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Barah Mulut

Ramai yang tahu mengenai barah payu dara, barah pangkal rahim atau barah prostat. Namun, bila ditanya mengenai barah mulut, ramai yang terpinga-pinga?

Pengetahuan mengenai barah mulut yang terhad mungkin disebabkan penyakit itu tidak berada di carta teratas barah pembunuh di Malaysia. Dengan tabiat merokok dan pengambilan alkohol selain kebiasaan tradisi sesetengah kaum - mengunyah sirih - sebagai faktor risiko, barah mulut perlu diberikan perhatian.

Barah mulut bukan masalah kesihatan di Malaysia, ia berlaku di mana-mana. Di Britain jumlah pesakit barah mulut meningkat 4,700 orang setiap tahun dengan sekitar antara 1,600 hingga 1,800 meninggal dunia setiap tahun (atau seorang dalam setiap lima jam).

Dalam kes barah mulut, penyakit itu bukan saja menjejaskan mulut tetapi lidah, bibir, tekak, kelenjar air liur, sinus dan lantai mulut. Namun, pada peringkat awal serangan, ia tidak mendatangkan sakit atau rasa tidak selesa.

Justeru, ramai pesakit tidak menyedari masalah yang mereka hadapi dan berjumpa doktor hanya selepas barah berada pada tahap ketiga atau keempat.

Di seluruh dunia, sebanyak 405,318 kes barah mulut dilaporkan dengan 2/3 datang dari negara membangun. Negara paling ramai penghidap barah mulut ialah India dan Sri Lanka.

Kes barah mulut juga semakin meningkat di Eropah, Taiwan, Jepun dan Australia. Di Eropah setiap tahun 100,800 orang didiagnos dengan 40,000 meninggal dunia.

Di Amerika pula, 30,000 orang didiagnos kerana barah mulut setiap tahun. Walaupun ada kecanggihan teknologi dalam kemoterapi dan teknik pembedahan, selalunya merawat barah mulut adalah cabaran kepada petugas perubatan disebabkan pesakit hanya mendapatkan rawatan apabila serangan barah sudah kritikal.

Statistik Malaysia

Kes barah mulut di Malaysia juga tidak jauh bezanya dengan senario di tempat lain. Daftar Majlis Barah Kebangsaan (NCR) melaporkan barah mulut berada di tangga keenam dan ketiga barah paling biasa ditemui di kalangan lelaki dan wanita keturunan India. Malah, barah mulut di kalangan lelaki dan wanita India merangkumi 5.2% dan 7.7% daripada semua jenis barah.

Kajian di hospital seluruh Malaysia antara 1994 hingga 1998 mendapati selepas kaum India, barah mulut kerap menyerang penduduk Bumiputera Sabah dan Sarawak diikuti orang Melayu dan Cina.

Seperti juga kes di Amerika, di Malaysia dan Britain, cabaran yang paling sukar dalam pencegahan dan rawatan barah mulut adalah kebanyakan penduduk tidak tahu mengenai barah mulut. Ini dibuktikan dengan kajian Yayasan Kesihatan Pergigian Kebangsaan British 2007 mendapati separuh daripada populasi di Britain tidak pernah mendengar mengenai barah mulut.

Justeru, mereka akan datang ke hospital apabila barah berada pada tahap yang serius dan sukar diubati. Di Malaysia pula kebanyakan pesakit lebih gemar mendapatkan rawatan alternatif berbanding moden. Ia sekali gus menyukarkan rawatan selain pengetahuan mengenai barah mulut di kalangan sesetengah pengamal perubatan biasa yang terhad.

Pada peringkat awal barah mulut mungkin hanya tompok-tompok putih, merah atau ulser di dalam mulut. Justeru, tidak ramai pesakit menyedarinya sebagai permulaan barah mulut.

Simptom Barah Mulut

* Ulser dalam mulut yang tidak sakit dan tidak juga sembuh selepas tiga minggu

* Pembentukan segumpal tisu di mana-mana bahagian mulut

* Tompok putih atau merah di mana-mana bahagian mulut

* Susah untuk menelan, mengunyah, bercakap, menggerakkan rahang atau lidah

* Rasa kebas pada lidah dan kawasan sekitar mulut

* Sakit kerongkong berpanjangan untuk lebih enam minggu terutama perokok yang melebihi usia 50 tahun

* Bengkak pada rahang

* Bengkak pada leher lebih tiga minggu

* Sakit telinga yang kronik

* Berat badan menurun

Faktor Risiko Barah Mulut

+ Merokok

+ Minum alkohol berlebihan

+ Pernah mengalami masalah saluran pernafasan atas sebelum ini

+ Usia yang meningkat

+ Amalan mengunyah sireh

+ Kurang mengambil sayur atau buah-buahan dalam diet



Lagi info tentang BARAH MULUT :

Ulser Mulut Boleh Menyebabkan Barah
Gambar Barah Mulut Akibat Merokok






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Metabolic Syndrome

There are 5 ‘conditions’ for classifying metabolic syndrome – a large waistline is one of them.

The metabolic syndrome is a known risk factor for increasing your risk of heart disease.

My husband recently went to the doctor and was told he had something called the metabolic syndrome. I have never heard of this before. Is it serious? Can he die from it?

The word metabolic means the biochemical processes in your body. Metabolic syndrome is a term for a group of conditions that usually occur together, increasing your risk of getting heart disease, diabetes and stroke.

It is a risk ratio that doctors can calculate to tell how likely you are to get serious diseases like cardiac arrest (heart attack).


To this day, not all doctors agree that metabolic syndrome is a separate disease or even deserves its own classification. It used to be called Syndrome X or insulin resistance syndrome by some people.

What are the conditions for me to be diagnosed as having metabolic syndrome then?

There are 5 conditions that are included in the metabolic risk factors for heart disease. These five conditions usually occur together. If you have at least 3 out of these 5, then you can be diagnosed as having metabolic syndrome.

1. A large waistline – if you have excess fat in your abdominal area, which means you have an ‘apple shape’. This is a greater risk factor than having fat in your buttocks or thighs.

2. A high triglyceride level in your blood. (Or if you are already on anti-trigylceride medication.)

3. A low HDL (high-density lipoprotein) cholesterol level in your blood. Remember, HDL is the good cholesterol and LDL is the bad cholesterol.

4. High blood pressure. (Or if you are already on medication to treat high blood pressure.)

5. Higher than normal fasting blood sugar. If your blood sugar is mildly elevated, it could be an early warning sign of diabetes. This actually shows that you have resistance to insulin, the hormone that stores sugar and fat in your body.

The more risk factors out of these that you have, the more likely you are of developing heart disease, stroke or diabetes. A person with metabolic syndrome is twice more likely to develop heart disease than a person who doesn’t and 5 times more likely to develop diabetes.

Most people usually have two or three components.

Why are some people more likely to get metabolic syndrome?

You are more likely to get metabolic syndrome if you are overweight or obese and do not exercise often. Researchers have shown that the underlying process is actually insulin resistance.

Insulin is a hormone made by your pancreas. Its function is to regulate blood sugar in your body. When you eat food, it goes into your digestive system and intestines. It gets processed and glucose, as it is called when it is broken down into small molecules, is absorbed into your blood-stream. Your blood carries the glucose to your tissues for fuel with the help of insulin.

Unfortunately for people with insulin resistance, their cells don’t respond as readily to insulin as normal people do, so glucose doesn’t easily enter their cells, thus leaving more glucose in their bloodstream.

This will in turn stimulate more insulin to be released into the bloodstream, and increased insulin will in turn also increase your trygylyceride level. It will also adversely affect your kidneys, leading to an elevation in blood pressure.

The elevated blood sugar in people with metabolic syndrome is not high enough to qualify as diabetes.

What causes insulin resistance?

No one knows for sure to this day but scientists postulate that it is due to a combination of factors that include genetic and environmental ones.

Insulin resistance apparently runs in some families, passed down from parents to children.

If I have metabolic syndrome, what can I do?

If you are overweight, you should definitely concentrate on losing weight and getting more exercise. About 30 to 60 minutes of moderate exercise a day is recommended, such as brisk walking.

Losing as little as 5 to 10% of your body weight can reduce insulin levels and decrease your risk of getting diabetes.

You also have to modify your diet, eating more vegetables, fish and whole grains. Limit foods containing unhealthy fats and red meat. And if you are smoking, you should stop.

If all this doesn’t work, then your doctor might have to prescribe you medication. If you have high blood pressure, then you might need antihypertensive medication. The same goes for high cholesterol and triglycerides. There are also insulin sensitisers to help your body use insulin more effectively.

Some people also go on low dose aspirin to help prevent heart attack and stroke.


More info on METABOLIC SYNDROME here.






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Mengandung di Luar Rahim


Kandungan di luar rahim membawa risiko tinggi kepada nyawa ibu dengan kebarangkalian agak rendah kandungan mencapai tempoh penuh kandungan dengan selamat.

