Saturday, 31 July 2010

They deserve more qualities

How many of us realized about the importance of geriatric healthcare?

I am glad that Asian Medical Student Conference (AMSC) 2010 Indonesia did a very good job in emphasize this theme to be put up. Survey was done in old folks home and the community in Sabah to compare the quality of life in the elderly.

I am not part of this program but I think this is something that the young people regardless you are a professional or not or whether this thing involve in you right now. Getting old and having different life aspect is something that we can deny right now but not in the future. We may in denial about this topic right now, but I hope this let us think for a moment. What about your relatives which need attentions? What about those that have raised you up and take good care of you until you leave home and pursuing your dream?

Take a look at this in Xu Vin's blog : Are Malaysian Elderly Getting Enough? 

It won't take a lot of time to read. But it takes a lot to absorb and rethink..
Thank you!



Leptospirosis sounds very alien to me when I first heard it in the wards 2 weeks ago. All of sudden, there were a few leptopspirosis patients admitted which a few I asked said it is really rare. Out of curiosity, which is a very late curiosity for me, I just went to read about it. In the books I owned, none of them actually tell me what leptospirosis is.

Leptospirosis (or known as Weil's disease / syndrome  or canicola fever)

- a bacterial zoonotic disease caused by spirochetes of the genus Leptospira
- transmitted to human by allowing water that has been contaminated by animal's urine to come in contact with unhealed breaks in the skin, eyes or mucous membrane.

- urine of infected animals & contagious as long as it is moist
- primary host : rats, mice & moles (rarely mammals such as dogs, deer, rabbits, hedgehogs etc)
- transmitted by the semen of infected animals as well. (Slaughterhouse workers are at risk via contact with infected blood / body fluids)
- human become infected via contact with water, food or soil containing urine from infected animals.

Occupations at high risk
- Veterinarian
- Slaughterhouse workers
- Farmers
- Sewer workers
- People working on derelict buildings (abandoned)
- Rowers
- Surfers & whitewater paddlers

- Biphasic disease (After the first phase resolves, patients briefly asymptomatic until the second phase)
- 1st phase : flu-like symptoms (fever, chills, myalgias, intense headache, vomiting)
- 2nd phase : meningitis, liver damage (jaundice), renal failure
- Some presented with abdominal pain, red eyes, diarrhea & rash
- Symptoms appear after 4 to 14 days of incubation period
- Due to wide range of symptoms, its infection is often wrongly diagnosis and not recorded into the statistic.

A few of the different diagnosis for this symptoms : Dengue fever, malaria

Complications : Meningitis, extreme fatigue, hearing loss, respiratory distress, uraemia, renal interstitial tubular necrosis that will lead to renal failure, liver failure and cardiovascular problems.

Some relevant investigations
- The microorganism is found in blood for the first 7 - 10 days, then moves to kidney. Then, it was found in fresh urine after first 7 to 10 days.
- Blood and urine both need to be taken for investigations
- Renal profile
- Liver function test (increased in AST, ALT and Gamma-GT)
- Leptospirosis is confirmed by Enzyme-Linked Immunosorbent Assay (ELISA) and PCR

- Doxycyline as prophylaxis for adventure travelers to high risk areas
- Treatment objectives : To suppress causative agents & to fight complications
- Antibiotics : Cefotaxime, doxycyline, penicillin, ampicillin, amoxicillin
- Supportive treatment : Detoxification, normalize hydro-electrolytic balance, administration of glucose & salt, dialysis in severe case that had caused renal failure, corticosteroid in gradually reduced dose (prednisolone)

Things are MORE serious if it infects dogs....

- Liver and kidney most commonly damaged
- Vasculitis, edema & potentially disseminated intravascular coagulation (DIVC)
- Myocarditis, pericarditis, meningitis, uveitis are the sequel
- Vomiting, failure to eat, reduced urine output (dark/ brown urine), lethargy

- Leptospirosis must be a differential diagnosis for dogs if there is sclera icterus (jaundice of the eyes)

Those not only happens in human, but dog as well...


Thursday, 29 July 2010

Long case

Wednesday, 28th July 2010

I was awake a few times by my house mates' alarms for a in wee hours. Every time I was awake, I told myself "long case", then I looked at the time, I off to sleep again. But I did not dream of anything about case in the hospital. I didn't remember what is in my lala land, anyway.

Off to hospital while sending text to Nalini. Then I met her and Hiang Jin around Ward 5. I am not very nervous at that moment. Nalini kept prompting me with a lot of questions about investigations and management I would like to do in different diseases. I didn't really study much the night before, nothing run through my mind and I went to bed early.

