sombre week

from last week, in the span of a week plus, 3 extremely young souls left this world early. very early.

Today, having to review the chains of events leading to this deplorable state, the same recurrent melodies of harsh reminders and solemn grief talk played to the air. To the people involved, without a doubt, those tunes will be drilled deep, not only into their cochlea, but also driven sharp into their heart, and probably changed their affection towards maternal care. As for the others, it probably sounded like the classical background music in the mall, where everyone wanders in the most carefree manner. Their minds wander although physically well seated in the gloomy room today.

Something that I admire about my former head was his ability to form a policy that counter every crisis that popped out. Some would probably laugh it off as a knee jerk reaction, but i think the little thing that he did made the whole world of difference.

In the midst of the meeting, the electricity went out not once, but twice. Almost as if the demised ones were with us in the room, forbidding us to go on further the story-telling of the series of unfortunate events.

Two repairmen came and stood all proud and experienced, looking in from the opened door. Obviously, we're all fanning ourselves in that stuffy, semi-dark room, lest for the escaped sunshine from the evening sun seeping in.

And the elder one asked, "Tak de elektrik ke?"
I whispered aloud, bordering on rudeness and sarcasm, "You nampak ade elektrik ke?"

And they got back to work, getting the electricity back, only to have the black out back after 20mins after they left.

A lot of things are pretty obvious and do not really require any further elaboration.

Just yesterday, I managed to just asked them about diagnostic level for the modified glucose tolerance test to rule out gestational diabetes mellitus, and four out of four, all post-tagging, already almost 2 months in our department, couldn't tell me the right level. Something is terribly wrong not to know the most basic knowledge about the most common medical disorder in pregnancy. One even had the balls to show me the "reference range" stated in the result slip, refuting my claim of the level given by me.

A few weeks ago, it was worse. I was told that her detailed history revealed the patient had no menstrual problem at all, but somehow I had a sixth sense to reconfirm by asking the patient again. True enough, she was having heavy menses flow, and also passing out good size clots. When she heard the patient saying clots, she had the balls to repeatedly raised her tone to the patient - "Clots? Really got clots?" This already gone beyond the failure to recognize problems to falsifying or toning down the patient's problem.

Like I said, a lot of things are pretty obvious and do not REALLY require further elaboration.

To highlight where they get their balls from, would be an overstatement at this point of my career.

I kept my fingers crossed, hoping something must be ironed out, at some point of time.

P.S.
I knew all along who had been reading my rantings.
It's in the fine gestures and body language.
Those fine details never fail to fascinate me.

the best disappearance award goes to...

(drumrolling...)... Dr. Mohd Noor Azam Mohd Nazri...

A TRAINEE doctor in Alor Setar went missing on two occasions after being tapped on the forehead by a mysterious young woman clad in a red tudung, reported Kosmo!

Mohd Noor Azam Mohd Nazri, 26, had gone missing for the third time and his mother Natrah Shaari believed that the same woman was behind it.

Natrah, 52, said her son first went missing on May 3 after the red tudung-clad woman tapped him on his forehead inside a lift in Sultanah Bahiyah Hospital at 6.30am.

“My son found himself at the Sungai Petani City Square shopping complex two days later and found that his mobile telephone and RM500 were missing,'' Natrah was quoted as saying.

Natrah said her son told her that the same woman approached him on May 12 as he was walking to the hospital car park, and he found himself at the Kuala Kedah jetty two days later.

Natrah said her son lost his watch and RM300.

She said her son went missing again on May 16 and had yet to return home.

Either this is the sci fi local version of the 'Jumper' or he's finding excuses to go lepak in Sungai Petani or Langkawi and got conned by his girlfriend of the watch, handphone and RM800.

I'm guessing he's now probably in Penang.

dogs - men's best friend... and weapon!

a great article about canine superiority and that special bond with human in the most vicious and violent background of war and battle...

