Sunday, November 30, 2014

Seoul Garden, Megamall Kuantan

Yesterday morning, Farah and I went to Teluk Cempedak to do some revision for our final pro exam that will be held next year. We started at 9.30am and finished at 1pm. 

We revised on O&G (pregnancy-induced hypertension, pre-eclampsia, eclampsia, anemia in pregnancy) and Surgery (dysphagia, achalasia, GERD, esophageal cancer).

Usually we took turn to do study group in our house. It felt nice to have a change of environment.

Selfie before study lol

After zuhr, we went to mahallah to take Shuk out. Guess where were we going? 

To Seoul Garden!

We had our lunch there, and boy the food were yummyyy!!

Korean style

Ohh I am hungry alreadyy
Lamb was goodd!!

Full stomachh

Happy hour! :D

We spent more than an hour there. They had a lot of food - chickens, LAMB, beef, vegetables (pakchoy!), RICE, fishcakes, sushi, fruits and a variety of drinks.

A total of RM112.50 for 3 person

If you bring your student card, you will get a few ringgits discount.

1 Adult (Lunch + Drink) = RM 34.98
Student Card + free drink = RM 28.99

Thai Tom Yam Soup = RM 4
Taxes (10% service charge + gov tax) = RM 15.52

So...if you are a student, and you bring your student card and two other friends coming here, the total fee + taxes would be around RM 35.50 per person, for this all-you-can-eat buffet at Seoul Garden. 

You can stay as long as you want and eat as much food that you like - if you have enough room in your stomach! Hehehe

Ok back to the story. After lunch, we went shopping for my friend's blouse. In the evening at 530pm, we all went back home.

The End.

As for todayy, it's a stay-at-home day!! Yayy!! Hehehhe

Byebye youu! And have a good dayy!! :D

Friday, November 28, 2014

Of Personality Disorders


I feel like there are a lot of things that I haven't finished yet! Ahhh. For now, case write up is finished... next I can focus on my second seminar on dissociative disorder, and then 2 case presentations that I have to write properly and then the long overdue my dad's power point slides on stress anddd the design for sisters tshirt.

Serves you right. Who told you to procrastinate, huh Nurul Ainn??!

Okay relax relax. Don't stress yourself out. Stress is not good. Take a deep breath in...and out. In...and out. Feel better now?

Okay cool.

Before I get back to work, I am going to tell you about...PERSONALITY DISORDERS!

Ehem ehem. Before we go any further, do you know what is personality?

Personality means the characteristic behaviour responses of an individual, based on his internal or external experiences. It is individualistic, unique, stable, hence making it predictable.

So when a person has personality disorder, it means that the person's behaviour deviates from the normal range of variation found in majority of people, resulting in significant impairment of adaptive functioning and/or personal distress.

How many types of personality disorders do we have?

Based on DSM-IV-TR, our fellow American psychiatrists have grouped the personality disorders into three clusters : Cluster A, Cluster B, Cluster C and Others.

I have drawn some pictures so that you can imagine better.


CLUSTER A : the odd and eccentric cluster.


These disorders involve the use of fantasy and projection and are associated with a tendency toward psychotic thinking. Patients may have a biological vulnerability toward cognitive disorganisation when stressed.

Source here


CLUSTER B : the dramatic, emotional and erratic cluster.

These disorders involve the use of dissociation, denial, splitting, and acting out. Mood disorders may be common.

Source here


CLUSTER C : the anxious or fearful cluster.


These disorders involve the use of isolation, passive aggression and hypochondriasis.

Source here


OTHER PERSONALITY DISORDERS

Other personality disorders are depressive, passive-aggressive, sadomasochistic, sadistic, self-defeating, personality disorder due to general medical condition and personality disorder not otherwise specified.




You can remember about these disorders by associating each one of them with people that you know of. Some of the examples our lecturer gave:

1. Histrionic - Kim Kardashian, who is such a drama queen and likes to draw attention to herself

2. Narcissistic - Kanye West, who thinks he is better than Taylor Swift, criticising her in public

3. Sadomasochistic - Christian Grey from 50 Shades of Grey ;)

I have some friends who fit some criterias of these disorders, so I just remember them when I think about Antisocial, Avoidant and Histrionic.

