Cardiac Cachexic Syndrome.... wow

Cardiac Cachexia (CC) syndrome, is a complication of CHF(Congestive Heart Failure)
I didnt know this, until i start reading my Harrison's
it is a sign of bad prognosis. and related to age, sex , LV ejection fraction and exercise capacity.

it happen when generalized lose of body lean mass, tissues, fat and skeletal. Therefore, patient is weak and very weak, asthenic syndrome.
pathogenesis: neorohumoral and immunologic disbalance.

• increase amount of norepineprine,epinephrine, cortisol, renin-angiontensin aldosteron system activation 
• and increase plasma inflamatory cytokines that is TNF-a.

increase of above mentioned lead to catabolic imbalance n metabolic imbalance and later lead to wasting...

so that about it lah... the cascade that bring to dead end= CC...

Angel and Devil.....

so it was Halloween.2010.. 

ninie and I decided to come in pair.
it was a long journey to prepare for our splendid attire...
going up n down the town to find the convincing enough outfit. But, it worth for what we did, at least we get a free entrance to MATRIX.. means our costume is convincing enuf.. to scare the soul awaY... hahaha

Credit goes to dearly Mollen... for all the effort given to do this angelic costume.. n bear up with my unsatisfied remarks on the baju initially..

However, it turn out well....

my DEVIL is super Hot wei.....


present to u... ANGEL N DEVIL....

wake me up.. when september end....

Its been so long before i managed to finish my summer holiday stories..
well.. semester had started two months ago.. time speed .... without u even realizing it.

so many thing in my mind. my new semester resolution....which i planned as if like i'm going to build the entire Rome...so far not much have been accomplish beside slacking it gradually...
Lord, Please HELP ur helpless child here...

waking up... just another day... time speed...
now its November.... i took this pictures after few days returning from malaysia....

my russian tour.....2010

so as i had said.. so many plan ... dearly plan of vacation....
so i m going to tell a bit.. i hope not so much .. the places that i visited in russia
After about 5 years staying here.. in this ex Soviet country...
only now, i have the chance to visit those places....they call it SPLENDID... RUSSIA...


we left Kursk, by train after dust, but its ... so there u go.. a mix feeling in me...
my greatest worry is... oh my, i m travelling with my 20kg luggage, with extra laptop, bag.. documents...........
how great!!! so finally reach moscow, thanks to few generous friend that stay in Moscow, who allowed us to leave our stuff in their hostel.... the long travel up n down to and fro metro station...the worries of getting lose in the big crowd.... our stop was in Part  Kultury station.. FYI, this is one of the station involve in MOSCOW METRO BOMBING 2010... scarry!!!

But it all went well, except on our stop to the Sheremetyevo airport, we were confused which terminal should we go down.. since it was like a to z terminal... but a kind russian lady directed us, ... spaciba ...
 thax to Scarlett, we managed to get a cheap so called air-asia airline, to travel to st. peterburg... heheheheh
compare to travel long way 12 hours by bus from moscow to SPB, or a day from Kursk to SPB...


sO we finally reach SPB(st. peterburg) AKA.. PITER!!!too much for an intro.. just look true the photos.. that i uploaded k....

 Scarlet Sailing Festival...

 

 

 

 

 

 

 

 

oh yeah!! i m back for another 2 months

hello again..
so its the end of june... exam down.....

Thank God for the great great favor during my exam...
Cant do it better without Him..
Dei Gracia...

So now, my holiday is about to start.... with all the plan ahead of me...
is there any better, beside asking DEI... since i have no one else to ask only Him...

LET THE HOLIDAY BEGIN!!!!

my little friend.. vennessa!!!

i m stress!!! i don't even know why? its not like the exam is tomorrow. I still have another 4 or 5 days to prepare.. but frankly speaking this time exam really make me nuts...

Trying to study but.. i just going trough with it... so what I do.. I will just take a break.. till i have the mood just hope that I have enough time...

this is a year before.. 2008..

Well, Little girl name Venessa.. she is my dearly cousin..so cute.. looking at her.. really a remedy..

No worries.. The smile in her face, the cheer.. JUST SIMPLY put a chuckle back in my heart..
Maybe I'm too stress that trough her smile it indirectly release the endorphine hormone... that at least can help me to compensate this stress level

I do miss this little girl.. try to make friend with her but.. she is so attached with Abang J... even get jeolous when Jerry was busy doing his stuff...
So, what I did was trying to attract her attention but still not success until I get her soap bubble refill.. that how i managed to get into her attention.. trying to persuade me.. to get the bubble refill middle of the night.Since it is late so i told her tomorrow...
so the next morning, early in the morning after waking up.. the first thing was she said to me :

 KAKAK,.... BUBBLE FOR VENESSA........

 so cute... so adorable.... so brought this little girl to the kitchen n refill it with the dish wash... she was happy and start blowing the bubble... Try to show me even , the bubbles... 

So that is the story about this little girl, every year if I go back .. I need to buy her heart over n over again... I recall previous year. Hang out with her almost all the time, just carry her all around babysit her... till the time i wanted to go back... she didn't want to let go...was crying... KIDDOS...

this recent year, she was fast asleep.. too much of bubble... when I leave... 

this is the bubble look.... 2009

Oh.. i miss that little girl.. vennessa.. 

every year I come back,  she grow taller and thinner.. ..

since only once a year i only meet her, i always have to rebuild the friendship with this little fellow...

Here I come again.. my dearly ven ven... Kakak Miguel MISS U... see what next after bubble... 

siapa suka makan ice batu...

PAGOPHAGIA

it is a compulsive consumption of ice or iced drink. 

related with IDA( iron deficiency aneamia) , it is said chewing ice may give a good ease 

toward the iron deficient.

It is also somehow ease the glossitis pain such in PVS(Plummer Vinson Syndrome).

may compensate the