Odysseys of George

My friends and I, are planning our next dive to this place – that many know not of — mainly because it is a scuba diving paradise. But even among divers, this place isn’t a favourite plainly because it is not just 26 km off the coast of quiet fishing town of Kuala Dungun, Terengganu, Malaysia but also has many challenging dive sites.

Cited as “The Best Diving in Peninsular Malaysia” Asian Diver Magazine 2002 Annual Edition, it consists of Pulau Tenggol (Tenggol Island), Pulau Nyireh, Tokong Timur, Tokong Burung and Tokong Talang/Tokong Kemudi, Tokong Laut. Some divers even call it “Sipadan of Peninsular Malaysia” with its beautiful rock formations and wall dives akin Sipadan. The currents here can be very strong and sometimes difficult to predict.

Tenggol and its surrounding islands offer good visibility with teeming of marine life, including sharks, rays, nudibranch and a wide variety of hard and soft corals.

Scuba Diving Tenggol Island, Malaysia

Water temperature:

27 – 28°C (80 – 82°F) on average, up to 31°C (89°F) in summer months

Suit:

Skin to 3mm shortie

Visibility:

10 – 20 metres (30 – 65 feet)

Type of diving:

Reefs and drift diving

Marine life:

Eagle rays, jacks, trevallies, fusiliers, barracudas, tuna, humphead wrasse, Christmas tree worms, sponges, sea anemones

When to go:

It is possible to visit Malaysia at any time of year, but the rainy season that runs from June to September can cause rougher seas and lower visibility. The months of July and August suffer from the heaviest rainfall. Avoid east coast destinations between November and January

How to get there:

Malaysian Airline System and Air Asia offer regular flights from Kuala Lumpur to Terengganu arrviving at Sultan Mahmud Airport. Taxis are readily available at the airports for city transfers. It’s about one and half hour drive to Dungun. Alternatively you can catch the flight from Kuala Lumpur to Kuantan and from Kuantan, it is an hour and forty minutes drive by taxi or car. Kuala Terengganu is the main hub for express bus and coach travel in and out of the state. Long distance taxis are also readily available and all these coaches and taxis will pass throught the main road to Kuala Terengganu via Dungun.

Taken from Tenggol Island Beach Resort

Will update with pictures once we come back.

48 year old lady presented with bilateral breast lump. On examination, vague breast lump at upper outer quadrant of both breast. Negative risk for malignancy. Had a procedure done in a beauty parlour 25 years ago.

Any guesses?

The elderly lady above demonstrates a case I saw in my clinic recently, but my patient was way younger in her early 30s. She developed this weakness over the left side of the face which was rather sudden in onset 3 days prior. She was otherwise very well and there was no history of trauma, infection or ear symptoms. There was neither any headaches nor any weakness associated to the upper limbs and lower limbs. She was otherwise well.

She had all the findings as the picture above, actually exactly like the elderly lady above. So what was wrong?

Well, this condition occurs when the nerve which is responsible for the control of facial muscles becomes swollen or inflammed causing the muscles to paralyse or weaken. It is usually abrupt with no apparent cause. This syndrome was first described in 1821, by the Scottish anatomist and surgeon Sir Charles Bell. From then, this condition was called Bell’s palsy. It is an interesting disease but a scary phenomenon for patients.

The nerve involved is called the facial nerve. The path of the facial nerve is complex; this may be the reason the nerve is vulnerable to injury. Two portions of the facial nerve leave the brain at the cerebellopontine angle, traverse the posterior cranial fossa, dive into the internal acoustic meatus, pass through the facial canal in the temporal bone, then angle sharply backwards, where they pass behind the middle ear and exit the cranium at the stylomastoid foramen. From here, the facial nerve bisects the parotid gland, and then terminal branches extend from the parotid plexus to innervate the muscles of facial expression.

Though the cause is still yet unknown, many believe that majority of them are due to viruses. The most common being the herpes simplex virus, which also causes cold sores and genital herpes. Other viruses that have been linked to Bell’s palsy include the herpes zoster (chickenpox and shingles) and Epstein Barr (infectious mononucleosis).

Bell’s palsy occurs more often in people who:

* Are pregnant, especially during the third trimester, or who are in the first week after giving birth
* Have diabetes
* Have an upper respiratory infection, such as the flu or a cold

Like my patient, there is also a genetic predisposition where most of them have recurrent attacks of Bell’s palsy but this is rare.

For most people, Bell’s palsy symptoms improve within a few weeks, with complete recovery in three to six months. About 10 percent will experience a recurrence of Bell’s palsy, sometimes on the other side of the face. A small number of people continue to have some Bell’s palsy signs and symptoms for life.

Eye care, steroids, pain control and reassurance are the main essence in the treatment of Bell’s palsy.

Well it has been some time since I have written anything medical based. So, I was thinking and realized that for something so common this particular problem is so little discussed with public. Then again, I guess the reason being that despite knowing much about it, we still find this a difficult issue to treat.

So what is Dyspepsia? continue reading…

At last the monsoon is over. I can already smell the cool salt breeze of sea water. I can imagine the beaches the coconut trees and the calmness of the island.

It is the first dive for the year, and it for me is more like a refresher to check out my dive equipment which had just been recently serviced. Also, I was anxious to see how my strobes and underwater camera behaved after being dry for almost 6 months.

The location : Salang, Tioman Island.
The Dive center: Fishermen Divers

We set off about close to midnight with another 2 friends who were going to do their Advance Open Water Course. Our journey would take us along the North South Highway to Air Hitam exit. From there, we head towards Kluang town and proceed through winding roads of Felda Nitar reaching Mersing at about 3.30 in the morning. The ferry was at 5am thus allowing us to take some power nap.

The interior of the ferry was so very cold. Shivering and cursing the cold, we reached Salang at 7am. My body met my soul and heart which seem to have reached the island a few days earlier.

6 dives in 3 days 2 nights. The visibility was acceptable approximately 15 to 20m and weather conditions were good. The dive guide wasn’t so great but the best dive was the last dive at Salang Jetty. It has never failed to excite me.

Armed with my trusted G7 and Ikelite casing and 2 YS110 Sea n Sea strobes, I present some pictures I took from some of the dive site namely Tiger reef, Batu Malang ( Unfortunate Rock), Chebeh Island, Labas, Roger Wreck and finally Salang Jetty.

I came across this while surfing through MMR blogpost. Even before reading it, I had sensed that this would be something that would move me.

As I read the first paragraph of the post, I immediately realized that this was something long due and very appropriate – A tribute to the late Tan Sri T.J.Danaraj, the founder of the medical faculty University Malaya. A visionary man who had managed to have an impact on me even though he never thought me.

We stand on the shoulders of Giants is a teaching blog dedicated to the late Emeritus Professor T J Danaraj, the foundation Dean of the University of Malaya Medical Centre. The blog is moderated by Dr. Wong Yin Onn.

I remember presenting about this great man, during my batch Deepavali Festival as a tribute to him. We felt that little was done to honour this man, so much so that many present UMMC medical students hardly even know him.

I end this with a letter he once wrote which I copied from that very blog. An encouraging note to all……….

Dear …….,

T.J. Danaraj

TJ Danaraj