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FAQ Tentang Bengkung

Apa kebaikan memakai bengkung?

Mengikut ilmu perbidanan moden, kegunaan bengkung, terutama bagi ibu bersalin normal adalah untuk mengelakkan kemasukan angin sejuk di liang-liang perut. Selain itu dapat memudahkan pengeluaran angin panas dan kotor iaitu dengan ikatan barut dan ubat yang sempurna.


Bagaimanakah ciri-ciri bengkung yang baik?

Bengkung yang baik adalah bengkung yang mempunyai diameter yang panjang menutupi daripada paras bawah dada sehingga ke bawah pinggul. Ini dapat memberi sokongan yang kukuh ke atas rahim.



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Diameter bengkung yang pendek akan menyebabkan ia mudah terangkat ke atas. Ini akan menjejaskan kedudukan rahim kerana bengkung itu akan menekan rahim ke bawah dan menyebabkan posisi rahim menjadi rendah. Selain itu, bahagian pinggul serta paha akan tertinggal seperti terlebih isi dan akan menjejaskan potongan badan. Di bahagian pinggang mengecil sedangkan di bahagian atas dan bawah kelihatan besar. Ia juga akan membatasi pergerakan anda dan akan lebih berhati-hati apabila bergerak.

Berapa lama perlu memakai bengkung ketika dalam pantang?

Ketika dalam pantang bengkung seelok-eloknya dipakai sepanjang masa dan hanya ditanggalkan ketika mandi. Ianya mula dipakai dari hari ke-4 sehingga habis tempoh pantang atau seberapa lama yang anda kehendaki selepas tempoh pantang.

Sebaik-baiknya anda mempunyai 2 helai bengkung agar dapat menukar bengkung untuk membersihkannya. Kebersihan amat penting agar tidak timbul masalah lain seperti kegatalan atau kerengsaan pada kulit.

Bolehkan saya memakai bengkung selepas pembedahan?

Anda perlulah mendapatkan nasihat doktor anda sebelum memakai sebarang bengkung. Terdapat bengkung yang mempunyai ciri-ciri tertentu (seperti bengkung strap-on) yang boleh dipakai selepas pembedahan. Pastikan ciri-ciri ini adalah sesuai untuk anda. Bengkung yang tidak mempunyai ciri-ciri khas hanya boleh dipakai selepas luka sembuh atau atas nasihat doktor anda (selepas 2 minggu atau lebih).

Bagaimana pemakaian bengkung dapat membantu saya?

Pemakaian bengkung yang kemas dapat membantu mengembalikan bentuk badan ke bentuk asal dengan lebih cepat. Ia juga dapat mengekalkan posisi yang baik terutama bagi ibu-ibu yang menyusu anak.

Bengkung juga baik untuk menyokong tulang anda kerana selepas bersalin berat tidak lagi ditanggung oleh tulang belakang anda. Selain itu, ia juga menyokong dan menguatkan otot-otot abdomen yang lemah akibat regangan ketika mengandung.

Perlukah memakai minyak dengan bengkung?

Minyak berubat boleh digunakan sebagai pelembab kulit. Ianya bagi mengecutkan peranakan, mengempiskan perut dan merampingkan pinggang.


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Mouth Rehabilitation (Smile Makeover)

Teeth restored to ideal height, proportions, and bite, using crowns, veneers, and bridges.

by Dr. Sim Tang Eng

Full mouth rehabilitation involves the restoration of most of the teeth, if not all the teeth, in both the upper and lower jaws. If the situation allows and the treatment plan so indicates, the restoration can also involve only one jaw, either the upper or the lower jaw.


Because the extensive restoration of the teeth often positively impacts on the facial appearance of patients by restoring facial heights and giving the patients fuller lips, full mouth rehabilitation is also referred to as 'non-surgical facelift' or 'smile makeover'.



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Procedures

The procedures, if properly indicated and performed, do indeed make patients look younger and rejuvenated, besides restoring chewing function and enhancing smile aesthetics. However, not everybody is a candidate for this procedure. If not properly indicated, the results can be catastrophic, to say the least.

Below are the most common reasons for carrying out full mouth rehabilitation.

Bruxism

Extensive wear or attrition affecting almost all the teeth in the mouth due to bruxism, which is nocturnal parafuntion grinding of teeth. This wearing down of teeth can be so severe that the teeth can be shortened significantly, sometimes even causing the exposure of the pulp (tooth nerve), which may make root canal therapy necessary.

The facial height or length of face is partly determined and maintained by the presence of upper and lower teeth. Shortening of the teeth due to wear and tear causes the lower jaw to come closer to the upper jaw, thereby causing a shortening of the lower third of the face.

Short teeth due to excessive wear.

This can actually give rise to an aged appearance. The attrition of the upper front teeth also results in an absence of tooth display when the lips are slightly parted, as in speech or during smiling. This gives an impression or illusion that the patient is without his or her front teeth.

In fact, it is often this aesthetic concern that motivates the patient to seek consultation and treatment. In this situation, full mouth rehabilitation not only addresses the issue of restoring lost tooth structure and function, but also improves the facial profile and smile aesthetics of the patient.

Medical Problems

Severe wear of teeth can also be caused by medical problems such as bulimia nervosa and gastroesophageal reflux disease. Both medical conditions result in chemical erosion of the teeth, particularly the palatal surfaces of the upper teeth, due to the reflux of gastric acid. The tooth wear is made worse if the patient also suffers from bruxism.

The effects of this type of tooth wear on facial profile and smile aesthetics are similar to those caused by bruxism. In order to protect the tooth structure from further destruction by gastric acid reflux, the ideal restoration involved in full mouth rehabilitation for this type of tooth wear will be full coverage ceramic crowns.

Ceramic veneers, which cover only the facial surfaces of the teeth, are not suitable as the palatal surfaces will continue to be attacked by acid erosion. The patient must also be treated medically by the appropriate medical specialists.

Loss of Teeth

Early loss of posterior teeth or molars that are not replaced often results in collapse of the bite. The occlusal loading or biting force which concentrates on the remaining front teeth often results in excessive wear or even affects mobility of these teeth.

In such cases, the patient will require full mouth rehabilitation to restore the missing posterior teeth with either bridges or implants and the front teeth will need to be restored to normal function with either crowns or veneers.

Painful Mouth

Painful conditions of the temporomandibular joint (TMJ), jaw muscles, and even headaches can result from poor occlusion (bite) due to excessive tooth wear.

Smile Makeover

Full mouth rehabilitation is sometimes carried out electively to improve the aesthetic appearance of the smile. In such cases, the procedure is usually referred to as a smile makeover, usually to address :

1. Dark tetracycline-stained teeth that are resistant to tooth bleaching or whitening.

2. Slight spacing or gaps between teeth due to hypodontia (congenital absence of several teeth) or early loss of some teeth, resulting in shifting or movement of the adjacent teeth.

3. Mild crowding or mal-position of the teeth

4. An uneven smile line due to a slanting or canted occlusal plane (horizontal plane of teeth arrangement when patients are viewed face on).

Multiple Phases

It must be pointed out that full mouth rehabilitation involves multiple phases. First of all, a thorough examination of the mouth is carried out. Your dentist will take note of the condition of existing teeth, especially the wear patterns, in order to ascertain the cause of the wear.

Your gum will also be evaluated and assessed for the presence of any gum disease. Any tooth decay and gum disease must be treated first before embarking on full mouth rehabilitation.

Radiographs are an integral part of the examination to assess the health of the roots of teeth, the supporting alveolar bone, and also the TMJ. Any hidden pathology of the jaw bone and hidden decay in between the teeth can easily be detected on radiographs as well.

A thorough analysis of your occlusion (the way your upper and lower teeth bite together while at rest and during function) has to be done. Impressions of your teeth will be made to produce models of your jaws. Your bite pattern and jaw relationships will also be recorded using a specialised instrument called a face-bow.

