Nov 27, 2009


Some people's favourite food is lobster, crab or some oyster.

But my favourite food is the simple egg, especially sunny side up. cheap and tasty.

When I was dirt-poor, back in my undergraduate days, I would go to the mamak, order plain rice and only an egg. damage RM1.00.

And those arts of egg really keep me very happy indeed. Not my own creation, but I found them.
My favorite is the 4th with the green bunny, which one is your favourite?

Nov 24, 2009

Keeping abreast of things

Grateful to: Dr. R for more solo flights on Lap BTL, and first Lap & dye. I bloody addicted to laparoscopy. Probably it’s not an addiction, more of peer pressure over here.

Definitely, I had to thank Palmdoc, for the update on Breast Cancer screening. If you’re too busy to read through the whole long article, let me spare you the agony and cut the chase. The main point is

1 pushing mammogram screening age from 40years old to 50years old, and less mammogram repeats, probably 2-yearly rather than annually.

2 self-breast examination is NOT, yes, NOOOOOOOOOT recommended, as it doesn’t reduce the harm, but increase anxiety and unnecessary insults to the breast.

After breaking few sweats over few games of table tennis over lunch break, I rushed back to the clinic. As usual, the bulk of patients after lunch break usually aren’t many, usually in multiple small crowds, won’t even make an illegal gathering counts.

I sat down in my comfy chair, absorbing the lyrical ambience of low-volumed Jason Mrez’s wonderful vocal creations, waiting for my first patient to scroll in, err… I mean stroll in. Too much of computering is really getting me pretty confused, at times.

An elderly Indian auntie made small steps into the room. I welcomed her with a smile (yes, I guess sports-induced endorphin is a good thing), and showed her the seat.

She doesn’t look too happy to me. It is not like she is unhappy, nor ill or depressed, but her face seemed to show some sense of helplessness, with a hint of shyness. Yes, by right, elderly people should be indulging in any shyness, even in the slightest degree.

Gently and slowly, I flip opened the blue ‘gynaecological’ card on my table, which is slightly yellowish at the sides, probably being eaten up by its age.

conversation ensued...

- You’d been us since 1999, are you coming with a new problem. I hope we can help you.

- Not really, actually I removed all my uterus and ovaries and already stopped hormone replacement treatment years back and I am very comfortable

- Ok, and so today, you’re here… (I finally found the referral letter for today)

- My last mammogram done was 3 years back, when I stopped my follow up in HRT clinic. I would like to repeat one for screening. And I called many people, and asked the health clinic, and after few roundabouts, they referred me here since I was previously follow up here and can get mammogram appointment here.

- Huh? (Total disbelief) Oh, so actually you came today to get us to get the mammogram screening from my radiology colleague?

- Yes.

- Ok, don’t worry, let me sort out with my colleagues at health clinic, I don’t think O&G clinic on an Antenatal Clinic day should be for getting mammogram appointment. Somemore, so much time and effort being wasted.

I called the person of which the John Hancock was on the referral letter. She answered the phone, probably thinking at the receiving end, I was going into fit and start scolding her with lots of harsh words.

telephone dialogue...

- Hi, I’m xx from xx. You’re xx from xx

- Ya.

- I called regarding patient wanting to get mammogram screening and …

- Oh, I called the Radiology department, and they won’t give us the mammogram forms, so we can’t order it from health clinic. So they asked us to refer to O&G clinic to get it since she was previous from there.

- Err.. (Disbelief X infinity) even for health promotion, normal health clinic can’t order it?

- Yes, I will talk to my FMS (family medicine specialist) about this.

- Ok. Thanks for the wonderful info.

Health promotion, the frontline of prevention of diseases, definitely failed miserably in the Bolehland. Probably, we’ll need an 1malaysia clinic that can order the mammogram for screening.

Hopefully, it won’t take a million years for the health clinic seriously given enough power and jurisdiction in running health promotion.

I blinked in disbelief, mainly because the health clinic manned by doctors led by a specialist unable to do things right, will the 1malaysia clinic able to do it better only with health assistants?

Nov 20, 2009

climategate | fake global warmers exposed !!

Grateful to: Mopiko for providing me soothing cooling temporary relief for my itchy rashes


With the follow up from the 2012 disaster film, I guess global warming and all the climate change is a pretty worrying thing.

Evrenye Fighter
mindblowing evidence...

Thanks to a hacker, and wattsupwiththat, somehow manipulation of data had been exposed.

