Howzit 25

EXCITEMENT in STORE for MANIPALITES!

Welcome to the 25th edition of HOWZIT. Following the request of some readers, we have attempted to make HOWZIT a magazine for leisure reading with a minimum of heavy stuff and lots of photos.

The photos are sourced from our own cameras, phones and the social media which are not copyright material. My apologies for not being able to include the tons of special rated material as HOWZIT will then be banned altogether by the regulating authorities.

There are two major upcoming events in store for our MAAM members this year, not to forget our various CPD, sporting as well as social events happening the whole year round.

The main one would be our MAAM AGM which is happening on 9, April 2016. Our association is really aiming high as for the first time in history, the AGM is happening at a great height, 32 levels up, to be precise. The venue is on level 32A at Capri by Fraser Kuala Lumpur over in Bangsar South City. Hoping for a superb attendance this time round.

The next major event which is following on to our inaugural 1st Global Manipal Alumni Health, Science & Technology Convention held on 7 & 8, August, 2014 is the 2nd Global Manipal Alumni Convention 2016. It is scheduled for 15 & 16, December 2016 at Clarks Exotica in Bangalore. So, do keep your diary marked. More information may be made available on our website when we receive them.

Apart from our regular CPD activities, the more energetic of our MAAM members embarked on a series of sports activities known as SPORTIVO which have taken on rather well. The reports and pictures are elsewhere in this issue of HOWZIT.

We need contributions in the form of articles and photos for HOWZIT. It can be on any subject of good taste. Do note however, that it may be subject to editing prior to print. Do send your contributions to [email protected], attention of The Editor.

Dr. Koh Kar Chai
Editor

PRESIDENT’s MESSAGE

Dear Members of the Alumni,

Two years have passed since I took up this post.

It has been a slow two years as compared to the earlier two when everyone was kept on their toes prior to the Global Event. The 2nd Global Scientific Event is slotted for 15th & 16th of December 2016 in The Clark Hotel, Bangalore. For more information please log on to the website at: http://globalmanipalalumniconvention.com/

A big thank you to all members for the great support extended to me and my committee. My most sincere wishes and compliments to the committee who have been doing great with moving the association forward.

CPD activities have been going on well under the stewardship of Dr. Koh Kar Chai who formed the SSS – Society of Scientific Studies. The SSS will be handling all CPD activities of MAAM. CPD is an area of focus for the Association and has many benefits to its members.

We also had an Alumni trip to the Rainforest Festival and although the number in attendance was small, they had a whale of a time. We do hope that more Manipal Alumni will take advantage of future alumni trips. The customary Alumni convention was held in December, 2015 and this time as it was held in Melaka, we had several new alumni and senior Melaka Manipal students attend. The committee has been debating on making the quarterly newsletter, the HOWZIT only available as an e-copy. This will cut unnecessary costs of printing and postage. We do hope all members will support this plan as we do not have an unending source of income to support printing large numbers every 4 months in a year.

Hats off to Sportivo, the sports sub-committee managed by Dr. Siva and other younger Alumni. They are injecting more activities into the Association and we hope soon senior members will also join in their regular sporting activities. Please do get onto our website to update yourself on coming events. The committee worked hard to organize the get-together at GAB and the events during our AGM but without getting online and being aware of what is happening it is hard to get all members onboard.

Dr. Arun Kumar
President,
Manipal Alumni Association Malaysia

MAAM SECRETARY’s REPORT 2014 to 2016

The new committee took office from the 8th of August, 2014 and since then has had 10 committee meetings. We co-opted 4 ordinary members to help with the programs and plans for the new term. This includes, the past President, Dr. Nirmal, past Secretary, Dr. Thomas John, Dr. Mohandas and Dr. Rishya. Each committee member had been given a portfolio to oversee and report during the committee meetings.