These records will then be used to mount your jaw models in the correct spatial position relative to your face on a special device called an articulator, which is a mechanical instrument used to simulate jaw movements.

With this done, we have your jaw models that move in almost the same manner on the articulator as your jaws do in your mouth. This way, a very detailed analysis of your occlusion and problems can be done, and an appropriate comprehensive treatment plan can be formulated.

A diagnostic mock-up of the final ideal occlusion and teeth arrangement will also be done on the mounted models on the articulator. That will form the blueprint of the entire treatment, much like an architectural drawing for a proposed building.

Photographs, both intra-oral and extra-oral, also aid in the treatment plan. Proper diagnosis and treatment planning is key to the eventual success of the treatment. The treatment plan may call for an inter-disciplinary approach with referrals to an orthodontist, oral surgeon, and endodontist.

As such, full mouth rehabilitation may involve multiple treatment stages and may take from a few months up to even a year or more in complicated cases. In cases that involve painful TMJ and jaw muscles, the patient may need to undergo bite readjustment by wearing a plastic bite splint to reposition the jaws to the optimal position before commencing on the actual treatment.

If your request is for a smile makeover, your dentist will need to address your specific concerns and expectations, besides carrying out the detailed examination and bite pattern analysis described above.

Interview

A proper interview is vital to assess whether the patient's expectations are realistic and achievable. You have to bear in mind that a smile makeover is an elective procedure which, unfortunately, involves invasive preparation of most, if not all, teeth in the mouth. Therefore, unless it can achieve the objectives you expect, you have to consider this option very carefully.

Since full mouth rehabilitation involves the preparation of all the teeth in the mouth, the patient's original bite pattern or occlusion will be lost with the removal of the biting surfaces of the teeth. A new occlusal scheme as determined by the diagnostic mock-up will be incorporated into the treatment to ensure that the patient will end up with a proper bite when they receive their new ceramic restorations.

Post Treatment

A very common problem faced by patients who have undergone such extensive treatment is the inability to bite and eat properly for many months. While some patients with better adaptive ability and robust TMJ eventually overcome the problem, there are also a few who need to have the whole treatment redone.

Therefore, behind the facade of the perceived nice set of new teeth, the central issue in full mouth rehabilitation and smile makeover is proper management of occlusion and biology of teeth and gums.

Not only should you look good immediately after the new white crowns and veneers are cemented, but the results must be long-term and the treatment should not adversely affect the health of your teeth, gums, and TMJ.

It is very easy to get excited and carried away when your dentist promises you a 'winning smile' because it is such an emotional thing, but it would be wiser for you to seek a second or even third opinion as to whether you should proceed with the treatment.

The last thing you want is to have your 'winning smile” turn into 'waning smile' because of a wrong diagnosis, improper treatment plan, and lack of the required clinical skills to carry out such a demanding treatment.


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Kelebihan Menyembelih Binatang



Masyarakat Barat termasuk aktivis hak asasi haiwan menganggap perbuatan menyembelih haiwan yang dilakukan umat Islam mempamerkan sikap tidak berperikemanusiaan kerana banyak darah tertumpah ke bumi terutama ketika amalan korban pada Aidiladha.

Undang-undang Barat

Di Barat, undang-undang mereka memperuntukkan supaya haiwan dikenakan kejutan elektrik di kepala sebelum dibunuh, kononnya bagi memastikan haiwan itu pengsan terlebih dulu sebelum ia dibunuh.

Selain itu, kononnya tindakan mereka itu bertujuan untuk menghalang binatang berasa sakit sebelum ia mati. Tetapi sekali lagi apakah pandangan Barat ini benar?

Pendirian Islam

Pendirian Islam mengenai apa yang boleh dimakan dan apa yang diharamkan adalah jelas terutama membabitkan daging. Dalam Surah al-Maidah ayat 5, Allah SWT menyatakan :

"Diharamkan kepada kamu (memakan) bangkai, dan darah, dan daging babi, dan binatang-binatang yang disembelih kerana yang lain dari Allah, dan yang mati tercekik, dan mati dipukul, dan mati jatuh, dan mati ditanduk, dan yang mati dimakan binatang buas, kecuali yang sempat kamu sembelih, dan yang disembelih atas nama berhala."

Selain itu, Islam juga mengharamkan memakan daging haiwan tanpa disembelih seperti mencucuk leher, menghempap dengan batu atau cara selain daripada sembelihan. Islam mengajar supaya sembelihan dilakukan dengan pisau tajam bagi memotong bahagian leher untuk memutuskan dua urat utama atau urat mareh. Kaedah ini dikaji pakar Jerman.

Haiwan Tidak Mengalami Kesakitan

Pakar itu, Profesor Wilhelm Schulze [rujuk di Wikipedia] dan rakannya, Dr Hazem di Sekolah Perubatan Veterinar, Universiti Hannover, Jerman, mencari kaedah terbaik proses mematikan haiwan bagi mendapatkan daging yang bersih dan segar.



Kajian itu bertajuk, 'Cubaan untuk mengesan kesakitan dan rasa sedar mengikut kaedah konvensional (pistol kejutan) dan agama ketika menyembelih lembu atau kambing' (Experiments for the objectification of pain and consciousness during conventional (captive bolt stunning) and religiously mandated (ritual cutting) slaughter procedures for sheep and calves) [download kertas kajian], menyimpulkan kaedah sembelihan adalah terbaik kerana lebih berperikemanusiaan.

Mereka menyimpulkan bahawa amalan mengenakan kejutan elektrik ke atas haiwan sebelum dibunuh seperti yang diamalkan oleh Barat, mendatangkan kesakitan yang amat sangat pada haiwan. Dalam kajian itu, beberapa alat pengesan dipasang di pelbagai tempat pada otak haiwan. Alat itu dimasukkan menerusi pembedahan khas dan haiwan terbabit dibiarkan untuk pulih selama beberapa minggu. Beberapa ekor haiwan itu disembelih mengikut kaedah Islam menggunakan tindakan pantas, memotong urat leher dengan pisau tajam. Beberapa ekor haiwan lain dibunuh mengikut kaedah barat menggunakan pistol kejutan (captive bolt pistol - CBP).

Ketika ujian dijalankan, rekod electroencephalograph (EEG) dan electrocardiogram (ECG) dicatatkan bagi mengetahui keadaan otak dan jantung semua haiwan terbabit ketika proses penyembelihan dan kaedah CBP. Hasil ujian mendapati menurut kaedah Islam, 3 saat pertama ketika disembelih, EEG tidak mencatatkan sebarang perubahan pada graf sama seperti sebelum penyembelihan. Keadaan itu membayangkan bahawa haiwan itu tidak berasa sebarang kesakitan ketika atau sebaik saja pisau memotong urat leher terbabit.

Untuk 3 saat kedua, EEG mencatatkan keadaan tidur lena atau tidak sedar diri. Ini disebabkan banyak darah mengalir keluar dari badan. Selepas 6 saat, EEG mencatatkan paras sifar, menunjukkan haiwan itu tidak merasai sebarang kesakitan. Ketika mesej otak (EEG) jatuh ke paras sifar, jantung masih mengepam dan badan haiwan masih dapat bergerak akibat tindak balas daripada saraf tunjang, menyebabkan semua darah keluar dari badan haiwan menghasilkan daging yang selamat untuk dimakan, menurut penyelidikan itu.

Bagaimanapun, ketika mengkaji kaedah CBP, haiwan dikesan terus pengsan sebaik saja menerima tembakan CBP dan EEG menunjukkan bacaan amat sakit pada haiwan itu. Jantung haiwan itu berhenti berdenyut lebih awal selepas terkena kejutan berbanding haiwan yang disembelih. Keadaan itu menyebabkan banyak darah masih terkumpul dalam daging dan ia sebenarnya tidak selamat untuk dimakan.

