Friday, December 25, 2009

X'mas eve

Its finally Christmas eve. Unfortunately for this year, Christmas drops on a Friday. Usually there would be a public holiday. However, with Friday being a weekend here in Kelantan, it seems we have one less public holiday for this year. Nevertheless, after yesterday' steamboat, I've followed up the Christmas celebration with another excellent dinner. After all, whats a celebration without a feast? haha.
Bread Master
Today's dinner was in the bread master cafe situated approximately 1km from KB mall where a freak accident occured recently. The cafe isn't especially outstanding from the outside, partly due to the old sign board where the color has already started to fade off. However, the food here is better than the looks of the shop to say the least.

Icy Larva-3/5
We started off with an appetizer, the Icy Larva. For this dish, it kinda new to me. Its actually served with an ice-cream and a red hot kopi O in a separate container. To be honest, this dish is not only interesting in the look, but also the taste. I've never imagining adding ice-cream to kopi O, and I've never thought it would taste good. haha
UFO Toast with Ham and Cheese- 3.5/5
This is also one of the nice appetizer that we ordered on the day. The ham and cheese is separated in 2 compartments of the bread. Mixed with the vegetables, its taste is excellent. Too bad the price makes it less worthwhile though.
Oriental Sauce Chicken Chop-4.5/5
This is one of the main course of the night. Chicken chop seems to be one of the most common and most popular choice of food in Kelantan. There's various shops selling different kind of chicken chop, but I have to say, this is one of the best. Not only is the piece of meat large, it doesn't consist mostly of the flour used to cover the meat. The sauce is sweet and the garlic bread is excellent!

Bread Soup- 3/5
This is a dish that is one of its kind. Instead of using fruits or vegetable(wintermelon) as the container of the soup, they used the bread. Mushroom soup inside a well baked bread. Too bad the bottom of the bread is too thick. But then again, a thin one would have leaked all the soup.
Fresh Frozen Cheese Cake- 4/5
Last but not least is the cheese cake. This cheese cake has a layer of biscuit under it topped with a thick layer of pure cheese. Excellent for cheese lovers.

Well, thats about it for the Christmas eve dinner I guess. Hopefully on Christmas day itself there will be better things ahead. Merry X'mas and a happy new year to all!

Thursday, December 24, 2009

New fish tank

Woohoo...after taking a long holiday from rearing fishes, I've finally made a come back! haha. After seeing a nice fish tank of my friend's, I've gone to the shop to make my purchase of a new tank and also the fishies. 3 new guppy and 3 barbs. All in all, I guess I am still a kid deep down, being all excited with the fishes. Hehe. Hopefully will keep my motivated to sit down and study...XD

Steamboat at LX

Another holiday beckons, and yes, a gathering finally! We had a first steamboat for sometime. There was quite a good turn out with a total of around 17 people. Too bad we hadn't played any games, if not, it would have been super interesting. But then again, its not like this is the last time anything of sorts will happen....XD I had a great time, and I hope everyone else did too....Weee~

The teams- Cooking team and Clean-up Crews

Growing up ain't that much fun

Recently, I have had to hand in a form which has a very big influence over my future 'well-being'. The form contains the location that I am applying for my housemenship training after graduation. Without much hesitation, I've decided that I want to be posted in either Penang island/mainland/Sg. Petani. Its not like I have a choice anyway. If not, the 3 choices would have been Penang Island x3.

To be honest, certain things are really troubling me. From the final final exam of my undergraduate programme(hopefully?), to the future work and work place. Final exams are always a headache for me, as I have not really enjoyed the things that I have been taking since I have left mathematics. Its just so very difficult for me to memorize things.(or maybe I guess I am just lazy?) Deep down, I know I have been panicking as I have just turned myself completely away from studying lately, putting my leg completely off the pedal. I have to pull myself back together and walk this last walk confidently, but it seems I need some extra motivation which have been lacking in my study.

