Fikri Shaini
@fikshai
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Primum Non Nocere. RCSI Dublin. PMC Penang. 🐼
SungaiPetani | Dublin | Penang
Joined December 2011
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Picture can never do justice to this kind of beauty.
#mycupoftea
#unfollowfikshai
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Ada seorang Dr pernah ckp waktu teaching,
"If my student decided to become a fulltime housewife, I'm okay with it. At least I know they are educated housewife that can perform CPR and tell all the makciks about diabetic medication doesn't cause kidney failure when gossiping".
Kalau perempuan ada degree, rugi ke dia pilih utk jadi housewife?
Kalau perempuan ada degree kemudian dia pilih untuk jaga anak dia di rumah dan jadi full housewife, rugi ke dia?
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After a few days of MCO 2.0, we saw an increasing amount of suicidal attempt brought to our emergency dept. Truly, this pandemic has brought so many worries and sadness to people around us.
Be kind to everyone and support each other.
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*Encounter with antivaxx parents @ 4am*
Dr: Encik kenapa taknak vaccine anak?
Bapa: *senyap*
Dr: En tahu vaccine tu apa?
Bapa: *senyap*
Dr: Vaccine ni encik, bacteria yg dah mati atau dilemahkan untuk menghasilkan antibodi dalam badan anak encik. Kalau terkena jangkitan penyakit
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When you go to overseas, bangladeshi dngn pakistani la yg akan mudahkan hidup sbnrnya. Depa la yg buka kedai halal, buka masjid, raikan Malaysians dngn jamu makanan, bagi daging, ayam etc. Some of them pernah kerja dkt malaysia, and so far none of them talk bad about Malaysia
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RM 300 juta setahun. Imagine, we can build a 250+ bedded hospital with that amount of money. And it is per year for 15 years. Each state can get one new hospital. Bnyk improvements that we can do to our healthcare system. 😔
Pemberian kontrak kenderaan melibatkan 32 unit Toyota Vellfire dan 3,000 Honda Accord untuk menteri dan pegawai tinggi kerajaan bernilai RM300 juta setahun bagi menggantikan kenderaan Proton Persona dan Saga sebelum ini
#sinarharian
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Tahukah anda, setiap hari Pegawai Kesihatan di setiap daerah akan mengambil sampel air yang telah dirawat dari beberapa punca dan akan dihantar untuk ujikaji bagi melihat kandungan bakteria serta bahan terlarut. Jika melebihi kadar tertentu, loji rawatan air akan ditutup.
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Fuhh. Yg ni baru betul sila duduk dan jangan lari.
Senior Consultant Paediatrician (Pro-Vaccine) vs Freelance Medical Doctor (Anti-Vaccine).
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Kerana wujudnya parents sebegini, Kedah mencatatkan kadar kes penolakan vaksin tertinggi di Malaysia dari tahun 2013-2016.
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"When you're a houseman, be better that your medical officer. When you're a medical officer, be better than your specialist. When you're a specialist, be better than your consultant. When you're a consultant, remember you used to be a houseman".
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Apparently, all this extension bed or broken furniture tiba tiba hilang waktu audit. Ward yg previously overcrowded with 50+ patient suddenly back to normal census of 40.
im sorry but what is this hospital kerajaan?? this looks super dodgy and sad. my atuk tengah nazak and he use to be a government servant. he is entitled to get first class room but what did they say, “bilik penuh”. all his years as a kastam feels like nothing 💔do better msia
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Ayuh kita mogok. Tapi kita mogok on our offday. Because whatever happen, patients come first.
KKM tidak mampu menyerap sepenuhnya Pegawai Perubatan Siswazah (HO) ke jawatan tetap termasuk graduan tajaan kerajaan.
16,407 HO telah dilantik secara kontrak dan 1,152 masih menunggu.
Kenyataan penuh Men. Kesihatan
@DrDzul
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There's one ignorant MO in the ward scolding houseman few months ago
"Do you want me to speak to you in Jawi?".
I hope with recent polemic, he realized that jawi is not a language tapi tulisan 😂
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Budaya fearmongering sebab nak jual product ni sangat la unethical. Kualiti air dalam negara sentiasa dipantau, jadi jangan percaya sangat ckp ckp penjual penapis air ni.
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I noticed some of my colleagues are excited to post photos of what they are doing at hosp. Be it, masuk ot, handling babies or doing procedures. But always be mindful, never to jeorpadize your patient confidentiality and privacy.
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*Disclaimer. I'm not against using water filter of any type, but I'm against using fearmongering technique to help sells your product.
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Semua orang nak merasa ihsan dalam bekerja. Tapi when you are working with colleagues yg kuat mengular, boss yg tahpapa hormonal and patient yg tak cooperative, rasa mcm hilang ihsan. Pergi kerja just to settle your things and go back hoping that no shit left behind.
