May 4, 2015

MOG Clinical Little Book

Got bugged by Zizi. 

Here's my little book on MOG Clinical, painstakenly compiled. 

All the best to my battlemates (past, present and future)!!

Feb 26, 2015

But it didn't


8 years ago, when my wife needs to travel 40mins everyday to her first job, apple green Myvi was her first car.
We called it Little Green (in Mandarin 小青), where 青 also have the double meaning of youth.
We thought it would be worn out from heavy daily travelling on the roads of Johor.
But it didn’t.

Every month, part of her salary would go to installment of payment for Myvi.
We thought it would exhaust our money for dating and entertainment.
But it didn’t.

We got engaged and need to move up north to Sungai Petani for my first job with Myvi.
We thought it would break down in the long journey with our stuffs packed up.
But it didn’t.

My family grew bigger with my first newborn, and we commuted every week to Penang with all baby’s stuff (stroller, cradle and etc) in MyVi.
We thought it would slow down its performance.
But it didn’t.

Every Chinese New Year and long holidays, we would travel down to and fro Johor-Penang with my baby.
We thought the journey would be restless and sleepless time for my baby.
But it didn’t.

When I had my second child, we got ourselves a bigger MPV type of car.
We thought Myvi can retire from further usage.
But it didn’t.

It continued to serve me well and even followed me when I got transferred to Petaling Jaya for my postgraduate program.
Myvi was my wheels going around the town and beyond, sticking with me through thick and thin, taking me to courses and conferences, meetings and meet-ups, gatherings and get-togethers, exercises and entertainments, until the completion of the program.

There were bumps, scratches, punctures, wears and tears but with proper mobile attention and repairs, it humbly marches on with honor and pride.
We thought it would have ended its service after the long journey of 100,000 km, going from North, Central and South peninsular.
But it didn’t.

It seems like it matters a lot to小青 for it to win a buffet of petrol from “Myvi, the Love of Nation” contest.
But, it didn’t.

It already won the heart of my entire family.

Thank you, 小青.

by Pilocarpine 3.1.2015
@MYPerodua #MyviNation




Feb 3, 2015

My three firsts

For the past 3 days, I had my 3 firsts...

Sat, first time organizing a surprise dinner...
It's for my dearest birthday which also doubles as reunion dinner for her and her machi. Distance made some of us tired. The food was overrated but still the environment was just nice for a nice chat by the bay and the kids love exploring the live sea creatures in captivity.

Sun, first time being Oncall as Specialist.
Luckily, MOs Oncall was all cekap (Sk,Az,Ad), Had a head entrapment for breech delivery in the morning, a shoulder dystocia in the evening and uneventful lap salpingectomy for ectopic at midnight. Rather cool overnight that simple Kenduri was in place at nursing counter. (excuses for getting fat)

Mon, first time running my own Gynae OT.
From the outside, I looked calm and collected, but inside scared like chicken shit. Thanks to Sifu, Senior Specialist DrA, I did my first supervised vag hysterectomy and perineal repair.
Subsequently, I did my own solo total hysterectomy with the help of cekap MO assistant (Gh).

And I was having low grade fever from Friday
after my plateletpheresis on Thurs (to attain platelets for a kid in ICU)
and on regular paracetamol up till today.
Probably some viral fever...

Jan 26, 2015

Obgy Drugs Masterlist

Here's a compilation of drugs that been used in ObGy that possibly make their way to the postgrad exam questions, most likely OSCE in Clinical Master Part 2 Exam.

Download here.

Jan 22, 2015

How little ones dies?

It seems that the article singled out prenatal care, prenatal steroids, prenatal antibiotics and use of high frequency ventilation in helping increase survival of the little prems.

I summarized it as first wave of mortality is in the first month due to resp distress syndrome, and the second wave from second to third month due to necrotising enterocolitis.

It's 3 months of critical postnatal life for the little ones.
A study published this week in NEJM looked at the incidence and causes of death among extremely premature infants from 2000 to 2011. The investigators prospectively collected data on over 22,000 extremely premature infants born in one of 25 Neonatal Research Centers. They followed them from birth to 120 days (or to death, discharge, or hospital transfer, if one of these occurred first). If hospitalized for more than 120 days, infants were evaluated for death until 1 year of age.Roughly one fourth of the infants died during their birth hospitalization (6075 deaths). Over 40% of deaths occurred in the first 12 hours after birth. Earlier gestational age at birth was linked to a worse outcome; infants who died had a mean gestational age a little over 24 weeks, versus 26 weeks in the infants who survived. Their mothers were also less likely to have received prenatal glucocorticoids (62% versus 88%).Overall, through the years, mortality declined. The number of deaths per 1000 live births was 275 in the 2000-2003 period; 285 in the 2004-2007 period; and 258 in the 2008-2011 period (P=0.003). The study detected significant changes in neonatal care across these periods. There was an increase in the percentage of women receiving any prenatal care, as well as the percentage receiving prenatal glucocorticoids. Use of prenatal antibiotics decreased, while use of high-frequency ventilation increased, more than doubling among the most premature infants.Trends in cause of mortality also shifted. The number of deaths attributed to respiratory distress syndrome and bronchopulmonary dysplasia decreased from the 2000-2003 period to the 2008-2011 period (from 83 to 68 per 1000 live births). This decrease accounted for more than half the decline in overall mortality. The number of deaths attributed to immaturity, infection, or central nervous system injury also fell. There was, however, an increase in the number of deaths attributed to necrotizing enterocolitis (from 23 to 30 per 1000 live births).“The increase in mortality attributed to necrotizing enterocolitis may be related to improvements in the early survival of infants who would have otherwise died before they reached the typical postnatal age at which necrotizing enterocolitis occurs,” the authors hypothesized.While this study was not designed to evaluate causality, it identified an improvement in overall and pulmonary-related mortality among extremely premature infants concurrent with changes in neonatal practice. The authors concluded, “Our findings underscore the continued need to develop and implement strategies for reducing the potentially lethal complications of premature birth.”- See more at: