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credit : myhealth.gov.my
Buasir

Apa itu buasir?

Buasir adalah salur darah vena yang membesar di bahagian bawah rektum dan dubur. Ia akan membawa masalah apabila ianya menjadi radang atau bengkak. Buasir boleh diklasifikasikan kepada dua bergantung kepada lokasinya iaitu buasir luaran atau buasir dalaman. Kedua-dua ini mempunyai simptom dan masalah yang berbeza.

Buasir dalaman
Merupakan salur darah vena yang bengkak di lapisan dalam rektum. Pesakit akan mengadu terdapat pendarahan selepas membuang najis tanpa kesakitan. Ada juga pesakit yang akan terasa seperti unjuran yang terkeluar dari dubur selepas membuang air besar. Unjuran ini mungkin hilang sendiri atau ada juga yang perlu menolak balik unjuran ini ke dalam.
Buasir luaran
Merupakan salur darah vena di bahagian bawah kulit luar dari dubur (lihat gambar 1). Pesakit akan mengadu sakit, berdarah, gatal atau bengkak semasa membuang air besar. Kesakitan yang dirasai seseorang itu mungkin berbeza. Ada orang yang mungkin merasa sedikit tidak selesa, tetapi ada juga yang merasa panas atau amat pedih. Sakit yang kuat mungkin berlaku akibat salur darah yang tersumbat oleh darah beku.
Mengapa buasir terjadi?

Buasir adalah penyakit yang sering berlaku. Ia boleh terjadi kepada mana-mana individu tanpa mengira umur tetapi selalunya dilihat pada orang dewasa 30 tahun ke atas dan wanita mengandung. Ia sering dikaitkan dengan meneran semasa membuang air besar dan keadaan sembelit. Wanita mengandung mungkin mengalami buasir kerana pembesaran janin menyebabkan tekanan ke bahagian dubur dan juga akibat perubahan hormon. Selain itu, orang yang berlebihan berat badan, berdiri dalam jangka waktu yang lama setiap hari atau selalu mengangkat benda berat mungkin menghidapi masalah ini. Kesemua keadaan tersebut menyebabkan penambahan tekanan kepada salur vena di rektum dan dubur dan menyebabkan pembengkakan dan pembesaran.

Perlukah saya berjumpa dengan doktor?

Dapatkan nasihat dari doktor sekiranya anda mengalami pendarahan semasa atau selepas membuang air besar. Doktor perlu memastikan bahawa pendarahan tersebut berpunca dari buasir dan bukannya dari penyakit serius yang lain seperti kanser usus. Pemeriksaan untuk kanser usus perlu dibuat bagi mereka yang:

Berumur 40 tahun ke atas.
Mempunyai sejarah perubatan kanser usus atau ahli keluarga/ saudara yang mengalami kanser usus.
Mengalami sakit atau ketidakselesaan perut.
Mengalami pembuangan najis tidak menentu seperti selalu cirit-birit dan/atau sembelit.
Kurang berat badan tanpa sebab tertentu.
Apa yang boleh saya lakukan?

Ada beberapa langkah yang boleh diambil untuk mengelakkan buasir dan mengurangkan simptomnya:

Elakkan sembelit
Lebihkan pengambilan serat dalam pemakanan anda dengan memakan buah-buahan,sayur-sayuran hijau dan bijirin. Jika ingin memakan roti atau bijirin, pilihlah yang mengandungi bijiran penuh (wholemeal).
Lebihkan minum air, sebaik-baiknya lapan gelas sehari.
Lakukan senaman setiap hari.
Elakkan pengambilan julap yang boleh menyebabkan cirit-birit dan menerukkan lagi masalah buasir. Anda boleh mengambil julap yang mengandungi serat tinggi seperti Fybogel yang bertujuan untuk mengelakkan sembelit.
Mengurangkan kesakitan
Mandi dengan air suam untuk mengurangkan kesakitan dan kegatalan.
Jika terdapat pembengkakan, gunakan ais supaya bengkak surut atau duduk di dalam besen yang berisi air garam.
Ambil pil untuk mengurangkan sakit seperti paracetamol, aspirin, atau ibuprofen.
Terdapat banyak produk krim sapuan atau supositori yang berada dipasaran untuk rawatan buasir. Kebanyakkannya tidak mempunyai bukti yang kukuh bagi keberkesanannya. Produk-produk ini mungkin boleh mengurangkan simptom tetapi penggunaan berterusan tidak digalakkan. Ini kerana ia boleh menyebabkan masalah kulit disekeliling dubur.
Bila saya perlu pembedahan/prosedur?

Selalunya buasir akan hilang/baik tanpa rawatan jika anda mengambil langkah-langkah untuk mengelakkan buasir seperti di atas. Walaubagaimanapun, sekiranya ia berterusan dan mengganggu anda, dapatkan nasihat doktor.

Pembedahan/prosedur untuk rawatan buasir boleh dilakukan sama ada di klinik atau perlu kemasukan ke hospital:

Prosedur di klinik:

‘Rubber band ligation’(lihat gambar 2), boleh dilakukan bagi rawatan buasir dalaman. Rawatan ini adalah sangat ringkas dimana gelung getah yang kecil dipasang dipangkal buasir menyebabkan aliran darah ke kawasan tersebut terhenti dan buasir tersebut mengecut.
‘sclerotherapy’ di mana sejenis cecar contohnya Phenol disuntik ke dalam buasir tersebut menyebabkan dinding saluran vena tersebut mengecut.
Prosedur rawatan di hospital:

‘Hemorrhoidectomy’ di mana pembedahan dilakukan untuk mengeluarkan buasir tersebut. Pesakit yang menjalni prosedur ini mengambil masa 2-4 minggu untuk pulih.
‘Doppler guided transanal hemorrhoidal dearterialization’ di mana mesin ultrasound digunakan untuk mengenalpasti aliran darah arterial terbabit yang kemudiannya disekat.
‘stappler hemmorhoidectomy’ merupakan pembedahan untuk membuang bahagian tisu yang longgar yang menyebabkan buasir keluar dari dubur.
Bolehkah masalah buasir ini berulang?

Ya, buasir boleh berulang walaupun pembedahan telah dilakukan. Oleh itu adalah penting bagi anda untuk mengelakkan sembelit,tidak meneran semasa membuang air besar dan menggelakkan perkara-perkara lain yang boleh menyebabkan buasir seperti yang dibincangkan di atas.

Buasir bagi wanita mengandung

Buasir semasa mengandung sering bermula diperingkat akhir kandungan sehingga akhir waktu berpantang. Masalah buasir dikalangan wanita di Malaysia mungkin kerap berlaku akibat amalan berpantang. Ada amalan berpantang yang menyarankan ibu-ibu untuk mengurangkan minum air dan mengelakkan memakan buah atau sayur-sayuran tertentu. In mungkin akan mengakibatkan masalah buasir. Oleh itu, ibu-ibu dinasihatkan untuk berhati-hati ketika berpantang dan mendapatkan nasihat dan rawatan doktor sekiranya mengalami sembelit atau simptom buasir semasa tempoh berpantang.

Semakan Akhir        :        20 Jun 2014
Penulis/Penterjemah        :        Dr. Naemah Shariffuddin
Akreditor        :        Dr. Fitjerald Henry
Penyemak        :        Dr. Heselynn Hussein

seribulan

Studying sugary drinks and cancer risk
Chazelas and team examined the links between the intake of sugary drinks and various forms of cancer in 101,257 French adults aged 42 years, on average. The researchers obtained the data from the NutriNet-Santé study.

The drinks they examined included "sugar-sweetened beverages" such as soft drinks, syrups, fruit drinks, 100% fruit juices without any added sugar, milk-based sugary drinks, sports drinks, and energy drinks.

The researchers also considered artificially-sweetened drinks, that is, "all beverages containing nonnutritive sweeteners, such as diet soft drinks, sugar-free syrups, and diet milk-based beverages."

kokonut

How to boost immunity and prevent yourself from falling ill

How many times have you rescheduled a meeting or work appointment because you were feeling under the weather from having a cough, cold, flu or sore throat? Have you asked yourself, “Why am I constantly plagued with infections and illness whilst some colleagues never seem to be sick?”

The reason is attributed to their strong immune system.

Each day is precious and when you’re sick, there is so much you miss out on. It is clear that keeping our immune system healthy and strong should be our first priority if we are to avoid disease and achieve optimum health.

How we age and our quality of life also depends on the health of our immune system although there is no single magic bullet to strengthen it. A comprehensive approach is required.

Protect your body

Germs and adverse environmental conditions like haze, extreme weather changes, constant air-conditioning and pollution from inhaling cigarette smoke can put your health at risk. Rising cases of influenza in all forms fuelled by lack of exercise, sleep deprivation and increased stress weakens the body.

The only thing that determines whether you remain healthy or succumb to an infection is the state of your immune system. Is it able to protect your body against infectious organisms and other pathogens?

The immune system is composed of billions of white blood cells including macrophages, neutrophils, lymphocytes and natural killer cells, much like how the armed forces is made up of the army, air force and navy.

These immune cells are tasked to neutralise disease-causing pathogens like bacteria, viruses, fungi, parasites and even cancerous cells. Hence, the immune system is the body’s first line of defense, and we should strive to keep it strong.