Untuk persenyawaan biasa, pertemuan di antara benih telur dan sperma berlaku di tiub fallopian. Telur yang difertilisasikan ini sepanjang tiub fallopian akan bertambah bilangan selnya sehingga ke satu bentuk yang dinamakan blastosis, dengan bilangan selnya di antara 70 hingga 100. Penanaman blastosis berlaku di endometrium di dalam rahim dan ianya akan membesar.

Mengandung di luar rahim berlaku apabila penanaman (implantasi) terjadi di tempat lain selain dinding dalaman rahim. Kadar tumbesaran kandungan akan terbantut dan perlu didiagnosa dan dirawat dengan segera.

Kebanyakan kandungan di luar rahim berlaku di tiub fallopian, namun begitu, implantasi juga boleh berlaku di tempat-tempat lain seperti di rongga abdomen, ovari dan sebagainya. Disebabkan ruang untuk membesar terhad di dalam tiub fallopian, tiub tersebut boleh pecah dan menyebabkan pendarahan yang banyak dan ini menggugat nyawa. Keadaan ini genting serta getir dan rawatan segera perlu dilakukan untuk menyelamatkan nyawa.

Sekiranya dikesan awal dan tiub masih lagi utuh dan tidak pecah serta tahap hemodinamik yang stabil, pesakit boleh dirawat dengan ubat ataupun sekiranya pembedahan diperlukan, pembaikian serta restoratif tiub dapat dilakukan. Ini penting sekiranya pesakit masih ingin menambah bilangan ahli keluarga pada masa hadapan. Sekiranya tiub terpaksa dikorbankan, bermakna pesakit hanya bergantung pada satu tiub untuk keupayaan reproduksi.

Mereka Yang Berisiko

Statistik di barat menyatakan mengandung di luar rahim berlaku setiap 50 ibu mengandung. Kebelakangan ini, insiden mengandung di luar rahim meningkat.

Tiub fallopian yang abnormal memberikan risiko yang tinggi untuk implantasi kandungan yang abnormal. Kejadian tiub fallopian abnormal berlaku di kalangan mereka yang mempunyai faktor risiko berikut:

* Mempunyai jangkitan di organ rahim, tiub fallopian dan juga organ-organ pelvik berhampiran. Secara kolektif, jangkitan ini dipanggil jangkitan keradangan pelvik.

* Sejarah lampau mengandung di luar rahim.

* Sejarah kemandulan.

* Sejarah pembedahan di pelvis dan juga abdomen.

* Endometriosis

* Penyakit tularan seksual.

* Pembedahan yang melibatkan tiub fallopian seperti sterilisasi tubal. Keadaan ini menyebabkan pergerakan telur yang telah difertilisasi terencat dan implantasi berlaku di tempat lain.

* Merokok

* Mengandung pada umur yang lanjut.

Ada yang mengandung di luar rahim tetapi tidak mempunyai rungutan. Ada pula yang tidak tahu yang beliau mengandung. Lazimnya simptom-simptom yang dialami serupa dengan simptom mengandung seperti mual,loya,letih tidak bermaya dan sebagainya.

Rawatan

Berdasarkan kepada kestabilan petanda penting dan juga tempat berlakunya implantasi abnormal, rawatan mungkin dilakukan secara pembedahan ataupun tanpa pembedahan.

Tanpa pembedahan

Sekiranya pesakit stabil dan saiz kandungan kecil dan masih utuh, ubat methotrexate, iaitu sejenis ubat anti neoplastik kanser digunakan. Ubat ini menyebabkan sel-sel berhenti bilangannya, menyebabkan kandungan berhenti dan diserap oleh badan. Bukan semua dapat menerima kaedah perawatan ini. Mereka yang menyusu badan serta masalah kesihatan lain tidak dibenarkan perawatan secara kaedah ini.

Biasanya ubat ini diberikan sekali sahaja, dan proses penyerapan kandungan memakan masa sehingga 4-6 minggu. Darah akan diamati paras hormon hCG pada sebelum, selepas tiga hari dan juga selepas seminggu. Paras hormon ini sepatutnya menurun dan sekiranya keadaan sedemikian tidak berlaku, pesakit dinasihatkan menjalani pembedahan.

Mungkin dalam tempoh tersebut, pesakit perlu berada di wad untuk diamati perkembangan petanda penting badan.

Methotrexate adalah satu ubat yang merbahaya, semasa dan juga seketika selepas perawatan. Pesakit dinasihatkan supaya mengelakkan daripada :

* meminum alkohol
* memakan vitamin yang mengandungi asid folik
* memakan ubat tahan sakit jenis NSAID (non steroidal antiinflammatory drugs)
* melakukan hubungan kelamin(hentikan sementara).

Kaedah tanpa pembedahan mungkin menyebabkan pesakit mengalami sakit-sakit di bahagian abdomen dan mungkin juga pendarahan faraj. Juga simptom-simptom lain seperti loya-loya dan muntah-muntah, kekerapan membuang air besar dan juga pening-pening.

Beritahu doktor serta jururawat sekiranya pesakit dirawat secara tanpa pembedahan dan tiba-tiba mengalami kesakitan abdomen yang amat sangat ataupun tahap kesakitan bertambah, pendarahan melalui faraj bertambah, rasa pening serta ingin pitam dan juga degupan jantung dirasai bertambah. Mungkin jika implantasi abnormal ini pecah dan berdarah, kaedah rawatan lain perlu dilakukan.

Melalui pembedahan

Terdapat dua cara pembedahan, iaitu secara pembedahan terbuka dan juga secara laparoskopik. Apa jua kaedah pembedahan ini, tujuan asas mereka adalah untuk membuang implantasi abnormal yang berlaku, menghalang pendarahan selanjutnya daripada memudaratkan nyawa.






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FAQ on Swine Flu

What is Swine Influenza?

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. Swine flu viruses cause high levels of illness and low death rates in pigs. Swine influenza viruses may circulate among swine throughout the year, but most outbreaks occur during the late fall and winter months similar to outbreaks in humans. The classical swine flu virus (an influenza type A H1N1 virus) was first isolated from a pig in 1930.

How many swine flu viruses are there?

Like all influenza viruses, swine flu viruses change constantly. Pigs can be infected by avian influenza and human influenza viruses as well as swine influenza viruses. When influenza viruses from different species infect pigs, the viruses can reassort (i.e. swap genes) and new viruses that are a mix of swine, human and/or avian influenza viruses can emerge. Over the years, different variations of swine flu viruses have emerged. At this time, there are 4 main influenza type A virus subtypes that have been isolated in pigs : H1N1, H1N2, H3N2, and H3N1. However, most of the recently isolated influenza viruses from pigs have been H1N1 viruses.

Can humans catch swine flu?

Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others. For example, an outbreak of apparent swine flu infection in pigs in Wisconsin in 1988 resulted in multiple human infections, and, although no community outbreak resulted, there was antibody evidence of virus transmission from the patient to health care workers who had close contact with the patient.

In short, spread of swine flu can occur in 2 ways :

* Through contact with infected pigs or environments contaminated with swine flu viruses.

* Through contact with a person with swine flu. Human-to-human spread of swine flu has been documented also and is thought to occur in the same way as seasonal flu. Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.

How common is swine flu infection in humans?

In the past, approximately one human swine influenza virus infection every one to two years in the U.S., but from December 2005 through February 2009, 12 cases of human infection with swine influenza have been reported.

What are the symptoms of swine flu in humans?

The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhoea.

Can people catch swine flu from eating pork?

No. Swine influenza viruses are not transmitted by food. You can not get swine influenza from eating pork or pork products. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 160°F kills the swine flu virus as it does other bacteria and viruses.

How does swine flu spread?

Influenza viruses can be directly transmitted from pigs to people and from people to pigs. Human infection with flu viruses from pigs are most likely to occur when people are in close proximity to infected pigs, such as in pig barns and livestock exhibits housing pigs at fairs. Human-to-human transmission of swine flu can also occur. This is thought to occur in the same way as seasonal flu occurs in people, which is mainly person-to-person transmission through coughing or sneezing of people infected with the influenza virus. People may become infected by touching something with flu viruses on it and then touching their mouth or nose.

What do we know about human-to-human spread of swine flu?

In September 1988, a previously healthy 32-year-old pregnant woman was hospitalized for pneumonia and died 8 days later. A swine H1N1 flu virus was detected. Four days before getting sick, the patient visited a county fair swine exhibition where there was widespread influenza-like illness among the swine.

In follow-up studies, 76% of swine exhibitors tested had antibody evidence of swine flu infection but no serious illnesses were detected among this group. Additional studies suggest that 1 to 3 health care personnel who had contact with the patient developed mild influenza-like illnesses with antibody evidence of swine flu infection.

What other examples of swine flu outbreaks are there?

Probably the most well known is an outbreak of swine flu among soldiers in Fort Dix, New Jersey in 1976. The virus caused disease with x-ray evidence of pneumonia in at least 4 soldiers and 1 death - all of these patients had previously been healthy. The virus was transmitted to close contacts in a basic training environment, with limited transmission outside the basic training group. The virus is thought to have circulated for a month and disappeared.

