Be In The Know

Be In The Know

January 17, 2017

Article credit :
www.nst.com.my/

Health screening is a way to detect risks for early intervention, writes
Kasmiah Mustapha

Prevention is better than cure. And one of the steps for prevention is medical screening. According to the NHS UK, screening is a way of finding out those at higher risk for a health problem so that early treatment can be offered or information given, to help them make informed decisions.

Columbia Asia Hospital Puchong’s chief medical officer Dr. Thiyagu Rajagobal explains the importance of medical screening.
WHY SHOULD PEOPLE GO FOR MEDICAL SCREENING?

Medical screening is the first step in prevention of diseases for doctors and patients.

It aims to identify the possible presence of a disease when there are no signs and symptoms. It is a preliminary test to look for possible diseases the person could face in the future.

Through medical screening, we can detect the risk of these diseases early. It helps if the person knows about his health so he can take the necessary steps to reduce the risks. With early detection and treatment, a person can avoid severe or life-long symptoms.
WHAT KIND OF SCREENINGs ARE NECESSARY?

There are various types of medical screening depending on age, gender, family history and risk factors.

From age 19 to 39, we recommend the basic screening which includes a chest X-ray, electrocardiogram, full blood count, lipid profile, liver function test, renal function test and urine test.

However, if these people are obese or have a family history of diseases such as diabetes or hypertension, we suggest they choose a comprehensive screening package because they have a higher risk of developing diseases before the age of 30 or 40.

Those aged 40 and above should opt for a comprehensive package that includes tumour marker, mammogram, prostate specific antigen (PSA), pap smear, upper abdomen ultrasound and breast ultrasound.

However, the tumour marker screening need not be routinely done but preferably conducted on the advice of doctors depending on the patient’s risk factors. A high reading does not mean one has cancer, while a normal reading does not exclude cancer.

PSA is the only tumour marker that is fairly specific and is usually done for those above 50 years.
WHAT ARE THE DISEASES THAT CAN BE DETECTED THROUGH MEDICAL SCREENING?

Conditions such as hypertension, diabetes, high blood cholesterol, infection, autoimmune diseases, liver and kidney disease. It is also used to detect certain types of cancer.
WHEN SHOULD SOMEONE GET A MEDICAL SCREENING?

It depends on age, gender and risk factors. But the best way is to have it done once a year. Regular screening helps to detect conditions that may develop after the last screening. As such, it is important for you to go for regular screening tests at the recommended frequency.
HOW EFFECTIVE IS MEDICAL SCREENING IN PREVENTING DISEASES?

The test is valid but the indicators may not be 100 per cent accurate. In certain cases it can be over-diagnosed or misdiagnosed.

For example, if a result is false positive it means the person does not have signs and symptoms of the disease but the indicator shows there is a disease present. Similarly, in a false negative the person has the signs and symptoms but the results are normal.
WHAT HAPPENS IF THE RESULTS ARE POSITIVE FOR A DISEASE?

It is important to note that the result is not a confirmed diagnosis just because the indicator is positive. Further tests are needed before a person can be diagnosed with the disease.

For example, if we detect a person’s blood sugar to be high, we are not going to diagnose him as diabetic. We will look into other external factors such as if he had fasted well or taken food before the blood test or had a heavy meal the night before.

We will also look at his urine test to see if glucose is present. We will then ask the patient to monitor his condition for one week, eat well and exercise and come back for further tests.

We also need to consider the signs and symptoms and family history. That is how we decide whether the patient needs to go for further treatment or be referred to a specialist to confirm the diagnosis.
IS THERE A POSSIBILITY THAT WITH FURTHER INVESTIGATIONS, THE RESULT WILL NOT BE VALID ANYMORE?

When a person goes for a medical screening, he or she must be free from infection or disease. If, for example, he or she had an infection a week prior to the screening we may still see some changes in the blood even though the person has recovered at the time of screening. But that does not mean the person has a disease.

The test is valid at the point of time it is taken but it may not be conclusive and we need to do a thorough investigation and other specific tests.

