MikeLigalig.com

Strength and inspirational to all.

Can a god die? (referring to his declining health)

-Tiberus, Emperor of Rome

Quote from: chicogon on March 09, 2011, 02:36:01 PM
March 8, 2011

hehehe guapodoy man ka kaayo, father!

Quote from: cujo on March 10, 2011, 03:25:44 AM
From quotes of Arguments and Quarrels.

hehe i can tell you're a woman who loves to read.

** very popular board question


Military Veteran becomes paralyzed upon hearing airplane engines.

What is the diagnosis?

A: PTSD (post traumatic stress disorder)

A business plan should be a work in progress. That's because your business will evolve over time, and be influenced by outside factors such as the economy and local conditions. Even successful business owners should maintain a current business plan to ensure they remain knowledgeable on the elements that can affect continued success.

    *
      Business Plan Executive Summary
      The executive summary is Part 1 of the business plan and is the most important section of your plan. It provides a concise overview of the entire plan, along with a history of your company. This section tells your reader where...
    *
      Market Analysis
      The market analysis section is Part 2 of the business plan. This section should illustrate your knowledge about the particular industry your business is in. It should also present general highlights and conclusions of any marketing...
    *
      Company Description
      The company description is Part 3 of the business plan. Without going into detail, this section should include a high level look at how all of the different elements of your business fit together. The company description section...
    *
      Organization & Management
      Organization and Management is Part 4 of the business plan. This section should include: your company's organizational structure, details about the ownership of your company, profiles of your management team, and the...
    *
      Marketing & Sales Management
      Marketing and Sales Strategies is Part 5 of your business plan. Marketing is the process of creating customers, and customers are the lifeblood of your business. In this section, the first thing you want to do is define your...
    *
      Service or Product Line
      Service or Product Line is Part 6 of your business plan. What are you selling? In this section, describe your service or product, emphasizing the benefits to potential and current customers. For example, don't tell your readers...
    *
      Funding Request
      The Funding Request is Part 7 of your business plan. In this section, you will request the amount of funding you will need to start or expand your business. If necessary, you can include different funding scenarios, such as a best...
    *
      Financials
      Financials is Part 8 of your business plan. The financials should be developed after you've analyzed the market and set clear objectives. That's when you can allocate resources efficiently. The following is a list of the...
    *
      Appendix
      The Appendix is Part 9 of your business plan. This section should be provided to readers on an as-needed basis. In other words, it should not be included with the main body of your business plan. Your plan is your communication tool

http://www.sba.gov/category/navigation-structure/starting-managing-business/starting-business/writing-business-plan/essential-elements-good-busines

65 year old man presents with paranoia, obsessive compulsion, delusion of neighbours following him, presents with introverted lifestyle.

What is diagnosis?

A: Cluster A personality disorder with possible schizoid tendency

Treatment: Neuroleptics (Thioridazine, fluphenazine, chlorpromazine ) + adjutant psychoanalytic psychotherapy

10 year old child "spaces out" in class. During spells, the child has a slight quivering of the lips.

Diagnosis?

A: Absence Seizures

Treatment: Ethosuximide

Mandatory information for Surgical interns, anesthesiology intern, surgical nurses, nurse anesthetists etc.


CNS drugs must be lipid soluble (cross the bbb- blood brain barrier) or be actively transported

Drugs with decreased solubility in blood = rapid induction and recovery times.

Drugs with increased solubility in blood = increased potency = 1 / MAC

   where MAC = Minimal alveolar concentration


Examples: N20 has low blood and lipid solubility, and thus fast induction and low potency. Halothane , in contrast, has increased lipid and blood solubility, and thus high potency and slow induction.

Quote from: Lorenzo on March 10, 2011, 02:45:22 AM
25 year old woman presents with sudden monocular vision loss and slightly slurred speech. She has a history of weakness and parethesias that have resolved.

What is the diagnosis?

A: Multiple Sclerosis

Treatment: Steroids, Interferon

25 year old woman presents with sudden monocular vision loss and slightly slurred speech. She has a history of weakness and parethesias that have resolved.

What is the diagnosis?

A: Multiple Sclerosis

43 year old man experiences dizziness and tinnitus. CT shows an enlarged internal acoustic meatus.

What is diagnosis?

A: Schwannoma

Treatment: Surgical removal

Patient's tongue protrudes toward the left side, and patient exhibits a right-sided spastic paralysis.

Where is the lesion?

A: Left medulla, CN XII

Man presents with 1 wild, flailing arm. Where is the lesion?

A: Contralateral subthalamic nucleus (Hemiballismus)

Quote from: Lorenzo on March 10, 2011, 02:38:35 AM
A 60 year old asian man  presents with acute knee pain and swelling. X-RAY shows joint space without erosion.

What is the diagnosis and what would you find on aspiration?

A: Pseudogout; rhomboid calcium pyrophosphate crystals in aspirate.

Treatment?

A: Long-term NSAID treatment, colchicine, allopurinol.

A2: Advise patient to stay away from high cholesterol intake

A 60 year old asian man  presents with acute knee pain and swelling. X-RAY shows joint space without erosion.

What is the diagnosis and what would you find on aspiration?

A: Pseudogout; rhomboid calcium pyrophosphate crystals in aspirate.

25 year old woman presents with a low grade fever, a rash across her nose that gets worse when she is out in the sun, and widespread edema.

You are concerned about what disease?

A: SLE (systemic lups erythermatosus)

X-RAY show bilateral hilar lymphadenopathy. What is diagnosis?

A: Sarcoidosis

Soccer player who was kicked in the leg suffered a damaged medial meniscus.

What else is likely to have been damaged?

A: Anterior cruciate ligament ("unhappy triad")

Grumpy and strict. Or in the proverbial Binisaya, "Bongkinot".

I notice that medical students are guilty of being and exemplifying this trait. I know that i demonstrate it sometimes.

One wonders if this sense of being is the reason that people generalize medics as being 'arrogant' and 'rude'. But they should also understand that the work and experience makes one this way.

They say that in the first couple of years, medics are ideological and believe that 'they can do anything'. Fellowship and post-residency years takes that away from medics, so they say. Really? Is that true?

