Sunday, September 30, 2012

SELF BREAST EXAMINATION


I had a 23 year old patient diagnosed with Breast Cancer ; Stage 4. It’s not odd to have end stage cancer at that certain age but I must say it is rare. Early symptoms are easy to detect by having a self breast examination.  Early detection is way 100% better than getting mastectomy at the later stage. There is no better cure for it but to do a self-assessment or BSE Breast Self Exam. So I will share a simplified chart on how it is done. 


It is best done 2 to 3 days after the menstrual period when breasts are no longer tender and swollen. For menopausal woman, it can be done on the first day of every month. TIP: It is best to keep a calendar of menstrual cycle to keep the notion on track. If you notice a lump, discharges from the nipple, dimpling or puckering of the skin, you should see a doctor at once. 

Saturday, August 4, 2012

Non Ulcer (Functional) Dyspepsia


Dyspepsia is  the term given  for group of symptoms that originates  problem in the upper part of the abdomen. Non Ulcer Dyspepsia causes pain and dysfunction of the upper tract of the gastro intestinal system.
Pain and discomfort may be encountered in an intermittent pattern. Symptoms usually come and go more often and is always related to eating. The most common symptoms include: heartburn , bloating, belching, fatiguability, nausea and vomiting, easily gets full after a small meal. Other symptoms resmebles that of an ulcer like.

other related site: http://www.patient.co.uk/health/Dyspepsia-Non-ulcer-(Functional).htm

Sunday, July 15, 2012

Thursday, July 5, 2012

Nursing dream turns sour in the Philippines, no hiring for Nurses.


Nursing dream turns sour in the Philippines


If you go into an American hospital, a Japanese elderly care centro, a British hospice or even the clinics at the centre of the recent violence in Libya and Syria, you are likely to find a nurse from the Philippines working there.

Filipinos' reliability and high level of English, coupled with the fact they are willing to accept jobs almost anywhere in the world, have proved a lifeline for many countries in need of nurses and care-workers.
It is an arrangement that has always seemed to work well for the Philippines too.

Not only is nursing a highly respected profession here, it has also been traditionally viewed as a passport out of poverty for many.

But in recent years, this dream has turned sour.
There are far fewer jobs than there once were, leaving tens of thousands unemployed.
At the beginning of this year, more than 200,000 registered Philippine nurses could not find work, and an estimated 80,000 are graduating this year to join an already saturated job market.

"It's so disappointing," said Tina Siuagan, who has been looking for a nursing position since she left university three years ago.

"You can't help but question: 'What's wrong with me, why can't I get a job?'"


'Not hiring'
When she started her degree, Tina could not have foreseen the global events that would mean her qualification would change from being a pathway to a good career into one that would probably not lead to a job at all.

But at the end of her four-year course, it was already painfully evident.
"When these nurses graduated, it was exactly the time the global economy went into recession," said Alvin Dakis, president of the Alliance of Young Nurse Leaders.

"Western countries were not hiring, so they're all now stuck in the Philippines."
To make matters worse, many countries have recently been trying to train more of their own nurses and therefore discouraging the hiring of foreign staff.

As a consequence, visa requirements - especially in the US and Europe - have gotten much tougher, restricting Filipinos to job opportunities in their own country.
And with so many applicants for every job, Philippine hospitals are only recruiting those with many years of specialist experience, leaving most graduates with nothing.

Lucrative jobs
A decade ago, it all seemed so simple.

Would-be nurses, most but not all of whom were female, studied and worked for a few years in the Philippines before taking up far more lucrative jobs abroad.

Such jobs not only meant the nurse was well provided for, it often meant that the money he or she sent home to the Philippines would provide for the rest of the family too.

"For almost 10 years, nursing was flavour of the year. Everyone went into nursing," said Catherine Castaneda from the Commission on Higher Education.

"All the parents wanted their children to go into nursing. Many rural folks had to sell their carabao - their water buffalo - and even their property just to send their child to nursing school."
Nursing schools opened up all over the country, and especially in the capital, Manila, to cash in on this demand.
And even now, many of these schools are still operating, churning out yet more graduates every year.

'No regrets'
Given the changing economic climate for nursing graduates, both the government and education providers are actively trying to stem this tide of unemployed nurses.
According to Ms Castaneda, the Commission on Higher Education has drafted strict rules for all nursing schools.

"Out of all the fields of study in the Philippines, the most monitored one is nursing," says Ms Castaneda.
The exams have got harder - only about half the students pass - and any school with below average results for more than five consecutive years is asked to close.

Government ministers repeatedly tell students who are thinking about studying nursing, even those partway through a nursing degree, to look at allied courses like medical technology and pharmacy instead.

And many nursing graduates are encouraged to find jobs in the call centres which are springing up around the Philippines. Some of these are taking advantage of their medical knowledge by offering back-office services for hospitals and clinics.

