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rectal bleeding

2012-02-08T18:06:00.003+08:00

What is rectal bleeding (hematochezia)?

Rectal bleeding (known medically as hematochezia) refers to the passage of red blood from the anus, often mixed with stools and/or blood clots. (It is called rectal bleeding because the rectum lies immediately above the anus, and although the bleeding indeed may be coming from the rectum, as discussed later, it also may be coming from other parts of the gastrointestinal tract.) The severity of rectal bleeding (i.e., the quantity of blood that is passed) varies widely. Most episodes of rectal bleeding are mild and stop on their own. Many patients report only passing a few drops of fresh blood that turns the toilet water pink or observing spots of blood on the tissue paper. Others may report brief passage of a spoonful or two of blood. Generally, mild rectal bleeding can be evaluated and treated in the doctor's office without hospitalization or the need for urgent diagnosis and treatment.

Rectal bleeding also may be moderate or severe. Patients with moderate bleeding will repeatedly pass larger quantities of bright or dark red (maroon-colored) blood often mixed with stools and/or blood clots. Patients with severe bleeding may pass several bowel movements or a single bowel movement containing a large amount of blood. Moderate or severe rectal bleeding can quickly deplete a patient's body of blood, leading to symptoms of weakness, dizziness, near-fainting or fainting, and signs of low blood pressure or orthostatic hypotension (a drop in blood pressure when going from the sitting or lying position to the standing position). Rarely, the bleeding may be so severe as to cause shock from the loss of blood. Moderate or severe rectal bleeding usually is evaluated and treated in the hospital. Patients with signs and symptoms of reduced volume of blood often require emergency hospitalization, and transfusion of blood.

Origin of rectal bleeding (where the blood comes from)

Most rectal bleeding comes from the colon, rectum, or anus. The colon is the part of the gastrointestinal tract through which food passes after it has been digested in the small intestine. The colon is primarily responsible for removing water from the undigested food and storing it until it is eliminated from the body as stool. The rectum is the last 15 cm of the colon. The anus (anal canal) is the opening through which stool passes when it is being eliminated from the body. Together, the colon, rectum, and anus form a long (several feet in length), muscular tube that also is known as the large intestine, large bowel, or the lower gastrointestinal tract. (The esophagus, stomach, duodenum, and small intestine are referred to as the upper gastrointestinal tract.)

The colon can be divided further into three regions; the right colon, the transverse colon, and the left colon. The right colon, also known as the ascending colon, is the part of the colon into which undigested food from the small intestine is first deposited. It is furthest from the rectum and anus. The transverse colon forms a bridge between the right and the left colon. The left colon is made up of the descending colon and the sigmoid colon. The sigmoid colon connects the descending colon to the rectum.

The color of blood during rectal bleeding often depends on the location of the bleeding in the gastrointestinal tract. Generally, the closer the bleeding site is to the anus, the brighter red the blood will be. Thus, bleeding from the anus, rectum, and the sigmoid colon tends to be bright red, whereas bleeding from the transverse colon and the right colon tends to be dark red or maroon-colored.

In some patients bleeding from the right colon can be black, "tarry" (sticky) and foul smelling. The black, smelly and tarry stool is called melena. Melena occurs when the bleeding is in the stomach where the blood is exposed to acid or is in the small intestine or colon for a long enough period of time for the intestinal bacteria to break it down into chemicals (hematin) that are black. Therefore, melena usually signifies that the bleeding is from the upper gastrointestinal tract (for example, bleeding from ulcers in the stomach or the duodenum or from the small intestine) because the blood is exposed to stomach acid or is in the intestines for a longer period of time before it exits the body. Although it is possible for melena to occur with bleeding from the right colon, blood from the sigmoid colon and the rectum usually does not stay in the colon long enough for the bacteria to turn it black.

Rarely, massive bleeding from the right colon, from the small intestine, or from ulcers of the stomach or duodenum can cause rapid transit of the blood through the gastrointestinal tract and result in bright red rectal bleeding. In these situations, the blood is moving through the colon so rapidly that there is not enough time for the bacteria to turn the blood black. Sometimes, bleeding from the gastrointestinal tract (upper or lower) will be so minimal that it will not cause either rectal bleeding or melena. In such situations, blood can be found only by the use of special tests done on samples of stool. (See occult gastrointestinal bleeding)

Occult gastrointestinal bleeding

Rectal bleeding needs to be distinguished from another type of gastrointestinal bleeding, occult gastrointestinal bleeding. Occult gastrointestinal bleeding refers to a slow loss of blood into the upper or lower gastrointestinal tract that does not change the color of the stool or result in the presence of visible bright red blood. The blood is detected only by testing the stool for blood (fecal occult blood testing) in the laboratory. Occult bleeding has many of the same causes as rectal bleeding and may result in the same symptoms as rectal bleeding. For example, slow bleeding from ulcers, colon polyps, or cancers can cause small amounts of blood to mix and be lost within the stool. It is often associated with anemia that is due to loss of iron along with the blood (iron deficiency anemia).

What are the causes of rectal bleeding?

Many diseases and conditions can cause rectal bleeding. Common causes include:

anal fissures,
hemorrhoids,
cancers and polyps of the rectum and colon,
diverticulosis,
abnormal blood vessels (angiodysplasia),
ulcerative colitis,
ulcerative proctitis,
Crohn's colitis,
infectious colitis,
ischemic colitis, and
Meckel's diverticula.

Anal Fissure

An anal fissure is a fairly common, painful condition in which the lining of the anal canal is torn. An anal fissure is caused by constipation or a forceful bowel movement, though a tight anal muscle also may be a contributing factor. Once the skin is torn, each subsequent bowel movement can be painful, and the pain often is severe. The amount of bleeding that occurs with an anal fissure is small and usually is noticed in the toilet bowl or on the toilet paper as bright red in color. The symptoms of an anal fissure are commonly mistaken for hemorrhoids, but hemorrhoids generally do not cause pain with bowel movements.

Hemorrhoids

Hemorrhoids are masses or clumps ("cushions") of tissue within the anal canal that contain blood vessels. Although most people think hemorrhoids are abnormal, they are present in everyone. It is only when the hemorrhoidal cushions enlarge that hemorrhoids can cause problems (such as bleeding or anal discomfort) and be considered abnormal or a disease. Like anal fissures, bleeding from hemorrhoids is usually mild and does not cause anemia or low blood pressure. Rarely, a person may develop an iron deficiency anemia as a result of repeated hemorrhoidal bleeding over several months to years.

