Ancora Imparo

Tuesday, December 22, 2009

Monday, December 21, 2009

Detective Conan

A phone call
from a detective Conan
NERVOUS
+
Contemplating
of a new beginning
of a new journey

is this what i really want?
is this is the best for me?

Saturday, December 12, 2009

Dua

How i wish that i have not been given any choices
How i wish that i knew it
But my sixth sense doesn't allow me

Saturday, November 21, 2009

Arrghhh
Tensenye ngan VIA ni..
semua benda jadi x tenang
solat pun x tenang
buat yg basic jer
bila solat pun fikiran bleh pikir lain..
nampak sangat hati dah jauh dari Tuhan
apelah hamba Tuhan sorang ni
makan pun ntah pape..
dah malas nak masak
rindu makanan mak
tido pun dah x lena..
mimpi yang bukan2..
banyak perasaan yang dipendam
ya saya tahu saya cepat terasa hati
so semua benda
masuk jadi mimpi ngeri..
x tahu nak baca ape..baca buku EMQ
teringat anatomy x baca lagi
baca anatyomy ingat physiology x baca
pastu buat clinical test
physiology plak x baca..
pharmacology
psychiatry!!!
craig hassed
murtagh
ken jones!
arghhhhhh
charger handphone plak rosak!

Wednesday, November 18, 2009

OSCE : Apa yang masih ku ingat

1. Station 14 - Newborn examination.
Im pretty competent doing this examination because i practice this almost everyday in the nursery. But, DANG,Forgot to wash hand !

2. Station 15
Sterilization. She want to do tubal ligation...seriously i need to improve my communication skills..

3. Station 16 - Reading

3. Station 1 - Asthma Planning chart
I'm expecting emergency asthma. Not explaining to the parents how to use the ventolin...oh how i had to explain stuff to parents!

4. station 2 - Burn
Hahaha..never study emergency treatment for burn with all the chart and pictures..so mmg totally goreng

5. Station 3 - Breastfeeding
Huh..paling x suka punya station..apa barang doktor kena terang pasal breastfeeding. Ni semua kerja Lactation Consultant! Ni smeua kerja Australia Breatfeeding Association la ni..duk promote breastfeeding smapai restaurant pun kena breastfeeding friendly..tapi x yah aa masuk dlm OSCE

6. Station 4 - Reading kot

7. Station 5 - Undescended testes
Yes, akhirnya kuar gak surgical peads..taking history, investigation and explain manegemnet to parents lagai. i thought this surgical peadiatric would be hernia, pyloric stenosis or malrotation with valvulus or Hirchprung disease..Aku nampak examiner tuh kasi aku CLEAR PASS..Alhamdulillah

6. Station 6 - Meningitis
Explain to parents managemnet or meningitis. Hampeh..x ingat aku jawab viral or bacteria meningitis..sbb dah gugup..

7. Station 7 - Development Delay
I just simply hate Denver chat. Dahle bagi situation panjang dlm paragraphy ape yg budak tuh bleh buat in term of Personal development, Fine Motor Development, Gross motor development and speech and language. Pastu during neuro exam..ada ytg x betul..ish..nak bakor je kertas tuh..
Yg aku ingat aku letak je differential diagnosis aku Austism spectrum disorder, Hearing Problem, Behavioral Problem yadda yadda

8. Station 8 - Reading

9. Station 9 - Sexual transmitted disease
I got Chlamydia. Forgot to inform that im responsibble to report the infectious department and treat the partner.. Habislah mamat tuh ada infertility problem in the future!

10. Station 10 - Termination of pregnancy
Seperty biasa taking history, investigation and managemnet

11. Station 11 -

12. Station 12 - Reading

13 Station 13 -PCOS
Dang! Ingtakan kena explain management PCOS kat makcik tuh..punyalah rush...habis masa aku..menyesal x amik history betul and investigation..Examiner tuh kata investigation aku x lengkap..dpt 5/7

Sunday, November 1, 2009

My Only Wish

All your armies, all your fighters
All your tanks, and all your soldiers
Against a boy holding a stone
Standing there all alone

In his eyes I see the sun
In his smile I see the moon
And I wonder, I only wonder
Who is weak, and who is strong?
Who is right, and who is wrong?
And I wish, I only wish
That the truth has a tongue

Thursday, September 17, 2009

Giggle..giggle..

