Nuffnanger :-)

Saturday, August 8, 2009

6th Day of Elective

2day is Saturday, but we still go to Normah Hospital, but it's half day only. Reached Normah at about 9.25am, saw Dr. Kho performed flexiblescope. The patient was very nervous, complaint of dysphagia for 1-2 years, but on and off, he said the food can be swallowed, but he felt something stucked inside the throat. There are no cough, no epistaxis, ear and nose function normal. The doc investigated and found everything is normal and good, it's probably due to the stress the patient had, or what we called Psychosomatic Syndrome. We then got to see colonoscopy screening test. The woman's mum had colon cancer, so she came here to check for tje colon, the endoscope went in until ileocaecum valve, Doc found a quite big polyp (5mm)and took it out to be sent for laboratory testing. I went to Ophthalmology department and met Dr. Dennis Kong. Saw a diabetic patient with diabetic retinopathy. The patient suffered from macular hemorrhage at quite severe stage, need urgent laser surgery to prevent leakage, blockage or abnormal angiogenesis of the eye blood vessels.So for every diabetic patients, control your blood sugar level and get your eyes checked every year before it's too late!!! Common eye diseases including Glaucoma and cataract too..Learnt quite a lot from Dr. Kho today, a kid came with parents. He had epistaxis (nose bleed), the parents were so worried. Dr. Kho said in this case he is treating the parents, not the kid, lol! In children, epistaxis is very common, it's spontaneous, self-limiting and most probably caused by burst of vessels on near the nasal openings, so there is no serious problem, just need to know what to do when there is nose bleed, press on the correct position and tilt your head slightly downwards, press till the blood stops. Besides, we got to see NPC (Nasopharyngeal Carcinoma). Common signs we can see are cervical swelling, history of nose bleeding, unilateral conductive deafness, eustachian tube blocking with fluid in middle ear. How to differentiate it from parotid gland infection? By pressing on it, if your fingers can get in between the mandibular bone, then it's unlikely to be parotid gland infection, it will be NPC. We got to meet the case of hemorrhoids, phylloides tumour (mostly benign rarely malignant), hirsutism, polycystis ovarian syndrome and etc. Went back at 12.30pm today, wohoo!!!! Later will be going Damai Beach..


No OT today!!!

Lesson of the day:

Dr. Dennis Kong (Ophthalmologist) said:

In Medicine, History taking is very important, 70 % of the diagnosis comes from the history!!!!

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