My friends think that I have some traits of Obsessive-Compulsive Personality Disorder. Hahhaa they are so funny. My best friend said that I used to be that severe. She mentioned the time when we were in foundation centre about 6 years ago. Even when I make single spelling/writing mistake on a piece of A4 paper, I would get a new paper and start writing again, from the start. I still do that even now, hahahaha shhh don't tell her. But it's only when I am doing my work alone, of course. 

Yeahh I admit, I was a bit of a perfectionist back then. But I dont fulfill those criteria for OCPD okayy. I only have some of the traits. Let's see how many do I have:

1. is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost - I only exhibit half of this criteria

2. shows perfectionism that interferes with task completion (eg. is unable to complete a project because his or her own overly strict standards are not met) - sometimes yes

3. is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity) - noo I still have time for my friends, and funn!  

4. is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification) - I dont think I am that inflexible

5. is unable to discard worn-out or worthless objects even when they have no sentimental value - I keep stuff that I like and throw away stuff too

6. is reluctant to delegate tasks or work with others unless they submit to exactly his or her way of doing things - hahahahha. okay this may be true. guilty as charged!

7. adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes - ohh I do spent a lot on shoes!

8. shows rigidity and stubbornness - a liiiitlee bit maybe

So out of 8, I only got at most three! We need 4 to diagnose OCPD, so I am not having this disorder yayy!! Hahahaha

Now you can diagnose yourself if you have any of these personality disorders!

Excuse me, I have to go take a shower and do my work work workk!!

Toodles. 

Tuesday, November 25, 2014

Of Sleep and Clinic Patients

Tonight is like every other night when I don't feel like studying. Usually I end up reading magazine, or reading news on Facebook, or sleeping in this comfy bed. Ahh even now I feel like going to bed and stop writing this post, even though I just written a few meaningless sentences. Initially I planned on studying a bit, but now I don't feel like doing it.

I like sleeping. Especially when you are feeling tired from all the day work, sleeping feels like heaven! Or or, when you have some problems and you don't want to think about it anymore, you can sleep on it! Or when you miss someone so much that you wish you can go there and be with that person but you can't, then go to sleep! It's amazing how much a good sleep can do to you. Ahh I feel like sleepingggg.

Speaking about sleep, based on what our doctor told us, almost every psychiatric disorders can present with sleep problems. For example, in schizophrenia, patients may have trouble in initiating sleep because they keep hearing voices. In anxiety patients, they will have trouble initiating sleep as well, because they are always anxious, anticipating on what's going to happen the next day. In post-traumatic stress disorder patients, they have trouble in maintaining sleep, because they keep having nightmares or flashbacks. For patients with melancholic depression, they will have early awakening as one of the symptoms. In bipolar patients, they have reduced need for sleep. They do not feel the need to sleep because in their mind, they have a lot of things to do and a lot of plans to be carried out. 

It is important for us to regulate our sleep. If our biological clock has been set to a specific pattern, our body will get used to it, and we will be able to do our daily activities effectively. I am advising myself as well, sometimes when there is a lot of work to do, you lost track of time, and push yourself to finish your work even though you know it's time for you to sleep.

Now putting sleep talk aside, I am going to tell you about the patients that we met in psychiatric clinic this morning, with Dr.Hanisah. Oh oh before that, here's a story. I went to the clinic and wanted to clerk a patient for my case presentation. I met with a couple, who both have psychiatric disorders! They were both Dr.Hanisah's patients. The husband is 51 years old, diagnosed with anxiety disorder. The wife, 30 years old, has bipolar disorder. They were very talkative and cooperative. The wife was really supportive of his husband, and remembered every single details about his husband's condition, like when was he started to become sick, what were his presenting symptoms etc. 

She talked like a normal person - you could never imagine that she can kill two people and had been arrested in jail because of that. Yeah, we were shocked when we heard about that from our doctor. The incident happened when she was in her manic state. She killed them by using a knife.

But but that's not the main story I wanted to tell you. It's this one. My friend Aida clerked this one female patient, in her 30s I think, who came with symptoms of mild depression. That was the first time coming to the clinic, accompanied by her husband. Here's the catch : Her depression was because recently, he caught her husband cheating on her! It's the same husband who was coming with her to the clinic! 

