Monday, June 20, 2022

4123. FINAL VIDEO. Part 1/2. A stray cat has a gigantic facial abscess. Is it a malar abscess or a cat fight abscess?

YOU TUBE SCRIPT SUMMARY. Video 2/2.  

A stray cat has a gigantic facial abscess. Cat fight or malar abscess? 

HOOK.
Use Video 1/2 HOOK at 0:00 - 0:12 in Part 1/2. 

Images x 2.  BKTP Vet Educational Image.   "Warning to viewer...." Image.

INTRODUCTION.

This 10-year-old female spayed calico cat wandered around the factory premises. The owner saw her swollen face, said to be a duration of 3-4 days. IMAGE THIS CAT and normal cat face.

TREATMENT OF FACIAL ABSCESS IS LANCE AND DRAINAGE Toa Payoh Vets treated her under anaesthesia by lancing and draining the foul-smelling pus from the swelling.

TREATMENT OF MALAR ABSCES IS TOOTH EXTRACTION. Her upper 3rd premolar cheek teeth was loose and decayed, hence confirming that the diagnosis was a MALAR or cheek abscess. This cat's loose malar tooth was extracted by Dr Sing. The other remaining teeth were given a dental scaling if normal.



DIFFERENCE BETWEEN A MALAR AND CAT FIGHT FACIAL ABSCESS In a CAT FIGHT FACIAL ABSCESS, the malar tooth would usually be normal and its roots would be firm. Cat fight abscesses usually do not have loose malar teeth unlike in in this case.




CONCLUSION

In 2022, a stray cat is rarely seen in public. (Video of a stray cat in the playground - Narrate - Singapore children are happy to see a stray cat as most of them do not have cats as pets. Howeve they are not comfortable stroking the stray cat. Some stray cats are careful of people as they have had been hunted by the town council contractors using nets, medicated food and traps. Their numbers had been reduced considerably by the town councils culling them. Some members of the public complain about noisy cats fighting at night outside their residences and spraying urine onto their garden. During the SARS period, cats were said to be a carrier of SARS viruses infecting people and large numbers were removed by the contractors employed by the authorities. THE CAT WELFARE SOCIETY

Those seen are the kind efforts of The Cat Welfare Society and the community of stray cat caregivers sending the cats for sterilisation by the vet and then released in public places like playgrounds and parks. You can identify them. They do not have normal shaped ear tips as the left ear tip had been cut away after sterilisation (IMAGES).

OUTCOME FOR THIS CAT WITH GIGANTIC FACIAL ABSCESS The cat was an inpatient for 3 days at Toa Payoh Vets. The owner did not bring her to Toa Payoh Vets for help or review. He said the cat had recovered fully after two weeks and he had enjoyed his trip to Seoul with his elderly friends when the cat was an inpatient. (Video of him travelling). He was most happy that his stray cat survived the anaesthesia and kept her strictly indoors after the treatment (Video of factory premises and area and cat images comparing swollen face with one not swollen).

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A stray cat (Video 2/2) has a gigantic facial abscess. Cat fight or malar abscess? This is Part 2/2.  HOOK same as for Part 1/2 -The cat had a big right facial swelling (show video footage of the swelling as in Part 1/2).

In Part 1/1, Mr Tan, the owner brought the cat to Toa Payoh Vets for consultation. Mr Tan decided to travel overseas as planned (video footage Korea trip), leaving the cat with Toa Payoh Vets for anaesthesia and surgery of the facial abscess.
 
1.  DEFINE ABSCESS. Abscess is a localised collection of pus.

2. TOOTH ROOT ABSCESS
What Is a Cat Tooth Abscess? A cat tooth abscess is an inflammatory reaction to infection from a dead tooth. This infection around the root of the tooth leads to destruction of the bone. The painful bony infection and inflammation can spread to the soft tissues of the face and create a swelling of the cheek or chin.(VIDEO OF HANDPHONE pus squeezed out).


3. CAT FIGHT FACIAL ABSCESS
The main difference is that a cat with a cat fight abscess does not have rotten teeth and inflamed gums.


ANAESTHESIA AND SURGERY 

1. ANAESTHETIC RISK OF DEATH
"Your cat needed to be sedated and anaesthesized for surgery," Dr Sing advised Mr Tan. "As she is aged and the blood test showed she is very sick, she may not survive the anaesthesia". 