Gum Disease

2012-02-06T10:13:00.000+08:00

Do you think gum disease is something that only happens to people your grandparents' age? Think again! Teens can get gum disease too, and it can cause problems from the simply embarrassing (like bad breath) to the serious — like pain and tooth loss (which is both embarrassing and serious!).

What Is Gum Disease?

Gum disease is also known as periodontal (pronounced: per-ee-oh-don-tul) disease.

Periodontal disease is an infection of the tissues and bone that support the teeth. Untreated gum disease can become very serious, causing teeth to become loose or fall out.

Gum disease is usually caused by a buildup of plaque, an invisible sticky layer of germs that forms naturally on the teeth and gums. Plaque contains bacteria, which produce toxins that irritate and damage the gums.

Hundreds of types of bacteria live in the mouth, so keeping plaque at bay is a constant battle. That's why brushing and flossing every day — and regular trips to the dentist — are so important.

Who Is at Risk?

Certain things can make teens more likely to develop gum disease. Some may inherit this tendency from their parents. The snacks you eat also can put you at risk of developing gum disease — especially if you grab fries and a soda in the mall after school and aren't able to brush immediately after eating them. You probably know that sugar is bad for your teeth, but you may not know that starchy foods like fries also feed the acids that eat into your tooth enamel.

If you have braces, fending off plaque can be tougher. Plus, some medical conditions (including diabetes and Down syndrome) and certain medicines increase the risk of gum disease.
Running yourself down with a lousy diet, too little sleep, and too much stress leaves you more vulnerable to infection anywhere in the body, including your gums.
Girls have a higher risk of gum disease than guys. Increases in female sex hormones during puberty can make girls' gums more sensitive to irritation. Some girls may notice that their gums bleed a bit in the days before their periods.

For severe — and early — gum problems, though, the real bad guy is tobacco. Not only does smoking lead to bad breath and stained, yellowed teeth but recent research also shows that smoking is a leading cause of gum disease.
According to the American Dental Association (ADA), people who smoke cigarettes and chew tobacco are more likely to have plaque and tartar buildup and to show signs of advanced gum disease. They are also more likely to develop mouth cancer in the future.

ow It Progresses

Gum disease progresses in stages. Believe it or not, more than half of teens have some form of gum disease.

Do your gums bleed when you floss or brush your teeth? Chances are you already have the mildest form of gum disease — bleeding gums are usually a sign of gingivitis (pronounced: jin-juh-vy-tus). Other warning signs of gingivitis include gum tenderness, redness, or puffiness.

If plaque from teeth and gums isn't removed by good daily dental care, over time it will harden into a crust called calculus or tartar. Once tartar forms, it starts to destroy gum tissue, causing gums to bleed and pull away from the teeth. This is known as periodontitis (pronounced: per-ee-oh-don-ty-tus), a more advanced form of gum disease.

With periodontitis, gums become weakened and form pockets around the base of teeth. Bacteria pool in these pockets, causing further destruction of the gums. As periodontitis spreads, it damages deeper gum tissue and can eventually spread to areas of the jawbone that support the teeth. This can cause teeth to become loose and fall out. Though periodontitis is rare in teens, it can happen. If it's not treated, it can cause real trouble for your teeth.

What should you do to avoid these problems? See your dentist if you notice any of these signs of gum disease:

bleeding of the gums that occurs regularly when brushing or flossing
discoloration of gums (healthy gums should look pink and firm, not red, swollen, or tender)
any sign of gums pulling away from teeth
bad breath that won't go away
loose teeth

Tracking It Down and Treating It

Gum disease can be sneaky, sometimes causing little or no pain or irritation before permanent damage is done to your teeth. That's why regular dentist visits are a must. With X-rays and a thorough examination, a dentist or dental hygienist can spot trouble before you know it's there.

The earlier that gum disease is caught, the better. Adopting better brushing and flossing habits can usually reverse gingivitis. Sometimes your dentist will also prescribe antibiotics or a special antibacterial mouth rinse to tackle the problem.

Once someone develops periodontitis, it isn't as easy to control. Usually there is widespread infection of the gums that needs to be treated. This may require several special treatments either by a dentist or a periodontist, an expert who specializes in the care of gum disease.

Some of the ways dentists and periodontists may treat periodontitis are:

Scaling or root planing. These deep-cleaning measures involve scraping and removing plaque and tartar from teeth above and below the gum line.
Antibiotics. These and other medications are often used together with scaling and root planing to stop the spread of infection and inflammation in the mouth. They come in several different forms that range from medicated mouthwashes to antibiotic-containing gels or fibers that are placed in gum pockets to slowly kill bacteria and help gums to heal.
Surgery. Advanced cases of periodontitis may require a dentist to open and clean badly diseased gum pockets, then stitch the gums back into place to fit more snugly around the teeth.
Gingival grafting. If gum tissue is too diseased to sew back together, a dentist removes healthy gum tissue from another part of the mouth and stitches it into place. The graft replaces the diseased tissue and helps to anchor the teeth, giving them an improved appearance.

While undergoing treatment for periodontitis, it's especially important to take special care of your teeth and gums to see lasting improvement. This includes flossing and brushing every day and quitting habits that mean bad news for the mouth, such as smoking or eating sugary snacks between meals.

Prevention Tips

Fortunately, there's good news: Gum disease is usually preventable. Just take care of your teeth, starting now. Don't wait!

Brush twice a day for at least 3 minutes each time (about the length of your favorite song) and floss daily. If you're not sure whether you're brushing or flossing properly, your dentist or dental hygienist can show you the best techniques.
Always brush with a toothpaste that contains fluoride; some dentists also recommend daily mouth rinses containing fluoride.
Use a toothbrush with soft, polished bristles, as these are less likely to irritate or injure gum tissue. Be sure to replace your toothbrush at least every 3 to 4 months — a worn-out toothbrush can injure your gums. (Some toothbrush brands contain color indicators on the bristles to remind you to replace them when they become worn.)
Eat a healthy diet. Avoid snacks and junk foods packed with sugar that plaque-causing bacteria love to feed on.
Don't smoke! Cigarettes and chewing tobacco cause mouth irritation and are very unhealthy for gums and teeth.
Regular dental care is extremely important in helping to keep your mouth healthy. Visit your dentist for routine care — especially cleaning — at least twice a year. Your dentist can remove hardened plaque and any tartar that you're not getting to with brushing or flossing.

