bright and shiny II

oh my. sorry cant help myself.. happy gile kot hari ni. i know i exaggerated sumtimes.

da 4 hari demam. rase serba tk kena. rase nk escaped. and today i decided to follow my gut and go to O&G. semangat. i miss obgyn. i miss to watch labor. i miss to do pv. i miss the smell of fresh newly born baby.  pergi dlm pkl 5. ke outpt dulu, borak2 dgn nurse. igt nk stay kt outpt boleh buat pv, tp sebab dr tk kenal, segan. tgk 1 case je; abortion. blighted ovum n terus ikut masuk dlm.

masuk2 dlm terus nmpk dr azab.  hidayah, right? :D and dr abd zaher and dr bidur and dr tarek. semua dr kegemaran ade. yeay. pt kt labor room ramai tp semua 1 finger, 2 fingers. alahai. duduk2 je tunggu tgk2 ultrasound, ade refer case dr miri, discuss case dgn dr, usha2 eager HO br, lol. and naik atas sekali tgk cs dgn dr shawky. case menarik, breech lat left position. dr buat buat incision kt uterus kt left. and ade manouver jaw flexion shoulder traction. rare tau.

then masa da kt bwh tgh tk buat ape2 tiba2 dr shawky tanya, nk assist dr bidur buat CS tk? chehh reply buat muka cool je kn dpn dr, nk. dlm hati melompat2. terus naik atas dgn lajunya kn, tk menyempat.

oh my!! heeeeee. basuh tgn dgn iodine, pakai scrub and sterile glove and i  assist dr bidur. for the 1st time i hold the uterus, freshly sterile instrument; rase panas lg. and newly born baby fresh from oven. penuh dgn vernix caseosa. masa kena bwk baby ke neonates rooms, cautious sgt sbb selalu terbyg ape tau, masa bwk baby tu tiba2 tjatuh. hishhhh. jauh, dlm 10m ade kot. berdebar2 bawak baby. dr tanya2 jgk, ape name type of suture, ape yg dr tgh buat. nasib baik boleh jwb. nurse; shereen n dr bidur guide every single step ape yg nk kena buat. wee!. seronok.

da siap, tgk dr bidur buat E&C. rase gritty sensation of the endometrium. tk suka. ngilu. then dr azab panggil. hidayah, scrub in with me. :D again. dr azab buat laju gle kot. skjp je da siap. boleh la rase beza assist dr perempuan n dr lelaki. tlng assist pegang forceps waktu nk cut rectus sheath & peritoneum. widening the sheath, yg adegan selalu nmpk dr tarik sheath tu dgn sepenuh tenaga, kuat jgk tau resistant die. then baby keluar, bwk baby pergi bilik neonates. hold the uterus masa nk bersihkn then close. uterus, peritoneum, rectus muscle, rectus sheath, subcut fat, subcut tissue, skin. layer yg paling penting: uterus and rectus sheath, kena buat double layer continous suture and hold thread tarik kuat2. liable for hg and abdominal hernia kalau suture ade defect. check any bleeding point in every layer then hbs close, letak iodine & plaster.

da pkl 10 igt nk balik, turun bawah skjp tgk ade rezeki 3 cases NVD serentak. tgk skjp 2 case. da pkl 11 blk.

oh my. gembiranya. hari ni dlm sejarah. for the 1st time assist delivery. 2 cases CS. hoho. ade org senyum sampai tidur la mlm ni. :))

elective obgyn

hbs da 10? hari elective obgyn kt shtby. tentula sgt seronok.! all time fav subject. tp masih pk2 lagi nk ke amik obgyn? bebanan kerja sgt berat. hari tu tegur dr azab, 3 hari da tk blk rumah stay kt hosp. memang miserable la tgk. tk tahu la mampu tk kalau betul2 nk jd obgyn-ist.

btw nk share few interesting cases.

