Pneumococcal can cause death

one of the diseases involving  lungs infection  is pneumonia.

Pneumococcal infection refers to an infection caused by Streptococcus pneumoniae.



USUALLY lung function for a person to decline gradually from the age of 20 years.

If there is no disruption of the lung such as chemicals from the environment or a healthy lifestyle, health organs can be maintained until old age without any problems.

Unhealthy lifestyle such as smoking or exposure to a foreign substance from the environment causing various infections of the lung resulting in serious damage.

Infection of human respiratory system can involve the respiratory tract, bronchitis infection and infection of the air sacs and pneumonia.

According to the Director of Respiratory Medicine Institution Kuala Lumpur, Datuk Dr. Abdul Razak Muttalif, one disease involving pneumonia is pneumonia that is a chronic disease caused by the bacterium streptococcus pneumoniae.

"Of the 90 percent of pneumococcal disease is only 10 percent of it can cause serious illness.

"The bacteria cause infection in other body parts of the body such as the lining of the brain and spinal cord (meningitis), blood infections (Bacteraemia), infection of the lungs (pneumonia) and ear infections (otitis media).

"Streptococcus pneumoniae can cause deadly disease that leads to death. Estimated 1.6 million deaths occur every year due to these bacteria," he said during an event to introduce the vaccine PREVENAR 13 for adults in Kuala Lumpur recently.

Based on the report of the World Health Organization (WHO), pneumococcal disease has been detected to be the killer of the adult when in 2002 of 896,000 deaths worldwide.


 Risk groups

In addition to adults, the disease is also attacking the children, aged five years and below.

"The children, aged two years and below are some of those who are susceptible to the disease, especially those who do not receive exclusive breastfeeding during the infant, too exposed to cigarette smoke and do not get immunized disease.

"For the adults, those aged 55 to 65 are at the risk of contracting pneumococcal disease," he said.

Dr. Abdul Razak said the pneumonia can cause serious diseases such as meningitis, ear infections, pneumonia and blood.

He said, headache, vomiting, sudden fever, swollen eardrum, shortness of breath or rapid, faint and so is a sign of infection.

More dangerous, the disease is capable of infecting others through bacteria spread by patients.

"These bacteria can be spread when a patient or person in this bacterium cough or sneeze.

"A person can also get this infection when touched something with pneumococcal bacteria that can pass through the human body cavities such as the mouth and nose," he added.

Said Dr. Abdul Razak, who has been infected with this disease are also at risk of getting infected again.

The best step to prevent the disease is to get the vaccine and immunization which not only can reduce the disease but also reduce the mortality rate.

reference Utusan article

Vertigo effects stability




DIZZINESS are feeling may be difficult explained. It's like the head or around rotating or twisting or the condition in which a person is not stable and feels like fall or faint.

Dizziness can also cause a person to feel as if the light head and dizziness that made it hard to walk straight.


Many people who feel dizzy actually have a type of dizziness vertigo symptoms cause drowsiness spinning, body sway or unbalanced.

You may feel that you are moving or twisting or moving room was also turned around you. Vertigo can be caused a number of different problems involving the ear or brain.


Some of these problems are not serious, while others can be life threatening. Today's column will describe the symptoms of vertigo and help you to know when the appropriate time to get help.


The most common symptom of vertigo symptoms include feeling: l spin (you or the space around) l l Feeling shaky feeling off balance these feelings can arise and fade can occur a few seconds, hours, or days. You may feel worse when moving the head. Changes in body position (standing, lying down) and when coughing or sneezing. In addition, other symptoms are: Vomiting or nausea l l Have a headache or be sensitive to light and sound l overlapping vision (double vision) l Have trouble speaking or swallowing, or feel weak l Difficulty in breathing, sweating and heart movement If you see a doctor quick ear, nose, throat (ENT) for the treatment of vertigo, you should explain how long the symptoms last, what triggers the symptoms, and related problems. These indicators can help find the cause of vertigo.

The cause of the most common causes of vertigo include: l ear problems - calcium deposition or formation (otolith) in semisirkular vessels, inflammation and certain infections can cause problems in the vestibular system. Vestibular system includes the ears and nervous system, which controls balance.


Benign paroxysmal postional vertigo (BPPV), Meniere's disease and vestibular neuritis (neuronitis or labyrinthitis vestbular) are three of the most common causes of vertigo due to inner ear problems.

BPPV is due to the formation of calcium in the ear called the otolith deposited in the channel should not be in semisirkular.


Vertigo in BPPV usually occur lasting several seconds to several minutes. Vertigo is usually triggered by head movement in a certain direction.


Meniere's disease is a condition that causes repeated injuries synonym three symptoms of vertigo, hearing loss and noise in the ears (tinnitus).


Vertigo that occurs may last several minutes to several hours. It may be due to the formation of fluid in the cochlea ear.


Vestibular neuritis, also known as labyrinthitis, probably due to the virus that causes swelling or inflammation around the nerve.


Those who experience this inflammation will experience severe vertigo, nausea, vomiting, and difficulty walking or standing. These problems may last several days. Some people also have difficulty hearing in one ear.


l accidental head injury, trauma or after surgery of the head can affect the vestibular system in various ways, and lead to vertigo.


l Medications - Medications can occur but rarely affecting the ear or brain function and lead to vertigo.


l Migraine - in a condition called vestibular migraine, vertigo can be caused by migraines. Vertigo usually occurs together with headaches, although sometimes symptoms do not occur simultaneously.


Brain problems such as a stroke or TIA (transient ischemic attack), bleeding in the brain or multiple sclerosis can also cause vertigo.


When to seek help? You need to seek help immediately if you experience dizziness or vertigo along with any of the following: l Dizziness or severe headaches l body temperature above 38 Celsius l overlapping or troubled vision clearly see Trouble speaking or listening l l Weakness in arms or leg l Inability to walk without assistance Blackouts l l l Numbness in body parts l Vomiting Chest pain without stopping In addition, you should seek help immediately if you experience vertigo that lasts a few minutes or more if: l It Ever suffered a stroke aged l l have risk factors for stroke (hypertension, diabetes, smoking) If you experience dizziness or vertigo that comes and goes but does not have the above problem, please make an appointment with an ENT doctor or neurologist.


They will do a physical examination and may conduct further testing, depending on the examination and medical history.


For most people vertigo treatment, vertigo is disturbing but it is not due to serious problems. Treatment for vertigo aimed at treating the underlying cause (if the cause is known), relieve symptoms caused vertigo and help with the recovery of vestibular rehabilitation.


Treatment for symptoms If you have severe vertigo and ended for a few hours or days, the doctor may recommend medications to relieve severe vertigo symptoms such as vomiting. Treatment with medication is usually not necessary if the vertigo lasts only a few seconds or minutes.


Treatment medications may include antihistamines, anti-vomiting medication or sedative drugs may be used depending on the patient's condition.


Most of these drugs make you drowsy, so do not take it before work or drive.


You just need to take prescription drugs to treat the symptoms of severe vertigo and should stop when the symptoms decrease.


Restructuring canalith repositioning (otolith) is a treatment that can be recommended for people who suffer from vertigo due to BPPV.


Treatment will be performed by a nurse or therapist in the office by moving your head in a certain position with the head hanging down at the head of the bed, sometimes called the Epley maneuver.


You may be given instructions on how to do the same movement at home, if needed. This movement promotes calcium salt deposited to move to the inner ear should be, where it will be reabsorbed.


You may start to feel better after this treatment or within one or two days. Your doctor or physiotherapist will teach certain movements that can help to restore the vertigo.


Restoration work way to help your brain adjust in response to changes in the vestibular system. This therapy can also help train your eyes and other senses 'learn' how to juggle.


This therapy is most useful when it is initiated as soon as possible after experiencing vertigo. When restoring, you are taught to do exercises at home.


For example, you might start by focusing on a blank background objects and move your head slowly to the right and left and head movements in looking up and down. You will perform this exercise for a few minutes two to three times a day.


If you have difficulty standing or walking because of vertigo and risk to fall, you should talk with your doctor, nurse, or physiotherapist about the concern.


To reduce the risk of falling, harmful factors at home such as telephone lines or electricity loose and slippery carpet should be avoided.  reference

Chronic obstructive pulmonary disease (COPD)


Daxas in tablet for COPD patient - credit


MANY ads are made, various campaigns here and there, the millions of dollars invested but smokers still can not leave this dangerous habit.

In fact there is a saying, 'if you want to die, die'. Maybe they do not feel any effect now, but 10 or 20 years, they may be traded between Chronic Obstructive Pulmonary Disease or chronic obstructive pulmonary disease (COPD).


