Human Physiology Explains Hadith Rasulullah saw!

Assalamualaikum everyone!

Couple weeks before Hari Raya Aidil Fitri, it was in the middle of Block 9: Renal and reproductive, when something triggered in my mind. Masa tu lecture Puberty under Dr Hamdi. He asked us to go through the reading materials at home and will have discussion to replace the lecture. Maksudnya he was not going to teach us and replacing the lecture slot with active learning. Banyak jugaklah lecturer start adapting this kind of new way of teaching. Masa year 1 dulu, A/P Dr Willian yang banyak buat lecture macam ni, followed by other lecturers.

Balik kepada cerita asalnya. At the end of lecture, aku ada persoalan tentang hypogonadism and physiology of penile erection. I have no interest to discuss regarding hypogonadism here but more on physiology of penile erection. *Nasib baik aku study elok-elok penile erection ni, dia keluar in block exam weh with 6-7 marks!)

Jadi seorang Aishah pun ajukan soalan kepada Dr Hamdi. Done with hypogonadism part, aku proceed with,

“Is there any relationship between fasting with penile erection?”

Dr Hamdi took some time and he did explain to me using medical jargon (by which I will translate later.)

Stimulation of penile erection requires parasympathetic activation that will make corpora cavernosa to fills will blood and lead to penile erection. And on the other hand, the other stimulus of parasympathetic activity that contributes to relax and digest is by eating. Thus, when you

 Eat àStimulation of parasympathetic activity à penile erection. Bingo!

Having said that, other stimuli of penile erection play their roles as well.

But he added, that is just theoretically and not that conclusive. So just now this thingy triggered my my mind so apa lagi, aku cari kat NCBI! And guess what find out? Hehehehehe…

Yes there are few studies that support this hypothesis and conclusion from that study is that

“Ramadan intermittent fasting might be associated with decrease in sexual desire, frequency of sexual intercourse and serum FSH level.”, Talib, Canguven, Al-Rumaihi, Al-Ansari & Alani.

So jom kita kaitkan dengan hadis Rasulullah;

Sabda Rasulullah s.a.w. maksudnya:
“Hai orang-orang muda, sesiapa di antara kamu yang mampu berkahwin maka hendaklah dia berkahwin kerana ia (iaitu perkahwinan) itu dapat mengawal mata dan kemaluan. Barangsiapa yang tidak mampu, maka hendaklah dia berpuasa kerana ia (iaitu puasa) akan menjadi penjaga baginya”.

Ada satu dkumentasi kat National Geographic yang aku tengok tadi, aku tertarik dengan satu ayat dia.

"Religion explains thing that science can't explain"

The sentence not necessarily true but.. Religion(dalam konteks ni, Islam) is supported by science.. or in other words, Science explains Islam!

p/s: Aku sangat amazed dengan negara barat yang not came from medical background tapi knows the basic medical jargon and they even hafal nama ubat diorang. Unlike Malaysian that lack of awareness to know their ubat. Contohnya ubat tahan sakit. There are few jenis of painkiller, plus, they even know what is NSAIDs and indication of anti-histamine.

Since kita duk war-warkan Malaysia Baharu, so why not kita jadikan Malaysian knows more on basic things and lebih rajin cari maklumat melalui laman akademik. Ni bila kahwin 2 bulan tapi scan baby umur 10 minggu mulalah si suaminya meroyan.

Translation: Our body ada dua komponen untuk berfungsi dengan baik, iaitu somatic nervous system(dapat kita control contohnya berjalan etc) dan autonomic nervous system. Bawah autonomic nervous system kita ada parasympathetic(yang memainkan peranan dalam pencernaan dll) dan sympathetic( memainkan peranan penting dalam situasi genting (fight and flight) seperti kena kejar anjing; dimana adrenaline akan dirembeskan). Dua komponen ni saling berkerjasama dan kita tak dapat kawal tapi kita boleh kawal dari segi stimulusnya. Salah satu kepentingan dia adalah receptorsnya penting as a target untuk ubat-ubatan. Contoh? Ubat hypertension(tekanan darah tinggi) target reseptor untuk sympathetic activity. Macam aku mention tadi, sistem pencernaan akan diaktifkan semasa dan selepas kita makan, dan sistem pencernaan ini dikawal oleh parasympathetic action. Justeru, ereksi zakar(penile erection) juga akan teraktif!

