Dec 3, 2014

few tips

fakta 1: shark bertulang rawan (chondrichthyes), bukan bertulang / bony-fish (osteichthyes)

fakta 2: hemoglobin tanpa oksigen berwarna biru gelap keunguan. maka warna kulit yang jelas kebiruan (sianosis) itu bukan tanda unik tapi tanda kelebihan hemoglobin atau kekurangan oksigen darah (contoh: gangguan fungsi pernapasan seperti hipoventilasi)

fakta 3: aseton dapat dilepas keluar melalui pernafasan (fruity odor breath) dan air kencing (fruity odor urine), maka nafas dan air kencing yang bau sedap itu bukan unik tapi kemungkinan tanda penyakit (contoh: kencing manis -biasanya type 1 DM- dengan komplikasi diabetic ketoacidosis)

fakta 4: tubuh mengambil masa beberapa saat untuk membetulkan kesan sistemik (termasuklah keseimbangan acid-base) akibat gangguan pernafasan, maka janganlah sering2 atau lama2 bermain dengan nafas (contoh: tak bernafas beberapa lama kemudian tarik nafas pendek, atau tarik dan hembus nafas cepat2 - yakni pemasukan O2 dan pengeluaran CO2 yang tidak seimbang) kerana ia dapat mengganggu kerja tubuh (tanpa kita sedar yang tubuh sedang bekerja keras membetulkan kesan main nafas tersebut)

-pada orang yang minum 2L air per hari-
fakta 5: jumlah air kencing per hari adalah sekitar 1-2% dari keseluruhan darah yang ditapis di ginjal. jumlah normal air kencing adalah sekitar 1-2L per hari (dapat naik atau turun tergantung dari berat badan, usia, pemasukan cairan).
Maka cubalah untuk tampung jumlah air kencing (hadkan pemasukan cairan 2L/hari) dan ukurlah jumlah air kencing untuk hari tersebut (24jam). Ia dapat mengukur sebagus mana fungsi ginjal (hanya kira2 kerana fungsi ginjal dipengaruhi banyak faktor seperti diet, aktiviti harian dll - sebab itu kalau pergi lab untuk ukur air kencing maka banyak syarat2nya, itu semua untuk mendapatkan hasil yang lebih baik mengenai fungsi ginjal)

fakta 6: range jumlah air kencing sekitar 1mL/berat badan (kg)/jam (contoh: berat badan 50kg, maka rata2 penghasilan air kencing adalah 50mL/jam).
Urinary bladder mula dirangsang bila terisi oleh sekitar 150mL air kencing (timbul rasa nak kencing tapi tak kuat) dan sangat dirangsang bila terisi sekitar 300-350mL air kencing (wajib kencing =). Maka logiknya kita akan kencing setiap 3-6 jam sekali, namun kerana biasanya urinary bladder tidak sepenuhnya dikosongkan (sisa kurang dari 50ml -refer merckmanuals- , atau mungkin sekitar 10mL-refer ncbi), maka interval buang air kecil mungkin sedikit berbeza (sesuai perangsangan pada 150mL atau pada 300mL).Maka kekerapan kencing kurang dari 2jam sekali atau lebih dari 6jam sekali kemungkinan menunjukkan masalah ginjal
(sekali lagi diingatkan, fungsi atau kerja ginjal dipengaruhi banyak faktor seperti aktiviti, luas permukaan tubuh, diet dll)

Namun jika dapat diukur jumlah air kencing 24 jam lebih bagus agar dapat diketahui fungsi ginjal.
*oliguri (jumlah urin lebih dari 100mL/24 jam tapi kurang dari 400ml/24jam ) - details kemungkinan penyebab refer emedicine
*anuri (jumlah urin kurang dari 100ml/24 jam, atau mungkin hampir atau tiada langsung pengeluaran urin ) - details kemungkinan penyebab dapat refer righdiagnosis

fakta 7: pada volume 150mL urinary bladder mula dirangsang tapi perangsangan tidak begitu kuat hingga kita dapat menahan kencing (dengan mengawal otot urethra eksterna) tetapi rasa kencing akan tidak dapat atau susah ditahan bila mencapai 300mL.

