semalam adalah hari kopok lekor..

Yesterday went to Kong's and grabbed a pack of Indian Mackerel aka ikan kembong & a pack of sogu flour( tepung sagu jenama sogu). As soon as I arrived at my kitchen, without hesitant I defrozed the 7 fortunate IM and sketching a plan of my modified fish sausage recipe. Hehehehehe. Then I took out my largest knife ever in my kitchen and started the smelly fishy IM work. Pergh! the smell is a pure odour of defroze frozen fish! Lovely! Luckily I got blocked nose and I wanted to keep my congested nose to decongested till the end of my work. After stripping the skin of IM out, I removed the big bones and letting the small bones of the fish to stay with its beloved muscle aka fish meat. Why? I wanted to feel the pricking sensation of fish bone on my tongue.LOL. Actually, I was in lazy mode on that time. After fishy work including few times manual washing without washing machine like Japanese fish experts who use a washing machine step to neutralize the toxic of poisonous deadly delicious fish, which if the inexperienced people prepare the fish to eat, it will cause absolute death to the eater. So I excluded the washing machine step because of no washing machine inside my house and the IM is well known non-toxic and harmless fish. Then mince or blend the fish to a smaller minute texture..hmmm...I put 2 and half tea spoonful of salt which is equal to 12.5g of table sea salt into the blended fish and mixed them well.























For the flour, I used 2 type of flour, which are sogu flour and tapioca starch flour.The proportion of the fish, sogu flour and tapioca starch flour is 6-7 fish: 300g : 90g. We can modify the ratio as I was following my modified fush sausage recipe. Mix the flour and fish well, add some water and make them doughy like, not too soft, not too firm, not too hard in consistency. Then shape the mixture to whatever shape u want, but I transformed my mixture into nice short shape like sausage and put them in hot boiling water. Wait for few minutes until the sausages floating indicate they are already cooked. cool down a bit and nah! dah siap!







p/s: sealed in plastic wrap in chiller









Subhanallah! Sedap! Alhamdulillah! Yum Yum!

salam

skrg kul satu empat puluh tiga pagi...


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QT interval response during standing-induced tachycardia can help in diagnosing long QT syndrome

Feb. 16, 2010( Medscape)

Summary : The QT interval response during sinus tachycardia induced by standing can serve as a useful bedside test in diagnosing long QT syndrome.

Basis for Study : The goal of this study was "to determine whether the short-lived sinus tachycardia that occurs during standing will expose changes in the QT interval that are of diagnostic value."

Detailed Summary of Study : 68 patients with long QT syndrome and 82 control subjects underwent ECGs while resting supine and then after getting up quickly. Changes in the QT interval in response to standing were then analyzed to see if they could distinguish between the groups.

Results/Body : Although the subjects' heart rate accelerated by the same amount in both groups upon standing, the average QT interval shortened in the controls but increased in the long QT patients. During maximal tachycardia the corrected QT interval increased significantly less in the control subjects than in the patients. "Receiver-operating characteristic curves showed that the test adds diagnostic value."

Sources & Other Links ; Viskin S, Postema PG, Bhuiyan ZA, Rosso R, Kalman JM, Vohra JK, Guevara-Valdivia ME, Marquez MF, Kogan E, Belhassen B, Glikson M, Strasberg B, Antzelevitch C, Wilde AA.. The response of the QT interval to the brief tachycardia provoked by standing: a bedside test for diagnosing long QT syndrome. J Am Coll Cardiol. 2010 Jan 22.


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Aromatase Inhibitors vs other endocrine therapies for treatment of advanced breast. cancer

Feb. 16, 2010(Medscape)
Authors : Gibson Lorna, Lawrence David, Dawson Claire, Bliss Judith

Review Group : Cochrane Breast Cancer Group

Abstract : Endocrine therapy removes the influence of. oestrogen on breast cancer cells and so hormonal treatments such as. tamoxifen, megestrol acetate and. medroxyprogesterone acetate have been in use for many years for advanced breast cancer. Aromatase inhibitors (AIs) inhibit oestrogen synthesis in the peripheral tissues and have a similar tumour-regressing effect to other endocrine treatments.. Aminoglutethimide was the first AI in clinical use and now the third generation AIs, anastrozole, exemestane and letrozole, are in current use. Randomised trial evidence on response rates and side effects of these drugs is still limited.

Objectives:
To compare AIs to other endocrine therapy in the treatment of advanced breast cancer in postmenopausal women.

Search strategy:
For this update, the Cochrane Breast Cancer Group Specialised Register and the Cochrane Central Register of Controlled Trials (CENTRAL) and relevant conference proceedings were searched (to 30 June 2008).

Selection criteria:
Randomised controlled trials in. postmenopausal women comparing the effects of any AI versus other endocrine therapy, no endocrine therapy, or a different AI in the treatment of advanced (metastatic) breast cancer. Non-English language publications, comparisons of the same AI at different doses, AIs used as neoadjuvant treatment, or outcomes not related to tumour response were excluded.
Data collection and analysis:
Data from published trials were extracted independently by two review authors and cross-checked by a third. Hazard ratios (HR) were derived for analysis of time-to-event outcomes (overall and progression-free survival). Odds ratios (OR) were derived for objective response, clinical benefit, and toxicity.

