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!