There may be changes in the results after a week or two. That is the reason we do not start medication immediately after screening but ask the patient to monitor his condition, eat right and exercise.
ARE PEOPLE AWARE OF MEDICAL SCREENING?

I think they are aware of the need to do it but they may not want to do it. The excuse is they don’t have time but they can schedule the test to suit them.

They can log on to a hospital’s website, select a test and set an appointment. The test may take up a day or even half a day. Others think they are healthy and do not need medical screening. But medical screening is done when they are no signs or symptoms. If you are already diagnosed with a disease, there is no point for medical screening.

You may have mild symptoms that could be related to some condition and a medical screening can help answer this. You may be putting on weight without reason or feeling tired.

These could be part of ageing but it could also be due to some diseases. It is better to have it ruled out rather than ignored.
WHAT THE READINGS MEAN

WHILE medical screening is not a confirmed diagnosis, the results are an indicator of a person’s risk. It is not easy to understand the results if you are not a health expert or a doctor. Below is a guideline on what the numbers mean:
BLOOD ANALYSIS
The result of medical screening is not a confirmed diagnosis.
1. Fasting Blood Glucose

Purpose: To detect diabetes

Result: Normal range for blood glucose is between 3.9 and 5.5 mmol/L. If the reading is above this level, it is a suspected diabetes case.
2. Renal function test

Purpose: To detect kidney failure

Result: Based on creatinine and urea readings.Urea range should be between 2.8 and 8.1 mmol/L and creatinine between 44 and 80 mol/L. If both readings are higher than the range, it indicates kidney failure.
3. Liver function test

Purpose : To screen for liver infection or liver disorders.

Result: The series of tests measure the levels of certain enzymes and protein in the blood. Levels that are higher or lower than normal can indicate liver problem.
4. Lipid profile

Purpose: To detect blood cholesterol level.

Result: For LDL (bad cholesterol), level should be less than 4 mmol/L. For HDL (good cholesterol), the level must be more than 1 mmol/L. Medication must be considered for high blood cholesterol level.
5. Venereal Disease Research Laboratory (VDRL)

Purpose : To detect syphilis, a sexually-transmitted disease

Result : A positive result may mean the person has syphilis. However, further tests are needed to confirm.
6. Erythrocyte Sedimentation Rate (ESR)

Purpose : To detect inflammation in the body.

Result: The normal range is 0 to 22 mm/hr for men and 0 to 29 mm/hr for women. Abnormal range may indicate inflammatory diseases such as systemic lupus erythematosus or rheumatoid arthritis.
Urine Feme

Purpose: To detect kidney failure and diabetes

Result: If there is glucose, protein and blood present in the urine, it may suggest diabetes or kidney disease.
Tumour Markers

Tumour markers, through a blood test, are useful to diagnose cancer and are done to monitor response to treatment once cancer is detected.

There is a high chance of false positive and false negative. Further tests are required to confirm diagnosis. These include:

Carcino-embryonic Antigen (CEA): to screen for colon/rectal cancer

Prostate Specific Antigen (PSA): to screen for prostate cancer

CA 125: to screen for ovarian cancer

CA 153: to screen for breast cancer

Alpha Feto-Protein (AFP): to screen for liver and germcell cancer

“We can detect the risk of these diseases early. It helps if the person knows about his health so he can take the necessary steps to reduce the risks.” Dr. Thiyagu Rajagobal
Newspaper:

Be in The Know – New Straits Times, 17 January 2017

Click for Online Article:

Be in The Know – New Straits Times, 17 January 2017
.


Berpada-pada Makan di Rumah Terbuka Aidilfitri

May 17, 2022

KUNJUNG-MENGUNJUNG ke rumah sanak-saudara, teman atau menghadiri rumah terbuka pada Aidilfitri ini perkara wajib lazim dilakukan, dan pastinya akan dihidangkan dengan aneka juadah.

Justeru, dalam keterujaan menyambut raya, sama ada tuan rumah atau tetamu perlu merancang jenis juadah yang diambil dengan kuantiti dan menu sihat bagi mengelak pelbagai masalah kesihatan.

Menurut Pakar Diet Columbia Asia Hospital – Setapak, Siti Sarah Mohd Juzup, sebagai tuan rumah, perancangan menu perlu dilakukan dengan teliti supaya tetamu dapat menikmati hidangan juadah yang seimbang.