Author visit to Seoul, recently, at the invitation of famous Japanese pharmaceutical company, Takeda, to attend a conference entitled The Epic Asia Survey epidemiology and effects of COPD in Asia, provide new knowledge of the disease.

COPD is a disease that raises the burden of harm in Asia. It is a kind of lung disease due to respiratory stuck rigidly caused damage and pneumonia.


According to the World Health Organization (WHO), it is a major health problem involving an estimated 65 million people around the world.


COPD is also the fifth most important cause of death worldwide and the WHO predicts it will occupy the third place in 2030.

Epic Asia survey emphasizes the heavy socio-economic burden and difficulties facing people with COPD. More than three out of 10 respondents in Malaysia do not work full time due to illness.


Associate Professor Department of Medicine at Duke-Nus in Singapore, Professor Sam Lim, said COPD is a heavy burden, especially in Asia.

"Many people still do not realize the dangers of this disease due to lack of exposure and knowledge. COPD is synonymous with smokers, with 90 percent of this disease due to smoking but many take for granted about it.


"For heavy smokers, you are advised to stop immediately to prevent harm in the future. It should be noted, COPD attacks in silence.


"We would not be aware of its presence until I feel some discomfort and difficulty breathing, but most of that came to the doctor does not know they have COPD," he said.


Important new results of a survey entitled "Epidemiology and Impact of COPD in Asia '(Asia survey Epic) found that COPD affects quality of life and impact on work productivity.


In fact, results of a survey conducted Takeda Epic Asia in Asia covering 112,000 households in China, Hong Kong, Indonesia, Malaysia, Philippines, Singapore, Taiwan, Thailand and Vietnam involved more than 1,800 respondents had experienced a confirmed or suspected COPD throughout Asia, including 200 Malaysian respondents, provide information on the burden, perception and understanding of progressive disease fatal.


According to the survey Epic Asia, the spread of COPD among those aged over 40 years in this country cover about five percent of the population.


Chief Lung Care and Critical Heart Medical Center Philippines, Dr. Teresita de Guia had argued that, viewed as a burden of COPD in Asia.


"Awareness of the impact of COPD is still low and it is really disturbing. Many take lightly because of symptoms such as cough thought it was just normal things without knowing it can have negative consequences if not treated.


"Early treatment able to prevent COPD worse. Take a healthy lifestyle and do not smoke. See a doctor if feeling unwell because prevention is better than cure, "he said.


Deputy Director of the Institute of respiratory disease and the National Clinical Trial Basis Guangzhou Medical College, Professor Jin Ping Zheng said early detection can reduce the symptoms of COPD that does not tip over.


"Many of those who used to come to see the doctor at the last minute. So, not much can be done. In fact, not difficult to refrain from COPD.


"Above all, stay away from cigarettes as the main cause of it. COPD is not a common disease because it affects the patient. It also causes patients are unable to work full-time because often suffer from health disorders, "he said.


In the meantime, the Director of Respiratory Medicine Institute, Hospital Kuala Lumpur (HKL) Datuk Dr Abdul Razak Abdul Mutallif, said recent survey revealed Epic Asia in the past 12 months, respondents in Malaysia remained in the home on average 67 days due to illness suffered.


"Depending on the extent of the disease, COPD can make it difficult to perform normal daily activities such as work and bath. Indirectly, it inhibits one's ability to work when the disease becomes severe.


"People with COPD usually make the decision to stay at home and do not want to go out because it is too difficult," he said at the launch of Daxas (roflumilast), recent treatment of COPD patients are able to reduce the risk of COPD lung attacks in the capital, recently.


Oral medication is now available in all private hospitals and in the planning of public hospitals distributed throughout the country in the form of tablets.


It is recommended as maintenance treatment severe COPD associated with chronic bronchitis in adult patients with a history of increasing progressive disease and act as an additional therapy addressing bronchodilator.


"COPD is a disease of growing concern in Asia and should be dealt through various approaches. The healthcare industry should strive to disseminate information about the disease in order to improve the diagnosis rate by educating those who experience these symptoms.


"The latest information from Epic Asia as well as the latest treatment options allows healthcare professionals confirm the diagnosis and management of COPD more effectively," he said.


Roflumilast has a unique method of action of the enzyme inhibition fosfodiesterase 4 (PDE4). It reduces inflammation activity Tues


When used in tandem with major maintenance therapy, it provides the added benefit of reducing the risk of disease from getting worse.


Recent data also show, roflumilast able to stabilize patients who often suffer from COPD from getting worse.


Also present, Chief Respiratory Unit, Universiti Kebangsaan Malaysia Medical Centre (HUKM) and President of the Association of Thoracic Malaysia, Dr Roslina Abdul Manap, and Managing Director of Nycomed Malaysia, Kwa Kheng Hoe. reference

Best rehab centers for drug addiction treatment in Asia



I was amazed today when searching for rehab centers information. I can't believe it that Thailand is providing the Best rehab centers for drug addiction treatment and alcohol in Asia.

http://thecabinchiangmai.com/

The Cabin is Asia’s best and most respected drug and alcohol addiction treatment centre.

Located in a private riverside location just outside the beautiful city of Chiang Mai in Northern Thailand, our pioneering and effective inpatient addiction treatment model has seen us gain an exemplary reputation amongst medical professionals and the wider rehabilitation community as a world-class alcohol and drug rehab centre equal to, or better than, the best private drug rehabs in the West. Focusing on substance abuse and the underlying mental health issues such as depression and anxiety that often accompany it, The Cabin offers effective alcohol and drug inpatient addiction treatment that works

Breastfeeding help you lose weight


image credit



QUESTION


Dr, what is the best way to lose weight. I also want to ask, is it true the weight will decrease when breast-feeding and increase after stopping breastfeeding?



Answer

Weight problems are very sensitive for women. I know a lot of women out there tried various slimming products and  willing to spend a lot of money for this problem.

It would be natural, as a woman and wife, we all hope to be able to maintain an attractive body shape to pleased her husband.

Once you give birth, it is not easy to lose weight. Furthermore, when fully breastfeeding completely, we can not take medication arbitrary but will affect milk production or harm the baby.

The patience to lose weight for breast-feeding mom is not an impossible thing, but it requires patience and commitment. This is because, the process of losing weight while breast-feeding should be done slowly to avoid any complications to the milk given to the baby.

Basically, breast-feeding does not make weight gain. Even according to the study, mothers who breastfeed lose weight more easily than mothers who do not breastfeed because breastfeeding uses between 200 to 500 calories per day. However keep in mind, we still have to keep eating.

There are a few guidelines that may be helpful for mothers who want to lose weight. Most of all mothers need to drink enough water. Enough water to launch the body's systems, including maintaining our metabolism at the proper rate. Preferably just drink water half an hour after eating. Mothers are advised to eat when the stomach is hungry. They will also have to remember the Prophet words, "Eat when hungry, stop before you full". The best of all is to eat four to six times a day with small quantities. Prefer breakfast. Breakfast has to be taken within an hour after waking up.

Food eaten must be chewed slowly. Best even if the food is chewed 44 times to reduce the burden of digestion. In addition, the brain will receive satiety signals at the right time. If you eat very fast, the brain does not have time to give the signal that we're over-full. Reduce the conversation while eating to avoid over-eat.

Foods consumed should be balanced. Studies show that many people are overweight due to inadequate nutrition. Lack of protein will cause the body can not produce enzymes (enzymes made up of amino acids) that is sufficient to digest food. In addition, the lack of protein usually have a very high appetite. Protein usually makes us feel satiated in the longer term. Vitamin B6 is an important nutrient in fat metabolism. If less, fat can not be burned and accumulate excessively.

For conclusion, the food consumed should be balanced. Cut down on sugar and junk food. Sugar provides calories with no nutritional value. Sugar also increases the potential of diabetes mellitus when intake is not controlled. While junk food contains high salt, caused uncontrolled appetite and associated with the risk of hypertension (high blood pressure).

Do more physical activity. I'm sure the mothers do not have a problem to increase physical activity. Although not able to spend the time to the gym or aerobics, mom are always busy with daily tasks. Physical activity at least 15 minutes, twice a week is highly recommended.

However, for those not able to make time for exercise, it is better to take an alternative such as using the road farther to get to a place by walking, walking while swinging hand, doing housework, leisure activities with their children, and climb stairs instead of the elevator .

