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Shouldn't treat catheter colonizer

Every day we encounter cases of catheter-related bloodstream infection. With the increasing incidence of Diabetes leading to renal failure, more and more people are going for dialysis. More people in dialysis, more catheter was inserted for the purpose of that. 
Using venous catheter for dialysis came with a risk which is - infection. The catheter is one the favorite place for bacteria to hang out. Produce their biofilm and just stay there forever. You flush it, you wipe it with alcohol, whatever you do, it will not move away easily. 
Then came the decision of attacking them with antibiotics and this is where everything goes wrong. 
To diagnose catheter-related infection, the best method is to quantify the growth from the catheter. Catheter tip culture usually will tell us whether a patient has a catheter-related infection or not. It's difficult to do and labor intensive. Thus, a semiquantitative approach was developed. This method was much easier to do. Just culture the tip of th…

Good Luck For Mpath Part 1 Student

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It has been a long time since I've updated this blog.

Here today I would like to update by giving a wish of good luck to all Part 1 Mpath students that are currently taking their exam in UITM Sungai Buloh.

Best wishes for all of you including my wife.

Ann also for Part 2 student which started their exam last week.

Surprisingly Hep C was not included in this year part 2 exam. Well, that's good cause possible bonus question for next year. :)


Antibiotic discrimination

The issue of racial discrimination is on going uptrend. In America, people the black community that has been oppresssed for quite sometime are demanding their equals right. In our country Malaysia, the Malays are demanding their rights from whoever is oppresing them.

Discrimination can be deadly.

And one the deadliest discrimination is antibiotic discrimination. Some doctors hate certain antibiotic without any particular reason and love another antibiotic also for no reason. For example, cloxacillin. This antibiotic has been around for ages. It has been doing its job quite amazingly clearing up Staphyloccocus infection from every site you can imagine. It is cheap and available in oral form and parenteral form.

But, a lot of people hate it. They favour more fancier drugs such as Amoxicillin-Clavulanate, pipperacillin-tazobactam, cephalosporins, and the most favourite antibiotics among all, carbapenems.

Without any particular reason, people just hate prescribing cloxacillin. It’s not co…

Congratulation to those who pass the entrance exam! : Master Of Pathology.

Congratulations to those who pass the exam today. And those who did not, there will always be next year.

And for those who did pass the exam.. I know you can't sleep tonight awaiting the interview.

Don't overthink. Just answer honestly. This is not a medical school interview or exam. I believe those who came this far, are not a mere house officers who just finish the last posting few weeks ago. Everyone are experienced medical officer who has a story to tell. Enough experiences to answer what the interviewer will ask.

1. Be honest. Don't be a liar during interview, unless you are Frank Abagnale Jr.

2. Don't be a yes man. Even if they ask you to jump into the ocean you will say yes. Bad idea. This is about your future. Not to get score in exam. You already pass the exam.

3. Tell your future plan realistically. Don't make up story, for example, you plan you will not get married or pregnant, not until you became specialist or you said you will go to a remote area in r…

It's getting busier

First year pathology : No life, read book until vomit.

Second year Microbiology: Honeymoon... I will read book when I feel like I want to read.

Third year Microbiology: Damn busy with presentation, research sample collection and writing, case report writing, and 2-3 text book to finish reading before entering final year, oncall, elective attachement.


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Who is overusing antibiotics?

The question remains.. if antibiotics overused is a big cause for antimicrobial emerging resistant, then who is overusing antibiotics in the first place?

Many debated this and try to point a finger to each other. Doctors try to blame pharmacist, pharmacist tries to blame doctors, both blame veterinary in the end. Veterinary point finger back to doctors. Its crazy, imagine a meeting with three people in the same room.

Nevertheless, science is based on evidence. We have to prove our blame.

I would also at some point in time used to blame pharmacist on this. When I started working as a medical doctor, I once visited a pharmacy to treat myself. Without revealing myself as a medical doctor, I would ask for a course of antibiotics and it was so easy to get one. More frequently I visited a pharmacy to buy something, they would be a customer who would ask for antibiotic for their fever and running nose, and to my surprise, they would get what they want without much hassle. The only th…

The Same Malaysia: Labuan Still Not Opposition

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Referring to my previous post:


The New Malaysia - Labuan Now the Opposition  I was surpirsed when Labuan was the only remaining federal territory that became opposition during last election. 
However, as expected, by many Labuanese / Labuanite  (Labuan people whatever your called them), BN will not be relevant anymore in that island. This is due to the most reason of people voting for BN  because they were afraid of Labuan becoming an opposition state. Labuan was pretty comfortable under BN leadership. Not many, however, realized that government can be changed. As a Labuanite myself working outside this lovely island, I can see how big changes were approaching before the election. I have told my family that changes going to happen this year and Labuan might end up being in the opposition after all by supporting the government. 
But, Labuan people were very contained. They made their choice. And it happen. 
The weird part is, Sabah has fallen to the opposition forming a new government,…