Sebagai tetamu pula, pemilihan makanan perlu diambil secara bijak dan teratur agar tidak melebihi keperluan diet seharian.

Ketika hari raya, perlu merancang berapa rumah terbuka yang ingin kunjungi dalam sehari. Dengan ini, kita dapat merancang berapa kalori yang terkumpul melalui hidangan di setiap rumah dikunjungi.

"Sekiranya berkunjung ke rumah terbuka pada waktu tengah hari, kita sepatutnya menikmati hidangan juadah mengikut kalori untuk makan tengah hari.

"Di rumah terbuka yang berikutnya, pastikan kuantiti makanan diambil kurang daripada rumah pertama dan begitulah seterusnya," katanya.

Tuan rumah perlu prihatin

Beliau berkata, sebagai tuan rumah seharusnya menyediakan hidangan seimbang kepada tetamu, iaitu berasaskan lima kumpulan makanan iaitu karbohidrat, protein, sayur-sayuran, buah-buahan dan lemak.

Sediakan minuman rendah kalori seperti minuman air kosong. Pastikan air kosong sentiasa dihidangkan supaya tetamu boleh membuat pilihan.

Tuan rumah boleh juga mengasingkan susu dan gula untuk minuman seperti teh atau kopi.

Elakkan hidang minuman berkarbonat dan minuman manis.

Tetamu bijak buat pilihan menu

Sebagai tetamu, pilihlah makanan rendah kalori seperti buah-buahan sebelum mengambil makanan yang lain.

Hadkan juga pengambilan makanan berlemak atau bersantan dan hanya ambil kuantiti sedikit sekiranya tiada pilihan seperti satu atau dua sudu makan.

Hadkan pengambilan makanan manis yang dihidangkan seperti dodol, wajik dan kek.

Kuantiti berpada-pada

Kawal pengambilan makanan dengan menggunakan pinggan yang kecil. Cara ini mengelakkan pengambilan makanan yang banyak.

Selain itu, makanan perlu diambil dengan kuantiti yang sedikit. Sebagai contoh untuk hidangan satu rumah, makan sebiji ketupat bersama seketul sahaja rendang ayam dan satu sudu makan kuah serta sayur.

"Bagi kuih raya pula, cukup sekadar satu atau dua biji kuih di setiap rumah dikunjungi. Pemilihan kuih raya perlu yang rendah kalori dan rendah gula.

"Elakkan pengambilan makanan secara berulang-ulang. Jangan lupa, makan secara perlahan supaya menikmati makanan yang diambil.

Perkara utama mesti diingat ketika ke rumah terbuka ialah elakkan kekenyangan terlampau supaya kalori diet seharian tidak lari daripada jumlah biasa," katanya.

Pemilihan jenis air minuman perlu dititikberatkan. Meminum air kosong boleh mengurangkan kalori seharian, selain elak minuman berkarbonat atau minuman manis.

Tip untuk elakkan makan berlebihan di rumah terbuka:

Amalkan konsep suku suku separuh semasa mengunjungi rumah terbuka.

Lebihkan pengambilan makanan yang tinggi kandungan serat untuk merasa kenyang lebih lama.

Berhenti makan sebelum kenyang

Kunyah makanan secara perlahan supaya dapat menikmati juadah sepenuhnya

Amalkan waktu makan teratur meskipun jemputan rumah terbuka tidak mengikut waktu

Banyak minum air kosong elak ambil makanan berlebihan

Siti Sarah Binti Mohd Juzup

Dietitian

Columbia Asia Hospital – Setapak

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PDF and Online Articles:

Berpada-pada Makan di Rumah Terbuka Aidilfitri – Berita Harian Online, 8 Mei 2022

Artikel ini disiarkan oleh Berita Harian Online, 8 Mei 2022.

