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

Curious

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

女人的天敌

有人说,‘女人的天敌是时间。’
我说,‘女人的天敌是男人。’
时间,再美的样貌都可以无情的摧残,
但是,美丽的内在,再多的时间,
都无法被它消磨去。
同样的,再深的伤痕它都可以帮你复原。
男人就不同了。
一个男人,可以让女人高兴,幸福,
也可以让她伤痕累累,
让她泪流满面,
让她的生活没有色彩,只有黑色。
男人啊,对女人好点吧!

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 weak.lol. 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

咋到!

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:怎样的男生才会吸引到你们的注意力呢?
B:哦,我只是会注意到俊男罢了。
对面坐了几个人。。。
B:咦,那个男生蛮好看的。
A:哪一个?
B:(指着一个不男不女的男生)那个咯!
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- http://panda-chama.blogspot.com/2009/07/yam-yam-and-jerry-lee.html). 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.

Idioventricular
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.

Review of Me

Long time ago... I created a list of targets for myself. Lets see how I've fared.
Here's the list:
1. To finish the medical course with the minimum time, which is 5 years without the need of repeating.(so far so good)
2. To at least get an A for once during the period of my life as a medical student.(yay, target achieved!! last year...wakakaka)
3. To learn scuba diving(no sign of achieving this yet...time oso dun hv for nw T_T)
4. To travel to
a)Australia
b)Singapore
c)England
d)Italy
e)Japan(another one yet to be achieved...but am planning for back packing in europe after finals next year, so hopefully will have some improvement)
5. To be able to drop my weight to around 75kg and maintain it. (This one is a total disaster. I got lost and went the other way around >.< 90++kg and still counting...swt)
6. To be a decent person. ( decent is the opposite of me for now)
7. To create a blog and maintain it.(yay, obviously still doing well)
8. To own a beautiful house with a seaside view.(cant even buy 1 meter square of land for now)
9. To be a millionaire by the age of 40.(23 already and still dependant on 'PaMa' enterprise)
10. To assemble a desktop from parts.(nid money...>.< most prob first thing to do when i earn my first month of salary)

Yikes...2/10...swt.... fail miserably.

Adding on another few objectives:
11. To be more than just an average student.
12.To start to keep photos of events in life...otherwise when i lost my memory, that's it for me.lolz
13.To improve dota-ing skills to yikoko-ish level.haha
14.To take the basic life support and advance cardiac life support course before i start to work.
15.To study a few different language.
16.To improve my stamina and have one more shot at this years futsal tournament.(i wan better than to reach the last 8 >.<)
17.To work back in Penang.
18.To improve my way of thinking. Think fast think critical and act. No more think without actions.

No trip for me...

A trip has finally been planned for this sat, sun and monday...to langkawi... and the best part IS-----teng teng teng teng....I CAN'T GO!!! After hoping for a trip for such a long~ time(i can feel my neck becoming longer). Things like tis seriously dents my interest in studying( and there wasn't much to begin with).
No trip .....Get many many photos back and show me k guys? erm.... on second thought, maybe that's not such a good idea. Take many many photos, but DUN show me is better i think...haiz. damn u books!!!!

Tuesday, July 7, 2009

Beginning of the end

My final year(hopefully there won't be a six month extension) has officially started. With it comes all the ward rounds, the on calls , seminars other practical sessions. It has just been 3 days into the new semester, but there is a sense of ending as exams are really not that far away. 9 months and thats it. Still missing life in Penang, I have to drag myself out of bed everyday around 7 oclock in the morning. By the time i reach my room(which luckily is kinda comfortable after my personal touch here and there, weeeee....), i am completely worn out. But then again, being me, however worn out i might be, there must be games. I think my motto should be ' game is essential for life'.

Finally the broadband issue reached a conclusion with me cancelling the registration with the tesco branch in KB and gone for the KB mall branch instead. The tesco branch has really been such a nuisace with a poor attitude and making broken promise with every breath that they have. Its so annoying to be dealing with this guys(to be precise, its a few gals...>.<)

For today, I have just had my session in first aid. Not the first time already, but the guidelines for basic life support really do change fast(4 yearly). Just only realised that medical personales have to take the courses at their own time yesterday. Haiz... they should say earlier ma, then i can spend my holiday taking these courses instead T_T. Nevermind la, can do anything bout it now... Weighing my options on whether to go back this weekend or not. Feeling like going home and get a new specs made, but then again...2 days how to get my specs done wor...haiz...