Working in hospitals, as a doctor, seems so unlike what I've hoped for in my life. Yes, being a doctor is a sacred job. But, it is also a scary job. There can't be another job that is as delicate as handling a patient's life and death. Every decision you make counts, every second counts. One wrong move, and 'puff', your patient's gone knocking on heaven's door(or hell maybe?) Nevertheless, its not this that worries me. Instead, it is the long working hours that will threaten what I have always wanted- my freedom. I love my control of myself, my time, my activity. But then, once work starts, there's a total lack of control over my life. Sigh...

Its obviously hard to be a grown-up, but then again, its not easy growing up either....

Sunday, December 13, 2009

Happy birthday XD

Haha...Another fun 'yamcha' session which included the birthday celebration of our long time member SL. Hope she'll have a good year ahead. hahaha

Lately, thursday have really been worth looking forward to.With the weekly yamcha session on thursday night, its just plenty of fun. Too bad HN wasnt here this week. Hopefully there's gonna be another session the following week. Wonder if there will be a bowling session as well?

Thursday, December 10, 2009

Missing paper

Seems like all good things comes to an end.
Instead of happily getting my marks for the end posting exam for the O&G posting,
I get a message by the academic office saying,
'sorry, but we have misplaced your paper,
so, now we don't have your result.
You might need to resit the paper.'
What the heck?
An apex university and they can't even keep a piece of paper safe...swt...

Tuesday, December 8, 2009



Sunday, December 6, 2009

Pet hamster...

Its raining season in Kelantan now, and most of the time i have is either spent in my room... The lack of human contact apart from with my roomate is making me seriously considering getting a pet hamster. Nevertheless, it seems to get some objection from my parents as I had a bit of a problem with animal fur when I was young. With my finals exam coming in exactly 119 days more, I can really do well with a company for studies. Imagine having a hamster running on a wheel in front of you while you studying, its kinda fun...n maybe teaching some tricks to it when i'm free(i doubt anyone does that). well, the thing that caught my attention is that hamster basically are stupid...Yes, stupid, and that kinda reduces the chances of it getting on my nerve. But then again, if it ever does getting on my nerve, I am practically less than a fling away from my window...hoho.
Aren't they just adorable?--------->Hope I can get to find some small cage soon, then off i go to a pet shop for one of those hamsters. But then again, I have no idea as to how to take of them just yet...Any suggestions? Or maybe I should just head over to Yikoko's blog and feed his online hamster?

Thursday, November 5, 2009

Unfortunate event

Today is really a miserable day. After fetching my sis who came to visit Kelantan to breakfast, we noticed that when we gone back to the car, the glass on the backdoor was broken, and my bag was stolen. Ironically, i remembered to ask my sister to bring her bag out of the car, I forgotten my own. Although this is the first time this thing happened to me, but it has happened numerous time at that particular place already. Sad to say, our local enforcer seems to be incapable to do anything about it. From this, I not only have to replace the glass and also tint it, I also lost my lab coat, pen torch, stethoscope, and one of my book. All in all, a lost of at least Rm500 is expected. Really is a freaking miserable day....飞来横祸

Thursday, October 29, 2009






Monday, October 19, 2009


Dang...the weather is so unpredictable nowadays.
Its super hot in the afternoon. And it rains so heavily so suddenly sometimes.
Can't the weather be just rain, rain , rain and more rain?
So, looking forward for this weekend where i can just sit in front of my computer and play ROSE^^

Wednesday, October 14, 2009

As predicted...

Sometimes somethings are so obvious that it will happen exactly as u imagine it. XD. As expected, B didn't turn up for the presentation yet again. Can't say i am at all surprised. The funny thing is that the doctor say that maybe B needed a HIV test as someone mentioned that B's diarrhea problem has been chronic/long-term, which was wat i was saying to my frends about the day before. Lolz.