Hindari Penyakit

Kajian juga menunjukkan kaedah mematikan haiwan yang digunakan oleh Barat dan bukan Islam, turut dikatakan menjadi punca kepada penularan wabak penyakit lembu gila daripada haiwan kepada manusia. Kaitan ini didedahkan menerusi kajian yang dijalankan oleh Universiti Texas dan Agensi Pemeriksaan Makanan Kanada. Ia menyatakan, kaedah kejutan pneumatik (iaitu menembak bola besi ke otak lembu diikuti dengan mengenakan tekanan udara tinggi) menyebabkan kerosakan tisu otak serta saraf tunjang haiwan itu.

Laporan ini amat menggemparkan kerana tisu otak dan saraf tunjang adalah bahagian yang paling terjejas teruk jika dijangkiti penyakit lembu gila dan apabila ia hancur akibat kaedah berkenaan, bakteria serta protein penyakit lembu gila akan merebak ke daging. Malah, lebih menggemparkan, kaedah ini digunakan ke atas 30-40% lembu yang dimatikan untuk diambil dagingnya di Amerika Syarikat.

Secara umumnya, sebarang penyakit daripada haiwan dapat dihindarkan dengan cara sembelihan. Ini kerana darah yang merupakan bahantara kuman, bakteria dan toksin dikeluarkan dengan banyak dari badan haiwan dalam proses penyembelian.



Daging Lebih Lembut, Segar dan Bersih

Malah, kajian lain yang dijalankan di seluruh dunia juga mendapati daging menjadi lebih lembut dan segar berbanding daging yang tidak disembelih menurut Islam seperti ujian yang dijalankan ke atas ayam sembelih dan tidak sembelih. Ia juga akan kekal segar dalam masa yang lama disebabkan kurangnya darah dalam daging.

Kaedah Islam juga memastikan saluran udara, kerongkong dan 2 urat leher dipotong tanpa menjejaskan saraf tunjang. Kaedah ini membolehkan darah keluar membuak-buak dari badan haiwan dan menghasilkan daging yang bersih. Jika saraf tunjang terputus, fiber saraf ke jantung akan rosak menyebabkan jantung terhenti dan darah akan terkumpul di dalam daging.

Darah perlu dikeluarkan sepenuhnya sebelum kepala diceraikan. Keadaan ini akan membersihkan daging itu kerana darah bertindak sebagai perantara kepada mikro-organisma.

Belas-kasihan Terhadap Haiwan



Kajian terbabit jelas membuktikan bahawa penyembelihan menurut kaedah Islam adalah cara yang terbaik bukan saja untuk kebaikan haiwan itu sendiri tetapi juga memberi manfaat kesihatan kepada manusia. Selain itu, Islam mengenakan beberapa langkah lain bagi memastikan penyembelihan ini dapat disempurnakan dengan lebih baik.

Dalam aspek ini, Nabi Muhammad SAW pernah mengarahkan supaya sentiasa belas kasihan terhadap haiwan dengan memastikan pisau yang digunakan benar-benar tajam bagi mengurangkan rasa sakit. Islam menjelaskan, proses menyembelih perlu dilakukan dengan pantas bagi memutuskan salur darah ke saraf otak kerana saraf ini yang menghantar mesej kesakitan kepada otak. Dengan itu, haiwan tidak akan berasa sakit ketika disembelih. Pergerakan dan kekejangan yang berlaku selepas haiwan itu disembelih, bukan akibat kesakitan tetapi akibat denyutan diikuti keadaan tenang.

Selain itu, sunnah Nabi Muhammad SAW juga menegaskan, adalah tidak wajar seseorang penyembelih, menajamkan pisaunya di depan haiwan yang akan disembelih atau menyembelih seekor haiwan itu di depan haiwan lain.

Dengan bukti ini, seharusnya aktivis hak asasi Barat berkempen supaya menggunakan kaedah Islam ketika proses penyembelihan serta mensasarkan kecaman mereka terhadap kaedah selain daripada Islam yang terbukti lebih kejam dan tidak berperikemanusiaan.


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Kelebihan Berkhatan


Berkhatan adalah pembedahan kecil yang dilakukan bagi membuang kulit hujung (muncung) zakar. Tujuan utamanya ialah untuk menjaga kebersihan. Sebagai satu tuntutan agama, berkhatan adalah satu kebiasaan dalam masyarakat Islam di Malaysia.

Prosedur ini dilakukan ketika kanak-kanak berumur antara 5 hingga 12 tahun dan amat digalakkan ketika mereka berumur 10 tahun ke bawah bagi menghindar sifat malu dan mereka perlu bersih dari najis dan kekotoran sebelum mengerjakan solat 5 waktu.

Kelebihan Khatan

Kebersihan - Mengelakkan Smegma

Kulit yang berlebihan pada hujung zakar mempunyai iklim yang amat sesuai untuk pertumbuhan kuman kerana ia sering cedera, lembap dan bersifat menakung. Ia menakung kotoran saki baki air kencing dan menghasilkan longgokan putih dan berbau busuk yang dikenali sebagai 'smegma'.

Smegma ialah najis yang membatalkan air wuduk dan sembahyang. Smegma juga menjadi faktor penyebab jangkitan kuman pada zakar seperti phimosis, paraphimosis atau balanitis. Dalam keadaan yang serius, ia menyebabkan kesakitan yang teruk dan kesukaran membuang air kecil.

Elak Jangkitan Kuman Salur Kencing

Kajian telah membuktikan bahawa bayi yang berkhatan mempunyai 10 kali lebih rendah kadar risiko jangkitan kuman salur kencing berbanding mereka yang tidak berkhatan. Jangkitan kuman salur kencing pada kanak-kanak kecil adalah serius kerana tanpa rawatan ia akan merosakkan fungsi buah pinggang dan mengakibatkan kuman tersebar ke seluruh tisu badan.


Mengurangkan Risiko Kanser

Berkhatan juga mampu mengurangkan risiko penyakit kanser terutama kanser zakar, prostat, serta kanser serviks (pangkal rahim) dan payudara kepada wanita.

Telah dibuktikan bahawa kuman yang dinamakan Human Papilloma Virus (HPV) adalah antara faktor pencetus kanser serviks di kalangan wanita. Kuman ini didapati berlindung di bawah kulit hujung zakar dan dipindahkan kepada wanita semasa persetubuhan. Terdapat kajian menunjukkan jika semua lelaki berkhatan, maka sebanyak 20% kadar kejadian kanser serviks boleh dielakkan. Virus sama juga boleh mencetuskan kanser payudara.

Kajian pemerhatian turut menunjukkan risiko kanser zakar rendah di kalangan mereka yang berkhatan, lebih-lebih lagi bagi mereka yang berkhatan pada umur kurang dari satu tahun. Hasil dari kajian ini, ramai orang bukan Islam juga mengamalkan khatan.

Kajian di beberapa negara Eropah menunjukkan lelaki yang berkhatan mempunyai kadar risiko kanser prostat 2 kali lebih rendah. Kejadian kanser ini ada hubung kait dengan penyakit kelamin di mana lelaki berkhatan mempunyai risiko yang rendah untuk mendapat penyakit tersebut.

Mencegah HIV

Pada 28 Mac 2007, Pertubuhan Kesihatan Sedunia (WHO) telah mengeluarkan kenyataan penting berkenaan kaedah pencegahan kuman HIV. Kenyataan itu berbunyi,
'Kajian saintifik telah membuktikan tanpa sebarang keraguan bahawa lelaki berkhatan mengurangkan kadar perpindahan kuman virus HIV kepada wanita atau isteri. Seeloknya, berkhatan dilakukan sewaktu berumur lebih kurang satu tahun kerana kadar risiko dan komplikasi prosedur lebih rendah'.

Berkhatan juga telah mula diamalkan di negara yang berisiko tinggi akan jangkitan HIV seperti di beberapa buah negara di benua Afrika.