To build a strong immune system, we need to:
* Strive for 30 minutes of exercise daily, at least five times a week. Physical activity and regular exercise help improve the ability to sleep, which in turn reduces stress. Studies have found that stress is linked to many health problems, including suppression of the immune system.

* Aim for at least seven hours of sleep daily as the body perceives lack of sleep as a form of stress and thus, reduces immune response.

* Consume a daily diet rich in fruits and vegetables as our diet plays a major role in strengthening our immune system.
A truly healthy immune system depends on a continuous intake of a balanced mix of vitamins and minerals. Unfortunately, in today’s fast-paced society, many of us are not consuming adequate amounts of fresh fruits and vegetables required to keep our immune system working optimally. Getting enough antioxidant vitamins coupled with minerals will help support the immune system to fight off colds, flus and other illnesses.

Follow a daily guide

Some beneficial immune-boosting nutrients include:

• Vitamin C – also known as ascorbic acid, this is a water-soluble vitamin which has been shown to stimulate both the production and function of the immune cells to fight germs. Rich sources of vitamin C include oranges, papaya, broccoli and strawberries.

• Vitamin D – has been found to be an important factor in immune health. Countless studies have linked low vitamin D levels to higher risk of developing influenza. Vitamin D receptor cells have been found on immune cells in which vitamin D binds to and aids the immune system by reducing levels of inflammatory proteins whilst increasing the amounts of antimicrobial proteins that destroy invading germs. Good sources include salmon, tuna, beef liver and egg yolk.

• Zinc – an essential trace mineral, it is probably widely known for its role in the immune system by increasing the production of white blood cells to help the body fight infection. Sources include oysters, poultry, mushroom, cashew nuts and pumpkin seeds.

• Garlic – is well known throughout history as a food that fights infections from bacteria and viruses. Allicin is one of the immune-stimulating nutrients in garlic that is released when you cut, chop or crush the cloves.
Garlic stimulates the activity of immune system cells that destroy cold and flu viruses.

• Echinacea – research shows that it increases the number of white blood cells to fight infections. However, two other studies funded by the United States-based National Center for Complementary and Alternative Medicine found that echinacea did not help in colds for neither children nor adults.

• Yeast beta glucan – one of the most powerful nutrient to strengthen our immune system, yeast beta glucans are the only beta glucans that are able to activate the neutrophils and prime them to “battle”. Without them, our innate immune cells remain “sluggish”. One form of yeast beta glucan that has been in the limelight recently is whole glucan particle (WGP) beta glucan, which is derived from the cell walls of a highly-purified, patented strain of baker’s yeast (Saccharomyces cerevisiae).

For greater protection against germs, infections and illnesses, consider supplementing your diet with all of the above nutrients.

Keep your immune system in check, all the time.

kokonut

Seeing clearly

Cataract is one of the leading causes of blindness in older adults, but there is still a lack of awareness surrounding the condition

An almost routine part of growing older is having to cope with not having our senses as tip-top as they were in our younger days. When it comes to sight, cataracts are relatively common among older adults — if it is not you, someone you know has probably had to deal with that cloudy gauze over their eye.

Despite this, it appears that we may not be as informed as we should regarding the condition. According to the Alcon More to See Survey, released in conjunction with World Sight Day in October, many of Asia’s senior citizens may be lacking vital eye health knowledge when it comes to cataracts.

Involving some 2,400 respondents aged 60 and above across six Asian countries including Hong Kong, India and South Korea, the survey revealed that up to 62% of Asians over the age of 60 believe cataracts can be prevented. More worryingly, 44% believed cataracts should be fully developed before treatment. While age–related cataracts are a part of getting older, the progressive disease can lead to visual impairment and blindness unless treated.

When compared to touch, taste, scent and hearing, 90% of those surveyed, people aged 60 and older, see vision as the most important of the five senses. However when it comes to eye check-ups, many do not regularly see an eye care professional. Approximately 12% of those surveyed indicate they almost never see an ophthalmologist; 19% of those surveyed said they almost never see an optician; and 18% almost never see an optometrist.

The survey also seems to match up to previous local studies conducted in Malaysia. A National Eye Survey (NES) conducted in 2014 found that 216,000 Malaysians became blind because of delays in cataract surgery, and the condition also caused 272,000 others to be visually impaired. The NES also found that among 63,000 Malaysians aged 50 and above who were blind, 60% could have been treated. A further 350,000 people in the same age group had low vision, with 80% being treatable.

“While lifestyle factors may impact cataracts, it’s a progressive disease that can only be treated by surgery,” says Dr Wong Jun Shyan, Consultant Ophthalmologist at the International Specialist Eye Centre in Kuala Lumpur. “Waiting isn’t the answer. If you have any symptoms, including blurry vision, see an eye care professional and seek advice on how and when you should be treated. Annual check-ups are also very important for seniors and it worries us that so few are regularly seeing an eye care professional.”

Cataract facts

A cataract is a clouding of the normally clear lens of your eye. The lens of your eye is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. But as we age, some of the protein may clump together and start to cloud a small area of the lens.

For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window. Most cataracts develop slowly and appear not to disturb your eyesight at first. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.

Despite popular belief, there are no sure-fire ways of preventing cataracts – at least not scientifically. Most cataracts are a result of ageing and long-term exposure to ultraviolet light; the protein in the lens changes from the wear and tear it takes over the years.

Some are caused by injury and certain diseases and in rare cases by exposure to toxic materials and radiation. Occasionally cataracts are present at birth, due to the baby’s mother having had rubella during the pregnancy, or due to genetic defects.

However, there are some risk factors that researchers suspect increase the possibility of getting cataract, such as smoking and diabetes. “Diabetes-related vision problems are a big problem here, so it’s important to manage your diabetes if you have it,” says Dr Wong. “Studies have also shown that smokers are twice as likely to develop cataracts, and the risk increases further if you are a heavy smoker.”

Most of us know the tell-tale symptom of a cataract — cloudy vision. However, almost half of the respondents in the Alcon survey could not name more than one symptom; some 12% even mistakenly listed ‘itchy eyes’ as a symptom of the condition.

Other possible signs of cataract include light glare and sensitivity; colours looking faded or “yellowed”; seeing halos around light or light sources; having double vision in one eye; or even needing to change your eyeglass or contact lens prescriptions too frequently. “Needless to say, if you’re having to go to change your glasses every so often compared to before, you should get your eyes checked regardless of your age,” adds Dr Wong.

Cataract surgery meanwhile, involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is positioned in the same place as your natural lens. It remains a permanent part of your eye.

For some people, other eye problems prohibit the use of an artificial lens. In these situations, once the cataract is removed, vision may be corrected with eyeglasses or contact lenses.

Dr Wong says that while some may be concerned about having their eye go under the knife, cataract surgery is now a rather routine procedure unlike the times of yesteryear. While there may be some discomfort following surgery, healing generally takes place within eight weeks.

“As with most types of surgery, there is a risk of infection and bleeding. That said, if your cataracts are left untreated, the more likely and immediate concern is that it will slowly cause you to go blind,” he adds.

seribulan

                Enam kawasan baharu di Sarawak diisytihar kawasan jangkitan rabies            
                                                                        Bernama |                                                 

Julai 13, 2019 18:13 MYT                                   
                                                                                          
               
            
            
                                                                                                                                                                                Pemilik anjing diminta menghantar anjing mereka untuk divaksin dan memberi jaminan bahawa setakat ini tiada anjing yang telah divaksin, mati. - Gambar fail
                           

KUCHING: Enam kawasan baharu di Sarawak dikenal pasti sebagai kawasan jangkitan rabies, menjadikan jumlah keseluruhan sebanyak 63 kawasan sejak diisytiharkan pada 2017.

Timbalan Ketua Menteri Datuk Amar Douglas Uggah Embas berkata antara kawasan terlibat ialah sebuah rumah panjang, Rh.Samueh Adeng di Engkilili yang terletak di luar 10 kilometer radius kawasan jangkitan rabies.

Beliau berkata lima lagi kawasan ialah Kampung Seroban dan Kampung Siantan di Serian, Kin Chu Shin di Batu Kawa dan Kesuma Resort di Petra Jaya di sini, serta Tanjung Durian, Siniawan di Bau.                                                

"Makmal Jabatan Veterinar negeri telah melakukan ujian terhadap 14 sampel dari Kuching, Serian, Bintulu, Kapit dan Sri Aman dari 5 hingga 12 Julai.

"Enam sampel yang diuji positif rabies adalah daripada enam kawasan terbabit termasuk rumah panjang manakala sampel dari Bintulu dan Kapit negatif," katanya yang juga Pengerusi Jawatankuasa Pengurusan Bencana negeri dalam kenyataan pada Sabtu.

Sementara itu, Uggah meminta pemilik anjing menghantar anjing mereka untuk divaksin dan memberi jaminan bahawa setakat ini tiada anjing yang telah divaksin, mati.

Beliau berkata Fasa 5 operasi merangkumi Sri Aman, Lubuk Antu dan Betong akan bermula dari 31 Julai hingga 3 Ogos.

"Saya merayu kepada pemilik anjing untuk menghantar anjing mereka untuk divaksin. Tolong beri kerjasama kerana rabies adalah penyakit yang mengancam nyawa," katanya.