Main results:
Thirty-seven trials were identified, 31 of which were included in the main analysis of any AI versus any other treatment (11,403 women). No trials were excluded due to inadequate allocation concealment.The pooled estimate showed a significant survival benefit for treatment with an AI over other endocrine therapies (HR 0.90, 95% CI 0.84 to 0.97). A subgroup analysis of the three commonly prescribed AIs (anastrozole, exemestane, letrozole) also showed a similar survival benefit (HR 0.88, 95% CI 0.80 to 0.96). There were very limited data to compare one AI with a different AI, but these suggested an advantage for letrozole over anastrozole.AIs have a different toxicity profile to other endocrine therapies. For those currently prescribed, and for all AIs combined, they had similar levels of hot flushes and arthralgia; increased risks of rash, nausea, diarrhoea and vomiting; but a 71% decreased risk of vaginal bleeding and 47% decrease in thromboembolic events compared with other endocrine therapies.

Authors' conclusions:
In women with advanced (metastatic) breast cancer, aromatase inhibitors including those in current clinical use show a survival benefit when compared to other endocrine therapy.

Implications : Historically, the treatment for advanced (metastatic) breast cancer has been with hormonal treatments such as tamoxifen or the progestins MA or MPA. This review confirms a survival benefit of treating advanced (metastatic) breast cancer with the third generation aromatase inhibitors (anastrozole, exemestane, and letrozole) that are being used clinically today.

Citation: Gibson L, Lawrence D, Dawson C, Bliss J. Aromatase inhibitors for treatment of advanced breast cancer in postmenopausal women. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD003370. DOI: 10.1002/14651858.CD003370.pub3.


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FDA Announces Possible Safety Concern for HIV Drug Combination

FDA NEWS RELEASE
For Immediate Release: Feb. 23, 2010
Media Inquiries: Erica Jefferson, 301-796-4988; erica.jefferson@fda.hhs.gov
Consumer Inquiries: 888-INFO-FDA( from medscape for iphone)

Review of data indicating life-threatening heart abnormality underway

The U.S. Food and Drug Administration today announced preliminary data suggesting that Invirase (saquinavir) in combination with Norvir (ritonavir) may have potentially important adverse effects on the heart.
When used together, the drugs may cause prolongation of the QT and PR intervals on an electrocardiogram. Prolongation of the QT interval may lead to a condition known as torsades de pointes, an abnormal heart rhythm. Prolongation of the PR interval may also lead to an abnormal heart rhythm known as heart block. With torsades de pointes or with heart block, patients may experience lightheadedness, fainting, or abnormal heart beats. In some cases, torsades de pointes may progress to a life-threatening irregular heart beat known as ventricular fibrillation.
Review of the data is ongoing. Preliminary findings suggest that some patients using Invirase and Norvir may be at an increased risk for heart abnormalities leading to irregular heart rhythms. For example, the risk for torsades de pointes may be increased in patients who are also using medications known to cause a heart disturbance called QT interval prolongation. The risk may also be increased in patients who have a history of QT interval prolongation.
Patients using Invirase should talk to their health care professional about any questions or concerns they have about Invirase. Patients and health care professionals should report any side effects from the use of Invirase to the FDA’s MedWatch program:
http://www.fda.gov/safety/MedWatch/default.htm

Invirase is an antiretroviral medication that was first approved in 1995. Invirase is used in combination with Norvir and other antiretroviral medicines to treat HIV in adults. Invirase does not cure HIV infection, may not prevent you from developing HIV-related illnesses, and may not prevent you from spreading HIV to other people.
This early communication is in keeping with FDA’s commitment to inform the public about ongoing safety reviews of drugs. FDA will communicate its findings to the public as soon as the review is complete.
Invirase is marketed by San Francisco-based Genentech, a subsidiary of the Roche Group. Norvir is marketed by Abbott Park, Ill.-based Abbott Laboratories.

For more information:
FDA Drug Safety Communication: Ongoing safety review of Invirase (saquinavir) and possible association with abnormal heart rhythms


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Decreasing the fat content of milk served in schools can increase consumption while reducing calorie and fat intake

Feb. 16, 2010( Medscape)

Summary : Replacing whole milk with low-fat or fat-free milk and serving only fat-free chocolate milk in New York City school cafeterias "decreased the amount of fat and calories apparently consumed by students without decreasing overall school milk purchases, thereby maintaining student consumption of calcium and important vitamins."

Basis for Study : New York City’s Department of Education changed its school milk policies in an attempt to combat childhood obesity. This article summarizes the impact of these changes on students’ intake of milk, calories and fat.

Detailed Summary of Study : Starting in 2004, whole milk was replaced by low-fat or fat-free milk in school cafeterias, and chocolate milk was changed from low-fat to fat-free. The changes were instituted city-wide in 2006.

Results/Body : "By removing whole milk and switching from low-fat to fat-free chocolate milk, NYC public school milk-drinking students were served an estimated 5,960 fewer calories and 619 fewer grams of fat in 2009 than they were in 2004. Other school systems can use these results to guide changes to their own school food policies." Contrary to concerns that removing whole milk would reduce children's milk intake, "school milk purchases per student per year increased 1.3% in fiscal year 2009 compared with 2004 purchases"-from 112 half-pints per student in 2004 to 114 in 2009.

Sources & Other Links : Alberti PM, Perlman SE, Nonas C,et al. Effects of switching from whole to low-fat/fat-free milk in public schools—New York City, 2004-2009. MMWR 2010;Jan 10/59:70-73


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