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No HO today during ward round.
Need to cover ward round and visiting clinics as well today - nephro and neuro. Then settle ward work, procedures and discharge. Sepatutnya balik 330, settle semua 730pm.
My hosp punya HO except 6th poster akan ditarik ke tertiary. So official la no HO after this. MOs semua da almost burned out, sbb ward work became unbearable, Clinics load like shit. My sp friend already started doing round alone. Chest clinic 50-60s pts only 3 doctors.
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Some genius in the past decided to cut down the number of medical school graduates. Katanya, we are producing too much. Then decided to introduce contract system.
Now, lack of supply and too much uncertainty due to the contract system. Thank you to the so-called genius.
1. The Star reports that the Health Ministry has seen a 50% reduction in the number of housemen since 2019, following a drop in medical graduates.
This decrease has led to a maldistribution of housemen across government hospitals offering housemanship.
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Why lytic cocktail should be given in this order?
1. Calcium gluconate
2. Dextrose
3. Insulin
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Hg punya persatuan takmau fight untuk hg punya wellbeing, so keep your mouth shut when our organisation want to fight for ours. You dont have right to condemn.
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DKA Principle of Management
D (dehydrated- give 0.9% NS)
K (give K+ to correct hypokalaemia)
A (give Actrapid to bring down the sugar)
Diabetic Ketoacidosis :
Remember these triad
1) Hyperglycaemia - > 250 mg/dL
2) Ketosis
3) Acidemia - pH < 7.3
✌️✌️
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Idk why, every time lepas marah mesti rasa bersalah. Bersalah like, I can do better by not being angry. Lepas tu palpitations for hours and replaying the incident and wondering whether I've done the right thing. 😥
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You know you are burnout, bila postcall hg accident. But you feel nothing. Numb.
Life goes on. Balik rumah, tidoq like nothing happen.
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Kenape ramai doktor suka rant kat soc med yang keje dorg susah? I mean byk je profession lain yg susah, overwork,… — Escapism. Our own way of expressing ourself. When you work throughout the day, for the whole week with less break…
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Despite the system collapsing, we all tried our best for benefit of patients.
That is why I stay and try to push for the better. At least for now.
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Dr: Okayla En, nnti kami bagi sign satu borang pengesahan yg En menolak vaksin. Nanti berkemungkinan anak En tak boleh bersekolah dngn kanak2 lain. Tak kesian ka encik?
Bapa: Tak, saya still takmau vaccine.
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Setuju yg Paris kotor, compared to other European countries.
And yes, bnyk pickpockets and money scam esp dkt area tourist attractions. If Paris is popular with 'Friendship Bracelet' scam, Istanbul dngn 'Shoe Shine'. So when travelling, always aware with common scam dkt situ.
PARIS KOTA CINTA YANG MEMPERDAYA
Kota Paris yang terkenal dengan menara eiffel, kononnya lambang cinta dan romantik. Itu mungkin pendapat sesetengah orang, bagi aku itu hanyalah sebuah metos. Realitinya kota paris adalah kota penuh tipu daya.
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Dr: Vitamin K pun encik taknak bagi?
Bapa: Kenapa kena bg Vit K?
Dr: VitK penting untuk elak pendarahan kpd bayi. Bayi baru lahir, VitK dia rendah dan boleh menyebabkan pendarahan, terutamanya bahagian otak. Kita ada satu case kt NICU, baby tak bg VitK, berlaku pendarahan otak
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Even the best of us have their worse moment.
Even the strongest of us have their breaking point.
You havent had yours, you shouldn't judge theirs
Be humble even you struggle.
So why did you take medicine in the first place if you're going to complain for being exhausted and tired all the time? Why not give the space you took in medicine to those who are willing to do it all and take the exhaustion as happiness? Be grateful.
#selfreminder
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Nanti bila dah jd pensil, akan ada satu dilema yg besar jgak.
Dilema 2B or not 2B.
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DKA Principle of Management
D (dehydrated- give 0.9% NS)
K (give K+ to correct hypokalaemia&
A (give Actrapid to bring down the sugar)
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Bapa: Okay, VitK boleh bagi.
Dr: Vaccine?
Bapa: Vaccine tak perlu, saya tolak.
Dr: Encik dngn wife vaccine tak sebelum ni?
Bapa: Tak, kami dua dua mmg tak vaksin.
*facepalm*
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I attended a course this year, which the speaker sejak dari awal smpai akhir course keep on emphasizing that success = to having a lot of money to spend which I disagreed.
For me, being successful is when you're able to give back to the society in any way within your ability.