The source of the virus, the exact time of its introduction into Fort Dix, and factors limiting its spread and duration are unknown. The Fort Dix outbreak may have been caused by introduction of an animal virus into a stressed human population in close contact in crowded facilities during the winter. The swine influenza A virus collected from a Fort Dix soldier was named A/New Jersey/76 (Hsw1N1).

Is the H1N1 swine flu virus the same as human H1N1 viruses?

No. The H1N1 swine flu viruses are antigenically very different from human H1N1 viruses and, therefore, vaccines for human seasonal flu would not provide protection from H1N1 swine flu viruses.

How can human infections with swine influenza be diagnosed?

To diagnose swine influenza A infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some persons, especially children, may shed virus for 10 days or longer. Identification as a swine flu influenza A virus requires sending the specimen to laboratory.

What medications are available to treat swine flu infections in humans?

There are four different antiviral drugs that are licensed for use in the US for the treatment of influenza : amantadine, rimantadine, oseltamivir and zanamivir. While most swine influenza viruses have been susceptible to all four drugs, the most recent swine influenza viruses isolated from humans are resistant to amantadine and rimantadine. At this time, it is recommended the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses.

Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

How long can an infected person spread swine flu to others?

People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What can I do to protect myself from getting sick?

There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health :

* Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
* Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
* Try to avoid close contact with sick people.
* If you get sick with influenza, stay home from work or school and limit contact with others to keep from infecting them. Avoid touching your eyes, nose or mouth. Germs spread this way.

What should I do if I get sick?

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include :

* Fast breathing or trouble breathing
* Bluish skin color
* Not drinking enough fluids
* Not waking up or not interacting
* Being so irritable that the child does not want to be held
* Flu-like symptoms improve but then return with fever and worse cough
* Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

* Difficulty breathing or shortness of breath
* Pain or pressure in the chest or abdomen
* Sudden dizziness
* Confusion
* Severe or persistent vomiting


How does swine flu spread among pigs?

Swine flu viruses are thought to be spread mostly through close contact among pigs and possibly from contaminated objects moving between infected and uninfected pigs. Herds with continuous swine flu infections and herds that are vaccinated against swine flu may have sporadic disease, or may show only mild or no symptoms of infection.

What are signs of swine flu in pigs?

Signs of swine flu in pigs can include sudden onset of fever, depression, coughing (barking), discharge from the nose or eyes, sneezing, breathing difficulties, eye redness or inflammation, and going off feed.

How common is swine flu among pigs?

H1N1 and H3N2 swine flu viruses are endemic among pig populations in the United States and something that the industry deals with routinely. Outbreaks among pigs normally occur in colder weather months (late fall and winter) and sometimes with the introduction of new pigs into susceptible herds. Studies have shown that the swine flu H1N1 is common throughout pig populations worldwide, with 25% of animals showing antibody evidence of infection.

In the U.S. studies have shown that 30% of the pig population has antibody evidence of having had H1N1 infection. More specifically, 51% of pigs in the north-central U.S. have been shown to have antibody evidence of infection with swine H1N1. Human infections with swine flu H1N1 viruses are rare. There is currently no way to differentiate antibody produced in response to flu vaccination in pigs from antibody made in response to pig infections with swine H1N1 influenza.

While H1N1 swine viruses have been known to circulate among pig populations since at least 1930, H3N2 influenza viruses did not begin circulating among US pigs until 1998. The H3N2 viruses initially were introduced into the pig population from humans. The current swine flu H3N2 viruses are closely related to human H3N2 viruses.

Is there a vaccine for swine flu?

Vaccines are available to be given to pigs to prevent swine influenza. There is no vaccine to protect humans from swine flu. The seasonal influenza vaccine will likely help provide partial protection against swine H3N2, but not swine H1N1 viruses.

Source : CDC.gov


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Breast Milk Prevents Infantile Colic


Breast milk is the best source of food for an infant. Not only does it contain the necessary nutrients for the development of the baby, but through breast milk, infants acquire probiotics.

The sterile milk presumably picks up the friendly bacteria during its passage through the nipple and into the infant. One of the probiotic strains that babies acquire via breastfeeding is Lactobacillus reuteri Protectis.

Studies have shown that babies who are born via caesarian section and premature babies are slower to acquire friendly bacteria compared to those who are born naturally and at full-term.

Breastfed infants also develop a probiotic-rich gut compared to formula-fed individuals. This makes them less susceptible to infectious diarrhoea and other gastrointestinal problems.

Infantile Colic

One of the symptoms of gastrointestinal problems is infantile colic. It is one of the most common problems within the first 3 months of life, affecting as many as 1/3 of newborns.

Emerging science on probiotics has shown that specific probiotic strains offer an effective solution for infantile colic, infection in children and pathogenic diarrhoea.

In a study published in Pediatrics 2007 by Savino and co-workers, Lactobacillus reuteri Protectis showed very promising results in the treatment of infantile colic. According to a study published in Applied and Environmental Microbiology, results confirmed that L.reuteri colonised the human stomach, duodenum and ileum.

Dietary supplementation with this beneficial probiotic strain induced a significant increase in immune cells which could translate to better health protection and fewer illness episodes.

This is further confirmed by a study conducted by Weizman and co-workers who demonstrated that infants fed a formula supplemented with Lactobacillus reuteri Protectis or Bifidobacterium lactis BB-12 had fewer and shorter episodes of diarrhoea as compared to the control group.

There is now substantial evidence that supplementation with probiotics reduce Helicobacter pylori colonisation in the gastric mucosa. The probiotic strain L.reuteri Protectis possesses the ability to interfere with H. pylori adhesion to epithelial cells.

A clinical study by Dr Francavilla in 2008 has shown that Lactobacillus reuteri Protectis effectively inhibits H.pylori growth and suppresses H.pylori infection, thus reducing dyspeptic symptoms.

L.reuteri given during and after H.pylori eradication therapy also markedly reduces the frequency and intensity of antibiotic-associated side effects.

A good dose of 100 million cfu daily for 4 weeks is advised. However, it is important to note that the inhibitory effect of H.pylori is observed specifically in the L.reuteri protectis strain. This probiotic could easily be obtained, either in drops or tablet form, from pharmacies and hospitals.


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Fungsi Organ Hati

Kerosakan hati akibat hepatitis mungkin membawa kepada sirosis dan kanser hati.

Sejauh mana anda mengenali hati sendiri? Hati yang banyak digunakan dalam frasa kata harian jarang mendapat perhatian dari sudut kesihatan berikutan jarang berlaku kes penyakit yang amat teruk berbanding masalah jantung, buah pinggang atau kanser.

Pada dasarnya, ramai di antara kita yang mengambil mudah kesihatan hati memandangkan ia antara organ yang paling pantas tumbuh kembali. Keupayaan tersebut menyebabkan jarang berlaku masalah hati di kalangan orang dewasa, di samping tempoh rawatan penyakit hati yang mungkin lebih pendek berbanding penyakit lain.

Kebelakangan ini, lebih tumpuan mula diberikan kepada organ malang ini berikutan peningkatan kes jangkitan virus yang menyebabkan hepatitis atau keradangan hati. Bagaimanapun, secara umumnya, orang ramai masih mengambil ringan betapa pentingnya organ ini dalam kehidupan seharian mereka.

Fungsi Hati

Hati merupakan organ dalaman dan kelenjar terbesar di dalam badan manusia yang memainkan peranan penting dalam penyahtoksikan serta metabolisma badan. Hati merupakan antara organ utama di bahagian abdomen dan berada di bawah tulang rusuk.

Kedudukan hati selalunya di bawah rusuk sebelah kanan tetapi ada juga individu yang hatinya terletak di sebelah kiri.

Organ ini banyak fungsinya, bukan sahaja dalam metabolisma makanan malahan sebagai penawar toksin atau apa juga racun yang masuk ke dalam badan. Fungsi menguraikan ubat dan racun ini amat penting bagi mengelakkannya menjadi racun dan merosakkan badan.

Hati juga boleh menukar sesetengah bahan menjadi bahan aktif yang boleh digunakan badan dan membuang bahan sampingan berbahaya yang dikeluarkan melalui najis atau air kencing.

Hati juga menghasilkan hempedu yang disimpan di dalam pundi hempedu untuk digunakan dalam proses penghadaman lemak. Selain itu, hati turut berfungsi sebagai kilang simpanan untuk gula, lemak, protein dan vitamin yang akan dikeluarkan mengikut keperluan badan.

Kerosakan Hati

Kesemua fungsi-fungsi ini akan terganggu jika berlaku kerosakan pada hati. Kerosakan hati boleh menyebabkan kegagalan hati berfungsi dengan mendadak (akut) dan boleh menyebabkan pesakit koma akibat pengumpulan toksin di dalam badan.

Walaupun kegagalan akut fungsi hati jarang berlaku, jumlah kematian di kalangan pesakit yang mengalaminya amat tinggi dan boleh berlaku dalam masa beberapa minggu sahaja.

