Monday 29 December 2008

Palestine: who should be blamed for?





Mahmoud Abbas, the Palestinian president, has blamed Hamas for triggering Israel's deadly raids on Gaza, by not extending a six-month truce with the Jewish state.

He also blamed Hamas, which controls the coastal Gaza Strip territory, for disrupting national unity talks that could have paved the way for general and presidential elections.

"We have warned of this grave danger," he said in Cairo, Egypt, on Sunday.

"We talked to them [Hamas] and we told them, 'please, we ask you, do not end the truce. Let the truce continue and not stop", so that we could have avoided what happened."

However, Fawzi Barhoum, a Hamas spokesman, said he was "surprised" by Abbas's claim.

"He downplayed the sufferings of our people in Gaza and belittled their pains, providing justification of the holocaust and war waged by Israel," he said.

Abbas, whose Fatah movement has been at loggerheads with Hamas, said maintaining the truce could have helped the Palestinians avoid the raids, which have so far killed more than 280 people over the past two days.

Nour Odeh, Al Jazeera's correspondent in Ramallah, reported that senior figures had supported Abbas in his call on Hamas not to abandon the truce.

She added that during an Israeli election year, a hardline position towards Palestinians has always won more seats, making the timing particularly risky for Hamas.

"Not just Abbas, but people close to the circles of decision-making in key Arab states, said that Hamas was warned that breaking the ceasefire or not keeping it would result in mayhem and bloodshed," she reported.

Ayman Mohyeldin, Al Jazeera's correspondent in Gaza, said the stance at all levels of the Hamas leadership was the same: "They will remain defiant in the face of any attacks and that the movement is larger that an single assault or attack.

"That they were democratically elected by the Palestinian people, and only through the ballot box will they leave the political scene."

Hamas argues that Israel violated the truce by failing to ease its 18-month blockade on the Gaza Strip.

'Inaction'

Egypt's foreign minister has also blamed Hamas for preventing hundreds of wounded Palestinians from entering Egypt via the Rafah crossing for treatment - the only crossing that does not border Israel.

Ahmed Aboul Gheit said the wounded were "barred from crossing" and he blamed "those in control of Gaza" for putting the lives of the injured at risk.
But Barhoum denied the accusations, saying that Aboul Gheit was taking advantage of the "massacre and the suffering", to "cover up the state of inaction in Egypt".

Odeh said two lines were being taken on the Palestinian-Israeli issue with Arab states divided between those supporting the Hamas line of armed resistance and not recognising Israel, and those that preferred non-confrontational options.

"More now than ever, they are divided along regional lines of competition of interests in which states are using the Palestinian paper to tug between one another and gain that regional influence.

"There is a lot of anger toward the helplessness and the realisation that in such dire times, Palestinians have been unable to set aside their political differences."

Ground operation

Dozens of tanks and personnel carriers were seen parked at several points near the boundary between Israel and Gaza on Sunday after Israel's defence minister warned it could launch a ground offensive in addition to its air bombardment.

Ehud Barak vowed to "expand and deepen" the bombing raids, unleashed in retaliation for persistent rocket fire into the south of the country from Gaza.

"If it's necessary to deploy ground forces to defend our citizens, we will do so," his spokesman quoted him as saying on Sunday.

The cabinet gave the green light to call up 6,500 reserve soldiers, a senior official told reporters after the meeting.

Jacky Rowland, Al Jazeera's corespondent in Jerusalem, said: "This move gives the Israeli army a lot of leeway to commit troops to this operation as and when they see fit.

"If the fundamental objective of Israel is to change the situation on the ground, clearly they will not be able to do that from the air, they will need to commit ground troops.

