2016

Cortisol ate my muscle more than anything else. Past two weeks chittagong have been cruel to us..you knew people are cheating you but you can't do anything about it..that's the funny thing about this world..it laugh at your pain..being a foreigner in a foreign soil,far from family never been an easy thing..that's the moment when you realized that this world is fully of shit and craps everywhere in the form of humans..human that only seek you when they needs you.

Well,who give a damn about the shitty humans.They can't be changed.Anyway 2016 still seems unsteady with new environment..Let's  see what new shit it can throw at you this year..

A Typical Lecturer Straight from Satan's Cave.

This is a continuation of The first Lesson I Learnt in My Medical School


                                                               Chapter 6


 The Sir looked unembellished, in his late 40's with a nerdy glasses, a typical lecturer straight from Satan's cave. That's how he looked at the 200  students standing in front of him. 
'His sinister smile is his trademark I guess',Jeeva whispered .
'Muddddhheedaaa",I whispered back.(it means shut up,but if u add some tune to the word while whispering ,it might means stfu too).

 'How many foreigners are here? Raise your hand!',that was the first sound we heard from his mouth.If you were him, you could see about 20 raised hands while all the local student's head turned towards us, scanning and counting in their heads.I noticed some of students from our group of 20 seems proud of themselves.The proud smiles were there on their faces as if they going to receive a medal .Meanwhile the remaining us looked nervous -and I'm one of them.

'All move to the middle,tara teri',he said using the microphone..

The sir asked us to move to the middle of the lecture hall;to the stairs and we were clueless.Damn.It was way worse than what I imagined Jeeva might caused.That's how I felt. The lecture hall was in a mourning silence..

"I studied in UK,' he uttered few words and linked it to his college life.

"They used to bully me lot.So I don't respect them too',he continued while we were standing in the middle,on the stairs, holding our pen and books, listening to him with full attention.

'So sit on the floor.That's what you get from me",he concluded.

I was just 3 when some Britain junkies bullied him.'It wasn't his fault.He was gifted with such an annoying face that ended up with people bullied him',Shaun whispered.Shaun is a modern Punjabi boy from Malaysia too.He is my new classmate too along with Mugil,Raj,Roshan and few others that I still can keep remember.He never wears a turban,that is why I meant him 'modern'.


Since we don't have any options ,we sat on the floor.
'what the fuck la this?Is this why paid so much to be here,sitting on the floor",Jeeva asked me slowly.
'If he see us talking,don't know what else he might do la..So shut up and just write something',I said.

 Some of the Malaysian girl showed 'seriously??' kind of face, while the boys just goes with the tide like an emotionless statues except this boy from Ipoh,Ajay.I only met him once in this few days and he was abnormally friendly then.. He was seriously down and his facial muscles couldn't hide it.

Who wouldn't actually? You wore your new fresh whitish lab coat and the reality was you have to sit on the floor..The floor that hundreds of muddy and dusty slippers just walked onto- a pair of it was mine, just replace the slipper with shoe. With his nicely ironed blue shirt and polished black shoe, it definitely wasn't a pleasant morning for him,and us..and definitely not a good start for any student..
10 minutes before 12pm,he ended the class and walked his way out...

to be continue..





   
   

Island and I

By lakdhes

What's special about the isolated island in the picture..Anyone that have been here will knw what's special about this archipelago ..When we reached there, we met  two Czech guys  that was kayaking along with us.(but we reached first,biasalah)..One of them was 202cm tall ..His height made me curious and that's how I started the conversation. Okay, let's skip the random shit, but one of them was talking about what will happen if they trapped on an island. Well, everyone knws abt Robinson's story that we read during our secondary school.I can't recall the real Robinson C's name, bt he survived many years on that island with Friday because there was plenty of fresh water for his survival on that Island.
Drinking sea water would actually be a squit-ticket to die, since it will fry your kidney..So let me share about the last thing u can do when u trapped on an Island and you can't find fresh water to drink. That's when I felt i should tell him about enema.An enema may be used as a last-resort method for rehydration, particularly if the only available fresh water is contaminated and unfit for drinking..(if you drink the dirty water, then you will die sooner due to  severe dehydration caused by vomiting and diarrhoea.) The reason is that the water would be readily absorbed by the colon while avoiding any gag reflex and vomiting caused by the contaminants.
#donttryitathome
#justaninfo
#ifyouknwBearGrylls
#thenyouwillknwallthis

Relationship Goals:Sucks

Maybe the past is like an anchor,
Holding us back..
Maybe you have to let go,
of who you were,
to become who you will be..