Prof. Dr. Sheikh Anwar, my long case supervisor met us in Endoscopy Room which give us no clue at all what we were going to do. Some groups only did teachings instead of observed long case. Some group did very typical and classy observed long case where all your group members and the supervisor watching you taking history from the patient and do physical examination as well. We joked that we will be learning endoscopy today and pass our long case without efforts.

That proved 5 of us wrong when he brought us out of Endoscopy Room and took a lift up back to 6th floor (I just came from there to 1st floor). We wanted him to turn left when we reached 6th floor because most of us know better the case in Ward 5 and 6. Anyway, our wish was not granted, he turned right! Maybe supervisor is always right.. Duh. Then each of us were assigned to a patient all at the same time. He gave us 30 minutes to take history and perform physical examination plus preparation for our case presentation. He informed us that he will be around this ward watching 5 of us at the same time.

History taking and physical examination went all right for me. My patient presented with shortness of breath for the past 1 week with known history of asthma. So, I proceed with respiratory examination. Well expected, I missed out something again. Trachea deviation, this time. Presentation was usual and I was able to give a few differential other than the clear provisional diagnosis in the history.

My Q&A session was pretty bad.

1. How do you grade asthma?
I am not sure, doctor. Is it the same grading as shortness of breath by NYHA?
=After that, he didn't really say anything. I didn't know the answer actually=

2. How do you grade the severity of asthma?
Emm.. I am not sure about this.
=You grade the severity by assessing whether the patient can speak one full sentence in a breathe=
(Yikes! How can I forget about this???)

3. What is your management for this patient?
For immediate management, I will first sit the patient upright and give her oxygen for 100%. I will then give her salbutamol with ipratoprium to relieve her asthma. After that, IV assess, if she is dehydrated, I will give normal saline IV. Besides, I will give steroids as well such as hydrocortisone. At the same time, I will do an ECG on her. Later, I will ask for investigations such as ABG, FBC, lung function test and etc...

Fortunately, I didn't get much questions from him as I had mentioned a lot during investigations and I gave my reasons and expected values. Bronchial asthma is something I had prepared and I was lucky to get the patient. Anyhow, 2 out of 3 questions I started with "I am not sure", which I think it was kind of bad as the question was not very tough.

After everyone had present their case, our supervisor seems to be happy but he did not give any comment. He just mentioned that everyone was not bad. I guess we can pass, but not distinction, I guess. However, in my opinion, my group members did a good job. Most of us did not stumble during the presentation and tried to convince the supervisor even though we seems to be shaky in some parts.

There goes my first not very typical observed long case with half of my big group members (Group G). Hope we didn't disappoint Dr. Ting (my supervisor) and Dr. Arif (my registrar) after 6 weeks of teachings.

Next, short case on 6th August, last day of Internal Medicine before we have a week of break and also Sue Ann's birthday.. See ya

P.S to my brother, Sam : My patient did not run away and is not crazy...

Wednesday, 28 July 2010

People in my life..

It is a blessing to have so many lovely people around me throughout my life
Looking back at those pictures, I certainly have grown up a lot
Mentally, physically, social & most important, I am more independent now
Once in awhile, I hope the time to slow down for a moment
So that I can enjoy my teenage life longer
Anyway, time flies whenever I want it or not

My big family *The Leongs*

Daddy, Mommy, Bro & I

High school friends
On the left were pictures when we were still in SMK Canossian Convent
On the right were pictures of us after we graduated high school

Kolej Matrikulasi Johor
Roommates, practicum Hayat 50, Bulletin Board members

Pre-clinical years
From semester 1 to semester 4

Night events during university life
Warisan Mesra with buddies
Junior Welcoming Night when I was junior & senior
Medic Night

Some adventures
FRIM jungle trekking & hiking (very strenous) + canopy walk
Broga Hill hiking and extreme activities

Other events
AMSA Sabah, Pesta Ang Pow in KTSN, EAMSC KL 2010

Other than just medical stuff, of course we need some fun
Ice skating with PBLmate, Eye on Malaysia with friends, birthdays celebration



Tuesday, 27 July 2010


A lot of famous blogs are about their life & clubbing..
Yeah, clubbing and pub...
Yes, clubbing....
Clubbing and party..
And clubbing..
And party...
Bla bla bla...

Well, for me, I have never club before..
Not very interested in it..

When I heard clubbing, it is not the dark place with disco ball, lights and music cross my mind

It was this!



Monday, 26 July 2010

Just covered 5km...

I lost a few kg during my break in between my 2nd year and 3rd year.
Jog with some aerobics and stretching...
It feels really good!