Reviewed by: Charlie J. Inga, DDS
Date reviewed: November 2011

Colonic Diverticular Disease

2012-01-08T08:38:00.002+08:00

Colonic diverticulosis is among the most common diseases in developed Western countries. In the United States, diverticulosis occurs in approximately one third of the population older than age 45 and in up to two thirds of the population older than 85 years,^1,2 and it also affects a significant proportion of younger adults.

Figure 1: Click to Enlarge

Definition and causes

A diverticulum is a saclike protrusion in the colonic wall that develops as a result of herniation of the mucosa and submucosa through points of weakness in the muscular wall of the colon. The colonic diverticulum is a false or pulsion diverticulum-that is, it does not contain all layers of the colonic wall. Diverticulosis indicates the presence of multiple diverticula and generally implies an absence of symptoms (Fig. 1). Diverticular disease implies any clinical state caused by diverticula, including hemorrhage, inflammation, or their complications. Diverticulitis describes the presence of an inflammatory process associated with diverticula. Its pathogenesis is attributed to genetic and environmental factors (Box 1).

Genetic factors

Environmental factors

Low-fiber diet
Obesity
Decreased physical activity
Corticosteroids
NSAIDs
Alcohol
Caffeine intake
Cigarette smoking
Polycystic kidney disease

Epidemiologic factors

Age
Geography
Life style
Ethnicity

Treatment

Medical Treatment

Complicated diverticulitis refers to acute diverticulitis accompanied by abscess, fistula, obstruction, or free
intra-abdominal perforation. In the absence of complications and systemic signs and symptoms, patients with mild abdominal tenderness may be treated conservatively. Conservative treatment typically includes dietary modification and oral or IV antibiotics. This has been shown to be successful in 70% to 100% of patients.^37,38,40
Uncomplicated diverticulitis may be managed in the outpatient setting with dietary modification and oral antibiotics for those without fever, excessive vomiting, or marked peritonitis, as long as there is the opportunity for follow-up. If these conditions are not met or the patient fails to improve with outpatient therapy, hospital admission is required.
Antibiotic selection should be based on appropriate coverage for gram-negative rods and anaerobic bacteria.⁴¹ Conservative treatment will resolve acute diverticulitis in 85% of patients, but approximately one third will have a recurrent attack, often within a year.^5,42,43
After recovery from the first episode, use of fiber prevents recurrence in more than 70% of patients.^44,45 Immunosuppressed or immunocompromised patients are more likely to present with perforation and fail medical treatment.^41,42,46
Approximately 15% of patients develop pericolonic or intramesenteric abscess.^47,48 Abscesses smaller than 2 cm in diameter may resolve with antibiotic treatment without any further intervention, whereas larger abscesses may require percutaneous drainage. This may prevent an emergency operation and multistaged surgeries involving the creation and closure of stoma.^42,48,49

Figure 3: Click to Enlarge

After resolution of the initial acute attack, the colon should be thoroughly evaluated with colonoscopy or contrast enema radiography.

Surgical Treatment

Surgical treatment of the disease can be evaluated emergently or electively, based on the stage of the disease and clinical presentation. Emergent sigmoid colectomy is required for patients with the following:

Diffuse peritonitis
Failure of conservative treatment
Persistent sepsis despite percutaneous drainage
Very low threshold, immunosuppressed, and immunocompromised patients who are likely to fail medical treatment and present with perforation.

Intraoperative surgical options are based on the status of the patient and the severity of intra-abdominal contamination (Hinchey classification; Box 6 and Figs. 3 to 6).⁵⁰ The desired surgical option is resection of the diseased segment with primary anastomosis, with or without intraoperative lavage or resection, and anastomosis with a temporary diverting ileostomy (Figs. 7 and 8). In advanced stages of peritonitis, Hartmann's procedure (sigmoid colectomy, end colostomy, and closure of the rectal stump; Fig. 9) is the preferred operation, but it has been shown that the closure operation (Hartmann's reversal) is not only technically challenging, but may be also associated with significant postoperative morbidity and mortality.⁵¹

Box 6: Hinchey Classification
Stage I: Diverticulitis with confined paracolic abscess
Stage II: Diverticulitis with distant (pelvic, retroperitoneal) abscess
Stage III: Diverticulitis with purulent peritonitis
Stage IV: Diverticulitis with fecal peritonitis

Figure 4: Click to Enlarge

The decision for elective colectomy after recovery from acute diverticulitis should be made on a case by case basis. After the first attack, about one third of the patients will have a later, second attack. After the second attack, another one third of patients will have another attack.^40,42 Factors affecting decision making for elective surgery include the following:

Age
Medical condition of the patient
Frequency, persistence, and severity of the attacks
CT-graded severity of the attack as a predictor of failure of medical treatment and possible risk of secondary complications
Inability to exclude carcinoma.
Conservative treatment of a complicated diverticulitis attack

There is no clear consensus regarding two widely debated points in management. First, the number of attacks of uncomplicated diverticulitis is not necessarily a determinant for appropriateness of surgery, because it has been shown that elective surgery after recovery from uncomplicated episodes might not decrease the likelihood of later emergency surgery or overall mortality.^40,46,52-54 Second, patients younger than 50 years may have a higher cumulative risk for recurrent diverticulitis; however, whether they are at increased risk of complications or recurrent attacks remains debatable.^{5,28,40-42,54}

Figure 5: Click to Enlarge

There are several important points regarding surgical technique. From a technical standpoint, the resection should be carried proximally to the compliant bowel and extend distally to the upper rectum. After sigmoid colectomy, an important predictor of recurrence is a colosigmoid rather than colorectal anastomosis. The proximal margin of resection should be in an area of pliable colon without hypertrophy or inflammation. Resection of the diseased colon must be the desired goal, along with removal of the entire thickened colonic segment(s) but not necessarily all the proximal diverticula-bearing colon. Laparoscopic colectomy is appropriate in select patients and has advantages over open laparotomy, including less pain, smaller incisions, and shorter recovery. There is no increase in early and late complications^55,56 and cost and outcome are comparable with those of open resection.⁵⁷
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Prevention

Prevention can be achieved by elimination of the factors involved in the pathogenesis of this disease (see Box 1). Increasing the proportion of fiber in the diet, along with an increase in fluid intake, will help keep more diverticula from forming and also will help keep the existing condition from worsening. Additionally, alteration of lifestyle by weight reduction and exercise can limit the contribution of other causative factors.
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Special circumstances

There are special circumstances in which the general recommendations for the diagnostic workup and treatment of diverticulitis may not apply. These are closely associated with the presence of factors such as manifestation of the disease, patient's response to the disease, and treatment.