' geroniwooooooooff....'


that flying dog...

from an accessory to being heavily accessorized

the obedient training of 'controlled aggresiveness'

vapor-wake dog

little piggy modelling portfolio

Alright, finally, after a few thousands photos taken and my money well had run dry, I guess it is time to put my photogenic son up for sale modelling work offer. I did some modelling when I was little as well, I guess partially having my gene, things shouldn't be thAT difficult.

Here's his portfolio of uncensored, unprocessed images taken by amateur photographers with the semi pro camera.

natural sly laugh at the close up


cool, 'come challenge me' look


the 'oh my god, u saw me!' look


see no evil...


taste no evil...


smell no evil...


the 'twilight saga' look


naturally... natural...


down angle shot

Finally, on cloud nine, after session completed

Model: Aedan
Manager: Mrs Pilo
Age: 4 years old and 1 day (At the day of the session - 27 April 2011)
Place: Garden outside First World Hotel, Genting Highlands
Camera: Canon G10
Photographer: Pilo & Mrs. Pilo
Style coordinator: Mrs Pilo
Pose coordinator: Pilo

Attire:
Green and Jeans Jacket, sponsored by Aunt TKM
Jeans long trousers & 'Nike' shoe, sponsored by Mrs Pilo
Undergarments - not applicable

Those who are seriously considering hiring him for any modelling, please leave a comment.
Details can be discussed later.
Please book early to avoid disappointment.

ini hebat punyer hobi

spot diagnosis: precocious puberty...

the real big spender

Just when u thought that orang putehs are the big spender, well, in the event of wedding, the big spender award went to Indians. Hands down.

Check out the top 10 most expensive wedding list compiled by Natalie Jaro

For these folks, if their wedding day(s) weren’t the happiest days of their lives, then something is seriously wrong. If you thought your wedding was astronomical, try these top ten of the most extravagant weddings to date ranging from $2 million to $78 million dollars where broadcasting your wedding vows to the world is as important as showing the lining of your wallet.

10. Tom Cruise and Katie Holmes ($2 million)

They’re still together, almost 6 years later, Tom Cruise and Katie Holmes and they come in at number 10 on the top ten list of grandest weddings of all time. After Tom proposed to Katie on the top of the Eiffel Tower, 19 months before the wedding date, they were married in Italy at the 15^th century castle, Odescalchi Castle in Rome on November 18^th, 2006. Giorgio Armani designed all the apparel for the bridal party and Andrea Boccelli gave a musical performance. The wedding was attended by 150 guests. The couple honeymooned in Maldives following the elaborate wedding event.

9. Paul McCartney and Heather Mills ($3 million)

Fireworks, grand feasting and dancers dressed in Indian costume performed for Paul McCartney and Heather Mill’s wedding in 2001. The $3 million dollar wedding ceremony took place in County, Monaghan, Ireland. The ceremony was held in St. Salvador’s Church and the reception took place at Castle Leslie with 300 guests. Heather Mills wore a dress she herself fashioned and carried roses named after her husband. Following their affair they honeymooned at a private island in Seychelles. They spent their first evening on a $20 million yacht for $19,000 a night.

8. Liza Minnelli and David Gest ($3.5 million)

Held at the Manhattan’s Collegiate Church in 2002, with a sum total of 850 wedding guests, the wedding was a monumental event with guests including Natalie Cole singing “Unforgettable”, a 60-piece orchestra also kept the guests entertained along with Tony Bennett. The wedding included a $40,000 6-foot, 12-tier cake, a staff of 500 and a bill of over $700,000 in flowers.

7. Elizabeth Hurley & Arun Nayar ($7 million)

Wed on June 29, 2006, Elizabeth Hurley and Arun Nayar, an Indian businessman married in a 15^th century castle in Sudeley Castle in Gloucestershire in Britain. The festivities lasted for 8 days across the 2 continents of Europe and Asia. The proceedings began at Sudeley and then the wedding party traveled to Umaid Bhawan Palace in Jodhpur, India. The palace suite cost $10,000 a night.