fakta 8: jika pengeluaran air kencing tidak normal, contoh tersekat-sekat, mulai keluar lambat , bercabang, dll itu semua menunjukkan kemungkinan adanya kelainan pada saluran kencing
(contoh: air kencing bercabang - kemungkinan ada kesan parut pada saluran kencing yang memecahkan pancaran urin kepada dua atau lebih arah)
(contoh: tersekat-sekat - kemungkinan adanya sumbatan hingga aliran pengeluaran air kencing terganggu)

Nov 2, 2014

sains dan agama

ini bukan nak bicarakan bagaimana nak harmonikan antara sains dan agama menurut aqal, tapi sekadar nak luahkan apa yang bermain di minda hasil fikiran terhadap nas dan kalam ulama dengan sains

1) frekuensi bunyi: antara manusia, haiwan dan alam kubur
Dari Aisyah Radhiallahu ‘anha, ia berkata: Suatu ketika ada dua orang tua dari kalangan Yahudi di Madinah datang kepadaku. Mereka berdua berkata kepadaku bahwa orang yang sudah mati diadzab di dalam kubur mereka. Aku pun mengingkarinya dan tidak mempercayainya. Kemudian mereka berdua keluar. Lalu Nabi shallallahu’alaihi wa sallam datang menemuiku. Maka aku pun menceritakan apa yang dikatakan dua orang Yahudi tadi kepada beliau. Beliau lalu bersabda: ‘Mereka berdua benar, orang yang sudah mati akan diadzab dan semua binatang ternak dapat mendengar suara adzab tersebut’. Dan aku pun melihat beliau senantiasa berlindung dari adzab kubur setiap selesai shalat” (HR. Bukhari 6005)

2)  dua dunia: antara teori wormhole dan hari kebangkitan (qtafsir, eramuslim)
namun hubungan ini tidak kuat sebab dinyatakan dalam al-Qur'an bahwa di bumi baru tersebut (as-sahirah) gunung2 diratakan sehingga terlihat rata atau plain. Maka kemungkinan besar masih tetap di bumi sama tetapi diperbaharui oleh Allah setelah kejadian kiamat

3) patogen dan larangan agama
contoh larangan makan dalam bekas emas dan perak
Sesiapa minum dalam bekas perak sesungguhnya dia menuangkan dalam perutnya api Jahannam.
Direkod oleh Bukhari (no: 5311) dan Muslim (no: 2065).

juga kalam makna umum dari kalimah syaitan adalah sifat yang membawa keburukan. Sifat sebegini turut ada pada selain manusia dan jin (surah an-nas) termasuk kuman (microscopic pathogens) dan benda2 merosakkan seperti arak (dikategorikan khaba-is)


4)  dimensi alam: antara teori dimensi berbeza dan alam ghaib
perbezaan antara dimensi alam malakut dengan alam syahadah
termasuklah laju gerak malaikat yang dicipta dari nur
juga laju gerak jin yang dicipta dari api tanpa asap
juga laju manusia yang dicipta dari pelbagai unsur tanah
kepelbagaian unsur ini menimbulkan perbezaan2 fizikal

namun ini juga tidak cukup kuat untuk dipastikan kerana ia berkait perkara ghaib yang tidak boleh kita sabitkan kecuali dengan dalil naqli

namun, apa pun, prinsip penting agama tidak boleh kita pisahkan tiga unsur utama yaitu mentauhidkan dan mentaukidkan tauhidkan Allah, mempelajari dan memahami hukum hakam dan cara beramal, dan ketiga adalah prinsip akhlaq, adab, tafakkur dan hikmah beramal dan mematuhi hukum hakam syariat. Apa yang ditemukan sains, ia bersifat datang kemudian dari dalil naqli maka sewajarnya kita hanya menerima dalil aqli yang tidak mencanggahi dalil naqli (macam konsep teori dan law dalam kajian sains, law sifatnya tetap dan hanya berubah konteks seperti keumuman hukum gerak Newton (Newton laws of motion) dikhususkan dengan adanya hukum fizik quantum,  tetapi teori sifatnya masih diperdebatkan)

kalau ada yang lain yang aku terfikir, insyaAllah aku update~

Nov 1, 2014

Derma buah pinggang

Hyperfiltration during pregnancy or in humans born with one kidney or who lose one to trauma or transplantation generally produces NO ill consequences.

By contrast, humans who have persistent injury that destroys a comparable amount of renal tissue, progress to end-stage disease.