Setakat ini, Sarawak merekodkan 19 kes rabies dengan 18 kematian, sejak wabak itu dikesan di negeri ini.

-- BERNAMA                                                

Amalinarazi

BERITA|MALAYSIA

Diabetes, hipertensi dan hyperlipidaemia paling mendadak dalam kalangan generasi muda


KUALA LUMPUR: Kaji selidik Kesihatan dan Morbiditi Kebangsaan (NHMS) pada 2015 menganggarkan beban penyakit kronik tidak berjangkit (NCD) seperti diabetes, hipertensi dan hyperlipidaemia dalam kalangan rakyat Malaysia berumur 18 tahun ke atas adalah sangat tinggi, persidangan Dewan Rakyat diberitahu hari ini.

Timbalan Menteri Kesihatan Dr Lee Boon Chye berkata peratusan penyakit kronik NCD paling tinggi dicatatkan adalah hypercholesterolaemia iaitu sebanyak 47.7 peratus rakyat Malaysia menghidap penyakit itu diikuti hipertensi (30.3 peratus) dan diabetes (17.5 peratus).

"Beban penyakit hypercholesterolaemia dalam kalangan golongan muda mengikut kategori umur bagi umur 18 hingga 19 tahun adalah sebanyak 22 peratus, 20 hingga 24 tahun (26.5 peratus), 25 hingga 29 tahun (33.7 peratus), 30 hingga 34 tahun (44 peratus) dan 35 hingga 39 tahun (49.7 peratus).

"Manakala beban penyakit hipertensi dalam kalangan golongan muda mengikut kategori umur bagi umur 18 hingga 19 tahun (6.7 peratus), 20 hingga 24 tahun (9.4 peratus), 25 hingga 29 tahun (13.2 peratus), 30 hingga 34 tahun (15.9 peratus) dan 35 hingga 39 (23.9 peratus)," katanya.

Beliau menjawab soalan Datin Mastura Mohd Yazid (BN-Kuala Kangsar) yang ingin tahu apakah penyakit kronik yang paling mendadak dalam kalangan generasi muda dan peratusannya.

Dr Lee berkata sebanyak 17.5 peratus atau 3.6 juta rakyat Malaysia menghidap penyakit diabetes dengan peratusan golongan muda yang menghidap penyakit itu mengikut kategori umur bagi 18 hingga 19 tahun sebanyak 5.5 peratus, 20 hingga 24 tahun (5.9 peratus), 25 hingga 29 tahun dengan (8.9 peratus), 30 hingga 34 tahun (10.6 peratus) dan 35 hingga 39 tahun (12.9 peratus).

"Kaji selidik itu juga menganggarkan sebanyak 17.7 peratus rakyat Malaysia mempunyai indeks jisim tubuh (BMI) obes.

"Peratusan generasi muda yang obes mengikut kategori umur bagi mereka berusia 18 hingga 19 tahun sebanyak (11.7 peratus), 20 hingga 24 tahun (12 peratus), 25 hingga 29 tahun (18.3 peratus) 30 hingga 34 tahun dengan (17.2 peratus) dan 35 hingga 39 tahun (20.5 peratus)," katanya.

Dr Lee berkata kementerian menyedari beban penyakit NCD dalam kalangan golongan muda amat membimbangkan dan memberi fokus terhadap strategi pencegahan dan kawalan NCD pada peringkat awal mengikut Life Course Approach berdasarkan Pelan Strategik Kebangsaan Penyakit Tidak Berjangkit 2016-2025.

-- BERNAMA

berakit2kehulu

What you need to know about irregular periods

The normal length of a woman's menstrual cycle is 28 days, but this varies between individuals. Irregular menstruation is when the length of the cycle is more than 35 days, or if the duration varies.
A period, or menstruation, is the part of the menstrual cycle in which the endometrium, which is the lining of the uterus, is shed. This appears as bleeding from the womb that is released through the vagina.

Periods usually start during puberty, between the ages of 10 and 16 years, and they continue until menopause, when a woman is 45- to 55-years old.

Irregular periods, also called oligomenorrhea, can occur if there is a change in contraception method, a hormone imbalance, hormonal changes around the time of the menopause, and endurance exercises.

Treatment for irregular periods during puberty and around the menopause is not usually necessary, but if irregular periods occur during the reproductive years, medical advice may be necessary.

Causes
A number of factors increase the chance of irregular menstruation. Most relate to hormone production. The two hormones that impact menstruation are estrogen and progesterone. These are the hormones that regulate the cycle.


Hormonal influences

Life cycle changes that influence the hormonal balance include puberty, menopause, pregnancy, and childbirth, and breastfeeding.

During puberty, the body undergoes major changes. It can take several years for the estrogen and progesterone to reach a balance, and irregular periods are common at this time.

Before menopause, women often have irregular periods, and the amount of blood shed may vary. Menopause occurs when 12 months have passed since the woman's last menstrual period. After the menopause, a woman will no longer have periods.

During pregnancy, menstruation ceases, and most women do not have periods while they are breast-feeding.

Contraceptives can cause irregular bleeding. An intrauterine device (IUD) may cause heavy bleeding, while the contraceptive pill can cause spotting between periods.

When a woman first uses the contraceptive pill, she may experience small bleeds that are generally shorter and lighter than normal periods. These usually go away after a few months.

Other changes that are associated with irregular periods include:

extreme weight loss
extreme weight gain
emotional stress
eating disorders, such as anorexia or bulimia
endurance exercise, for example, marathon running.
A number of disorders are also linked to missed or irregular menstruation.

seribulan

                Diabetes, hipertensi dan hyperlipidaemia paling mendadak dalam kalangan generasi muda            
                                                                        Bernama |                                                 Julai 17, 2019 16:13 MYT                                   
                                    

               
            
            
                                                                                                                                                                                Beban penyakit hipertensi dalam kalangan golongan muda mengikut kategori umur bagi umur 18 hingga 19 tahun (6.7 peratus), 20 hingga 24 tahun (9.4 peratus), 25 hingga 29 tahun (13.2 peratus), dan 30 hingga 34 tahun (15.9 peratus). - Gambar hiasan

                           
                                                                                        KUALA LUMPUR: Kaji selidik Kesihatan dan Morbiditi Kebangsaan (NHMS) pada 2015 menganggarkan beban penyakit kronik tidak berjangkit (NCD) seperti diabetes, hipertensi dan hyperlipidaemia dalam kalangan rakyat Malaysia berumur 18 tahun ke atas adalah sangat tinggi, persidangan Dewan Rakyat diberitahu hari ini.

Timbalan Menteri Kesihatan Dr Lee Boon Chye berkata peratusan penyakit kronik NCD paling tinggi dicatatkan adalah hypercholesterolaemia iaitu sebanyak 47.7 peratus rakyat Malaysia menghidap penyakit itu diikuti hipertensi (30.3 peratus) dan diabetes (17.5 peratus).

"Beban penyakit hypercholesterolaemia dalam kalangan golongan muda mengikut kategori umur bagi umur 18 hingga 19 tahun adalah sebanyak 22 peratus, 20 hingga 24 tahun (26.5 peratus), 25 hingga 29 tahun (33.7 peratus), 30 hingga 34 tahun (44 peratus) dan 35 hingga 39 tahun (49.7 peratus).                                                

"Manakala beban penyakit hipertensi dalam kalangan golongan muda mengikut kategori umur bagi umur 18 hingga 19 tahun (6.7 peratus), 20 hingga 24 tahun (9.4 peratus), 25 hingga 29 tahun (13.2 peratus), 30 hingga 34 tahun (15.9 peratus) dan 35 hingga 39 (23.9 peratus)," katanya.

Beliau menjawab soalan Datin Mastura Mohd Yazid (BN-Kuala Kangsar) yang ingin tahu apakah penyakit kronik yang paling mendadak dalam kalangan generasi muda dan peratusannya.

Dr Lee berkata sebanyak 17.5 peratus atau 3.6 juta rakyat Malaysia menghidap penyakit diabetes dengan peratusan golongan muda yang menghidap penyakit itu mengikut kategori umur bagi 18 hingga 19 tahun sebanyak 5.5 peratus, 20 hingga 24 tahun (5.9 peratus), 25 hingga 29 tahun dengan (8.9 peratus), 30 hingga 34 tahun (10.6 peratus) dan 35 hingga 39 tahun (12.9 peratus).

"Kaji selidik itu juga menganggarkan sebanyak 17.7 peratus rakyat Malaysia mempunyai indeks jisim tubuh (BMI) obes.

"Peratusan generasi muda yang obes mengikut kategori umur bagi mereka berusia 18 hingga 19 tahun sebanyak (11.7 peratus), 20 hingga 24 tahun (12 peratus), 25 hingga 29 tahun (18.3 peratus) 30 hingga 34 tahun dengan (17.2 peratus) dan 35 hingga 39 tahun (20.5 peratus)," katanya.

Dr Lee berkata kementerian menyedari beban penyakit NCD dalam kalangan golongan muda amat membimbangkan dan memberi fokus terhadap strategi pencegahan dan kawalan NCD pada peringkat awal mengikut Life Course Approach berdasarkan Pelan Strategik Kebangsaan Penyakit Tidak Berjangkit 2016-2025.

-- BERNAMA                                                

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Thalassaemia: Are You a Carrier?