Lakdhes. . .

Jungle trekking-moments

The stairs by lakdhes

What's special about this place.Well recently I met this person here. A complete stranger but was quite friendly.Unfortunately, I can't recall her name now.  She asked me a question after some random chat.Honestly my knowledge was shallow regarding her question then.

She asked me, if botox can make our face pretty, why not inject it into our blood and make it work generalized for all the muscles(the way she asked was really  funny).haha,I realized that this type of innocent  questions are the one that at times help us to improve and make us learn something beyond the syllabus of our books. Like once someone asked me, is cancer contagious? Like if a mosquito bite a cancer patient and us next, will we get cancer too?
Lol..

What is the answer..haha...
Comment if you know..

Depression Care

I'm watching you...
and I wish to listen..
you're not alone..
share with me..




infomedic/fb

How to sleep better

Tips for getting better sleep:

1.Establish a regular bedtime and a relaxing bedtime routine—examples might include taking a warm bath or listening to soothing music.

2.If you can’t fall asleep after 15 to 20 minutes, get out of bed and go into another room. Do something relaxing, such as reading quietly with a dim light. Don’t watch television or use a computer, since the light from their screens has an arousing effect. When you feel sleepy, get back into bed. Don’t delay your scheduled wake-up time to make up for lost sleep.

3.Use your bed only for sleeping or lovemaking. Avoid reading and watching television in bed.

4.Don’t take long naps during the day. If you need a nap, restrict it to 20 to 30 minutes in the early afternoon.

5.Get plenty of exercise. Build up to 45 minutes of moderate exercise nearly every day. Get your exercise early in the day. Try some easy stretching exercises or yoga to relax your muscles and your mind at bedtime.

6.Whenever possible, schedule stressful or demanding tasks early in the day and less challenging activities later. This helps you wind down at the end of your day.

7.Don’t go to bed hungry, but don’t eat a big meal right before getting into bed. If you want a bedtime snack, keep it bland and light.

8.Limit caffeine and consume none after 2 p.m.

9.To decrease middle-of-the-night urination, don’t drink any fluids after dinner.

10.Avoid alcohol after dinnertime. Although many people think of it as a sedative, it can get in the way of quality sleep.

11.Be sure your bed is comfortable and your bedroom is dark and quiet. Consider a sleep mask or earplugs.

12.Practice relaxation breathing. Use slow breaths, especially when you exhale.

Murmur

Heart murmurs are sounds produced by turbulent blood flow in the heart, particularly the heart's valves. Heart murmurs can be found in babies or develop later in life. Generally murmur is not a condition,but a sign which will leads to condition like mitral regurgitation and aortic stenosis .That is why sometimes student have to study  murmur along with MR,AS etc.

It can be classified according to:

Timing and Cadence

Systolic murmurs occur between the first heart sound (S1) and the second heart sound (S2). Diastolic murmurs occur between S2 and S1. In addition, timing is used to describe when murmurs occur within systole or diastole. For example, early systolic, midsystolic or late systolic. 

Duration

Heart murmur duration refers to the portion of systole or diastole that the murmur occupies. Terms used include short and long. Murmurs lasting throughout systole are referred to as holosystolic or pansystolic. 

-pansystolic murmur usually associated with mitral regurgitation.

The first and second heart sounds are normal but 

a mid-frequency rectangular murmur fills all of systole.

Pitch

Evaluation of the murmur's pitch should be made by classifying the pitch (frequency) as low, medium or high. The stethoscope's bell can be helpful with low pitched sounds while the diaphragm is used for medium or high pitched sounds.

Shape

Some murmurs are described by the sound's shape. Common classifications include crescendo (increasing intensity), decrescendo (decreasing intensity), crescendo-decrescendo (increasing then immediate decreasing intensity). Crescendo-decrescendo is also called diamond shaped. Rectangular, also termed plateau indicates a heart murmur of constant intensity. 

Tonal Quality

Listen for additional aspects of the murmur's sounds. Heart murmurs may have qualities that can be noted as musical, harsh, blowing, booming, sharp or dull.

