Wednesday 9 May 2018

14. NEW SKILLS. Acquire digital photography skills. Tourism photography

May 8, 2018, 10 am - 11.30 am. Bright sunshine.  Esplanade and Merlion, Singapore. Tourists.
Acquire skills of digital photography by practice.

I share how the following photos were taken by me.

CAMERA
Canon DSLR EOS 70D, Lens  EFS 55-250mm


P mode, AF, Stabiliser On, One point AF, Continuous Mode 

SOFTWARE
Photoshop Adobe CC




It takes around 3 hours to process selected photos for posting on this webpage.


Young people must have the 4 virtues:
persistence, determination, confidence and humility.
Learn to cultivate a clear mindset and not let negative thoughts get in the way.
Acquire new skills like digital photography.  





At the Esplanade















A tour manager needs to account for the number of travellers before the coach moves to a new destination. Much stress for her since many travellers do not bother to be punctual or be together.  




Use shadow/highlights in Adobe to lighten up the face. It was in deep shadows originally.






Sitting on the railing can be rsiky as the child can fall into the sea.



Taking pictures of two senior citizens, probably her dad and uncle.
The boy is not interested in presentation




A Singapore tour guide managed to elicit smiles from the presentation.




Aged mother takes photos for daughter

Posing for photo on the Esplanade Bridge







At the Merlion




At this spot, many tourists pose with "surrender" hands. I cannot figure why.













A vivacioous lady friend


Good friends visiting Singapore





Good health shows in her smile








Tourists enjoy taking photos in the Merlion area. In December 2017, the Merlion was dirty and the spout had rust stains. I wrote to the Singapore Tourism Board to let the officials know it was an eye sore for photographers. No reply from the Board. Today, I note the Merlion had been painted white and looks great on photography. 

Wednesday 13 February 2013

11. Internship. An ossifying fibroma inside an old dog's mouth


tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS
toapayohvets.com

Date:   14 February, 2013  

Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits
Trust & Audit: A rare case of a hamburger tumour inside the mouth of an old dog 
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   14 February, 2013  
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2013-0131

Blog 1286.

Good dental hygiene is very important for people and dogs as some oral tumours form when the mouth is not clean. Yearly dental check ups will be ideal. In February 2013, I encountered a case of a dog with bleeding in the mouth and face. "Oro-nasal fistula also known as malar abscess or carnaissal abscess," I said to the two interns very confidently as this was a common problem in old dogs that seldom if ever was sent for dental check ups or scaling.

I was 50% correct. There was a large oral tumour shaped like an oval elongated tumour! Veterinary medicine throws surprising oral tumours to me even after 40 years of practice! The dog was eating food under this tumour which expanded to fit the length and width and height of the oral cavity. The length of this tumour was estimated to be 10.5 cm long. I doubt I will ever see another case similar to this.

Dr Daniel operated to remove this "hamburger" tumour using electro-surgery. I was present for a few seconds during surgery as this was his case and I had confidence he would be able to perform this surgery.

"There was a lot of bleeding," he told me when I audited this case on Feb 12, 2013 (yesterday) and phoned the owner as well. He packed the back of the mouth with gauze swabs to prevent inhalation of blood into the lungs. Around 90% of the length of the tumour was excised electrically and then the remnants.  He electro-coagulated the bleeders in the remnants so that there would be no more bleeding.  Electro-cautery was effective in preventing bleeding.
 


The 50% calculated dosage of domitor and ketamine IV anaesthesia was just sufficient for surgery, with top up of isoflurane gas via the mask. This formula is now used by the vets for IV anaesthesia. It took some time to convince vets that this is a safe and effective formula as all vets have their own judgments and preferences of using various anaesthetics. Stocking a variety of anaesthetics is very costly as they expire and so I don't permit associate vets to order their favourite or their vet professors' choice. A veterinary surgery must be able to sustain its profitability and most associate vets don't bother with this aspect as they are not accountable for the bottom line.    

Histology confirmed it is non-cancerous. It is known as a ossifying fibroma, originating from the soft palate according to the operating vet. There was also oro-nasal fistula which I diagnosed on first visual inspection and the rotten teeth black teeth as you can see from the image, were also extracted.  Blood test had not shown any abnormal findings and so this dog was fit for anaesthesia and survived without any problems.  In this case, the profuse bleeding from the excised tumour could be inhaled into the lungs and cause death by asphyxiation if electro-cautery had not been used to seal all bleeders successfully.

From my phone call, the gentleman owner of this dog is most happy. As far as the dog owner is concerned, his old Chihuahua is OK and eating and that surgical outcome is what matters in the final analysis. "How long has this tumour exist?" I asked him. "I don't know as I don't look inside the mouth," he said. This is a very rare case of a "hamburger" oral tumour.

Yearly dental check up of your dog over 3 years of age with your vet will prevent most oral tumours and rotten loose teeth.

MY COMMENTS ON MANAGEMENT OF THIS CASE:
1.  Electro-surgery was the correct choice.
2.  IV anaesthesia with top up IV would be the choice in this case as isoflurane gas use by mask was not practical. However, the IV anaesthesia at 50% had lasted a sufficient amount of time to complete 90% of the surgery and isoflurane gas top up was effective in this case.

IV anaesthesia top up, the drugs would be injected with the IV drip or the syringe with the drugs would be attached to the IV catheter.  

This webpage:
http://www.bekindtopets.com/dogs/20130214ossifying_fibroma_oral_dog_toapayohvets.htm
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research