Clearly, there is a critical amount of primary nephron loss that produces maladaptive deterioration in remaining nephrons (renal progression). The pathologic correlate of renal progression is the relentless advance of tubular atrophy and tissue fibrosis.

The mechanism for this maladaptive response (renal progression) is the focus of intense investigation

-Hypothesis (first step): persistent glomerular injury produces local hypertension in capillary tufts, increases their single-nephron glomerular filtration rate (GFR) and engenders protein leak into tubular fluid

(source: Harrison's principles of internal medicine, page 2289)

Jadi, janganlah takut untuk derma buah pinggang =)

Oct 7, 2014

Ginjal

Ginjal adalah salah satu organ tubuh yang penting

Ginjal mempunyai beberapa fungsi penting antaranya:
  1. Memelihara keseimbangan air dan elektrolit
  2. Memelihara tekanan arteri
  3. Glukoneogenesis
  4. Memelihara keseimbangan asid dan basa (acid & base)
  5. Mengekskresi bahan toksik dan produk hasil metabolisme
  6. Berperan dalam eritropoesis
Fungsi ginjal dalam memelihara keseimbangan air dan elektrolit adalah melalui pengaturan sekresi dan reabsorbsi air dan elektrolit terutamanya natrium (Na+). Elektrolit lainnya yang turut diekskresi antaranya adalah magnesium, kalium, fosfat dan kalsium. Fungsi ini tergantung kepada sejauhmana kemampuan ginjal mengekskresi zat2 tersebut per minit. Dan ini penting diketahui kerana keseimbangan antara asupan atau pemasukan zat dan ekskresi zat harus dipertahankan supaya tidak terjadi kerosakan ginjal akibat bebanan kerja berlebihan yang berterusan yang terpaksa dilakukan oleh ginjal. 

Fungsi ginjal dalam memelihara tekanan arteri adalah melalui fungsi keseimbangan cairan dan elektrolit, juga melalui fungsi pelepasan hormon renin.

Keseimbangan asam basa (acid-base) dipertahankan secara bersama dengan fungsi paru melalui ekspirasi. Hidrogen disingkirkan melalui fungsi ginjal dan paru bagi mengelakkan asidosis dan dipertahankan bagi mengelakkan alkalosis. Pengaturannya sesuai keperluan fisiologi tubuh.

Bahan toksik dan produk hasil metabolisme turut diekskresi oleh ginjal, antaranya hasil metabolisme ubat2an, hasil metabolisme asam nukleik dan asam amino, hasil pemecahan sel darah merah (bilirubin). Fungsi ekskresi ini dipengaruhi keperluan tubuh terhadap bahan2 tersebut. Jika berlebihan, ia dibuang.

Ginjal juga berperan dalam eritropoeisis atau proses pembentukan sel eritrosit atau sel darah merah melalui penghasilan eritropoeitin. Eritropoetin adalah hormon yang mengawal eritropoesis.

Feb 22, 2014

Kalam Omar Kasule

copy pasted from omarkasule
ISLAMIC MEDICAL EDUCATION RESOURCES-04
0709-Towards a Motivated Medical Student
Presented to freshmen students of the Faculty of Medicine Indonesia Islamic University Yogyakarta, Indonesia on Friday 7th September 2007 by Professor Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) Professor of Epidemiology and Islamic Medicine University of Brunei Darussalam and Visiting Professor of Epidemiology University of Malaya WEB: http://omarkasule.tripod.com

1.1 MOTIVATION TO CHOOSE A CAREER IN MEDICINE:
What motivates students to enter medical school will affect their commitment to practice of good medicine. Medicine is a vocation and success in it requires special aptitude and motivation. Two processes are going on. Schools and society form the character of the student and knowledge base pre-medical school. During medical school and after graduation, there are influences from the profession and from colleagues that affect the physician’s motivation. The motivating factors range from the idealistic to the pragmatic material rewards. It is difficult to undertake a valid survey research of the reasons for choosing a medical career. Many students will consciously or unconsciously talk about altruistic motivation. The real motivators may be prestige, status, family/peer pressure, and expectation of material rewards. Students are idealistic on entry into medical school. They talk about studying medicine to become physicians and serve the community. Towards the end of their education, many students talk about benefiting from their education to find a job, enjoy easy life and have a high social status.

