STUDENT---TEACHER

i was having a class with a teacher dat day..

the lesson was about teenagers/adolescent health
we discusses alot
including teenage pregnancy
then tetiba cikgu ni bgtau satu contoh problem ni
bebudak x faham
then cikgu tu bg analogi
"mcm saiful la.."
bebudak masih belum dapat catch up lg siapa saiful
tetiba cikgu tu menyambung
"anwar bapak ikan, saiful anak ikan"
terkejut monkey i.
i xtau la murid lain fikir mcm mn

bukanlah niat i nak kutuk sape2, cuma terfikir, sbg guru, sepatutnya bukan hanya mengajar ilmu dunia, tp mendidik anak bangsa dengan cara pemikiran yg betul
i pun sbnrnya byk lg kena belajar
sekadar mengambil pengajaran drpd kisah ini..

MUST THINK CRITICALLY

sekadar perkongsian untuk kita sama2 jadi manusia yang menggunakan akal untuk berfikir...

td kelas dengan sorang doktor pakar kesihatan keluarga. bincang ttg contraceptive method (cegah hamil).

DR.F : when did the contraceptive method was introduced? which era?
aku pun jawab memcah keheningan yang menyelubungi para student dengan menjawab "the era of prophet muhammad"
dr. F : hmm, ya.. so what kind of method did they use that time?
aku : withdrawal (azal)
dr.F : ok, true, dats the natural method. that include calendar n symptoms method. but actually its started even before that. i mean which century? 20's? 30's?

then there was a pin drop silent indicates that none of the students have any idea about that.

dr.F : it was around 1916 right? what was happen dat time?
one of the student was making a try : world war..hehe
dr. F : (smiling)... was it? world war? ok, so where do u think the contraceptive methods introduced? which country?
student : china..
mr F : hmm, nope..
student : .....
dr. F : it was actually started in europe. u know why? that time, women think that it was unfair for them compared to the men. becoz both of them enjoy the excitement of sex but only women got the consequences (pregnancy). so they started thinking how to overcome the situation. so they introduced contraceptive methods including the condoms, diaphragm n develope scientific research about that.. but we as muslim, do we accept that?
student : its ok in some purpose. for example, the parents want to space the children becoz they want to plan for education for the children.
dr. F : good. . so is there any method that is not allowed in islam?
aku : permanent method like vasectomy and tubectomy.
dr.F : ya.. so is there any evidence that contraceptive method is allowd in islam?
aku : ya, there was a hadith which saying that there was a companion of rasulullah came to him and told him that he practiced azal and rasululullah did not object the method. means he allowed contraception in that kind of way.
dr.F : excellent! actually there were some narrations and differ , but we can take that one. some narrations said it was not allowed.
dr. F : so why do u think the purpose of WHO introduce contraceptive method to all countries?
student : to limit the population.
dr. F : good! so why they want to limit the population? dont u feel angry when they want to limit the poplulation in your country? meanwhile your country is not belongs to them, our country is ours. so why must they limit us? and why must we follow them? i want all of u to think critically..
student : they want to limit the population may be because of economic factor. maybe due to increasing index of poverty in the population.
dr. F : do u think God create this alam with poverty? can u please name what asset do malysia has?
student : paddy field, petroleum, rubber estate..
dr. F : ya! and much more.. so why must people limit the population just becoz they afraid of poverty? God never create us with lacking.. so who do u think actually making the existence of poverty?
student : GOVERNMENT!!
DR. F : (laugh politely). hmm, actually the system right? orang kaya makin kaya, org miskin makin miskin. kekayaan bumi tak diagih dengan seadilnya. dont u think so? ada ke org kaya nak bg duit dia kat org miskin? not likely right?
student : (very2 agree)
dr. F " ok, now i want to ask, which country leads the economy?
student : CHINA!
DR. f : GOOD.. so what do u think make them leads the world economy?
student : (silent... no idea..)
dr. F : its becoz menpower right? becoz of large population, they have more menpower, they work more, they produce more and they lead the world economy. so can u think the consequence of contraception to our country? its actually to make us weak.. its all ZIONIST PLAN!

those written above are some valuable lessons i got today from my lecturer. i admire her very much. she married an english man but masih kekalkan jati diri muslim dan melayu nya walaupun telah tinggal di europe selama 17 tahun.. subhanallah..

summary of this entry :

boleh nak jarakkan kehamilan tapi jangan hadkan.. kerana apa yg rasulullah sarankan tu mmg the best la. rasulullah kata baginda bangga dengan umat yg ramai, hikmahnya more men power, lg ramai org bekerja n productivty lg hebat, buktinya negara china.
pastu, perempuan bkn islam fight untk contraceptive method sbb taknak mengandung. bg mereka mengandung tu adalah kesan buruk ke atas mereka yg mana kesan tu takde pada lelaki. mereka rasa tuhan tidak adil . jika kita tgk , apa yg islam suru tu mmg cantik. dengan perkahwinan, both lelaki n perempuan kena bertanggunjawab dengan hasil keseronokan mereka. so tiada istilah tidak adil. in islam, the purpose of sex adalah to build the next generation n the excitement is the 'side effect' . but in non muslim culture, for them , the purpose of sex is for enjoyment, excitement and mereka anggap anak adalah 'side effect' (note : side effect = kesan sampingan)

cantik kan islam...

IS THESE THE SUITABLE WORDS TO DESCRIBE...??

PRIM
DEMURE
UPRIGHT

I KNOW WHAT I DO... and i am responsible for what i do

BENEFITS OF CHILLIs

Chillies are excellent source of Vitamin, A, B, C and E with minerals like molybdenum, manganese, folate, potassium, thiamin, and copper. Chilli contains seven times more vitamin C than orange.

Ever since its introduction to India in 1498, chillies have been included in Ayurvedic medicines and used as tonic to ward off many diseases. Chillies are good for slimming down as it burns the calorie easily. Chillies stimulate the appetite, help to clear the lungs, and stimulate digestive system.

Capsaicin : Chillies have vitamin C and Vitamin A containing beta-carotenoids which are powerful antioxidant. These antioxidants destroy free radical bodies. Usually, these radical bodies may travel in the body and cause huge amounts of damage to cells. These radical bodies could damage nerve and blood vessel in diabetes.

The antioxidants present in the chilli wipe out the radical bodies that could build up cholesterol causing major heart diseases such as atherosclerosis.

Chillies have antioxidants that can destroy cholesterol which could cause major disease like atherosclerosis and other heart diseases. Other disease like cataract and arthritis like osteoarthritis and rheumatoid arthritis. It also dilates airway of lungs which reduces asthma and wheezing.

Detoxicants : Chillies acts as detoxifiers as they removes waste products from our body and increases supply nutrients to the tissues. It also acts as gastrointestinal detoxicants helping in digestion of food.

Pain killer : Chillies stimulates the release of endorphins that are natural pain killers. It relieves pain caused due to shingles (Herpes Zoster), bursitis, diabetic neuropathy and muscle spasm in shoulders, and extremities. It also helps in relieving arthritic pains in the extremities.

Antibiotic : Chillies brings fresh blood to the site of the infection. The fresh blood fights infection. The white blood cells and leukocytes present in the fresh blood fights viruses.

Brain : Capsaicin stimulates brain to excrete endorphin and gives a sense of pleasure when ingested. This is the reason people get addicted to chilli.

Cancer : It has been noted that vitamin C, beta-carotene and folic acid found in chilli reduces the risk of colon cancer. Chillies such as red pepper have cartonoid lycopene, which prevents cancer disease.

Heart Attack : Chillies have vitamin B6 and folic acid. The vitamin B reduces high homocysteine level. High homocysteine levels have been shown to cause damage to blood vessels and are associated with a greatly increased risk of heart attack and stroke. It also converts homocysteine into other molecules which is beneficial to lower cholesterol level.

Lung disease : Chillies gives relief from nasal congestion by increasing the metabolism. It also dilates airway of lungs which reduces asthma and wheezing. It relieves chronic congestion in people who are heavy drinkers.

Cigarette smoke contains benzopyrene which destroys the vitamin A in the body. The vitamin A present in chilli reduces inflammation of lungs and emphysema caused due to cigarette smoking.

exam is just around the corner...

this time im writing again in the midst of hectic time.. this evening after asar i cancel my joging schedule to substitute my group study... hypertension, insulin COPD so on... O' Allah, garnt my wishes... make it easy for me ....

semua orang diuji dalam kehidupan ini.. begitu juga aku. ujian yang ALlah bg kepada setiap hambaNYA berbeza beza, tanda begitu eksklusif layanan ALlah pada hamba2NYA... sejauh mana kita berjaya menghadapi ujian itu bergantung kepada sejauh mana kita beriman bahawa kita milik ALLAH.. astaghfirullahal azhiim... ampuni aku ya ALLAH atas khilafku...

begitu juga yang dinamakan EXAM... setiap hari dalam fikiran seorang mahasiswa tipikal, akan hanya ada, HOW TO SCORE EXCELLENT IN MY EXAM?? without knowing, without thinking, without realizing that life is actually more than that. life is not just all academic stuffs. tak hairan lah jika ada pelajar perubatan yang ditipu hartanya selepas graduate dan bekerja sebagai housemen officer..

kegagalan lepas memang satu ujian hidup yang besar untuk aku. memandangkan aku ini bukanlah mukminah yang sangat hebat, maka aku kira , kegagalan akademik kali lepas adalah kifarah dosa2ku.. by hook or by crook i have no choice, i have to accept the fate n take ibrah from it n make efforts to improve my life in the future. sounds easy right? but actually its not that easy... too many obstacles i had to face and enough to make me traumatize by that experience.. all i can say tp people is "I AM NOT STUPID AND I WANT TO PROVE IT TO ALL OF U". bcoz what i've gone thru all these while cannot be describe by words... only ALlAH and me know..

talking about EXAM, adakah selepas saya bergelar siswazah dengan segulung ijazah ini , maka ujian/EXAM akan berakhir? it depends if i want to further my studies. but let think, what if I DIE TOMORROW??? jangankan ijazah, final exam minggu depan pun saya x sempat.. yang saya sempat apa? EXAM DI ALAM BARZAKH.. yang menjadi audit kepada nilai amalan saya di atas dunia ini ... muhasabahlah wahai diri... jangan kita taksub kepada dunia, atau kita tidak seimbang dalam menguruskan dunia dan akhirat sehingga kita rugi di dewan peperiksaan mahsyar... di situ, sekecil2 amalan akan dihitung.. n turning back....

