well and have no fuss about Housemanship - they can even drive daily to work and back, and back to their homes in the villages far away during weekends or off days.
----------
What is possible after Housemanship?
Graduate doctors can pursue further studies or specialise after successful completion of their compulsory 2-year Housemanship.
They can go for either a Master of Medicine (MMed), Master of Science (MSc) or Doctor of Philosophy (PhD).
MMed is 4 years.
MSc is 1-2 years.
PhD is 3-6 years.
1. Master of Medicine (MMed)
If doctors go for MMed, they become specialists in a special area of expertise (eg Gynaecologist, Orthopedic surgeon, Gastroenterologist, Pathologist, Pediatrician, Medicine specialist - Endocrinologist/Diabetes specialist etc). Without a further degree, the doctor is just a general physician (medical officer, MO) and can do private general practice (GP, doktor private) or locum.
The MMed program can only be taken up by medical graduates who have completed 2 years Housemanship at a Govt hospital. The MMed program is four years at a public university - USM, UM or UKM. After MMed, the graduate is an expert (pakar perubatan) in his/her area of specialization.
As a medical specialist later on after graduation from MMed, doctors who work in medical/surgical dept get a Clinical Allowance (about RM3k) on top of their monthly salary.
If they are a specialist after MMed, but do not run clinics or see patients daily (eg posted to non clinical/surgical/medical dept), they get a Critical Allowance on top of their monthly allowance. Critical Allowance is 3/4 of Clinical Allowance. Doctors in a Lab-based dept get a Critical Allowance.
2. Master of Science (MSc)
This is not wroth doing for a graduate doctor. The MSc will not make them a specialist but just an expert (with extra knowledge) in a specific related research area, not a clinical practice area or specialization. They can only get a Critical Allowance after graduation and if they work at a Govt hospital.
3. Doctor of Philosophy (PhD)
The MMed degree is not a match for a PhD. The MMed degree is a coursework plus research beginning in year 2. The PhD is an entirely research program from year 1 and lasts many years. They can never be one and the same. They just don't match at all.
It is not worth doing a PhD as the medical graduate only gets a Critical Allowance after all. It is better for the medical graduate to do Housemanship and then MMed, become a specialist and then go for PhD.
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External links:
http://successful-housemanship.blogspot.my/2013_12_01_archive.html?m=1
http://lifenotless.blogspot.my/2013/02/housemanship-where-and-which-is-best.html?m=1
https://forum.lowyat.net/topic/1238484/all
BTN for east coast graduates
The letter also specifies where they must do a BTN course (eg for east coast graduates, they have to report at BTN Besut). The BTN course is 5 days (Monday, 2 pm - Friday, 1 pm). Brothers are best to send and pick up for the BTN course as Monday is a work day and Friday is for Solat Jumaat. Can stop at any masjid along the way. Planning is necessary. Besut is 2 hours drive from P. Chepa airport. Going to BTN Besut is easy, but graduates may need to hitch a ride with friends from BTN Besut to the airport in P. Chepa.
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Housemanship Guide 2016-2018
Housemanship is done immediately after graduation and lasts 2 years. It involves attachment to a few select hospitals which have vacancies for house officers (HO). Not all hospitals have the necessary expertise and facilities for housemanship training. Learning during this time is by tagging - follow other doctors and the team. The working hours are long, tiring and heart-wrenching.
A houseman has to try and meet set targets (eg handle 10 deliveries in 2 weeks at O&G).
A warning letter comes if targets are not met ... can either remedy or get kicked out for good.
This is roughly what daily life is like as a houseman:
Night before: charge handphone and powerbank.
5:00 am: Get up. Wash and have breakfast (instant oats) and drink something (eg Milo).
6:00 am: Pray solat Subuh. Bathe, iron clothes and get dressed. Pakai tudung and kasut.
6:30 am: Drive/chauffeured to hospital (fathers are best drivers at this early hour).
7: 00 am: Clock-in at O&G section (or whichever you are assigned to during prior orientation).
8: 00 am: Start work by tagging other doctors and the team.
2:00 pm : Solat Zohor. Light lunch.
5:00 pm: End of day job. Clock-out. Solat Asar.
5:00 pm: Start of on-call job. Clock-in.
8:00 pm: Solat Maghrib.
11: 00 pm: End of on-call job. Clock-out. Go home before midnight.
11:00 pm: Pick up at O&G department (fathers are best to pick up their daughters at this hour).