You also must always think positive and be patient because this weight reduction is only about two kg in a month. Continue with breastfeeding because there are many more benefits that you will get.

reference

Treating thyroid disease





Reference : Coordinator of Women's Health Development Unit (Obstetrician & Gynaecologist)
School of Medical Sciences Campus Health. Universiti Sains Malaysia, Kubang Kerian, Kelantan. ">


QUESTION:

I have heard of thyroid disease is more common in women than in men. Recently my sister-in-law was diagnosed with the disease during pregnancy. Why pregnant women has higher risk of this disease and what is the treatment. Please explain more about it.


ANSWER:

Thyroid disease is more common in women than in men. The disease can occur during and after pregnancy. However, this disease is safe and easily treated if diagnosis and treatment done at the early stage.

The thyroid gland were divided in two, like a butterfly. Two hormones released this gland the hormone thyroxine (T4) and triiodotiroksin (T3). This hormone controls the metabolism (energy production) man. If your thyroid is not functioning properly, it affects the health, especially weight gain, depression and energy levels.

With a high metabolism, you may feel hot and vice versa. So the thyroid glands help the body function running on safe and effective rate. This gland controls performed by the pituitary gland in the brain, through the thyroid-stimulating hormone. When high levels of thyroid hormone, and hyperthyroidism disease will arise if the hormone levels are too low, the disease also occurs in hypothyroidism. Other diseases such as diabetes mellitus can also interfere with thyroid hormone production.

There are tests, examinations and specific symptoms that can be used to diagnose thyroid disorders. You may also be suffering from other diseases arising from the functioning of the thyroid gland, which is irregular.

There are two types of thyroid disease hyperthyroidism and hypothyroidism are common in women than men. Four ratio of thyroid disease in women aged 20 years and above for the reasons and reasons that are not known until now.

Hipotiroidisme disease occurs when the thyroid gland does not function optimally until the hormone is not produced sufficiently. Ingested drugs to treat excessive thyroid function can also cause disease in hypothyroidism.

Typically, hypothyroidism disease caused by inflammation of the gland, called thyroiditis. The disease is also known as Hashimoto's disease which is an autoimmune disease that stimulates the body's defenses to produce antibodies against the thyroid gland. As a result, the brain produces a signal through thyroid-stimulating hormone to the thyroid gland to work harder. As a result, the gland grows and called goiter. Finally, the thyroid gland can no longer produce hormones needed by the body.

Hypothyroidism symptoms are swelling of legs, disturbed memory, sluggish, lazy, powerful sleep, the body often feel cold and can cause heart problems if not promptly treated. Patients suffering from this disease is easily treated, but had to take hormone thyroxine for life. Doses of medications can be changed periodically depending on the level of thyroid hormones.

Hipertiroidisme occurs when the thyroid gland is producing excessive hormones. Usually it is due to an autoimmune disease and the human body was capable of producing antibodies that stimulate the thyroid gland. Hyperthyroidism occurs when the thyroid gland is overactive and produces too much hormone thyroxine. Grave disease is the major cause of increased glandular activity. In addition, the drug taken for hypothyroidism may cause hyperthyroidism, so doctor supervision is very important. Symptoms of hyperthyroidism are weight loss, frequent bowel movements, sweating, palpitations, tremors, impaired vision and increased appetite.

Treatment given will cut the production of thyroid hormones. Medication to reduce heart palpitations may be given. If treatment is given failed, may be treatment with radioactive iodine will be given to destroy part of the thyroid gland. Surgery is also one of the treatment methods.

Thyroid disease during pregnancy may pose a risk to you and the baby. That is why health checkups is really important during the first visit to the maternity clinic.

With treatment, you can conceive normally and safe. Your treatment may  receive altered dose, while blood tests and other tests deemed necessary will be done.

Radioactive iodine treatment will not given to pregnant patients. There are some mothers experience postpartum thyroid problems. This is called postpartum thyroiditis. Thyroid hormone levels usually return to normal mothers involved quickly. However, there are some parents may experience in the future hypothyroidism. It should be pointed detection test or a blood test is not a routine thyroid hormone during prenatal examination.

In fact, the thyroid can cause death if not treated immediately, especially to pregnant women and unborn babies that cause miscarriage, premature delivery, small fetus and mental retardation. The case is usually under the supervision of specialists who usually monitored in 'combine clinic' which is a specialist obstetrics and endocrine specialists. Don't worry, it's safe and easy to treat.

Menopause treatment : Positive facing menopause



Question:

I now have reached the age of 45 years. Alhamdulillah, after a checkup, my health is still at a good level. FYI Dr., I now also ready to deal with any potential disease especially menopause. I just want to ask, what is the risk of diseases that are faced by women late 40's and how prevention.

* Thank you, Suzana, WA.

ANSWER:

Aging is a major health problem for women aged 40's. It is often associated with menopause. Menopausal problems, normal hit women ages 50's. If they live up to 80 years, these people have 30 years to go through this life. In addition to symptoms of menopause, women involved also have other problems. Among osteoporosis (brittle bones), increased body weight, dry, wrinkled skin and itching, easy hair loss, often tired, sleepy, movement and response to slow, difficult to control the bladder, for instance always leak when coughing, medical problems such as diabetes mellitus (diabetes), hypertension (high blood pressure), hiperkolesterol and risk of cancers including breast cancer, colorectal (bowel), uterus and egg plant (ovary).

To weather this period of time, various preparations have to be done. Symptoms that would change women 40's who among aging fatigue and breathlessness, sleeplessness, insomnia busy and very easy to sleep. To menopause, women will always feel warm milk (hot flushes), the most significant in terms of depression and psychiatric easy to feel isolated. This happens because female hormones cause mood down and no. This group is also at high risk of suffering from osteoporosis. When age, the bones of the joint begin to feel sick especially the spine.

Not all women will face, but the possibility is there. But for women, this is not the end of life because there is no treatment to overcome this problem. Importantly, each one taking the initiative to undergo screening tests such as blood tests to find out the levels of glucose and cholesterol, test mammogram, pap smear, ultrasound tests in the pelvis and bone densitometry test. Important screening test done at least once in two years. For example, cancer regardless of age and initial inspection should be done for early prevention.

SuplemenDalam making preparations to control the disease, all women need to control their lives wisely. In addition to health care by taking vitamins and supplements, they need to take a good diet. For example, for women going through menopause, your body metabolism will be low. Furthermore, they suggested reducing meal, choose quality food, high protein, preferred vegetables and fruits. In addition, they need to control the intake of glucose and carbohydrates.

Consistent healthy lifestyle, everyone needs to do some exercise. Among the advantages of exercise to reduce stress and the risk of obesity. Many women do not know the problems of the menstrual cycle is affected by obesity. Therefore, weight control is essential. In addition, exercise can balance and strengthen muscles. However, exercise is necessary according to age ability. For those who are tired, do not have to run. Just plenty of run as the morning at least to sweat.

With knowledge and positive thinking, woman could face menopause phase with fun and quality. Therefore, I recommend reading a book called madam Menopause: Face it without emotion, published by John Wiley & Library in 2010. The book contains the information needed by women to prepare themselves to deal with life during and after menopause. It details all of the facts to be known as well as feedback from medical practitioners that are considered personal issues. In addition, there is evidence of the symptoms experienced by women who are approaching menopause phase, and how treatment can be taken to relieve the women who need this assistance. Indeed, menopause is not the point for a life full stop. Celebrate with a smile of joy. Presence menopause signifies the true survival for every woman.

reference : Utusan Malaysia, ask doctor

risk of inherited prostate cancer



Question

I AM 31 years old and will be married in the middle of next year. However, recently, my father was diagnosed with prostate cancer a chronic rather serious level. In fact, he is still undergoing treatment at a private hospital at the moment. My question is, what is my true also at risk of the same disease? Is there any way to avoid it? Can the doctor explains the symptoms of prostate cancer and how treatment?



Answer

Relative risk, relative to prostate cancer is twice as high compared to other men. This is due to prostate cancer have a close genetic relationship. In fact, not only brothers, but brother and my uncle's brother also has the same risk.

Prostate cancer can be detected early by screening blood test PSA (prostate spesific antigen). Because your father is suffering from prostate cancer, you need to undergo PSA testing when reaching the age of 45 years.
For men who do not belong to the high-risk group, they can begin to undergo PSA testing after the age of 50 years and this test must be passed every year.

Normal PSA levels generally less than 4 ng / dl. If someone is found to have a PSA level greater than 4 ng / dl, a urologist will recommend to test trans rectal prostate biopsy (TRUS) is operated. This test is performed through the anus in which the prostate gland tissue will be taken with the help of ultra sound. This test is important to confirm the presence of cancer and stage of prostate cancer.