...kalau hampa dok faham jugak, aku tataulah nak explain camne dah....

Love, Aishah

December 2017

For the whole week I’ve been telling myself that “Aishah, this 3-days Christmas holiday you must post something, a must!” Yes, yes because I’ve thinking that I’m useless and not done anything much in influencing(?) motivating people or anything for ummah that literally means me and animal has no difference.

Today I see, so many people woke up with the aim of doing good deeds and I am amazing how people think could affect others. Just like how I was affected by what read, watch, etc. And how people touch my heart just by their attitude ;)

I’ve been taking elective class of ‘Learning Disability’ for this semester and Alhamdulillah, Alhamdulillah, I made a good wonderful choice even though I was ‘ is this a right decision? Would this course quite heavy?

Well, what kind of life I’ve go through that aku nak amik course yang agak berat. Well, initially my option was Biomedical Physiology but to think of, well, ‘ bila lagi kau nak belajar satu ilmu baharu?” mestilah When taking biomed physio, senang nak score, medical student right,  and gaining ilmu that will be gained confirm-confirm will be or has been learned in my core course. So after few minutes of thinking, I dropped Biomed Physio and took Learning Disability under Dr Chan, also from Fakulti aku.

The last day of 2017. Maafkanlah sis Aishah ni yang busy tahap gaban that end up continuing her post that should be posted on Christmas but end up on today.

2017. I have been flying numerous time (jap eh kira jap.) sebelas kali for this whole 2017(excluding masa aku year 1 dulu that belongs to 2016) from just flying, macam-macam benda yang aku belajar. Aishah is growing up until one point she don’t feel like something wrong when travelling alone. Mum and daddy, can I go travelling somewhere, alone? Of course lah tak. Sebab I have one little sister yang obsess dengan aku. Eheh. Let’s summarise this year.

1. My big brother got married with his wonderful soulmate and also awesome SIL. Biarpun aku tak balik masa diorang nikah, deep in my heart, aku doakan jodoh mereka berkekalan hingga ke syurgaaa.

2. My second brother habis contract kat Penang and decided to settle down kat kuantan. He just came back from Umrah once habis contract, and now kerja apa entah mak and ayah cakap. Nanti balik aku interview dia haha ok tak berkait.

3. My kakak still with kerja dia as junior executive and macam biasa, tiap-tiap kali balik dari KL for sure akan mengadu how thing goes on in her workplace.

4. My second sister just started her work in Ambank  and yeah, she return to Malaysia for good dah.

5 My little sister masih lagi dengan azam dia yang untuk kurus since beberapa tahun yang lepas(seriously no kidding)

And 2017 depicts that we re having new member in the house—volkswagen! Eheh.

And let’s come back to me, the owner of this blog that writing despite she’s having final exam on 2 January… Well who cares about new year when you have 2 generic exam on 2^nd January and elective exam on 6^th January… my FIRST clerking patient on next Monday.. and, End Of Block 7 Examination that starts on 16^th January. Gone all my life. Haha well not. I’m having big plan ahead. Eheh.

Azam tahun ni? Post new entry regarding Learning Disabilities. Pass Year 2 with flying colors and eligible to sit for First Professional Exams with flying colours as well, amiiin amiiiiin!! Other than that? Just renew my 2017’s azam I guess.

Tahun ni jugak PBL-mate menjodohkan aku dengan budak PBL sebelah and I was like. Dari block 5 year 1 until Block 7 berterusan gossip. Serious talk, please, please, please, guys, jangan cuba nak jodohkan someone with someone else. You tak tahu how hard I have to handle when people keep mentioning A*** to me despite I don’t have any feeling to him. Everyone says he’s handsome, genious, religious but hey, it’s killing me to live on having related to someone that u don’t want to. Please pray for Aishah, please. 

That's it. Moga legalah hati.
End of December 2017.

Love, Aishah

Hospital Visit, GIT

Assalamuaikum and helllloooooo.

