The issue of Melamine tainted milk from China had been up for some time but I was surprised by the fact that not many medical students know it and there are even more that simply do not care or mind to find out. Here is a small article on the basic knowledge of Melamine and hopefully this would help you to more or less grasp the severity of this problem.

Melamine is an organic base which contains some 66% of nitrogen by mass. Melamine is use in producing durable thermosetting plastic and polymeric cleaning products. Some of the end products are glues, erase boards, counter tops, fabrics and flame retardants. It is also used in making high-resistance concrete and fertilizers.

Melamine derivatives of arsenical drugs are used in the treatment of African trypanosomiasis!

Due to it’s high content of nitrogen, some manufacturers added melamine into milk and infant formula to fool the government in the protein content tests. With that, the protein content of the food will appear higher than the normal value.

When melamine is consumed, it can combine with cyanuric acid (which is permitted to be present in some non-protein nitrogen additives used in drinking water) can form insoluble melamine cyanurate, which could crystallize in the renal microtubules. It would damage the renal cells and in the end cause kidney failure. Other than that, it could also lead to reproductive damage, kidney and bladder stones.

In 22 September, nearly 53,000 people had become ill and almost 12,000 people hare hospitalized, affecting mostly babies and kids who consume these milk and infant formula products.

Русcкий : Множественная Миелома

It is a cancer of the plasma cells, which are the immune system cells in bone marrow that produces antibody.

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(Xray below)

This elderly man was admitted with complains of nausea, vomiting, pain abdomen and was in a state of delirium. He has also been losing weight for a while. Here is the xray of his skull.

A skull xray showing multiple lytic lesions. This xray is classical of these lesions.

The cause of his symptoms was hypercalcemia.

The symptoms are classical description of hypercalcemia: bones, groans and psychic moans.

An easy mnemonic to remember Multiple Myeloma is CRAB

Calcium (hypercalcaemia)

Renal failure

Anaemia

Bone lesion (lytic lesion/pepper pot skull)

Here is something to take your head off those thick books.

A friend of mine recommended me this-  Failblog

## Warning ##

Not recommended for students who are easily addicted to funny , crappy images

The author would not bear any responsibility if any of the following or any unforeseen situations happens.

1. Student fails to prepare for classes

2. Student got addicted to the blog and keep clicking “next”

3. Student fails medical school

4.Student laughs too loud till hostel “mama” barges into the room

Adoption Fail

Ski Fail

Braille Fail

Mascot Fail

OK. Back to studies please!

Ol’ school fashion is indeed making its way back into the fashion industry of today. If u can recall, the checks, the fedoras, the VEST!!! Yes, VEST s are indeed becoming one of the most popular ‘items’ these days.

The term vest derives from French veste, Italian vesta, veste “robe, gown”, Latin vest is “to clothe”. In fact the vest was introduced by the King of England back in the 1660’s. King Charles II declared his resolution of fashion for clothes (which is the vest) for the purpose of teaching the nobility thrift. (haha, dun see the point though)
Well, vest in the “oldern” days used to be worn under the blazer by men as a form of a formal attire. But as fashion (and the music industry – thanks to Justin Timberlake) is one hell of a crazy uniquely astounding amazing expression of taste and ideas (as one quoted) it has materialized the old traditional monotonous concept of vest. Even the donning of the suit vest in women is proving its come back.

Vests do come in different shapes and sizes and materials and styles basically ranging from :-

Button up vest (Left), to sweater vest (R) and suit vest (L) (Middle), to in-bankerly worsteds and pinstripes (Right), and “odd vests,” in solid colors, checks and suede.

Here, are some tips on how to carry the vest image right:-

For da’ gals

• A long white button up shirt, vest, blackleggings, heels.
• A white shirt that has the tuxedo ruffles at the top, vest with a black pencil skirt, or with dark was trouser jeans (or even with those checks pleated skirts).
• Vest with any sleeveless top with skinny jeans and heels.

