CaRIng and CaREfRee

Herb and Heart - Another Case

2012-01-24T16:48:00.003+08:00

A 54 year old lady has been my patient for the last two years and on treatment for her hypertension. I normally carry out blood investigations for my patient on an annual basis. Her first blood picture was within normal limits but the second one about five months ago showed that her fasting blood sugar had gone up to near diabetic level.

Having determined her haemoglobin, I did a test to determine her glucose handling capability through glycated haemoglobin or HbA1c. Sure enough the level was at the limit of 6.5%, indicating that she is experiencing an impaired glucose tolerance state. Having explained to her about the condition she is now facing, she has asked that she be put on a diet to control her sugar intake. After two months the fasting sugar level had slightly decreased. She was encouraged.

On the fourth month, the sugar level seemed to have stabilised but still at the impaired tolerance level but I noticed her pulse rate had gone down to 54 beats per minute. She also admitted of being increasingly tired and listless. Her blood pressure was, however, normal.

From my experience with patients when there is a decrease in pulse rate to this level what we term as bradycardia (Pulse rate lower than 60 beats per minute ), the patient must have taken something which is cardioactive (affecting the heart) like some drug or foods containing such agents.

The lady denied taking anything besides the medication for her hypertension. I was not satisfied and kept gently asking her to think of what she had been taking the last month or so which was not in her normal diet. After some cajoling and patience on my part, she revealed that she has been taking an ulam ("salad" in English) twice a day in increasing amount to reduce her sugar level in the body!

I immediately knew what it was and mentioned it to her, yes, it was the same herb/fruit called "jering" in Malay or its botanical name Archidendron Jiringa It has a bitter taste and the local people believe it reduces the sugar level and cure diabetes!

"Buah Jering" tree

"Buah Jering" Pod

I told her to stop taking the fruit/herb as somehow it has an effect on the heart. She stopped it and after about two months her heart rate had returned to normal but her sugar level had again increased and I decided to put her on an anti-diabetic medication as unsupervised diet control and use of herbs could be detrimental to her.

It is sad that people are taking herbs which they think are not chemically active and end up having adverse effects on their organs such as the heart and liver.

The problem is these so called herbs are not properly researched and no one knows about what dosages people need to take to have desirable effects and control of side-effects. A lot of experiences are anecdotal in nature and no one could say for sure that their disease status became better following all these herbs ingestion. I have seen more negative effects on the users of these herbs. But then of course these are clinic patients, that kind of statistics are not valid.

A concerned doctor has cautioned over the use of this fruit here

The doctor's letter was in response to an article on buah jering's purported medicinal properties in the same news portal this link The lack of information on the use of this herb/legume could cause undesirable medical conditions in some patients who are out to prove that they can do away with western medications.

Gong Xi Fa Cai 2012 -Lunar Year of the Water Dragon

2012-01-23T17:01:00.000+08:00

A Year Full of Hope and Accomplishments

Wishing all my blog visitors a healthy,happy and prosperous new year of the Dragon. May this year be healthier for all and fruitful for my stock market friends. The Dragon is a symbol of good fortune and the year ahead is envisaged to be filled with color,drama,lavishness and unpredictability ( just like any other year I suppose!).

Anyway it is good to feel that the year is somehow blessed and that whatever we do with determination and goodness in our heart, is going to be successful.

While continents like Europe is facing the worst economic crisis in their recent history, we in Malaysia is not that badly off though our economy is sure to be affected by the lack of demands for our exports by the EU countries.

I read about how countries like Spain, Italy and Greece have to restructure their labour laws to enable an increase in productivity like lessening the number of annual holidays and firm policy on workers' retrenchments. It's unheard of before but is happening now due to inability to pay their huge debt, too much borrowing and spending, poor income generation and lack of saving.

Good Fortune to All

On a personal level, I feel sad reading about those who are declared bankrupt at so young an age and apparently there are 41 people who are declared as such daily in our country. I really feel that financial knowledge and a culture of saving should be introduced when you are at the primary school level. A young mind is easier to impress.

Let's hope that the Dragon year will live up to its reputation of bringing in Good Fortune to us all. Though I must say we must not forget to make efforts to work harder and not leave things to just luck.

Merry Christmas!

2011-12-25T03:32:00.001+08:00

Wishing all my blog visitors a Merry and Blessed Christmas. It is that time of year again for us to count our blessings and be grateful that we are still here to join in the fun and festivities.

The management staff of my husband's company gave us a delicious Christmas fruit cake. Here it is:

The Box

The fruit cake

The Greeting

The decorative art

The cake was big and we were not likely to finish it so I brought pieces of it to the clinic to be shared by the staff. It was nice to be able to celebrate an occasion where everyone join in and have fun. Christmas is such a special period that the waiting is actually more exciting than the actual day. Days of shopping and gift wrappings are the most enjoyable part. Giving makes one humble when looking at the joy on the faces of the receivers. If only we have more such get-together occasions!

Failure to Thrive and Recurrent Diarrhea in an Infant

2011-12-22T15:31:00.007+08:00

Two weeks ago a young mother brought in a seven-month old baby who looked alert and active and constantly smiling, however, she was small and light for her age. The presenting complaint was that she had been having recurrent diarrhea since the introduction of an infant formula feeding at the age of four months.

According to the mother the child was born within the normal birth weight of 3.1 kg and was fully breast fed till the age of three months and gaining weight well. The problem started when the mother gave her cereals and cow milk-based infant formula. The baby started having loose foul-smelling stools,passing lots of wind,bloated abdomen,appears constantly hungry and always crying. As expected she has not gained any weight for the last three months.She weighs at six kg, well below her weight for age which should been about eight kg .

The mother who is young and only received primary education, is at her wit's end trying to grapple with the problem. She has changed the infant formula brand once but the problem has not resolved. I noted down the name of the brands. Interestingly her first child also has suffered from the same condition, namely "intolerance" to infant formula. As a result the elder child is rather growth-stunted and slow in her milestones. I cannot help but feeling sad despite trying to be professionally detached. I wonder about the child's brain development. this condition is so preventable that it is a dereliction of duty on any health staff who look after these children and yet missed the signs,symptoms and most importantly the history!

The tragedy is the mother has been bringing both children to the local Mother and Child Services and has been told time and again to prepare the milk "properly". Without specific help and advice how does this lowly-educated woman know what to do? She doesn't have enough milk so she claims and the child needs to be fed.

Having listened to her history and description of the signs and symptoms and on physical examination of the child, I immediately made a diagnosis of cow's milk allergy in this infant. She cannot tolerate cow's milk due to possible genetic abnormalities in her gut. Looks like her elder sibling also has the same condition. The two infant formulas that she mentioned are cow's milk-based. She is subsequently advised to switch to a soy protein-based infant formula.

Cow's milk products- A good source of protein

The mother comes today with a broad smile on her face holding her contented baby who has finally recovered from the diarrheal condition. The weight should start to pick up soon. Unfortunately the woman is from a different state and will return home at the end of the week and so I would not be able to get the joy of following her infant up.

The family came here for the school holidays and decided to try our clinic. They are very grateful to have come to us. I advised her to continue attending regularly the Child Health Clinic in her State to monitor her child's growth. Moreover her child might outgrow the cow's milk allergy by the age of two or three. After which cow's milk products could be gradually reintroduced.

I feel relieved for the family.Imagine their months of anxiety and stress! Helping them to solve the problem is yet another invaluable feeling of satisfaction for me.

Stomach pain, headache and anaemia - A triple Whammy

2011-11-27T17:43:00.003+08:00

I have observed among my female patients in their late thirties and mid-forties who suffer simultaneously from these conditions, namely an epigastric pain (stomach pain), headache and malaise and weakness which is found , upon blood investigation, to be anaemia ( haemoglobin lower than 12 g/l ).

Their description of the recurrent headache is not unlike the migraine features. Most of them have suffered from these stress-related malady from their teens. Some have aura prior to the headache while others do not report any such event. Most of these patients have such a bad attack that they self-medicate. As they are not properly followed up by a doctor, they just keep buying those painkillers over the counter (OTC), at times from various pharmacies. In Malaysia, there is no stringent control over the use of these drugs.

And so over the years they gradually suffer from the effects of these drugs, referred to as non-steroidal anti-inflammatory drugs (NSAIDs) such as mefenamic acid and ibuprofen. These drugs have an erosive effect on the stomach mucosa (lining) and causing gastritis and later peptic ulcers.

Unremitting stomach ulcers gradually leads to recurrent bleeding and over time the chronic blood loss leads to anaemia.

And so such a patient has the three medical conditions simultaneously. And the history is almost always similar.

I have made it my practice to really educate those young girls who come to me with recurrent headache or recurrent stomach pain to avoid the unnecessary use of pain killers to prevent this triple whammy later in their life. It is traumatising for these people to finally end up coming to the clinic/hospital frequently at the peak of their life.

The cliché, "prevention is better than cure" cannot be overemphasised. A simple knowledge on how to manage your sentinel medical condition will help a long way in maintaining your quality of life.

Migraine but treated as hypertension

2011-11-01T23:16:00.001+08:00

MM a 45 year old teacher who has been on my hypertension clinic follow up for two years, one day asked me whether her younger sister, JM could come and see me for her hypertension problem . Of course I would not mind. The sister, five years younger finally came to see me a few months back.

I let her to slowly narrate me her problem and later I was able to summarise it as someone who has been suffering from frequent attacks of migrating headaches since her early twenties and had been taking a lot of pain killers that had led her to suffer from epigastric pain accompanied by nausea and vomiting

Five years ago she had gone to see a doctor due to intractable headaches, nausea and vomiting with blurring of vision. The doctor took just one reading of her blood pressure and then told her that he had high blood pressure and needed an antihypertensive (blood pressure-lowering drug). She has been taking the drug ever since whilst her frequency of headaches had not receded.

Lately she had been having more frequent attacks which according to her were brought on by stress. At the same time she had increased her dose of over the counter (OTC) cafergot, to relieve her headaches. And she had been going to different doctors who continue to prescribe her with the antihypertensive for her supposed high blood pressure and pain killers for her chronic headaches which by this time have the characteristics of a migraine.

Migraine headaches can be debilitating and affect quality of life.

I monitored her hypertension for about two months and noticed that her blood pressure was consistently abnormally low despite my lowering the medication dosage. I decided to rest her from the drug for two weeks with a daily home monitoring of her BP and observed that she actually did not have hypertension (BP > 140/90). I promptly stopped the medication and concentrated on her migraine. I told her that she has to stop taking pain killers and cafergot as her liver is showing some injury from such drug usage based on her deranged liver function tests. The likelihood of her suffering from chronic peptic (stomach) ulcers is also great due to those painkillers.

After a general neurological assessment, I then prescribe a drug, a tricyclic anti-depressant for her as an off-label treatment for migraine. The medication has greatly reduced the headache attacks and she has felt so much better. Of course not all people respond alike. Some migraine sufferers do no benefit from this drug, JM is just fortunate to have responded well. I also tell her to have a headache diary to record all the circumstances that could trigger her attacks like foods, drinks and emotional situations. Identifying these factors could help her to manage the attacks better.

In the meantime her blood pressure has remained normal and so does not warrant any drug.

There are many pitfalls regarding the diagnosis of hypertension as it could be influenced by many factors like over-anxiety and extreme tiredness and lack of sleep or even pre-consultation caffeine drink. It is also unwise to start this lifelong treatment based on just one reading of the sphygmomanometer. Unless the BP is extremely high, monitoring it for a week or so would give an idea whether there is actually hypertension.

So JM who has been on treatment for her "alleged" hypertension for more than five years actually just needs an appropriate medication for her migraine headaches.

Amanah Saham Nasional (ASN) units on "sale" and dividend in two months' time

2011-10-13T23:07:00.000+08:00

This morning I went to the local ASNB (Amanah Saham Nasional Bhd) branch to update my AS1M (Amanah Saham 1 Malaysia) book. It is always a good feeling to see your dividend in print! And by the way, as many of us know if you do not take out the dividend as it is annually credited to your account, you are actually unleashing the power of the "compounding principle". The accumulated amount is, however, subject to the annual rate of inflation which would affect the "value" of your money in the future so just be mindful.

Not withstanding,this mechanism of multiplying your money is excellent for young people who have many years of working before their retirement either in the private or public sector or anyone else (businessman) for that matter. Saving for one's old age when one's capacity of income generating is greatly reduced is clearly a responsible practice.

Now for those who still want to make more money in a couple of months' time and are eligible to purchase the variably-priced PNB unit trust managed by ASNB, you can buy ASN whose price has come down slightly from 0.85 to 0.80 per unit and the dividend to be declared in about 10 weeks' time is expected to be more than 5 sen per unit thus giving you a better dividend yield compared to the fixed priced PNB unit trusts.

Transaction fee currently discounted by 2%

As it is variably priced, like ASN2 and ASN3, there is an up-front transaction fee of 5% but for the period till end of this year, the fee has been discounted to 3%. The rate will revert to 5% in the new year (2012). It is a good way of "parking" your available money for temporary investment. When you decide to sell after the dividend is declared, there is no more transaction fee. Of course, depending on the unit price after the declaration of the dividend, you will either have a major or minor gain but unlikely to lose.

I was made to understand that ASN unit price is benchmarked against the Bursa composite indices and if the current notable recovery on the stock market is any indication, one would expect the unit price to rise in the new year. The upcoming election is expected to momentarily excite the market despite the palpable external financial turmoil.

Honestly, I am envious of people who are eligible to purchase this unit trust as there is a high probability that they will gain. A caution here though, any decision you make to buy this unit trust is entirely at your own risk.

Benign Prostate Hypertrophy (BPH) and hypertension and......

2011-10-09T01:12:00.000+08:00

My 52 year old patient RM has been on my hypertension clinic follow up for the last 12 months. Before that he was seeing other doctors. As he is a serial defaulter of his treatment, he keeps changing doctors earlier on to avoid, most probably, being rebuked by some of them.

RM is an educated man holding quite an important senior position and he also travels outstations quite often. Besides having signs and symptoms of an enlarged prostate and a history of hypertension, he also suffers from chronic constipation and urinary retention, strangury, frequency and nocturia. All these symptoms are likely to be the effects of his enlarged prostate.

I also observed that RM always looked depressed and not forthcoming about his condition especially with respect to his medications. I found out that he also defaults his urology clinic appointments (for the management of his prostate problems).

On his third visit I noticed his blood pressure to be rather low, 108/72. I asked him whether he was taking any other drug beside the blood pressure lowering drug that I have prescribed for him. He denied this. I was worried and after the consultation, told him to return any time he felt an unusual discomfort. He looked, as expected, rather depressed.

His following appointment was in August 2011 but he never turned up.

He came in early October with the complaint of numbness on the left side of his body. He had defaulted for two months. He also failed to keep his urology appointment. At first I thought he was suffering from a mild stroke due to a high blood pressure as he admitted he had not taken anti-hypertensive drug for the last two months. But his blood pressure was strangely within normal limits. I also could not elicit any signs of a weakened left side of his body. His sensory and motor responses were normal so as his muscle tone and power and there was no other neurological deficits.

I was scratching my head as to what was going on with this "non-compliant" patient. I asked him again what other medication he was taking and he had better tell me if he wanted me to help him. After what seemed a long time, he admitted he was taking a drug to increase his urine flow. Then it dawned upon me that RM has been taking a drug called terazosin which also acts as a blood pressure lowering drug. That explained the low blood pressure recorded on his last visit. He was taking a double dose of "anti-hypertensive"!

It is therefore no wonder he experienced discomfort due to a low blood pressure whenever he was taking my prescribed drug. When he stopped the medication, he felt better and so he defaulted. I painstakingly explained the accidental blunder to him. I might not have continued the anti-hypertensive's prescription had I known he was on terazosin.

On this non-scheduled visit, he admitted his urinary symptoms, accompanied by back pain were getting worse. Wanting to be referred to the hospital , he came up with the complaint of left-sided body numbness which was, however, not verified by specific physical examination.

Giving him the benefit of the doubt, I referred him to the emergency department of the hospital for further evaluation and observation . Prior to that I took the opportunity to advise him to always cooperate with the doctor so that his condition can be better managed.

And honestly, it takes great patience not to dislike this kind of patient. Despite his reluctance to cooperate and his defaulting twice on my clinic, I have never admonished him, that is the reason he keeps returning but unfortunately he stretches it a bit too far and ends up not helping himself.

Urinary incontinence : An 11- year suffering

2011-10-08T22:47:00.003+08:00

Last week a lady of 50 came to the clinic complaining of pain whenever she passes water (urinate) and this has been going on for many years. It has become worse for the last few years and whenever she goes to a private or government clinic in her home town, she is given the standard treatment for urinary tract infection, that is a course of antibiotics and bladder cleansing solution. But the condition keeps on recurring and she has lost track of how many similar treatments she has received.

She traveled a distance of about 130 km ( about two hours' drive) to come to the city to get another medical opinion.

I decided to engage her by asking about the history of her condition. She married in her early teens. Her problem started about 11 years ago since the birth of her last child, her twelfth (12th)! It was a home delivery and she suffered from a uterine inversion , she said "semua peranakan saya keluar" ( my uterus came out ) and had to be pushed back in at the hospital. She has been on an injectable contraceptive ever since then.

I probe on the nature of her urination. From the answers I summarize the following; she feels a sense of heaviness as if something is coming down there (private part), she has urine dribbling, aching pain in her back and pelvic region, she has frequency (urinating many times a day ) and also urinating many times at nights (nocturia) and at the same time she feels she could not empty her bladder completely and urine keeps leaking and more so whenever she coughs (stress incontinence -loss of control of her bladder).

Her urine test showed the presence of a small amount of red blood cells but it was the physical examination of her genital area which confirmed my suspicion. There was an irreducible bulge coming down her vagina. The condition is referred to as pelvic organ prolapse most likely to be uterine. Prolapse of the uterus is the downward movement of the uterus due to weakened muscle of the pelvis likely as a result of injuries during childbirths.

The obstetrics history (twelve deliveries) of this poor lady testifies to her present predicament. No amount of antibiotics is going to help her unless her basic physical problem is treated. Her long suffering is due to poor diagnosis of her symptoms. A proper history taking could have avoided her unnecessary poor quality of life. As it is, none of the doctors who attended to her ever examine the genital area. Her gynecological problem requires to be managed at the secondary care level (by a hospital gynaecologist) through referral which was what I promptly did.

Steve Jobs- Farewell to a Global iCon

2011-10-06T23:01:00.002+08:00

I join the world today in mourning the passing of a great inventor and a computer genius, Steve Jobs on 06 October 2011. His accomplishments are legendary and his legacy will be remembered for generations to come. Macintosh, iPod,iTune,iPad and iPhone are Apple products brought to us through the collaboration ,innovation, vision and efforts of Steve Jobs.

Steve Jobs, Apple Products and Apple Shares

He changes the world of computing and makes it more delightful wherever we are.

I just like to re post some of selected net photos on Steve Jobs as memories on my blog.

The young multimillionaire

The Apple of the World's eye

Innovator and marketeer extraordinaire - iPod 2001

The world loves Apple


Turtle-neck sweater,Levi 501 jeans, trainers


iPhone launching 2007

Steve Jobs's silhouette on Apple logo- Tribute by Jonathan Mak (Hong Kong)

The outpourings of tributes the world over for Steve is just amazing. He is indeed the Apple of the world's eye.

Quotable quote from:

Interview with Wall Street Journal, 1993

"Being the richest man in the cemetery doesn't matter to me… Going to bed at night saying we've done something wonderful… that's what matters to me."

What a remarkable man!

Thank you Steve, we will miss you.

May you rest in peace

Life of Steve Jobs

Born in San Francisco in Feb 1955 to students Joanne Schieble and Syrian-born Abdulfattah Jandali - adopted by a Californian working class couple
Had a summer job at Hewlett-Packard while at school - later worked at Atari
Dropped out of college after six months and went travelling in India, where he became a Buddhist
Launched Apple with school friend Steve Wozniak in 1976 - first Apple computer sold the same year
Left Apple amid disputes in 1985 but returned in 1996 and became CEO in 1997
Bought Pixar animation company in 1986 for $10m
Married in a Buddhist ceremony in 1991 - has three children with his wife and a daughter from a previous relationship
Had a personal wealth estimated at $8.3bn (£5.4bn) in 2010
Diagnosed with pancreatic cancer in 2003, and after three periods of sickness leave, resigns as Apple CEO in August 2011

Medicalisation of pre-Disease States

2011-10-05T16:18:00.000+08:00

Have you heard of talks about preventing a chronic disease by using drugs? It sounds attractive if you could prevent diseases such as diabetes and hypertension (high blood pressure) by just taking drugs. It is of course highly attractive for drug makers (pharmaceutical companies) to expand their business to include a lot more people as to increase their already gargantuan profits for shareholders.

