ISUOG part7

The last day had come. It was Saturday, the Sentosa Island seems quite busy. We had a good breakfast in Siloso Beach Resort. The staff were very helpful. They served the breakfast just like what we ask them. We need to get to Capella at 8.00am so we asked them if they can served us earlier and they did very good. The last lectures were good too. Too bad, we had to rush back to our resort for check out before noon. Since our flight was 9.30pm, we asked again the resort if we could late check out and they said yes! we had asked this before but they said that our room is already booked by someone. If they could let us stay for another day, we could just finished our last day of the course without much hassle. So, rather than walking back to Capella, we just lay on bed and get some rest before going back to Malaysia. At 5.30pm, we took a taxi to Airport which cost us S$35 for 3. There, we managed to get halal food wich is Popeye fast food rest. Not as delecious as KFC but the halal is what matter most here. After that, we went for solat and made our way to boarding room. 9.30pm the flifght took off with a couple of emergency alert caused by bad weather, we landed at 10.20pm and luckily my husband was already waiting for me. God, never felt this feeling since we had our baby. Missed him so damn much!

ISUOG Part6

On the second day of the course, on Friday, I was too dehydrated to focus on what they were teaching in front. I spent almost the whole morning sleeping. At the tea break, i took as many mint as I can and also the mineral water to refresh myself and thank God it worked very well on me. So, despite wasting the morning lectures, I started to focus on what they were teaching in the afternoon and evening until the end of the day, we went for souvenir hunting!!! Not much to buy with only S$100 cash in hand. So, I just bought cheap souvenirs for my family esp my little baby and big baby... At 10.30pm, I went to bed to recuperate myself and prepare myself for the last day tomorrow hoping that I will not sleep in lecture anymore....

The Training Aspects Of The Ultrasonographer

The Training Aspects Of The Ultrasonographer

The level of expertise required in ultrasound scanning can be divided into 3 levels, i.e. level 1, level 2 and level 3. The objectives and requirements are as below:

Level 1 (Basic)

Objectives:

1. To understand the basic functions of the ultrasound scanner and its optimum utilisation.
2. Reliably confirm viable pregnancy using abdominal scanning.
3. Make accurate measurements to assess gestation age in first and early second trimester including CRL, BPD, HC, FL, AC.
4. Diagnose multiple pregnancy.
5. Establish foetal presentation.
6. Assessment of liquor volume – AFI/single pool.
7. Exclude placenta praevia.

Requirements:

Attendance at one basic course and the remainder in an accredited hospital by members of a board run by Obstetrical & Gynaecological Society or Ultrasound in Medicine or Perinatal Society of Malaysia or senior members of the Obstetrics department of the accredited hospital.

Perform 100 ultrasound scans under supervision with a logbook consisting of 30 cases comprising of the following:

1. Ability to do mid and late pregnancy scans and to obtain appropriate measurements for gestational age.
2. Ability to come to a conclusion regarding viability and maturity in early pregnancy problems.
3. Identify common adnexal masses.
4. Ability to scan for assessment of liquor volume.

Level 2 (Intermediate)

Objectives:

1. Detailed scanning of the mid-trimester foetus (routine).
2. Detection of foetal anomalies at any gestation including basic foetal echo.
3. Doppler studies and its application in obstetrics.
4. Application of transvaginal scanning (TVS) in pregnancy.
5. Amniocentesis.

Requirements:

Attended accredited – intermediate and/or advanced courses.
1 year experience after basic level accreditation and incorporation into postgraduate training programmes.

• Master in Obstetrics and Gynaecology.
• Post MRCOG in accredited hospitals.

Level 3 (Advanced)

Objectives:

1. Ability to do advanced procedures for foetal diagnosis and therapy.
2. Provide second or expert opinion in doubtful cases.
3. Provide training for Level 1 and Level 2 courses.

Requirements:

1. Attended accredited courses e.g. RCOG/RCR in Foetal Medicine for 1 year or accredited local courses.
2. Scholarship in recognised Foetal Medicine training centres abroad.

e.g.

• DDU (Australia)
• RCOG/RCR course accreditation
• MMed (Foetal Medicine) Birmingham

source: http://www.cornerstone-msc.net/perinatal-malaysia

p/s: i'm still at the intermediate level. wish can further in Postgraduate......