Jangan compare diri sendiri dengan orang lain and apa yang dia ada. Bangga dengan apa yang kita ada and strive harder kalau ada goals sendiri.
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tak lah teruk sehingga boleh menyebabkan kematian atau kecacatan kekal.
Bapa: *senyap*
Dr: Ada sesiapa bagitahu encik ka yg vaccine tak elok?
Bapa: Takda.
Dr: Jadi kenapa taknak vaccine anak, nanti kesian kt anak kalau terkena penyakit yg jarang jumpa.
Bapa: *senyap*
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Unit KMAM (Kawalan Mutu Air Minum) di bawah Pejabat Kesihatan Daerah akan mengambil dan menguji kualiti air setiap hari. So that you have clean water for drinking.
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Decided to stay because I dont want mistreatment that happen to my father, jadi dkt other patients. Nowadays, I always advocate my stroke patient accordingly, assess them properly and treat them and their caretaker nicely. Those who never go through it, will never understand it.
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Bertambah lagi colleagues resign. No more floaters, no more HO. Expected to work at full capacity with half capabilities. Everything will collapse, soon. And at that point we are beyond any repair.
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To new colleagues joining us later, hanya satu pesan yg boleh dititipkan. Be humble. Be it you are a first, third or final poster. Doesnt matter if you are a leader or a follower. Be humble, and you'll find things becoming easy insyaAllah.
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When you work in a team, never call out your teammates mistake/s in front of others or in public.
It reduces their confident and productivity.
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We had an eventful day today. Our patient required large amount of blood transfusion. Our bloodbank currently out of O+ blood, kindly donate if you are O+.
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"Kenapa ambil BCG, tapi masih boleh kena TB?".
BCG provides protection against severe extrapulmonary forms of TB such as TB meningitis. However, BCG is unreliable in protecting against pulmonary TB, which accounts for most of the disease burden worldwide. (WHO)
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Lagi ramai orang sihat, actually lagi bagus for all of us. Less workload and better doctor-patient relationship which can maximize patient care.
Currently, we have 1 doctor for every 632 population which more than what WHO suggested which is 1:400.
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@fatinhaznina
Arguements yg selalu they brought up is vaccine contain benda tak halal.
2. Vaccine agenda yahudi.
3. 'zaman tok nenek kami tak vaccine, tapi hidup ja sampai ke tua'
4. Kalau dah ajal, ambil vaksin pun boleh mati.
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People working in tertiary, thinking they are Gods managing single subspecialty. Thinking those in primary and secomdary, are just mere referrologist that dont know how to manage cases.
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InsyaAllah, will be serving Sungai Petani people for the next two years. Doakan.
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Tiada yg lebih mengecewakan bila tau patient defaulted medications sbb seek traditional treatment. Perawat tradisional suruh berhenti makan ubat hospital supaya *tak campur*
Unfortunately, brought in dead today. Skipped all medication for the past 2 weeks and deteriorate badly.
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I know that certain MO doesnt like working with first poster. If you dont like working with us, how can we progress and become competent as you prefer?
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For every action, there's a reaction. And for every reaction, there's chain reaction.
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Beza rate oncall
Weekend call (24jam 8am to 8am next day) - RM220, i.e RM9.16
Weekday call (8am to 8am next day) - RM200, i.e RM 8.13
Locum rate, RM40 per hour. Sehari buat locum 24H, dah cover oncall pay untuk ~5oncall.
doktor yang korang nampak kaya ialah
- doktor pakar
- doktor yang ada buat side income
- doktor di hospital / klinik swasta
- doktor dalam bidang estetik
kalau doktor biasa yang ko nampak keje tak henti2 kat hospital tu, tu semua doktor yang underpaid 🤣
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Out of ventilator, out of medications and out of resources. And those above, out of touch.
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Consequences of free healthcare.
Active smoker, baru lepas heart attack 2 weeks ago (angio done, stented), discharged well. Cont smoking, now datang in-stent restenosis.
People dont appreciate it when its free. Keep on abusing the system.
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Time winter, locals tak pakai bright color. If you go to overseas, pakai bright color during winter confirm akan jd mangsa scam or pickpocket.
Masa travel, pakailah pakaian yang berwarna terang dan bersesuaian supaya gambar nampak menarik untuk di jadikan kenangan. Jangan asik pakai jeans, t-Shirt, baju kurung lusuh or wat so ever , cuba lah pakai Blouse ke peplum ke kebaya ke baju pengantin ke selagi ianya sepadan .
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@fairuz_azmi83
@CapaAjuan
@AFYI47
"Totally abolish gambling as seen in Kedah".
Habistu kedai Magnum 4d dkt taman sejati tu apa, toto 4d dalam pekan sungai petani tu apa? Ni yg berlesen, yang tak berlesen pun penuh berceretek.