Kesediaan Anak

Adakah anak-anak anda bersedia untuk dikhatankan? Sebagai ibu bapa, amat penting bagi kita memastikan fizikal dan minda anak kita sihat sebelum berkhatan. Ia dapat mengurangkan komplikasi.

Kanak-kanak berada di dalam ketakutan bila mana ayah dan ibu menyuruh mereka berkhatan. Prosedur lebih mudah apabila kanak-kanak tersebut berada dalam keadaan tenang dan faham apa yang akan dilakukan oleh doktor kepada mereka. Maklumat yang tidak tepat menyebabkan ada kanak-kanak menjerit semasa prosedur dijalankan, malah ada yang cabut lari.

Minda kanak-kanak lelaki perlu dipersiapkan terlebih dahulu sebelum prosedur dapat dilakukan dengan mudah dan selamat. Berilah asuhan agama yang mendalam kepada mereka. Terangkan kenapa berkhatan digalakkan dalam agama Islam. Beritahu mereka kelebihan berkhatan.


Membawa kanak-kanak lelaki ke majlis kenduri berkhatan adalah cara yang baik. Ia memberi idea kepada kanak-kanak tersebut betapa pentingnya berkhatan.

Kadang kala, kita perlu menjanjikan benda kesukaan mereka seperti alat permainan komputer atau basikal jika mereka bersetuju berkhatan. Ianya bukanlah rasuah tetapi sekadar pemudah cara.

Andai anak lelaki anda bersetuju untuk berkhatan, maka bawalah mereka berjumpa doktor atau mereka yang bertauliah. Anak anda perlu diperiksa oleh doktor bagi mengetahui tahap kesihatan dan juga bagi menghindarkan komplikasi prosedur tersebut.

Doktor perlu mengetahui dan memastikan zakar anak anda normal, anak anda tiada penyakit hemofilia (penyakit gangguan pembekuan darah), tidak mengambil ubat yang boleh mengakibatkan pendarahan seperti aspirin atau warfarin, tidak menghidap penyakit jantung reumatik dan penyakit lain seperti kencing manis, sawan, asma dan alahan. Kanak-kanak yang mempunyai masalah sebegini akan dirujuk kepada doktor pakar bedah bagi menentukan kaedah berkhatan yang sesuai dan selamat.

Prosedur

Bagi kanak-kanak yang normal dan sihat, pembedahan 'dorsal slit' adalah kaedah berkhatan pilihan Kementerian Kesihatan kerana ia mudah dan selamat. Kaedah-kaedah menggunakan peralatan moden seperti Tara Klamp atau Smart Klamp juga boleh digunakan. Walaubagaimanapun, kaedah ini hanya dilakukan di klinik atau hospital swasta kerana kosnya adalah lebih tinggi berbanding kaedah pembedahan di hospital atau klinik kerajaan.

Pada pagi sebelum ke hospital atau klinik, pastikan anak anda mandi dan beri penekanan kepada kebersihan zakar. Sebelum prosedur dilakukan, pastikan anak anda sudah membuang air besar atau kecil agar tiada sebarang masalah semasa prosedur dilakukan.

Selepas mendaftar dan borang keizinan prosedur ditandatangani, anak anda akan dimasukkan ke bilik pembedahan kecil. Anda boleh menemani anak anda dengan syarat segala prosedur bilik bedah diikuti. Sebelum prosedur, kawasan sekeliling zakar dibersihkan menggunakan bahan pembunuh kuman (disinfektan). Ia untuk memastikan kuman sekeliling tidak menjangkiti luka khatan kelak.

Ubat bius setempat diberikan agar anak anda tidak merasa sakit sepanjang prosedur. Malangnya suntikan ubat bius kali pertama sedikit menyakitkan. Sebaik sahaja anak anda mengatakan tidak sakit selepas kulit zakar mereka dikepit, maka doktor akan memulakan pembedahan. Untuk makluman semua, ubat bius hanya menghilangkan kesakitan. Anak anda masih boleh merasa zakar mereka disentuh dan dikhatankan.

Sebahagian kanak-kanak menganggap sentuhan gunting itu menyakitkan. Mereka akan menjerit kesakitan walaupun hakikatnya zakar mereka sudah kebas. Kanak-kanak sebegini akan diberikan ubat tidur atau ubat penenang. Pembedahan kecil ini kebiasaannya memakan masa antara 30 hingga 45 minit, bergantung kepada berlakunya komplikasi atau tidak.

Pemulihan

Selepas prosedur siap, zakar akan dibalut sedikit ketat bagi mengelakkan pendarahan dan mengurangkan bengkak. Anak anda akan dimasukkan ke tempat khas untuk memastikan tiada pendarahan selepas prosedur dan dibenarkan pulang selepas pendarahan dan kesakitan terkawal. Ubat penahan sakit (seperti parasetamol) dan antibiotik dibekalkan untuk 5 hari berikutnya. Anak anda dinasihatkan agar mengelakkan pergerakan cergas dalam jangkamasa 24 jam selepas berkhatan.


Selepas prosedur, zakar anak anda akan membesar dan lebam. Jangan risau, keadaan ini adalah normal. Ia akan beransur sembuh dalam 1 atau 2 minggu.

Peringatan! Ibu bapa diarahkan membawa anak mereka ke hospital dengan segera jika berlakunya pendarahan atau zakar membengkak luar biasa. Doktor akan membuat pemeriksaan dan jika perlu zakar anak anda akan dibius sekali lagi bagi membolehkan doktor mencari punca pendarahan dan menghentikannya.

Penggunaan krim berubat untuk mencegah jangkitan kuman tidak digalakkan kerana bahan ini kebanyakannya menghakis pertumbuhan tisu baru dan ini melambatkan proses penyembuhan. Cara mudah untuk mengelakkan jangkitan ialah dengan merendamkan zakar anak anda ke dalam air suam yang sudah dimasak dan diisi satu sudu garam selama 10 hingga 15 minit berulangkali setiap hari sehingga luka betul-betul sembuh.

Sakit selepas berkhatan adalah fenomena yang normal. Kadar kesakitan adalah subjektif bergantung kepada persepsi kanak-kanak tersebut. Sebahagian daripada mereka tidak merasa sakit tetapi sebahagian pula mungkin melolong kesakitan.

Jika ubat penahan sakit diperlukan, sila ikut nasihat doktor. Berlebihan dos atau kekerapan mengambil ubat tanpa panduan doktor boleh membahayakan nyawa anak anda. Sebagai contoh, berlebihan mengambil dos paracetamol mengakibatkan kerosakan hati dan kes sebegini telah beberapa kali berlaku di negara kita. Berjumpalah dengan doktor jika kesakitan tidak terkawal dengan dos ubat yang diberikan.

Jangan risau berkenaan benang jahitan pada luka zakar anak anda. Ia akan diserap dalam jangkamasa 2 minggu. Jika luka telah sembuh dan benang masih wujud, dapatkan khidmat doktor untuk membuangnya. Membiarkan benang terlalu lama mengakibatkan wujudnya lubang-lubang kecil pada kulit zakar. Ia menyebabkan ketidakselesaan atau kesakitan semasa persetubuhan apabila mereka dewasa dan berkahwin kelak.

Kesimpulannya, berkhatan adalah pembedahan kecil yang amat digalakkan kerana terdapat pelbagai kebaikan yang telah dibuktikan oleh kajian saintifik. Persediaan fizikal dan minda amat penting kepada anak anda agar prosedur yang dijalankan selamat dan anak anda akan sembuh dengan cepat.


Lagi info tentang BERKHATAN di sini.






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FAQ on Vertigo

by Dr Y.L.M

Just the other day, I experienced a sudden bout of dizziness. This dizziness was unusual. I saw everything around me spinning round and round. I had to sit down on the ground. I visited a doctor and he told me I had vertigo. What is it?