1. 25y G1P0. quadriplet. GA: 21week. come for ANC. examination: fully dilated cervix. thus = abortion. mx: termination of pregnancy. dr deliver all 4 viable fetus by vaginal delivery. tp tk boleh nk buat ape la kn sbb tkde equipment kt nicu utk support fetal maturity. kene let go je semua. tk dpt full hx sbb emergency dr outpt. tk rase pt undergoes induction utk multiple px tu sbb umur muda lg. sedihkn.
2. GA: 21w. vagina examination: 3fingers dilatation, 50% effacement, semiform. fore water rupture. u/s: single viable fetus. memang nmpk ade heart beat. ini pun same consider as abortion jgk. n more dangerous sbb fore water rupture can cause infection lead to chorioamnitis. mx: admit to hosp and induction of labor by ecobolic with umbrella of antibiotic. sbb br 21w so tk perlu risau rupture uretus sbb fundus level bwh umbilicus lg. so boleh je if pt tk perlu admit. if >24weeks, kene caution ade possibility for rupture uterus pt memang kena admit.
3. GA: 32w. cx dilatation 2fingers. mx? dexametasone for 48hours with tocolytic. mula2 tk paham knp kena bg tocolytic? bg je la ecobolic terus deliver cpt sbb kalau 28w pun boleh hidup ape tah lg 32w. dr kate, no. we need the time that 48hours for action of dexametasone for fetal lung maturity. 
4. knp PET kena buat CS? tk pernah terpk ape indication, mechanism for CS. mcm strong fact, asal PET=CS. dr kate main mx for PET ialah TOP. so mane2 boleh either NVD or CS. cuma CS lebih jimat masa than NVD. seriously tk pernah tahu. igtkn sbb PET CI utk NVD. 

byk spend kt labor room bwh & outpt. lots of u/s. and dr ajar amik sheet simple and senang je. tkde byk2 & complicated mcm blajar kt theory. belajar theory memang paham. tp ble dpt case tk reti nk manage. ble discuss case br lebih paham theory.

ohh i'm soo into obgyn. harapannya wktu elective ni dpt assist delivery. hmmpp. tk dpt la. tp dpt belajar in detail pun seronok jgk. the only practical thing i did was fed the infant! haha tkde kaitan pun dgn obgyn. buat pv pun tk dpt. tk pe la, lain kali. doctor da welcome kn dtg la ble2 lg, for sure will come back again 1 day.

berakhirnya elective maka officially start study leave. 10days to go. doakn rajin study & kurg tido. besar dugaan study leave time summer + puasa. 

bye2 shatby.

p/s: they off to haramain today :( sob2.
pp/s: the accusation, it was really hurt. oh why it always suddenly come across my mind??
ppp/s: "the less you care. the happier you will be".

post osce obgyn

1st gathering alextweetfam. 

what happens in twitter stays in twitter. :D

some of us. credit to nut.

alhamdulillah. osce obgyn end very well :) not so perfect, but satisfied!

next! written neuropsychiatry. i did not very well in osce neuro. and i still upset thinking about it. *sigh. my last hope on written exam. hopefully can cover a part of it.

let's strive for success! and for the sake of our future patient.

post revolusion

sampai2 cairo pukul 430pg walid da dtg tunggu. tk tahu dr pukul berapa walid da dtg, n uruskn bas utk ke semua muhafazah lg. tentu sgt penat. pukul 6 gerak blk alex dgn walid & 29 yg lain. esok walid nk pergi cairo lagi pergi umrah plak. buat susah je walid dtg jemput kami. terima kasih walid.

pasca revolusi. 1st impression: tk byk berubah, n sgt sejuk! bukan sejuk spring. sejuk winter yg kene pkai baju2 tebal dlm rumah & saratoga lagi. hypothermic shock~ msia da la sgt panas. kesan2 revolusion byk kt tepi2 jalan. dinding2 tu byk di cat dgn bendera mesir & tulisan peristiwa 25 januari. ana masri, uhibbu baladi. kereta kebal ade lg. trafic makin sesak sbb kereta park kt bahu jln. mungkin da tkde polis nk lock kereta. wonder, before ni derg park kt mane?