What do you mean by totally abolish gambling? Care to explain.
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Teach and guide your first poster as how your seniors guide you. I was blessed with great seniors when I was a first poster and I'm always thankful for them.
Guide your first poster to do the job, so that you wont have to do it. It makes your job lesser and easier.
Faham kalau nak marah first posters kalau dia org buat salah. Tapi tak faham why need to make them feel like they are useless. Tak faham mindset taknak kerja dgn first posters. All of us used to be first posters kan. Ke ada yg start HO being senior poster? 😏
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I realized that this kind of job is not for those who are kind and naive. This job is for those yg pandai mengampu. If you are good at that, you'll survived even though you are not that good in term of knowledge and carrying out plans.
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End of 5th posting.
Twenty months as a houseman, twenty more reasons to stay humble, twenty more reasons to keep on living.
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To new colleagues joining the medical fraternity, my advice is never to let your title as a first poster to limit your ability and never to use that title to escape from responsibility. First poster is where you learn from your mistake and progress becoming better.
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The hardest thing to do in the ward currently is to educate the educated parents.
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Its a noble and humble profesion. But the people in the profesion is not.
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The bad things about being a guy is you cannot cry out loud due to fear of being judged as weak. Hence, we tend to keep our emotions and it cause damages to our soul.
To my struggling friends, just cry and dont give a damn. Things will eventually get better.
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"Kalau semua kesilapan boleh diselesaikan dgn perkataan maaf,maka tidaklah Tuhan jadikan syurga dan neraka".
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Received the text after long day at work. Rasa dihargai when people thanked you for your small effort in helping others. Thank you for appreciating the small effort that we do.
Is it just me or are the government texts from MKN getting more and more useless? From actual useful information, I’m just getting warnings not to spread false news and now this? I appreciate the sentiment but this is not the appropriate platform.
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Collapsing on every level.
More and more MO + specialist quit. Baru bulan April dah ramai quit the system.
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@larikesurga
@IniAlannn
Betul. Sebab tu saluran paip air ditukar secara berkala dan air yg diambil untuk sample diambil dari beberapa punca (yang telah melalui saluran paip tersebut). Air kotor boleh jgak jd bila kita tak servis tangki simpanan air di rumah.
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System is dying, and will collapse soon. Once collapsed, it is beyond resuscitation.
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Thinking about the future is like sailing into uncharted seas. You can always plan, but you'll never know what's ahead.
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People still make fun of suicidal person. Dari go through satu masalah, kena go through masalah kecaman netizen. They'll suffer more.
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Dalam system yg cacamerba ni, in the end those who try to do the most, suffer the most.
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Overdose of Insulin cause hypokalaemia. It cause potassium to shift intracellularly.
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@AdibAsyrafLerr
Setuju dngn pendapat hg. Tapi, antivac malaysia mmg akan quote dia bila sembang pasal vaccine. Sbb tu aku rasa better depa panggil ja dia terus walaupun sepatutnya takyah bg exposure langsung.
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This job will be great if everyone treat each other with kindness. Treat your colleagues like how you treat your patient. Be kind to everyone.
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Prolonged use of OHA or Insulin does not cause kidney failure. The progression of the disease itself cause CKD.
🔘Dont Forget That Most Common Cause Of
Chronic kidney Failure:🔻
🌕Diabetes (DM)🌕
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@noraariella
@ImanAbdulRahim
Sememangnya ada yg mati from not being vaccinated. Legally, we cannot exposed identity of the dead because of patient confidentiality.
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Thread on Premature Babies.
Posters from NICU HSAH.
1. What is premature babies?
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Had coffee for berbuka after like one month without coffee. Now my heart palpitating like the first time I saw you.
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Current management RAHMAN
R- Resuscitate (red zone)
A- Aspirin 300mg crushed
H- Heart score
M- Morphine
A- Antiplatelets (T. Plavix/Clopidogrel)
N- Nitrates
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Its been a year since I graduated from medical school. I've never thought that we will survive this far if not without support from those around us. Hopefully, things will be much better in upcoming years.
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Hard day at work
When you are left with only one ventilator available, two patients gasping and needing intubation.
You have to let go one of them, and it disturb your conscience.
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Years ago, aku literally ingat baby shower tu mandikan baby. So aku tanya, baby tak keluar lagi nk mandikan siapa? Years ago tu time noob gila first year medschool.
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Masuk branula kelabu, poke at least 18 kali, yg ke 19 baru kita insert successfully.
Yang mana kutuk doc tak reti bersyukur tu hangpa buat lek ja. Jangan layan.
Tapi kalau dia masuk hospital, kasi masuk branula kelabu.
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