Summary

The incidence of diverticular disease, particularly diverticulitis, has increased in industrialized countries.
Diverticular disease can be classified as symptomatic uncomplicated disease, recurrent symptomatic disease, and complicated disease.
Conservative or medical management is usually indicated for acute uncomplicated diverticulitis. Indications for surgery include recurrent attacks and complications of the disease.
Surgical treatment options have changed considerably over the years, along with the development of new diagnostic tools and surgical approaches.
Indications and timing for surgery of diverticular disease are determined mainly by the stage of the disease. In addition, individual patient risk factors, along with the course of the disease after conservative or operative therapy, play a significant role in decision making and treatment.

Hearts

2012-01-01T11:49:00.000+08:00

2 Hearts 2 talk

After a good movie that touches my heart, guess is time to share out with people of hearts out there.
We should have two hearts.
A heart that we learnt in Science. Then another heart:
A heart that should be perfect full.
Perfect full of memories, experiences,emotions with loves from heros and heroins.
It's a heart that owns us, and belong to us.

Best of hearts from people around us
It's a wonderful feeling to have 2 hearts,
One to keep us alive,
One to make our life shines.
After all,
we have a perfect heart that will touches someone's heart and shines.
- A tribute to my dad -
You are home in our heart.

History of 2011, 7 nights 8 days at a hospital

2012-01-01T11:31:00.000+08:00

I called it 7 nights 8 days as it changed me a bit again, another experience of my life, this time in a hospital! At least not a ghost house!
You can say it sure was not a pleasant one to have but, essential to do it of some very moral doing and thinking, more to family stuff. Some times you just need to do some thing that you ought to do, as a member of a family! Just planning to write in blog after going through the draft made in hospital.

I had to write using my sleek hand phone in the dark, and save to draft as everyone seemed to be sleeping even though not enjoying in the bed in hospital, what you expect! You might be thinking what about myself! Well, I considered lucky enough with the blue and white strap folding chair for me to get some sleep, even though not much!

I never thought that taking care of the elderly is much worse than the babies I had in the previous years..or I might go for more....ha!
People said you will never learn what is happiness without going through the sadness, true enough, that was my feeling after the 7 & 8 X.
To be continue..............

A New Year again!

2012-01-01T10:32:00.004+08:00

Ya, sure it's another new year.
So, seemed like as usual everyone look back as history, and look front for hope and wishes. Lots of fireworks, wishes, shows, discounts, more visions and missions and many more.
Guess that's the way people celebrate new year every time! A bit bored but that's how it is life on earth for us. Anyone has better suggestions, out there?
As for me, I watched movies and stuck at home until the morning, alone, Well, not exactly, my 2nd watched with me, the 3rd sleeping and the eldest some where watching fireworks and sms me. As for the partner, sleeping ahead for the next day cycling, with friends. Guess if this is going to go on every year, I might as well go some where else to enjoy than to wait at home. Lost my mood of doing any thing when think of that.

Hey! Those of you out there who are having families, do spent time with your family and not friends unless you don't have any better thing to do at all and are alone. Time like this are meant to spent with members of family and not others. Who will take care of you all the time if not the members of family. Your friends can only visit you and may be a better one might take care you for some times but not all the time, right! So wake up and see who are waiting to spent time with you during festive seasons. Leaving them and enjoying yourself out there with the others makes them sick and will plan for something else the next time.

Looks like this very new year I am not satisfied with the outcome even though it's different with the usual doing. How many of you with families are doing that? And what do you expect your family members to do, waiting for you at home while you having fun out there!
Ya, sure I got it. I or we can join them as well but it's some thing that I/we don't wish to do!
Do ask what your family members what they wish to do during festive seasons and not planning your own fun and left them out!
Just a friendly reminder that family means together.
Ohana!
Ohana means family, family means nobody....gets left behind....or forgotten....by the alien, Stitch.
Ya, may be too influence by the emotional story.
Any way,
Happy 2012 Year!!! Another year to make history and do remember your family!

stpm final papers 2011 need to refer to the 2help blog on your right

2011-11-02T19:34:00.001+08:00

Best of luck in STPM
Pahang - Perakaunan, P.Perniagaan, P. A

check out 2 hearts 2 talk at http://stpmacctgdayc.blogspot.com

2011-07-26T21:58:00.005+08:00

How to create champions from sports?

2011-07-25T22:09:00.005+08:00

Guess it's time to write on sports.
Just felt frustration, when people became selfish in sports, be the one who organize or the one in charge, short sighted in future achievement and as such, fail to gain respect and victimized the true talented athletes.
To be continue............

It is immoral to link your advertisement attached2someone's writing without permission

2011-07-22T16:49:00.005+08:00

Motivation is needed all the time for everyone - Butterfly that never fly, refer e store & beauty

2011-07-22T15:27:00.010+08:00

old age story

2011-07-13T22:19:00.001+08:00

Old age is what people are afraid of mostly, be our parents or any old folks out there:
Some are afraid to die painfully.
Some couldn't face it and plan to make it short by suicide.
Some live poorly each and every day, yet they insist to live.
Some have to live with lots of medicine around and each day.
Some need to go in and out of the hospital frequently, seeing doctors more than their children.
Some try to eat healthily just to hope to live longer or leave peacefully and less pain.
Some were abandon and live in old folk home waiting for time to end.
Some are still on the streets walking around, holding out hands for donations.

However, you can still find:
Some are eager to live longer even though knowing time is near, fighting for life.
Some are eager to live more with sickness at final stage, fighting for recovery.
Some are hoping to recover and live for a little more time hoping for more traveling.
Some are sick but remain positive and able to live which creates miracle to people around them.
Some are taking lots of medicine each and every day, hoping will recover totally one day.
Some are happy that the children are nearer to them when their day are near the end.
Some are relieve that someone still care for them even though they are busy trying to survive each day .
Some take up singing, dancing, cooking, exercise each day to make their life colorful without thinking of ending.

What about you?

Just live each and every day and appreciate the life you have.
For no one knows the end of the day we will have.
A day will still pass whether you are happy or not.
Old and death is the same path everyone needs to face and walk on it bravely, without any more fear.
For you have live your life to the fullest! Yeah!