6. Delphine Arnault and Alessandro Vallarino Gancia ($7 million)

Who said a bride isn’t worth it, especially when she’s the daughter of the wealthy French businessman, Bernard Arnault? A father coined the ‘pope of fashion’ in France too means of course, a fancy dress, in fact, one so fancy that it was fashioned by the famous designer, John Galliano. It certainly was a price you’d not find on the racks at David’s Bridal either. Add to a wealthy bride a wealthy groom with a family with a wine dynasty business and you’ve got a splendid party, with of course, plenty of fine wines. They couple wed in 2005 at the Cote d’ Azur in France. The venue was decorated with 5,000 white roses. Harper’s Bazaar called it the “Wedding of the Year”.

5. Wayne Rooney & Coleen McLoughlin ($15 million)

Okay if that previous wedding bill wasn’t enough to impress you, try doubling that with a few little extras and you’ve got the wedding of Wayne Rooney and Coleen McLaughlin at $15 million. Colleen McLoughlin, a television presenter/product endorser plus a Manchester United/England football star resulted not only in an expensive wedding but an interesting one at that. The 4 day wedding ceremony took place in Villa Durazzo in Portofino Italy on June 12, 2008. With stunning views of the Italian Rivera on a yacht with 64 guests flown in on five different private jets, the ambiance was beautiful. After spending almost $4 million dollars on a dress designed by Georgia Chapman’s Marchesa label, guests had to wonder if the budget had run out after being served pizza for the reception. In the end, they were able to cut costs of $5 million by allowing Britain’s OK! Magazine to publish exclusive information and pictures about the event, that is, after the pizza was served.

4. Vikram Chatwal and Priva Sachdey ($20 million)

Let’s make it an even 20 after 15, that is, $20 mil, and then everything will be up to par for the wedding of Vikram Chatwal, son of a New York hotel magnet and a jet-setting hotelier and actor and for his model/actress/investment banker bride, Priya Sachdey (who ever said a man couldn’t have it all). The wedding took place on February 18^th, 2006 and is known as one of the most luxurious weddings ever in all of India. Bill Clinton was on the guest list along with many other well-known, high-powered people. The wedding took place over 10 days and was spread across 3 cities in India (Mumbai, Udaipur, and Delhi). There were 600 guests from 26 countries who were all retrieved for the event on chartered jets.

3. Miss Yugoslavia Aleksandra Kokotovic and Andrey Melnichenko ($30 million)

Topping a $20 million dollar wedding isn’t easy but for Miss Yugoslavia Aleksandra Kokotovic and Andrey Melnichenko, it wasn’t hard with a $30 million dollar extravaganza that made history in world famous weddings. Andrey Melnichenko, the Russian billionaire and founder of MDM Bank and the Serbian model, Miss Yugoslavia Aleksandra Kokotovic married in Cote D’ Azur, France on September 3^rd, 2005. There were performances by Christina Aguilera and Whitney Houston for a full house of guests of the rich and famous. The singers alone cost $3.6 million each to perform.

2. Sheikh Mohammed bin Rashid Al Maktoum and Princess Salama ($44.5 million)

The Arabs really know how to have a wedding party and especially the ruler of Dubai who married Princess Salama in 1981. The wedding earned a place in the Forbes list of “Billionaire Weddings”. A stadium was built just for the occasion to entertain 20,000 guests for 7 days of luxury.

1. Vanisha Mittal & Amit Bhatia ($78 million)

The Indians, however, outshined the Arabs on November 18^th, 2004 when Vanisha Mittal & Amit Bhatia wed in what is recorded as the most expensive wedding in history. 1,000 guests from around the world attended after each had received a 20-page silver card to the event which included all the lavish details the entire venue that lasted for 5 days. The party took place at the finest chateau and garden in France, the 17^th century, Vaux le Vicomte. The bride, Vanisha Mittal, daughter to the steel tycoon Lakshmi Mittal and Amit Bhatia, the investment banker wed in sheer riches. A performance by Kylie Minogue the pop singer was the high-lighted attraction to the event. 100 different dishes were prepared by a top Calcutta Chef and the wine cost $1.5 million. The costs of everything else we’ll leave to your imagination!