egyptians sgt semangat nmpk kitorg. terasa mcm tourists. n terasa mcm masa 1st year dulu. tk ramai melayu. seronok. blk rumah kemaskn ape yg patut. baju sebakul tinggal tk basuh before blk hari tu. sejuk2 mcm ni, alahai lemahnya nk basuh baju. dgn bag tk unpack lg. masa2 ni terigt kt bibik.

pukul 3 ptg da tido. terjaga da 1pg slash pukul 7pg kt malaysia teringat mak ayah adik2 kucing2. :/ hug, kiss & cuddle budak2 manja (adik & kucing) kt rumah. bersihkn sangkar bg makan kucing, dgr bibik membebel main kejar2 dgn adik suruh mandi pergi sekolah, breakfast same2.
oh my~ da start homesick. basuh baju & siapkn kemas2 bilik and call rumah. oh. oh. bergenang air mata.

2nd day pergi hosp shatby dgn sahabat handai. seronok ade teman blk awl jgk. rinduuu! tgk delivery. cr semangat nk study.  sampai2 terserempak dr hisham tgh odw nk blk. tegur borak sekejap, glad to see some familiar faces. kt nvd ade dr magdi. tgk 1 nvd dgn 1 ectopic pregnancy. da. nvd td blur try igt blk normal mechanism of delivery, tgk CTG pun tk igt mcm mana nk bace. operation ectopic pregnancy td penat igt blk anatomy. fuhhhh. lama sgt cuti ni. sakit kepala.singgah mcD take away utk dinner.

circadian rhythm tk betol lagi. smlm amik caffeine tp amik anti histamine jgk, so caffeine tkde effect. lps isyak da tido. pastu pg td pukul 8pg da tertido blk. bgn2 sakit kepala overslept. asyik makan je. sbb sejuk. n pms. mkn sgt byk.

jadual exam da keluar. our final exam will start on 31/3. lambatnya. da la blk awl. but, no regret. n next sem hbs few days before eid fitr. means almost a month puasa ramadhan kt sini. thank you Allah for the opportunity. tp fikirkn study leave & exam masa summer & puasa 15jam, besar dugaan. iA will be great experience before leaving egypt. setahun setengah lg, lajunya masa berlalu.

gallery obgyn

G3 P2. prev 2 cs. in labor, cx dilatation 6cm. emergency cs to prevent rupture of uterus.

see the weather. huhhhhhhhhhhhhhh.

focus pd shoulder dystocia. definition: arrest delivery of shoulder & trunk after head already delivered outside the vulva.
Q: pelvic causes of obstructed labor? soalan TBL tk dpt jwb. T_T 

diagnostic laparoscopic of infertility. see the screen, yes the globular structure is uterus.

empty operation theater

close up in operation theater, near the window. cool view is't? 

bye bye obgyn. 

officially da hbs da sebulan course obgyn. da tkde 3rd part da. it was awesome! clinical round in 2nd part lg byk attached dgn assistant prof and resident. compare to 1st part, lg byk blajar dgn professor. same saje, boleh belajar dgn sesiapa. semangat nk belajar tu yg penting. kn? :)

21 NVD, 12 CS, 1 hysterectomy, 2ectopic, 1 D&C, 1 PV. wahh satisfied! :))

i'm gonna miss all nice professors, assistant prof, residents, anesthesiologist, neonatologist and nurses in hosp shatby. yes, for sure i will come back again 1day.

hello neuropsychiatry. iA another new interesting subject to learn. :) *try to be positive though not mentally prepared for new round tomorrow.*

harlequin ichthyosis baby

harlequin baby. boleh bace kt sini. ptg smlm baby ni lahir kt hosp shatby by ceasarian section. err. gambar real boleh google sendri la. sbb tk berani jgk nk tgk lama2. ni kot yg org melayu kata anak ular?.nasib baik tk menjerit atau over react lebih2. boy or girl tk sure. genital organ tk well developed or mayb ambiguous. rasa sungguh bernasib baik bersyukur dilahirkn normal cukup sifat. hari ni alhamdulillah baby tu hidup lagi. tp dr kate, mayb die pun tk boleh survive lama. byk sgt defect. general congenital anomalies. yg obviously kt kulit. try pegang, keras. huhhhh. tknk2 tgk pun stay lama jgk kt dlm bilik baby hari ni.

