الحمد لله رب العالمين
والصلاة و السلام على رسول لله وعلى آله و صحبه و سلم

1. In surgery, to be specific, in dealing with electrolytes, there's something we call "The Rule of 40".

2. The rule describes important points to be considered in dealing with potassium. There are basically 4 items, which are;

i. Not more than 40 mmol added to 1 litre solution
ii. No faster than 40 mmol/hour (to be infused)
iii. Make sure its urine output is at least 40 ml/hour
iv. Maximum amount can be given is 4 x 40 mmol/day (=160 mmol/day)

3. Potassium is really important, as a slight mistake in dosage or rate of infusion/injection could be lethal.

4. Once a upon a time, not long ago, there was a dramatic mistake in an operation that led to the death of the patient. It was a high profile case, as I could find no article or news regarding the case. My professor, Prof Dr. Hala Ezzat told us last week. I doubted it at first, so then I asked another professor, Prof Dr. Nadia El-Sharqawy. She told us the same, it did happen.

5. On that odd day, the operating surgeon was asking for one injection of an antibiotic. It was a minor surgery by the way. Unfortunely, the nurse by mistake handed the doctor an injection of potassium chloride instead. The solution was injected, and that was it. The patient died on the spot! He got immediate cardiac arrest on diastole. (As far as I know, one ampoule of potassium contains 5 ml of potassium. Each ml contains 2 mmol) My Allah bless his soul...

6. What made the case more interesting is, the patient was the son of the Minister of Health of Egypt at that time, who is, until now, an internationally well known respectable surgeon!

7. That former minister is Prof. Ibrahim Gamil Badran. He is the one responsible for establishing one of the biggest medical scholls in surgery, and is known as the Father of Surgery in Egypt. You can see his profile here. http://www.ias-worldwide.org/profiles/prof99.htm

8. May this case be a great reminder for us, doctors-to-be, that potassium kills, if given in certain amount and certain rate. And the safe range is really small. Another electrolyte that also has to be taken into consideration as serious as potassium is Calcium.

9. Don't you(and me) ever get tired of mastering medicine. We deal with lives. A slight slip, and the patient dies. May Allah bless us...

و الحمد لله رب العالمين

السلام عليكم و رحمة الله و بركلته
الحمد لله و الصلاة و السلام على رسول لله

1. I'm now in Anaesthetology rotation. It's stunning! Really cought my attention.

2. The second lecture was about General Anaesthesia (GA), by Prof. Dr. Nadia As-Sharqawi. She was really cool, with experience as vast as 35 years of service in both private & university hospitals, local & overseas. I guess she is something like 60s (didn't bother to ask).

3. As we were discussing about muscle relaxant of choice during any surgery, Prof. Nadia told us the famous story of Su'ad Nasr's death. The dark side of anaesthetology. The story that gave bad reputation to aesthetic & reconstructive surgery (or surgery generally speaking) in Egypt.

4. Suad Nasr was a famous Egyptian actress in early 1980s. And she died on 5 January 2007 after she went into coma due to some complication in the liposuction surgery back in 2006. Wikipedia says that the cause was an overdose of anaesthesia. However, our Prof. Nadia begged to differ.

5. According to her, Suad Nasr's operation was a hard one. She meant, hard position. Suad Nasr had to be positioned so that she lie on her abdomen. This change in position is one of the hardest challenge for the anaesthetist which is responsible for the patient's endotracheal tube, which basically conveys oxygen to the patient.

6. It's been said that, during the process of changing Suad Nasr's position, that the endotracheal tube slipped out. She was of course on muscle relaxant, which is a standard substance given to patient that is being operated upon. So, Suad Nasr was unable to self-breath, and the anaesthetologist was unable to promptly fix the tube back to it's place. And...snap! That was it! After more that 5 minutes without any oxygen, she went into coma, which heralded to her horrible death. May God bless her soul.

http://a5eerela5bar.blogspot.com/2009/01/death-of-soad-nasr_06.html

http://en.wikipedia.org/wiki/Suad_Nasr

7. A slipped endotracheal tube intra-operation equals potentially fatal consequences.

8. Being a doctor, you are playing with lives. It's no joke. And even worse, when it is someone popular. It's not funny at all.

9. Happy graduating for my newly graduated friends in faculties of medicine all over Malaysia and Jordan University of Science & Technology (JUST). Congratulations!


والحمد لله رب العالمين

الحمد لله ربّ العالمين
والصلاة و السلام على رسول الأمين سيّدنا محمد ولى آله و صحبه أجمعين

السلام عليكم و رحمة الله و بركلته
الحمد لله و الصلاة و السلام على رسولله


1. I'm trying my best to consistently attend Dr. Hussein Khairy's morning lecture and ward round each day. And here comes one of the most important subject, "Fluid & Electrolytes".