"When we look at the full range of air strikes, it does seem that any ground operation would indeed be far-ranging and involve hundreds of troops."


source: Al-Jazeera
Doa Qunut Nazilah

اللهمَّ إناَّ نجعَلُكَ فِى نُحُورِ أعدَاءِناَ وَ نَعُوذُ بِكَ مِن شُرُورِهِم اللهم بَدِّد شَملَهُم و فَرِّق جَمعَهُم وَ شَتِّت كَلِمَتَهُم وَزَلزِل أَقدَامَهُم وَ سَلِّط عَلَيهِم كَلباًَ مِن كِلاَبِكَ يا قَهاَّر يا جَباَّر يا مُنتَقِم يا الله يا الله يا الله

اللهم يا مُنزِلَ الكِتاَبِ ويا مُجرِيَ السَّحاَبِ ويا هاَزِمَ الأَحزَابِ إِهزِمهُم إِهزِمهُم إِهزِمهُم وَانصُرناَ عَلَيهِم


Ya Allah,

Sesungguhnya kami meletakkan-Mu di batang-batang leher musuh-musuh kami,

Dan kami berlindung dengan-Mu daripada kejahatan-kejahatan mereka,

Ya Allah,

Leburkanlah kumpulan-kumpulan mereka,

Pecah-belahkanlah dan kacau-bilaukanlah persatuan mereka,

Goncangkan pendirian mereka,

Dan hantarkanlah anjing-anjing Kamu kepada mereka

Wahai Tuhan Yang Gagah Perkasa,

Wahai Tuhan Yang Maha Menghukum,

Wahai Tuhan Yang bersifat Murka,

Ya Allah, Ya Allah, Ya Allah,

Wahai Tuhan yang menurunkan kitab,

Wahai Tuhan yang mengarakkan awan,

Wahai Tuhan yang menewaskan bala tentera al-ahzab,

Kalahkan mereka,

Kalahkan mereka,

Kalahkan mereka,

Dan menangkan kami ke atas mereka.

Ameen...

p/s: Bilakah akan berakhir andai ummat tidak bersatu

Wednesday 17 December 2008

COUNTING DAYS...

VIVA for ENT : list will be out tomorrow morning and must be there by 9.30am. Viva session right after that! Huh, another miserable night...
anyway, just had bachelor's party for one of my housemates, she's getting married soon...very very soon...congratulations M....may the mawaddah and mahabbah be yours...

counting days for the viva list outa..
counting days to go back ( KL)
counting days to PD
counting days to go home (my beloved hometown)
counting days...and days...
until the breathing stop..
so use the time and days given by HIM to the fullest...
you are alive today for improvement!!!!!!


all the best..

Tuesday 16 December 2008

when people doubt .....

Date: 16 December 08 ( sis birthday's anniversary)
viva ophtalmology
Huh, my ID was listed. First time in my life. Called up for VIVA...hikmah is always there for those who think...
However it went on well but not that smooth......