About the signs of this disease, there is no specific indication for prostate cancer. It's just like a sign of a urinary tract blockage due to an enlarged prostate gland. These include problems such as:

* Slow urinary stream
* Urine is a trickle after urination
* Had to wait long for urine out
* It should be straining to produce urine
* Often the toilet at night.

At a later stage, the patient will experience pain in the bones, especially the spine. Physical examination can also detect prostate cancer.

Through this examination, the doctor will insert a finger into the anus to examine the shape and hardness of the prostate gland. However, if the cancer can be detected with the fingers, most likely it has reached a late stage.

There are various ways to treat prostate cancer. If detected at an early stage, prostatectony radical surgery can be done. This surgery involves the removal of the prostate gland.

Apart from that, the cancer in the early stages can be treated in a way bracytherapy. In this way, radioactive items will be added to the prostate gland and through this treatment, the prostate gland is not removed.

Prostate cancer at a later stage were treated by hormonal manipulation. This is because cancer of the prostate gland hormone testostorone need to spread. Thus, the so-called anti-androgen drugs are given to lower testostorone levels in the body and to control this spread from the prostate gland. This medication is available in tablet or injection form.

Testostorone hormone levels can also be reduced by means of surgery. This surgery involves the removal of both testicles.

reference Bharian ask doctor segmen with Dr Zulkifli

Simple treatment of diabetes

photo Utusan


Just imagine how your life if lost senses of sight, using a wheelchair due to a stroke or gangrene leg (leg cut) in addition to high-risk heart attack while not yet reached 40 years of age.

That's what awaits diabetes patients due to failing to control the disease, whether through lifestyle changes, not wanting to take medication or take traditional medicine will.

Situation is exacerbated if among them were diagnosed with diabetes from an early age.

Diabetes mellitus is a metabolic problem that causes the syndrome level high blood sugar (hyperglycemia) whether due to production problems (diabetes first type) or function (sensitivity) of insulin (diabetes or gestational diabetes of the second kind).

Most adults have diabetes mellitus type 2 (T2DM).

However, many people with T2DM can not control the disease with anti-diabetic drugs, respectively, they run the risk of complications.

Professor of Diabetes Medicine University of Leicester, Professor Melanie Davies told at least 67 percent of people with T2DM risk of deterioration of renal function is high and about 30 percent have experienced deterioration in the United States.

Meanwhile, eight to 10 diabetic patients with renal impairment have a higher risk of serious complications such as hypoglycemia and cardiovascular disease conditions.

"Therefore, patients in dire need of oral anti-diabetic drugs (OAD) that can be trusted with the safety profile and better tolerance of an easy to use regardless of the patient's renal function.

"Most of the OAD is not recommended or require dose adjustment and close monitoring for creating significant barriers to people with T2DM with the deterioration," he said at the launch of the drug (T2DM) newest Trajenta by Boehringer Ingelheim and Eli Lilly.

Trajenta is approved as a treatment of diabetes medication dosage strength (five milligrams, once a day) for adult patients. The Drug Control Authority (DCA) under the Ministry of Health has approved Trajenta as recommended in adult patients with T2DM to improve glycemic control together with diet and exercise, as monotherapy single treatment or in addition to metformin, sulfonylureas or metformin and sulfonylureas.

Add Professor Melanie, Trajenta can be taken with a dose for all patients regardless of kidney or liver failure.

"It offers the benefits afforded by DPP-4 inhibitor class with the efficacy and good tolerance and neutral in terms of weight and create a low risk of hypoglycemia and also provides the added advantage of no dose adjustment regardless of the patient's kidney and liver function," he said.

These positive developments are sure to delight people with T2DM, especially in Asia because the spread of diabetes has increased from two to five times in the last two decades compared to 1.5 times in the West.

Furthermore, due to the side effects associated with inappropriate OAD, patients may find it difficult to comply with the recommended treatment. Compliance rates of patients with T2DM is between 65 percent to 85 percent for the OAD and 60 percent to 80 percent for insulin.

"Trajenta provide a variety of benefits that are effective and appropriate for most people with T2DM," said Managing Director of Boehringer Ingelheim Malaysia Sdn. Limited., Cheong YK.

He added that many people with diabetes are often concerned about weight gain or hypoglycemia which reduces compliance with medication.

"Trajenta no effect on weight when used as monotherapy and can be taken at any time, with or without food, providing better control of T2DM without compromising patient care," he added.


reference - Utusan

careful taking the erection medicine


image credit medscape

Question:

I found out from a friend about medication PDE5 inhibitors. I want to ask what is the scientific name of this drug and can I buy it at a pharmacy?
Worried Men
Answer:

PDE5 inhibitors are often used to treat erectile dysfunction penis or erectile dysfunction (ED). These drugs act widen blood vessels to the penis shaft through vasodilation.

When this happens, more blood will be pumped into the shaft of the penis and the penis will become erect.

There are three types of PDE5 inhibitor that is sold in the market, namely:
Sildenafil (Viagra) in the form of 50 mg and 100 mg.

Vardenafil (Levitra) in the form of 20 mg.

Tadalafil (Cialis) in the form of 10mg.

The three types of drugs can be found in the local market. However, before buying the medicine, his need to be checked as well as acquire preskrepsi doctor first. This is important to ensure that relatives can take this drug without any harm.

Relatives are not allowed to take PDE5 Inbitor if at the same time, take an alternative medicine nitrates such as nitroglycerin is often used for heart patients.

You also have to be careful with PDE5 inhibitors medications if taking drugs treat high blood pressure. This is because it can cause complications such as low blood pressure as well as lead to dizziness problem.

All three of these drugs began to take effect after 30 minutes. However, life expectancy in the body of this family of drugs is quite different.

Viagra and Levitra will be in the body for four hours before being excreted. This means brother can get an erection and have sex in that period.

Cialis will be located in the body for 36 hours. Consequently, the intake of each drug is different. The maximum dose for Viagra and Levitra is a piece a day while Cialis piece for two days.

Brother should also discuss with your doctor to identify the most suitable pills taken.

In addition, there are several things to be alert if you want to practice medicine of this kind of PDE5 inhibitors. It would be:

PDE5 inhibitors medications require stimulation and physical stimulation to get an erection. This means that if there is no physical stimulation such as touching, kissing or hugging, relatives may not get an erection even after taking PDE5 inhibitors.

PDE5 inhibitors will not prolong the duration of erection or prolongs intercourse. It just helps get the required hardness to penetration penis.

PDE5 inhibitors may not raise one's desire or libido.

Have to be optimistic when taking PDE5 Inbibitor. If they fail to get an erection with only one dose of PDE5 inhibitors, does not mean that it failed to help you. Should be tried at least four seed before switching to another type.

Viagra and Levitra require intake of fatty foods to help absorption.

PDE5 inhibitors will not help to further stiffen the penis if taken men who do not have ED problems.

There are some side effects that can be experienced in case you take PDE5 inhibitors. However, it is the low percentage (between two and three per cent). Side effects of this medication are mild, namely:


  • Muscle pain especially in the back.
  • Feel like getting influenza (flu like symptoms), such as a stuffy nose.
  • Headaches.
  • Warm face (facial flushing).
  • Pain in the epigastrium.
refence Bharian

Worried with penetration problems



question:

DOCTOR, I got married last year. After over a year of marriage, I still have not been blessed with children.

The problem I face is when to have sex, my penis never entered into the vagina until exhausted. Only the head of the inlet only. What is the cause we did not have a child?
Another, I faced cuts in the cover. Why is this happening and what I fix this?



Answer:

ON your problem, I conclude the factors why your penis does not get into the vagina. For his information, the state of a woman's vagina will be wet, expands and extends when it is ready to have a sexual relationship at the same time can receive your shaft with easy entry.
However, the condition is referred to as vaginismus as experienced brothers in which a man can not include a full shaft of the penis into the vagina a couple.

Vaginismus is a condition where a woman's vagina can not accept a man's penis penetrating and can cause pain when penetration occurs. This was due to pubococcygeus muscle contractions occurring reflex or out of control.

These symptoms often occur in young women previously had never experienced penile penetration. There are several factors that can cause this vaginismus. Among them:

Or fungal infections of the bladder and vagina.
Less vaginal moisture problems.
Experience sexually abused or raped.
No experience or knowledge of sexual intercourse.
Fear of getting sick when penetration occurs especially when having sex for the first time.
Not ready for sexual intercourse.

