how to treat dengue

1. determine when is the leaking/critical phase starts:

- symptoms: vomit diarrhea, epigastric pain.

- signs: pleural effusion

- lab: drop in alb (minus 6hr) raised hct

2. determine when is the expected completed 48 hr

3. then we know when is the resorption phase should start

4. calculate how much fluid has been given: net cumulative positive divide with weight

expected total leak

5. type of fluid to be given:

• maintainance drip: 2ml/kg/hr or 1ml/kg/hr +orally
• leak: first 24hr: 1-2 ml/kg/hr, next 24hr: 0.5ml/kg/hr
• deficit
• insensible loss: febrile: 500ml/day
• on going loss: volume to volume repolacement --> diarrhea, vomiting, pv/pr bleed

then u get total fluid to be given perhr

6. check whether patient has other complications: sepsis, hepatitis, carditis, AKI

7. monitor

• abg 2hrly --lactate, hco3, hct
• fbc 4hrly -- hct
• coag, lft, ck, rp --may be bd

8. approaching expected reabsorption phase: REDUCE DRIP REDUCE DRIP watch out features of overload, kiv frusemide, may need intubation

amarah

my feeling at this moment...marah and geram grrr

Palestine ooo palestine

Recently and now we are all upset angry hate and sewajtu dengannyer with the act of israels on our humanitarian convoy to gaza...
Am may not be the best person to judge or comment but as a person I just don't understand why the israels have to attack the tank? Why they are so afraid till they have to bomb the tank? And what really upset me, America still did not do anything... Just imagine if it is Iran or any other country did that America will be the first country to deploy their army to attack that country. But when it comes to Israel America proudly says well they do what they have to do... Mmm so sad....

What we as a Muslim and human can do to help palestinian???
Should we go and announced for jihad to fight the israels?
Should we do what israels do???

I personally think no we cannot do that. Allah knows best. There must be other way to fight israels...
One of it stop buying israels product.
May be difficult but insya Allah, if all Muslim bersatu hati then surely we will win...insya Allah. I believe may be it is difficult not to buy all their product at 1 time but let start with 1 product first. Then we move to 2, then 3 then so on.

Let's not be too hypocrit ok. As I fou myself bought so many their product. So let's start with 1 product this week. Then move to other next week.

Insya allah

world cup 2010

who will win this year?

is it brazil again?

or will it be german or holland?

well maybe not England this year....

weekend is almost over....

my new pc darling

reborn reflexiology

my experience at reborn reflexiology today is so different from other massage centre i normally went.

initially i opted for 2 hr full body massage. my masseusse is from china. as she begins she keeps on saying angin.. pinggang angin. like thousands time. then she asked...kawin? i said no, not yet. she continued her massage then she said again...kawin, no angin. i said ha???

agaknyer she tak puas hati, she called an interpreter, cik...masseusse ni kata cik byk angin... so dia cadangkan cik buat bekam... ka wi (agaknye la)

so i said. mmm okla....

and the result is wow!!! urut dia mmg best, and the bekam is an added bonus.

i will surely come again to this massage centre....

I bought 27 inch iMac yesterday, but tomorrow only can get it as today I am on call... Can feel the vibe now, didn't feel sad even pun is leaving for Sri lanka today and am on call today... The aura is felt already... Can't wait for u iMac!!!!!

If I can Turn back time...

I did not expect to see him again as I fear how would my reaction be... And it happened today 2.6.2010. And I really dunno how to reacted. All I did was avoid any conversation with him. Then I realise it is so childish.... Hallo we are a grown up ppl so act like an adult. I did tried... Act like an adult. As if nothing happen. As it it never happened but... It failed... Terribly feels wrong and looks awkward... It hurts, really hurt. Gosh thank god it's only for a few days only. I can't imagine if it's not. Then I will sure I will gila already. Huhu!!!

Why and why it happened to me???