My daily vent. Back to work.

Either that wallpaper goes, or I do.
~~ Oscar Wilde, writer, d. November 30, 1900

All my possessions for a moment of time.
~~ Elizabeth I, Queen of England, d. 1603

Now I shall go to sleep. Goodnight.
~~ Lord George Byron, writer, d. 1824

I am about to -- or I am going to -- die: either expression is correct.
~~ Dominique Bouhours, French grammarian, d. 1702

As arteries grow hard, the heart grows soft.

-H.L. Mencken

Hearts will never be practical until they are made unbreakable

-The Wizard of Oz

Nobody has ever measured, not even poets, how much the heart can hold.

-Zelda Fitzgerald

Quote from: cujo on March 09, 2011, 06:44:30 AM
In a true tragedy,both parties must be right.

                                          Georg W.F. Hegel

I learned long ago never to wrestle with a pig.You get dirty,and besides,the pig likes it.

                                           Cyrus Ching

lawom kaajo!

Las Andalucianas! Muy bonita!

Toro! Toro!

Los Senores


El Senor de Banderia


Los Ninos en la Fiesta


Santa Maria y Jesus Cristo

Note: i find it beautiful how the Spaniards even have a head dress for their cattle pulling the statue of Mother Mary and Baby Jesus.

The name of this event is called Fuengirola Feria, a festival in Andalucia, SPAIN.

Quote from: morras on March 10, 2011, 01:49:07 AM
Nani Gaitan, She is probably a typical Andalusian beauty, the problem is that few photos and no good.





Nazaret Mesa Alcalde, another beautiful Andalusian less typical.





Angela Zamora de Burgos

Senorita Gaitan is beautiful. Very ethnic. She looks like she has Arabic beauty in her.

Beautiful, diba?

Strict beauty of Andalucian Women..

Quote from: morras on March 09, 2011, 11:41:37 PM
I think the most beautiful women are in Valencia, Alicante, Canary Islands and Madrid. The Catalan are also very beautiful, but almost all are daughters of Andalusian parents, as Vanessa Lorenzo and Patrizia Ruiz

Ah yes, Valencia...but of course.

Vanessa Lorenzo, is indeed very beautiful. Gorgeous lips!

Quote from: morras on March 09, 2011, 11:36:46 PM
Carla Nieto's eyes



She is Catalan

ah, Catalan. Beautiful!

More Catalan beauty:

obsession, the cologne

Quote from: greenmachine on March 08, 2011, 04:50:53 PM
OCD obsessive-compulsive disorder

example:

an obsessed stalker will follow her prey.

histological sample:



note: the vertical line bar represents the epidermal lining.

Epidermis



The epidermis is the outer layer of the skin,[1] which together with the dermis forms the cutis. The epidermis is a stratified squamous epithelium,[2] composed of proliferating basal and differentiated suprabasal keratinocytes. The epidermis acts as the body's major barrier against an inhospitable environment.[3] In humans, it is thinnest on the eyelids at .10 mm (0.0039 in) and thickest on the palms and soles at 1.5 mm (0.059 in).[4] It is ectodermal in origin.

source: wikipedia

Male Nurses in the Cardiac ICU



Left to right: Some of the male nurses on the Cardiac SICU include Raycor Faderuguos, Aaron Crowther, Ryan Cristosomo, Nick Long, Michael Dawson, Julian Olivares, Shawn Sullivan, Ian Morris, Matt Plourde, Steve Heslop and Patrick Balao.


Note: of the male nurses, 3 of them are Filipino.

These nurses are John Hopkins Hospital Cardiac Unit Nurses.
John Hopkins Hospital is The Best hospital in the Eastern United States.

Tribute to the Filipino Male Nurses!

More Power!

Traditional Spanish Beauty..

Carla Nieto is beautful. She is from Northern Spain? Her Gaulic beauty is so evident. Wow, so soft white skin. Her body needs to be massaged and caressed..






are her eyes green or hazel?

morras,

i specifically find the the beauty of the ladies from andalucia and burgos -- exhilarating. Their dark black hair and creamy, milky complexion sets fire to my heart.

ay, que guapitas, las sonrisas!

hehe, padayon mga baji sa mundo!

Quote from: hofelina on March 09, 2011, 03:20:28 PM
There are kids here missing sexually assaulted and killed. Once the killer is captured and declares he is not in his mind, he got a minimum of 3-5 years, after serving the sentence  he starts to repeat the crime again. If one of the victim is your child, Lorenzo, how will you react?

Simbako, Manay. Pero, as a clinician, i know the importance of psychological trauma and especially on the minds of adolescents who have not yet developed (physically and mentally). I am a firm supporter of behavioral institutions , which are run by the state, in order to correct any abberation in children who have questionable guardians , or who fail in raising the children accordingly and fail to provide a stable home, and a stable psychological environment. It is unfortunate that many of the ones commiting the same crime grow up into adults and perpetuate the same thing over and over again. However, theirs is a product of environmental conditioning and stagnation. That is all they know.

Hypothetically speaking, Manay, if ever my child were killed by someone, of course i would be devastated by the catastrophe. But if we believe in God and the resurrection of the soul, then we trust that our loved one will be raised in Glory, and enjoy the first fruits of salvation in Christ Jesus. It is not up to me to decide death to a person. And i believe that the state should not be condoning death as well.

We all have the right to change, and the right to live, even the murderers. In the end, these people also have lives. I leave vengeance and the dispelling of vengeance to God , alone.

As one who believes in the sanctity of human life, and a firm believer of the rights of the unborn, all human life is precious to God. Whether they be fetus, to the mentally retarded, to the dying, and even those who are killers. In my opinion, if we kill them, we become no better than them.

Thanks for the very question. God Bless!

sometimes the metro, sometimes the cta buses, sometimes my suv, sometimes my two feet.

hahahah @ "do you take red bull or coffee with you cup of noodles ?" ngek!

hahaha   

Medical School Dating: Living the Dream

Puahaha love it! Enjoy, guys

Med TV (Part 1 of 2)

QI Medical Student Joke

For example: Brazil nut trees (Bertholletia excelsa) are dependent on several animal species for their survival.