P/S: yikoko says that a new rose server which is the titanRose is coming up soon with all the quests and gears and gems...wee~

Saturday, July 4, 2009

When the perfect gal meets the perfect guy-01

Sean was waiting for the bus heading towards town as he prepares his first day at work. Standing at 5 feet 7 inches high, Sean was a medium built guy. His well combed hair along with the dark frame glasses on his face gave him a nerdy look. Everything was in place and he was extremely excited to be going in for work in his dream company. He has been hoping to land the job for a long time since his interview 2 months ago. Finally the letter arrived last weekend asking him to fill in the vacancy left by a senior employee who had retired. With his heart pumping hard and hands trembling slightly, he went on board of the bus.

"Wonder what will happen today? What will my colleagues be like? Will I have my own cubicle?" Questions after questions arise in the highly imaginative mind of his. He hadn't pay much attention when a lady in her early 20s came in and sat beside him. He had a glance of her but then soon got lost deep in his thought again. When the bus stopped at KL central, Sean got off and sped towards the direction of the monorail. Suddenly, he realized that the face that had appeared before him was somewhat familiar, but he couldn't actually recall why. Nevertheless, he was almost late for work already. He just swept the thought out of his mind and continued forward into the monorail.

Reaching at the office, Sean took a look at his watch. "825am. 5 minutes early, luckily I am not late for my first day at work.", he thought to himself. Taking a deep breath, he took then handle of the door and gave it a push. The office was well furnished, with all the instruments and equipments put well in place. The floor was laid was a grey carpet with a few spots on it, possibly as a result of the coffee spilled on it occasionally. Sean walked towards the secretary desk and tried to catch the attention of young secretary who was busy on the phone as well as on her desktop. Upon seeing Sean, the secretary mouthed,' he's waiting for you inside.' to him. Sean understood and walked towards the office beside the desk. He knocked and entered after there was answer from within.

"Good morning Mr Lee. I am Sean Chew. I have received a letter asking me to report for work here today."
"Ahhh, yes yes, Sean. Come, have a seat. Celine will be right in to bring you to your seat and give you your assignments. "

To be continued...

Friday, July 3, 2009

Niga mania~

After watching so many nigahiga videos, I must say i am quite enjoying his videos. Copying his style, i would like to write out a script base on the mould of the nigahiga's 'how to be....' video.

*Computer sound: Owning!!!*
A: No... why am i feeding again?!
B: Damn, we lost coz u fed too much.*starts throwing punches at A'
A: ouch , ouch!!!

Mysterious sound: Hey you!
A: Who? Me?
Mysterious sound: Yes you!
A: My Dota wargod?
Mysterious sound: Tired of getting bullied in dota?*A nods* Tired of the never ending godlike ultra feeding spree?*A nods again* How to be a dota pro is the dvd for u!
*throws dvd to A, A catches, throws another at A and A falls to the ground*
Mysterious sound: This dvd come with 2 of ur very own personal trainers.

C: Hello, my name is jugger-yunero-tauren-lunatinker-feeder-pucky-pro
D: Hello, my name is... Gab

C&D: Ever dream of being a pro in dota? dream no more. Being a pro dota is as easy as it gets. Just follow the following laws and u will be an instant hit in the dota society.

C: lesson one, a pro dota kaki must dota all the time of the day, no matter the time. Food, work and sleep are all a waste of time.
*shows someone dota even in the toilet, when the boss is not looking, using leg to dota when he is sleeping, and dota in the room while days turn into nite'

C: lesson two, play with other dota kaki who are noobier than u. Remember, playing with noobs makes u feel so pro!
*C: yo, s'up man? lets dota to9 la... D: yeah sure.
C: (whisper) he is so noob he cnt even name one hero in the game. Items oso duno hw to buy....
Shows C playing with D, and the computer says 'owning'.
C: Yesh, I pawned you!!*

C: lesson three, never use the shortkeys for skills as it makes ur mouse controlling hand slow. Practice using ur mouse to click the skill and cast it as soon as u can.