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Dietetics & Nutrition
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Bersenam, Tinggikan Kaki & Pakai Stoking Khas Boleh Elak Ibu Hamil Kejang Kaki

February 17, 2019

Kekejangan pada bahagian kaki dan betis yang biasa dialami di akhir trimester kehamilan meresahkan ibu. Ia sangat menyakitkan!
PUNCA KEKEJANGAN KAKI

Sememangnya rasa kejang di kaki memang sering terjadi kepada wanita hamil terutamanya pada trimester akhir. Saat perut sedang membesar ke tahap maksimum, kekejangan ini memburukkan lagi keadaan. Ramai yang menganggap ia berpunca daripada kekurangan kalsium, benarkan?

Menurut Dr Norintan Zainal Abidin Shah, Pakar Perbidanan & Sakit Puan Columbia Asia Seremban, bahagian rahim yang semakin membesar menyebabkan saluran darah tertekan.
Keadaan ni menyebabkan darah sukar untuk mengalir ke atas (dari kaki ke jantung). Pengaliran darah yang semakin sukar ini menyebabkan kaki terasa kejang.
5 TIP REDAKAN KEKEJANGAN KAKI BAGI IBU HAMIL

Suplemen kalsium sering digunakan untuk merawat kekejangan kaki tetapi ia tidak banyak membantu. Sebaliknya, ibu akan dinasihatkan untuk:

Bersenam
seperti berjalan kaki (bukan berlari atau joging) untuk mengaktifkan pengaliran darah dari kaki ke jantung.

Meletakkan kaki di atas kerusi lain
ketika duduk berehat.

Memakai stoking khas (pressure graded stockings)
 yang boleh dibeli di farmasi.

Meminta bantuan suami
mengurut kaki untuk melancarkan pengaliran darah.

Rendam kaki di dalam air suam
 atau tuam kaki dengan tuala suam. Ia dapat membantu pengaliran darah di kaki.

PERKARA PERLU DIKETAHUI TENTANG SUPLEMEN KALSIUM

Suplemen kalsium penting untuk
pembentukan tulang dan gigi bayi.
 Jika anda tidak mengambil suplemen kalsium secukupnya,
 bayi akan “mencuri” kalsium daripada ibunya. Ini menyebabkan tulang anda mengalami kehausan kalsium.

Ibu juga perlu terus mengambil suplemen kalsium sewaktu berpantang dan ketika menyusukan bayi kelak. Vitamin D pula penting untuk memastikan pil kalsium yang dimakan boleh diserap ke dalam badan.

Wanita yang
kekurangan kalsium akan mendapat risiko osteoporosis di masa hadapan.
 Wanita hamil dan menyusukan anak memerlukan 1000 – 1200mg kalsium sehari. Tetapi jangan makan kalsium berlebihan kerana ia boleh menyebabkan masalah sembelit dan batu karang.

Dr. Norintan Zainal Abidin Shah

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Seremban

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PDF and Online Articles:

Bersenam, Tinggikan Kaki & Pakai Stoking Khas Boleh Elak Ibu Hamil Kejang Kaki – Majalah Pa&Ma, 17 Februari 2019

Artikel ini disiarkan oleh Majalah Pa&Ma, 17 Februari 2019

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Beware, weekend warriors! [Press Clipping]

April 08, 2012

See our Press Clipping:

Star Special,

8 April 2014


BFM Health & Living Live 2016 - Our Love Affair with Food

June 27, 2016

This is an edited recording of the panel discussion that was held at the BFM Health & Living Live 2016 on April 2nd. In Part 4 of 6, presenter/producer Ezra Zaid spoke to Consultant Orthopaedic Surgeon Dr Harjeet Singh, Consultant Dietitian Indra Balaratnam and Personal Trainer Noel Chelliah about our love affair with food. This affair has led to us be the most obese nation in South-East Asia. It has to stop.

Listen to the podcast
here
.


Birth Plan

Birth Plan

August 05, 2015

Photocredit:
www.babble.com

When it comes to where and how a woman gives birth, it’s now as much about what the soon-to-be mother wants and what a doctor can provide.

Crucially, it’s also about writing it all down to ensure that everybody understands what needs to happen, and a birth goes as smoothly as possible. This is the birth plan.

Dr. Norshida Brahim, consultant obstetrician and gynaecologist from Columbia Asia Hospital - Cheras, explains the importance of coming up with a birth plan and how to write a good one.

