Archive for the ‘Medical’ Category

September Transfers

Posted: October 3, 2015 in Medical, Professional


These were the cases transferred in September

1. Pancytopenia (later diagnosed acute leukaemia)

2. K/c AIHA for packed cell transfusion

3. TRO TB Meningitis: (later diagnosed viral meningitis with latent PTB)

4. Acute pancreatitis

From 7 cases down to 4… hopefully October have less than that.


Transfer frenzy

Posted: August 13, 2015 in Medical, Reflection


I wasn’t clear of my purpose here in Faraway Land apart from giving specialty services to the community. With limited support and resource, there is only so much that i can do. Today, 2 weeks into August, i have transfered 6 cases to the tertiary centre.

1. Right testicular torsion

2. Acute nephrotic nephritic syndrome TRO cause

3. Acute on chronic rheumatic heart disease for echo and further management

4. Vulval hematoma secondary to trauma

5. Prem 30 weeker VLBW 1.1kg for NICU support

6. Prem 35 weeker SGA 1.75kg for establishing feeding but sent over for maternal indication (HELLP syndrome)

I guess all of them are indicated and all of them were sent during the day. None needed to be sent at night. That is definitely a more realistic objective for me. To stabilize the clients over the night to prevent transfer in wee hours.

Later case number 7 was transferred…

7. Meconium Aspiration Syndrome: ventilated

Working with a limited resource

Posted: August 9, 2015 in Medical


One full week has passed and it’s my first weekend here. I must say that my things-to-do-list diminish quite fast since there is very little distraction. That should render the workforces here to be very efficient indeed, or become very inefficient since there are so used to the laidback environment. I guess all depends and goes back to the individual preferences. 

Resources are surely limited. Money, material, manpower: the 3M that is essential for any organization to run. I am tasked to set up an intensive care unit; a task that my previous predecessors since 2012 were unable to perform. 

My main concern now is oxygen supply. The largest tank currently available is 1400 (which will probably last me slightly more than 2 hours). 

Insist on buying? Or rent 20 medium sized canisters?


Coombs Test

Posted: August 6, 2015 in Medical


Coombs Test 

a.k.a Coombs’ Test/Anti-globulin test,

Aims to detect antibodies (IgG/IgM/C3) that may stick to the red blood cells (RBC) and cause RBC destruction.

2 types: Direct and Indirect

A normal result means no RBC clumping

Direct Coombs Test

  • Detect antibodies that are stuck to the surface of RBC
  • Possible causes of positive test
    • Hemolytic anemia
    • Erythroblastosis fetalis (hemolytic disease of the newborn)
    • Infection (EBV/Mycoplasma/Syphilis)
    • Chronic diseases (Leukemia/SLE)
    • Transfusion reaction

Indirect Coombs Test

  • Detects free-flowing antibodies against RBC
  • Possible causes of positive test
    • Autoimmune/drug-induced hemolytic anemia
    • Erythroblastosis fetalis
    • Incompatible blood match (in vitro)

Coombs Test

Coombs Test (Adapted from Wikipedia)

Onlookers,  A reminder to myself; “KUN FAYAKUN” (كُنْ فَيَكُونُ). If Allah says, “Be! And it is…” All things in this world are a loan from Him, and He can take them away in an instant. MasyaAllah.


I took up the chance to visit my Sri Aman abode by volunteering for a supervisory visit there and Betong.

It was an excellent feeling to come back and I was warmly greeted by familiar faces. Two main questions that were asked: “why lost so much weight!?” And “are you married!?”


After seeing 72 out of 111 outpatient and 6 inpatients, we resumed our day with an hour of CME about a transfer checklist. I went home later to see a superficial defect in my master bedroom probably due to aircond leak😭. I ended the day with dinner with Kak Pija and family.


The next day was the trip to Betong. All 42 cases came and we ended at 1pm. After lunch, prayers, inpatient visit and CME, I headed home to Kuching which took 3.5 hours drive.

I felt more useful and appreciated in district setting. I guess id be happier in August 😊


Posted: December 2, 2014 in Lifestyle, Medical, Professional


December 1st, signified the start of my metamorphosis, from a low-life squashable caterpillar waiting to become an elegant butterfly and seeking freedom in this ethereal world. Alhamdulillah, and may Allah always be with me in my journey.

I am taking one month leave without pay for the whole of December to recuperate from all the psychological wounds in the hope that i start anew in my new place with a fresh mind. Where exactly? December 9th will reveal it all… Malaysia has its way of NOT fulfilling requests if a person works in the government sector (probably “they” have the satisfaction of separating families from each other) but if i got the place that i want, alhamdulillah. If not, there are always other options…private sector is one of them *sigh.

It was a hectic day. I was initially told that if i have not handed the hard and soft copy of my project, i wont be able to obtain the senate letter and therefore could not register in Putrajaya. It turned out that it is not necessarily so… Once i have passed my viva session, the letter would be out the same day. I took that letter at 8.30 am and drove all the way to Putrajaya. I spent the whole morning in Putrajaya to four places, Main office, Bahagian pengurusan latihan, sumber manusia, and perkembangan perubatan with lots of forms to fill. Any chance to merge everything to one place and make everyone’s life easier? Any chance of having a paperless community? Perhaps… But in Malaysia it would be very slim and probably will start to happen after i die. But the staff who handled all the process were very pleasant. Thank you! 😊

I was placed temporarily in Hospital Serdang, but since i took leave, i was not obliged to register (although the staff in charge only informed me after i reached there). 😳


I am now in my coccoon. Lots of activities have been laid out for the month and i am very excited. But there are still three caterpillar jobs need to be fulfilled before i fly away…

1. thesis copy to HOD. Printing sent, and will complete today evening. I will meet the HOD tomorrow.

2. One mortality report. Urghhh

3. Publishing my thesis. This can be done slightly later.

Mariah Carey’s words in one of her songs.
🎼Spread your wings and prepare to fly, For you have become a butterfly,
Fly abandonedly into the sun🎤