There are several types of treatment that can be given to women who suffer from vaginismus. This depends on whether arising from physiological or psychological effects. A woman who is experiencing this problem should consult a gynecologist or psychiatrist to get appropriate treatment.

Available treatments include sensate focus treatment and desensitization treatment with vaginal dilators. The process of 'dilatation' requires a woman purporting to insert the penis into the vagina sticks and objects used be enlarged in size gradually. Sexual counseling can also be given to women who lack knowledge in sex.

I hope this explanation will help solve the problem of penetration if his brother's wife vaginismus problem. Before that, my wife can try to stimulate greater focus on foreplay.

Keep right up his wife ready for penetration. Also make sure he felt comfortable during sexual intercourse.

If vaginal dryness problems, his need to use a lubricant gel available in the market such as KY Jelly. Brother also spoke of the wound in the skin in front of the penis. This may be due to vaginal dryness causing skin abrasions during sexual intercourse.

For his information, pregnancy can still occur if penetration in situations where ejaculation is half the vagina. These factors caused a strong ejaculation can lead sperm into the cervix.

At the same time, relatives can also consult with the fertility specialist where semen examination can be performed to determine the level of sperm health and sperm count is in your semen.


source berita harian with Urologist expert Prof Madya Dr Zulkifli Md Zainuddin

Chocolate reduce risk of stroke

image credit to kenali-haslinda



Husband, father, brother or sister you buff brown man? Do not worry, chocolate provide benefits for men who 'love'.

The study, conducted by a team of researchers in Sweden showed men who regularly eat chocolate less risk of stroke.

The study has been published in a journal of neurology, which is more than a decade of research involving more than 37.000 men who like to eat chocolate.

Measures of male chocolate eaten in the study is equivalent to one-third cup filled with chocolate chips.

With regular consumption of padaan measure has reduced 17 percent higher risk of stroke compared to men who did not eat chocolate.

This is not the first study to indicate the benefits of chocolate on the human cardiovascular health.

Previously many other studies show chocolate aficionados have lower risk of system-related diseases such as heart disease, stroke and high blood pressure.

"What these chocolate fan to reduce the risk of stroke is the flavonoid content in it," said Susanna Larsson, a researcher from the Karolinska Institute in Stockholm, who is also head of the research involved.

Larsson also made the same study last year against women and also found the same results.

According to the study, is a flavonoid compounds that act as antioxidants.

It has a very good effect on blood pressure, cholesterol and blood vessel function.

In the study, the range of Swedish men aged 49 to 75 years reported eating as usual and also eat chocolate as their side food.

After 10 years of monitoring, only 1.995 of the total number of men involved in the study suffered a stroke for the first time.

Larsson's research group also lists other factors involved in their study such as weight, diet, and whether they have high blood pressure or otherwise.

"Although the factors mentioned above have been taken into account but men who eat a lot of chocolate to get a 17 percent reduction in the risk of stroke," he said.

Meanwhile, a researcher, Richard Libman, who is also Vice Chairman of the Department of Neurology at Cushing Neuroscience Institute Manhasset, New York, the United States said, flavonoids are not only found in chocolate or even other foods such as apples, broccoli, soybeans, tea and nuts.

"But the facts found above does not mean people can eat chocolate anytime.

"Consider the negative effects of chocolate consumption such as obesity and type 2 diabetes," she said.

source Utusan

Healthy lifestyle to avoid piles


image credit to Bupa

A woman who has just given birth suffer from hemorrhoids from getting worse when pregnant and had a normal delivery. The woman suffering from piles for large presses intestinal contents and cause constipation.

After delivery, buasirnya worse. Doctors advised him last piles soaking in warm salt water for 10 to 15 minutes to mengecutkannya.

Consultant General Surgery, Medical Centre Kelana Jaya, Petaling Jaya, Dr. Jonah Azariah said, patients now have healthy and do not need to undergo surgery.

"But if the piles are not terrified, half body surgery done under local anesthesia.

"Usually the surgery using a laser to reduce the pain and the blood," he said when met at his office recently.

Dr. Jonah adding that there was also a physician using staples or staples or rubber band to tie the hemorrhoid to stop the blood flow.

This technique will cause hemorrhoids off on their own within two to four weeks.

"Hemorrhoids or hemorrhoidal disease is a disease that occurs in the anus. It occurs when the blood vessels and swelling around the anus (rectum and anus)," he said.

According to her, hemorrhoids can strike anyone, regardless of age and gender.

"Normally, the early signs occur during straining, especially when constipated stools cause cell swelling superimposed anal canal," he said.

Constipation Dr. Jonah can occur due to infection in the gut, including gastric, those who suffer from constipation since childhood, less dietary fiber, colon cancer and large bowel disease incredible.

"Usually patients piles over 40 years should undergo colon screening to find the cave.

Elastic tissue "A young patient usually suffers from a tumor or cancer and colon preferably checked using the scope," he said.

The probability of those aged between 20 and 50 years are more prone to hemorrhoids but there are also cases of babies suffering from hemorrhoids because of abnormalities in the intestine.

Dr. Jonah said, there are also piles that are not caused by bowel problems but at the end of the intestinal blood vessels are blocked.

"Usually when constipation, patients should be straining every defecation causes the blood back to the heart difficult.

"Blood vessels are clogged and cause swelling of blood elastic tissue loose, thin or missing, causing severe hemorrhoids," he said.

Dr. Jonah said, there are four stages of hemorrhoids. For the first and second stages of the patient can be treated without surgery.

"Patients should take the drug at the right dose for shrinking hemorrhoids, stopping bleeding and bowels," he said.

At level three, usually 10 per cent as a result of hemorrhoids bleeding can not be stopped with medication. Usually hemorrhoids are tied with a rubber band to restrict blood vessels and hemorrhoids are removable in two weeks.

At stage four when the situation worsened, leading to bleeding and pus but elastic tissue remains, surgery should not be carried out.

"However, when the situation is getting worse because of the elastic tissue is lost, surgery should be done," he said.

Dr. Jonah said, hemorrhoids patients should change their lifestyle to stay healthy.

"Patients should be eating well with foods cut out, preferred fiber, drink plenty of warm water and exercise.

"Preferably stop smoking, drink less alcohol and spicy and use the toilet seat," he said.

If the problem recurring hemorrhoids, Dr. Jonah advise patients immediately consult a doctor for further treatment.



reference Utusan

Pap smear prevent cancer




EVERY minute, a woman diagnosed for cervical cancer in the world. Cervical cancer or cervical cancer can cause the entire uterus removed and cause the woman can not be pregnant anymore.

Even the delayed detection can be life-threatening due to the severity of the cancer which is the second highest killer of women in Malaysia after breast cancer!

Cervical cancer can happen to any woman ever have sex even once no matter the age and lifestyle as it is caused by human papillomavirus infection (HPV) during intimate contact.

Ironically, cervical cancer can be prevented with early detection through pap smear but women give a thousand and one excuses to avoid doing the test that could save this life.

Shame among their main reasons. For them, belly and show the private parts in front of the doctor in conscious is something that is very embarrassing.

Some even imagine the doctor inserts act like a spatula tool uterine wall then dig them as something very painful and then choose to submit only the likelihood of developing cervical cancer.

Consultant Obstetrician and Gynaecologist Prince Court Medical Centre, Dr. Paul Tay Yee Siang said Malaysians still lack awareness about the importance of doing a pap smear on the ground such as shame and fear.

"Some feel they are too young to get cancer when it has no regard to age and test it also helps to save lives because it can detect the abnormal tissue or infected with HPV and the potential to become cancerous from the beginning.

"HPV is a virus that is common and after it is detected through pap smear, it can be cured with regular treatments to prevent it getting worse then turn into cancer.

"Many people do not have to do a pap smear and cervical cancer detection later suffered and unfortunately it was too late to save his life," he said.

What is a pap smear Pap smear is also known as the Papanicolaou test created by Dr.. Georgios Papanikolaou (1883-1962).

Some tissue taken from the base of the cervix when the test was done and the tissue is sent to a laboratory to detect the abnormal tissue and potentially become cancerous.

Cervical cells usually do not turn into cancer cells overnight. Normal cells will change, over time, ranging from two to 10 years before becoming a cancer cell.

Pap smear regularly have the opportunity to detect potential cells become cancer cells and early treatment provides opportunities for us to heal.

During the procedure pap smear, the doctor can also detect polyps and infections.

Dr. Bright pap smear procedure. Paul, about five minutes it takes to undergo the test and it is not painful as it is often described only have a little discomfort.