At the back of a successful Convention, the new committee had its work cut out for the new term. Building from the Convention and proceeding with the philosophy of increasing CPD activities, the committee formed a subcommittee headed by Dr. Koh Kar Chai called The Society of Scientific Studies of MAAM. This Society is responsible for the CPD activities of the Malaysian Alumni Association, Malaysia. Two types of CPDs were conducted

a) CPD events which were endorsed by MAAM which included:

  1. Obstetrics, Gynaecology & Reproductive Medicine CPD 2015 held on 18, Jan, 2015 at Tropicana Medical Centre.
  2. purP.O.S.E. (Pfizer One Stop Education) workshop 2015 held on 15, March at Four Points by Sheraton, Penang.
  3. WATTZupDoc Symposia Series on Primary Care Medicine held on 25 & 26, April, 2015 at Le Meridien, KL.
  4. PLUS SYMPOSIUM Primary Care Clinical Updates held on 14, June, 2015 at Hilton, KL.
  5. PLUS Symposium-Primary Care Clinical Updates held on 23, Aug, 2015 at G Hotel, Penang.
  6. A Natural Breakthrough Therapy for Inflammation-Useful in OA held on 5, Sept, 2015 at the Royal Selangor Club, Dataran Merdeka.
  7. Real World Asthma Control for Healthcare Professionals held on 5, Sept, 2015 at Eastern & Oriental Hotel, Penang.
  8. PLUS Symposium-Primary Care Clinical Updates held on 20, Sept, 2015 at Double Tree by Hilton Hotel, Johor Bahru.
  9. Pain Focus Workshop held on 29, Nov, 2015 at Aloft KL.
  10. WATTZupDoc Symposia Series on Primary Care Medicine held on 23rd & 24th, January 2016 at Le Meridien Kuala Lumpur.

b) CPD events organised by the Society of Scientific Studies:

  1. Manipal Alumni Scientific Programme held on 16th May, 2015 at Holiday Inn Kuala Lumpur Glenmarie in conjunction with our AGM 2015.
  2. MAAM-MMMC CPD Programme held on 4th Dec, 2015 at Melaka Manipal Medical College in conjunction with MAAM Convention 2015.

MASH (Manipal Alumni Science & Health) Journal

MASH (Manipal Alumni Science & Health) Journal was launched during the Convention 2014 by the Minister of Health and the first issue was completed in early 2015 and Volume 2 is now up and available on the Manipal Alumni webpage.

Headed by Dr. Premkumar, the Editorial Board comprises of Alumni from around the world. Application for ISSN number has been submitted and it is soon to be a journal of repute. We want to encourage Alumni in Malaysia and around the world to submit articles including research work, reviews, comments, case reports and opinions to The Editor at [email protected] Hopefully in time to come the Journal will be indexed and have an ISI Impact Factor.

Disaster Relief Efforts

In late 2014 the East Coast and parts of Northern Peninsula were inundated by terrible floods. MAAM stood up to the needs and worked together with MERCY Malaysia and other agencies to provide medical relief. Dr. Jeyanthi was involved as a volunteer with a Mercy Mission in Perak.

Later in 2015, Nepal was affected by a devastating Earthquake. 2 Manipal Alumni, Dr Paul Victor and I travelled to Nepal and conducted Disaster Relief Clinics. We also conducted a donation drive and succeeded in collecting about MYR$7000.00 from members and also Manipal Alumni from overseas. This collection was used to provide essential items such as water filters and tarpaulin used for tents during the relief efforts. This is not Association money but rather funds that were collected for disaster relief only. The fund still has about RM$1000.00 left.

Rainforest Festival Trip

The 2015 MAAM trip was to the ‘The Rainforest World Music Festival’ in Sarawak. Held from the 7th to the 9th of August, 2015, the Festival is a unique music event that brings together on the same stage renowned world musicians from all continents and indigenous musicians from the interiors of the mythical island of Borneo. 32 Manipal Alumni and family joined the trip including Alumni from USA, Australia and India. It was a vacation to be remembered for a lifetime and part of the reason was because when you put likeminded Manipal Alumni together anywhere they gel and have a marvellous time.

Howzit Newsletter

The 24th volume of the ‘Howzit’ was published in Nov, 2015 and has been posted to all members. We have also published an e-copy of the Consensus summary of the 1st Global Manipal Alumni Health, Science & Technology Convention, 2014 and this is available on our MAAM webpage.

