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Here I am testing the patient's visual acuity using the Snellen Chart

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Week 2 of Internship in Primary Care Clinic

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Week 2 of Internship in Primary Care Clinic

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1. Your name, matric number, date
Emillia Elza Thomas, A174762, 01/08/2022

2. How is your progress?
I believe my performance has improved from the first week. I was less nervous and was able to carry out tasks given more confidently. During this week, there were several patients who came in for medical check-up for pre-employment and higher education purposes whereby we had to carry out full phased physical examination involving eyes, ears, cardiac, respiratory, abdomen, breast especially for females and many more. We also had to perform mandatory blood test for basic parameters such as full blood count, renal profile, lipid profile, liver function test and urine test. Doctor took the liberty to teach me on how to perform phlebotomy in a manner that is least painful to the patient. I also had the opportunity of observing how a pap smear test is conducted in a patient with risk of cervical cancer. Furthermore, I was taught on the proper technique of administering vaccine via intramuscular(IM) route on the deltoid muscle of a patient and was given the chance to administer it on patients as well. I was also taught to perform an IM injection on the buttock for pain relief. I was apprehensive at first as I did not want to hurt the patient but it turned out well after all. Besides the procedures, I have also learnt a few lessons during consultations as well. I have learnt that supplement consumption is still high in our country. It may have its pros but there are certain products that do not have evidence on the long term side effects. Since the marketing base of supplements are high, patients would still purchase them as an alternative to modern medicine as they pose a mindset that supplements are safer and have less effect on their liver and kidneys as compared to medication prescribed by doctors.

3. Points to remember from week 2!

For IM injection on the deltoid, the needle should be injected 90 degrees to the middle of deltoid muscle which is 2.5-5cm below the acromion process. The needle length differs based on age, weight and body mass.

When carrying out visual acuity test using the Snellen Chart, the patient must be standing 6m from the Snellen chart.

Not all supplements are necessary for our body as too much consumption can harm the kidney and liver. It is important to educate the society to consume supplements that have been authorised to be safe without lasting side effects. It would also be best to consult your doctor before taking supplements to ensure that it is safe for long term use.

4. Your feelings & thoughts
I feel grateful for this opportunity as I get to learn and apply what I have studied in medical school during my internship here. Not only that, I also manage to learn communication skills via consultation between doctor and the patient. It is truly inspiring to see how the doctor uses simple analogies to explain a disease/condition and the purpose of medication. This would help patients to understand their disease and would encourage them to be compliant to the medications. There are times that are challenging especially when I perform certain procedures but I aspire to keep practicing.

5. ONE good thing from what you did that you can practice now!
The good thing that I learnt this week was how to perform an intramuscular injection. Before performing the procedure, we have to ask if the patient is on anticoagulants or if they have any bleeding disorders as they are contraindicated in IM injections. I also learnt that before performing deep IM injections, I need to aspirate first to avoid injecting the vaccine/medication into the vessels.  I would also need to brush up on my anatomy to learn on the important sites to administer IM vaccine to avoid injecting the nerves or vessels. It was challenging at first and since it was my first time. Doctor also gave me some words of encouragement which inspired me to practice more and remember the crucial key points to be used in the future.

6. Any difficulties/concerns? How did you cope?
While I was administering the IM injection, I was concerned whether the patient was in pain and was worried if my method of injection would put them in further discomfort. I always made it a point to observe their body language and fortunately the patients were kind enough to reassure that I was doing okay. If the patient was not comfortable with having a medical trainee administering the injection, I would immediately allow the doctor to take over to put the patient at ease. To ensure that my technique improves over time, I would put in extra effort to practice on more patients so that in the future I will be able to administer these injections more smoothly.

7. Your plan for next week (Week 3)
I wish to master my skill on phlebotomy since I haven’t been able to perform it. I am also looking forward to learn various other cases and broaden my horizon of knowledge not only in the aspect of medicine but generally as well.

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This is the dressing set containing kidney dish, gallipot with sponge, bryant forcep and non-toothed dissecting forceps.