ISUOG Part5

On the Thursday, after having our breakfast, we headed to Capella Hotel for our ISUOG course. It started at 8am. It was on Fetal Echocardigraphy. The speaker are Rabih Choui from Germany and David Paladini from Italy. Both are very experience in Ultrasound. Wish I can have a chance to be trained by them. The lunch time came, but end up I was starving and also got diarrheoa. what a shame! the lunch didn't served the halal or vegetarian food and I just ate the seafood stew which made my stomach more and more upset! At 5pm, the three of us got to got out earlier to get something to eat! The first plan was to search how to get to Changi Airport by MRT but the plan was changed to plan to get halal food in Arab Street. As we were very adventerous, we managed to get it even if it means I have to walk in such a great pain (You know how it feel....walking with a diarrheoa....hmmm). on the way to our hotel, I was too Dehidrated, exhausted due to what i have said before (can't say it further..the experienced were totally censored), But still I have to walk until I reach my bed and I went to sleep at 12pm.

ISUOG Part4

Last Wednesday, my unit boss Prof Dr Azlin, my friend Yan and me were travelling to Pulau Sentosa Singapore on AK703 at 12.45 pm for ISUOG . We stayed in Siloso Beach Resort which is the most affordable resort in the island but, the hospitality and the food (the vegetarian one) very well satisfy my need. We reached Sentosa at 3pm. Since we were there 1 day earlier,once we got the room, we were all are ready for next adventure!! Exploring the island on foot!!! The first place we managed to conquer was the Imbiah Look Out which we went for 4D Magix. The combos comprises The Pirates, Log Ride and Desperados but we only took the 'The pirates and Log Ride' combo. Those two were very interesting and heartblowing. We were taking photos here and there and strolling to Merlion and then before we knew it, we were all in Universal studio. The studio was surrounded by the hotels and casino. We kind of dissapointed to get to know the tix for the Universal studio is S$66 and only available until 6pm only. But we were there at 6.30pm. So, despite the pricey tix, it was also closed. so, we were just taking more and more pics around the Waterfront station. The, at 7pm, we went to our room for a fresh cloth and solat. At 9pm with highly energised, we paid a visit to our friend Kak Anson who stayed in Hard Rock Hotel which was very, very, very luxurious! mindblowing! Then, at 11.30pm we headed back to our room to get rest but, we don't sleep actually, the three of us managed to get permission by the staff to let us swimming in the swimming pool at 11pm in our pyjamas.hehe. That was very exciting thing to do! At 1am we were all very tired and try to get some rest for the real ISUOG course tomorrow....

ISUOG part??

Now, I am in the middle of Changi Airport waiting formy boarding time. Really can't wait to see my baby and husband after 4 days being apart of them. Isuog gives me so many new knowledge in ultrasound which made me very very grateful for what Im doing right now. It's worth the money I'd spent on this course and of cpurse can't thank enough to my boss and colleuge for their help. My big Boss Prof Dr Mohd Jamil had helpme with the fees and my 'small' boss help me with the meals and fare and my collegue aso help me with the meals and fare. Kind of 'segan' with all those help. I vowed that I will work harder and learn harder so that I will improve my skills to showhowmuch I appreciate their help. Too much help that I can't thank enough....my bording time is 8.40pm and i should go now!

I'm Going to ISUOG!

Well going to IUSOG is one of my target this year. Alhamdulillah I manage to get fees sponsored by Toshiba and manage to save some money for return air tickets and lodging. I should be happy and excited about this but, all I can think of right now is how can I live away from my baby son. Never leave more than 2 days but now I have to send him to his grandma's house for 5 days which means I have to sleep without him for 5 nights. I almost cry this morning. I'm so not happy to have to leave him . All I can do is praying hoping that I'll be fine. I know he'll be fine with his grandma. But it's me I'm worried about. I've had a fever before when I left him with my sister for only 1 night. What can go worser than this?

Hamburger Sign??

In obstetric ultrasound, we may find many funny terms such as Hamburger sign, Lambda sign, frog eye sign, etc.... This picture shows hamburger sign which indicates the baby's gender is female.

ISUOG Part3

InsyaAllah on Wednesday, I'll be going to Sentosa Island. Hopefully everyhing will going smoothly as planned...