Ambiga's wishlist

2011-07-11T18:58:00.000+08:00

Bersih 2.0, as the organisation has branded itself for the 2011 rally, is chaired by former Bar Council president Ambiga Sreenevasan. Ambiga served as president of the Bar from 2007 to 2009 and is a recipient of the U.S. State Department's International Women of Courage Awards.

Ambiga has summed up the main issues raised by the organisation she leads as "unhappiness... in the Sarawak [election], unhappiness about corruption, [and] unhappiness about the independence of our institutions."^[25] She said demands made during the first rally in 2007 have not been addressed, hence the follow-up rally.^[20]
The communiqué issued by Bersih issued in 2007 called for reforms to Malaysia's first past the post electoral system, ensuring the independence of the Election Commission (EC), eliminating electoral practices deemed unfair to opposition candidates, eliminating corrupt campaign practices, equal access to the media for all political parties, and instituting a caretaker government during election periods, among others in the long term.^[26] It also asked for immediate action to introduce indelible ink to prevent multiple voting, the abolition of postal votes, a complete revision of the electoral roll and equal access to state-owned media for all political parties.

Be Heard & wanted change - Bersih

2011-07-11T18:45:00.001+08:00

Their objective is to be heard of a fair way of election, that's what the 'Bersih' wants and aims.
If the government is willing to be open and listen to the view, no rally would be held, would it?
The view was not being taken into consideration since 2007, that's why the rally need to be done as to show what their objective is!
A fair and free election!!
Is not too much,
is needed and
is supported as is what the rakyat wants.
Because it is what you call 'demokrasi'.
The world is full of unfairness, but we need to cut down most of it if not all.
This is one of the voice, so listen!!

No one wants rally, or anything that will make the country worsen.
But if there are no options given, then something needs to be done!
And it really take lots of courage and sacrifices to.....
Voice up!
Be Heard!
Be sensitive to the wants!
Be FAIR in your doings!
That's what all of us want!
Don't turn away their voice as it will be picked up by someone against you, definitely, whether they are taking advantage or not!
If you think there are silent supporters,
There are silent oppositions too, out there! Watching closely!
When things went too wrong,
People will fight for it!
If not, who do not want PEACE!
No one wish to do this unless there is something wrong, some where?
Some party might take advantage, just as you know, but if you do not bother, what you expect the fair ones to do? To turn to?
Do you think once the country's economic situation is improved and household incomes are increased, Malaysians would be happier and the BN government would receive more support. Yes, they will, if there is a fair and transparent election to go with it!
Do you think by hoping to or just make them keep quite again by scary tales will turn them away? No, they will never let it be, knowing the unfairness are there, taking all the risks, as they are fighting for truth, nothing but the truth!

Thus, no options, no chance to be heard. Only the united group walking in the street will pull their attention, don't you think it is so effective?
That's why we can see all types of rally in our world, as they are refuse to be heard, so they need to act to be heard!!
So, let's open up your arms and listen.

We have a youth voice up previously!
Now, we have a group voice up recently!
What next?

Do you need the whole world to act to make you listen!
Don't let situation gone out of hands!
Don't regret when it's too late!
Don't destroy a country just build up using unfairness!
Because it is very unfair to the people in it!
FAIR is what everyone wants and a country need to stay in PEACE thru fairness.
Don't put our country on the list of disturb or problem countries!

Bersih - what Malaysians want & what you need to know

2011-07-09T18:05:00.003+08:00

Automatic voter registration
Reforms to postal voting
Use of indelible ink
Access to the mainstream media for opposition parties
A minimum campaign period of 21 days
Independence of institutions
An end to electoral graft

Indelible ink

Indelible means "un-removable". Some types of indelible ink have a very short shelf life because of the quickly evaporating solvents used. India, Philippines, Indonesia and other developing countries have used indelible ink the form of electoral stain to prevent electoral fraud. The Election Commission in India has used indelible ink for many elections. Indonesia used it in their last election in Aceh. In Mali, the ink is applied to the fingernail. Indelible ink itself is not infallible as it can be used to commit electoral fraud by marking opponent party members before they have chances to cast their votes. There are also reports of 'indelible' ink washing off voters' fingers.^[14]
Postal voting describes the method of voting in an election whereby ballot papers are distributed and/or returned by post to electors, in contrast to electors voting in person at a polling station or electronically via an electronic voting system.
It is of benefit to people who may not be able to attend a polling station in person, either through a physical disability or absence from the locality. This method of voting is available to voters upon application (sometimes with restrictions) in statutory elections in many democratic nations.
On the other hand, concerns about postal voting have been raised as to whether it complies with the requirements of a secret ballot, in that people cast their vote outside the security of a polling station, and whether voters can cast their vote privately free from another person's coercion. There have been cases of electoral fraud with postal votes in the United Kingdom (including in Birmingham at the 2004 European and local government elections in the UK)^[1]^[2]^[3]
Postal voting can be a way to prevent manipulation of an election through "get out the vote" efforts, for instance, in state conventions of a society, in which supporters of a cause or candidate transport in their supporters by bus in order to vote and then bus them home again.
Voter registration is the requirement in some democracies for citizens and residents to check in with some central registry specifically for the purpose of being allowed to vote in elections. An effort to get people to register is known as a voter registration drive.

