Monday

Lesson 9:12:12.

Source; medscape.


Pregnancy diagnosis. The arrow is pointing to the yolk sac as seen within the gestational sac (GS). The yolk sac is usually identified before the GS is larger than 10 mm. Likewise, if the yolk sac is larger than 7 mm without signs of a developing fetal pole, the chance of an abnormal pregnancy is increased.



Pregnancy diagnosis. This is a gestational sac (GS) that measures approximately 2 X 3 cm, without evidence of a yolk sac. When the GS is larger than 10 mm and no yolk sac is identified, an abnormal pregnancy is likely. This particular situation is referred to as a blighted ovum or an anembryonic pregnancy.




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Menstruation.

Menstruation.
Physiology.

Menstruation is the shedding of the functional layer (upper two-thirds) of the endometrium after sex steroid withdrawal.

The role of the functional layer is to prepare the uterus for implantation.

The basal endometrial layer (lower one-third) provides tissue for regeneration during the following cycle.

This shedding process, which consists of three phases (menstrual, proliferative, and secretory), is repeated approximately 300–400 times during a woman's reproductive life.

It also occurs in primates and bats.

Menstruation indicates that conception has not occurred.

OHOAG: source.
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Thursday

Rhesus Negative

People who are rhesus positive or RhD positive have a protein known as D antigen on the surface of their red blood cells. People who do not have the D antigen are known as RhD negative. Most people are RhD positive but this varies slightly depending on your ethnic origins:
-85 per cent of people of white European origin are RhD positive
-94 per cent of people of African origin are RhD positive

-90 per cent of people of Asian origin are RhD positive

Rhesus status only matters if an RhD-negative mum is carrying an RhD-positive baby (the child inherits this from an RhD-positive dad). If some of your baby's blood gets into your own bloodstream, your immune system may react to the D antigen in the baby's blood as if it were a foreign invader and produce antibodies against it. This is known as sensitising.

Sensitising is not usually harmful in a first pregnancy, but when you become pregnant again, and if your new baby is RhD positive, the antibodies in your system can cross the placenta and attack the blood cells of your baby, causing anaemia, jaundice or in severe cases, heart or liver failure. This condition is called haemolytic disease of the newborn (HDN).


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Saturday

Breastfeeding / Fact #10.

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Thanks For Reading.
God bless.



The next step: phasing in new foods

To meet the growing needs of babies at six months of age, complementary foods should be introduced as they continue to breastfeed. Foods for the baby can be specially prepared or modified from family meals. WHO notes that:
  • breastfeeding should not be decreased when starting complementary feeding;
  • complementary foods should be given with a spoon or cup, not in a bottle;
  • foods should be clean, safe and locally available; and
  • ample time is needed for young children to learn to eat solid foods.

Wednesday

Breastfeeding / Fact #9.

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Work and breastfeeding

WHO recommends that a new mother should have at least 16 weeks of absence from work after delivery, to be able to rest and breastfeed her child. Many mothers who go back to work abandon exclusive breastfeeding before the recommended six months because they do not have sufficient time, or an adequate place to breastfeed or express and store their milk at work. Mothers need access to a safe, clean and private place in or near their workplaces to continue the practice.

Tuesday

Breastfeeding / Fact #8.

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Support for mothers is essential


Breastfeeding has to be learned and many women encounter difficulties at the beginning. Nipple pain, and fear that there is not enough milk to sustain the baby are common. Health facilities that support breastfeeding - by making trained breastfeeding counsellors available to new mothers - encourage higher rates of the practice. To provide this support and improve care for mothers and newborns, there are now more than 20 000 "baby-friendly" facilities in 152 countries thanks to a WHO-UNICEF initiative.

Monday

Breastfeeding / Fact #7.

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Regulating breast-milk substitutes

An international code to regulate the marketing of breast-milk substitutes was adopted in 1981. It calls for:
  • all formula labels and information to state the benefits of breastfeeding and the health risks of substitutes;
  • no promotion of breast-milk substitutes;
  • no free samples of substitutes to be given to pregnant women, mothers or their families; and
  • no distribution of free or subsidized substitutes to health workers or facilities.

Sunday

Breastfeeding / Fact #6.

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HIV and breastfeeding

For HIV-positive mothers, WHO recommends exclusive breastfeeding for the first six months unless replacement feeding is:
  • acceptable (socially welcome)
  • feasible (facilities and help are available to prepare formula)
  • affordable (formula can be purchased for six months)
  • sustainable (feeding can be sustained for six months)
  • safe (formula is prepared with safe water and in hygienic conditions).