UnNatural Ways Only When Needed

Medicalisation of pre-disease states is virtually giving drugs (medicating) to healthy people with the objective of preventing chronic lifestyle diseases. It is not unlike immunising people against preventable diseases such as diphtheria and measles but in this case the mode of prevention is through the stimulation of antibodies to fight against the disease agents such as viruses and they are not given everyday.

However studies done a few years back did not provide a conclusive evidence that an antidiabetic drug could prevent the disease, in fact modification of lifestyle like proper nutrition, maintenance of ideal weight and exercises, is noted to be just as effective.

Giving drugs to healthy people will make them feel like patients and could affect their quality of life especially if they suffer from adverse side-effects as often seen among patients on medications. At the same time there is the rise in costs to the society in terms of spending more on drugs with questionable outcomes and increasing use of health care (increased economic burden).

If you notice many people are taking vitamins in the belief that they would keep them healthy. The business of vitamins marketing is expansive. Healthy people who would get most of their vitamins through proper nutrition have opted to take the easy way out by ingesting these pills and then telling themselves that they are feeling better and healthier... a self-fulfilling prophesy. This vitamin intake also gives a false sense of security especially when it is unaccompanied by healthy lifestyle practices.

Suffice to say the medical fraternity is generally against prevention of diseases such as diabetes and hypertension through the use of drugs as current evidence and health economic considerations do not justify their clinical use.

Amanah Saham 1 Malaysia (AS1M) - Higher Declared Dividend in 2011

2011-09-27T14:09:00.006+08:00

The last dividend declaration for PNB's Unit Trusts for 2011 is AS1M. This is the second year the fund has come into existence since its launching in August 2009 by our Prime Minister. The first year's (2010) dividend was nothing to shout about at 6.38 sen per unit. Many investors were kind of disappointed as they thought being the latest, it would give a 7 sen per unit or more like the previous funds such as ASM. The Sime Darby's cost overruns and a negative hit on its shares in middle of last year was blamed for the lacklustre performance of the fund.

The Chairman (L) and CEO (R) of PNB at AS1M's 2011 dividend declaration on 22 Sept 2011

This year, the second dividend has been declared at 6.50sen per unit , an increase of 0.12. A slight increase given the current market turmoil. Well, it is more than three times the bank rate so it is no wonder that the fund has been fully subscribed by the non-Bumiputra (Chinese). Allocation for other ethnic groups are still available. According to PNB, as at 20 September 2011, 5.49bilion units of the fund are being held by 270,598 investors.

AS1M transactions are currently suspended from 21 September to 2 October and you can update your book on 3 October 2011 as the dividend is automatically credited there.

It is comforting to get the dividend during this current market's poorest performance, reminiscent of the 2008 financial meltdown. I was thinking of parking my AS1M's dividend in another unit trust which is variably-priced and that is set for a better dividend yield but am worried that after its dividend, to be declared in January 2012, the unit price would plunge as to wipe off all of my gain ! So I had better be on the defensive by keeping it in AS1M till such a time when the market returns on the road to recovery.

It is wise to stick to capital preservation during stock market's unusual down-trend.

The fun has virtually gone out of the equity market right now and I have stopped looking at my portfolios' dwindling values. Let me just be happy with my AS1M dividend for the time being and dream a little......

Diamond-studded Kitty ring at USD4,250.... for decor only :)

Stock Market Shaking, Oil and Gas Stocks Tumbling.

2011-09-22T22:58:00.003+08:00

There is a sense of loss as I look, transfixed at my rapidly tumbling portfolios. My oil and gas counters have all taken a hit. Apparently the managers of foreign funds have again decided it is not worth putting their money in Asian stocks due to an anticipated poor demand from America and Europe affecting our exports. So they take flight to other so-called safer haven.

My Pchem ,at an all time high of 7.50 about three months back has collapsed at 5.68 this morning. My Dialog is at an all time low now at 1.97 after a high of 2.70 and I bought them at 2.19 and so is my Kencana bought at 2.93 and now a measly 2.53 and as luck would have it I did not buy Armada whose IPO I failed to get. Thanks goodness!

Remember Armada was listed on 27 July 2011, hardly two months have passed, and open at 3.65 and has gone up to 4.50 and look at today, the price has tumbled down to 3.45! Shall I buy now? Or should I wait for it to fall further nearer to its IPO price of 3.03? Honestly, nobody could tell whether this declining trend will continue or stop. Everyone appears jittery. One day up, the next day down and now, down and down.

Armada is falling down,falling down.....

The European Union's dallying on robust debt restructuring solution for Greece's potential default and the American's job problems have all affected worldwide investors' confidence. The IMF (International Monetary Fund) has warned that time is getting short as stock markets around the world are reacting negatively to current economic outlook and recession fear.

The present market uncertainty is extremely bad for investors. For people like me who have the tendency to buy and hold,despite many pundits' advice against it, we are at the losing end as our shares depreciate greatly in value, reminiscent of the fall in October 2008, precipitating a GFC (global financial crisis).

Things have to move on nevertheless.We have yet to reach the trough.

I am eyeing Armada after selling off my CMMT today at 1.32 and which I bought at 1.04 last year. I am afraid to wait as I did with Dialog as the recession is looming if the Feds and the European Big Guns are not doing anything to shore up markets' confidence . Like it or not, our market is affected by their actions and manipulations.

I feel sorry for the politically-embattled Angela Merkel, the Chancellor of Germany as her people, the German taxpayers, are getting fed-up of aiding Greece which doesn't seem capable of putting her financial position back on track. And the Feds might have to come up with yet another quantitative easing 3 ( printing new money guys!) to help those banks to lend money for businesses in US. If they do then we will see some market recovery here in Asia including Malaysia.

Rather convoluted I must say this globalisation thing!

Fungal infection - How does it look like on your back?

2011-09-17T00:49:00.001+08:00

An obese 52 year old single mother has been my patient for a couple of years. She comes regularly for a follow-up of her hypertension ( high blood pressure). Her condition is under control with her present medication. And she is not a diabetic.

On one or two occasions she complained of itchiness on her arms. Upon examination, I diagnosed it as a fungal infection (tinea corporis) and prescribed her an anti-fungal regimen and after some weeks the lesions had cleared.

Last week she came for her review and at the same time she said she had been coughing for the last two weeks or so and had difficulty breathing when her coughs were bad. As per my practice, I wanted to listen to (auscultate) her chest. Whilst most local primary care doctors would just put their stethoscope on the back with the clothes on, my medical trainers had always insisted that we asked the patient to lift up their clothes and examine it that way. Observe the chest movement of the right and left side before auscultation.And that is what I always practice.

I auscultated the lung from the back and found that the lady had an abnormal breath sounds on her left lung and diagnosed it as bronchitis.

But there was something else I observed on her upper back. It was a large area of fungal infection which looked migratory and active in the lower middle of her back with visible scratch marks around it. I asked her whether she knew about this or has she got any itchiness over this area. She replied yes, and she had been asking her only child, a son to apply some kind of an over-the-counter cream on it. I asked her whether she knew what the area looked like and of course she did not know because it was on her back. Her son just described it but she really could not visualise it. As it is very itchy she even had some kind of heat treatment on the back to relieve it.

Migrating fungal infection on the back

I asked her permission to take a photograph of the lesions and show it to her. She was surprised to see the picture. The skin infection is fungal and she needed the right cream to treat it. I have a feeling she had been applying a steroid cream which temporarily relieved her itchiness but actually made the infection worse through extension as the fungus thrives on steroid!

Her problem is further compounded by her heavy attire and tight hair scarf (hijab) which is relatively inappropriate in our hot weather. The excessive sweating promotes fungal growth. I advised her to use cotton material and not to cover her head at home and maybe use the normal scarf for the time being while her back condition is being treated.

So concerned was she about her modesty that she had never admitted her skin problem on her back. Moreover she thought it was simple itchiness as she could not see it. Inappropriate therapy had worsened the condition and her heavy clothing did not help at all.

I am prescribing her a local anti-fungal regimen failing which I might have to resort to an oral therapy. Had I not asked her to lift up her blouse for her chest examination, I would not have seen this treatable skin disease. Left untreated the disease would eventually burn itself out but in the meantime she could get other skin infection due to the constant scratchings and the discomfort of itchiness could disturb her sleep and affect her quality of life.

Chronic Cough - the Magic of a Correct Diagnosis

2011-09-14T10:49:00.008+08:00

A 21 year old female office worker came in yesterday morning complaining of cough for the last six weeks. She had been to see a doctor who gave her a week's prescription of an antibiotic which she said she took once daily (1000mg) but she did not know the name when asked. She was also given a cough syrup and a decongestant which she also religiously took but her coughs persisted.

She was getting desperate as she coughed so much at work in an air conditioned office. And she admitted that her coughs were worse at night and had disturbed her sleep and made her irritable. She looked miserable and she was also extremely worried about getting PTB.

As per our clinic protocol for coughs lasting more than three weeks, I did a screening for PTB (pulmonary tuberculosis) consisting of a chest xray, sputum for AFB (acid fast bacilli) for three morning consecutively. I also took her blood for FBC ( full blood count) and an ESR (erythrocytes sedimentation rate), a non-specific indicator of increased inflammatory activity in her body.

But most important I asked about her medical and family history. Yes, the father had PTB a long time ago but has been treated. Yes, her younger brother suffered from asthma but has more or less recovered over the years . No, she has never had asthma but she offered the information that when she coughed so bad she could hear a gritty sound in her chest. And currently she is all congested and her nose is all blocked.

I examined her chest and found it to be clear of any abnormal sounds. Her chest Xray was also normal apart from a mild congestion on her right lower lobe. Her FBC showed an allergic picture with an elevated neutrophils and ESR was mildly elevated as expected in an inflammatory condition but not too high as seen in chronic conditions such as PTB or connective tissue diseases like SLE (systemic lupus erythematosis)

There are other causes of chronic cough such as post-nasal drip and GERD (gastroesophageal reflux disease) but the history pointed to more of a recent irritant causing increased secretions and bronchospasm giving rise to incessant coughing. I surmised that her problem started with an upper respiratory tract infection likely to be viral and this was not properly managed as she was later put on (likely) a broad spectrum antibiotic and long term anti-tussive and anti-congestant that somehow served to irritate her bronchiolar linings causing bronchospsm, increased secretions and narrowing of her airways. The narrowed airways prevented normal clearance of the accumulating secretions.

What she needed was a bronchodilator to reduce the spasm and clear her airways. That was what I gave her. Before she left my clinic yesterday I asked her to return the next morning and show me the antibiotic which was prescribed to her for my information as I wouldn't want to give the same one in case she needed it.

Early this morning she turned up with a piece of paper on which she wrote the name of the antibiotic which she got via phone from the private clinic. Unfortunately it was some garbled word which didn't look at all like any antibiotic that I knew of despite looking up in the internet! Anyway that information was no longer important to me.

What is important to me is the smiling and happy woman I see today. She says she no longer has any cough. She slept well last night after taking two oral doses of the medication I gave her. She couldn't even cough out any sputum this morning for the AFB test as her chest and throat have miraculously cleared overnight. She said her friends also commented that she no longer coughed irritably.

When she got up from the chair to leave she bent forward, extended both her hands and cupped my right hand tightly to thank me and said that she'd never been so relieved in weeks.

I am very pleased with her fast response to the medication and this is the kind of cases which gives me a deep professional satisfaction.

It's sexually transmitted and It's gonorrhea!

2011-09-12T16:46:00.000+08:00

A 45 year old lady has been coming to the clinic with the complaint of recurrent foul-smelling vaginal discharge since a year ago and was seen by various doctors who treated her for vaginal candidiasis (fungal infection). She was quite distressed by the time I saw her as the condition never seemed to go away. She admitted going to both government and private doctors and found no relief despite being given antibiotics as well.

I decided to engage her by asking about her family life including her sexual history. Yes, she is married with four children and now working as a housekeeping staff in one of the local hotels and no, the husband is most of the time outstation and comes home only every now and then and that rings a bell for me. I decided to take a high vaginal swab and test for sexually-transmitted disease (STD) organisms like gonorrhea, chlamydia and trichomoniasis and there the result before me " intracellular diplococci, morphologically similar to Neisseria gonorrhea", there you are, the source of her malady. She was promptly given an intramuscular injection of an antibiotic most suitable to treat the disease.

I informed her to tell her husband to come to the clinic for a similar treatment as required under infectious disease protocol. She told me her husband was still outstation and she appeared reluctant to come with him for an STD counselling. Anyway, I advised her to get her husband treated as some gonorrhea cases in men have no symptoms. I also carefully suggested to her that this kind of condition normally thrives in cases of having multiple sex partners so it is wise to avoid such a situation. As a health personnel, we have to educate our patient on the nature of the disease and its transmission.

Usually in a busy practice local doctors would hardly ask patients for a sensitive history, preferring to shoot in the dark by treating the commonest condition in a woman with vaginal discharge that is candidiasis, a fungal infection. The tragedy is when every time she comes in she sees a different doctor and so the history of treatment is not really scrutinised. Often the same therapy is repeated as in this poor woman's case.

Today she comes for review six week-post treatment and reported that her condition has cleared for the first time in months! A disease needs to be correctly diagnosed and given the right treatment to be cured. I am relieved for her.

Averaging Up or Down- My Experience

2011-09-11T01:12:00.001+08:00

As I was reading an article on this topic by one of my favourite bloggers,Musicwhiz, I was reminded of my own experience in dwelling on such activities or shall I call it "plunging" into them?

It was in early 2007, nearly a year before the global financial crisis. I met with an accident and had to stay home for almost a month. As I sat in front of my computer with my left leg in a plaster cast, I noticed that the market was in an unusual vibrant mode, call it a bullish trend if you like. I had much earlier bought some "Renong" shares which was later converted to UEMworld and the unit cost then was 1.25. This counter suddenly became active and as it was going up, I kept buying without really understanding the principle of averaging up, mind you. Had I known the risk I would have been in fear and more careful.

My effort was well rewarded though, as by the time I sold off all of my UEMworld shares at 4.40, I had made a small fortune all in a matter of eight weeks or so. I was extremely pleased with myself and that rather massive gain was used to buy other shares and make up my variety of portfolios. Well, it was a success story, one based on instinct rather than a careful study of the fundamentals of the company. Certainly not to be emulated by anyone worth his salt. Average up and gain?

Then in the first quarter of 2010, as I was looking at the trend of the various sectors in the market, I noticed that the technology sector was doing relatively well in rotational plays. The new kid on the block, JCY whose IPO was at 1.60 had even gone up to 1.98. Then suddenly JCY, along with the other technology stock prices like Notion, started to fall. Mindful of the possible opportunity to buy low, I went headlong into the market and bought JCY shares at 1.52, well it was below the IPO price wasn't it? Then it fell again and I kept buying till I realised that I was putting my money into a bottomless pit and ceased averaging down forthwith.

The Greek sovereign debt woes and worries on its contagion effect as well as the fall in demand for hard disks had battered down the technology stocks and I came by the news rather late. I lost a substantial sum of my hard earned money on this stock when my broker advised me to dispose all of it early this year at 0.58 sen. Luckily I followed his advice as a few weeks later it still continued to fall and now I think it is at 0.40 sen. Certainly nothing to be celebrated. Average down and lose!

I used the proceed to buy the Pchem IPO in trading and service sector and as luck would have it I was successful and able to compensate for the loss when this newly acquired stock went up by RM2.00!

In my little experience ,averaging up in a bullish market proved to be lucky and lucrative despite the apparent risk and my averaging down, while seemingly clever, in a volatile market still in the shadow of the recent GFC (global financial crisis) was disastrous. And my final disposal of the technology stock at a great loss was a fortunate decision as it went down still lower and would have suffered greater losses had I held on to those shares. And my good luck with Pchem had single handedly turned around my financial status.

There was an interesting comment which pointed out that if you keep averaging up, you are a masochistic (pain-loving) and if you do the same by averaging down you are a hedonistic (pleasure-seeking). Tell you what, when I was performing those two actions I hardly thought of the pain or pleasure.... I was just having fun with Mr Market!

MRCB or ARMADA and Market Volatility

2011-08-12T16:33:00.010+08:00

I have some fund available for investing following my failure to secure Armada IPO last month. Instead of keeping it in some unit trust accounts, I have decided to see how the market performs with regards to Armada. It does not seem to come down, in fact it is going up gradually defying analysts' prediction of its fair value being about 3.92. Instead it goes up to 4.20. I am not about to put my money in this overvalued stock. So I wait.

My oh My!

Then that precipitous fall at New York stock market occurs on 5 Aug, DJI index declines by over 500 points, the single largest dip since 2008, and followed by other world markets the following Monday 8 Aug; Malaysian stock exchange is no different.I note an ocean of red with many favourite stocks which were making gains the week before falling by as much as 15%. I see Armada goes down to 3.80 and another stock, MRCB which I am monitoring falls from 2.55 to 2.16. I am debating which one, Armada or MRCB that I want to acquire. I read about the market not likely to recover in the short term, I read about when one goes bottom-fishing and I read all about the gloom surrounding most markets and so I waited.

Bumi Armada

Then market suddenly rallies on 10 Aug based on the Feds promise to keep interest rate to almost zero for two years and everywhere the stocks return to black! (Re: my last posting on Back to Black :D). After doing some simple calculation on stock yields, I decided on 10 Aug to get those MRCB shares which opened at 2.16 on Monday but has climbed back to 2.20. Well I thought I was not going to wait any longer, just close my eyes and told my remisier to queue for that price and I got them in less than 20 minutes... Gosh some guys really wanted to dispose of those shares! I just hope my luck holds out, in this volatile period one is supposed to focus on capital preservation and not going headlong into investing but remember no risk, no gain!

The next day, 11 Aug Thursday, MRCB along with other stocks fell again ( following Wall Street of course the evening before) and this time based on remarks about Germany's and France's exposure to down-rated Spanish and Italian bonds... Ghee, what else could be there that are going to affect the market? I know the British riots do not affect it, I supposed when China, US or the economic giants of Europe cough, we will all be sneezing as well ( a cliché I know). And so I saw the value of my MRCB stock went down to 2.09 overnight. Immediately I rang up Jenny my stock broker to buy additional MRCB shares at 2.10 to dollar cost average. But she never rang me back as the robust stock held up at 2.20.

Angela Merkel and Sarkozy - a Powerful Pair

World markets return to black on 12 July following Wall Street overnight recovery after Angela Merkel the German Chancellor and Sarkorzy, the French President indicated that they would get together to discuss the eurozone debt and that their exposure to Spanish and Italian bad debt is not critical. And so my MRCB shares return to 2.23 as for now.

What a historic week for stock markets around the world! After a week of the most volatile trading sessions since the global financial crisis, the Dow Jones rose 423 points yesterday, but it remained 301 points in the red ahead of this Friday's session .Morgan Stanley Smith Barney vice-president Fabiola Gibson told the Australian online that "The difficulty in a market like this is that no one has time to think. In a market like this you need nerves of steel."

This extreme volatility tends to erode investors' sentiment towards equities and no wonder everybody is buying gold pushing the price of the metal at an all time high.

Well for the small time retail investor like most of us "the nerves of steel" is an option for people who find investing challenging where gaining and losing is part of the game. Just sit back and relax!

Stock Market - An Ocean of RED and Back to BLACK

2011-08-05T15:49:00.002+08:00

Since early this year I have been following news on the world's financial health especially the recently protracted partisan haggling in raising American debt ceiling. Their Congress managed to resolve the impasse just hours before default on 2 Aug 2011 much to the relief of the financial world. Most of the writings point to another possible GFC2 (global financial crisis). Things have been further confounded by Europe's sovereign debt crisis which seems to have defied remedies and threatens more euro-zone economies.

Like most investors, I am worried , yet I hesitated to offload some of my stocks early last week. My hesitation does make a poor investor out of me. The intransigence was an opportunity lost. Despite being a small-time market player for quite some time, I must admit I am no savvy investor. I have created wealth no doubt but not as much as it should had I been more decisive and less greedy ... ooops!

Last evening saw the worst Wall Street sell-offs in two years. The world has seen it coming. Investors just fled the market on news of American worsening economic data and the failure of the stimulus packages to spur her economic growth. The Dow Jones Industrial Index was down by more than 500 points. I foresaw an ocean of red in our own stock market the next day which is today and as sure as the sun rising from the east, the ocean of red stares at me from the screen of my computer when market opens.


Market free falls at New York Stock Exchange Aug 4 2011 (WSJ)

Ocean of RED at Bursa Top Volume Aug 5 2011

Following the DJI steepest decline since 2008 yesterday, panic selloffs also hit other Asian stockmarkets . And the Australian stock market wiped off nearly AUD56b this morning. It seems that it is a natural reaction for most investors to panic and convert what they have got in the market around time like this to cash and someone has made a remark that if this was the favoured technique, it should have been done before the crash!