11:30 pm: Reach home, bathe and have dinner/supper. Solat Isya'. Write short notes in logbook.
12:00 am: Sleep. Totally knocked-out.
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“Housemanship provides an opportunity for new graduates to be further trained, supervised and guided so that they can become safe and competent doctors. On top of the four monthly rotations in six major clinical disciplines – general medicine, paediatrics, general surgery, orthopaedics, obstetrics and gynaecology – one obligatory posting in emergency medicine, anaesthesiology, psychiatry or primary care is also a must under the two-year housemanship training,” explains Dr Noor Hisham.
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Are there problems with Housemanship?
Yes and No.
Some doctors think good of Housemanship, some think otherwise.
Many doctors give up on their Housemanship and move to other areas of work.
Many persevere and make it successfully through their Housemanship.
Many leave medical practice by doing a postgraduate degree (eg Master of Medicine, MMed) and enter teaching at the university.
Many still engage in surgery and run clinics at university hospitals.
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What is Housemanship?
The Housemanship is necessary after completing the undergraduate medical degree (MBBS/MD).
There is an interview to evaluate the students 8 months after graduation.
The graduate is asked where she/he wants to do Housemanship.
A letter is issued from the Ministry of Health, MoH (Kementerian Kesihatan Malaysia, KKM).
The Housemanship is for 2 years at an appointed hospital.
Can't switch hospitals unless for valid reasons - anak premature masuk NICU etc.
Can't take leave unless for valid reasons - anak sakit dan kena jaga di NICU/ICU, ibu sakit dan meninggal, urusan nak kahwin etc (2 weeks leave allowed at most).
Can only do Housemanship at appointed hospitals as not all hospitals have the necessary depts, expertise, and capacity to take in Houseman to train them for 2 years.
There are 6 postings at 6 depts, for 4 months each posting, plus 1 month extension if necessary.
There is viva/written exam at the end of each posting.
If pass can continue to next posting.
If fail, must repeat another 1 month of the failed posting, and then proceed if pass.
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An example of Housemanship at HRPZ II in Kota Bharu, Kelantan:
1. Posting O&G, 6 June 2016 - 28 Sept 2016 (4 months)
2. Posting Surgery, 29 Sept 2016 - 28 Feb 2017 (4 + 1 months)
3. Posting Medicine, 1 March 2017 - June 2017
4. Posting July-Oct 2017
5. Posting Nov 2017 - Feb 2018
6. Posting March - June 2018
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Some issues:
The major issues before/during Housemanship for female doctors are:
1. Bila boleh kahwin? Preferably after successfully completing Housemanship.
2. Bila boleh beranak? Preferably after successfully completing Housemanship.
3. Bila boleh independent? After first pay, first month of Housemanship.
4. Bila mampu berdikari? After first pay, first month of Housemanship.
Since the Housemanship is a very trying period, the houseman can start live alone at nearby rented places or Houseman quarters at the appointed hospital.
For most unmarried women, the Housemanship is very trying and leaves no time and energy for a good life. It drains the person, and worse still is she has her menses. If in this poor unmanageable state, it is not advisable to live apart or alone, but to continue to live with one's family while highly dependent. Only decide to get married when things have stabilized and life is manageable. Otherwise family problems will crop in and the marriage will tend to fail.
Some ladies have managed to get married soon after arrival from overseas after their MBBS/MD or during their undergraduate days. However, they still have to depend o others to look after their babies or children - usually their aged mothers or childcare centres. Most mothers prefer to cook, send and care for their married daughters who are undergoing Housemanship. They also do babysitting.
Most unmarried ladies dread and cannot cope with Housemanship. Their personal problems, attitudes, mood swings and menses add to their difficulties. They cannot adjust to Housemanship life. They make life difficult for themselves and others around them. They threaten to give up and scare their parents and siblings.
A few unmarried ladies are wonderful and can manage well and have no fuss about Housemanship - they can even drive daily to work and back, and back to their homes in the villages far away during weekends or off days.
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What is possible after Housemanship?
Graduate doctors can pursue further studies or specialise after successful completion of their compulsory 2-year Housemanship.
They can go for either a Master of Medicine (MMed), Master of Science (MSc) or Doctor of Philosophy (PhD).
MMed is 4 years.
MSc is 1-2 years.
PhD is 3-6 years.