Membership

We have seen a dramatic increase in our membership over the past two years, from just over 800, to 1462 last year and now standing at 1743 members. The numbers have been on the increase with younger alumni joining. Of course disappointingly the conversion of student members to life members post qualification has not been many but the committee is working on this by organising events that younger alumni find keen to be involved in, including futsal tournaments.

MAAM

website MAAM Website has been undergoing steady improvement. There is a picture gallery which will allow members to log on and view and download pictures of our events including the recent Convention photos. The upgrading and updating of our website is thanks to the efforts of Dr Roshan, our Vice-President. He has also created a smartphone application which can be downloaded for free. Please get onto to it if you haven’t already.

Resolutions passed at the last EGM on 4th December, 2015.

Resolution to Amend the Number of Committee Member

Proposal to increase committee members to 5 compared to only 3 now was approved unanimously. The 2 additional members will include the Immediate Past President and a committee member representing Dental or Pharmacy or Engineering Alumni

Resolution to increase Life Membership Fee

It was proposed to increase Life Membership fee from RM$200.00 to RM$500.00. Resolution was passed with a simple majority vote of those present.

The committee however decided that it will give a 2 year grace period before enforcing the new membership fee.

In the interim, we will promote for increased membership at the old registration fee.

Both Resolutions have been sent to ROS for endorsement.

MAAM Convention 2015

The Annual Convention for 2015 was held in Melaka and we have to record our sincere thanks to Melaka Manipal Medical College including the Dean, faculty and students who helped make it a success. The CPD was held on the 4th of December, followed by Salsa Night at Novotel rooftop. The decorations made it a sight to behold and even though there was a bit of drizzle it didn’t stop the gyrating and boogie-woogie moves on the dance floor.

The Gala Dinner on day two was an even more extravagant affair as the guests were dressed to kill and were entertained by a pretty talented band. Even the children had loads of fun with a Halloween party organized to keep them entertained. The event was more meaningful with the presence of young alumni and some of the final year students from MMMC.

MAAM SPORTIVO – Sports Subcommittee

On the 16th January 2016 the Manipal Alumni Association Malaysia (MAAM) had launched its new bimonthly sports event called MAAM Sportivo which consist of Futsal & Pool (Billiards). The first of these events took place at Sports City Futsal, Petaling Jaya from 3.00-5.00pm and the MAAM team played against Lincoln University College & students from Pusat Perubatan Universiti Malaya. Around 20 players were involved and few rounds of matches each lasting 15 minutes were played.

The pool (billiards) took place at Walk Inn Bistro, Dataran Three Two Square, Petaling Jaya from 9.00pm onwards on the same day. Our MAAM team comprising of boys & girls played against the in house team of Walk Inn Bistro. The second similar event was held on the 12th of March, 2016. This is attracting a lot of younger alumni but it is also open to all MAAM members so we will keep you informed of the coming events so you can either participate or cheer and support. Kudos to Dr. Siva and his team – our X gen of Manipal Alumni!

LOSS of Meeting Room

Ever since the beginning of 2016, MAAM has only a postal address but no physical facility to call it’s own. In a bid to reduce our expenditure, it was felt that it may be more sensible not to maintain a physical office which will only be used for the occasional meetings.

It has been interesting to hold our committee meetings in a variety of venues. One of them was the abode of Dr. Nirmal, our Immediate Past President, who opened up his “mansion” for our use. He also offered his services as a Master Chef, cooking up a storm to ensure that we will not go hypoglycemic during the meeting. There were however conditions that were set, and that is we had to do the cleaning up (including crockery) and that there was to be no left over of food. We gladly agreed wholeheartedly. The meeting went on smoothly interspersed with discussions on the lavish spread of food offered to us.

The other venue was at a futsal court. It was amazing to see that the meeting was conducted successfully amidst the futsal players’ shouts and curses whilst they played their games. It was a wonder that none of the committee members who attended developed hoarse voices as they had to make themselves heard during the meeting.