Hola hola my pretty and fabulous peoples on the earth

Yes,
I'm already on-board in MAS
I will definitely miss you gorgeous!!!

Pray for my safety
and also
wish me
that i will keep myself restrain + away from this culprit
MAS Temptations In-flight Shopping

BTW, I'm enjoying this book.

I'm loving it!!!

To Mi mi mot
Raya nanti, kamu pilih tudung yg match, pakai lipgloss, tidor jangan lewat ye
bila solat raya jgn la escape
janganlah pakai baju spiderman pergi solat ye..
i will definitely miss you darl..
send my regards to
JOn jon, Qemala, Mek Sarah, Fauziha, Yati

Monday, September 14, 2009

Health Economics : Paying for Pharmaceuticals

1. Regulation in some countries including Australia also includes ensuring access to medications irrespective of income. The Malaysian pharmaceutical market reflects more closely the free market model, where competition between providers is the cost control mechanism.

2. Australia‟s National Medicine policy (NMP) has four main objectives..

2.1timely access to medicines that Australians need, at an affordable cost to individuals and the community;
2.2. medicines meeting appropriate standards of quality, safety and efficacy;
2.3. quality use of medicines; and
2.4. maintaining a responsible an viable medicines industry

In Malaysia the National Pharmaceutical control Bureau has as one of its objectives the quality and safety (via a legislative framework) of pharmaceutical products to improve the health of the population

3. Many governments go further, however by reimbursing consumers for at least part of the cost of prescription drugs, on the grounds that access to life enhancing medicine should not be related to ability to pay. The Australian government achieves this objective through the Pharmaceutical Benefits Scheme (PBS). The Malaysian government however does not regulate prices (Barbar et al, 2007)

4. Australia has a two tier system of drug regulation:

4.1. The first tier is the approval of a prescription drug for marketing by the Therapeutic Goods Administration (TGA) and the Australian Drug Evaluation Committee (ADEC).
4.2. The second tier is consideration for reimbursement under the Pharmaceutical Benefit Scheme (PBS).

5.The PBS accounts for approximately 90% of prescription expenditure and the Australian government has been able to negotiate prices for prescription drugs under the PBS at prices that are 50-70% of the world price.

6.The effect of patents on prices

When new drugs are listed on the PBS the company applies for a patent, hence drugs are listed at a price premium. The patent period enables the company to cover its costs of research and development and consequently provides an incentive for companies to participate in research and development. Once the patent period has expired then the price subsidy is reduced to that of the generic equivalent. If patients want to continue with the original drug then they pay the difference between the generic price subsidy and the premium price. To assist consumers, the government has recently enabled pharmacists to offer a generic equivalent, irrespective of whether the trade name appears on the script

7. Malaysia – Prices

Medicines vary in price across the country. International Comparative studies on prices of essential medicines have found that pharmaceuticals sold by the private sector in Malaysia can be higher than international reference price standards. The study found that prices were relatively more expensive in Malaysia than other similar countries, raising questions of affordability of pharmaceuticals (Hill 2007). A number of potential supply-chain mark-ups were identified. Further, medicines both dispensed and prescribed by doctors can result in high mark-ups being charged (Hill 2007). Medicines sold in the private sector also varied across the country and were found to be higher than the international reference price

References
Babar, ZUD, MIM Ibrahim, H. Singh, NI Bukahri, A. Creese (2007). Evaluating Drug Prices, Availability, Affordability, and Price Components: Implications for Access to Drugs in Malaysia‟ PLOS Medicine 4(3): 466-475

Hill, S (2007). Medicines Prices and Malaysia – Untangling the Medicines Web‟, PLOS Medicine, 4(3):411-412

Salkeld et al (1998). Pharmaceuticals‟ in Economics and Australian Health Policy, Sydney: Allen & Unwin, p.115.