Weddings are a happy time for all, especially for the guests who were able to attend the top ten most expensive weddings in history. Of these wedding events, the real two questions are who is still together and who will be next to top the list?

the contemporary Dāna

Happy Visakha to all Buddhists all around the world!

The Malay word Dana which meant a fund, takes its form from the Pali/Sanskrit word of Dāna, which grossly bring about the meaning of generosity.

Dāna, is one of the perfection that Buddhism encouraged. Yet, through this virtuous practice, it became a prime target of many parties who go all out to take advantage of this generosity to accumulate their own wealth.

If you'd watch the famous local production movie 'WooHoo', you'll remember a vivid scene when a guy masquerading a multiple characters to con the Char Koay Teow hawker to donate as much as money for him, quoting multiple charity bodies, from the school board to the temple. If you haven't watch it, one should go look it up. Although, the impersonation may seems like complete jokes, but the massive increase in these so-called charity bodies, all well-equipped with letters from police, letters from doctors, photos of the unfortunates, the premises, and etc, is really something real. Happening, right here, right now.

Just for the information of people condemning or condoning the practice of monks in begging for money, well,

in Theravada Buddhism, monks (Pāli: bhikkhus) and nuns go on a daily almsround (or pindacara) to collect food. This is often perceived as giving the laypeople the opportunity to make merit (Pāli: puñña). Money should not be accepted by a Buddhist monk or nun, although nowadays not many monks and nuns keep to this rule (the exception being the monks and nuns of the Thai Forest Tradition and other Theravada traditions which focus on vinaya and meditation practice).

Whether or not contemporary modification of the practice of almsround is justifiable, I guess it is up to the situation or the circumstances that force such changes.

A story about the novice monk and the master monk at the river came to my mind. I guess lots should have heard about this story by now. In short, a girl was at the river bank with them. To make sure the girl safely crossed the river, and not being swept by the rapid undercurrent of the river, the master monk carried that girl on his back to the other side.

The novice monk was pretty disturbed after that and the next day, he asked the Master monk "Are we, monks, not supposed to be close or touch women? How can master carry that girl?" "I already let go off her at the other side of riverbanks, why are you still 'carrying' her?"

Changes in contemporary Dāna is not a must, but it is just the nature of things. Everything changes, well encapsulated in the words of Dhamma as sabbe sankhara annicatti (All things are subject to changes)

I believe we should move on from charity to philanthropy.

Here's top finance-blogger Dali's take on Charity vs Philanthropy (full article here)

Charity and philantropy are not just money, but time and planning.

Much of the contributions to disasters such as the Asian tsunamis and Katrina in US is Charity. Charity is a gift made without any expectations beyond the immediate alteration of a need (giving to a beggar).

Philanthropy takes a more strategic approach as it addresses social challenges such as poverty and inequality, education, health, environmental degradation.

Therefore the need to advance and strengthen philanthropy for social investment and social justice is urgently needed for the following reasons:

• Decline in volunteerism and giving
  
• Reduced role of the state as a provider of social services
• Diminishing resources for civil society
• Growing disparities in society
• Severe environmental degradation
• Poor mobilizisation of indigenous philanthropy

Worldwide philanthropic models are undergoing sea of change. Company portfolio’s now include social investments and social audits. Consumers are purchasing products from companies that practice ethics and corporate citizenship. Contemporary philanthropy is increasingly organisational in nature.

Global challenges as well as factors like education, economic success are transforming the field of philanthropy. Donors too are concerned about making the world a safer place. Philanthropy is sharing of private wealth through vertical (Corporate) and horizontal (community giving). Strategic Philanthropy is to integrate vertical and horizontal forms of philanthropic giving.

To end, when we find ourselves trying to second guess the real intentions of a philantropist, revert the question to yourself. To the philantropists, it would be encouraged that all go through more self introspection when it comes to altruism - its just your soul, really.

Even if we're not loaded with bucks, we can put in our time and planning.