Okay since aku baru balik dari uptown and roommate aku keluar jalan-jalan, housemates Sarawakian ada yang balik, ada yang pergi dobi and ada keluar berjimba dengan kawan-kawan (post EOB phenomenon), so I’m all alone! Final exam EOB 7 is done and I have 2 days of ‘holiday’ before we start with Block 8. Korang, doakan result EOB 7 aku dan rakan-rakan classmates pass with flying colours. Amiin, Amiin, Amiin. Semoga kalian dipermudahkan urusan and segala doa kalian, kembali kepada anda. Amiin.

Nak rant sikit on last visit aku ke SGH(Sarawak General Hospital). It was seriously, seronok!

Okeh, So GIT tu apa? GIT tu actually gastro intestinal tract. Ususlah simple word dia.

Hospital visit ni actually dah start dari Block 1((atau known as Modul in other universities such as UITM. Aku dah cerita what block is in my previous entry hehe))  which is dari aku year 1 lagi. Motifnya untuk kitorang being exposed to clinical years and how the setting of current hospital is. Setiap block ada tema-tema dia contohnya Block 3, Haematology and Immunity, kitorang pergi hospital untuk lawat blood bank. So we being exposed to machines and the principles behind blood donating, how to store, criteria, how medical officer there sort blood, RBC, glucose etc. But this time, for Block 7; Gastrointestinal System, kitorang pergi hospital untuk clerk patient yang diagnosed with masalah kesihatan yang berkaitan dengan Gastrointestine tract (GIT). GIT ni along the way dari mulut ke anus and orgas yang associated with it.

Since kitorang medical students ada 141 orang, our coordinator divides us into 3 groups based on PBL(kumpulan kecil untuk melaksanakan Problem-Based Learning. Ala-ala tutorial setiap minggu dimana kitorang diberikan satu situasi and we have to detect what disease the patient have. Then kitorang jumpa balik and discuss together on Friday.). PBL aku fall on last field visit, Isnin 8 January.

Tapi setiap PBL 11 hingga PBL 15 will need to send only 4 representatives for each PBLs; dua pergi surgical ward, dua lagi pergi Medical ward yang lain stay kat fakulti and help us untuk prepare slide untuk kitorang present akan apa info kitorang dapat dari patient. Aku dengan Ho wakil untuk clerk patient di Surgical ward while Faizah and kak Nithiya  kat Medical Ward.

Clerk patient is actually a process of dapatkan malumat dari patient. Dari profile, chief complaint, symptoms, social history, past medical history and any related untuk dapatkan differential diagnosis. Untuk dapat definitive diagnosis, usually kena buat pemeriksaan fizikal atau makmal (Physical and lab investigation)

Kitorang sampai SGH(dari Main campus, dalam 20 mins perjalanan naik bas) around 1:20 pm.

Mak aihh teriknya matahari. Seriouslah kena pakai labcoat? Well, we need to. Cari punya cari, jumpalah bangunan ward. Well, takde lecturer yang join us actually. Just clinician that we will meet them there.

Sampai bawah bangunan, lift penuh. Aini ajak kita 20 orang naik tangga. Habis satu tingkat aku Tanya Aini.

“Aini, surgical ward tingkat berapa?”

“Tingkat 7, shah.”

MasyaAllah. Gaya hidup sihat di tengah hari yang panas bendering ni. Baru je keluar dari bas yang ber-aircond dah berpeluh balik. Naah, it’s okey. Patient family should be prioritized first. Kalau aku pun, aku segan nak naik lift. Their family warded kot.

Tapi Medical Ward aras 8. Hehe. Selamat satu tingkat.

Done part 1. Sampai ward lelaki, lecturer aku panggil kita 8 orang duduk setempat. Dia brief shortly what we’re going to do. Done with that, kitorang berpisah. Each two of us akan dapat patient sorang. Aku dapat sorang pak cik tua. Tangan bertatu.

Masalah orang semenanjung bila duduk Sarawak ni ialah, aku tak reti nak differentiatekan antara non-Muslim dengan Muslim. Even non-Muslim pun nama dia pakai bin atau binti. Nasib baik bertatu.

