Mar 12

Deep Vein Thrombosis ( DVT )

By taqidoc Radiology No Comments »

Definition

Deep venous thrombosis is a condition in which a blood clot forms in a vein that is deep inside the body.

Causes

Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow. If the clot breaks off and moves through the bloodstream, it can get stuck in the brain, lungs, heart, or other area, leading to severe damage.

Risks for DVT include:

  • Immobility which causes blood flow in the veins to be slow. Slow flowing blood is more likely to clot than normal flowing blood.
    • A surgical operation which lasts more than 30 minutes is the most common cause of a DVT. The legs become still when you are under anaesthetic. Blood flow in the leg veins can become very slow.
    • Any illness or injury that causes immobility increases the risk of a DVT.
    • Long journeys by plane, train, etc are thought to cause a slightly increased risk of DVT. This is probably due to sitting cramped for long periods.
  • Faulty blood clotting is an uncommon cause. One example is an inherited condition that causes the blood to clot more easily than normal (factor V leiden).
  • The contraceptive pill and hormone replacement therapy (HRT) which contain oestrogen can cause the blood to clot slightly more easily. Women taking ‘the pill’ or ‘HRT’ have a small increased risk of DVT.
  • Damage to the inside lining of the vein increases the risk of a blood clot forming. For example, a DVT may damage the lining of the vein. So, if you have already had a DVT, then you have a higher than average risk of having another one sometime in the future.
  • Older people are more likely to have a DVT, particularly if you have poor mobility or have a serious illness such as cancer.
  • Pregnancy increases the risk. About 1 in 1000 pregnant women have a DVT.
  • Obesity also increases the risk of having a DVT.
  • Bedrest
  • Cigarette smoking
  • Fractures
  • Giving birth within the last 6 months Continue reading »
Mar 10

Skeletal survey…what x-rays should you order.

By taqidoc Radiology No Comments »

Many of us do not know what is necessary for a skeletal survey and what the indications are….

Well…to cut it short…Here’s some knowledge about Skeletal survey.

Definition

A skeletal survey is a systematically performed series of radiographic images that encompasses the entire skeleton or those anatomic regions appropriate for the
clinical indications.

Indications and parts to be x-rayed as below:

1. NAI ( NON ACCIDENTAL INJURY )

CHEST
AP / PA view, erect if possible
SKULL
AP/LATERAL
LUMBAR SPINE
LATERAL
PELVIS WITH LL
(In 1 film where possible,if not then 2 films.)
AP to include the toes
BOTH UL
AP, done separately to include finger tips.
2) FOR GENETIC ABNORMALITIES

CHEST
AP/PA, erect whenever possible
SKULL
LATERAL
LUMBAR SPINE
LATERAL
PELVIS
AP
L SIDE UL
AP
L SIDE LL
AP
3) RENAL OSTEODYSTROPHIES

CHEST
PA/AP
SKULL
LATERAL
LUMBAR SPINE
LATERAL
PELVIS
AP
BOTH HANDS
PA
That’s all for today…..Enjoy!
Mar 05

Hysterosalpingography…radiographic evaluation of the uterus and fallopian tubes.

By taqidoc Radiology No Comments »

Introduction

Hysterosalpingography (HSG) is the radiographic evaluation of the uterus and fallopian tubes and is used predominantly in the evaluation of infertility.

The primary role of HSG is in the evaluation of the fallopian tubes.

Ultrasonography (US) is currently used for evaluation of the endometrium (ie, abnormal uterine bleeding, polyps) and pregnancy, whereas magnetic resonance (MR) imaging is used more in the evaluation of the uterine myometrium (ie, uterine contour, myomas) and the ovaries. Continue reading »

Feb 28

Welcome home juniors..

By taqidoc Daily Life No Comments »

The main reason I went to the airport today to greet my younger sister on her returning home from egypt for she had finished her study there. I never  thought I would meet most of her batch. Hamdan, Zulhizami, Iqbal, Daing,Adlina and Izwan were  there at KLIA arrival hall.

From left : Zulhizami,Iqbal, Hamdan,Daing and Laili ( my younger sis )

Daing and Laili.

Anyway, Congratulations and welcome home to you guys.

Munir and Firdaus, When are you guys coming back?hehe.

Make sure you tell me the date cause if I’m free I will greet you at the airport…

Wish you guys all the best with your interviews and future profession….Be ready to become safe doctors. Hehe

Don’t be shy to ask opinion or anything from your seniors…We’re always ready to answer all your Qs….

Salman, Nasri….I need your help in case asked.Hehe

Adios.

Feb 27

Leatherman charge Tti….multitool branded pertama buatku.