The doctor will insert a speculum which is a device like a duck beak into the uterine route (through the vagina) and then put the brush 'cyto' into it.

Brush 'cyto' small is used to scrape some tissue on the cervix to rotate 360 ​​degrees, and the cells were placed in a special bottle and sent to the laboratory.

"If normal, she may repeat the Pap smear test again in the next one to two years and if not normal, then follow-up testing is required.

"We hope to detect early changes in the level of such lesions because the virus can turn into cancer within 10 years," he said.

He added that up to 80 percent of women infected with HPV will in their lives and it depends on whether the immunity it will remain and get worse or go away so easily.

Who needs a pap smear As described, the woman who had sex should undergo pap smear especially those aged 20 to 65 years every two years.

If the first test result is normal, women can be reduced to three years.

Pap smears should be done routinely because it could happen again in the period as long as there is sex.

An estimated four out of five sexually active women are infected with HPV during their lifetime even if they only have one or two pairs only.

More frightening when often no symptoms or signs of cervical cancer in the early stages of the period also able to treat them.

"Most at risk are those who have very active sex. In most western countries, these tests normal and about the campaign conducted in earnest," he said.

Strictly speaking, a woman in Malaysia to take the initiative to do pap smear as a precautionary measure.

Do not worry because it is relatively simple and it is done by a trained doctor!

source Utusan

Incredible orgasm


The Sun newspaper reported on the New Jersey woman aged 44 who suffered from the condition rarely occurs that achieve orgasm or orgasm is up to 100 times a day.

Diagnosed with persistent genital arousal disorder (PGAD) or the rise of sensual repetitive, Kim Ramsey, a nurse said to have sat on the bag of frozen peas on reaching climax non-stop for four days.

Media and readers reacted to this by playing the Ramsey problem words that carry two meanings, "Again?" New York Post seems to complain about that, "some girls get all the fun."

Despite the excitement of others to make a joke, for Ramsey's own situation is not something to be laughed at.

"People who do not understand this problem assume Multiple orgasms a blessing but I all the time in pain.

"Unfortunately, not much can be done in terms of medicine at this time, but most doctors only consider my situation as hypersexsuality or overpowering sexual power," he said.

Gynecologists and founder of the Institute for Women in Pain in Pennsylvania, Dr. Robert Echenberg said women like Ramsey often misunderstood or underestimated diagnosis by a gynecologist, who will ask them thankfully better than the girls who fail to achieve orgasm or orgasm.

"The doctor is not treating patients involved," he said.

GangguanNeuropsikiatri who is also PGAD, Dr. Marcel Waldinger Ramsey compares with a "toothache in the wrong place."

According Echenberg, PGAD should be included in the context of chronic pelvic pain - issues experienced at one time by 20 per cent of women in the productive age.

This phenomenon is introduced into the medical world in a study in 2001 by Sandra Leiblum, the founder of modern sex therapy.

Waldinger and other experts since then formulate PGAD as neurological problems caused by pudendal nerve cells are important senses that trigger lust.

According to Waldinger, PGAD grow when the nerve is compressed and began to strike at random, causing the clitoris dorsal nerve (DNC) her first pacemaker.

As a result, women who suffer with this nervous all the time on the verge of sensual experience.

In exceptional circumstances, a slight touch or movement on the private parts quickly makes them excited.

Not only will it cause them to be uncomfortable when in the boardroom or in the public transport, it affects their sex life: as peak orgasm should be a source of suffering sexual favors.

"The Rise of the ongoing lust certainly upsetting and painful even makes her angry," Waldinger said.

In addition, frozen peas, is another remedy for women who are tired and their genital apparatus outcry? Some drugs may be able to reduce the sensation but for now, no effective long-term treatment.

For Ramsey, there is nothing he can do except pray more women who feel they have PGAD doctors to appear before the medical world could give serious attention to this problem.

- source Newsweek 10 September 2012.

Hepatitis C is a silent killer


TODAY if you have health problems such as fever, pain in the right side of the body, weakness, lethargy or so, you should immediately consult a doctor.

This is because of the problems you may be infected with an unknown disease is there and there were times when it has reached a chronic stage.

As the disease hepatitis C, it is difficult to detect infection by the patient's own because it always strikes without bringing specific symptoms or prolonged.

The disease is also categorized as a silent killer because many patients do not know they are infected themselves until many years but there is a reach tens of years.

Based on statistics from the World Health Organization (WHO), 60 percent to 70 percent of hepatitis C patients will suffer from chronic liver disease, while five percent to 20 percent will suffer from cirrhosis, while one per cent to five per cent will die from cirrhosis or liver cancer.

According to Consultant Physician and Gastroenterologist, Kelana Jaya Medical Centre, Dr. Jamal Malik Abdul Buhari, what a sad, most cases of hepatitis C are known only after the disease reaches a more chronic or even many patients believed to have been diagnosed with the virus far earlier.

He added that no less that only become aware of their bodies after the virus habitat health deteriorated due to liver failure or liver cancer growth.

"Because the disease is categorized as silent killer, you out there are encouraged to perform a blood test to detect the disease.

"This is due to hepatitis C through a blood test and can be detected early confirmation of the disease.

"And it should be noted these diseases affect people of any gender and age," he said when met recently.

He added that, even if a blood test can detect the presence of hepatitis C virus easily, but most people today refuse to do so.

Elaborating on the disease, said Dr.. Abdul Malik, it is not only due to infection can be transmitted even if the patients taking one drug, blood transfusion, alcohol consumption, unhealthy sexual habits as well as by injection such as body piercing, tattooing (tattoo) and drug injection.

Apart from that, Dr. Abdul Malik insisted they are at high risk for this disease are those who have excess weight, people with diabetes and hypertension patients.

Usually there are seven types of hepatitis viruses detected worldwide, the virus hepatitis A, B, C, D, E, F and G.

However, viruses that are commonly found are hepatitis A and E.

But according to Dr. Abdul Malik, the only hepatitis B and C, which can turn a possible chronic damage to the liver.

Meanwhile, according to Consultant Hepatology, University Malaya Medical Centre, Professor Dr. Rosmawati Mohamed, about 170 million people worldwide are infected with chronic hepatitis C and more than 350,000 are estimated to die each year from liver disease associated with hepatitis C virus

He further opportunity to cure hepatitis C patients with existing treatments, including the discovery of new drugs that are classified as a type of anti-viral drugs.

However Dr. Rosmawati advise patients who have recovered to avoid risky behaviors as a new hepatitis C virus can attack the same patient.

At the same time, besides always take care, early treatment of hepatitis C disease can also save lives.

.. source Utusan

Back pain at the young age

credit science photo library



QUESTION:

DOCTOR, I always have back pain on reaching age 25 this year. Do I have osteoporosis. Is this bone disease can be cured?



ANSWER:

Back pain is a common problem in all ages except children. Virtually every person will experience at least once in their lifetime. If the problem persists, they may experience symptoms should immediately consult a doctor. At least they have to get the doctor's opinion the cause of back pain experienced.

Sometimes back pain can be caused by common problems such as lifting, posture while working at the office and so on. When lifting things, many are often bent down, but they should bend the legs to carry the required motion. The office workers sitting at the table and facing the computer for hours without stretching.

SeriusWalaupun serious diseases such as cancer and spinal infections, is rare in young women, but other diseases can also cause back pain such as coral reefs should be considered. Patients should not be dependent on painkillers because it can cause side effects in the long run, such as damage to the kidneys and the risk of gastric pain.

Osteoporosis is rare in young women without other causes that may be experienced at the same time. Factors that may increase the risk for developing osteoporosis are among the professional athletes that use energy at optimum levels such as marathon runners, women lack of exercise and a low calcium diet, women who are too skinny and have a small body frame of bones, women with a family history of osteoporosis , women who smoke, have trouble absorbing the nutrients, have low estrogen levels may be due to premature menopause (menopause at a younger age), chemotherapy and suffer from a lack of vitamin D.

PerubahanSakit back is generally divided into two groups. Nearly 90 per cent of cases are in the 'function' of back pain without detectable changes in X-ray or scan Magnetic Resonance Imaging (MRI). Many of these patients were women working or married. Most of them work and sit in a chair for too long. As I have been informed that inappropriate sitting posture contribute to back pain.

Another feature of this group is their lack of exercise or recreational activities because of busy with office work and home. They are not physically and mentally healthy. Fatigue, stress and pressure somehow make them feel lower back pain more than the average person. Work lifting heavy objects that rarely do trigger symptoms of severe back pain because of the wrong technique and physical weakness.

