Novel anticoagulant may be higher risk for stroke for periprocedural anticoagulation!

Periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation may entail a small but statistically increased risk of stroke or transient ischemic attack, according to a meta-analysis of 10 observational cohort studies.
The meta-analysis, which included 1,501 patients on periprocedural dabigatran (Pradaxa) and 2,356 on warfarin, had dual primary end points.
 One was stroke or TIA, which occurred in 0.7% of the dabigatran group, compared with 0.2% of those on warfarin – a statistically significant difference (P = .0007), Dr. Benjamin A. Steinberg reported at theannual meeting of the Heart Rhythm Society.

Major bleeding, was recorded in 1.6% of the dabigatran group, with a closely similar 1.7% incidence in the warfarin group.

Rates of cardiac tamponade, a secondary end point, were also similar: 1.1% with dabigatran and 0.9% with warfarin.
Conclusion: Dabigatran posted higher risk of stroke periprocedural anticoagulation with equal risk of bleeding and tamponade comparing to warfarin

reference:http://www.clinicalneurologynews.com/specialty-focus/cerebrovascular-critical-care/single-article-page/dabigatran-post-af-ablation-may-be-riskier-than-warfarin/d31a9058a1e408e770118a8a01eaf8e1.html?email=FANGPENANG@GMAIL.COM&ocid=899726

Past and present

1 day when i pass through old town coffee shop. I suddenly realize why youngster nowaday over spent !

Previously we are happy with old style coffee shop nowadays younster minimum will be in old town coffee shop as below. what is the difference ?

The food taste is the same , price wise minimum 2 times. Old style coffee shop one curry mee 3-3.50. New style curry mee 7.90-8.90. coffee at old style 1.20. New style 3.90

See the difference same taste with and without aircon plus style equal to 2-2.5 times overspent !

BN or alternative

Election is round the corner. If you are a Malaysian , you can smell and feel it as both BN or Parti alternative (component of DAP , PKR and PAS) doing kempen and ceramah every where. Bersih 3.0 around the corner, PTPTN to be abolished under influence of Anwar Ibrahim ,transformasi national under BN and etc. Every one try their best to fish the votes. As election came, we are the boss of our next leader. BN plan for 2/3 majority since last tsunami 308 only won by simple majority and loss some state seat also .
As a Malaysian and a voters , i think this is the tough decision to choose between 2 parti as there is pros and cons especially if you are the neutral person with middle income like me.As a physician who deals with clinical problem and issue, let me analyse for you why it's so difficult for all Malaysian! First and foremost, both parti also seems corrupted. Sand scandal in Selangor although they claims themselves innocent ! Cow issue by Dr sharizat although she said the involve is the Husband ! Both not seems to be trustworthy anymore. Second issue,  transformasi national vs cheap petrol, free PTPTN and all welfare. BN quickly give 500 to low income household, clean water and better infrastructure to people. Penang DAP give 100 to senior residents, 200 for newly born and etc, promise a cheap and good low cost house in Batu kawan in future etc.Everything seems to be in balence in this moments. What about Kedah ? Nothing ! Kelantan , nothing ! What benifits middle income people like me, nothing from both parti ! we are the neglected one ! They don't care about us (quote by Late Micheal Jackson). Free PTPTN ? Is it possible ? Yes, but the money for beneficial students will be limited. Do you remember when that is no mandatory payment from people who borrow PTPTN , the benefit students is limited comparing now !In other words, if PTPTN free, then many students will fail to pursue for study in future. The victims will be the parents to borrow from others or worse still unable to pursue study anymore. As a son or daughter , we got a responsible to pursue our tertiary study by using PTPTN and paid back later when we are working so that other people got the change to study ! If PTPTN abolished, what will happens to the one already paying ? are they going to get back their money? It seems to be a sweet lie for fish the university votes and end up they are start protesting for something impossible and unfair to previous PTPTN holder! Seriously , i don't like the thing of made other people to do stupid thing and get bitten for you personal interest !
any how , I think the way both party doing already been too much . They try to politicize every issue. Ultimately, the one play with the fire the most, going to kill themselves. Let's do the maths by yourselves !

A talk with Prof Falagas

A famous prof from Americafor microb came to penang, Malaysia to give a talk . I trully learn a lot from him.
a concise and brief presentation from him is not something which we may learn from books.
summary on my other blog for those interested.)just clicked highlighted.

sepsis wih IVig

today i came across a young lady with ovary salphingo abscess presented with severe sepsis with DIVC. It raise my question whether immunoglobulin should be used. So i search through the cochrane review and found it is good for Adult but not for paeds pt. evidence may sumarised in this.

New ways to detect my website

today marked the new era for my website. Now if you got QR reader for iphone or ipad by clicking the qr reader and scanned my QR code. IT will automatic went to my website.
QR reader is available for free in iphone.

enjoy!
from wikipedia
A QR code (abbreviated from Quick Response code) is a specific matrix barcode (or two-dimensional code) that is readable by dedicated QR barcode readers, camera telephones, and to a less common extent, computers with webcams. The code consists of black modules arranged in a square pattern on a white background. The information encoded may be text, URL, or other data.
Common in Japan, where it was created by Toyota subsidiary Denso-Wave in 1994, the QR code is one of the most popular types of two-dimensional barcodes. The QR code was designed to allow its contents to be decoded at high speed.

PC fair 2012 another sardine

What you would do for post call. Even you are tired, people like me won't me went to pc fair to see update products.

Picture above shown a lady pose with Intel mega billboard.
As usual is another sardine events.
Packed with people. nothing news other than China products which allowed streaming tv to watch without paid and download.Harddisk price so so and not so exciting.Certain antivirus produce good deals. Certain chicks look cool but some are not so exciting.
Here is certain photo took with my handphone.

Kaspersky chicks. Products sucks!

collected rubbish

Free gift earned by buying microsoft wireless mouse via lucky draw.