SAMA-SAMALAH KITA BERUSAHA UNTUK MENGHADAPI EXAM DI DUNIA DAN DI AKHIRAT....

nasihat untuk diriku..

Jika ingin tahu akhlak sebenar seseorang, lihatlah dia sewaktu dia sangat marah;
Jika ingin melihat kehebatan akhlaknya lihatlah dia sewaktu berurusan dengan orang yang mencerca & membencinya
Jika ingin lihat keadilan mindanya dan kebaikan pola pemikirannya, lihatlah cara dia berbincang dengan pandangan berbeza dengannya.

dear my future husband

Dear Future Husband,

I will cook. I will clean. I will shop. I will be the best housewife, ever, inshallah.

I will dress up for you, I will maintain my appearance for you. I will make sure to be the best wife I can be, inshallah.

I will have as many children as you want. I will raise your children to be the best they can be. I will be the best mother, inshallah.

As long as you promise me one thing, take me to jannah.


AND YOU, MR.#### , dont worry about things dat still not happen, bcoz i promise u, i will always be on your side in times of hardship and joys... dont worry..

i agree to marry u, bcoz i attracted to your personality.. keep it up.. =) . n see u again in JANNAH insyaALLAH..

and in order to meet u in JANNAH, i must obey u..becoz that is the condition dat ALLAH gives me if want to go to JANNAH.. so dont worry ya... i will always obey you.... insyaALLAH...

dont worry... :-)

How Does Caffeine Work in the Brain?

First, How Does Sleep Work Without Caffeine?
To fully understand how caffeine works a person must understand how sleep works. The chemical adenosine accumulates in the brain when it is awake and active. In the basal forebrain, the cells are responsible for wakeful arousal and have adenosine receptors that inhibit them. It is as if they are moving really fast and then the adenosine attaches to them and slows them down, causing sleepiness. They actually inhibit them by releasing a second messenger in the cell, which increases the activity of certain genes, leading to a long-lasting affect that sustains sleep for hours. That is how sleep works.

So, How Does Caffeine Affect Adenosine and Sleepiness?
Caffeine belongs to the xanthine chemical group. Adenosine is a xanthine that is naturally occurring in the brain, used as a neurotransmitter at some synapses. Because of their relation, caffeine looks a lot like adenosine to nerve cells and therefore binds to adenosine receptors in the basal forebrain. The cells then can no longer sense adenosine because caffeine is taking up the receptors. Instead of slowing down, the nerve cells speed up and stop the person from getting tired.

What Else Does Caffeine Affect in the Brain?
As a result of the blocked adenosine, there is increased neuron firing in the brain, which causes the pituitary gland to think that there is some sort of emergency. It then releases hormones telling the adrenal glands to produce adrenaline. This has many effects on the body– liver releases sugar into the blood for extra energy, pupils dilate, heart beat increases, breathing tube open more, etc. Caffeine is also said to increase dopamine levels much like amphetamines do, which produces a euphoric effect. It potentially does this by slowing the rate of dopamine re-uptake.

What Are the Effects of Caffeine on the Brain?
In answering this question, I am referring mainly to coffee drinkers, which I myself am. That is how most people consume caffeine. Adenosine reception is important to sleep, especially deep sleep. There is a cycle that can exist when people drink coffee after a certain point in the day. Caffeine has a half-life of 6 hours, which mean that if a person drank 200mg of caffeine, 1-2 cups of coffee, at4:00pm, then at 10:00pm, 100mg of caffeine would still be in the system blocking adenosine reception. The person may fall asleep, but would miss out on the benefits of deep sleep. That increases tiredness the following day, also increasing the desire for coffee. When in this cycle, some people experience splitting headaches, and many repot extreme tiredness and depressed mood. The headaches have been found to be most likely from the dilation of blood vessels in the brain. The depressed mood is most likely just a rebound from the recent manipulation of dopamine.

What is this analogous to?
My analogy is of a computer lab that many students need to use to get important work done. Think of each computer as an adenosine receptor and each student as adenosine. When they are all seated, the lab is quiet without much movement. This would be when a person becomes tired. One day a bunch of other students beat them to the computers and started playing games on them. The computer lab then becomes loud and busy with activity. These game-playing students are like caffeine getting in the way of the adenosine. The pituitary gland could be like the faculty, whom is alerted of the situation in the lab and panics because the hard-working students can’t get their work done and there are a bunch of them standing in the hallway outside the lab. The faculty then send other people, who are analogous to adrenaline, to the lab. These people cause even more activity

kerinduan di puncak menara sujud..

Melewati siang dalam kepenatan jiwa
Menyusuri malam dengan kesunyian hati
Gumpalan dosa mengikuti jiwa yang kering
Sesal isak meremas persendian raga

Dalam bulir-bulir waktu
Berkejaran rasa, menjelma menjadi alunan sesak
Tanpa harapan, tiada tujuan
Melangkah dalam kehampaan

Mengejar kebahagiaan semu
Bersama nyanyian tanpa makna
Tertawa lepas di atas altar maksiat
Gelak hati merintih dalam kepedihan

Nun jauh dari naluri suci
Arak memabukkan menari-nari
Tanpa cacat dalam gelas putih
Hingga memabukkan diri ini
Melebur dalam lautan dosa
Malam terasa memekakkan gendang telinga

Masa bergulir melahirkan remang-remang asa
Warna hitam mendung berganti menjadi bianglala indah
Dalam pusaran waktu cinta-Nya menyapa
Mengalir sejuk ke relung jiwa yang tandus
Jeritan tangis pilu menghampar
Menyesali ruh dan jasad yang tlah tersesat jauh
Hidung tersumbat oleh dosa-dosa masa lalu
Jiwa tertatih ingin berdiri, menggenggam erat Kasih-Nya

Ya Allah,
Dalam kehampaan jiwa
Tlah Kau tuangkan air cinta-Mu
Pada diri yang tlah berlumur dosa
Pada hati yang bersimbah kemunafikan

Ya Allah,
diri malu mengharap ampunan-Mu
Namun kuyakin Engkau teramat Penyayang
Meski hamba-hamba-Mu berserakan dosa

Ya Allah,
dalam sesal tak bertepian
Ku ingin teguh berjalan dalam keridhaan
Rinduku pada-Mu menggelora
Menggebu dalam puncak menara sujud
Genggam jiwa yang sedang meronta
Mengharap luapan dosa Engkau Ampuni
Dalam puncak menara sujud khusyuk pada-Mu
Pasrah ini kugantungkan.

DALAM SUJUDKU…. (nukilan : miftahul jannah )

dalam sujudku,
aku memohon ampun kepadaNYA,
atas khilafku,atas lemahnya aku,
kenapa diri ini seolah olah begitu degil,
untuk menerima hakikat bhawa aku mampu sbnrnya,
mungkin kah kerana jasad menzahirkan bahwa aku tidak mampu,
atau kerana aku sebenarnya masih trauma dengan ujian yg menimpaku..

Dalam sujudku,
aku memeberitahu DIA,
kau tahu ya ALLAH, kau dengar ya ALLAH,
malah Kau tahu apa yg aku lalui,
tapi mengapa ya ALLAH,
aku masih rasa lemah meskipun aku tahu,
KAU tidak pernah meninggalkan ku..
Dalam sujudku,
aku menangis,
aku tahu KAU rindu akan tangisanku,
kerana itu KAU berikan aku ujian seberat ini,
yang kurasakan tidak mampu lagi kupikul,
aku merintih kepadaMU,
YA ALLAH, KAU yang menciptakanku,
KAU yang mengetahui setiap inci perkara mengenaiku,
KAU lebih kenali aku lebih drpd aku mengenali diriku sendri,
namun kenapa aku merasakan seperti KAU juga seperti mereka..
yang seperti semberono memilihku untuk sesuatu yg aku tdk mampu ya ALLAH
ya ALLAH, aku tahu KAU tidak pernah silap,
tapi hatiku terlalu degil ya ALLAH untuk menerima perlantikanku..
KAU lebih tahu ya ALLAH apa yang bermain di gejolak hatiku..
Maka ya ALLAH, perkenanlah doaku..
aku mohon ruang untuk aku kembali mendekatiMU dengan cara yang kutahu tenang pd diriku…
aku rindu padaMU ya ALLAH…
beri aku ruang ya ALLAH….
perkenankanlah permintaanku…..

characteristic of TYPE A PERSONALITY

Type A personality has almost become a household word. The relationship between type A personality and heart disease has become a common knowledge, at least, among physicians and their afflicted patients. In spite of its wide publicity and media attention, criteria of type A behavior or personality still remain vague. Even the so-called experts don't diagnose it correctly. There are two cardinal features of type A that we must remember, namely, "time urgency or time- impatience" and "free-floating (all pervasive and ever-present) hostility."
One employee, an astute observer of human behavior, gives the following description of his boss Arthur:

"Arthur talks real fast at the rate of 140 words per minute or more. His voice is grating, harsh, irritating, excessively loud, and just generally unpleasant. His posture is tense with abrupt jerky movement. Every few minutes, he raises his eyebrows in a tic-like fashion. Likewise, every few minutes, he raises or pulls back one or both shoulders in a tic-like fashion.