1.2 MOTIVATION PRE-MEDICAL SCHOOL:
Choice of a medical career fulfils a communal obligation, fardh kifayat. In some cases it may be an individual obligation, fard ‘ayn, where there is no other physician in the community. Families and communities should encourage children to enter the medical profession where there is a shortage of medical manpower. Imaam al Shafie underlined the importance of medicine when he said: ‘I know of no discipline of knowledge after knowing the halaland the haram that is more noble than medicine. He regretted the monopoly of medicine by people of the book[i]when he said that that Muslims lost one third of all knowledge and left it to the Jews and Christians that Muslims lost one third of all knowledge and left it to the Jews and Christians. Students should be taught that study of medicine contributes to preparing the ummah’s strength, i’idaad al quwwat[ii] and restoring Muslim dignity[iii]

1.3 MOTIVATION DURING THE MEDICAL SCHOOL:
Including Islamic values in the medical curriculum will motivate students towards excellence. Including Islamic values in the curriculum inculcates in students the culture of service and putting the public good before personal interests.

1.4 MOTIVATION AFTER MEDICAL SCHOOL:
The following Islamic concepts are motivating for the physician: the search for excellence, ihsaan[iv] and bearing witness against other communities[v], good deeds, and fulfilling amanat This implies that this ummat must lead the destiny of humanity and its members must excel in work as befits leaders who must set the example for others. Good work, ‘amal salih, is the basis for all human endeavors by a Muslim.

1.5 FINANCIAL COMPENSATION
The physician working in a materialistic society is torn between contradictory forces of greed and service. Service should have the higher priority but the material rights and privileges of the physician should not be forgotten because he also wants to live a happy life. The prophet talked a lot about payment of the physician. The physician fee should be fixed and known in advance. The prophet paid the cupper who operated on him[vi]. The physician fee must be known in advance according to the general principle, idha istajarta ajiiran fa a’alimuhu ajrahu[vii]. It is a sin to fail to agree on a fee for service in advance, ‘uqubat man lam yufi al ajiir ajrahu[viii].

2.0 EARLY MUSLIM PHYSICIANS AS MODELS OF MOTIVATION
2.1 IMPORTANCE OF ROLE MODELS
The student should be taught about the Islamic heritage in medicine as a motivator for excellence. There are several good books about these physicians such as ‘Uyuun al anbau fi tabaqaat al atibba by Ibn Abi Usaibat in the 7thcentury of hijra. The model of the earlier physicians is inspiring to the young ones. They were encyclopedic and all-rounded in their knowledge. They would lead prayers in the mosque, go and research on medicine, and may be return to teach Qur’an. The main lesson for the young student is that the ancient Muslim physicians were able to excel while they maintained their Islamic identity. Islam is not incompatible with excellence in science or medicine. There are several accounts of achievements by early Muslim medicine written by Muslims and non-Muslims. The Muslims may overstate while the non-Muslims may understate and in-between lies the truth. Early Muslim physicians excelled in several medical fields.

2.2 PHYSICIANS OF THE 3rd CENTURY H
Abubakr Muhammad Bin Zakariyyah Al Razi (251-313H/865-923 CE), a Persian and a student of al Tabari, wrote more than 100 books the most famous being al Hawi al Kabir (in full ‘al Haawi fi Sina’at al Tibb) in 30 volumes. It was translated into Latin and reprinted many times in Europe. His other books were: al Mansuuri andTibb al Ruuh. He was interested in chemistry and is said to have prepared absolute alcohol from fermented sugar. He invented a scale for measuring specific gravity. He made detailed clinical observations. He described smallpox. He investigated women’s diseases, obstetrics, hereditary diseases, eye diseases, small pox, and measles. He discovered surgical sutures. He used anesthetics. He used ammonia to control diarrhea. He considered psychological factors in the treatment of disease. He was director of hospitals in Baghdad and his native land in Rayy.

2.3 PHYSICIANS OF THE 4th CENTURY
Al Shaikh al Rais Abu Ali Al Hussain Bin Abdillah Bin al Hassan Ibn Sina (370-428 H / 980 – 1037 N) wrote many books the most famous being al Qanuun fi al Tibb, a 14-volume encyclopedia on disease classification and causes, therapeutics, simple and compound medicines, hygiene, and functions of the body. The book was translated into Latin and had a major impact on western medicine being taught until the 18th century CE. Ibn Sina recognized that TB was contagious. He accurately described the symptoms of diabetes mellitus. He discovered ancylostoma. Besides medicine, Ibn Sina made contributions to science, mathematics, chemistry, and philosophy.

