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Botak, Keguguran Rambut Masalah Keturunan


oleh Siti Nor Afzan Kasiman

Masalah keguguran rambut ekstrem merupakan satu mimpi ngeri bagi seseorang wanita. Bagi individu yang berpegang kepada konsep rambut mahkota wanita, mereka pasti ghairah untuk memiliki rambut yang sihat dengan gaya terkini.


Syampu

Menjaga rambut tidak cukup dengan hanya bersyampu 3 kali seminggu. Kulit kepala juga memerlukan perapian dan vitamin yang cukup untuk kekal sihat tanpa sebarang masalah seperti kegatalan, kelemumur dan jangkitan kuman.

Ramai pihak beranggapan bahawa silap memilih syampu, pengambilan serbuk perasa (monosodium glutamate) dalam masakan serta faktor penuaan sebagai sebab utama keguguran rambut, namun itu hanya penyebab sampingan.


Punca Keguguran

Realitinya, tekanan (stres) dalam kerjaya atau kehidupan menjadi pencetus kepada masalah keguguran rambut yang serius terutama membabitkan golongan lelaki. Walaubagaimanapun, botak bukan hanya terhad kepada lelaki tetapi wanita turut mengalami fenomena sama.

Pola keguguran rambut lelaki (male pattern hair loss - MPHL) yang biasa terjadi pada kaum Adam sering dikaitkan dengan faktor genetik. Mungkin ramai tidak menyangka botak tiada kaitan dengan faktor genetik, tetapi hakikatnya, keturunan kerap menjadi punca keguguran rambut.

Ia boleh diwarisi daripada sebelah ibu atau bapa dan boleh berlaku terhadap lelaki ataupun wanita. Kedua-duanya cenderung untuk mewarisi gen botak.

Akibat daripada warisan gen rambut gugur tersebut, individu terlibat berisiko tinggi untuk berdepan masalah keguguran rambut yang mampu menipiskan rambut namun tidak semuanya berakhir dengan botak.

Namun, keadaan yang dikenali sebagai androgenetic alopeciaini boleh bermula pada usia belasan tahun, 20-an atau 30-an. Dalam satu kajian, hampir 50% anak-anak kepada lelaki atau wanita botak akan mewarisi gen tersebut.


Berperingkat-peringkat

MPHL terjadi secara berperingkat-peringkat. Masalah itu bermula dari kawasan tengah kepala, ia mampu merebak hingga ke seluruh kepala. Ramai lelaki memilih untuk berdiam diri dan tidak berasa ia satu keperluan untuk berjumpa dengan doktor hanya kerana masalah rambut semakin menipis.

Malah, lebih 80% lelaki tidak tahu apa itu MPHL dan menganggap ia berlaku kerana faktor usia sedangkan masalah ini tidak akan melarat jika dirawat daripada awal.

Individu yang mengalami MPHL disarankan mendapatkan rawatan berkesan dengan menangani punca asas masalah tersebut.

Kajian Penyelidikan

Masalah keguguran rambut yang berisiko terjadi kepada setiap orang berkenaan turut mendorong ramai penyelidik untuk tampil menjalankan kajian.

Antaranya, beberapa ahli akademik dari 2 universiti di Jerman iaitu Universiti Bonn dan Universiti Dusseldorf menjalankan kajian mengenainya. Mereka mendapati gen botak sememangnya diwarisi.


Sekumpulan penyelidik di Victoria, Australia mendapati, keguguran rambut di bahagian tengah dan hadapan kepala meningkat selari mengikut usia. Ia memberi kesan sehingga 57% wanita dan 73.5% kepada lelaki yang berusia 80 tahun ke atas.

Laman web Perpustakaan Medem Medical turut melaporkan, kira-kira 40 juta lelaki di Amerika Syarikat berdepan dengan masalah MPHL.

Menurut laman tersebut, seorang daripada 4 lelaki mulai botak pada usia 30 tahun, dua pertiga mulai botak pada usia 60 tahun ke atas. Tambah laman itu, nisbah untuk mendapat gen botak adalah 4 dalam setiap 7 orang.

Selain tekanan dan faktor genetik, faktor pemakanan tidak seimbang, penyakit tiroid, masalah sistem imunisasi, pengambilan dadah atau ubat-ubatan tertentu, kurang penjagaan rambut, trauma dan jangkitan kulit kepala boleh menyumbang kepada keguguran rambut dan botak.


Rambut Sihat

Pertumbuhan rambut individu dewasa yang dipengaruhi oleh hormon seks iaitu androgen boleh mengalami fasa pertumbuhan di antara 2 hingga 6 tahun dengan kepanjangan kira-kira 0.35 milimeter (mm) sehari. Selepas fasa tersebut, proses pertumbuhan akan berehat untuk beberapa bulan.

Rambut yang sihat dan normal memiliki beberapa ciri khas seperti berkilat, mudah lentur, tidak mudah patah dan boleh menyerap air.

Keguguran rambut di antara 50 hingga 100 helai sehari adalah normal namun jika ia tidak dipantau, keguguran mungkin akan menjadi lebih serius lebih-lebih lagi jika individu tersebut berada dalam kelompok berisiko tinggi untuk botak.