"I know the high risk," Mr Tan replied. "I had sent sick stray cats to the vet for anaesthesia and some did die on the opeating table."  He signed the Anaesthesia Surgery consent form so that he knew the advantages and disadvantages of treatment compared to non-treatment.  

2. SURGERY. The rotten and loose malar tooth is extracted if it is present. In this case, it had dropped off earlier. Then the abscess is lanced using a scalpel blade (IMAGE)  and drained.
 This was performed during anaesthesia. IMAGES as below 

The cat was an inpatient for 3 days and went home. She recovered fully after two weeks. This stray cat was fortunate that Mr Tan was kind enough to send her for early treatment of her Malar Abscess. She recovered fully after two weeks at home to recuperate and be nursed by Mr Tan.


CONCLUSION - STRAY CATS HAVE POOR HEALTH.

Flea and deworming treatment were done by Mr Tan as the cat was infested with fleas. The fleas hopped onto this cat's fur from contact with another flea-infested stray cat. (IMAGE of fleas). Fleas pass on worms to the cat, hence deworming was advised.

Stray cats are homeless cats but MOST pet cats will wander outdoors if given a choice of freedom to roam. The community of caregivers will give them food and water (IMAGES), but they rarely bring them to the vet for dental check ups to prevent Malar tooth abscess.


MORE INFORMATION AT:

https://2010vets.blogspot.com/2022/06/4123-gigantic-facial-abscess-in-stray.html


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SCRIPT FOR VIDEO PRODUCTION


HOOK - 10-second footage of consultation and anaesthesia/surgery with least bloody scenes. Video at:

https://2010vets.blogspot.com/2019/03/3460-stray-female-10-year-old-cat-has.html


Pt 2/2 is at:
https://www.youtube.com/watch?v=0p6UnO0xX8Q
Video - Part 2 shows surgical treatment - lance and drain the abscess, dental scaling and extraction of the decayed upper right premolar tooth. 


MIDDLE AND CONCLUSION -  Narrate the slides


The diagnosis was

Malar AbscessThe cat’s white blood cells at the infected roots of the malar tooth eliminated the bacteria. Pus formed and spread to the nasal sinus

A gigantic facial swelling below the eye appeared. This was a Malar Abscess  The 10-year-old cat recovered fully  two weeks after surgery




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Pt 1/2 video. Consultation with Dr Sing Kong Yuen. A factory cat has a gigantic facial abscess.
https://2010vets.blogspot.com/2019/03/3460-stray-female-10-year-old-cat-has.html

Pt 2/2 is at:
https://www.youtube.com/watch?v=0p6UnO0xX8Q
Video - Part 2 shows surgical treatment - lance and drain the abscess, dental scaling and extraction of the decayed lower right premolar tooth. Flea and deworming treatment were advised.






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20 Jun 2022. A GIGANTIC FACIAL ABSCESS IN A STRAY CAT
Dr Sing Kong Yuen, BVMS (Glasgow) 

A rare case of a gigantic facial abscess in a stray cat kept in a factory in Ang Mo Kio. The vast majority of facial abscess cases are cat fights leading to bacterial infections inside the face. There will be swellings below the lower eyelids. Soon, the swellings ruptures into holes draining pus.

Cats do suffer from Malar Abscesses, equivalent to Carnassial Tooth Abscesses in the dog. However, Malar Abscesses are rare in cats. I had encountered one or two cases at Toa Payoh Vets. The only treatment is EXTRACTION of the decayed loose malar tooth.

This case could also be a Malar Abscess case as stray cat owners rarely take the cats for dental check ups annually. This cat was permitted to stray in the factory grounds and must have had fought with other cats.

The cat recovered fully after treatment including drainage of the foul-smeling pus. The owner and his wife used to house stray cats in rented Pasir Ris boarding kennels which have had been demolished by the government.





















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VIDEO


MORE INFORMATION AT:

https://2010vets.blogspot.com/2022/06/4123-gigantic-facial-abscess-in-stray.html


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DETAILS



THE CAT HAS A GIGANTIC FACIAL ABSCESS – PARTS 1 AND 2.

Part 1/2 is this video is also shown on FACEBOOK on Mar 4, 2019.

https://2010vets.blogspot.com/2019/03/3460-stray-female-10-year-old-cat-has.html



The care-giver contacted me at 10 am. He used to keep over 20 stray cats in a kennel place in Pasir Ris kennels some 20 years ago. Now he has this cat and another two cats in his factory shop in Ang Mo Kio. This cat lived in the factory unit but roamed freely within the factory according to him and had never been sick for over 10 years.