Thalassaemia is an inherited blood disorder. It instigates the production of abnormal red blood cells in your body, which leads to less or fewer red blood cells. This can cause a host of health complications if left untreated.

We speak to Dr. Chan Lee Lee, an experienced paediatrician from Subang Jaya Medical Center, who reveals what you need to know about thalassaemia.

Urban Health: What causes thalassaemia?

Dr. Chan Lee Lee: Thalassaemia is a hereditary disease, which means that children inherit this condition from their parents.  The transmission of inheritance is “autosomal recessive” which means that both father and mother must be thalassaemia carriers (also known as thalassaemia minor) before a child can be born with full-blown thalassaemia major.



UH: How does thalassaemia affect a person’s lifestyle?

Dr. CLL: A person with beta thalassaemia major has chronic anaemia and will require regular blood transfusions throughout his or her life.  The effects of chronic anaemia will impose some restriction in physical activity while the side effects of regular monthly blood transfusions include regular hospital visits and medications to help overcome iron overload.  A person who has thalassemia minor (a carrier) is expected to lead a normal life.



UH: What are the signs and symptoms of this disease?

Dr. CLL: Within six months, a baby with beta thalassaemia major will demonstrate a pale complexion, poor appetite, poor weight gain/ poor growth. Examination by a doctor will confirm anaemia that includes enlargement of abdominal organs such as the liver and spleen. Appropriate blood tests will confirm the diagnosis.   Some children demonstrate similar symptoms a little later — around 12 to 24 months.



UH: What are the complications experienced by a person with thalassaemia?

Dr. CLL:  The number of complications experienced is related to the quality of treatment a patient receives.  If a patient does not receive adequate blood transfusions on a regular basis, he experiences chronic anaemia, generally becomes thin and does not achieve normal height. The facial bones will expand, giving a typical “thalassaemia face” accompanied by a bloated abdomen.  If he is following a good transfusion programme, then he should look fairly normal with satisfactory growth.  However regular blood transfusions lead to iron overload and the patient needs an efficient method to remove the excess from the body — in other words he also needs iron chelation therapy for life.  If the excess iron is not removed then complications that affect many organs will occur.  A patient with excess iron may end up with liver failure, hormonal and growth failure as well as heart failure.



UH: Can you explain more about the inheritance of this disease? What are the precautions parents should take?

Dr. CLL:  As mentioned earlier, thalassaemia is an inherited disease whereby each parent contributes an abnormal gene to the child before the full-blown disease is present.  So whether you are a father or a mother, you need to know if you carry the thalassaemia gene before you decide to have a child.  If you are a carrier and your spouse is also a carrier, then you need to understand the consequences because every pregnancy has a 25 percent chance of producing a child with thalassaemia major.  If you are a carrier and your spouse is normal, then your child will be normal but you will have a 50 percent chance that every pregnancy produces a carrier (thalassaemia minor) child.

As the beta thalassaemia gene occurs in about three to five percent of our Malaysian population, all prospective parents should know their thalassaemia status and are encouraged to go for appropriate blood tests to determine their status.



UH: What are some of the recommended methods to manage this disease?

Dr. CLL:  A patient with thalassaemia major needs adequate blood transfusions to ensure normal growth and development from the time of diagnosis and then for the entire lifespan of the patient.  This must go hand in hand with good iron chelation therapy so that life-threatening complications of iron overload do not occur.  The Malaysian government has given some priority to tackle the problem of thalassaemia in the country and information on this can be found on the web page of the Ministry of Health.  In addition, most hospitals are able to manage and treat patients with this disease.

Currently the only way to cure thalassaemia major is by performing a haematopoietic stem cell transplant or bone marrow transplant.  This is a major undertaking where an appropriate stem cell donor must be identified and the patient himself must be well enough to undergo the transplant.  A few specialised units in Malaysia are able to offer transplant services but parents must be fully aware of the risks and benefits before they embark on this type of treatment.



UH: How prevalent is thalassaemia in Malaysia?

Dr. CLL:  Based on a recent nationwide survey, an estimated 3500 patients with thalassaemia major were identified but I believe this is far below the real number.  The carrier rate is running at three to five percent for the beta thalasasemia gene and three to 15 percent for the alpha thalassaemia gene.



UH: What are some of the ways to prevent this disease?

Dr.CLL: Couples who carry the gene may have to decide not to have a child. If they are unable to make such a decision, they may opt for pre-natal diagnosis, which means that they test their pregnancy/foetus for thalassaemia major status.  If a thalassaemia major foetus is identified, the couple may need to terminate the pregnancy.  Of course, these are major decisions and religious, social and cultural practices need to be taken into account.



UH: Are there different types/stages of thalassaemia?

Dr. CLL: The common types of thalassaemia in Malaysia are alpha and beta thalasaemia. Beta thalassaemia major is more common because the person is able to live with medical treatment.  Alpha thalassaemia major patients, on the other hand, do not live long as the child either dies in the womb or soon after delivery.

Thalassaemia is also subdivided into thalassaemia major, which requires monthly blood transfusion for life or thalassaemia intermedia, which requires less frequent blood transfusions although complications that are seen in thalassaemia major, habitually present themselves.  Many people afflicted with thalassaemia intermediate are diagnosed only later in life.



UH: If a person has been diagnosed with thalassaemia but is planning to start a family, what is your advice for him or her?

Dr. CLL:  For a person who is diagnosed as a thalassaemia carrier and plans to have a child, then it is crucial to find out if the spouse also carries the thalassaemia gene.  The implications were explained earlier but that person should consult a haematologist or a geneticist to get further details and explanations on their risk of transmitting the thalassaemia gene.

As for the person who is diagnosed with thalassaemia major from infancy, the chances of conceiving a child are low and he or she usually needs a lot of medical attention and assistance in order to have a baby.



11.   UH: If I do not have any family history of thalassaemia, do I still have to go and check my status?

Dr. CLL:  Many young adults do not realise that they carry the thalassaemia gene until they give birth to an affected thalassaemia major baby.  So every individual, especially those who are planning to start a family, should get checked.  There is no age limit for the blood tests.  Anyone older than six months can be screened for thalassaemia.

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Teeth Grinding in a Child



When your child won’t stop grinding his teeth…


Teeth grinding or bruxism in children is an issue that is not addressed very often because it is a condition that is usually associated with stressed or tired adults. However, children certainly experience bruxism although how and why this condition occurs among little ones, differs slightly compared to adults.

Children usually experience bruxism when they are teething. According to Dr. Wong Ruen Yuan of the Smile Link Dental Group, “An estimated 15 to 33% of children grind their teeth regularly. This occurs when they develop their desidus (milk) teeth at six to eight months old and again at six years old when they start to develop their permanent teeth.” Dr. Wong adds, “At complete eruption, maybe 12 years old, the habit will usually stop.”



Stressed or teething?

The main difference between adult bruxism and teeth grinding in children according to Dr. Wong is that, “Adult teeth grinding is almost always because of pressure, stress and anxiety. Bad sleep quality can also contribute to teeth grinding. 80% of night-time teeth grinding occurs subconsciously.” In children however, it is usually the growth of new or permanent teeth that leads to grinding their teeth.

However, a child can also be stressed which can trigger teeth grinding. Dr. Wong states, “Kids can grind their teeth because of stress too. Sometimes, parents may stress their children over school and exams. It is also possible for the child to carry on grinding their teeth well into adulthood.” Another thing that can add stress on a child is a new addition to the family such as a new baby sister or brother or a change in routine such as having a new teacher at school.

You know it’s time to take your child to the dentist when he or she complains of soreness in their jaw or face or pain when they chew food. If you hear the sound of grinding when your child sleeps, it is a good indicator that your child is grinding his teeth.



No more ice-cream

If your child regularly grinds his teeth, they can become worn down. Teeth that are worn down will be sensitive to temperatures and this will cause all sorts of problems. For instance, your child won’t be able to enjoy his ice cream or cold beverages because of sharp, shooting pains.

Dr. Wong adds, “They may suffer from a sore jaw in the morning, pain in the facial muscles, or even temporomandibular joint disorder (TMJ) in serious cases.” TMJ is cluster of conditions that affects the temporomandibular joint which are small joints that connect the lower jaw to the temporal bone of the skull. If your child still sleeps with you and your partner, you may experience sleep disruption because of the noise.



A simple solution

Usually a simple trip to the dentist will get Junior to leave his teeth-grinding days in the past and get back on the road to wellness. Dr. Wong says, “In serious cases such as TMJ and headaches, a mouth guard is prescribed. This mouth guard is worn at night to prevent grinding.” These mouth guards are made out of soft acrylic, which prevents the upper and lower teeth from grinding together to help prevent further damage. He also advises that during the day, parents should remind their child not to clench their jaw or grind their teeth.

The mouth guards look like the ones used in contact sports. The dentist will take a mould of your child’s teeth so the guard will fit perfectly. The reason why the guard should be used only at night is that bruxism happens subconsciously which is harder to control. During the day, when the child is awake, mum or dad can correct his behaviour with a gentle reminder.

According to Dr. Wong, “Muscle relaxants are only prescribed in very serious cases. We will usually investigate the cause of the stress and work to reduce it in order to help the child.”

He urges parents to lighten the child’s daily responsibilities. “Give them a wonderful childhood without unnecessary courses or classes. Let them follow their interests.”