Effects and controversy

Laws requiring individual voters to register, as opposed to having the government register people automatically, have a strong correlation with lower numbers of people turning out to vote where voting is voluntary. This lower turnout is especially concentrated among low-income voters and young voters — i.e., those least likely to vote no matter what the registration requirements.^{[citation needed]} Because of this, such laws are often controversial. Some advocate for their abolition, while others argue that the laws should be reformed, for instance: allowing voters to register on the day of the election. This tactic, called Election Day Registration, has been adopted by several U.S. states: Connecticut, Idaho, Iowa, Maine, Minnesota, Montana, New Hampshire, Wisconsin and Wyoming.
A political campaign is an organized effort which seeks to influence the decision making process within a specific group. In democracies, political campaigns often refer to electoral campaigns, wherein representatives are chosen or referendums are decided.
Electoral fraud is illegal interference with the process of an election. Acts of fraud affect vote counts to bring about an election result, whether by increasing the vote share of the favored candidate, depressing the vote share of the rival candidates or both. Also called voter fraud, the mechanisms involved include illegal voter registration, intimidation at polls and improper vote counting. What electoral fraud is under law varies from country to country.
Many kinds of voter fraud are outlawed in electoral legislation but others are in violation of general laws such as those banning assault, harassment or libel. Although technically the term 'electoral fraud' covers only those acts which are illegal, the term is sometimes used to describe acts which although legal, are considered to be morally unacceptable, outside the spirit of electoral laws or in violation of the principles of democracy. Show elections, in which only one candidate can win, are sometimes considered to be electoral fraud although they may comply with the law.
In national elections, successful electoral fraud can have the effect of a coup d'état or corruption of democracy. In a narrow election a small amount of fraud may be enough to change the result. If the result is not affected, fraud can still have a damaging effect if not punished, as it can reduce voters' confidence in democracy. Even the perception of fraud can be damaging as it makes people less inclined to accept election results. This can lead to the breakdown of democracy and the establishment of a dictatorship.
Electoral fraud is not limited to political polls and can happen in any election where the potential gain is worth the risk for the cheater; as in elections for labor union officials, student councils, sports judging, and the awarding of merit to books, films, music or television programmes.
Despite many instances of electoral fraud, it remains a difficult phenomenon to study. This follows from its inherent illegality. Harsh penalties aimed at deterring electoral fraud make it likely that individuals who perpetrate fraud do so with the expectation that it either will not be discovered or will be excused.
The media of Malaysia include television, radio, newspapers, and web-based media such as bloggers. Many media outlets are either owned directly by the government of Malaysia (e.g. Bernama) or owned by component parties of the Barisan Nasional coalition government (e.g. the Media Prima group, which is owned by the United Malays National Organisation).

Freedom

The regulated freedom of the press has been criticised. Although critics concede that journalists "probably won’t be hauled off and shot" for being critical of the government, it has been claimed that the government creates a chilling effect through threats of reduced employment opportunities and refusing journalists' family members "a place at one of the better public universities". Legislation such as the Printing Presses and Publications Act have also been cited as curtailing freedom of expression.^[1]
In 2007, a government agency — the Malaysian Communications and Multimedia Commission — issued a directive to all private television and radio stations to refrain from broadcasting speeches made by opposition leaders.^[2] The move was condemned by politicians from the opposition Democratic Action Party.^[3] The directive was later withdrawn by the Energy, Water and Communications Ministry.^[4]

Hope of Bersih purpose for free and fair act in election as fallen on deaf ears

2011-07-09T18:03:00.000+08:00

Wikepedia news (source):
The 2011 Bersih 2.0 rally (also called the Walk for Democracy) is a demonstration in Kuala Lumpur held on 9 July as a follow-up to the 2007 Bersih rally. The rally, organised by the Coalition for Clean and Fair Elections (Bersih), is supported by Pakatan Rakyat, the coalition of the three largest opposition parties in Malaysia but has been deemed illegal by the government. Bersih, chaired by former president of the Bar Council Ambiga Sreenevasan, are pushing the Election Commission of Malaysia (EC) to ensure free and fair elections in Malaysia. It has demanded that the EC clean up the electoral roll, reform postal voting, use indelible ink, introduce a minimum 21-day campaign period, allow all parties free access to the media, and put an end to electoral fraud.
Public gatherings without police permits are illegal in Malaysia. The police have vowed to stop any rallies from taking place on the day. Having originally planned to march through the streets of Kuala Lumpur, Bersih has decided to hold its rally at Merdeka Stadium after consultations with the Yang di-Pertuan Agong, Malaysia's head of state.
Two counter-rallies, led by Malay nationalist movement Perkasa and the youth division of the ruling United Malays National Organisation (UMNO), were initially announced. Perkasa called off its counter-rally due to the inability to secure a venue and permit.
The rally was attended by more then 20,000 people, who entered the city from various points. However, the protestors were unable to congregate at Merdeka Stadium as many were forced to disperse by police who were heavily deployed throughout the city. Many Bersih and opposition figures, including Ambiga, were arrested. Police revealed they arrested more than 600 people.
Supporters of Bersih claim that demands for electoral reform made during the 2007 demonstration have fallen on deaf ears. Meanwhile, detractors of Bersih and supporters of the Perkasa and UMNO Youth counter-rallies dismissed Bersih's demands for electoral reform as well as accused Bersih of, among others, harbouring an opposition political agenda, attempting a coup d'état, and threatening to disrupt public order.

Bersih

A scene from the 2007 rally. Protestors on the left are dressed in yellow. They are met by the Federal Reserve Unit, the riot police (in red helmets). Standing in between the protestors and the riot police are PAS's Jabatan Amal volunteer unit (dressed in maroon).

Bersih, short for the Coalition for Clean and Fair Elections (Malay: Gabungan Pilihanraya Bersih dan Adil), is a coalition of 62 non-governmental organisations founded in November 2006.^[1]^[18] Since its founding, Bersih has been supported by the three main opposition parties, Parti Keadilan Rakyat (PKR), PAS, and DAP.^[18] Bersih is the Malay word for "clean."^[19]
The first Bersih rally on 10 November 2007 was estimated to have drawn between 30,000 to 50,000 people.^[16]^[20] It was broken up by police using tear gas and chemical-laced water cannons.^[16]^[21] The rally was said to play a major role in helping the opposition parties make big gains in the 2008 general election.^[20]^[22]
Bersih 2.0, as the organisation has branded itself for the 2011 rally, is chaired by former Bar Council president Ambiga Sreenevasan. Ambiga served as president of the Bar from 2007 to 2009 and is a recipient of the U.S. State Department's International Women of Courage Awards.^[23]^[24]

[edit] Demands

Ambiga has summed up the main issues raised by the organisation she leads as "unhappiness... in the Sarawak [election], unhappiness about corruption, [and] unhappiness about the independence of our institutions."^[25] She said demands made during the first rally in 2007 have not been addressed, hence the follow-up rally.^[20]
The communiqué issued by Bersih issued in 2007 called for reforms to Malaysia's first past the post electoral system, ensuring the independence of the Election Commission (EC), eliminating electoral practices deemed unfair to opposition candidates, eliminating corrupt campaign practices, equal access to the media for all political parties, and instituting a caretaker government during election periods, among others in the long term.^[26] It also asked for immediate action to introduce indelible ink to prevent multiple voting, the abolition of postal votes, a complete revision of the electoral roll and equal access to state-owned media for all political parties.^[26] A statement on 15 June also called for:^[27]

Automatic voter registration
Reforms to postal voting
Use of indelible ink
Access to the mainstream media for opposition parties
A minimum campaign period of 21 days
Independence of institutions
An end to electoral graft

After agreeing to abandon plans for a street demonstration, Bersih also called for a Royal Commission into election practices.^[28]

Realiti of scholarships finally

2011-06-20T19:53:00.002+08:00

After a few months of controversy on the scholarships.
It appeared to be an impossible dream for most of the appealing. This also meant that whatever the political party had predicted if this problem are not solve will come true.
Let's recall what they had predicted.