Pesakit juga boleh mengalami pendarahan teruk akibat kegagalan hati menghasilkan faktor pembekuan darah.

Gejala Kerosakan Hati

Antara gejala masalah hati adalah hilang selera makan, muntah, demam dan badan menjadi gatal di banyak tempat. Pesakit juga mungkin menunjukkan simptom mata berwarna kuning dan air kencing kuning keemasan seperti teh ‘O’ pekat.

Pesakit juga mungkin akan perasan warna najis yang kurang pekat kerana hati tidak dapat menghasilkan hempedu (yang memberikan warna najis). Pesakit juga mungkin mengalami simptom penyakit kuning, loya, sakit pada kawasan hati dan hati bengkak.

Punca utama keradangan hati di Malaysia adalah akibat jangkitan virus, bakteria, fungus atau parasit. Virus merupakan punca utama hepatitis di negara ini, dengan Virus Hepatitis A (HAV) yang merebak melalui minuman dan makanan paling banyak ditemui.

Selain HAV, virus hepatitis jenis B (HBV) dan C (HCV) juga kerap ditemui di Malaysia berbanding jenis D, E, F dan G yang jarang ditemui di Malaysia. Virus Hepatitis E (HEV) mempunyai ciri-ciri yang hampir serupa dengan HAV seperti merebak melalui air atau orang yang menguruskan makanan.

HEV bagaimanapun kerap ditemui di India dan Bangladesh dan boleh di bawa masuk ke negara ini oleh imigran dari negara terbabit.

Penawar Hati

Keupayaan hati untuk tumbuh semula, dan lebih pantas berbanding organ lain membolehkannya menggantikan tisu hati yang rosak. Namun, ini tidak bermakna pesakit tidak perlu 'menjaga hati' mereka kerana memikirkan hati boleh membaiki diri sendiri.

Semua pesakit hepatitis perlu mengawal pemakanan, pengambilan nutrien dan juga mengelakkan pengambilan ubat, kecuali yang perlu. Pesakit perlu mengurangkan benda-benda berlemak, banyakkan pengambilan karbohidrat serta jauhkan dari mengambil ubat-ubatan termasuk paracetamol.

Mereka juga perlu memastikan pengambilan protein dan air secukupnya untuk membantu pemulihan hati serta mengambil suplemen vitamin tertentu seperti vitamin K untuk masalah pendarahan.

Bagi jangkitan HAV iaitu yang paling banyak berlaku bagi hepatitis akibat jangkitan virus, kebanyakan pesakit sembuh akan sendiri dan tidak perlu dimasukkan ke wad. Pesakit HAV dianggarkan pulih sepenuhnya selepas kira-kira 45 hari, dan virus tersebut juga akan hilang sepenuhnya dari badan pesakit.

Jangkitan HBV dan HCV bagaimanapun mungkin memerlukan rawatan ubat tertentu seperti interferon, ubat bagi mengurangkan replikasi virus dan ubat untuk menggalakkan penghasilan antibodi. Hampir 10% pesakit HBV dan sehingga 50% pesakit HCV mungkin akan menghidap sirosis dan kanser hati. Dari segi keberkesanan ubat yang digunakan pula, jangkitan HCV lebih sukar dirawat kerana kadar keberkesanan rawatan cuma 40% berbanding 60% untuk HBV.

Pemindahan Hati

Kebolehan istimewa hati untuk tumbuh semula memudahkan pendermaan hati memandangkan hanya sebahagian kecil organ tersebut diperlukan untuk transplan kepada pesakit yang memerlukan. Tisu hati juga dapat tumbuh kembali menjadi organ hati yang penuh walaupun jika cuma tinggal 25% tisu hati yang sihat.

Walaubagaimanapun pemindahan hati selalunya dilakukan bagi kes hepatitis yang bukan berpunca daripada jangkitan virus atau kuman. Pesakit yang mengalami kerosakan hati akibat jangkitan mempunyai risiko hati baru yang dipindahkan turut dijangkiti.

Jika tiada lagi virus atau kuman punca hepatitis di dalam badan pesakit, doktor mungkin akan menimbangkan untuk melakukan pemindahan hati. Pemindahan hati untuk hepatitis yang berpunca daripada bahan kimia atau toksin lebih mudah dilakukan.

Namun, sebarang toksin perlu dibuang terlebih dahulu dan pesakit yang ketagihan (ubat atau alkohol) perlu dipulihkan dahulu sebelum pemindahan hati dijalankan.

Ini dapat mengelakkan pembaziran hati yang didermakan kerana ia juga akan rosak jika toksin, ubat atau alkohol terus diambil pesakit. Antara individu yang akan mendapat manfaat besar melalui pemindahan hati adalah pesakit hepatitis autoimun.

Janganlah kita mengabaikan kesihatan mana-mana organ sekalipun, termasuk hati, dengan alasan ia dapat pulih sendiri dan tidak membawa maut dengan serta-merta. Bayangkan hati seperti otak dan tulang belakang yang membolehkan kita menggerakkan badan serta menjalankan aktiviti harian.

Tanpa hati, kita bukan sahaja akan mati, malahan akan hilang kawalan dalam fungsi kimia utama badan yang tidak jauh bezanya dari perlahan-lahan menjadi lumpuh. Sayang diri, sayang hati.


Lagi info tentang HATI di sini.






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Diabetic Retinopathy

A diabetic is also at higher risk of getting cataracts.

by Dr. Y.L.M.

Can diabetes affect the eyes?

Unfortunately, the answer is yes. Most people who have diabetes mellitus that is well controlled have no major problems with their eyes. But if your diabetes has not been well controlled for a long period of time, then you can get something called diabetic retinopathy as one of the many complications of diabetes. You can also develop cataracts.

Diabetic retinopathy can occur in both types of diabetes – type 1 (the insulin dependent one that usually occurs from a young age) or type 2 (the insulin resistant one that can develop in later ages).

The longer you have had diabetes, the likelier you are to develop diabetic retinopathy. You are also more likely to develop it if you have high blood pressure, high cholesterol, are pregnant or if you smoke.

Diabetic retinopathy will affect both your eyes.

What is the retina?

The retina is the sensory tissue that lines the back of your eye. It has many layers and contains millions of photoreceptors (cones and rods) that capture the light rays that go through your eye and converts them into nerve impulses.

These impulses are then carried via the optic nerve to the back portion of your brain where the images you are seeing are translated into something that makes sense.

The macula is a very dense, cone-packed area within your retina which is responsible for central vision – which you use most of the time to focus on an object. In the very centre of your macula is the fovea.

Your cones are responsible for bright light and colour vision and your rods are responsible for dim light vision.

Your retina functions as a screen. If anything happens to occlude this screen – especially around your macula area – you are going to have trouble seeing.

What is diabetic retinopathy?

Diabetic retinopathy is a term given to the disease you get in your retina which is caused by diabetes. The reason you get diabetic retinopathy is uncontrolled sugar levels in your bloodstream. The excessive sugar level damages the fine blood vessels in your retina.

The weakened walls of your blood vessels begin to bulge. These are called microaneurysms. The miceoaneurysms may leak blood into your retina or burst.

There are four main types of diabetic retinopathy:

1. Background retinopathy – the early stage.

2. Maculopathy – your macula begins to be affected. This is more serious because your focused vision begins to be affected. The macula may also swell with blood and fluid.

3. Pre-proliferative – the period before new blood vessels start growing in your retina.

4. Proliferative – the most serious sort. Abnormal blood vessels grow in your retina. They may leak blood into the jelly substance that forms your eyeball – the vitreous. These new blood vessels run havoc around your eye, causing your retina to scar and detach from the back of your eye. They may even interfere with your optic nerve and the normal flow of fluid from your eye, causing pressure to build. You can go blind this way.

The most advanced and dangerous stage of diabetic retinopathy is the advanced proliferative stage, when new blood vessels rupture, causing further scar formation. The scar tissue can pull the retina away from its normal position at the back of the eye (right).

Now I am worried. Is blindness the only way to tell if I have diabetic retinopathy? Isn’t that too late for me?

No. When you have been diagnosed with diabetes mellitus, you should already be regularly seeing a doctor for stringent sugar control. Your doctor should be periodically examining your retina for any early signs. Most of the time, you may have diabetic retinopathy already and not know it.

People who have symptoms may have spots floating within their vision (bleeding occurring on your retina or vitreous), blurred vision in itself (when your macula is affected), poor night vision (when your rods are affected), dark streaks or a red film that blocks your vision, and actual loss of vision.

Once I get diabetic retinopathy, is there any hope for me? Or am I doomed to become blind?

Of course there is hope! The most important thing is to control your blood sugar levels so that the damage to your blood vessels can be halted.

Early diabetic retinopathy is not usually treated but monitored by your doctor.

Once you have proliferative diabetic retinopathy, you can get photocoagulation laser treatment to stop the leakage of blood and fluid into your eye. Rest assured, it is painless and rapid. Lasers can also shrink your abnormal new blood vessels.

There is also a procedure to remove blood from the centre of your vitreous. If your retina does detach, lasers can also seal it back to your eye.




