Odysseys of George

A young boy swallowed a foreign object and presented to us a few days later. He was otherwise well but the parents were very anxious. This was his Abdominal Xrays.

A closer look:

What is that?
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So we decided to go fishing. We put in a scope (OGDS) and found the foreign object.

Used a net basket to catch it and took it out slowly through the mouth.

The marble:

Please don’t put objects into your mouth!

Wow! I am beat! After a month of quiet ward, my ward is suddenly packed with complicated problems. Am I complaining, well not really!

I was on call yesterday and as usual the call was eventful. To summarise, it was exciting especially for this three cases.

The first, was an on table referral from the obstetric team. This was about a pregnant lady who was at term with her pregnancy and suddenly presented to us for very severe abdominal pain. An emergency surgery was performed to deliver the big baby of 4kg. Surprisingly, her abdomen was completely normal except for this:

A common presentation in pregnant women. Her abdominal pain was caused by blocks or clusters of hard stools impacting her large intestine. Almost two thirds of her large bowel were packed and clustered with these hard stools.

Advice, please to all pregnant women, drink plenty of fluids, eat lots of fibres and if constipated get some laxatives.

Next, was a young lady in her teens who was involved in a road transport accident and this was her CTscan findings.( not clear - sorry!)

She had shattered her left kidney but luckily, she was very stable. Her case was taken over by the urology team.

The last but not least, this elderly lady presented with an bowel obstruction and had a large tense right lower abdomen mass. Her scans are as below. Care to make a guess?

Care to guess the last scans?

International Nurses Day is celebrated around the world every May 12, the anniversary of Florence Nightingale’s birth, who is widely considered the founder of modern nursing.The theme for 2007 is: Positive practice environments: Quality workplaces = quality patient care.

So to all my nurses of today and yesteryears, Happy Nurses Day.

**Update**

The nurses in my ward had a small celebration thingy for the nurses day. Thanks to the ward sister, Sr Nariah, it was simple and sweet. It brought smiles to all the ward staff. She also got each of them a rose.

So after five years of being in the silent, our Department of Surgery, Selayang Hospital decided to have our very first Departmental Family Day. This was held on the 28th April at FRIM(Forest Research Institute of Malaysia) It is a beautiful place and very vast.

They were the workhorse behind the success of this event.

Well, for a first time, I can safely say, everybody enjoyed it. I did not win any presents though but the were many to give away and make many very happy.

My congratulations to the working committee and all those who participated to make it a success.

Ex gratia
From Wikipedia, the free encyclopedia

Ex gratia (sometimes ex-gratia) is Latin (lit. ‘by favour’) and is most often used in a legal context. When something has been done ex gratia, it has been done voluntarily, out of kindness or grace. In law, an ex gratia payment is a payment made without the giver recognising any liability or legal obligation.

The phrase is pronounced ex grah-tsee-ah.

In 1994, the government implemented the Ex-Gratia Scheme for government servants who gets involved in an accident or injured in the line of official duty.This was then amended in 2001.to follow the PERKESO/SOCSO Scheme. The difference is that a civil servant do not make contributions to this scheme and therefore the financial benefit is 20% less compared to that of SOCSO.

This scheme covers:
1. ex-gratia payment for accidents and permanent disability or death done either as a bulk payment or monthly payments according to certain formula
2. payments for various partial disability
3. diseases identified as occupational hazards

This scheme actually covers contract staffs, temporary staff and permanent staffs.

Further information:
http://www.treasury.gov.my/

For those who missed this article in The Star (3rd October)

PSD: Doctor who died eligible for ex-gratia

PUTRAJAYA: The doctor who died after an accident in an ambulance is eligible for an ex-gratia payment, according to the Public Services Department (PSD) and Treasury.

PSD corporate communications unit head Hasniah Rashid said although Dr Norbaizura Yahaya was not confirmed as a doctor at the time of death, she was eligible for the compensation as long as she was a government staff member.

She said the ex-gratia scheme was provided for all government servants under a 1994 Treasury circular amended in 2001, which stipulated that a staff member injured or killed while on duty, even if not confirmed, was entitled to compensation.

“In her (Dr Norbaizura’s) case, the Health Ministry is conducting an investigation and will propose the payment (quantum) to the Treasury, which will then relay the final decision to the PSD on the next course of action,” she said.

On Sept 4, Dr Norbaizura was accompanying a patient in an ambulance from Seremban Hospital to Selayang Hospital when the vehicle burst a tyre at the expressway near Bangi and landed in a ditch.

The 24-year doctor from Sabak Bernam, who suffered injuries to her head, ribs and lungs, went into a coma and died 16 days later.

Any comments?

Well I will try to put up the Ex-Gratia file!