Showing posts from 2018

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

The Same Malaysia: Labuan Still Not Opposition

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 formin

Another New Intake for Pathology Master: Lab Based instead of Clinical.

The season has just begun. Master of Pathology intake in Malaysia will be held soon, this can be seen evidently when there are more people picking up their dusty old Robin's Pathology book out from the bookshelf. I can see Pathology MO has started reading in preparation for the entrance exam. The exam will be held next January on 17th and 18th, 2019 at Universiti Putra Malaysia (UPM). It follows the trend, the last location for final exam will be the location for the next entrance exam. Next Part 1 pathology exam will be held in UITM though, for the first time in history. Rest assure, there will be a preparation course and mock Exam this November 12th. This is a must go course for all candidates trying to pass the entrance exam. This course will be held in Institut Kanser Negara (IKN). Date and venue are subject to change depending on their meeting decision in KKM and among other universities, but I am pretty sure this information is close enough to the real one. There could

HIV Stigma: Do you really understand about it?

Recently, there has been a great length of debate regarding increasing HIV cases in Malaysia. Statistic has proven that the number of new HIV cases are highest among male group who had sex with male @ homosexual male. All this number is important and need to be crunched and analysed properly to make sure our HIV prevention program can be implemented properly. A few question arise in term of HIV control - How do we control the spread of HIV among this high risk group. Before anyone can came up with an ultimate solution, a few Malaysian jumped into that band wagon with religious flag and start campaigning against homosexual group including transgender. This issue has been politicised, religion were use as a fuel to increase the heat, and this is exactly how HIV was spread in the 80s until it became a pandemic. Stigma. Stigma. Stigma. People do not understand about Stigma. Source from CDC When someone enter medical school, HIV is a must know virus among all virus. We have stud

Proton Ertiga Xtra: What so Xtra about it?

This post is a bit side tracked. My intention to write only Microbiology related post right now but everyday is microbiology for me, so I get a bit boring. Thus, I am trying to write about something else. As usual, after a cup of coffee, my mind will have this flight of ideas until I can’t function anymore. Can’t even write anything. Then, I think about something that happen recently. My wife bought a car which is Proton Ertiga. I am not a fan. But she loved it due to its spacious interior design. I am no car reviewer but I am so frustrated to surf over the internet and no one actually really reviewing this car properly. Most of the review was on the previous edition of Proton Ertiga and not the Xtra version. Maybe because it was new. Those big blog did wrote something about it but most of it just touch the superficial company guided information which does not reflect on the real perspective of the owner of the car. Again, I am not a car reviewer and I am not going to review this

A Bad Microbiologist

When there is good, there is also bad. As human we could not run away from making a mistake. Mistake is the norm of the nature. Even in the nature, there will be some mistake happening everyday but that mistake make it perfect. The imperfection make everything beautiful. A bad person can only be a bad person if he or she kept making the same mistake over and over again. With this definition in our mind, a bad microbiologist would be equals to those that repetitively make the same mistake throught out their career. One mistake that many microbiologist neglect is the mistake of not seeing a patient and relies only on a piece of paper - Pathology Request Form. For many microbiologist, this request form is the utmost important thing of all. I do agree that the form was very important. It contain a crucial information that would help in making a diagnosis, hence delivering the right treatment to patient. We who are working in the lab would make a big fuss if a clinician decided to sen

The New Malaysia! : Labuan Now Is the Opposition.

It was finally over. Malaysian has spoken. The choice has been made. I am so grateful to be one of the people that witness a historical event in Malaysia, the change of government after 61 years. Hopefully Malaysia will head to a new and better direction after this. It was very difficult to talk about politics in recent years and months before the election. As a government servant, eventhough as a citizen, we are entitled for our own opinion but everytime we spoke, there will be fear that our position will be jeopardized based on our political preferences. I can say that most of the government servant are not supporting the previous BN government because we as government servant are the one who can see how our government works in the first place. When the previous government said that our economy is good, we in the governent saw different thing. We saw how much budget was cut and how difficult it is to provide a high quality services without proper funding. When goverrnent issues

Melliodosis is a protean disease

One of my lecturer in medical school always told us that melliodosis is a protean disease. He told us that it can be presented with so many different thing. Patient can come with pneumonia, or maybe cellulitis, or soft tissue abscess, or just fever without any other apparent cause. Protean according to him is a mythical God during ancient roman time which usually pictured as a man having multiple face on one head. Thus according to him, melliodosis can be pictured like that too. I am glad ( why?) to work in a state where meliodosis is not uncommon - Sabah, Malaysia. I have encountered quite a number of patient, most of them did not survived because of this disease. It is very difficult to diagnosed by a non experienced clinician. Because it did not have a spesific type of clinical presentation, many misdiagnosed it for other condition. I, too, has fell victim into such cases. How can you expect a diabetic patient presented with mild fever and cough, very stable, able to walk, mak

Bacterial Identification: How do they do it?

Magic.   Magic is far from getting a correct identification of bacteria.   I am pretty sure 90% of medical doctor do not know what is going on with the blood culture they have taken from a patient. They would only expect that some result will be handed to them stating the name of the bacteria and what antibiotic that is susceptible to it. It is just like magic. They must be some magical machine that we use by entering a certain amount of blood and it magically processes until a piece of paper came out at a different port as a culture result.   The process however are more complicated than that. With the help of technology ,however, we were moving ahead quickly to the future where magic could really happen like what I had described above.   Microbiologist used to culture the blood specimen everyday. Once it reaches the lab, a drop of blood will be streaked on to a culture plate and put into an incubator. One day later, the culture plate will be reviewed. One day la