They had been married for 20 years (20 years can you imagine how long is that!) and they have four kids. The husband was having an affair with his office mate, a friend of his wife! The office lady had been to their house before! It started last year, when the wife noticed that the office lady was becoming close to his husband, but she never suspected that the two were a couple. It was until one month ago, when she confirmed her suspicion. She asked her husband's friends from office, and she got to know that his husband and the office lady had been going out for quite some time. 

And you know what? The office lady - she is already married as well!! But her husband lives in another city, and they have no kid. It's really sad, right? How can you not be depressed by that? Then I asked Aida, how come is she still staying with her husband? If it were me, I would have left him! And the husband - how nice of him to bring the wife to the clinic! And then Aida said that the husband still loves his wife and could not let her go. At the same time, he also loves the office lady. Pfftt. Guys. If he really loves his wife, he would never think of cheating on her in the first place!

Other than that, we met a 44-year-old male patient who was a drug abuser, his last intake was in August this year. He has a supportive wife and siblings. Even when he was using cannabis and methamphetamine, his wife still stays with him for 13 years! That was sweet. He presented with auditory and visual hallucination as well as persecutory delusion and delusion of control. When he was sick, he can see a big snake going inside his body.

And our last patients were a mother and her son. The mom is 46-year-old with anxiety disorder, while the son is 16 years old, having anxiety personality trait. When doctor interviewed the mother, who is a high-school teacher, she said that she had shortness of breath, giddiness, numbness of hands and legs. Those were the symptoms of a panic attack. She told us that she always get that when she thinks about her work. She had to take care of her school's koperasi account, and mark SPM students' papers. She is a workaholic and perfectionist, always like that since adulthood. She rarely take her family out for a holiday. 

We could see how she interact with her son at that time. Even though her son told us that he likes playing badminton and swimming, the mother kept saying that she thinks that it is better if her son starts to jog. Even if he does not like jogging, he can try it first and start from now. She was imposing her personal opinions on her son, and that's not healthy. When she asked her son if he has had any stress before, she made it sound like a teacher interrogating a student. Doctor told us later when they went out of the room, that they both need to address the problem in the way they communicate as well. A mother should give room for her children to choose what they want to do, and encourage them. The children should not do what the mother wants them to do. Yes, I totally agree with doctor. Let us children do what we like to do!

Anywayy, its getting late and I need to sleeeppp.

You have a good day, and take care of your sleep!


Ahh I want eggs. Fried rice with eggs.







Friday, November 21, 2014

Cinderellaa!!

Oh wow look at her beautiful dress and her glass shoes they are amazingg!!



When there is goodness, there is MAGIC! Can't wait to watch this movie!

And...this guy performed on Muzik Muzik (TV3) just now...cool songg



Anyway you have a good weekend!! 

Byebyeeee :D

Thursday, November 20, 2014

5 Random Thoughts

1. THE POWER OF POWER POINT SLIDES

I have this habit of spending too many hours on my presentation slides. For example, my last seminar on 'Management of Substance-Related Psychiatric Disorders' - Amphetamines & Methamphetamines that I presented yesterday. Do you know how much time I spent on making them? THREE HOURS!! That was crazy, right?

There are soo many things I have in mind when I think about power point presentation. What theme colour do I want for my slides? The style? Pictures? Photos? Fonts? Animations? Need videos? How can I make my presentation more interesting? How can I get the message across effectively?

For me, slides are important (VERY VERY IMPORTANT!) when you want to present something. Slides are useful to help your audience understand what you want to say. Interesting slides can make up for what you lack in the way you present your topic.

The first thing I look at when someone is talking in front, is their presentation slides. You can tell a lot about the person based on how their slides look like. When I look at some of my friends' and lecturers' power point slides who have not aligned their wordings, I would imagine to click 'Ctrl A' and 'Ctrl J' just to make the words neat. I would think on how they use combination of colours in their slides, how every one of them has different style of creating the slides, are they consistent throughout the whole presentation and how can I improve the slides. That's a bad habit, I knowww. Hahhahaha.

I am far from perfect, but I try to put extra efforts on my slides. Here here, I let you see them. It's better if you view them on Slide Show though.