By taqidoc Travel 4 Comments »

Sebenarnya banyak jer multitool yang murah yang dijual dekat pasar malam tapi kenapalah aku beli Leatherman charge yang harganya sangat mahal? Bukan apa, aku beli sebab aku lebih pentingkan kualiti. Aku sebenarnya dah ada multitool buatan china, 3 kesemuanya tapi kualiti logam yang digunakan cukup lemah. Ada satu multitool aku yang aku beli dekat pasar malam..harga lebih kurang RM30..saiz dalam 7cm. Aku guna pemutar skru rata dia, skali skru tu ketat, aku pun gunalah tenaga lebih sikit, terus rosak pemutar skru dia. Fungsi dia memang OK..tapi yer la…kalau lemah macam tu macam mana nak buat kerja…Jadi aku pun belilah satu Leatherman Charge Tti.

Multitool? Banyak orang tertanya apa kemende multitool tu. Multitool sebagaimana namanya multi bermakna banyak dan tool bermakna alat. Secara mudahnya multitool ni satu alat yang mempunyai pelbagai fungsi di dalamnya.

Multitool yang baik ialah multitool yang mempunyai fungsi asas alat survival seperti pisau,gunting,gergaji,pembuka tin,playar,pemutar skru Philip dan rata.

Tak nak cerita panjang, terus ke Leatherman Charge Tti.

Multitool ini mempunyai 19 fungsi dengan 8 bit drivers.

Pemegang multitool ni diperbuat daripada titanium dan ia memberi keselesaan kepada pemegangnya. Berbeza dengan model-model lain Leatherman seperti Leatherman Wave dan Surge, pisaunya diperbuat daripada S30V logam yang tahan karat dan lebih kukuh.

Selain daripada pisau, fungsi-fungsi lain termasuklah seperti di bawah:

  • 420HC Serrated Knife with Cutting Hook
  • Needlenose Pliers
  • Regular Pliers
  • Wire Cutters
  • Hard-wire Cutters
  • Wire Stripper
  • Wire Crimper
  • Large Screwdriver
  • Large Bit Driver
  • Small Bit Driver
  • Scissors
  • Wood/Metal file
  • Diamond-coated file
  • Saw
  • Bottle Opener
  • Can Opener
  • 8 in | 19 cm Ruler
  • INCLUDED BITS: Phillips and Flat Tip Eyeglasses Screwdriver Bit, Hex 5/32″ and 9/64″ Bit, Hex 1/8″ and 7/64″ Bit, Hex 3/32″ and 5/64″ Bit, Hex 1/16″.

( Sorry….susah nak translate semua kat atas tu…baca jer la )

Ciri-ciri istimewa alat ini:

  • Diperbuat daripada besi tahan karat dengan pemegang titanium.
  • Pisau dan pisau bergerigi mudah dibuka dengan hanya menggunakan sebelah tangan.
  • Semua alat mempunyai pengunci untuk mengelakkankan daripada tertutup.
  • Gelang penggantung.
  • Klip poket yang mudah dipasang dan dibuka.

  • Bekas kulit atau nilon.
  • Waranti 25 tahun.

Ukuran alat:

  • 4 in | 10 cm (tutup)
  • 8.2 oz | 232 g ( berat )
  • 2.9 in | 7.37 cm (panjang pisau)

Bit kit tambahan boleh dibeli berasingan.

Bit drivers for Leatherman Charge.

Aku dah test alat ni selama seminggu. Memang top quality punya barang.

Pisau tak payah cakap la.Tajam. Tengok video kat bawah kalau nak kepastian.

Leatherman Charge vs Leatherman Wave

Gergaji aku masih belum cuba lagi.

Pisau bergerigi pun tajam. Hujung pisau bergerigi lagi tajam berbanding dengan pisau biasa.

Gunting walaupun kecil tetapi tajam. Aku cuba potong daun plastic dengan gunting multitool ni dan potongan terhasil cukup cantik. Pada mulanya aku ingat macam gunting plastic. Tapi anggapan ku silap sama sekali.

Lain-lain masih belum guna lagi.

Kalau sesiapa yang minat memancing atau travel…memang patut ada satu la alat multitool ni. Aku cadangkan Leatherman sebab dia ada untuk pelbagai jenis aktiviti dan yang penting syarikat ni memang specialized dalam multitool.

Swisstool ok ke? Bagi aku ok jer…tapi logam yang digunakan tak sekuat Leatherman.

Apa-apa pun aku  gembira sebab akhirnya aku dapat juga memiliki Leatherman Charge Tti setelah setahun aku study pasal ni.

Harga ? Retail price kat Malaysia RM982 itu kat UFL. Kalau dekat dealer dalam forum lowyat RM800.

