banjir kilat

"Banjir, salahkan kerajaan. Orang buang anak, salahkan kerajaan. Lama-lama, diri sendiri sembelit pun salahkan kerajaan....."

jangan jadi mcm linda

ko yang terrbaik.. terbaik.. terbaik

hari ini.. hari yang dinanti,..

aku doa.. ko mampu berdiri..

biar berlari, seiring mendaki..

mengecapi, apa hajat di hati..

menggapai impian yang pasti..

agar esok.. dengan kaki sendiri..

engkau berdiri, mendabik diri..

ini usaha, keringat hati..

setiap kerah, tenaga hakiki..

berbanggala hati.. 

jangan terduduk sepi..

sbab setiap rezeki..

Tuhan yang Bagi..

Happy Birthday!!

aku doa.. ko dapat hadiah yang terbaik!

Jangan bangga sangat izat!

terduduk aku,,

dikala melihat itu..

aku hanya percaya satu..

yang aku mampu..

tapi terkadang,, diuji begitu..

aku malu..

kerna, tak pernah ku endah dulu..

bahawa, apa yang dimimpi, tak macam tu..

pilu.. pilu..

resah dihati, siapa yang tahu,,

harihari menunggu waktu..

tatkala ku lupa pada yang Satu..

lalu ujian mendatang, mengujiku..

nyata aku lupa, siapa penciptaku..

aku berpaling, dikala batu menuju..

meragui kasih, yang didamba itu..

Ampunkan aku ya Tuhanku..

aku malu padamu..

sungguh aku tak tipu..

kenapa kau uji hati yang baru..

tergoyah kaku... setiap pasakku..

ampunkan aku, tuhan yang satu..

dikala begitu..

baru ku tahu..

baru ku tahu apa dayaku..

yang tak mungkin mampu..

dan tak pernah mampu...

melawan takdirMu...

ps: dapat kurang dr 1/2 for final!!!!!!!

kisah remedy.. =)

Clinic: Low frequency SNHL

berdetap detup jantung.. bila dapat info yg kena remedy klinik

konfius, down, demotivated, confident totally crush.. n so.. n so..

each n every negative particles flow along my blood

but the gud things.. I already at home... dapat tgk muka ibu.. cium tangan abah.. riuh riang gembira adik2.. its nourishing! terisi jiwa, terubat luka...and yes,, hidup aku.. hnya ada keluarga...

itu cerita lain.. 

perihal kisah ini...

Case History:

56/ Male, came with complaint about ear pain at both ear, when using cellphones. the problem only noted when using it. He had consumed multiple drugs for his multiple disease, such as hypertension, diabetes, GERD, prostate problem, and other.. no other related problems.

Audiological Findings

Otoscopic Examination: Clear EAC, TM intact, no collapsing ear canal

Tympanometry: Type A bilaterally

Acustic Reflex: showed left probe effect pattern

Pta: mild- moderate SNHL at Lf bilaterally..

Management:

ENT referral, for ear pain

Issues

Lf SNHL usually cause by what? in my head.. it is only Meniere's Disease. but, since im smart to notice that there're no other significant problems that usually related with this, i did not deliver to patient about it.. if i do so, i can cause misdiagnosis.. n so? jahanamla!!!

after a while, i do find out what are the other causes that can cause Lf SNHL? it may caused by 1) genetic mutation, 2) secondhand smokers........... 

and then.. i realize.... how my case, should be SIMPLE!!!!

Clinic : Unilateral Hearing Loss

Last week, its my practical exam, and i got Unilateral hearing loss cases

History

• 24/ Male
• alleged of hearing problem on left side
• started after MVA (early last year), doctor diagnosed hearing organ and nerve affected
• have balance problem
• left ear ringing sound, that occurred continuously
• no other significant problem related

Audiological Findings

• Otoscopic Examination: Clear EAC, with intact TM bilaterally
• Tympanometry : Type A bilaterally
• Acoustic Reflex: Tone effect pattern
• PTA : 
• Right : Mild SNHL
• Left : Profound SNHL

Management

• ABR ( SOL) - for Unilateral tinnitus, and Unilateral HL. Even if its above output limit of the ABR, this test can be done to check the consistencies, avoid functional HL.
• Tinnitus therapy : main goal is to achieve habituation. counselling is important
• Balance test: to check on the vestibular system. 
• Communication Strategies : to ensure patient able to be a competent comunicator
• ENT referral: for management ( 1- Unilateral HL --> even if the MVA can be the possible causes, to ruled out retrocochlear loss is important, 2- balance problem
• monitor hearing : since he have only one side hearing, its important to preserve his hearing. 