His tongue is indented due to chronic pressure against the back of his upper incisor teeth. When he speaks, you can hear a click because he has to separate his tongue from his upper teeth in order to open his mouth. You can hear his breath as he continuously sucks in air to speak rapidly. He sighs as he exhales which is not a sigh of relief but a sigh of frustration and emotional exhaustion. He blinks every couple seconds. He frequently exhibits beads of perspiration on his forehead and upper lip even at normal room temperature.

The skin of his lower eyelid has become brown because of a diffuse and permanent deposit of melanin. His facial expression with glaring eyes and lowered eyebrows make him look hostile. His lower eyelid is raised permanently which makes him look like he's staring at you. He looks aggressive and determined because the muscles surrounding his mouth are always tight. His thin lips are slightly pulled on both sides, and a visible bulge is created by tense jaws which make him look angry with an artificial smile. He has a habit of rapidly retracting the sides of his mouth that sometimes bare his teeth."

Arthur exhibits all of the noted physical signs of type A behavior (TAB). In fact, consider Arthur as the personification of TAB. If Arthur does not change himself, he will have a cardiac disaster before the age 65. Note that the prediction of heart disease before age 65 for him is not a mere possibility, it is a certainty.

Above we have depicted a comprehensive description of the scientifically identified physical characteristics of TAB. Let's now return to the two cardinal psychological characteristics of TAB, namely, the time-impatience and the free-floating hostility. Here are a few questions that I have adapted from Dr. Friedman's assessment techniques to determine each of the two characteristics. Regard these informal questions merely as pointers and not as the standard scientific assessment of TAB disorder.

Following questions may be asked to determine the presence of time-impatience 1. Do you eat fast and leave the dinner table immediately ? 2. Does your partner or any close friend tell you to slow down, become less tense, or take it easy? 3. Does it bother you a lot to wait in line at cashier's counter or to be seated in a restaurant? 4. Do you usually look at TV or read the paper while eating? 5. Do you examine your mail or do other things while listening to someone on the telephone? 6. Do you often think of other matters while listening to your partners or others? 7. Do you believe that usually you are in a hurry to get things done?

Pervasive and ever-present hostility can be assessed by the following questions: 1. Do you often find it difficult to fall asleep or difficult to stay asleep because you are upset about something a person has done? 2. Do you believe that most people are not honest or are not willing to help others? 3. Do you become irritated when driving or swear at others? 4. Does your partner, when riding with you, ever tell you to cool or calm down? 5. Do you often have a feeling that your partner is competing against you or is too critical of your inadequacies? 6. Do you grind your teeth or has your dentist ever told you that you have done so? 7. Does the car-driving errors of other drivers, the indifference of store clerks, or the tardiness of mail delivery upset you significantly?

Dr. Friedman has identified two psychological and six physical signs as major indicators of TAB. According to him these eight signs are almost always diagnostic of TAB. The two psychological signs are: 1. Presence of impatience or easily induced hostility. 2. Constant apprehension of future disasters (which is not a symptom of an anxiety disorder or depressive disorder). The six physical signs are: 1. Excessive perspiration of the forehead and the upper lip. 2. Teeth grinding. 3. Indentation of the tongue due to its chronic pressure against the top incisor teeth. 4. Tic-like retraction of the upper eye lid. 5. Tic-like retraction of the corners of the mouth. 6. Brown coloring of the skin of the lower eyelid.

In another article, I will discuss ways to modify type A behaviors and characteristics.

hasil attach kat klinik kesihatan...

Hasil attach kat farmasi klinik kesihatan…..
Lasix = ferusemide
Bactrim = co-trimoxazole
Zantac = ranitidine
Methyl cobalt = mecobalamine
MTF = metformin
Daonil = glibenclamide
Diamicron = gliclazide
Lopid = gemfibrozil
CML = chlorampehicol (eye drop, ear drop,cream/lotion etc)
LMS = methysalicylate (cream/lotion)
Bacampicillin = potassium chloride (for UTI??)
Papase = prolase
Adalat = nifedipine
Piritone : methotrexate maleate
HCT = hydrochlorothiazide
Lamotrine = diphenoxylate
Maxolone = metoclopramide
Zinnat = cefuroxime
Bisolvon = bromhexine
MES = mist ammonium appecacuanha (ubat batuk)
FES = erythromycin
Voltran = diclofenac sodium
Buscopan = hyoscine
Tapi satu saya tertarik, ubat BISOPROLOL… bentuk dia bentuk LOVE.. dan pharmacist tu x letak kat luar. Macam ubat terkawal. Sbb siap ada borang pharmacist tu kena isi. Agak2 kenapa ye? Kena Tanya kaklong ni…

case scenario : hypertension

Case Information

CC/HPI: A 37 year old white male with an otherwise unremarkable past medical history presents to his doctor for routine physical. He presents with no complaints.
Past Medical History: None
Medication History: None
Vaccination History: up to date.
Adherence/Medication Use Behaviors: Patient was on time to doctor's appointment.
Drug Allergies/Adverse Effects: NKDA
Pharmacy/Medical Payment: Employer Insurance
Medications Administered by: Self
Family Medical History:
Father/Mother: unremarkable
Siblings: unremarkable
Children: none
Other: none

Social History:
Residence: single apartment
Occupation: office worker
Smoking: none
Diet: fast food
EtOH: none
Education: Masters degree
Illicit Drugs: none
Family/Social Environment: lives alone

Symptom Analysis:
Head, Eyes, Neck, Throat: Denies blurriness or change of vision, confusion, speech and cognition disorders.
Heart: Denies chest pain and palpitations.
Lung: Denies shortness of breath.
Gastrointestinal: Denies abnormalities of frequency, color, and consistency of stool. Denies bowel pain or cramping.
Gennitourinal: Denies abnormalities of frequency, color, and consistency of urination.
Musculoskeletal: Denies weakness, cramping, pain or paralysis.
Extremities: Denies numbness, tingling, coldness, or color abnormalities.
Neuro/Psych: Denies anxiety, depression, sleep disorders.

Physical Exam:
Head, Eyes, Neck, Throat: Patient presents with no facial asymmetries or drooping. No abnormal venous pulsations. Fundoscopy not performed.
Heart: S1 and S2 heart sounds present. No murmurs. No S3 or S4 sounds present.
Lung: Lungs clear to auscultation. No wheezing, crackles or ronchi. Percussion produces neither dull or hyperresonant sounds.
Abdominal: Normal active bowel sounds present. Non-tender and non-distended. No bruits over aortic, renal or illiac positions.
Extremities: Bilateral pulses present that are regularly regular rhythm. Hair symmetrically present. No nail clubbing present.
Neuro/Psych: Patient is amiable and cooperative. Responsive to questions and commands.

Vital Signs:
Temp: 98.6 F
Heart Rate (right arm): 74 (regularly regular)
Blood Pressure (right arm, sitting): 152/94
Respiratory Rate: 16 breaths/minute
Height/Weight: 5'11'' 190 lbs (BMI: 26.5)

Discussion

Most will consider this discussion overdone especially in this patient who presents with an unremarkable presentation. However, the thoroughness of our discussion here will set the stage for further cases that have relevant presentations of hypertensive complications. This discussion will first establish a diagnosis followed by rationale for how that diagnosis was derived. Following diagnosis, we will establish a likely prognostic course in this patient if left without intervention. Finally, we will discuss the best interventions to take in this patient to promote the best prognostic outcome.

Diagnosis
With a single first measurement of blood pressure, in this patient, it is not appropriate to jump to a diagnosis of hypertension. Academically, guidelines recommend three separate measurements of an elevated blood pressure (>140/90) within a six month period prior to a hypertension diagnosis[1]. Acquiring patient specific medical and social history is vital in directing a relevant diagnosis. Hypertension is a "silent" disease that presents with no symptoms. However, complications of organ damage secondary to hypertension have symptoms that are useful in providing a sense of how serious this patient's hypertensive status, if any, presents.
We first need to evaluate any acute causes of an elevated blood pressure reading. The first might be an error in reading. Academically, guidelines recommend a 5 minute period of resting with no consumption of caffeine or nicotine products prior to the exam. It is usually difficult and impractical in a real clinical setting to follow this. There are also cases of "white coat hypertension" that occur when a patient's presence in a clinical setting cause acute increases in blood pressure.
Acute causes may also be drug or substance related, notably caffeine, nicotine, non-steroidal anti-inflammatory drugs (NSAIDs), and illicit substances such as cocaine and amphetamine. This patient denied any use of illicit drugs or medication history.
We may rule out other improbable causes such as sleep apnea. Patient denies sleep disorders. Chronic kidney disease is unlikely. Patient denies abnormalities in urination. Primary aldosteronism is unlikely as this patient denies muscle weakness or fatigue. Thyroid disease is unlikely as this patient denies mood, energy, appetite or weight change abnormalities. Patient also presents with no other abnormal cardiovascular findings, typical of thyroid disease.
Next turning to risk factors we clearly see an elevated weight (BMI: 26.5) and a regular diet of fast food. This patient does not smoke, use illicit drugs, or excess alcohol. We are not certain of his family history of blood pressure, though he does not admit to remarkable family medical problems.
Prognosis
Even if we assume this patient has hypertension, we are not certain of this patient's cholesterol levels to accurately determine his future risk of cardiovascular disease. Considering worst and best case scenarios of at goal and not-at-goal cholesterol levels, we can estimate this patient's 10 year risk of cardiovascular disease at 1% to 6%[2]. This means that if his blood pressure remains unchanged we have the following best and worst case scenarios. If his cholesterol is at goal (HDL is 40 and Total Cholesterol is 160) his risk of having a myocardial infarction, ischemic stroke, peripheral arterial disease, heart failure or death from cardiovascular causes is 1%. On the contrary, if his HDL is 30 and Total Cholesterol is 290, it is 6% likely for the aforementioned to occur.
Intervention Options
Despite no diagnosis, the lack of presenting end-organ damage complications make candidate interventions in this patient simple. He would clearly benefit from a reduction in his weight, increase in exercise activity and modification of his diet whether or not he has hypertension. Antihypertensive medications might not be helpful at this time as we do not have a formal diagnosis. While they would most likely not harm the patient, their benefit in preventing cardiovascular events in this patient would be questionable. Finally, it would be important to get a laboratory reading of this patient's cholesterol levels to make a formal prognostic risk assessment of future cardiovascular events.


