IMU C209

testing...

2011-08-02T14:40:00.002+08:00

just to see how many of you actually still visit this site. Kindly post in the chatterbox on your right hand side. Based on the response then we might do something nice. ;)

Deaths after chiropractic upper cervical spine manipulation

2011-04-21T21:32:00.001+08:00

Sent to you by ko via Google Reader:

Deaths after chiropractic upper cervical spine manipulation

via Morsels of Evidence by Michael Tam on 5/04/11

Journal reference: Ernst E. Deaths after chiropractic: a review of published cases. Int J Clin Pract, July 2010; 64(8): 1162-5 ^[1]

Link: http://dx.doi.org/10.1111/j.1742-1241.2010.02352.x

Published: 16 June 2010

Evidence cookie says...

Chiropractic, specifically, high-velocity, short-lever thrusts of the upper spine with rotation is associated with numerous deaths.

Most of the deaths were secondary to vascular accidents of the vertebrobasilar system.

There is no good evidence for this therapy for any medical condition.

General practitioners should advice their patients considering chiropractic therapy to avoid upper cervical manipulation.

Article details:

Study design:

systematic review of case studies

Study aim:

to summarise all cases in which chiropractic spinal manipulation was followed by death

Study conclusion:

Numerous deaths have occurred after chiropractic manipulations. The risks of this treatment by far outweigh its benefit. ^[1]

Critical appraisal:

Are the trial results valid?

Internal validity: Wikipedia

Is it unlikely that important, relevant studies were missed?

Yes.

electronic searches of a number of databases
bibliographies of articles searched
several experts were contacted for further data

Were the criteria used to select articles for inclusion appropriate?

Yes.

case reports included if they provided information on human patients who had died after receiving one or more treatments from a chiropractor

Were the included studies sufficiently valid for the type of question asked?

Yes.

only qualitative exploration of the data was intended

Were the results similar from study to study?

N/A

What were the results?

Outcomes:

26 fatalities were published since 1934 (to September 2009)
most of the victims were relatively young; 14 below the age of 40
the type complication associated with death frequently related to a vascular accident leading to thrombosis and cerebral infarction
the time between treatment and death ranged from 1 h to 58 days; in 10 cases, it was 1 day or less
many other fatalities seem to have remain unpublished

Will the results help me care for my patient?

External validity: Wikipedia

Are the participants different to my patient?

range of patients, many young receiving community chiropractic treatment

Is the treatment feasible?

N/A

Were all the clinically important outcomes considered?

the cases looked specifically at death
cerebrovascular accidents not resulting in death were not included in this systematic review
it is probable that the systematic review substantially under-estimates the burden of death (due to unpublished reports) and serious adverse outcomes
this limitation, however, strengthens rather than weakens the conclusion

Are the treatment benefits worth the potential harms/costs?

chiropractic, specifically, high-velocity, short-lever thrusts of the upper spine with rotation is associated with numerous deaths
there is no good evidence that it is effective therapy for any medical condition
this particular form of therapy is not worth the potential harms

Study weaknesses (summary)

published case studies likely grossly under-represent the true number of cases
review of deaths following chiropractic only; other serious outcomes not resulting in death not reviewed
study methodology cannot be used to calculate estimates of incidence
although causation is implicated, it cannot be assumed by this review

Study strengths (summary)

provides a summary of all the case reports in the medical literature
the limitation of evidence is likely to be a gross under-estimate; the study conclusion is unlikely to be incorrect

Biases and conflicts of interests

nil declared and none seem obvious

Clinical relevance to primary health care

Chiropractic treatment of the upper cervical spine, specifically, high-velocity, short-lever thrusts with rotation has been reportedly associated with vascular injury and occasionally death.

This systematic review of all published case studies of death following chiropractic, confirms this association. Almost all of the deaths resulted from a vascular accident of the vertebrobasilar system. This study was not designed to estimate an incidence figure.

Given that there is no good evidence that chiropractic treatment of the upper cervical spine is effective therapy for any condition, the potential harm far outweighs the benefit. General practitioners should advice their patients considering chiropractic therapy to avoid upper cervical manipulation.

References

Ernst E. Deaths after chiropractic: a review of published cases. Int J Clin Pract, July 2010; 64(8): 1162-5

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Updates

2010-10-21T20:46:00.002+08:00

The "downloads" section for Sem 7 and 8 has been updated. Do check back from time to time.

Paeds : Meningitis

2010-05-29T22:04:00.001+08:00

This is a very good website on childhood meningococcal infection.

A Smooth, Shiny Tongue

2010-05-15T14:27:00.003+08:00

A Smooth, Shiny Tongue

via NEJM - Image of the Week by NEJM on 2/4/09

A 77-year-old woman presented with an insidious onset of fatigue and a burning sensation of the tongue on swallowing food. Six years earlier, she had undergone a total gastrectomy for early gastric cancer, which was . . . [Click Link to read more]

Hand, Foot, and Mouth Disease

2010-05-15T14:26:00.002+08:00

Hand, Foot, and Mouth Disease

via NEJM - Image of the Week by NEJM on 4/7/10

A 4-year-old boy presented with a 5-day history of mild fever and malaise and a 3-day history of a vesicular rash involving his hands (Panel A), feet (Panel B), tongue (Panel C), and buttocks. This . .[Click Link to read more]

Classification of Sutures (CSU)

2010-05-14T22:11:00.000+08:00

Discussion

2010-05-01T12:36:00.000+08:00

A new post from the MMR about doctors choosing to leave Malaysia to work elsewhere. What I found interesting was in the NST article quoted - 20 out of 209 of the new UKM medical graduates this year will be doing housemanship training in Singapore. That's 10% of the entire year! :s

To C209.. It is public knowledge that our degree is only recognized in Malaysia... Anyone planning to work overseas and take another qualifying exam eg USMLE, AMC? What would stop you from wanting to leave Malaysia?