2. I try my best to avoid talking or writing about politics now, especially if it's beyond my knowledge, as things (Malaysian politics) have become more complicated than ever.

3. But my mind tells me otherwise. One interesting thing that I got from the "fluid" lesson, can't hardly be avoided from being related to politics.

4. As a matter of fact, 60% of our body weight consists of fluid. Considering an average human being of 70 kg body weight, he will have 42 litres of fluid in his body. From that 42 L, 3.5 Litres of the fluid is in intravascular compartment, which is 5% of body weight. It is quite interesting knowing that out of 42 Litres of total body fluid, only 3.5 Litres that greatly affects our body. Subhanallah...

5. Our main concern in most of the situations (like trauma, shock, hypertensive crisis, etc) lays upon regulating this 3.5 Litres intravascular fluid. We add some more fluids, electrolytes, plasma proteins etc to make sure this 5% of body fluid stable. And in most of the cases, this 3.5 Litres that is causing us problems.

6. Out of 30 millions of Malaysian citizen, only 13 millions voted for the 13th GE. That was more or less 40% of the population. Only 40% of the population who decided the leadership of the country, generally speaking.

7. Most of the time, the national policies are determined by few, maybe tens or hundred of Malaysians in the Parliament. Even bigger decisions for the country are being determined by even lesser number of brains.

8. Remember, that the World War 1 started merely by assasination of an "Archduke", and ended with 9 millions fatalities.

9. The World War 2 was started by few leaderships of few countries, and ended with 75 millions fatalities, which made the WW2 likely the deadliest conflict in human history. It needs only one man to push the "YES" button to change the world. Look at Aghanistan and Iraq. Look at other poor countries.

10. As historians said, "war is started by few, and suffered by many". Indeed, it's not only the war. It applies to pretty much everything.

11. In any community or civilization, only few will decide the future of the rest. Be it the president, prime minister, politicians, the academicians, the scientists, the 'ulama', the artists, whoever they are. The rule is, the few will decide for the many.

12. How many students who participates actively out of a hundred in your classroom? Out of millions of citizens, how many who speaks out for their rights?

13. The question is, can we let this phenomenon to continue? If it is really the rule, should we be the "few" who changes and decides, or the "many" who follows and being changed?

"Be the change you want!"

والحمد لله رب العالمين

السلام عليكم و رحمة الله

الحمد لله و الصلاة و السلام على رسول لله


1. Have you ever be in a situation where you can't focus studying in your classrom because you feel that your classmates are too loud? And you started to blame them for your inability to focus.

2. Quite frequently that you blame the noisy surrounding in the mosque for your un-khushoo'-ness, while you can play mobile games for an hour full of khushoo' in the middle of street without being affected by the surroundings.

3. Almost everything bad that is happening to you comes from others. Bad exam results, bad traffic, your bad temperament, your headaches, oily foods, coming late to class, rising cost of living, bumpy streets, dirty room, bad house, and the list goes on. The blame is always on other than yourself.

4. As a medical student, I'm trained to be a good observer. To find the cause of a disease, the 'what' behind any clinical manifestation. To well manage and treat a patient, we should be pretty sure what is the underlying cause. We need to take a good history, do thorough clinical assessment & precise investigation before diagnosing a patient. Then only can we manage or treat him/her accordingly.

5. It is quite a dissappointment to see people putting blame on somebody else for something without relevant reason (sometimes, without any reason).

6. It's a shame when there are groups of Malays trying to boycott Malaysian Chinese products and even publicise their effort. Some more 'ultra' ones even put "Boikot Barang Cina DAP" as their cause. It's a shame because their are doing that as an effort to improve the economic status of the Malays (well, as they claim...). What kind of mind-class is that?

7. Do they even think about what have brought the Malay to it's economic status quo today? Do they even read? Do they even merely speak to any economist? Do they even bother to know, who actually gave multi-million ringgit of federal goverment's contracts to the 'selected' Chinese 'towkey' at the first place? And they shouted, "Hidup Melayu" ?

(Well, I've got some interesting stories about this high-ranked 'perompak' Melayu. Got it from a young Malay CEO of an electrical industry. I'd love to share it, but, not in this post lah ok...)

8. Some also blame few individuals and local movements when they are talking about Christian missionaries, while they(the blamed individuals & local movements) haven't got any authority over the country at all?