These large canopy trees found in the Amazon rainforest, rely on the agouti, a ground dwelling rodent, for part of their life cycle. The agouti is the only animal with teeth strong enough to open their grapefruit-sized seed pods. While the agouti eats some of the Brazil nut's seeds, it also scatters the seeds across the forest by burying caches far away from the parent tree. These seeds then germinate and form the next generation of trees. For pollination, Brazil nut trees are dependent on Euglossine orchid bees. Without these large-bodied bees, Brazil nut reproduction is not possible.



http://www.jacksbromeliads.com/theamazon.htm

too cute !

tsk tsk tsk.

ESTP man sigoro ko.

Pharmacotherapy in Dementia Treatment


   * Cholinesterase inhibitors such as donepezil (Aricept), galantamine (Reminyl), or rivastigmine (Exelon). These drugs were developed to treat Alzheimer's disease, but they may be tried in other dementias to improve or maintain mental function. Studies indicate that this class of drugs holds promise for the treatment of people with vascular dementia. Both donepezil and galantamine have been shown to improve mental function with few side effects.7 Rivastigmine may help people with dementia with Lewy bodies, but side effects such as nausea, vomiting, and weight loss are common.8 At present, cholinesterase inhibitors can slow but not stop the progress of dementia. It is not clear how long these medicines will work. They may only stop the progress of dementia for a short time.

   * Memantine (Namenda). This new type of medicine can slow the late stages of Alzheimer's disease. It may also benefit those with mild to moderate vascular dementia.8 More studies are under way.

   * Antidepressants to treat depression. They must be used carefully because they can cause delirium in people with dementia. Antidepressants that have the fewest side effects in people with dementia are SSRIs, such as fluoxetine (Prozac, for example) and citalopram (Celexa).9

   * Medicines to ease anxiety, agitation, aggression, and hallucinations, which can become worse as dementia progresses. Some of these medicines, called antipsychotic drugs, are not approved by the FDA for the treatment of dementia. Studies of people with psychosis due to dementia who were treated with these medicines, including Zyprexa and Risperdal, found an increased risk of death.10, 11 Discuss this risk with your doctor before using these medicines.

http://www.webmd.com/alzheimers/tc/dementia-treatment-overview?page=2

Initial Treatment for Dementia:

    * Take vitamins for a deficiency of vitamin B12.
    * Take thyroid hormones for hypothyroidism.
    * Have surgery to remove a brain tumor or to reduce pressure on the brain.
    * Stop or change medicines that are causing memory loss or confusion.
    * Take medicines to treat an infection, such as encephalitis, that is causing changes in mental state.
    * Take medicine to treat depression.
    * Get treatment for reversible conditions caused by AIDS.

Quote from: Candijaynon on March 09, 2011, 12:40:16 PM
Bayolet beauty po...

hehe sweet beauty pood!

aww, puydi ba -- sweet bayolet beauty?

ESTJs take their energy from the outer world of people and external events. They prefer dealing with facts and the present, and makes decisions using logic. Their life is organised on a logical basis. They are therefore practical, and likely to implement tried and trusted solutions to practical problems in a businesslike and impersonal manner. They prefer to ensure that the details have been taken care of rather than spend time considering concepts and strategies.

ESTJs are doers who roll up their sleeves, dig in, and proceed directly to get the job done. They use logic and analysis as guiding principles for their lives. They are quick to decide and set a plan of action. They marshall resources in an organised fashion, implement, and follow through. They like closure. They focus directly on tasks to accomplish and are able to anticipate the steps needed to complete an assignment. In doing so, they see what might go wrong and take necessary preventive action. They monitor events continually and make sure that commitments, both their own and those of others, are honoured and the job gets done. They are at their best in situations that have some structure to them and involve activity not contemplation, and in which an end product is desired.



ESFPs take their energy from the outer world of people and external events. They prefer dealing with facts, which they usually takes at face value. They also prefer dealing with the present and with people, and probably derives much enjoyment out of friendships. Their life is flexible, living it very much in the present, and responding to things as they arise. They are impulsive and friendly, seeking enjoyment out of life, and makes new friends easily. They like taking part in solving urgent problems, such as fire-fighting or trouble shooting. They operate best in practical situations involving people.

ESFPs are friendly, outgoing, fun loving, and naturally drawn to people. They are enthusiastic and exuberant, and are usually well liked by others. They are good a meeting people and helping them enjoy themselves. They are sympathetic toward people and generous with their time and money. They want to be where the action is, and they will often stir things up in their own special way. At their best, they are able to realistically meet human and situational needs in a fun and lively way.



ESFJs take their energy from the outer world of people and external events. They prefer dealing with facts, and making decisions on the basis of personal values. They like dealing with people, and organises life on a personal basis. They are very warm people, seeking to maintain harmonious relationships with colleagues and friends, who are a very important part of their life. They can find conflict and criticism very difficult to handle. They have a strong sense of duty and loyalty, and are driven by a need to belong and be of service to people.

ESFJs are helpful people who place a high value on harmony. Paying close attention to people's needs and wants, they work well with others to complete tasks in a timely and accurate way. They follow through on their commitments. They like closure and prefer structured, organised situations in which warmth and compassion are shown. They contribute to others by anticipating their day-to-day concerns and handling them with warmth and efficiency. They are at their best in organising people to get a job done.



ENFPs take their energy from the outer world of people and external events. They prefer dealing with patterns and possibilities, particularly for people, and makes decisions on the basis of personal values. Their life is flexible, following new insights and possibilities as they arise. They are creative and insightful, often seeking to try new ideas that can be of benefit to people. They may sometimes neglect details and planning, but they enjoy work that involves experimentation and variety, working towards a general goal.

ENFPs are initiators of change who are keenly perceptive of possibilities, and who energise and stimulate through their contagious enthusiasm. They prefer the start-up phase of a project or relationship, and are tireless in the pursuit of new-found interests. They are able to anticipate the needs of others and to offer them needed help and appreciation. They bring zest, joy, liveliness, and fun to all aspects of their lives. They are at their best in situations that are fluid and changing, and that allow them to express their creativity and use their charisma.