Yeah I know it's exams next week, but I know some of you still read :)

[Plenary] - Nosocomial Infection & Principles of Antibiotic Therapy by Prof Victor Lim

2010-05-01T10:12:00.003+08:00

Nosocomial Infection

Antibiotic Therapy

Psy!!

2010-04-27T22:36:00.002+08:00

Since this blog is like so dead lidat.. i've come n try to spice it up more!!!

1) Side effects of typical antipsychotics and the treatment for each of it!
2) Psychotic symptoms
3) Depressive symptoms

Come come.. sama sama belajar melalui teknologi!!! =D

Case #1: Orthopaedics

2010-04-12T19:48:00.005+08:00

A 14 year old boy complained of pain in the left forearm after falling down from a motorbike which allegedly skidded.

1. What radiological abnormalities are seen in the AP/Lat view of the left forearm?

2. What is the management of choice for this patient's forearm injury?

Answers next week! Please post your answer by clicking "comments" below :)

(Picture c/o Wilkinson)

Update 1/5/2010 Answers:
1. Greenstick fracture of the ulna. Salter-Harris type II fracture and closed dislocation of the radius. Also known as a Monteggia fracture.
2. I kinda lost my notes for this patient o.o But if I remember correctly in the wards the patient was managed conservatively with an above elbow cast was applied (there were no external injuries, I forgot to mention). Refer to Apley's for the exact details la :)

Electives/Selectives Coordinator

2010-03-31T14:15:00.001+08:00

Please take note, Dr Sangeetha(Int Med Department) has taken over Dr Sulaiha as the Electives/Selectives Coordinator. If you have any enquiries reg selectives/electives please kindly refer to her. Thank you.

Psychiatry: Lecture - Psychiatry and the Law

2010-03-24T22:16:00.000+08:00

Lecture From Dr Agnes LS

Psychiatry: Seminar on Mood Disorders

2010-03-21T15:04:00.002+08:00

Powerpoints here.

Credits - Group A

Psychiatry: Seminar on Psychotic and Delusional Disorders

2010-03-21T14:25:00.001+08:00

Seminar: Psychotic and Delusional disorders

Credits: Group A

Psychiatry: Seminar on Organic Brain Disorders

2010-03-21T14:24:00.001+08:00

Important topic! Powerpoint from Dr Selvi is included.

Seminar: Organic Brain Disorder

Psychiatry: TBL Drug Abuse and Dependence

2010-03-18T15:01:00.005+08:00

Drug Abuse and Dependence Powerpoints

Ethical Issues in Addiction

Credits: Group A

WHO guidelines on antiretroviral therapy

2010-03-13T11:41:00.000+08:00

WHO | Rapid advice: antiretroviral therapy for HIV infection in adults and adolescents

WHO | Rapid advice: use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants

WHO | Rapid advice: revised WHO principles and recommendations on infant feeding in the context of HIV – November 2009

Plenary: Forensic medicine 12/3/2010

2010-03-13T10:53:00.002+08:00

Download Introduction to Forensic Medicine

Download Forensic Medicine: Trauma

O&G Normal Labour

2010-03-11T22:43:00.001+08:00

power point presentation of normal labour

click here

[Obstetric & Gynecology] - TBL - Obstetric Collapse: Pulmonary embolism & amniotic fluid embolism.

2010-03-10T17:28:00.002+08:00

Pulmonary embolism - click here.

Amniotic fluid embolism - click here.

Psychiatry: New Files added

2010-03-10T12:47:00.004+08:00

Click HERE.
Seminar: Signs and Symptoms in Psychiatry
TBL: Disorders related to alcoholism
Seminar: Organic Therapies

Credits: Group A

[Psychiatry] Seminar: Somatoform Disorders

2010-03-10T12:40:00.001+08:00

Somatoform Disorders
Contents:
Somatoform Disorders
Factitious Disorders
Malingering
Dissociative Disorders
Culture bound syndromes

Thanks to Wilkinson, Yoke Ching, Lalita, Tjun Hoe for preparing the slides
Thanks to Jo Wearn for compiling the slides.

[PSY] Lecture-Introduction to Psychiatry

2010-03-06T12:24:00.003+08:00

Lecture-Introduction to Psychiatry (-from Jo Wearn)

[Psychiatry] Seminar: Child & Adolescent Psychiatry

2010-03-05T22:16:00.002+08:00

Child Abuse
Developmental Disorders
Learning Disability
Eating disorders
Attention Deficit Disorders
Other Childhood Pyschiatric Disorders

Thanks to Yoke Ching for compiling the powerpoints. Thanks to Yoke Ching, Karmen, Ada, Ken Seng, Hui-Xin and Lalita for preparing the slides.

[Obstetric & Gynecology] - TBL - Antenatal Fetal Monitoring

2010-03-04T18:54:00.001+08:00

Click here for powerpoint.

Happy CNY

2010-02-12T22:20:00.000+08:00

Well these days it seems more non-C209 people read this blog than us....But anyway, wish everyone a great 'Tiger' Year ahead *rawr* :)

RISK - GLOBAL DOMINATION

2010-02-05T21:10:00.002+08:00

MARCH OF THE BLACK ARMIES.

YELLOW - LIPSIANG = ELIMINATED
RED - YU GIN = SOON TO BE ELIMINATED
BLACK/GREY - VICTOR!!

=p

The Hero.

2010-01-27T22:32:00.001+08:00

Click here to find out who's the hero of C209.

Meeting your Tutors

2010-01-21T12:18:00.003+08:00

Hi guys,

Just wondering if you've noticed the tutor grouping posted on the notice board(next to Sem 6 notice board). If you have not met your tutor, please do so as soon as possible because you will eventually need your tutor's approval for your electives and selectives. And, it's only polite, right :)

Enjoy the last 3 weeks of Semester 6!

