Sunday, November 25, 2007

Malaysia, Penang, 17-19 Nov 2007: Living With Thalassaemia
Drugs, Needles & Syringes


Thalassaemia is the commonest gene disorder in the world. In South-East Asia, about 1 in 20 persons carry the genes that can cause the disease. Thalassaemia major occurs when a child inherits affected genes from both parents, who may themselves be healthy carriers. A major thalassaemic suffers severe anaemia and requires Applying local anaesthetic cream to injection siteapproximately monthly transfusions from infancy. While life-sustaining, cumulative blood transfusions over a prolonged period results in iron deposition in various organs in the body. The iron is toxic, and causes heart, liver and endocrine organ dysfunction. Indeed, heart failure from heart iron overload is the commonest cause of premature death in thalassaemia major.

The body is evolutionarily programmed to conserve iron: except for menstrual blood loss, there exists no physiological process to rid the body of excess iron. With regular blood transfusions, many major thalassemics survive childhood only to die from the complications of organ iron overload in their teens and young adulthood. Since the mid 1970s, the iron chelator desferrioxamine has been used to remove excess body iron in thalassaemia major. The drug, which induces negative body iron balance only if given continually throughout life, has to be administered subcutaneously for 8 to 12 hours, at least 5 nights a week. Patients typically start desferrioxamine injections from childhood. Nowadays, there are 2 other iron chelating drugs: deferiprone and deferasirox, both oral drugs. Deferiprone appears to be very good at eluting iron from heart muscle, especially when used in combination with desferrioxamine. A few patients develop dangerously low levels of white blood cells with the drug, which limits its use. Deferasirox is a new oral chelating agent with similar efficacy to parenteral desferrioxamine. It is forbiddingly expensive, and out of the economic reach of most thalassaemia major patients.

The Penang Thalassaemia Society is a NGO that is dedicated to promoting the cause of thalassaemia patients in North Malaysia. The committee members comprises patients, parents, medical personnel and other volunteers. Through private charity, it has achieved remarkable success in funding expensive patient treatment: PenangSubcutaneous desferrioxamine infusion via portable pump thalassaemia patients have access to state-of-the-art medical care. Further, the Society organizes camps for patients and families to educate them about the disease and its treatment.

I attended the 11th Penang Thalassaemia Camp on 17-18th Nov 2007, my second time in 2 years. The theme focused on compliance to iron chelation treatment. It was a humbling experience to watch the thalassaemia major patients perform their personal nightly ritual of desferrioxamine injection in a communal setting. For one child, it was the first time the parent learnt to prepare the desferrioxamine solution and inject the drug into the abdomen of the child. For another child, it was to be the first time she injected into herself. Alas, she could not do it at the last minute. Mummy did it for her that night, the nth thousandth time. There will always be tomorrow.

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Sunday, November 11, 2007

London, United Kingdom, 16-20 Nov 2006: Bassae Frieze
Amazonomachy & Centauromachy


The Temple of Apollo Epikourios the Helper/Saviour) was built as a thanksgiving to Apollo for deliverance from a plague in c 430 BC. Ictinus, architect of the Fallen Amazon & comradeParthenon, probably worked on this temple before the Parthenon. Sited in the small state of Phigaleia (Arcadia, Peloponnese) in the remote Arcadian hills, at 3710ft on a narrow terrace of Mt Kotilion, and surrounded by ravines (bassai), its inaccessibility helped preserve much of the temple (lost until 1765 AD) from marauders.

The temple is renowned for its single remarkable Corinthian column, the earliest known specimen in ancient Greece, as well as the Bassae Frieze. The Frieze, now in the British Museum in London, originally lined the inner walls of the temple, perched high on columns 7 metres above ground near to the ceiling. Despite the high relief, the sculptures could not have been well seen. When found, the 23 slabs of Centaur & Lapith fight to the deathmarble were lying in confusion amid rubble. The actual sequence of the placement of the individual segments of the Frieze is uncertain.

The Frieze depicts 2 battles: the Amazonomachy and the Centauromachy. The Amazons were a mighty race of valiant women warriors. They fought fearlessly against the Greeks (led by Herakles?). The Centaurs were invited guests of the Lapiths at a wedding feast. Feted by wine, their wild nature surfaced. After one Centaur attempted to ravage the bride, fighting broke out between the Centaurs and their Lapith hosts. The overarching theme in both sequences is the struggle between Civilization (the Greeks and the Lapiths) and barbarous Nature (the Amazons and Centaurs).