ESTPs take their energy from the outer world of people and external events. They prefer dealing with facts, which they usually views objectively, and they makes decisions on a logical basis. Their life is flexible, consisting of a series of activities that interest their. They are action oriented problem solvers, and prefer to work with practical organisational issues. They can be impulsive, and likes taking part in trouble-shooting-type work. They can sometimes neglect follow-through, but will work best when there is a lot going on that needs organising and solving.

ESTPs are action oriented, pragmatic, outgoing, and realistic people. In situations that require resourcefulness, they use their quickness and flexibility to find the most efficient route to accomplishing whatever needs to be done. They are lively, entertaining, and fun. They like to be where the action is and participate fully in what is happening. Characteristically, they are direct with their comments and mince no words. They are at their best in situations that require an orientation to the present and a direct, no-nonsense, pragmatic approach.



ENFJs take their energy from outer world of people and external events. They prefer dealing with patterns and possibilities, particularly for people, and makes decisions using personal values. Their life is organised on a personal basis, seeking to develop and maintain stable relationships with those people they likes. They are actively concerned with promoting personal growth in others. They are also highly sociable, and expressive of feelings towards others, but can find conflict and criticism difficult, particularly if it might damage long term relationships. They work best in situations involving people.

ENFJs are lively and enthusiastic facilitators who apply warmth and vision to helping people and meeting their needs. They are aware of people's aspirations and develop plans of action to make those aspirations into reality. They like organisation and closure. They are at their best facilitating situations that require interpersonal sensitivity. They are tolerant and appreciative of others, seeking involvement with them in life's tasks. They are able communicators who are liberal in showing appreciation for others.
ENTJ

ENTJs take their energy from outer world of people and external events. They prefer dealing with patterns and possibilities, and making decisions after considering the consequences of the various courses of action. Their life is organised on a logical basis. They tend to control life, organising systems and people to meet task oriented goals. They often take the role of executive or director, using a business-like and impersonal approach. They may appear intolerant of people who do not set high standards for themselves or don't seem to be good at what they do.

ENTJs take charge quickly and deal directly with problems, especially in situations that involve confusion and inefficiency. They provide structure to the organisations to which they belong and design strategies to accomplish their personal and organisational goals. They develop broad, action-oriented plans, and supply the necessary energy and momentum to see that these plans are accomplished. They are "take charge" people who organise their own and others' external environments. They do not take "no" for an answer; instead, they use their resources to find a way to meet the challenge. They re at their best in using their analytical and strategic thinking.


ENTPs take their energy from outer world of people and external events. They prefer dealing with patterns and possibilities, and making decisions on a logical basis. They are adaptable, tending to focus on new ideas and interests as and when they arise, particularly if they involve increasing their competence or skill. They are ingenious problem solvers, constantly trying new ideas out, and can seem to enjoy a good argument. They are interested in instigating change, and operates best in overcoming new difficulties where the solution requires the application of creative effort.

ENTPs are known for their quest of the novel and complex. They have faith in their ability to improvise and to overcome any challenges that they face. They are highly independent, and value adaptability and innovation. They may be several steps ahead of others in encouraging and valuing change. They hate uninspired routine and resist hierarchical and bureaucratic structures that are not functional. They need freedom for action. With their entrepreneurial tendencies and broad understandings, they push against all odds to further their projects. They are at their best in changing circumstances in which they can develop conceptual models and devise strategies to effectively navigate through change.



INTJs take their energy from the inner world of thoughts and ideas. They prefer dealing with patterns and possibilities for the future, and making decisions using impersonal analysis. Their life is organised on a logical basis. They are strategists, identifying long term goals and organising life to meet them. They tend to be sceptical and critical, both of self and others, with a keen sense of deficiencies in quality and competence. They often have a strong intellect, yet are able to attend to details that are relevant to the strategy.

INTJs are strong individualists who seek new angles or novel ways of looking at things. They enjoy coming to new understandings. They are insightful and mentally quick; however, this mental quickness may not always be outwardly apparent to others since they keep a great deal to themselves. They are very determined people who trust their vision of the possibilities, regardless of what others think. They may even be considered the most independent of all the sixteen personality types. They are at their best in quietly and firmly developing their ideas, theories, and principles.



INFPs take their energy from the inner world of thoughts and ideas. They prefer dealing with patterns and possibilities, especially for people, and prefers to make decisions on the basis of personal values. Their life is flexible, following new insights and possibilities as they arise. They is quiet and adaptable (up to a point - when their values are violated the normally adaptable INFPs can surprise people with their stance). They will seem to be very interested in ideas, and they may sometimes make very creative contributions. They has a hidden warmth for people and a desire to see self and others grow and develop. They prefers to undertake work that has a meaningful purpose.

INFPs focus deeply on their values, and they devote their lives to pursuing the ideal. They often draw people together around a common purpose and work to find a place for each person within the group. They are creative, and they seek new ideas and possibilities. They quietly push for what is important to them, and they rarely give up. While they have a gentleness about them and a delightful sense of humour, they may be somewhat difficult to get to know and may be overlooked by others. They are at their best making their world more in line with their internal vision of perfection.



INTPs take their energy from the inner world of thoughts and ideas. They prefer dealing with patterns and possibilities, and making decisions on a logical basis. Their life is flexible, following new insights and possibilities as they arise. They are quiet and detached, and adaptable (up to a point - sometimes they may stop adapting, insisting that there is a clear principle at stake). They are not interested in routine, and will often experiment or change things to see if they can be improved. They operate at best when solving complex problems that require the application of intellect.

INTPs are known for their quest for logical purity, which motivates them to examine universal truths and principles. They re constantly asking themselves and others the question "Why?" and "Why not?" Clear and quick thinkers, they are able to focus with great intensity on their interests. They appreciate elegance and efficiency in thought processes and require them, even more so, in their own communications. They may be seen as unwilling to accept what everyone else regards as truth. While often low key in outward appearance and approach, they are as "hard as nails" when challenging a truth. They do not like to deal with the obvious. They are at their best in building conceptual models and developing unusual and complex ideas.