It is envisaged that markets will continue to be tough for the next couple of months in the absence of any short-term resolutions of prevailing macroeconomic issues and investors have been advised to balance up the need for return with the absolute need to preserve their capital. It is not the time for borrowing and investing.

The Present Cliche - Credit The STAR

Well, for people who have the fund to spare for the longer term (one or two years?), it is the time to buy up those battered down stocks and wait for them to come back to black for long-term gains, reminds me of the popular song of the same name by the late and tragic British singer and composer Amy Winehouse.


Amy Winehouse-RIP

Savvy and lucky investors would have capitalised on this large hiccup in the market. As for me I tend to be wise after the event..... rather unfortunately.

Just as well I am still hanging on to my precious money and not silly enough to buy the coveted Armada shares last week, the price was rather low this morning since its launching on 28 July 2011. Time to buy I guess.. no, no, just let me wait a little bit longer as Armada's trading is in USD and I note that the greenback is weakening..... Typical me I would say. By the time I decide it would have been Back to Black.

Adamo-Inch'Allah (Italian)

2011-07-30T13:08:00.003+08:00

This is the Italian version performed by Adamo Salvatore. You can search for the English version if you want to understand what he is saying. The version is beautiful to my mind with poignant message on the conflict in the Middle-East.

"Requiem for millions of souls

Of people lying in nameless tombs

In heaven there's room for them all

Now enough blood, Salam! Shalom!"

Paul Mauriat - Inch Allah (1967)

2011-07-30T11:29:00.005+08:00

Paul Mauriat's music has never ceased to give pleasure and amaze his fans the world over. This particular piece I found today is so soothing to my mind that I practically and unconsciously become relaxed and so I would like to share this with my music-loving blog readers.

This is an instrumental interpretation of the original song by Adam Salvatore. It has been put into several versions, Spanish, French, English and Italian. I love the Instrumental version by Paul Mauriat best as it is universal. However to give that feel of a person singing this composition I want to post it on the Italian version as it seems to be more sedate and kind of romantic. I think Insya Allah means "God Willing".

I would also like to share a couple of comments I like on Youtube about this great,classy and gifted composer:

** May there be a special place in Heaven for people like you Mr. Mauriat who have never failed to bring us such delight and unspoken wave of memories with your gift of music. You live on in our hearts.

WINDYCLAIR

The message from Japan :
** Hello, thanks a lot for your uploading it. This is my very favorite music. Though Paul Mauriat is no longer living, he left many many beautiful performance and music. I will continuously listen to them, and have a good time.

Thank you.

Financestaff

Go on, close your eyes and listen to this heavenly gem..

Paul Mauriat - LOVE IN EVERY ROOM ( EL AMOR ESTA EN CADA HABITACION ) ...

2011-07-23T12:33:00.000+08:00

Bumi Armada.. say what you like, investors just love it!

2011-07-21T22:35:00.006+08:00

Bumi Armada, as expected, made a fine debut today at its relisting and I really want to congratulate a dear friend of mine DMJ who made that massive capitalisation. Gosh! that was really cool . He got 98% of his IPO application! Real lucky. Armada trading under trading and services sector opened at RM3.65 and closed at RM 4.14, more than 35% of its IPO price of RM3.03.

DMJ cleared 30% of his position at RM4.10 this afternoon... so dinner at Tatu Coffee House Shangri-La resort is on his house, ( instead of on the house ).

The stock performed well despite the current worries on American default ( I really don't think America is that foolish to make that happen) and Eurozone debt. You can see that the New York stock market is really volatile as it is rather clueless on the resolution of those two issues. So I secretly thought that Armada would not have risen so fast. In fact when my remisier Jenny rang me up on the opening price, I told her to wait till it comes down to below RM3.60... that was a joke, by 11 am, Jenny came back and reported that the price had gone up to RM3.92 and by that time my appetite for the stock had gone sour.

As I was watching Atlantis's historic final landing at 5.57pm this evening on my desktop, I was also listening to CNN business news on my flatscreen and understood that sentiment had gone up again because of better reported companies' earnings and market went up yesterday and today it seems to have improved further. Could tomorrow, being a Friday be a day of minor selling off for Armada? Anything could happen over the weekend so some people might just take their profit and sleep well over the weekend.

Interesting to watch guys, tomorrow I will go to the market again and offload the refunded ESA at whatever the Armada's price when I note any sign of a minor profit taking... see I was not successful this time though I cannot really complain seeing that my MSM is doing quite well. My friend did not get MSM IPO so it is fair that now he is successful with Armada though I am rather envious at the number of shares that are allotted to him because my successful MSM IPO was only at 30% from the total number applied.

A Market analyst has put a target price of Armada at RM3.91 at 25x PE based on earnings in 2011 and first quarter of 2012 but also with respect to other big cap O&G service providers' peak cycle P/E's but today's closing price beat the analyst's prediction. In fact I believe, on many occasions, it is the investors who determine the price they are comfortable with and in some cases, not unhappy to lose.

Bumi Armada is a good counter based on its fundamentals,good governance and book orders but we must be aware of its potential downsides affecting the stock price and possible dividends, for examples the company is subject to risks such as the following:

Cyclical O&G industry- growth decreases at end of cycle
Project execution risks e,g cost overrun or delay with penalty imposition
Unexpected vessel downtime- breakdown/repairs
Forex losses due to weak USD ( as most earnings are in USD)

Okay people, you buy this stock at your own risk ( read the prospectus!) as I am only trying to convince myself to buy this stock before the company reaches its peak cycle for which it would be like Pchem or MHB and for me it is part of the fun I derive from investing. Lose or gain is taken as a challenge in creating wealth. If you are going to fret over losing money in the stockmarket, go somewhere else to multiply your precious "ringgit".

Happy investing and good luck to the well-informed risk-takers.

Atlantis Final Return to Earth

2011-07-21T17:54:00.063+08:00

NASA TV

Space Shuttle Atlantis lands at the Kennedy Space Center at Cape Canaveral, Florida. The landing of Atlantis marks the end of NASA's 30 year space shuttle program. Picture: AP

It was a momentous event for Space science-loving people especially for those who have worked in the shuttle program for 30 years to see Atlantis, the last of the three shuttles, returning from its last mission into outer-space and landed at the Kennedy Space Center just before 6am EDT on 21 July 2011.

Following this, Atlantis like the other two remaining space shuttles, Discovery and Endeavour is heading for a museum, to be visited and admired by the public. What a fantastic machine!

Among the most important program's objectives is the building of the International Space Station (ISS) which has proved to be a united international collaboration since the end of the "worthless" COLD WAR. The shuttle astronauts have also, over the years, helped to set up and maintain the Hubble telescope giving us spectacular images of the universe. The program has also enabled many scientific research in the various fields including medicine and engineering to be conducted in space. Undoubtedly, the shuttle is an ICON of American science and technology.

It is inspiring to listen to what Commander Ferguson of Atlantis said about their space journey would only be completed once they manage to make the young continue the quest for space exploration for the future of humanity.... well said, Commander. In this limitless universe, it is impossible that we are alone. The continued quest into outer space might see human discovering another earth-like planet - interesting? Frightening? One will never know unless one gets there.

A NASA official also said that in order for America to advance, going deeper into space and far beyond, they need to change and ceasing the shuttle program is a form of change for them to concentrate on more ambitious projects of reaching other planets for example, Mars and maybe an Asteroid.

Bravo America! And thank you for your endeavours for the benefits of all of humanity and what a great space nation!

Gout and Secondary Cellulitis

2011-07-20T17:00:00.002+08:00

A 61 year old man came in this morning and he specifically requested to see me. I was quite touched though this was not the first time that patients had made that kind of special request. This man had a more than 28years history of hypertension, heart disease and gout. He was actually being followed up by a Cardiology clinic at the General Hospital but had been coming to the clinic and saw various doctors for simple aches and pain.

I greeted him as he was hobbling into my clinic. He had a swelling on his right foot and according to him it had been there for the last four to five days following his attendance of the Sultan of Brunei's birthday a week before. He had felt some pain in his right foot and had attributed it to the gout that he had been suffering from. It seemed that the attack came on just when he had to go to the palace where he had to wear shoes. So as the skin area above his first metatarsal began to swell, he had forced his shoes over it and bit his lips and took a painkiller.

He went to a doctor who prescribed him with indomethacine, a non-steroidal anti-inflammatory drug (NSAID) and told him to rest at home but the swelling had become bigger, extending up to to his right ankle, the tenderness had also worsened and he was beginning to feel feverish.

He looked well despite his temperature of 38deg C (normal 36.8). I took one look at his right foot and noted that it was no longer a simple gout but has become a rapidly spreading skin infection (cellulitis) as his right groin nodes were palpable I could see that this man needed a rapid antibiotic therapy which could only be given through an intra-venous line so I quickly referred him to the Emergency Department of the GH for admission possibly for 24 hours and following which an oral antibiotic would follow and he could return home to rest. Cellulitis can be dangerous as it could spread over the whole body and causing fatal septicaemia.

Foot cellulitis- red,swollen,warm and tender

What could have happened was his affected foot, upon being squeezed into his shoe, had the swollen area scratched and thus provided an entry for the surface germs causing rapidly developing cellulitis.

I took an x-ray of the foot and tested his random blood sugar (RBS) just to exclude any trauma and the possibility of diabetes before sending him off to the hospital.

Bone spurs on Ist big toe joint -site of constant gouty attacks

It is sometimes difficult at the primary care level to distinguish between a gouty attack and a cellulitis. My usual question is whether the person is feeling off-colour and that the swelling is extending Unless you ask the patient you are going to just give him a painkiller and ask him to go home only to suffer from a worst outcome.

He gave me permission to to take the photographs of his affected foot and that of his x-ray for my record purposes.

Banana - What has it got to do with her heart?

2011-07-20T00:39:00.003+08:00

Two months ago this 51 year old hypertensive patient of mine, SS, came for her usual follow-up. She has been my patient for the last two years and has attended clinic regularly. It has been my practice to always feel the pulse of all my hypertensive patients before I take their blood pressure. And so when I felt for SS's pulse that instant, I could feel her pulse bounding and her heart rate was increased compared to the last visit. And she was not on any drug that could have caused an increase in heart rate.

I then asked her whether she could feel her heart beating stronger and faster than usual. She then related, yes, for the last six week or so she did sense her heart was beating abnormally. I then asked her whether he had taken any another drugs or herbs without my knowledge, for which she denied vehemently.

Now what was it? I persisted by asking her what had she been eating which was different in terms of amount or frequency for example caffeine-containing drinks such as coffee. She thought hard about it then reminded me that I once told her to reduce fatty foods as her cholesterol level was abnormal and that she was on a cholesterol-lowering drug so for the previous two months before coming to see me she had decided to take bananas as it does not have any fat according to her. Yes, she took six bananas each day and since then she had experienced her heart beating faster but did not attribute it to anything,... Ahah..

I immediately advised her to stop taking bananas especially in that amount because banana is known to convert amines in the body into 5-hydroxytryptamine (5HTT) or serotonin which can cause an increase in heart rate and strength of the heart beat especially in some predisposed patients. Had I not examined her pulse, she would not have voluntarily given me that information and an undesirable heart outcome could occur in the long term.

Taken daily in large amount can make some peoples' hearts go "bananas"

Today she returned to report that she had not been feeling her heart racing since she stopped the large daily intake of bananas. I felt for her pulse and noted that the rate had returned to normal though the bounding was still there.

It is indeed my work-satisfaction to be able to detect a risk before it becomes another medical mishap. This can only be done with careful physical examination and history taking and engaging patients on their health habit.

Medical Error and the Medically-illiterate Patient

2011-07-19T22:37:00.004+08:00

A fifty-seven year old lady came in 10 days ago with a complaint of discomfort and feeling faint (light-headedness) for the previous two weeks. Now this lady has been on on my hypertension clinic follow-up for the last six months. For many years she had been treated by a general practitioner for hypertension and was prescribed with a beta-blocker to be taken once a day. She came to our clinic when she noticed that her headache was getting worse.

As per our medical protocol, patients detected to be hypertensive are fully investigated to determine their biochemical status with respect to their signs and symptoms. Prescription of medications is based on their allergy history and drug tolerability . Antihypertensive drugs are prescribed in stepwise manner, what is called "titration" of drugs and dosages. So with this lady she was started on a drug which unfortunately had induced a rapid heart rate. To counter that relatively common side-effect, another drug was added. Upon further monitoring, her blood pressure was still high for which another class of antihypertensive drug was further added. During this time she was coming to the clinic fortnightly. Her blood pressure eventually had stabilised in the normal range.

So it was rather out of the ordinary for her to come 10 days ago with the presenting complaints. Her blood pressure was on the high side and she admitted that she did not take the medications for the last few days because of the discomfort she had felt following the ingestion of the three drugs. Now I was stumped. What had happened to her in that short duration?

But as luck would have it, this very pleasant lady brought out her three sachets of medications and laid them out on my table. Yes, I always ask my patients to bring along all their medications especially when they are not as well-educated so that I could explain explicitly which drugs could be causing their adverse effects if there were any. And also to reconcile with my medical notes.

Examples of drug sachets and a blister pack that is inserted in a sachet

Upon checking the sachets, I noticed that perindropril was interchanged with amlodipine sachet and atenolol was in its original sachet..... Dear me! She had inadvertently changed the drugs and their respective sachets and was following the direction on the individual sachet which was stated in terms of tablets rather than actual dosage in milligrams. And so this patient had mistakenly taken twice the dose of perindropril ( an ACE inhibitor) and half of the dosage of amlodipine and this combination had somehow depressed her blood pressure below the desired level and she became light-headed.

My medical notes for the month previously was 2mg (half a tablet ) of perindropril and 10mg (one tablet) of amlodipine. This has become a medical error to me, the fact that the drugs were mixed up as the patient did not take precaution to keep her medications in the respective original sachet, And I also noticed that the sachet did not bear any name of the drug instead it was taken for granted that the patient would put back her drug in the right sachet, which did not happen in this case.

Having explained the slip-up. I advised the patient to take each medication and then return each blister pack back immediately to its original sachet and then only take the other drug and do the same thing. Even if the Pharmacist has stated the name of the drug on the sachet, a medically illiterate patient has a higher risk of not being able to discern them.

It would have been a disaster had those drugs been more biologically active such as L-thyroxine or digoxin due to their more immediate adverse effects. Due diligence on the part of the health personnel and the patients themselves is critical to prevent such consequences.

Anyway, the lady patient came in today and her blood pressure was in the normal range and her discomfort and light-headedness had all but disappeared and I am very pleased with the outcome. Indeed, it has been a lesson in medical error for all of us at the clinic. We certainly cannot take our patients for granted and any measures that can be taken to reduce this medical error would certainly improve our patient care.

Winter Sonata

2011-07-18T23:45:00.001+08:00

Constantly In My Heart

2011-07-18T20:10:00.000+08:00

LoVe and CoMmiTmENt

2011-07-17T12:46:00.001+08:00

My Audio Tonic

2011-07-17T10:04:00.002+08:00

Spare Me A Minute Of Your Time

2011-07-17T08:55:00.001+08:00

City of Brisbane - Revisited and Reunited

2011-07-16T23:53:00.036+08:00

I feel suddenly sentimental and my mind is singing away as I picture myself faraway in some romantic city with someone I love walking hand in hand on a cold and beautiful winter evening. Such pure bliss... just walking in grateful silence. Nestling close, with Paul Mauriat's interpretation of Bach's Toccata playing non-stop in the background.

Brisbane city where my heart will always be

I also posted my favourite classical composer, Mozart's pieces, Symphony No 40 and Andante to accompany my sentimental walk and that Corazon de Nino by Raul Di Blasio serves as fantastic food for my restless soul. And the sound of that baby whimpering in the background is tagging at my heart strings.

Music so beautiful is mind-calming and soul-appeasing. A world without music is a Sad World.

	A		treasured view
A View of Anzac Square from Sofitel's Coffee House

Brisbane Sofitel Central where I stayed

My recent visit to Brisbane (fondly referred to by locals as Brissy) and reunion with a dear old friend was a trip down memory lane. The city has been transformed into a vibrant place with creative urban redevelopment. Beautiful architecture and places of recreations and the arts. Casinos are mushrooming mostly patronised by wealthy Asians from Hong Kong and mainland China!

Somehow it is less than the Brisbane I used to know. Many familiar buildings are gone. A Pedestrian Mall has come out right on Queen St with underground tunnel and bus routes... I was kind of lost. Only the majestic Brisbane City Hall looked pleasingly recognisable and served as a landmark for me in the city where I spent nearly 10 years of my life. I studied at UQ ( Queensland University) at St Lucia.

The old City Hall building.... the square is an ice-skating ring during winter

The new Brisbane Magistrates Court building on George St looked imposing. It wasn't there before. My UQ friend, now a member of Queensland Judiciary, took me to visit the building and I could not help noticing the high-tech security features guarding it. Walking in the transformed city I came to my old favourite departmental stores, Myers and David Jones on Queen St that have taken on a totally new look upon mega rebuilding and renovation. Bayard, Cubana, McDonald and East have all gone....

New Brisbane Magistrate Court building with state of the art security

The city's landscape has changed as the sleepy south bank has been redeveloped into an area for public to rest and play. An incredible array of recreation spots and creative designs are on display. There is a big new library, a modern art museum, a theatre complex, a performing arts centre, a gargantuan Ferris wheel like the London Eye and all kinds of restaurants dotting the area connected to the city by an artistic white bridge.

The city awoke to claim its place as another world's capital city following the hosting of the Commonwealth Games in 1982. They suddenly discovered that they could move faster... and as they say, the rest is history.

There were,by the way, no signs of the recent devastating floods of January 2011. The whole South Bank Complex, the City's Pride, was re-opened just a week before our visit following a massive cleaning up by city folks with the Mayor himself scrubbing the floor of the underground car park by the Brisbane river. Just fancy that! The Lord Mayor, by the way, is celebrating his 100-day in office this week. The office is elected not appointed like in Malaysia.

Sofitel Coffee House.... memorable luncheon

Lunch and afternoon tea at Sofitel and dinner at Sebel, how can I ever forget the joy of a reunion.

And Paul Mauriat's Toccata continues to play on ceaselessly in my mind.

Lingering Secret Memories

2011-07-16T22:45:00.002+08:00

This is Toccata by Paul Mauriat and played beautifully by his grand orchestra. This piece brings memories of time past not only for me but for many fans of Paul who passed away at the age of 81 in 2006. With his passing his orchestra is also no more. But his legacy of mesmerizing compositions will go on to delight people who find music enchanting and relaxing.

PAUL MAURIAT - El Bimbo

2011-07-16T21:13:00.000+08:00

Wolfgang Amadeus Mozart - Piano Concerto No. 21 - Andante

2011-07-16T20:32:00.000+08:00

Spurring Your Soul

2011-07-16T17:49:00.001+08:00

Wolfgang Amadeus Mozart - Symphony 40 in G min KV 550

2011-07-16T12:51:00.000+08:00

Ending a long love affair with....

2011-07-12T13:57:00.002+08:00

Caught you didn't I? Sorry there is nothing as sordid as you thought in this posting. Actually I am selling off all of the remainder of my PICORP shares today despite the market being down, in fact I am disposing the blinking stock, on buy and hold silly strategy, at a ridiculously low price. I bet the person who bought them is laughing out loud today. Oh, it doesn't matter when I am already compensated by sweet gain on my successfully acquired MSM IPO shares recently ( please don't be jealous AC and gang!).

The reason I went headlong to discard PICORP purchased before 2008 world financial crisis was to buy KENCANA Petroleum on news of its merger with SAPURA Crest (kicked myself for selling this gem despite knowing it was going to go to 4.20. I bought it at 3.63 in January this year and sold at 3.93!). Never mind if the investment bank was saying not to buy KENCANA at higher offer as the stock has been fully valued because sometimes people are not listening to stock analysts especially in this volatile market period. I am just hoping the crude oil prices will not dive steeply as to indirectly affect the income of both of these oil and gas companies.

You know what? I feel a sense of relief offloading PICORP, never again will I touch penny stocks. I learnt my lesson the hard way, buying a stock based on people's recommendation is one of the downsides of investing. Another wise-after -the event lesson is not to be greedy. Anyway, in my experience, it is better to stick to well-known companies with tangible outputs and so my purchase of blue chips TM,MAXIS and AXIATA when their prices were low prove to be my investing highlights.

I am also sad to sell off my THPLANT shares bought during the heyday of plantation stocks being the darling of investors. The consolation about THPLANT is during the massive selldown of plantation stocks in 2009 the company graciously gave us bonus issue, one to one and when the price recovered slightly many of us made gains. And it also gave relatively high dividends. I will buy back this stock later.