Cheers

Quick Guide - Management of DM Type 2

2010-01-21T12:18:00.001+08:00

Quick Reference Guide - Management of Type II Diabetes Mellitus - From Malaysian CPG 4th Edition (Via Malaysian Medical Resources)

IMS this Thursday

2010-01-19T17:16:00.001+08:00

Please be informed that the IMS on Fever is on 5.00PM, THURSDAY, 21st JAN 2010, in JBLT. Sorry if I have caused any confusion.

Break for Chinese New Year & Hari Raya 2010

2010-01-18T14:33:00.001+08:00

Hi guys, this is from an SAD email. Hope it can help you plan ahead for your vacation/plane tickets :) Do keep in mind it may be subject to changes.

--

Chinese New Year

Sunday, 14 February 2010

Monday, 15 February 2010

As the first day of Chinese New Year falls on Sunday, Tuesday 16 February will automatically be a public holiday.

Hari Raya

Friday, 10 September 2010

Saturday, 11 September 2010

As there will be no teaching and learning activities during the week of the above festivals, the Management has decided to the following:

To close the University on the next three (3) working days involved in the week of Chinese New Year (Wednesday 17, Thursday 18 and Friday 19, February 2010).

To close the University on the next three (3) working days involved in the week of Hari Raya (Monday 13, Tuesday 14, Wednesday 15, September 2010).

Fwd: Parking at the Clinical School

2010-01-08T16:57:00.001+08:00

Dear Students,

As you may be aware that the 2 pieces of land outside the Clinical School have been cleared up yesterday. Therefore, students can now park their cars at the area. The parking capacity is approximately 30 cars.

NO CARS will be allowed to park along the road from Monday, 11 January 2010 onwards.

The University would like to advise all students to drive with extra caution and slow down your speed when driving along the road and inside the University to prevent the occurrence of any unwanted accidents.

Regards,
Gabriel Tan

New SRC Committee

2010-01-04T23:47:00.003+08:00

Thank you everyone for sacrificing half an hour of your lunchtime to come for the SRC elections. Results are as follows:

SRC Committee, C2/09
Vice President: Jer Ming
Vice Secretary: Christy
Vice Treasurer: Jo Wearn
Junior Cultural Rep: Tharveen
Junior Liaison: Zahabiya
Junior Sports Rep: Hazwan

Assistant Batch Rep*: Yuan Liang (*taking over from Jer Ming)

Congratulations to the new committee. Please give them your whole-hearted support so that they can carry out their tasks effectively in the coming year :)

Speechless result

2010-01-04T20:38:00.004+08:00

the picture explain everything. Study hard everyone. =)

Jer Ming

2009-12-30T09:11:00.004+08:00

Dear C209, this, is our dear assistant batch rep.
Sleeping in longkang
Trying to act cute.

So, guys please treat him nicer. If not he will continue behave like this. Thanks.

Ps : jerming dont delete this post. and dont kill me.

Because Ass. Batch Rep says the blog is dead...

2009-12-28T23:17:00.000+08:00

Fam Med Wound Dressing Class.

(contributors to this blog, please feel free to add your pictures to this post(esp ru-di-an hui)....:p )

Exam Timetable

2009-12-18T02:12:00.006+08:00

Date	Time	Paper
16th December 2009	2.00-3.15PM	Family Medicine
17th December 2009	2.00-3.15PM	Surgery
17th December 2009	3.30-4.45PM	Internal Medicine

ALL VENUES: SEMINAR ROOM 1-5, GROUND FLOOR

You will only sit for the papers the posting you have gone through so far.
DOs:

This is an MCQ paper so bring 2B pencil and eraser.

Student ID
Be punctual
DO NOT:
bring any electronic devices
All the best!

Make sure your patients are alert conscious and communicative...

2009-12-11T20:25:00.001+08:00

Original post by Dr Yew here

Plenaries 11th Dec 2009

2009-12-11T20:24:00.001+08:00

Study Design and Quantitative Methods - Prof Yadav 11th Dec 2009
Complementary Medicine - - Prof Yadav 11th Dec 2009

Patient Safety, Dato Kew

2009-12-08T23:57:00.002+08:00

The powerpoint is here.

Internal Medicine TBL diarrhoea

2009-12-08T23:56:00.000+08:00

Gastroenteritis
Acute Gastroenteritis
Diarrhoea
Stool Culture

(-I forgot who presented these powerpoints. Thanks to everyone from Internal Medicine)

Updates from IMU Alumni

2009-12-03T18:03:00.001+08:00

9 December 2009: Alumni Talk, Dr Sekhar Cyrill Pillai (M1/94), Bukit Jalil

Dr Sekhar will be coming to IMU for a talk on pathway for pediatric training. He is currently working as General Pediatrician and will begin begin his training in paediatric neurology at Children's Hospital at Westmead . The talk will be held at 3.00 p.m.

17 January 2010: IMU Open Day

Come visit us for IMU Open Day and experience a brand new IMU. We have open a new oral centre, expand our research centre and renovate the whole building. Reunite with your lecturer and IMU staff.

--From IMU Alumni email newsletter

Taking Time for the Self on the Path to Becoming a Doctor

2009-11-21T13:56:00.003+08:00

Over the next two weeks in hospitals and medical centers across the country, new medical school graduates will begin their internship. Among their many worries — moving to a new city, meeting new colleagues, adjusting to medical training — is a more profound, existential concern that had once plagued me.

Do I have to lose my self in order to become the doctor I want to be?

I learned the answer to that question partway through my internship. Not in the hospital but in the checkout line of a local grocery store.

The customer in front of me was an older woman — she wore a faux camel-hair coat and had hair dyed a matching color. I remember that she had wanted her groceries bagged in a particular fashion, but the sales clerk, a young woman with impossibly long pink acrylics, was perplexed by the woman’s demands.

I felt as if I had stepped into an avant-garde theatre production. Each time the young woman bagged the groceries, the older woman admonished her and asked her to go through the process yet again. The muscles of my jaw tightened with each round of bagging, and even though I was off for the day, all I could think was: I’ve got sick patients to take care of, I can’t wait for this!