1. Master of Medicine (MMed)
If doctors go for MMed, they become specialists in a special area of expertise (eg Gynaecologist, Orthopedic surgeon, Gastroenterologist, Pathologist, Pediatrician, Medicine specialist - Endocrinologist/Diabetes specialist etc). Without a further degree, the doctor is just a general physician (medical officer, MO) and can do private general practice (GP, doktor private) or locum.
The MMed program can only be taken up by medical graduates who have completed 2 years Housemanship at a Govt hospital. The MMed program is four years at a public university - USM, UM or UKM. After MMed, the graduate is an expert (pakar perubatan) in his/her area of specialization.
As a medical specialist later on after graduation from MMed, doctors who work in medical/surgical dept get a Clinical Allowance (about RM3k) on top of their monthly salary.
If they are a specialist after MMed, but do not run clinics or see patients daily (eg posted to non clinical/surgical/medical dept), they get a Critical Allowance on top of their monthly allowance. Critical Allowance is 3/4 of Clinical Allowance. Doctors in a Lab-based dept get a Critical Allowance.
2. Master of Science (MSc)
This is not wroth doing for a graduate doctor. The MSc will not make them a specialist but just an expert (with extra knowledge) in a specific related research area, not a clinical practice area or specialization. They can only get a Critical Allowance after graduation and if they work at a Govt hospital.
3. Doctor of Philosophy (PhD)
The MMed degree is not a match for a PhD. The MMed degree is a coursework plus research beginning in year 2. The PhD is an entirely research program from year 1 and lasts many years. They can never be one and the same. They just don't match at all.
It is not worth doing a PhD as the medical graduate only gets a Critical Allowance after all. It is better for the medical graduate to do Housemanship and then MMed, become a specialist and then go for PhD.
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External links:
http://successful-housemanship.blogspot.my/2013_12_01_archive.html?m=1
http://lifenotless.blogspot.my/2013/02/housemanship-where-and-which-is-best.html?m=1
https://forum.lowyat.net/topic/1238484/all
Saturday, 28 May 2016
Staphylococcus aureus (S. aureus)
Historical perspectives and milestones:-
Staphylococcus [staffʺə-lo kokʹəs]
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810938/pdf/ET-1909.pdf
From the Greek staphyle (bunch of grapes) and kokkos (berry), Staphylococcus is a genus of gram-positive spherical bacteria that commonly cause surgical and skin infections, respiratory disease, and food poisoning.
In 1880, Scottish surgeon Sir Alexander Ogston (1844-1929) first described staphylococci in pus from a surgical abscess in a knee joint: “the masses looked like bunches of grapes.”
In 1884, German physician Friedrich Julius Rosenbach* isolated and differentiated 2 strains of staphylococci colonies by their color: S. aureus (from the Latin aurum, gold) and S. albus (Latin for white). S. albus was later renamed S. epidermidis.
*Anton J. Rosenbach (1842-1923), a German surgeon
4. Discovery of Staphylococcus aureus by Rosenbach in 1884
5. Earlier synonyms for Staphylococcus aureus:
S. aureus infections:-
S. aureus research on defense mechanisms:-
Staphylococcus [staffʺə-lo kokʹəs]
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810938/pdf/ET-1909.pdf
From the Greek staphyle (bunch of grapes) and kokkos (berry), Staphylococcus is a genus of gram-positive spherical bacteria that commonly cause surgical and skin infections, respiratory disease, and food poisoning.
In 1880, Scottish surgeon Sir Alexander Ogston (1844-1929) first described staphylococci in pus from a surgical abscess in a knee joint: “the masses looked like bunches of grapes.”
In 1884, German physician Friedrich Julius Rosenbach* isolated and differentiated 2 strains of staphylococci colonies by their color: S. aureus (from the Latin aurum, gold) and S. albus (Latin for white). S. albus was later renamed S. epidermidis.
*Anton J. Rosenbach (1842-1923), a German surgeon
- Accidental discovery of penicillin by Fleming
- Dr Mathews Duncan first used the term 'sapraemia' to describe bacterial chemical poisoning.
- Papers published on Micrococcus Poisoning by Sir Alexander Ogston in 1882, Scottish surgeon to the Aberdeen Royal Infirmary
Ogston, A. (1882). Micrococcus Poisoning.
J Anat Physiol. 1882 Jul; 16(Pt 4), 526-567. PMCID: PMC1310038.