Last weekend (it was yesterday + the day before yesterday), I walked and jogged on Tyng's treadmill.
In 2 days, I covered about 5km...
Can do better actually..
I am not used to running on treadmill yet..
I am looking forward for more km to be covered on the treadmill..
But then, only I realized in another few more weekends, I am off to Tanjung Karang..
I must bring my running shoes there!


Joining me, anyone?

2006 School's Sports Day


Sunday, 25 July 2010

My blog in

Click for a larger view (if this is not large enough)

Take a look at the 'LINKS' on the bottom right
The title CF Camp is a link to my blog post,

For those who had went to Broga Hill joining the OUTBAC or who is interested, take a look at the website


Saturday, 24 July 2010

Cousin's birthday in Pavilion KL

Happy Birthday to Qi Ern & Qi Ying!
Sweet 16, girls..

So, we are heading to Pavilion to hunt for food for their birthday
Haha XD

Up with the pictures!
My cousins, Ern & Ying are so shy for pictures, so it will either my own face in there or other stuff

Pavilion KL

Food Republic for late breakfast
Pavilion is the only place with Food Republic, I am so delighted to see it again as the last time I saw it was in Ion Orchard, Singapore
My spaghetti bolognese & cousin's farfalle carbonara with ham from Western Cuisine
Uncle's ice kacang from dessert & fried wo tip + sausages from Little Taiwan

Classic Cuisine Cheese (Triple C)
Wonderful top up in my spaghetti...

Then we went to have a walk while waiting for Tyng to finish her exam
picaBot, the floor cleaning robot!
Very useful for big houses and busy + lazy people
The promoter told us it is good for people with pets and hairy stuff in the house
(Ying and I exchanged look when the guy mentioned 'hairy stuff' because our floor used to have a lot of falling hairs. So, we are the so-called 'hairy stuff')

Some cars exhibition that didn't really caught our attention

Mouth-watering chocolates displayed at the counter!
Chocolate frog (reminds me of Harry Potter)
Teddy bear, diamond, spoon-shaped chocolates & etc.

Left : Fair Lady Frappe, Miss Coco Frappe (Hot - background picture), Snow White Mocha Frappe
Fair Lady stands for Belgian milk chocolate frappe
Miss Coco stands for only Belgian chocolate
Snow White stands for Belgian white chocolate

Shepherd's Pie

The fondue - Chocolate Affairs!
With kiwi, oranges, strawberries & bananas
The chocolate is very warm at the bottom, nice one!
The best combination for me was kiwi + chocolate
Orange + chocolate was really a new thing

There you go!

End results - solidified chocolate!

I applied for mCoupon for Clinique free 5-day trial packet in Facebook
After a few minutes of consultation, I got 2 Free 3-Step try-ons

Signing out now, people
Hope you enjoy!
National Geographic Store is a very cool place..
(My birthday!)


Friday, 23 July 2010

Skinny? Thin? Slim?

Skinny.. Thin.. Slim...
They are totally different!

I just want the latter

I am so jealous people that is thin
Not exactly the 'lidi' type
I just want my extra flabby pieces out of my body
I have been exercising and eating regularly

But I certainly didn't want to be like this!

Too skinny!
In my opinion, being a clothes model, too thin won't make the dress looks nice anyway


Wednesday, 21 July 2010

Music & Heart

I used to hate Wednesday when I was in primary and secondary school
Know why?
It was my piano lesson day!
I am very annoyed by the fact that I need to practice at least an hour a day or more for better results
I never follow the rules as always
I will only do it for less than 30 minutes
Scales, arpeggio or asparagus, I won't care as I hardly find it make sense

Not until I flipped through a near 2 years old Readers' Digest (issue of August 2008)

I don't remember the title of the article, but this is what it says...

Perhaps those piano lessons you were forced into as a child did you some good after all.
A study published in Heart magazine found when subjects were played samples of music, the faster the tempo, the more the listeners' breathing and heart rate rose; but afterwards this arousal dropped to a lower level than before the music was played.
Moreover, the effects was stronger on those subjects with musical training (wherein you learn to synchronize breathing with the music). Researchers suspect this relaxing effect could be good for the heart 


Sunset out my windows

Photography has never been easy
Having Samsung Wave has make things quite easy for me, as I don't have knowledge of photography
I saw this sunset outside my room and was eager to take a picture of it

I forgot to change the mode in my phone

Let's see what is the difference

Portrait Mode

Landscape Mode

Color of Fall Mode

Sunset Mode

So, is sunset mode out-stand the other mode for a real sunset?


Tuesday, 20 July 2010

Restaurant City, I'm back!

Restaurant City comeback!

