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"

adik baru?

comel kan <3

pening? berpusing2....?

headache, spinning, giddiness, imbalance, is a common symptom yang orang selalu cakap.. belum lg yg rasa loya, muntah.. ish.. of course la burden yang paling best... kadang2 ada lagi best, symptom2 tu hanya jadi bila kita pusing kat 1 posisi. contohnya, mcm mendongak ke,,, toleh kiri or kanan...atau mana2 la.....


vertigo...
is a symptoms that usually arise due to vestibular dysfunction. the vestibular organs is semicircular canal, utricle and saccule that house in our ear. an impairment can cause imbalance that varied in degree of severity, and usually associate with nausea and vomitting..

pernah rasa mabuk laut? mabuk jalan?? pening.. berpusing?? serius kan?? nak jalan pun tak boleh.. nak lari laju2 pun terhuyung hayang..

common symptom.. yang nampak remeh.. tapi.. sangat menyakitkan..

usually, vertigo ni.. yg tahap severe.. yang merumitkan hidup patient, doctor usually akan prescribe betaserc, untuk control symptom2 tu.. tapi tula.. sbb vestibular system ni systemnya rumit.. n takde direct measurement yang dapat dilakukan untuk objectively detect mana part yang damage..

that's why, even kat m'sia.. vestibular problem ni selalu di pandang sepi.. sbb takde kepakaran.. sbb takde modal.. it's a huge area which demand highly specialty... yang aku taw.. Hospital serdang merupakan hospital yg dipilih untuk vestibular system.. tp, so far.. takde lagi rasanya exact test yang asses vestibular function
(even ENT.. busy la.. ) 

main professional which can asses this system, is actually audiologist.. there is many assessment that we learned theoretically, but then there's limit practical where we can actually used it. HUSM practically had "klinik pening" which specialized for those who having vestibular problem. my university also had started to do so.

VEMP, Caloric testing, Rotational Chair, ENG/VNG, is actually the test that can detect dysfunction indirectly, by measuring the nystagmus of the eye. but then, by comparing with multiple test, we can specifically specify which organ is impaired...


ps: kerja nanti,, nak bukak klinik pening jugak..~~~

references:
http://en.wikipedia.org/wiki/Vertigo

kuning??? merah?? aku pilih..

'only politicians see the grass is greener on HIS side!'

jadi... saya nak duduk atas pagar.. tuntutan demonstrasi ni berasas.. tp, cara dan medium usaha mencemar nama negara, amannye... harmoninya malaysia...tak releven kot guna reformasi.. kita kan negara merdeka.. yg ada kerajaanya.. nk gulingkan kerajaan tetiba.. and nak jatuhkan kepala malaysia.. mcm tak best plak aku pkay..


melayu dan islam berbeza kan. pkay melayu.. emosi.. pkay islam.. simbolik perpaduan itu kan.. berbeza gerak kerja sebenarnya.. aku sayang Malaysia..kita tggu jer pilihan raya nanti.. suarakan demonstrasi korang tu... demokrasi, revolusi dan reformasi tu kan....

kadang2 aku pk... buat perhimpunan time cuti semester.. mesti almost yg berhimpun tu mahasiswa.. sedey kan... wehla.. kerajaan bg ptptn, jpa... belajar.. majukan negara.. tak aku nafikan yg suara mahasiswa ni, besar.. kuat dan lantang andai bersatu.. tp,, pkay smart sikit okay kan... banyak cara lain kot,,, korang belajar la pandai2.. tinggi melangit.. pastu, masuk politik.. fight jadi perdana menteri.. apa yang susah.. buat negara sendiri sudahh....

aku ni anak pesara tentera.. daging2 dalam badan ni, aku rasa semua duit kerajaan.. buku teks dulu.. free je aku dpat.. kerajaan jugak yang bantu.. sekolah,, hospital.. ish.. aku rasa banyak baik.. dari buruk...

apahal yang waktu najib baru nak jadi gini.. baru sepenggal... kita tggu je pilihan raya nanti ye.. =)

apa 3 ingatan sulong Nabi Muhammad SAW sebaik saja tiba kat Madinah waktu hijrah baginda??

1) bersalam-salaman sesama manusia

2) infakkan harta

3) kerapkan qiyamulail..

bersalam-salaman kan teras perpaduan.. 

if u deaf n blind, then u lost connection with things and people..