9. For me, we have three main problems here. First, we put the blame on something/somebody without strong evidence, or even without any evidence at all. We base our blame on emotion or mere speculations. Second, we put the blame on the wrong target. So, we are missing the real problem, hence, giving the wrong treatment. Third, we like to put on the blame, nothing more. Just blame something or somebody, that's all.

10. At the end, things become even worse, as we put the blame on the 'pseudo'-problem, not the real one. With the problems we are facing today, which are as diverse as ever, we are just getting off the pitch. We stand in front of an issue, put some blames on somebody, and stand still. Wait and see.

11. Please don't get me wrong. I'm not saying that we have to blame ourselves for every problem that comes accross us. That is totally irresponsible. But worth remembering that, when you point your index to someone in front of you, the other 4 fingers are pointing right to yourself.

12. As 'Brain' (from the cartoon series "The Pinky & The Brain") always asks 'Pinky' each night, "what are we pondering tonight?..." , we should also ponder, how do we put on our blame. And how can it solve the real problem or treat the underlying disease.

13. Putting on blames by itself, is an art. Appreciate it, and do not misuse it, as it is important and powerful, only if it's properly used.


والله أعلم

والحمد لله ربِّ العالمين

السلام عليكم و رحمة الله و بركاته

الحمد لله و الصلاة و السلام على رسول لله


1. "Semangatnya, sampai sanggup balik seminggu je untuk PRU!" Ini adalah reaksi mak saya apabila memberitahu bahawa saya sudah membeli tiket kapal terbang pulang ke Malaysia.

2. Mengapa saya sanggup pulang dari Mesir ke Malaysia selama hanya seminggu? Ia bertitik tolak dari tarikh PRU 13 yang kebetulan 'kena' dengan beberapa cuti umum di Mesir. 1/5 (Rabu) cuti Hari Pekerja. 3/5 & 4/5 adalah Jumaat dan Sabtu, cuti hujung minggu di Mesir. 5/5 & 6/5 (Ahad dan Isnin) pula cuti umum perayaan masyarakat Kristian, Sham An-Naseem. Majoriti universiti dan fakulti memberi cuti sehingga 9/5 (Khamis). "Elok sangat lah tarikh PRU 13 ni!"

3. Saya sudah mendaftar sebagai Pengundi Tidak Hadir (PTH). Maka, nama saya secara automatiknya tidak akan tersenarai di pusat mengundi di Malaysia, kerana saya perlu mengundi di kedutaan. Namun, kebetulan biasiswa bulanan JPA masuk lebih awal dari biasa untuk bulan 5, ditambah pula elaun buku, maka saya mempunyai lebihan wang saku lebih awal dari biasa!

4. PRU 13 mencatat rekod pengundi pertama kali (first time voter) paling tinggi dalam sejarah, kurang lebih 80%. Saya merupakan salah seorang daripadanya. Ini merupakan pengalaman pertama saya sebagai seorang pengundi, dan juga penggerak jentera, jika saya pulang. Maka, saya merasakan harga pengalaman itu tidak ternilai berbanding wang ringgit.

5. Alhamdulillah, biarpun hanya 3 hari sebelum dan 4 hari selepas tarikh mengundi, suasana PRU 13 dapat dirasai secara langsung.

6. Ramai yang bertanya saya, "Apa yang kau dapat dari PRU 13 ni?"

7. Saya melihat, PRU 13 menyaksikan kesedaran politik (political awareness) dalam kalangan anak muda jelas dirasai. Rakan-rakan yang selama ini senyap menyepi dari membincangkan isu-isu kenegaraan, sudah mula bersuara. Laman-laman media sosial seperti 'facebook' dan 'twitter' memainkan peranan utama dalam membawa arus maklumat.

8. Namun, dengan kadar peningkatan tahap kesedaran politik anak muda yang tinggi, memerlukan peningkatan tahap pemikiran dan pendidikan yang tinggi juga. Malangnya, kadarnya tidak seimbang. Kebebasan penyebaran informasi yang melaut luas, tidak seimbang dengan kematangan pemikiran rakyat, terutamanya anak muda. Sebagai contoh, tiada peningkatan kadar membaca yang menyusuli kadar kebebasan maklumat. Tiada sifat mencari sendiri maklumat, menapis dan berfikir seterusnya membuat pertimbangan berasaskan pendirian sendiri. Anak muda seronok menerima dan menyebar informasi dengan semangat dan emosi, sekadar mengikut 'arus kebangkitan'.

9. Situasi ini sudah tentu sukar dibendung oleh 'orang-orang tua' atau pimpinan parti, seterusnya meningkatkan kecenderungan semangat anak muda ini dimanipulasi.