Issues encounter

1) Masking dilemma - undermasking likely to occur..

2) Change to insert phone, to reduce masking

3) BC start at poorer ear

4) vibrotactile respond - ensure with patient =)

and..... i get to remedial my clinic...

i not yet that competent =)

3rd semester

and.. this is a post after a Year,, i stopped wrote on it...

what a long year.. a semester.. perhaps..
i just finished my 3rd semester this year...!!

and yet.. need to remedy my clinics.. again!

turning 23rd

buat yang dilahirkan hari ini....
Selamat Hari Lahir...

terima kasih..

i.t.u s.a.h.a.j.a

okay.. homesick! titik...

 Selesai sudah cuti semester.. yang paling lama dalam hidup student.. 4 bulan weh.. untuk UIAMan la..=)
and finally.. the final date is coming closer.. dari 3,2,1, dan kosong.. hari itu hampir tiba..

macam2 la kenangan yang jadi.. selama 4 bulan ni..

 MEI 2011
Pratikal time... posting kat HTAA...yang best.. aku dapat kenal kawan2 sekelas yg se-posting dengan lebih dekat.. dapat belajar macam2.. belajar buat spagetti.. belajar makan bergembira.. tgk Nur Kasih.. belajar jalan kaki kat Kuantan ni.. meredah mydin, Kamdar.. sebab nak pergi ECM.. makan nasik lemak... tggu bas... meronda2 kat kuantan parade.. n yang paling best Cool Blog.. huhuhu

Macam2 jadi... ada hari guru...ada beday sendiri..n so.. n so... dapat belajar banyak.. sbb supervisor boleh ajar direct, hari2 posting,, 5 kali seminggu.. biarpun setengah hari... klinikal hur.... hmmmphh!! =) kaw2...

belum lagi yang tggu bas,, di bawah panahan matahari... duk kat tepi jalan.. menyumpah pak cik bas... kejar2 bas... aiiihh..... macam-macam....

Aku sedar.. yang,, tak payah berkepit dengan kawan sorang2.. tak tentu pun dia sahabat mati aku.. kawanla selagi ada yang nak kawan...

sebab.. if  kawan yang kita pegang tu tinggalkan kita..

kita akan sorang2.. sedih sorang....

semestinya takkan ku lupa pertolongan kawan2 n staff DASLP yang bantu aku dapatkan hostel untuk posting di bulan berikutnya.. =)

 JUN 2011
Bulan yang paling aku takutkan... berjauhan dengan keluarga dan rakan2.. n membawa nama UIA ke Hospital Serdang.

tak takut ke duduk sorang2? jaga diri sendiri.. tak kenal sape2? tak sure pun, if kita dpat tak buat yang terbaik, dgn tidak menghampakan harapan supervisor2? ibu bapa? menggelabah kot.. n aku tau.. mana2 kawan2 aku yg posting berseorangan... pasti rasa benda yang sama....

bila lain protokolnya.... "mcmni ke UIA ajar?"
bila salah tekniknya.. " UIA tak ajar ke?"
bila berbeza sikapnya.... " senior awak cakap lain"
bila berterabur diagnosisnya.... " Student *** boleh buat jauh lebih baik dr awak"

mana nak pertahan pendapat.. mengembang teori.. menjaga nama dan maruah.. semua tindak tanduk org lihat, dan bandingkan.. streess oooo...

tp.. aku syukur,,, dpt tempt di mana menjdi pusat pilihan 3 U audio.. supervisor aku dh supervise 3,3 Students dari U yang berbeza.. demand dia lain.. gred nak dicapai semua tinggi2.. n aku bersyukur.. dapat survive.. membawa sejuta pengalaman..

