I am voting for change

Haven't written here for so long.Feel like ages.Anyway, i just wanted to say that i will vote for change because i believe serious changes are required in the health sector of the Maldives.

Changed

Treatment guidelines are always changing and its a must to know them when they change so that we can treat patients more efficiently.
The most recent changes came to the guidelines of treatment of Acute Ischemic Stroke.Its a very common scenario, especially when working in a casualty department or an A& E to see patients who come in and eventually gets the above mentioned diagnosis to their condition. In the April 12th issue of Stroke ASAP, the authors have stressed upon using of recombinant tissue plasminogen activator with in 3 hours of onsent of stroke symptoms. I wonder whether this is available in Maldives.
The other changes that came in to practice guidelines was the changes that came to the Cadio-Pulmonray resuscition sequences. I wonder whether IGMH has a resus team who responds to all arrest cases like they have here or elsewhere in the world?! I believe its very important to to have themedical team trained and refreshed constantly about CPR so that all can work more efficiently in an emergency life threatening situation like cardiac arrest.

By the way, i have seen "Pirates 3". Wow!! It was one big adventurous ride.The highlight of the outting was me having a perfect classic cinabbon and a tropical blast at Cinnabon while watching shoppers walk by, parents being dragged by their kids and vice versa, kids falling while running after runaway balloons. ( take note that there's a lot of kids involved in this scene) *smiles

Feeling Lite

Now that the one year of my internship is over, i feel very light and like i am flying. Then again i hit the ground with rapid acceleration when the idea that i will be responsible for lives hits me.That thought brings me down to earth alright.
I have been busy in Pediatrics and particularly in NICU the past two months and couldn't blog.All i do when i get home is get some food and sleep and sleep.Until its time to go back to hospital.Life all of a sudden seems to be very predictable for me. Isn't that boring??It's supposed to be,but i didn't get time to think about it until now.
Now that i have some free time, i did some normal girl stuff.Went to the mall,shopped a bit, watched "Disturbia". I say it's one cool movie. I like the kid in it.What's his name again?Hmm.. can't remember. Now i want to go and see "Pirates" third part. I love Johnny Depp and the piraty and unhygienic look everybody has in it.In how many years did the pirates took a shower those days? :-)
What am i blabbering about here today??!!! Here comes the substantial part of this post.
I recommend www.bmjlearning.com and especially the foundation programme for all the doctors in training and in their internships.I think going through their simulation center modules will help through some of the most clincal decision making one has to face in A&E.

AArrrrghhhhhhhhhhhhh!!!!!

This is where the dogs congregate every night since the spring started and howl, bark and do whatever they do together until sunrise. This is a little nice park just in the back yard common to four apartment buildings and in one of them i live in.Now it seems like this is home for the midnight frolicking of the dog kingdom.I haven't being able to sleep well in the nights because of this barking and howling.It's only 8pm in the night and they have started their opera show!!!! Aaaarrrghhhh!!! I just want to scream at them and throw at them bags of water and kick their butts!!!!!

Last menstrual period

It's been drummed into us during our clinical rotations of general surgery that "every female who's of the age of menarche is pregnant until proven otherwise". To ask them about their last menstrual period (LMP). But this concept clearly escapes doctors a lot and mistakes are being made everyday which can affect the outcome of pregnancies.I remember this particular incident which happened during my CAT days in IGMH. I was assisting an Indian doctor that day and so there came Mrs.X with her husband to us about a vague abdominal pain she was having since one week. She looked generally well and she doesnt seem to be in severe pain and she described it to be vague and occasional.The doctor asked a few questions,and asked me to give the patient a request form for an abdominal x-ray.After a few mins,Mr & Mrs.X came back with the x-ray and lo & behold what a sight greeted us!!
Through the x-ray staring at us ( more like screaming at us) was a single fetus of approximately of 18 weeks old with it's cute umbilical cord,eyes and fingers nearly visible. I was horrified. I doctor's face went blank. She made some stuttering apologies and blamed the patient for not telling her that she was pregnant. Mrs.X said that she had no idea that she could be pregnant. The doctor cunningly kept the x-ray with her and sent off the patient telling her that she has to follow up with an obstetrician. Since that day, this particular incident has occupied my thoughts during odd times. What was this doctor thinking? What was her preliminary diagnosis? Intestinal obstruction? Anyone who deserves to be called a doctor should know the signs and symptoms of intestinal obstruction and as i remember well,the patient was not presenting with any of it. She didn't even ask for the correct view of abdominal x-ray needed for such a case.

Meticulous history taking and a simple lab test will rule out any doubts of a pregnancy and will save doctors facing situations like this. This is the way we are taught in medical school and some how, most of us forget what's important during the course of time. I just wanted to share this with everyone who is in a medical school or is a doctor so that this experience will stay with them everyday as it does with me.

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Oh,dear sweet God! Just take this immense pain in my heart & set me free.

Expression of Love

Yesterday when i went down early in the morning to catch the bus to work,i found that some guy had expressed his love to his girl on the road with spray paint.I am guessing that these words "I love u so much" are painted on the road infront of the girl's apartment.I found it very sweet that the guy went into so much trouble to do it in the middle of the night so that his girl would see it when she comes down in the morning.Good to know that sweet soppy kind of love still exists in this world. *winks ;) u can see that the romantic side of me is thinking that there's really a girl and a guy involved with this incident. :-)