MAAM CONVENTION 2015 in Melaka

by Prishalini Gunalan

MAAM CONVENTION 2015 in Melaka
by Prishalini Gunalan

From Behind the Shades of a Student Member

I was asked to volunteer at the MAAM event one weekend to replace a fellow classmate who was down with Dengue fever. Assuming that it would be a bunch of healthcare professionals reminiscing about life as Manipal students back in their prime years, I almost didn’t go. I did not like the idea of spending the entire weekend doing that when I had an enormous pile of work to be done.

Oh, how wrong my ignorance proved to be. It was a weekend that changed my perception on becoming a doctor altogether. I met wonderful people who shared so much of their experience with us, the final year students in medical school with no blinking clue about what was out there waiting for us.

They did reminisce about their student life but what really hit the nail on the head was the fact that the one thing almost every one there had in common. They all told me the same thing, Manipal had changed their lives. I stood in awe as I had mind-blowing conversations that made me question my existence. “Live, don’t just exist,” someone told me at the end of the party that night.

But my existential crisis aside, the Salsa Night on the first day of the event was a huge success. The organizers couldn’t have picked a better venue for it, at the rooftop of Novotel Hotel, Malacca. The cool breeze and great music worked its magic into everyone’s inhibitions and at the end of the night; the guests were on the dance floor showing off their groovy moves. Oh, they partied hard and much to our delight, the party went on despite the light drizzle.

The Gala Dinner on day two was an even more extravagant affair as the guests were dressed to kill, even the children who had a Halloween party organized to keep them busy.

Over all, what really impressed me, as a part of the internet culture and the era of Whatsapp and Facebook, was the unity and the perseverance everyone had to keep the Alumni going. It was like passing down the values to each generation of Manipalites to “keep the flame burning” (in the words of a very wise surgeon I had met that night). Well, sir, when our time comes to hold this wonderful association together I can only hope that we are half as dedicated as the current members of the Alumni. I am definitely looking forward to the next time I meet all these amazing people.

MAAM CONVENTION 2015 in Melaka SALSA NIGHT

On the first evening of our convention, we had the SALSA night. Having it on the roof top of Novotel was a good choice of venue. Overlooking the skyline of Melaka with a continuous breeze definitely set the tempo for the night, not to mention also the fantastic decor of the floor.

The slight drizzle mid way through the affair did not dampen the spirits, in fact the spirits rose, judging from the styles of dancing which did not really fit in with the salsa theme of the night.

The number of headaches seen the following morning was testament to the success of our Salsa Night.

MAAM-MMMC CPD in Melaka

In the morning of the first day of our MAAM Convention 2015 at Novotel Melaka, we held the MAAM-MMMC CPD which was held in the Melaka Manipal Medical College campus in Melaka.

The invited external speakers were Dr. Vicknesh Krishnan, Mr. Fabian Hung, Dr. Mohd Hanizam Bin Jaafar and Dr. Shanthi Palaniappan. Two speakers from MMMC graciously consented to speak at the CPD event, Professor Dr. Eswara Uma who spoke on affairs of the teeth in children and Professor Dr. M. V. Kumar who spoke on nostalgia in medical practice.

Our appreciation goes to Melaka Manipal Medical College and it’s Students’ Council for arranging both the venue and the refreshments. Our heartfelt gratitude also goes to Gribbles Pathology (M) Sdn Bhd, Novartis Corporation (M) Sdn Bhd, Takeda Malaysia Sdn Bhd, AbbVie Sdn Bhd, Bio Nutri Science & Resources and KinsMedic Sdn Bhd, without whom it will be difficult for us to hold this event.

MALAYSIAN MEDICAL ASSOCIATION and MALAYSIAN MEDICAL COUNCIL ELECTIONS

This is the time of the year again when the Malaysian Medical Association is gearing up for it’s AGM and yes, it is also the time for election campaigns to begin. Our MAAM members have been at the forefront many a times when it comes to holding office at the Malaysian Medical Association. Candidates from MAAM have done well in the past due to the support from our own members and it will be no different this year.