13th Oct

Yesterday started off with me missing the morning rounds for the 3rd week in a row... I have been so lazy in going to the morning rounds lately. Rather spend my time studying in room or watch movie and surf the net. The aura of laziness has ensnared me since the week of holiday. I was looking forward for a full free day, until at night at least, to do my case report or study a bit since end posting exam was just next week. Nevertheless, the best laid plans was burnt to soot as i soon received a message saying that a replacement class will be held that afternoon. And i was one of the person doing the short-case presentation. I was half excited and half worried. Excited as its one chance to practice like in the exams, but worried for my lack of knowledge. For some obvious reasons, my self confidence has been running low ever since i entered medical school except for some occasional boost.
By around noon(basically just an hour after i woke up XD), i was hungry and was really tempted to make a call to McD for a delivery. However, i decided against the temptation and ate bread and drank a small box of milk instead. Munching on my bread, i also started to surf the net for some news regarding the red hot MCA. CSL and OTK aint my favourite person, but its such a joy watching them tear each other apart. In-fighting is such a typical prelude of a collapse of a dynasty or era or watever u wana call it. When i finished, it was around 1 oclock. I wanted to do my report, but with 230pm(the time for the class) looming, i feel i would be doing it half heartedly and went to watch an episode of CSI instead. Darn lazy bug won again. Its 2-0 to the lazy bug.
As i was about to step out of my room to go to the class, i received another message saying the class was postponed again to the following morning. Dang! Another sudden change of event. As I told my friend about the cancelled class, we decided to order McD for lunch. So much for resisting temptation. The delivery reached around 330pm. By that time, I have already finished one part of my report. As the time was neither lunch time nor dinner time, i decided that tis would be my 'luch-ner'. I soon came to regret it when i went to play football in the evening. My whole stomach was full of food. It was so hard for my feet to carry my extra heavy body around, it was much more harder when there was food. Playing football in my campus nowadays is darn hard as there simply isnt much of us chinese playing. The most we could get was around 10 people. Too many Aces aka bigcards around i guess. lolz. Eventually, we had to join the indians to play for the day as there were only 4 of us. It was so frustrating playing with people who just cant appreciate ur contribution. Scoring a goal was the only thing i could do to show a freaking fella who keeps on shouting at me and boy was i glad i scored a goal. Nah, eat that!
After bathing and resting a bit, I went to the hospital for the night's teaching. This was supposed to be done in this afternoon as well but was delayed as the doctor wasnt free. My frend B and SC was supposed to be presenting short cases for this session. By the time the class started, B was still nowhere to be seen. According to his sms, he was in a toilet somewhere, suffering from stomach ache. He has had a long history of stomach ache when he is at the ward. Sometimes i worry if he has any serious illness. Anyway, i took his place to present the short case instead.(he is suppose to take my place for the short case tmr morning, but we ll more stomach ache i hope.fingers crossed.) The doctor choose a case for me, and i was sweating my guts out when he told me to perform a neurological examination of the legs. I immediately remember joking with my roomate the day before saying that i might be so unlucky to get the examination for the legs. Turns out, this is exactly the topic i was saying. Never joke around at night man! And due to lack of practice, even though i knew what i nid to check for, i couldnt really do it. Added with my total nervousness, it turned out to be catastrophic. >.< Yeeshhhhh! Nevertheless, i was glad i took B's place. I would rather the mistakes happening now rather than during the exams. haha. Which reminds me, the FB lucky meter told me i was 26% lucky today... Perharps it was rite?lolz

And not to forget, Happy birthday dad!

So much to study~

Its already mid October. I am at the end of my third posting with only 4 more to go... I used to complain a lot that i nid to study too much notes. But obviously, things can go much much worse...and here i m, stuck with so many books. Worst part is, i have to read most of them>.< My cupboard full of books. Its just by the windows...

My study table which is a total mess with all the books and papers and pens and the other cupboard of books just above the table...
Even my computer table is fully loaded with books...(and a necktie too...lolz)should be called the book table instead.>.< And this is the stack of books which ended under the bed coz i m using them so much lately i was lazy to put them back in the cupboard, and they say the scariest thing under ur bed is the boggy man...Yikes!