Footnote: STAY AWAY FROM DRUGS!!


2. THE POWER OF WRITING

“It is by sitting down to write every morning that one becomes a writer.” (Gerald Brenan)

“A professional writer is an amateur who didn’t quit.” (Richard Bach) 

“And what, you ask, does writing teach us? First and foremost, it reminds us that we are alive and that it is a gift and a privilege, not a right.” (Ray Bradbury)

“Be courageous and try to write in a way that scares you a little.” (Holly Gerth)

“The secret of good writing is telling the truth.” (Gordon Lish)

One of my dreams is to publish a fiction novel and a childrens' book. I don't know when can I achieve those, but some day I will. (Go Go Ainn!!) I try to push myself to write every day, although most of the days I am just too preoccupied with my school work. Doing seminar slides, revising chapters in Kaplan, on-calls once every week, writing case presentations or I am just too lazy to write. Not to mention the days when I opted to go to bed early rather than being productive. Hahahaha.

I believe that it takes quite some time to develop a skill. For instance, if you want to become a writer, you must start to practice writing as early as possible. If you want to become a doctor, you must be willing to keep learning as medicine is rapidly evolving. On the other hand, if you want to become an animator, or work in multimedia industry, you have to sharpen your computer skills, art skills and do more of creative thinking. If you want to become a housewife and have cute kids, well, that's the easiest. Go find a husband. Oh wait. That's not as easy as it sounds like. LOL 


3. THE POWER OF BLUE EYES

My friends told me a story about this one Malay lecturer in our university, who is married to an American guy who has blue eyes! (I know, so cool rightt) And they have cute children! Mixed parentage, I am intrigued by that idea. 

Oh, the guy reverted to Islam before he got married to our lecturer. Another point that made my heart melt. How often do you find a guy who is willing to put his energy and precious time to learn and understand a new religion, and practise it as a way of life? I hope they will stay together and be happy for the rest of their lives.


4. THE POWER OF LOVE

Have you ever love someone so much that you feel like you wanna hug him so tight and never let go? And even start a family together and and have beautiful babies?

Hmmm wait a second. For all you know, he might not even feel the same way towards you. That would be embarassingggg. Stop thinking about the what-ifs, will you?! Just sit there quietly, and live your life. If you are not meant to be together with him, then there's nothing much you can do. Okay Nurul Ain??

Okay! Nexttt!!


5. THE POWER OF THINKING

In psychiatric clinic this morning, we met a 25-year old Malay female, divorced a year ago, who came with chief complaint of auditory hallucination and somatic delusion for one year duration. She was with her mother and younger brother in his 20s. She was brought due to her becoming unmanageable at home. She talked to herself, painted the house walls, had irritable mood and always wandered outside the house. When asked about her socio-occupational functioning, her mother said that she can help her mother doing house chores. For example, she can cook. But the family seldom eating what she cooked. Sometimes, she cooked fish without removing the internal organs (tak buang isi perut).  

Doctor then looked at us, and told us that we need to further clarify what the family told us. Like in this case, the mother told us the patient can cook. But when asked further, she was lacking in the way she prepared for the food. Family members always trying to normalise about patients' symptoms, so that they do not want to make them appear severe.

She was shy, avoiding eye contact and leaning forward on her chair with her back facing against us. She was not cooperating well, and had superficial rapport. What's interesting to note is about her delusion. She asked doctor to give her prescription on her headache, eyes, and stomach problems. When doctor asked why what's the problem with your head, she answered, 'I have headache. I feel like there's a hoe (cangkul) inside my head. I feel like someone is using that hoe to make me feel headache'. Regarding the stomach problem, she said 'I feel like my uterus (rahim) is on the outside of my body, not inside'. That is somatic delusion. When asked more about her eye problems, she refused to answer.

That was her first time coming to the clinic, and first time meeting doctor. Doctor said that she did not ask further about her symptoms, because she wanted to build rapport and to keep the patient coming for follow-ups. She has a one-year-old son. When asked about him, she got teary eyes. It's interesting to see Dr. Hanisah clerk and interact with the patient and her family members. She makes it as if it's very easy to get history in psychiatric patient. I really like her style.


Ohh it's getting late I need to go do my work noww.