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Thursday, November 08, 2007

Berlin, Germany, 11-15 Oct 2006: Pergamon Altar
Gigantomachy & Telephos Frieze


Pergamonmuseum was built to house the amazing marbles excavated from the site of the Zeus Altar in present-day Bergama, Turkey. The Pergamon Altar consists of an enormous outer frieze and an inner smaller frieze that surrounds the altar proper. The outer frieze depicts the Leon & Aither, Gigantomachy, South FriezeGigantomachy: the epic war between the Giants (many of whom have animal attributes) and the Gods on Mount Olympus. The inner frieze relates the story of Telephos, legendary founder of Pergamon, and son of demigod Herakles and Auge.

Gigantomachy. At nearly 120m long, this huge frieze surrounds the four sides of the base of the altar. The East Frieze features the major Gods, culminating in the battles between lightning bolt-wielding Zeus and Porphyrion, and powerful Athena and Alkyoneous, leader of the Giants. PHerakles, father of TelephosAlkyoneous is unceremoniously plucked from the grasp of his mother, Gaea, from whom the Giant draws strength and sustenance. The West Frieze opens up to a broad staircase that leads to the Altar.

Telephos Frieze. The frieze is the earliest known extant specimen of narrative sculpture. King Aleus, fearing the prophecy that his future grandson shall overthrow him, commits his daughter Auge to virginal priestesshood. She attracts Herakles and bears him a son, Telephos. Her father casts her out to sea in a boat, and abandons her son to the elements. She is LAgamemnon & Orestes' nurse look on in horror as Telephos threatens to kill the boyrescued by King Teuthras in Mysia, while her son is discovered and protected by Herakles. Telephos grows up, finds his way to Mysia, where he distinguishes himself in battle and is rewarded by King Teuthras. He eventually succeeds the king. As ruler of Mysia, he fights against the Greeks, who are sailing to Troy to wrest Helen back from Paris. Inflicted with a non-healing wound by Achilles, he seeks help from the sibyl Clytemnestera. She advises him to kidnap her only son Orestes, in order to pressure Agamemnon, the boy's father, into persuading Achilles to heal his wound, thus fulfilling the prophecy, "He that wounded shall also heal." Achilles is however no Asklepios. Odysseus correctly guesses that it is Achilles' sword, not his person, that will do the healing. His wound cured, Telephos went on to guide the Greek contingent to Troy.
Athena vanquishes Alkyoneous, Gaea wails uncontrollably
Gigantomachy:Alkyoneous-Athena-Gaea-Nike group, East Frieze

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Blog item posted by R S Tan @ 7:47 PM   1 Comments

Saturday, November 03, 2007

Berlin, Germany, 11-15 Oct 2006: Neighbourhoods & Buildings
Neoclassic East & Postmodern West


Berlin sprawls: a giant city of several distinct boroughs. Since the fall of the Wall, the city centre moved to the historic heart of the German capital, Mitte. Former decaying easternStatue, Facade, Altes Museum districts have received much-need rejuvenation. Hip Prenzlauer Berg has become a trendy residential area with eclectic restaurants and a lively bar scene.

Unter den Linden, the main thoroughfare of former East Berlin, runs westward from Alexanderplatz (with Swedish-made Cold War icon, Fernsehturm or TV Tower) to Brandenburg Tor. Museumsinsel (Museum Island) is the crown jewel of this tree-lined avenue, containing within the compact Spree Island, the exuberantly baroque Berliner Dom (fronting the Lustgarten) and five world-class museums, including Altes Museum (which houses the Egyptian Museum) and the august Ziggurat-inspired Pergamon Museum.

The famous quadriga-topped Brandenburg Tor on Pariserplatz marks the margin of the former Berlin Wall. During the Cold War, West Berlin underground trains run through heavily-guarded Geisterbahnhöfe,Potsdamer Platz ghost stations: passengers did not get off, or on. Französischer Dom and Deutscher Dom are found in nearby Gendarmenmarkt.

The green expanse of Tiergarten stretches to the west of Brandenburg Tor. The Berlin Philharmonic and several museums (e.g. Gemäldegalerie) comprising the Kulturforum, are sited here. Imposing silhuoettes of modern edifices and skyscrapers at Potsdamer Platz create a stark juxtaposition to the adjacent horizontal spread of Mitte architecture.

Sited in the former West Berlin, the Kaiser Wilhelm Gedächtniskirche (Emperor William Memorial Church) in Kurfürstendamm and Libeskind-designed Jewish Museum are poignant sobre reminders of the city's war past and the Jewish Holocaust.

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These are the 30 countries that I have ever set foot on. Airport stopovers don't count!