Listen to the podcast
here
.


Bleeding From Your Bottom

Bleeding From Your Bottom

February 03, 2020

Enlarged haemorrhoids can become so unpleasant, especially if left untreated, that the person suffering from them has to use a special pillow to sit down anywhere.

If you don’t want to increase your risk of getting piles, refrain from using your electronic gadget in the toilet.

You can be king of the throne, but make sure you don’t overstay your “visit”, because prolonged use of smartphones while on the toilet seat is a contributor to haemorrhoids, also known as piles.

This “Toilet Newspaper Syndrome” is described as long hours of sitting on the toilet seat because the individual is engrossed with reading materials.

“People have this habit of reading seated on the toilet and this should be avoided.

“Make sure there are no reading materials or gadgets in the toilet.

“Just go in, do your stuff and come out. Retrain your toilet habits to prevent haemorrhoids, ” says consultant general and colorectal surgeon Datuk Dr Meheshinder Singh.

Haemorrhoids are the displacement of cushions of blood vessels under the anal wall lining.

When the walls of these vessels are stretched, they become irritated, inflamed and start bulging.

Then the haemorrhoidal cushions, which are a natural part of the body’s anatomy that aids bowel movement, either swells inside (internal haemorrhoids) or outside (external haemorrhoids).

Internal haemorrhoids don’t cause any pain and usually don’t require treatment unless they start to bleed, while external haemorrhoids are painful and cause discomfort and bleeding.

Haemorrhoids can develop from increased pressure in the lower rectum due to excessive straining during bowel movements, sitting for long periods of time on the toilet, being sedentary, having chronic diarrhoea or constipation, obesity, pregnancy, having anal intercourse, eating a low-fibre or high-spice diet, regular heavy lifting, family history and ageing.

Although haemorrhoids can be unpleasant and painful, they can be easily treated in the early stages.

Unfortunately, the majority of patients are too embarrassed to consult a doctor.

Why so shy ?

As with most healthcare issues in Malaysia, we often wait until we reach a dire situation before seeking medical intervention.

By then, extreme measures have to be taken to remedy the situation.

Dr Meheshinder says, “Patients delay treatment because they are embarrassed, as nobody likes showing their backsides; they also relate it to surgery or they fear incontinence.

“So they seek treatment elsewhere and are misdiagnosed, which is sad.

“They might have had the symptoms for years and when I examine them, they have stage 4 colorectal cancer.

“Piles don’t turn cancerous, but they may coexist with cancer, hence if you have bleeding, it is important to go for a rectal examination with a clinician to make sure you’re not missing out anything.

“Patients above 45 should perform a colonoscopy to rule out the risk of malignancy.

“I’m paranoid about this because a lot of times, I’ll catch a polyp or a tumour.”

The ageing process is also a risk factor as the ligaments in the area tend to disintegrate.

Thus, the mechanism that holds them in place weakens and prolapses, causing the patient to strain while defecating.

“Even if you have a little thread sitting in your anal canal, you will feel uneasy; that’s how sensitive the area is.

“With internal haemorrhoids, we can solve the problem in the clinic by using rubber band ligation, ” he says.

Rubber band ligation is a procedure in which the haemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the haemorrhoid.

The choice of procedure depends on the symptoms and severity of the problem, but usually, a conservative approach is taken, i.e. dietary changes, drinking adequate water, eating fibre, etc.

If all these have been addressed and no improvement is seen, then drugs are prescribed.

“If things still don’t work, then we advocate something more invasive, such as surgical modalities.

“There are so many techniques out there to address the issue of pain, but despite the procedures, the incidences of recurrence are still there if no lifestyle modifications are made.

“If it is not bothering you, there is no need for surgery.

“When you overdo things, that’s when you run into problems, ” points out Dr Meheshinder.

He was speaking at the Don’t Sit On It Lah roundtable session organised by French-based pharmaceutical company Servier Malaysia recently.

Also at the session was consultant general and vascular surgeon Datuk Dr Ho Teik Kok, who adds, “Most of the time, patients suffer from constipation, and when they strain, the pressure is transmitted downwards to the legs and veins, and can lead to chronic venous disease (CVD).”

