I can say that as well after receiving and talking to a few lecturers they do coexcist.

Just had some bedside teaching about diastolic heart failure (and had a glance at all the heart function clinic letters for a patient admitted under med) - basically it's all about fluid balance and beta blocker, and there is nothing much else to treat. A quick read in uptodate showed that there is not much data about diastolic heart failure. ?ACEI ?diuretics ?probably beta blocker. Difficult! Thats why you need to go to heart function clinic lol

The recipe for chronic heart failure management comprises of the following:

1. Diuretic (to get rid of oedema)
2. ACE I (improve survival and quality of life)
3. Beta blocker (reduce myocardial oxygen demand)
4. Restriction of fluid intake

In Malaysia, CHF is usually diagnosed clinically with radiological evidence. However, not every CHF patient can get echo due to limited resources in KKM. Also, echo is usually done by medical assistant, so the reliability remains questionable

I have a very dumb question here, Angiotensin II has various functions, which of it is the most prominent? Is it constriction of vessels as I remember?

Excuse the interruption, but thie article is quite "enlightening"...

"One of the many things that make Malaysia in general such an appealing retirement option is its high standard of health care. Hospitals are well-equipped and modern, and most medical personnel speak fluent English. In addition, health care costs are very low, and the quality of care tends to be excellent. Since Malaysia does not have any medical schools, all physicians practicing medicine here have received their education abroad, mainly in the European Union, Australia, New Zealand, Canada, and the U.S. Health care is of such a high standard and so reasonably priced that Malaysia is one of the world’s top medical tourism destinations, with visits growing at a rate of 30 percent annually."

Article here:

http://money.usnews.com/money/blogs/On-Ret...largely-unknown

Am just talking about diastolic HF, not HF in general.

Ahh, sorry, I didn't read your post properly.

Yeah, I must admit I dun really know how to treat diastolic HF. Haven't encountered a pure DHF before.

---

Added on December 19, 2012, 11:31 pmTotal rubbish article. Sounds like promotional gimmick by our gomen.

This post has been edited by hypermax: Dec 19 2012, 11:31 PM

vasoconstriction.. hypertrophy of the heart... renin release which triggers aldosterone release... Na retention..increase fluid retention.. BP raised..

---

Added on December 20, 2012, 12:02 amyeah CCB will also cause peripheral oedema which is very hard to get rid off. so its best to avoid.

This post has been edited by zstan: Dec 20 2012, 12:02 AM

hello guys, im new here.
im spm grad and interested in doing medicine.
i have questions regarding a level
should i enroll to college in jan or march.
let say i enroll in january.
then, what if i get good result for my spm(which in march) then apply for scholarships and got offers for overseas.
what im afraid/unsure is if i reject those offers and continue my a level will i get to receive scholarship again to do pre med/degree?

and what subjects should i take for a level.
i have done my homework and thinking of taking chemistry and biology.
but idk what to take for 1 more subject.
if can i really dont want to take physics and take mathematics instead.
but for medicine do i really have to take physics or there is other option?

thanks in advance

If you get a straight A's result for your SPM, you can try and might get the JPA scholarship to do medicine. They will sponsor you to do the A-levels and send you wherever they like after that.

eg; We got JPA students in MSU-IMS Bangalore who did their A-Levels in MSU Shah Alam.

If you don't mind being sent anywhere to do medicine by JPA and don't have the $$$ to do it privately... just apply and take the JPA route if it is offered to you~

---

Added on December 20, 2012, 8:15 amHere is a blog of one of my juniors (JPA scholar) and her experience:

http://www.tzequan.blogspot.com/2012/03/i-...end-myself.html



This post has been edited by CyberSetan: Dec 20 2012, 08:17 AM

Edited - read wrongly.



This post has been edited by podrunner: Dec 20 2012, 08:34 AM

How was your mock exam results?

I have friends whom enrolled for jan/march intake, and they dropped out half way because they've gotten the scholarship, of course they have to restart again. It depends really. Some just have a backup plan just in case they didn't get the scholarship.

physics is a part of medicine but I don't think it's a prerequisite for doing med. (do pardon if i'm wrong)

of course you can scroll through the many MANY posts in this thread before deciding that medicine is for you.