For da’ guyz

• Any long button up shirt (of course the shirt color has to somehow match the color of your vest)
• A suit vest with a polo T with either black jeans or dark colored jeans (an addition of a fedora will definitely make your look stand out)
• Any casual T’shirts with a rugged pair of jeans will go well with a simple black vest.

*An addition of a fedora will definitely make your look stand out. Of course make sure the vest hits the belt right and that the vest isn’t boxy but form fitting.*
With all that erudition, go to your nearest store and pick out a cool looking vest and just go insanely artistic and just ROCK IT BaBEh…!!

That was how my Dad described him and truth be told, it perfectly fits him. I’ve known his Time in a Bottle and Operator for the longest time but unfortunately, I couldn’t remember the lyrics to google and didn’t know what his name was. Then, came the last day of summer ’08 when my father and me went through his old records and I found Croce. That was nothing but sheer miracle.

Jim Croce’s smooth voice first became known to the world during the mid- and late-60s. Dabbling in mainly folk rock, James Joseph Croce ["crow-chee"] was famous for his guitar tunes and, as I’ve repeated twice, his soothing voice. One look at his face, I guess, nobody thought he could sing like that, eh?

His music tends to be either playful [Bad, bad Leroy Brown; Rapid boy]  or hopelessly romantic [I'll Have to Say I Love You in a Song; Time in a Bottle]. The romantic side of Croce touches me deeply. It talks about unrequited love, nostalgic memories, broken heart like no other could say it.

Unlike most of today’s performers, Croce’s lyrics were nothing short of inspirations from God – Take this, for instance from Lovers’ Cross:

“‘Cause now it seems that you wanted a martyr
Just a regular guy wouldn’t do
But baby I can’t hang upon no lover’s cross for you”

And another example from Time in a Bottle:

“If I could save time in a bottle
The first thing that I’d like to do
Is to save every day
Till eternity passes away
Just to spend them with you”

Just for comparison sake, we’ll take an example of his more tongue-in-cheek songs:

“You don’t tug on Superman’s cape,
You don’t spit into the wind,
You don’t pull the mask off that Old Lone Ranger,
And you don’t mess around with Jim”

At the age of 30, at the beginning of his success, Jim Croce died in a plane crash, that same evil fate that claimed another great – Buddy Holly – and tried unsuccessfully to include Travis Barker of Blink 182 earlier this year. [Aaliyah was an accident, not evil fate] His posthumous single – I’ll Have to Say I Love You in a Song – is the third of such category to top the charts.

I personally listen to Croce whenever I have an emotional turmoil. I find his music to have a soothing quality, even his rock-and-roll numbers. Maybe it’s the voice, maybe it’s the lyrics, I don’t know. He’s the only guy who I have an emotional adoration on. [Let's face it, he's too ugly for a physical adoration]

Sustagenius! used Youtube videos instead of imeem because I know how Hiroshima people hate music that autoplay itself. See, Sustagenius! so considerate. You can show your appreciation in the form of monetary tributes or belanja him makan.

This new bluish tram is sighted somewhere near Lenin Square underground station not long ago. I believe that some of us must have saw this early, but hopefully this would be a piece of ‘good news’ for the others who is yet to witness this. Is it the Russian government getting richer nowadays or what?

With smooth sliding doors, I personally think that this new tram carry less people compared to the old ones. The same situation I seen in London when the new underground trains actually have less space compared to the old ones. If so, what is the purpose of upgrading?

These public transport does not use up fuel, but why does the bus fare and tram fare keep on rising? The same thing goes for the marshrutka price. I’m happy that I’m going out from here soon enough before everything start to cost more.

So i was told that guys should not be ecxluded in the matter of fashion updates…hence this is how the topic of “how to wear a tux” came about. When it comes to dressing up, most guys opt for a traditional costume or the usual slacks-n-shirt look. Most of them do not go to the extend of dressing up or putting on a suit! However, if the evening calls for a tuxedo, guys, you don’t have to be worried about looking like a penguin by the time you’re done reading this article.