Vertigo is not a disease, but a symptom. It is described as a spinning or whirling sensation that is caused by a disturbance in your balance or equilibrium. This is usually as a result of a disorder in your vestibular system.



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If you experience a sensation of you yourself spinning, that is called subjective vertigo. If you think the objects around you are spinning instead, that is called objective vertigo.

Vertigo is worsened when you move your head, change your position, or lie down.

I have never heard of a vestibular system before. Where is it?

These actually involve the structures in your inner ear, and the nerve that connects it to its corresponding area in your brain, namely your brainstem and cerebellum.


Your sense of balance or equilibrium is maintained by this vestibular system. It allows you to stand upright, maintain your balance, and move. It coordinates and processes information from your inner ears, eyes, muscles, joints, fingertips, palms, soles, jaw, and gravity receptors on your skin and maintains how you balance yourself.

When your head moves, the signals are transmitted to your inner ear's labyrinth, which contains three semicircular canals surrounded by fluid. The labyrinth then relays the signals to your vestibular nerve, and thereupon to your brainstem and cerebellum, which are the areas of the brain that maintain posture, balance, coordination, and your sense of placement.

Because your vestibular system is so closely connected to your hearing (auditory system), anything that affects your auditory system can also affect your vestibular system.

Is vertigo dangerous then? Is it very common?

Vertigo in itself is dangerous if it makes you fall and injure yourself, such as if you experience it when you are on a balcony with a broken railing and somehow fall over!

The cause of vertigo has to be ascertained, and whether it is dangerous or not will depend on what is actually causing the vertigo, such as a tumour that is impinging on your vestibular system.

Vertigo is so common that 4 out of 10 people will actually experience it at least once in their lifetimes. It is more common in women than men, and also in older people.

What causes vertigo?

The causes of vertigo can be divided into 2 areas relating to which part of your vestibular system is affected – peripheral (inner ear) or central (vestibular nerve, brainstem and cerebellum).

In a lot of cases, no cause for your vertigo can be found.

Under peripheral vestibular disorders, the most common causes are :

* Benign Paroxysmal Positional Vertigo (BPPV). This one occurs most often when calcium debris builds up in one of the semicircular canals in your inner ear. It also occurs when your inner ear is affected by infection or injury.

This type of vertigo is usually intermittent and only lasts for a few seconds. It may be exacerbated by a change in your position, such as when you get out of bed or get up from a chair suddenly. Since it affects the inner ear, BPPV may also be accompanied by hearing loss.

* Meniere's disease. This happens when the pressure in your inner ear fluid fluctuates. It is also accompanied by ringing in your ears (tinnitus) and progressive deafness.

* Ear poisoning (also called ototoxicity) by some medications (the aminoglycoside group of antibiotics, certain anti-cancer medications containing platinum, antiepileptics, antidepressants) and chemicals such as lead, mercury and tin. Alcohol can also cause vertigo.

* Infection of the vestibular nerve (vestibular neuritis).

Central vestibular disorders may include anything that can affect that part of your brain, such as stroke, injury, migraine, multiple sclerosis, diseases that affect the entire body (such as kidney disease or thyroid disease), tumors, and so on.

Is vertigo treatable?

Definitely – treat the cause, and you get rid of the vertigo. If vertigo is caused by a drug, for example, you have to stop the drug. If it is caused by an infection, then the doctor will have to treat the infection with antibiotics.

BPPV can be treated with something called canalith repositioning, in which, basically, the patient is guided by the doctor to perform a series of head and body movements designed to reposition the calcium deposits in your ear canal! If this fails, you can take meclizine, an oral anti-vomiting drug.

Meniere's disease can be treated by reducing your salt intake and being prescribed diuretics.

There is also a form of physiotherapy for vertigo, in which you perform a series of exercises to improve your balance. It is called Vestibular Rehabilitation Therapy.


More info on VERTIGO here.






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Ketagihan Alkohol


Dari segi perubatan, pengambilan sedikit alkohol boleh menyembuhkan penyakit tertentu tetapi jika diambil secara berlebihan ia dianggap sebagai penyalahgunaan alkohol dan boleh membawa kepada ketagihan alkohol. Ketagihan alkohol merupakan satu penyakit yang boleh memudaratkan kesihatan fizikal, tingkah laku dan emosi peminumnya.


Kesan Fizikal

* Merosakkan tindak balas refleks mental dan fizikal
* Barah otak, lidah, mulut, esofagus, larink dan pundi kencing
* Merosakkan organ hati seperti sirosis, steatosis dan hepatitis
* Ulser dan gastritis
* Kecederaan otak dan masalah saraf
* Masalah jantung dan tekanan darah
* Kekurangan zat makanan dan gangguan dalam perut
* Kegemukan (obesiti) atau berlebihan berat badan
* Masalah seksual
* Kecacatan kelahiran seperti sindrom alkohol janin (FAS)



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Sindrom

Ketagihan meminum alkohol merupakan satu gejala yang sangat serius yang boleh dicegah. Ia boleh memberi kesan buruk kepada mangsa serta keluarganya. Kanak-kanak yang lahir dari keturunan yang mengamalkan alkohol mudah terdedah kepada simptom ini :

# kepala kecil
# kurang tinggi
# hilang ingatan
# masalah jantung
# masalah pembelajaran
# koordinasi yang lemah
# kekurangan berat badan
# kecacatan kaki-tangan serta sendi

Masalah yang akan dialami oleh mangsa ialah :

* masalah kesihatan mental
* waktu perbelajaran yang terganggu
* kelakuan seksual yang luarbiasa
* menghadapi masalah disiplin
* masalah dadah dan alkohol
* sukar menjaga diri seperti menjadi kutu rayau

Langkah Pencegahan

# Ketahuilah had dan batasan anda dan kekalkan prinsip ini

# Anda digalakkan minum dalam kuantiti yang sedikit

# Selang-selikan minuman beralkohol dengan minuman lain (air mineral, jus buahan, kopi, soda)

# Makan sambil minum, makanan dapat membantu melambatkan penyerapan alkohol ke dalam badan

# Cari jalan lain untuk menenangkan diri anda selain dari alkohol (hobi, senaman, aktiviti fizikal dan menonton wayang)

# Sedarilah bahawa anda sebagai simbol dan model yang baik kepada anak-anak anda kerana mereka belajar dari apa yang mereka lihat

# Jangan meminum alkohol semasa memandu, ketika mengambil ubat-ubatan atau mengendalikan mesin. Perbuatan yang demikan memudaratkan anda

Peringatan : Meminum alkohol/arak adalah HARAM di sisi Islam


Lagi info tentang ALKOHOL di sini.






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Khasiat Buah Naga


Secara amnya, pakar sependapat dan mengakui buah naga kaya dengan potasium, ferum, protein, serat, sodium dan kalsium yang baik untuk kesihatan berbanding buah-buahan lain yang diimport.


Kajian juga menunjukkan buah ini boleh mencegah kanser usus, selain mencegah kandungan kolesterol yang tinggi dalam darah dan pada masa sama menurunkan kadar lemak dalam badan.



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Secara keseluruhan, setiap buah naga merah mengandungi protein yang mampu mengurangkan metabolisma badan dan menjaga kesihatan jantung, serat (mengawal kanser usus, kencing manis dan diet), karotin (kesihatan mata, menguatkan otak dan menghalang penyakit), kalsium (menguatkan tulang) dan fosferos (pertumbuhan tisu badan).

Buah naga juga mengandungi :

* zat besi untuk menambah darah
* vitamin B1 (mengawal kepanasan badan)
* vitamin B2 (menambah selera)
* vitamin B3 (menurunkan kadar kolesterol)
* vitamin C (menambah kelicinan, kehalusan kulit serta mencegah jerawat)

Satu lagi fakta menakjubkan ialah berdasarkan kajian terkini, khasiat buah naga tidak terhad kepada buahnya, tetapi turut wujud pada keseluruhan pokok dan sering dijadikan pencuci mulut yang lazat.