Gambar sekadar hiasan

Youu...have a good dayyy!! Byebyeee :D

Wednesday, November 19, 2014

In the Rain

Yesterday's morning rain was so heavy! I was driving to the hospital using the highway. I could feel my small car swaying when hitting the puddles off water. Had a moment of flashback.

I noticed there were cars who did not turn their headlights on. That's dangerous! What if other drivers cannot see your car? Accidents might happen!

Come follow me:


You..have a good day, and be safe! Drive carefully!

Byebyee.

Sunday, November 16, 2014

Of Mural and Feast

Our Final Year Project aka Oh My English program had finally ended yesterday. It was a memorable experience...especially the mural part! Hehehehe

Committes prepared the required stuff for the event
Yess - this was before
Initially, we wanted to use a projector to project the mural image on the wall. But we forgot to take into account of the fact that it was morning time, and obviously the image will not form clearly on a bright day. So we decided to just paint by hand. We started at about 9.30am, and at 1.30pm, the work was finished.

Then my friends came over at my house for a feast! :D

Nasi tomato, Ayam masak merah, Kari kambingg - and muffins!
At about 5pm, I went to the mural again to do some touch-ups.

I brought Bibik and Adlin to help out hahaha
As it was starting to get dark, and raining again, we finished up real quick and then went back home. I resisted the urge to go back again and add some more flowers. Hahaha

Rain rain go away,
Come again another dayy
And the final result is....


It wasnt exactly the same image as I expected, but it was close enough. If I were to be strict, I would have asked them to paint the wall with the exact colour as the proposed design, and the pictures must be precise. But hey, I have learned how to compromise. I knoww I can be difficult to work with, and I am fussy about certain things. My bad! Hahahaha

Honestly, I don't like to see the slanting words down there (I painted that and I hate it). And the empty space below the words. And the arabic words (I drew that too, and I don't like it). I can totally do better than that!

It was really fun working together with my friends to finish the project. Yun the Mixer, Kerie the Artist, the tall guys Azam and Farabi, Masitah aka Sally, Irfan, Luqman, Farisham and others who helped us paint our project. A group of amateur painters ;D 

Colourful flowers
Love itt!! :D
Now you..have a good weekenddd!! :D

Friday, November 14, 2014

A Cozy Night

Tonight's weather is cold, but nice. A good time to snuggle under the blanket, watching movies in your laptop. I'll do just that after this, hahaha. 

But before that....here here, psychiatric drugs that are commonly used in HTAA. Our friend took these very helpful pictures and posted them in our whatsapp group:

Antipsychotics (typical, atypical)

Antidepressants (TCA, MAOI, SSRI, SNRI)
Antimanic drugs

And....six of us went for home visit. We went to Kampung Kurnia, Kampung Padang, and up to Gambang area to meet the patients. Basically, to give their monthly intravenous medication.

With one of the patients
They have a hyperactive cat =..=''

Last but not least, the very random doodle in this cold nighttt:

I wanna fly like a butterflyyy!

Now that the blog has been updated...time to be under the blankett!! Hehehehe

Night night you!! Have a good dayy!! :D

Wednesday, November 12, 2014

Quick One

Quick update before I go to bedd. Here is my result slip on the last posting's exam:

No 14 out of 26
3 of my classmates almost got Distinction (like A++)!! They are really good students! Unlike me, who is plain lazyy alll the time hahaha

Honestly, I don't feel like competing. I am satisfied with just average and I am okay with it. I just want to pass the examsss.

I wanted to write more about what we learned in Psychiatry today, but my mind is too tired to thinkkk I need sleeeepp....I'll write more next time kayy.

What are you waiting for? Go to beddd already

 Okayy...youu have a wonderful dayy..and don't be lazyy!! 

Go do something, anythingg!! Byebyeee :)

Sunday, November 09, 2014

Of Delusions

I have told you that the five of us clerked a patient who was diagnosed with Schizophrenia last Friday oncall. The patient was a Malay female, aged 29. She was admitted on the same day we clerked her. She had history of delusion, hallucination and abnormal behaviour for one month duration. In her case, we thought that she had relapse due to non-compliant to medications.