We need to realize our role to advance and strengthen philanthropy for social investment and social justice to minimize the growing differences in society, the lack of resources for civil society, the environmental decline and the declining role of state in providing social services.

Happy Wesak to all

a galacti ae?

Part of my clinical interest is dissection. Not just body dissection. Also literate dissection, which simply means I dissect out the phrase that people like to use as whole and look deeply into every words. I do that only for academic purpose, otherwise purely for the entertainment during stressful times in clinic.

For the last 2 weeks, in the absence of the medical officer in-charge of the clinic, I had to struggle through lunch hours, finishing the clinic barely few minutes to 2pm. And some people think doctors made them wait for few hours just because we're hiding in the room blasting off the Elvis Zombies with the Machine Gun Plants, in between patients. Of course, many left around 1pm when they see there are no more patient's folder in the tray, while a few continue to see the patient they still holding up in the rooms. And on top of that, after finishing clinics, I gotta rushed back to my ward to see to it that everything got carried out before I'm stuck in meeting/pm clinic/some departmental formal gathering which usually started around 230pm. I guess my main bulk of nutrient came from swallowing my own saliva and the residual breakfast that I had stuck between my lower molars, assuming those amylase haven't knock them out yet by then. Thank God my parotids are working well.

It is relatively not uncommon for house officers to turn to me, holding on to a patient’s folder, semi-clerked and semi-examined, eager to discuss the patient with me, asking the most simple yet (fill in vulgarity here, please) question - “Errr, Dr. Pilo, are you available?”

This may sound like a question, but it is anything but. It is a cry for help as much as a cry for lunch.

My reply would be - “No, I am already married.”

Someone echoed this answer on my behalf today. I am truly surprised. Possibly, my dark twisted annoying purposeful misinterpretation had finally found a fan.

I am more surprised to see another patient in the ward which I had committed to having Group B Streptococcus (GBS) had been re-labeled as GBS negative but Streptococcus agalactiae positive.

GBS is important in obstetrics mainly because adequate antibiotics coverage should be given, usually in the event of prolonged membrane rupture, mainly to prevent neonatal streptococcal pneumonia which is associated with grave outcome. If my memory doesn't fail me, one in four will die if not properly treated.

Just for the sake of academic dissection, GBS is actually the Group B groupings of streptococcus microbes.

Streptococcus is

a genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes[2] and the lactic acid bacteria group. Cellular division occurs along a single axis in these bacteria, and thus they grow in chains or pairs, hence the name — from Greek στρεπτος streptos, meaning easily bent or twisted, like a chain (twisted chain).

... for people who can't handle heavy reading - it's a bacterial that grows like a chain.

Before streptococcus being grouped by Lancefield, they are being grouped by their hemolysis (breaking down of blood) potential.

alpha, ironically, unlike alpha dogs, only breakdown partially.
beta breaking down completely and
gamma is a no-action, lame to blood.

Then, the beta-hemolytics are subgrouped by Lancefield based on specific carbohydrates in the bacterial cell wall.

· Group A - Streptococcus pyogenes

· Group B - Streptococcus agalactiae

· Group C - Streptococcus equisimilis, Streptococcus equi, Streptococcus zooepidemicus, Streptococcus dysgalactiae

· Group D - Enterococci, Streptococcus bovis

· Group E - Streptococcus milleri and mutans

· Group F - Streptococcus anginosus

· Group G - Streptococcus canis

· Group H - Streptococcus sanguis

· Group L - Streptococcus dysgalactiae

· Group N - Lactococcus lactis

· Group R&S - Streptococcus suis

· other Streptococcus species are classified as non-Lancefield Streptococci

Just if one is wondering, who is smart fella by the name of Lancefield, well, her full name is Rebecca Craighill Lancefield (January 5, 1895 – March 3, 1981) was a prominent American microbiologist. Yes, the smart ones are usually the females. Life aint fair, right?

As a conclusion, yes, streptococcus agalactiae IS group B streptococcus. Possibly, the microbiologist who wrote the report trying to test or prank us, since the conventional results usually comes in clear 'Group B Streptococcus' tag. That person probably is a she, i think.