1. tgk 2 delivery twins td. 1 deliver normal vaginal delivery, both cephalic. and lg satu ceaserian section, both breech. 
2. total, tgk 3 breech delivery today. all by caeserian section. jaw flexion, shoulder traction. 
3. assist dr buat D&C (dilatation and curretage) case: abortion. gestational age 10w. tlng dr grasp upper lip of cervix dgn vollosellum. and rase gritty sensation of endometrium. krikkrikkrik. errrh ngilu!
4. applikasi grip pd patient. 

ke ER. ramai pt perempuan mlm ni. and kt ICU penuh, 2 pts meninggal. alahai la. sorg sbb stab wound. and lg sorg sbb shock dt renal failure. rasa cm kesian tgk dr usaha sedaya upaya selamatkn pt, buat CPR & ambu bag pt non stop berapa lama tp bad prognosis, rase cm.. sia2 je. hurmm tp memang kerja doctor la kn. tiba2 terlintas mampu ke hadapi semua tu nanti. kerja non stop cmni.

terlintas terpikir mcm ni sbb sepnjang hari ni memang non stop dr pukul 8 pg td. kira spend almost the whole day kt hosp jgk la kn hari ni. pastu masuk OT td, berdiri je kn tgk surgery. case intestinal volvolus & extradural hematoma. both tak tarat nk tgk sampai hbs. sekejap je kt ER da lari blk. 

tk tahu nape hari ni penat sgt. mungkin sbb spend byk masa dlm OT berdiri je. tgh round obgyn skrg seriously memang penat. almost every day stay after class. n kdg2 dtg mlm2. minggu 1st and 2nd tahan lagi. memang rasa enjoy. seronok la kn buat bende yg kte suka. ni br masuk minggu ke-3. tak kn da pancit kot. terlintas lagi, mampu tk nk jd dr mcm ni. 

ok da selamat malam.

second day.

second day in second round OBGYN.

I

da dpt semangat blk. td stay lps kelas sampai pukul 630. tk byk case. tp dpt la tgk 1 ceaserian section and 1 normal delivery sampai hbs. seronok. :D

II

jd nomad dan menumpang kump lain dgn dr yg mengajar laju tidak menarik lansung. tp kalau masuk group 8 tkpe.haha.

III

female. coma since after ceasarian section yesterday. caused of coma, still unknown. mayb intracranial hg. dt? unkown. admitted to ICU.

investigation finding: accumulation of blood in the perineum.

a surgery is perform to evacuate the blood and find source of bleeding.

then mayb observation the pt. n btw, the dr use PDS to ligate the a. 

IV

primigravida. full term. epileptic since birth. last attack 5 months ago. took 2 epileptic drugs. err i dont remember the name. surgical hx of tonsillectomy. indication for ceaserian section because afraid attack of epilepsy during labor. CS was perform under general anaesthesia. safely deliver a baby girl. the dr use continuous unlock and horizontal mattress suture on uterus. continuous unlock suture on rectus muscle and rectus sheet. and subcuticular suture on skin. total duration of surgery: 25 minute. woah.

V

how to use pinard stethoscope?

put the pinard on maternal abdomen. put ur ear on the other end of pinard. remove ur hand. try listen to fetal heart sound and identify site of maximum intensity. 

do not touch the pinard while u trying to listen the fetal heard sound.

yeay. i did it!. listening to the real fetal heart sound by pinard for the 1st time!
n i still wonder why pinard is better than stethoscope?