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Dengkur Jejas Kualiti Tidur

Posisi tidur dan keletihan boleh menyebabkan seseorang berdengkur.

Anda cukup tidur? Bagaimana dengan pasangan atau ahli keluarga anda? Mungkin anda lesu walaupun selepas berjam-jam tidur akibat apnea (aliran udara terhalang), sementara pasangan anda pula lesu kerana melayan alunan dengkur anda sepanjang malam.


Dianggarkan hampir 5.55 juta penduduk Malaysia, tidak mengira jantina dan umur, menghasilkan orkestra dengkur setiap malam, sama ada 'berdengkur tetap' ataupun 'berdengkur sambilan'.

Masalah dengkur bukan sahaja mengganggu penghidap malahan orang di sekitarnya, dan mungkin menjejaskan kualiti tidur lebih 1/3 penduduk negara ini setiap malam.

Dengkur juga mengganggu ketenangan percutian dan perjalanan jauh di dalam bas, kereta api mahupun kapal terbang. Ada juga pasangan yang terpaksa tidur berasingan kerana tidak tahan dengan ‘dengungan’ berpanjangan setiap malam.



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Dengkur Bukan Apnea

Masalah struktur sekitar salur pernafasan biasanya akan menyebabkan dengkur berpanjangan sementara masalah hidung tersumbat, keletihan dan penggunaan ubat tertentu menyebabkan ‘dengkur sambilan’.

Gangguan tempoh dan kualiti tidur penghidap dengkur dan orang di sekelilingnya dalam jangka panjang dikhuatiri membawa kepada masalah kesihatan yang lebih serius. Tidur tidak cukup atau kurang kualiti mungkin membawa kepada diabetes, tekanan darah tinggi, penyakit jantung, strok serta gangguan fungsi dan ketahanan badan.

Dengkur adalah sesuatu yang hanya berlaku ketika tidur dan ia berbeza berbanding apnea. Penyempitan salur udara menyebabkan pergolakan tekanan udara dan getaran palet lembut (lelangit) serta dinding farinks. Getaran ini seterusnya menghasilkan bunyi khusus dengkur.

Apnea pula merupakan halangan penuh salur pernafasan (hidung atau mulut) sehinggakan penghidap berhenti bernafas sekurang-kurangnya 10 saat, berulang kali semasa tidur. Dengkur dan apnea mungkin hadir bersama atau hanya salah satu sahaja.

Bahaya utama adalah apabila penghidap dengkur mempunyai Apnea Tidur Halangan (OSA) yang teruk, menyebabkannya berhenti bernafas lebih 30 saat, berulang kali semasa tidur.

Boleh Menjejaskan Kesihatan

Oleh itu, individu yang berdengkur perlu menjalani ujian tertentu bagi menentukan klasifikasi dengkur biasa, sehinggalah ke tahap OSA yang teruk.

Individu yang mengalami dengkur biasa tidak menghadapi banyak masalah selain bunyi dan keselesaan tidur (penghidap dan ahli keluarga). Namun, individu yang berdengkur dengan kuat dan mengalami OSA yang teruk mungkin terjejas kesihatannya dalam jangka panjang.

Tahap teruknya apnea ditentukan melalui kiraan setiap jam, rendah (10 apnea sejam), sederhana (20 hingga 30) atau teruk (lebih 40 apnea sejam).

Dengkur dan apnea boleh menyebabkan kekurangan oksigen ke otak dan jantung, menjejaskan fungsi otak dan tekanan kepada jantung (jantung makin besar, denyut jantung dan pernafasan makin laju).

Gangguan tidur pesakit jelas kelihatan jika mereka masih mengantuk di waktu pagi sementara kanak-kanak kelihatan sukar memberi tumpuan.

Populasi Pendengkur

20% populasi penduduk Malaysia mempunyai masalah dengkur. Ia lebih kerap berlaku di kalangan lelaki dan individu berumur lebih 40 tahun. Namun terdapat juga peratusan kecil penghidap dengkur di bawah umur 30 tahun.

Mereka yang kuat minum minuman beralkohol dan mempunyai berat badan berlebihan juga lebih mudah berdengkur,” Kanak-kanak juga mungkin berdengkur, selalunya berpunca daripada masalah tonsil.

Gangguan Kepada Keluarga

Masalah dengkur turut menjejaskan tidur pasangan serta keluarga penghidap, dan selalunya merekalah yang mengenal pasti masalah tersebut.

Sering kali pasangan penghidap yang mengadu tentang masalah dengkur tersebut sedangkan penghidap sendiri tidak mengakui atau tidak mengaitkan kelesuan serta sering rasa mengantuk dengan masalah dengkur.

Sebenarnya ia bukanlah sesuatu yang memalukan kerana dengkur juga boleh berlaku jika seseorang itu terlalu letih dan juga dengan peningkatan usia. Ini kerana otot dan tisu lembut di sekitar salur pernafasan akan semakin kendur, seterusnya bergetar atau menghalang aliran udara.

Orang kurus juga boleh berdengkur. Bunyi dengkur yang kuat pula tidak bererti masalah dengkur yang teruk, sebaliknya kehadiran apnea yang menentukan bahaya kepada penghidap.

Rawatan

Terdapat bermacam kaedah rawatan ditawarkan untuk mereka yang berdengkur atau mengalami apnea.

Kajian waktu tidur boleh dijalankan di rumah atau hospital, sementara kaedah rawatan mungkin semudah membetulkan posisi tidur dan mengurangkan berat badan, atau mungkin memerlukan pembedahan jika ia teruk atau membahayakan kesihatan.

Rawatan untuk mengurangkan atau menghentikan dengkur juga dapat meningkatkan kualiti tidur pasangan dan keluarga, mengurangkan bilangan ‘muka-muka lesu’ di sekolah dan pejabat.

Dengkur sememangnya bukan sesuatu yang perlu dimalukan, terutamanya dengan satu daripada lima rakyat negara ini berdengkur. Namun, rawatan perlu dipertimbangkan jika ia mengganggu rehat anda dan keluarga, terutamanya jika dengkur anda diiringi masalah apnea.

Dapatkan maklumat terkini mengenai cara menguji dan merawat masalah dengkur anda melalui internet atau doktor pakar telinga, hidung dan tekak (ENT). Kembalikan kesunyian malam keluarga dan tingkatkan kecergasan pagi anda.


Lagi info tentang DENGKUR di sini.






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Salt Can Cause Cancer

by Dr. Tee E Siong

When we speak of salt intake, most people are aware that excessive intake is linked to hypertension, which in turn is a risk factor for heart disease and stroke.

Not many people realise that excess salt intake is associated with some cancers, particularly stomach cancer. This is yet another factor linking foods and drinks and the risk of cancer.

What Are Sodium and Salt?

Sodium is an essential mineral that is required daily in a small amount of 500mg or half a gram a day for adults. Sodium plays a major role in regulating water balance in the body. It is also important in maintaining the body’s ability to regulate acid-base balance, transmit nerve impulses, regulate cell membrane function and muscle activity, and absorb and transport certain nutrients. Sodium is also a component of sweat and tears.

Sodium is a component of salt or sodium chloride; indeed nearly half (almost 40%) of sodium chloride is sodium. Sodium in food is naturally present or is added during processing or cooking, or both, usually as table salt or monosodium glutamate.

You cannot always tell by taste if a food is high in sodium. For example, staples in the diet such as cereal products (bread and breakfast cereals), canned foods, margarine or butter and processed foods are often high in sodium even though they do not taste salty.

Sodium Use and Misuse

The body has a large reserve of sodium, and a deficiency is not likely to occur under normal circumstances since people are continually eating sodium-containing foods.

Studies have shown that a relationship may exist between salt intake and the incidence of hypertension or high blood pressure because the sodium in salt causes the body to accumulate fluid. Any excess fluid puts greater pressure on the walls of the blood vessels, creating higher blood pressure.

For many people with high blood pressure, reducing salt in the diet will help to bring it to within normal range.

Rationale on Reduction of Salt Intake

Data from surveys indicated Malaysians consume much more salt and sodium than they actually need. With affluence, there is an increasing trend of eating out (fast food outlets are highly popular) and takeaways which tend to be high in sodium.

There is also an increased consumption of processed and canned foods which are also high in sodium. Hence it is most appropriate to remind Malaysians to choose food low in salt. This write up focuses on another health hazard of excess intake of salt, namely cancer.

Salt and Cancer – The Evidence

Upon reviewing all available evidence, the World Cancer Research Fund (WCRF) expert panel concluded that :

* Consuming too much salt can be harmful to our health, increasing our risk of stomach cancer. The critical factor is the overall amount of salt. Hence, salted and salty foods are a probable cause of stomach cancer.

* On the other hand, non-starchy vegetables, and specifically allium vegetables (e.g. onions, garlic and leeks), as well as fruits probably protect against stomach cancer.

* There is also limited evidence suggesting that pulses (legumes), including soya bean and soya products, protect against stomach cancer.

Salt and salt-preserved foods are probably a cause of stomach cancer.