Crown Rump Length

CRL= It is measured from the end of the crown to the end of the bottom of the fetus. This measurement only significant until 13 week. After 13 weeks, the measurement should include the BPD, HC, AC and FL.

What does a diagnostic medical sonographer do?

A diagnostic medical sonographer is a highly-skilled professional who uses specialized equipment to create images of structures inside the human body that are used by physicians to make a medical diagnosis. The process involves placing a small device called a transducer against the patient's skin near the body area to be imaged. The transducer works like a loudspeaker and microphone because it can transmit sound and receive sound. The transducer sends a stream of high frequency sound waves into the body that bounce off the structures inside. The transducer detects sound waves as they bounce off the internal structures. Different structures in the body reflect these sound waves differently. These sounds are analyzed by a computer to make an image of the structure(s) on a television screen or that can be recorded on videotape.

Sonographers have extensive, direct patient contact that may include performing some invasive procedures. They must be able to interact compassionately and effectively with people who range from healthy to critically ill.

The professional responsibilities include, but are not limited, to:

• obtaining and recording an accurate patient history
• performing diagnostic procedures and obtaining diagnostic images
• analyzing technical information
• using independent judgement in recognizing the need to extend the scope of the procedure according to the diagnostic findings
• providing an oral or written summary of the technical findings to the physician for medical diagnosis
• providing quality patient care
• collaborating with physicians and other members of the health care team.

Sonographers must also be knowledgeable about and limit the risk from possible exposure to blood and body fluids. Many sonographers also assist in electronic and clerical scheduling, record keeping, and computerized image archiving. Sonographers may also have managerial or supervisory responsibilities.

source: http://www.sdms.org

Final Year Medical student exams....

This week, I was involved with the student's exam. Just as a person in-charge for the short cases exam. This year, they change to a new format which is manned OSCE. Thank God they come up with this brilliant idea. before, I was busy like nobody bussiness. Running here and there to make sure the patients' list is always updated. At the end of the day, i was too tired. But the new format really helps a lot! I don't need to running and rushing anymore. It is much much better and smooth and peacefull.... All I have to do, is to make sure that they are all in their place and just be there if any department need my help. But so far, we managed smoothly. So, i wish all the students the very best of luck! You all are the new generation of medical doctors we hope to help the nation.

3D image

Ni detail scan yang aku buat untuk one chinese patient. She is diabetic so, the liquor is a bit high. I took this big chance to capture some photos for the mother. And this is the result. I was pretty happy to get this photo. Not only the mother was so happy, I was too....I should say, this is the biggest success so far in capturing the prenatal photos...:0)

Bengkel Hala Tuju Pegawai Sains.

Today is the last day of the workshop. we were working very hard yesterday to come up with our own specific job description. Life is tough but doing this was tougher....I didn't come for the first day because we have to rotate to make sure the ultrasound service is not affected. So, I just came for the second and last day because we still in the middle of making ends meet. I was so grateful that I came yesterday's slot. It really help me much on realising what are my task. So, after this workshop I know very sure how to handle my work and my carrer advancement. :)

Gud News!

hehe, bestnya...Yan dapat sponsorship maka, dapat lah aku mengendeng...hikhikhik...Sentosa Island! here i come!

Friend In Need Is A Freind Indeed....

Someone told me before, it's hard to find a true friend once we step into adulthood. We can never find a true friend like we ever have in our school days. I still remember the person who told me this. But, the fact is, it is true. Even the person who told me about this, I can never trust anymore. Never again! Too many things happened between us yet making it worser day by day. I don't know what had gone wrong. All I know we both trying to get the same thing and got 'em in different condition. But, I never see it as a reason for us to falls apart. But that person did. In my way of friendship, we can share every single sweet and bad moments with our friends. But that person maybe thinks that I'm looking down on him/her which makes that person avoiding me. The fact is, he/she is looking down on me. Maybe that person thinks that I can never accept him/her for what he/her have?? For God sake! I not that kind of person!! I die for other people! I'm doing everything to make people happy.....until one day, I came to realise that no one appreciate all those things and I started to shrink my scope to only me and my family....My husband had adviced me to be realistic. Help people who need my help but don't be too ignorant. But, you know what? Being ignorant sometimes is good. Less stress! :) .