What I am going to tell you is about her delusion. I was amazed by how her mind works. Upon questioning, she told us that she has black magic, where she can make anyone suffers by using her power. She believes that she is a royal person, coming from a wealthy family. Her parents are both prince and princess. She owns state of Pahang, and all of us are her people. Yes, all means including five of us. And even that hospital building, she owns it. That is grandiose delusion. She also believes that she had been on television and magazines, and they were all talking about her. That is delusion of reference. She believes that a famous singer (Radhi OAG) fell in love with her, and asked her to take care of his cat. They were in love with each other. That is amorous delusion. She believes that she is married to Radhi OAG and her boyfriend. Her boyfriend once used black magic on her. He also had strangled her, and wanting to kill her. That is persecutory delusion. She also believes that her thoughts are known to other people, and sometimes people can read her mind. That is thought broadcasting.

She believes that she gave birth to a cat named Koko and the cat is actually a snake. She taught her "cat" how to read everyday. She believes that all five of us are also her children. She even gave us names. She believes that she had been smoking cigarette since she was in her mother's womb. She believes that she has two personalities, one is Agung (a royal) and another one is a Pakistan mix with a different name. She has many mothers, and one of them is Santubong. That is bizarre delusion. And we all know, according to DSM-IV, only one Criterion A symptom is required to diagnose schizophrenia if you have bizarre delusion.

The five characteristics of delusion are:
1. False unshakable belief
2. Firmly held by the patient
3. Not consistent with cultural and social background
4. Always pathological
5. Cannot be corrected by reasoning

When we clerked her, my friend asked me to ask questions to "break" her belief. When she told us that she gave birth to a cat/snake, I asked "Can a human give birth to snakes?" She said "Yes". Then I asked "How is that possible?". She remained silent. Regarding her secret love with Radhi OAG, I told her that Radhi is already married, and have kids, how can he love her? Then she said, " Yes, we were in love, but we had to keep it in secret. Nobody knows." When she said that she was all over the television, I told her that she cannot be an Agung, since all of us have not seen her face on any TV channel. But she still said that she has been on TV. When being pushed further, she kept quiet.

When the patient talked about her black magic power, she was looking right into my eyes. I was sitting next to her, and I had a moment of fear. When she suddenly covered her mouth and giggled with no apparent reason in the middle of our conversation, we asked the reason why. She said that she had been hearing her boyfriend's voice. That, was enough to give me chills.

We tested her abstract thinking. "What is the similarity between a table and a chair?", I asked. She then answered, "A table and a chair are like siblings. They are similar, and very close to each other". I looked at my friend - she was trying very hard not to laugh.

So that's a bit about delusions in a schizophrenic patient. Interesting, right?

Oh its almost midnight. I better go to sleep.

Youu, have a good day...and goodnightt! :)

Saturday, November 08, 2014

Of CorelDRAW 12

This morning, I attended this workshop: 

The poster 


Introduction by MC

YB Andansura




The teacher



Yesterday, when my Mom asked me whether I want to attend the course or not, honestly I was a bit reluctant. I do like graphic courses like this, I really do, and we only have to pay RM5 that's cheap - but I am not really into politics hahahhaha

I told my parents about it and here's what they said:
I love my parents they are cute! LOL


It was a good workshop though. I learned a lot from the instructor. CorelDRAW is better than Adobe Photoshop, and I like it. Even though I didnt stay for the evening session, I am glad that I attended it.

I would have stayed if the female participants (6 of them altogether) decided to stay. But they all went back home, some of them had to prepare lunch for family, some had work to do etc. I was not keen on being the only female in a room full of guys, so I went back home and took a nap instead. Haha

I told my Mom that I enjoyed learning the course, and she went like 'haa..tulahh, umi dah cakap..apa yang mak suruh tu dengar je..tadi cakap tak suka lah, kan sekarang suka..awak tau tak kita sebagai rakyat malaysia ni wajib mengundi, nanti Allah akan tanya awak mengundi siapa..etc.' I just laughed.

In the workshop, the instructor gave us free copy of the software. We learned how to make a poster:

Corel interface

It's quite easy to use. If you know how to use Adobe Photoshop, then you will have no problem in using CorelDRAW.

And now...I am going to do a bit of designing - and exploring my new software.

Youu have a good day!! :D