From emails hacked out of the Climactic Research Unit of the University of East Anglia:

From: Phil Jones

I’ve just completed Mike’s Nature trick of adding in the real temps to each series for the last 20 years (ie from 1981 onwards) amd from 1961 for Keith’s to hide the decline. Mike’s series got the annual land and marine values while the other two got April-Sept for NH land N of 20N. The latter two are real for 1999,

while the estimate for 1999 for NH combined is +0.44C wrt 61-90.

To which is replied to by one guilty (or self-protecting and nervous) soul:

I’m not too comfortable with this, and would rather not sign — at least not without some real time to think it through and debate the issue. It is unprecedented and political, and that worries me.

And there is this long list of collection rebuttal of global warming. Pretty impressive.

I guess perhaps, there's no point in worrying about global warming right now, but still, being environmentally-friendly should be all the way starting right from now. Maybe when global warming is real, there's really no turning back.

P.S. Damn. So i can't really blame the hot sun for my rashes. Maybe I am just allergic to @#$#$*&. Yeah, I meant to swear. Relieved - but not completely.

pathophysiology of twisted news

fail owned pwned pictures

Stumbled upon this piece of news

GOPENG: V. Divyashree, who died in the bridge collapse incident at SK Kuala Dipang in Jeram on Oct 26, had wanted to be a doctor and her UPSR results were testament to what might have been.

The SJK (T) Gopeng pupil scored four As and three Bs in the exam. Her father, K. Vasudevan, 34, said Divyashree had wanted to become an orthopaedic surgeon so that she could determine why he was so skinny.

“It was one of the reasons she tried to do well in her studies,” said Vasudevan when met at his home in Taman Changkat Golf after obtaining Divyashree’s UPSR results on Thursday.

”She was very competitive and wanted to succeed in everything she did,” he added.

Divyashree, 12, and two other pupils, N. Dina Deve and M. Devatharshini, both 11, drowned when a suspension bridge they were on collapsed. All three were attending a 1Malaysia camp.

Vasudevan, who works as a technician in Kuala Lumpur, said the family was proud of his daughter’s achievement.

and i posted it in facebook and I got several comments.

"Divyashree had wanted to become an orthopaedic surgeon so that she could determine why she was so skinny." Interesting...

Yew Shiong Shiong
er... orthopedic causes for cachexia? er... osteosarcoma? Paget's? Ehler's Danlos? some sort of syndrome?... crap, i'm stumped...
Chow Kar Meng
hmm... every1 has a dream, i guess such trivia issue would gain readership ? I can find more heart wreaking stories around net/blog than this.
Poongundran Pannerselvan
For god's sake. It's a twelve year old girl. Can you tell all these diseases when you are tweve years old of course not. So what's the great harm to have such an ambition. Now that she's gone just let her rest in peace no need to torment on her ambition
Poongundran Pannerselvan
And I'm sure this orthopaedics thingy was told by her parents and not her as she's no longer around. For a parent who have just lost their child even the most utter nonsense could mean a gem of an issue to them. So if you guys can't sympatise and show some empathy, the least that you can do is not to post crappy messages like this
Seriously, i think the one who is truly ridiculing the unfortunate girl is the one who contributes to that twisted statement. The best bet is on the journalist, to spice up the news piece.

As much as I sympathize (I couldn't empathize yet) all the victims, I also sympathized the ridiculous progress of this incident. I really couldn't believe it when I read about the news about YB Ngeh filing a motion in Parliament to cut RM 10 (YES!! RM 10) from the salary of Ministry of Education because of this incident.
  1. what does education have to do with this incident? the bridge is open for public,right?
    are you saying asking students to cross a bridge a potential dangerous activity?
    you expect the students to sit down, indulge in DOTA and call it a valid extra-curricular?
  2. the person who are evidently involved in the construction should be charged in court for murder, or at least manslaughter. There is no use shutting down the company, and let the individual start another company, and start killing people and cut another 10 bucks off some minister's pay.
  3. RM10. Wow! Like that's going to make a big difference - for a minister.
The fact that someone need to grow up to be not just any doctor, but to be an orthopaedic surgeon to determine why she is skinny, perhaps does tell us how pathetic the state of healthcare now.

Why can't she go to see a doctor and find the solution to her being skinny or underweight immediately, and not wait till she all grown up?
Or was her family being marginalized in the past when seeking treatment and health advice for being skinny?

Speaking of healthcare, I read in awe of the pekeliling on 1malaysia clinic.