Unable to bear it any longer, I stepped forward and bagged the woman’s groceries myself, shoving the plastic bags into her arms while resisting the urge to push her on her way. I imagined steam rising from my head as I ranted. But a part of me was as shocked as the people still standing in line. I had never lost my temper in a store, and I had never raised my voice in public. Now, a few months into internship and with a three-minute provocation, I had the capacity to act like a grizzly bear sprung loose from a trap.

I walked out of the store horrified. That night thinking back on the event, I grew more ashamed of my behavior. But I also realized that it was not the first time I had snapped. Over the previous months, I had thrown myself into my work and shunned everything I once enjoyed and nearly everyone I loved. I believed I needed to do so in order to become a surgeon.

But I had lost my self in the process, and the stress made me irritable. I was no longer the nonconfrontational person I once was.

I had, for example, raised my voice a couple of days earlier at a receptionist in the radiology department when she couldn’t schedule my patient for a CT scan. I had scolded a nurse who had had the misfortune of being the fifth person to page me as I scrambled to finish a procedure. And only a week prior, I had squabbled with my family after my mother innocently asked, "Why do you have to work so hard?"

According to a study from the Johns Hopkins University School of Medicine in Baltimore, I am far from the only doctor who has behaved this way. The researchers interviewed residents, or doctors in training, from seven different specialties and found that they set themselves up for burnout by accepting, even embracing, what they believed would be a temporary imbalance between the personal and professional aspects of their lives. While the young doctors interviewed defined well-being as a balance between all those parts, many felt that their medical training was so central to their ultimate sense of fulfillment that they were willing to live with whatever personal sacrifice was required, even if it meant a temporary loss of a sense of self.

I spoke to the lead author, Dr. Neda Ratanawongsa, who now practices general internal medicine at San Francisco General Hospital and is an assistant professor at the University of California, San Francisco.

“It’s partly a coping mechanism,” Dr. Ratanawongsa said. “We tell ourselves that we can do everything but not at the same time, so we are going to put off the thing that defines us as a person — time with children, running a marathon, painting, playing music — in order to get trained because being a doctor is also rewarding.”

That delayed gratification works well initially because residents believe it is only temporary. “A lot of what matters to residents at this time is the sense that they are learning to care for patients well and growing as doctors. They feel that what they are doing is going to be worth it.”

But when the imbalance persists for longer than initially expected, professional growth is not enough to sustain most young doctors. “The ones who are happier,” Dr. Ratanawongsa observed, "are the ones who have held on to one or two things and have said, ‘I’m not just another resident. I play the guitar, I run races, or I go home to family.’ They don’t do these things to the same extent as they did before residency, but they do them enough to maintain a sense of self.”

Residents who don’t find this balance are at risk of burnout, clinical depression or, more commonly, subtle forms of stress. “These residents may feel that even if they can give excellent care most of the time, there are times when they snap at a patient or don’t order a test fast enough because they are so burnt out."

Although her study focused on doctors in training, Dr. Ratanawongsa sees the same challenges among doctors who have finished and are currently practicing. “There is always this expectation that at some point things will turn around. The interns say, ‘When I finish internship and become a second-year resident, things will get better.’ The residents say, ‘When I finish training, I will finally have balance again.’ And doctors in practice may believe that they will find more balance once they have retired.”

The danger is that physicians may end up leaving the work force or will become less effective caregivers. Dr. Ratanawongsa suggests that doctors learn how to create a better sense of balance in their lives from the moment they begin training. “We are taught to put our patients before ourselves; it’s in our charter of professionalism. I agree with that, but I also think there has to be some sense that I matter, too, at some point. If something important is going on with our loved ones or with ourselves, we need to be able to advocate for ourselves. And we need time to reflect on who we are and where we are going.”

In the months after that incident at the grocery store, I continued to devote my life to my training — there was no other way to become the surgeon I wanted to be — but I also learned to find time for myself. Even 18 years later, I can still remember those moments away from work well — late morning breakfasts with the Sunday Times in hand at the greasy diner down the street from the hospital, glorious springtime drives in a friend’s used convertible, afternoons running on a boardwalk and walking along the beach. I lost a few extra hours of sleep each time I did something for myself; but in the end I, and my patients, would gain much more.

“My belief,” Dr. Ratanawongsa said, “is that doctors will have a greater capacity to know their patient as a person if they know themselves. That kind of knowledge requires a sense of balance and an understanding of why they chose to become a doctor. It comes down to their capacity to be an empathic, caring and compassionate provider; and it comes not from their medical knowledge but from their soul.”

“This is something we should never sacrifice, even temporarily.”

By PAULINE W. CHEN, M.D.

Adapted from The New York Times. Original article is available here.

Dr NKM's Blog

2009-11-21T13:13:00.003+08:00

Woah! Dr Nilesh has a blog!

For people who need a daily dose of anatomy ;) (No neon green + pink + purple fonts though..)

(Link found via SRC BJ VP Med)

[TBL - Internal Medicine] - Poisoning

2009-11-21T12:54:00.003+08:00

TBL on Poisoning Case 1(Dorothy), Case 2(Tjun Hoe)

Paraquat Poisoning Notes

Mechanism of Vomiting Notes(Yoke Ching)

Compiled by Dorothy. Thanks!

Dengue Management in Adults CPG 2008

2009-11-15T14:08:00.007+08:00

Dengue Fever Management in Adults, 2008 - Clinical Practice Guideline, Malaysia (Courtesy of Christy. Thanks!)

Patient safety lecture, Emergency Medicine Workshop, Lunch hour lecture

2009-11-15T02:13:00.000+08:00

Hi,

Lecture on Patient Safety by Dato Kew(which was supposed to be on last Friday) has been rescheduled to 12.30PM, 23rd November.