Therapeutic Intervention
The most outcome benefiting intervention at this time would be to counsel this patient on lifestyle modifications as well as laboratory assessment of his cholesterol. The "Dash Diet" has been the lifestyle recommendation of choice for patients with hypertension[3]. For this patient, it recommends four servings each of fruits and vegetables daily, seven servings of whole grains, with limits of 2.5, 1.5, 0.5, 2, and 0.5 servings of dairy, meat, nuts/beans, fats, and sweets respectively. Also, the American College of Sports Medicine recommends 20 to 30 minutes three times weekly of endurance exercise training to drop systolic blood pressure by 10 mmHg[4].

Follow-Up and Monitoring
This patient should return in less than sixth months for a repeat measurement of his blood pressure and follow-up on results from his cholesterol testing.

Economic Analysis
The goal of economic analysis is to determine the value of certain health interventions or the burden of not intervening to aid in decision making. No precedence exists for the health economic evaluation on a patient level. This section follows the common taxonomy of economic analysis for decision making as well as the author's introduction of Real Options Analysis (What is this?). Our economic analysis will involve a population of 100 individuals that match the same characteristics of the patient here. Our application of Real Options Analysis will allow for evaluation on a patient level.

Preliminaries
Economic analysis requires the development of models which require assumptions and parameters. We will evaluate a horizon of 10 years under the following assumptions:
Diastolic blood pressure and the related pulse pressure will have no prediction on 10 year cardiovascular disease risk.
The mean and variance of all inputed values does not change throughout the horizon.
The only therapeutic options available are diet and exercise.
There is no difference in cost between patients' existing diet and the DASH diet.
DASH low sodium diet will reduce systolic blood pressure a mean -8.9 mmHg (95% confidence interval: -6.7 to –11.1) over 30 days[5].
Exercise as recommended will reduce systolic blood pressure a mean -10 mmHg (95% confidence interval: -7.5 to -12.5) over 30 days[4].
No additional blood pressure improvements will accrue after the initial benefit.
The blood pressure never worsens over the horizon.

Model
Figure 1 shows the model to be employed. The decision to be evaluated is comparing the impact of DASH diet and exercise versus doing nothing. The 'M' is a Markov Model (see introduction to Markov Modeling here) of which we evaluate shown in Figure 2. The markov model assumes a single change in blood pressure with a subsequent influence on cardiovascular disease outcomes over the 10 year horizon. At study initiation the blood pressure may stay the same, or drop to within 120-139 or <120. This blood pressure state has a corresponding impact on cardiovascular disease risk.
Table 1 shows the probabilities of these transition states. These were calculated from the mean and standard deviations of the studied outcome of diet[5] and exercise[4]. Instead of modeling a continuous blood pressure change, this allows for the modeling of states which may more accurately reflect the systolic pressure variability throughout the horizon.
Calculating such involved first combining the mean and standard deviations of the two interventions assuming independence in both of their outcomes. Then, we calculate the distributions based on the new mean and standard deviation. Finally we calculate the cumulate distribution of patients at different states.
The combined mean of -8.9 mmHg from [5] and -10 from [4] is a simple sum to -18.9 mmHg mean change. The standard deviations of 2.2 and 2.5 respectively were calculated from the formula . Thus the combined standard deviation was calculated to be 3.3.
Calculating the distributions involving using a statistical package, in this case R Cran, using the "rnorm" function with the inputs of mean=-18.9 and sd=3.3. The syntax is data <- rnorm(10000,18.9,3.3).
To calculate the percentage of patients transitioning to normotensive state we calculate the cumulative distribution of those that had >=20 mmHg. The syntax for this calculation in R is length(data[data>=20])/10000. To calculate the percentage of patients transitioning to a normotensive state we calculate the cumulative distribution of those that had <=10 mmHg. The syntax for this calculation in R is length(data[data<=10])/10000. Finally, calculating the cumulative distribution of patients transitioning to the prehypertensive state was simply the remaining. Table 1 shows the probabilities of these transition state calculations.
Table 2 shows the 10 year probabilities of cardiovascular risk given our uncertainty of patients' cholesterol levels. These were calculated using the framingham risk calculator. The two different transition probabilities take into account the uncertainty of the patients' cholesterol values. The lower and upper value correspond to Total and HDL inputs of 160, 40 and 280, 35, respectively. The other inputs were male 37 years old, non-smoker, and not on blood pressure therapy. The SBPs were inputed as 150, 135 and 118, respectively.

Figure 1. Decision Model for Economic Analysis (Case # s1htn.m.37)


Figure 2. Markov Model for Outcomes of Blood Pressure Lowering (Case # s1htn.m.37)

Table 1. Transition Probabilities of Blood Pressure States

Ending
State With Treatment Without
Treatment
140-159 1% 100%
120-139 60% 0%
<120 39% 0%

Table 2. Transition Probabilities of CVD States

SBP State p (CVD)
140-159 1% to 6%
120-139 1% to 4%
<120 1% to 3%

Budget Impact Analysis

Table 3. Input Parameters


Cost Effectiveness Analysis

Disclaimer: Patient information in this case is fictional and for educational purposes only. Any similarity to real persons or events is coincidental. Information contained in this knol is not to replace medical advice from a licensed health care provider. The author of this knol does not produce or endorse content from advertisements on this page.

tanda2 telah mendapat cinta ALLAH

Antara Tanda-Tanda Telah Mencintai ALLAH

1. Solat bukan lagi semata-mata kerana perkara fardhu yang wajib tetapi adalah perkara yang dinanti-nanti dan dirindu pada setiap saat seperti seorang kekasih yang rindu untuk bertemu kekasihnya
2. Zikir bukan lagi semata-mata kerana sunnah yang dituntut melainkan kerana perasaan asyik dan tenang jiwa bila menyebut nama ALLAH yang Maha Agung seperti seronok dan asyiknya seorang kekasih menyebut nama kekasihnya
3. Nama ALLAH sentiasa disebut-sebut di dalam hati, fikiran dan sanubari sehingga terbawa-bawa dalam tidur juga menyebut namaNYA seperti seorang kekasih yang selalu bermimpi dan mengigaukan kekasihnya sewaktu beradu
4. Melakukan ibadat & ketaatan bukan lagi kerana ingin mendapat balasan pahala atau kerana takutkan azab neraka, tetapi kerana rasa tanggungjawab dan kecintaan yang mendalam dan merasa sangat bersalah apabila terlalai dari melakukan ketaatan yang telah sebati dilakukan selama beberapa waktu seperti seorang kekasih yang sanggup melakukan apa saja yang disukai kekasihnya dan membenci apa saja yang dibenci kekasihnya semata-mata kerana perkara itu disukai atau dibenci kekasihnya
5. bila hanya kepada ALLAH tempat bergantung dan tempat pengaduan segala perkara
6. bila tidak lagi mendengar panggilan dan kata-kata orang sekelilingmu kerana asyiknya memuji dan memuja ALLAH seperti asyiknya seorang yang sedang mabuk bercinta dengan kekasihnya
7. bila celaan & hinaan orang dengan mengatakan gila, sakit, atau tidak siuman hanya kerana kita terlalu rindu dan sentiasa mengingat dan memuja kebesaran dan nikmat ALLAH seperti halnya seorang kekasih yang gila bayang dan kelihatan suka menyendiri kerana mengingat dan memuja kekasih hatinya.

tanda2 awal cinta ALLAH

Antara Tanda-tanda awal:-

1. Solat tidak lagi menjadi perkara berat untuk dilaksanakan sebaliknya akan sangat mudah dan dinanti-nanti waktu hadirnya.
2. Mula merasa menunaikan solat sesuatu yang mengasyik & menenangkan jiwa & fikiran sehingga sangat seronok untuk melakukan sebanyak-banyaknya seperti seorang kekasih yang seronok untuk menatap dan mengadu kepada kekasihnya dengan sebanyak-banyaknya
3. Zikir kepada ALLAH adalah menjadi kata-kata yg paling digemari walaupun kadang-kala terlalai atas urusan duniawi
4. Kurang bercakap atau tidak bercakap yang sia-sia (bercakap bila perlu sahaja)
5. tiba-tiba hilang perhatian kepada material duniawi seperti kalau dulu suka berbelanja atau bersuka-ria atau suka kepada hiburan maka kini mula menjauh diri kerana hilang minat sebaliknya lebih suka menyendiri dan muhasabah diri
6. sering menangis bila mengingat dosa yang pernah dilakukan sekalipun sangat kecil
7. sering menangis kerana takutkan azab neraka yang tidak mampu menahannya
8. sering mengingati bagaimanakah keadaan menghadapi azab kubur
9. sering merasakan bahawa nyawa akan dicabut malaikatmaut pada bila-bila masa saja
10. tidak runsing atas segala yang berlaku pada dirinya samada masalah atau musibah yang datang melanda kerana percaya atas apa yang ALLAH kehendaki ke atasnya adalah kebaikan
11. sentiasa bersyukur tetapi bimbang saat menerima nikmat ALLAH yang merupakan satu ujian menguji keimanan diri
12. sering khuatir tindakan yang dilakukan pada setiap waktu apakah diberkati dan dirahmati ALLAH atau dimurkai Tuhan
13. sering merasakan musuh paling utama adalah diri sendiri yang mempunyai sifat2 mazmumah yang sukar dibendung dan dikawal
14. tiap saat merasakan telah melakukan banyak kesalahan dan dosa
15. sentiasa meminta ampunan dari ALLAH dan yakin bahawa ALLAH adalah Tuhan Yang Maha Pengampun lagi Maha Penyayang
16. sering muhasabah diri pada setiap hari dan malam

a story of today.-->>aku dan masyarakat...