Nak tau harga aku dapat berapa…msg me.

Feb 25

Selamat Menyambut Maulidur Rasul.

By taqidoc Uncategorized Comments Off

Feb 22

15 Ways Smoking Ruins Your Looks.

By taqidoc Health Comments Off

Smoking impacts appearance

If you smoke, you already know you need to quit. It’s bad for your heart, lungs, brain, and even your sex life.

But let’s face it: You’d have kicked the habit yesterday if smoking’s ill effects were a bit more obvious. What if each cigarette created a black pockmark on your face, for instance?

Well, smoking does damage your looks. Read on to discover 15 ways smoking is ruining your appearance. Continue reading »

Feb 20

Gathering @ Hidir’s house.

By taqidoc Daily Life 3 Comments »

Well..last night was the best night ever for me…How long has it been since I last met Salman, my best friend. I think it’s been 1 and 1/2 year already. Through this 1 and 1/2 year, we just contacted each other via phone only..For Hidir, I last met him was only 6 months ago. So, it was not that nostalgic than I met Salman.

Getong and Muslim were also there…Getong, seriously you look slimmer than I last saw you. For muslim, think you still the same compared to last I met you.

Abai…good luck with your housemanship…hehe..make sure you survive….

Me? They all said I have gained weight. I admit that….when I last met them my weight was just 80 ++ kg but now I’m 110 kg…hehe…Think I need to reduce some weight and burn my fat…
Anyway…got pictures of last night gathering…

From the left : Getong ( heikal ), Chan ( Muslim ) , Abai and Salman ( The most handsome guy on earth…Haha ).

Salman and I. ( My body size was almost equal to his. But now I’m a heavyweight )

Chan and Abai look so serious…they must be discussing about national  issues…

Big smile from Salman….Future Terengganu YB…haha

Hidir and his son,abbas lutfie

Discussing various topics from establishing a private hospital to politics.hehe.

Hopefully we can have this kind of gathering again near future.

For Nasri,Munir, Firdaus, Ilham, Hazri and Zuhdi, make sure you’re free to come in case invited.Hehe.

Feb 16

Alternative route to Kajang and Seremban.

By taqidoc Daily Life 1 Comment »

I’ve been using LEKAS( Lebuhraya Kajang-Seremban ) highway in these 2 days to go to Seremban and it is quite fast to reach there. I just need 15 minutes and voila it’s Seremban already. I don’t think many people know about the highway yet as not many vehicles use the route.

This picture taken near the Seremban exit of LEKAS highway. Of course I’m not the one who took the picture. It’s my wife who took it.
This picture taken a few kilometers before Seremban exit.

Guess what?You just have to pay RM1.50 from Nilai to Ampangan. That’s really cheap. Compared to usual highway you have to pay RM3.10 to go to Seremban from Nilai.

My usual route is from Nilai to Senawang and have to pay RM4.10.  Imagine how much I have to pay everyday for to and fro drive from Nilai to Senawang..RM8.20. That’s really waste of money right? Luckily I found this new route and use it…Just have to pay RM3.00 for a return trip.

Is there any other route to Seremban? Free one? Of course there is. There’s an old road to Seremban. You need to go to Nilai Old Town first. Go until you find a junction and there, you will find a sign board shows Seremban. Just take that route and you will reach Seremban with hassle free like the LEKAS highway. It takes about 25 minutes to reach Seremban. With LEKAS highway, you will reach Seremban within 15-20 minutes.

This is the best map I can get to show the way to Seremban. It’s an old road. You need to turn to jalan Labu to go to Seremban.

My workplace is at Kuala Pilah, to be exact Kuala Pilah Hospital. I used to use Nilai-Senawang-Kuala Pilah route. But now its different. My new route is Nilai-Ampangan-Pilah.

It used to take me 1 hour and 10 minutes at fast to reach there. That was when the Bukit Putus road was used as the only route to go to Pilah. Then at the end of last year 2009, the new highway was built and opened, it saves me 15 minutes to reach Pilah. And with this new highway I think it saves me more, maybe 20-25 minutes to reach Pilah. If I’m right I just need 45 minutes to reach Kuala Pilah from Nilai. Need to test the time tomorrow.

I studied the LEKAS map. It seems like the highway begins at Kajang and ends at Paroi only. People says it ends in Kuala Pilah town. I wonder where they get such info.Hehe.

So far, the highway ends at Ampangan only, Paroi exit still under construction.

LEKAS map is as below:

Feb 15

The differences between chikungunya and dengue fever.

By taqidoc Medicine Comments Off

Types

Chikungunya

Dengue
Causative agent a virus which belongs to the genus Alphavirus, in the family Togaviridae. any of four closely related viruses, or serotypes: dengue 1-4.