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Week 2 as a medical assistant in a clinic

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Week 2 as a medical assistant in a clinic

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1. Your name, matric number, date

Anchita A/P Mottiakavandar, A175104, 30/7/2022

2. How is your progress?

I am very happy with my progress this week if compared with last week. This week I felt I have adapted more in the clinic setting. I was allowed by the doctor to take history and present it to them even before the doctor meet the patient. Every time I present my case doctor would praise me and he would correct me if I make mistakes. This week I was able to learn how a proper blood test will be taken form the patient. Firstly the patient will be asked to sign the consent form and since its under a company the patients’ are doing this blood test mandatorily, there will be baseline test requirements like the full blood count, renal profile, lipid profile, liver function test and etc. Later blood will be drawn in vacuum tube of different colors. For instance,  the lavender tube will be used for the full blood count. I was able to assist few more simple dressing procedures this week. I was also able to recall on the correct method to take blood pressure manually using the manual sphygmomanometer.

3. Points to remember from week 2!

- Phlebotomy specifically refers to the single-use needlestick for drawing blood specimens. Whereas venipuncture refers to the broader concept of entering the vein for either drawing blood or administering an IV for an extended period, phlebotomy is limited to blood-sample collection.

- It is very vital to check the patient ID and name multiple times before sending to the lab to avoid mistakes like handing the results to a different person.

- Its important to note that after alcohol do not re-palpate to locate the vein. Instead before using the alcohol we can use a small cap and make the impression on the area that we are going to insert the needle. In this way we wont have the necessity of re-palpating the vein.

-Its is important to note that all vacuum tubes should be gently inverted, and  labelled as soon as the procedures are done.

4. Your feelings & thoughts

I am feeling very happy as I am able to learn and recall lots of information from my clinical postings. Its very inspiring for me personally when the doctor shares all his clinical day memories. He have shared with me what are the do’s and don’t that I have to always pay attention as  a medical student. This experience altogether has made me feel very much elated.

5. ONE good thing from what you did that you can practice now!

I would say the technique of venipuncture. Even if I have been in whole full year in clinical years I would always feel the scariness when I have the thought that “am I going to find the vein”. So when the procedure was done to the patient the Dr took some time and taught me the ways to find the vein .I felt that I would be more confident the next time I am going to perform it myself .For example  ,I was told its vital to first know the vein involve which is the cephalic, median cubital and basilic vein. Later we can locate the vein by palpating.  However if for instance the patient’s vein is difficult to be located maybe because the person is obese then we can tell the patient to make a fist and again try locating it or else bend the arm little bit and try locating it in that way.

6. Any difficulties/concerns? How did you cope?

The difficulties would be that since its very rushing in a clinic setting its very important to be vigilant .Sometimes there will be some patients with new chief complaint and if I am busy looking at other stuff then I would miss it. However I am able to cope since the staffs there are very friendly so they would always help me out and tell me not to worry much.

7. Your plan for next week (Week 3)

My plan for next week is to engage and learn more on the hands-on part .Maybe next week I would also pay more attention on how the medications are prescribed to the patient accordingly.

Thank you.

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WEEK 2 ELECTIVE POSTING CHINESE MEDICINE

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WEEK 2 ELECTIVE POSTING CHINESE MEDICINE

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1. Your name, matric number, date
Augustine Sia Siew Hieng, A174685, 30/7/2022

2. How is your progress?
For the second week, I can see my interest towards chinese medicine growing and definitely gain more mastery on the use of chinese medicine in preventive health. However, I still felt the slight difficulty to adapt to terms used in Chinese medicine, which is different from modern medicine. I also learnt about the pathological process leading to the subhealthy condition and how to treat them.

3. Points to remember for week.
The visceral organs are able to interact with one another through meridians, therefore it is important to maintain the dynamic balance of Yin and Yang Qi to prevent the interruption of Qi which can impair the health of visceral organs, leading to subhealthy condition.

Practical examples of Yin deficiency include overwork which depletes fluids (Yin element) in the body. Yang deficiency due to prolonged exposure to cold environment. Qi deficiency includes lack of regular exercise.

It is possible to remediate the subhealthy condition of body function by the use of Yin and Yang tonifying herbs

4. Your feelings& thoughts
I felt very happy and refreshed as I was able to learn something that had never been taught in medical school, whole new concept underlying the same diseases.

5. ONE good thing from what you did you can practise now!
I can now apply the theory of five elements in adjusting the environment triggers that changes the dynamics of balance in Yin and Yang. For example, I use the herbs dang gui to balance out the excess of Yin Qi.

6. Any difficulties/concerns? How did you cope?
The concerns I have is that I will misunderstand the topics covered in the courses because there are only recorded lectures and no instructor to ask if I want to clarift some questions. I cope with the issue by doing more research online for clarification.