"How long has the cat has a swollen face?" I asked him. "3-4 days," he said. That was an explosive ballooning of the cat's right facial area in just 3-4 days. The bad odour of rotten eggs wafted up when I incised the abscess. It indicated a flesh-eating gas-forming bacterial infection. What to do?

The cat was anaesthesized. Xylazine 0.01 ml + Ketamine 0.1 ml IM which was the least dose to sedate. Isoflurane gas and oxygen via gas mask was given to top up the anaesthesia when needed. The swelling was lanced with a scalpel blade. Foul smelly thick brownish red pus flowed out of the cut. I used 3% hydrogen peroxide as an antiseptic after releasing the pus into the kidney dish.

Then I used copious amounts of normal saline to irrigate and clean up the inner part of the skin wound. Blood test showed very high numbers of white blood cells and neutrophils indicating a severe bacterial infection.

Prompt treatment by the owner saved this cat's life as the infection spread rapidly within 3 days. The cat did not have fever or become emaciated, showing that the owner did seek early veterinary intervention.

The old cat woke up fast from anaesthesia as the dosage given was very low. The risk of dying on the operating table is very high in old pets, hence the use of isoflurane gas top up is the safest procedure rather than a higher dose of injectable sedatives. She went home with oral antibiotics and painkillers.

UPDATE: As at Mar 9, 2019, no complaint from the care-giver. The cat had fully recovered and was eating as normal. He still wandered freely in the factory premises.

Cat facial abscesses are due to cat fights. This cat was neutered. In general, it is best to neuter the male cat and keep the cat at the factory shop/home to prevent cat fights during wanderings. This cat recovered fully after two weeks.

PHOTOS AND VIDEOS are at:

https://2010vets.blogspot.com/2019/03/3460-stray-female-10-year-old-cat-has.html



The diagnosis was

Malar AbscessThe cat’s white blood cells at the infected roots of the malar tooth eliminated the bacteria. Pus formed and spread to the nasal sinus

A gigantic facial swelling below the eye appeared. This was a Malar Abscess  The 10-year-old cat recovered fully  two weeks after surgery


Pt 1/2 video. Consultation with Dr Sing Kong Yuen. A factory cat has a gigantic facial abscess.
https://2010vets.blogspot.com/2019/03/3460-stray-female-10-year-old-cat-has.html

Pt 2/2 is at:
https://www.youtube.com/watch?v=0p6UnO0xX8Q
Video - Part 2 shows surgical treatment - lance and drain the abscess, dental scaling and extraction of the decayed lower right premolar tooth. Flea and deworming treatment were advised.




WARNING. Part 2/2 contains surgical procedures on treatment of the malar abscess in this cat. Viewer discretion is advised.


IN CONCLUSION

This infected RIGHT upper 3rd premolar tooth in this jaw had decayed and dropped off before treatment. The bacterial infection of its roots HAD spread upwards to the SINUS of the face (IMAGE) over a short period of 3-4 days to form the gigantic facial abscess. This is diagnosed as as malar or carnassial tooth abscess. 



UPDATE: 

Video - Part 2 shows surgical treatment - lance and drain the abscess, dental scaling and extraction of the decayed lower right premolar tooth. I advised to owner to deflea and deworm this cat. Fleas were crawling all over her fur (IMAGE).

As at Mar 9, 2019, no complaint from the factory owner. The cat had fully recovered and was eating as normal. She was a spayed cat but still wandered freely in the factory premises. She was infested with fleas (IMAGE). It is best to keep the spayed cat indoors to prevent cat fights during wanderings. Fortunately for the cat, she did not die under anaesthesia as she was septicaemic DURING ANAESTHESIA. . (DEFINE SEPTICAEMIA). She recovered fully after two weeks. 



Pt 1/2 is at:  

https://www.youtube.com/watch?v=0p6UnO0xX8Q

PHOTOS are at: https://2010vets.blogspot.com/2019/03/3460-stray-female-10-year-old-cat-has.html













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FINAL  VIDEO PART 1/2





FINAL  VIDEO PART 2/2







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The 3-act structure prevents boredom. Arranging events in an order that conflict causes change, which in turn causes more conflict, building and building, until the story's final confrontation and resolution. 3 acts. Beginning, middle and end. 

From a plot point of view: Set-up, Conflict, Resolution
From an emotional POV, Attraction, Tension, Satisfaction
From a thematic POV. Subject, Development, Fulfillment.