Saturday

Breastfeeding / Fact #5.

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Why not infant formula?

Infant formula does not contain the antibodies found in breast milk and is linked to some risks, such as water-borne diseases that arise from mixing powdered formula with unsafe water (many families lack access to clean water). Malnutrition can result from over-diluting formula to "stretch" supplies. Further, frequent feedings maintain the breast milk supply. If formula is used but becomes unavailable, a return to breastfeeding may not be an option due to diminished breast milk production.

Friday

Breastfeeding / Fact #4.

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Long-term benefits for children

Beyond the immediate benefits for children, breastfeeding contributes to a lifetime of good health. Adults who were breastfed as babies often have lower blood pressure and lower cholesterol, as well as lower rates of overweight, obesity and type-2 diabetes. There is evidence that people who were breastfed perform better in intelligence tests.

Thursday

Breastfeeding / Fact #3.

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Benefits for mothers

Breastfeeding also benefits mothers. 
  • The practice when done exclusively 
  • often induces a lack of menstruation, which is a natural (though not fail-safe) method of birth control. 
  • It reduces risks of breast and ovarian cancer later in life,
  • helps women return to their pre-pregnancy weight faster, 
  • and lowers rates of obesity.

Wednesday

Breastfeeding / Fact #2.

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God Bless.


Health benefits for infants

Breast milk is the ideal food for newborns and infants. It gives infants all the nutrients they need for healthy development. It is safe and contains antibodies that help protect infants from common childhood illnesses - such as diarrhoea and pneumonia, the two primary causes of child mortality worldwide. Breast milk is readily available and affordable, which helps to ensure that infants get adequate sustenance.

Tuesday

Breastfeeding / Fact #1

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WHO recommends

WHO strongly recommends exclusive breastfeeding for the first six months of life. At six months, other foods should complement breastfeeding for up to two years or more. In addition:
  • breastfeeding should begin within an hour of birth;
  • breastfeeding should be "on demand", as often as the child wants day and night; and
  • bottles or pacifiers should be avoided.

Sunday

Typhoid Fever.

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Typhoid fever : Background and Transmission.


Typhoid fever, also known as enteric fever, is a potentially fatal multisystemic illness caused primarily by Salmonella typhi. The protean manifestations of typhoid fever make this disease a true diagnostic challenge. The classic presentation includes fever, malaise, diffuse abdominal pain, and constipation. Untreated, typhoid fever is a grueling illness that may progress to delirium, obtundation, intestinal hemorrhage, bowel perforation, and death within one month of onset. Survivors may be left with long-term or permanent neuropsychiatric complications.
S typhi has been a major human pathogen for thousands of years, thriving in conditions of poor sanitation, crowding, and social chaos. It may have responsible for the Great Plague of Athens at the end of the Pelopennesian War.[1] The name S typhi is derived from the ancient Greek typhos, an ethereal smoke or cloud that was believed to cause disease and madness. In the advanced stages of typhoid fever, the patient's level of consciousness is truly clouded. Although antibiotics have markedly reduced the frequency of typhoid fever in the developed world, it remains endemic in developing countries.[2]

Transmission

S typhi has no nonhuman vectors. The following are modes of transmission:
  • Oral transmission via food or beverages handled by an individual who chronically sheds the bacteria through stool or, less commonly, urine
  • Hand-to-mouth transmission after using a contaminated toilet and neglecting hand hygiene
  • Oral transmission via sewage-contaminated water or shellfish (especially in the developing world)[3]
An inoculum as small as 100,000 organisms causes infection in more than 50% of healthy volunteers.[4]
-source-

Friday

Demam Kepialu. / Tifoid.

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Bakteria salmonela Typhi.

DEMAM KEPIALU.
  • Sakit kepala yang kuat
  • Perut meragam dan sakit perut
  • Sembelit yang diikuti dengan cirit-birit
  • Demam panas (suhu badan tinggi) berterusan selama 3- 4 minggu
  • Ruam di badan.

CARA JANGKITAN DEMAM KEPIALU.
  • Penyedia dan penyaji makanan yang tidak membasuh tangan
  • Memakan makanan yang tercemar oleh kuman demam kepialu
  • Pembuangan najis di merata-rata tempat
  • Hinggapan lalat yang membawa kuman demam kepialu


GEJALA-GEJALA DEMAM KEPIALU
  • Demam yang berterusan dan memerlukan rawatan rapi
  • Pendarahan pada usus jika tidak dirawat segera
  • Mata layu dan cengkung
  • Tidak sedarkan diri dan meracau.