There will be an emergency orthopaedics workshop in Kolej Pembantu Perubatan Seremban on 12th December 2009. The workshop will deal with management of orthopaedic emergencies e.g. limb fractures, neck injury, pelvic injury etc. There will be lectures and some practical sessions conducted by IMU lecturers. Fee is RM20/person If you are interested please let me know.

Dr Eric Kian Saik Lim, Consultant Thoracic Surgeon, Royal Brompton Hospital and Senior Lecturer, National Heart and Lung Institute, Imperial College School of Medicine, London, UK and Editor of the Book, Medicine Surgery - An Integrated Textbook will be in Kuala Lumpur in December 2008. He is very keen to meet up with the Clinical School Faculty and students.

CtME has scheduled a lunch-hour talk in Clinical School on Monday, 14 December 2009 from 12.30 - 1.30pm at the John Bosco Lecture Theatre, Ground Floor. The title of his talk is : " Medicine & Surgery - Integrating the Two Great Intellectual Domains of Clinical Practice"

Agenda
-It will be a 30 mins presentation followed by 30 mins discussion, Q & A.
- There will be a book display and author signing after the talk.
- Light refreshment will be served after the talk.

Thanks!

Cheers
Mezhen

[IMS Plenary] - Perioperative Care by Prof Yushak

2009-11-13T17:01:00.002+08:00

Available HERE. Thanks to Qian Hui!

Fwd: Donation for Kg Orang Asli Serendah

2009-11-10T22:54:00.001+08:00

Dear All,

Prof. Ong Kok Hai, Student Services Department and Student Representative Council will be organising a "Gift of Sight Project and Health Screening Session" at our adopted village, Kg Orang Asli Serendah, Kuala Kubu Bharu. Details of the event are:

Date: 6 December 2009, Sunday
Venue: Kg Orang Asli Serendah, Kuala Kubu Bharu.

We are calling all philanthropists of IMU to donate clothes, books, toys and other goods that you are no longer use and in good condition to the villagers. Kindly send all donations into the box placed next to the elevator at Level 1 Clinical School. Thank you.

We thank you in advance for your kind donations.

Regards

Aznah Arshad
Student Service Department

C209 party

2009-11-06T00:03:00.000+08:00

Hi all,

As announced during last Wednesday's lecture, we are having a bbq party at Qian Hui's house on Tuesday, Nov 10 starting at 6pm. As this is a potluck, pls help by either
1) contributing snacks, drinks, dessert(eg ice cream)
2) contributing to the bbq fund(any amount you wish, however we would recommend around 10 ringgit-give to Qian Hui/Yu Gin/Jo Wearn)

Please bring only halal food.

If you are interested, please RSVP to this email with the method you wish to contribute by Sunday so that we can make the necessary preparations. Thanks a lot.

Mezhen

Note on Prof Esha's lecture

2009-11-05T13:09:00.001+08:00

Please note that the powerpoint for Prof Esha's lecture is not available, only a hard copy. C1/09's batch rep is photocopying for our whole batch(all 65 of us) I will let you know when I receive the notes. Thanks guys, -Mz

plenary this wed, thur, fri

2009-11-03T12:31:00.000+08:00

Dear all,

Please note the revised plenary schedule for this week. ATTENDANCE IS COMPULSORY. I will inform your posting leaders also. Thanks a lot.

Wed, 4th Nov 4.30PM- Accidents, Poisoning by Prof Esha (Note: postponed from last week)

Thurs, 5th Nov-3.30PM-Research proposal lecture

Fri, 3-5PM-Ethical Issues in Medicine, by Tan Sri Abu Bakar-PLEASE COME BY 2.45PM

Thanks guys, have a nice day

Cheers

Mezhen

Elective Program website(Elearning login)

2009-11-03T12:27:00.002+08:00

Dear all,

Medical Selective/Elective program in the clinical school has been coordinated successfully over the years by dedicated staffs in Academic and Student affair departments. It has so far run pretty smoothly for our students and we are also accepting many more applications from foreign students all over the world to do the attachment with our faculties.

It is thus the time for information about the program and clinical oppurtunities provided by our university is made available online. The IT staff in BJ has kindly assist us in making this a success. For access to the website (Elective/Selective program in IMU E-Learning Portal) you just need to click on the link and use yor own username & password. Foreign/International students can also access it as guests.

http://elearning.imu.edu.my/course/view.php?id=356

There is a forum for discussion (on line - for queries/feedbacks etc) and a space for downloading excellent reports for all to view.

The site is still at an infantile stage. There is definitely lots of room for improvement thus I most welcome any comment from you or viewers.

Thank you so much. For further information/details, please do not hesitate to contact me or staffs in AAD Seremban.

Regards,

Dr. Sulaiha

Elective Coordinator,

Clinical School, Seremban

Final Kg Angkat(Batu Pahat) Name List

2009-11-02T00:31:00.005+08:00

Dear all,

This is the final Kg Angkat name list. Please let me know if you still want to sign up so I can put you on the waiting list.(We might be able to send more people to go)

As of 2nd Nov, 30 have signed up.

-please refer your email for more info-

C2/09 players for Sports Week, Kg Angkat CONFIRMED DATE

2009-11-01T19:01:00.004+08:00

Hi C209,

Hope all of your EOPs went well and hope everything goes well in your new posting! New group leaders for Fam Med are Zi Yen & Hui Xin, Surgery is Yu Gin, Internal Medicine is Yuan Liang. Thanks to them for volunteering as leaders and hope everyone will cooperate and make their lives easy in the next 7 weeks :)

1. Sports week is THIS week! if you want to play let me know by today or tomorrow. If you are playing for our batch, please take note of the TIME and VENUES on the notice board in IMU, most sports should start around 6. (I don't have one with me now)

Monday-Ping Pong & Pool. PP-Terence Ngui. NEED ONE MORE FEMALE FOR POOL

Tues-Basketball
Male 5 on 5-Geowin, Chee Keen, Terence.
Female 3 on 3-Denise, Lilian, Esther.