(DENV 1, DENV 2, DENV 3, DENV 4)

Infection with one serotype does not protect against the others.
Season widespread in most parts of the country but is most active after the rains.
Mode of transmission Infected Aedes Aegypti /albopictus bite
Incubation period Time from infection to illness 2-12 days but is usually 3-7 days In order for transmission to occur the mosquito must feed on a person during a 5- day period when large amounts of virus are in the blood; this period usually begins a little before the person become symptomatic.  Some people never have significant symptoms but can still infect mosquitoes.  After entering the mosquito in the blood meal, the virus will require an additional 8-12 days incubation before it can then be transmitted to another human. The mosquito remains infected for the remainder of its life, which might be days or a few weeks.
Symptoms
  1. Fever
  2. Headache
  3. Fatigue
  4. Nausea
  5. Vomiting
  6. Muscle pain
  7. Rash
  8. Joint pain

It can also be asymptomatic.

Acute chikungunya fever typically lasts a few days to a couple of weeks.

Some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.

 Symptoms of infection usually begin 4 – 7 days after the mosquito bite and typically last 3 – 10 days.  In order for transmission to occur the mosquito must feed on a person during a 5- day period when large amounts of virus are in the blood.

High fever and at least two of the following:

  • Severe headache
  • Severe eye pain (behind eyes)
  • Joint pain
  • Muscle and/or bone pain
  • Rash
  • Mild bleeding manifestation (e.g., nose or gum bleed, petechiae, or easy bruising)
  • Low white cell count

Generally, younger children and those with their first dengue infection have a milder illness than older children and adults.

Warning sign:

(emergency) if

  • Severe abdominal pain or persistent vomiting
  • Red spots or patches on the skin
  • Bleeding from nose or gums
  • Vomiting blood
  • Black, tarry stools (feces, excrement)
  • Drowsiness or irritability
  • Pale, cold, or clammy skin
  • Difficulty breathing
Diagnostic testing 1. Based on the patient’s clinical features, places and dates of travel (if the patient is from a non-endemic country or area), activities, and epidemiologic history of the location where infection occurred.

2. Lab test à to detect virus-specific IgM and neutralizing antibodies in serum or CSF.

3. In fatal cases, nucleic acid amplification, histopathology with immunohistochemistry, and virus culture of biopsy or autopsy tissues can also be useful.

 1.Diagnosis of dengue fever is generally easy in endemic areas and during epidemics due to the typical symptoms and characteristic signs of dengue fever. But if the cases are mild, they may look like other viral disease.

2.Laboratory diagnosis of dengue fever is done by IgM ELISA (enzyme linked immunosorbant assay), paired serology during recovery or by antigen-detection ELISA during the acute phase. There is also leucopenia (lees number of leukocytes or white blood cells, generally less than 5,000) and thrombocytopenia (reduced number of platelets in circulating blood). Dengue virus also can be easily isolated from blood in the acute phase by using mosquito inoculation or mosquito cell culture.
Treatment Symptomatic treatment:

1.Rest

2.Drink plenty of fluid

3.Use analgesics
Analgesics:

Ibuprofen, naproxen, acetaminophen, or paracetamol.

Aspirin should be avoided.

 Analgesics:

Like paracetamol and acetaminophen.

Avoid ibuprofen,naproxen or aspirin.
Can pregnant women become infected and pass the infection to their child? Yes. Most infections will not result in the virus being transmitted to the fetus. The highest risk for infection of the fetus/child occurs when a woman has virus in her blood (viremic) at the time of delivery Yes. Transmission to the fetus is rare.
Can the virus transmitted to a child by breastfeeding? No. No.

Research shows the presence of anti-dengue antibodies in breast milk and colostrum, which suggests that breastfeeding actually protects your baby from the dengue virus in case of a dengue infection.
Mortality rate Fatalities are rare. DHF is a more severe form of dengue infection. It can be fatal if unrecognized and not properly treated in a timely manner. DHF is caused by infection with the same viruses that cause dengue fever. With good medical management, mortality due to DHF can be less than 1%.
Prevention Avoid mosquito bites.

  1. Use insect repellent.
  2. Wear long sleeves and pants.
  3. Have secure screens on windows and doors to keep mosquitoes out.

Get rid of mosquito sources such as emptying standing water from flower pots etc.

Limit exposure to mosquito bites for infected person to avoid further spread.

References:

http://www.babycenter.in/pregnancy/complications/dengue/

http://nethealthsite.com/diseases-with-d/52-dengue-fever.html

http://www.cdc.gov/ncidod/dvbid/Chikungunya/CH_FactSheet.html

http://www.cdc.gov/dengue/

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