Jika terdedah kepada persekitaran kotor dan berhabuk, kulit kepala yang sering gatal boleh mendapat jangkitan kuman atau alahan kepada bahan kimia.

Sekiranya dibiarkan tanpa rawatan, ruam akan timbul dan bagi kes serius, gelembung berisi air kesan daripada radang kulit akan terbentuk. Pada peringkat ini, individu tersebut boleh mengalami kebotakan serius.


Diet dan Kebersihan

Untuk mendapatkan rambut yang sihat, amalan mengambil makanan seimbang sangat penting.

Meninggalkan diet secara keterlaluan boleh menyebabkan keguguran kerana hampir 90% komponen rambut terdiri daripada protein. Diet yang tidak sihat dan kurang mengambil protein akan menjadikan rambut lemah dan mudah gugur. Banyakkan pengambilan zat seperti kalsium dan zink kerana ia boleh menyihatkan rambut.

Penjagaan kebersihan dan kesihatan rambut juga tidak boleh diabaikan. Rutin bersyampu sekurang-kurangnya 2 kali seminggu dan pemilihan sikat yang sesuai mampu mengurangkan risiko keguguran rambut.



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Depression After Stressful Event


by Dr. Milton Lum

Life has its ups and downs. When down, one feels unhappy or miserable. This can last for a few days. However, depression, which is also known as depressive illness, is different. The unhappy feelings can last for weeks or months and start to interfere with the activities of daily living.

It is estimated that about one in 10 persons will suffer from depression at some point in life. However, the true incidence may be different because many depressed people do not seek medical help or the diagnosis is not made.


In general, women are more likely to suffer from depression than men, with more than twice the number of women with the condition compared to every man. However, as men are less likely to seek help, this may contribute to their greater tendency to commit suicide.


Depression affects all ages, including children. The likelihood of depression is increased if there is a family history of the condition.

Depression can be a severe illness. However, with appropriate diagnosis, treatment and support, most sufferers can make a full recovery.

Causes

There are various causes for depression, and several factors that can precipitate it. They include stressful life events, e.g. illness, worries about job or money, separation, divorce, bereavement. When stressful events occur, the majority of people need time to get over it. But the risk of depression increases if one ceases socialisation with family and friends.

Some pregnant women are prone to depression after childbirth ('postnatal blues'). This has been attributed to hormonal and physical changes, as well as the additional responsibilities after giving birth.


The risk of depression is increased if a diagnosis of a chronic or life threatening illness, eg heart attack, cancer, is made. Head injuries are often an unrecognised cause of depression. Even minor head injury can result in damage to the pituitary gland, which affects the hormones controlling the thyroid gland, causing symptoms like tiredness and decreased libido, which can lead to depression.

Some individuals are prone to depression because of personality traits, like low self esteem. This may be due to genetic inheritance or life's experiences, which can have a marked effect on one's perception of oneself later in life. A family history of depression increases the risk.

The risk of depression is also increased if one is isolated from family and friends.

It is not uncommon for a number of causes to act in combination, eg illness followed by separation or divorce.


Substance abuse or excessive alcohol consumption increases the risk of depression. The alcohol or drugs or isolation leads to poor self esteem, which in turn leads to a vicious cycle of further isolation and increased consumption of drugs or alcohol.

Increasing age and difficult socio-economic circumstances are additional factors that increase the risk of depression.

Clinical Features

The clinical features of depression are varied. Although the clinical features of grief are similar to that of depression, there is a difference between them. The former is a response to a loss, whilst the latter is an illness. Depression affects the sufferer's work, family and social life, unlike that of a person who is in grief.

The features of depression are also present in other conditions, like bipolar disorders, in which the sufferer alternates between depression and mania. The symptoms are similar to that of depression, but during the manic phase, the sufferer's behaviour can cause self-harm.

The symptoms of depression may be psychological, physical and/or social.


The psychological symptoms include continuous feelings of hopelessness and helplessness, low self-esteem, feelings of guilt, irritability, poor motivation, little interest in surroundings and events, difficulty in decision making, suicidal thoughts, and reduced libido.

The physical symptoms include changes in appetite or weight, menstrual cycle changes, constipation, reduced libido, altered sleep patterns, vague aches and pains, slow movement or speech and tiredness.

The social symptoms include poor work performance, avoidance of family and friends, lack of interest in enjoyable activities, and difficulties with family members.

The features of depression may be insidious without the condition being recognised. Its seriousness is described by doctors as follows :

* Mild depression has some impact on daily life.

* Moderate depression has significant impact on daily life.

* Severe depression makes the activities of daily life nearly impossible.

When a person with features of depression consults a doctor, the latter will conduct a physical examination to exclude conditions which present with similar features, eg hypothyroidism.

A diagnosis of depression is made through interviews and questionnaires. There is no laboratory test for depression. It is crucial that one is honest and frank with the doctor, who can then make a diagnosis after excluding other physical or mental health conditions.