sbnrnya aku pun xtau kenapa dalam banyak2 peristiwa, situasi dan kondisi yg pelbagai dalam masyarakat yg aku jumpa setiap hari, aku pilih kisah hari ini untuk dikongsi. kisah ini kisah biasa, malah ada banyak lg kes yg lebih menyentuh hatiku yg kusaksikan pada patient2ku. mungkin ada sesuatu sbb kenapa ALLAh gerakkan hatiku untuk berkongsi kisah ini..

hari ini, 16 november 2011. aku ke klinik seperti hari sebelumnya. ini hari kedua aku di klinik slps hari yg begitu sibuk semalam. alhamdulillah hari ni pesakit x ramai seperti semalam, tp tetap ramai juga sbnrnya. hari ni pagi aku bertugas bhgn consultation pesakit. so agak free pagi ni. petang aku bertugas di bilik rawatan. tp krn sedikit mslh teknikal, aku setuju untuk tukar jadual dgn my colleague yg ada appointment dgn dr gigi. hajatku ingin gunakan waktu pagi tu untuk buat test HIV untuk persediaan perkahwinanku dengan pilihan hatiku x lama lagi insyaALLAH. tp selepas ditanya pd staf di kaunter, katanya HIV test adalah pd waktu petang. maka xpelah, aku pun menuju ke bilik rawatan.

satu demi satu pesakit masuk mendapatkan rawatan. kebanyakannya adalah pesakit ulser kaki diabetes. pesakit x putus2 masuk. selepas aku memasukkan branula ke salur darah seorang pesakit untuk dimasukkan drip, masuk seorang ibu bersama anak lelakinya, awal 20-an. eh, makcik ni dah pernah jumpa dah 2 bulan lepas ni kat emergency department hospital. dia datang untuk apa ni. drpd perbncgn dgn pembantu pegawai perubatan, tahulah aku bahawa dia ingin set up medical check up untuk anak lelakinya it yg bakal masuk ke institut kemahiran mara. aku kenal makcik ni, masih ingat peristiwa kat emergency dulu, dia menangis nangis taknak masuk wad sebab katanya xde sape nak jaga anak tunggalnya itu. kini, dia mengiringi anak lelakinya untuk buat medical check up. seingat aku dulu, mak aku biarkan sorang2 je pergi buat medical check up. terkontang kanting aku cari haluan sendri kat klinik masa tu. masa PPP tgh set up appointment tu, tba2 maknya memandang aku dan tiba2 bersuara "nak ambik bahagian ke-ju-ru-te-ra-an au-to-mo-tif" sambil tersenyum lebar.. aku hanya tersenyum melihat senyuman bahagia si ibu. cara dia bgtau aku menampakkan dia sungguh bangga dengan anaknya.
seketika kemudian PPP bertanya kepadanya, "saya set up appointment kamu jam 8pagi esok ye, kat sini". si ibu pun tergelak kecil dan bertanya kepada anaknya, "blh ke pukul 8". si anak mcm serba salah tp x berkata kata apa pun tp tersengih2. aku hanya memerhati memandangkan pesakit seterusnya belum masuk lg. tba2 makcik tu bersuara pada kami "pukul 8 ni x bangun lg ni. sbb malam2 dia pergi gym, balik lewat" . si anak pandang aku, aku pandang dia. dia senyum. adehh. main mata ngan aku pulak budak kecik ni. kau ingat aku heran ke kau pergi gym. aku sbnrnya heran, kau ni bangun semayang subuh x???... hmm, bangun kot, tdo balik.. aiseh, bahaya mung ni dik.. semoga kita sama2 baiki diri ye dik..

yang aku nak ulas kat sini ialah, sama2 kita muhasabah beberpa perkara di bawah
1. betapa bangganya seorang ibu apabila anaknya blh sambung belajar. walaupun setahu aku kejuruteraan automotif, kalo sijil tu mcm pomen kereta la. kalo diploma or ijazah lain cerita. bukan niat nk pndg rendah x, tp nak katanya mak ayah kita sgt bgga ngan kita no matter what. kalo blh nak kecoh satu kampung. tp apa yg kita buat kat universiti?? layan awek?? belanja awek??? sama2 kita muhasabah..
2. ibu bapa hari ni mementingkan martabat dunia. xpe habit pergi gym lewat malam sampai balik lewat, tdo lepas subuh. bangga anak blh smbg belajar tp bagaimana dgn akhiratnya? sama2 kita muhsabah..
3. apasal budak kecik tu pandang aku mcm tu? dia ingat semua perempuan bodoh ke.. hanya perempuan bodoh je rasa lelaki yg ikut intensive training kat gym tu (tp peribadi muslim xde) cool. aku x heran lelaki mcm ni. walaupun kau baru 18/19/20 tahun, dan body kau mmg mcm model, aku x heran...
4. adehh, aku x manja mcm tu, sbb anak tunggal kot. xpela, dah dewasa nanti jaga mak kamu mcm mak kamu jaga kamu ye..

THINK...

duit bukan segala-galanya tetapi segala-galanya memerlukan duit.. tanpa 20sen, maruah anda tergadai kerana tak dapat melangsaikan hajat di tandas... is it right??

intelektual bukan segala2nya, tp tanpa intelektual, tak wujud ilmu. tanpa ilmu , kita xleh nak ubah nasib hidup kita. kita takkan rasa kalau kita dah biasa hidup senang..

bapa saudaraku batuk berdarah (hemoptysis)

sedang aku asyik stadi, jam 12.15 malam, tba2 mesej facebook masuk. drpd adik lelakiku.. katanya bapa saudaraku batuk berdarah. setengah jam kemudian, mak ayah aku pula kol, bertanyakan aku perihal tersebut..

Table 47-1: Differential Diagnosis of Hemoptysis
Source other than the lower respiratory tract
Upper airway (nasopharyngeal) bleeding
Gastrointestinal bleeding
Tracheobronchial source
Neoplasm (bronchogenic carcinoma, endobronchial metastatic tumor, Kaposi’s sarcoma, bronchial carcinoid)
Bronchitis (acute or chronic)
Bronchiectasis
Broncholithiasis
Airway trauma
Foreign body
Pulmonary parenchymal source
Lung abscess
Pneumonia
Tuberculosis
Mycetoma ("fungus ball")
Goodpasture’s syndrome
Idiopathic pulmonary hemosiderosis
Wegener’s granulomatosis
Lupus pneumonitis
Lung contusion
Primary vascular source
Arteriovenous malformation
Pulmonary embolism
Elevated pulmonary venous pressure (esp. mitral stenosis)
Pulmonary artery rupture secondary to balloon-tip pulmonary artery catheter manipulation
Miscellaneous/rare causes
Pulmonary endometriosis
Systemic coagulopathy or use of anticoagulants or thrombolytic agents

mereka memerlukan aku....

MY SECOND CASE REPORT IN ORTHOPEDIC..

SPINAL DEFORMITY... SCOLIOSIS

is it carpal tunnel syndrome??

since about 2 weeks ago.. i had a feeling of tingling sensation (paraesthesia) in my rignt hand, most prominent on my palm. the first time i noticed this was when i woke up from bed one morning.. i had to sentap2 my hand hoping that i goes away. i thought it was bocoz i might be sleeping tight on my palm.

so what is CARPAL TUNNEL SYNDROME? i will explain after i finish my exam this week, insyaALLAH

HOMEWORK BY DOCTOR CUN, CUN GILER!!!

name of the LA drugs...
Lignocaine (Lidocaine): It is a commonly used local anaesthetic drug. After administration, it has a rapid onset of action within 3 minutes. If adrenaline is combined, the duration can be extended to as long as 1 or 2 hours.

Bupivacaine: It is a potent local anesthetic and takes up to 30minutes for full effect and has a longer duration of action.

Benzocaine



site of blockade
maximum dose of the drugs
signs of toxicity of the drugs..