Kitorang start approach dia. Ho awal-awal cakap (in mandarin)

“You go first talk to him, I read the case report”

Bismillahirahmanirrahim.

“Selamat petang pak cik, maaf ganggu pakcik. Pakcik busy ke..?” aku Nampak dia dah sedar tapi tak moving. Cuma dia macam geleng-geleng.

“Saya Aishah, ni kawan saya, Ho. Kitorang pelajar perubatan nak tanya pakcik beberapa soalan untuk kitorang present kat specialist kitorang.” (Aku tau aku tersasul banyak perkataan English. Kalau nenek aku, aku akan make sure aku guna bahasa Melayu penuh. Sebab certain uncommon English nenek aku tak faham sangat. Warghh I miss my nenekk).

 Aku nampak pak cik tu macam angguk-angguk sikit. Okeh dia faham bahasa Melayu. So takpayah aku keluarkan Bahasa Sarawak aku yang agak kelaut. Alhamdulillah. Btw, bahasa Sarawak lagi susah dari Sabah. Sabah at least diorang guna bahasa baku Melayu tau. Tapi kalau Sarawak, hilang terus segala perkataan Melayu dia. Contoh; sekarang-kinek.

Aku alihkan kerusi tepi dia, aku berlutut sambil kepala aku separas dengan muka dia. Sebab pakcik ni macam tak larat langsung nak bangun. Maafkan saya pakcik sebab terpaksa ganggu rehat pakcik.

“Pak cik nama apa?”

“XXXXXX”

“Nak saya panggil pakcik apa ya?”

“XXXXXX”

“okay.. pak umur berapa?” Okeh pak cik ni cakap something tapi aku tak faham. Aku sambung je soalan apa-apa yang terlintas.

“Kenapa pak cik datang ke hospital?”

“Sakit lutut ###” ayat last dia aku tak faham. Tapi dia tunjuk kat bahagian perut dan joint jari ibu jari dia. Aku terlintas gout. Ok. How to kaitkan  sakit kat lutut

“Ada sakit kat mana-mana lagi?” Aku tengok pak cik tu pandang je aku. Tapi tak cakap apa-apa. Aku ingat aku tanya soalan tadi. Ke suara aku tak terkeluar? Ke suara aku dalam kepala aku je? Sebab dia diam je, aku pun masuk ke part social history.

“Pak cik dah kahwin?” Still, dia takde respon. Tapi dia tunjuk telinga. Ting! Pak cik ni ada masalah pendengaran!

“Pak cik dah kahwin ke?”

“Pak cik tak dengar, dekat sikit.”

“Pak cik dah kahwin ke??” Okeh pak cik tak dengar jugak. Aku naik risau dah. Aku dah increase volume aku 7/10.

Last.

“Pakcik dah kahwin ke??” Tiba-tiba aku rasa aku macam tengah goda seorang pakcik tua berumur 86 tahun. 9/10 dari suara aku dah wehh tapi dia still tak dengar. Aku rasa aku dah tarik perhatian patient lain satu ward.

So aku senyum kat dia, aku pergi kat Ho yang tengah belek  case note. Ho ada masalah sikit untuk baca short form words. So kitorang sama-sama bincang apa yang ada dalam case note dia.

Rupa-rupanya menantu dia yang jagakan. Tapi masa kitorang sampai, menantu dia tengah cari makan. Waduhhhh. Begitu rupanya. Lepas menantu dia datang, terus aku dengan Ho temuh ramah beliau. Kalau kamik tauk siklah kmk terjerit kat pak cik ni.. mesti pak cik annoyed dengan I kan. Im sorry, pakcik.

Chied complaint; Upper GI Bleeding. Haematochezia(passing stool with blood). History of taking NSAIDs(ubatan tahan sakit.), malaena(stool with digested blood) haa I think aku tahu sakit apa ni. Sebab pak cik ni tengah transfuse darah. Sah,patient ni berkaitan dengan ulcer in GIT. Tapi aku tak sure peptic ulcer tu gastric or duodenal ulcer. Since communication with patient is a bit of trouble, we have to depend more on case report and his SIL. Tengok result endoscopy; duodenal ulcer D1/D2.