Constipation, which can lead to piles, can also lead to CVD, which includes varicose veins.

Pressure on the veins

Those with occupations involving a lot of standing, such as hawkers, teachers, chefs, factory workers, those in the food and beverage, and retail service, cabin crew, nurses and those who wear heels for long durations, are at risk of developing CVD.

Pregnant women are the subset of patients at risk of developing both haemorrhoids and CVD.

According to the 2019 Chorus (Chronic Venous And Haemorrhoidal Diseases Evaluation And Scientific Research) Study published in the Wiley Online Library, more than 50% of patients seeking help for piles also have CVD.

“Most patients are unaware of CVD (they only know of varicose veins) and how it can progress to more severe stages leading to leg ulcers.

“They often present at very late stages, ” says Dr Ho.

In both haemorrhoids and CVD, there is increased pressure in the veins that could be caused by various factors, such as damage to the valves – these send blood back to the heart in one direction and prevent backward flow.

He explains: “When the veins get distended due to prolonged standing etc, it leads to reflux where blood is not able to go back to the heart.

“The blood then pools back to the leg and increases pressure, leaving more white cells in the blood.

“This damages the valves and causes the white cells to go out through the skin. That’s when the skin starts to darken.

“Initially, just the veins are visible (spider veins, varicose veins).

"There may also be pain or cramps in the leg, especially in the evening. This gets better in the morning as the fluids are drained while sleeping.

“When it gets worse, patients start getting venous eczema, itchiness and skin ulcers.

“A minor knock can cause bleeding because of the high pressure in the veins.”

Treatment for CVD also depends on its stage.

Oral drugs are effective in relieving pain and swelling.

Factors to work on include losing weight, not wearing tight clothing, especially in the tummy/thigh areas, wearing proper shoes (avoid high heels) and wearing compression stockings.

Dr Ho says, “If it’s more serious, when there are ulcers, patients need surgical intervention or injections.”

No urge to poo

Three years ago, freelance writer Yvonne Lee Shu Yee, 47, embarked on a guided tour to Japan, and for seven days, she didn’t poo!

She had always suffered from constipation due to prolonged sitting to teach music, but never sought medical advice, preferring to get solutions from the pharmacy.

“I always read in the toilet whenever I tried to pass motion. It was a struggle so I would always strain and bleed.

“I was ‘successful’ once every four or five days, ” she recalls.

But in Japan, Lee just didn’t have the urge, despite feasting on all sorts of Japanese delights.

“On the return flight, I wanted to poo, but I couldn’t, so when I arrived home, I bombed seven days worth of sushi!

“From all that straining and bleeding, I nearly collapsed and my husband rushed me to the clinic.”

She eventually saw a surgeon and was diagnosed with Grade 4 haemorrhoids. Surgery was the only option.

Today, Lee has learnt her lesson and has made numerous lifestyle modifications.

One thing for sure is no more reading in the toilet!

On how often one should have a bowel movement, Dr Meheshinder says, “If your pattern has been like that, e.g. five days once all the time, I wouldn’t worry about it, but if the pattern changes, then seek advice.”

Adds pharmacist Datin Mariani Ahmad Nizaruddin, “A lot of clients don’t really present all their symptoms to us. They don’t tell until we ask.

“They prefer anything topical instead of drugs. Often, they like to use enemas, which can complicate matters.

“Pharmacists are trained to understand the patient’s complaint and medical history before providing the right advice or encouraging them to see a doctor.

“It would be ideal to have a system sharing these medical information between patients, pharmacists and doctors, ” she says.

Dato' Dr. Ho Teik Kok

Consultant General & Vascular Surgeon (Visiting)

Columbia Asia Hospital - Petaling Jaya
MBBS (UM), MRCS ( Edinburgh), MRCS (England), Intercollegiate FRCS General & Vascular Surgery (UK), Certificate of Completion of Training (UK), PhD in Vascular Surgery (UK)

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PDF and Online Articles:

Bleeding When You're On The Toilet? It Might Be Haemorrhoids – The Star Online, 18 December 2019

Bleeding From Your Bottom – The Star, 15 December 2019

This article first appeared in The Star Online, 18 December 2019

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General Surgery
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Bloodless Surgery, Dr Shanker Sathappan [BFM - Podcast]

March 16, 2011

Find out about bloodless surgery - what it entails, procedures and under what circumstances should one opt for it - as Consultant Laparoscopic Surgeon Dr Shanker Sathappan explains.