So here I am today ending my love affair with non-performing stocks held for more than three years and "uncautiously" beginning a new affair with oil and gas stocks. actually I have begun this affair in January this year by purchasing SAPURACrest and DIALOG. I am keeping the latter but it is climbing very slowly albeit steadily.

Looks like I am going to regret acquiring KENCANA at this knee-jerk high price today for the short term but I am taking the long position on this one. Yes, CAVEAT EMPTOR... is ringing in my ears!

Colonial Mentality of Certain Asians in Hospitality Industry

2011-07-10T20:58:00.002+08:00

I have traveled rather extensively around the world particularly the Asian region. I have noticed one particular annoying habit of some Asians when dealing with their kind and Caucasians. I want to relate some of my experiences on this matter.

Pan Pacific KLIA-used to stay here many times

Have you all ever noticed when you are in the hotel, the staff will usually politely ignore you if you were an Asian but will vigorously wish "good morning sir, how are you sir this morning..blah..blah .." loudly when they see an "orang putih" (Caucasian)? I was going to breakfast one morning in a local 5-star hotel when, as I entered, nobody said anything and then when a couple of Europeans came after me , I could hear the friendly greetings erupted behind me. Here I was a professional and paying the same hotel rate and for all you know the Europeans, in this case, Australians could be welders in their country and was given such warm greetings. I did complain to the hotel manager and after that I found I was acknowledged vociferously by the staff of that hotel. I hope they do the same to other local patrons.

In Indonesia was the same. Once I stayed at the Borobudur hotel in central Jakarta and a friend a British (Caucasian) World Health Organisation (WHO) Consultant was with me. I entered the handicraft store at the hotel first as I wanted to buy some silver jewellery, my colleague, Gordon just wanted to accompany me and he was slightly behind. I went straight to the jewelery counter and would you believe it? The sales girl moved quickly over to where Gordon was and asked what he wanted to buy, completely ignoring me! I heard Gordon say " No, it's the lady over there (that's me) who's got the money". I was riled up and told Gordon we were just leaving!

Hotel Borobudur, Jakarta

Another occasion at the Sukarno-Hatta airport as I was arriving in a taxi I could see a man with a trolley coming over to me only to veer off when he saw the taxi behind mine had a Caucasian man. Another man behind the first had to come to collect my bags! Ironically after our bags had been offloaded to the check-in counter, the Caucasian tipped the worker RP500 (60 sen Malaysian) and I gave the worker who collected my bag RP2000 ( about RM2), I heard the man arguing with the European who completely ignored him and moved off. Serves him right I thought.

Coffee House at Manila Pavilion

Then there was an incident at the Pavilion Hotel in Makati Manila when I was coming back from shopping with another UNICEF French Consultant, Jacques. As we entered the lobby two security staff searched my bag and pointed some gadget all over my body before allowing me to enter. The strange thing was Jacques, a tall good looking European, was not even checked the way I was! Anger overcame me as we went to the Coffee House and I refused to drink and was quite upset at the unfair treatment. Then Jacques did something surprising. He pulled my hand and virtually dragged me out of the hotel and we re-entered the lobby and before everybody, he said in a loud voice, " Check me! I want to be checked too!". The two security personnel were rather bewildered as they quickly pressed the gadget over Jacques's body. It was hilarious. Then we went to the Coffee House with my friend Andrew from Sarawak and I drank happily with a cheese cake too paid by Jacques. I always remember the Frenchman.

MAS cabin staff are one of the best in the world

My most recent unfortunate incident was three weeks ago. Having shown my boarding pass to the female staff at Gate C26 at KLIA satellite building for MH139 bound for Australia, I proceeded through Channel A towards the business class cabin. As I was walking I heard a male voice calling out to me and said in a rather loud tone, "Excuse me the economy class is this way!" pointing to Channel B in full view of other passengers. I was stunned and in a split second I realised that this male MAS ground staff, seeing that I was an Asian, had thought that I could not possibly afford business class. I was irritated and told him, " Yes, I am on economy but I am coming through THIS WAY!" and proceeded to the business cabin and promptly complained to the Leading Steward about the behaviour of the pathetic ground staff. As it was, I was the only Malaysian in the cabin but that did not mean that the staff should make any assumption on anybody. I have lodged a formal complaint against this staff who has sullied MAS's reputation.

I have traveled on business class during my international assignments many times but I have never encountered a blinking MAS staff with a chip on his shoulder. Would he have behaved the same way had I been a Caucasian? I very much doubt it.

These are examples of people who are stuck with colonial mentality, pandering to the "orang putih" as if these people cared for them. I related this bad habit to my Aussie friend JDC and he cheekily said, yes, Asians seem to give preference to Caucasian male travelers especially if they are six-foot tall ( like him!) and in a nice suit.... my "pied" Your Honour!! (that's "foot" in French).

Brisbane International Airport

Ironically, I was treated very nicely at Brisbane International business class check - in, was invited to Qantas Club lounge and graciously ushered in to the cabin by a Caucasian MAS ground staff on my flight home.

Let's Light this Shuttle One More Time! : Historic final launch of Atlantis STS135

2011-07-10T01:16:00.009+08:00

NASA Commemorative Patch

Stayed up late last Friday 8 July 2011 to watch the shuttle Atlantis being launched from Kennedy Space Center, Florida. It blasted off at 11.29pm our local time. This is the last launch of the 30 year US shuttle program which started in 1981 with the shuttle Columbia.

Atlantis blasting off into history on Friday 8 July 2011- Credit:NASA

Atlantis blasted off at 11:29 a.m. EDT (1529 GMT) from Launch Pad 39A at NASA's Kennedy Space Center, thrilling huge throngs of spectators who had descended on Florida's Space Coast to see the swan song of an American icon. NASA estimated that between 750,000 and 1 million people turned out to watch history unfold before their eyes.

"On behalf of the greatest team in the world, good luck to you and your crew on the final flight of this true American icon," shuttle launch director Mike Leinbach told the astronauts just before launch. "And so for the final time, Fergie, Doug, Sandy and Rex, good luck, Godspeed and have a little fun up there."

"Thanks to you and your team, Mike. We're not ending the journey today, we're completing a chapter of a journey that will never end," Atlantis' commander Chris Ferguson replied. "Let's light this shuttle one more time Mike and witness this nation at its best. The crew of Atlantis is ready to launch."

The above were the exchanges between the Atlantis shuttle commander Ferguson and the launch Director at Kennedy Space Center.

After 135 launches over 30 years, the space shuttle will never streak into the sky again.

The three remaining shuttles, Discovery, Endeavor and Atlantis are being retired to the museum. The other two shuttles, Challenger and Columbia met with accidents in 1986 and 2003 respectively with the loss of 14 astronauts. All together more than $200 Billion had been spent on the program over the period.


The four Atlantis crew with Commander Ferguson on the right	: Credit NASA

Space shuttle Commander Chris Ferguson and crew mates Pilot Doug Hurley, and Mission Specialists Sandy Magnus and Rex Walheim are on their way to the International Space Station

The 12-day mission will deliver the Raffaello multi-purpose logistics module filled with more than 8,000 pounds of supplies and spare parts to sustain the International Space Station (ISS) operations after the shuttles are retired. STS-135 is the 135th shuttle flight, the 33rd flight for Atlantis and the 37th shuttle mission dedicated to the station assembly and maintenance.

May Atlantis return safely to earth as scheduled on 20 July 2011.

It has been an awesome human endeavor and fantastic space mission on the part of USA to run the program enabling many scientific research to be undertaken, the launching of the Hubble telescope to study the universe and the establishment of the International Space Station (ISS). No wonder people are rather emotional and sentimental following the termination of the program.

I cannot help but marvel at those skilful people who are involved in this industry for the last 30 years and the brave and intelligent men and women who were astronauts carrying out individual mission. Many useful spinoffs from this space program have improved the fields of e,g health, electronics, engineering and telecommunications and not to forget the old Hubble being tuneups many times by the shuttle crews over the years to give us some of the most spectacular views of the universe!

Thank you to the vision of the leaders of America, the world has also benefited from your dream. And farewell to all three shuttles, the astronauts who operated them and all NASA staff who are also being laid off because of the program's termination. You are all indeed the greatest team in the world!

Space shuttle Atlantis STS135 final launch: NASA video

2011-07-10T00:05:00.001+08:00

Bumi Armada IPO, here we go again!

2011-07-04T02:08:00.006+08:00

Many of my friends were not successful in their application of the recent MSM IPO and this next news-grabbing IPO may just be their next best bet. I am sure many keen investors are not going to miss this relisted stock under Ananda Krishnan's stable of companies. Such companies are reputed to be infused with good governance so you can be sure that investors will flock to get their IPOs!

Foreign funds managers' interest in this IPO is also expected to be high.

Bumi Armada is an oil and gas services provider. Yes, they provide the mechanization for oil exploration currently in more than four regions of the world. It is I believe the only company based in Malaysia that is involved in this niche industry. Bumi Armada was taken private in 2003 when its share price was RM7. Its relisting was postponed several times due to world's financial crisis and economic uncertainties.

The number of shares offered for retail investors are much more than that of MSM which by the way had a fine debut on 28 June with an upside of more than 30% of its institutional IPO price. We should expect Bumi Armada to have that kind of debut . Your chances of getting this IPO shares are slightly better than MSM.

The IPO price for Bumi Armada is set at RM3.15 and the closing date is on 7 July at 5pm and its listing on Bursa will be on 21 July. As I've just returned from Australia, I am unable to truly garner my finances to apply for this IPO so I am forced to sell my PNB units to get the necessary cash. I am , by the way , offloading my non-performing stocks just so I will be able to put back a good percentage of my withdrawal.

I will only perform my ESA on 6 July a day before the closing date as I am waiting for other financial sources to apply for this IPO so as to increase my chances of getting a portion of it. It is conceivable that at balloting the more shares you apply the greater the chances of you getting it. Many of those who applied less than 20k shares for MSM recently had failed to be picked out.

The post-listing price of Bumi Armada is not expected to be wildly dictated by market forces as its anchor institutional investors like PNB and Insurance and investment companies are expected to keep their investment for up to two years. Pricing the IPO at RM3.15 seems to provide the company some kind of buffer in case the world economy becomes more volatile or decline on Greek Debt woe, American uncertain economic data and the easing of the economy by China. The globe is indeed interrelated now by default.

However those who could withstand the current volatility pressure will eventually benefit. That is why it is important to buy shares using your own money and not otherwise.

And so here's wishing you all the best of luck again for your application of the Bumi Armada's IPO units.

Electronic Share Application (ESA) through a Cool Bank

2011-06-10T20:00:00.003+08:00

One of my friends, SW was desperate today when he suddenly discovered he could not perform the ESA for MSM IPO using his HSBC credit card. He has just returned from a week long outstation duty this morning (Friday 10 June) and the following two days are weekend and the closing date for this IPO is on Monday 13 June.

The problem was due to his losing his old credit card which had been registered and LINKED to his CDS (Central Depository System) account with Bursa Malaysia and he forgot to re-register the new replacement card. The time was 3pm and according to his HSBC banker the registration would take three days to be activated. And the most that they could help is to activate it by Monday but that itself she was not sure as the registration is done centrally. SW was flabbergasted and told me his predicament. I was sorry for him then there was a bright spark.... I told SW to quickly withdraw his required cash from his HSBC Premier account for the number of IPO units to be applied with an extra cash and rush to Maybank.

I rang up my banker Patricia at Maybank and asked her to help SW open a new account into which he put in his cash. This was accomplished in less than 15 minutes with Pat's efficient service. I was thinking of SW performing an online share application which is a special facility at Maybank but Pat went on a step further by asking SW to perform an ESA using his new Maybank ATM card..... what? No registration like the other bank?.... "No" said Pat you just need to key in your CDS account number into the ATM machine and hey presto! You have your application!! SW was over the top and I am getting a free dinner on Saturday evening at Hyatt Regency.

As the bulk of my savings is still with HSBC and my ATM card is actively linked to my CDS account, I will still use their ESA facility. At HSBC ATM machine you need not key in your CDS account number as it has been LINKED so that is the difference. There are pros and cons I supposed in the two systems. The cons is when you lose your card and have a new one and most likely you will forget to re-register till the next IPO comes along. And what if when the time is restricted?

Had I known about this Maybank ESA system before, I would not be so frustrated late last year when I too failed to perform the ESA for MHB IPO at HSBC due to my replacement ATM card not being "registered". Certainly Maybank appears more friendly for stock market investors as it has both an online share application facility as well as ESA service without the hassle of prior registration.

When you are loyal to an organisation, you will miss what others have to offer. I was a loyal customer at HSBC and paid the price for it. MHB IPO was 3.60 and today's price is 8.10.... what a loss of an opportunity!

Well, I am glad I have opened an account with Maybank at least I would not be caught again with a "useless" ATM card when performing an ESA. I have an alternative now.

And good luck SW hope you will be successful with your MSM IPO after your foul-up at HSBC.

And the moral of the story is.... HAVE CASH WILL TRAVEL.

Shangri-La Sojourn

2011-06-08T19:22:00.000+08:00

To ease my tension at work, I decided to follow my husband on his business trip. Yes, I wanted to chill out and later get back rejuvenated. And so I found myself in a dreamlike surrounding by the beach and mostly in the resort oasis with the spa in the veranda and the sound of waves to lull me to sleep. What a wonderful life!

The Resort's Ocean Wing frontage

The evening of our arrival we ate by the pool about 500m from the beach. There were nine specialty stalls serving all kinds of foods, Chinese, Indian,Malay,European,Korean,Japanese to cater to all to your taste. I chose one which served various vegetables , some seafoods, pasta, eggs and condiments which the chefs fried in seconds in a wok under an extremely high temperature. While enjoying the foods, suddenly the torrential rain and wind lashed at the large permanent gazebo and the staff immediately ushered us to the inner area. Oh, it was quite an experience eating in such windy and rainy (romantic) atmosphere with your hair flying about you. In the photo the diners had all run away from the periphery and sought refuge at the centre of the gazebo.

Hawker-style dining by the pool

The next day was spa day for me after watching a DVD " Hatchiko- A Dog's Story" which tugged at my heart and used up a lot of tissues. It was just heart rending to see how loyal a dog was to a master even after he was dead the dog still came to the train station to wait for him for 10 years , a true story in Shibuya , Japan. Come to think of it I didn't know why I chose that DVD.. maybe the dashing Richard Gere's factor.

The quaint spa has an electronic curtain for privacy and you can fill it with water at any temperature and there is plenty of L'occitane essential oil to give that refreshing feel and you can also pick some frangipani flowers blooming next to your room and put them in to create that Spa atmosphere.Must have been hours in there with a soft music in the background.

Okay no more story just to show you some pictures of my short sojourn in this truly world-class resort both in service and facilities.

Beachfront Entrance

Hillside Entrance

The entrances facing the verdant
hills and at the back facing the
exclusive pool shielded by flower-hugging vines, coconut trees and beautifully landscaped surrounding. The pool is lined by blue parasols and beach chairs with plentiful of soft-fluffy towels. A kiosk serving tidbits and drinks is just at one corner.

The Veranda facing the pool and beach

The Spa on the Veranda

Door to the pool and beach

The room is spacious and tastefully
decorated. The minibar was stuffed with goodies. There is a coffee maker and a large canister of ice-cubes.
The lighting was just right, not too
dim like some hotels and not too bright.

Welcoming fruits and chocolate

The air-conditioning is just perfect.I love the rest room with a
a lovely painting to accompany you. The shower room has a large shower head with water coming out like real rain and there is a built-in bench for you to just sit.....meditating?


Sofa just for you with the spa in the background

Attractive wall detail design

Well I had a whale of time mostly by myself enjoying the peace and tranquility leaving all the world's troubles behind. Really a great way to recharge your battery. I would do this at least three times a year as a form of mental relaxation and as a form of pampering myself with everything being done by others who are there to please you. When you return to the world of reality you will appreciate life better at the same time reduce any sense of drudgery in your life.

PICORP, JCY,UNICO and HSL in that order- My basis of clearance.

2011-06-06T16:53:00.001+08:00

It can be discomforting clearing off a stock especially one which was doing well at one time but somehow had fallen on hard time and never seem to be able to get up. In fact this stock was recommended to me by someone I know ( that itself should have raised a red flag!) three and a half years ago.

Had I not been that over hopeful ( read "greedy") I would have made quite a substantial sum on this stock. I bought it at 40 sen and at its height of value it was 80 sen per share. Just fancy that, I was waiting for it to be 1.00! But it fell precipitously after 2008 financial crisis and with that my relatively large investment. Apparently the company's bad foray into an African country had also added to the slide.

Its dividend last year was 0.41% per share and this year it has gone down to 0.10 %, at first I thought it was 10 sen and was rather momentarily elated till my better half calculated the dividend yield and reminded me that at 25% , the company must have been doing astoundingly well but how come its unit price remains less than 30 sen for almost three years following the financial meltdown? Then it dawned upon me that the dividend is one hundredth of a sen so multiply that (0.001) with my shareholding . Though my dividend amount is still in the thousand bracket but I have had it. I want to find a reason to dispose a large chunk of it and move on with some other stock. So my broker managed to clear off 57.5% today. I am happy to get rid of the rest pretty soon. I will not go near a penny stock ever again. PICORP is the last of the Mohican!

Next is JCY and I have posted last year on my greatest blunder on this technology stock. Actually I was still reluctant to clear it off as I was thinking the stock would recover following the Eurozone debt recovery perhaps in two years' time but Charles my broker ( not financial advisor mind you) poured cold water on it and told me unless the company diversified, it was a twilight industry.

Anyway initially I had wanted to sell all my Dialog shares because it had gained 29% since my purchase early this year but Charles advised against it. Dialog, in oil and gas sector, had potential said him. So there goes my JCY today, at least I won't see too many reds in my table of portfolio. I lost substantially on this stock. It wiped up all of my AXIATA gain. I will not touch any technology stock for a long while.

I was mulling over selling some of my plantation stocks. I used to have five of them but have cleared my position in MHC,Kwantas and Swkplnt. As my luck would have it all three rose right after I sold them as if they were waiting for me to get off the bandwagon. For example I sold Kwantas at miserable 1.58 and I bought it high during the plantation craze at 4.70 and following my disposal it went up to 2.50!

It has been a yo-yo time for me with moments of hope,excitement,up,down,yawn, welcome then to the world of investing. By the way, I have given up on my earlier strategy of buy and hold under this current volatile era.

Now between my THPLNT and UNICO, which one to go? Well the former gives really good dividend and during the financial crisis the company was magnanimous, it gave us bonus issue one to one and I greatly benefited from that gesture. So the choice is clear, UNICO has to go. I kept this stock for a long time hoping that IOI would buy it but the rumour has never materialised. In the meantime their 4% dividend annually has somehow reduced my losses.

I have a recurrent love affair with HSL, the construction stock based in Sarawak. I bought this stock in the middle of 2009 when it was 0.80 sen. I bought quite a lot. It gradually rose and my best selling price was 1.90 late last year. But somehow the price has been idling around 1.70 especially after the Sarawak State election in April 2011. I do not have a good vibe about this stock at the moment. I have made nearly 113% on HSL so time to say goodbye for now and find another just as exciting. I am keeping MRCB, another construction stock because I have slightly more faith in it.

And what do you know? My clearance sale has netted me the fund for MSM IPO's application beginning with that number 33. I need all the luck as the public portion of this IPO is only 14.06mil (2%).

MSM Malaysia Holdings Bhd IPO ... nearly missed it

2011-06-04T23:53:00.003+08:00

As I have been busy planning for my Aussie trip and working hard as well as keeping abreast with my professional fields like attending seminars, reading journals and doing CME (continuing medical education) online, I almost overlook the exciting upcoming MSM IPO. Yes, the prospectus was issued online on 2 June to coincide with the opening of this IPO application. The closing date is 13 June and its listing is scheduled on 28 June.

It is really a short period just before my travel and I have to muster some fund to apply for this IPO. The current offer unit price is at RM3.38 (just look at that number... quite enticing isn't it ? Especially for those who believe in numeracy and feng shui ( I am guilty of this madness!). The final price will be 97% of the institutional price offer which is determined through book building. Now where do I get this fund? Making it worse , I believe in the number 33 whenever I apply for an IPO.

Well, if there is a will there is always a way. This IPO should not be missed by anyone who is a local stock market investor. Just try our luck, if we are successful well and good, if not at least we participate in the balloting. Imagine if we don't apply at all, there is absolutely no way we are going to know our luck. It is analogous to having a horse to ride than no horse at all!