What is The Link to Cancer?

Studies reviewed by the expert panel showed that there are several possible ways in which a high salt intake can bring about increased risk of cancer.

Firstly, there is evidence from animal studies that high salt intake damages the lining of the stomach.

Secondly, excess salt intake has been shown to increase the formation of N-nitroso compounds (e.g. nitrosamines or nitrosamides) in the body. Several of these N-nitroso compounds are known human or animal carcinogens (cancer-causing substances).

In addition, a high salt diet may enhance the action of carcinogens in the stomach. Furthermore, salt intake may facilitate helicobacter pylori infection; this bacterium is an established cause of stomach cancer.

WCRF Recommendations

In view of available scientific evidence, the recommendation of the WCRF is therefore to limit consumption of salt. Their public health goals, which are for populations and are therefore principally for health professionals are :

* Population average consumption of salt from all sources to be less than 5g (2g of sodium) a day

* Proportion of the population consuming more than 6g of salt (2.4g of sodium) a day to be halved every 10 years

The personal recommendations, meant for people, as communities, families, and individuals are :

* Avoid salt-preserved, salted, or salty foods; preserve foods without using salt

* Limit consumption of processed foods with added salt to ensure an intake of less than 6g (2.4g sodium) a day

Recommendations From Other Dietary Guidelines

In a review of the dietary guidelines of 18 countries in different parts of the world, including Malaysia, it is found that all the dietary guidelines examined had a specific message on the restriction or reduction of salt/sodium intake. The wording of the message varies, but basically the recommendation is to use salt sparingly and choose foods low in salt.

Most of the guidelines provide reasons/rationales against excessive salt intake. In all cases, the main reason given is that sodium (from salt) is directly linked to hypertension, which in turn is a risk factor for heart disease and stroke.

A few countries also mention that excessive salt intake is associated with stomach cancer and nasopharyngeal carcinoma (commonly known as nose and throat cancer).

At the same time, a World Health Organisation (WHO) expert consultation had recommended that since dietary intake of sodium, from all sources, influences blood pressure levels in populations, it should be limited so as to reduce the risk of coronary heart disease and stroke.

The population nutrient intake goals of the WHO expert consultation recommends a maximum of 5g of salt per day. This should take into account total sodium intake from all dietary sources. The need to balance this with potassium intake is also emphasised.

Practical Ttips to Reduce Salt Intake

* Choose fresh fruits, vegetables, meats and unprocessed grains because they are generally low in sodium. Most convenience foods contain added sodium compounds and “fast foods” are often high in sodium.

* Choose home-cooked meals made with fresh produce where possible. This gives you more opportunity to control the amount of salt in your diet. Use a small amount of salt in cooking and avoid sprinkling extra salt in food.

* Limit consumption of highly salted foods and condiments such as soya sauce and oyster sauce. Check nutrition information panels on food labels and select processed foods and snack items with less salt or sodium.

* The taste for salt is learnt and can be unlearnt. One can learn to enjoy the flavour of foods without salt. Gradually reduce, then cut out, the salt you add during cooking or at the table. Your taste buds should adjust within a few weeks, allowing you to enjoy the true taste of food and notice more subtle flavours.

* Spices, herbs, garlic and lemon add flavour to food quickly and easily; use these instead of salt.

The choices we make on what we eat, drink and how active we are each day will together provide us important protection against chronic diseases at all times in life, from childhood to old age.

Remember, little changes make a huge difference! Take positive steps today.


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Kentang dan Keledek

Kalau bercakap tentang risiko obesiti dan diabetes akibat kentang goreng dan kerepek berperisa seperti yang banyak ditemui di para-para jualan snek dan restoran makanan segera, itu tidak termasuk dalam penerangan ini. Kentang dan keledek yang bukan diubah sifat semula jadinya adalah kaya dengan nutrien dan baik untuk manusia.

Kentang dan keledek mempunyai nilai khasiat yang tersendiri. Misalnya, keledek mempunyai lebih serat dan vitamin A, manakala kentang pula mengandungi lebih banyak mineral penting seperti zat besi, magnesium dan potasium.

Keledek yang bersaiz sederhana sudah mengandungi banyak zat vitamin A, sepertiga zat vitamin C, 15% serat dan 10% potasium yang diperlukan sehari. Bagi kentang pula, bagi setiap 100 gram kentang yang direbus, ia hanya menyumbangkan sebanyak 66 kalori.

Dua jenis ubi ini sememangnya tidak menjejaskan kesihatan selagi tidak sering dimakan dengan keju, krim masam, atau mentega. Kesemua bahan tersebut mengandungi lemak yang merendahkan indeks glisemik dalam hidangan.

Kesimpulannya, kaedah penyediaan kentang atau keledek yang sihat adalah apabila ia dimakan secara rebus atau panggang. Ia jauh lebih baik daripada ubi yang telah diproses untuk dijadikan kentang goreng atau kerepek bergaram.

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Seeing Unborn Baby Using Ultrasound

An ultrasound can give important information about whether the baby has any abnormalities.

by Dr. Nor Ashikin Mokhtar

Remember in 2005 when Tom Cruise bought an ultrasound machine for his home, so that he could monitor his wife Katie Holmes’ unborn baby?

Medical experts in the US were alarmed and outraged that this could occur. The ultrasound examination is not a game, but a medical procedure that is performed by trained experts as an important part of prenatal checkups.


What exactly do doctors look for in an ultrasound? How will this information help expecting mothers? Are there any risks involved?

What is Ultrasound

Ultrasound is the technology of using high-frequency sound waves to create an image. These sound waves are directed at the foetus using the 'transducer', which is the gadget that is run gently over the stomach. The sound waves are then bounced back to produce a picture on the screen.

This 'picture' tells the proud parents-to-be whether their baby will be a boy or a girl, or whether there is more than one baby!

An ultrasound should routinely be done for all pregnancies during the first trimester. During this ultrasound, the doctor will look for a number of things, such as to confirm whether the pregnancy is in the uterus, the viability of the foetus (is the heart beating?), the number of foetuses and the size of the foetus to look for whether it corresponds to the period of the pregnancy.

The cervix, that is the mouth to the womb, the uterus, as well as the ovaries are also scanned for any abnormalities.

In the second trimester, the ultrasound is performed to look for any anatomic or structural abnormalities - where the placenta is implanted, and how the fluid around the baby looks. If any abnormalities are found, the doctor will continue to evaluate them in the third trimester. The final ultrasound will also be done to monitor the foetus’ growth and size.

The third trimester ultrasound is not done routinely, and only if there is a need to follow up on a significant problem found in the earlier ultrasound such as if the foetus is not growing as expected or there is concern regarding the well-being of the foetus.

Abnormalities

An ultrasound can give important information about whether the baby has any abnormalities. Firstly, the obstetrician will look at whether the placenta is normal. For instance, is it implanted too low in the uterus, which might cause bleeding during pregnancy? Or is it implanted in a location that will interfere with a vaginal delivery?

The ultrasound will also show whether any organs, such as the kidneys or brain, are missing or not developing well. Structural abnormalities, such as a hole in the heart, abnormal spine formation and other congenital problems, may also be spotted.

The doctor will also use the ultrasound image to measure the bones and the size of the head, in order to check the growth of the foetus.

The ultrasound is also important for mothers who have problems before or during pregnancy, such as hypertension, diabetes or certain infections. If the mother has a high risk pregnancy, then tests such as chorioinic villous sampling can be done as early as 8 weeks onwards.

Other tests include amniocentesis, placental biopsy and umbilical cord sampling, all of which are used to analyse abnormalities in the baby’s chromosomes. Some of these tests can be invasive and relatively riskier than others, so you should discuss every option with your doctor before making a decision.

Of course, every parent-to-be will hope and pray that the ultrasound does not show any abnormalities in the first place. However, it is important to remember that the ultrasound is not a fool-proof test. It cannot pick up every single detail about the foetus, so there may be abnormalities that cannot be found in an ultrasound, or there may be instances where it is difficult to determine the sex of the baby.

Safe Technology

Because an ultrasound uses sound waves, and not radiation, an ultrasound will not harm your unborn baby.

However, it is still unwise to overuse or abuse this technology. You cannot have an ultrasound done whenever you wish just because you feel like 'having a look' at the baby, or you want to see how much it weighs.

The ultrasound has to be used at the right time, for the right reasons. If a mother does not have any risk factors, further ultrasounds – other than the basic one or two – are not necessary.

It is also important that the ultrasound be performed by the appropriate expert - the foetal medicine specialists - when looking for foetal anomalies and in assessing high risk pregnancies so that they know what to look for. An untrained eye looking at the picture could miss some crucial information or problems with the baby.


More info on ULTRASOUND here.






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Degupan Jantung Kencang


Oleh : Hafizah Iszahanid

Pernahkah degupan jantung anda menjadi sekencang seperti pelari marathon sedangkan anda hanya duduk di kerusi? Sebenarnya degupan jantung yang laju atau tidak normal itu disebut sebagai atrial fibrillation (AF), iaitu masalah 2 ruang atas jantung (atria) yang berdegup sangat kencang dan tidak terurus.