[Dr Wee said these government officers set their own selection criteria and did not follow what the Cabinet had decided.

“If this trend continues, many Barisan Nasional parties will have to close shop because such a practice will only scare away young voters.
“Many talented young people will also be driven away and this will make the brain drain problem even worse,” he told a press conference at Wisma MCA yesterday.
Dr Wee said students who scored full A+ in the SPM examination were not given priority during the selection process, and were only offered open scholarships for government matriculation programmes or vacancies at local universities.
An open scholarship for matriculation studies is financial assistance given to students only after they have obtained good results during their first year in the programme.
“However, students who obtained poorer results were awarded scholarships to study at universities overseas,” he said.]

Looks like whatever they had predicted will happen after all, as they don't really care any more.
We can roughly know what is going to happen during the election as they failed to fight or show their influence in the matter.
What they had achieved are for those who are scored all A+ in all their subjects. This meant that those who are taking the subject of Mandarin will be a loser as only a handful of them scored A+ in Mandarin.
So, some students with 10A+ and A in Mandarin will not have the opportunity at all as previously hoping eagerly yet disappointed for the second time. As for those who are taking 9 or 10 subjects without Mandarin are consider lucky as their appeal are look into.
Those students who are already in matriculation was told that their cases are not looking into as they are consider bad luck to be in that group. This was told by the matriculation students where officers from JPA held a meeting with them recently. As for the diploma cases, they are being taken care of and given the choice of the field they intent to pursue, better than those in matriculation.
What do you think of the JPA officers' answers will affect the students? Think again. Of course, they have created a group of unhappy ones and they have decided what to do in future, definitely. How can we blame them as they are not treated the right way it should or given a better reason for not getting any changes! Just given a reason of 'nasib tak baik'.
The situation is just like asking the students to love and yet they are not being love!
This also meant that those students taking more subjects especially mandarin will be on the losing side.
What should the students do to their mother tongue that they love? This will surely affect some of them if not many.
Another sad ending.
It's better that the political party involved should not have taken up this responsibility as the risk of not fulfilling are high. However, they had tried and it only showed how much they can! A pity job that will definitely affected the trust given.

Runners4joy: more runs4u

2011-06-12T13:01:00.000+08:00

Runners4joy: more runs4u: "Cherok To'kun Charity Run 2011 Date: 12 Jun 2011 Time: 7am Venue: Padang Awam, Jalan Kolam Cherok Tokun BM Penang Categories: Men and women..."

Runners4joy: April & May run

2011-06-12T13:00:00.000+08:00

Runners4joy: April & May run: "Go Hadyai Marathon 2011 Saturday, May 7, 2011 Penang AAA: Race against time Run for Life Beach Run Penang AAA: Race against t..."

Property man of the year 2010- Dato' Alan Tong Kok Mau, the Condo King

2011-06-10T22:02:00.000+08:00

Watch the video of someone who said:
To be successful, you need to put in a lot of handwork, very hopeful start, encouraging and treat everyone as family.
To be inspire by him of his far sighted vision, watch the video at,

http://www.vervesuites.com/onair6.html

Malaysia scholarship mess and politics interfere - voice of the victims,suggestions, problems

2011-06-07T22:39:00.001+08:00

These are appeals from the students who became victims of the adults doing:

July 13 2011 (The Star) & by M. Rajah (Obviously not farsighted enough) Frankly speaking
(1)
“I am not asking to be sent abroad. I would be very happy just to have the opportunity to further my studies.
“Even those who did not do as well as me were given scholarships and I am sad to have been overlooked,” she said.

It was sad that a financially needy student, who scored 8A+s, did not qualify for the scholarship.
“But the scholarship has instead gone to an 11A+ student whose family can afford his or her tertiary education,”

“On one hand, the purpose of the scholarship is to reward top scorers but on the other hand, what happens to good students who miss the cut marginally but really need assistance?”

Suggestions:
a) why not just publish the full list of recipients with their SPM or STPM results? This will settle the issue once and for all. What is there to hide?
b) there is an urgent need for a total revamp of the award system.
c) it’s only fair that the authorities set aside a larger provision for those from poor and middle-income groups. c) And should those from the poor families not make the number, only then could the remaining awards be given to the deserving rich ones
d) The provision of a quality education is the responsibility of the Government to ensure nation building and prevent the brain drain.
e) scholarships for undergraduate studies should be given out for places in local universities while scholarships for overseas studies should only be given for postgraduate courses.
f) Fair disbursement is the recognition which, will in the long run, encourage our brilliant minds to serve the country.
g) JPA is in obvious need of some of these brilliant minds as well to help put its house in order.

Problems arise:

a) these irregularities arise because of the department officers’ self-interpretation of the current system where the formula for scholarship disbursement is based on allocating 60% of the 1,500 places based on the country’s racial composition, 20% on merit regardless of race, 10% for Sabah and Sarawak bumiputras and the remaining 10% for students who are socially disadvantaged

b) Those who have attained excellent results but are from well-to-do backgrounds should not deprive the deserving students from low- and middle-income families.

c) Often, financial constraints and poverty are the main reasons that hold many brilliant Malaysians back from pursuing higher education, irrespective of race.

d) In the past, priority for the needy was the norm. Sadly, these days it is sometimes who you know who can help pull strings that decides if a scholarship is awarded. Otherwise, it is based on the interpretation of the officers in charge of who is “deserving” and falls under the respective quotas.

e) If the authority that has been given the task to fairly disburse scholarships is unable to carry out its mandate, it reflects a failure on the part of the Government to help deserving brilliant minds to further develop their potential and contribute to the development of the nation.
This in the long-run will only encourage the young minds to look for alternatives elsewhere, such as Singapore that offers scholarships to attract quality workforce from beyond its own borders.

f) should the JPA scholarship controversy remain unsolved, many frustrated parents from the middle-income group will (and some already have), look for scholarship opportunities for their school-going children to join, for example, Singapore’s high schools and junior colleges, just to ensure that they have a clearer path for tertiary education there, instead of in Malaysia.

g) JPA is obviously not far- sighted enough to realise that this perennial controversy over the disbursement of scholar- ships will eventually intensify the current brain drain facing our country.
Being the key recruiting agency for the country, the JPA should take its role seriously in giving recognition to deserving students.

syllabus for Perakaunan Ting. 6

2011-06-07T14:45:00.000+08:00

Perakaunan T6

life

2011-06-05T10:48:00.000+08:00

Life can take away our ages, but not our memories.
People can take away our rights, but not our capabilities.
Time can take away our days, but not our hopes.
Tides can take away the sand, but not the beautiful scenery
Money can take away our opportunities , but not our dreams.
There is always a hope and a dream out there and
we are always able to hope, to dream no matter what happens!
We just need to stand on what we believe and what we are capable and what we want after all.
And live life to the fullest!