Saturday, September 26, 2009

Holiday ending

Tomorrow is the last day of the raya holiday. It really flew by. When the time is so enjoyable, i just can't get enough of it. With the return to the campus, my struggle for PRO 3 will have to begin. On the other hand, there is some other little assignment of 'Titan Rose' that i will have to take care of. Its a new server of the popular online game 'rush on seven episodes'. Hopefully, i will get to study effectively while also enjoying myself with this excellent game. This will be enough to make my day^^

Saturday, September 5, 2009


Lately, I have been posted at Besut hospital for my district posting. According to my friends, this posting should be quite relaxing, which is quite true apart from some glitch that happened during our time here. The things we do here are kinda practical apart from the lectures given by the supporting units. I can't seem to see the importance of those knowledge they intend to give us via the lectures with our career. Worst of all, all the information thought to us weren't really that big of a deal as most of it was just common knowledge. Somehow, a few of us just ignored the lectures completely.>.<

From my time in this posting, I noticed certain things. First of all, I now realize why our general population DO NOT want to participate in talks held by the ministry. The speakers are sometimes ridiculous(though there are exception to this point, who did an excellent job). Most of them are just ignorant. They spend hours and hours talking, never getting near the main point. Instead, they keep on hitting around the bushes and talk about irrelevant things here and there. In psychiatric, we refers this as circumference thought. Round and round the main point and yet never reach the actual point.

Secondly, I can only say that its really hard to dislike a person. However, I think I found one soul that makes me feel extremely surprised that it can still survive here till the present day. I mean, we can only be selfish to a certain degree. But, this particular person, is the master of selling all fishes. Like being selfish isn't enough, that person have the gut to accuse other people of being selfish. Attention seeking, pityful behaviour of it really irks me to the fullest. The title of drama queen seriously have to be given to that particular person. Tears, emo behaviour, all have been used to get attention. One more thing is about the person's questions. Asking questions in classes are extremely beneficial, provided, you use ur common sense. Don't ask useless question la darn selfish! Cis!

Last but not least, during the time of this posting, our group leader seems to be so incapable. Everything also can't clarify properly. Time of class, time the bus will be reaching everything also wait till the very last minute only tell. Then, when telling someone, she assumes the whole group will know already. What is this man? Show some responsibility la. ish....


Its been a while...
Lately, i've been kinda sentimental i would say. Suddenly refreshing memories of the past. Thinking of what had happened, what i have done and what i have not. Certain memories makes me miss those old days a lot. Certain memories just cast doubts on my self confidence.
Thinking back, there seems to be some regrets on things that I could've done then. But, those were not the ones that hurt most. Instead, it was those things that I was powerless to do that hurt the most...Being powerless to do something, the feeling is such dreadful, its like a powerful vortex sucking all the air around you, suffocating you. What a scary feeling...

Friday, August 14, 2009

My god!!! Don't show me your stupidity!*Quote roastme*

RTM reporter Eliani Mazlan, 26, who took the witness stand on the third day of Karpal’s sedition trial, was cross-examination by Jagdeep Singh Deo.

Jagdeep: Do you know which party is Karpal Singh from?

Eliani : I am not sure.

Karpal who was also present, could not help smiling in amusement when she said that.


Jagdeep: At page four, paragraph two of the video transcript, Karpal said: “In fact, I’ve stated very clearly that ‘we’ will sue the Sultan together with the new State Government as defendants if they persist. Are you sure? Karpal said he would sue the Sultan? What does it say?

Eliani: We.

Jagdeep: It is not I.

Eliani: But it could mean himself.

Jagdeep: We could mean I? Is that what you are trying to say? What was said in the transcript?

Eliani: We.

Jagdeep: So you agree that ‘we’ is not ‘I’?

Eliani: Yes.

Jagdeep: You agree that your understanding is completely a misunderstanding?