MY FIRST CASE REPORT IN ORTHOPEDIC

MR. M

C3 N C4 SUBLUXATION

menjadi isteri kepada seorang pejuang agama ALLAH

bismillah.. sesungguhnya aku x layak menulis coretan/artikel ini. namun ku gagahkan juga semangat di hati agar artikel ini boleh mengingatkan ku di kala aku lemah kelak..

pertama sekalinya, sungguh aku merasa tdk layak menerima / mengkhitbahkan diri dengan seorang yang di hatinya mendaulatkan kecintaan pada perjuangan agama ALLAH. sungguh aku tdk layak. aku tdk sehebat itu untuk berpasangan kan muslim sehebat itu. di hatiku masih banyak yang perlu dibetulkan. di hatiku masih banyak yang perlu ditarbyahkan..

jujurnya, perempuan mana yang tidak mahupun lelaki yang baik untuk menjadi imam kepada bahtera rumah tangganya. perempuan mana yang tdk mahupun lelaki soleh untuk menjadi ayah kepada anak2nya yang bersih.. semua orang mahupun yang baik2. begitulah juga aku.. walaupun aku ini tidak layak dengan orang baik2. aku biasa sahaja orangnya. typical umat akhir zaman yang berusaha sedaya upaya untuk survive dalam dunia akhir zaman yang penuh cabaran ini.

namun takdir menentukan ALLAH menemukan ku dengan calon suami yang cukup diredhai agamanya. cukup disenangi akhlaknya. dan cukup sejuk di mata keluargaku itu yg penting juga.. tp kini apabila dimuhasabah diriku, terasa dia layak mendapat muslimah yang jauh leboih baik daripada diriku.. jujurnya itula yang aku rasai.. namun, mana mungkin lamaran ditolak pada waktu2 begini, kami tiada masalah melainkan diriku sahaja yang rasa terlalu tidak layak untuk insan yg tegar hatinya pada perjuangan.. bukan aku tidak menyokong perjuangan. malah aku juga sebahagian daripada perjuangan ini, namun dalam perjuangan ini terlalu ramai muslimah2 yg hebat2 membuat aku rasa siapalah aku untuk berdamping dengannya. ya , AKU MASIH SEBAHAGIAN DRPD PERJUANGAN INI. namun aku tdk hebat. tapi jauh di sudt hatiku.. aku perlukan imam sepertinya, yang boleh membawa aku ke syurga. aku sedia dibimbing... cuma aku merasa tidak layak untuknya...

kerana rasa rendah diri inilah aku merelakan jika suamiku kelak ingin menikahi muslimah yg jauh lebih baik diriku. boleh jadi muslimah tersebut mampu menjadi pendamping terbaik untuknya berbanding diriku..

menjadi isteri kepada seorang pejuang islam, jangan diimpi dapat bermanja, krn suamimu belum tentu ada masa untukmu dan anak2...
menjadi isteri kepada seorang pejuang, jangan diimpi dapat hidup senang, boleh jadi simpananmu juga terpaksa dihabiskan untuk menyokong perjuangan....
menjadi isteri kepada seorang pejuang, jgn diharap tangisan mu di kala kesusahan ada yg memujuk, krn banyak lg perkara yg lebih besar untuk diuruskan berbanding melayani emosimu...
menjadi isteri kepada seorang pejuang, pelindungmu belum tentu adalah suami mu, tiada bezanya, pelindungmu tetap adalah ALLAH azza wa jalla..

jika kamu bakal isteri kepada syabab yg meletakkan kecintaannya kepada ALLAH dan rasul, bersedialah... bersedialah untuk ditarbyah zahir dan batinmu dengan mehnah perjuangan... moga ALLAH kuatkan hatiku...

Dan di antara tanda-tanda yang membuktikan kekuasaanNya dan rahmatNya, bahawa Ia menciptakan untuk kamu (wahai kaum lelaki), isteri-isteri dari jenis kamu sendiri, supaya kamu bersenang hati dan hidup mesra dengannya, dan dijadikanNya di antara kamu (suami isteri) perasaan kasih sayang dan belas kasihan. Sesungguhnya yang demikian itu mengandungi keterangan-keterangan (yang menimbulkan kesedaran) bagi orang-orang yang berfikir.

And among His Signs is this, that He created for you mates from among yourselves, that ye may dwell in tranquillity with them, and He has put love and mercy between your (hearts): verily in that are Signs for those who reflect.

ARRUM AYAT 21

buah hatiku pendamai emosiku...

walaupun takde anak sendri, n taktau la bila ada peluang ada anak sendri (terpaksa consider kemampuan n rezeki dari ALLAH juga kan..) , aku cukup terhibur dengan telatah sepupu2 kecikku... mereka kat atas ni.. namanya muqri dan muchlis... muqri is along n muchlis is adik..

masa gambar ni diambil, aku beru lepas hujan lebat (crying) sebab stress dengan kerja yg melambak n semua nak jatuh atas kepala aku... malas nak cerita panjang, cerita pun x guna juga kan, diam lebih baik. suka hati la orang nak fikir apa..

petang tu aku stress, aku terus keluar dr dewan kuliah, aku nangis meracau racau hehe.. astaghfirullah.. lastly aku capai kunci kereta, angkut baju2 semua masuk kereta n aku cadang memang terus nak balik rumah yg jaraknya 100km juga kot. tp ALLAH direct me to my uncle's house in seksyen 25 shah alam, aku masa tu mmg x sempat dah nak beli buah tangan untuk mereka, terus je direct p umah diorang. sampai je depan pagar, dengar suara bebudak tu

"ma, kak ji ma . kak ji" sambil melonjak2 kegembiraan.
adiknya yang lebih cool hanya berbunyi "aji, aji" mengajuk perkataan abangnya sambil ekspresinya macam terpinga pinga. haha. maklumlah.. budak baru belajar.. si adik masa tu hanya pakai pampers. masuk je umah, si adik hulur baju sepasangnya minta dipakaikan. si along pula baru je nak pakai baju. alih2 aku kena buka balik jersey dia tu sebab pakai terbalik!!

masa tu aku layan bebudak tu je kejenya.. mmg aku lupa terus semua masalah aku. bahagia ya ALLAH.. terima kasih ya ALLAH. kalau aku balik ke rumah aku, aku taktau apa jadi. boleh jadi aku buat perkara di luar batasan.. nauzubillah.. sebab hakikatnya aku jarang menangis krn masalah. kalau aku menangis time aku mengadu pada YANG ESA , sbb masa tu aku ada privacy untuk menangis sepuasnya. sebenarnya zohor sebelum tu aku dah menangis bagai nak rak masa solat sunat ba'diah.. aku tau pelbagai masalah dalam kerja pengurusan yg menekan aku skrg. aku berdoa pd ALLAH agar lindungi aku, agar bimbing aku...tp x sgka petang tu jugak ALLAH uji shgga begitu klimaks sehingga aku terpaksa keluar dr majlis.

aku ajak my isteri pakcik n both her sons jalan2. lastly, ngan ayah dia sekali nak ikut. moh ler kite.... kita nak p mana ni? jom jalan2... si along pun menyambung, CARI MAKAN. yes!! pakcik belanja ok? pakcik pun ok je. dah la kena buli kena drive, pakcik aku nak duk belakang ngan si adik. mengada betull.. lastly maghrb tu kami makan kat burger king. hehe. pakcik belanja xpe. lepas hnntr diorang n solat mghrb, hatiku cenderung untuk kembali ke tempat tersebut. ditambah lagi dipujuk rakan2ku yg masih di sana. aku pun balik ke tempat td.. aish.. mata bengkak ni, muka sembap, memang selekeh betul keadaanku masa tu .. naik2 je ke dewan, guess what i found at the front door???? ALLAHu... jangan la dia nampak keadaanku.. tolongla jangan pandang...... ALLAH.... apala nasib aku... sudah jatuh bukan setakat ditimpa tangga, hmm

ana muslimah..

Wanita...

"Ketika Aku menciptakan seorang wanita, ia diharuskan untuk menjadi seorang yang istimewa. Aku membuat bahunya cukup kuat untuk menopang dunia; namun, harus cukup lembut untuk memberikan kenyamanan".

"Aku memberikannya kekuatan dari dalam untuk mampu melahirkan anak dan menerima penolakan yang seringkali datang dari anak-anaknya."

"Aku memberinya kekerasan untuk membuatnya tetap tegar ketika orang-orang lain menyerah, dan mengasuh keluarganya dengan penderitaan dan kelelahan tanpa mengeluh."

"Aku memberinya kepekaan untuk mencintai anak- anaknya dalam setiap keadaan, bahkan ketika anaknya bersikap sangat menyakiti hatinya."

"Aku memberinya kekuatan untuk mendukung suaminya dalam kegagalannya dan melengkapi dengan tulang rusuk suaminya untuk melindungi hatinya."

"Aku memberinya kebijaksanaan untuk mengetahui bahwa seorang suami yang baik takkan pernah menyakiti isterinya, tetapi kadang menguji kekuatannya dan ketetapan hatinya untuk berada disisi suaminya tanpa ragu."

"Dan akhirnya, Aku memberinya air mata untuk dititiskan. Ini adalah khusus miliknya untuk digunakan bilapun ia perlukan."

"Kecantikan seorang wanita bukanlah dari pakaian yang dikenakannya, susuk yang ia tampilkan, atau bagaimana ia menyisir rambutnya.Kecantikan seorang wanita harus dilihat dari matanya, kerana itulah pintu hatinya, tempat dimana cinta itu ada."

DUHAI HATI... BERSABARLAH...

•✿•Jika wajah penat memikirkan dunia, maka berwudhulah..
•✿•Jika tangan ini letih menggapai cita-cita, maka berdoalah..
•✿•Jika bahu ini tidak kuasa memikul amanah, maka bersujudlah..