LANGKAH PENCEGAHAN DEMAM KEPIALU.
  • Basuh  sayur-sayuran dan buah-buahan sebelum dimakan
  • Basuh semua pinggan mangkuk menggunakan air bersih
  • Minum air yang dimasak
  • Makan makanan yang sempurna dimasak dan masih panas
  • Tutup semua makanan
  • Letakkan makanan di tempat tinggi
  • Guna tandas yang sempurna
  • Jaga kebersihan persekitaran
  • Hapuskan tempat pembiakan lalat
  • Basuh tangan sebelum makan, selepas ke tandas, selepas membuang sisa / sampah sarap atau memegang bahan mentah
  • Pilih gerai dan pengendali makanan yang bersih.

-source-

Majlis Persaraan Anggota. 13.10.2011.

"Doing special favors
In a dozen different ways
Looking out for others
With no thought
Of thanks or praise
Treating workers like a family,
Setting good examples, too
These things make a wonderful boss
And they all apply to you!"



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Appreciation
Preparation
more pictures.

PKS Course: 22 Sept 2011.

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more pictures...

Saturday

BAJET 2012. ucapan

FOKUS KEDUA: MENGUNGGULI MODAL INSAN, MENCERNA KREATIVITI DAN MENCETUS INOVASI


47. Program Transformasi Luar Bandar atau RTP merupakan pelengkap program transformasi menyeluruh negara. RTP akan mentransformasikan kawasan luar bandar supaya mampu menarik pelaburan swasta, menyediakan peluang pekerjaan dan kegiatan ekonomi serta menggalakkan generasi muda kembali berkhidmat. Oleh itu, Kerajaan akan melaksanakan beberapa langkah seperti berikut:

Kedua: Mewujudkan Dana Perkhidmatan Profesional bagi golongan profesional seperti peguam, doktor dan akauntan untuk membuka firma di pekan-pekan kecil. Bagi tujuan ini, dana berjumlah 100 juta ringgit akan disediakan oleh BSN secara pinjaman mudah dengan kadar faedah empat peratus. Di samping itu, surat cara perjanjian pembiayaan skim ini turut diberi pengecualian duti setem;


FOKUS KEEMPAT: MEMPERKEJAP PERKHIDMATAN AWAM

56. Bajet 2012 akan memperkenalkan Sistem Saraan Baru Perkhidmatan Awam atau SBPA yang akan menggantikan Sistem Saraan Malaysia atau SSM. Sesungguhnya, SBPA digubal dengan matlamat mentransformasikan Perkhidmatan Awam Malaysia supaya menjadi organisasi yang lebih dinamik, responsif dan berorientasikan prestasi. SBPA akan memperkenalkan prinsip perubahan radikal dalam pengambilan dan pengisian jawatan serta pembangunan kerjaya dengan teras pengekalan atau penamatan perkhidmatan penjawat awam berasaskan prestasi kerja. SBPA ini mempunyai elemen-elemen berikut:

Pertama: Mewujudkan Dasar Pemisah atau exit policy bagi penjawat awam yang berprestasi rendah dan mereka yang memilih untuk meninggalkan perkhidmatan;

Kedua: Menambah baik struktur gaji penjawat awam melalui pembentukan gaji sebaris dengan mewujudkan lebih banyak mata gaji supaya penjawat awam terus mendapat kenaikan tahunan bagi tempoh yang lebih lama. Dengan itu, gaji maksimum bagi sesuatu gred adalah lebih tinggi daripada sekarang. Contohnya, jika di bawah SSM, bagi seorang guru pada gred DG48, gaji maksimum adalah 6,325 ringgit dan 39 sen, kelak, di bawah SBPA, gaji maksimum beliau akan meningkat 37.7 peratus kepada 8,710 ringgit. Bagi guru bukan siswazah pula, jika di bawah SSM kini, yang berada pada gred DG34, gaji maksimum adalah 3,860 ringgit dan 52 sen, kelak nanti, di bawah SBPA ia akan meningkat 39 peratus kepada 5,370 ringgit;

Keempat: Kenaikan Gaji Tahunan tidak pernah disemak sejak 1991. Mulai tahun 2012, Kenaikan Gaji Tahunan penjawat awam akan ditingkatkan antara 80 hingga 320 ringgit mengikut gred. Di samping itu, bagi penjawat awam yang menerima opsyen ke SBPA, akan mendapat faedah kenaikan gaji, di antara 7 hingga 13 peratus.

