A Heavy Dose of Sports #1.1 - Malaysia GP

The Formula 1 fun-fare has hit KL since the beginning of the week with all the big names an appearance or two at chopping malls and shops. The current session seems less of a drool compared to before with the emergence of new teams such as Ross Brawn's to eat away at the McLaren-Ferrari dominance. This can only be a good thing in a sport that seemed to become less popular as the years gone by, not helped by the retirement of big names such as Michael Schumacher and Mika Hakkinen, and the credit crunch. F1 seems to be like a sport of access.

Personally I have never been to an F1 race, home or abroad. The main gripe being the traveling and parking. Maybe one day I will take Irfan and Idlan to watch one. I predict wins this weekend for both Jensen and Brawn Racing.

Update on Sunday, April 5, 2009 at 8:13AM by Haris Abdul Rahman

Button grabbed pole from Trulli. Hopefully it doesn't rain this evening. It usually doe at 5pm around here!

Update on Monday, April 6, 2009 at 1:07AM by Haris Abdul Rahman

Missed the first 20 minutes. When I switched on, Button was second, waiting for the leader to pit. Then suddenly the downpour and the fuss.

That's what happens when you put profit before the sport. Forcing the flag off back 2 hours for the benefit of European time zone. Don't they learn Geography out there, like 5 pm during monsoon season = rain? Shock! Horror! Looks like we risk not being awarded further race from the looks of it. However the half points should be interesting, just like when Niki Lauder beat Alain Prost by half point to win the Championship in the early Eighties.

A Dose of Medical News #1.3 - Deferring HIV Treatment

This is an interesting one. The NA-ACCORD group looked at more than 17000 patient with HIV in Canada and America. First they look at those with CD4 counts of between 351 and 500; which 25% of them took up HAART and the rest deferred. In the group that deferred, there is 69% access mortality (p<0.001). They also looked at another cohort with CD4 counts of more than 500. Again, in this group 24% of people took up HAART. There is 94% excess death in the deferred group.

The conclusion, early treatment seems to be better. However, oftentimes it is hard to justify starting treatment in asymptomatic patient with near normal CD4 counts. I shall refer to my ID physicians here for further comments.

A Dose of Medical News #1.2 - Adding Clopidogrel to Aspirin in Patient with Atrial Fibrillation

Being a Haematologist, I know the pain of having to take warfarin and its potential interaction and pantangs!Yes, Rivaroxaban and Ximelagatran maybe around the corner but while we wait, how about a good dose of antiplatelets instead of trusty old warfarin?

The ACTIVE trial investigators published their results if we add 75mg of Clopidogrel on top of Aspirin. It significantly reduces the rate of stroke by 28%, at the expense of increased risk of major bleeding by 57%. There is no reduction in the rate of myocardial infarction (heart attack). Hmmm! It may have a place in young patient.

A Dose of Medical News #1.1 - Rosuvastatin in Prevention of VTE

Over the last few years, there have been postulations about the connection between venous and arterial clotting mechanism. It was thought although the end product is the same, the precipitant may be different. Platelet activation for arterial and stasis for venous. This led to the use of aspirin - an antiplatelet agent - in treatment of ischaemic heart disease and stroke, both due to clots in the arterial system. In the treatment of deep vein thrombosis (DVT)  - economy class syndrome - and pulmonary embolism, a condition that can kill.

Researchers based in Harvard has published a paper recently using an agent previously exclusive used to prevent arterial thrombosis in prophylaxis against DVT and PE. The team collected data on 17000 healthy subjects taking a cholesterol-lowering agent Rosuvastatin, and basically see what happens to them in a period of many months. The results showed that the group taking Rosuvastatin significantly developed less episode of DVT compared to their matched counterparts taking placebo. Unfortunately there were no difference in the incidence of pulmonary embolism.

The result is clearly positive but I have yet to ascertain its impact on general practice. The usual measure used to prevent clots during surgery is to give a dose of heparin to the patient. This has clearly reduced the risk of DVT and PE for those undergoing surgery. This study I am sure is looking at a different setting. Unfortunately statin is not without its side-effects and I cannot justify putting my patients on it just for prevention of DVT especially if the benefit can only be seen after many months. However with all this study, it is the pattern of effect that is more important. I am sure there will be a more direct comparison of this drug maybe at a different dosing against the already established heparin because the main advantage of this agent is, there is no risk of bleeding that we often encounter with the use of heparin. 

Photography Chemo Regime #1 - Introduction

After taking upon myself to write about photography, I thought I might start by introducing my gear. I have been using Canon for a number of years. I used to borrow my uncle's T70 in the pre-EOS days, before getting myself an EOS-500N in 1997. It was a good camera but needed a better lens. I then upgraded to EOS 5 in 1999 and over the years bought the 50mm f1.4, 75-300 IS (the first lens with image stabilisation) and the 100mm Macro. I was using this kit regularly until I went digital in the summer of 2003 with the Canon G3. G3 was a great compact. Even at 4MP the lens was superb and all the posted UK pictures were from this camera.

Unfortunately I lost all my camera gear except the G3 during shipping home. I nearly given up photography all together but as my boys were growing up, I realised the power of photography in documenting them growing up. The focusing mechanism on my G3 was starting to become unreliable, and the lure of digital SLR was too much. In December 2007, I bought the EOS 400D, the entry level camera. Instead of upgrading the body, I feel that the what is in front (the lenses) and behind (the skills of visualising the shots, then manipulating it post-production) is more important than the camera body itself. I went through a few online seminars and invested heavily on quality glasses. My main lenses are the 17-40mm f4L, 50mm f1.4, 70-200 f4L IS and the 60mm EF-S macro. Each of the L lenses costs twice the lens body!

In terms of genre, I like sweeping landscape with blue skies and flower macro photography, mainly orchids and waterlillies. My main problem is getting the skin tone right. My camera tended to render them too warm (with a red tint). I therefore prefer black and white portraiture. For the landscapes and macro, I can crank the saturation up a few notches without noticeable problem. Since my wife wanted a small compact, we got ourselves the Sony T500. It can shoot decent quality HD video which is a boon. However, personally I would have preferred the Lumix LX-3, with a bright f2.0 Leica lens at the wide end.

For post-production, I use either my MacBook Pro or iMac desktop with Photoshop CS4 (the latest). I also bought a couple of Kubota actions to streamline my photoflow. I used to exclusive in RAW, but I find it too time consuming. I therefore switched into RAW+jpeg, only opening the RAW files if I need to do major tweaking. I also use the Wacom tablet with the Photoshop.

In the near future, I will going for the Speedlight 580EX flashgun, tying it with my 7 year-old 420EX for remote flash. Ultimately I will go for a full-frame digital body in the EOS 5D mark II plus a standard L zoom. I also wish that before I leave for Australia I can do a roadtrip on the west coast shore road from Penang to KL, or even maybe down to JB. My late grandmother was originally from Sabak Bernam, so I might stop over on the route. I plan to publish the journey online in a blog. 

A quick photo news before signing off, Panasonic will launch the GH1 before end of April. I am also eager to learn about the new DSLR offering from Canon the EOS 500D. It will be a 15MP crop body camera but capable of producing HD videos, but disappointingly 1080p at only 20fps.

From next week onwards, I will be concentrating more on news and recent pictures I have taken. Thanks for reading.