Gais, kalau berak ada darah, muntah berdarah, najis warna hitam, it’s a medical emergency. We need to know what is the underlying cause.

The point of me writing this entry is that;

• 1.       Thank you, thank you any of you, yang mak bapaknya, pernah diwarded, dan didatangi medical students, yang seek for experience and knowledge from you. Thank you for giving us chance to broaden our knowledge and sharpen our skills. You know that you really made a big contribution for helping us becoming a doctor. Thank you.
• 2.       There’s no joke in passing stool with blood(najis berdarah). It could be haemorrhoid secondary to liver problem, any ulcer or it can be anything. Even pak cik yang aku clerk haritu, we need to stop clerking for a while because dia nak defecate and I can see blood in his ‘litter box’(?). Treatment could be surgery (?) or I’m not sure because not everyone can tolerate with surgery. Tapi banyak jugak aku tengok diorang present with Peptic Ulcer Disease(PUD) secondary to chronic(long term) usage of NSAIDs(pain killer for any cause of reason such as back pain etc). Besides, that pak cik of his third blood transfusion for only 1 day ++ since warderd.

I think that’s all from me for this time. Please do pray for me and my batch mate promoted to year 3 and pass year 2 with flying colours this year (and pray for my EOB 7 result pass with flying colours! Amiin, amiin. ;)

East Malaysia, Kuching

Assalamualaikum.
So, it almost come to the end of semester holiday. Tak banyak sangat input yang aku dapat dari segi $$ but dari segi affection, i could say that i got 100%. Family lah, of course.
Well, life has never been expected. Sometimes the path changes to the direction you cant ever dream of it. Setahun jugaklah aku dah merantau di bumi kenyalang berbekalkan passport DPT.

Setahun,
aku belajar erti berdikari; dari kolej ke aiport sorang-sorang, check in, naik flight, learnt on how to 'get new friends aka networking', masa atas flight, act professiolnally, takleh nak berhuha macam dulu, learnt on menunggu berjam-jam fligh delay, transit at KLIA, berlari bagai tak cukup tanah kat airport(i even berlari and tercungap-cungap kat imigresen haha alah bukan pegawai tu ingat muka aku pun =,= so malu ke apa belakang kira.)

Bila belajar kat bumi kenyalang ni, dah dikira kau belajar overseas negara orang kecuali part matawang and politik je yang sama. Because the bahasa, the culture, crusines, adat, adab, sangat-sangatlah berbeza yang buat aku rasa macam in a new world. Dulu ada seribu tanda tanya pasal bumi kenyalang ni and banyak gil benda yang jauh dari what i expected earlier. Sarawakian sangatlah bijak dan cantik. lelaki hensem2 weh sungguh tak tipu. Tapi aku ni hati batu kot. teringat kat orang semenanjung je. Eheh. Plus, biarpun kau ada bestfriends kat bumi ni, tapi sebab lain tempat asal(flight available tak sama in fact in certain negeri takde direct flight blaa blaa, most of the route you have to take it on your own). Bagi aku, tak semua orang boleh ada pengalaman ni and it's worth it.

Dan bila berada di bumi ni jugaklah, kau lihat ramai gila orang yang silaturrahimnya terjalin kerana Islam semata. Aku siap pernah tido kat sebuah kampung dengan kawan aku. Memang baik sangat cikgu tu siap belanja makan, hantar pi airport bagai. perkenalkan dekat family dia. Besides, kampung dekat dengan unimas ni memang selalu student unimas hantar for foster program. And my foster family sangatlah baik layan kitorang macam anak sendiri biarpun language barrier tu boleh tahanlah. You get to learn so much of things that you cant even imagine. It is beyond of theory and only available through experiences.

Dan kat sini jugaklah, kau belajar untuk lebih banyak diam dan memerhati. Kau belajar on never judge a person by its cover. Kau belajar untuk mendoakan orang lain dalam diam tanpa perlu kau mengenalinya. Mendoakan kebaikan keatasnya apabila melihat kesusahan hidup dia sebab kau percaya bahawa doa saudara muslim yang lain tanpa penegetahuan rakannya amatlah mustajab.

I see something, that I never have that chance to watch it Peninsular Malaysia. ;)