Management

Management is determined by the type of depression and the patient’s individual circumstances. It usually involves a combination of self-help, talking therapies, counseling, and medicines.

Mild depression often improves by itself. Talking to a family member, doctor, relative, or friend can be helpful. Antidepressant medicines are not usually prescribed as first-line treatment.

Moderate depression or mild depression that is not improving is managed with talk therapy or antidepressant medicines.

Severe depression is managed with talk therapy, behaviour therapy, and antidepressants. A combination of treatment modalities is usually more effective. The assistance of a mental healthcare team, which includes a psychiatrist, psychologist, and nurses, is helpful.

Cognitive behaviour therapy helps a patient understand how current behaviour and thinking is having an effect on him or her. It focuses on helping and teaching the patient how to alter his or her thinking and behaviour, to enable the patient to challenge negative thoughts and feelings.

Counseling helps a patient discover alternative solutions to his or her problems. The counselor assists the patient, but does not tell the patient what to do.


AntiDepressants

There are several types of antidepressants. They are categorised into a selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin norepinephrine reuptake inhibitors (SNRIs) and monoamine oxidase inhibitors (MAOIs).

Antidepressant medicines are not addictive, but withdrawal symptoms are common if they are stopped suddenly or a dose is missed. The side effects vary with individuals and the type of antidepressant.

SSRIs increase the brain’s levels of serotonin, a compound which is thought to improve a person’s mood. They are as effective as the older TCAs, and have fewer side effects. The side effects of SSRIs, which include dry mouth, nausea and headaches, ease off with the passage of time.

Except for fluoxetine, SSRIs are not prescribed to children because there are reports of increased risk of self-harm and suicidal tendencies.

TCAs increase the brain’s levels of serotonin and noradrenaline, thereby improving a person’s mood. The side effects, which include dry mouth, blurred vision, constipation, problems passing urine and drowsiness, usually ease off after about 10 days.


SNRIs, which came on the market more recently, increase the brain’s levels of serotonin and noradrenaline, thereby improving a person’s mood. Their mode of action differs slightly from the SSRIs and TCAs.

MAOIs are sometimes used to treat depression. The side effects of MAOIs include blurred vision, nausea, trembling, increased appetite, and difficulty sleeping. They can also cause a marked increase in blood pressure, leading to severe headache, chest pain, rapid heart rate and stiff neck, which is a medical emergency.

People who are taking MAOIs must not take food containing tyramine, eg pickled fish or meat, cheese. One should also not consume alcohol or fermented liquids. A list of such foods will be provided by the doctor.

As there are interactions between the MAOIs and many medicines, one should only consume the latter after checking with the doctor.

If there is no improvement after several different types of antidepressant medicines, the patient may be prescribed lithium in addition to the current medicine. The effectiveness of lithium carbonate or citrate depends on its optimum blood level. Excessive levels can be toxic. Because of these reasons, regular blood estimations of lithium are necessary.


Electroconvulsive therapy (ECT) is prescribed for severe depression when antidepressant medicines and other treatment modalities have not been effective. ECT involves giving an electrical 'shock' to the brain via electrodes placed on the head. It is usually done under anaesthesia. The side effects include muscle aches, nausea, headache and memory problems.

Regular follow-up is necessary for the management of depression. It is essential to follow the advice of the doctor, particularly on the consumption of antidepressant medicines.

With the help of family, the attending doctor and other healthcare professionals, relatives and friends, the majority of sufferers from depression can and do recover.


More info on DEPRESSION here.






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Punca Kelemumur Pada Rambut


Rambut adalah mahkota buat wanita. Menjaganya bukan sukar namun tidak juga mudah. Tidak kena gaya ia mudah rosak, berkelemumur, gugur dan beruban sebelum masanya.

Biar berkerudung, penjagaan rambut tetap diutamakan apatah lagi ia memerlukan lebih perhatian berbanding mereka yang tidak. Kulit kepala yang tertutup dalam tempoh lama mengundang peluh yang akhirnya bercampur minyak semula jadi lalu mengundang masalah kelemumur yang serius.


Punca Kelemumur

Setiap individu perlu mengetahui analogi, fisiologi dan punca biasa untuk lebih memahami dan menjaga kesihatan rambut.

Biasanya masalah kelemumur ini disebabkan beberapa perkara :


1. Seborrheic dermatitis (gatal-gatal, kulit kepala berminyak)

Punca biasa menyebabkan kelemumur. Ia kelihatan merah, kulit kepala berminyak diselaputi keruping putih atau kuning. Ia bukan sahaja berlaku pada kulit kepala malah di kawasan kulit yang mengandungi liang minyak, seperti kening, tepi hidung, belakang telinga, tulang dada, celah kelangkang dan kadangkala pada bahagian ketiak.

Seborrheic dermatitis juga boleh berlaku dari usia bayi dilahirkan (ruam lampin) dan beransur hilang pada usia satu tahun.

Bagi mereka yang dijangkiti HIV, masalah ini lebih serius berbanding biasa. Biasanya doktor boleh mengenal pasti pesakit yang menghidap HIV berdasarkan keadaan kulit kepala mereka yang mengalami kegatalan serius hingga merebak ke bahagian lain.

