This is a must visit eatery at Jalan Sultan Idris Shah (Brewster Road) just before the Police Station. The place is called "aSow gallery CANTEEN". The word "canteen" means a small cafeteria or snack bar. What makes this gallery different is the picturesque plants that are displayed rather than photos or paintings.
Look at these lovely plants hanging from the top and growing from the bottom, and even from the walls. The potted plants are irrigated by a myriad of tiny plastic water pipes.
The beverage cum pay counter is indeed unique. It is very simply constructed with ventilation brick blocks.
What fascinates me most are these terrariums. Lovely as they stand, especially this huge construct in the middle. Some small pieces are for sale.
Great artwork on display at 22 Hale Street Heritage Museum for the week. Many water colour paintings are from members of the Urban Sketcher group.
There are also photos of birds and landscapes.
Very interesting photos are presented by the Karst group from the Kinta Valley. The magnificent limestone caves and underground water canals are more remarkable. These wonders of nature need to be preserved. Most disturbing to hear that some mining companies are blasting the limestone hills nearby.
In 1933, Towkay Leong Sin Nam (梁桑南) built a residential bungalow at Cameron Highlands. The site is 1530 meters above sea level. Picture shows Sir Shenton Thomas with the owner at the front of bungalow.
The name Yi Yun Court “怡云阁”, which means “enjoying panoramic views of clouds atop the pavilion”, greets guests at the entrance gate on the road leading to the bungalow.
The bungalow had been built with a unique architectural design. He inscribed on the building the congratulatory message “情良中心”（Love Center) given to him by the Governor of the Straits Settlements Sir Cecil Clementi Smith (马来联邦钦差大臣,海峡殖民地总督金文泰).
Picture shows the original bungalow without the added upper floor over the covered walkway linking the main building and the tower. A network of hidden underground tunnels, below the rooms' wooden floorboards in the main building and the tower, allowed escape and food stockpile for the occupants during emergencies. Leong Sin Nam was pro-China during the raging Sino-Japanese war.
The first Chefoo School was opened in China in 1881. It moved to Cameron Highlands in 1952. From 1954 to 1959, Chefoo School used the bungalow as a missionary school for children.
In 1964, the Overseas Missionary Fellowship (OMF) bought the bungalow and used it as a place of rest and spiritual renewal for members of OMF as well as local pastors and missionaries from other Christian organizations. The bungalow is now called the OMF
To live we need to be able to breathe. Breathing is natural and automatic. Breathing well however is a choice because we need to exercise the respiratory muscles and also treat any underlying disease that causes airflow obstruction or impairment of gas exchange.
There is a saying that goes; "when you can't breathe, nothing else matters". How true!
1. Principle 1: Focus on Relationships
v19 “So then, let us aim for harmony in the church…”
Harmony is not when there is no argument. Harmony is when people are pleased
with each other and agree with each other, when people relate well with each
other.
Relate: Put yourself in the other person’s shoes. To relate is to understand the
other person. The first step is to be a great listener.
Understand this, my dear brothers and sisters: You must all be quick to listen,
slow to speak, and slow to get angry. (James 1:19 NLT)
2. Principle 2: Invest In Others
v19 “So then, let us aim for harmony in the church and try to build each other
up.”
Building each other up involves investing in others.
God gave all of us 3 types of resources: Time, Energy, Money.
We start by choosing 1-2 person whom you are close to, someone we can relate,
and meet regularly to talk about 3 things: Personal life, Spiritual life,
Organizational Life.
3. Principle 3: Encourage Others
v20 “Don't tear apart the work of God over what you eat…”
The focus of this verse is not about eating, but about not tearing apart the work
of God. The Work of God is faith building. We do so by encouraging others.
“Let us think of ways to motivate one another to acts of love and good works.
And let us not neglect our meeting together, as some people do, but encourage
one another, especially now that the day of his return is drawing near.”
(Hebrews 10:24-25).
Adapted from Sermon by Rev Jonathan Chan on 11/6/22.
Blessed are those who mourn, for they will be comforted. Matthew 5:4. From comfort comes happiness and joy.
The Kingdom of Heaven is here, but not yet is a common expression of the state we are at the moment on earth. Jesus introduced the spiritual Kingdom of Heaven which resides in our hearts (body, mind and soul).
When a person sins against God, the Holy Spirit convicts him. Realising the sin committed the person mourns, repents and seek forgiveness.
