Bismillah, Assalamualaikum wbt.
Well, hari ni excited sikit sebab berjaya mendapatkan risalah eh,majalah al-ustaz edisi ke 9.kenapa excited sangat? haha...
Sebab saya excited sebabnyeee... ok sebelum tu saya nak cerita dulu.Sebagai seorang bekas pelajar perubatan di sebuah universitas terkemuka di Ejip (
So, apa masalahnya dengan belajar paediatric????
Nampak tak apa masalah dia? Pembaca-pembaca blog saya mesti bijak dan budiman, mesti tau kan apa kekurangan dia.hehe.
Tapi takpe, saya nak jugak cakap. Sebenarnye ni baru satu sheet, ada satu sheet lagi tu physical development, tapi tak jmpe dalam laptop usang saya ni.mungkin dalam PC rumah,
Jadi, dalam majalah alustaz ni ada dikepilkan carta aliran tu. Ana fikir amatlah berguna untuk diri ana sendiri mungkin juga family2 ana atau sesiapa saja = )
Assalamualaikum and hello guys. Since i didn't know all of my viewers, it lil bit awkward for me to keep this blog 'alive'. Hehe. By the way, its ok then. This is my blog and this blog is not for "tatapan umum" =p
Well, being graduated from abroad medical school is not as proud as u graduated from local medical school. Really! Since our most beloved country is very tough and strict in documentation compared to abroad especially the country that i have learnt too much medical knowledge. After reading some experiences,heard some rumors and glimpsed at others fb comment, i think as oversea medical graduated we need to be more tougher than a stone. =). After having some discussion with some friend, it is worrisome that i didn't knpw so much about how to write discharge summary, referral report and etc.
So, to ease some burden in the future, it is better to have some idea about discharge summary and referral report before i'm starting to be hospital-servant :) .
Reference: http://mrpalsmy.wordpress.com/tag/discharge-summary/
10 contents of a discharge summary documents the patient’s hospitalisation which includes:
- the reason(s) for admission
- significant physical and other findings(e.g. brief clinical statement of chief complaint and history of present illness)
- significant diagnoses and co-morbidities(example, Principal diagnosis: Cellulitis and gangrene, left foot and lower leg. Comorbidities: Diabetes mellitus, insulin dependent, controlled. Staphylococcus aureus coagulase positive septicemia. Urinary retention)
- diagnostic and therapeutic procedures(example, Principal procedure: Amputation, left leg, above knee. Secondary procedures: Suprapubic cystostomy with permanent suprapubic drainage)
- significant medication and treatments(medical and surgical) and patient’s response to treatment, including any complications and consultations
- patient’s condition/status at discharge
- discharge medications and all medications to be taken at home
- follow-up instructions(patient education when applicable), to patient and/or family (relative to physical activity, medication, diet, and follow-up care) including instructions for self-care, and that the patient/responsible party demonstrated an understanding of the self-care regimen
- unless contrary to policy, laws, or culture, patients are given a copy
- a copy is provided to the practitioner responsible for patient’s continuing or follow-up care
What do I think are the important aspects of a hospital discharge summary?Reference: http://thehappyhospitalist.blogspot.com/2010/04/my-shortest-hospital-discharge-summary.htmlIn the last year or so we have been asked by our hospital transcription service to also dictate the patient's condition on discharge. I've often wondered why. Well, it seems like the Joint Commission has mandated that six components be present for a discharge from an acute to a subacute care facility. What are the six mandated Joint Commission components for a hospital discharge summary?
- Include the main diagnoses during the hospital stay
- Include a description of the surgeries and procedures during the stay.
- Include relevant radiology and blood work results.
- Include a list of the consultants and their subspecialty involvement.
- Include a brief (that's key) summary of the complicating conditions and hospital events.
- Include an accurate list of the medications on discharge, including as needed medications.
- Include a list of pending labs or studies and recommendations for further outpatient studies or labs.
- Strive for one page or less.
Interesting. I never knew one could regulate a discharge summary. It's hard to imagine how one could define each component. Is there a multiple choice we can click on? It all seems so silly. First of all, do they mean stable vs unstable? Or are we supposed to document how badly they smell? Or that they look especially ugly on discharge day. Or perhaps the Joint Commission wants to make sure they are financially secure on discharge. Or perhaps they mean IQ status. Maybe they want us to document how good a father the patient is. It just seems so confusing.