Wed-Male futsal(5+3 subs)
Hazwan & team

Thurs-Badminton
Male-Yap & Tharveen
Female-

Good luck to all the players!

Take note: All teams except for Male Futsal are combined with Sem 7

2. The following have signed up for Kg Angkat. Confirmed date is 19th & 20th Dec, Kg Java in Batu Pahat. Please let me know if you want to sign up or pull out. I'm not sure if we are staying the night in Batu Pahat, most likely not. Will let you guys know when I get more details. PLEASE TAKE NOTE that EVRYONE MUST go for Kg Angkat project at least ONCE while in Sem 6-9. This will contribute to your final Sem 10 portfolio.
(Refer updated post above for name list)

Thanks and have a great week ahead!

Cheers,
Mezhen

New Dean of the IMU Clinical School

2009-10-25T18:14:00.001+08:00

Dear all,

We are pleased to announce the appointment of Dato Kew Siang Tong as the new Dean of the IMU Clinical School for a period of 3 years. Dato Kew will take over from Dato Kandasami with effect from 1 November 2009. As Dean of the Clinical School, Dato Kew will provide the leadership for the implementation, quality assurance and continual improvement of the programmes of the Clinical School.

On behalf of IMU, we wish to express our deepest gratitude to Dato' Kandasami for his leadership role and contribution towards the development of the Clinical School during his tenure as Dean of the Clinical School from March 2005 to October 2009.

We congratulate Dato Kew on her new appointment and hope that everyone will extend their fullest cooperation to Dato Kew in her new role.

Regards
On behalf of Prof Victor Lim
Executive Dean

eMedicine CME Case Presentations

2009-10-17T16:21:00.003+08:00

eMedicine CME Case Presentations presents a new case each week.

Just register yourself and view the case presentation. They have MCQ for diagnosis at the end of every case.

Can improve in writing case reports too. =D

[IMS Plenary] - Blood & Blood Products by Prof SK Cheong

2009-10-14T23:10:00.002+08:00

Blood & Blood products, Prof SK Cheong

IMS slides and Growth and Nutrition lecture coming soon. Sorry!

Heart Sounds and Murmurs - Texas Heart Institute (mp3 files)

2009-10-13T20:34:00.001+08:00

Link: http://www.texasheart.org/Education/CME/explore/events/eventdetail_5469.cfm (via shareaholic)

Marking Sheet EOP Surgery Posting

2009-10-13T17:49:00.005+08:00

Finally a blog post from Surgery posting. Cause i realize all posting leaders had post something here but there's nothing posted up for Surgery posting.

Ok, this is very IMPORTANT --> the marking scheme of our End Of Posting clinical exam.
Everyone will get this sheet of paper before the exam (It's actually with me now, i will distribute to you guys soon), then, bring this paper along with you and give it to ur examiner DURING your EOP exam. Your examiner will evaluate you using this marking sheet, so PLEASE don't forget to bring it!!!!
Surgery EOP Marking Sheet.

Btw, i'm sure Mezhen had email everyone of us this link, it's a Physical Examination Videos' website that we found during one of our CSU section. This link can be used in all postings!

That's all from surgery posting. I hope all of our group members have fun in ward 3A, 3B, 8B, Endoscope room, SOPD, OT, HPD and HTAN.

=End=

Happy 3 Friends!!!!

2009-10-07T23:41:00.005+08:00

This is what the fam med + some surgery people do when there's time to play ~ ~ =D

pictures credited to yenyen
=p

[TBL - Family Medicine] - Hypertensive Retinopathy & Diabetic Retinopathy

2009-10-04T12:40:00.005+08:00

Sharon Ngu has prepared and shared this presentation on Hypertensive Retinopathy with everyone.

Download HERE.

And this is the presentation on Diabetic Retinopathy prepared by Wenna.

Download HERE. Enjoy!

Peace out! =)

Family Medicine - Teaching and Service Clinic

2009-10-03T09:26:00.004+08:00

Attention to Group 1 in family medicine, Dr. Teng will be having his teaching and service clinic on Monday morning.

[TBL - Family Medicine] - Classifications of Antihypertensives

2009-10-02T20:57:00.003+08:00

The Powerpoint presentation attached in the link below is prepared by Kai Lein in one of our TBLs. Thanks Kailein! =)

Download here.

Click here to view the lecture given by Dr Tai to Internal Medicine on Antihypertensive Therapy (previously posted up by Jo Wearn).

Important! IMU Clinical School 10th Anniversary Celebration

2009-10-01T19:11:00.003+08:00

(reposting to http://imuc209.blogspot.com)

I've tried to keep it as short and to the point as possible, please read on.

The Clinical School will be celebrating its 10th anniversary next week with a series of events. Semester 6 is required to participate in every event. Don't worry, it's not extra assignments, just need you guys to come to eat free mooncake, play lanterns and there will be a couple of fun activities. This is the time for C209 to show our presence as a batch, and erm, celebrate the 10 th anniversary of CS :)

I understand that everybody is busy with their respective ward work, on calls and TBLs, so I have made a few arrangements as below. I hope that everyone can at least participate in ONE EVENT, and I will also be coordinating with your respective posting leaders. Thanks a lot

MONDAY

8.30PM Mooncake festival party(free dinner!lanterns!)- at least 10 people from C2/09 to attend. Please bring your housemates along! I will doing a head count of people who want to attend on Friday IMS(tomorrow)

TUESDAY

5PM-6PM Medical Charades - we need one team of 10 people from C2/09 to participate(either as competitors or audience) Basically its charades with medical words. Eg someone will have to act out the word 'hyperthroidism'....and the rest will have to guess what it is. I will do a head count tomorrow after or before IMS.