Stres juga boleh mengundang masalah seborrheic dermatitis menjadi lebih teruk.


2. Kulit kepala kering, gatal dan berkeruping

Ia disebabkan cuaca panas. Bentuk keruping disebabkan kulit kepala kering biasanya kecil-kecil dan kurang berminyak berbanding lain-lain punca yang menyebabkan kelemumur.

3. Kurang mencuci rambut

Jika anda tidak membasuh rambut dengan kerap, minyak dan sel kulit daripada kulit kepala akan terbina, menyebabkan kelemumur.

4. Psoriasis

Masalah kulit berpunca daripada pengumpulan sel kulit mati yang menghasilkan keruping berwarna perak. Ia biasa berlaku di lutut, siku tetapi boleh juga berlaku pada kulit kepala.

5. Ekzema

Jika anda penghidap ekzema, kelemumur adalah masalah biasa.


6. Sensitif pada sesetengah produk

Kadangkala sensitif kepada sesetengah jenis produk rambut menyebabkan kulit kepala menjadi kemerahan dan gatal. Terlalu kerap mencuci rambut juga boleh menyebabkan kelemumur.

7. Jangkitan yis malassezia

Malassezia hidup pada permukaan kulit kepala hampir kesemua individu dewasa tanpa menyebabkan sebarang masalah. Namun kadangkala, ia berkembang tanpa terkawal, merembeskan lebih minyak daripada folikel rambut. Ini menyebabkan iritasi pada kulit kepala dan menggalakkan lebih banyak sel kulit terhasil.

Lebihan sel kulit akan mati dan tertanggal dan bercampur dengan minyak daripada rambut dan kulit kepala, menyebabkan ia kelihatan memutih, berkeping dan jelas kelihatan pada rambut juga pakaian anda.

Walaubagaimanapun punca sebenar malassezia tidak diketahui. Boleh jadi disebabkan terlalu banyak minyak pada kulit kepala, perubahan hormon, tekanan, masalah saraf seperti parkinson, sistem imun terganggu, tidak mencuci dengan kerap, dan semua masalah menyumbang kepada kelemumur.

Rawatan Kelemumur

Masalah kelemumur yang serius boleh diatasi dengan pengambilan syampu anti-fungus. Agen seperti ketoconazole, bifonazole dan ciclopiroxolamine (juga dipanggil ciclopirox) yang terdapat dalam formula berlainan seperti krim, gel, losyen dan syampu boleh membantu mengatasi masalah ini.



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Hirsutism - Wanita Bulu Lebat


oleh Hafizah Iszahanid

Lelaki berbulu lebat mungkin dianggap macho, tetapi keadaan sebaliknya bagi wanita. Malah, berbanding lelaki, wanita berbulu lebat lazimnya mengundang perhatian kerana dianggap memalukan.

Apakah ini biasa atau petanda masalah kesihatan? Dari segi perubatan, masalah pertumbuhan bulu berlebihan ini dikenali hirsutism. Corak pertumbuhan dan sebarannya mirip lelaki dan lebih ketara pada bahagian muka, dada, sekitar areola, punggung, paha serta sekitar alat sulit.


Secara amnya penyebab hirsutism terbahagi kepada beberapa punca iaitu pengeluaran atau penghasilan hormon androgen berlebihan, komplikasi pengambilan ubat-ubatan selain impak penyakit kronik yang dialami individu berkenaan.


Androgen Berlebihan

Bagi wanita, hormon androgen dikeluarkan oleh kelenjar adrenal dan juga ovari dengan fungsi asalnya untuk mengawal nafsu syahwat. Sistem pengeluaran hormon ini kompleks dan dikawal oleh kelenjar di otak, pituitari dan juga hipotalamus.

Ada beberapa keadaan yang akan menyebabkan berlakunya pertambahan androgen iaitu masalah obesiti, sindrom ovari polisistik, gangguan hormon, hiperprolaktinemia, penyakit akromegali, hiperplasia kongenital adrenal dan sindrom Cushing.

Hirsutism boleh berlaku akibat barah ovari juga barah kelenjar adrenal. Barah jenis ini menyebabkan berlakunya peningkatan paras hormon adrogen dalam tubuh wanita.

Selain itu, pengambilan sesetengah jenis ubat juga boleh memberikan kesan sampingan berlakunya hirsutism dan juga hipertrikosis. Hipertrikosis adalah keadaan bulu-bulu yang tumbuh di tempat yang bukannya di bawah pengaruh hormon androgen.


Rawatan

Hirsutism ada kalanya bersifat kekal namun bergantung kepada penyebabnya. Bagaimanapun, secara umum kesan hirsutism sukar pulih. Ia mungkin boleh dikawal atau dirawat secara pembedahan dan pengambilan ubat-ubatan.

Apabila hirsutism berlaku, bulu-bulu yang ada hanya dapat dihapuskan secara fizikal, manakala rawatan penyakit yang menyebabkan hirsutism akan membantutkan pertumbuhan bulu-bulu baru.