VI

female. full term. P2 G0+1A. during admission, cervix dilatation is only 2 fingers(4cm), 50% effacement, cephalic presentation, membrane rupture. 20min later, dr did PV. cervical dilatation up to 3 fingers(6cm). the next 5min is 3.5 fingers(7cm). the next min is 4 fingers(8cm). and then the next minute is fully dilate. she is primigravida, and she go through the 1st stage of labour less than 30minute! (normal: 12-16 hour) woah! precipitate labour.

2nd stage of labour.

1.evacuate the bladder by urinaty cath

2.do episiotomy after give local anaesthesia

3.mechanism of labor. descend. increase flexion. int rotation. extension. restitution. ext rotation.

4.deliver the baby. support the perineal. baby boy. :))
5.cut the umbilical cord

3rd stage of labour
1.evacuate the bladder
2.massage the uterus while try to extract the umbilical cord.

3.pull out the placenta after appearance signs of placenta separation. (mode of separation: inverted umbrella)

4.after pulling out the placenta, rotate it repeated and slowly to pull out together the remnant. 

5.check if any remnant left inside the uterus.

6.check if any laceration or tear

7.suture the cervix laceration

7.suture back the episiotomy

VII

i finished read face & brow presentation during waiting in the labor room. kira da study la kn hari ni. :))

VIII

3 cases of severe pre eclampsia and 1 case of placenta previa marginalis admitted for observation.

da mengantuk. ke kelas tafaqquh td pun da tersengguk2. esok cuti. yeay! kene bace breech.

buku & nota2 peds tk kemas lg. haha.

mr ong

battle dgn mr ong semalam ramai yg tewas. 

-_-

ok, move on~ next! PEDS. 2 hari lg. 

post mcq obgyn

smlm, sgt bersemangat utk exam hari ni.

and hari ni pergi exam dgn penuh confident walaupun cm tak la well prepared sgt. tp boleh la nk kate bersedia dgn yakin utk exam hari ni. utk obgyn sentiasa bersemangat kn.

jadual kate pukul 9. tp start pukul 10. haih. n nasib baik group kami yg start dulu. mungkin esok shift group A start dulu pula. ok tak kisah la.

exam mcq 50 soalan. for 30 minutes?? oh!

n ble bace soalan, it's soo dr rocca's. agakla susah. should be da patut boleh expect kn. 5 minutes left and still i got 7? questions not answered.

tak sempat double check. tak sempat nk scan buku cuba recall topik kt page mane, tak sempat nk pk lame2, ape yg terlintas, tu yg terus jwb.

huhh. tak pela. da usaha sehabis daya, doa. iA kullu kheir..

obgyn mcm sgt surgery la. and peds sgt mcm int med.

blaja surgery/obgyn cm tak berat sgt, n kitorg really enjoy the lessons dlm class tak mcm int med/peds yg sgt byk bende detail2 semua kene tahu.

tp end up ble exam, subject yg mcm senang tu tak la senang mane pun sbnrnya n lg tak tahu nk jwb instead of subject yg lg byk kene nk bace yg lg berat tu lg mcm boleh la nk jwb jgk.

esok osce obgyn. markah lg byk dr mcq. tp lg tak tahu nk bace ape. -_-

conference ObGyn

skrg da hbs 2 minggu kt pead. bosan. sungguh. though skrg tgh round pead, tp almost everyday lari pergi ObGyn lg. minggu 1st kt round, tak jumpe prof lansung. sume assistant dr saje yg ajar setiap hari. cikgu tak semangat ajar, kami pun kurg semangat belajar. kelas round hari2 hbs awl an. haih. setiap hari tgk budak2 yg sakit. kesian. kalau neonates & infant boleh tahan lg. tp kalau budak2 yg da besar sket cm tak tau nk layan. right now, for sure i'm not into internal med or peadiatric. semangat da hbs over sgt guna kt ObGyn sampai kt pead skrg semangat da habis da.

yg best kt pead cume tak de beli buku mahal dan hbs pukul 2/3 setiap hari. ermm.. tapi kelas habis awl tak la best sgt pun.