The exception will be when contenders for the same position are both MAAM members. That is when the candidates will then have to lobby for support from within MAAM.

This time round, the election candidates for the MMA National AGM are

    • Datuk Dr. Kuljit Singh for the post of President Elect
    • Dr. Ravindran Naidu for the post of President Elect • Dr. Koh Kar Chai for the post of Honorary General Secretary
    • Dr. Saraswathi Bina Rai for the post of Honoray Deputy Secretary

Not to be forgotten is the Malaysian Medical Council elections where our MAAM members are candidates as well. Do not forget to support them there too. They are

  • Dr. Arun Kumar A/L Beshamber Nath
  • Dr. Elangovan A/L Subbiah
  • Datuk Dr. Kuljit Singh A/L Mahindar Singh
  • Dr. Parmjit Singh
  • Dr. Thillai Nathan A/L T. Pushpanathan

Commencement of ACUTE PAIN SERVICES at MANIPAL HOSPITAL KLANG, MALAYSIA

Dr. Sham Kumar Sadanand PJK, MBBS (KMC Manipal), M. Anaes (Uni.Malaya)
MBA( Strathclyde), Consultant Anaesthesiologist & Intensivist

Introduction

In line with current trends in improving the quality of patient care and satisfaction, Manipal Hospital Klang(MHK) embarked on a pilot programme towards the development of a formalized Acute Pain Service (APS). This pilot programme was commenced by our Anaesthetic Department in June 2015 with a more formalised post operative analgesia protocols and a bedside education program for the nurses with training in proper pain scoring methodology.

Basis of the APS

Perioperative pain starts from the time of hospital admission to the first 72 hours after the surgery, which varies in intensity due to the subjective variations. A good perioperative pain management provides good postoperative analgesia and is associated with less morbidity and mortality. On the other hand, unrelieved postoperative pain may not only delay the recovery and discharge process, but also can potentially lead to chronic pain conditions. The solution to this problem lies in setting up of the Acute Pain Service (APS) based on evidence-based approaches within the available resources with accountability. A good regional anaesthesia service can be crucial to any APS as it provides timely application of appropriate pain relieving methods, which improves the overall postoperative pain management and patient’s hospital experience. Unfortunately, the regional anaesthesia services are not well recognized, defined or structured and their function varies from hospital to hospital in Malaysia. Nowadays, we are witnessing an upsurge in the APS, especially in developing countries. Anaesthesiologists are usually the lead physicians who work closely with the paramedical staff and decide about the analgesic modality while managing side effects and assuring patient safety. Ideally, the APS pathway should include patient assessment, pain management delivery, documentation, patient’s awareness programs, audits and defined performance criteria for evaluation.

The important components of the APS are as follows:

  1. Multidisciplinary team comprising anaesthesiologists, surgeons, nurses and pharmacists. The team should define the needs and suggest the equipment and infrastructure besides providing guidance to develop and manage the APS
  2. Acute pain management protocols and modalities of APS.
  3. Regular pain assessment methods and guidelines to control pain within a defined time scale.
  4. Continuous professional development and teaching programs.
  5. Regular meetings, cooperation and networking amongst the members of the committee.
  6. Patient education and information regarding pain, treatment options and their side effects.
  7. Safe and secure central data keeping for a regular follow-up.
  8. Audits on methods, patient satisfaction and cost-effectiveness.

At MHK we endeavour to provide the best to our patients and are now are in the process of training our nurses, doctors and eventually pharmacists in the various aspects of the APS. Clinical pain nurses play an important role in providing direct patient care. They coordinate, monitor and evaluate the services and liaise directly with our anaesthesiologists. Our Anaesthesiologists in turn liaise with our Surgeons from the very onset to plan the patient selection and preferred treatment modality. Pain nurses also act as a link amongst the various members of the APS team. The ward nurses are responsible for assessing the pain intensity, providing medications rescue while monitoring for efficacy and adverse effects. Patients should also be educated that any pain above 3 (on a 0–10 Visual Analog Scale) is not acceptable and they should inform the attending staff and seek intervention. The Pharmacy unit will be trained to extend its help in consultation with the APS and organizes the pain medication upkeep.