Having said that, it is time also for me to clear off the comatose "crocodiles" in my current portfolio.To let them continue being in coma is not going to give me any excitement every now and then. In fact, the clearance will add to my needed fund.

I have downloaded and read the prospectus and have decided to go for this IPO. I will keep some fund just in case my application is not successful and have to buy the shares in the open market. By hook or by crook I must have this stock despite some people voicing out their lack of confidence in a GLC.

Yes, MSM Malaysia Holdings Bhd previously known as Malaysian Sugar Manufacturing Co. owned by billionaire Robert Kuok , was sold to FELDA (Federal Land Development Authority) about two years ago at the cost of RM1.25 billion. It is a leading sugar producer that controls about 57% of the domestic market. It will be listed under the consumer product sector in Bursa Malaysia.

GLC or not, sugar is needed in our daily life. Of course for some it is a controlled use by virtue of their medical condition!

Good luck to all applicants!

To Australia with Malaysia Airlines and here I come Dear Edna.

2011-06-01T01:37:00.001+08:00

I had planned to visit Australia in February 2011 but due to the massive floods in Queensland, I was advised to postpone it. My journey will start from Kuala Lumpur to South Australia and crossing up the continent to Eastern part, the state of Queensland where I spent eight years of my life studying at a high school and later at the Queensland University at St Lucia and finally at Herston Medical School.

I am flying with Malaysia Airlines, what else? Their business class is truly world class and also because they've again extended to me an Enrich Gold Card facilities so my loyalty is entrenched so to speak.

I haven't been back to my Alma Mater for many years despite being "harassed" by my host family to visit them. Yes Edna is getting old and she did mention in her last Christmas card that if I didn't come this year I might not see her again... that kind of disturbed me so I resolved to fly soon as I can to see her. Edna helped me a lot when I was a student and I cannot forget her.

Unfortunately my husband is not able to come due to his heavy commitments.

Well, I have done some googlings and found out so many things have changed in Brisbane. Gosh, I used to drive in the city and now Queen Street has been closed off and becomes a pedestrian mall! There is a lot more shopping malls coming up and my University now looks like some new place because of new buildings filling up those empty spaces I used to know. Can't wait to see the new Brisbane. Might meet some friends as well if time permits as my time in Brisbane is extremely limited.

I will be staying at Sofitel Brisbane and move around from there. Will post my travel later.

The Doctor and the Pharmacist with an Attitude

2011-05-30T23:31:00.003+08:00

I have been rather tensed lately. No, it's not due to too many patients, in fact I enjoy seeing patients, talking to them and gently cajoling those with chronic conditions to take their medications regularly. What I was unhappy about was the unilateral action of a pharmacist who took it upon herself to determine what prescriptions she would delete. I have never realized this till out of concern for my patients I have asked them to return to me once they received their prescriptions from the pharmacy so that I could advise them which tablets/syrup I was referring to during the consultation.

And so one mother came back to complain that the Pharmacist did not want to give her the syrup I prescribed for her three-year old. I called Miss X the Pharmacist and she told me that the syrup was not supposed to be given to a child less than five. I am quite conversant with drugs and I know that cough suppressant and sedative drugs are no longer recommended for children but the one I prescribed was not in this category.

I asked Miss X to bring over the list of drugs in this not-recommended group. True enough there were 23 drugs on the list and the one I prescribed was not on it! So Miss X was quite surprised herself as all this while she had been deleting other doctors' prescriptions as well and none of them ever complained!

Yes, none of the doctors ever complained because their patients follow the flowchart in the clinic religiously. Patient comes to see a doctor and then goes to the pharmacy and finally goes home. In my selected patients the flowchart is modified such that after the pharmacy they come back to see me!

On another occasion an asthmatic who, after several trips, sometimes in the wee hours of the morning, to the hospital emergency department, had finally decided to come to the clinic. From the history I could discern that this young man had been having bad bouts of asthmatic attacks for which no structured and regular treatment had ever been prescribed to him. Having examined him physically especially listening to his chest, I decided not only to give him the medication which relieves his acute attacks but also one which when used everyday would help reduce the number of attacks.

What did our clever Miss X do? She deleted the daily inhaler because she told the patient usually only one inhaler is prescribed for a first time-diagnosed patient. She did not have the courtesy to contact the doctor. She was acting like one. Again I engaged Miss X by focusing on the clinical condition of the patient, his inflamed, swollen bronchiolar smooth muscle cells that trigger incessant attacks require cellular stabilization through the daily inhaler. Granted that a mild asthmatic would only require the rescue inhaler only but not in this particular patient. And by the way since when the B.Pharm can do the work of an M,B;B,S?

In Malaysia due to the present healthcare arrangement, it is common that you see Pharmacists prescribing antibiotics and even anthypertensives and blood sugar-lowering drugs! In developed countries like the UK and US , they absolutely and legally cannot do that. The practice in Malaysia is very disconcerting and can affect patients negatively. Like the patient who was given painkillers NSAID for a long time by a Pharmacist for her arthritis ended up having erosive gastritis and a bleeding peptic ulcer.

Coming back to Miss X, I told her to liaise with me in future in case she feels like being a doctor. By the way, UK-trained Miss X is our new Pharmacist with an attitude. We had no problems with our old one who had resigned to open her own Pharmacy.

Really , remaining professional can sometimes be rather challenging..

My BLoG - DoINg It My WaY

2011-05-30T01:30:00.005+08:00

Some of my friends and readers have suggested that I separate my postings on medical subjects from those on stock-market and other stories. I am sorry to say that I am unable to follow the suggestions as I do not wish to feel tied up to a subject. I write whenever I feel like it and not because I have to.

In this blog are all about my expressions, thoughts and experiences that I would like to share with people who are interested to read them. I want to avoid the drudgery of writing in many blogspots. So those who are interested in my professional experiences can just look up the relevant topics and those who want to read about my stock-market rantings and raves on successes and failures can do so by following such topics .... all under one roof, one blog.

I am mulling over changing my blog's look but I love Sam the Koala so much that I wonder how it would be without her. Anyway I have changed my blog's title to reflect what I am about.

Happy reading!

Young hypertension - and Now it's KM's Story.

2011-05-30T01:01:00.001+08:00

Following my extensive history taking of YM's high blood pressure case, I managed to persuade her live siblings, a sister and a younger brother to come to my clinic for screening and investigations. Attend the clinic they did.

Her younger sister MM had normal Blood pressure but was advised to return in six months for another check-up and unfortunately her younger brother, 30-year old KM was found to have high blood pressure. So high at 190/120 that an instant blood pressure lowering drug had to be given on the spot!

Actually following the death of his elder brother at the age of 29 due to a stroke the year before had made KM visit a government clinic early this year. He was investigated under a protocol of young hypertension where a kidney and hormone profile were studied for any curable abnormalities. An ultrasound investigation was performed and the radiologist reported that it was normal. So the referring primary care doctor informed KM that the investigation was normal as well.

And so KM thought that as his kidneys and relevant hormone level were normal, he did not need the medication given to him earlier by the doctor. He stopped taking the medications for the last three months and had been suffering from headaches and tiredness since then. He did not return to the clinic. Instead he came to mine because his sister YM persuaded him to.

I could see that KM requires more education on his medical condition. Not only education but motivation and support as well. Now, here is a young man who has this chronic disease and is supposed to take lifelong medication. He obviously does not understand it and greatly resents the thought that he needs daily medication. His job as a tourists' guide also makes taking and remembering to take daily medication a chore. Disease and medication counseling are essential in his case.

It is critical for him to accept his condition and be on lifelong treatment. I gently told him that we all could not choose our parents and hence our genetic make-up.

He defaulted treatment earlier because he did not understand his disease condition, its complications and prognosis. I have focused on disease advocacy, explaining his conditions and the medications and blood monitoring that he needs. So far KM has been responsive and I hope he continues to be so for his sake. Currently his blood pressure is stable and his organs such as the liver and kidneys are showing parameters that are within normal limits. And so far he has kept all his appointments with me.

I pray for all the KMs of this world.

Young Hypertension - and YM's Multitude of Medical Conditions.

2011-05-23T23:42:00.001+08:00

YM came in today to review her blood results and also to complain about her incessant coughs lasting more than three weeks. She was the young lady who was the subject of my last posting. Her kidney function was essentially normal but her urine showed the presence of blood (hematuria) and albumin (albuminuria), these are not good signs. On top of that she also had a high level of cholesterol and triglyceride ( another form of lipid in the body). Her thyroid function test was normal.

Her coughs started following an acute episode of tonsillitis for which I had prescribed a course of antibiotics for her. The tonsillitis had healed but the coughs continued and were worse at nights when it was colder. Last night was particularly bad. The coughing had made her unable to sleep. I asked her about a family history of asthma and she admitted that her younger brother was suffering from asthma and that she had childhood asthma! I examined her chest but could not elicit any signs.

The clinic protocol is when a patient has been coughing for more than three weeks, a pulmonary Tuberculosis (PTB) screening needs to be done. So I ordered for sputum examination on three occasion and a chest x-ray. The chest radiograph showed heavy congestion in the middle lobe of her right lung. Otherwise no other signs suggestive of TB. I prescribed her with a combination of two antibiotics for a week.

Now, I have asked her a month ago to wait for her menses and to come to the laboratory for specific day of the menstruation to take blood for hormonal studies to diagnose the cause of her absent menstruation/infertility. Unfortunately the menses was still absent (for six months) and today I requested the hormonal studies to be conducted straightaway. The studies are designed to determine the cause of her prolonged absent menses ( secondary amenorrhea) and for later referral to the Gynaecologist.

YM had gone to see the Cardiologist I referred her to. Unfortunately all relevant radiological investigations are slotted for October 2011 due to the hospital's heavy workload. One of the essential investigations was to exclude renal stenosis (narrowing) so I asked her whether she could afford to get it done in private which would take only a few days. She promptly said yes. I filled out a form for her and sent to to my colleague, a private Consultant Radiologist. And I also noted that the heart specialist had given her a six -month appointment. To me it is a rather long time of waiting. I put myself in her shoes. I place her on my clinic follow-up every two months. She needs the necessary motivation at this early stage to continue with her life-long medications. It is what we at primary care do best.

Fortunately her blood pressure reading had stabilised within normal limits. But her high blood cholesterol and triglyceride was troubling. A young person should not have this aberrant lipid picture. I have tried asking my patients with high blood lipid to control their diet,less fried foods etc but I can tell you, only one (10%) person out of ten succeeded; that too because he did not eat outside foods. YM travels a lot due to the nature of her job so I started her on a cholesterol lowering drug plus dietary advice.

And so, in a matter of about six weeks, I have discovered YM, a 30-year old lady professional, who initially came with a complaint of a bad headache, to have the following: Hypertension, secondary amenorrhea. infertility, hematuria. albuminuria, hypercholesterolemia, hypertriglyceridemia, lobar pneumonia and infection-triggered asthma.

So young a life, so fraught with medical conditions! I will ensure she has the best care we can give.

The Medical Certificate – Beyond Consultation

2011-05-23T22:01:00.000+08:00

A 31 year old woman, YM, came in a month ago with a complaint of nausea and headache which she ascribed to a long holiday in Kuala Lumpur. She returned the night before and slept in the following morning. Actually she had to work but could not make it so the main reason her coming to see me was to get a medical certificate.As usual I engaged my patient so that they would relate their medical history. I do this often in the hope of looking for areas where I can advise on preventive medicine.

I asked her whether she was married; yes she was for two and a half years. Then I proceeded asking her about her menses like the last date of her normal period, the cycle any pain etc. Her last menses was in Nov 2010 and it had yet to come though all her pregnancy tests had proven negative. I didn’t take any chances I still ordered for UPT (urine for pregnancy test) and Urine microscopy. Both were negative.

Then I asked her whether she wanted to have children, yes, she replied. I asked her why she did not get herself investigated for irregular and prolonged amenorrhea (absent menses). No, she said because she did not know how to go around it.I persisted by asking her what her normal complaints were whenever she went to see a doctor, she replied normally headache and tiredness. No, no blurring of vision.

Without asking all those probing questions, I would’ve just given her a medical certificate and perhaps an anti emetic and a pain-killer and then send her off. But I felt uneasy. She was only 31, an active young professional with a menstrual problem, failure to conceive and recurrent headaches. Something was not right.

I proceeded to take her blood pressure and could not believe my hearing and my eyes that the first recording was 190/120 (normal for her age is 120/80). I asked her to lie down for about 30 minutes. After resting, the next reading both lying and sitting and standing was 190/118, essentially the same. I prescribed immediately a short-acting anti-hypertensive and measured her blood pressure an hour later and it went down to 150/100.

Before I could ask her about her family history, she volunteered by saying that her mother suffered from high blood pressure and that her brother died of a stroke at the age of 30! That’s it the red flag was up! There could be a genetic predisposition in this woman and that she needed to be investigated fast and fully and given blood pressure-lowering medication before the high pressure gradually destroys target organs such as the brain, the heart and the kidneys.

For young hypertension the work-up is slightly different because you need to look for preventable causes such as Conn’s syndrome or renal artery stenosis (narrowing). Both are operable and the hypertension can be cured.Without wanting to waste anymore time on diagnosing her condition, I ordered all the tests and promptly referred her to a Cardiologist for more evaluation and extensive investigations. High blood pressure in a young person, if not detected and treated early will lead to a premature death, just like YM’s brother, dead at 30. And as illustrated, probing history taking is extremely important in preventing such a death.

That was the longest “Medical Certificate” consultation I ever had. But I feel satisfied.

AHB -Amanah Hartanah Bumiputera's first dividend halved.

2011-05-10T21:58:00.003+08:00

I was tickled pink with one of my Bumi colleagues, DMJ's adventure or was it misadventure? with this REIT. When this product was launched last November 2010, he went along to the nearest Maybank in late December hoping to apply for some units. He could not have registered immediately as he had wanted to write in a cheque so he applied first for 1000 units with the cash that he then had. When asked into which account he wanted the dividend to be credited to he promptly gave his foreign bank's account number.

Busy as he was, he forgot about topping up his units. Once you are registered you can then issue a cheque but our friend failed to do that. So recently when the dividend was declared in April , he calculated his meagre gain and found that it was about RM20. Then a week later after his RM20 was credited into his bank account, to his dismay he found out that RM10 was deducted as bank charges! So he received only 50% of his dividend :) There would not have been any bank charges had he had an account with Maybank which manages the REIT.

He learned the hard way . The moral of the story is to read your prospectus before your purchase of any unit trust/stocks but how many people usually do that?

By the way, if I am not mistaken all the 1.5b AHB units have all been taken up and they are launching another 0.5b units sometimes this year. So those eligible people who missed out on the first launch can apply this time around. And don't forget to open your account with Maybank.

By the way, if you had 200K AHB units, the bank charges at RM10 per transaction would only be at about 0.3% of your dividend at the current rate of 6.2 sen per annum.

Playing with figures and statistics can be fun! Sorry DMJ...

Stock Market and the Usual Yo-Yo

2011-05-07T02:05:00.001+08:00

Things have kind of cooled down at the stock market following the relatively good rally in early March. During that rally I saw my champion stock Pchem rising up to 7.58, acquired at the unit price of 5.04, the massive YO in the form of a rise would have made many investors off-loading their stock but not me. Is it a case of unexplained attachment or is it pure greed? ( I cringe when I type this word). My broker Charles also shook his head.

I was talking to a bank manager a few weeks back who said his friend working in the oil and gas company got 400K Pchem (IPO) shares through a loan and he offloaded them fast as the stock recovered slightly following its weak debut.The man regretted it by early March. He managed to repay his loan but he made a pittance. And just imagine he was overly relieved to be able to repay that loan!

My philosophy is if you were going to sweat over a loss in the short term, then you shouldn't enter the stock market. It is not for the faint-hearted and it is not for "chickens" who responded at the slightest negative news. Especially when you have selected a company to invest in based on its quality fundamentals. Because all stocks are subject to a Yo-Yo. You have to know the pattern of the trend, some people use the market charts data to make their move and this mix of fundamental and market charts data will actually determine actions on your stocks.

By the way, my principle is never to borrow to acquire stocks!

And so yours truly is waiting, don't know for what, and now witnessing the Pchem price falling to less than 7.00 as a YO sets in.. It is strange when the price is low, that is the time I get restless and itching to sell. Obviously not the characteristic of an intelligent risk-taker! So let us see whether the stock will climb back to its highest peak under this yo-yo environment. I believe it will.

This evening I heard that the US job data for April has shown a more than expected figure and US market sentiment is buoyant again ( another YO in the making!) and the European stock markets also have gone north, so you can expect Malaysian stock market will open ( with a YO) higher this coming Monday. I am not that sure what the impact of the death of Osama has on our Bursa but there was a positive sentiment in the Middle East market particularly Egypt. Others are still waiting for any possible response from some members of the organisation the murdered Osama led. If there is then you can expect a YO.

I also notice my Sapcres and Dialog stocks are having the same swing along with the other stocks except those genuine non-speculative ones like the REITs and hmmm..... PICORP. When the international fund took flight just before CNY, almost all the desirable stocks took a beating but not PICORP... I almost smiled at myself as this stock, held for almost three years, doesn't suffer a Yo-Yo for the last two years. So still waiting patiently for it to recover from its prolonged YO... you never know.

And watch out for TM as its YO will come-a-calling soon.

My GreEn EsCApaDe

2011-05-03T16:39:00.007+08:00

Whenever I am tired of reading or working especially on my computer, I would go on the green escapade to relax my eyes. Fortunately I have just to open my clinic window and look at my favourite green especially when there is a beautiful breeze caressing those leaves, making them move ever so languidly. My mind seem to be rejuvenated just looking at the green things in my surrounding. I would like to share some of my favourite views.

The Dancing Trees

The view of green against a clear blue sky is very soothing. I just focus on those leaves and feel my eye muscles relax. The light breeze adds a kind of musical tune as the leaves move from side to side and around the air currents. It was indeed a peaceful sight.

I have to imagine the interaction of leaves,breeze and sunlight as they present a picture of peace,harmony and beauty. Let my mind soar as it strives to derive simple joy by just being with nature. My escapade is complete as tranquility overwhelms me with surges of pleasurable sensations coursing through my body. Reminds me of a poetry by Lord Byron.... How do I love thee... Let me count the ways....In my case, how do I love Nature... Let me list the ways..

I have some favourite green around my house. Take a look at my curry tree just outside my kitchen window. It also dances beautifully in a breeze. The curry leaves are used, well, in curry to create that sweet pungent curry smell. I have also seen people boil nuts such as chickpeas (kacang kuda) with curry leaves to bring out that oomph flavour.

Next to the curry tree, I have a mango tree, Harum Manis, given to me some years ago by my favourite Health Sister Theresa. The tree has been bearing sweet mangoes without fail all these years. I thought of Theresa whenever I eat the mangoes. Such is an enduring memory! There is also "limau purut" tree which I planted using a sapling bought from an old lady at an open Sunday Market. It also bears fruit continuously. Besides using it for cooking, I also use it as hair shampoo. And there is also a henna tree next to the lemon tree. I have yet to use it to color my hair in a natural way. And close to it is a "Belimbing Buluh" tree given to me by my retired Rural Nurse, Angela. The fruit is used to add that sourish flavour to some dishes and I have used it to relieve an early sore throat. Thanks to Angela!

Often at nights when it is breezy and quite, I could hear the leaves of my mango trees rustling by my bedroom window.


Trees that I planted

Yes, I also planted some pandan shrubs for cooking purposes. Oh you can really add lovely fragrant smell to your "nasi lemak", cakes and porridge using this herb and yes when I am sitting on a lazy chair just outside my laundry waiting for my clothes to be washed, I could smell the exquisite scent especially in the evening or when it just stops raining.

The Fragrant Pandan

The pandan plant grows exuberantly especially when you just let it be so every now and then I have to prune it otherwise it will march right into my neighbour's fence. Ever once my exasperated neighbour asked our gardener to prune the marching pandan as he said there could be snakes under its convoluted roots!

But I can tell you that the plant is actually a mild natural insecticide. No cockroaches will come near when you put pandan leaves in the vicinity.

My neighbour only likes to grow flowery plants. His house is full of colorful bougainvillea, roses and hibiscus while mine is full of green. There were times when his wife asked my amah for some pandan leaves to add fragrance to her cooking! during festive season, the pandan leaves are sold in a small bunch for RM2 at the market, it used to be RM1 but the increase in petrol price has shot up transportation cost of these market produce. So my nurses would troop to my house to help me prune this plant and they get their share of pandan for free.They also prune my "limau purut" plant as they need the leaves for festive delicacy, the rendang!

My favourite vitamin C source is the guava. I used to have two of this wonderful trees. They were given to me by my Hospital Assistant Joseph some years ago when I moved to my present bungalow. One of the trees succumbed to insects' infestation. It used to produce rather longish fruit but less sweet but this surviving one produces rounder fruits and are much sweeter.