Eliani: I am not sure.


The short section above was taken from the Star newspaper over Karpal Singh's sedition trial. Its just unbelievable that our news reporters are so ignorant towards our own society. How can this people report the happenings around us when they themselves don't even know who's who and what's happening? This incidence completely shows the incompetence of some of the people whom we trust to deliver the daily happenings. They don't know the obvious facts, they can't understand statements and they manipulate statements. 'I' and 'we' are replaceble? As my dear teacher once said, 'My god! Don't show me your stupidity!'

here's one other from the malaysian insider...

Utusan Malaysia reporter Mohd Nizam was the one involved this time.

Mohd Nizam was questioned earlier by the deputy public prosecutor Azlina Rasdi.

Azlina had asked Mohd Nizam to tell the court who was at the press conference as well as where it was held, before requesting the reporter read the press release provided.

She also asked him to summarize the contents to the court.

Mohd Nizam: “If the Sultan still wants to pick Zambry as mentri besar then Pakatan Rakyat government has no choice but to take legal action.”

He added that after the press conference there was a question and answer session. He told the court that a reporter asked Karpal if he would be suing the sultan.

“Karpal said yes,” Nizam said in his testimony which was later challenged by the defence.

During cross-examination, Jagdeep had asked the 38-year-old reporter: “Do you agree that his (Karpal) view on the constitution is sought after?”

Mohd Nizam: “I am not sure.”

Jagdeep: “Do you agree that he (Karpal) is known as a smart laywer?”

Mohd Nizam: “I am not sure.”

Jagdeep: “If you still do not know after eight years working then you should start doing your work properly.”

Jagdeep then proceeded to ask him if he understood the press release since it was in English.

Mohd Nizam: “I only understand it in general and not thoroughly.”

Jagdeep then asked the reporter if he agreed that what was said in the press conference was only an opinion of the constitutional crisis in Perak.

“I only report and do not give opinion,” Mohd Nizam replied.

The answer appeared to irritate Jagdeep who accused Mohd Nizam of being insincere.

Jagdeep then told Mohd Nizam to read part of the press release to the court.

Mohd Nizam: “Although the orders have been confirmed by the Sultan. If the decision is ultra vires then the decision can be adjudicated by the court.”

Jagdeep then asked Nizam to explain what ultra vires means to the court.

Nizam looking confused and replied: “To insult.”

Jagdeep then told Mohd Nizam that his misunderstanding of the word had caused chaos in the country because the word actually means “beyond the powers”.

Mohd Nizam was then asked what questions were thrown at Karpal during the press conference.

Nizam explained that reporters wanted to clarify if Karpal meant that he was going to bring the Sultan to court.

“So do you agree that Karpal did not say that he will sue?” Jagdeep asked.

“Agree,” Nizam replied.

Oh my farking gawd...can Utusan's news be trusted at all???RTM oso got reporter like tis! This calls for a SCREENING man...Ignorance is just not allowed in the news sector, stupidity is even worst! Roastme pls roast them!!!

*Forgive my language...this ignorant bastards really annoys me to the spine...

Monday, August 10, 2009


applePie has juz received news that he doesn't nid to go to kampung today... but then, wat will happen to the district posting? now completely blur about wats going to happen next~~

Another adventure

Later today, I will be off to Besut for my district posting. Should be something quite fun to look forward to. Apart from some personel problems, its expected to be a busy yet interesting times ahead. A trip to Pulau Perhentian seems to be on the books but not really sure will it be carried out. Its been quite a long time since I have gone travelling away from the comforts of my home in Pg or away from my campus. It's said that there will be an excellent connection at the hostels at the district hospital. Wonder if that's true... Gonna use it to the maximum if able XD But then again, with my hardisc 6 feet under, I wonder if I can stock enought movie for the rest of my final year. haha.