ACT 1 - ATTRACTION.
Grab the reader's attention by establishing the genre and mood, which create the anticipation of desired feelings such as laughter for a comedy or tension in a thriller. 

First, introduce the main character with whom the reader will bond. You estabish the main problem which captures the reader's interest and creates curiosity and anticipation as to how the protagonist will solve his dilemma. The opening hook is an essential emotional element in this act.

Several types of opening:
1. Hero in action.  Introduce the protagonist in the middle of conflict (most common opening, most effective---character bonding and drama). This hero in action opening gives you a choice to focus on e.g. character's uniqueness or character empathy (misfortune or mistreatment). 

2. Villain in action. 
3. Backstory/prologue  eg. traumatic prologues
4. Spectacle e.g stunts, special effects, over-the-top events generate thrill for the reader. Joyous occasions like a wedding (The Godfather).
5. Mystery. Intriguing event that arouses curiosity in the reader, making him wonder what is going on, is also a great way to open a script. Alien, The matrix,E.T. --- where are we? Who are these characters, what are they talking about, what's going on?

6.  Unique world. World of the mafia (The Godfater), world of aliens on earth (Men in Black), the Amish world, panoramic bird's-eye view of a future Los Angeles - Blade runner. 

7. Exposition. As long as the basic information about the world of your story is intereswting and crucial to the understanding of the plot e.g. the scrolling exposition (Star Wars). 

8. Breaking the fourth wall. A rare but effective way to open a story with a character speaking directly to the reader which creates immediacy and connections. e.g. voice-over eg. American Beauty or Sunset Boulevard or having the character speak directly into the camera, thus "breaking the fourth wall", e.g. High Fidelity, Ferris Bueller's Day off or Annie Hall.  

9. Book-ended flashback  A popular device or structure to open period pieces or detective stories that involves investigation of a past event.  Eg. Titanic, Amadeus, Citizen Kane, The Bridges of madison County or Double Indemnity. Make sure the past is more important than the one in the present. 

10. STORY TELLING USING THE 3D's to sell a product or service
Details
Dialogue
Discovery
All wrapped up in Drama


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Images of stray cats in Singapore




4122. A rare case of cavity in the Carnassial Tooth causing oro-nasal fistulas




20 Jun 2022. A RARE CASE OF CAVITY CAUSING ORO-NASAL FISTULAS
Dr Sing Kong Yuen, BVMS (Glasgow) 

A rare case of cavity in the Carnassial Tooth causing oro-nasal fistulas in a poodle. The vast majority of cases affecting the Carnassial Tooth or 4th premolar tooth is infection of the roots of the tooth, causing pus to migrate to the nasal sinuses. There will be swellings below the lower eyelids. Soon, the swellings ruptures into holes or facial wounds.

Many dog owners think the dog has suffered some traumatic injuries resulting in facial wounds with oozing pus or blood and pus. Some vets may misdiagnose these oro-nasal fistulas are facial wounds.

However, such wounds do NOT heal despite medication. The only treatment is EXTRACTION of the decayed loose carnassial tooth.

In this case of cavity in the crown of the tooth, ROOT CANAL TREATMENT will be the treatment of choice, but it will be expensive compared to DENTAL EXTRACTION.  

Goto: www.toapayohvets.com to read up on several cases seen in the past decades.

MORE INFORMATION AT:
 https://2010vets.blogspot.com/2022/06/4122-rare-case-of-cavity-in-carnassial.html


4121. An old dog with 3 seizures. What is the cause?

16 June 2022. An old dog had 3 seizures. Why?

The owner wanted a 2nd opinion on why her dog had a 3rd seizure. She had consulted a vet who took a blood test and said there was liver disorder. He wanted further blood tests to check whether the old dog had Cushing Disease. The owner did not wish her dog to undergo more tests and so declined. 

"Blood tests are needed to check whether the dog really has Cushing Disease before prescribing medication," I told the lady owner who had consulted me when her dog was a puppy. "There are effective medication from the vet for Cushing Disease in the dog."

She had shifted far away and was busy at work. So proximity to vets was important and Toa Payoh Vets was distant from her home. So I had not seen the dog.

She ordered online two herbal supplements. One claimed Cushing Disease "treatment" and the other claimed "Skin disease" treatment. 

"Since the blood test was done one year ago," I advised a recent one to check the liver disorder. "There are many causes of seizures or fits in the older dog," I told her.  Many of the younger generation do their research on the internet and some may buy the herbal supplements to treat their dogs. In this case, I advised stopping the herbal supplements as seizures still persisted. The "skin disease" herbal supplement were of no use, as the old dog had developed a few skin warts which are part of ageing in some dogs. Warts are caused by papilloma viruses.