All day - Kolam making in front of student lounge - open to everyone

WEDNESDAY

Deadline for IMU Art competition - every posting to hand up at least 2 essays AND at least 2 artworks/graphic design on the theme "IMU CLINICAL SCHOOL TEN YEARS IN THE FUTURE" - will coordinate with your posting leader on this. If anyone wants to submit multiple entries, I will be forever indebted to you;)))

THURSDAY

Congkak and Telematch - Not sure how many teams we need, will update you. But I was told we will need at least 10 people also for each event.

SATURDAY

I will be attending the 10th anniversary dinner at KLCC on behalf of C2/09 ;)

(repost to http://imuc209.blogspot.com)

Thanks for reading.
(viewed and approved by JerMing =D)
support Mz.
C209~~~

[IMS Plenary] - Prenatal Diagnosis by Dato Siva

2009-09-28T00:01:00.003+08:00

Hope everyone had a great holiday! Prenatal Diagnosis, by Dato Siva now available for download HERE.

Have a good week!

There are no classes in life for beginners: right away you are always asked to deal with what is most difficult.
Rainer Maria Rilke

CHELSEA CHELSEA

2009-09-27T00:29:00.003+08:00

CECH OFF AS CHELSEA STUMBLE

picture paints a thousand words eh =p

PS > for chelsea fans..just for fun...dun take it seriously..made this especially for lipsiang wan k.. =D

Misc

2009-09-23T22:26:00.006+08:00

Is it okay if i post some other things that are not academically related?
Cause the blog looks like abit dead lidat =(
Comments?? =D

Batch rep dun angry ar =p

(MZ-Non academically related = football??? Haha, go ahead assistant batch rep, I'm not a 'dictator' ;p)
(jerming - edit my post summore say not dictator.!! LOL =p non-academic meaning anything from sports to some other 'rubbish' hahaha.. but say is easy.. doing it is hard.. so we shall see if i really will do it not =D)

(ian - OK guys, while our BatchRep and AssistantBatchRep are having their fight, let's get things sort out a little. I've invited everyone in our batch to be the author on this blog, which means all of you can post anything you want, be it academic or non-academic, on this blog. Of course, those posts will be moderated. Anything inappropriate will be removed. Other than that, have fun! =D )

(jerming - changed Ass to Assistant.. sounds nicer eh.!! =D )

Updated 23/9: October lectures, Surgery journal, Clinical practice guidelines

2009-09-22T00:01:00.024+08:00

1. Hi, just to remind everyone about the lecture schedule for October:
(Note: Schedule is available for download in the sidebar...However take note below)

**FRI 2 OCT 2009 - IMS Anaemia (**Attendance compulsory even if you are not presenting)

**WED 7 OCT 2009 - Growth & Nutrition, Prof Moti (Date in previous schedule is incorrect)

FRI 9 OCT 2009 - No plenary
WED 14 OCT 2009 - Blood and Blood Products, Prof Cheong
FRI 16 OCT 2009 - No plenary
FRI 23 OCT 2009 - IMS Jaundice (**Attendance compulsory even if you are not presenting)

Attendance is compulsory and as always your dear posting leaders will be taking attendance.

2. Mr Ng CH has kindly let us access the Surgery articles he has downloaded from the Oxford Journal of Surgery. The whole folder is about 105 MB. It is available in his folder in the I drive under "Lecture notes", if I am not mistaken. I drive is only accessible via library computers as per my previous post, so please take note of that :)

3. I have around ten people who want a copy of the CPGs. However, I just realized that for me to carry that 10 or so copies of that around will be a bit crazy for me, since I don't have a car :( I'm really sorry. I don't have your names right now so I want to know if it's ok for you to photocopy it on your own, you can borrow my copy.

Alternatively, the Malaysian CPGs from 2002-2007 are here (Link courtesy of Malaysian Medical Resources) and recently updated CPGs are available on the Ministry of Health website.

Have a great week ahead!

p/s Just a note: I have not received Dato Siva's ppt. It is with a senior. Will put it up as soon as I get hold of it. Thanks!

I drive - Clinical School

2009-09-21T23:48:00.004+08:00

Just a note - the I drive for Clinical School is only available for access at the library computers. It is not available online!!

[Lecture] Fluids, Electrolytes and Nutrition by Dr Jenny - 18 September 2009

2009-09-18T17:43:00.007+08:00

The presentation by Dr Jenny on Fluids, Electrolytes and Nutrition is HERE. Have a great Raya break guys!!

[Lecture - CFCS] Healthcare System of Malaysia by Dr Tan KL - 18 September 2009

2009-09-18T17:40:00.009+08:00

The presentation by Dr Tan KL on the Healthcare System of Malaysia, 18th Sept 2009 is available HERE.

Updates from Batch Rep Meeting

2009-09-15T23:09:00.002+08:00

IMPORTANT:
Dato' Kanda has seen several Sem 6 students only arriving after ward rounds has finished. He wants me to remind everyone that you are supposed to be in the hospital by 7.30am everyday.

Masks, gloves and other PPE can be obtained from the Sisters at CSU if you have difficulties getting them from the wards due to shortage in PPE supplies right now. Just go to CSU and ask the sisters in charge.

1. KUALA PILAH HOSPITAL - Our batch will be the first to use the new IMU building at Kuala Pilah Hospital. Surgery Group A will be the first IMU students to have their TBL in Kuala Pilah :)) Dato Kanda has advised everyone to be careful when driving to Kuala Pilah as the road is very winding and narrow. The new(safer?) highway was scheduled to be open before Raya but it is still not open. Better be safe than sorry :) Right now only Surgery posting students go to Kuala Pilah but IMU is planning to extend this to other postings as well.

2. NEW HOSPITAL - Hospital Kluang will be available in the near future as an additional teaching hospital for IMU.

3. REPORTING PROBLEMS DURING POSTING IF you have any problems in your posting, e.g. allocation of timetable, allocation of TBL lecturers, problems in the wards/clinics, problems with colleagues(ahem) please let me know so I can help you resolve these issues or bring these issues up in the batch rep meeting.