Well, as you can see basic science can be rather interesting to indulge in, especially if you're NOT sitting for an examination on them.

Or else, life would be a bitch.

Glad that's all history behind me now.

Phew!

misunderstanding

credit: caldwell tanner

misunderstanding can be really a pain in the ass sometimes most of the times.

lighter moments

a lighter moment during ward round in a maternity ward with the long row of beds with preggies

27/M/G1P0 @ 37w2D

a house officer presented...

"this is a twenty seven years old male G one P zero at .... oops... "

and few weeks later,

"what's the weight of the baby by scan?"

a different house officer post tagging...

"it's three thousand four hundred and thirty three grams."

"oh, so how heavy is that in milligrams?"

"Err.... hmm... "

In another wards, same day...

"So is the throat swab taken for H1N1?"

Chorus of house officers... "Yes!"

"So what's H1N1? What virus is it?"

HO1: Err... H1N1 virus..
HO2: (silent)
HO3: flu virus (after overheard preliminary whispers of HO4)
HO4: influenza virus

"So, what's H? What's N?"

HO1-4:(blank stare, as if H1N1 is a fresh virus hitting our shores)

Conclusion: A small prospective study on the knowledge of house officers on the knowledge on Influenza A virus of H1N1 subtype can safely conclude that only a minority (25%) knows that it is an Influenza virus and everyone (100%) do not really give a damn what the f does H or N stands for.

hydrotherapy - can't live without it

somebody wondered.

why being in the department at the brink of collapse,
with the shocking scarcity of registrars,
with the possibility of doing 10 on calls per month from June onwards
with all the swarming demands to run workshop, course
with the daily clinics running into 1 to 2pm, sparing only a quarter of an hour for lunch

why knowing after all the stress and labor of exam,
and knowing risk of failing it being similar to the rising rate of C-Sections

i still can keep that broad smile and lovely sunshine in my heart

that is because with my family and kids, all my venom and bitterness simply melts away

LOOK!! the latest design in swimwear - AEROPLANE SWIMMING TRUNK

Bad pilot or excellent homicidalTaliban?


Guess what, you're in water!


Sporting the 'eyeware as hairband' style

flights of water... before take off


on route... to the other side

sharing some emo moments...


she ain't heavy... she's my overweight, chubby, cute moi ang

Hair (hell) - raising incident

3 minutes of videos showing few students bullying a fellow student by cutting and pulling her hair created a turbulence in the cyberworld.

the pathetic move for the mainstream media to censor the culprits' faces is just a pathetic.
the ministry's move to suspend the culprits by 2 weeks also created the subsequent wave of turbulence.

the bigger joke was for him to stress the importance of enforcing mobile phone bans in curbing such a problem in the future.

honestly, I believe the society had run wild with its own failed logic and common sense.

conversely, i felt suspending the four bullies for 2 weeks is definitely way too long for them. It only continue to deprive them more of the necessary disciplinary action, counselling or education that they were being deprived of all this while.

the person who should be suspended is the people behind our current school system or our education system that allows such decline of discipline to continue to slide. Matter as grave as this don't happen in a blink of an eye.

This expose, in its own ugliest ways, had succeeded where no other could have achieved in a decade in slowing or perhaps deterring the culture of bullying in school, thanks to the rowdy crowd of facebookie, and indirectly the mobile phone and youtube together with the few star actresses of short video clip.

i fully agree that education ministry should not play judge, but the very least, they should recognize this problem is real, and come up with a proper game plan after a proper detailed investigaton. I am sure the public is eager to hear about it, not just the knee-jerk reminder on the handphone ban, like someone sweeping dirt under the carpet. Face it. You don't see it, doesn't mean it is not there.

Looking upon our own medical fraternity with the overproduction of house officers leading to reduced clinical exposure, it is just a matter of time, when we have our own hair-raising revolution.

Only time will tell.

playing pebbles?

or source of indulgence?

the world's story by what its inhabitants consume and indulge in.