Lagi info tentang BUAH NAGA di sini.






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SMS Danger (While Driving)


by Rashvinjeet Singh Bedi

Studies show that the collision risk for drivers who text messages while driving goes up 23 times over those who do not do so as text messaging takes the eyes off the road for too many seconds.

As the experts say, it only takes a second for an accident to happen. There is more concern now that more people seem to be texting while driving, a task labelled as 'very distracting' for drivers.

Out of the 73 billion messages Malay­sians sent last year (2008), one can only wonder how many were sent out while behind the wheel of a vehicle.

United States Laws

This subject has come under close scrutiny of late in the United States, where many states have been introducing laws to ban texting while driving. This follows several major accidents linked to texting in the past few months.

Data from the American Transportation Department revealed that 11% of drivers in fatal crashes had been distracted at the time of the accident in 2008, compared with 8% in 2004.

The spike in text messaging and use of mobile phones in recent years is believed to have aggravated the problem although it was unclear how many accidents were due to texting specifically.

Malaysia Statistics

There are no statistics available in Malay­sia on the phenomenon but Malaysian Institute of Road Safety Research (MIROS) says that distracted driving contributes to out-of-control driving.

This, in turn, is one of the biggest contributors to accidents.

For collisions in 2007, out-of-control driving contributed to 23% (1318 out of 5672 cases) of fatal accidents and 14% of overall accidents (3674 out of 27035 cases). It is probably higher here compared to Western countries as more Malaysians use their phones and text when driving.

Major Culprit

MIROS believes that mobile phones are one of the biggest distractions. Phones are a major culprit even though we have laws prohibiting their use while driving.

It is believed that road safety has a lot to do with prevailing culture and while the mobile phone has given us a sense of urgency, it has become a distraction.

When the phone rings, there is a compulsion that we have to pick it up. The mobile phone provides promptness but this is dangerous when driving.

Texting is worse than talking. There are cases where even motorcyclists are texting. This is very dangerous because their concentration level is minimal.

It will be difficult to prove that a driver was texting. It is easier to spot a driver who is holding his mobile phone to his ear and slap him with a summons of RM300 than one who is texting.


Hands-free Also Distract

Studies have shown that using a hands-free device causes as much a distraction as talking on the phone.

When talking (without hands-free kit), we do not have full control of the steering wheel and our concentration is divided between the conversation and the road.

When using the hands-free device, only our concentration is divided. But studies overseas have shown that both scenarios impair our judgement similarly.

So logically, this would mean texting presents more danger than talking, as our eyes are off the road for more seconds.

Study

Last month (October 2009), a study by the Virginia Tech Trans­portation Institute (VTTI) in the US found that drivers sending or receiving text messages take their eyes off the road much longer than they do when talking or listening on their mobile phones.

The study found that the collision risk for drivers who sent text messages went up 23 times over those drivers who did not use texting devices. It also showed that text messaging had the longest duration of eyes off road time (4.6 seconds over a 6-second interval).

The study compared this to a driver traveling the length of a football field (about 110m) at 88kph without looking at the road.


Accidents Happen in a Snap

It must be reminded that accidents happen in a split second – a vital second in which one needs to make a decision and react.

When we are driving, we make a lot of decisions and this includes split-second decisions. We have to factor in the risk behaviour of others. If we are distracted, we might not be able to react in time or we might make a wrong decision.

For example, if the motorcycle comes in front of us suddenly and if we are distracted, we might not be able to stop our car in time.

If we come to a T-junction and are turning right, we have two decisions to make – judging traffic on the near side and the far side. This is called the acceptance gap. If we are distracted, we might underestimate the gap, especially if it is dark or if we are being obstructed.

Distraction

Driving under influence of alcohol or drugs is the most dangerous distraction because the driver may not be in the right frame of mind. Lethargy is another major distraction.

Other forms of distractions include smoking, eating and fiddling around with electronic devices such as the radio or GPS.

Distractions outside the vehicle would include billboards, improper road signs and even accidents. Even fellow passengers could be a form of distraction.

We could have children making noise behind. This could increase the stress and anxiety levels. Drivers could react by speeding and driving recklessly.

As for the distraction caused by mobile phones, what can be done to stop drivers from using these devices other than the issuance of summons?

The Invincible Feeling

People have probably used their mobile phones before but nothing bad happened. But using the phone is a strict no-no. We should put it on silent while driving. We have survived thousands of years without mobile phones.

All it takes are two seconds' loss of concentration to cause life-long suffering. No amount of money can reverse that. Is it worth the risk?.


More info on SAFETY here.






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Lawak Masalah Pendengaran


Udin pergi berjumpa doktor mengeluh tentang isterinya yang sudah hilang pendengaran.

"Berapa burukkah pendengarannya?" tanya doktor.

"Entahlah, doktor. Yang jelas saya mesti menjerit kalau nak berbual dengannya."

"Okey, cuba buat macam nie. Berdiri sejauh 6 meter darinya, lalu katakan sesuatu. Kalau dia tak boleh dengar kamu, berdirilah lebih dekat sedikit darinya, lalu katakan yang kamu katakan tadi. Kalau dia tidak juga dengar, dekatkan jarak sedikit demi sedikit. Dengan begitu saya akan tahu berapa jarak maksima pendengarannya."

Maka, Udin pulang ke rumah dan mendapati isterinya sedang memasak di dapur. Dari jarak 6 meter dia berteriak, "Kita makan apa malam ni?"

Tak ada jawapan. Lalu dia jalan depan sedikit lagi, berhenti pada jarak 5 meter dan menanyakan hal yang sama. Juga tak terdengar jawapan. Begitu juga pada jarak 3 meter.

Akhirnya, ia berdiri di samping isterinya. "Kita makan apa malam ni?" katanya separuh menjerit.

Si isteri dengan mata yang berlinangan dengan air mata, lalu menjerit, "Untuk keempat kalinya aku beritahu, KARI KAMBING!!!!"


Lagi info tentang HILANG PENDENGARAN di sini.






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Understanding ADHD

by Assoc. Prof. Teoh Hsien-Jin

Attention deficit hyperactivity disorder (ADHD), a developmental disorder, typically presents itself in childhood, usually by the age of 7. It is one of the most prevalent childhood behavioural disorder. Worldwide, ADHD is said to affect 3% to 5% of the population.


ADHD can impact all major aspects of a child's life, including socialisation, academic achievement, physical and psychological wellbeing, and many more. However, research has found that some people do show a decline in symptoms as they age.

The symptoms of ADHD also seem to respond to treatment, proving that though ADHD is a serious diagnosis, it does not reflect a bleak future for people living with it.



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Symptoms of ADHD

There are generally 3 core features that are observed in children with ADHD, which are inattention, hyperactivity, and impulsivity. In addition to that, some secondary features include impaired intelligence and academic achievement, socialisation difficulties, and emotional problems.

Inattention – Children with this symptom usually have a hard time sustaining their attention on tasks and they get easily distracted and bored with the tasks given, usually within a few minutes. More specifically, they are often easily distracted by irrelevant sights and sounds, failing to pay attention to details, and making careless mistakes. They find it difficult to follow instructions, often jumping from one activity to another.


Hyperactivity – Hyperactive children are constantly in motion and they often move around touching and playing with anything they see. They also talk incessantly. They find simple tasks like sitting still difficult. In young children, behaviours such as darting out of the house or into the street and climbing and jumping are often observed as these children seem to have boundless energy.

Impulsivity – Impulsive children appear to be unable to curb their immediate reactions or think before they act. It is observed when the child often answers a question before the questioning is completed, has difficulties waiting for his turn, and is always interrupting people. ADHD children showing signs of impulsivity are also restless, have difficulty staying still, and talk excessively. This symptom may also lead to anxiety, panic attacks, agitation, and depression.