D:If u follow all our advice, it shld b sth like tis...

*"Owning" from computer.
A: Yesh, I pawned all of them...wakakakakaka. Die noobs die.
Gangster: Damn, how dare you pawn me so much?
Gangster whacks A and ends him with a green ball*
PWNED



TEEHEE

p/s:gab and cipong, i m counting on u guys to act tis script out already. TQ.lolz

Irony

Lately, I've been trying to get online via the Celcom broadband. As I have just recently changed my handset, I have to try to figure out how to set up the phone as a modem. Ironically, the net is the place I can have the information. So, in order to get online, I have to get some information for the net first,cool!

情歌MV

video
今天,看见这一段MTV之后,感触良多。回忆起了好多好多,心里的感觉好像被融化的冰一样,而且还有一点酸酸的呢。等待的‘情歌’,已经出现了吗?突然想 起来,两人相见到相爱,再从相爱到一起走人生的旅程,是非常不容易的。他或她,是经过了多么多的考验,都还陪在自己的身边。不但同甘,而且共苦。爱一个 人,不是一定要拥有她。但当有了她,要更珍惜,不要得过且过。能有你的陪伴真得谢谢你哦!

P/S:Thanx orange for the introduction of this nice song^^
29th June-Day 1 back to Kelantan...
Today, after sleeping at 3 something in the morning, I woke up around 7am. After breakfast with my dad, he fetched me home. I saw some aunties who were my mum's friends and went by to say hello and had a little chit chat. After that, when I went home, I noticed one thing. I left my keys on my dad's car!!! In the end, had to call him back and take the keys from him. Hopefully din make him late for work.haha. After that, on the journey to KB, i drove ard 3 hrs of the journey. Unbelievable eh, especially after sleeping for a mere 4 hours. haha. shhhh, dun tell my frend ok? after we changed driver, i immediately started to 'fish'. By the time i reached my friend's house in KB, i think that i have caught a few bucket loads of fishes already.haha. Went and met some frends then yamcha for the day. we did went to tesco and i reregistered for the student package of broadband. went home and stare at the simcard for a long time hoping that i can use it soon. but then, after a few tries setting up, without any signs of success, i went to bed.

30th June-Day 2 back to Kelantan...
Today, slept till ard 12pm... really lazy and tiring. also, i was feeling rather down as i have to restart life without my reliable gangs. Miss you guys so much man!!! furthermore, tis is the 2nd day i hv been deprieved of internet access. I got a call from my dad saying that celcom called him. It seems that i have been blacklisted by celcom as i have not paid my balance for the last account of broadband. The amount i owed was RM4.40. swt...So, in the end, i went back to tesco and payed the balance. according to the worker there, the case was closed and i shld b able to use the net by the next day. so, i went back home looking fwd for the next day. I also went Chiang Mai restaurant for dinner tat day to celebrate my gf's belated bday. enjoyed the keng som fish, the fried kangkung and the pandan chicken. At nite, it was a super duper nice nite...after the dota session in the afternoon, we continued at nite. Til 5am...haha

1st July-Day 3 back to Kelantan...
Bibipu have reached kelantan!!! i din manage to join the others to fetch him as i was laying unconcious at the bed until 1pm. After that, went out again and help mel take her things to her house as well as dota a bit. Cleaned mel's house then at nite went to help mel to pack her home. supper with bibipu till 3am in the morning.nth much today.

2nd July-Day 4 back to Kelantan...Today
today slept til 11 sth. woke up, bath and went china town for lunch. After that, went to bibipu n green bear's house to help a bit cleaning their house. Went celcom for the broadband prob. according to them i nid to contact the providers at tesco. so, i called the number they gave me. and i was asked to go to tesco to get my money back as the package i wanted was unavailable already. when i reached tesco, i was told, that my form was with celcom now...ish...and that there is a chance my registration can go through. they ask me to wait for another day before they call to confirm if the registration is void or not. swt lo....then, to9, finally, i can online and tis was the end product.haha. dota one game. hopefully life will improve a lot more...