I left my restaurant as a junk for more than a month before I dig it out again 
Before this I was super addicted to this game that I kept my eyes on it almost every single minute
Feeding my workers
Taking away the dishes for them
Cleaning the toilets

Not that I had lots of time for it now 
(The loading is always slow)
I just feel like redecorate it

My restaurant new look
Without much changes 
Except it is more colourful now
And less systematic

To level up faster :
- Arrange the table around the stoves
- Put 4 stoves in between with 4 cooks and 4 waiters
- Waiters turn 180 degree and walk straight line faster than diagonally
- You don't have to assign anyone as janitor anyway
- Toilet is not a necessity, popularity won't go down when your customer couldn't find the toilet


Monday, 19 July 2010

5 minutes

I remembered what Mr. Eric Amaladas told me when I was in leadership camp during Form 5
He said :
When you are late, you are not only wasting your own time.
You are wasting the others time as well.
Let's say,
If you are late for 5 minutes and there are 10 people waiting for you
You are not only wasting 5 minutes
You had wasted (5 minutes x 10 people) 50 minutes

We might not realized how important a 5 minutes for other people
However, we realized how many people were killed by breast cancer in a minute

5 minutes can rescue anything
Human, animals, plants
If everyone in this world take 5 minutes to do something good
The world has reach peace in 5 minutes
Dreams may come true

Take 5 minutes to pray to God
5 minutes to love your family and miss them, pray for them
5 minutes to bless your friends
5 minutes to love your life
5 minutes to thank God that you are able to do this now

Thank you for reading this
I hope I didn't waste your 5 minutes


Some people can be...

A lot of things left unexplained

Some people can be so smart, even they did less
Some people can be so good looking, even they did not apply anything
Some people can be so slim, even they eat a lot
Some people can be so healthy, even they smoke and take alcohol
Some people can live longer, even they were totally wrong in laws
Some people can be so lucky, even nothing was done
Some people might have start thinking whether I am talking about him/her, even when I am just talking to myself

Some people can have so many times, even when they are reading this....


Sunday, 18 July 2010

Next station

This is going to be my next station

Theobroma Chocolate Lounge

Be ready to melt in me, baby choco...


Saturday, 17 July 2010

Here in My Home

Home Sweet Home
My holidays not so soon yet, but I am now home for less than 48 hours
Back to Segamat with my cousins and uncle to visit my grandpa
Besides, it is also a place to relax, out of the big city
It is also a chance for me to be with my parents
And love the smell of my house

Durian season is here since weeks ago
I missed the durian 'jatuh' part
No more durians on the trees
Oh ya, forget to tell I once had 2 durian tress at home
Now, only one surviving...

The one and only mini durian on the tree
Took this picture on a mini portable stairs
I am quite shaky actually as the stairs I stepped on was so unstable
Need my mom to hold me and cousin to hold the stairs

Leong's papaya tree

Flowers in my house
I am not good in gardening
So, I didn't know the name of the flowers

I like this one!

Taiwan mochi
Mango & coffee flavours
It is very sweet for me

Japan dried salted salmon
It was very stiff
So hard to chew
(The redness on my face was due to facial done just few hours ago)

Swing made by my dad long long time ago
We are still playing with it 

My dog, Dao Dao
With his steel water bowl..

The one I miss a lot..
Nanyang Kopitiam's Special For You Coffee
(Fei Nei Mok Sok in chinese)

Sunset from the back of my house
Sungai Segamat..


Thursday, 15 July 2010

Vorzüglich! (Delicious!)

Time for some German food.
This is my first time trying out German food.

Munich Gastro Bierhaus


Very elegant and comfortable surrounding
It is quite dark for me, actually
Restaurant + beer house (bierhaus)

I don't remember what is this
Sorry, but it is nice..

Iced Cappuccino

Mushroom Soup
The aroma of this soup is totally unbeatable
Before it was served and landed on our table, we can actually smell it coming
Totally, something that makes the next table turn their head to you

Penne Pasta with Carbonara sauce

Fish and chip
It is very fulfilling as the portion of the fish is really big
Don't let the picture fools you!

Some very typical German food
German sausages
Or should I called it Frankfurter?

Speaking about fish & chip, it was like the most common dish I would order whenever I had my meal in a Western restaurant
I lost count how many fish and chips that I had tried
Munich Gastro Bierhaus had definitely served the top fish & chips I had digested, so far
I might blog a lot about food and drinks, but I am not a food expert yet
I can be very choosy sometimes
Anyway, just bring me to any place I can find food, I will definitely had something to fill me

For beer lover, Munich Gastro Bierhaus served

German Beer
Australian Beer 
Belgium Beer
Local Beer (Malaysia)
Mixed Imported



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