♥::♥ Ikhlaskan semuanya dan dekatilah ALLAH s.w.t ♥::♥
✔agar tunduk disaat yang lain angkuh,.....
✔agar teguh disaat yang lain runtuh,....
✔agar tegar disaat yang lain terlempar,..

mulianya wanita adalah pada memuliakan suaminya

Asma binti Yazid Al Anshari rha, pada suatu ketika datang kepada Rasulullah SAW..dia berkata, Yaa Rasulullah, saya datang kemari sebagai utusan kaum wanita, sungguh Engkau adalah utusan untuk kami , laki-laki dan wanita..Untuk itu, kami sebagai kaum wanita telah beriman pada Allah , juga kepada Engaku..Kami sebagai wanita selalu tinggal di dalam rumah saja, tertutup dalam hijab-hijab kami, dan kami selalu sibuk dengan tugas-tugas untuk melaksanakan dan menunaikan hajat serta keinginan suami, dan kami selalu menggendong dan mengasuh anak-anak kami. Sedangkan laki-laki selalu melakukan pekerjaan yang mendatangkan pahala bagi mereka. Mereka dapat sholat jumat, sholat jamaah 5 waktu. Begitu juga , mereka dapat menengok orang sakit, ikut serta dalam upacara jenazah dan mengantarkannya, serta selalu dapat pergi berhaji. Dan yang paling utama dari semua itu, mereka dapat pergi ke medan jihad. Jika mereka pergi haji, umroh ataupun jihad, maka kamilah yang menjaga harta-harta mereka di rumah-rumah kami, kami jugalah yang menjahitkan baju-baju mereka, dan memelihara anak-anak mereka. Maka apakah kami tidak akan mendapatkan pahala yang sama dengan mereka???

Rasulullah SAW mendengar pertanyaan semuanya itu dengan penuh perhatian, kemudian dia berpalinng kepada para sahabatnya. Kemudian Rasulullah SAW bersabda ‘apakah kalian pernah mendengar pertanyaan dari seorang wanita yang lebih baik daripada pertanyaan wanita ini?? Sahabat itu berkata “Ya Rasulullah, bahkan kami tidak mengira bahwa wanita dapat bertanya seperti itu..Setelah itu Rasulullah SAW berbalik kepada si penanya tadi yaitu asma’ rha..Kemudian dia bersabda “Dengarkalnlah dan perhatikanlah dengan baik, lalu sampaikanlah kepada para wanita yang telah menyuruh engkau kemari bahwa jika para istri berbuat baik kepada suaminya, selalu mentaatinya dan melayaninya dengan baik, dan selalu membuat suaminya dalam keadaan gembira, maka itu semua adalah suatu yang sangat berguna. Jika semua ini dapat kalian kerjakan, maka kalian akan mendapatkan pahala yang sama dengan kau mlaki-laki”

Mendengar jawaban Rasulullah SAW, Asma’ rha sangat bergembira hatinya, kemudian ia segera kembali jumpai kaumnya..
Hadirin yang dimuliakan oleh Allah SWT pernah suatu ketika para sahabat melihat orang ‘ajam menghormati para raja dan pemimpinnya dengan bersujud..kemudian berkata kepada Rasulullah SAW, Padahal engkau lebih berhak untuk dihormati ya Rasullah SAW, tapi rasulullah SAW melarang para sahabatnya untuk melakukan yang demikian kepadanya..kemudian rasulullah SAW sabdakan “ Seandainya saja aku diperbolehkan oleh Allah SWT untuk memerintahkan seseorang bersujud kepada selain Allah SWT, maka aku akan perintahkan kepada seorang istri untuk bersujud kepada suaminya”

Pernah suatu ketika ada segerombolan unta bersujud dihadapan Rasulullah SAW..kemudian para sahabat rhum berkata “Ya rasulullah jika binatang ini saja bersujud kepada engkau, maka sesungguhnya kami lebih berhak untuk bersujud di depan engkau” tapi rasulullah SAW melarangnya dan bersabda "Seandainya saja aku diperbolehkan oleh Allah SWT untuk memerintahkan seseorang bersujud kepada selain Allah SWT, maka aku akan perintahkan kepada seorang istri untuk bersujud kepada suaminya”

111 wasiat rasulullah s.a.w utk wanita solehah

ciri2 wanita sebagai calon bidadari syurga...

sebenarnya penulisan ini adalah ringkasan daripada buku yg dihadiahkan calon suamiku... untuk memperincikannya, terpaksa u all beli sendri.. i just bg dlm bentuk point shj..

111 wasiat baginda kpd wanita2 calon bidadari syurga..

1. taat pada suami
2. selalu menyenangkan hati suami
3. jgn menerima tetamu yang dibenci suami
4. menerima ciuman suami di bulan puasa
5. jgn berbuat dosa besar
6. redha terhadap qadha dan qdar ALLAH
7. niat yang ikhlas
8. selalu berkata benar
9. larangan melakukan persetubuhan pd siang hari di bulan ramadhan
10. keutamaan mempunyai anak perempuan

11. islam menghargai kaum wanita
12. jauhi jiwa yang kotor
13. wajib menuntut ilmu
14. wanita berhak dalam memilih jodoh
15. pahala bg org2 yg bersifat sabar
16. berpegang teguh pd agama ALLAH
17. kemurahan rezeki
18. menyedikitkan makan
19. berkorban pd jalan ALLAH
20. larangan meminta cerai

reflexes

abdominal reflexes contractions of the abdominal muscles on stimulation of the abdominal skin.
accommodation reflex the coordinated changes that occur when the eye adapts itself to near vision; constriction of the pupil, convergence of the eyes, and increased convexity of the lens.
Achilles tendon reflex triceps surae r.
acoustic reflex contraction of the stapedius muscle in response to intense sound.
anal reflex contraction of the anal sphincter on irritation of the anal skin.
ankle reflex triceps surae r.
auditory reflex any reflex caused by stimulation of the vestibulocochlear nerve, especially momentary closure of both eyes produced by a sudden sound.
Babinski's reflex dorsiflexion of the big toe on stimulation of the sole, occurring in lesions of the pyramidal tract, although a normal reflex in infants.
Babkin reflex pressure by the examiner's thumbs on the palms of both hands of the infant results in opening of the infant's mouth.
baroreceptor reflex the reflex response to stimulation of baroreceptors of the carotid sinus and aortic arch, regulating blood pressure by controlling heart rate, strength of heart contractions, and diameter of blood vessels.
Bezold reflex , Bezold-Jarisch reflex reflex bradycardia and hypotension resulting from stimulation of cardiac chemoreceptors by antihypertensive alkaloids and similar substances.
biceps reflex contraction of the biceps muscle when its tendon is tapped.
Brain's reflex extension of a hemiplegic flexed arm on assumption of a quadrupedal posture.
brain stem reflexes those regulated at the level of the brain stem, such as pupillary, pharyngeal, and cough reflexes, and the control of respiration; their absence is one criterion of brain death.
bulbospongiosus reflex contraction of the bulbospongiosus muscle in response to a tap on the dorsum of the penis.
carotid sinus reflex slowing of the heart beat on pressure on the carotid artery at the level of the cricoid cartilage.
Chaddock's reflex in lesions of the pyramidal tract, stimulation below the external malleolus causes extension of the great toe.
chain reflex a series of reflexes, each serving as a stimulus to the next one, representing a complete activity.
ciliary reflex the movement of the pupil in accommodation.
ciliospinal reflex dilation of the ipsilateral pupil on painful stimulation of the skin at the side of the neck.
closed loop reflex a reflex, such as a stretch reflex, in which the stimulus decreases when it receives feedback from the response mechanism.
conditioned reflex see under response.
conjunctival reflex closure of the eyelid when the conjunctiva is touched.
corneal reflex closure of the lids on irritation of the cornea.
cough reflex the events initiated by the sensitivity of the lining of the airways and mediated by the medulla as a consequence of impulses transmitted by the vagus nerve, resulting in coughing.
cremasteric reflex stimulation of the skin on the front and inner thigh retracts the testis on the same side.
deep reflex tendon r.
digital reflex Hoffmann's sign (2).
diving reflex a reflex involving cardiovascular and metabolic adaptations to conserve oxygen occurring in animals during diving into water; observed in reptiles, birds, and mammals, including humans.
elbow reflex triceps r.
embrace reflex Moro's r.
finger-thumb reflex opposition and adduction of the thumb combined with flexion at the metacarpophalangeal joint and extension at the interphalangeal joint on downward pressure of the index finger.
gag reflex pharyngeal r.
gastrocolic reflex increase in intestinal peristalsis after food enters the empty stomach.
gastroileal reflex increase in ileal motility and opening of the ileocecal valve when food enters the empty stomach.
grasp reflex flexion or clenching of the fingers or toes on stimulation of the palm or sole, normal only in infancy.
Hering-Breuer reflex the reflex that limits excessive expansion and contraction of the chest during respiration prior to sending impulses to the brain via the vagus nerve.
Hoffmann's reflex see under sign (2).
hypogastric reflex contraction of the muscles of the lower abdomen on stroking the skin on the inner surface of the thigh.
jaw reflex , jaw jerk reflex closure of the mouth caused by a downward blow on the passively hanging chin; rarely seen in health but very noticeable in corticospinal tract lesions.
knee jerk reflex patellar r.
light reflex
1. cone of light.
2. contraction of the pupil when light falls on the eye.
3. a spot of light seen reflected from the retina with the retinoscopic mirror.
Magnus and de Kleijn neck reflexes extension of both ipsilateral limbs, or one, or part of a limb, increase of tonus on the side to which the chin is turned when the head is rotated to the side, and flexion with loss of tonus on the side to which the occiput points; sign of decerebrate rigidity except in infants.
Mayer's reflex finger-thumb r.
Mendel-Bekhterev reflex dorsal flexion of the second to fifth toes on percussion of the dorsum of the foot; in certain organic nervous disorders, plantar flexion occurs.
micturition reflex any of the reflexes necessary for effortless urination and subconscious maintenance of continence.
Moro's reflex flexion of an infant's thighs and knees, fanning and then clenching of fingers, with arms first thrown outward and then brought together as though embracing something; produced by a sudden stimulus and seen normally in the newborn.
myotatic reflex stretch r.
neck reflexes reflex adjustments in trunk posture and limb position caused by stimulation of proprioceptors in the neck joints and muscles when the head is turned, tending to maintain a constant orientation between the head and body.
neck righting reflex rotation of the trunk in the direction in which the head of the supine infant is turned; this reflex is absent or decreased in infants with spasticity.
nociceptive reflexes reflexes initiated by painful stimuli.
oculocardiac reflex a slowing of the rhythm of the heart following compression of the eyes; slowing of from 5 to 13 beats per minute is normal.
open loop reflex a reflex in which the stimulus causes activity that it does not further control and from which it does not receive feedback.
Oppenheim reflex dorsiflexion of the big toe on stroking downward along the medial side of the tibia, seen in pyramidal tract disease.
orbicularis oculi reflex normal contraction of the orbicularis oculi muscle, with resultant closing of the eye, on percussion at the outer aspect of the supraorbital ridge, over the glabella, or around the margin of the orbit.
orbicularis pupillary reflex unilateral contraction of the pupil followed by dilatation after closure or attempted closure of eyelids that are forcibly held apart.
palatal reflex , palatine reflex stimulation of the palate causes swallowing.
patellar reflex contraction of the quadriceps and extension of the leg when the patellar ligament is tapped.
peristaltic reflex when a portion of the intestine is distended or irritated, the area just proximal contracts and the area just distal relaxes.
pharyngeal reflex contraction of the pharyngeal constrictor muscle elicited by touching the back of the pharynx.
pilomotor reflex the production of goose flesh on stroking the skin.
placing reflex flexion followed by extension of the leg when the infant is held erect and the dorsum of the foot is drawn along the under edge of a table top; it is obtainable in the normal infant up to the age of six weeks.
plantar reflex irritation of the sole contracts the toes.
proprioceptive reflex one initiated by a stimulus to a proprioceptor.
pupillary reflex
1. contraction of the pupil on exposure of the retina to light.
2. any reflex involving the iris, resulting in change in the size of the pupil, occurring in response to various stimuli, e.g., change in illumination or point of fixation, sudden loud noise, or emotional stimulation.
quadriceps reflex patellar r.
quadrupedal extensor reflex Brain's r.
red reflex a luminous red appearance seen upon the retina in retinoscopy.
righting reflex the ability to assume an optimal position when there has been a departure from it.
Rossolimo's reflex in pyramidal tract lesions, plantar flexion of the toes on tapping their plantar surface.
scratch reflex a spinal reflex by which an itch or other irritation of the skin causes a nearby body part to move over and briskly rub the affected area.
spinal reflex any reflex action mediated through a center of the spinal cord.
startle reflex Moro's r.
stepping reflex movements of progression elicited when the infant is held upright and inclined forward with the soles of the feet touching a flat surface.
stretch reflex reflex contraction of a muscle in response to passive longitudinal stretching.
sucking reflex sucking movements of the lips of an infant elicited by touching the lips or the skin near the mouth.
superficial reflex any withdrawal reflex elicited by noxious or tactile stimulation of the skin, cornea, or mucous membrane, including the corneal reflex, pharyngeal reflex, cremasteric reflex, etc.
swallowing reflex palatal r.
tendon reflex one elicited by a sharp tap on the appropriate tendon or muscle to induce brief stretch of the muscle, followed by contraction.
tonic neck reflex extensions of the arm and sometimes of the leg on the side to which the head is forcibly turned, with flexion of the contralateral limbs; seen normally in the newborn.
triceps reflex contraction of the belly of the triceps muscle and slight extension of the arm when the tendon of the muscle is tapped directly, with the arm flexed and fully supported and relaxed.
triceps surae reflex plantar flexion caused by a twitchlike contraction of the triceps surae muscle, elicited by a tap on the Achilles tendon, preferably while the patient kneels on a bed or chair, the feet hanging free over the edge.