Or they might put you in one of the local private Us.

Good testimony from your junior. Reminds me of how I prayed to God, and waiting for a long time for the answer. Still, I wish to come back to sarawak/sabah to serve my people one day, but I don't think it'll be that soon.

India's med course is much expensive compared to the local private Us, is that correct?

MMC need Chemistry, Biology and Maths/Physics.. so you dont have to take Physics.. I didnt

Monash Australia doesnt even require Biology.

I do think that you need to reread my question more carefully, I know about all those but which of it is dominant? (Hence hypermax's: (improve survival and quality of life))

well for my trial,
science subjects i got 'C' for chemistry/physics and 'B' for biology.
'A' for mod maths and 'E' for add maths (40 marks).
will i get accepted to a-levels with this?(for january intake)
but im pretty confident i can scores in my real spm.

since i was child my dream was to be a scientist but change my mind to be a doctor instead.
(since it looks like the profession dont do well in malaysia and i dont really have wide knowledge about being a scientist)
but now i got really interested and sothisphicated to be a doctor.
and it's my dream to be a doctor now.
i cant see myself doing other jobs than being a doctor.
i think my personality matches for doctor and can withstand the pressure of being a doctor

You can get into an a-level program. Not sure about the scholarship though.

When you see your doctor, you only see less than 10% of what they do. Other things involve frustrating things like dealing with authorities, problem-solving, politics, medico-legal issues, bad bosses and trying no to kill someone. In addition to trying to keep up with the latest drugs, invention, research findings etc

Mostly yes... except a few IPTS... eg; Perdana Uni~
(can do MBBS almost three times over in India with their tuition fee)

All of these happen concurrently when angiotensin 2 binds to the AT1 receptors. There's no dominant process and it is a positive feedback mechanis. However if you are talking about short term and long term eeffects of excess angiotensin 2 circulating ijbthe body then vasoconstriction and bp increase takes place first and hypertrophy comes later at a slower rate. Hence if you dont treat it your condition will get more and more worse. Which brings back to improving survival rate and qualityof life. Hope I answered your question.

This post has been edited by zstan: Dec 20 2012, 12:53 PM

vasoconstriction and sodium reabsorption.

was reading an article on AT2r, which is rather interesting

http://hyper.ahajournals.org/content/35/1/155.full

http://circres.ahajournals.org/content/83/12/1182.full

However i think sartans and prils are pretty much the same in terms of efficacy. Still there are conflicting data saying one is better than the other.

Any clinicians can clarify the selection of sartans over ACEI? (apart from when the patient cannot take ACEI).

---

Added on December 20, 2012, 2:04 pmmakes me think that you're now talking in jargon to be sophisticated.

It takes more than just 'dreams' to be a doctor. It takes more than 'personalities' to be a doctor. What IS the right personality to be a doctor actually?

Also, you can withstand the pressure being a doctor, like syd G said, it's not as simple as you think, even I don't quite fully understand what i'm venturing into. I'm certain the pressure then is much greater than what I'm experiencing now. To think about you'll be responsible for ones life, is different from the actual thing when you are holding the person's life in your hands.

I'm not discouraging you. just asking you to think twice Ain't everyones cup of tea when it comes to the lifestyle.

This post has been edited by onelove89: Dec 20 2012, 02:04 PM

your results suggest you are NOT suitable to become a doctor....there are so many people with straight as even in the trial exam, they will be more qualified....most students do get better final results in spm compared to the school trials, but it is unlikely and unusual for students to do dramatically better, so that trial result will translate into mostly b's and a few low a's in the final result...if you get any c in the sciences and maths, you will NOT be allowed to enter medicine, as a mmc ruling....

but you are lucky this is malaysia, as it is one country where you can buy a doctor's degree...

if you manage to get at least b's in sciences and math,
you can do a pre-u, like a levels, and if you do get at least 3b, and have the money, you can enter one if the numerous ipts med schools.....

however, scholarship is out of the question....your grades are not good enough....

i would however advise you to change you mindset, and prepare yourself for a career in something else...just because you want to be a doctor, does NOT mean you can, or should be allowed to....i do NOT think you are academically qualified....

This post has been edited by limeuu: Dec 20 2012, 03:01 PM