H1N1 has been really rampant lately. People are starting to die here and there. Numbers increasing everyday very significantly. However, certain measures carried out seems pretty controversial. With the current handling of the problem by our ministry of health, its kinda hard to see this danger resolve. Our campus has even decided to meet all of us in the Dewan Utama at 9am later. Heard its for a talk on H1N1. Wonder if the decision to gather the whole population of the campus wise considering that there are outbreaks in the campus lately. I somehow feel pretty certain that this move will just escalate the matter and cause our campus to temporary shut down in the very very near future. Maybe then I can have my holiday...XD

Although annoyed by certain individuals lately, i feel kinda comfortable in the condition i am in currently. Life is very enjoyable now with the amount of workload and play in a just nice condition. Too bad all this isn't gonna last. In 10 months, all this will be gone. Studies will end, friends will be leaving to pursuit each other's career. Thinking about it really makes the heart feel kinda soury. Time moves really fast, too fast to me to appreciate every thing that I have or had...

Thursday, August 6, 2009


Lately, some happening around me are really making me very 'emotional unstable'. For one, our doctor, who is really a good man in truth, seems unable to understand his students. His intentions are good, but yet, his approached are less than acceptable. He can easily forget what he told us one day ago and starts to blame us on this and on that. He doesn't care if you have other classes or seminars but when he want to see you, you must be there. He likes to tell you the time of his class and expect you to be early while he comes crawling in after 2 hours. Dicipline, he says is extremely important. Well, that is obviously not seen in you my dear sir.

Another thing is that, I realize that our group isn't even as co-operative too. After discussion with the whole group and reaching a decision, there are individuals that just ignored the decisions and take their own path to do things. If you can't accept the decision, please say so. Don't do things that is beneficial to yourself and will cause trouble for others. You are totally ignorant you stupid girl! You have stood in my way once, and you stood in my way again. One more time and you're history!

Some people likes to act cute and play dumb. Furthermore, they are selfish in learning while expecting others to treat them generously. Responsibility is another thing that the person seriously lack. Please man, be normal a bit! Your histrionic personality just makes me hope that you end up in a psychiatric ward.

Working alongside this kind of people is really an exercise for my heart. And its full time too! Darn...

Tuesday, July 28, 2009

Unpredictable ending

Haiz...People say life is terribly unpredictable. Any life can be taken away at any moment. Any effort can be written off any time. Anything can be twisted in any possible way. 1 month, it isn't long enough to build a career, but it sure is enough to build certain things....end of story?or more to come?

Friday, July 24, 2009


Sometimes I wonder, if given a choice, would you choose a person who loves you more or a person whom you love more to be your spouse? and why?

Thursday, July 23, 2009

1 down 9 to go...

3 weeks and one posting gone. Moving across the street from the A & E to the anesthetic department. Another short posting. Time flies around here, people don't even walk anymore, they FLY, yes FLY. Things move faster than they usually do. Log books, reports, presentations stack up sooner than you even get to open ur mouth to complain. Even weekends seems shorter than they are, all used up to heal up the tired body for another week's struggle. but then again, there is always time for some snooker, some dota, some football and volleyball.kekeke.Another 9 more postings and that's it for me...huhuhu, gan chiong~ weeee~

Friday, July 17, 2009



Thursday, July 16, 2009

Ambulance and resuscitation

2 days ago, when i went for oncall, I had an indifferent encounter. There was actually a call for the ambulance. The exciting thing was that i get to follow along. So, without thinking much, with my face mask on, i hopped onto the ambulance. At first, I was kinda worried if I would be suffering from motion sickness as in my mind, ambulance 'fly' on the roads. Furthermore, there is no seatbelt at the back seat. To my amazement, the ambulance seems to be 'crawling' instead. I think the ambulance might have gone so much faster if I were the one on the wheel.Lolz. the only difference between the ambulance driver and me is, I cant drive pass a red light. >.<

I was suffering from fever that day, but i went oncall anyway. I was also coughing so the face mask was on me all the time when I was in the hospital. I had no idea where we were going and what case we were tending to. We headed into a small kampung and stopped by a wooden house with lots of people crowding inside. When we reached the patient's side, he was unconcious with an intravenous line on his hand. After some history taking by the doctor, I realized that the patient had tuberculosis. TB!!! and he was an intravenous drug user, meaning, there is a high chance he is HIV positive. Waaaaa!!! From that moment onwards, I was extremely careful not to take of my mask. I dun wan to catch his TB bugs when I myself is The patient was later sent to Hospital Kota Bahru then we went back to USM. All in all, it was a kinda different experience.