- Reason for hospitalization
- Significant findings
- Procedures and treatments provided
- Patient's discharge condition
- Patient and family instructions (as appropriate)
- Attending physician's signature
Here are the real problems with the hospital discharge summary process.
- Failure to dictate in a timely manner. This is most commonly a problem with subspecialty services who take weeks upon weeks to dictate their discharge summary while the hospitalist has admitted and discharged the patient three times since their sentinel subspecialist admission.
- Failure to include any relevant information. When a physician assistant on the orthopaedic service dictates a hospital discharge summary on an 85 year old who spent 12 days in the hospital with a heart attack, acute renal failure and two cardiac resuscitations and dictates nothing more than the procedure name and random thoughts of the day, you know that no thought was put into the process. But then again, nobody gets paid less for a poor job, so why bother putting any effort into it?
- Using English as your second language. If your transcriptionist can't understand you, you have a problem. Speak slowly so you don't get back a hospital discharge summary filled with medical transcription errors.
- Dictations that are way too long. This is a discharge summary of the hospital stay, not a minute by minute, hour by hour, day by day account. If you are too wordy in your discharge summaries you need to know that everyone hates you. Nobody reads them except you. Nobody thinks they are a masterpiece except you. A summary is meant to be brief. Make it brief. Whenever I admit someone, I pull up old records. What are the only things I look at on the DC summary? Diagnoses and discharge medications. Everything else is noise. Plus, it's expensive to pay someone to transcribe all that nonsense. If someone really wants to get to the fine details, they can pull up the EMR comparisonrecords.
- Failure to carbon copy the hospital discharge summary to the primary care physician AND other subspecialists taking care of the patient. If they don't get your records, why bother with the summary at all?
Bismillah..
Penyakit influenza sangat mudah menular krn ia disebarkan melalui udara. Meskipun rehat yang cukup dan minum air secukupnya terapi berkesan untuk penyakit ini,namun pencegahan masih merupakan kaedah tetap yang terbaik," prevention is better than cure".
Melatih kekebalan tubuh akan membantu tubuh melawan virus influenza.Caranya ialah dengan:
1) Tambahkan potongan bawang putuh yang segar ke dalam sup. Kajian mendapati bawang putih akan meningkatkan sistem imun selain itu kandungan allicin dalam bawang putih mengandungi kompenan antivirus.
2) Penggunaan makanan yang kaya dengan vit C seperti kiwi, strawberi, oren,nanas, atau anggur.Vit C akan
meningkatkan fungsi sistem
imun dan melindungi tubuh dalam melawan jangkitan.Vitamin ini juga memberi perlindungan daripada kerosaka. radikal bebas* ( * free radical )
3) Bila anda menggunakan supplement secara rutin, cubalah memilih yang mengandungi 'Gingko Biloba'.Herba yang berasal dari China ini diketahui meningkatkan pengaliran darah dalam tubuh.Perjalanan darah yang lancar akam membantu penghantaran vitamin & mineral yang diperlukan.
4) Lindungi tubuh daripada serangan virua dengan menganbil tiram. Kandungan mineral zink dalam makanan laut identik dengan afrodisiak ini juga memiliki efek antivirus.
5) Salah satu sayuran yang disyorkan untuk meningkatkan kekebalan tubuh adalah bayam. Kandungan asid
foliknya akan memicu produksi sel sel baru dan memperbaiki DNA.Sayuran hijau ini juga kaya vit C ,serat dan antioksida.Cuma elakkan memasak bayam terlalu lama untuk mendapatkan manfaat yang optimum.
Bismillah
- Surah Al-Fatihah- Untuk menerangkan hati dan menguatkan ingatan
- Surah Maryam- Bagi memudahkan ibu bersalin dan memperolehi anak yang sabar dan taat
- Surah Luqman- Bagi memperolehi anak cerdik akal dan cerdik jiwa
- Surah Yusuf- Bagi memperolehi anak cantik rupa dan cantik akhlak
- Surah Hujurat- Bagi memperbanyakkan air susu ibu dan anak bersifat berhati-hati
- Surah Yasin- Bagi menenangkan hati dan anak tidak terpengaruh dengan godaan syaitan yang mengajak kepada maksiat
- Surah At-Taubah-Bagi membersihkan jiwa dan terpelihara dari maksiat
- Surah An-Nahl- Untuk melahirkan anak yang berdisiplin
assalamualaikum wbt,
"Doktor,saya takut jarum!"