In the meantime, another 10 per cent suffer from natural back pain with changes detected in X-Ray and MRI. Most of them suffer from the problem of deteriorating spinal cartilage structure known as degenerative disk disease;, and sometimes slip disc (intervertebral disc prolapse).

Disk is cartilage between spinal segments. It works as a shock absorber and allows movement (mobility) of the spine. It declined with the age of the disk loses moisture. This can be detected by MRI. It should be noted that not all of the degenerate disc causing back pain. This is because the slip disk occurs when the disk decline, prominent and pressing on the spinal cord. The signs are back pain accompanied by pain head to toe and below the knees.

From my observation, insha-Allah you experienced back pain are not serious, because most likely due to back pain from the first batch of 'function'. Of course, this pain can be cured. It is not due to osteoporosis. Nice to see a specialist bone (orthopedic) for further examination and appropriate course of treatment can be given.

source Utusan

Mamogram or ultrasound


STATISTICS show increased cases of breast cancer in women. Incidence of breast cancer sufferers was 1:19 in the country making it the most common cancer among all ethnic groups in the country.

Scan can usually detect cancer in stages 1 and 2 and most likely still be cured.

Radiology Consultants Kelana Jaya Medical Centre, Datin Dr. Fatima Moosa said for stage 1 cancer, nearly 90 percent can be restored.

"According to the standards of the United States (U.S.) women aged over 40 years are recommended mammogram once a year until the age of 50 years for screening every two years.

"After 70 years of age, a mammogram can be performed at any time when needed," he said when met at his office recently.

All women are at risk of getting breast cancer, however, more than 70 percent of cases occur unidentified source.

Dr. Fatima added, usually the risk of getting breast cancer increases with age, but women with a family history of cancer has a high chance of having the disease.

Women who have had cancer are at high risk for attack once again.

Women with lobular carcinoma also often attacked by cancer and those with early menarche and late menopause after the age of 55.

Additionally women who do not have children or give birth after the age of 35 are more prone to breast cancer.

Those who take high-fat diet, alcohol and smoking are also exposed to the risk of breast cancer.

Hence to avoid breast cancer, tests need to be done to detect it.

Usually mammogram is used to detect cancer at an early stage of the recovery potential is higher.

Scan is important because early treatment can be done and usually they are diagnosed with breast cancer have no risk.

Mammograms were only performed on women aged 40 years and above because fat cells have begun to decrease.

If mammograms only for women aged 40 years and above how to diagnose women under the age of 40?

Dr. She said, women under 40 years old is recommended to use ultrasound technique if suspected of having breast cancer.

"However ultrasound scans only certain areas only and depends on skilled operator and only for the target area," he said.

Ultrasound is very sensitive but not specific as mammograms.

"Ultrasound can not scan a breast portion," he said.

However, do not worry about the test because the radiation dose is low and can be done every year.

Thus the message Dr. Fatimah, if there are abnormalities in the breast, do not hesitate to see a doctor though not yet 40 years old.

source Utusan

Fasting for pregnant women


DOCTOR,
Conjunction with the fasting month, can not the doctor for any guidance for pregnant women like me. I am now five months pregnant. I am concerned that if facing any problem while fasting because this is my first pregnancy.

Mrs. R,


ANSWER

During Ramadan, many of us rush to catch up fast blessed with perfectly working practices. For women who are not pregnant, would it not be a problem. However, many pregnant women do not want to miss. Most doctors and scholars also encourage pregnant women not to fast if it is harmful to the woman or the baby in her womb.

If fasting is not harmful, they can be fast with a guide to fast during pregnancy from a doctor so that they are guaranteed healthy.

Alhamdulillah, Mrs lucky this time because of pregnancy in a lot of these advantages. You have a very good chance you educate children from the womb to identify the author. So, not surprisingly, despite being pregnant, not less than the mothers who still want to perform the duty of fasting. They want to reap the benefits of Ramadan to join the increasing worship. God willing, Madam can try to fast like the other mothers who are pregnant and choose to continue in the holy month of fasting.

Defer masaNamun, there are also mothers who stubbornly remain fast and determined to not breaking even already showing symptoms of hypoglycemia such as dizziness, nausea, trembling and almost fainting or fainting. They postpone the time for breaking. The enormity of a full month of fasting for them.

Mothers who continue to force themselves to fast without considering the actual pregnancy is harmful to the unborn child itself. In fact, the child can experience hypoglycemia and calorie malnourished useful for long term growth.

Of course not mean that all these blessings if we are not healthy offspring. In this case, it is not fair to the woman continued to fast because it is harmful to them.

Pregnancy is not a disease but a physiological condition that may be experienced by any woman. So, when there were no health problems in the mother or the unborn child and they both are under the supervision of a doctor, they were allowed to fast as usual.

To decide whether a mother is required to fast or not is highly dependent on nutrient conditions, thus fulfilling her infant nutrition. In other words, the question of nutrient should get serious consideration by pregnant women. It is also important during pregnancy the mother should think about the needs of himself and his children are burdens. If you do not change eating habits, children in the womb will also be affected. Malnutrition is any part of it will affect their health.

NutrienAlhamdulillah, Mrs. is at the second trimester (months four to six content). Normally, during the initial content of the first three months, pregnant women are experiencing symptoms of nausea, dizziness and vomiting that often, it is best not fast.

At this time, babies need the nutrients and calories are very high from the mother. If you are not experiencing problems, you may fast. Ideally, if the mother wishes to abandon the best time is during pregnancy four to six months. Mothers are advised to always get the supervision of a doctor.

Mothers who have the disease, it is recommended not to fast if you have severe allergies (always weak, nausea and a shortage of water in the body), chronic diseases such as diabetes mellitus, hypertension, kidney disease, anemia during pregnancy, oligohidramnios (mentuban water that bit), heart disease, infant growth retardation and bleeding during pregnancy.

There are pregnant women eating guidelines that should be practiced during Ramadan.

A mother should not make the pregnancy as an excuse for overeating, especially during Ramadan. Food pyramid can be used as a guide to get a nutritious and balanced diet. Taking a variety of foods as well as quantity is important.

To ensure the body's defenses strong enough, the mother must give priority to food with high calories and protein as meat. It also causes delayed stomach hungry. However, the claim is not as high caloric demands increase in other nutrients. Avoid intake of carbohydrates and sugar because it just adds calories. Fiber and vegetables, do not be forgotten.

Have lots to drink water and milk to meet the daily demands of two to three liters a day. If not, drink plain water only, may be mixed with juices, syrups and the like. Drink water throughout the night and if frequent urination, it is a good sign and shows a person does not become dehydrated. Normally a pregnant woman needs about two liters of water a day.

Therefore, to ensure sufficient water supply to the body, you should drink more water after the time of breaking fast. Then relax for about an hour before eat a meal break.

KeseimbanganTujuannya giving advance balance of the digestive system. Remember, do not overeat and avoid foods with high salt content such as eggs and salted fish. Puasalah breaking slowly so that the stomach would not be surprised. To aid digestion, chew your food well.

So that you could sustain hunger, increase his take-fiber foods which are abundant in vegetables and fruits. The body takes longer to digest the food much fiber. In addition to fiber and protein, preferably prepared foods that contain vitamins and minerals, and supplements that are fresh, vibrant body throughout the day.

In conclusion, pregnant women can fast if they have a strength and not experiencing a complication of pregnancy. For which there is no power from the disease since before marriage or suffered during pregnancy, may break and need replacing again.

Reference, Utusan Online

Diabetes and fasting



image credit to maryvancenc.com


Fasting in patients with Type 2 Diabetes Mellitus (T2DM) depending on personal decisions.

But they should seek advice based on specific guidelines through discussions with health professionals.

T2DM diabetes is most common, but which comprises about 90 percent of diabetes patients around the world.

Senior Consultant Medicine and Endocrinology, Professor Dr. Nor Azmi Kamaruddin said, whether high or low risk patients had complications related to the practice of fasting depends on the level of their disease.

"For example, diabetics who experience severe hipoglesemia or blood sugar is very low making the patient unconscious or requires a third party within three months before Ramadan.

"Or the patients with a history of repeated hipoglesemia categorized as high risk and should not fast during Ramadan," he said. Nor Azmi.

He said studies conducted observations in five countries found that nearly 20 percent of patients with T2DM who are Muslims have the highest hipoglesemia by 45 per cent of Malaysia (24 per cent, UAE (18 per cent, India (13 [percent) and Saudi Arabia (10peratus) .