God will bless and comfort the sinful person who mourns about his inapt actions, and true repentance will bring about happiness. Happiness then becomes joy, which has a deeper sense of fulfilment and contentment, when he is liberated from the sin which he had committed.
A believer of Christ holds fast to the teachings of Christ. Unfortunately he is tempted to do things which are sinful in the eyes of God. Believers are still sinners (while in this world) who require a total cleansing from within and this cleansing is made possible by the presence of the Holy Spirit who continuously counsels the believer and corrects his inner character.
When a believer sins there are consequences or punishments which may be meted according to moral, civil or God's Mosaic laws. The Holy Spirit convicts a believer of wrong doing and continues to counsel him so as to bring the believer back to walk in the righteous, straight path again.
The believers' only God is truly loving and ever faithful and will forgive the sins of the believers when they repent and turn away from their sins and repeat them no more.
God forgives and saves, judges and rewards the believers. There is no condemnation to hell for the believer as he is saved when he puts his faith in Christ, obeys his commands and live according to God's purpose and will. His God's loves and keeps His promise of every lasting life for all who believe in Him.
This Get Well message was made using Canva. Several steps involved. First to choose the background picture. Selected a picture with many fruits as fruits are usually given when visiting ill persons. Second comes the message and choosing the fonts and colours to go with it. Then needed to frame the words with some added transparency. The signature came with a new tool just available in Canva. Finally took some time to select an appropriate bible verse to go with the message. Chose John 14:21. Hope you like it!
I have taken the liberty to split up the long virtual workshop on Managing Cough and Excessive Phlegm into several smaller video segments. The segments contain information on how to perform home chest physiotherapy. These videos are suitable for patients having chronic bronchitis, COPD, bronchiectasis, cystic fibrosis, lung infection etc.
This is a
picture of the passion fruit flower. This flower is also known as the “flower
of five wounds”. The purple flower is believed to resemble the wounds of Jesus
Christ.
The Passion
of Christ includes the time period from the night prior to the crucifixion of
Jesus until his death upon the cross. Much emphasis has been placed on this
time period to emphasize the sufferings of Jesus leading to his death and His
ultimate sacrifice for sin. This time period is traditionally marked by His
time in the Garden of Gethsemane, and includes His prayers, betrayal by Judas
Iscariot, abandonment and denial by His disciples, arrest, trials, beatings,
and period of time on the cross.
Jesus died
on the cross and rose from the dead on the third day. His resurrected body was
witnessed by many people, including His disciples. Jesus is alive today.
Before
Jesus ascension to heaven he spoke of His Great Commission to His disciples. Jesus
said in Matthew 28: 18-20. “All authority in heaven and on earth has been given
to me. Therefore, go and make disciples of all nations, baptizing them in the
name of the Father and of the Son and of the Holy Spirit, and teaching them to
obey everything I have commanded you. And surely I am with you always to the
very end of the age”.
This is an interesting topic. The ejection fraction is a measurement of left heart function obtained during echocardiography. The question is how does the heart fail when the measured EF is normal?
Heart failure is an important cause of shortness of breath which has to be differentiated from lung causes of shortness of breath. Often the distinction between the two conditions is not obvious clinically without further investigations. Relevant investigations include ECG, NT proBNP (blood test), echocardiography, chest x-ray and coronary angiography.
Heart failure with preserved ejection fraction is a type of heart failure with normal or near normal ejection fraction and objective evidence of diastolic dysfunction.
More than half of heart failure patients have heart failure with a maintained ejection fraction. The illness primarily affects the elderly, accounting for 4.9 percent of the population over the age of 60. It appears to be more common in women, and it is projected to become more widespread as people live longer.
Link to this interesting article which I have read:
Feger, J., Worsley, C. Heart failure with preserved ejection fraction. Reference article, Radiopaedia.org. (accessed on 24 Mar 2022) https://doi.org/10.53347/rID-93980
Monday, February 28, 2022
Tracheostomy for Ventilated Patient
Doctors struggle to accurately predict which patients will require prolonged mechanical ventilation. Doctors need a clear understanding of the nature and typical course of chronic critical illness.
Communication about chronic critical illness should begin before its onset and, ideally, as early as the initiation of mechanical ventilation (or even at decision-making about whether to initiate ventilation). Doctors should inform not only of the risk of death in the ICU, but also the chance the patient might survive but remain dependent on the ventilator and other intensive therapies for a prolonged period.
These initial discussions allow a longer time for doctors to “cultivate prognostic awareness” i.e. the capacity to understand prognosis and the likely illness trajectory and help patients and families prepare psychologically and practically for further developments.
Based on the available evidence, routine placement of tracheostomy prior to day 10 of mechanical ventilation is not indicated. General consensus is that a tracheostomy should be placed after day 10 if the patient is likely to require more than a few additional days of ventilation i.e. the patient will neither be liberated from the ventilator nor die in the near future i.e. the patient is chronically critically ill.
Benefits of tracheostomy include:
Improved patient comfort
Easier oral care and suctioning
Reduced need for sedation or analgesia
Reduced accidental extubation
Improved weaning from mechanical ventilation
Easier facilitation of rehabilitation
Earlier communication and oral nutrition
Facilitated transfer to lower level of care
Early Complications:
Bleeding
Air leak causing subcutaneous emphysema, pneumothorax, pneumomediastinum
Damage to the swallowing tube (esophagus)
Injury to the nerve of the vocal cords (recurrent laryngeal nerve)
Tracheostomy tube can be blocked by blood clots, mucus, or pressure of the airway walls.
Late Complications:
Accidental removal of the tracheostomy tube
Infection in the trachea and around the tracheostomy tube
Trachea may be damaged by pressure from the tube resulting in bacterial infections and scar tissue formation
Delayed Complications:
Thinning of the trachea from the tube rubbing against it (tracheomalacia)
This presentation is by Dr Richard Ng who is an Ipoh City Councilor.
There are several facts which I find very interesting:
Paloh Ku Miu was the Chinese Temple located near the Kinta River Jetty where the Chinese immigrants arrived. The deity was brought from Penang to Ipoh by Leong Fee. Leong Fee came to Malaya during the 1st wave of Chinese Migration.
The table on Chinese ethnicity in the late 1800's and early 1900's showed that the Cantonese outnumber the Hakkas in Ipoh.
The Hakkas were mainly tin miners whereas the Cantonese were mainly traders.
In the early days the Ipoh settlement was mainly located on one side of the Kinta River. On the other side of the river the Chinese reared pigs. The pig styes produced an overwhelming offensive stench for the settlement depending on the direction of blowing wind. The British relocated the pig styes far away from the settlement and Yau Tet Shin bought up the land to build houses. This was the beginning of the New Town of Ipoh across the other side of the Kinta River.
The Cantonese Trail has many interesting heritage sites. Very importantly it also included many business sites in the City. These sites will be of great interest to the people of Guangzhou who are also Cantonese. They will be willing to explore Ipoh to find out why their clansmen migrated to this place in the early days.
The presentation is rather long but I am sure it will be worth your time going through the whole presentation.
Today 19th January, is the Death Anniversary of Leong Sin Nam. Very glad to see the statues restored and put back in their original positions. Some bolts were added to securely fasten the statues to the base.
Here we see members of Perak Kaying Association paying their respect to LSN. Conspicuously absent were the food offerings and the Min Tet School band due to COVID Pandemic SOP regulations which had to be followed strictly. Also noticeable was the dwindling crowd. This ceremony has been in existenence for the last 82 years.
The church mentoring programme has to start with a willing believer who volunteers to become a mentor to either believers or pre-believers. The mentor needs to have the spiritual gifts and talents which are desirable to the mentee. The mentor need not be a perfect person but must be spiritually matured.
Mentorship to believers can be formal as through sermons or Bible studies. Mentoring can also be informal like during small group meetings, youth and senior fellowship meetings.
Mentees can learn and be transformed in their work cultures, attitudes and skills. They can also gain knowledge on how to self improve. Bible knowledge can be imparted by the mentor or self learnt from books or web.
All these teachings and transfer of knowledge can occur in the church, workplace, Alpha on line course, Kopitiams, restaurants or even while holidaying or travelling.
The mentor-mentee programme for pre-believers should be regarded as an introduction of life skills and knowledge. It allows for the building of trust and the establishment of long term relationships between mentor and mentee thus forming a base for future evangelism.
Some notes on how to start a Mentor Mentee programme for youths in church.
The Mentors must be seen to possess personal values which can be passed on to Mentees. And the Mentees must have a desire to learn from their Mentors. There must be a match in needs and also personal chemistry to develop a good learning experience.
The Mentor must be willing to offer his services of teaching. Perhaps it will be a good idea to provide a CV of the Mentor so that the Mentee will have an idea of the kind of learning experience he or she will gain from the programme.
Some of the other valuable assets of the Mentor are work experience, professional knowledge, corporate or public status, Christian Bible knowledge and leadership qualities. The Mentor needs to be authentic and honest in his work.
Some points to consider when starting the programme include time and place of meetings, frequency of meetings and their duration. Postings of 3 months with rotations amongst other Mentors serve best the interests of both Mentors and Mentees. The engagement can also be in the form of an internship or a career placement.
Lung ultrasound has come in vogue during the COVID pandemic. LUS is simple to perform and can be readily done at the bedside. LUS performed well, together with a proper clinical history and physical examination, can help clinicians reach a diagnosis quickly before needing to perform more extensive investigations like HRCT scans of the lungs.
Indentification of B line artifacts in the lungs can mean pulmonary oedema (heart failure), interstitial syndrome (interstitial lung disease), infections (viruses or bacteria) and ARDS (acute respiratory distress syndrome).
LUS is a useful screening tool at the bedside in ward or emergency room. The ultrasound machine can also be used to scan other organs of the body (heart, blood vessels, liver, kidneys, etc) at the same sitting providing more useful clinical information.
Leong Sin Nam's tomb vandalised. Not a pretty sight at all. Two cement statues torn off the sidewall and thrown onto the floor. The heads of the model guards detached at their necks. The worship alter also ripped off from the table and thrown onto the floor.
Utter disrespect for the departed and needing the family to pay for repairs which the money could have been better given to charity for people lacking in food and clothing during the pandemic and floods.
We need more civic minded people to care for public amneties and private property. Distruction of property should never be condoned and the culprits should be brought to justice.
Blue bloaters is the name used to describe COPD (chronic obstructive pulmonary disease) patients who are overweight, puffed up, having difficulty breathing, lacking oxygen (hence the blue, cyanotic discolouration) and have leg swelling due to right heart faillure. COPD is mainly caused by cigarette smoking.
These patients are hypoxic with low oxygen saturation and some with carbon dioxide retention. The brain adapts and is reliant on the low oxygen in the blood to drive breathing. As such, an overdose of oxygen, removing the hypoxic drive, will make them worse leading ultimately to deeper respiratory failure, carbon dioxide narcosis, respiratory arrest and death.
Therefore, it is very important for caregivers to know exactly how much oxygen (litres per minute) to give to these COPD patients. Some of these patients may only need to maintain their SpO2 at only 90% to 93% as they are used to these low oxygen to drive ventilation and to "blow out" the carbon dioxide.
Please consult your doctor for medical advice and not to give too much oxygen to these COPD patients. Arterial blood gas analysis is required to make a proper diagnosis for these patients.
A CT scan of the lungs will give better definitions than a plain chest x-ray. However, CT scans are more expensive, needs an appointment and person will receive more radiation.
God created man in his own image. Man is to acknowledge God as the creator of the universe. Man is to have faith and trust in God that His will is always good for his creation. With this understanding God will co-create and co-rule with man on earth.
Man can eat of all the fruits in the Garden of Eden except from the Tree of Knowledge of good and evil. This test followed by temptation of the serpent created doubt that God should only be the one knowing what is good and evil. Man wanted to be like God and disobeyed God's command not to eat of the fruit from the Tree of Knowledge.
Before the Fall, man is allowed even to eat the fruits from the Tree of Life which allows for an eternal relationship with God.
After accepting Christ as Lord and Saviour, a Christian needs to be transformed in body and mind and present themselves as living sacrifices to God's purposes. While living in the Kingdom of God, the Holy Spirit who dwells and then fills a Christian's body and mind will transform him or her to become more Christ-like.
Transformation of the mind includes spiritual maturity, ability to discern what's good or bad and obedience to God. The subsequent change in a person's attitude and character, made possible from transformation of the mind, will allow for behaviour modification resulting in Christ-like behaviour and actions.
Installed this trailles on New Year's day. Really simple with these rust proofed rods and clips. Just clip away the rods at the top then clip others in the middle of the standing rods. Planted beans and passion fruit.
2021 went by rather quickly. The pandemic was on everyone's mind. Into 2022, the Omicron variant maybe another major threat.
But, let's be hopeful. Lets plan for a greater future together. A better world. Prayerfully Malaysian politics become a trustworthy reality where politicians work for the betterment of the citizens. There must be an end to corruption, race and religious polarisation.
Happy New Year then to all. Pray for good health, prosperity and spiritual maturity.
Video created to bring awareness of important symptoms of lung diseases. Also helps listeners to take note of certain details regarding each symptom. Detail descriptions of various symptoms will help the doctor zoom in and focus on certain diseases of the lungs and their differential diagnosis.