7. Your plan for next week(Week 3)
Next week, I will be learning about Yin and Yang tonifying herbs. I will aso learn about the pharmacological basis and mechanism of action of Yin and Yang tonifying herbs with their benefits.

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WEEK 2 IN LEARNING ABOUT CURANDERISMO THRU COUSERA 

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WEEK 2 IN LEARNING ABOUT CURANDERISMO THRU COUSERA 

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1.Mohamed Aiman Syakeer Bin Mohamed Mustakim, A168701, 31/7/2022

2.Week by week, day by day, my excitement in learning curanderismo is just increasing. From a person who does not know anything about traditional plant, this course have made me feel learning curanderismo is super fun although it takes a lot of time to fully understand the benefits. Personally, I can see my own improvements day by day.

3.For the second week discusses the origin of plants of the Southwest and their usage for the digestive system. I have discover curative remedies of plants of the Southwest.Im now be able to describe curative remedies of plants for the Digestive System and also are able to analyze curative remedies of plants of the Southwest for medicinal purposes.

4.Personally I feels that week 1 is harder than Week 2 as it has exposed to new things. However, everything that I have learned from Week 1 is very essential to understand whatever I learned in Week 2. Although it is comparably easy, what I learned in Week 2 is even more details on how curanderismo brings lots of benefitst. I need to reread whatever I have learned to retain the knowledge for a long period of time.

5.Now im able to explore even more traditional plants thatcan be used as a medicine especially local traditional plants

6.The difficulty i found during my second week of elective posting is forgetting the key points i learned from first week.However i overcomed it by reviewing the note from 1st week once again and then i was able to recall it again.

7.I plan to finish the lessons for next week as soon as possible to recap back what I've learned throughout the first few weeks. Hopefully I can manage my time well to make my plan works!

Thank You

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1. Your name, matric number, date
Teoh Yu Xuan, A174444, 29/7/2022

2. How is your progress?
This week I am more involved on hands on experiment. On Monday I helped in preparing the agar and buffer for electrophoresis.
Unfortunately, I was sick and had to be absent for a day.
When I went back, I helped in sample extraction for liquid chromatography–mass spectrometry (LCMS).
For the last two days of the weeks we were taught on DNA extraction techniques.
As for the project for genomic variant, I have finally finished analyzing 112 samples from Orang Asli population. As for this week, I am trying to organize the data to make interpretation easier. This is challenging since I have found about 18000 SNPs. Thus, I am learning on how to use Pivot Table in Excel to help in organizing data.

3. Points to remember from week 2

Electrophoresis is used to compare genes on a larger scale, while sequencing is used to compare genes on a base scale.

LCMS is used to measure the metabolites which are found in the sample. By measuring the metabolites, we can determine the health status of the person/animals.

DNA extraction can be done through human blood. However, it emphasizes a lot about the techniques to avoid contamination in DNA.

4. Your feelings & thoughts
For this week I am a little fearful since there is a lot of information to process. I am not only involved in the project bioinformatics but I was also involved in hands-on procedures.

5. ONE good thing from what you did that you can practice now!
Always be ready to learn more about new things to broaden my view of this world.

6. Any difficulties/concerns? How did you cope?
Since it is new for me to approach bioinformatics, I was a little lost in the workflow on what to do next. I coped by asking my supervisor and seniors in here as they will have more experience on this.

7. Your plan for next week (week 3)
I plan to continue to arrange my data and start to list down the SNPs that are important in the disease and that are prevalent in my Orang Asli sample. As similar to last week, I plan to learn more on the bioinformatics workflow through my supervisors and seniors here.

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WEEK 2 ELECTIVE POSTING ON HERBAL MEDICINE

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WEEK 2 ELECTIVE POSTING ON HERBAL MEDICINE

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1.  Your name, Matric Number, Date
Neetyaa Sre A/P Paranthaman, A175173
31/7/2022

2. How is your progress?
I am much more motivated and happy   with my progress this week.For this week, the lesson plan was how botanicals medicine work and the role of herbal medicine in Mental Well being, Woman Health and Musculoskeletal pain. So on the first part of the lesson plan for this week I was introduced on the contents of herbal medicine and how it is being prepared and the potential ingredients that are being added in herbal preparation.The For the second part i learned on the types of plants that can be used to aid in the symptoms involving mental wellbeing,woman health and mucsuloskeletal pain.For this week,there were more reading materials such as content on the mechanism of action of the herbs, method of preparation, potential side effects and contraindication.Once again, at end of the week I had a quiz and for this time I have improved on my scores for the quiz.