27-30 april conference ObGyn. 27hb student conference kt ObGyn department. 28hb kt dept lg, 29&30 kt hilton green plaza. masa student conference, 5 org wakil malaysia present compete dgn total 17 participants include dr malaysia, egypt dan lebanon. bangga kot semua dpt top 10. and 1st place also malaysian. congrats guys. korg hebatla!

nk g conference kt green plaza. tp tak jumpe masa sbb kelas pead jalan cm biasa. kalau dak2 ObGyn bolehla, sbb derg cuti sepanjang conference ni. ajk derg ponteng kelas pead, tp semua bagus2 tak nk tinggal kelas. tp td nasib baik TBL habis awl pkl 10 n some of us decide nk g conference kt GP n blk before lecture pkl 1230. yeay ade pun org nk pegi.

for the 1st time i join international conference. whoaa rase inferior. tp seronok! jumpe dgn dr2 ObGyn kitorg dulu. and kwn2 derg bdak arab yg join conference kelmarin ade sekali, derg friendly. dr nermean going to present tomorrow n dr nk sgt kitorg dtg. cm kecewa gk kot for sure la tak dtg sbb esok sukan lg penting. td dr bersungguh crkn kupon makan break & lunch tuk kitorg. sbb kitorg student free, so tak dpt la makanan sume. nk join byr le300 kitorg tak mampu.

cm serba salah td, dr walid semangat crkn kupon makanan. tp tak amik sbb da nk blk kuliah blk. kalau amik pun tak sempat nk guna. mkn break pukul 1230 and lunch kul 5. nk dtg ptg ni, ade kelas arab. kalau tak, boleh je nk dtg lg. aiyokkk rase serba salah dgn dr td. nape la tak amik je kn, at least amik hati dr.

best an lawat booth2 pharmaceutical dpt beg2 free. haha. n sbb da belajar, ble derg terangkn semua pun paham. seronok.

esok day light saving. huhhh masa tido kurg sejam.

sang cerdik

slps kelas sang cerdik tidak terus pulang ke rumah kerana ini minggu terakhir sang cerdik di bahagian hamil dan sakit puan, jd sang cerdik ingin mendapatkan manfaat sebaiknya. sang cerdik melangkah masuk ke tingkat 2 bilik pembedahan hosp ibu dan anak, shatby. dan menyarungkan kot makmal tanpa membutang seperti yg selalu sang cerdik lakukan. penutup muka juga tidak dipakai oleh sang cerdik kerana menyesakkan pernafasan dan bukan la satu kewajipan utk memakai penutup muka sbg pemerhati.

nasib sang cerdik baik kerana dr heba baru saje hendak memulakan pembedahan mengeluarkan bayi ke atas seorg perempuan hamil yg mengalami darah tinggi, kencing manis dan usus tersumbat. sang cerdik dgn bersemangat berdiri di sebelah dr bedah supaya dpt melihat operasi pembedahan dgn jelas. operasi pembedahan bermula dan dr bedah memotong satu demi satu lapisan bermula dari kulit ke lapisan bwh kulit, kulit rectus, otot rectus dan menampakkan rahim. sedang dr bedah memotong salah satu lapisan, sebuah pembuluh darah kecil telah terpotong dan menyebabkan darah terpancut keluar. satu situisi yg jarang sang cerdik saksikn sepanjang sebulan sang cerdik di bahagian hamil dan sakit puan. agak teruja juga sang cerdik menyaksikan kejadian.

tanpa sang cerdik sedari semua org di dalam bilik pembedahan memandang sang cerdik. oh sang cerdik ada buat ape2 salah ke? atau sang cerdik terlalu teruja sehingga menarik perhatian 2 pakar bius, pembantu dr bedah 1, pembantu dr bedah 2, cik misi, dan 3org dr pelatih. dr bedah juga menoleh ke arah sang cerdik.


sang cerdik terkesima.

nasib sang cerdik kerana berdiri di sebelah dr, tak membutang kot makmal, tak memakai penutup muka, dan tak punya vaccine hepatitis B atau C. *sigh

premature vaginal delivery polyhydramnios twin

lessons for today.
i stay after class till 730pm. and i learned a lot!