Growing that toothy smile

For younger children (six months and above) whose milk teeth are coming in, get teething rings for them to chew on. This will help stop them from grinding their teeth.

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Glaucoma In Children

By Edeline Anne Goh

You might know of 1 or 2 people in your life who have been diagnosed with glaucoma and it is highly likely that they are in the senior age group. However, no parent will expect a child or a baby as young as a few months old, to be diagnosed with this eye condition.

Dr Suraiya Mohamad Shafie, Paediatric Ophthalmologist from OPTIMAX, Seremban speaks to Urban Health about glaucoma in children and explains why there is no age discrimination when it comes to this disease.

UH: HOW DOES GLAUCOMA DEVELOP IN CHILDREN?

Dr Suraiya: Glaucoma is a condition whereby there is an increase in the pressure inside your eye, known as intraocular pressure which causes pressure damage to the optic nerve and loss of vision. The pressure rises as a result of accumulated aqueous humor (fluid inside your eye), which normally flows out of your eye naturally. In patients with glaucoma, the aqueous humor is not drained properly due to abnormal development or injury to the drainage tissues in the eye. Thus, the fluid collects inside the eye and causes an increase in intraocular pressure.

There are many causes of paediatric glaucoma. It can be hereditary or associated with other eye or systemic disorders. Most cases of pediatric glaucoma have no specific identifiable cause and are considered to be primary glaucoma. Secondary glaucoma is typically associated with other eye diseases such as aniridia, systemic conditions, medications such as steroids, eye injury or eye surgery.

UH: WHAT ARE THE RISK FACTORS AND CHANCES OF A CHILD DEVELOPING GLAUCOMA?

Dr Suraiya: Paediatric glaucoma is relatively rare. Primary congenital glaucoma occurs in approximately 1 in 10,000 births while some are hereditary. About 10% of primary congenital glaucoma cases are inherited. Children with certain eye or systemic conditions or children who have had to use steroids for medical conditions have a much higher risk of developing glaucoma. Children with a history of eye injury or eye surgery may also develop glaucoma.

UH: WHAT ARE THE SIGNS AND SYMPTOMS THAT PARENTS OR GUARDIANS SHOULD LOOK OUT FOR?

Dr Suraiya: The symptoms may not be apparent in children. Each child may experience symptoms differently and it is important to note that glaucoma can affect one or both eyes. The following are the most common symptoms of paediatric glaucoma:

For children who are below two years of age:

• Unusually large eyes
• One eye looks bigger than the other
• Excessive tearing
• Cloudy eyes
• Child closes one or both eyes when exposed to sunlight
• Child becomes irritable and fussy if there is eye pain and discomfort
  

Among older children:

• Sensitivity to sunlight or bright lights such as from a camera flash
• Difficulty adjusting to darkness
• Eye aches or headaches
• Frequent blinking or squeezing of eyes
• Red eye
• Vision loss
  

UH: WHAT IS YOUR ADVICE FOR PARENTS WHO SUSPECT THEIR CHILD MIGHT HAVE DEVELOPED GLAUCOMA?

Dr Suraiya: Take the child to an ophthalmologist for a proper assessment and examination. Early detection and treatment is very important to prevent loss of vision. Late detection, which causes a child to be deprived of treatment, may lead to blindness.

UH: WHAT ARE THE TREATMENT OPTIONS CURRENTLY AVAILABLE IN MALAYSIA?

Dr Suraiya: It is important to start treatment for glaucoma as soon as possible to prevent permanent vision loss.

The main aim of treatment in glaucoma is to lower the intraocular pressure and may include:

• Medical treatment involving the use of topical eye drops and oral medications. These treatments help to lower the eye pressure by either increasing the drainage of aqueous humor from the eye or decreasing the production of fluid inside the eye.
• Surgical treatment, which aims to create an opening in order to drain fluid from the eye.  There are two main types of surgical treatments namely filtering surgery and laser surgery. Filtering surgery (also known as micro surgery) involves the use of small surgical tools to create a drainage canal in the eye. Laser surgery on the other hand uses a small but powerful beam of light to make a small opening in the eye tissue.
  

Multiple procedures are often required to successfully control glaucoma.  After surgery, medication may still be necessary to control intraocular pressure. Both medication and surgery have been successfully used to treat childhood glaucoma although children with glaucoma may require lifelong medication, treatment and follow up.

UH: WHAT ARE THE TYPES OF SURGICAL PROCEDURES AVAILABLE?

DR SURAIYA: SURGICAL PROCEDURES USED TO TREAT GLAUCOMA IN CHILDREN INCLUDE THE FOLLOWING:

Trabeculotomy and Goniotomy
Trabeculotomy and goniotomy, are the most common surgical interventions in younger children. Both procedures involve opening the drainage canal of the eyes.

Trabeculectomy
Trabeculectomy surgical procedure involves the removal of a part of the trabecular meshwork drainage system, allowing the fluid to drain from the eye. It creates a guarded opening from the front of the eye to a space underneath the conjunctiva.

Iridotomy
A small hole is made through the colored part of the eye (iris) to allow fluid to flow more freely in the eye. The surgeon may use a laser to create this hole, known as laser iridotomy.

Cyclophotocoagulation
A procedure that uses a laser beam to freeze selected areas of the ciliary body  (the part of the eye that produces aqueous humor) to reduce the production of fluid. This type of surgery is usually performed in severe cases of paediatric glaucoma.

UH: CAN A CHILD WHO HAS BEEN DIAGNOSED WITH GLAUCOMA DEVELOP ANY OTHER EYE CODITION?

Dr.Suraiya: Many children with glaucoma develop other eye problems such as myopia (nearsightedness) that require glasses. In these children, amblyopia (lazy eye) and strabismus (crossing or wandering eye) occur more frequently and may require treatment with either patching or surgery. Despite early and aggressive treatment, permanent vision loss can still occur.

UH: WHAT ARE YOUR TIPS TO PREVENT GLAUCOMA IN CHILDREN?

W TIPS ON HOW TO PREVENT GLAUCOMA IN CHILDREN?

Dr. Suraiya:  Most of the time, there is no way to prevent glaucoma. However, regular and complete eye examinations may aid in early diagnosis as well as timely and proper treatment to prevent vision loss.

UH: IF GLAUCOMA DEVELOPS AT A YOUNG AGE, IS THERE A HIGHER CHANCE OF OVERCOMING THE CONDITION?

It doesn’t matter whether glaucoma occurs at a younger age. What matters most is early detection and treatment as loss of vision can occur at any age. The ultimate goal of glaucoma management is for the child to have a normal life.  Although lost vision cannot be restored, it is possible to optimise the child’s remaining ability to see. Early diagnosis and treatment are essential for a successful outcome.

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Denggi meningkat ke tahap membimbangkan di Kelantan
Bernama | Diterbitkan pada Julai 21, 2019 06:00 MYT

Denggi meningkat ke tahap membimbangkan di Kelantan

Kes demam denggi di Kelantan menunjukkan peningkatan membimbangkan apabila 2,030 kes direkodkan dalam tempoh 1 Januari hingga 13 Julai. - Gambar Fail

PASIR PUTEH: Kes demam denggi di Kelantan menunjukkan peningkatan membimbangkan apabila 2,030 kes direkodkan dalam tempoh 1 Januari hingga 13 Julai tahun ini berbanding 518 kes dalam tempoh sama tahun lepas.

Pengarah Jabatan Kesihatan Kelantan, Dr Zaini Hussin berkata, Kota Bharu merekodkan kes tertinggi demam denggi dengan 730 kes direkodkan diikuti Tumpat (273 kes) dan Bachok (156) dan bakinya di jajahan-jajahan lain.

"Tiga kematian turut direkodkan dalam tempoh sama membabitkan dua kes di Kota Bharu dan satu kes di Bachok," katanya kepada pemberita selepas merasmikan Program Kayuhan Sihat Kelantan-Terengganu di Hospital Tengku Anis di sini, pada Sabtu
Seramai 300 peserta mengambil bahagian dalam program berkenaan membabitkan kayuhan sejauh 40 kilometer yang berakhir di Kampung Beting Lentang, Besut, Terengganu.

Mengulas lanjut, Dr Zaini berkata, peningkatan kes demam denggi berikutan keadaan cuaca tidak menentu selain amalan kebersihan di kawasan persekitaran rumah yang tidak dititikberatkan penduduk di lokaliti yang terjejas dengan penularan demam tersebut.

Beliau berkata, keadaan dijangka bertambah buruk antara dua hingga tiga kali ganda pada sambutan Aidiladha bulan depan apabila perantau mula pulang ke kampung halaman masing-masing.

"Ini kerana Kelantan merupakan negeri tertinggi mencatatkan kes demam denggi dan dikhuatiri perantau akan membawa demam berkenaan pulang ke tempat mereka mencari rezeki selepas cuti perayaan tamat.

"Hospital Raja Perempuan Zainab II (HRPZII) di Kota Bharu juga kini tidak boleh menampung jumlah pesakit demam denggi kerana wad khas yang dibuka bagi menangani kes berkenaan sudah pun penuh dan hanya menerima pesakit-pesakit kritikal sahaja," katanya.

Bagaimanapun, tambahnya lagi, Jabatan Kesihatan Kelantan akan memastikan pesakit tidak kritikal untuk menerima rawatan sebaiknya dan ditempatkan di hospital-hospital kerajaan yang berdekatan.