 "the miracle worker"

it's a story of hellen Keller, with her teacher anne sullivan.. a deaf and blind child who having these impairment and lost communicating with the world. struggling to communicate, to express feeling, share thought and interest, this child is having emotional disturbance with anger explosion. but then, her family had lost hope and motivation to fight with their child life. when hellen throw tantrum and anger, her families gave a sweet to settle down the behavior. 

anne sullivan, a teacher also blind when she is small. she's is a best student in her university. hellen's mother seek helps from hellen's father friends, who actually an educator in that university. anne was sent as home educator, to teach hellen.

hellen who was pre-lingual deaf and blind child, had no exposure on verbal communication. thus, tactile mode of communicating is the only option that can give a help. anne helps to teach hellen on how to do so. the best part is how anne taught hellen to spell doll. it was the first word that she learned. 

this movie had taught me on how noble the field of an educator. patience, hope, motivation, soul, love and care is the important ingredient that helps. to teach and be thought, is 2 different things. each play different role. each play their own character. 

in my point of view, the movie gave a best paradigm to explain on the path that i will go in the future. it gave a best inspiration, passion and motivation to teach about life. who in this life belief on the capability of a deaf and blind child to learn and understand things? but this high motivation teacher belief in the faith that this child can be thought. 

banyak ilmu yang di dapati free2 dari movie ini.. kasih ibu.. kasih guru.. abang.. ayah... percaya untuk berjaya.. impian.. semua2 lah.... best!! tak rugi tengok.... 

sayangnyer... cd tak available kat m'sia.. ni pun supervisor bg tgk, sbb kawan dia beli kat UK... 

perlu suh Nor bazlinda balik uk belikan satu

hearing aid itu... analog

assalamualaikum wbt..
seperti tertera di atas, dan kita sedia maklum, yang hearing aids masa kini, semuanya digital.. dah takde dah org pakai hearing aid analog,yang zaman tok adam dulu... guna skrudreba kot nak adjust... orang kata,, barang lama.. heheh.. tp, bulan praktikal di hospital serdang yg lalu.. aku jumpa seorg patient 3 tahun, yang pakai hearing aid jenis analog.. yang lagi best.. bone vibrator body worn hearing aids...

harus tak terkejut aku???? selalunya jumpa semua digital.. nak check,, buat 6 ling sound.. check pakai stetoclip.. paling muudah.. bg aku la.... ni, dpat body worn aid, bone vibrtor plak tu,, aku nak test cammaner??? bateri?? 2AA kot,, bateri tester tu pun.. muat kerr?? pening.. gabra...  semua ada beb.. takut woi.. takut....

patient plak... dah takut + terkejut tgk HA dia,, agak2.. patient cammane yg pakai hA tok adam ni?? harusla those yg takde lubang telinga, or cuping teling yang kecik tetapi, organ pendengarannya masih sihat... sapa2 yg ada masalah recurrent infection pun boleh pakai kan.. lagi saper.. blur2...

patient aku?? atresia + microtia... telinga yg atresia sebelah,, microtia lg sebelah.. telinga atresia tu je yg cochlea nye OK.. yg microtia.. rosak... sbb aku jd cm excited,, teruja gila nak check patient cmani kan.. so aku sibuk la nak tgk tlinga dia.. takkan la aku nak tanya mak dia.. "mcik,, telinga mana yg cacat,,?? yg mana ada lubang?" cm tak bgus kan.. so aku tgk sendiri... kira belagak la.. hahahaha... tp salah aku kot, sbb tak nak baca case report dia yang mmg sah2 tulis pasal citer masalah yg dia ada... tak cukup experience kot.. hehhe..

patient ni dh pakai BC vibrtor tu, since 1 years old.. tp, since skrg dia dah lasak.. dah taknak pakai.. sbb seyesly, HA itu bulky.. n berselirat gila ngan wayar2.. feeedback pun giler.. asal gerak,, mesti ada feedback.. jdnye.. dia malas dh la nak pakai.. yg aku tgk.. parents pun cam dah hilang hopes ngan device.. tp,, yg bagusnya.. dia ada speech... bia pun sikit.. tp ada.. benefit of early intervention kan??