ISTJs take their energy from the inner world of thoughts and ideas. They prefer dealing with facts, and making decisions after considering the various options. They organise their life on a logical basis. They are quiet, serious and well prepared for most eventualities. They are a keen observers of life, developing a good understanding of situations, which is often not expressed. They have a strong sense of practical objectives, and works efficiently to meet them.



INFJs take their energy from the inner world of thoughts and ideas. They prefer dealing with patterns and possibilities, particularly for people, and makes decisions using personal values. Their life is organised on a personal basis. They often have a private sense of purpose in life, and works steadily to fulfil that goal. They demonstrate a quiet concern for people, being interested in helping them to develop and grow. They are good at developing insight into people, though it can often remain unexpressed.

INFJs are future oriented, and direct their insights and inspiration toward the understanding of themselves and thereby human nature. Their work mirrors their integrity, and it needs to reflect their inner ideals. Solitude and an opportunity to concentrate thoroughly on what counts most is important to them. They prefer to quietly exert their influence. They have deeply felt compassion, and they desire harmony with others. They understand the complexities existing within people and among them. They do not call a great deal of attention to themselves, preferring that their contributions speak for them. They are at their best concentrating on their ideas, ideals, and inspirations.



ISTPs take their energy from the inner world of thoughts and ideas. They prefer dealing with facts and making decisions on a logical basis. Their life is flexible, demonstrating an interest in acquiring new information that leads to a practical understanding of the way the world works. They are quiet and detached, and adaptable (up to a point). They are often good at solving organisational problems that need to be thought through. They are curious about how and why things work, and can seem impulsive, sometimes producing surprising ideas or doing something unpredictable.

ISTPs are realists who apply expediency and reasoning as they manage and adapt to situations. They are aware of what is going on in the environment and are able to respond quickly to the actual facts, making sure the odds of success are in their favour. They do not like to be tied down and will feel hamstrung when they must operate within tight structures and schedules. They are able to anticipate immediate, practical needs in situations and to present a logical, straightforward plan for meeting those needs. They are at their best in situations that require immediate attention.



ISFPs take their energy from the inner world of thoughts and ideas. They prefer dealing with facts and people, and making decisions on the basis of personal values. They are adaptable (up to a point), quiet and friendly. They are interested in people, enjoying their company preferably on an individual basis or in small numbers. They take a caring and sensitive approach to helping others. They enjoy the present, and tends to dislike confrontation and conflict. They usually acts as a very supportive member of a team.

ISFPs are gentle and compassionate, open and flexible. They are considerate of others and do not force their views and opinions on them. They often focus on meeting others' needs, especially those who are less fortunate. Having a quiet, modest, self-effacing style, ISFPs avoid disagreements and seek harmony with people as well as with nature. They enjoy life's precious moments and often add a touch of beauty to the environments where they spend their time. They are at their best ensuring others' well-being.


ISFJs take their energy from the inner world of thoughts and ideas. They prefer dealing with facts and people, and making decisions on the basis of personal values. Their life is organised on a personal basis, seeking to enjoy relationships with people they likes. They are quiet, serious observers of people, and are both conscientious and loyal. They prefer work that involves being of practical service to people. They are often concerned for and perceptive of how other people feel and dislikes confrontation and conflict.

ISFJs are sympathetic, loyal, considerate, and conscientious. They will go to any amount of trouble, when it makes sense to them, to help those in need. They operate most comfortably in situations where rules are well defined and where traditions are to be upheld. They focus on providing practical help and services for others and for organisations they serve. They are often self-effacing in getting the job done, and they are willing to make necessary sacrifices, especially for their families. They are at their best quietly providing assistance and making sure things are in proper order.


http://www.new-oceans.co.uk/new/mbti16.htm

Which one are you?

This medical research report , which was one of 8 required reports during my Internal Medicine Rotation, was reviewed by the Heads of Internal Medicine. They were rather interested in the reports of anemia cases in third world countries. The reason for their interest was because the fact that anemia prevalent in adolescents is usually nutritional -based, a common in poorer countries, which is alien to many American hospital systems.

In my report, and defense, 85% of the questions they asked me was about the consumption rates of the children in India, and in that region of the world. With 5-6 questions regarding enzyme deficiencies.

It was rather interesting how they were interested on the nutritional factor. Quite interesting. I  did not expect such a heightened interest in the nutritional factors.

Any questions on anemia, hemoglobin levels, treatment, prevention, etc are welcome.

by: A. Lorenzo Lucino Jr, 4th Year Medical Intern (MD & Ph.D program)


Male Adolescents and Adults


A significant percentage of adolescents in the developing world are anemic, causing considerable health consequences for this age group. Among adolescents, prevalence rates of anemia are closer for males and females in some parts of the world. The prevalence of anemia is disproportionately high in developing countries, due to poverty, inadequate diet, certain diseases, pregnancy and lactation, and poor access to health services. Young people are particularly susceptible because of their rapid growth and associated high iron requirements (1). Anemia is a critical health concern because it affects growth and energy levels. Anemia is typically defined as a hemoglobin level of less than 13.0 g/ dL in males and 12.0g d/dL in females (3). It is also important to note that indications for anemic cases are either dietary deficiency or an underlying pathologic process or disease. It is important to note also that iron deficiency anemia is the most prevalent among women of childbearing age and is more common in developing countries (3).
Adolescence is an opportune time for interventions to address anemia. In addition to growth needs, girls need to improve iron status before pregnancy. In pregnancy, it is associated with premature births, low birth weight, and perinatal and maternal mortality. Girls often enter their active reproductive years in late adolescence with poor iron status. Because pregnancy requires more iron for increased blood production, an iron deficit can result in negative reproductive consequences(1). Considering the high demands of hemoglobin levels in females, it is understandable that a hemoglobin level of 12.0 g/dL would be considered anemic in appropriation of the physiologic responsibilities of the female sex (2)
Boys and girls both need iron for growth during adolescence, and girls have a continuing need to replace iron lost during menstruation. Body growth slows down late in adolescence, at which point the iron status of boys appears to improve, which indicates the anatomical strengthening of the body at maturation. As the male body matures, the body is not pervious to injury and can take damage and heal faster. Adult men, therefore, typically have larger iron stores than women (1) and thus correlates why males don’t become anemic until their hemoglobin levels hit 13.0 g/Dl. This is one of the reasons why adult males won’t realize that they are loosing hemoglobin due to substantial stores of such.