But despite the statistics and the newspaper headlines, there are still many young Filipinos who remain determined to go into nursing whatever the cost.
For the past three years, Angeline Veraga has been working as an unpaid volunteer in the cancer unit at Manila's East Avenue Medical Center.
She is a nursing graduate, and she has also done several short courses in certain specialist areas, but she has still not found any work at home or abroad.
For someone who studied nursing with the aim of being her family's main breadwinner, it is a bitter pill to swallow.

"My parents feel like I'm still going to school because they give me some money every day," she said.
"It's very difficult. At my age I should be the one helping my family, not them helping me."
But Angeline still has her heart set on a career on nursing.

"I don't regret being a nurse. Every time I go home I feel so blessed at being able to help someone, even though I don't get anything in return."

Despite all the difficulties, with that level of dedication, perhaps the Philippines will still be known for its nurses in years to come.

Sunday, July 1, 2012

Leprosy (Hansen's Disease) ; Mycobacterium Leprea


Leprosy (Hansen's Disease) is a typical disease that causes skin sores, skin  and nervedamage, muscle weakness and inability to feel through the skin. It has been widespread and known since the biblical times. 

The main cause is the Mycobacterium Leprae. Before it was known to be incurable, individuals with Leprosy was used to be isolated in "Leper Colonies", but now science have evolved with answers for cure. Effective medications have been discovered in the United States and other developing countries. 

It is common in tropical and subtropical places. However the gravity of contaminating other individuals is not likely high because the bacteria  has a very long incubation period. You will never know if a person have it because most likely the symptoms appear in the latent phase. 



Symptoms:

  • skin sores which may be lighter that the normal skin color and has decreased sensation to pain, heat and touch. 
  • skin stiffness and  dryness
  • muscle weakness and numbness on the affected areas of the body specifically on the hands and feet, could also lead to loss of fingers and toes 


Tests

  • Skin lesion biopsy and skin scarping examinations



Treatment

  • Dapson, Rifampicin, Clofazamine, Fluroquinolones, Macrolides and Minocycline


Prevetion
Avoiding CLOSE and LONG physical contact with untreated individuals. Patients on long term tretments are not highly contagious. 

Monday, May 28, 2012

Pre-eclampsia ; signs and symptoms



Pre-eclampsia is referred to as pregnancy induced hypertension characterized by increase in blood pressure and excess protein in the urine by 20 weeks of pregnancy. If left untreated can cause fetal and maternal death.
signs and symptoms

classifications:
A.  Mild Preeclampsia
    symptoms:
    BP of 140/90
    1+ to 2+ proteinuria on random
    weight gain of 2 lbs per week on the 2nd trimester and 1 lb per week on the 3rd trimester
    Slight edema in upper extremities and face

B. Severe Preeclampsia
    symptoms:
    BP of 160/110
    3-4+ protenuria on random
    Oliguria (less than 500 ml/24 hrs)
    Cerebral or visual disturbances
    Epigastric pain
    Pulmonary edema
    Peripheral edema
    Hepatic dysfunction

Management:
1. Hypertension Therapy
2. Magnesium Sulfate
3. Dietary and Nutritional factors
4. Fellatio

source: wikipedia.com

Sunday, February 19, 2012

Cast Care







A cast is placed on an injured bone or muscle to immobilize and protect the affected area for healing and to relieve pain. Plaster of Paris and Wadding sheet are used to do the trick. 


TIPS to remember for the care of patient's with casts. 
1. ALWAYS keep the cast  CLEAN and DRY. A cast with wet drains causes infection if not managed properly. 
2. When bathing the patient, make sure to cover the cast with plastic.  
3. Do not lean or push the cast because it can break and deviates the purpose of immobilization. 
4. Scratching the skin under the cast, putting lotions or powder is never allowed for it can break the skin underneath. To relieve itching under the cast, try pointing a hairdryer on a cool-air setting down the cast.
5. A sling may be attached to the cast involving the upper extremities. Crutches may be needed to walk if the cast is on the leg , foot or ankle. 
6 Elevating the casted area can prevent swelling. . 
7 ALWAYS check for signs of COMPARTMENT SYNDROME such as sever pain, altered sensation of the affected part, absent pulses , tense and swollen shinny skin with obvious bruises and congestion of the digits with prolonged capillary refill time. 



Thursday, February 16, 2012

International English Language Testing System - IELTS



When you plan to study, live or work to other countries like Australia, United Kingdom or Canada  , a prerequisite requirement  before you apply is to have a proof of language proficiency. One of the best that I know of is IELTS , International English Language Testing System. Much easier and systematic. Depending on the course of  study, a student must know which type of test should be taken. 

IELTS has two selections. Firstly The Academic which is suitable if a student plans to study (post-graduate) on a foreign land, that requires complex use, and understanding of academic language. Second and Lastly is The General training, much easier than the latter one and is required for immigration purposes. Both have four modules: listening , speaking, reading and writing. 

It is best advised to take time to practice and enroll in a center where classes are held.

DECEMBER 2011 NURSES LICENSURE EXAMINATION RESULTS



The results for PRC NLE December 2011 Board Takers are in!

NLE Result for December 2011 takers.