SANTAPAN ROHANI MAKANAN JIWA

Renunglah kata2 ini , moga2 madah ini dapat menyedarkan kita tentang dosa yang selalu kita lupakan , moga dengan mengingati dosa , datang rasa2 kehambaan , kerana rasa2 inilah yang Tuhan mahu di dalam sebarang tindakan;

1- "Setiap hari kiralah dosa-dosa kamu, setidak-tidaknya mengingatinya, janganlah kenang kebaikan kamu, anggap sahajalah tidak ada kebaikan"


2- "Merintihlah dengan dosa, janganlah merintih dengan buta, menangislah dengan dosa, jangan menangis dengan orang menghina, sedihlah dengan dosa, janganlah sedih dengan orang kata."


3- "Kita hamba Allah ini kenalah menyesal selalu, lebih-lebih lagi di waktu bersalah, mengeluhlah selalu nasib kita belum tahu, merintihlah selalu terutama dengan dosa-dosa kita, mengakulah lemah di hadapan Tuhan sekalipun kita serba ada, menangislah selalu kerana kita tidak dapat elak dari dosa moga-moga dengan cara ini Allah rahmati kita."

25.8.09

:. young women without menses! .:

bismillahirrahmanirahiim...
alhamdulillah..alhamdulillah.alhamdulillah.
even though today is a hectic day for me,but i feel like to write something here.
it seems like i really want to relief my tense after doing my PBL task last night! just now we already finished all triggers in one session.. but,i feel like i know nothing..so,i have to study more! Yeah,that's the point is!

this week trigger is about a female,20 years old,who already married and don't have problem in her sexual intercourse came to see a doctor complained about never having menses(amenorrhea).on further questioning,there's no family history of same problem. there's also no headache,no vomiting,no galactorrhea( milk out from breast before its time),no abdominal mass/pain and no dyspareunia (pain during sexual intercourse). on examination, revealed that her vagina is short,no uterus and cervix,normal ovaries,hormonal profile is normal, laparoscopy of fallopian tubes were visualised and attached to each other by a fibrous band(abnormal development of sinovaginal bulb/vaginal plate,so development of upper part of vagina and uterus resulting in absence of uterus).she also has anormal female genotype 46,XX.

so,from this information, this patient is having a congenital malformation of female genital tract(falopian tube,uterus and vagina).because her vagina is short and there's no uterus.the diagnosis is mullerian agenesis/MRKH(Mayer Rikitansky Kuster Hauser) syndrome.this MRKH syndrome is refer to the vaginal agenesis(short vagina) and absence of uterus with normal ovaries and the patient has normal female genotype.
we can exclude :

1. AIS(androgen insensitivity syndrome),PCOS(polycystic ovarian syndrome), gonadal dysgenesis- because of her normal female genotype.

2. pituitary tumor/prolactemia-because no galactorrhea,no headache,no visual defect.

so, what to say to this patient??? oo its quite a big problem how to counsel this patient and her husband!

the patient will feel so irritate or stress if we directly say that" you will not get menses and cannot have ur own children!u can't pregnant because no uterus!we can do nothing about it and if both of u want children,just make a surrogate mother(donate the ovum to other person) or doing adoption."...aaah...naudzubillah..

so,
thanks Allah for giving me healthy and normal female characteristics like now..
alhamdulillah..
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