Tajuk buku yang saya teruja terus membaca. Buku ini sesuai untuk bacaan umum malah amat sesuai untuk bakal-bakal doktor mahupun junior doktor. Buku ini banyak mengupas isu-isu semasa, bagaimana cara pemikiran masyarakat sekarang mengenai perubatan moden. Sekarang di Malaysia ada pelbagai lapisan masyarakat,bermula dari yang muda hingga ke generasi tua. Sememangnya generasi tua malah ada segelintir generasi muda ini menolak dan kurang mempercayai perubatan moden. Saya sendiri pernah mendengar cerita-cerita,riwayat-riwayat ganjil yang saya sendiri pun susah nak percaya tapi itu semua kuasa Allah. Ada pesakit yang sudah mendapat breast cancer tahap 4 dah metastasis tapi dengan perubatan tersebut mampu menyembuhkan. Saya sendiri tak tau nk komen mcam mana.Tapi apa-apa pun kita berubat haruslah berubat dengan cara betul.Kalau lapar ikhtiarnya makan makanan yang mengenyangkan.Bolehkah kita makan pasir? Andai seseorang itu percaya yang pasir mampu mengenyangkan maka itu adalah tahyul juga termasuk dalam syirik dan kurang cerdik. Dalam buku karangan Dr.Zubaidi ni, beliau ada mengupas mengenai bagaimana cara berubat dengan betul apa itu tahyul apa itu khurafat. Saya memetik dari bukunya,
"secara mudah, khurafat dan tahyul adalah suatu perbuatan yang tidak berasaskan fakta dan dalil yang benar.Tiada bukti saintifik yang mengatakan perubatan yang dilakukan berkesan dan tiada juga dalam nas al-Quran dan hadis"
Banyak lagi yang beliau kupas dalam buku tersebut,dari permasalahan perempuan contohnya,penghasilan breast milk fron non-pregnant woman, bahaya maggie,kesihatan anak kecil sampailah kepada permasalahan trypanophobia iaitu takut kepada jarum yang ketara. Selain itu beliau juga mengupas masalah rawatan lintah. Sedikit info yang ingin saya kongsi melalui pembacaan saya.Lintah mampu menghilangkan hemoglobin (Hb) sebanyak 0.7g/dl. Biasanya rawatan lintah ni 4-5ekor. Jadi secara kasar seseorang yang menjalani rawatan lintah ni kemungkinan besar akan kehilangan sebanyak 3.0-3.5g/dl. Cuba bayangkan seorang pesakit anemia* yang menjalani rawatan tersebut,sudah tentu merbahaya.
*Anemia is defined as a low Hb concentration which is less than 13.5g/dL for men and less than 11.5g/dL for female.
Pesakit anemia akan mengalami simptom-simptom seperti keletihan, sukar bernafas, mungkin pitam, degupan jantung yang kuat,pening, mungkin akan mengalami sakit dada.
Yang paling saya tertarik mengenai Dr.Zubaidi ni adalah kata-kata penutupnya.
"Di celah-celah masa yang terluang setelah selesai merawat pesakit,saya mengorbankan waktu rehat dengan menjawab pertanyaan emel dan melayani pelbagai pertanyaan kesihatan di ruangan chatting sebuah laman web sosial.
Semua ini saya lakukan dengan harapan, ALLAH memandang usaha saya sebagai suata ketaatan kepada-Nya.Harapan saya agar ALLAH menjadikan perkongsian pengetahuan dan pengalaman saya sebagai satu amalan jariah yang berkekalan.Semoga kita sampai di destinasi yang sama walaupun jalan kita agak berbeza.Aminn"
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Salam 1) mungkin Ulnar nerve budak ni injured...ada claw hand. 2) mungkin Median nerve budak ni injured...pointing index test.. 3) mungkin ....
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