The average hemoglobin levels in adolescent males were 10.69g/dL. For adult  males age 50-59 years of age, had the lowest level of hemoglobin levels of 10.43g/dL. The highest levels of hemoglobin was found in the 18-19 year old males with a value of 11.6g/dL(Graph 1). One also notices that a related factor of such differences is the older groups had a higher variance in medical conditions that contributed to the disparity in hemoglobin levels as compared to the adolescent groups. Adolescents suffered 6 specific kinds of medical conditions while the older adult population suffered over 18 kinds of medical ailments (Graph 1).

In this study a total of 145 males were considered to be anemic and the underlying cause of it included trauma, hypertension, gastrointestinal problems, more than 1 causes, cellulitis, surgery, cancer, hepatitis, chronic obstructive pulmonary disease, coronary artery disease, seizure, alcohol-related diseases, diabetes mellitus, urinary disorders, malaria, snake bite, drugs and even other causes. The most common cause of anemia in adult men is trauma, which was a substantial 39% of all anemia cases in adult men.
In adolescent males (age 12-15) trauma was the most common cause. There were also other factors such as surgery, gastrointestinal problems, drugs, or more than once cause of illness that led to anemia, which were substantially less as compared to the underlying pathologies seen in adult males(Graph 2).

In adult males (18-59) the majority of anemic cases also fell into the category of trauma. The second most common group of males was gastrointestinal and other causes of illness. The source of bleeding can come from peptic ulcers, colon cancer, hemorrhoids, fissures, infection, and inflammatory bowel disease, disease of the intestines or polyps in the colon (Graph 3). Naturally, these underlying pathologies effectively disturb the homeostasis of hemoglobin levels and can explain the overwhelmingly large anemia cases in adult males as compared to adolescent males. Gastrointestinal bleeding can also come from excessive use of aspirin, an NSAID, and is one of the major causes of acute tubular necrosis as well as in cases of liver toxicity, pancreatic toxicity and ulcerations in the duodenum if taken for chronicity (4). It is important to note that many men may not be aware they are bleeding enough to affect their iron levels (2) considering the population we are studying in a third world nation individuals may not be medically aware of the importance of continued medical checkups due to financial limitations or other reasons (3).

The other groups had clinical conditions of chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, surgery, hepatitis, malaria, snake bite, urinary problems, alcohol abuse and cancer (Graph 3).

For this study, the values to analyze were only limited to hemoglobin levels. We are not able to conclude whether the conditions are associated with the patients ailments for the other disorders. In order to fully understand which type of anemia is present other reference laboratory values are needed for the evaluation of anemia(3). The values including blood hemoglobin are serum iron, serum ferritin, mean corpuscular volume, red blood cell width, and total iron binding capacity and reticulocyte count (1, 2). This would help one to understand the type of anemia present being microcytic, normocytic or macrocytic. This would greatly help one to identify the underlying clinical condition in correlation with anemia presentation.



Works Cited:


Senderowitz. “Young People and Anemia”. Youthnet Publications: 1998

Harris, Lynn. Iron Deficiency Anemia in Men. 2004.
<http://www.associatedcontent.com/article/359733/iron_deficiency_anemia_in_men.html?cat=70>

Karnath, Bernard M. Anemia In The Adult Patient. Review of Clinical Signs. 2004.
< http://www.turnerwhite.com/memberfile.php?PubCode=hp_oct04_anemia.pdf>

Daily Aspirin Therapy: Understand the benefits and risks. 2010.
< http://www.mayoclinic.com/health/daily-aspirin-therapy/HB00073>

Quote from: hubag bohol on March 09, 2011, 12:24:10 PM

tsk tsk tsk, a poor therapeutic reinforcement. poor psychologist and poor psychiatrist sigoro ning author. 

Quote from: Lorenzo on March 09, 2011, 11:48:22 AM
For those who support the difference between medicine and classic psychology. There are those who would suggest that the two (alternative medicine) and (medicine) are in different platforms, however, the fact remains that medical doctors still do practice psychotherapy , per se, the behavioral psychiatrists. We have to note that the father of psychoanalytic psychotherapy was himself a practicing MD, Freud.

In medicine, especially treating the many forms of behavioral and cognitive disorders, there has to be an understanding that psychopharmacology is best synergistic with psychotherapy.

case in point: in treating acute manic disorders, GAD (generalized anxiety disorders), panic disorders, phobias, etc.

we usually treat patients who are suicidal, clinically depressed, substance abuse problems by treating the symptoms and then registering them to therapy classes and/or support groups with a certified and licensed group therapist.

thanks for sharing the article tho. a bit biased and one sided tho, imho.

another example:

patients who are diagnosed with schizophrenia, they are given standard anti-psychotics as well as anxiolytics.

in addition to this regimen, they also attend therapy and support groups to deal with their cognitive aberration.

two months ago when i was doing my medical psychiatry rotations , i saw patients who were diagnosed with schizophrenia (catatonic, paranoid etc forms) ; they were given standard regimen but also were attending therapy in addition to the regimen.

just to add lang ha.

“Trust in the Lord with all of your heart; do not depend on your own understanding. Seek his will in all you do, and he will show you which path to take.”

Proverbs 3: 5-6

Be joyful always; pray continually; give thanks in all circumstances, for this is God's will for you in Christ Jesus.

1 Thessalonians 5:16-18

Let the word of Christ dwell in you richly as you teach and admonish one another with all wisdom, and as you sing psalms, hymns and spiritual songs with gratitude in your hearts to God.