Summary:
Examiner: How are you?
Me: I'm good.
Examiner: What is commensal ? ( i c no introduction man)
Me: It is one organism carrying pathogen...
Examiner: what do u understand by bacterial commensal.
Me: sorry, commensal is a normal bacteria in our body, but can become virulent if there is stimulus. ( what an answer? )
Examiner: Yes, so commensal is our normal flora. So how commensal in our intestine work?
Me: ( this is ophtal session..anyway ) Ya, they protect our intestinal epithelial layer by neutralizing acid etc. It gives a protective mechanism to the intestine. ( i dont think while saying this)
Examiner: ok..so what do u know about toxoplasmosis. .what is the name which affect eye.
Me: (think and think). Sorry i cant remember
Examiner: toxoplasmosis gondii
Me: ya.............( long sigh)
Examiner: How do they infect eye?
Me: it presents in the cat's faeces. When it comes in contact with human, it will infect eye causing....
Examiner: directly?
Me: No, it is when the faeces become in contact with food and human ingest food , so at the same time they will transmit to human?
Examiner: In the form of?
Me: Egg
Examiner: what group of organism toxo is?
Me: protozoa
Examiner: what else toxo can affect human.
Me: hmmm..through vertical transmission ...from mother to baby from vaginal delivery?
Examiner: u mean directly cause infection?
Me: not really it can affect the baby throughout the gestation period.
Examiner: How?
Me: mother and foetus sharing the same circulation, such as placental .......
Examiner: yes, through placental. Ok whatelse can vertical transmission cause infection to the eye?
Me: such as ophtalmia neonatarum ( why do u start off with this?)
Examiner: whatelse in ophtalmia neonatarum?
Me: chlaymidia...and is that CMV is one?
Examiner: yes chlaymidia is one, whatelse?There are few more...(smiling with my CMV answer)
Me: im not sure
Examiner: ok how do u diagnose toxo?
Me: through blood ..im not sure about serology test for toxo.
Examiner: so which antibody rise?
Me: IgM if acute, IgG if chronic ( bluppp)
Examiner: so which one transmitted through placental?
Me: IgG ...im not quite sure..but it is either IgG or IgM..but i think IgG ..
Examiner: so in baby which one is high ? IgG or IgM...
Me: errr..IgM if acute, IgG if long enough..( huhu)
Examiner: ok..how toxo can cause to the eye?
Me: it can cause retinitis then eventually optic atrophy...
Examiner: Ok...tell me the causes of corneal ulcer?
Me: firstly trauma, second......
Examiner: (stopping me)no i want the agent?
Me: ageing?
Examiner: agent.
Me: ok, it can be caused by bacteria, virus, fungus, protozoa..
Examiner: what protozoa..
Me: ( pause ).....is that toxo is one? (pause)...ya acanthamoeba..
Examiner: yes, so who normally got this?
Me: contact lens wearer.
Examiner: tell me how do u diagnose fungal corneal ulcer?
Me: first we put dye, then see under the blue light.......using slit lamp..
Examiner: No, we have done with that.
Time's out!!!!!!!!!! ( Miss P said)
Examiner: never mind tell me how do you diagnose fungal?
Examiner 2: like another organism, how do u investigate?
Me: ya, scrap the ulcer then do culture and sensitivity. Sensitivity is to determine antifungal agent
Examiner: yes, that is the investigation.Ok u may leave now.
Me: thank you.


that was the end of my viva. Middle of the session ( pooling of my precious tears!!)
that was when my meibomian gland , conjunctival goblet cell and lacrimal gland were united to give away lipid, mucus and aqueous respectively....

all the best for my ENT tomorrow....
included below some info on toxoplasmosis GONDII...

How It Spreads
People can catch toxoplasmosis from:

* touching or coming into contact with infected cat feces (cats get the infection from eating infected rodents, birds, or other small animals)
* eating raw or undercooked meat that's contaminated
* eating uncooked, unwashed fruits or vegetables that have been contaminated by manure
* being born with it (a woman who gets a toxoplasmosis infection while pregnant may pass the parasite on to her unborn child through the bloodstream)

Although infection doesn't normally spread from person to person except through pregnancy, in rare instances toxoplasmosis can contaminate blood transfusions and organs donated for transplantation.
Signs and Symptoms

Toxoplasmosis passes from animals to humans, sometimes without causing any symptoms. When kids do have symptoms, they vary depending on the child's age and the immune system's response to the infection. (As with humans, infected cats often don't show any signs of a toxoplasmosis infection.)

Toxoplasmosis infections in people fall into three basic patterns:

1. congenital toxoplasmosis, in which a child becomes infected before birth
2. toxoplasmosis in otherwise healthy kids (with the same symptoms a pregnant woman may have)
3. toxoplasmosis in kids with weakened immune systems

Congenital Toxoplasmosis

When a pregnant woman (even one who has no symptoms) catches toxoplasmosis during pregnancy and remains untreated, there's a chance that she could pass the infection on to her developing fetus. Babies who become infected during their mother's first trimester tend to have the most severe symptoms.

However, it's rare that a woman who got toxoplasmosis before getting pregnant will pass the infection on to her unborn baby because she (and, therefore, her baby) will have built up immunity to the infection. It can occur, though, if a pregnant woman who's had a previous infection becomes immunocompromised and her infection is reactivated. Generally, it's probably a good idea to wait to try to get pregnant until at least 6 months after a toxoplasmosis infection.

Up to 90% of children born with congenital toxoplasmosis have no symptoms early in infancy, but a large percentage will show signs of infection months to years later. The few who show clear signs of infection at birth or shortly after may be born prematurely or are unusually small at birth.