Dalam pada itu, Dr Zaini berkata, pihaknya akan menggiatkan kempen menjaga kebersihan di kawasan sekitar rumah selain mengambil tindakan tegas kepada mana-mana pihak yang menyebabkan nyamuk aedes membiak.

-- BERNAMA

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A Spinning World

Do you feel like the world around you is spinning? It could be vertigo.

You get up from your chair and you suddenly feel like the floor you’re stepping on is uneven. It feels like you’re standing on a boat sailing on rough seas. Vertigo can create these feelings and those suffering from this condition often describe a dizzy, unbalanced sensation. Like the world is spinning around them.

For those who don’t suffer from a severe case of vertigo, life can go on with very little disruption but for a small group of patients, vertigo can be crippling especially if they are not receptive to treatment. Consultant General and Paediatric Ear, Nose and Throat (ENT) Surgeon at Assunta Hospital, Dr. Lim Wye Keat explains the medical details and treatment options for vertigo.

Getting to know vertigo

Vertigo is a relatively common health problem among adults and the chances of experiencing it increases with age. According to Dr. Lim about one in 20 new patients he consults, have vertigo. “Vertigo is a problem with the balance system in the body,” explains Dr. Lim. Your balance system includes your inner ear, eyes, brain, spinal cord and lower limbs. “The balance system is part of your neurological system. It is responsible for keeping your body upright, even with your eyes are closed,” continues Dr. Lim. “It helps you to stand up straight and look left or right. Your balance system also help your eyes follow moving objects without feeling uncomfortable.”

Vertigo is often believed to be a disease but Dr. Lim clarifies that,“It is a symptom, not a disease.” Vertigo can be a symptom of several medical conditions which includes stroke and Benign Paroxysmal Positional Vertigo (BPPV). The difference between a disease and a symptom is that, the former refers to the source of a problem and the latter is a feeling or an experience that the patient reports. According to Dr. Lim, there are two types of vertigo —central vertigo and peripheral vertigo.

Peripheral vertigo

This condition is caused by a problem present within the balance mechanism of the ear. The inner ear, which is part of your body’s balance mechanism has two parts which are the cochlear and vestibular labyrinth. Characteristics of peripheral vertigo include reoccurring episodes of dizziness or imbalance. This can be accompanied by nausea and vomiting. Possible causes of peripheral vertigo include BPPV or Meniere’s Disease. BPPV occurs when tiny calcium particles gather in your inner ear. Meniere’s Disease on the other hand is the buildup of fluid in your inner ear. This then changes the pressure in your ears. Symptoms of Meniere’s Disease include vertigo, ringing in the ear and hearing loss.

Central vertigo

Central vertigo on the other hand, is a condition tied to your central nervous system. Characteristics of central vertigo include spinning or an imbalance which goes on for days. At times, central vertigo may be accompanied with a headache, numbness on one side of your body or paralysis. Patients experiencing central vertigo need to be treated by a neurologist as it is linked to your central nervous system. Possible causes of central vertigo include a brain tumour or stroke.

Identifying vertigo

There are many reasons why a person may feel dizzy. Besides vertigo, other conditions such as hypoglycaemia and lack of sleep can cause dizziness. So, how does a medical expert diagnose vertigo? Dr. Lim explains that, “Firstly, I spend quite a bit of time talking to the patient and understanding what they are feeling. I will then proceed to conduct a physical examination to confirm the diagnosis. This includes examining the eyes. For patients with acute vertigo, their eyes jerk. This is called nystagmus.”

Once the doctor confirms that you are suffering from vertigo, he will recommend the next step in your treatment plan. If you’ve consulted an ENT specialist but you are suffering from central vertigo, you will then be referred to a neurologist. However, if you have been diagnosed with peripheral vertigo, the ENT specialist will advice you on the best treatment option.

Treating peripheral vertigo

With ENT being his area of expertise, Dr. Lim treats patients with peripheral vertigo. “For patients with mild vertigo, you may not need any form of treatment as your body learns to readjust by itself,” Dr. Lim says.  However, for patients with more severe symptoms, treatment options include oral medication to manage the symptoms such as dizziness and vomiting. Physiotherapy is another option which can help patients regain their quality of life.

“Physiotherapy for patients with vertigo is known as vestibular rehabilitation therapy. This is conducted by a physiotherapist and its aim is to make your body readjust to its body system,” says Dr. Lim. “The physiotherapist will guide the patient through a series of repetitive movements. Eventually, your body will learn to readjust and this will reduce the effects of vertigo.”

Besides physiotherapy, Epley and Semont maneuvers are two forms of exercises used to treat patients with BPPV. Both exercises must be conducted by a trained medical expert and last for about 15 minutes each. If patients did not experience any positive results from these treatments, surgery of the inner ear may be recommended if the patient is a suitable candidate.

“As for patient with central vertigo, treatment depends on the cause of vertigo. For example, if the patient has a brain tumour, the patient will then undergo surgery to remove the tumour,” says Dr. Lim. Vertigo is a condition that is more common among the older age group but it can also affect a person at any age. If you think you may have vertigo, don’t ignore your symptoms. “If you experience any symptoms of vertigo, consult a doctor,” advises Dr. Lim. “Many cases of vertigo may resolve by themselves but some of can be persistent.”

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Najis, hama burung merpati mungkin punca murid SK Tanjung Puteri Resort sesak nafas, muntah
Bernama | Diterbitkan pada Julai 23, 2019 23:21 MYT


Najis, hama burung merpati mungkin punca murid SK Tanjung Puteri Resort sesak nafas, muntah
Mohd Khuzzan (kiri), Aminolhuda (dua, kanan), Dr Selahuddeen (dua, kiri) dan Guru Besar SK Tanjung Puteri Resort Padzlan Monthel (kanan) meninjau keadaan kelas yang terpaksa dikosongkan ekoran dipenuhi najis burung di siling bumbung. --fotoBERNAMA


JOHOR BAHRU: Kerajaan negeri tidak menolak kemungkinan insiden murid Sekolah Kebangsaan (SK) Tanjung Puteri Resort di Pasir Gudang, di sini, mengalami sesak nafas dan muntah-muntah yang berulang turut berpunca daripada pencemaran najis dan hama burung merpati di beberapa bilik darjah sekolah terbabit.

Pengerusi Jawatankuasa Kesihatan, Kebudayaan negeri Mohd Khuzzan Abu Bakar berkata pencemaran najis dan hama itu yang berlaku sejak sekian lama menyebabkan bau yang kurang menyenangkan.

"Ini mungkin juga antara faktor-faktornya (penyebab murid sesak nafas dan muntah). Jadi kita minta Kementerian Pendidikan agar segera mengatasinya," katanya kepada pemberita selepas melawat sekolah itu di sini, hari ini.

Sementara itu, Pengerusi Jawatankuasa Pendidikan, Sumber Manusia, Sains dan Teknologi, Aminolhuda Hassan yang turut melawat sekolah berkenaan berkata najis burung itu tidak hanya di lantai kelas malah turut didapati di ruang balkoni tingkat empat sekolah terbabit.
"Perkara ini dah lama nampaknya. Kalau tidak mana mungkin boleh banyak najis.

"Saya juga dimaklumkan bahawa pihak kementerian telah pun datang melawat dan diharap tindakan menutup ruang kemasukan burung ke dalam bumbung kelas serta kerja-kerja pembersihan dapat dilaksanakan segera kerana kesannya dapat dilihat dari segi pernafasan yang mana tidak sesuai untuk kanak-kanak terutama yang masih bawah 12 tahun," katanya.

Selain itu, beliau juga meminta pihak sekolah dan guru agar menggunakan kelas-kelas lain buat sementara waktu untuk mengajar murid bagi mengelak pencemaran najis mengganggu pernafasan murid.

Dalam pada itu, Pengarah Jabatan Kesihatan Johor Dr Selahuddeen Abd Aziz berkata pencemaran najis burung itu boleh mengakibatkan simptom sesak nafas yang lebih teruk berbanding yang dialami murid sekarang.

"Dalam istilah kesihatan, kita sebut ia sebagai sebagai 'pneumonitis over lung' yang membawa kepada beberapa simptom antaranya sesak nafas, namun ia bergantung kepada tempoh berapa lama mereka terdedah kepada pencemaran," katanya.

-- BERNAMA

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The Importance of A Good Night’s Sleep

By Evangeline Majawat

Chubby baby Allison is at peace. With one thumb in her mouth and lying in her mother’s warm embrace, Ally as her parents fondly call her, is fast asleep and content. Not even her elder siblings’ shouts can wake her from this slumber. “Don’t let this peaceful moment deceive you. She will scream blue murder the moment I put her down,” says Ally’s sleep-deprived mother Yohana McPherson. “She will only sleep in my arms as I’m rocking her.”

McPherson is her wits’ end. The mother of 3 children ranging from five-years-old to eight-months-old complains that she has not had a proper night’s sleep since Ally’s birth. “You come to equate parenthood with sleep deprivation. Yet I feel guilty because I feel tired all the time and don’t have the energy to enjoy my children’s company,” she explains. “People say (parenthood) gets easier with time and as you have more children but I must have missed that memo because it seems to be getting harder as I get less sleep!” confides McPherson. Even baby Ally is cranky as she is not getting enough sleep.