JULAI- SEPTEMBER
ibu...
 itu jer yang aku leh simpul...
cuti yang mendekatkan aku dgn ibu ku..
cuti yang mengajak aku bersama ibu..
membantu..
menjaga...
membersih...
mendreba kereta..

aku seronok.. dpt tolong ibu jaga meksu dan dani.. yang bertambah2 riuhnya..
aku seronok dpt tolong ibu.. jagakan Dani, agar ibu dpat pergi bertadarus di bulan Ramadhan..
aku seronok dpt tolong ibu menjaga, dan mengemas rumah..
aku seronok dapat tunaikan apa sahaja yang ibu pinta, dgn tulang 4 keratku..
aku seronok,, dapat jadi.. apa yang ibu doakan...
bawak ibu pusing satu manjung ni..
bawak ibu berterawikh di bulan Ramadhan..

dan... aku seronok.... sebab dapat selalu di sisi ibu.. di kala dia letih.. lelah dan penat...

peluang yang tak semua orang dapat..berbakti pada org tuanya.... aku syukur.. sbb dapat peluang tu.. peluang utk jaga ibu... untuk gembirakan ibu.. ringankan beban tugasnya... jaga makan pakainya... Alhamdulillah..... syukur tuhan!












mesti ati sangat rindukan IBU.. seyesly!! nak habis study cepat2... n keja rajin, agar dapat buat ibu.. always senyum!!!

now.. Bestie saya.. ni ha~~~
muka pun serupa kan? 
org kata, saya adik ibu.. sbb muka saya mmg tua pun... n ibu.. selalu nampak muda...


bia jauh t...
akan selalu telipon ibu ye... no worry~~~!!!

doakan ati...

Ati nak jadi yang halal untuk rahmat Allah, dan syurgaNya

mengimbau.. dulu...

semakin bertambah umur..
semakin terasa turunya keringat..
lemahnya semangat..
hilangnya kudrat.... (mood: tua)

sekarang ni dah start dah nak sakit-sakit badan.. sakit pinggang.. bunyi tulang ketuk ketak...
dah lama pakai rupanya badan ni..

suddenly.. waktu mengemas.. saya terpandang..
1 kotak... yang tersimpan kemas... hmm.. berhabuk dah..
bila bukak.. sedih tgk... banyak surat.

kertas itu kekuningan..
seiring dgn pertambahan umur.. hmm.. bila sehelai2 surat dibuka.. perasaan itu mengamit..
rasa yang dah lama takde..
rase yang dah lama aku lupa..
perasaan itu.. betul2 mencengakam hatiku...

ada rasa yang aku banggakan..
ada rasa yang aku kesalkan..
semuanya bercampur baur.. dan akhirnya.. semua itu..
rencah rempah.. yang menambah warna hidup aku....

banyak cerita yang tercoret di sini.. segala2 kisah zaman RPS aku.. n.. aku tak bole nafikan yang RPS adalah part hidup yang aku gembira.. mostly... kat sini.. aku belajar.. kawan.. hidup..
banyak cerita-cerita gembira.. yang seronok.. yang masih terletak kat kotak hidup aku.. tapi.. yang paling terkesan... adalah.. rasa menyesal itu... kesal yang merobek hidupku skrg...

banyak yang hilang... dan segalanya2 aku judikan utuk perasaan aku waktu itu.. alasan yang mudah,, adalah... semua orang suka disayang.. dan disayangi... dan itu. sangat-sangat meendidik aku..

tapi.. hari ini.. bila aku buka.. bait-bait kata..
aku sedar yang sebenarnya..
banyak yang aku buang... tanpa aku pernah teliti.. betapa..
semuanya berharga..!!

ni yang paling mahal ni... sapa ada lagi?