Other signs and symptoms, if there are any, may include:

* fever
* swollen glands (lymph nodes)
* jaundice (yellowed skin and eyes caused by abnormal levels of the liver chemical bilirubin)
* an unusually large or small head
* rash
* bruises or bleeding under the skin
* anemia
* enlarged liver or spleen

Some babies with congenital toxoplasmosis have brain and nervous system abnormalities that cause:

* seizures
* limp muscle tone
* feeding difficulties
* hearing loss
* mental retardation

They're also at high risk for eye damage involving the retina (the light-sensitive lining at the back of the eye responsible for sight), resulting in severe vision problems.

If a child is born with congenital toxoplasmosis and remains untreated during infancy, there's almost always some sign of the infection (often eye damage) by early childhood to adolescence.
Toxoplasmosis in Otherwise Healthy Kids

A healthy child who becomes infected with toxoplasmosis may have no symptoms of infection or only a few swollen glands that:

* usually appear in the neck
* are sometimes tender to the touch
* may become larger and smaller over several months

Most kids won't experience any long-term problems if they go undiagnosed and untreated.
Toxoplasmosis in Kids With Weakened Immune Systems

Kids whose immune systems are weakened (for example, by AIDS, cancer, or medications taken after organ transplants) are at special risk for severe toxoplasmosis infections. Especially in children with AIDS, toxoplasmosis can attack the brain and nervous system, causing toxoplasmic encephalitis (an inflammation of the brain) with symptoms that include:

* fever
* seizures
* headache
* psychosis (a type of severe mental illness)
* problems with vision, speech, movement, or thinking

Duration

Although toxoplasmosis parasites may grow and multiply within a week of entering a person's body, it may be weeks or months before symptoms of infection appear (if they appear at all).

Once someone becomes infected with toxoplasmosis, the infection remains in the body for life, usually in a latent (inactive) form that won't cause side effects or harm. The infection can be reactivated, however, if the immune system becomes compromised by an HIV infection or cancer therapy.

In a child with a healthy immune system, mild symptoms of toxoplasmosis (such as swollen glands) usually pass within a few months, even without medical treatment. But kids born with severe congenital toxoplasmosis may have permanent vision problems or mental retardation. And in a child with a weakened immune system, toxoplasmosis can be fatal.
Diagnosis

Doctors can, but rarely do, diagnose toxoplasmosis through laboratory tests that check for microscopic parasites in the blood, spinal fluid, amniotic fluid, placenta, lymph nodes, bone marrow, or other body tissues.

More frequently doctors order blood tests to measure the level of antibodies (substances that are part of the body's defensive immune reaction) produced to fight the parasites.

Sophisticated new genetic tests can identify the DNA-containing genes of toxoplasmosis parasites once they've invaded the body. These tests are especially useful for checking the amniotic fluid for evidence of congenital toxoplasmosis in a fetus. Obstetricians may use ultrasounds to help diagnose congenital toxoplasmosis. But these tests aren't 100% accurate and can lead to false-positive results.
Treatment

Unless someone has a weakened immune system or is pregnant, there's often no need to treat a toxoplasmosis infection — symptoms (such as swollen glands) usually go away on their own in a few weeks or months. However, kids should always be checked by a doctor because swollen glands can be a sign of other illnesses.

If a pregnant woman develops an infection, a treatment plan will be developed in consultation with her doctor and an infectious disease specialist. Research has shown that treating the mother can help decrease the severity of the disease in the infant but won't necessarily prevent transmission of the infection from mother to child.

Children born with congenital toxoplasmosis are treated with different combinations of anti-toxoplasmosis medications, usually for 1 year after birth. A specialist typically will determine which medications to use and for how long.

In healthy older kids who develop serious toxoplasmosis infections, treatment usually lasts 4 to 6 weeks (or at least 2 weeks after symptoms are gone). Kids with weakened immune systems often need to be hospitalized when they develop toxoplasmosis, and those with AIDS may need to take anti-toxoplasmosis medication for life.
When to Call the Doctor

Call your doctor immediately if your child develops symptoms of toxoplasmosis and:

* is already being treated for AIDS or cancer
* has a condition that affects the immune system
* has been taking medications that weaken the immune system

Also call the doctor if your otherwise healthy child develops any of the symptoms of toxoplasmosis.

