I'm so stressed out...

Tiredness can make you lose your balance..your control and ultimately the common sense..

For the past 3 weeks, I felt so much overworked...especially since having so many oncalls in such short duration...my oncalls have been every other day...which means that my life is solely confined to the hospital. it's either you're oncall or you're post calls. Alhamdulillah the specialist has been such wonderful sport about it..i mean in regards that i'm not performing that well currently.

What i'm worried is that the patients are at risk when we're not in our optimum shape..

This is all about taking care of patient..making sure that they get the best treatment that they should...

But the thing is..doctors are very much human and very gullible for errors. What more if they are under pressure and stress...

I personally do not mind getting up early for ward and preparing for the patients.. but i cannot perform my best when i have just finished my oncall that morning and directly start the next day of job..if the calls were in fact not so eventful, then it is understandable..

Working under enormous pressure and stress is daunting...especially when you are very much tired.

I had actually cracked during the ward round after so many Every other day calls..

Throughout this 2 weeks, there have been so many poisoning cases , whereby the patients had intentionally drank weedkillers, paracetamol overdose, and many more.

These patients are mostly under stress and many of them did take the medications intentionally with the intentions to either to relieve the stress or had suicidal ideation.

It worries me that what length that people are able to do to relieve their problems..this does not concern only the patients, mind you...

a whole lot of doctors are also under pressure and stress...and many of them manifest by way of quitting the job or not appearing for work.

And that does sit inside the minds of so many houseman...including myself...

sometimes, it feels that it is not worth it to suffer through all this whereby we have other choices..

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Ya Allah, aku berlindung kepadaMu dari kebingunan dan kedukacitaan, Aku berlindung kepadaMu dari sifat lemah dan malas. Aku berlindung kepada Mu dari sifat penakut dan bakhil. Aku berlindung kepada Mu dari beban hutang dan penindasan orang....

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Paracetamol poisoning ( Panadol)

- Paracetamol is converted to a toxic metabolite. N-acetyl-p - benzoquinonimmine, which is normally inactivated by conjugation with reduced gluthathione. After a large overdose, glutathione is depleted and the toxic metabolite bind to liver cell membranes causing necrosis.

What they present with:

symptoms over the first 24 hour include anorexia, vomiting, and diaphoresis, but the patient is fully conscious.

Hepatic enzymes begin to rise 48 hours after ingestion and peak at 72 - 96 hours. REcovery starts after approximately 4 days unless hepatic failure develops.

Symptoms at this stage : Right upper quadrant pain, jaundice, confusion,somnolence and coma.

Organophosphate poisoning;

organophosphosphorus insecticides include malathion, parathion, dichlorvos, and diazinon.

what they present with:

wide spread muscarinic and nicotinic effects:

- muscarinic: nausea, vomiting, miosis, abdominal cramps, urinary and fecal incontinence, bronchorrhea, diaphoresis, salivation, lacrimation, cough and dyspnea

nicotinic effects:

twitching, fasciculations, weakness, cramps, and hypoventilation with respiratory failure.