I

elder primary gravida which is 1 of high risk pregnancy is common in female dr. HA HA.

II

i watched 3 caeserion section. 2 pre eclampsia and 1 abortion.

satisfied! because i watched 1 complete surgical operation from the beginning till the end. procedure plng lama masa dr suture blk layer by layer from uterus till the skin. all the procedures take average about 30-45 minutes. and 1 of the pre eclampsia women got breech pregnancy. btw i didn't know the case is abortion until death fetus came out. hoh! tak boleh tgk. boleh jadi nightmare kot. i dont know how long was the fetus death in uterus, IUFD (intra uterine fetal death). the fetus is small but all the limbs are present. the head is shrinked and i'm not sure the face was developed or not. huh scary. terus lari keluar pergi bilik baby.

III

while i'm watching a nurse feed a baby, then she gave the baby to me. and i'm holding a newly born few hours baby at my arms! the nurse saids, ma takhofish. do not be afraid. sbb die tgk org cm kekok kot pegang baby. hoho. wow sy da pegang baby br lahir! :D

IV

coincidentally i met again the dr that explain about neonatal at emergency room last saturday. but today i met him at operation theater. and he recognized me. yeay! dr kacak sungguh kot. hihi. hi. how are you. aaaa. speechless sekejap. haha. xley bla. so i'm with the same dr again explain about neonatal. 1 of the babies got stridor and another 1 dr called him/her box head. i dont know if there is actual term box head in neonates.

V

a women recently admitted with abdominal distention like pregnant and complain of abdominal pain. drs did vaginal ultrasound but urinary bladder is full so they cannot see the uterus. they evacuate the bladder and did vaginal ultrasound again. guess what? uterus is empty! huh. then they did pregnancy test by urine test. negative. so the women come to wrong department and maybe psychological that she may think she is pregnant. they transfer her to hospital Miri for further management of the case.

VI

A pregnant women recently admitted ER. look in severe pain. and keep asking drs when she can deliver the baby. cervic dilatation just about 3 fingers (cervix dilatation must 5 fingers or 10cm for vaginal delivery). surprisingly, 1 of male dr just pull the women from bed. speak in a badtempered way order her to walk by HERSELF to labor room. and he just push her to labor board. OMG! so bloody rude. the dr is so arrogant! tiba2 terus rase cm hilang respect an. nk tercampak air mata tgk. the women in pain and the drs still can make a joke among them n laugh loudly in the labor room. they should have respect and treat in-labor-pain-pregnant women nicely as human being.

VII

1 of nice male dr (not the arrogant 1) offered me to do cervix examination. but i refused as i'm scared and not ready. yet. hoh cuak, tak berani lg kot nk masukkn tangan dalam cervix perempuan yg tgh sakit nk bersalin. then i regret why i'm refuse? aiyokk. offer susah nk dpt.

VIII

i wait about 1 hour and half for normal vaginal delivery. only 1 case available when i go to emergency room. Hx: 28y old. 26weeks of pregnancy. twin. UTI. polyhydramnios. cervix dilatation 4 fingers. and the women still in bed and not yet go to labour room. dr did cervical examination and i saw a fluid on the bed. 1st i thought the water just broke. but it is not physiologically because dr told me it was induced to withdraw excessive amniotic fluid by put the fingers on cervix and push on her abdomen slowly. then huge amount of water came out made like she lie on water-bed and wet all the floor around the bed. just like a waterfall? came out from vagina. and suddenly the baby just come out with the water. both baby. OMG! seriously tergamam. sbb pt bukan kt labor room. drs pun cm kelam kabut amik instrument utk sambut baby, potong cord, etc. hoh! normal pregnancy are 38-42 weeks. this is pre-term labor so both babies are very small, i think just about 20cm. huh. speechless. rase cm tak boleh nk berdiri sekejap an. huuhhhhhhhhhh.