Triceps surae reflex.
vestibular reflexes the reflexes for maintaining the position of the eyes and body in relation to changes in orientation of the head.
vestibuloocular reflex nystagmus or deviation of the eyes in response to stimulation of the vestibular system by angular acceleration or deceleration or when the caloric test is performed.
withdrawal reflex a nociceptive reflex in which a body part is quickly moved away from a painful stimulus.

NORMAL RANGE LAB INVESTIGATIONs

Blood
Coagulation (Hemostasis)

Bleeding time (Ivy) < 9 minutes
International Normalized Ratio (INR) 0.9-1.2
Partial thromboplastin time (PTT) 28-38 seconds
Prothrombin time (PT) 10-13 seconds

Hemogram

Hematocrit (Hct)
Female 0.370-0.460
Male 0.420-0.520
Hemoglobin (Hb)
Female 123-157 g/L
Male 140-174 g/L
Mean corpuscular volume (MCV) 80-100 fL
Mean corpuscular hemoglobin (MCH) 27-34 pg
Platelet count 130-400 X 109/L
Red blood cells (RBC)
Female 4.0-5.2 X 1012/L
Male 4.4-5.7 X 1012/L
Red cell distribution width (RDW) 11.5-14.5%
Reticulocyte count 20-84 X 109/L
Erythrocyte sedimentation rate (Westergren)
Female < 10 mm/hour
Male < 6 mm/hour
White blood cells & differential
White blood cell count (WBC) 4-10 X 109/L
Segmented neutrophils 2-7 X 109/L
Band neutrophils <0.7 X 109/L
Basophils <0.10 X 109/L
Eosinophils <0.45 X 109/L
Lymphocytes 1.5-3.4 X 109/L
Monocytes 0.14-0.86 X 109/L

Chemical Constituents

Albumin (serum) 35-50 g/L
Alkaline phosphatase (serum) 35-100 U/L
Aminotransferase (transaminase) (serum)
Alanine (ALT; SGPT) 3-36 U/L
Aspartate (AST; SGOT) 0-35 U/L
Gamma glutamyl transferase
Female 10-30 U/L
Male 10-35 U/L
Amylase (serum) <160 U/L
Bicarbonate (HCO3) (serum) 24-30 mmol/L
Bilirubin (serum)
Direct (conjugated) <7 µmol/L
Total <26 µmol/L
Calcium (serum)
Total 2.18-2.58 mmol/L
Ionized 1.05-1.30 mmol/L
Chloride (serum) 98-106 mmol/L
Cholesterol (serum) <5.2 mmol/L
Low density lipoprotein (LDL) <3.37 mmol/L
High density lipoprotein (HDL) >0.9 mmol/L
Cortisol 160-810 mmol/L
Creatine kinase (CK) (serum) 5-130 U/L
Creatinine (serum)
Female 50-90 µmol/L
Male 70-120 µmol/L
Ferritin 10-250 µg/L
Folic (Folate) 7-36 nmol/L
Glucose fasting (serum) 3.3-5.8 mmol/L
Hemoglobin A1C 4-6%
Iron (serum) 11-32 µmol/L
Lactate dehydrogenase (LDH) (serum) 95-195 U/L
Lipase (serum) <160 U/L
Magnesium (serum) 0.75-0.95 mmol/L
Osmolality (serum) 280-300 mmol/kg
Oxygen saturation (arterial blood) (SaO2) 96-100%
PaCO2 (arterial blood) 35-45 mm Hg
PaO2 (arterial blood) 85-105 mm Hg
pH 7.35-7.45
Phosphorus (inorganic) (serum) 0.8-1.5 mmol/L
Potassium (serum) 3.5-5.0 mmol/L
PSA (Prostate Specific Antigen) 0-4 µg/L
Protein (serum)
Total 60-80 g/L
Albumin 35-50 g/L
Sodium (serum) 135-145 mmol/L
Thyroid-stimulating hormone (sensitive) 0.4-5.0 mU/L
T3 (free) 3.5-6.5 pmol/L
T4 (free) 8.5-15.2 pmol/L
TIBC (Total Iron Binding Capacity) 45-82 µmol/L
Transaminase - see Aminotransferase
Triglycerides (serum) <2.20 mmol/L
Troponin T (TnT) <0.01 µg/L
Urea nitrogen (BUN) (serum) 2.5-8.0 mmol/L
Uric acid (serum) 180-420 µmol/L
Vitamin B12 74-516 pmol/L


Cerebrospinal Fluid

Cell count <4 x 106/L
Glucose 2-4 mmol/L
Proteins (total) 0.20-0.45 g/L

Urine

Calcium <7.3 mmol/day
Chloride 110-250 mmol/day
Creatinine 6.2-17.7 mmol/day
Osmolality 100-1200 mOsm/kg
Potassium 25-120 mmol/day
Protein <0.15 g/day
Sodium 25-260 mmol/day

differential diagnosis for LYMPHADENOPATHY

Acute Lymphoblastic Leukemia
Acute Myelocytic Leukemia
Brucellosis
Coccidioidomycosis
Cystic Fibrosis
Diaper Dermatitis
Gaucher Disease
Histiocytosis
Histoplasmosis
Hodgkin Disease
Human Immunodeficiency Virus Infection
Juvenile Rheumatoid Arthritis
Kawasaki Disease
Measles
Mononucleosis and Epstein-Barr Virus Infection
Neuroblastoma
Niemann-Pick Disease
Non-Hodgkin Lymphoma
Pediculosis (Lice)
Plague
Rhabdomyosarcoma
Rubella
Sarcoidosis
Serum Sickness
Streptococcal Infection, Group A
Syphilis
Systemic Lupus Erythematosus
Taenia Infection
Toxoplasmosis
Tuberculosis
Varicella