How Many Hours Do You Need?

Executive Liza Ahmad Fazil suffers from sleep deprivation too although for different reasons. Her sedentary lifestyle and work-related stress cause her to feel restless at night and on many occasions, she suffers from insomnia. Baby Ally, McPherson and Liza are often moody and exhausted because their bodies and minds are not rested.

According to the National Sleep Foundation (NSF) in the United States, the amount of sleep that is needed to function at your best, differs between individuals and depends on their ages. The accepted optimal hours of sleep for various age groups are as follows:

• Newborns (0-2 months) – 12 to 18 hours
• Infants (3-11 months) – 14 to15 hours
• Toddlers (1-3 years) – 12 to 14 hours
• Preschoolers (3-5 years) – 11 to 13 hours
• School children (5-10 years) – 10 to 11 hours
• Teens (10-17 years) – 8.5 to 9.25 hours
• Adults – 7 to 9 hours
  

When You Don’t Get Enough Sleep…

Your body needs sleep as this is the time it grows, heals, processes information and rests. Poor sleep blights your immune system and cognitive functions and affects your general well-being. Researchers at Britain’s Warwick medical school found links between disrupted sleep patterns with major health problems. The study published two years ago stated that a person who slept less than 6 hours a night and had disturbed sleep had a 48 per cent chance of developing or dying from heart disease. They also had a 15 per cent chance of suffering or dying from a stroke.

“The development of bones and brain happens during sleep for babies and children.  (Sleep) is also the time when their little brains download and computerise whatever they learned when they were awake,” says child sleep consultant Sarah Ong. Ong, who is the founder of Sleep Champ Baby, which offers baby sleep expert services, also says babies and children need more sleep because their biological clock and their awake window — the moment they wake from the last sleep to the next nap — is smaller. This sleep pattern changes as they get older.

Well Life Gastro and ENT Clinic’s ENT surgeon Dr. Azida Zainal Anuar clarifies that natural changes in the brain means changes in sleeping patterns in the elderly. “Their sleep becomes more fragmented. They will still sleep a similar number of hours, just not through the night. This is why older people tend to need naps during the day.”

Stages of sleep

When you slumber, you go through a sleep cycle involving two types of sleep: rapid eye movement (REM) and non-rapid eye movement (NREM). Each one of these cycles has different physiological and neurological features.

REM is when your brains processes information. Brain activity increases during this period and dreaming occurs and it generally takes place about 90 minutes after you first fall asleep.

NREM, on the other hand, is made up of four different stages. Stage 1 happens when you get drowsy. This is the transition period when you drift in and out of sleep and lasts between 5 to ten minutes. Your muscles relax and you are easily disturbed. In Stage 2, your heart rate slows down and your body temperature decreases. This stage is known as light sleep. Stages 3 and 4 are when you enter deep sleep. During this time, your body gets to work to restore itself and brain activity slows way down. Stages 3 and 4 are characterised by delta brain waves, known as slow waves because they have a very low frequency.

One sleep cycle consists of the several stages of NREM followed by REM sleep. Ong explains that a baby’s sleep cycle lasts for about 45 minutes with longer REMs. This gradually shortens with age. An adult’s sleep cycle is between 60 to 90 minutes with REM taking only 25 per cent of it.

Quality Is The Key

Some of us are ‘short sleepers’ and blessed with the ability to thrive with less sleep. An article published by the Wall Street Journal two years ago highlights that short sleepers are energetic, outgoing, optimistic and ambitious and function well without the need for caffeine or naps to power them through the day.

However, the article also stresses that only one to three per cent of the population fall into the short sleeper category. Many who think they can survive on five to six hours of sleep are actually sleep deprived.  “These (short sleepers) are an exception. The majority of us need our sleep,” stresses Dr. Azida.

Work and social demands as well as the increased use of technology, especially the Internet, means most of us are not getting enough sleep. Researchers and sleep experts including Dr. Azida and Ong agree that quality is as important as quantity. Sleep deprived people think they can replace or make up for the hours of staying awake but “make up” sleep is often disruptive rather than restorative.

It’s also important to note that alcohol and smoking reduces the quality of sleep. “People who drink alcohol say they sleep better but when you do the electroencephalography (EEG) test on them, it shows that they’re not getting quality sleep,” points out Dr. Azida.

Falling asleep

Overstimulation of the mind and stress can keep you awake. Dr. Azida advises hard workers to put away their smartphones and laptops before dinnertime. Surprisingly, children and even babies can suffer from sleep problems. Waking up too many times during the night, trouble getting the child to bed, fighting during nap times or needing a sleep prop (rocking, breastfeeding or pacifier) are common complaints from sleep deprived parents. According to Ong, a baby can start sleep training at six-months-old.

Consistency is key when you are sleep training your child. “It’s more about the parents being trained as their children will follow their lead,” says Ong. She adds that parents must establish sleep routines and habits and stick to them.  One easy way to prepare children and adults for sleep is to set a fixed routine in a sleep-friendly environment. This could be as simple as taking a warm shower before bedtime and reading in a softly lit bedroom.

Eat Well, Sleep Well

Certain foods are sleep-friendly while others are notorious for keeping us awake. Here’s a quick list for both.

Sleep-friendly foods include:

• Dairy and soy products
• Whole grains and carbohydrates
• Nuts and seeds
• Eggs, poultry, seafood
  

Avoid foods that are:

• High in fat
• Heavy and spicy
• Contain caffeine. No coffee or tea (except for herbal teas). Remember, even chocolates contain a certain amount of caffeine.
  

Go to sleep!

Here are some guidelines you can use get to yourself a good night’s rest.

• If you like reading before bed, make sure you use soft lighting
• Listen to soft, relaxing music
• Do some easy stretches
• Don’t bring your work to bed
• Switch off your phone.
• Avoid checking your emails before you sleep
  

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KKM tingkat kesiapsiagaan hadapi potensi penularan virus Ebola di Kongo
Bernama | Diterbitkan pada Julai 21, 2019 06:16 MYT

KKM sentiasa mengambil langkah berjaga-jaga sejak pertubuhan itu mengisytihar virus berkenaan sebagai PHEIC di negara Afrika barat itu mulai 2014. - Gambar fail/REUTERS

KUALA LUMPUR: Kementerian Kesihatan (KKM) akan terus memperkukuhkan pemantauan dan kesiapsiagaan bagi menghadapi potensi penularan virus Ebola (EVD) berikutan wabak itu diisytiharkan sebagai Public Health Emergency of International Concern (PHEIC) di Republik Demokratik Kongo (DRC).

Ketua Pengarah Kesihatan, Datuk Dr Noor Hisham Abdullah berkata, KKM sentiasa mengambil langkah berjaga-jaga sejak pertubuhan itu mengisytihar virus berkenaan sebagai PHEIC di negara Afrika barat itu mulai 2014.

Usaha yang dilaksanakan termasuk pemakluman langkah pencegahan dan kawalan infeksi kepada anggota KKM di pintu masuk antarabangsa dan memberi penekanan pengurusan kes yang disyaki mengikut garis panduan pengurusan EVD.
"Saringan kesihatan bagi pelawat dari negara tersebut telah sedia ada dijalankan di pintu masuk antarabangsa. Justeru, aktiviti saringan kesihatan ini akan diperkukuhkan lagi bagi mengesan gejala jangkitan EVD,

"Penumpang atau anak kapal yang disyaki mempunyai gejala EVD akan dirujuk ke hospital yang dikenalpasti bagi pemeriksaan dan rawatan lanjut," katanya dalam kenyataan, pada Sabtu.

Dr Noor Hisham berkata, langkah lain yang dilaksanakan ialah bagi kes Person Under Investigation (PUI) EVD akan dilapor kepada Pusat Kesiapsiagaan dan Tindakan Krisis (CPRC) Kebangsaan, mempertingkatkan pengetahuan berkaitan EVD kepada masyarakat dan pelawat serta sentiasa bekerjasama rapat dengan semua agensi berkaitan secara berterusan untuk memperkukuhkan kesiapsiagaan KKM.

Pada 17 Julai lepas, Pertubuhan Kesihatan Dunia (WHO) menerusi kenyataan Mesyuarat International Health Regulations (2005) Emergency Committee mengisytihar kejadian penularan Ebola di republik itu sebagai PHEIC.

Bagaimanapun, pertubuhan itu tidak mengeluarkan sebarang larangan atau sekatan untuk ke negara terbabit dan negara yang dijangkiti juga tidak dikenakan sebarang sekatan perjalanan dan perdagangan di peringkat antarabangsa.

KKM akan terus memantu situasi kejadian penyakit ini dan sebarang perkembangan daripada pihak WHO akan dimaklumkan dari semasa ke semasa, katanya.

-- BERNAMA

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Stressful experiences can age brain ‘by years’

Stressful life experiences can age the brain by several years, new research suggests. Experts led by a team from Wisconsin University’s school of medicine and public health in the US found that even one major stressful event early in life may have an impact on later brain health.

The team examined data for 1,320 people who reported stressful experiences over their lifetime and underwent tests in areas such as thinking and memory. The subjects’ average age was 58 and included 1,232 white Americans and 82 African Americans. A series of neuropsychological tests examined several areas, including four memory scores (immediate memory, verbal learning and memory, visual learning and memory, and story recall).