Sweet and Succulent Guava

The tree has never failed to fruit several times a year and they are in abundance. Unfortunately, at times the fruits are infected by the nasty fruit flies when I forget to cover them at an early fruiting stage. Well, when you have this fruit almost everyday you tend to forget that the tree needs tender loving care.

On the flat ground at the end of the hillslope at the back of my house I have banana trees and pygmy pandan coconut trees. You have to drink the coconut water from my tree to taste the exquisite pandan-scented liquid. Actually I did not know that I had this kind of coconut species till one day we bought a couple of coconuts, noisily advertised, as having sweet taste with pandan smell at a stall. It was lovely so the next day we returned to the same place where the stall was but the vendor was no longer there! We went everywhere looking for the rare coconut but no one else was selling them. Then one day my gardener got hold of some coconuts from OUR TREE and hey Presto! It was the pandan genus. Fancy that ! All those years we just watched the coconuts falling to the ground untouched.

Well, that is my green escapade, covering most of the senses, visual,audio,taste and smell. I derive great pleasure with GREEN around me.

William and Kate on the Procession Route - The Royal Wedding - BBC

2011-04-30T00:53:00.000+08:00

Kate Middleton's Wedding Dress Revealed - The Royal Wedding - BBC

2011-04-30T00:47:00.000+08:00

William and Kate Kiss on the Balcony - The Royal Wedding - BBC

2011-04-30T00:44:00.000+08:00

The Royal Wedding-Joining the Sentimental World in Celebrations

2011-04-29T23:54:00.002+08:00

Westminster Abbey on 29 April 2011

Feeling good about things and feeling happy for people who are happy are good for your own psychic health. I believe people who are interested in others in the most positive way are in the "normal spectrum" and these are the people who make up a healthy and caring society. I am thus transported into the world of "feel-good" moment.

The wedding today of Prince William, the grandson of Queen Elizabeth of Great Britain to his fiancee, Catherine Middleton is indeed a memorable occasion watched by two billion and celebrated by millions of British and tourists in London today 29 April 2011.

I spoke on the phone to a colleague just before 5pm today and before we ended our conversation, she reminded me to watch the wedding live on ASTRO Channel 700. The excitement is palpable.

I am happy for the couple and wish them well though I cannot forget the sad and tragic end of William's mother, Princess Diana in 1997 ( I remember hearing her death when I was on a flight back from London in late August and just a week before she was having a holiday with her two sons, William and Harry! All splashed up in the local papers).

I want to record this day in my blog as millions join in to celebrate the Happy Occasion of Diana's son and his beloved Kate, the future King and Queen of England, at Westminster Abbey today, 29 April 2011. The Abbey was also where his mother's funeral was held.


Prince William and Kate announced engagement and wedding date in Nov 2010


THE wedding Dress by Kate Burton of Alexander McQueen

The wedding vow

The wedding ring

Duke and Duchess of Cambridge


The Prayer


Queen Elizabeth the Grandmother (wearing canary yellow at the wedding)

The late and lovely Princess Diana, Prince William's mother


Sealed with the traditional KISS on the balcony of Buckingham Palace


The adoring crowd

I can go on and on with the pictures but these are my chosen memories of the Royal Wedding on 29 April 2011, my way of joining the sentimental world to celebrate a beautiful LOVE STORY.

May God bless the marriage of William and Catherine and may they emulate William's paternal grandparents, Queen Elizabeth and Prince Phillip who have been married for 64 years!

Elton John - Circle Of Life

2011-04-20T19:09:00.000+08:00

The Lung - A Man's Pain and a Woman's Instinct - AN UPDATE

2011-04-20T12:25:00.000+08:00

This morning I received a text from CLK that her husband's lung biopsy was positive for tuberculosis (TB)! And they are all praising the Lord for that result. Why are they praising the Lord? As TB is a chronic infectious disease which requires prolonged daily medications. Some of the drugs used are really distasteful. The daily injection can be rather daunting.

Still they praise the Lord because the pleural effusion is not caused by cancer. The therapy for cancer carries much more risks and morbidity and the outcome is usually uncertain depending on the level of spread. At least those TB germs, if not the resistant type, will be amenable to anti-TB treatment regime. The intensive treatment will go on for three months following which a chest X-ray will be taken to evaluate its effects.

On reflection, it is not common for a rather wealthy person to have come down with this infection unless he got it much earlier when his socio-economic situation was not so good. TB is generally a poor man's disease. However if there are infected people around you, you may be easily infected yourself especially when your immune status is compromised. This makes me think about FK's continuous use of steroid for his sinus!

AHB- Amanah Hartanah Bumiputera's First Dividend

2011-04-19T22:46:00.001+08:00

For those who are eligible to subscribe to this Reit, AHB, you would be pleasantly surprised that an early first dividend has been declared and paid on 19 April. I happened to come across this information when I visited Maybank, the manager of this Reit recently. The dividend is at 2.17 sen for 123 days since it was first launched in November 2010. For those who bought the maximum units of 200K, you all would be laughing all the way to the bank.

Apparently at that rate, it would work out to be about 6.20 sen per annum, slightly lower than PNB's unit trusts and much lower than the market-quoted Reits which by the way is subject to price variation unlike AHB. And another special investment for Bumi is Bank Rakyat new units which, by the way, according to my friends are hard to get as the waiting list is very long. At an annual dividend of 15 sen, who would want to miss out on this?

Anyway I am sticking to my PNB unit trusts and Credit Pacific and of course occasional forays into the stock market. Currently the market is rather deserted after the short rally in early April. Managed to offload my Uemland at 3.16 while my purchased price was at 2.29. Not always lucky though.

Happy investing and Happy Easter!

The Lung - A Man's Pain and a Woman's Instinct

2011-04-19T13:21:00.002+08:00

Yesterday afternoon, an elderly lady, CLK rang me up to thank me profusely for referring her husband, FK. to a Respiratory Physician at the General Hospital. She was relieved that a diagnostic and confirmatory investigation was performed on him and now awaiting a laboratory result for definitive treatment.

FK is a fit 74 year old man who was a Vice-President of an international resort. He exercises at the gym almost daily and is not a smoker. He always prides himself in being able to keep up with young people at his age. Both he and CLK are active members of their church. I caught him self-medicating on an anti-diabetic drug for a number of years and had managed to persuade him to be on my Diabetes clinic follow-up. He always gives the impression that he is healthy and that nothing is wrong with him except for his sinus. If possible he would avoid a doctor like the plague!

About two weeks ago the couple turned up at my clinic without an appointment. According to CLK three nights before coming to see me, FK woke up from his sleep with an excruciating pain on the left side of his rib cage. They called up their regular private doctor and were told that it was not a heart attack. Apparently the pain was relieved by a warm pack and panadol. His doctor also gave him a course of antibiotic as he felt feverish the next day. FK did not have anymore pain after that and his fever had subsided but his wife felt something was not right and decided to see me.

When asked how he was feeling, FK answered confidently that he’d never felt better. There was no more pain and he slept like a baby following the episode which he attributed to muscular sprain. He also blurted out that his wife was being paranoid.

After getting a further history of his complaint, I proceeded to examine his respiratory system and my auscultation (examination via stethoscope) of his chest revealed a reduced air entry and there was a dull percussion (tapping) on his left lower chest. I decided to order a chest x-ray. And I am posting the image below:

Left pleural effusion has been confirmed by CT-Scan

One look at the X-ray I could see that the left lung was abnormal in term of size and position. It looked like there was a space-occupying material pushing his lung away from the pleura (the side of lung nearest to the rib cage). He needed to have a CT-scan of his thorax (chest) to determine and confirm the nature of the X-ray abnormality of the left lung. His right lung appeared normal.

I referred him to my colleague in the hospital respiratory unit with a request that he himself see the patient. Cutting the story short, the scan showed the presence of fluid in the abnormal space .in medical jargon, the condition is referred to as pleural effusion. A diagnostic tap was done and more than one liter of straw coloured fluid was extracted and a sample sent for laboratory diagnosis.

Well there are several causes of pleural effusion such as chronic infection, immune diseases and abnormal cell growth (cancer).The result has not come back and I am praying for FK and his loving wife.

A woman’s instinct is often amazing.

Maybank is .... a Cool Bank

2011-04-17T23:00:00.006+08:00

I have been a loyal customer of HSBC bank for many years. I would swear by its impeccable service especially in Premier Banking. It is like going to a house where you sit on soft sofa, have brewed coffee or tea, read coffee table books, "decadent" magazines such as Tatler Malaysia and use the internet while waiting for your banker to attend to you. Banking has indeed transformed over the years. The only problem now that I have with HSBC is that they do not have facilities to buy IPOs online neither can I pay my income tax in the same manner. So I am forced to look for a local bank to get this service.

Well, when I purchased a forgettable structured product in 2008 from CIMB ( a local bank), I opened an account there and was treated to their kind of premier banking but somehow it was not the same as HSBC. The atmosphere at that particular branch was rather boring and the lighting was dim. The space was not ideal maybe because they are renting the premises. Staff were not that welcoming when you step into the bank. There was a security guard who asked you what type of business you want to transact. Anyway I closed the account once I got back my three-year fruitless investment!

Then I remember Maybank, I nearly bought its shares two years back when it was 5.80! So I trooped to the branch nearest to my clinic. The building is purpose-built and you can see that they are able to use their space quite nicely. I remember going to this bank some years ago when I had to send some money to a relative who had the account with the bank. Then the counter was like the old bank set-up, positioned in one unfriendly line. There was a security guard asking what you wanted to do and there was no one coming to offer help when you appeared confused, not knowing what to do and where to get your number etc.

As I entered the bank this time, there was a welcoming desk where a staff with a ready smile was stationed and she immediately gave me a number and told me where to go. Now I noticed there was no more long boring counter, instead you see many desks with staff in smart black and gold trimming uniforms sitting and attending to customers. There were nice sofa for you to sit while waiting for your number to be called. I was attended to almost immediately. A real corporate feel.

I was thoroughly impressed.

Passbook in a jiffy!

Everything was done pretty fast, while I was changing my PIN number at the nearest ATM machine, the staff darted off to the teller to remit my initial deposit and I got my passbook in a jiffy. When came to the internet banking activation, a helpful supervisor came over and told me one of her staff would guide me. It was a breeze and I was very satisfied with the service.

It was quality service and this is what banking should be like. I was thinking about what their private banking would be like. But if their ordinary banking is so good why would I keep RM250K just to be pampered by the exclusive service? As I am already enjoying Premier banking at HSBC, why would I tie up more money as my banking with Maybank is only for services I cannot get at HSBC. That money is better kept liquid so that I can conduct my stock market activities without hassles.

Anyway my experience at Maybank is pleasant and most impressive. It is very good to see that they have also transformed their banking services in line with quality global standard and these speak volumes of their leadership. I hope they maintain this culture of excellent service.

Congratulation to the CEO of Maybank, Datuk Seri Abdul Wahid Omar as all these positive transformation has materialised under your watch.

Maybank is now KawanKu (my friend).

50th Anniversary of the First Man in Space -12 April 1961

2011-04-13T01:52:00.003+08:00

Yuri Gagarin- the First Man in Space

It was the greatest exploration for man when Yuri A Gagarin, the Russian cosmonaut successfully orbited the earth for 108 minutes in his Vostok 1 spacecraft on 12 April 1961. He inspired the race for space technology and its potential for mankind. Unfortunately there was no sophisticated camera to record his view of our Earth. All the same Gagarin is a hero to his countrymen and also to the world. We celebrate his achievement because it embodies the spirit of exploration and discovery. In doing so we are reflecting the past and looking forward to the future.

It is also worthwhile to note that space exploration and research now are collaborative rather than competitive. US, Russia and other technologically advanced countries such as Italy, France, Japan, Great Britain and Canada are all contributing towards mutual benefits in space science as can be seen in the planning , construction, operation and maintenance of International Space Station (ISS). International astronauts are taking turn to conduct all kind of space research in ISS.

Google joining the Global Celebration of Yuri Gagarin, First Man in Space

Yuri Gagarin who died in a plane crash seven years after his orbit of the earth will never be forgotten. Children should read about his historic flight for inspiration. In fact activities to commemorate this historic flight into space could have been arranged to get the children interested to learn and know more about space science. Role modelling is important in children's development. Our children are our hope for the future of our beautiful planet. I would really like to see a Malaysian as a dedicated space scientist and a true astronaut and not just a space tourist. Will it be in my lifetime? I doubt it.

ASD -Amanah Saham Didik is fully subscribed but not to worry.....

2011-04-12T02:48:00.005+08:00

Bumiputra-only product

Last week I met avid fellow investors and we were talking about investing in the low risk PNB (Permodalan Nasional Berhad) products as a means of getting regular income at a rate higher than the bank. As everyone knows there are products which are reserved for Bumiputra and those open for non-Bumiputra.

Among those that are open to all irrespective of ethnic groups are ASN3, AS1M,ASM and ASW for which all non-Bumi portions have been fully subscribed! Hopefully additional units will be issued for these unit trusts in the near future so that more young people entering the economic realm will be able to join these long-term investment opportunities. The attractive aspect of the products is that they have different financial years where dividends are distributed. ASM and ASW will be by June and AS1M in September so you are able to get regular income throughout the year.

Among the products exclusively reserved for Bumiputra are ASN,ASN2, ASB and ASD. For a long time these products apparently according to my Bumi friends, have not been fully subscribed. So those with money to spare have been putting their money in the last two as they are fixed-rated. However last week according to my friend SJ she could not get anymore ASD units as it has been fully subscribed. Thinking fast I told her not to worry wait till the middle to late July because some units are going to be released by some investors. The reason is simple. Many people tend to park their excess money for a few months just to get the dividend. And ASD dividend will be distributed on July 01. The dividend rate is likely to be more than 6.35 sen per unit declared last year according to record.

It seems the way to get more income for people is to park their money just before the dividend is declared then they will transfer back the money to another fund for the next respective dividend. Have you ever thought of doing that? I think you can do that if you are sure you could get back in. May not be easy for fully subscribed funds though.

I am seriously thinking of parking my AS1M fund in a state-owned variable -rate unit trust if I am sure that its dividend rate is going to be high ( this unit trust has higher dividend yield) and to be distributed at the end of the year. Park it just after AS1M declares its dividend in September then try to get back in again in February the following year. You have to be fairly active in your various transactions to do this.

Dynamic parking (reallocation/relocation) of excess fund seems to be a logical strategy, I think this is what some people are doing to make their money work harder for better income generation.

Stretching your money !

So best of luck to people who are adventurous!

Admiring the Japanese - one month after the Devastating Earthquake on 11 March 2011

2011-04-10T06:01:00.006+08:00

Four weeks back Japan suffered the worst living nightmare in its recorded earthquake history. The videos only generalise the enormity of the disastrous earthquake which is 10 on the Richter scale. More than 10,000 people are dead and twice more recorded as missing. The calamity multiplies in severity with the resultant tsunami and the radiation fear from badly damaged nuclear plants in the areas worst affected.

A picture is worth a thousand words and a Video multiplies those words. I have re-posted three selected videos from youtube to just indicate the extent of the calamity.

Words cannot describe the extensive annihilation that follows and the radiation fear that hugs the people of Japan. Heart-rending videos flooded our TV lounges. Our heart goes out to them. Despite the complete loss of possessions and lives the Japanese people have shown to the world what a disciplined and dignified people they are. There is hardly a loss of social order, opportunistic profiteering, looting and fighting. People quickly get organised and infrastructures are speedily repaired. Indeed they are just an amazing people.

Japan is wealthy and its people are hard working. They thrive socially and economically in a resource-poor environment. The disaster has set back Japan economically in many ways but I believe the Japanese will rise to the occasion and rebuild in no time.

It seems to me the Japanese are resourceful because of the geographical make up of their country and the potential threats of earthquake as their islands are surrounded by active volcanoes termed as the "Pacific Ring of Fire". Nature and natural disasters bring out the best in the peoples' characteristics when they learn to act and feel as one people in the spirit of interdependence.

SAKURA- Lovely Japanese cherry blossoms

In Malaysia while we are grateful that we do not suffer from devastating natural disaster, we find that we are lacking some positive attributes of a great people. If only we could learn from the Japanese.... no, not only in manufacturing cars.

Japan is one of our world's productive members. They have given so much to the world such as cars, walkman (precursor of iPod), Sony, Mitsubishi, National-Panasonic, slippers, sumo wrestling, Ninja, shushi, Kaizen, 5S you name it, they are all from Japan, the Land of the Rising Sun. So in their hour of need the world should come together to support them.The earlier Japan recovers, the better it is for the world.

When I drive my Toyota Camry, I think of Japan fondly. I am also a hardcore fan of Kose, Shiseido and Noritake porcelain and would have loved to learn karate!

Fukushima Nuclear reactor explosion 14 March 2011

2011-04-10T04:39:00.001+08:00

Earthquake on 10 Richter Scale in Japan 0n 11 March 2011

2011-04-10T04:28:00.001+08:00

The earthquake-triggered Tsunami hitting a Japanese town 11 March 2011

2011-04-10T04:23:00.002+08:00

Music as a Therapy and Music as A delight

2011-04-03T12:15:00.004+08:00

I have always loved music and songs. In fact I was quite interested in singing when I was a young girl in a boarding school. My music teacher Miss Chua would encourage me to train my vocal and I remember when "Do Re Mi pi Ca So" were supposed to be vocalised at the different frequency length of your larynx or voice box and you were supposed to breathe in deeply when making certain sound so that you can modulate your voice making it beautiful to hear! Gosh if only I was not talked into doing medicine! (just joking guys). Anyway the late Miss Chua is my favourite teacher and I have always loved her like my mother. She made me love music. Bless her soul.

When I was working in a General Hospital, there was this elderly Pharmacist whose wife was a music teacher and somehow he got hold of all his interested staff to come up with a musical ensemble and they would go around the wards in the afternoon to play their soft beautiful music for patients and I could see that the patients' eyes would light up and as they smiled. They enjoyed listening to the music irrespective of ethnic groups. Beautiful music is universal. That is music therapy for you and it worked everytime for convalescing patients, speeding up their recovery at least emotionally.

Music is the expression of the soul. Good music and songs would never fail to make me high even in my saddest of moments.I used to buy a lot of CDs sometimes just to get that beautiful piece from an album but now with music sharing on the net I no longer have to bother wasting money buying unnecessary pieces. Just download those that you specially love and play them to your heart's content!

I love good music and songs particularly those with meaningful lyrics. That is why I chose 'It's the climb" originally made famous by Mylie Cyrus and beautifully covered by Joe McEllery, the 2009 Britain's Got Talent champion.Listen to the lyrics of "It's the climb" you can see that it is about a person who keeps on trying and trying despite the obstacles. It's the challenges which make you stronger as you go through life and not what you finally achieve..... "It ain't about how fast I get there, it ain't about what's waiting on the other side...".

Yes, I must admit that when things get a lit bit worked up and when life becomes a chore, I take refuge in listening to music. Actually I love classical music and used to listen a lot to Tchaikovsky, Mozart, Chopin, Beethoven and Edvard Grieg but I figure I should also be listening to NEW music and current singers like Lady Gaga, Justin Bieber, Michael Buble, Usher and of course Mylie Cyrus so that my brain's nervous connections are making new wiring routes instead of just sticking to well known paths of favourite classical music that can play in my mind the minute I think of them!

I think you can keep your mind fresh and alert by stimulating it with a variety of organised sounds that are music and songs. The other way towards stimulating your mind is by reading a lot and imbibing knowledge, others' experiences, new ideas, concept and theories. Your mind needs to be constantly challenged to remain active. Fill it with happy sounds and good and positive thoughts.And of course good nutrition.

It is good to post something not related to my work or the stock market because life, after all, is about balance. My PChem, by the way, is doing exceedingly well that it is currently boosting my mood as well :D.

Anyway this morning I woke up with a certain music, a piece from Peer Gynt Suite by Grieg called "Morning" and I am posting it here to be played for my pleasure and for those who find music as therapeutic and delightful. Enjoy.

Spiritually uplifting and soul-calming

2011-04-03T10:00:00.000+08:00

ThE CLimB.... sOmE tiMeS I'm GoNNa hAVe To LOse

2011-03-26T01:52:00.005+08:00

Space Science and my Big Dream

2011-03-10T14:11:00.020+08:00


Discovery preparing to lift off on 24 Feb 2011

Discovery landed safely back on Earth at Kennedy Space Centre Florida on 9 March 2011 after a flawless mission - Credit NASA

I stayed up early this morning to watch the safe landing back on Earth of Discovery from its 39th and final flight to outer space. It lifted off on 24 Feb 2011 and was in space for 13 days mainly docked at the International Space Station (ISS). It transported storage space and repair materials as well as the first humanoid robot named Robotnaut2 or R2 to help enhance the operations of ISS and its research laboratory space and technical capabilities.