AF boleh menyebabkan seseorang itu berdegup melebihi 200 hingga 300 kali dalam seminit. Satu ketika dulu, AF tidak dilihat sebagai masalah yang mengancam nyawa dan ia kerap dikesan pada orang tua.

Namun, hari ini, AF turut dikesan pada golongan semuda 14 tahun. Selain itu, ia kerap terjadi di kalangan orang muda yang masih aktif bekerja, bersukan dan tiada masalah kesihatan (seperti diabetes atau tekanan darah tinggi). Mengapa senario itu terjadi sukar dijelaskan.



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Faktor Risiko Strok

AF adalah faktor risiko tertinggi yang boleh menyebabkan strok.

Degupan jantung yang kencang melebihi 200 hingga 300 kali dalam seminit menyebabkan ia tidak boleh mengepam dan mengecut (contract) dengan baik. Malah, dalam satu kajian oleh Institut Jantung Framingham, Massachusetts pada 1996 menunjukkan strok yang dikaitkan dengan AF dua kali lebih fatal (mendatangkan maut) berbanding strok yang tidak dikaitkan dengan AF.

AF juga mungkin disebabkan komplikasi masalah jantung, diabetes atau tekanan darah tinggi.

AF boleh bersifat sekejap ada, sekejap tiada hingga pesakit tidak menyedari dia berhadapan dengan AF. Namun, AF juga boleh terjadi pada tahap kronik.

Rawatan AF

Selalunya masalah AF ditangani dengan pemberian ubat-ubatan, tetapi ia tidak memberi kesan yang sama kepada semua pesakit. Ini kerana ada pesakit yang boleh sembuh dengan ubat tetapi ada pesakit yang masih mengalami AF walaupun selepas menerima rawatan.

Justeru, satu lagi rawatan yang diberikan jika terapi ubat-ubatan gagal ialah prosedur kateter (tiub) radiofrekuensi ablasi (ablation - prosedur memusnahkan tisu di satu-satu kawasan). Dalam prosedur berkenaan, tenaga radiofrekuensi akan digunakan bagi memusnahkan tisu abnormal yang menyebabkan AF terjadi.

Biasanya, kateter akan dimasukkan ke jantung melalui kemasukan kecil pada vena dan terus ke jantung. Ia dimasukkan ke vena melalui kaki. Di hujung wayar kateter ada elektrod yang menghantar gelombang radio bagi menghasilkan tenaga. Tenaga itu memusnahkan tisu jantung yang menyebabkan atrial tidak berdegup dengan betul.

Bagaimanapun, prosedur ini memakan masa hampir 5 jam kerana ia memerlukan doktor menjelajah dan melakukan ablasi atrium kanan dengan menggunakan satu kateter elektrod yang sebenarnya direka untuk atrium kiri.

Justeru, ia perlu dilakukan dengan berhati-hati bagi mengelak terkena struktur organ berdekatan seperti saluran makanan (esofagus).

Institut Jantung Negara

Sejak 1999, Institut Jantung Negara (IJN) sudah menjalankan prosedur ini dalam masa dua jam menggunakan teknologi kateter yang lebih inovatif dalam merawat AF. Kaedah baru ini membolehkan satu prosedur invasif minimum dalam jangka masa yang lebih singkat.

Malaysia adalah antara dua negara pertama di Asia menggunakan teknologi ini selain Hong Kong.

Prosedur ini dibuat bagi mengasingkan secara elektronik vena pulmonari daripada atrial kanan. Elektrod boleh dihidupkan serentak untuk satu bulatan kateter. Kaedah ini memendekkan masa prosedur AF kepada dua jam saja.

Kaedah baru ini membolehkan katerer sampai ke vena pulmonari dan prosedur boleh dilakukan dengan cepat dan selamat.

INFO Atrial Fibrillation (AF)

* AF adalah masalah daripada ruang atas dalam jantung, biasanya di atrium sebelah kanan.

* Ia membabitkan vena di bahagian pulmonari yang membawa darah diperkaya oksigen daripada paru-paru.

* Untuk sampai ke bahagian pulmonari, dilakukan dengan memasukkan kateter melalui kaki pesakit sebelum kateter dipandu ke kawasan itu dan dengan sejumlah tenaga radiofrekuensi yang terkawal ia berupaya memusnahkan tisu kardiak.



Lagi info tentang JANTUNG :

7 Tip Jantung Sihat
Bagaimana Serangan Jantung Terjadi
Sistem Saraf Kawal Tindakbalas Jantung
Manfaat Coq10 Untuk Kesihatan Jantung/Darah Tinggi

Artificial Heart
Heart Valve Disease
More Young Malaysians At Risk From Heart Disease






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Brittle Bone Disease

Out of 100,000 people worldwide, about 6 to 7 people are affected by osteogenesis imperfecta (also known as brittle bone disease), a group of genetic disorders that mainly affects the bones. Relatively rare, this disorder causes a person to have fragile bones which may fracture easily, often from mild trauma or no apparent cause.


What causes osteogenesis imperfecta (OI) or brittle bone disease?

OI is caused by an abnormality in the genes that code for proteins that are involved in collagen production. As collagen is an important protein in our bones that keeps them strong, people with brittle bone disease have weak bones because they have poor quality collagen in their bones.

There are a few types of OI. The types can be distinguished by their signs and symptoms, although their characteristic features overlap. Increasingly, genetic factors are used to define the different forms of OI.

Who can get OI?

OI can be passed down by either one, or both parents to their child although there are some cases – usually with very bad OI – where OI is caused by a new genetic mutation. OI affects both girls and boys.

What are the signs and symptoms?

The main symptom of OI are broken bones, or fractures. Some babies with severe OI are born with fractures that have taken place in the womb or during delivery. Others have their first fracture soon after they are born.

Usually, young people with OI break bones easily. Just falling over can cause a fracture.

Thankfully, although the bones break very easily, they also mend easily. For reasons unknown, the risk of breaking bones becomes less as a person gets older.

Besides fractures, people with OI can also have :

* Loose joints/ ligaments
* Blue or grey colour of the ‘white’ of the eye - the sclera
* Discoloured or fragile teeth
* Lots of bruises
* Deafness from fractures of bones in the ear
* Hernias
* Excessive sweating

How is OI diagnosed?

The diagnosis is made by doctors from how many broken bones one has had. Other symptoms include blue or grey whites of the eyes. Sometimes someone with OI will have none of these symptoms and diagnosis can be very difficult.

X-rays can sometimes show up old fractures or changes in the bone structure that suggest the condition. But most of the time, x-rays and even bone density scans are surprisingly normal.

Genetic studies on skin samples (biopsies) can sometimes help confirm OI. But a 'negative' test does not rule the condition out. It just means you might have an unusual genetic change that has not been found before.

What are the treatments available?

Treatment is mostly good orthopaedic care when people with OI get a fracture. It is important that each fracture heals in a good position, and patients are encouraged to start moving around as soon as possible to keep their muscles and bone as strong as possible for a full recovery.

Bisphosphonates are being increasingly administered to increase bone mass and reduce the incidence of fracture.

For young people who get a lot of fractures, metal rods can be inserted into weak bones to help hold them together and stop them from breaking.

The care of OI patients is a multidisciplinary one. Team members may include an occupational therapist (OT), a physical therapist (PT), nutritionist, an audiologist, an orthopedic surgeon, neurosurgeon, lung specialist, and nephrologist, amongst others.


More info on BRITTLE BONE DISEASE here.






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Artritis 'Memakan' Sendi


Oleh : Norlaila Hamima Jamaluddin

Sakit terseliuh kaki ketika bermain futsal mengambil masa hampir seminggu untuk hilang. Itu baru terseliuh, bagaimana agaknya kesakitan ditanggung pesakit artritis yang menderita sakit sendi setiap hari, terutama pada waktu pagi sebaik bangun tidur.

Artritis, terutama artritis reumatoid, menyerang ramai orang pada kemuncak hidup mereka. Antara kebimbangan utama pesakit ialah sama ada mereka dapat terus menjalani hidup dengan baik dan mempunyai karier seperti orang lain.


Sebenarnya pesakit artritis (tidak kira apa jenis artritis) masih boleh bekerja jika penyakit mereka terkawal. Ini sebabnya kita perlu tahu tanda awal sakit sendi dan segera berjumpa doktor supaya masalah anda dapat dikesan secepat mungkin. Semakin lama dibiarkan, masalah sakit sendi boleh bertambah buruk, terutama jika ia disebabkan keradangan pada sendi.

Keradangan ini secara perlahan-lahan ‘memakan’ dan merosakkan sendi sehingga menyebabkan sendi seseorang bukan saja berubah bentuk, tetapi hilang fungsinya sama sekali. Dalam keadaan ini, tidak banyak boleh dilakukan kecuali menjalani pembedahan penggantian sendi.