3. Points to remember from week 2.
The first point to remember to always check on the content of the herbal medicine since there maybe chemicals added to herbal preparation to increase its effectiveness.This kind of preparation just bring up more side effects to its users.

The second point would be to know the mechanism of action of herbs in order to know how it aids in the symptoms. By knowing this, I would not on which part of the plants to be used and how much of it that is suppose to be used in order to not have any complication to its users.

The third point would be I should be aware of the side effects and contraindications of the respective herbs so that I can advice and educate patients. when they have a wiling to try herbal medicine as an alternative.One of the point I take note that patients who consumes blood thinners are usually contraindicated to take herbs as alternative in relieving their symtoms since most herbs has interaction with blood thinners.

4. Your feelings and thoughts.
I feel throughout this week lessons made  me to realise the importance in taking a patients history throughly so that we can determine the patient is suitable to have herbal medicine as an alternative. I felt more determined in obtaining a patient history now as herbal medicine maybe a part of a patient's wellbeing.Using herbal medicine may sometimes interact with the drugs consume by a patients which cause the drug to not be efficients thus causing patient to feel that the drugs are not helping in treating their symptoms or disease.

5. One good thing from what you did that you can practice now.
For this week, there was a demonstration video on herbal preparation and the method use was infusion method where it was a method where you use the flowers,leaves,roots and seeds on a herb and then pour near-boiling water over the herb and allowing it the herb to steep.This method will help in releasing the essence of the herb and also hot water will help to decrease the microorganism content.This infusion method was easy to do and this had been my routine since I learned the method from the video. I oftenly use mint leaves for the infusion and this oftenly soothes my mind and makes me to have a relaxing feeling which benefits my mental wellbeing. I will also like to try this method by using chamomile leaves in order to make chamomile tea,

6. Any difficulties/concerns?How did you cope?
One of my concern some the herbs recomended are not readily available in Malaysia however the lecturer listed down few other herbs which can be used for the same function. In that list,some of the herbs are availaible and easily accesed in Malaysia.This also means I will need to do some reading on herbs found in Malaysia before advicing patients on the use of herbal Medicine.

7. Your plan for next week (Week 3).
My plan for next week will be following the lesson plan which will be covering the uses of herbal medicine in upper respiratory disease and skin conditions. Next week,a skill workshop will be held to teach on the way to communicate to patients about Herbal Medicine and I am really looking forward for it.

Thank you.

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1. Hashwin Singh a/l Tejpal Singh, A174849, 30/7/22.

2.
Hands on experiments:
I have started carrying out my experiments. On Monday this week I changed the media for my newly activated SW1353 cells. Then I also enriched the DMEM media used to facilitate cell growth by using antibiotics and foetal bovine serum. On Thursday, I looked at the cells under the microscope to see that the cells were growing rather slowly. Therefore, I changed the media again to ensure that the cells would have enough nutrition and nourishment to grow. On Friday, there we enough cells to subculture. Therefore I subcultured the existing cells into two different flasks to allow faster growth and to prevent overcrowding. I have also completed the lab reports for all my experiments this week.

Review paper:
I have completed the evidence table. It is now under review by my supervisor.

3. Points to remember:
a) Always plan and mentally carry out the experiment before actually doing the experiment so that you do not forget any steps/important apparatus that must be sterilised.
b) When carrying out laboratory experiments, it is very important to write complete lab reports as not only does it enhance information retention, it also can be used as a reference later on.
c) Learn to use clear and concise language when summarising the findings from an article.

4. I feel extremely motivated. I feel conflicted between being a clinician or a lecturer/researcher after I complete my medical degree.

5. Always plan for the future and write down those plans!

6. Since it was my first time doing lab work that was technique sensitive, I made some mistakes here and there. I coped by having Dr Pang, a lecturer/researcher from Newcastle University teach me and walk through all the laboratory procedures with me.

7. Start writing my paper if given the green light by my supervisor. If not, I have to correct the evidence table.
I also have to subculture the cells again and cryoprecipitate some of the cells. I also may begin inducing inflammation in the SW1353 cells if the conditions allow me to.