Saya Tahu Saya Tak Cantik | iluvislam.com + discover the beauty of islam

Saya Tahu Saya Tak Cantik | iluvislam.com + discover the beauty of islam

Anatomi : Telinga Tengah ( Bhg 2)

..... last entry, rasanya aku dh citer tentang anatomical features of middle ear.. jd hari ni, nak tambah sikit.. agar dapatla jugak ilmu ini menambah knowldege yang aku sedia ada.. memantapkan ilmu2 yang mungkin sikit banyak, aku dh lupa.. hope.. i get something beneficial jugak....

Kepentingan utama telinga tengah adalah untuk menguatkan bunyi. Dan organ yg paling berusaha kuat untuk menambah kekuatan bunyi adalah tulang-tulang oksikel. Tulang2 yang dimaksudkan adalah; 1) Malleus, 2) Incus dan 3) Stapes

for those yang tak tahu.. these were the smallest bones yang ada kat badan kita..

Tapi..

biar pun kecik.. tapi manfaatnya.. MasyaAllah... betulla apa org kata.... kecik2 cili padi.. lagi kecik.. pedas lebih lagi.. huhuhu....

As yang kita tahu.. terdapat prbezaan environment simboliknya di antara teling tengah dah telinga dalam.. Telinga dalam,, rumahnya dipenuhi air, dan telinga luar didiami udara. Jadi, terdapat perbezaan ketumpatan antara 2 medium ini.. Yang mana.. sekiranya bunyi disalurkan.. hanya 0.01% sahaja yang akan initaiate receptors of hearing. 99.9 % akan reflected back.. Jadi, ossciles, play an important role, to avoid impedance mismatch ni..

Tulang2 berikut membantu menguatkan bunyi yang disalurkan sebanyak lebih kurang 20dB.. Ada 3 mechanisme yang terjadi untuk penambahan bunyi2 ini.. Yang mana; 1) Area Ration, 2)  Lever Action and 3) Buckling Mechanism......

Ketiga2 mechanisme ni, berlaku pada frequencies 100Hz hingga 2kHz. 2kHz and above??? Outer ear yang akan tolong amplify..

......

‎"Biarkan orang lain menjalani kehidupan yang kecil, tetapi kamu jangan! 
Biarkan orang lain memperdebatkan soal-soal kecil, tetapi kamu jangan! 
Biarkan orang lain menangisik kepedihan-kepedihan kecil, tetapi kamu jangan! 
Biarkan orang lain menyerahkan masa depan mereka kepada orang lain, tetapi kamu jangan!" 

— Habiburrahman El Shirazy

"Adjustment is always better than Argument...

 A Meaningful silence is better

than meaningless words..."

... shh.... i'm talking!

Talking To The Moon 

I know you're somewhere out there
Somewhere far away
I want you back
I want you back
My neighbors think
I'm crazy
But they don't understand
You're all I have
You're all I have


Chorus:

At night when the stars
light up my room
I sit by myself

Talking to the Moon
Trying to get to You
In hopes you're on
the other side
Talking to me too
Or am I a fool
who sits alone
Talking to the moon

I'm feeling like I'm famous
The talk of the town
They say
I've gone mad
Yeah
I've gone mad
But they don't know
what I know

Cause when the
sun goes down
someone's talking back
Yeah
They're talking back

Chorus:

At night when the stars
light up my room
I sit by myself
Talking to the Moon
Trying to get to You
In hopes you're on
the other side
Talking to me too
Or am I a fool
who sits alone
Talking to the moon

Ahh Ahh,
Ahh Ahh,

Do you ever hear me calling?
Cause every night 
I'm talking to the moon
Still trying to get to you

In hopes you're on
the other side
Talking to me too
Or am I a fool
who sits alone
Talking to the moon

I know you're somewhere out there
Somewhere far away

liver transplant?

case study :
HISTORY
Patient 6 years old, female. She came with her father. Her father want to sent her daughter into special school, because he found out that her daughter had difficulty in understanding expressive language. She seems confused, and father want to fill in OKU form for her daughter.This child had history of liver transplant since she is 4 years old. Currently on medication, to avoid negative rejection from her body.