When to wear a tuxedo

If an invitation to any special occasion (wedding, formal dinner event, convocation etc) say that it’s “optional” to wear a tuxedo, then you don’t have an option – wear a tux. Then again, even if it doesn’t state the attire, you should go to the extra effort of showing your young lady friend that you’re a man of taste and wear one for that romantic evening. You really don’t have to have an invitation as an excuse or a reason. Her affection should be enough of an incentive – it will be worth it! Other than that a tux will definitely strike an impression in any job interview.

Ways to wear a tuxedo

Tie options: The first thing you should know when you’re learning how to wear a tuxedo is that you have three tie options to decide upon: first is the pre-tied bow tie. The second is the actual bow tie, which takes a steady hand and a bit of practice. If you’re in a rush, don’t even think about this one. Third, a black tie adds a modern touch to any tux and is best for an evening with a younger crowd.

Collar styles: The band collar with the two small points facing down is what you usually get if you rent from the tux shop. However, if you have a pinpoint French-cuffed shirt of your own, wear it instead. Why? First, you know it will fit. You’ll also be more comfortable and you won’t have to pay for a lousy shirt rental.

Shoes: Two words for you: Black leather. Just wear your own black shoes, but make sure they are a simple capped toe and polished to a high shine. You’ll be happier during the event and the next day.

Which style of tuxedo should you wear?

1. Single breasted jacket is the all purpose and classic style that will fit all body types

2. Double-breasted jacket always looks better on taller men because of its boxy shape and cut. If you are under six-feet tall, stay with a single-breasted jacket.

Bending the rules

Wearing only the jacket is probably the single best way to dress up a pair of jeans. The mere act screams rebel, so if you’re not confident in yourself with this kinda look, try something else.
Wearing the jacket and trousers with a matching black shirt for a modern look is worth trying if you’ll be attending any event other than a wedding. The shirt, however, must be exceptionally well-made and look as good on its own as it does under the jacket.

sharp-dressed man

Men have a terrible tendency to ridicule the fashions that once made men. Men sometimes still want to go to the party, but don’t think they should dress up. If you don’t want to wear the appropriate attire, then you might as well stay home. Otherwise, just try out the ‘tux’ look and enjoy the fun. The ladies are wearing actual dresses. Your efforts will be rewarded.

A friend of mine just told me that Goths are extreme Emos. SHOCKING, ain’t it? Let me clear this out:

The Goth fashion in one phrase is Morticia Adams. Black hair, pale skin ~ though not necessary, black eyeliners, black nails. The dressing style is highly inspired by the Elizabethan and Victorian fashion, spefically black in color, very morbid, very highly erotic even when usually a Gothic dress covers more than it shows.

The Gothic look has obviously been inspired by the 30s and 40s silent horror movies when the make-up and costume had to speak more about the characters. And synonymous with the stereotypical Gothic look is, of course, Vlad Tepes himself, that is to say, the potrayal of Dracula in most movies.

Male Gothic clothing involves usuall, though not limited to, black trenchcoats. Robes and highly fashionable and extravagant suit is also not uncommon. Apparently one unspoken rule of the male Gothic fashion, they show minimal skin ~ Sleeves are never short.

Goth jewelry, if any, often revolves around heavily decorated crucifixes and simple ankhs. They’re always silver, though.

Personality-wise, Goths, while not extrovert, are generally friendly, try to bring about a mysterious air about them and quite laid back, letting their presentation tell of their Gothic inclination. Though mostly populated by white people, Black, Asian and even Arab Goths are commonplace.

Emo on the other hand:

They started in the mid 80s with the emocore post-punk music scene. Followers then often tend to overpierce and borrowed the eyeliners and black theme from the Goths while retaining most of the punk fashion. These hardcore rockers died in the mid 90s. Unfortunately, a bunch of kids in the early 2000s googled emocore and said, “Hey, I’m emo, too!”