Some of the contents I brought up here just to state my personal opinion.
If I am wrong (yes, bumi mana yang tidak ditimpa hujan), do correct me. Thank you.
Dengan wujudnya perkhidmatan ini ianya dijangka dapat membantu
mengurangkan beban pesakit di klinik kesihatan di kawasan Bandar sedia ada .
Dalam hal ini akses masyarakat untuk mendapatkan rawatan ringan
terutamanya di kawasan bandar dapat ditingkatkan
The city or the suburban areas is crowded with hospital and clinics with abundance of health care facility, while the kampongs and rural places were less equipped, most defaulted follow up because they couldn't rake up enough money to pay the taxi man to take them from their house to the hospital near the 'kawasan Bandar'. Tragically, some even succumb to their death on the journey to the 'kawasan Bandar'. I do not have valid solid stats, but I think my colleagues at Sabah or Sarawak have lots of those tragic tales of real citizen of 1malaysia dying or suffering because that bloody1hospital/clinic is so bloody far1. Or maybe, they had stopped telling those tales, because it had became a norm and nobody listened to them anyway.
1malaysia (tetapi tidak termasuk kawasan kampung dan pedalaman)?
Secara amnya skop yang dicadangkan adalah skop perkhidmatan yang boleh
dikendalikan oleh Penolong Pegawai Perubatan dan Jururawat Terlatih. Ianya
• Perkhidmatan rawatan ringan
• Susulan kes penyakit kronik
• Melakukan prosedur rawatan ringan
• Membuat notifikasi bagi penyakit berjangkit
• Menstabilkan pesakit sebelum dirujuk ke hospital berdekatan bagi kes kecemasan
• Perkhidmatan makmal menggunakan point of care test
• Pendispesan ubat
• Khidmat nasihat / promosi kesihatan kepada pesakit
The public don't even trust the some doctors nowadays, would you expect them to seek treatment to a clinic manned by Medical Assistants and Nurses?
Besides, if they can't dispense MCs, majority won't be interested, anyway.
If they can dispense MC, I think it would be an instant hit, no matter how unethical it would be.
Chronic illnesses have a higher risk of complications to arise.
Are the MAs and nurses well-equipped with the knowledge to detect those complications, when even the typical average-hardworking doctor may miss them?
To dispense medication? Any pharmacist commenting on this?
Kes yang diluar bidang Penolong Pegawai Perubatan akan dirujuk ke klinik
kesihatan atau hospital berdekatan dimana perkhidmatan disediakan oleh
Pegawai Perubatan. Bagi rawatan kecemasan, perkhidmatan yang disediakan
ialah menstabilkan pesakit sebelum dirujuk ke hospital berdekatan
Failure to recognize impending calamity, this flow of medical referral might probably cause delay in commencing early treatment to reduce morbidity or mortality. Putting a 'safety net' clause of a doctor is somewhere readily available ain't that convincing.
Kerajaan telah meluluskan peruntukan sebanyak RM 10 juta untuk operasi 50
klinik di seluruh negara setahun.
That's RM 0.2 million of taxpayer's money per clinic, probably wasted. Although, nurses are already in shortage in hospital, even there were rumours about taking in foreign nurses, and now, a good number of them had to be sent out to this clinic.

V. Divyashree, you had passed away, trying to enlighten us all the sorry state of civil engineering and healthcare in our country.

I hope someone is listening.
I hope everyone is listening.
I hope you rest in peace.

Summer Love

Nov 18, 2009

anatomy of modern woman

Anatomy Model Woman

Whatever you give a woman, she will make greater.

If you give her sperm, she’ll give you a baby.

If you give her a house, she’ll give you a home.

If you give her groceries, she’ll give you a meal.

If you give her a smile, she’ll give you her heart.

She multiplies and enlarges what is given to her.

So, if you give her any crap, be ready to receive a tonnes of shit.

Nov 17, 2009

no pants for women

grateful to: Dr. Haliza and Dr. Jackie for being the main pillars behind my study which got me into 1st place in state clinical audit, beating O&G specialist from Kulim to a close second. Nevertheless, I wasn't happy that they only gave each of us 7 mins to present (verbal diarrhoe all the way), and they serve lousy lunch (probably because no budget at the end of year).

They (whoever it is) said that good luck and bad luck came in a cycle. I just didn't realize that cycle was so fast as in few hours. After clinching the title, I had to travel on the hospital transport back to my hospy. The air-conditioner broke down, and the hot weather outside was simply toasting me while creating a mini mobile sauna for everyone in it. Yes, looking at the bright side, probably I could lose some weight by the time I got to my hospy. On the contrary, I developed rashes and bloody itchy ones all over my arms and thighs.

Worst of all, I had to give my opportunity to do procedures in elective OT today a miss because surgery and rashes isn't the coolest combination. Ever.