Respiration and Patient Position

Respiration or patient position can influence murmur intensity as well as heart sound splitting. Generally , murmurs increasing with expiration originate with left side (aortic or mitral) valves, while murmurs increasing in intensity with inspiration originate with tricuspid or pulmonary valves.

Additional:

1.diastolic murmur- a heart murmur heard at diastole, due to mitral obstruction or to aortic or pulmonic regurgitation with forward flow across the atrioventricular valve; it has a rumbling quality.

2.prediastolic murmur- one occurring just before and with diastole, due to aortic regurgitation or pulmonic regurgitation.

3.presystolic murmur- one shortly before the onset of ventricular ejection, usually associated with a narrowed atrioventricular valve.prediastolic murmur one occurring just before and with diastole, due to aortic regurgitation or pulmonic regurgitation.

4. mitral regurgitation - a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. 

5.aortic stenosis -is the narrowing of the exit of the left ventricle of the heart.It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occurs due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercise. Signs of heart failure include shortness of breath especially with lying down, at night, and with exercise as well as swelling of the legs. Thickening of the valve without narrowing is known as aortic sclerosis.

Sunrise :A different day,different questions

If Ozone in the Earth's stratosphere is created by ultraviolet light striking ordinary oxygen molecules containing two oxygen atoms O2, splitting them into individual oxygen atoms and when the atomic oxygen then combines with unbroken O2 and  created ozone, O3,why ozone can't be create artificially?because it's super unstable ?and if ozone really healing itself after banning of cfc,will the earth temperature reduce like before?or only skin cancers cases will reduce?

and if the is major tectonic plates movement ,will the Pangaea forms again? At least,can we see the Lemuria again?Travel by road to Australia perhaps?

books drive me crazy n leads to neurosis..zZzzZz

p/s- a year from now,when u read this again,this shouldn't be a question anymore.

an year
a year

Why people using both since  ( y ) is not a vowel .  Fat-finger syndrome?

Clinical examination

Easy Clinical Examination 

Not mine.

How to overcome Depression

How to overcome Depression

How to be happy?
How to be more confident?
How to be attractive?
Is there any ways?
The answer depends on  you.Others can only guide you,but end of the day,it's all about you.

Why people become depressed?
What is depression actually..?
Wikipedia define depression as a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being.
Science addressed it as a feature of some psychiatric syndromes such as major depressive disorder.


People with depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed or restless. They may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present.It's a lot of shit,but you will never understand it fully without experience it.

What depressed people do is,they  isolate them self from others,They feel  no body cares about them.They want to be alone.But deep inside,they need someone ,something that can help them to overcome it.Who the fuck likes and want to be depressed in the first place.As the last solution,they will commit suicide and end their life when all the prescribed drugs failed to help them.Before they choose the ultimate decision,they will search on net for ways to overcome depression  without contact someone in person.The feeling will be like you're drowning and you really,I mean really wish that someone will give a hand to you and bring you out from your misery.

1.So,what is the way to overcome this.It took me many years to find the real solution and I decided to share it with others.Who cares how many people will read this,how many people will comment on this post.I don't care.Confidence is not  'they will like me'.Confidence is 'I will be fine even if they don't.'First of all,how do I know how many people likes me out there with this uncertain world.Human are good pretender.So,never care about others.That is the first step you apply to avoid being depressed thinking you're not good.The moment you compare yourself with  others,that moment it self you are below them.Never compare your self with other doesn't matter how successful they are.Some might be an athlete ,a bodybuilder,a successful business man,entertainer,public figure.You might compare your self for not being them,but wait..Did you try nor put any effort to be like others?
But you're good in comparing with others since comparing is easy.Sounds unfair?Definitely yes.
Stop comparing with others.You never know your capability without trying.You might be the same level as others when you try.Maybe a step above them.So,don't judge yourself without trying and doing something .



2.and about people being depressed because of relationship, do you know what is the main culprit for this?We never get enough care and attention from our partner.When this happened,we never move on but still going after them and get nothing but shit.One reason why people keep going after their useless partner is love.Others might be memories.Correct?What is love?Just a cocktail of endorphins and P.E.A that drives us crazy.We might think we will never find someone like them again,anymore.Bullshit.You will smile for your stupidity when you get someone better than your ex a day.The reason why we going after them again and again and why we can't move on and why in the first place we seeking for their attention is the same reason.We are not busy enough with ourselves .We don't love our self and that's why we can't decide what we like and do it on our own.Since we are being lifeless and from no where,when someone like us and we are in a relationship,all we need is their time and attention.How can we expect others to do the same for us in the name of love.Love is about being strongly a part and being strongly together at the same time.They will do their own stuff and you will do your own and at the right time,you both will go for a date,interact,cuddle,what ever shit it is,you both should do it together at the right time,but definitely not 24/7.If one partner is lifeless and and got nothing better to do,that is the moment when love Satan arise.So,the problem is not with the partner,but you(I'm not including the assholes that betray and having many girlfriends and boyfriends at a time).Keep yourself busy and productive.Then you will know the difference. 