According to the wise men on the Mountain of Wikipedia, Emo fashion nowadays constitutes of “tight jeans on males and females alike, long fringe (bangs) brushed to one side of the face or over one or both eyes, dyed black, straight hair, tight t-shirts (sometimes short sleeved) which often bear the names of emo bands (or other designer shirts), studded belts, belt buckles, canvas sneakers or skate shoes or other black shoes (often old and beaten up) and thick, black horn-rimmed glasses.” The bangs are 100% wajib – without them, you ain’t no Emo, no matter how white you are. Being not so hardcore like their predecessors, Emos have only one or two piercings. Scroll down below for a pic of an Emocore – not Emo.

Emos also dominate almost 50% of the blogosphere – the other 50% being camwhores and very small traces of we others.

As a stereotype, Emos are often assosciated with introvertness, depression, self-injury and suicide. One should not forget that Emos are also assosciated with whinings and groups of people who hates the whining. They’re also predominantly white. Take it from Sustagenius! if you aren’t as white as a Ku Klux Klan bedsheet, do not attempt to be Emo.

As visual aid, here are some pictures for reference:-

Gothic Man

Gothic Eroticism

Goth Couple Playing into the Male Domination Stereotype

Emo Uniform

Emo Clique

Egad, run! It's Emo camwhores!

Emocore NOT Emo

Electronic fetal Monitoring (EFM) will be use to monitor the status of the fetus when the labour is condired to be of ‘high risk’.  Such group would include hypertension during pregnancy, meconium stained liquor, abnormal FHR (Fetal Heart Rate) and can also be use during active period of labour.

Today we are going to talk about CTG (Cardiotocography) and how to interprate a CTG strap.

First of all, one of the transducer shall be put over the fundus of the uterus, while another at the place where the fetal heart beat is best heard. And then the FHR and Uterine Contraction will be recorded. These are few principles that one should know in order to interprete the CTG.

Baseline FHR- It is the mean of the peaks and depressions. Normal would be 110-150bpm (beats per minute)

Baseline variability - It is the oscillation of baseline FHR excluding acceleration and deceleration. Normal would be 10-25bpm

Acceleration – It is the increase of FHR for more at least 15seconds. Normal would be 2 in 20min

Deceleration – It is the decrease of FHR below the baseline by 15bpm or more. Normal would be none or early.

The deceleration pattern could be early, late and variable.

Early deceleration means the FHR begins to slow down at the beginning of UC. The lowest point of deceleration conincides with the peak of UC.

Late deceleration means the FHR begins to slow down after the onset of the contraction. The lowest point is thus after the UC and usually FHR would return to normal before the next contraction.

Variable deceleration means all other patterns of FHR slowing which not necessarily related to UC.

Lag time is the time taken for the FHR to reach the lowest point (nadir) from the peak of UC.

Sinusoidal pattern is the stable baseline FHR without any acceleration. This is usually associated with fetal anaemia, feto-maternal hemorrhage and fetal hypoxia.

That’s all for this time. Read this and try to find more articles online. Hopefully you wouldn’t be so blur when the teacher shows you the CTG in the future!

SVT is a narrow complex tachycardia (narrow QRS) with HR of 140-250/min.

Symptoms include pounding chest, chest pain, shortness of breath (SOB), dizziness and loss of consciousness.

One has to recognize this ECG and perform immediate management.

Non-pharmacological maneuver:

1. Vagal stimulation ( effective in 25% of cases)
2. Valsava maneuver
3. Cold water immersion

(google it yourself)

Pharmacological :

1. Adenosine 6mg stat. Follow by 12mg after 5min and another 12mg after 5min (effective in 80%)

**The ECG showed that adenosine (effects that last for about 20s) that stuns the AV node (transient blockade) with widening of the QRS complex for a short period of time before the heart rate returns to normal at the rate of 75 beats perminute with the normal atrial sinus taking back the normal activity**

During treatment(pharmacological):

Post-treatment: