Ignore this post

I haven't ran in so long that my legs are aching after jogging less than 2.4km
The effects reach a maximum day 2 post jogging
But I feel the effects already
Sedentary lifestyle = decreased effort tolerance
Irregular meal timings = increased irritability
Increased irritability + decreased effort tolerance = very pek chek

Notable articles of the week

Something slightly more academic than my usual rants.

Diagnosis and management of carotid atherosclerosis: BMJ 2013;346:f1485; doi: 10.1136/bmj.f1485 - Refer symptomatic patients with 50-99% stenosis or asymptomatic patients with 70-99% stenosis for surgical revascularization. Medical therapy for symptomatic patients using plavix (CAPRIE trial), BP control, statins, smoking cessation, 2.5 of moderate intensity exercise per week. Medical therapy for asymptomatic patients? Not mentioned.

Use of caffeinated substances and risk of crashes in long distance drivers of commercial vehicles: case-control study: BMJ 2013;346:f1140; doi: 10.1136/bmj.f1140 > suggests that consuming caffeine for the purpose of staying awake can reduce the risk of an accident. But results subject to bias (state regulations for work and fatigue and reporter bias).


Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administrative databases: BMJ 2013;346:f880 doi: 10.1136/bmj.f880 > suggests that current users of high potency statins (defined at rosuva 10mg, atorva 20mg, simvastatin 40mg) are 34% more likely than users of low potency statins to be hospitalized for AKI within 120 days of starting treatment.

Nearing the end of the beginning

It has been almost a full 10 months since I graduated and turned into a house officer.
I still remember the nervousness and unease that came towards the end of my final year in medical school. Then, there was a lot of uncertainty over 1. residency 2. exams 3. HOship yada-yada.
Well, that hurdle was overcome.
I went through 4 months of orthopedics (one of my favourite subjects) before plunging into internal medicine - working under endocrine consultants for 5 months! - before jumping into renal medicine for a short 1 month.
My brain is undergoing a constant stress every day I go to work, but I am not sure if my number of brain cells is increasing - I know for a fact that brain cells don't multiply after a certain age.
So I buy lots of supplements for my brain in the form of textbooks which I don't read, exam questions which I don't do, journals which I barely read. Possibly an overt expression of insecurity and maladaptation.

Anyway.
The year of the snake has just begun. Lots of opportunities for self improvement. My advice to self remains: enjoy this year while it lasts. After all, I only get to be a houseman once.

The land of a thousand smiles

The flight to Bangkok took just over 2 hours. We breezed through immigration and quickly arrived at the airport lobby where our guide was due to meet us. He arrived late (or perhaps we didn't see him) but soon we were speeding down a Bangkok highway towards the crowded city centre.

The evening air was slightly warmer than I would have liked. But we had a fantastic dinner at one of the restaurants near our hotel comprising steamed fish and Tom Yum Soup.  In fact, in retrospect, the meal we had that day was probably the best among our 4 days of travel.

Sambal Kangkong, Tom Yum Kung, Steamed Fish, Green chicken Curry at  "Ban  Khun Mae" Restaurant

We planned to visit the Grand Palace, Wat Pho and Chinatown on our first day. From our hotel at Siam Square, we took the skytrain to Saphan Taksin ferry terminal, planning to take the ferry up north. To our slight surprise, we were met with dozens of other tourists at Saphan Taksin. Evidently, this was a popular route.

The view of Chao Praya river from the river cruise

The Grand Palace, an impressive sight from the Chao Praya river, appeared even more awe-inspiring up close. Although smaller in size compared to other royal abodes, the majestic, gold-tiled buildings and abundant flora conveyed a quiet and peaceful charm amidst the oppressive heat and even more oppressive tourist crowd. A moment was spent in quiet introspection within the Wat Phra Kaew, or the temple of the emerald Buddha, before we headed out for a stroll in the palace grounds, admiring the Buddhist murals that covered the inner walls of the palace.

The majestic Wat Phra Kaew, which houses the emerald Buddha

The Phra Thinang Chakri Maha Prasat, which serves as a throne hall, at the Grand Palace.

We recharged with cola and coconut juice at the cafe near the palace exit as we completed our tour, then headed to a nearby restaurant where we had our fill phad thai/ grilled pork rice amongst other dishes. A walk around the palace brought us to Wat Pho, where we admired the giant Reclining Buddha amidst peaceful surroundings.

The Reclining Buddha at Wat Pho

Close-up of one of the feet of the Reclining Buddha.
The feet showcase a total of 108 auspicious symbols of Buddha.

From Wat Pho, it was a simple matter of taking the next ferry from Tha Thien down to Ratchawong where we could alight and explore Chinatown. 

People alighting from the cross-river ferry at Tha Thien ferry terminal

Wat Arun, or temple of the dawn, as seen from Tha Thien ferry terminal