3.and for those who being depressed with studies, .. 

Hemicrania Continua

Hemicrania Continua:
Persistent One sided Headache(for easy search) 

The reason why  I select this picture: she's very pretty. 

Many times, when someone asked me about their persistent unilateral headache, I tried my best to know the cause and it's type.Either , migraine , cluster, tension, hormonal and etc..but a day, I came across this, something wasn't in the book.Maybe not in the books that I was using. :P 

For many times,I have seen myself doctors prescribed paracetamol, aspirin for patient with  persistent headaches, but they kept coming back with the same complaint.So the doctor at time asked the patient to do a CT scan and CT reveals nothing.Then I came across this type of headache that responds well for Indomethacin (for sometime maybe).This is just an info, so If you having any of the symptoms, don't make your own assumption.Just check with you doctor before taking the over-the-counter drugs.

Hemicrania continua  is a persistent unilateral headache . It is usually unremitting, but rare cases of remission have been documented. Hemicrania continua is considered a primary headache disorder, meaning that it is not caused by another condition.

The following diagnostic criteria are given for hemicrania continua:
1.Headache for more than 3 months fulfilling other 3 criteria

2.All of the following characteristics:
-Unilateral pain without side-shift
-Daily and continuous, without pain-free periods
-Moderate intensity, but with exacerbations of severe pain

3.At least one of the following autonomic features occurs during exacerbations and ipsilateral to the side of pain:
-Conjunctival injection and/or lacrimation
-Nasal congestion and/or rhinorrhea
-Ptosis and/or miosis

4.Complete response to therapeutic doses of indomethacin, although cases of hemicrania continua that do not resolve with indomethacin treatment have been documented.

A variant on hemicrania continua has also been described, in which the attacks may shift sides, although meeting the above criteria in all other respects.

Main features differentiating Hemicrania continua from cluster headaches (migrainous neuralgia, etc) are the higher frequency and shorter duration of attacks, higher incidence in women, and the response to treatment with indomethacin. Also hemicrania continua is not associated with cranial nerve palsies.

Remember, check with your physician for better information.

Happy Birthday :A gift for you.

From her eyes,I could realized that she is getting mad at me.The moment I took a cigarette from Marlboro box,the smiling face changed drastically into a look that I can't explain.It was cute.I just keep looking at her while trying to light it with a matchbox.-Lighting a cigarette with  a matchbox is more stylish than lighting with a lighter.

'Smoking isn't good for health',she started the conversation.

I just nodded while taking  a match  from the matchbox.

'Don't smoke,please.I don't like',she said with a cute expression.

"I  will go out ,smoke and come',I said.

'Even at out,don't smoke,please,for me,she literally begged.

'Why should I stop?why for you?' I questioned.

'Up to you.You decide',she uttered after  6 seconds,and walked passed me towards the door.

I just stand feeling bad  in that smoking free cafe near the hospital.I shouldn't  hurt her,especially the only pretty and cute girl at this place.Girls like her seldom talks to me.But,she is someone that definitely not in my league but keep coming after me.I can realize that it is a good and  a bad sign for me.

After days,she still never talk to me.I don't miss her,but it was awkward seeing each other everyday without even a hi.It was 11th,her birthday.So I just brave my self to wish her,However,I can't resist her too.

I started with :

"Hi,Happy Birthday'.

'Thank you',she replied with a smile.I missed that smile.

.

"I won't lie to you that I stop smoking already'.

'I smoke less in a day compare to days before 2nd October'.

'Slowly,I will stop permanently.Trust me,the only person that I never lied before is you'.

She smiled,wider than the previous smile.I know she was convinced with what I just said.

'I want to tell you something',she said.

'Maybe you won't be my friend,or we won't be closer like before'.