58. Dunia yang semakin maju menyaksikan keterdepanan dalam teknologi dan sains perubatan. Hari ini, kita adalah sebuah negara yang secara relatifnya muda namun suka tidak suka, pada suatu masa nanti kita turut akan menghadapi fenomena biasa yang berlaku kepada mana-mana negara sedang meningkat maju dan maju. Antara elemennya, kadar kelahiran berkurang, keluarga memilih untuk mempunyai bilangan anak yang lebih kecil dan kadar penuaan meningkat. Lalu, adalah tidak ekonomikal sifatnya dalam keadaan begini jika umur persaraan tidak dilanjutkan, sedangkan harus barang diingat bahawa kerajaan akan menanggung kos gratuiti dan pembayaran pencen.

59. Ternyata, penjawat awam yang berumur antara 55 tahun hingga 60 tahun masih boleh memberi sumbangan berdasarkan kemahiran dan pengalaman mereka. Oleh itu, Kerajaan bersetuju untuk melanjutkan umur persaraan wajib daripada 58 tahun kepada 60 tahun bagi mengoptimumkan sumbangan pegawai perkhidmatan awam. Pelanjutan ini tidak akan menjejaskan peluang pekerjaan kepada generasi muda kerana sektor awam dan swasta akan terus mewujudkan peluang pekerjaan baru.

FOKUS KELIMA: MEREDAKAN INFLASI DAN MENGIMARAH KEHIDUPAN RAKYAT

85. Kerajaan akan terus menyediakan perkhidmatan kesihatan terbaik untuk rakyat, terutamanya rawatan berkualiti, peralatan terkini serta persekitaran lebih selesa. Bagi tahun 2012, sektor perkhidmatan kesihatan akan diperuntukkan 15 bilion ringgit untuk perbelanjaan mengurus dan 1.8 bilion ringgit bagi perbelanjaan pembangunan. Ini melibatkan antaranya pembinaan dan menaik taraf hospital termasuk di Bera, Kuala Krai, Dungun, Sri Aman dan Tuaran serta menambah baik blok bersalin di Hospital Putrajaya. Kerajaan juga akan menambah baik 81 klinik kesihatan luar bandar di seluruh negara dan membuka 50 klinik 1Malaysia.

87. Langkah yang sama akan diambil untuk menambah baik Hospital Kuala Lumpur (HKL) yang merupakan nadi perkhidmatan kesihatan di kota dan dikunjungi hampir 3,000 pesakit luar setiap hari. Demi keselesaan warga kota, hospital yang berusia 141 tahun dan merupakan hospital tertua di Malaysia ini akan dinaiktaraf supaya menjadi sebuah hospital primer negara dilengkapi dengan peralatan terkini dan canggih dengan peruntukan 300 juta ringgit. Dari peruntukan ini, 50 juta ringgit akan digunakan untuk membina sebuah sayap baru HKL khusus untuk rawatan pesakit luar.

88. Kerajaan juga memahami beban kerja pegawai perubatan di mana mereka bertugas berterusan melebihi 45 hingga 120 jam seminggu. Situasi ini sememangnya tidak kondusif untuk mereka memberi rawatan berkualiti. Oleh yang demikian, Kerajaan telah memperkenalkan jadual kerja luwes atau fleksi Pegawai Perubatan Siswazah, di mana waktu kerja di jadual semula kepada purata 60 jam seminggu. Bagi menggantikan Elaun Luar Waktu Bekerja Biasa, Kerajaan memperkenalkan Elaun Khas Waktu Bekerja Fleksi sebanyak 600 ringgit sebulan berkuat kuasa 1 September 2011. Bagi pakar dan pegawai perubatan, Kerajaan juga bersetuju menaikkan elaun on-call semalaman antara 30 hingga 80 ringgit berkuat kuasa pada tarikh yang sama.

98. Pada masa ini, barah pangkal rahim (kanser servik) merupakan barah kedua tertinggi di kalangan wanita Malaysia. Kemajuan dalam sains perubatan telah membolehkan penyakit ini boleh dicegah melalui suntikan imunisasi. Kementerian Pelajaran Malaysia dengan kerjasama Kementerian Kesihatan Malaysia telah melaksanakan suntikan imunisasi secara percuma kepada murid perempuan tingkatan satu di semua sekolah Kerajaan, bantuan Kerajaan, swasta dan antarabangsa mulai bulan April hingga Mei 2010.

