Farhan 🇲🇾

HLMT Takaful Advisor | Public Gold Dealer | 013-3324227

[Farhan 🇲🇾 @mfarhanafi]

Takaful pada hari ini adalah keperluan, bukan pilihan.

Ramai rasa takaful ni beban, kerana mereka belum rasa beban yang sebenar bila tiada takaful.

Orang dulu-dulu kata sediakan payung sebelum hujan.

Hanya 10% daripada gaji anda digunakan untuk bertakaful.

[Sparky ⚡️ @seigologies]

@HKontrak @DrDzul Rehat jer kalau masa rehat.. nurse bukan tuhan lagipun nurse tu kan pekerjaan yang dibayar gaji untuk melakukan kerja saja.. xde punya org2 politik tu nak hargai korang.. habis kerja balik lepak ngan keluarga masing2 nnt korang susah ke sakit ke igt ada depa nak kisah? Lupakan la

[HartalDoktorKontrak @HKontrak]

Staf yang berkerja sistem shift tak pernah ada waktu rehat sejam pukul 1-2pm setiap Isnin-Khamis dan 12.15-2.45pm hari Jumaat.

Kalau 8-3pm, itulah waktu kerja penuh. Pukul 3pm pun bukan balik terus, passing over boleh sampai sejam.

Sekali lagi, banyak faktor perlu dipertimbang.

[Iqbal Cilisos @Iqtodabal]

> cuba selesaikan masalah beban hospital kerajaan
> paksa orang bayar utk guna insurans kat hospital swasta
> orang batalkan insurans swasta sebab tak mampu bayar dan lagi ramai pergi hospital kerajaan
> ???
> masalah asal semakin teruk

Siapa si bangang punya kerja ni?

[Bitcoin Malaya @bitcoinmalaya]

Young people, you need to wake up.

You are getting robbed.

🦴 No permanent appointment

🦴 No pension scheme

🦴 No transparency on salary and promotion schemes for contract-based servants. No matter how hard you work, you can only wait and be deemed inferior.

🦴 No respect from the permanent superiors, admins and politicians. Easily dumped.

🦴 No equality between contract-based and permanent servants.

🦴 No freedom/flexibility. They have absolute control over you. "Don't follow order, let me remind you kontrak sahaja".

On the contrary,

The permanent seniors give the whole civil service a bloated teh-tarik lazy image. But you are paying the price.

The politicians messed everything up, yet still taking fat checks and pensions. But you are paying the price.

Economists telling you this is a new normal and to lower your expectations.

People chanting "kontrak lagi bagus so korang tak malas!".

Your mental health will go wreck.

You lose opportunities, respect and freedom. And this is just the beginning. You must proactively look for opportunities elsewhere.

Wake up.

[Jack (EMNote) @jackcfchong]

Thyroid Storm
(Severe Thyrotoxicosis)
https://t.co/Azpu8Mx7Vf

[HartalDoktorKontrak @HKontrak]

Berhenti jela kalau dah tak suka sangat, ramai boleh ganti.

Penat dah eh nak explain.
Setiap kerjaya ada pathway yang berbeza.

Medical field ni, tak boleh quit dan terus diganti.

Seorang MO yang dah ada 5 tahun pengalaman, tak boleh diganti oleh med student yang baru grad. Y?

[Faiz Edzahar @faizedzahar]

Setakat aku pergi mengopi di Zus sambil kerja remote.
Password wifi mereka semua sama.

nozuswithoutu

Sama-sama.

[pharmahub @pharmahub_]

Cetirizie used for :

🔻CETIRIZINE

▫️C - Combats hay fever and seasonal allergies
▫️E - Effective in treating chronic urticaria (hives)
▫️T - Treats symptoms of allergic reactions like sneezing and itchy eyes
▫️I - Inhibits the action of histamine, reducing allergy symptoms
▫️R - Relief from indoor allergies, including those to dust mites and pet dander
▫️I - Ideal for managing itchy skin rashes
▫️Z - Zero to minimal sedative effects compared to older antihistamines
▫️I - Improves quality of life for allergy sufferers
▫️N - Non-drowsy formula suitable for daytime use

Note: Cetirizine is a widely used antihistamine for allergy relief. It's known for having fewer sedative effects than some older antihistamines. As always, it's important to use it as directed and consult a healthcare provider, especially for long-term use or if combining with other medications.

[Farhan 🇲🇾 @mfarhanafi]

I just did locum yesterday in a GP clinic for 8 hours with rate rm50 per hour. Plus some incentives for procedures, total I get yesterday about RM422.

And then KKM doctors are being forced for labor with multiple times oncall and paid with shitty rate. Better we do locum outside

[nazferatu 🍉 @nzranasr]

Baru hantar oncall claim for December 2023.

Haih, 52 hours of work for RM550 🥹

[pharmahub @pharmahub_]

opioids from strongest to weakest

[pharmahub @pharmahub_]

#Quick_Medical_Info 💥💥💥

**Ponstan - Mefenamic Acid:**

🔵 It's a good pain reliever and fever reducer, but its anti-inflammatory effect is weak. Therefore, it may not be effective in relieving pain caused primarily by inflammation, such as acute gouty attack.