Secara kosmetik, bulu yang berlebihan ini boleh dikurangkan secara bleaching atau diwarnakan supaya kurang jelas kelihatan, cukur, cabut serta secara elektrolisis dan juga perawatan laser terutama bulu yang tumbuh di muka.

Namun bagi rawatan pengambilan ubat-ubatan, ia memerlukan rundingan lanjut dengan doktor. Pil cegah kehamilan pada dos estrogen yang tinggi boleh membantu. Bagaimanapun, ada banyak lagi senarai ubat-ubat boleh digunakan, tetapi perlu mendapat preskripsi oleh doktor supaya kesan samping dapat diminimumkan.


Wanita Hamil

Hirsutism juga boleh dialami wanita hamil walaupun ia agak jarang ditemui. Ini kerana wanita hamil alami paras hormon estrogen dan progesteron yang tinggi.

Tetapi ada juga wanita hamil yang mengalami masalah hirsutism disebabkan peningkatan hormon prolaktin. Penyakit kencing manis semasa mengandung juga memungkinkan keadaan hirsutism.

Hirsutism ketika hamil juga boleh dikaitkan dengan masalah hypereactio luteinalis iaitu berlakunya peningkatan paras hormon lelaki androgen ketika wanita itu berbadan dua.

Namun, bagi wanita hamil ia adalah satu keadaan peralihan yang berkaitan dengan hormon prolaktin. Oleh itu, jangan rungsing kerana ia bersifat sementara. Begitu juga jika hirsutism yang berlaku akibat hypereactio luteinalis.



FAKTA : Punca Pertambahan Hormon Adrogen

* Obesiti - Ia berkait rapat masalah insulin yang gagal memainkan peranan secukupnya.

* Sindrom Ovari Polisistik - Wanita yang mengalami sindrom ini biasanya mendapati diri mereka sukar hamil. Tubuh mereka cenderung gemuk, kulit berminyak, berjerawat, haid sedikit serta tidak menentu. Wanita yang mengalami sindrom ini mempunyai ovari yang berpolisistik serta paras hormon androgen yang tinggi.

* Masalah gangguan hormon seperti penyakit endokrin hipotiroid.

* Hiperprolaktinemia - Paras hormon prolaktin tinggi dalam badan. Hormon ini lazimnya berkait rapat dengan pengeluaran susu, walaupun wanita itu tidak hamil.

* Penyakit akromegali - Disebabkan peningkatan abnormal hormon tumbesaran dan juga kegagalan insulin.

* Hiperplasia kongenital adrenal - Ketiadaan atau ketidakhadiran enzim-enzim tertentu dalam badan yang menyebabkan lebih banyak hormon lelaki androgen terhasil.

* Sindrom cushing - Membabitkan peningkatan abnormal hormon-hormon steroid termasuklah hormon lelaki androgen.



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Anogenital Distance (AGD)


by Deborah Zabarenko

WASHINGTON (Reuters) - When it comes to male fertility, it turns out that size does matter. The dimension in question is not penis or testicle size, but a measurement known as anogenital distance, or AGD.

Men whose AGD is shorter than the median length - around 2 inches (52 mm) - have 7 times the chance of being sub-fertile as those with a longer AGD, according to a study published on Friday in the journal Environmental Health Perspectives.


Male Fertility

That distance, measured from the anus to the underside of the scrotum, is linked to male fertility, including semen volume and sperm count, the study found. The shorter the AGD, the more likely a man was to have a low sperm count.

This offers the prospect of a relatively simple screening test for men, said study co-author Shanna Swan of the University of Rochester Medical Center.


"It's non-invasive and anybody can do it, and it's not sensitive to the kinds of things that sperm count is sensitive to, like stress or whether you have a cold or whether it's hot out," Swan said in a telephone interview.

"If somebody's got a short AGD, particularly if they have problems conceiving, I would say get to the infertility doctor, because the chances are good that something is wrong."

Study

To reach their conclusions, researchers measured the AGDs of 126 men born in or after 1988, a small but statistically significant sample, Swan said.

The study did not address what might cause certain men to have short AGD measurements.

But previous studies, published in 2005 and 2008, looked at the possible link between mothers who were exposed to chemicals called 'phthalates' during pregnancy and the AGD of their infant and toddler sons.


Phthalates

Phthalates are a group of chemicals widely used in industrial and personal care products, including fragrances, shampoos, soaps, plastics, paints and some pesticides.

In these earlier studies, the scientists tested for the presence of phthalates in the pregnant women's urine. They found that women who had high levels of phthalates in their urine during pregnancy gave birth to sons who were 10 times more likely to have shorter than expected AGDs.

Swan, who also co-authored the earlier papers, said they showed the correlation between prenatal phthalate exposure and shorter AGD.

The latest study does not address prenatal phthalate exposure directly, "but it does answer the question of why we should care about AGD," Swan said. "And it does suggest that whatever is altering AGD is also altering sperm count."