10. Namun, ini lah cabaran masa kini. Cabaran sentiasa ada, semakin hari semakin kompleks. Dan ini adalah cabaran masa kini. PRU 13 ini menunjukkan tahap kematangan pemikiran anak muda kita. Ia bukanlah sesuatu yang negatif secara total.

11. Di samping itu, saya sangat tidak bersetuju dengan manipulasi media prima di Malaysia yang jelas-jelas berat sebelah. Namun, satu perkara yang saya seronok adalah, apabila mendapat tahu kebanyakan masyarakat di Bangi khsusnya dan Selangor umunya sudah tidak menonton TV 3, RTM atau yang sewaktu dengannya. Utusan Malaysia dan Berita Harian juga hanya menjadi kertas bungkusan nasi lemak. Alhamdulillah.

12. Saya bersyukur, DUN Bangi dimenangi oleh Ustaz Shafie Bin Ngah dari PAS, dengan tagline "Meneruskan Kecemerlangan". Rakyat Selangor, di Bangi contohnya menikmati suasana kehidupan yang baik. Selain dari pertumbuhan ekonomi dalam bentuk pembangunan pesat di sana-sini, budaya ilmu dan pengimarahan masjid bertumbuh subur sejak sepenggal PR menguasai Selangor. Itu salah satu perkara yang jelas dirasai di Bandar Baru Bangi.

13. Institusi masjid terletak di bawah Jabatan Agama Islam Selangor (JAIS), di bawah autoriti Kerajaan Negeri. Sejak PR mentadbir Selangor, institusi masjid di kebanyakan kawasan lebih bebas dan aktif. Namun, tiada pula saya dengar di Bandar Baru Bangi ini mana-mana masjid dimanipulasi untuk tujuan politik biarpun umum mengetahui Bangi adalah teritori PAS.

14. Kembali kepada persoalan asal. Apa-apa pun, PRU bukanlah segala-galanya, bukanlah pengakhiran. Sekarang adalah tempoh bekerja dan produktiviti. Semua lapisan masyarakat harus menyumbang dengan mempertingkatkan produktiviti dalam bidang masing-masing. Anak muda hari ini akan matang dengan peredaran masa, dengan syarat, mereka sedar apa yang mereka lakukan dan apa yang berlaku di sekeliling mereka. PRU 14 akan datang, anak-anak muda hari ini lah pula berada di barisan hadapan.


والحمد لله رب العالمين

السلام عليكم و رحمة الله و بركاته

الحمد لله و الصلاة و السلام على رسول لله


1. Alhamdulillah, tarikh keramat 5/5/2013 telah berlalu. Awal pagi 6/5/2013 SPR Malaysia telah mengumumkan keputusan PRU ke-13 dengan 133 kerusi parlimen dimenangi oleh BN dan baki 89 dimenangi PR. Kerajaan Pusat terus diterajui oleh BN, sesuatu yang amat berat di hati saya.

2. Ada yang menyatakan bahawa PRU 13 telah melabuhkan tirainya. Namun, saya berpendapat sebaliknya. Selepas keputusan PRU 13 diwartakan, masih ada 21 hari untuk mana-mana pihak menfailkan petisyen untuk membantah mana-mana keputusan PRU, atau mendakwa salah laku mana-mana pihak.

3. Pasca PRU 13, pelbagai perkara pahit manis berlaku. Ada yang menerima kekalahan masing-masing, ada yang bergembira dengan kemenangan, dan ada pula yang tidak menerima keputusan atas pelbagai dakwaan. Antaranya, pengundi 'hantu' dari kalangan warga asing, pengundi yang mengundi lebih dari sekali, peti undi 'tambahan'/haram, dan isu 'blackout'.

4. Hasil daripada kejadian-kejadian tersebut, muncul dua golongan ekstrim dalam kalangan yang kalah. Ada yang menolak semahu-mahunya keputusan yang tidak berpihak kepadanya, dan ada yang menerima seadanya sebagai muhasabah bersama, biarpun spekulasi kejadian-kejadian 'pelik' (seperti di atas) tersebar luas.

5. Rentetan dari itu, pihak PR diterajui DS Anwar Ibrahim menganjurkan himpunan demi himpunan bagi membantah keputusan PRU 13 yang lalu. Bermula dengan Kelana Jaya Selangor, dituruti beberapa lokasi lain sekitar Penang, Perak dan lainnya, himpunan ini kelihatan mendapat sambutan hangat dari rakyat, biarpun boleh dikatakan 70% daripada yang hadir adalah dari bangsa Cina.