And yes, just being plain grumpy and all, I decided to give out sexist statement like the title of this entry, hoping that every ladies who read it will prematurely go up in flame in anger and rage, probably the uninhibited ones may just express a few pleasant vulgar words silently in their heart.

No, seriously, as we stretched out our index fingers and blamed the islamic political party of being ultra-conservative, probably we should read up about what was happening in France.

Women banned from wearing trousers in Paris

A decree banning women from wearing trousers in Paris is still technically in force, it emerged on Monday, making the laissez-faire French capital theoretically stricter than hardline Sudan in the fashion stakes.

And there you have it, no pants for women, if you're in Paris. But of course, the argument is pretty alive, do click on the link if you're interested.

Talking about women in pants. I think they pretty much dominate it all. Women can wear pants in the normal everyday life, but men can't wear dresses or skirts, without appearing like, you know what.

After school days, my sister has always been wearing pants, and the only time to see her wear a dress would probably have to wait till she had to wear a wedding dress, or probably have the opportunity to travel to Paris. Unless of course, the society of today will accept such a thing as wedding trousers. I guess some girls just ain't that comfy with dresses or skirts. If not mistaken, my dearest's nephew also have this fashion preference.

I remembered back in my medical school years, there is actually a lecturer, I couldn't remember who. A guy, of course. He commented that all female medical students must wear long dress to respect the fraternity. Must, as in compulsory. All my coursemates, especially the ladies, listened ever so carefully, and opened their eyes widely looking at one another, probably thinking "What the heck?!?!" or at the extreme "WTF".

I wonder whether if he's still there giving this decree to my juniors.

What's my take on it?

I think everyone has a freedom to wear what they wanted to wear (or not wear), just be decent and appropriate. Don't cause road traffic accidents, showing less than 40% is probably acceptable. How you calculate that, don't ask me.

P.S. Never thought I would blog about fashion. All the itchy rashes probably trashing my testosterone, and raking up my estrogen.

Nov 16, 2009

Learning curve


No. Not yet.

Being the working parents, me and my dearest have to thank our lucky star that we are blessed with a babysitter that came to our house to take care of my little Aedan during office hours. A rare gem, indeed.

But, in the early hours of the day, the babysitter also has another job as the cook for the nursery down the road. Therefore, little Aedan has to be sent to the nursery, mixing with the little crowd.

Thanks to the learning vids of ‘Baby Einstein’, ‘Barney’ and the ‘Ai yo yo teacher’, Aedan is learning slightly ahead his age. All of sudden, he became a role model to all the little ones of nursery. Peer pressure, indeed.

The teachers frequently quote: Aedan also knows, why you all don’t know.

Somehow, I think what the teacher did, although seems motivating (or pressuring), is rather inappropriate as children should be left to learn comfortably in their own learning curve.

Aedan seems ‘smarter’ because he had familiarized himself with some of the ABCs, or the Sunday-to-Saturdays, because he watched those vids over and over and over and over and over again during his meal.

He wouldn’t eat if nothing is on the idiot box.

At this point, perhaps calling the telly idiot box doesn’t sound so appropriate.

Somehow, I really hope those educational shows help Aedan’s digestion, as after hundreds of repeats, somehow or rather they have the differing effect to my appetite and gastric emptying.

By now, Aedan already loves schooling. Not really the actual schooling without any real homework, nevertheless it is a good start though. And what truly matters is the nursery lacks in the ground work of discipline and morality.

As in Buddhism, the foundation is always with sila (disciplined morality), follow by samadhi (concentration) and finally with panna (wisdom).

With discipline, comes knowledge. But with knowledge, discipline must not be compromised.

It is in the laziness that will lead to lack of self belief, resulting in living a life not our own.

Nov 13, 2009

X-ray for...

Real life MCQ:

X-ray is used to detect abnormalities in:
A. Humerus
B. Chocolate
C. Skull
D. Spine
E. Candy

This a difficult one.

It is either B or E.

Maybe I am not in a good position to give any question about X-ray, because in my line of work, X-ray is the least used investigation. X-ray viewing box in the wards and admission center became notice board, and even after delivery, mother with high spiking fever, already taken every possible body fluid for culture, the simple roentgen ray for the lung to rule out chest infection in this H1N1 era crossed our minds only at the later part of the day.

It is either B or E. Is it?

The right answer is none of the above.

The image “” cannot be displayed, because it contains errors.

Perhaps, we do not have any trick or treating in Malaysia, but recently my Aedan received a fair amount of candies from the Nine Emperor Festival parade (Kau Ong Eah), I was skeptical regarding the fact of receiving candies from stranger.