A blood test is accepted by the lady. She wanted vaccination for her dog. "Vaccination is best done after blood test', I advised. "The big cherry eye caused intense discomfort. Your dog has tartar on his teeth, but he has panting occasionally. No heart murmurs but the dog may have heart enlargement."

"If the old dog has good dental health and prevention of diseases, he will live another 2 years. Some small breeds live up to 20 years in Singapore," I said. 

The dog has a swollen abdomen. "He passed gases often," the owner said. The dog did pass gas during my palpation of his tense swollen abdomen.  

We will wait 7 days to ensure that the dog has his antibiotics before dental scaling. Vaccination and removal of skin warts and cherry eye procedures will be done. The owner will stop feeding beans in her home-cooked food for her dog as they may cause flatulence or farting.  We will observe for seizures to know more about the cause.

UPDATES IN THIS BLOG:
    

 https://2010vets.blogspot.com/2022/06/4121-old-dog-with-3-seizures-what-is.html


 

Sunday, June 19, 2022

4120. A culture of good F&B Service from The Erasian Restaurant

Sunday 19 Jun 2022: Father's Day at The Erasian Restaurant. This is my 3rd visit.

Not so crowded as the music band played only on Fridays and Saturdays.
Waiter Mr Febrego,  about 40 years old, originally from Portugual had worked for 4 months. He would recommend food combinations e.g. the sour achar to go with pork belly. 

He was a Grab delivery man but now he works in F & B as he gets CPF (pension contributions) and working background if he were to live in Canada. A very jovial person in grey face mask!  His younger colleague wished me "Happy Father's Day" when we were in the gents' room.  This Restaurant has a culture of personalised service with a heart.  

A short shower. Hot and humid inside the non-air con restaurant. A good Father's Day celebration. Kat was present too.



Big families dine on Father's Day



Mr Febrego (L) with customer

 



4119. Photographing the daylight moon tips

 






19 Jun 2022. Sunday. Father's Day.
I took a photo of the moon at 7AM at the Esplanade, after sending LP to Gateway Theatre by 6.30 am.

www.instagram.com/toapayohvets



19 Jun 2022. 

COMPARE THE SHARPNESS OF THE MOON IMAGES TAKEN IN 2022 AND 2018.


Practice makes perfect. I show my 2 images of the moon seen at daylight in Singapore in 2018 and 2022.


In 2022, I place the camera on top of another DSLR camera. Both cameras are placed on the ledge on the partition wall of The Esplanade car park entrance. The DSLR Canon EOS 90D 18-200 mm lens camera points at the moon skywards.


I then touch the LIVE view LED screen. That means no clicking of shutter and much less shaking of the lens.


I will say that the 19 Jun 2022 image of the daylight moon is much sharper than the 2018 image which would be handheld or placed on a car roof top. The shutter button would be pressed to click...causing vibrations and less sharp image of the moon.

A tripod is best but I seldom use it.









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how I positioned the camera













4118. ADVICES FOR YOUNG PEOPLE. You can take good photos with handphones or smart phones

19 JUN 2022: ADVICES FOR YOUNG PEOPLE. You can take good photos with iphone 11 pro



Smart handphone images are as good as professional camera images.

1.  iphone 11 pro takes good photos too, but you need to acquire digital imaging skills like how to take good photos with the "rule of threes" and how to edit them using a good software like Lightroom.

You can use the photos 

  1. to sell as STOCK PHOTOS on commercial websites. For example, the following photos have been approved by www.shutterstock.com after I have had edited them. You can buy them from www.shutterstock.com/g/toapayohvets



2.  to market your products or services on social media or online platforms like Etsy, Shopee, Carousell etc.

2.1 to market products, for example, made by your elderly mother if she does dress making for dolls.

Some iphone 11 images are shown below.

MORE INFO AT:
https://2010vets.blogspot.com/2022/06/4118-taking-good-photos-with-iphone-11.html








Stock photo REJECTED by shutterstock.com/g/toapayohvets



Stock photo of shutterstock.com/g/toapayohvets

Stock photo of shutterstock.com/g/toapayohvets





Home-made reusable face masks


















2. Handphone photos

SINGAPORE - 21 JUN 2022: Senoko Power Station is a power generation plant with a licensed capacity of 3,300 megawatts and supplies about 20 per cent of the nation’s electricity needs.