'So before that I wanted to tell you this.You was one of the nicest person I have seen in years.I never lie to you too,even from the beginning ,when I first saw you at the parking lot.I still remember how we talked first.I don't know why,I just like something about you,all the time since I met you'.

'Ya,I like you so much.One day,if you like me back,do tell me.If you can take care of me,if you believe that I can take care of you and your family well,marry me,'she said .

"Happy Birthday',her Chinese friends wished,interrupting our conversation unmannerly.

I just moved few steps back and looked at her.She thanked them,turned and look at me..Lim and Theo gave a moderate size box as a birthday gift.That moment I realized,I don't even try to get a gift for her.Wonder whether she will like me as she said after this..

Lakdhes..

A personal Note for My Future

Dear friends,followers,readers of this blog..I'm sure most of the views are by medical students.Thanks for the comments and for adding me on Instagram and Facebook.Thanks to the mails too.It made my day.Those who interested to gain medical knowledge and share it to the world,do like this page here:

Infomedic

and those who interested in gossips,politics ,latest issues,do like this page :

Boss,Teh Tarik Satu.

I know no one will read this post.Who cares..
This blog of mine is solely for memories recall purpose..One day,I will read  back,from the beginning and smile myself.Maybe my kids will read all this too.If it is so,dear kids,I'm more notorious than my look.Please learn from my mistakes and be a better person than me. Life will be hard.You might read somewhere how bad is depression.But,trust me..You only will understand it when you face it by your own.Again,trust me,it can be overcome too.So,don't worry much,don't give a fuck about what others tell you,don't be shy,live your life the way you want.If you'r wrong,learn from the mistake and never do it again.In life,everything is about memories..Create lots of memories so that you can cherish it with anyone.From memories you will earn the knowledge beyond what is written in your books.So,choose wisely and create  good memories..And remember,expectation is a disease.So,don't expect lot.

And for those  who are reading this now,yes it's you..I don't know you,but thanks a lot for choosing this page.I would be more glad if I can be in your friend circle..Have a nice day.

by
Lakdhes

Sometimes When You Win,You Lose.

Money is numbers and numbers never end,
If it takes money to make you happy,your search for happiness will never end.

Wonder why people don't understand it.In the beginning,during my admission in this medical college,the college administrative department said no such thing as paying extra  tuition fees after 5 years.Let say you failed and have supplementary examinations,you only have to pay the term fees and exam fees after your 5th year.Even last year,when the embassy came and had a meeting with principle to ask why the Malaysian students keep failing in their exam while other foreigners passed,he mentioned the same-Only have to pay for the academic years.

But now they said new rules and asking extra money for the upcoming year once you finish your fifth year and having supple exams.How could from no where they creating new rules and wanted to implement it.If there is a new rules,it should be start for the new admission right..Only place on earth that will do such  crazy things is here.
Wonder how long and how much they want to steal from innocent students.If this kind of fucked up system being implemented,then what is the guarantee that they won't simply fail the student for money.

Now itself,if we go for exam,some don't like boys,some don't like girls,some don't like dark skin students and etc..Bias..Sometime they asked about our prime minister,palm oil ,Tun Mahathir ,talk cock and said the viva finish.When the result comes out,we failed in viva.So,if they already decided to fail Malaysian student,then why have to take the exam and creates such dramas.Passing at this place is all about plain luck and the examiner's mood.If he or she in good mood,you will pass. I guess ,we did  a big sin in our previous life.That's why we ended up here.. :P 
Basically we trapped here.Can't move forward and can't stop and go somewhere else.Age,parents,money ,everything have to be considered.Definitely we can't start fresh again,anymore. 

One of my friend,he is a smart student,was doing pre medic at Indonesia and wanted to continue his M.D there,but this agent lady,brainwashed his parents(including my parents)to send their kids here,to Bangladesh.She promoted  this place by using her daughter,(the daughter was studying here that time).But few years back,she transferred  her daughter to Indonesia because that agent lady knew that it's hard for foreigner to pass here.Such a bitch.She simply spoiled many students life for money.Such a greedy fat witch.And that boy,till now still couldn't clear the first professional exam.Whenever his father called and asked,will you finish this year..I really feel bad and angry with that agent lady.. Basically ,the agent cheated us for money.Hope she will understand a day that money is numbers and numbers never end,
If it takes money to make us happy,our search for happiness will never end.Wishing myself  to pass and get my ass out of this place soon.


By 

Lakdhes