Multi-Modal Analgesia.

The treatment modalities vary from non-interventional methods like oral non-steroidal anti-inflammatory drugs to intravenous or epidural patient controlled analgesia (PCA) with or without peripheral nerve blocks. Every member of the APS team must be involved with the continuous professional development (CPD) plan in the form of clinical, academic and patient educational activities. We at MHK are developing a training programme directed at the nurses and also the physicians and surgeons to assimilate the concept of this “Multi Modal Analgesic Approach” Patient education is important to exploit the benefits of APS to its maximum. Patients should have some idea about the pain management methods, their potential benefits, risks and side effects. The APS team must appreciate that any unrelieved pain may negatively affect the surgical outcome. The members of the team must also believe that the patients have all the right to expect good pain management with multiple options available for their perioperative pain. Today, a pain free post operative course is the right of every patient and not a privilege accorded by the goodwill of the doctors.

Our model at MHK

  1. Patient is made aware of the availability of the APS at the outpatient clinic when surgery is discussed.
  2. Patient selection is done by discussion between Surgeon and Anaesthesiologist
  3. Selection of technique discussed.
  4. Surgery planned.
  5. Patient seen by the anaesthesiologist and pain management options are discussed. Patient is made aware of the availability of the APS, their rights to pain control, what to expect and the Visual Analog Scale.
  6. Pharmacy is made aware of the medication requirements.
  7. Surgery proceeds.
  8. APS is commenced in the recovery and pain control is titrated by the anaesthesiologist.
  9. Protocols are documented and patient logged into APS register.
  10. Discharged to ward.
  11. Ward nurses monitor pain score four hourly as the 5th vital sign. Side effects are also monitored.
  12. If score exceeds 3 or side effects are encountered, the anaesthesiologist concerned is informed immediately for intervention.
  13. Process is continued for 48-72hrs depending on patient’s pain score and recovery.
  14. Protocol is terminated and all data logged for audit.
  15. APS committee will then meet on a monthly basis to audit and streamline the system

The surgeries selected were major laprotomies, total knee replacements, total hip replacements, spine instrumentations, mastectomies and multiple internal fixations in polytrauma.(28 cases) All the patients recorded a well controlled pain score below 3/10 with 3 patients recording breakthrough pain of 4-6/ which responded to rescue measures. Side effects were well controlled with the use of multimodal protocols and ganisetron for nausea and vomiting. All the patients had a fairy pleasant post operative period, early ambulation and expressed satisfaction with the analgesia offered. One patient has post operative basal bronchopneumonia which responded to antibiotics, early ambulation and incentive spirometry.

The myth about side effects and complications…..”you have to put up with it!”

On many occasions well planned protocols are abandoned due to side effects which develop from the onset or as the APS protocols go along. It has often been a knee jerk reaction to abandon the technique in progress. As a result the patient is left in pain and has an unpleasant post operative period with the development of substantial psychological trauma. In selected cases there has been recognised and documented chronic pain syndromes as a result of this inadequately treated pain. Classical situations being seen in post mastectomy, open cholecystectomy and thoracotomy patients. All the team members at MHK are being trained to understand the concept of pre-emptive control of these issues by the utilisation of techniques which can decrease these side effects. The aim is not to stop the APS protocol but instead to institute measures to control side effects.

Continuous development of our services

Clinical audits are the backbone of good governance. Good record keeping and data management are crucial. Records help in followup and evaluation of key outcome measures. Regular audits show whether the goals of the APS are achieved. Towards this we aim to utilise all data generated during the course of our development to further streamline and enhance our services for the best outcome.

Conclusion

Gone are the days when perioperative pain and discomfort used to be the most fearsome experience for any patient. The introduction of APS (including regional anaesthesia services) has increased the awareness amongst patients and medical professionals that proper pain management in perioperative period is important to enhance the patient’s well-being. At MHK our dedicated team aspires for excellence and good clinical governance, and appropriate organizational structure with the goal of achieving a pain-free hospital stay, especially for the surgical patients.