Agak-agak... apa masalah yang kita boleh noted?
 (1) Learning problem
 (2) On medication

AUDIOLOGICAL FINDINGS


No abnormality found out through otoscopic examination and tympanometry.
Play Audiometry  : mild to severe sensorineural hearing loss at high frequencies ( 2K : 55dB, 4K : 60 dB, 6K : 90dB)

Discussions
Earlier on testing, patient had difficulty in understanding the task of testing She seems confused, and cannot respond well in conditioned state. Tester had increase the intensity of the conditioned level up to 80 dB, but then, patient seems to show false-positive respond, by responding with guess. Instead of changing the task, tester had try to modify the test, by using lower frequency to condition, and she able to respond accordingly.

This child had showed a hearing loss that may replicate the condition of ototoxicity. Her hearing is dropping slowly, and yes, it damaging the high frequency far more earlier than the lower frequency. This is due to anatomic locations of the cochlear, and frequency selectivity that God create. The lower frequency is place in apex of the spiral, and this protecting this region.

Management?
The confusion and symptoms that this patient may reflected due to hearing loss that she had. It's hearing is slowing diminishing, and yet the important phonemes in understanding speech lying on the high frequency region. Thus the impaired cochlear that due to toxicity, can cause problems in understanding speech, discriminating words that had similar sounds, inaudibility of speech, and many more. The right management of the patient, is to adopt a hearing aids, that can helps in assisting during conversation. But then, special specification needs to be consider. The child had a near normal low frequencies threshold. We dont want to fit hearing aids that can increase the threshold of the better frequencies.

puasa kali ini

1 Ramadhan 1432H
kali ini...
tiada lagi waktu dimana pagi,
bangun ke kelas, sampai ke petang..


kali ini..
tiada lagi sahur, mengetuk pintu teman..
masak nasik.. minum milo.. makan kacang goreng merah..
ratah kurma... mcm takde dah makanan lain nak makan..


kali ini..
tiada lagi waktu..
di mana nak kena bawak keta g beli makanan..
berhimpit di trafik jam.. berbuka di padang..


kali ini..
takde lagi pilihan..
urm,, nak beli kat bazar mana? masjid ke? padang?


kali ini..
takde lagi nak kena on time beli popia..
borong air macam2.. semangat kuih tak hilang sama..


kali ini.. 
takde lagi nak semayang terawikh sama2..
mengejar takwa bersama...


semua dah takde.. 


dan semestinya.. yang hilang itu akan selalu kita kenang

1 Ramadan 1432H

May This Ramadan be as bright as ever.
May this Ramadan bring joy, health and wealth to you.

May the festival of lights brighten up you
and your near and dear ones lives.

May this Ramadan bring in u the most
brightest and choicest happiness and
love you have ever Wished for.

May this Ramadan bring you the
utmost in peace and prosperity.

May lights triumph over darkness.

May peace transcend the earth.

May the spirit of light illuminate the world.

May the light that we celebrate at Ramadan
show us the way and lead us together on the
path of peace and social harmony

Wish you a very happy Ramadan mubarak

1 Ramadhan 1432

saya teringat dekat awak

Sometimes I asked for strength but Allah gave me difficulties so that i will be stronger.

Sometimes I asked for wisdom but Allah gave me problems so that i could think the ways of solving them.

Sometimes I asked for prosperity but Allah gave me brain so that i could use it to become a successful Muslim.

Sometimes I asked for courage but Allah gave me dangers so that i could find the ways to overcome those obstacles.

Sometimes I asked for love but Allah gave me tears so that i could drop them when I see those orphans live without love.

Sometimes I received nothing that I wanted but Allah always gave me everything that I Need.