ObGyn seronok. bolehla.

.obstetric.

exam int med tak seteruk surgery-yg-rase-nk-mati.

khamis final exam, jumaat cuti n sabtu da start sem baru. nice kn?

welcome ObGyn. ObGyn seronok. hr ni br masuk 3rd day.

dr clinical round best. break setiap 45min sampai hbs kul 4.

jd tak rase cm lame sgt sbb ade break n dr ajar pun best.

n yg best kuliah dekat, kt shatby.

jd boleh pergi kuliah jalan kaki 15min saje. haha br sekali je la tp.

gap tgh hari boleh g library alex, boleh blk rumah,

n ade taman+bench kt dpn bangunan pead cm best nk duduk makan angin santai2 kt situ.

jadual, TBL, ILA mcm surgery. sabtu-rabu 9-4 n khamis half day.

i just wonder, kenapa kt surgery & ObGyn semua lecturer/prof lelaki?

kt surgery dulu memang lansung takde dr perempuan.

n kt ObGyn ni adela jumpe sorg, dr group kitorg. lecturer yg lain semua lelaki.

hari 1st, hbs kelas stay sekejap masuk labor room.

pengalaman 1st tgk normal delivery. hoh.

before ni pernah tgk caeserian section takla cm teruk sgt.

tak tgk full, dtg2 je baby da keluar n dr tgh nk bersihkn uterus.

nk pitam. tak larat nk tgk. @_@

dgr pt menjerit2, byk darah mbuak2, bau hanyir. urgh! ngilu rase.

n lps kelas td g tgk lg. tp belum dpt adapt. tak boleh lg nk tgk lame2.

lari pergi bilik baby. tgk baby2 comel sgt!

cm td ade 4 baby sekali. semua br lahir beberapa jam lps.

sorg meniarap merengek2. lg 2 tido nyenyak. lg sorg duk diam baik2. ha comel gle cm sorg tu kacau yg sebelah die tido. tangan tak duduk diam, menggeliat, merapai2 muka baby sblh. kalau da besar nanti derg jumpe blk, o kau yg bising kacau aku tido tu. haha. extrimities derg cyanosis. sejuk lg. kulit sgt lembut. halus kulit baby. n bau baby best. sgt berbeza la bilik baby dgn bilik labor. hoh. tak nk tgk labor lari g tgk baby.

kalau perempuan lps sakit2 bersalin then dpt baby. tgk that cute adorable little creature. mesti rase cm, berbaloi jgk sakit an..

sem br, mcm tak kelam kabut n santai2 lg.

skrg tgh distract myself with a lot of things

i'm try to let go. time will heals everything. hopefully.

go away! please.

keep myself busy, jd barula terasa hidup bermakna. :p

nk sambung balik kelas bA. project2 bermanfaat dgn sahabat handai. project masak&makan. grey's marathon. sukan. hang out. berlalala.

td ade tanye soalan. mcm mane kalau org tu tak baik, buat maksiat. tp die sembahyang. die bace Quran. kte nk judge die ape?

ntah nape timbul word judge. huh. salah soalan tu snanye.

the answer, tiba2 ada org mencelah jwb. kalau cm perompak/pelacur, die buat bende tak baik sbb nk menyara hidup. kalau tak, tak dpt duit utk makan, sara keluarga, etc. hurmm tak boleh jdkn alasan tu. jawapan cm tak dpt nk diterima sgt. then dpt jawapan yg cm best n memang terkesan kot.

maknanya solat die tak sempurna la. sbb solat dpt cegah perbuatan keji dan munkar.

org yg sempurna solatnya, pastinya tak buat maksiat kn. hurmm.