aided play.. bila pakai Bone vibrator tu.. accordingly with speech spectrum.. kiranya cam tunjukkan yg patient dapat full benefit with amplification.. tp tula.. alat.. dh tak competent....

apa yang bagus?? semestinya pakai BAHA.. takpun,, boleh nak pakai BC aids,, tp pakai ngan headband.. ala, cm baby selalu pakai tu.. lebih selesa n ketat.. instead of pakai yg brand lama jenis cekak kan?

  ni la contoh bone vibrator aid yg budak ni pakai.. tp, ni jenis digital ni.. dia pakai body worn.. mksudnya signal processor mcm walkman yg dilekat kat badan

 ni BAHA (bone anchored ha)..instead of pakai vibrator,, dia masukkan directly a device yg dapat stimulate cochlear. yg kat luar, just a device, yg collect bunyi. aka microphone, yg hantar signal kat brg di dalam

yg paling murah.. ni la.. getah headband... comfort.. menarik.. budak2 mesti suka pakai.. hehehe

banyak lagi ilmu yang harus di belaja.. once kita rasa ilmu tu suma dalam buku, n lecture berejam.. kita dah silap...

budak perempuan itu.....

assalamualaikum.. wbt..
alhamdulillah internship dah selesai.. kini masa untuk mengasah segala ilmu yang dicurahkan...
satu kes yang terkesan sangat di hatiku, yang terjadi bulan lalu..

patient 2y.o/ gurl.. yang datang bersama ibu bapanya..
parent concern about their child hearing.. main complaint, speech delayed..
there's   no history of pregnancy problem, neither any related risk that can cause hearing problem.
mother claimed that her daughter can produce /ma/, once,  but then there's no progress of speech afterward.

history taking had been conducted. patient is healthy...

audiological finding

1. otoscopic examination : clear ear canal with intact tympanic membrane on both ear
2. tympanometry: Type A bilaterally; suggesting normal middle ear function
3. Play audiometry (HP): attempted, but then patient unable to comprehend the task. Bone vibrator had been used  to condition the patient, she can understand when the vibrator is  vibrating. but, when, the bone vibrator place, she unable to do so
4. acoustic refflex: absent reflexes, ipsilateral, bilaterally..
5. ABR ( diagnostic) : no present waves at 100 dBnHL on right, and present of wave V at 100 dBnHL at left ear
6. DPOAE: absent emission on both ear at all tested frequency

thus, the finding may suggest.. profound hearing loss bilaterally, which is sensorineural loss. bilaterally...

the findings, showed, why she unable to comprehend the behavioral assessment. she cant do well, because 1) inaudible conditioned level, 2) familiarization; with her hearing level, she cannot hear the normal conversation level.. up till 90 dBnHL.. she's  not familiar on how the sound are, and what they are..

macamana nak explain? kat parent?? oohh yes!! i do cry

in real world.. how can u not sympathize on others fate? a child, yang harapannyer, bila besar nanti.. yang nak jaga ibu bapa.. seyesly.. comel mute sgt.. sangat2... tp,, sapa taw, di sebalik itu.. ada rahmat yang tuhan ambil..

jadi hari ini,, ujian tunjukkan yang anak tuan/puan ada masalah pendengaran la.. jenis kekal yang melibatkan saraf.. pada tahap yang sangat teruk... bunyi2 sekeliling kita ni, semua dia tak dengar,, kalau org bercakap2 ni, level dia dlm 60, tp anak puan/tuan ada masalah,, yang kalau 100 baru boleh dengar.. jadi, ini adalah penyebab la kenapa dia lambat bercakap..sbb dia tak tahu bunyi tu cammane, n sbb tu dia tak tau camane nak kuarkan bunyi tu... tu je.. bila tgk ibu dia nangis?? tersedu sedan.... nak cakap lagi? tak pyh cakap.. aku dah baik punya nangis dah pastu.. 

option untuk intervention.. buat waktu dan tika ini,, adalah hearing aid.. harus secepatnya dipakaikan.. ini adalah perlu sbb 3 tahun pertama, adalah penting for acquistion of speech and language.. if then, there's no visual benefit.. cochlear implant can be the best option...

sympathy n empathy.. it's 2 different things.. professional? or been the human being?