Be Careful with Other Person's Feeling

Those who just don't bother other person's feeling, at some other times will pay for that ............




So, as doctors, please bother............ otherwise your 'time' will come.

Insulin Glargine Alerts

July 1, 2009 — Three of 4 observational studies suggest an increased risk for cancer associated with use of insulin glargine (Lantus, sanofi-aventis), although these findings warrant further follow-up studies to confirm an association, according to the United States Food and Drug Administration (FDA).

The FDA is currently reviewing many sources of safety data for insulin glargine, including these newly published observational studies, according to an alert sent today from MedWatch, the FDA's safety information and adverse event reporting program.

The FDA currently is recommending that patients not stop taking insulin glargine without consulting a healthcare professional. No guidance regarding action to be taken by healthcare professionals has been issued.

Insulin glargine is approved to control blood glucose in patients with type 1 and type 2 diabetes.

The observational studies were published in the June 30 issue of Diabetologia,, the journal of the European Association for the Study of Diabetes (EASD). According to an EASD press release, one data analysis of 127,000 insulin-treated patients reported a statistically significant link between cancer and insulin glargine use compared with those using similar doses of human insulin. Among those receiving insulin glargine, there was an increase of 1 person with cancer for every 100 people receiving human insulin.

This study, conducted in Germany, also indicated a dose-dependent increase in cancer risk; 10 U of insulin glargine increased the risk by 9% whereas 50 U increased the risk by 31%.

As a result of these findings, studies were also conducted in databases from Sweden, Scotland, and the United Kingdom. The Swedish study found that compared with patients on other forms of insulin, patients receiving insulin glargine alone had a 2-fold increased risk for breast cancer. The Scottish study found a nonsignificant increased risk for breast cancer, whereas the UK study found no link between insulin glargine and any type of cancer.

According to the FDA, further studies are underway “to better understand the risk, if any, for cancer associated with use of [insulin glargine].”

Terkini tentang Selsema Ba... Ooops .. Influenza H1N1

Liow says it’s A(H1N1), Rais tells media to say ‘swine flu’

KUALA LUMPUR, June 25 – Shortly after Health Minister Liow Tiong Lai urged the media to use the term Influenza A(H1N1) as recommended by the the World Health Organisation, Information Communication and Culture Minister Datuk Seri Dr Rais Yatim said all media should return to using “swine flu” instead.

Rais said this was to ensure that the people realised the danger of the disease and to get the message across to them more accurately.

It is also easier for (radio and television) announcers to state “selsema babi” (swine flu) than H1N1 in Bahasa Melayu, he told reporters after an official visit to Pos Malaysia, here.

Rais also said that the ministry would monitor programmes broadcasting health-related advertisements to ensure that there was no confusion as to the accuracy of the message as well as the people’s understanding of swine flu/A(H1N1).

“We should not combine health-related matters with confusing advertisements," he said. – Bernama

Adequate frontliners to cope with H1N1 – Liow

KUALA LUMPUR, June 30 – Health Minister Datuk Seri Liow Tiong Lai said Malaysia is well prepared to handle the Influenza A(H1N1) outbreak as it has adequate medical frontliners to cope with the situation.

However, the public should not take the outbreak lightly as there was a possibility of the situation reaching “sustained local transmission”, meaning the source of infection being unknown, he said when winding up debate on a motion tabled by Dr Lee Boon Chye (PKR-Gopeng) on the flu in the Dewan Rakyat today.

“As such, we have to cooperate closely to fight the outbreak. The pandemic is here to stay and can be here for months. And we have to work together to fight it,” he said.

Liow also said Malaysia was still under the containment measure phase of the National Pandemic Preparedness Plan (NPPP), and had yet to go into the mitigation phase. “Everything is outlined in the NPPP. While there is local transmission, the disease is still under control because we know the source of infection and we are able to detect the patient. The contact point can still be traced,” he said.

Liow said if the swine flu reached the stage of sustained local transmission “we will have to close down most of the schools within the community and proceed with social distancing measures”.

He said that if the situation escalated to such a level, exit screening points in the infected community would be established even though it was not a recommendation of the World Health Organisation in handling the situation.