Abu Al Qasim Khalaf Bin Abbas Al Zahrawi (b. 912 N, d. 404 AH/1013 N) practiced medicine in Qurtuba in the reign of the Omayyad Khalifat Abdurahman the Third who ruled 912-961 N. His fields of interest were: surgery, pharmacology, and anatomy. He designed over 200 surgical instruments. His book Kitaab al tasriif liman 'Zajaza 'an Ta'liif  became a standard textbook of surgery. His other writings were Risala fi Tafdhil al ‘Asal ‘ala al Sukkar, Tadhkirat fi al Dawaa al Mushil [first medical encyclopedia in Andalusia], Maqala fi ‘ilal al Kula, Risalat fi al Baras, Kitaab al Iqtisad fi Islahi al Anfus wa al Jasad, Kitab al Aghdhiyat wa al Adwiyat, Kitaab al Jami fi al Ashribat wa ‘ilm al Ajinnat, Kitaab al Zina, Kitaab al Qaanuun al Muqtadab, Kitaab Mukhtasar Hilt al Bur li Jalinus. Al Zahrawi was an expert in cancer surgery and tooth extraction.

2.4 PHYSICIANS OF THE 5th CENTURY H
Ibn Zuhr produced 6 consecutive generations of famous physicians the most famous being Abu Marwan Abdu Al Malik Ibn Zuhr (b. 1091 or 1094 N d.487H / 1162 N), a contemporary of Ibn Rushd, who lived in Andalusia andMorocco. His main book was al Taysir whose full title is Kitaab al Taysiir fi al Mudaawat wa al Tadbiirtranslated into Latin and used in Europe.

2.5 6th CENTURY ONWARDS
Abu Al Waliid Muhammad Ibn Rushd (B. 1126 N d.  595 H / 1198 N) lived in Qurtuba in Andalusia. He was interested in philosophy and also practiced medicine medicine. He wrote a medical work called al Kulliyattranslated in Europe. He made the observation that smallpox infected only once.

Alau Al Ddiin Abu Al Hasan Bin Abu Al Hazim Al Qurashi Al Dimashqi Ibn Al Nafees (d. 686H / 1288 CE) was born in Syria but practiced in Cairo. He described blood circulation before William Harvey but this was not noticed in Europe. He authored sharh tashriih al qanuun in which he explained pulmonary circulation.


[i] (Al Suyuti)
[ii] (8:60)
[iii]  (5:54, 63:8)
[iv] (2:185, 3:134, 3:148, 4:40, 5:85, 6:160, 7:50, 10:26, 11:115, 13:22, 16:30, 16:90, 16:96-97, 16:128, 17:53, 22:37, 23:96, 27:89, 28:77, 29:69, 39:10, 41:34-35, 42:23, 51:15-19, 53:31-32, 55:60, 57:11, 57:18, 64:17)
[v] (2:143, 3:140, 4:69, 22:78, 39:69)
[vi] (Bukhari K34 B39)
[vii] (Nisai K35 B44, Zaid 654)
[viii] (Bukhari K37 B10, Ibn Majah K16 B4)

Change

bismilLahirRahmanirRahim

hopefully dapat ubah blog ini kepada blog perubatan dan kesihatan, either perubatan tradisional, kontemporari, moden, islam dll which yang aku tahu mengenainya

just wanna share opinion and knowledge =)

moga AlLah permudahkan =)

Jan 18, 2014

W.H.Y

bismilLahirRahmanirRahim

We are here, in this temporary world for a few reasons

And me, choosing this path (medical sciences) also for a few reasons

But..it hurts when suddenly you lost all the answers to the WHY

Even you have motivation but it wont be enough to push you through

The only why left is of surah al-mu'minoon about mu'min, they dont break their promises

And me? hoping to not break the promises made..

But it hurts knowing you have lost all the why's..

Feel part of the true meaning of 3ajal, 3ajalah, isti3jal


Human, we live to fulfil the why with how after knowing who

But, when the why isnt there..what to fulfil..lost in the jungle..