If you're pregnant, call your doctor immediately if you notice even one swollen gland, especially if you've been exposed to cats or have eaten raw or undercooked meat.
Prevention

If your cat is kept indoors and never fed raw or undercooked meat, then your family's feline probably has a low risk of catching or spreading toxoplasmosis. Still, you can also catch it from eating raw meats or uncooked produce that's contaminated.

Saturday 13 December 2008

mata pancaindera

Sebagai "booster" ..............



Ophtalmologi atau atau ilmu perubatan mata dikenal di Dunia Islam sejak abad ke-10 masehi, ketika para ilmuwan Muslim melakukan penelitian besar-besaran terhadap karya-karya ilmuwan Yunani. Hasil penelitian itu kemudian menggairahkan kerja-kerja ilmiah di bidang optalmologi yang ditandai dengan munculnya karya-karya monumental seperti kitab Tadzkiratul Kahhaliin dan Al-Kahhal.

Pada tahun 1905 Profesor J Hirschberg, seorang pakar mata dari Jerman, melakukan penelitian tentang asal-usul optalmologi bersama Asosiasi Medis Amerika yang berbasis di California.


Hirschberg mendapatkan fakta bahwa selama 250 tahun para ilmuwan Muslim telah memproduksi buku pegangan dasar-dasar optalmologi sebanyak 18 kitab. Ini lebih jauh lebih besar dibandingkan dengan ilmuwan-ilmuwan Yunani sepanjang Hippocrates hingga Paulus yang selama 1000 tahun hanya menghasilkan 5 kitab. Hirschberg menemukan kitab-kitab spesialis mata yang ditulis ilmuwan Muslim terdapat sekitar 14 kitab yang masih ada hingga kini. Sepanjang tahun 800 hingga 1300 Islam telah melahirkan tidak kurang dari 60 dokter spesialis mata yang juga menulis textbook dan monograf ilmu perubatan mata, sementara itu di Eropah sebelum abad 12 tidak memiliki seorang pun doktor mata. Penemuan-penemuan doktor pakar mata Muslim meliputi bola mata, conjuntiva, kornea, uvea, dan retina. Ilmuwan Eropah seperti Gerard Cremona dari Spanyol menghabiskan 40 tahun usianya hanya untuk menerjemahkan karya-karya ilmuwan Muslim. Di antara ilmuwan Muslim yang menuliskan penemuan-penemuan mereka di bidang optalmologi adalah:

Ali bin Isa

Ali adalah ilmuwan paling terkemuka di antara pakar spesialis mata di zamannya. Dilahirkan di Baghdad, Iraq, Ali menulis kitab Tadzkiratul Kahhaliin dan mengembangkan ilmu kedoktoran mata hingga menjadi rujukan ilmuwan Muslim lainnya. Kitab Tadzkiratul diterjemahkan ke dalam bahasa Jerman oleh Hirschberg dan Lippert pada tahun 1904 dan ke dalam bahasa Inggris oleh Casey Wood pada tahun 1936. Kitab karya Ali memang merupakan kitab ilmu kedokteran mata yang paling banyak dikutip oleh para ilmuwan lain. Kitab Tadzkiratul pertama kali diterjemahkan ke dalam bahasa Persia dan kemudian ke dalam bahasa Latin dan dicetak di Venesia pada tahun 1497. Para ilmuwan yang banyak merujuk karya Ali adalah Ammar bin Ali Al-Mosuli dan Abul Hasan Ahmed bin Muhammad At-Tabari yang menulis Kitabul Mualaja-ul Buqratiyya.

Ammar bin Ali Al-Mosuli

Lahir di Mosul, Iraq, sekitar tahun 1010. Ammar menulis Kitabul Muntakhab fi Ilajul Ayn dan banyak melakukan percobaan di Mesir. Buku Ammar banyak mengulas anatomi, ilmu penyakit, enam riwayat penyakit pasien untuk operasi katarak, dan kasus-kasus yang berhubungan dengan radang urat syaraf yang berhubungan dengan mata.