Intelligence and academic achievement – Children with ADHD commonly show some intelligence deficit characteristics such as general coordinating deficit, attention deficit, memory deficit, specific learning disability, and disorders of speech and hearing.

Socialisation problems – ADHD children also show symptoms of poor social judgment in their behaviour and relationships. As a result of this, such children have difficulties in making and sustaining friends as they show poor communication and socialisation skills.

Emotional problems – Some individuals with ADHD tend to have symptoms of emotional instability, which include excessive worrying, sense of insecurity, mood swings, and low self-esteem.

In addition, numerous children with ADHD have other serious social and emotional disorders such as depression, anxiety, bipolar disorder, and so on.

Arguments on ADHD

Is ADHD a real and behaviourally significant disorder?

For as long as ADHD has been recognised as a disorder, there have been arguments claiming that it is not. Opponents of the idea that ADHD is a behaviourally significant disorder claim that ADHD is merely a ploy and the symptom characteristics is actually brought upon by normal childhood energy and oversensitive parents.

Perhaps the most daring claim is that the symptoms of ADHD are exaggerated by pharmaceutical companies aimed at maximising their profits.

Nevertheless, based on the expert opinions of a group of highly educated professionals, which include the World Health Organisation (WHO), the National Institute of Health (NIH), and the American Psychological Association (APA), ADHD is not only recognised as a legitimate disorder, steps to improve the situation for people with ADHD have also been taken by these groups. The mutual acceptance is that ADHD is indeed a real disorder that is behaviourally significant.

Help is Available

Seeing that the symptoms of ADHD are highly impairing, naturally, as with other disorders, treatments are devised in order to improve such symptoms. These treatments include medical management, behavioural treatments (parent training), and child-focused treatments.

The most established and effective treatment for ADHD appears to be medical management. Medication can improve the individual's control of his ADHD symptoms, reduce aggressive behaviour, and reduce hyperactivity. Behavioural treatments also seem to be able to improve the academic performance and social behaviour of people with ADHD symptoms.

Parent training, which involves teaching parents how to specifically manage the ADHD symptoms of their children, has shown very positive results in reducing the severity of symptoms and problem behaviours at home.

Note that the diagnosis and treatment for ADHD may differ as the level of severity of this developmental disorder may vary across children. It is always important to seek the advice of your healthcare professional regarding the most appropriate intervention for your child.


More info on ADHD here.






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Tiga Peringkat Dengkur


Berdengkur adalah bunyi bising semasa bernafas, apabila sebahagian daripada saluran pernafasan atas seseorang tersumbat. Ia berlaku apabila terdapat sekatan pada aliran udara di dalam saluran pernafasan di bahagian belakang mulut dan hidung seseorang.


Bunyi itu dikeluarkan apabila tisu di bahagian atas saluran pernafasan bergesel dan bergetar di antara satu sama lain. Berdengkur bertambah kerap mengikut umur dan biasanya tidak membahayakan.



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Sebab-sebab Berdengkur

Lemah otot-otot pada lidah, lelangit lembut dan tekak.
Apabila otot tidak tegang akibat arak atau ubatan yang menyebabkan otot lemah, lidah akan tertolak ke belakang, menutupi aliran udara atau otot tekak tertarik masuk ke dalam tekak dan menyekat salur pernafasan atas.

Tisu tekak yang besar dan tebal.
Kanak-kanak yang mempunyai tonsil dan tisu adenoid yang membengkak selalunya berdengkur. Termasuk juga orang yang berlebihan berat badan dan mempunyai leher yang pendek dan besar.

Lelangit lembut dan uvula (anak tekak) yang panjang.
Uvula yang panjang akan mengecilkan rongga pembukaan dari hidung ke tekak. Getaran yang berlebihan dari tisu ini akan mengakibatkan dengkuran.

Saluran pernafasan tersekat.
Hidung yang tersumbat dan sukar bernafas menyebabkan individu lebih kerap menyedut udara untuk bernafas. Ini mengakibatkan ruang vakum yang berlebihan di dalam tekak, dan mengakibatkan tisu tekak yang lembut tertarik ke dalam dan mengakibatkan dengkuran. Antara sebab lain adalah batang hidung yang bengkok, polip dan jangkitan sinus.

Komplikasi

Wanita sanggup melakukan apa sahaja termasuk pembedahan untuk mengatasi masalah ini. Selain mengganggu keharmonian di bilik tidur, ia boleh menjurus kepada pergaduhan hingga berlakunya perceraian terutamanya apabila si suami tidak boleh bertolak ansur dalam perkara ini.

Sebaliknya, berlainan bagi wanita yang semula jadinya bersifat pemaaf kerana mereka lebih bertolak ansur terhadap suami yang berdengkur.

Biasanya masyarakat selalu memandang ringan kepada berdengkur. Walaupun berdengkur ini dilihat tidak serius tetapi sekiranya ia tidak diubati akan mengakibatkan penyakit lain seperti sleep apnea yang menyebabkan kegagalan jantung dan angin ahmar.

Dengkur boleh dikelaskan kepada tiga peringkat :

* Peringkat pertama - berdengkur yang ringan dengan 4 atau 5 kali dengkuran kemudiannya berhenti dan seterusnya diulangi lagi.

* Peringkat kedua - berdengkur yang sederhana iaitu berdengkur berterusan selama 10 hingga 15 minit dan bunyinya yang sama rata.

* Peringkat ketiga - berdengkur yang SERIUS diikuti dengan berhentinya pernafasan sehingga terjaga. Kemudiannya akan menarik nafas yang dalam dan keadaan ini diulanginya secara berterusan. Dengkuran ini dipanggil 'sleep apnea'

'Sleep apnea' boleh MEMBAHAYAKAN DIRI dan memerlukan rawatan selanjutnya.


Diagnosis

Bolehkah dengkuran yang kuat disembuhkan?

Pendengkur yang TERUK ialah mereka yang berdengkur pada mana-mana kedudukan atau mengganggu orang lain, sepatutnya mencari khidmat nasihat perubatan bagi memastikan keadaan itu bukanlah masalah 'sleep apnea'.

Pakar Telinga, Hidung dan Tekak akan memeriksa hidung, mulut, tekak, lelangit dan leher pendengkur. Kajian semasa tidur yang dilakukan di dalam 'makmal tidur' perlu bagi mengenal pasti tahap keseriusan dengkuran dan kesan kesihatan ke atas pendengkur tersebut.

Rawatan

Rawatan adalah bergantung kepada diagnosis yang dibuat. Pemeriksaan akan menunjukkan dengkur adalah disebabkan oleh alahan hidung, jangkitan, kecacatan atau masalah tonsil.

Rawatan diberi mengikut sebab-sebab yang dikenal pasti.

Pencegahan

Petua untuk mengurangkan dengkuran :

* Kurangkan berat badan jika anda mengalami masalah berat badan berlebihan
* Kurangkan pengambilan arak atau ubatan yang mempunyai kesan mengantuk pada waktu tidur
* Cegah pengambilan tranquilizer, pil tidur dan antihistamina sebelum tidur
* Elak pengambilan arak sekurang-kurangnya 4 jam dan mengambil makanan berat atau ringan dalam tempoh 3 jam, sebelum berehat
* Amalkan tidur pada waktu yang tetap setiap hari
* Utamakan posisi tidur mengiring daripada posisi terlentang
:: Tinggikan kepala katil anda lebih kurang 4 inci ke atas supaya posisi kepala lebih tinggi dan lidah tidak tertolak ke belakang


Lagi info tentang DENGKUR :

Dengkur Jejas Kualiti Tidur
Sleep Apnea in Children






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Abdominoplasty (Tummy Tuck)

by Dr. Yap Lok Huei

A flat and well-toned abdomen is something many of us strive for through exercise and weight management. Unfortunately, we sometimes cannot achieve our goals with these methods alone.