"It is estimated there are 1.2 million people with diabetes in Malaysia and more than half of them do not realize that they may have diabetes until severe diabetes develop complications such as blindness, kidney disease, nerve disease, cardiovascular disease or stroke.

"In addition, Survey of the Third National Health and Morbidity Survey, conducted in 2006 showed that, naturally significantly higher in urban than rural areas," he said.

Clearly, based on disease prevalence rates, Malaysians should not be nonchalant about monitoring blood sugar levels.

"They should eat moderately at the appropriate time. This is why fasting is quite challenging for people with diabetes who are Muslims.

"Fast foods are generally open with, but this is not recommended for diabetics because it can cause blood sugar levels increased dramatically," he said.

He said, since the drug should be eaten after a meal, patients with diabetes should not fast if they do not pre-dawn meal.

"They will be in the body for some time, causing decreased blood sugar levels if they do not eat. This will result in dizziness, drowsiness, tremors and headaches," he said. Nor Azmi.

He said Hipoglesemia or low blood sugar occurs when blood glucose levels to become too low for the body needs.

"Long intervals between meals with certain diabetes medications are risk factors that cause hipoglesemia.

"It is therefore important blood sugar level checked more frequently during a fast to better public health," he said.

Hipoglesemia he said, must be avoided because it can cause severe medical problems.

"If left untreated, can result in the loss of hipoglesemia aware or seizures that requires emergency treatment," he said.

He added that low blood sugar can occur even if a person to do all they can to manage diabetes.

"The level of low blood sugar is most often caused by certain diabetes, do not eat regularly or the work of more than usual.

"To reduce this risk, follow a regular eating schedule, and schedule of physical activity and regular medication. Discuss with the team of health experts to set a target blood sugar levels," he said. Nor Azmi.



reference Utusan Online

Fatty liver diet


Most cases of fatty liver due to obesity and body shape like an apple shape. credit Utusan


Did you know that the liver function is for storing energy, vitamins and minerals? Liver or liver also produces proteins, and remove waste from the body through urine, perspiration and so forth.

In fact issued by the American Liver Foundation, liver disease attack about one out of 10 Americans. In Malaysia, we find the figure of 20 people suffering from heart related diseases.

To ensure that we are suffering from heart or not, people are advised to undergo screening, and then followed by surveillance, if it can be detected early so treatment can begin earlier.

World Hepatitis Day this month, the President of Malaysian Liver Foundation (YPM), Prof Tan Sri Datuk Seri Dr. Mohd. Ismail Merican advised Malaysians to eat a balanced diet and high fiber.

Eat less fat, calories and be sure to have the ideal body weight.

This is because a healthy lifestyle is the cause of liver disease such as hepatitis and fatty liver.

Hepatitis

According to Dr. Mohd. Ismail, Sabah, Sarawak and Kelantan is a state that had the most number of people with hepatitis that may expose them to liver cancer. Liver cancer also is among the five most common cancer among men in Malaysia.

He said they are part of the 2.5 million people in this country who was diagnosed with the disease are mostly men.

"Based on statistics released by the foundation, Sabah and Sarawak had the highest rate in the country for people with hepatitis B virus and hepatitis A. Kelantan for five to eight per cent of Malaysians are carriers of Hepatitis B.

Dietary and lifestyle factors to be among the main causes of the disease increased among the population in the state, "he said.

The disease affects about 350 million people around the world. According to statistics, men are more people suffering from liver cancer and it may be due less concerned about hygiene and healthy eating is not as women.

The rest, they are found to be suffering due to infectious disease from mother to child, the sharing of drug needles, blood, mostly involving hepatitis B.

Dr. Mohd. Ismail said he seeks to intensify awareness campaigns about the disease can be life threatening in the country and also targeted to schools to enable the detection and treatment should be performed earlier.

In addition to hepatitis, YPM also stressed the danger of fatty liver is often associated with liver disease such as hepatitis.

What is fatty liver? The disease is caused by obesity and diabetes, but teenagers as young as 15 years are also at risk for heart disease as a result of both these problems.

Dr. Mohd. Ismail explained, also known as fatty liver NFLD (Non-Alcoholics fatty liver disease).

It is a condition in which a large amount of saturated fat membranes accumulate in liver cells through the process of steatosis.

Fatty liver is divided into two main groups, the normal fatty liver (steatosis), and fatty liver associated with inflammation (steatohepatitis).

PuncaSecara basis, the disease arises due to alcohol consumption, especially in Western countries. However, the situation is changing.

Today, cases of fatty liver in the absence of alcohol (NAFLD) is increasing. Changes in liver enzymes in an imbalance of abnormal metabolism leads to fatty liver problem.

Without specific symptoms, the disease usually affected those aged 40 years and above other people with obesity or diabetes. Most patients do not realize it. Because the disease is associated with metabolic syndrome (diabetes, extreme pressure and obesity), regular screening can not detect the presence of fat in the liver.

Add Dr. Mohd. Ismail, progress steatohepatitis can cause liver fibrosis, cirrhosis and liver cancer. As a result, it increases the risk of death for sufferers. Fibrosis or cirrhosis in the liver faced by between 15 to 50 percent of patients with non-alcoholic fatty liver steatohepatitis (NASH).

Rapid weight reduction is also invited to the existence of fatty liver. Thus, those who want to lose weight are urged to do it in stages.

"If you are suffering from obesity, chances are you have a problem of fatty liver is high," he said.

Diagnosis and treatment of ultra-sound test, followed by biopsy of the liver can detect the presence of fat.

Dr. Mohd. Ismail stressed that only by leading a healthy lifestyle and proper eating helps prevent the spread of the disease.

Although fatty liver is not a chronic disease, but this condition should be treated. Treatment depends on the cause. For example, if the patient is an individual who is a lot of drinking, he must reduce the land acquisition.

If the patient is an individual who is obese, she should be eating and weight control.

Worry about the effect of contraceptive pills


Worry about the effect of contraceptive pills

SALAM doctor. I'm happily married and has one child aged 2 years 8 months. I have been taking birth control pills 28 seed then switch to 21 seeds. At the beginning of last year, I stopped taking the pills. My problem now, I do not come from the period January 2011 until now. Make knowledge a doctor, I would like to have another child.

* FK, NSW.

ANSWER:

In medical terms, it's called post aAmenorrhea pill. It occurs when a woman does not come haidnya after stop taking birth control pill. Although it does not always happen, but this occurs significantly, at 0.2 to 3.0 percent. This means that in 1,000 women who practice birth control pill, a total of 2-30 people will experience this problem. Do you worry that the problem experienced is quite common.

When women take the birth control pill, estrogen and progesterone levels in the body is at relatively high levels. In turn causes the pituitary gland in the brain can not function normally. In women with normal menstrual cycle, the pituitary gland releases the hormone stimulator follicles (follicle stimulating hormone, FSH) and hormone Peluteinan (LUTEINIZING hormone-LH), which will stimulate the ovaries (egg plants) produce follicles containing the ova (female seeds).

This growing follicle releases the hormone estrogen. When these follicles mature and rupture, it releases an ovum. At this time (usually in the middle of the menstrual cycle or the 14th day of the menstrual cycle) is called ovulation and progesterone produced. When women practice birth control pills containing the hormones estrogen and progesterone, both of these hormones will be in the body at high altitudes. The increase in this hormone will give a negative response when the pituitary gland feels that enough estrogen and progesterone in the body. So the pituitary gland does not produce hormones FSH and LH indirectly, prevent ovulation. This will prevent the egg is released and the woman will become pregnant.

Often women practice birth control pills for long periods of time between one to two years while waiting for a newborn baby grow up. Since taking too long, the effect of the negative reaction in the pituitary gland will continue to be felt even if she does not take birth control pill again. This will prevent ovulation and menstruation.

Diagnosis and treatment of cases, doctors will give a diagnosis based on patient history who have taken birth control pill. Ultrasound scan examination (ultrasound) will show the ovaries with no growing follicles. In other words there is no blood kelihatan.Pemeriksaan follicles showed that the level of hormones FSH, LH and estrogen are at a very low level.

Typically, doctors do not give any medication for this problem. If the situation continues to occur for six months, then the doctor will provide medicines that contain the hormone progesterone for about five days to bring about menstruation. These drugs act very quickly, usually bleeding to occur after several days due progesterone pills.

However, should you know that the bleeding would be meaningless if there is no production of ova from the ovary. This is because the progesterone pill does not encourage the development of follicles in the ovary.

So fertile drug (clomiphene citrate) is supplied to encourage the development of a follicle for ovulation. It is best you consult a doctor for treatment.
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