LA TAHZAN YA MUSLIMIN, INNALLAHAMAAKUM!

| Encik hati... |

We can win life by all means if we simply avoid two things in our lives;

"Comparing with others" and “Expecting from others".....

jd encik hati... tenang ye

nasal related disease - Nasopharyngeal Carcinoma (NPC)

NASOPHARYNGEAL CARCINOMA (NPC)  

NPC is most of common problems. it's a development of squamous cell in the pharynx cavity. usually the common symptom that patient had is middle ear effusion. other symptoms are neck mass, cranial nerve palsy, epistaxis, trimus and headache. the known risk factor that triggering NPC are genetic, diet, EBV, and environment. EBV is  "Epstein–Barr virus (EBV), also called human herpesvirus 4 (HHV-4), is a virus of the herpes family, which includes  herpes simplex virus1 and 2, and is one of the most common viruses in humans. It is best known as the cause of infectious mononucleosis. It is also associated with particular forms of cancer, particularly Hodgkin's lymphoma, Burkitt's lymphoma, nasopharyngeal carcinoma, and central nervous system lymphomas associated with HIV.^[1] Finally, there is evidence that infection with the virus is associated with a higher risk of certain autoimmune diseases, especially dermatomyositis^{[citation needed]}, systemic lupus erythematosus,^[2][3] rheumatoid arthritis,^[3] Sjögren's syndrome,^[3] and multiple sclerosis "(wikipedia)

NPC usually treated by surgery, chemotheraphy, and radiotheraphy.

 

in audiology perspective

as, an audiologist, NPC can cause recurrent infection that may lead to conductive loss to progress to sensorineural loss. usually, NPC will showed Type C tympanogram that may suggest ET dysfuction. the condition may showed little prognosis, even after surgery. patient who had NPC may had high risk to have facial palsy, tis is due to severe infection that may spread to the nerve. if patient go for chemotheraphy, the risk of cochlear damage is still there. outer hair cells in the cochlea which play a role in mobilize the basilar membrane, is more susceptible to damage. if the OHC is damage, the frequency selectivity and loudness perception is affected to. the electomotility of the OHC is important for a person to hear low intensity stimuli. this active mechanism is so much important that able to ensure the transmission of the stimuli to higher auditory function.the drug used for chemotheraphy also can cause ototoxicity. aminoglycoside that used as antibiotics to control the infection also is toxic for our ear. 

References:

1. http://en.wikipedia.org/wiki/Epstein-Barr_virus
2. http://en.wikipedia.org/wiki/Nasopharyngeal_carcinoma

buat awak yang jauh di mata..

 

 

"Distance isn't a big factor in a relationship. Communication is. But most of all, commitment is the biggest........."

 

 

5 tahun beb!!!!

"A great relationship is formed because of 2 reasons : First is to find out the similarities & second is to respect the differences.."

for the last 5 years...

thank you.. for always been beside me..

thank you, for the guidance and advice,

thank you, for your huge help and understanding..

thank you for your patience, love and care

it had been 5 years..

5 years of emotion, fight and relationship of

F.R.I.E.N.D.S.H.I.P

"Thanks to hated me, U made me a stronger person
To loved me, U made my heart grow fonder
To envied me, U made my self-esteem grow stronger
To cared, U made me feel important
To entered my life, U made me who I am today
To who left, U showed me that nothing lasts forever
Special Thanks to YOU ,to stayed, U' showed me the true meaning of Love & Friendship.....!!

biar jauh.. berbeza..
ko gemuk.. dan aku kurus..
ko tinggi dan aku.. ehm katik.
ko tetap yang teristimewa, yg tak dapat ditukar ganti..








5 tahun berlalu..
penuh suka duka, yang mewarna hidup kita,
andai dapat diputar masa
aku doa agar aku berperangai lebih baik
me"limit" maki dan keji..
yang sangat sebati dengan diri ini..
tapi, kau.. tetap disisi..
selalu menemani dikala sunyi..
selalu tersenyum menghilang sepi,
merangka hidup yg penuh onak dan duri..
berada disisi, sama berlari..
terima kasih. dari hati ini..

saat aku ketawa.. ko turut bergembira..

ketawa bersama, menghilang duka..

di saat sedih, air mata merintih..

air mataku turut. membuatkan dikau sedih..

hati yang perih.. sama di rintih..

terima kasih koko...

kiki says...

"sayang awak... amat2"