On a sidenote, my economical status really needs some resuscitation after spending so much on books and a new printer. T_T

Sunday, July 12, 2009


前两天和朋友到D'klasik去喝茶。 谈着谈着, 就聊到俊男美女之类的事。当说到怎样的男生可以吸引到女生的注意力时,就被咋到了!
A:!!! 你的审美观很有问题哪!!!!咋到!

Saturday, July 11, 2009

Food food food...

As I have come to learn, Penang is really a heaven for food lovers, especially when I came back to USM. Had a few food trips during the holiday including a buffet session at the hotel beside one-stop(forgot the name zzz...) and also the buffet at redbox during Kid's birthday. But the trip to tonki bento seems to be one of the best...This is the outlook of the shop. Its just a regular house-turned-shop from the outside. Its located in Pulau Tikus by the way and NO, there isn't a lot of rats there!

This is the what we can see in the entrance. On the left on the entrance, there are some decorations like the japanese style clothes and some plants and drawings. On the right, there is the counter and also a small manga booth which is quickly ransacked by Meeku, Panda and lengzai Kid(seriously, there is proof- lolz
While waiting for the food, meeku spent his time with the manga from the booth while Kid and Panda had a discussion on fan.hahahaha
This is the inner part of tonki. Its not a really big restaurant but the interior design is quite unique. Each of the table are divide with a divider. U'll have privacy while u dine.(especially good for those who have smudges all over the face after meals...kekeke)
This happens to be the appetizer... erm...I can only comment that its quite nice, coz i have completely no idea what it is! XD
Yay, and here comes the main dish! Oh, made me suddenly feel hungry nw pulak...>.<
The main dish consists of 2 pieces of grilled salmon, 2 pieces of orange, a small portion of teriyaki chicken, some salad and rice. All for only RM19.90! Extremely worth it i say!(dai dou lak fu...) Sweet! Weee~~~~
And here is the soft shelled crab which Meeku has treated us^^ extremely tasty! Arigatone Meeku-kun!
Thats it for the trip to tonki. Wonder when will i get back there again. Thinking about it makes me drool~~~ Better get my breakfast first!

p/s: can anyone tell me when is bon odori?

Thursday, July 9, 2009

ECG made easy...My version-02(for emergency setting)

First degree heart block
In this situation, there will be prolong PR interval(more than 3 small squares in a 25mm/sec setting). The rhythm is regular. This is caused by a block in the conduction at the AV node.

Second degree heart block-Mobitz type I
This occurs when there is progressive slowing at the AV node. The PR interval will be progressively lengthening followed by a disappearing QRS complex, meaning a P wave without a QRS complex.

Second degree heart block- Mobitz type II
One or more QRS complex are dropped with the PR intervals remaining equal.

Third degree heart block
Occurs when there is complete blockage of impulse at the AV junction or at the common bundle branch.(sometimes at bilateral bundle branch as well). The RR intervals and the P wave intervals are regular. However, the PR interval are chaotic and irregular. Basically, the P wave and R wave are like from 2 different strips.

Premature ventricular contraction
This occurs due to increase automaticity of the ventricular walls or sometimes due to reentry phenomena. The QRS complex comes earlier than expected and is often a wide complex due to its ventricular origin. A PVC that comes in every second complex is a ventricular bigemini while ventricular trigemini is when it comes in every third complex.