Hirschberg mengungkapkan bahwa Ammar adalah ahli bedah mata paling cerdas dalam literatur Arab. Dalam kitabnya Ammar mengulas sekitar 48 jenis penyakit mata. Naskah kitabnya pertama kali ditemukan di Escorial Library, sebuah perpustakaan di Madrid, Spanyol. Meskipun lebih pendek daripada kitab Tadzikiratul karya Ali bin Isa, kitab karya Ammar berisi hasil-hasil pengamatan asli. Sampai abad ke-20, karya Ammar hanya terdapat dalam bahasa Arab dan sebuah terjemahan dalam bahasa Ibrani oleh Nathan Jew pada abad ke-13. Ammar adalah penemu metode operasi katarak dengan metode pengisapan menggunakan sebuah jarum cekung yang disisipkan melalui limbus, tempat bertemunya kornea dan selaput mata. Hingga hari ini, metode temuan Ammar ini masih dipakai.

Zarrindast Tangan Emas

Abu Ruh Muhammad bin Mansur Abdullah, yang lebih dikenal dengan nama Al-Jurjani, seorang ahli bedah dari Persia kelahiran tahun 1088, menulis kitab Nurul A?yun. Zarrindast menulis karya-karyanya sepanjang pemerintahan Sultan Malikshah yang terdiri dari 10 bab. Di bab ketujuh dia menguraikan sekitar 30 jenis penyakit mata yang mencakup 3 jenis operasi katarak. Ia juga mendalami anatomi dan ilmu faal mata. Sebuah bab dalam kitabnya membahas penyakit mata seperti katarak, trakhom (trachoma), skeral (sclera), dan korneal(corneal).

Al-Ghafiqi

Muhammad ibn Qassoum ibn Aslam Al-Ghafiqi (wafat tahun 1165) berasal dari Spanyol. Ia menulis kitab Al-Murshid fil Kuhl. Al-Ghafiqi banyak merujuk kepada karya Ammar bin Ali Al-Mosuli tetapi lebih menekankan penelitian pada jaringan otak yang berhubungan dengan mata. Masyarakat Cordoba sangat menghormati Al-Ghafiqi. Hingga kini nama Al-Ghafiqi terukir di rumah sakit di Cordoba, yang dipakai sebagai cara untuk mengenang jasa-jasa ilmuwan tersebut.

Ibnu Haitam

Dilahirkan pada tahun 965, Ibnu Haitam adalah orang pertama yang menjelaskan bahwa semua penglihatan mungkin terjadi karena sinar refraksi cahaya. Penemuan Ibnu Haitam dikembangkan dan disebarluaskan oleh ilmuwan Persia, Kamaluddin (wafat tahun 1320) yang banyak mengamati alur dari sinar cahaya di bagian dalam kaca dalam rangka menguji pembiasan dari cahaya matahari saat hujan menitis.

Kamaluddinlah orang yang pertama kali menjelaskan asal-usul gejala primer dan sekunder pelangi.




sumber: Majala Annida

http://arifperdana.wordpress.com/2007/11/20/penelitian-ilmuwan-islam-dalam-bidang-optalmologi/

IQ (eye queue) and EQ (ent queue)

Alhamdulillah written exam for Ophtal and ENt .....DONE! Leaving the hall with 1001 new knowledge and some % of satisfaction. After all, a human, he or she strives for something but the definite and ultimate outcomes are all Allah's job to decide. Alhamdulillah for that and hopefully me and friend will get good results....

Clinical exam would be more challenging. There is no other but master the skill.
Next schedule:

15 Dec 08: Long case ophtal at 1.00pm ( no quarantine for me...thank you Allah)
17 Dec 08:ENT Osce at 8.15am


with full of hope...with this....



with this....






and this....





as well as........






The main thing is IKHLAS..............seeking knowledge because of ALLAH.......

all the best!!!

Sunday 7 December 2008

Behind the scene (EarNoseThroat and Eye).

EID MUBARAK 10 Dzulhijjah 1429 H...
Alhamdulillah for has been given chance up to this stage ..23 years ? isn't it a bless for me and you?


schedule:

12th dec 08- MCQ for ophtalmology and ENT
venue: PMC library
07-12th dec 08-revision
Eiduladha ? In Penang......


All the best !!!