Stressful life experiences included things such as losing a job, the death of a child, divorce or growing up with a parent who abused alcohol or drugs. The results showed that a larger number of stressful events was linked to poorer cognitive function in later life.

When looking specifically at African Americans, the team found they experienced 60% more stressful events than white people during their lifetimes. Researchers said that, in African Americans, each stressful experience was equivalent to approximately four years of cognitive ageing.

The study, which has not been published in a peer-reviewed journal, was presented at the Alzheimer’s Association international conference in London.

Dr Maria Carrillo, the chief science officer for the Alzheimer’s Association, said: “The stressful events that the researchers were focusing on were a large variety … the death of a parent, abuse, loss of a job, loss of a home … poverty, living in a disadvantaged neighbourhood, divorce.” Even a change of school could be a stressful life event for some children, she said.

Dr Doug Brown, the director of research at the Alzheimer’s Society, said: “It remains to be established whether these stressful life events can lead to an increased risk of dementia.”

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Keracunan racun serangga: Enam murid dibenarkan pulang, seorang masih dipantau
Bernama | Diterbitkan pada Julai 19, 2019 20:55 MYT

Anggota Bomba dan Penyelamat serta pegawai dari Jabatan Kimia, melawat kelas di Sekolah Kebangsaan Linggi yang disyaki mengalami keracunan racun serangga hari ini. --fotoBERNAMA

SEREMBAN: Enam daripada tujuh murid dari Sekolah Kebangsaan Linggi yang dimasukkan ke Wad Kanak-Kanak di Hospital Port Dickson (HPD) akibat keracunan racun serangga jenis Organophosphaste dibenarkan pulang, kata Pengarah Kesihatan Negeri Sembilan Datuk Dr Zainudin Mohd Ali.

Beliau berkata sehingga tengah hari ini, hanya seorang murid sahaja yang masih ditempatkan di hospital berkenaan bagi pemantauan sehingga pulih dan dijangka pulang petang ini.

"Sehingga tengah hari ini hanya seorang murid sahaja yang masih berada dalam wad di HPD, manakala murid lain sudah dibenarkan pulang.

"Murid yang masih di dalam wad tidak kritikal dan hanya dalam pemerhatian sahaja, jika didapati sihat akan dibenarkan pulang petang ini," katanya kepada Bernama di sini, hari ini.
Semalam, seramai 24 pelajar sekolah berkenaan dibawa ke Klinik Kesihatan Linggi untuk pemeriksaan dan daripada jumlah itu, 12 pelajar dirujuk ke Hospital Port Dickson dan kesemua mangsa dilaporkan stabil.

BACA: 13 pelajar SK Linggi dikejarkan ke hospital disyaki keracunan racun serangga

Kes keracunan racun serangga dipercayai berpunca daripada kerja-kerja meracun di sebuah kebun cili berhampiran sekolah.

Sementara itu Menteri Besar Negeri Sembilan Datuk Seri Aminuddin Harun berkata kerajaan negeri memandang serius isu keracunan yang dialami pelajar itu, dan akan meneliti semula setiap kerja-kerja berkaitan projek pertanian yang dijalankan, yang menurutnya perlu dijarakkan daripada kawasan sekolah.

"Kita berharap kejadian sebegini tidak berulang kembali dan ini kali pertama dan terakhir berlaku di negeri ini. Saya harap pihak sekolah juga dapat mengambil langkah-langkah berjaga dan pencegahan berkenaan isu ini," katanya kepada pemberita ketika ditemui selepas menghadiri Pesta Durian Waghih di sini, hari ini.

-- BERNAMA

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Caring For Diabetic Feet

By Joanna Lee

Foot infections are one of the most common complications of diabetes. According to Chuah Siok Chin, a nurse at the Sau Seng Lam Diabetes and Stroke Rehabilitation Centre, 70% of all amputation cases in Malaysia are due to diabetes.

People with diabetes are at risk of serious foot problems because poorly controlled sugar levels can harden and constrict blood vessels that reduce blood supply reaching the small nerves in your arms and feet. This damages the nerves gradually, leading to a loss of sensation which starts usually from the tip of the toes.

Decreased circulation of blood supply can lead to cold feet, skin discolouration, legs aching when walking, reddish looking feet, a lack of hair growth on the feet and lower legs, and shiny skin on the lower legs.

Symptoms of nerve damage or “peripheral vascular neuropathy” includes a burning sensation on the feet, prickly or stabbing sensations, the feet feeling ‘icy’ and even having sensations like electric shocks. The irony is that because some patients can still feel a little sensation in their feet, they do not realise that these sensations are actually signs of nerve damage.

“One patient was known to walk with a nail embedded at the sole of his feet without noticing it for 3 days. He had to spend about RM10,000 on surgery later to remove the rust from his feet,” Chuah said. Even though nerve damage can occur in the hand as well, the feet in particular, have a higher risk of wounding.

Preventing amputation

Although everyone is susceptible to foot wounding, the risks are higher in diabetic patients who suffer from nerve damage. The good news is 75 percent of amputations due to diabetes can be prevented with patient education and good foot care.

One effective prevention is foot screening to check for nerve damage at the feet using tuning forks and monofilament pressure tests. Diabetes care clinics such as Sau Seng Lum also offer foot wound care and treatment, wound dressing services and clinical advice at a subsidised rate.

One frequent patient at the SSL Diabetes Care Centre is Sivaganesan, who had two toes amputated in his 20-year battle with diabetes. The first toe was removed after an injury, while the second was due to an infection. His amputations had made him more aware about foot care now.

Patients with from foot deformities such as bunions, callouses and corns, clawed toes, charcot feet (irregular rocker bottom feet), nail deformities, infections and fissures and cracks should practise extra care as they are at higher risk of amputation.

Changing mindsets

The typical Malaysian “last minute” culture also applies to healthcare, albeit with sad yet avoidable consequences. “They present themselves at the hospital too late, whereby at that stage, some already have septicaemia,” says nurse Chuah.

Another cultural aspect that hinders preventive foot care is the tendency for patients’ preference in listening to friends’ advice, or what nurse Chuah terms as the “direct selling” culture, as well as seeking help from bomohs and sinsehs.

“When a patient is told his toe needs to be amputated, he would say ‘wait, I will think about it first’, and then seek out the bomohs. By the time he comes back, it’s too late and we may have to amputate his entire foot by then due to infection,” she said.

Footwear and exercise are also important, not only for diabetic patients. “The wear and tear (of the feet) will add more to the wounds and we need to relief this irritational pressure so, good insoles are good investments,” says nurse Theresa Kung.

“People with diabetes need to care for their feet daily,” Chuah said. “The main key is awareness because prevention is better than cure.”

Essential Foot Care

• Always examine your feet for injuries or cuts
• Keep feet dry always especially between the toes
• Wear shoes and socks that allow your feet to breathe
• Soak or clean your feet in warm water daily
• Massage your feet with creams to increase blood circulation
• Place feet higher than head level when lying down
• Avoid crossing your legs when seated
• Be careful when cutting toe nails
• Wear closed slippers or sandals for protection against injuries
  

Source: Health Education Unit, Ministry of Health Malaysia

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                Najis burung merpati bukan punca pencemaran - Dr. Dzulkefly            
                                                                        Madiha Abdullah, Astro Awani |                                                 Julai 25, 2019 15:07 MYT                                   
                                    
               
            
            
                                                                                                                                                                                Pihak Kementerian Kesihatan akan membuat penilaian terhadap keputusan klinikal yang diperolehi, kata Dr. Dzulkefly. - Gambar Bernama

                           
                                                                                        SUBANG JAYA: Menteri Kesihatan, Datuk Seri Dr. Dzulkefly Ahmad menafikan najis burung merpati adalah penyebab sampingan kepada gangguan kesihatan pelajar di Sekolah Kebangsaan (SK) Tanjung Puteri Resort, Pasir Gudang.

Kata Dr. Dzulkefly, sesiapapun boleh mengeluarkan pendapat namun pihak Kementerian Kesihatan akan membuat penilaian terhadap keputusan klinikal yang diperoleh.                                                

“Pernahkah kami sebut tentang najis burung merpati ini? Tak pernah, jadi kembali kepada apa yang kita sebut tanpa menafikan hak sesiapa untuk beri pandangan.

“Pengarah Jabatan Kesihatan Johor sentiasa mengemas kini dan memaklumkan kepada kami, khususnya Datuk Dr. Chong selaku Timbalan Ketua Pengarah Kesihatan.

“Kita kembali kepada dapatan sebelum ini, iaitu keputusan klinikal dan simptom pesakit.

"Kami akan terus pantau situasi ini, tapi sehingga hari ini fenomena tidak seperti insiden Sungai Kim-Kim, di mana ada yang dimasukkan ICU," katanya dalam sidang media selepas merasmikan program Kurangkan Gula Hidup Sihat di Pasaraya Giant Subang Jaya hari ini.

Dr. Dzulkefly mengulas kenyataan Exco Kesihatan Johor, Mohd Khuzzan Abu Bakar bahawa hasil tinjauan yang dilakukan pihaknya mendapati beberapa kelas di tingkat atas sekolah itu terpaksa ditutup akibat masalah najis burung berkenaan.