Sunday, March 29, 2009

Jabpenis Celebration

want this on your mantlepiece?
If they want a penis THAT big its no wonder why birth rate is low....




All hail the Penis!



Very good drawing, complete with pubic hair XD




this is a very very interesting celebration by the Jabpenis people......they actually venerate the Penis! Considering the low birth rate in japan, maybe they should demonstrate how to use it :P











Wednesday, March 25, 2009

Writing a book......

wasn't easy! haha.....i really relied on my memory and experience in writing the new edition of PE booklet, because i forget to bring back the old one! haha...but i think the newer edition includes much more information than the old one. For example, want to know what's is Cogan's Lid Twitch sign? Just get a copy of the ____________________ for free!

I put ____________because i couldnt think of a title for the book yet........so any suggestion? Thank you :P enjoy the holidays!!

Sunday, March 22, 2009

Paktorlogist

This have nothing to do with medicine but to my Paktorlogist

I hereby announce that the Dean will be on Study leave till a date which is uncertain. Therefore the post of the Dean of Paktorlogy will be held by Prof Sam Jo Ee who is also the Head of Mammarology department.

The dean will go on leave(and on a mission) and will be back when he become more qualified to head the Fac.

Take note!! don't call me dekan anymore...i'm on study leave...yahooooo!! haha

Saturday, March 21, 2009

Stress Induced cardiomyopathy a.k.a broken heart syndrome

This is a rare condition. But rare conditions always result in death, dont they? so its good that we have an idea of what we're dealing with

BROKEN HEART SYNDROME

Management of Diabetic Neuropathy

These article is a good read. It is detailed and fun to read.

Management of Diabetic peripheral neuropathy

Friday, March 20, 2009

Diabetic Neuropathy

Ok...i know exam is over,results are out. But i would like to share these article as a revision for one of the most important disease in Medicine, diabetes.

Diabetes can affect all 3 division of the nervous system: sensory,motor and autonomic nervous system. The most common early presentation of diabetic neuropathy will be numbness of the extremities commonly described as "gloves and socks" numbness. It is a form of peripheral neuropathy and because of that, it affects all dermatomes. Therefore, during examination of diabetic foot to look for numbness one need not test according to dermatomes. Sensation is loss for both pain and light touch and for some reason, temperature sensation is not affected. Loss of proprioception is also an early sign, however, patient often does not notice this because the dominating or main problem to the patient is often sensory loss. The patient may also complaint of gait instability. Therefore, this sign must be elicited by the examining doctor.

In the motor division, neuropathy can take 3 forms : Acute painful neuropathy, diabetic amyotrophy and mononeuropathy. Acute painful neuropathy cause burning pain in lower limbs, typically at night. In severe cases even light touch can become intolerable. It can be precipitated by drugs such as itraconazole, commonly used to treat fungal infection in diabetic patients. Diabetic amyotrophy cause painful,marked wasting of the quadriceps femoris muscle. In extreme cases it cause absent knee jerk reflex. Diabetic mononeuropathy refer to involvement of only 1 nerve. The most common mononeuropathy is the carpal tunnel syndrome. Diabetes can also affect the cranial nerves, especially cranial nerve VII and III, causing diploplia. If more than 1 nerve is affected, the condition is called mononeuritis multiplex.

Autonomic neuropathy manifest in form of postural hypotension,atonic bladder with urinary retention, diarrhea etc.In long standing uncontrolled diabetes, gastroparesis can happen leading to uncontrollable nausea and vomiting mimicking intestinal obstruction. Diabetic patient often complain of syncope, lethargy, dizziness. Note that sometimes, these signs can be a side effect of the oral hypoglycaemic agent, e.g. diarrhea may be caused by Metformin.