Lover

by: Ibn al Farid (Translation)

Every part of my body awaits him,

even he's not with me, in every substance which are soft, tender, pure and happy.

Inside guitar string and melodious flute fused in vibrating tone.

And inside deer's grass field that are very fertile green, in a cool twilight and in bright of first beam of the dawn.

And in the foggy rain whom to go down from the cloud to the flower garden.

And when the wind blow so gentle bring his robe and spread to me a scent of rose fragrant in a soft of dawning day...

And when I kiss the lip of goblet, I smell of pure grapes in cheerful and happiness...

I'm not expelled from my country if he was with me ; my mind won't bothered everywhere we belong ; that place is where I was born if my lover also been there ; where there is a slope sand hill--- that's the place I will have to stop...

AN NAZI'AT (THOSE WHO DRAG FORTH)

Just read one of short Surrah of The Holy Qur'an and always being fascinated by the word of ALLAH SWT :) Alhamdulillah

بسم الله الرحمن الرحيم

..................

79:42

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Sahih International

They ask you, [O Muhammad], about the Hour: when is its arrival?

79:43

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Sahih International

In what [position] are you that you should mention it?

79:44

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Sahih International

To your Lord is its finality.

79:45

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Sahih International

You are only a warner for those who fear it.

79:46

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Sahih International

It will be, on the Day they see it, as though they had not remained [in the world] except for an afternoon or a morning thereof.

One Fine Day @ Tidung Island with Neurology Fellows

This is some of my collected image from Neuro Gathering event. Good job Galz! Proud of you ;p

One look is worth a thousand listens---Merrill C. Sosman (US Psychiatrist) 1890–1959

TOP MOVIES QUOTES that Raul Remembered...so far :p

1. A Walk To Remember (2002) :

Love is always patient and kind. It is never jealous. Love is never boastful or conceited. It is never rude or selfish. It does not take offense and is not resentful.

2. With Honors (1994) :

You shall no longer take things at second or third hand, not look through the eyes of the dead, nor feed on the spectres in books. You shall not look through my eyes either, nor take things from me, you shall listen to all sides and filter them from yourself

3. The Lovely Bones (2009) :

If I had but an hour of love, If that be all that is given me, An hour of love upon this earth, I would give my love to thee.

4. Love in the Time of Cholera (2007) :

I discovered to my joy, that it is life, not death, that has no limits.

5. The Brave One (2007) :

I always believed that fear belonged to other people, weaker people, and that it never touched me. And then it did. And when it touches you, you know that it's been there all along, waiting beneath the surfaces of everything you loved.

Pause Dependent Torsade de Pointes caused by amiodarone administration complicated by thyroid heart disease

31 years old female admitted

to ER with chief complaint syncope since 4 days ago. She just had undergone P1A0L1 spontaneous parturition 2 months ago, and in breast feeding period. She feels fatigue, palpitation and over-sweating since she delivered her baby. No history of congenital heart disease, hypertension in pregnancy, and this is the first time she got detected an arrhytmia.

Early VS :

Compos mentis, BP 90/50,HR 101x/min,RR 28x/min,Temp 36,0 C.

No detectable murmur, irregular pulses, no rhonchi, no wheezing. No enlargement of spleen and liver, with normal peristaltic sounds. No lower extremity edema.

ECG : VES bigemini running to Ventricular tachyarrhytmia.

Lab : Trombocyte=145.000;Ht=41%;

Random blood sugar=101mg/dl; Calcium=8.4mg/dl;

Na=141meq/l;K=2.8meq/l;Cl=104meq/l.

patient has administered Amiodarone 150

mg pushed;

continue with maintenance Kendaron drip 600mg

(start 2.1cc/hours) and suggested to check plasma

magnesium and thyroid function.

40 mins after admission, patient had undergone monomorphic VT followed by general tonic clonic seizure and GP decided to give cardioversion.

Neurology consultation suggested to prepare diazepam intravenous 10 mg pushed slowly. Neurologist recommendation to control metabolic deterioration and manage the tachyarrhytmia.

After 200 joules shock for 2 times, ECG changed back to VES bigemini multifocal but with worsening pattern of ECG that tend to show running VT.

After 5 hours treatment, patient developed to many forms of tachyarrhytmia :monomorphic VT-polymorphic, VT(Torsade de Pointes)-T wave alternans.

Result for plasm magnesium=1.9meq/l and

thyroid function:TSH=4.5 mcg/ml;

FT4=35 mg/dl;T3=2.8 mmol/l &T4=165 mg/dl.

In this scenario, General Practitioner had misdiagnosed patient without considering thyroid involvement in patient's arrhytmia. So, as a general guidelines for Ventricular tachyarrhytmia, GP gave amiodarone as drug of choice for this patient. Au contraire, Amiodarone worsening the patient's condition.

After Amiodarone's restriction, and 2 gr intravenous magnesium drip, patient start reducing her refractory Torsade de Pointes along the fits and back to the early ECG pattern when she came to the hospital.

Next question is, what are drugs that should she has for her arrhytmia.

"SONG OF MYSELF"
By : Walt Whitman

You shall no longer take things at second or third hand,
not look through the eyes of the dead,
nor feed on the spectres in books.

You shall not look through my eyes either,
nor take things from me,
you shall listen to all sides and filter them from yourself

Sweden Tour with Frey's eyes :) PART 1 : Flower

Beautiful part of the world that I haven't seen.

Thanks for beautiful pics Uncle Jeff. I hope you won't be bored to send them to me.

:)