MAAM SPORTIVO

On the 16th January 2016 the Manipal Alumni Association Malaysia (MAAM) had launched its new bimonthly sports event called MAAM Sportivo which consist of Futsal & Pool (Billiards).

The futsal took place at Sports City Futsal, Petaling Jaya from 3.00-5.00pm and the MAAM team played against Lincoln University College & students from Pusat Perubatan Universiti Malaya. Around 20 players were involved and few rounds of matches each lasting 15 minutes were played.

The pool (biiliards) took place at Walk Inn Bistro, Dataran Three Two Square, Petaling Jaya from 9.00pm onwards on the same day. Our MAAM team comprising of boys & girls played against the in house team of Walk Inn Bistro. Matches played were Mens Singles, Womens Singles, Mens Doubles & Mixed Doubles.

Overall it was a great start to this new event MAAM Sportivo.This event is mainly to get our alumni members together on a regular basis and also promote a healthy living style through sports. More than that it keeps our proud Manipal tradition & spirit alive!!

A VISIT to BEVERLY WILSHIRE MEDICAL CENTRE

Beverly Wilshire Medical Centre is a relatively new medical centre that caters for cosmetic surgery, aesthetic treatment and healthy aging. Located along Jalan Tun Razak, our first exposure to them was during our last MAAM AGM where they participated in our CPD programme, hence my visit to this medical centre.

Spread over three floors, they profess to have state of the art facilities with services offered by a team of highly skilled specialists. If you think you are not there yet, as far as looks and well being are concerned, you may pay them a visit. There may be special rates for fellow Manipalites. And no, you need not inform MAAM prior to seeking a consultation to Beverly Wilshire Medical Centre, as after all, you would want your visit there to be your personal secret

motor BIKING

Some years back, you would find many riders who are of a more senior age group as the prices of such bikes were rather prohibitive including the high cost of maintaining them.

However, the price of big/super bikes have come down by quite a fair bit with many models being assembled locally or in a neighbouring country. Though there are still many with a price tag above Rm100,000, choices are a plenty now in the sub Rm100k category. Even the sub RM50k class offer decent bikes for you to choose from.

Before taking up this hobby, apart from financial considerations, many would ask, is it safe? Being an ex biker who had literally kissed the tarmac before, I would say that safety risks are definitely higher. It is not you being surrounded by metal but it will likely be you first before metal if the untoward were to happen.

Safe riding is the topmost priority to be addressed before you go off riding with the wind in your face. Risk taking is for the rempits. Proper riding techniques need to be learnt. Knowledge of safety gear is important. It is just so easy for things to go wrong on a big/superbike with serious consequences including loss of life. A flick of your wrist on the throttle can bring extreme joy or disaster.

That said, why do guys and some gals take up riding as a hobby? It is hard to explain that feeling to a non rider, but to one who rides, the sound of the engine really revs up the heart of the enthusiast like your first love, be it the thumping of a single cylinder engine, the roaring of a V twin or the scream of the inline 4s. Then there is the heavenly chorus of the exhaust pipes. Describe the music of the exhaust note to a Harley enthusiast or to one who relishes Race Replicas and you can see the facial expression of one who is in Nirvana.

That said, why do guys and some gals take up riding as a hobby? It is hard to explain that feeling to a non rider, but to one who rides, the sound of the engine really revs up the heart of the enthusiast like your first love, be it the thumping of a single cylinder engine, the roaring of a V twin or the scream of the inline 4s. Then there is the heavenly chorus of the exhaust pipes. Describe the music of the exhaust note to a Harley enthusiast or to one who relishes Race Replicas and you can see the facial expression of one who is in Nirvana.

Types of bikes? Laid back easy riders, high powered scooters, super motards, cruisers, nakeds, supersports, choices are a plenty.

But do remember to take up an adequate insurance before you decide to ride and think of your loved ones. Happy and safe riding to all the riders out there.