“We have tight control measures at all entry points. A health declaration form for all visitors. We have taken these measures because we are still able to. We are still at the containment measure stage.

“Singapore is in mitigation (stage), Indonesia and Thailand are undergoing an outbreak, they need mitigation.

“We are trying our level best; we try to contain the pandemic to ensure that it will not spread. Once there is an outbreak, we will go into mitigation measures,” he said.

From his observation, Liow said, in countries such as Indonesia and Thailand where the pandemic had forced the nations to activate their mitigation phase, it had been proven that the virus transmitted quickly through human interaction and travel, making it highly possible for Malaysia to reach such a stage as well.

Liow also said that the virus was capable of undergoing mutation, causing more difficulties in containment and making it very dangerous.

When questioned regarding the ministry’s capacity in ensuring the safety of official entry points, he firmly stated that health officers and surveillance teams had been deployed to all the 53 official entry and exit points throughout the country.

Regarding unobserved illegal entry points used by illegal immigrants to enter the country, Liow told the house that he had requested more cooperation and help from the police and the immigration to monitor the situation.

The minister once again stressed that H1N1 virus did not spread through the consumption of pork or pork products, but it was airborne and transmitted through human interaction.

Speaking to reporters at the Parliament lobby later, he said he would give a full briefing on the swine flu in the Dewan Rakyat on Thursday. – Bernama

Health Ministry denies over-reacting to A(H1N1)

PUTRAJAYA, June 30 – The Ministry of Health today denied that it was over-reacting in handling the Influenza A (H1N1), stressing that it was being proactive in preventing the disease from spreading wider domestically.

The Director-General of Health, Tan Sri Dr Mohd Ismail Merican said the measures taken by the ministry had proven to be successful, as the number of cases recorded daily was not many when compared to most of the other countries in the region, and no death had been recorded yet.

“There are people who claim that since this is a mild and moderate disease, we should relax and concentrate on dengue, but dengue is an ongoing battle and we will never run away from our fight against dengue.

“But at the same time, here we are dealing with a pandemic situation with quite a significant number of deaths around the world. We don’t want that situation to occur in Malaysia.

“It is better to do a bit more than to do less and run into problems at the end of the day,” he told reporters here today.

He was asked to comment on the opinion that the ministry is over-reacting in handling the issue, despite the disease being mild and moderate.

Dr Mohd Ismail said it was true that the disease was mild and moderate, “but it is highly contagious”.

“It is also true that we cannot anticipate the emergence of a new influenza virus and the coming of a second wave, so if we relax now and we don’t test our measures now, we may not be prepared for the next wave,” he said.

Dr Mohd Ismail said the proactive measures taken by the government was also one of the factors in ensuring that the tourists continued to come to this country, even though there were cases of Influenza A (H1N1). – Bernama

Kelebihan Bulan Rejab

Sedar dak sedar, kita dah masuk ke Bulan Rejab, di mana selepas ini adalah Bulan Sya'aban, dan seterusnya berjumpa semula dengan Bulan Ramadhan Al-Mubarak yang sememangnya ditunggu-tunggu oleh kita semua.

Bulan Rejab adalah bulan ke-7 dalam kiraan taqwim Hijriyyah. Bulan ini termasuk salah satu di antara bulan suci dan dinamakan sebagai bulan Allah.

Nabi Sallallahu 'alaihi wasallam bersabda bermaksud:"Bulan Rejab bulan Allah, bulan Syaaban bulanku, dan bulan Ramadhan bulan umatku."

Bulan Rejab juga dianggap bulan istimewa kerana pada bulan ini berlaku peristiwa Isra' dan Mikraj Nabi Muhammad Sallallahu `alaihi wasallam.

Di antara amalan yang baik diamalkan di bulan Rejab ialah puasa dan bersedekah. Banyak hadis-hadis Nabi Sallallahu `alaihi wasallam menyebutkan tentang kelebihan puasa di bulan Rejab.