4. IT&COMPUTERS. New computers will be purchased to replace the old sloooooooow computers in the LT and seminar rooms. This will probably happen before the end of this year. More computers will be added to the library as well.

5. SPEEDING AT ENTRANCE TO IMU - We have received reports of IMU students speeding at the road entering the IMU campus. If you are the culprit, please stop endangering the lives of others!!! Just wake up earlier!!! If you are walking, please be careful when you walk back home!! IMU is currently liaising with the construction site manager to lower the height of the bump and place a mirror at the sharp bend.

6. LIBRARY - library hours will be from 8.30AM to 10PM everyday.

Thanks :)

Cheers
Mz

[Lecture - Internal Medicine] Hypertension therapeutics and Diabetes management by Dr Tai

2009-09-14T19:44:00.011+08:00

These two plenaries were lectures given by Dr Tai to Internal Medicine students this afternoon. Put it up here so people from other postings can have a look at it too. Might be useful.

Hypertension therapeutics
Hypertension

Diabetes management
Diabetes

JoWearn

-Thanks Jo, this is very very useful! Other postings should do this too! Share notes, interesting cases, TBL stuff etc etc:) MZ

Kampung Angkat Project 31 October 2009

2009-09-13T00:05:00.004+08:00

Hi guys,

Because of the overwhelming response to the Kg angkat project, we had to go by first come first served basis. The attached name list is the 24 people who will be going on 31 Oct 2009. There will be anotehr project in Batu Pahat in Dec but that's not confirmed yet. For the 31 Oct trip, a T shirt, food, and transport will be provided. Thanks everyone and have a great weekend:)

Cheers

Mezhen

1 Ang Chui Munn

2 Chee Chui Mei (Ada)

3 Christy Anne Lee Chang Hui

4 Denise Chew Ching Li

5 Dorothy Maria A/P Anthony Bernard

6 Karmen Lim

7 Ko Mezhen

8 Koh Kit Yuen (Esther)

9 Lalijah Nagenthiran

10 Lui Tjun Hoe

11 Priscilla Michael

12 Samantha Tee Mei Li

13 Simran Kaur Sidhu

14 Soh Si Ling

15 Tan Ek Guan

16 Tan Hui-Xin

17 Tan Qian Hui

18 Tharveen Nair a/l Chandrasekaran

19 Vishel a/l Soundarajan

20 Wilkinson Tan

21 Woon Yuan Liang

22 Yeap Jo Wearn

23 Yeo Siew Kim

24 Zahabiya Bt Mohamed Hussain

[IMS Plenary] Genetic Disorders & Couselling by Prof Boo - 11 September 2009

2009-09-12T23:16:00.007+08:00

Hi guys, this is the plenary. As usual ya, this is for the personal use of C2/09 students only. Please do not redistribute this material.

Click here to download.

Useful Links Added

2009-09-09T13:38:00.003+08:00

Hi guys,

I've just added a few useful links to the side panel of the blog. =)

I'm sure that you're already familiar with those links already, but there's a new one called IMU E-Learning Portal. This is the site where you can download study guides for TBL, various leraning resources etc. I have yet to find out what are all the services available in this site, but i bet it'll be useful.

Anyway, that's all for now. Good luck in your postings! =)

Masks for Wards

2009-09-06T15:42:00.001+08:00

We need 3 ply surgical masks for ward rounds - This applies to ppl doing surgery and internal med. I will be buying two boxes from Subang for people who are not able to get it by tmr due to various reasons....Thx!

From a very frazzled Mezhen currently rushing to pack her things to go back Sban

Buka Puasa Event

2009-09-06T14:44:00.003+08:00

Buka Puasa Event at IMU
Date: Tues, 15th Sept 09
Time: 7.00PM
Venue: IMU Clincal School Canteen
Dress Code: Malay Attire

--From Avinder C109

2009-09-06T10:48:00.002+08:00

About the certs, some people have received it only after 1 or 2 days. If you completed the course late(like I did) and can't have access to a printer, find this screen on your computer and print it out when you finish the course(better than nothing to show la..) in case the cert doesn't come to you by Monday morning.

Updated: Dato Siva's Assignment on Medical Ethics

2009-09-05T15:35:00.016+08:00

[updated sun 6th sept 1235am]

Hi guys,

This is extremely important, so please pass this information to your friends.

Please note that the ONLY way to obtain the certificate of completion of this course is by doing it as a registered user. All unregistered entry will not have its results recorded, therefore no certs.

This is how you register yourself.

First, click on this link to go on to the website.

When a username and password is requested, type in "kurs08" for both username and password.

Select "start the course" on the top left corner.

Then, type in any username AND password you desire.

You'll be then directed to this page. Fill up the details as required.

Click on "Submit", and you'll see this screen.

Then tada! you're registered. =)

To get the certificate - try re-logging in to the website after you finish the course, and check your email to see if you receive the cert (thanks tj!). If you still haven't got it, be patient, 'cause the site says something like this:

If all else fails - use translate.google.com and select Norwegian > English

Tasks:
1. Complete the course
2. Print out the e-copy of the certificate
3. Write a ~400 word summary of the course

Reminder: Hand up your assignments first thing in the morning on MONDAY, 7TH SEPTEMBER to your posting leader because we need to hand it up by noon. Late submissions will not be entertained.

p/s: for those who typed in kurso8 instead of kurs08, i typed it correctly but it is the font problem -_- sorry for the confusion.

[Lecture - CFCS] CFCS Briefing by Dr Tan - 04 September 2009

2009-09-04T22:50:00.004+08:00

Click here to download

[Lecture - Research] Getting Started in Research by Prof Teng - 04 September 2009

2009-09-04T22:37:00.003+08:00

Click here to download

Welcome to this blog

2009-09-04T22:14:00.000+08:00

Hi C2/09! Please check this blog from time to time for any announcements, updates or file downloads. Of course any urgent news will be announced to you by email or phone.

Cheers
Mezhen