Discovery is one other remaining three shuttles still operational, the other two are Endeavour and Atlantis. NASA used to have five shuttles for its space program. Challenger broke up at its launching in 1986 and Columbia burst into flame at its re-entry to Earth in 2003. I only remember the names of female astronaut teacher Christa McAullief from Challenger and Kalpana Chwla a naturalised Indian female engineer from shuttle Columbia. I remember feeling very sad hearing about the astronauts' death. And so with this particular Discovery flight I prayed for their safety and will continue to do so for Endeavour in April and Atlantis in June as they fly off to space and dock with ISS and return for the last time when the world will say farewell to all three of them as they are being retired after 30 years.

Apparently the orbital space program will be privatised leaving the US government to undertake deeper space projects which will cost billions of dollars. It seems if you have millions (in USD) to spare you may be able to go as a tourist to ISS and look at our planet Earth from out there!

I have dreamt of becoming an astronomer/space scientist and an astronaut since I read about Armstrong walking on the Moon and famously said " A small step for man and a giant step for mankind". Now what is it like to be walking in space with no gravity? How does it feel to be in that space suit? What is it like to see planet earth being suspended and orbiting in space? I was inspired to go into pure science through reading about this space program in magazines,newspapers and radio and TV.. there was no internet then mind you. With the availability of copious materials at your fingertip now ,any curious child would be just as inspired and probably more so. Just go to the NASA website and see the information that they have there for different visitors, public, student, researchers etcetera. How I wish our children are conversant in English and able to understand what they read and be inspired to excel in science because that is the edge for any country to be ahead in this globalised world.

Man on the Moon -1969 (NASA)

I believe children can be inspired from young to be interested in science. One needs to arrange related activities for them to be involved in. I had hoped that Malaysian schoolchildren would have taken an interest in shuttle flight program, just show them the video and what kind of things astronauts do. I saw many schoolchildren in US made time to witness the shuttle launching and look at space exhibits. They might not be astronauts but at least they can appreciate the great potential of scientific knowledge. We do not want children who ascribe everything to God and leave things as they are and are only contented to be technology users rather than technology inventors.

But I have this feeling that in Malaysia, people doing science are not that well appreciated. It is sad to see those clever children going into science and end up nowhere whereas their counterparts who are not so clever especially in maths end up doing Arts and becoming heads of civil service! It is a fact. I have come across a Medical Specialist who lamented that his academically weaker classmate became head of the Ministry he was in, earning more than him.. no wonder he left the service and has gone to Singapore, another brain drain.

Well back to my dream as you all know it remains a dream as I eventually discovered in Malaysia there was no way for you to go ahead with your ambition in space science as we just do not have the industry, the capability nor the money for that kind of program. You just have to be born in the right country I suppose. For now I can continue to dream and follow the space program development and also wonder at Hubble telescopic images as they are being transmitted to earth! And perhaps I would be among the first to know if there is a meteorite going off course and coming straight to Earth or if there is a solar flare cutting off all satellite and electronic communication on Earth.... and according to a prominent NASA scientist, there is one coming up in 2012, the last one was reported in 1889 when the effects were not really great as the world did not have satellites, mobile phones and internet then, now thinking about it is real scary. It reminds me of the Mayan calendar which stops on 21 December 2012. Will the world end then? And there are these goons going around US reminding people that something spectacular is going to happen on 21 May 2011... I just hope the stock market would not crash on that day.

Well, people actually I am inspired today to write this posting because I want to express my admiration towards NASA and all the people who make the shuttle space program possible for the last 30 years now that they are wrapping it up. So many experimental findings in space have been applied for the betterment of our human race, satellite communication is just one of them. There are also biological research in cancer therapy and many more. It's just a terrific and brilliant human effort.

As Discovery Flight Commander Steven Lindsey on the final flight STS 133 said and I truly concur, " Guys you rock!"

Farewell Discovery.

Facts on DISCOVERY

NASA's oldest and most travelled shuttle

1984 - (30 Aug) Inaugural flight

1990 - Carries the Hubble Space Telescope into orbit

1995 - First shuttle to be piloted by a woman ( Eileen Collins)

Carries the first African American spacewalker (Bernard Harris) and first sitting member of Congress (Senator Jake Garn)

2010 (Nov) Planned launch postponed after cracks emerge upon fuelling

2011 (Mar) Ageing shuttle due to be the first of the fleet to be retired following its final

Earth landing Wednesday 9 March after 39 successful missions.

Chronic Diseases and the Risks of Self-Medication

2011-03-09T22:55:00.003+08:00

The government has spent a lot of money on promotion and maintenance of healthy life style for her population. Health strategists went to the extent of having an annual disease-theme country-wide campaigns on such conditions as heart diseases and diabetes. Regular media advertisements, publication of booklets and brochures costing hundreds of thousand of dollars are main approaches to get to the masses, teaching and guiding them on how to achieve good health and avoid early development of chronic so called lifestyle diseases.

I think to a certain extent the massive health campaign has been successful in educating people on the need for proper nutrition and exercises.The emphasis is however on prevention and it so comes as no surprise that those who develop such chronic diseases are left to fend for themselves to manage their condition. Whilst many come to the clinic to get screened, diagnosed and managed on a lifelong basis, others especially those without any symptoms will carry on regardless till it is too late.

Some people will talk to their friends and compare signs and symptoms and self-medicate. Some will go to the private doctor and get diagnosed and prescribed anti-hypertensive or anti-diabetic whichever is the disease. As the cost of the drugs is quite expensive especially when one is supposed to take them every day, the patient has the tendency to be non-compliant. He/she would go to the clinic whenever he/she feels like it. For some working with the private sector, their employer would pay for the cost of the drugs but once they leave their job they would find the cost exorbitant. Being treated by the private sector is costly as well as once you are on a long term drug you need to have your blood monitored regularly for any adverse effects on your excretory organs such as the liver and the kidneys. The laboratory tests are indeed expensive. And so these patients will tend to self-medicate.

Despite the existing drug legislations in this country, you can get most drugs from the pharmacies without a doctor's prescription. Yes, the truth is stranger than fiction.

I come across three classic examples of self-medication. The first one is a man of 73, FK who has been taking anti-diabetic drug for the last seven years without any doctor's prescription let alone monitoring. The other one is also a man, YW aged 62 who has been taking an anti hypertensive drug for one year on his own and the third is SS a lady of 53 who has been on the same dose of an anti diabetic drug for the last five years on her own after defaulting from a private doctor's follow-up. Sometimes she takes and other times she doesn't.

FK has been having recurrent itchy skin rashes and has spent hundreds of dollars at the private skin clinic to no avail.YW came with jaundice (yellowing of skin and eyes) and some smart non-pacticing doctor told him that he had a high blood pressure and that he should take medication so he takes the same medication as his wife who I prescribed a beta blocker a year ago but was lost to my follow-up as she decided to buy the drug herself! Normally this class of anti hypertensive is not prescribed to a man! SS was on the same antidiabetic medication for a long time without being monitored. Her sugar level must have gone "yo yo" as she did not take it on a regular basis.

As expected all these three patients have deranged liver and kidney tests and their conditions are not clinically controlled. FK's skin rashes subsided once his sugar level was normalized. SS's abnormal thirst and heavy and frequent urination, signs of uncontrolled blood sugar, also subsided the same way once the correct dose of the drug was prescribed. YW who incidentally admitted taking some herbs ("misai kucing") as well, was observed to have high blood pressure despite his self-medication. His jaundice is a cause for concern as his blood test done a year back before he defaulted treatment had already showed evidence of liver disease. Chronic jaundice has many undesirable implications and needs to be thoroughly investigated. I proceeded to appeal to the three patients to understand that they needed regular monitoring and that the doctors are here for them.

But just how many people out there are self-medicating for their chronic diseases without knowing the risks? Their ability to purchase scheduled drugs from errant pharmacies ( and maybe even from online agents) is frightening. It is no wonder that there is a rising trend of cases of chronic kidney failure in Malaysia. With the advent of drugs such as Angiotensin converting enzyme inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB) whose prolonged use to treat high blood pressure, could affect the kidney function of some patients, it is imperative that these patients be properly monitored.

In medicine, you need to manage a patient like you would your loved ones. That is a real job-satisfaction.

Hypertension and my GA GA experience.

2011-03-08T16:19:00.001+08:00

For almost three months I have been scratching my head wondering what has gone wrong with the treatment for high blood pressure of a patient. This is a 62 year old female who speaks English fluently and dresses very smartly with a hijab ( head cover) and wearing long stockings. She has been my patient since 2009 and initially her blood pressure was well controlled with only one drug. In fact I complimented on her blood parameters which were excellent for someone her age. Both cholesterol and sugar level are normal.

However early this year her blood pressure has been climbing up necessitating another drug. As a doctor who have been treating many hypertensive patients, I noticed that it is better not to maximize the dose of only one drug to avoid unnecessary side effects. Instead patients seem to respond better if another class of anti-hypertensive drug is added to the regime. So that was what I did. Being overcautious I always ask patients whose drug regime I alter to return to the clinic after about two weeks or earlier should they experience some adverse effects.

Sphygmomanometer and Stethoscope - BP measuring set

This particular patient who I shall refer to as LP did not do either. Instead she claimed after taking the second drug she became dizzy and her blood pressure, according to her home electronic BP set was high (?). She immediately stopped the second drug and continued using the first drug for one month before she finally came to the clinic.

Her blood pressure was noted to be still high, needless to say and because she claimed she could not tolerate the second drug, I prescribed another class of anti-hypertensive and this time insisted that she should return to the clinic as instructed.

She returned after two weeks and her blood pressure was still high and yet she did not appear convinced with my measurement. Instead she related how low her blood pressure was when she measured with her home BP set. She repeatedly claimed that she became dizzy when she took the extra drug. I was getting exasperated but tried my best to remain cool outwardly. Because despite the lowest dose of the additional drug prescribed, her blood pressure was still high during that consultation. I asked my nurse to use the clinic machine to measure and confirm her blood pressure, yes it was high, more than 140/90. I was at my wit's end then it dawned upon me that she might be taking something else at home that could have brought down her blood pressure more than clinically necessary.

Further friendly probing revealed that she had been taking a herbal concoction "PEGAGA" (Malay name for a plant) since early this year for her varicose vein. My! This was the first time that she admitted that she had varicose veins. This is the sort of problems facing you when you examine a woman covered from head to toe because you cannot really describe her general physical appearance to help you in your clinical examination. I asked her to show me her legs. She was hesitant despite me being a woman myself. When she at last took off her long stockings then I observed the multiple tortuous coarse veins running down the back of the knees to her calves. According to her the herb helped reduce her bilateral foot swelling on prolonged standing. You can go here http://thestar.com.my/health/story.asp?file=/2007/7/29/health/18419175&sec=health for the news report on the herb.

Pegaga ( Centella asiatica)

Well, if the plant's chemical can reduce tissue swelling due to abnormal veins ( may well be through an enzyme like prostaglandin) I surmise, for lack of any scientific evidence that it could also interfere with or work in synergy with the drug I was prescribing to further lower her blood pressure causing her to feel faint and dizzy. It happens that she took the concoction in the afternoon whereas she saw me normally in the morning and her low blood pressure occurring usually in the late afternoon and evening. Most likely the effect of this plant chemical is period-dependent and as the effect wears off, her high blood pressure returns!

I told LP she has to choose whether she wanted to be treated by a doctor or be on her own medication. I warned her that there was no way to monitor the effects of "agents" sold over the counter as herbal medicine as there was no proper research on them in terms of dosages and frequency of use as well as on the side effects and drug interactions. A doctor cannot possibly monitor a patient who uses other agents/drugs behind his/her back. I told her either she stop using the herb and take a clinic's medication for her varicose veins or she can continue taking the herb but see another doctor.

She decided to stop the herbal remedy and is now being monitored for the best combination of anti-hypertensive drugs for her rising blood pressure. I also advised LP not to throw away her home BP set as most likely the low blood pressure incidences would not recur with the stoppage of the herbs. So far so good and my own "ga ga " blood pressure is returning to normal now!

JCY - Am wondering about the Company

2011-03-01T13:39:00.001+08:00

I am on the downside as far as my roller coaster ride with JCY is concerned. Today's price at 0.615 has wiped up 53.5% of my investment, a paper loss. And its recent financial quarter loss did not help matters. Looks like I am in for a long haul on this stock. I just hope that the company doesn't fold up under this intense low demand pressure. As the company was just listed in Feb 2010, its previous performance was not generally known unless you read the prospectus prior to listing that I must admit I did not as I bought the shares in July and Aug 2010. The opening price was 1.48 which was lower than its IPO price of 1.60 and the highest price before the precipitous fall was 1.98 I think.

JCY performance spiralling downwards

From my observation on economy-dependent stocks, JCY stock would likely to recover in 2012 -2013 as the Euro zone debt crisis eases triggering demand for computers in such countries. So I am supposed to bite my lip and slog along just like I did with SIME in 2008 and realised my effort by 2010. Somehow when you do this, time seems to crawl. Yet this is a form of acceptance so that I can move on with other wealth creating strategies.

So JCY can go as low as it wants to ( no more dollar averaging for me!) and I am going on the sideline and just watch and wait for the time when it turns around hopefully and then end my adventure with technology stocks. Come to think of it I am now wondering why did the company decide to list in Feb 2010 because within less than six months the stock tumbled badly. Usually when you supply materials to big manufacturers you would have got forward orders for the following year then you would have known about your receivables/risks already...... I am thinking aloud. If what I think and fear happened as it was here then we investors have to be really be on the look out for such companies and protect ourselves. Have I thought this way in July last year I would not have dollar averaged on three blinking occasions! No surging happiness in this stock.

Such are the challenges that small investors face! Some people would do anything to get at our hard-earned money so beware.

TM's Surging Profit and My Surging Happiness

2011-02-28T01:49:00.001+08:00

My trust in TM stock is paying off. I am very happy to read that its profit for financial period ending Dec 2010 is substantially increased and a dividend of 13.1 sen per share has been proposed.And not only that TM is going for an capital distribution for its investors 29 sen to a unit or is it to a ringgit invested? I have yet to get the clarification on this distribution if it is the latter then it would be a windfall for me... let me dream about this before being shot down!

I am relieved that I did not sell the stock to apply for PChem IPO last year as this turns out to be my Golden Goose. I will not let go this goose due to its regular high-dividend yield ( it is better than MAXIS in term of yield). In fact after the capital distribution exercise, it is expected that the stock price will fall just like in 2009 when TM gave a capital repayment of 98 sen per share, I am going to acquire some more units to make it 100K. So I can say goodbye to my non-performing stocks which I am tired of mentioning here. Yes, we need to buy blue chips as they will not disappoint in good and bad times. Forget about small caps as they will "torture" you with no end and test your patience and your fun. And do a lot of readings on companies you want to invest in and the industry they are involved in so that you would not regret like me and my JCY investment!

I am glad to know that many of our companies are doing well, for example Maybank,CIMB, KL Kepong, Axiata and they are rewarding their respective investors with good dividends. I hope that you all also have surging happiness in this present volatile period with Middle East turmoil and rising oil prices.

The feel good factor currently is fodder for talk on new mandate for present government leadership so be on the alert for those construction stocks! I am monitoring Gamuda.

BSDReit and CMMT- REITs Investment for Portfolio diversification and liquidity

2011-02-12T13:39:00.023+08:00

When I was first exposed to the concept of passive real estate investment as opposed to direct real estate investment, I was rather hesitant to participate because I was looking at quick gains. I am not talking about purchasing properties, renting them and sell them later at a higher price but rather on capital appreciation of investments in REITs listed on Bursa Malaysia ( stock exchange).

For people who are impatient and want to create wealth in a hurry, I supposed it is better for them to invest in well established companies' stocks, that is buying on the low and selling high. You are sure to improve your financial position on that premise. But it is not always easy to multiply your investment in that way for various reasons, one of which is when you find that the market is pretty saturated and desirable stocks' prices are already high.

So where do you put your available investing fund? Well in Malaysia many people would point to high performance unit trust fund such as those managed by PNB ( National Capital Ltd). These funds have consistently given annual dividends higher than interest rates offered by banks. It is not surprising that they are likely to be fully subscribed. Fixed deposits are another alternative for conservative investors even though the interest rate is not that attractive unless you do not know what to do with your millions.

Coming back to investing in REIT (Real Estate Investment Trust), if you study the dividend yield, you would notice that it is higher than FD and most stocks on the market. In fact the gross dividend yield in the FTSE Bursa Malaysia index is about 2.9%, while the average yield for a REIT in Malaysia is about 8%. REITs yield higher returns because commercial real estate generate a huge amount of cash flow from rentals.

Thus begin my foray into REIT investment. I applied successfully for IPOs of Starreit, Arreit and Twrreit and kept them for almost three years but found that except for Twrreit, the first two were not giving me my expected returns ( post financial crisis of 2008) so I cleared them off. Twrreit was affected by the global financial crisis just like the others but later staged a remarkable recovery and despite a relatively good dividend yield I sold it on its 15% capital appreciation. Then I bought BSDReit which manages plantation properties and CMMT, newly listed last year and manages "pure shopping" malls properties in Gurney Plaza, Penang, Sungai Wang Plaza, Bukit Bintang and the Mines near Kuala Lumpur. I have been to those malls and seen for myself their positive potentials.

BSDReit has promised an annual dividend of more than 8% and CMMT had estimated theirs at 7.6%. So far the former has not disappointed me. In 2009 it was 11.3% and in 2010 the annual dividend was 9.3% and this year the first dividend has been declared at 6.2 sen so I am expecting the annual dividend to be slightly higher for 2011. As for CMMT, it has recently declared an initial dividend of 3.6 sen and its positive reported earning through high capacity rentals will ensure that it achieves its promised dividend, in fact according to the CEO, would be higher than first estimated at its listing.

I see my investment in REITs as another form of diversification and for passive/conservative income generation. I am not looking at rapid capital appreciation as even though I bought BSDReit and CMMT at 1.40 and 1.04 respectively, I must admit the individual unit price hardly moves. Lately BSDReit has moved to 1.50 and CMMT has ever reached 1.13. As the unit prices are sustained by the yield factor, you can take it that their volatility will not be an issue. And as by its nature it is not attractive to foreign investors, you can sleep easy when the foreigners take out their investment in the stock market like the recent pre- and post- CNY flight of capital.

I am quite happy with my current REITs as I see them as an investment that bridges the gap between a fixed deposit (FD) and the stock market. It is low risk and more liquid than say owning a real property. Low risk means low reward but at the rate these two REITs are doing, I am contented especially whenever I think of some of my existing nightmarish stocks such as PICORP and JCY. In diversifying into REITs I am now having a balanced portfolio to counter my recent purchase of a couple of volatile oil and gas stocks...Ahah..

My new year resolution of being more low risk in 2011 went out of the window in the third week!


Contented Caterpillar (courtesy photo)

CIMB Dynamic Market Rider NID-i ..... Am really taken for a ride!

2011-02-09T04:04:00.006+08:00

I received the final statement on the performance of the investment product yesterday morning and in the afternoon the bank relationship manager texted me that my capital had been credited into my account (purposely opened for this product) and that he was sorry that there was NO DIVIDEND! Definitely worse than the normal FD but luckily my capital is "PROTECTED". I SMS the staff that I would come to the bank this morning and take out all the money and close my account.

No amount of persuasion would make me participate in any of their products. Once beaten twice shy.Anyway I also do not fancy when the chief of the Islamic Bank division of CIMB addressing me as "Dear valued investor" there is a certain coldness in the tone. Perhaps GLC Bank is like this, taking customers for granted. He should not have bothered to sign his name.

Actually I had a bad vibe about this investment the moment I chose it in early 2008(after being persuaded for its "expected high returns" and capital protection) and put my signature on the form and given my personal cheque. I regretted it almost instantly. I bought it without much thought as the closing date for the product was around the corner. After the financial meltdown in October 2008 I started to receive statement that the certificate value was lower than the capital and that made me upset especially when I read in the Singapore Law journal 2009 report that Capital Protection is not the same as Capital Guarantee.It doesn't matter now.

True, I should read the fine prints over and over again before putting my signature next time. And,yes, CIMB Dynamic Market Rider NID-i is good only for capital-protection, the touted high returns is garbage and to think that my 3-year investment is fruitless can be quite distressing even though I have had losses on the stock market which is supposed to be riskier and therefore tolerable. A real lesson learnt indeed.

