Gurun to Guar Chempedak

Here were some more pictures I had taken as I travelled up north to meet my friend during Raya.

Gurun main town.

Gurun market.

Guar Chempedak.

Guar Chempedak-Yan junction.

Gurun

Stopped by the roadside to buy sweet corns near foothill of Gunung Jerai.

Taiwanese sweet corns, 10 for RM9.00

SP Revisited

Here are few landmarks I recorded during my recent trip to SP.

The Store in town centre, where I frequented often in the past.

This one, probably the busiest road in town, regarded as "the aorta" of SP town. Lots of GP clinics (I once locumed) are located here. The police station, the railway station, hawker centre "wai sek kai", all within walking distance.

SP plaza, also housed the municipal offices.

One of the frequented shopping complexes in the past, was burnt down, now renovated it seemed, but still not opened for bussiness.

The new happenings in town, Lagenda Heights, a fast developing commercial centre in town. Tesco is there, everything you name it, found there.

You're Still You

Vegetarian Fair

Vegetarian Stores at Taman Free School

Very long queue over this store.

Famous Vegetarian Curry Mee
Price: RM 2.50 (Small)

Nine Emperor Gods fest begins
Devotees flock to vegetarian stores
Temple's holy ash highly sought after

A Love Before Time

Sperm Bank

Went to the bank today.
I used to work here before.

To donate sperm. No lah.

Well, to donate blood actually.

Got incentives for blood donor.

First, I was required to fill in a consent form and declared that I should not donate blood if Iam a bisexual, homosexual, or has history of indulging in high risk behaviours.

I felt a bit guilty, because I had history of high risk exposure. I 'mingle' with HIV patients and I had history of 'sharing' needle', albeit, accidental needle prick injury. But then, I am pretty sure I am 100% negative.

The technician used a Triple bag to collect my blood. No, they don't collect three pints of blood. The whole blood collected here will be separated immediately into packed cells, fresh frozen plasma and platelet concentrate. Thus, this bag is more costly.

This bag is usually used if one thinks that the donor is 'clean'. Therefore, it is only used for regular donors who regularly had their blood screened. In those donors whose status are unknown, or doubtful, they will use a single bag.

Usually, the donor's blood is screened for VDRL, Anti-HIV, HBs Ag and Anti-HCV Ab. Those in Kelantan will have their blood additionally screened for BFMP.

Come to think of it, blood transfusion actually carries a significant high risk of transmissable disease, especially other infectious diseases not routinely screened.

Dreaming My dream

Just my Imagination

Spot Diagnosis

22 years old gentleman, presented with this skin lesion of two years.

Erythema nodosum.

Aphthous ulcer.

What is the diagnosis?

In addition, he has scrotal ulcer, thrombo-embolic phenomenon (pulmonary embolism), serositis (pericardial effusion) and positive pathergy test.

History taking

A 65 years old lady with no previous medical illness, was admitted from the casualty with complaint of fever of one week duration associated with cough, shortness of breath on mild exertion and bilateral lower limbs swelling. Clinically, she was breathless with signs of heart failure.

This first thing I did before proceeding further was to look at her CXR. There was cardiomegaly with mild pulmonary congestion. In addition, there seemed to be some ?"cannon-ball" lesions/?consolidation. I looked at her blood counts (done earlier), Hb 7.0, TWBC 21, Plt 225. Renal profile was normal.

I then proceeded to a full and "thorough" history taking to find out what was the cause of her anaemia and CCF.

Then, I did a complete physical examination, including per rectal examination. Her vital signs were normal, she was febrile and there were signs of heart failure. Her ECG was normal.

I then came to a diagnosis of CCF precipitated by bronchopneumonia and severe anaemia.

But, what was the cause of the anaemia?

In fact, I had missed out one very important part of the history taking. That was the gynaecology history!

The nurse in charge informed us she noted that the patient had PV bleed in her diaper. No doubt, we did a PS and VE and found that she had a cervical carcinoma.

Though she might be way beyond her menstruation age, we should not miss out on history of PV bleed.

The above CT scan, confirmed she had lung metastasis.

Yummy Cod Fish Rice Set

Steamed Cod Fish rice set at Kocha Taiwanese Restaurant
Price: RM 18.90

Summary on Prevention and Treatment of Glucocorticoid-induced Osteoporosis

Uptodate 2006

Anyone want a Puki?

Got this picture from PenangHokkienPodcast.
This is probably the funniest song I have ever listened.
I laughed like hell.

Mid-Autumn Festival

Mooncake/Tanglung festival tonight.

I was just about to leave the hospital after near midnight.

It was quite a hazy day, but managed to catch a glimpse of the full moon.

Celebrating alone.

PSD: Doctor who died eligible for ex-gratia

PUTRAJAYA (The Star, 3rd October 2006): The doctor who died after an accident in an ambulance is eligible for an ex-gratia payment, according to the Public Services Department (PSD) and Treasury.

PSD corporate communications unit head Hasniah Rashid said although Dr Norbaizura Yahaya was not confirmed as a doctor at the time of death, she was eligible for the compensation as long as she was a government staff member.

She said the ex-gratia scheme was provided for all government servants under a 1994 Treasury circular amended in 2001, which stipulated that a staff member injured or killed while on duty, even if not confirmed, was entitled to compensation.

“In her (Dr Norbaizura’s) case, the Health Ministry is conducting an investigation and will propose the payment (quantum) to the Treasury, which will then relay the final decision to the PSD on the next course of action,” she said.

On Sept 4, Dr Norbaizura was accompanying a patient in an ambulance from Seremban Hospital to Selayang Hospital when the vehicle burst a tyre at the expressway near Bangi and landed in a ditch.

The 24-year doctor from Sabak Bernam, who suffered injuries to her head, ribs and lungs, went into a coma and died 16 days later.

Enigma

Recently released "A Posteriori"
(Translation: Retrospective or analyze past experiences)