J Anat Physiol. 1882 Oct; 17(Pt 1): 24–58. PMCID: PMC1310127
4. Discovery of Staphylococcus aureus by Rosenbach in 1884
The type strain of S. aureus subsp. aureus Rosenbach 1884 (DSM 20231T) was first isolated in 1884 from human pleural fluid by Rosenbach.
Staphylococcus pyogenes aureus
Staphlococcus pyogenes citreus
Micrococcus pyogenes
Micrococcus aureus
6. Misnomer: Streptococcus aureus
7. Earlier authority:
Staphylococcus aureus (S. aureus) classification:
http://www.gbif.org/species/3227657
Staphylococcus aureus (S. aureus) - Overview
S. aureus epidemiology:-
7. Earlier authority:
Staphylococcus aureus Rosenbach 1884
"Staphylococcus pyogenes aureus" Rosenbach 1884
"Staphlococcus pyogenes citreus" Passet 1885
"Micrococcus pyogenes" Lehmann and Neumann 1896
"Micrococcus aureus" (Rosenbach 1884) Zopf 1885
Staphylococcus aureus (S. aureus) classification:
http://www.gbif.org/species/3227657
- Kingdom: Bacteria
- Phylum: Firmicutes
- Class: Bacilli
- Order: Bacillales
- Family: Staphylococcaceae
- Genus: Staphylococcus
- Species: Staphylococcus aureus
- Full name: Staphylococcus aureus Rosenbach, 1884
- Common name: Methicillin-resistant Staphylococcus aureus (MRSA)
Staphylococcus aureus (S. aureus) - Overview
- Places found - nasal passages (nasal tract; nose), respiratory tract, skin
- Gram stain: Gram +
- Catalase test: +
- Shape: coccus (round)
- Pigment: staphyloxanthin (golden)
- Morphology:
- Colony morphology: smooth round colonies
- Spore formation: non-spore forming
- Motility: non-motile
- Forms spreading dendrites
- Bacteria photo gallery
S. aureus epidemiology:-
- Human indigenous bacterium; 30% healthy human harbour it in their nasal passages
- Not always pathogenic
- Can become pathogenic
- Major cause of staphylococcal disease
- Now have MRSA, which are resistant to antibiotics
- Between 1963-2012, there were 3085 cases involving MRSA reported worldwide
- Penicillin was discovered just before WWII ended in 1945
- There is no mention of year/date before 1944 ... listed as N/A online
- India: Undated (1); 2007 (1); 2012 (many cases)
- UK: Undated (1); 2012 (1)
- Palestine: 2012 (1)
- Mexico: 2012 (1)
- USA: Undated (8); 1963 (2); 2005 (114); 2011 (many cases)
- China: 1997 (125); 2002 (89); 2007 (203); 2010 (1); 2011 (1)
- Chinese Taipei: 2000 (20); 2006 (1)
- Belgium: 2011 (1)
- Brazil: 2007 (7)
- Poland: Undated (47); 1996 (6); 1997 (6); 1998 (4); 1999 (1,087); 2000 (44); 2001 (10); 2002 (20); 2003 (8)
- Germany: Undated (3)
- Australia: Undated (1); 1973 (201)
- Czech Republic: Undated (12)
- Republic of Korea: Undated (3)
- French Guiana: Undated (1)
- Netherlands: Undated (2)
- United Republic of Tanzania: Undated (2)
- Islamic Republic of Iran: Undated (1)
- Japan: Undated (1)
S. aureus infections:-
- Skin infections - causes abscess; eczema
- Respiratory infections - causes sinusitis; infect in-dwelling catheters
- Bloodstream - causes bacteremia
- Contaminated food - causes food poisoning
- Cigarette smoke boosts S. aureus virulence
- Emerging public threat - methicillin-resistant Staphylococcus aureus (MRSA) infection
- Clinical management of Staphylococcus aureus bacteremia in adults
- S. aureus clinical isolates - from in-dwelling catheters
- The emergence of antibiotic-resistant forms of pathogenic S. aureus (MRSA) is a worldwide problem in clinical medicine.
- in pediatric patients (less virulent)
- in adults (more virulent)
- Genome
S. aureus has a genome size of approximately 2.8 Mb, with a GC content of 32%. The chromosome contains pathogenicity islands and antibiotic resistance genes acquired through horizontal gene transfer of mobile genetic elements (MGEs). The MGEs occupy 15% to 20% of the chromosome. During outbreaks, S. aureus genomes develop single nucleotide polymorphisms (SNPs) and small genetic rearrangements and acquire or lose MGEs containing resistance or virulence genes.