Scholarship Realities and Cinderella scholarship

2011-05-25T17:36:00.006+08:00

Scholarships in Malaysia - a Cinderella dream for top scorers
We had seen how the Cinderella dream came true for Kate.
The scholarships in Malaysia is yet another C dream for Malaysian top scorers to realize their dream.
What do you need to do to achieve this type of dream, actually?
Just concentrate on your studies and obtained 11 A+, 10A+ and 9A+ to at least have some chances. Again, not all will get as the measurement for it kept changing from year to year. When you get it, you are consider very lucky.

You don't need to spend too much time on co-curriculum as it serve no purpose at all as they are not considering at all. They always said sports is important, but they never say, we don't look at sport when come to scholarships. A pity statement to highlight, but that is nothing but the truth. So much pushing in that statement making the students all rush to the running events held every year, just to get a certificate of participation and for those good ones, to get a better 'cemerlang' cert of no use.

A proof of it is a girl with 8A+ and 2As with excellent performance in sports, representing states and received awards for zones and winning so many champions in so many running events since primary until secondary; a blackbelt holder in Taekwando; an advance diploma holder in piano performance, failed to get oversea scholarship or twinning scholarship. She only managed to get the matriculation and local university scholarship which is also depending on certain criteria. She is also being consider have some luck than some of them who did not get it at all. Not any party in the politic could help her as she is consider far away from the 11, 10 and 9 A+ who are not actively involved in sports. Everyone around her said, you sure to get, you are so excellent in academics and non academics. Even the HM, her friends, teachers, relatives, beside her family members believed that she will never miss it, yet she was missed as the JPA don't know her, just that simple! An all rounder, they said couldn't even get it, what is so very wrong! Not many are like her, to be good in both. Usually the sports girls or boys don't do that well. However, her fate just faded like them.

This is the reality in Malaysia for those who wish to obtain schorlarships. Just concentrate on studies if you can and obtain 9As and above. Don't waste time like the pity girl who thought she stands a better chance even though with 10As, fulfilling 8A+, and representing using up lots of her time in something that did not help her to gain scholarship. She only learnt that life is hard in Malaysia, you have to be extra on everything and yet the chances of getting it is zero or very slim! This is the cruel side of life you need to face.

There were some even try manipulating to grab the scholarship by putting in some certificates of participation, lower salary and many more. No one knows except the God and you! There will be some rich ones to compete with the poor/middle ones who will not be able to sent their children overseas unless getting a huge loans. Not many will dare to take the move as you will need to repay back with interest.

What can we do about it? Nothing at all or nothing much. May be a bit of complaint here and there. The best is to have your own money to send your child overseas if you are capable. No need to think about this problem if you are rich. Pity to those who are not capable and will need to rely totally on this! It is a sad world after all. However, we will need to pick up ourselves again even though dissapointed and move forward again, hoping for the best to happen!

Guess, that's the only way we have to do to protect ourselves from the hurt and frustration that exist again and again to many of our poor boys and girls who are indeed excellent every year! This will surely make the brain drain even worst, maybe! This will open up their eyes in the chances they will face even more in future.

May God bless them with the uneven treatment they have to receive and be strong for there is always a chance. Don't give up on yourself and just move on, on this very uneven road we are facing as we will be even stronger with all the falls. We just need to stand up and move again. Anyway, you have gain something from being active, you gain friendship, learn to social, learn to adjust yourself in new environment, learning discipline, learn to appreciate and live your life to the fullest compare to others who did nothing but studying. You are an all rounder hard to find and everybody admire you. Because not everyone can be an all rounder person and can't be made. You are special and only the people who knows you know better. Too bad just some party(JPA) don't see it.

As for those lucky ones, just appreciate what you have gained and not asking for even better ones!

PSD havoc - what are the consequences

2011-05-24T19:50:00.000+08:00

Thursday May 19, 2011

Wee: Officers failed to award scholarships according to govt criteria

By NG CHENG YEE
chengyee@thestar.com.my

KUALA LUMPUR: Government officers who failed to follow Cabinet directives is one of the main reasons why top students failed to get the awards, said MCA Youth chief Datuk Dr Wee Ka Siong.
Many students who deserved the scholarships did not get the grants, but those who did not deserve them had successfully obtained the financial assistance, he added.
He described the situation where qualified students were unsuccessful in their scholarship applications was the worst this year in all the years when he handled appeals.
Dr Wee said these government officers set their own selection criteria and did not follow what the Cabinet had decided.

“If this trend continues, many Barisan Nasional parties will have to close shop because such a practice will only scare away young voters.
“Many talented young people will also be driven away and this will make the brain drain problem even worse,” he told a press conference at Wisma MCA yesterday.
Dr Wee said students who scored full A+ in the SPM examination were not given priority during the selection process, and were only offered open scholarships for government matriculation programmes or vacancies at local universities.
An open scholarship for matriculation studies is financial assistance given to students only after they have obtained good results during their first year in the programme.
“However, students who obtained poorer results were awarded scholarships to study at universities overseas,” he said.
Previously, the Government announced that 300 of the 1,500 Public Service Department (PSD) scholarships were given based on merit, regardless of race.
Dr Wee said this figure was sufficient to cater to the 363 full A+ scorers.
One of the students facing this problem is Chan Shu Ren from SMK Chung Ching in Raub, who obtained 11A+ in the SPM examination.
Shu Ren, who was present at the press conference with her father Chan Ah Kau, was offered an open scholarship for the government matriculation programme.
“I have friends from the same school who only obtained 8A+ and 9A+ but received PSD scholarships to study in countries like France and India,” Shu Ren said.

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