23 Jun 2022: Many believe that smartphone photos can not be good enough. The following two photos prove otherwise.

Smartphone photo NOT taken by Dr Sing Kong Yuen.

Such a beautiful morning photo with blue skies, white clouds and blue seas with Johore in the background .

The Senoko Power Station is a power generation plant designed by human beings. 

The sun may be said to be a power generator whose sunlight enables plants to do photosynthesis which sustains life on earth. Who design the sun?



3. Apple iPhone 11.




Moon above The Esplanade Forecourt Garden, 7 AM, 19 Jun 2022Apple iPhone 11Wide Camera 26 mm f1.88 MP, 2160 x 3840, 2.2 MBISO 32, 30 mm, O ev f 1.8, 1/666sBack camera lens 4.25mm f 1.8 





I stabilise the Canon DSLR EOS 90D on top of another
Point the camera to the moon. I do NOT press the shutter button
I pressed the LCD screen which does not vibrate
Hence the sharpness of the moon from high above


Friday, June 17, 2022

4117. Photography Tips - Vegetables in a supermarket.

 PHOTOGRAPHY TIP by Dr Sing Kong Yuen. Where do you focus in this case?


I focus on the brocoli in the centre of the view. I use single central focus on my DSLR Canon EOs 90D Camera, using P Mode.


This photo has been cropped as the bigger photo shows apples on the upper side. So the mid point of the photo where I focus on the brocoli will be not at mid point in this image. 


Practise makes perfect. I do not know whether this image is acceptable by www.shutterstock.com yet. 



Is asparagus a vegetable, a fruit, or an herb? Have you wondered too? 


Often seen as a sign that spring has come, asparagus is a delicious addition to many springtime dishes, including salads and veggie-filled frittatas. 


Asparagus (left, bottom) is a nutrient-dense perennial vegetable that grows in temperate climates around the world.





Thursday, June 16, 2022

2022 Advices For Young People - create, not consume series.

UPDATED BLOG written in  4 Dec 2020.
https://2010vets.blogspot.com/2020/12/3925-advices-for-young-people-create.html


"Create, Not Consume," I would advise young employees. It is easier said than done for 80% of the employees as they have priorities and responsibilities or just want to have fun after work. Some are not aware that many bosses have to cut business costs as employees demand pay increases yearly, but the net profits of the business decreases for various reasons. There is a shortage of employees after 2 years of Covid-19 pandemic, but that does not mean that the boss can pay higher salaries if businesses cannot sustain this situation.       


CREATE, NOT CONSUME 

1.  NEW SKILLS. If you are an employee, do know that your boss will hire a younger and less expensive replacement in time to come as intense competition lowers business profitability as one competitor will underprice, give cut-throat pricing and discounts.   

Make use of every second of your free time to acquire new skills by creating products or services, rather than spending a lot of time on computer gaming, watching movies or consuming entertaining services provided by others. An example in 2022 will be Tik Tok videos.

2.  TRAVEL INSIGHTS.  When you travel, be aware of the culture and businesses, rather than go from one point to another sight-seeing. 

For example, headwear sales in Chaung Tha Beach in Myanmar. The average tourist will do sight-seeing. 

However, if you look deeper, you will see the business aspects of the headwear sales---niche marketing.  How such sales person can earn a living. You have the sales strategy. Those people sells just one product or diverse products, doing cross-selling a related product and what customers are targeted.   


Young people to create, not just consume for their future 
when they are no longer young and strong to be an employee


Beach goer with children


Focus on one product to sell




More sources of revenue hopefully




Beach goers---younger generation and families




Different category of products for beach wear



Beach goers


Create your products to sell.
Focus on a niche market e.g. headwear in this example
Know who are your competitors and customers 
Product diversification
Cross-selling
Don't expect instant success. Many failures.
Hard work and perseverance

There is no guarantee of success but you will learn 
from failures and start another venture.

3946. Eyelid masses in the older dog - neoplasia, cyst, styes

Most common  type of tumour is the meibomian gland neoplasia. MeUsuibomian gland are oil producing glands for the eye. ductal epithelium or acinar gland (multilobulated pink or grey). 

uncommon Benign ones are papillomas, melanocytomas

Chalazion (meibomian gland cyst) usually together with tumours



Treatment


2-3 mm. can wait and see.

Small - cryosurgery two times

Medium - V-plasty

>10 mm  - rotating skin gtaft, H-plasty, Z-plasty