2. First complete genome sequence 2015
Genome Announc. 2015 Jul-Aug; 3(4): e00800-15.Published online 2015 Jul 16. doi: 10.1128/genomeA.00800-15PMCID: PMC4505135
First Complete Genome Sequences of Staphylococcus aureus subsp. aureus Rosenbach 1884 (DSM 20231T), Determined by PacBio Single-Molecule Real-Time Technology.Akino Shiroma, Yasunobu Terabayashi, Kazuma Nakano, Makiko Shimoji, Hinako Tamotsu, Noriko Ashimine, Shun Ohki, Misuzu Shinzato, Kuniko Teruya, Kazuhito Satou, and Takashi Hirano Okinawa Institute of Advanced Sciences, Uruma, Okinawa, Japan. Corresponding author. Akino Shiroma, Email: pj.ro.saio@amorihs.
S. aureus research on defense mechanisms:-
- Biofilm formation
- Adhesins
- Defensins
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Suggested additional resources and further reading
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Classic eBook Collection:
Catalog of scientific papers, 1800-1900; Subject Index; Royal Society of London. Volume 19. Published in 1908 by University Press in Cambridge. 902 pages. Written in English.
- Call number ABA-4714
- Digitizing sponsor Internet Archive
- Book contributor Gerstein - University of Toronto
- Collection gerstein; toronto
Can download the PDF and other versions.
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Encyclopedia of Genetics, Genomics, Proteomics, and Informatics
NCBI = National Center for Biotechnology Information
- Database resources of the NCBI http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781113/pdf/gkl1031.pdf
- Database resources http://www.ncbi.nlm.nih.gov/pubmed/17170002
- Home - Genome - NCBI http://www.ncbi.nlm.nih.gov/genome/
- Genomes - Genome - NCBI http://www.ncbi.nlm.nih.gov /genome/genomes/154
- Complete Genome Submission Guide http://www.ncbi.nlm.nih.gov/genbank/genomesubmit/
- Whole Genome Shotgun Submission http://www.ncbi.nlm.nih.gov/genbank/wgs/
- Shotgun Assembly Sequences: Genome (WGS) and Transcriptome (TSA) http://www.ncbi.nlm.nih.gov/Traces/wgs/
DNA information
- Nucleotide sequence accession numbers.
The complete genome sequences of the S. aureus subsp. aureus DSM 20231T chromosome and plasmid were deposited in DDBJ/ENA/GenBank under the accession numbers CP011526 and CP011527, respectively.
Protein information
Thursday, 26 May 2016
Ingrown toe nail
Ingrown toenail is a big problem that crops up all of a sudden. It is painful and pus can collect beneath the toenail and surrounding tissues. The affected toe is swollen, red and inflamed. What can be done?
There is no need to panic. Look around you and try to find something that contains alcohol or menthol. It can be any of the oils that you use when you get hurt. For most of us, we have minyak Mastika or any minyak angin. That is fine. You can use that. But there is a better oil to keep at home and always have in your home collection of medicinal oils. This is the tea tree oil. It comes in small bottles, 25 ml. You can purchase it at Guardian Pharmacy. Keep it handy. The one that I keep and often use is Thursday Plantation Tea Tree Oil 25ml (100% pure essential oil), which is an Australian brand.
There is no need to panic. Look around you and try to find something that contains alcohol or menthol. It can be any of the oils that you use when you get hurt. For most of us, we have minyak Mastika or any minyak angin. That is fine. You can use that. But there is a better oil to keep at home and always have in your home collection of medicinal oils. This is the tea tree oil. It comes in small bottles, 25 ml. You can purchase it at Guardian Pharmacy. Keep it handy. The one that I keep and often use is Thursday Plantation Tea Tree Oil 25ml (100% pure essential oil), which is an Australian brand.
For ingrown toenail, pour a drop of tea tree oil onto the painful ingrown toenail. Do that at least once a day for 3 days until the pain subsides.
Muslims pray 5 times a day and wash their feet when performing ablution - the oil is washed away. Re-apply tea tree oil to the painful ingrown toenail after each prayer, for faster healing.
Muslims pray 5 times a day and wash their feet when performing ablution - the oil is washed away. Re-apply tea tree oil to the painful ingrown toenail after each prayer, for faster healing.
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