99. Bagi membolehkan lebih ramai wanita untuk mendapatkan kemudahan imunisasi, Kerajaan akan menyediakan perkhidmatan suntikan percuma imunisasi HPV (Human Papilloma Virus) yang akan dilaksanakan oleh Lembaga Pembangunan Perancang Keluarga Negara di seluruh negara. Kos imunisasi ini adalah 150 ringgit bagi tiga suntikan. Untuk tujuan ini, peruntukan 50 juta ringgit akan disediakan pada tahun 2012.

100. Di samping itu, untuk menjamin kesihatan para ibu dan anak, maka sebuah hospital khusus untuk kaum wanita dan kanak-kanak akan dibina di Kuala Lumpur melalui perkongsian awam swasta dengan kos 700 juta ringgit.

107. Tidak pernah dilupakan adalah kebajikan warga emas terutamanya untuk mereka mendapatkan kemudahan awam seperti perkhidmatan kesihatan dan pengangkutan. Sukacita saya mengumumkan, mulai 1 Januari 2012, semua warganegara berumur 60 tahun dan ke atas akan dikecualikan caj pendaftaran pesakit luar di semua hospital dan klinik kesihatan termasuk klinik 1Malaysia serta pergigian milik Kerajaan. Mereka juga akan diberi diskaun 50 peratus tambang LRT dan Monorel.

114. Kerajaan yakin penjawat awam akan terus mempertingkatkan kualiti perkhidmatan dalam mempastikan agenda pembangunan nasional menjadi kenyataan. Dalam konteks ini, seperti yang semua ketahui, pada bulan Ogos yang lalu, Kerajaan telah pun membayar bonus setengah bulan gaji dengan bayaran minimum 500 ringgit kepada penjawat awam dan bayaran bantuan 500 ringgit kepada pesara.

115. Berdasarkan sokongan dan komitmen penjawat awam yang tidak terhargakan dalam mencapai matlamat pembangunan negara, sukacita saya mengumumkan tambahan bonus setengah bulan gaji dengan bayaran minimum 500 ringgit dan bayaran bantuan 500 ringgit kepada pesara Kerajaan. Bayaran ini akan dibuat bersekali dengan gaji bulan Disember 2011. Ini akan menjadikan jumlah bonus bagi tahun 2011 bersamaan sebulan gaji dengan bayaran minimum seribu ringgit bagi penjawat awam dan bantuan seribu ringgit bagi pesara Kerajaan. Bayaran ini akan memanfaatkan 1.3 juta penjawat awam serta 618 ribu pesara Kerajaan. Bayaran bonus dan bantuan dua kali pada tahun ini akan menelan belanja sebanyak 4 bilion ringgit.

Wednesday

Snellen Chart and Documentation.

Dear All, Thanks For Reading.


Lines on the Snellen chart are as follows
Use distance glasses
6 Able to read at 6m what can normally be read at 6m
‘6/​6’
‘9 Able to read at 6m what can normally be read at 9m
‘6/​9’
12 Able to read at 6m what can normally be read at 12m
‘6/​12’
18 Able to read at 6m what can normally be read at 18m
‘6/​18’
24 Able to read at 6m what can normally be read at 24m
‘6/​24’
36 Able to read at 6m what can normally be read at 36m
‘6/​36’
60 Able to read at 6m what can normally be read at 60m
‘6/​60’
Counts fingers; counts fingers held ½m distance
‘CF’
Hand movement; perceives hand moving ¼m distance
‘HM’
Perceives light; can see a torchlight when shone into eye
‘PL’
No light perception, abbreviated to ‘no PL ’, ie blind
‘no PL’
m = metres

Tuesday

Eye Examination.

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This post is meant for someone who is searching for the info right now.
Source; ohcs- handbook.

The history indicates the part of the examination to focus on. Asking about trauma, symptoms of pain vs irritation, loss of vision, and pattern and speed of onset. Examination includes visual acuity, optic nerve function (pupil reactions and colour vision), visual fields, eye movements and ophthalmoscopy to assess the ocular media and the retina (see box).
→
Acuity
→
Visual field
→
Extraocular movements
→
Ophthalmoscopy
→
Slit lamp examination
→
The indirect ophthalmoscope
→
External eye