Copyright © 2011 Reuters



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Sawan Babi (Epilepsi) Jejas Otak


oleh Hafizah Iszahanid

KITA kerap mendengar penyakit gila babi atau sawan babi yang lebih berkait rapat dengan kekejangan atau 'tarik' yang berulangan dengan penghidapnya menggigil sehingga memerlukan bantuan segera.

Namun, secara amnya tidak ramai yang mengetahui apa sebenarnya punca penyakit ini yang turut dikenali epilepsi dari segi istilah perubatan. Hakikatnya, penyakit ini berlaku hasil tindak balas masalah isyarat elektrik yang salah dalam otak. Atau ringkasnya, aktiviti elektrik otak yang normal diganggu oleh lebihan aliran elektrik dalam otak yang menyebabkan berlakunya masalah komunikasi sementara antara sel saraf.

Masalah Neurologi

Penyakit ini menjejaskan kehidupan lebih 180,000 orang dalam setahun dan di seluruh dunia, sekurang-kurangnya sejuta orang akan mengalami epilepsi seumur hidupnya.

Lebih membimbangkan, 2 juta kes baru dicatatkan setiap tahun yang membuktikan epilepsi adalah masalah universal dan antara masalah neurologi yang serius.

Bagaimanapun, bukan semua orang yang mengalami tarik atau kekejangan ini berhadapan dengan epilepsi. Ini kerana, ada kalanya, serangan sawan itu berlaku apabila pesakit berhadapan dengan masalah kekurangan air yang keterlaluan atau suhu badannya terlalu tinggi.


Punca Epilepsi

Namun, jika seseorang itu mengalami kekejangan dengan kerap tanpa sebab, ini mungkin gejala dia mengalami epilepsi. Malah epilepsi juga boleh disebabkan kecederaan otak, jangkitan otak seperti meningitis atau penyakit yang mengganggu pembentukan otak janin ketika dalam kandungan ibu.

Epilepsi ini juga boleh disebabkan kekurangan oksigen pada otak bayi kepada dilahirkan.

Epilepsi boleh menjejaskan bahagian otak yang berlainan dan ia terjadi dalam pelbagai cara bergantung kepada sel otak yang terbabit.

Sesetengah kes kekejangan ini menjejaskan keseluruhan badan pesakit dan menyebabkan penyebaran aliran elektrikal ke seluruh otak dan keadaan dikenali sebagai 'tonic-clonic'.


Kekejangan

Ada juga masalah yang lebih tertumpu iaitu aliran elektrikal hanya menjejaskan bahagian kecil otak yang dikenali sebagai 'kekejangan sebelah' yang menyebabkan pesakit sedikit keliru atau gangguan pergerakan motor atau kedua-duanya sekali, tetapi tanpa disedari individu berkenaan. Namun, ada juga kes yang mana pesakit mengalaminya dalam keadaan sedar.

Segelintir pesakit pula mengalami kekejangan jenis sebelah sebelum merebak ke seluruh otak menjadi kekejangan jenis 'tonic-clonic'. Kekejangan ini pula boleh berlaku beberapa kali sehari atau sekali beberapa bulan.

Apa yang pesakit alami sama ada hilang sedar, perubahan dalam penglihatan atau rasa tidak selesa pada perut sebenarnya bergantung pada jenis epilepsi. Sesetengah pesakit mengalami keadaan seperti bermimpi, yang lain mungkin mengalami perasaan gembira dan sedih yang bercampur aduk. Sementara ada yang mengulang-ulang pergerakan seperti mengenyit mata.


Rawatan

Bagaimanapun, bukan semua kes epilepsi memerlukan pembedahan. Doktor akan memberi rawatan lain seperti ubat-ubatan terlebih dulu. Namun, jika pembedahan diperlukan, alat khas bagi membantu mengesahkan aktiviti elektrik dalam otak manusia.

Otak mengandungi satu trilion sel berbeza dengan separuh daripada sel ini memiliki fungsi sel elektrik yang berlainan. Kuasa elektrik ini sangat kecil dan negatif, justeru alat khas digunakan bagi mengukur cas negatif berkenaan. Epilepsi datang daripada sel yang sakit dan umumnya ia terjadi pada bahagian otak tepi dan otak depan.


Magnetoencephalography (MEG)

Bagi pesakit epilepsi, kaedah magnetoencephalography atau MEG adalah teknik membantu mengesahkan antara sel yang sihat dan sel yang terjejas. MEG sebenarnya bukanlah keajaiban baru dunia perubatan. Ia sudah dikenali sejak 1968 tetapi di Malaysia dan Asia Tenggara, MEG cuma ada di HUSM.

MEG adalah teknik 'non-invasive' (tidak membabitkan pembedahan) bagi mengkaji epilepsi dan fungsi otak. Dalam kes epilepsi, MEG digunakan bagi mengenalpasti sumber 'epileptiform' dalam aktiviti otak yang berkemungkinan besar adalah sumber kepada berlakunya 'tarik'.

MEG memiliki keupayaan menentukan pemetaan otak bagi memastikan pembedahan dibuat dengan teliti tanpa kemudaratan. Malah dalam kes lain, ia mampu mengesan 80% kes berkaitan otak lebih awal dan tepat sebelum rawatan dibuat.


