Sungai Golok

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Lumbar Puncture Procedure

Lumbar Puncture Procedure Indication Diagnostic Meningitis Therapeutic Administration of drugs Decrease intracranial pressure Guillain – Barré syndrome Contraindication Increased ICP Patients under anticoagulant therapy Procedure If patient is under anticoagulant therapy Heparin Stop the drug 4 days prior to the procedure Aspirin Stop the drug 7 days prior to the procedure Instruments Lumbar puncture needle 22 Gauge Anaesthesia Injection Lignocaine Sample collection 3 samples 10ml each sample Microbiology Histopathology If repeated procedure indicated After 5 days of the previous procedure Complication Brain stem herniation Post dural headache Due to decreased ICP Prevented by 1 hour lying down before getting up Prevented by administration of paracetamol, caffeine, blood (epidural patch) Bowel & bladder incontinence Nerve damage due to negative pressure Infection
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History Taking

History Taking General Pain Location Since when Onset Duration Type Character Radiation Progression Aggravating / Relieving factor Postural variation Diurnal variation Seasonal variation Joint Pain Since when Onset Duration Type Character Which joint Any swelling, redness, wound Restriction of movement Aggravating / relieving factor Medication taken Postural variation Diurnal variation History of: Exercise Work Fall Fever Weakness Since when Generalised or not Whether it is due to diet Whether it is due to fever Fever Since when Onset Grade: High/Low Continuous/Intermittent Spikes per day if intermittent Worse in the morning/evening/night Associated with chills/Rigors Progression Diurnal variation Seasonal variation Medication taken Rashes Since when Which part of body Initial size Current size What colour Progression  Presence of itchiness Generalised / Localised  Symmetrical ...
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Furqan - Nabi Isa Ibni Maryam

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An-Nisa' 4:171 O People of the Scripture, do not commit excess in your religion or say about Allah except the truth. The Messiah, Jesus, the son of Mary, was but a messenger of Allah and His word which He directed to Mary and a soul [created at a command] from Him. So believe in Allah and His messengers. And do not say, "Three"; desist - it is better for you. Indeed, Allah is but one God. Exalted is He above having a son. To Him belongs whatever is in the heavens and whatever is on the earth. And sufficient is Allah as Disposer of affairs. Wahai Ahli Kitab! Janganlah kamu melampaui batas dalam agamamu, dan janganlah kamu mengatakan terhadap Allah kecuali yang benar. Sungguh, Al-Masih Isa putra Maryam itu, adalah utusan Allah dan (yang diciptakan dengan) kalimat-Nya yang disampaikan-Nya kepada Maryam, dan (dengan tiupan) roh dari-Nya. Maka berimanlah kepada Allah dan rasul-rasul-Nya dan janganlah kamu mengatakan, "(Tuhan itu) tiga,"Berhentilah (dari ucap...
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