And I found an interesting article and I decided to pimp it below. We never know when the danger will find our shore.

Is trick-or-treating dangerous? by Laura Fitzpatrick.
Halloween strikes fear into parents' hearts for reasons that have nothing to do with scary costumes. Hospitals have been offering to X-ray candy for decades, and this year a forensic lab in DuPage County, outside Chicago, will inspect suspicious sweets using technology that's usually reserved for homicide, sexual assault and burglary. Health officials are warning against letting kids scoop up candy with their germy hands, lest they spread H1N1 flu to other revelers. In Bobtown, Pa., spooked officials have banned trick-or-treating altogether. But is trick-or-treating really dangerous?

The most persistent Halloween bogeyman is tainted candy from strangers. The parental panic may stem from around 1964, when a woman handed out dog biscuits, steel-wool pads and ant poison (clearly marked with a skull-and-crossbones logo) to teenagers she deemed too old to be trick-or-treating. The horror story refuses to die down. "In recent years, there have been reports of people with twisted minds putting razor blades and poison in taffy apples and Halloween candy," Ann Landers wrote in 1995.

But were the reports true? For all the anecdotal evidence, the notion that psychotic strangers pose a danger to children has been repeatedly debunked. Only two children are known to have been killed by poisoned Halloween loot. In both cases, the perpetrators were family members who tried to exploit the trick-or-treating urban legend to throw police off their trail. Plenty of parents call poison centers to report concerns related to Halloween, says Gail Banach, director of education at the Upstate New York Poison Center in Syracuse, but overall complaints don't spike. And other experts agree that the concern is overblown. In 1985, Joel Best, a professor of sociology and criminal justice at the University of Delaware, studied media reports going back to 1958 and found no evidence "that any child has ever been killed or seriously harmed by a contaminated treat picked up in the course of trick-or-treating." Most of the 100 or so cases of alleged poisoning over the past 50 years, he adds, were probably hoaxes. "You can't prove a negative. You can't prove that it's never, ever happened," Best says. "[But] if it was happening, it would make the news."

So is there any likely candy-borne danger? Well, yes: eating your way to a bellyache. Dr. Tony Woodward, chief of emergency medicine at Seattle Children's Hospital, expects to see a few of those cases in any given year. "When they have a ton of candy in front of them, they're going to eat it," he says. Experts recommend filling kids up with snacks or dinner before sending them out so they'll be less tempted to nosh on sweets.

But even though candy doesn't pose much of a threat, trick-or-treating does carry safety hazards. According to the American College of Emergency Physicians, common Halloween injuries include eye wounds from sharp objects and burns from flammable costumes. The Poison Center's Banach notes that kids can have allergic reactions to face paint or makeup. "We always recommend that if you're using that kind of product, you test it out on a patch of skin before you put it all over your child to be the Incredible Hulk," she says.

But the biggest Halloween danger of all is car accidents. Children are more than twice as likely to be killed by a car while walking on Halloween night than at any other time of the year, according to a study by Safe Kids USA. Such tragedies are often preventable. Parents can make sure that costumes aren't too long, shoes don't make a child prone to tripping and masks don't restrict their vision. And parents of young children should accompany them on the walk around the neighborhood to keep them safe. "A lot of kids don't know the right way to cross the street because they're not walking anywhere on a regular basis," says Nichole Hodges, home safety coordinator for the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. "This may be a good time to provide that education as parents."

Ultimately, getting a child's candy X-rayed can't hurt — as long as parents aren't too preoccupied with overblown threats to watch out for real ones. "We do want to check the candy," says Hodges. "At the same time, we have to focus our energies on how kids are actually getting hurt."

Nov 8, 2009

Geminids | Penang


Early christmas gift for your loved ones.

A post wedding romantic moments.

Just takes time to sit down, relax and embrace the wonderful dynamic art of universe...

There will be meteor shower Geminids in Penang.

If you're from KL, this year Stargazer Scientific is organising a 2 days 1 night outing (11 – 12 Dec) to watch the Geminids at Penang National Park. Visit Stargazer site for more info.

If you're from Penang and another group will be having Geminids Shower observation on 13th Dec 2004, begin from 8pm onwards, at Pulau Betong, Balik Pulau (location between masjid and police station). Interested ones - please contact Mr Lim from Perseid Telescope. 04 6495250

If you're simply not a groupie, go to a dark (but safe), little lighting, vast landscape area, lay down a mattress, lie down comfortably and patiently wait for the meteor shower.

Make a wish when you see one. Wish for the best in 2010.

Of course, prior to that date, remember to pray for no clouds or rain.