Kaedah ini juga menjadi cara baru merekod dan menganalisa fungsi otak dengan mengukur magnetik yang dihasilkan aktiviti elektrik dalam otak. Rakaman ini memberikan ukuran fungsi berterusan yang berlaku pada neuron dan boleh menunjukkan lokasi neuron yang tidak berfungsi.

Secara ringkas MEG adalah teknik yang membantu mengenal pasti sumber aktiviti elektrik dalam otak manusia menggunakan ukuran magnetik non-invasive dan tidak menyakitkan, tanpa jarum, selamat dan tidak membabitkan sebarang unsur radiasi dan pembedahan. Malah, ia boleh dilakukan kepada kanak-kanak.

Teknik ini juga mampu mendiagnosis masalah angin ahmar, trauma pada otak, masalah sakit jiwa dan kemurungan serta membantu dalam bidang kognitif yang membabitkan terapi rehabiliti dan rawatan psikologi.



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Telefon Bimbit Rosakkan Sperma?


oleh Rokiah Abdullah

PULAU PINANG 15 Mac - Golongan lelaki mungkin perlu berhati-hati apabila menyimpan telefon bimbit di dalam poket seluar selepas ini berikutan dakwaan Persatuan Pengguna Pulau Pinang (CAP) bahawa tindakan itu boleh membawa kesan kepada sistem reproduktif mereka.

CAP mendakwa perbuatan menyimpan telefon bimbit di dalam poket seluar yang sering dilakukan kaum lelaki menyebabkan mereka berdepan risiko kerosakan sperma serta mati pucuk.

Sukar Jadi Bapa

Presidennya, S.M. Mohamed Idris berkata, keputusan itu berdasarkan hasil kajian pihaknya tahun lalu yang menunjukkan kaitan di antara sperma yang berkualiti rendah dengan tempoh penggunaan telefon bimbit dalam sehari.

Jelas beliau, hasil kajian itu menunjukkan pengguna yang membuat panggilan lebih daripada 4 jam sehari mempunyai bilangan sperma yang paling kurang dan paling rendah kualitinya.

"Penemuan itu menyarankan bahawa berjuta-juta lelaki di dunia kemungkinan menghadapi kesukaran untuk menjadi bapa kerana penggunaan telefon bimbit yang meluas.

Oleh itu, penggunaan telefon bimbit secara berlebihan menjadi satu faktor yang menyumbang kepada penurunan bilangan sperma selain obesiti, merokok, stres, pencemaran dan bahan kimia yang mengganggu hormon," katanya pada sidang akhbar di pejabat CAP di sini hari ini.


Antena

S.M. Mohamed berkata, lelaki yang membawa telefon bimbit yang diletakkan di bahagian tali pinggang atau dalam poket dengan 'keypad' mengarah ke luar pula akan menghadapi kesan yang tinggi kerana antena berada di belakang dan lebih hampir dengan tubuh.

Katanya, wanita yang sering meletakkan telefon bimbit di dalam beg sandang yang tergantung di sebelah payudara turut mendapat kesan terhadap kesihatan dalamannya.


Jarakkan Dari Badan

Beliau mendakwa pihak pengeluar alat komunikasi itu sendiri telah mengeluarkan peringatan mengenai risiko penggunaannya terhadap kesihatan pengguna.

"Misalnya, syarikat Apple dalam buku panduannya telah memberi amaran kepada pengguna agar menjauhkan Iphone dalam jarak sekurang-kurangnya 15 milimeter daripada tubuh.

Syarikat Blackberry pula menasihatkan pelanggannya supaya menggunakan telefon bimbit bebas wayar atau menjarakkannya seinci dari tubuh wanita hamil dan bahagian bawah perut remaja. Bagaimanapun, pengguna masih tidak mempedulikan kesan yang akan mereka tanggung itu," katanya.

Justeru, S.M. Mohamed menggesa para pengguna supaya tidak menggunakan telefon bimbit kecuali dalam kes-kes kecemasan dan sekiranya perlu gunakan pembesar suara pada jarak 20 sentimeter dari kepala.



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Bedwetting (Incontinence) in Children


by Dr. Milton Lum

The kidneys produce urine, which passes through the ureters to enter the bladder, a hollow and distensible organ that sits on the pelvic floor. The stored urine exits the body through the urethra, which is a tubular structure. This act (voiding) involves muscles, nerves, the spinal cord and the brain.

The bladder has two types of muscles. The detrusor muscle stores urine and contracts when emptying the bladder. The bladder sphincter is a circular group of muscles found at the bottom of the bladder. It automatically contracts to retain urine in the bladder and relaxes when the detrusor muscle contracts (when the urine gets into the urethra).


When the pelvic floor muscles contract, urine is held back in the bladder.


Newborn's Bladder

The newborn's bladder fills up to a certain set level at which the bladder muscle contracts automatically, leading to voiding. As the newborn grows, his or her nervous system matures. The brain starts receiving messages from the filling bladder through the spinal cord and also sends messages to the bladder.