Thus, some people opt for abdominoplasty, also known as tummy tuck. Abdominoplasty removes excess fat and skin, and in most cases restore weakened or separated muscles, creating an abdominal profile that is smoother and firmer.

Many women opt to undergo abdominoplasty, especially after pregnancy, when the abdominal muscles tend to remain lax, and the skin over the stomach becomes stretched and saggy – to help them get back to their pre-pregnancy figure.

Is It Right For Me?

Abdominoplasty is a highly individualised procedure. Ideally, as with any other plastic surgery procedure, this should be a change that suits you and should not be carried out simply to fulfill someone else's desires or to fit any sort of ideal image.

A good candidate for abdominoplasty procedure is an adult who is not far from his/her ideal weight, with an abdominal area that has not adequately responded to modification by diet and exercise.

Some of the categories of candidates are as follows :

1. After significant weight loss

With significant weight loss, many patients notice that while the fatty tissue is reduced, often the skin has been overstretched and does not contract back to a smaller area well. Thus the skin can become loose and saggy, and may require removal for correction.

2. The ageing process

Similarly, with age, the skin loses some of its natural elasticity and the muscles gradually weaken. The ageing process often has a pronounced impact on the abdominal region, resulting in a flabby, sagging midline. In such cases, a tummy tuck can have a rejuvenating effect on the entire body while making the person look younger, healthier, and more vital.

3. Genetics

Genetics do play a role in the overall shape of one's body. For some, the bothersome fatty tissue thickness that gathers in the abdominal region is resistant to diet and exercise although the person may be active and physically fit. Even someone in his 20s, 30s, or 40s may be genetically predisposed to stubborn abdominal roundness.


What Happens During The Tummy Tuck Procedure?

One or more incisions are made during the procedure. Endoscopic and mini tummy tucks have smaller incisions than other abdominoplasty procedures. Incisions will most likely extend from hip to hip and around the navel. Excess skin will be removed and tightening of the abdominal muscles will be done.

A small amount of liposuction may be performed to remove small pockets of fat. The incisions are closed using surgical stitches and, if necessary, the navel is repositioned.

The number and length of incisions that are made during a tummy tuck surgery will vary, depending upon the type of abdominoplasty that is being performed. There are different kinds of tummy tucks to address different kinds of aesthetic complaints.

The positioning of all incisions is always carefully planned prior to surgery to increase the likelihood that the resulting scars will be easily hidden beneath underwear, bikinis, and other swim wear.

Mini tummy tuck or a partial abdominoplasty - involves only a single, very small incision that is made below the navel.

Circumferential abdominoplasty surgery involves the removal of loose hanging skin from the entire hip area, including the back, and thus requires an incision that extends around the entire waist line.

Traditional tummy tucks involve one incision along the front of the abdomen from hip bone to hip bone.

Tightening of The Muscles

Tightening of the sagging abdominal muscle mass can be performed during abdominoplasty surgery. The skin is separated from the abdominal walls; the abdominal muscles are then pulled closer together and finally stitched into position to give a more toned position. The waistline can be made narrower, with a less protuberant front border of the abdomen.


Skin Removal

As abdominoplasty involves cutting away excess skin around the stomach region, often it is possible to eliminate or improve the appearance of stretch marks depending on the location of the incision. Stretch marks located slightly below the navel are often removed along with the excess skin while the remaining stretch marks often appear less prominent after tummy tuck surgery.

The stretching of the abdominal skin flattens the stretch marks, decreasing the degree to which they indent the skin.

When the abdominoplasty surgery is complete, the skin is sutured together using surgical stitches. The tummy tuck stitches will normally be removed in stages over a period of 2 weeks following surgery, but this is unnecessary if dissolving sutures are used. A surgical drain will also be inserted at the site of incision at the same time that the stitches are put into place.

The surgical drain helps quicken the healing process and often makes healing less painful because it drains fluids that build up up beneath the skin as the body works to repair the damage to the surrounding cells. The surgical drain is usually removed before the stitches, about a week after surgery.

Healing Process

Several factors determine the speed of a patient's abdominoplasty recovery, including the patient's overall state of health and physical fitness at the time of surgery, which type of abdominoplasty surgery was performed, and the patient's cooperation with the surgeon's post-operative guidelines.

Some patients will require up to 4 weeks of tummy tuck recovery time. Although it takes most patients several weeks or more to feel completely 'back to normal' and to see their final tummy tuck benefits, patients who were in good physical condition at the time of the surgery will have a shorter tummy tuck recovery time.

Tummy Tuck Scars

Post-surgical tummy tuck scars are unavoidable. The larger the amount of skin you would like to have removed during the tummy tuck procedure, the longer the scar will be.

Most qualified cosmetic surgeons will take great care to try to achieve good scars for their patients. Be conscientious about following post-surgical care instructions, as they are designed for your benefit. Patients who smoke have a higher risk of almost all of the complications of abdominoplasty surgery, including wound breakdown, fat necrosis and unsatisfactory scarring.

Amongst other things, cigarette smoke causes the blood vessels in the skin to constrict, decreasing the amount of oxygen being delivered to the skin cells. This will slow healing and make the wounds more vulnerable to breakdown and infection.

The general rule regarding tummy tuck scars is that the longer and more difficult the tummy tuck recovery process, the more noticeable the tummy tuck scars will be. Most tummy tuck scars become lighter and flatter with time, but they may appear to grow more noticeable before they begin to fade. Tummy tuck scars never completely disappear. In the latter stages of the healing process, a topical application on your scar may be helpful.

Topical Aid

Effective healing of a scar is the primary concern following surgery. Scar healing is a complex process and supporting the natural regeneration process of skin cells is important to minimise or eliminate scarring and to help heal and repair damage. Topical support for wound healing is one way to ensure an effective healing process and minimise the risk of scarring.

A user friendly topical application would be an oil-based product that spreads and is absorbed easily into the skin. Preparations containing purcellin oil in combination with vitamins A & E, and calendula have been known to help improve the appearance of scars.

This should be used in conjunction with guidance from your surgeon – do make sure that the wounds are fully healed before commencing topical treatments. Anecdotal reports suggest that moisturizing preparations which are oil-based, used in conjunction with gentle local massage, can reduce irritation and tightness of the wound scars.

Male vs Female Tummy Tuck

Abdominoplasty is a form of body contouring. A male tummy tuck differs from a female tummy tuck in that the surgeon is trying to achieve a very different body aesthetic. However, the underlying surgical principles and the way the results are achieved are very similar.

There are men who are concerned about having 'love handles', a 'pot belly', or a 'spare tyre'. Such concerns are not unfounded; right or wrong, our society places a high value on looking fit and young, for men as well as women.

Male abdominoplasty is a common procedure that can reduce the size of a protruding belly by removing excess skin and tightening the muscles in the midsection. Tummy tuck surgery for men can deliver a flatter, tighter, more aesthetically appealing abdominal contour.

Maintaining My Figure

Exercising routinely is essential and following a balanced diet would certainly help maintain the improved body figure post abdominoplasty surgery for many years. For some patients, occasional 'touch-ups' with limited liposuction may be necessary to help achieve their final contours.

Exercise after abdominoplasty is crucial for the maintenance of your new figure. Other benefits of exercising post abdominoplasty is that it will significantly aid in recovery, help reduce swelling, tones muscles, and reduces the chances of blood clots. However, this should be commenced only after your surgeon has given you the all clear, since exercising too early may increase the risk of disrupting your tummy tuck procedure.

It should be noted that abdominoplasty is not a weight-loss procedure! Thus, it is possible to gain weight after a tummy tuck, and if you do put on weight, it may reduce the impact of the contouring achieved after a tummy tuck. So do continue on your healthy new regime, monitoring what you eat in order to stay and live healthy!


More info on ABDOMINOPLASTY here.






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