The heart rate is around 20-40bpm. There is absence of P wave and QRS complex is widened. Idioventricular rhythm occurs when SA and AV node are not firing properly or firing slower than the ventricular pace maker.

Torsade de Pointes
It is paroxysmal(starting and stopping suddenly). The QRS complex will be wide and bizzare. Hallmark of this rhythm is the upward and downward deflection of the QRS complexes around the baseline. The term Torsade de Pointes means "twisting about the points".

Ventricular tachycardia
The rate is extremely high ranging from 100 to 250 bpm. QRS complex is wide and bizzare. Can intervene by giving amiodarone or lidocaine or cardioversion. Must be manage properly as it can soon deteriorates to ventricular fibrillation. Pulseless ventricular tachycardia requires defibrillation.

Ventricular fibrillation
VF is a chaotic rhythm originating from the ventricles resulting in no cardiac output. Requires immediate defibrillation and ACLS protocols.

Asystole/Ventricular standstill
Occurs when there is no more electrical activity in the heart. When this occurs, remember to increase the magnification of the cardiac monitoring to exclude fine ventricular fibrillation.

Premature junctional contraction
PJC arises from irritable focus at the AV junction. Characteristic includes absent or inverted P wave and also a shortened PR interval.

Junctional rhythm/junctional escape rhythm
The junctional rhythm occurs when the impulse originates from the AV junction-AV node and the bundle of His. The rate of the junctional rhythm is about 40-60 bpm. There will b absence of P wave or an inverted P wave. Normally has narrow QRS complex.

Accelerated junctional rhythm
Junctional rhythm with a rate of more than 60 bpm but less than 100 bpm.

Junctional tachycardia
Junctional rhythm with a rate of more than 100bpm.

Any mistakes please inform me.^^

ECG made easy...My version-01(for emergency setting)

Here's some short notes on some common ECG patterns...

Normal sinus rhythm
Rate of between 60-100 bpm(beats per minute)
Every QRS complex is preceded by a P wave and every P wave must be followed by a QRS.

Sinus tachycardia
Rate of more than 100 bpm in a normal adult but often it is limited below 150bpm. Results from sympathetic activation(ie due to pain, fever, hypovolemia)

Sinus bradycardia
Rate of less than 60 bpm in a normal adult. Athletes may constantly be in sinus bradycardia as they have better stroke volume.

Sinus arrhythmia
The rhythm is regularly irregular, with the rate increasing on inspiration and decreasing on expiration. This is commonly seen in children and less common in adults. Often, it is benign.

Sinus exit block/sinoatrial block
This results when the impulse from the sinoatrial(SA) node is block and does not depolarizes the atrium. Although there SA node is firing at the usual rate, the impulses are not passed on. There will be pauses equivalent to multiple P-P intervals.

Sinus pause/sinus arrest
This is resulted when the SA node fails to fire. The difference from sinus exit block is that the pause is normally not equivalent to multiple P-P intervals.
Premature atrial contraction(PAC)
PAC occurs when there is a premature firing from the SA node. This is due to increase irritability of the atria resulting in increased automaticity. Since the SA node firing is earlier, the complex comes earlier. Observe that in the strip, the P wave comes before the dissolution of the T wave. This causes the P wave to become abnormal(biphasic, raised, flattened...). A normal QRS complex(narrow QRS as it originates from the atria) follows the P wave.

Atrial Tachycardia
Often have a rate of between 170 to 230 bpm. The narrow QRS complex shows that it is supraventricular in origin and the rate differentiates it from sinus tachycardia.

Atrial fibrillation
Is a irregularly irregular rhythm. The chaotic rhythm and the absence of P wave is the hallmark of this dysrhythmia.

Atrial flutter
This results from an reentry circuit within the atria at a rate of 250-350. This dysrhythmia is recognized by the sawtooth appearance of the baseline.

Wolf-Parkinson-White(WPW) syndrome
In this condition, there will be presence of delta wave at the foot of the QRS complex. The delta wave is the hallmark of WPW.