Eventually, the child is able to stop the bladder from voiding automatically until the child decides when and where to void.

When the control mechanisms are immature or fails, it results in bedwetting (incontinence). Most children are able to control voiding by the age of 5 years. However, incontinence can occur in about 1% of those aged 18 years. Incontinence is twice as common in males as compared to females.



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Enuresis

There are certain medical terms used to describe incontinence in children :

* Primary enuresis is incontinence in someone who has never been dry for at least 6 months

* Secondary enuresis is incontinence that begins after at least 6 months of dryness

* Nocturnal enuresis is incontinence which occurs during sleep. It is also called night time incontinence

* Diurnal enuresis is incontinence which occurs when awake. It is also called daytime incontinence

There are several causes of bedwetting in children and they vary from the simple to the complex.


Nocturnal Enuresis

Nocturnal enuresis is more common than diurnal enuresis after the age of 5 years. The causes of nocturnal enuresis are not well clarified yet. Most cases result from a variety of causes that include slower physical development, an increased production of urine at night, a lack of ability to recognise bladder filling when asleep, and, occasionally, anxiety.

Nocturnal enuresis between the ages of 5 and 10 years due to a smaller bladder capacity usually disappears gradually as the bladder capacity increases.

The body produces a hormone called antidiuretic hormone (ADH) which reduces the production of urine. As less ADH is produced at night, the need to void is less. Sometimes the body does not produce sufficient ADH at night, leading to the production of more urine. If a child does not sense the increased volume of urine in the bladder and awakens to void, bedwetting will result.


Anxiety has been suggested as a cause of bedwetting in children between 2 and 4 years of age when they have yet to achieve total control of their bladders. Anxiety after the age of 4 years can also lead to nocturnal enuresis after the child has been dry for 6 months or more. The anxiety-causing events include angry parents or relatives, birth of a sibling, and unfamiliar social situations.

Incontinence itself can cause anxiety. Diurnal enuresis can cause anxiety that leads to nocturnal enuresis.

A strong family history of bedwetting is suggestive of genetic causes. Studies have reported that a child has an 80% chance of bedwetting if both parents had been bed wetters.

There is a small group of children who have physical abnormalities in their urinary tract which lead to incontinence, e.g. a blocked bladder or urethra, and nerve damage associated with spina bifida, which is a birth defect of the spinal cord.

Diurnal Enuresis

Diurnal enuresis is less common than nocturnal enuresis and usually disappears earlier than nocturnal enuresis.

An overactive bladder is one of the causes of diurnal enuresis. When the detrusor muscle of the bladder contracts strongly, the bladder sphincter may be unable to prevent voiding. This occurs frequently when there is a urinary tract infection (UTI), which is more common in girls because of their short urethras.

Many children who have diurnal enuresis have abnormal habits, the most common being infrequent voiding. They ignore the feeling of a full bladder and do not void for long periods for various reasons, e.g. not wanting to use the toilets at school. As the bladder is overfilled, the urine leaks. Such children are prone to UTIs, which in turn leads to an overactive bladder.

The causes of nocturnal enuresis may interact with infrequent voiding to lead to diurnal enuresis. These causes include small bladder capacity, anxiety, and physical abnormalities of the urinary tract. Pressure from a distended lower bowel, when a child has constipation, and caffeine-containing foods or drinks, that increase urine output, are other contributory causes.


Management

There are various management modalities available. They include no treatment, bladder training, medicines, dietary modification, and moisture alarms.

Most cases of bedwetting in children resolve spontaneously without any treatment as the child grows up. It has been estimated that the incidence of bed wetting reduces by 15% annually after the age of 5 years.

The body's changes with the passage of time include an increase in bladder capacity, resolution of an overactive bladder, the normal production of ADH, the resolution of anxiety provoking events, and the child learning to respond to the signals that it is time to void.

Bladder training involves exercises that help to strengthen and co-ordinate the bladder's muscles. The child learns to anticipate the need to void and to control oneself when there is no toilet nearby.

The methods used for nocturnal enuresis include determining bladder capacity, drinking less before bed time, and having a routine for waking.

The methods used for diurnal enuresis include voiding according to a schedule, avoiding caffeine containing foods or drinks, and relaxing the muscles. There is, however, no guarantee of success with these bladder training methods.

Medicine

There are medicines available to treat bed wetting. ADH levels can be increased with desmopressin, and an overactive bladder controlled with anticholinergics.

The medicine, imipramine, which acts on the brain and bladder, is used for short term treatment of nocturnal enuresis.


Moisture Alarms

Moisture alarms awaken a person when voiding starts. The device has a water-sensitive pad that is placed in the pajamas and is connected to a battery-driven control. An alarm goes off when moisture is detected on the pad. The child has to wake up when the alarm goes off and go to the washroom to void.

The use of such alarms may require another person to sleep in the same room as the child to awaken him or her.

Bedwetting is common in young children. It resolves spontaneously in most instances. Anyone whose child has bedwetting would benefit from a reassuring discussion with the doctor.


More info on BEDWETTING here.






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