6. Maka timbul pihak-pihak yang mula mencela tindakan DS Anwar Ibrahim dan 'sekutu' PRnya dengan penganjuran himpunan tersebut, ditakuti menimbulkan perpecahan dan huru-harandalam negara. Pihak ini meminta agar PR menerima dan redha dengan kekalahan dalam PRU 13 dan fokus dengan kerja-kerja yang menanti di kawasan yang dimenangi PR. Yang menarik, ada dari kalangan yang mengkritik tindakan DSAI ini adalah pimpinan tertinggi PKR sendiri.

7. Bagi saya, sebagai rakyat Malaysia yang patuh kepada Perlembagaan Persekutuan dan mendokong demokrasi, semua pihak perlu patuh kepada peraturan yang ditetapkan oleh pihak berautoriti.

8. Kita mempunyai sistem di mana, selepas diwartakan keputusan PRU, tempoh 21 hari diberikan kepada mana-mana pihak yang ingin menfailkan petisyen bagi menolak keputusan PRU atau mendakwa mana-mana kesalahan. Petisyen tersebut haruslah lengkap dengan bukti-bukti yang jelas. Kita juga mempunyai mahkamah yang, bagi saya, terbukti berintegriti. Disebabkan sistem itu wujud, maka rakyat harus berpaut pada sistem yang satu.

9. Dalam masa yang sama, tidak boleh menafikan hak sesiapa sahaja atau mana-mana pihak sekalipun untuk berhimpun atau bertindak selagi mana tidak melanggar peraturan.

10. Dalam kes himpunan 'blackout' ini, pada awalnya, saya berpendapat ianya patut diadakan bagi menunjukkan sokongan rakyat terhadap keseriusan dakwaan kepincangan pengurusan PRU oleh SPR, meningkatkan kesedaran rakyat untuk bangkit jika benar ada penyelewengan, dan juga untuk maningkatkan lagi sokongan terhadap PR. Tambahan pula, ia terbukti berjalan tanpa melanggar peraturan.

11. Namun, saya rasa kurang enak apabila isi-isi ucapan dan agenda himpunan tersebut banyaknya berkisar sentimen dan emosi, ditambah dengan sedikit dakwaan-dakwaan tanpa fakta yang kritikal.

12. Maka pendirian saya adalah, perhimpunan ini perlu diadakan, tetapi cukup bilangannya sekadar apa yang telah diumumkan dengan tempoh masa seminggu dua ini sahaja. Pengisian himpunan ini juga haruslah penuh fakta dan hujah profesional, bukan sekadar sentimen dan emosi. Selagi ianya berjalan mengikut peraturan, tiada siapa berhak menghalang usaha himpunan ini. Bagi saya, ianya bagus dari sudut meraikan semangat rakyat yang cintakan keadilan dan berani bersuara bila haknya dirampas.

13. Tapi apakan daya, politik berkait dengan memenangi hati rakyat. Politik juga menentukan arus semangat dan emosi pengikut. Selagi ianya mengikut peraturan, biarkan lah. Namun, dari segi moralnya, saya tidak bersetuju dengan mana-mana pihak yang cuba memanipulasi kecaknaan rakyat terhadap perkembangan politik dan semangat anti-penyelewengan rakyat. Apa-apa perkara pun, jika dilakukan secara berlebihan ianya tentu sekali buruk. Semangat dan emosi yang tidak disandarkan dengan kefahaman dan kewarasan akal fikiran, akan membawa keburukan lebih dari kebaikan.

14. Dalam masa yang sama, petisyen perlu disiapkan sebaik mungkin, demi membuktikan dakwaan-dakwaan keras PR terhadap SPR. Jika terbukti kemenangan sepatutnya berpihak kepada PR, ianya akan berpihak kepada PR. Begitu juga sebaliknya. Mahkamah akan mengumumkan keputusannya dalam masa 6 bulan.

15. Selaku rakyat Malaysia yang semakin matang dalam berpolitik, mari lah kita berfikir dan bertindak rasional. Jika semua pihak berbuat sesuka hati di luar kotak Perlembagaan Persekutuan, tentulah kekecohan berlaku.

16. Sejarah membuktikan, pihak UMNO sendiri pernah menfailkan petisyen terhadap keputusan pilihanraya, dan banyaknya gagal. Prnah juga PAS menfailkan petisyen terhadap satu kerusi DUN, dan menang. Maka, apa yang kita takuti?


والحمد لله رب العالمين

السلام عليكم و رحمة الله و بركاته

الحمد لله و الصلاة و السلام على رسول لله