Artritis tidak harus menjadi penghalang seseorang untuk hidup dengan baik. Secara umumnya pesakit masih boleh bekerja jika penyakit mereka terkawal. Pilihan sama ada mahu bekerja atau tidak terletak pada pesakit itu sendiri.

Kebolehan untuk bekerja juga bergantung kepada tahap penyakit dan sama ada pesakit boleh melakukan sesuatu kerja itu. Dalam hal ini pesakit boleh membincangkan kebimbangan mereka dengan pakar reumatologi atau fisioterapi untuk mendapatkan penyelesaian.

Mereka boleh memilih untuk tidak bekerja tetapi jika bekerja, ia bukan saja mampu mengelak pesakit terlalu memikirkan masalah dan penyakit mereka, malah mempunyai pendapatan tetap bagi menampung kos ubat serta dapat mengembangkan rangkaian sosial untuk berkongsi masalah.

Apabila disahkan menghidap artritis, biasanya pesakit dinasihatkan belajar menguruskan rutin apabila sendi mereka tidak mengalami keradangan dan kesakitan. Pada masa sama pesakit perlu memperlahankan rentak hidup atau mengagihkan kerja kepada rakan sekerja ketika mengalami keradangan.

Pembedahan Penggantian Sendi

Selain mengamalkan beberapa senaman dan mengambil ubat, masalah sakit sendi boleh diatasi dengan pembedahan penggantian sendi.

Bagaimanapun, ia langkah terakhir selepas kaedah lain seperti berehat, rawatan sejuk dan panas (meletakkan pek sejuk dan panas pada sendi), melakukan senaman, menggunakan penganduh (kain yang digantung pada leher untuk mengampu tangan yang sakit) dan pengambilan ubat gagal memberi kesan positif.

Penyakit artritis kadangkala boleh mendatangkan kerosakan teruk kepada pesakit dan mengakibatkan kesakitan dan lumpuh. Dalam kes begini, peralatan gantian tiruan atau pembedahan ortopedik diperlukan untuk melegakan kesakitan dan memulihkan pergerakan. Ini akan meningkatkan kualiti hidup seseorang pesakit.

Tujuan utama pembedahan sendi adalah menghilangkan kesakitan dan ini memberi kesan baik terhadap kelancaran pergerakan serta meningkatkan keupayaan seseorang.

Pembedahan sendi juga disyorkan apabila sendi tidak ada pada posisi sepatutnya atau menjadi cacat disebabkan keradangan berpanjangan.

Apabila keadaan ini berlaku, bahagian sendi terbabit berasa sakit dan tidak dapat berfungsi dengan baik. Dalam kes begini pembedahan disyorkan bagi mengatasi masalah kesakitan dan membolehkan sendi yang diserang berfungsi lebih baik.

Beberapa bahagian sendi dapat diperbaiki untuk tumbesaran dengan meluruskannya, iaitu sendi pada pinggul, lutut, tangan dan pergelangan kaki. Sendi ini berfungsi dengan lebih baik selepas menjalani pembedahan. Ia juga kelihatan lebih kemas dan kesakitan dialami berkurangan.

Persediaan Sebelum Pembedahan

Sebelum menjalani pembedahan, beberapa perkara perlu dipertimbangkan iaitu:

* Adakah pembedahan akan memperbaiki cara dan kualiti hidup anda? Setiap orang ada keperluan hidup berbeza. Justeru, pesakit perlu berbincang mengenai apa yang diinginkan dengan doktor.

* Keadaan kesihatan dan keupayaan anda untuk menanggung kesan pembedahan dan ubat bius. Masalah kesihatan seperti jantung, paru-paru dan jangkitan kuman mesti dirawat terlebih dulu sebelum menjalani pembedahan.

* Seseorang yang mempunyai berat badan berlebihan mesti mengurangkannya terlebih dulu kerana berat badan berlebihan menambah tekanan kepada jantung dan paru-paru ketika pembedahan. Pesakit gemuk biasanya menghadapi lebih banyak komplikasi pembedahan dan proses pemulihan juga sukar dan lambat. Malah, kegemukan dan berat badan berlebihan memberi lebih tekanan kepada sendi tiruan dan seterusnya boleh memendekkan jangka hayat sendi baru itu.

* Selepas melakukan pembedahan anda perlu menjalani peraturan ketat untuk sesi fisioterapi, senaman dan pengambilan ubat. Perkara ini mesti difahami sebelum menjalani pembedahan.

Jenis Pembedahan

Sinovektomi — Satu prosedur di mana lapisan sendi (yang dikenali sebagai sinovium) dikeluarkan daripada sendi untuk mengurangkan bengkak dan kesakitan akibat keradangan. Pun begitu selepas pembedahan, pesakit mungkin mengalami masalah sendi kaku atau keras. Tisu sinovial juga mungkin tumbuh kembali selepas beberapa tahun.

Reseksi — Pemindahan tulang atau bahagian tulang yang biasanya dilakukan apabila sendi pada bahagian kaki mendatangkan kesukaran atau kesakitan ketika berjalan.

Artrodesis atau penguncian tulang — Ini adalah pembedahan untuk menyatukan dua tulang, biasanya pada pergelangan kaki, pergelangan tangan dan ibu jari. Meskipun kejayaan pembedahan ini menghilangkan kesakitan, ia juga menghilangkan keanjalan sendi.

Artroskopi — Cara di mana pakar bedah memeriksa sendi menggunakan alat yang dinamakan artroskop iaitu tiub nipis yang mempunyai lampu di hujungnya. Kelebihan prosedur ini ialah sendi tidak perlu dibuka ketika pembedahan kecil dan ia juga dapat digunakan untuk pembedahan sinovektomi lebih rumit. Tempoh pemulihan pesakit juga lebih cepat.

Penggantian sendi (artroplasti) — Sendi yang rosak dikeluarkan dan diganti dengan sendi tiruan. Rawan pula digantikan dengan plastik tahan lama dan aloi atau bahan yang sama ciri dengannya sebagai pengganti tulang. Cara ini berkesan jika digunakan pada lutut dan pinggul. Ia dapat menghilangkan kesakitan keseluruhannya.

Berapakah Kosnya?

Kos keseluruhan rawatan bergantung kepada beberapa faktor seperti upah pakar bedah, hospital, ubat, terapi fizikal yang diperlukan, jenis implan, ujian dan rawatan khusus lain. Sukar menentukan kos sebenar terapi penggantian sendi. Rujuk kepada doktor atau syarikat insurans sebelum menjalani pembedahan.

Pun begitu, beberapa cara boleh dilakukan untuk mendapatkan rawatan tanpa mengira jenis artritis yang anda alami. Yang perlu dilakukan ialah bekerjasama dengan doktor, jururawat, pakar terapi, ahli keluarga dan paling utama diri anda sendiri.

Ini penting jika anda memilih pembedahan. Pembedahan mungkin cara terbaik untuk mengurangkan kesakitan, memperbaiki pergerakan dan untuk memperoleh kualiti hidup lebih baik.

Artritis boleh menyerang sesiapa saja. Pembedahan penggantian sendi pula memerlukan belanja besar, contohnya kos untuk peralatan gantian (lutut atau pinggul) saja berharga antara RM6,000 ke RM8,000.

Ini menyebabkan ramai pesakit daripada golongan berpendapatan rendah terpaksa menanggung penderitaan dan sesetengahnya perlu menggunakan kerusi roda atau menjadi lumpuh disebabkan arthritis.

Apabila keadaan ini berlaku, ia mendatangkan lebih banyak masalah dan meningkatkan beban pesakit serta keluarga.

Cara Menjaga Sendi

* Beri perhatian kepada gejala yang dialami. Jika sendi sakit, bengkak dan terasa panas berlarutan melebihi dua minggu, segera berjumpa doktor. Gejala ini boleh muncul secara perlahan-lahan atau mendadak.

* Dapatkan rehat dan tidur yang mencukupi.

* Elak tekanan berlebihan yang mungkin menyebabkan keradangan.

* Susun tempat kerja anda untuk mengurangkan usaha mengangkat, mencapai, mengangkut, memegang atau berjalan bagi menjimatkan tenaga (khususnya bagi pesakit artritis).

* Elak pergerakan berulang untuk tempoh panjang. Ubah aktiviti anda atau berehat selepas melakukan kerja setiap 20 hingga 30 minit.

* Lindungi sendi anda daripada sakit, tekanan dan keradangan dengan menggunakan splin atau alat perlindungan.

* Kurangkan perjalanan jauh kerana ia memerlukan banyak tenaga.

* Bersenam. Senaman membantu mengurangkan kesakitan dan menambah jarak pergerakan sendi. Ia juga boleh mengatasi kelebihan dan menjadikan anda lebih segar serta bertenaga. Jika menghidap artitis, belajar kaedah senaman yang bersesuaian dengan keadaan anda.

* Lakukan aktiviti menggembirakan. Kajian menunjukkan ketawa dan kegembiraan boleh merehatkan sendi, mengurangkan kesakitan dan meningkatkan kekuatan sistem imun badan.


Lagi info tentang ARTRITIS di SINI.






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