💠 It's the only NSAID that closes prostaglandin receptors in the uterus, making it the most potent NSAID in reducing bleeding associated with menstruation (also believed to be the strongest pain reliever for menstrual pain).

🟣 Not safe for pregnant women, but considered acceptable for breastfeeding as it is excreted in breast milk in amounts that do not harm the infant.

🟠 Allowed for children from 6 months old in specific doses, but Paracetamol and Ibuprofen are preferred in children due to greater global experience with their use.

🔴 Most NSAID associated with causing diarrhea, believed to be a response from the intestines to irritation.

[Dr. Roig @doctor_roig]

10/ End

Learning point:

Performing EKG every 10 minutes in patients with suspected acute MI can save many lives and avoid delays in appropriate management.

Thanks for reading this teaching case.

Here I share some classic EKGs that you might like https://t.co/kTFP9LftTu

[DocSplain - AI Doctor Explains @DocSplain]

Emergency Medicine AI Doctor (via https://t.co/v3fZjHBrFD):

From an emergency medicine perspective, your statement is highly relevant. Elderly patients often present with non-specific symptoms, such as "not feeling right," which can be the onset of serious conditions. Vigilance in evaluation is crucial given the high potential for true underlying medical emergencies in this population.

1. Dx: Acute Myocardial Infarction (AMI): Elderly patients may not always present with typical chest pain symptoms. "Just don't feel right" or feeling general weakness could be a manifestation of a silent MI. Ix will include EKG and cardiac markers (1).

2. Dx: Sepsis: Elderly patients with infections can present with generalized malaise or altered mental state instead of typical symptoms like fever, chills or focal source of infection symptoms (2).

3. Dx: Stroke: The elderly may describe their symptoms in a vague manner or simply say they feel "off" or "different" rather than report typical symptoms like sudden face drooping, arm weakness or speech difficulties (3).

4. Dx: Delirium: This is a common presentation in the elderly who are ill. It may mask as vague complaints due to fluctuating mental status, inattention, and disorganized thinking. Ix would focus on understanding the underlying cause of delirium, ranging from urinary tract infections to polypharmacy (4).
#AskDocSplain

In simpler terms, when older adults say they're feeling off without precise reasons, it can signal serious health issues like heart attacks, infections that have spread in the body, strokes, or a confused mental state triggered by a medical problem. The careful review of conservative or non-typical indicators is paramount when dealing with elderly populations.

References:
1. Canto JG, et al. "Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain". JAMA. 283 (24): 3223–9. 2000.
2. Gaieski DF, Mikkelsen ME, Band RA, et al. "Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department". Crit Care Med. 38 (4): 1045–53. 2010.
3. Harbison J, Hossain O, Jenkinson D, Davis J, Louw SJ, Ford GA. "Diagnostic accuracy of stroke referrals from primary care, emergency room physicians, and ambulance staff using the face arm speech test". Stroke. 34 (1): 71–6. 2003.
4. Han JH, Zimmerman EE, Cutler N, et al. "Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes". Acad Emerg Med. 16 (3): 193–200. 2009.

Do you have any other conditions or scenarios related to elderly patients feeling off that you'd like to discuss?
#MedTwitter
#MedEd #MedX

[Farhan 🇲🇾 @mfarhanafi]

@HMEmi6 @acaiijawa Emas keluaran amethyst Gold tu elok je. Dh byk kali emas amethyst tu masuk keluar arrahnu, elok je diorg check. Company yg buat program MLM gunakan emas amethyst tu jelah yg problem.

[عيشه @aishahshm_]

Salah satu kesan sensory anak overstimulation.

Dalam kes ni maybe anak ni terlebih rangsangan pada sensori visual (berdasarkan video), jadi anak mudah tantrum bila tak dapat apa yang dia nak (which is tv).

Dan lagi satu, sebab dah dijadikan ia sebagai rutin tengok TV sambil makan.

Bila anak makan sambil tengok TV/gadget kita panggil sebagai Zombie Eater/Mindless Eater.

Apa kesannya?

#ChildhoodIsCrucial

[aimansal @remasniefuchs]

@ObjectsInc @AppleDom_ @thesani92 Height is condition, but weight is option. They get triggered on something they can change cause they don't want to change.

[sangeetha_paedsdoc @lostpaedsdoc]

"890 specialists resigned from government service between 2018 to 2022, averaging more than four specialists leaving per week during that period"

#braindrain #kamibukanrobot

[Farhan 🇲🇾 @mfarhanafi]

Delusional @DrZalihaMustafa

[CodeBlue @codebluenews]

Contract Doctors ‘Happy’ With Permanent Offers: Zaliha

https://t.co/g6SHaoLs33

[CodeBlue @codebluenews]

Health Minister Dr Zaliha Mustafa has decided to maintain the status quo on doctor issues: no raise of on-call allowance, no point system for selection for permanent posts, no promotion to UD43 after housemanship, no backdating of permanent appointment.
https://t.co/2X3lpQqf7E