Colossians 3:16

Quote from: taga tigbao on March 09, 2011, 12:12:45 PM
May barko padulong sa Sugbo,
Ang nanakay, puros sundalo,
Si Tatay sista, si Nanay kanta,
Si Lola, nakaigit sa kusina. Hahahahaha.

ayy!

hehe ka cute. pero make sure that sterile ang tools!

March 7, 2011


Today i was caring for a patient who was in end-stage renal failure. As i was rotating with the head of surgery, Dr. B, i was selected to perform a rectal exam on the patient. Observed occult blood on the stool sample and had to consult the patient to agree to a colonoscopy.

Another medical student asked me, "why do we really have to ask him to consent to a colonoscopy when he's already going through renal failure?"

Before i could even answer, Dr. B, answered, "because it's protocol!"

I pray that I never become as arrogant as Dr. B in the future. aish!

Today we had a code yellow. They declared a code as soon as i got into the hospital today. I drove 30 minutes to the hospital for nothing, why can't they (the adminisration) develop a better communication channel so that students can evade having to drive to a , "oh sorry, they have a code yellow, you can't go in today."

As I walked out of the hospital, I was met with 8 other medics who were told the same thing, "you guys can't go in."

Truly, we were vexed. Waking up at 6 AM and then being unable to go in to work. It's worse than performing a rectal exam.

Whatever.

Quote from: islander on March 09, 2011, 02:08:58 AM
Dualistic thinking continues to pervade psychoanalytic views of psychopathology. The author points out the shortcomings of this perspective as represented in Mark Swoiskin's article, “Psychoanalysis and Medication: Is Real Integration Possible?” She contends instead that the latest scientific evidence does not support a dichotomy between organic (biological) and psychodynamic (nonbiological) factors in psychopathology. She presents two cases to illustrate both the challenge and the importance of reformulating psychoanalytic views in an integrated, holistic way.

http://www.atypon-link.com/GPI/doi/abs/10.1521/bumc.65.2.160.19397

For those who support the difference between medicine and classic psychology. There are those who would suggest that the two (alternative medicine) and (medicine) are in different platforms, however, the fact remains that medical doctors still do practice psychotherapy , per se, the behavioral psychiatrists. We have to note that the father of psychoanalytic psychotherapy was himself a practicing MD, Freud.

In medicine, especially treating the many forms of behavioral and cognitive disorders, there has to be an understanding that psychopharmacology is best synergistic with psychotherapy.

case in point: in treating acute manic disorders, GAD (generalized anxiety disorders), panic disorders, phobias, etc.

we usually treat patients who are suicidal, clinically depressed, substance abuse problems by treating the symptoms and then registering them to therapy classes and/or support groups with a certified and licensed group therapist.

thanks for sharing the article tho. a bit biased and one sided tho, imho.

Quote from: islander on March 09, 2011, 02:10:34 AM
gadamgo ko nga mora nig si bai lorenz inig ka-doctor na niya.

simbako! 

Its a tough call , to be able to decide who deserves a transplant or not. A huge responsibility rests on these people. Respect! 

What have you learned so far , an would like to impart to others in this journey we call life? Are there some hard life lessons you've learned, experienced that you feel was an ordeal , a blessing, etc? This is really open to people to express themselves regarding their personal reflection.
Talk and be heard..!

The manner of worship differs from person to person, the manner of expression differs, but the necessity of faith is integral to most. How do you strengthen your faith in God when times are antagonistic to the faith you have? Do share.

In your work/ profession, what are some of the responsibilities that are expected of you?

sophisticated lonely old man. from the looks of this, he's homeless, but is also enjoying wi-fi.

Hehehe hopefully someday we can also become the Calamay Capital of the Philippines.

an example:

an obsessed woman will follow a young man.

an obsessed wife will continue to hound her husband if he cheated on her.

Do re mi fa from "The Sound of Music"


The sound of music do re mi fa

Quote from: Lorenzo on March 09, 2011, 10:12:05 AM
For a long time I was a supporter of capital punishment. It was a recent epiphany that I had that made me relinquish my previous support for capital punishment. It happened during a conversation with a friend , who also was an advocate of capital punishment, and during the dialogue, he remarked, "those people in death row don't deserve life, but deserve death, i say kill them all..."

At first I agreed with him, but after a while, as he was talking about specific examples of the need to curve crime rates, I kept on thinking about what he said , "those people in death row don't deserve life..". In my mind i kept on asking the same rhetorical question, "but who are we to decide who deserves to live or die?"

At first, i was taken back. Here I was, a person who believes in the sanctity of human life , an advocate of fetal life, and a strong advocate of the rights of the unborn (as i am against abortion), but was at the same time supporting death penalty. Something didn't click.

That night, I sat down by my bedside table and opened the Holy Bible. I literally searched the scriptures that night in regards to what is said about life, and death, and there was one verse that I found that really touched me and I trust that it was the Holy Spirit who was guiding me to this verse, since I felt a spiritual awakening earlier that day -- on the notion of capital punishment.

The verse that I found was in Hebrews Chapter 10 verses 26 to 31:-


26 For if we go on sinning deliberately after receiving the knowledge of the truth, there no longer remains a sacrifice for sins, 27 but a fearful expectation of judgment, and a fury of fire that will consume the adversaries. 28 Anyone who has set aside the law of Moses dies without mercy on the evidence of two or three witnesses. 29 How much worse punishment, do you think, will be deserved by the one who has spurned the Son of God, and has profaned the blood of the covenant by which he was sanctified, and has outraged the Spirit of grace? 30 For we know him who said, “Vengeance is mine; I will repay.” And again, “The Lord will judge his people.” 31 It is a fearful thing to fall into the hands of the living God.

So thus the answer that I was searching for was given to me. Vengeance is the Lord's, not ours. It was then that I became an opponent of the death penalty.

Addendum:

I was also reminded that night of one of the Ten Commandments that God told Moses, "Thou Shall Not Kill..."

When Jesus was walking in the streets, he saw that the hebrews were about to stone a woman, Mary Magdalene, for the crime of adultery. The Jews were practicing their prophetic mandate of stoning an adulteress, as it was custom and requirement of the Law. However, Jesus told them, "which among you have not sinned? If any among you have not sinned, then you may cast the first stone..." Pero, all the Jews with rocks did sin. So it nullified the Law that they were trying to implement.