Had I put my money in a PNB unit trust at a regular dividend of 6% per annum for three years I would have made 20% out of my capital, a real big amount. For this overrated investment, I made air. So people my delayed gratification for this product was really an exercise in futility. Never again will I be adventurous with this organisation and with salespersons with glib tongue. Serve me right as well for not doing more research on this kind of investment products. And indeed diversification at times could be bad for some of us who are not really financially savvy. My only consolation is I did not maximise the investment neither did I agree to leave it for five years as suggested by the female staff who by the way has resigned from the bank ( I noticed the staff turnover is high in this bank).

I am taking out all my money plus an additional amount and tt it in USD to a private fund based in Hong Kong and recover my "opportunity loss" for the last three years in three years to 2015. No risk no gain as the saying goes, but this fund I am going into has a proven track record as my better half has been with it for the last 10 years and he is extremely happy with the consistent high performance even during the global financial crisis.

So here I go again for the fun ride and thank goodness, the fund is not named "MARKET RIDER". Come to think of it I now wonder how come the CIMB product did not ride on the vast global and local market improvement in 2009 and 2010? Was it riding on worthless investment products itself? I thought a structured product is exposed to multi equities/investments designed for optimum returns for investors. It looks to me that the product was a gimmick managed by foreign fund managers paid by the bank. I am now convinced that I was really taken for a ride!

Queensland Floods - Remembering My Friends

2011-01-26T03:03:00.006+08:00

I read and saw news being broadcast on the heavy rainfalls over northern Queensland especially in Rockhampton areas as 2010 was drawing its curtain. The accompanying flood was pretty bad by the second week the flood was reaching a "biblical" proportion with an "inland tsunami" rushing down to destroy everything in its path in Toowoomba, the Garden City, about 125 Km west of Brisbane. Harrowing stories of death and destruction were related. Cars were picked up and tossed about like toys in the surging water. Mothers, fathers, grandparents, daughters and sons whose lives were snapped by the torrential water in their homes and outdoors. Most of them without warning.

Toowoomba CBD in flood

Houses submerged

Toowoomba, Australia's cleanest city in 2008, brought a special memory for me as I did my elective posting as a medical student at the General Hospital there. The Superintendent was the late Dr Michael O'Rourke who was quite a personality who would call us female medical students following his ward rounds, with names such as Miranda and Mirabelle prompting my colleague Jenny to whisper that those names were actually used for cows! Jenny came from a farming town so she would know these things.

Even horses are not spared in rural Grantham QLD

The Drift Restaurant before it was carried away by the torrential water

Toowoomba in the Lockyer Valley, is at the higher elevation than Brisbane and it has a cooler weather. I still cannot believe how the flood could have inundated the city and its surrounding. That was on the 11 January 2011 then later the body of water along with the incessant rainfalls and high tide, came to Brisbane with the Brisbane river bursting its banks and torrential water ravaging the low-lying and flood- prone areas submerging many houses and businesses. I watched the TV news with disbelief at the volume of water clogging up the streets of the city causing total disruptions to traffics and communication. Even power was cut off to prevent untoward incidents. Such was the seriousness of the calamity.

The last big flood in Brisbane was in 1974 but this year 2011 seemed to be more disastrous as more development has taken place since then. A waterfront restaurant was unceremoniously carried away by the swollen Brisbane river. On 13 Jan I saw on TV the canopy of the cafe striking the bridge as it was being pushed by the surging water. It was an anxious moment. The day before that the owner was lamenting that he did not have insurance for that kind of disaster.

Brisbane River flash torrent

It was not a great flood, it was an inundation.

The scale of the disaster was enormous as much as 75% of the areas with houses, properties and businesses were affected. Losses have been estimated at billions of dollars. Many people are affected and some have lost everything. My heart goes out to the people of Queensland particularly Brisbane where I spent eight years of my life studying at a high school there and later at the Queensland University at St Lucia and at Herston Medical School. I could just imagine the level of devastation at the university campus with all those colleges, Grace college, St John, Emmanuel, Union and International House as they are just next to the Brisbane River! I also read that many houses in Toowong area were totally submerged. Many Malaysian students used to live in this suburb.I stayed at the lovely International House at Rock St when I was a medical student from year I to III and from year IV to VI clinical years in a flat nearer to Herston.

Queensland is special to me as I have made friends and met some great people during my stay there.

I remember my friend Julie Lauman from Rockhampton and I can only pray that she and her family are coping well with the flood situation should it affect her. Julie I know you as a strong person and I hope you continue to be so during this difficult time.

I know a friend from Toowoomba, Darryl Burstow now a prominent Cardiologist in Brisbane. Darryl, a quite but highly intelligent man in our group whose family has a thriving business in the Garden City. I am very proud of your achievement in the medical field. I hope you and your family are not too badly affected.

Being a high school student, I had a host family Mr and Mrs Emray with whom I have lost contact. They lived in Graceville which was inundated. I also recall my helpful and supportive Australian Education Dept officer, Mr Richard Whittington and his Indonesian wife,Christine and their three lovely children, who used to live in the suburb of Kenmore which I understand to have been affected badly as well. And Mrs Dobelis whom I used to stay with in Milton when I was doing matriculation. Milton was one of the most badly affected suburbs as it is near the river.Dear, dear Mrs Dobelis who was like a mother to me. I hope your son Maurice would look after you and ensure your safety and comfort.

Yes, my best friend Allison Powell now practicing in Bundaberg which was also inundated. Allison you are in my prayer. I hope you insured your GP clinic.

I also remember my dear friends Edna and Lito who used to own a house by the Brisbane River and later sold it and moved to Capalaba which I believe, is at a higher ground. I have yet to contact them. In fact I am supposed to visit them and my other old friends in Brisbane this February after so many years of leaving Brisbane but unfortunately I have to postpone the trip to June or July on account of the massive post-flood cleaning up that the city has to undertake. It is no joy when you see mud and things strewn all around the city. I want to see the Brisbane I left which was a beautiful city, clean and serene.

When I first stepped my foot in Queensland, I noticed many of the houses in areas such as Milton, Auchenflower and Rosalie were built on stilts. I did wonder why it was so and now I realised that the Brisbane river has been known to overflow and flooding had occurred in the past and only such houses were suitable in that situation. As the great flood seemed to occur a generation apart, people tend to forget and build their houses fairly low and as a result suffer terribly in terms of losses in their possessions.

Last but not least, I fondly remember my friend JDC I hope and pray that he and his family are safe and that his house is spared though the Brisbane CBD was closed for the days when the flood was peaking and he could not conduct his court cases. J if you read this posting you know that I have never forgotten you despite what had happened. I am following your court cases and the rulings you make. I remember when you were the young enthusiastic Barrister and I was the besotted medical undergrad, how you enjoyed telling me about your cases especially those you had won on technical ground.. Ahhh... I could hear now the melodious song "Nostalgie" by Julio Iglesias playing in my sentimental mind and of course your favourite song "Feelings" by Morris Albert... time now to wake up from my reverie..

Devastating Queensland floods truly sadden me as I remember my friends. You are all in my thought and prayer.

NB: For those of you who would like to donate to the Disaster Relief Appeal please go to the Queensland government website here http://www.qld.gov.au/floods/donate.html

May God bless you all for your kindness to fellow human beings.

Remembering 123 Waterworks Road

2011-01-26T02:56:00.001+08:00

Investment products diversification - where to park?

2011-01-13T17:01:00.000+08:00

About three months ago I received a letter from CIMB advising me that my investment product was going to reach maturity soon and as an expression of their "caring" attitude, they invited me to re-invest in another of their products.

Well I have long made up my mind not to enter into any more financial transaction like this. I supposed it would be fine if I had millions to play around with and yet I am still not comfortable with the thought that you cannot touch your money at any time you like as it's kind of locked in and left to breed or being bred by other people. The promise of high return is attractive plus the lower risk afforded when compared to the stock market. But somehow the element of some control is lost here. Put it this way, this kind of products is not for all types of investing characters.

I am looking to park my excess fund in an instrument I am happy with. Without the help of a financial advisor, I have to read a lot to personalize my financial planning . In this respect, suitable asset classes and careful choice of portfolios cannot be overemphasised.

Looking at dividend yield is important when unit trusts are selected. For example if you were going to park your money in a fund whose unit price is RM1.00, for say 100,000 units then you have to put in RM100,000.00 and if the annual dividend rate is 7% then you would get RM7000.00 at the end of the financial year. Consider then buying 100,000 units in a fund whose unit price is RM0.34, you then only need to fork out only RM34,000.00 and if this fund is giving a regular dividend of say 4% then you will get RM4000.00, a yield of 11.76% compared to the former of 7.0%.

So in line with my resolution to be more risk averse this year 2011, I have selected a fund with a high dividend yield and one that is not overly aggressive. This is done by studying its prospectus carefully.

I wonder though how long I can keep my resolution as the stock market has been bullish lately with FBM KLCI climbing up like nobody's business and with all these Economic Transformation Programmes going on, can I afford to keep on the sideline and just look?

CIMB Dynamic Market Rider NID-i reaching maturity at last.

2011-01-13T14:07:00.000+08:00

I am amazed at my rather impulsive action of buying the CIMB investment products in early 2008. I have written about this purchase in 2009 blog post on how worried I was about my capital being reduced or worse still totally wiped out following the financial crisis in late 2008. There was some discussion between the term capital-protected and capital guaranteed ( and now I am told under the sharia-compliant products, it is called "capital-preservation").

Following the Lehmann Brothers'collapse precipitating the global crisis in 2008, many of their products supposedly capital-protected were not honoured and many investors were left high and dry. Despite CIMB's assurance that the product is capital protected upon the three-year maturity date, I remain apprehensive. Though as the market picked up in 2009 and 2010, my apprehension gradually subsides.

I was talked into buying the product for its high return and capital protection which are attractive features for any investor. The downside is you are forced to leave it, like fixed deposit, untouched for three to five years, the longer you put it the more returns you would get. Unlike fixed deposit with a known interest rate, this product would have dividend calculation varying with market performance of variety of equities they are exposed to. So your investment is supposed to be relatively "safe" like the mutual funds/unit trusts.

I must admit I had never monitored the product's performance as it was rather complicated to access the web page. I gave up after a couple of attempts despite being informed on how to do. Perhaps I did not mind so much since my capital will be protected. I know that this is an indifferent investor's attitude. Please do not follow my bad example. Anyway, even if I monitored it, what could have I done before it reaches maturity? If it was not doing well and I withdrew then my capital is no longer protected so I decided to just ignore it and take things one day at the time. In less than three weeks my " Islamic Negotiable Instrument of Deposit- NID-i , will finally mature. Thanks goodness and I hope my delayed gratification mode is not an exercise in futility. I hope to get back my capital with some "great dividends".....

I will know whether it is worth leaving my money there for three years as I have calculated the returns (with compound interest) I would have got if I had put the same money for example in ASM for three years. Should it be lower than ASM-derived dividends, then I know I have been taken for a ride. When I bought the product I was told that I could get 10% more than ordinary PNB trust funds. Let us see whether what the bank says is what you get.

A non-medical disease - A Tragedy

2011-01-04T15:11:00.000+08:00

This morning a 61 year old male patient came in with a complaint of joint pain which, he claimed, was recurrent in nature. When I examined the joints there were really no evidence of inflammation like swelling, redness,tenderness or warmth. It was a rather non-specific kind of complaints.

Actually the patient had been on my follow up for almost one year since the first time I saw him in 2008. I found him then to be suffering from anaemia not amenable to treatment with iron tablets and after determining that the condition was not due to iron deficiency, I promptly referred him to the haematology (blood diseases) unit at the hospital. I did not see him for more than one year when he turned up in my clinic in the middle of 2010 with chronic cough and my investigation showed that he had TB. He was immediately put on anti-TB short-course therapy for three months and regularly monitored.

He seemed to have gone away for several months till he turned up again today at my clinic. He was still anaemic, thin and tired. His joints, despite his complaints were not flaring up, so what was it that made him come see me? My curiosity was promptly answered when he took out of his bag a letter from the Insolvency Department asking him to pay a certain amount of money owed from a loan company and he wanted to get a letter from a doctor to say that he could not work so is unable to pay the stated amount instead he wants to reduce it by 50%. He had borrowed the money some years ago to buy a car and according to him he was not able to meet his monthly commitment soon after and the car was taken from him and finally auctioned off.

Borrowing money for a lifestyle which one cannot afford is a disease. It is not the same as borrowing money for a vehicle which one uses, for example, to transport goods as part of a business deriving income. And what is a man of 61 doing at this late stage of his life paying off a loan for which he has no regular income and no saving? It is a desperate situation indeed. A doctor cannot treat this disease.

I wonder how many people are bankrupt as a result of keeping up with the Joneses. I suppose it only happens in urban areas where materialism seems to have been entrenched. It is also a lesson to people who fail to plan for their future which in this man, would include having the possibility of being burdened with diseases in old age thus unable to continue working for income.

Holiday in the sun by the pool and the beach

For those of us blessed with health and youth, it is time to have a proper financial planning if you haven't already started. Start with regular saving and then make the money work for you through prudent investing and diversifying. In the process, delayed gratification is essential. Health and especially youth, needless to say, are not forever. And remember a non-medical disease is a tragedy.

JCY and the "touching" Dividend of less than a Sen

2011-01-03T16:49:00.000+08:00

I wrote about the blunder I made by buying the technology stock in June 2010 before the Euro Debt Crisis was highlighted. As everyone knows, the IPO for JCY listed late in 2009 was 1.60 so who would blame me when I rushed in to buy it as it started to fall below the offer price? My only guilt was I did not read about the chip makers' supplier's news a week before! It was so funny that as it was falling, I kept on buying on the basis of dollar cost averaging. I only stopped when I read the news belatedly!

I bought the technology stock because I wanted to diversify my portfolios, as simple as that. Unfortunately I went in with the wrong step. My spirit lifted a bit a couple of months back when the JCY CEO maintained that this industry is cyclical and the time will come (When oh When?) that it will pick up again. So I am supposed to leave my money to hibernate in the market till such a time comes. I kind of decided to just let it be and not to think much of the stock for the time being. Let us see the development by 2012.

So it is indeed a surprise that JCY announced a dividend of 0.75 sen in the last week of December 2010. Oh gosh! I salute the company for honouring its promise to give a dividend from their annual profit though I have not expected this. I thought they need the money more than we do especially when they have to pay workers' salary, maintain their machinery, building etc. This is the company I will stick to till it has fully recovered.

What was really funny was when I calculated the amount due to me at the end of this month. I thought I had a windfall considering the substantial number of JCY shares I have. When I saw the amount I couldn't believe it, look Maxis has posted profit quarterly and yet the dividend for last quarter is only 8 sen. I have almost equal number of shares in both company.... then I realised that I needed to multiply it with 0.0075 and not 0.075!! A slip of the mind and a non-cerebral act of the pen, it is 0.75 sen and not 7.5 sen.

It is touching nevertheless. But I am sure JCY will be able to give its investors more dividend and perhaps a bonus once this "low demand" thing is over. In the meantime I hope the company will innovate its products as the new iPad apparently is no longer using the usual traditional hard disk drive but flash memory instead and as its popularity is increasing among the gadget-conscious consumers, it is time for the technology industry such as leading hard drive manufacturers, Western Digital and Seagate to formulate new strategy.

I intend to give the JCY dividend as "ang pow" come the New Year of the Rabbit!

Plantation stocks' rise and my usual dilemma

2011-01-03T11:48:00.000+08:00

Despite being much aware of the slowly rising CPO prices since the middle of 2010, I decided to let go three of my five plantation stocks in September 2010. The main reason was to purchase the recent Petronas related IPOs as well as I am currently putting more of my money into unit trusts. As you can discern, I am restructuring my portfolios

Whatever the decision is, it depends on the timing of the sale and a small investor like me would tend to attribute it to luck. Some savvy big shot investors would smirk and call this kind of transaction pure speculation.

Fortunately I left some shares in THPLANT and UNICO which are actually small caps among the plantation counters but they turn out an exciting climb especially the former which posted quick gain to surpass 2.00 before end 2010. Imagine that it had pitifully gone down to 1.47 early in 2010! The dormancy of the plantation counters for nearly two years from the point of the global financial crisis in 2008, made me very anxious to get rid of them at the very moment their price showed any indication of going up. And that, my friend, is the mistake many unseasoned investors make.

Having read some very sensible articles from wealth creation blogs especially from across the Causeway, I managed to balance my investing behaviour. One of the things that I learnt is that not to dispose of everything in your porfolios when the BEAR is sauntering in. Leave some as you need them to ride the BULL when it comes by. If you take them all out, then you have nothing to ride! Sensible indeed. I should have read the advice before I disposed of my MHC, SWKPLNT and KWANTAS. Anyway, my two plantation counters are riding at the moment.

Rising CPO price driving up plantation stocks

Yes, the CPO price is set to go higher as the demand especially by the two economic and consumer giants, India and China is set to increase. And it seems that due to La Nina effect causing heavy rainfall in parts of the world including us in South East Asia, the oil output will be affected causing a tight supply and not only that ( our fortune is someone else misfortune!), the weather pattern is also causing a drop in soybean output in South America, so palm oil will be the alternative for consumers. It is expected that this plantation stocks' uptrend will continue in the medium term till the middle of 2011. There you have it, ride the bull till it stops to catch its breath.

The reason I went big time for the plantation stocks in early 2008 was that these are the companies which "produce,market and profit" from the blood and sweat of the agro industry unlike finance stocks such as OSK, BURSA, MAYBANK, MANULIFE etc. But on the contrary, the finance stocks recovered much earlier and by much higher than the "product-based" stocks. Plantation stocks lingered like sick turtles while its finance counterparts were having quantum leaps, a good example is Bursa which went from the low 4.00 in late 2008 to a high 8.66 in November 2010! UNICO, on the other hand was about 0.50 in late 2008 and stayed at 0.98 for the better part of 2010. How unfair! Trying to invest on principle is not always the best strategy though I will still not buy those gaming stocks come what may.

So for this year onwards I am going into the finance stocks by selling off my agro stocks and other laggards and terribly slow coach like PICORP ( but keeping my TELCOS for regular high dividends as they churn out telecommunication services to their million of customers and earning good profit). Though most of the attractive finance stocks are already high, you just have to catch them when when they hit a low.

In the meantime, my remaining plantation stocks are riding the bull and will stop when my target is reached which I believe will be sooner than expected. I will not be greedy as I've also subscribed to a pearl of wisdom, that is, you should not hang on to your high performance stock too long, get out and leave some on the table for others to partake. For instance if I had made 2.00 per share, I should not wait till it goes to 4.00 per share though it very well will be, so that some other investors will make another 2.00 per share as well. So sharing the wealth is the best way of making this world a better place for all of us.

I hope those who are hanging on to the rising finance stocks will do the same :)

MAXIS - My First e-Dividend Notification

2011-01-01T16:47:00.000+08:00

I was pleasantly surprised to read an email message on my phone from Standard Chartered Bank advising me that my 8 sen per share Maxis dividend has been sent to my bank account on 30 Dec 2010. It went on to say "The crediting monies to your account will be subject to final clearance by the Clearing House and the Beneficiary Bank. In the event the above transaction to your account is not successful, a cheque for the same amount will be issued and sent to you at your address as per the Record of Depositor. Please retain the tax voucher.......Should you not received the payment please contact your Registrar accordingly".

Well, apart from being a cause for celebration for an end of year extra pocket money, I am very happy that they have placed this system of notification so that we would not miss checking our bank account. Promptly I checked my account through internet banking and noticed that it had not yet been credited, I expect it to be shown on my account by 5 Jan 2011. No longer do I dread not receiving any dividend cheque and having to pay for a missing cheque through no fault of mine. I also had a bad experience with a Tricor staff (share registrar) when I complained to her that my cheque had not arrived for nearly three weeks after the date of payment. She had asked me to pay RM10 for a new one! What cheek I thought.

This is the Dividend no 6 and including this latest one, Maxis has paid out 28 sen since it was relisted on September 2009. My calculation has shown that this is a much higher return than the bank and as good as PNB's unit trusts. While the share price has been kept relatively low, the company is making good its promise to give at least 50% of its profit as dividend. I was mulling over buying Bursa stock as it is now at its 12-month low, but I am thinking hard about injecting more investment into Maxis for regular high return like this at least for the next two years. I think this is a good investment for me ( I am not soliciting for anyone to buy the stock, CAVEAT EMPTOR!).

I am hoping my other Telco, AXIATA would announce a dividend soon though I am not really complaining as the stock price had uptrended more than 100% from the time I bought it.

So thank you Mr Ananda Krishnan for sharing your massive wealth with us small-time investors. And thank you policy makers for e-dividend that makes life much easier for busy investors. E-dividend will be compulsory by April 2011.

In the meantime, I am sure we will all continue to invest to drive our economy and financial market.