Saiful Bukhari is just the puppet. Who's the puppet master? mystery continues...

Everyday since 1997, we never stop reading about manipulated politics in our newspaper. Yesterday frontpage news was more hillarious! 'Can I **** you today?'. I'm not into any politics party or whatever. I'm just a Malaysian who tired and bored of things like this. The more i read about this case, the more I felt like someone is pulling someone's leg. When I read this line "Can I **** you today?", I think people out there who can easily believe it is true might be not clever enough to follow this case. Have you ever think that any rapist will ask their victim first?? I mean, will the abang kucing ask his victims "Adik, boleh abang ***** adik?". I really don't think that any rapist in this world is a polite enough to ask. They will just grab and do that dirty job and bye!bye!

Come on my dearest Malaysians. Just see for yourself, clearly in today's Utusan Malaysia. He is such a tall and tough man. There was also stated that he was once elected as a Vice President. So, guess he is not stupid to just let himself being the victim of an old man with backached. I'm not saying I in the defendant side or what. It's just that i'm sick of all this. All this are just reflect negative impression to other countries. Which affect our economy and affect my economy too. Please, just because some people are too greedy to get money and power, they ruins others lifes as if they are authorised to do all this. Please bear in mind, never play God.... Be united in the sake of our country, economy and for the sake of our children.

NT-1

NT- stands for Nuchal translucency.

Necessary in screening for Trisomies such as T21, T18, T13. It is measured when the pregnancy reaches 11-13weeks + 6days. Or the CRL is within 54-84mm. As it is just a screening, it does not indicates that the patient with NT measured >3mm is going to have abnormal baby. Because this is just a screening. If the NT is > 3mm the patient has to undergo minor procedure to aspirate a small volume of liquor for QF-PCR or karyotyping to see clearly the chromosomes of the fetus. These test will diagnosed the fetus.

ISUOG Congress In Singapore.-Part 2

Yesterday, I had spent the rest evening just to book a nice and affordable room in Sentosa Island. The rates in Sentosa is way too pricey. But still, I managed to get a good room for about RM300 per night for two. Isn't it great?? It's Siloso Beach Resort. Nearby the Universal Studio which been said to be opened sometime in March.The congress will be held in Capella Singapore. A 5 star hotel. Very expensive... I hope i can manage the transportation to and fro for the congress. Very hoping for the best luck! The fee is S$300 for sonographer. So, it's quite cheap for oversea course/ congress. The flight ticket is just RM183. So, everything prepared. Just waiting in patient for the 14th April. Hmm, I am so excited everytime I got a chance to attend any course or congress in ultrasound. I am so passionate about ultrasound and will always hungry for new knowledge...

Still lot of things to be settled....

After 3 days holiday, my body still aches here and there. Too many things to be done, yet too little space and time to do everything that i should do. I'd just spent my 'cuti wilayah' just to renew my passport which is not overdue yet but it is going to be overdued on the day i should be in Singapore. Meaning, i still have to renew on the very busiest day which is yesterday. My husband and my baby boy had spent the rest of the day sleeping in our national car in car park because waiting for me is just a boring thing for my energetic baby and tiring for my lovely supportive husband to make sure our son in his sight. It took me 3 hours just to q up in a loooooong line to use the kiosk which is said to be convenient. Which boils up my temper when it jammed because of overworked!Arghhh! But the Immigration personel managed to work it up. Thanks to them! Very-very much! To see so many people got rejected due to some technical problems really made me shivers caise i don't want to q up anymore for manual procedures. It was way too tiring! Duh! But Alhamdulillah, everything went fine until I decided to have lunch in Secret Recipe which we didn't find it any in Bangi after driving around for about 1 hour searching for it. So, it was Mc D again within 3 days...Not a good eating habits, I know! Then we rushed back to the Office to collect my passport and it took me 1 hour to wait for 40 peolpe in front me to collect theirs. Finally, at 4.15pm, I managed to get my new passport. Alhamdulillah. I quickly went to the prking lot and saw may husband and my baby both were in a deep sleep regardless the heat outside. Thank God for a good air condition system in our National Car! We headed back with 'mission accomplished mode' but at that point of time, I actually forgot about my baby's routine check up....well, it never end...responsibility goes on and on....they're never ends......