Ang meaning ani, to me, is that no man is fit to judge who should live or die. Since it is up to the Living God to give recompense according to what we did and according to the life of faith one in this life practiced.

By rescuing the woman, Mary Magdalene, from her would-be-killers, Christ directly tells us that death penalty is wrong. Even if the Law requires it. Afterall, Jesus Christ superceded the Law.




Jesus asked Mary Magdalene, "where are your accusers, my daughter?"

Shocked, Mary responded, "They are gone, Lord.."

Jesus said to her, "Neither do I condemn you. Now, go, sin no more..."

Beautiful Merciful Savior...

Quote from: hofelina on March 06, 2011, 07:19:22 PM
a piece of news to refresh you;

Vizconde murder case exemplifies state of justice system
Filed on December 26, 1999
By Raissa Robles

The life conviction yesterday of an ex-lawmaker’s son and five others from prominent families reflects the true state of the justice system.

It grinds exceedingly long when the accused are rich and powerful, but quite fast when they are poor.

Some 955 Filipinos have been convicted to death for crimes they have committed starting 1994 when capital punishment was restored. The bulk of them are poor, anti-death penalty advocates said.

In contrast, suspects in the massacre of the Vizconde family took three presidential administrations to convict and even now, their powerful families are talking of hammering the Supreme Court for a new trial.

In the seven recent executions by lethal injection, three of those put to death for the crime of rape did not kill their victims.

In contrast, ex-Senator Freddie Webb’s son, Hubert, and his friends not only murdered Estrellita Vizconde, 47, her daughters Carmela, 18 and Jennifer, 7, by stabbing them repeatedly, they also took turns raping Carmela, Paranaque Regional Trial Court Judge Amelita Tolentino said in her verdict yesterday which took four and a half hours to read out.

The crime took place in the early morning hours of June 30, 1991 but the convicts were arrested only in 1995 because Hubert Webb, “besides being rich and influential, had a father who was a congressman and later a senator of the Republic,” Judge Tolentino said.

Thank you for sharing this, Manay. Much appreciated.

For a long time I was a supporter of capital punishment. It was a recent epiphany that I had that made me relinquish my previous support for capital punishment. It happened during a conversation with a friend , who also was an advocate of capital punishment, and during the dialogue, he remarked, "those people in death row don't deserve life, but deserve death, i say kill them all..."

At first I agreed with him, but after a while, as he was talking about specific examples of the need to curve crime rates, I kept on thinking about what he said , "those people in death row don't deserve life..". In my mind i kept on asking the same rhetorical question, "but who are we to decide who deserves to live or die?"

At first, i was taken back. Here I was, a person who believes in the sanctity of human life , an advocate of fetal life, and a strong advocate of the rights of the unborn (as i am against abortion), but was at the same time supporting death penalty. Something didn't click.

That night, I sat down by my bedside table and opened the Holy Bible. I literally searched the scriptures that night in regards to what is said about life, and death, and there was one verse that I found that really touched me and I trust that it was the Holy Spirit who was guiding me to this verse, since I felt a spiritual awakening earlier that day -- on the notion of capital punishment.

The verse that I found was in Hebrews Chapter 10 verses 26 to 31:-


26 For if we go on sinning deliberately after receiving the knowledge of the truth, there no longer remains a sacrifice for sins, 27 but a fearful expectation of judgment, and a fury of fire that will consume the adversaries. 28 Anyone who has set aside the law of Moses dies without mercy on the evidence of two or three witnesses. 29 How much worse punishment, do you think, will be deserved by the one who has spurned the Son of God, and has profaned the blood of the covenant by which he was sanctified, and has outraged the Spirit of grace? 30 For we know him who said, “Vengeance is mine; I will repay.” And again, “The Lord will judge his people.” 31 It is a fearful thing to fall into the hands of the living God.

So thus the answer that I was searching for was given to me. Vengeance is the Lord's, not ours. It was then that I became an opponent of the death penalty.

Quote from: greenmachine on March 08, 2011, 04:50:53 PM
OCD obsessive-compulsive disorder

hard raba ni ka treat kai mental disorder man ni. it is a symptom that appears also with turrets syndrome. 

When i was 14 years old, i kissed a girl and told her best friend. The very next day, when i went to my locker, my then-subject of affection left an angry note. I forget the totality of the letter, but to paraphrase from my memory, it reiterated how angry she was at me and how she would never talk to me again. Attached to the letter was the ribbon i gave her during valentine's day. My first heart-break. 

I believe that this 'romantic' longing is merely one man's gladness in being able to communicate with an old friend whom he has terribly missed these past 3 years of no communication. Her voice, the sound of her undeniable laughter brings him to smile and reminds him of the many secrets the two shared in their college years, that he misconstrued the feeling of 'reconnection' with 'romanticism'.

Sometimes, i feel that as men, we have to discern our thoughts and our sentimentality in order to make a right and proper judgment.

Quote from: chicogon on March 09, 2011, 09:02:31 AM
The judge had just awarded a divorce to Boudreaux’s wife, who had charged non-support. He said to Boudreaux, "I have decided to give your wife $400 a month for support."

"Well, dat's fine, Judge," said Boudreaux. "And once in a while I'll try to chip in a few bucks, myself." 

bwahahahaha!

Quote from: chicogon on February 26, 2011, 06:09:52 AM
Power Rangers and Power Brokers 

hehe, delikado if power rangers kai mo combine ni sila ... 

Scenario: A man in his mid 20s has a long time female friend, his same age, and they reconnect after several years of distance. Is it okay for this man to have romantic feelings for his old-time childhood friend?

hehehe, dili.

Quote from: hubag bohol on March 07, 2011, 10:19:58 AM
Hmm. Unya OK ra pud modawat? 

the sad thing is that a majority in the philippines accepts it. dawaton nila. paliton ug kanonon. luoy pood bitaw because in the end, philippine politics depends on how much the runner has. tsk tsk tsk.