Antaranya sebagaimana hadis yang diriwayatkan oleh At-Tabarani daripada Sa`id bin Abu Rashid bermaksud :

"Barangsiapa berpuasa sehari daripada bulan Rejab maka ia seperti berpuasa setahun, dan barangsiapa berpuasa daripadanya (bulan Rejab) tujuh hari, ditutup daripadanya pintu-pintu Jahannam (neraka), dan barangsiapa berpuasa daripadanya lapan hari, dibukakan baginya lapan pintu syurga, dan barangsiapa berpuasa daripadanya sepuluh hari, tidak meminta dia kepada Allah melainkan diberikannya, dan barangsiapa berpuasa daripadanya lima belas hari, menyeru orang yang menyeru dari langit : " Sesungguhnya diampunkan bagimu dosa-dosa yang lalu maka mulakanlah amal", dan barangsiapa menambah (hari puasa), Allah menambahnya (kelebihan). "

Dalam hadis yang lain telah dikeluarkan oleh al-Khallal, daripada Abu Sa`id (secara marfu') bermaksud:

"Bulan Rejab adalah di antara bulan-bulan haram, hari-hari di dalamnya ada tertulis di pintu-pintu langit yang keenam, maka apabila seseorang berpuasa sehari daripadanya (bulan Rejab) dan menyempurnakan puasanya dengan penuh ketaqwaan kepada Allah, bercakaplah pintu dan hari tersebut seraya berkata: "Tuhan ampunkan baginya (dosanya)" dan jika dia tidak menyempurnakan puasanya dengan ketaqwaan kepada Allah, maka pintu dan hari itu tidak akan memohonkan ampun baginya, dan dikatakan padanya: "Kau telah ditipu oleh dirimu."

Oleh itu marilah memperbanyakkan amalan yang baik di bulan Rejab ini, bulan terbukanya pintu langit dan terbukanya pintu syurga. Sama-samalah kita merebut peluang ini dan semoga amalan kita akan diterima oleh Allah Subhanahu Wata'ala.

Sejukkan Hati

Baca dan dengarlah Al-Quran, nescaya hatimu kan tenang ...................

Wow...wow.....boleh claim rupanya

Kelayakan Tuntutan Perjalanan Masa Oncall

Hari ini kami semua menerima surat dari Bahagian Kewangan KKM menerangkan tentang ke'bolehtuntut'an elaun perjalanan to and fro semasa oncall. Surat yg panjang lebar itu dapatlah kami simpulkan bahawa :-

1. Oncall atau kerja lebih masa - extension dari waktu pejabat i.e. tiada perjalanan pergi / balik adalah TIDAK LAYAK CLAIM
2. Oncall Pasif atau aktif masa Cuti - perjalanan pergi balik LAYAK CLAIM
3. Jika diarah datang ke tempat kerja (walau tak berjadual) hari kerja @ cuti - LAYAK CLAIM tapi perlu Akuan Ketua Jabatan
4. Kelayakan tuntutan hanya untuk maksima 33 km sahaja sekali perjalanan (boleh lebih satu perjalanan sehari jika perlu)
5. Tuntutan dibuat mengikut jenis kenderaan yang biasa digunakan setiap hari semasa bekerja. Jika menggunakan teksi - hendaklah beri alasan yang munasabah, dan beserta buktinya seperti resit bayaran.
6. Semua tuntutan hendaklah melalui ketua jabatan (perlu akuan)

Tarikh berkuatkuasa hal-hal tuntutan perjalanan di atas 20 MEI 2009.


Harap INFO ini dapat membantu semua especially para doktor yg tak kesah sangat tentang hal-hal sebegini.

CME (28/06/09)

Today's afternoon mortality discussion was about a 57 year old woman with diagnosis of ESRF admitted electively for IJC insertion. She was well and asymptomatic. Right IJC was inserted on the next morning (after procedure explanation given and consent taken). However, she started to have problems in the evening. Noted to have bleeding from the site of insertion, which was associated with compressive symptoms of the airway, and during that time already in DIVC state. She was then referred to ICU team, but despite proper active management, she succumbed to death few hours later.

The issues that we learned today were :-

1. Safe procedures - sometimes can be dangerous
2. Early recognition of signs and symptoms of any complications of medical procedures
3. Stress on proper and adequate resuscitation management
4. Good medical procedure i.e skill - practice made perfect

This video shows the procedure of Internal Jugular Vein Catheterization. Let's learn.......