Listen to the podcast
here
.


Boba Danger

Boba Danger

August 16, 2019

Bubble Teas Are a Food Fad That May Prove to Be Dangerous to Our Health, Due to Their High Sugar Content.

BUBBLE tea has been in the news lately, not only for the long queues of patient customers lining up for a cup of their favourite brew, but also because of the high sugar content found in these beverages.

Columbia Asia Hospital – Setapak Consultant Internal Medicine Physician, Dr. Tan Wee Yong and Columbia Asia’s Dietician, Kong Woan Fei share their thoughts on this latest food craze.

Can bubble tea make you gain weight?
Dr Tan: I would say, yes. The main culprit is the sugar contained in the drink. On average, a cup of bubble tea contains 20 teaspoons of sugar. For a normal healthy adult, it is recommended to take no more than eight teaspoons of sugar a day.

Woan Fei: Bubble tea can definitely make you gain weight as it adds on to your extra daily calorie intake. One cup of bubble tea can contain at least 370 calories. The boba alone is 150 calories.

Can it cause diabetes?
Woan Fei: Drinking bubble tea will not cause diabetes directly. However, its sugar content can post a high risk of not only diabetes but also low immunity, accelerated ageing and tooth decay.

Is less sugar or no sugar bubble tea better for health?
Dr Tan: If you do request for less sugar, it will reduce the harm but not necessarily make it harm-free. We have to remember that in our daily intake, we also consume other products that contain lots of hidden sugar.

Woan Fei: When you hear brown sugar and fresh milk, you think ‘healthier ingredients’ but you must ask yourself, how much brown sugar is used? And what about the other ingredients, specifically boba? Of course, requesting for less sugar or no sugar is better but you still cannot categorize this as a harmless drink in view of the other ingredients.

Does bubble tea have any nutritional value at all?
Woan Fei: We term sugar as an ‘empty calorie' food. It means it only contains calories but is empty in all other nutritional value. There is no nutritional value from drinking a high- sugar beverage. I don’t encourage consuming milk from bubble tea either because milk with sugar is not the same as pure milk.

Is it acceptable for young children or the elderly to drink bubble teas?
Dr Tan: I do not think bubble teas are suitable for young children and the elderly. Bubble teas contain certain colourings and food additives. This can cause children to become hyperactive. For the elderly, their digestive system is slower and less active so food additives can cause them indigestion. The tapioca balls or boba or pearls in the bubble teas are hard to digest for elderly people.

Woan Fei: Did you know that one cup of brown sugar bubble tea contains three times more sugar than a can of soft drink? We’re talking about 20 teaspoonfuls of sugar in one cup of bubble tea. Children’s sugar intake should not be more than five teaspoonfuls a day. They should not be offered high-sugar beverages as this poses a risk of childhood obesity. Sugar will make them full and stop them from taking nutritious food that is essential for their development. Bubble teas are also not suitable for the elderly especially those with a background of chronic diseases. Besides, when you age, your metabolism slows down. Sugar slows down your metabolism even more, making you feel tired and sluggish.

In your opinion, do you think the bubble tea craze will blow over quickly or is it here to stay?
Dr Tan: I think this bubble tea craze is a fad. Even its packaging is designed like a cool fashion accessory that make Instagram-worthy pictures. Obviously, the main target is the ‘hip and cool’ youngsters. As we are in a fast-moving digital age, attention for this kind of product depletes very fast. Who knows by next year, there will be another new product sweeping over the country?

Woan Fei: In my opinion, it will blow over quickly due to its prices and almost similar taste albeit different brands. Recently I tried one just to know why people are crazy about it. And it is basically just fresh milk plus brown sugar plus brown sugar pearls. That’s it. Having said that, I must add that we are only human so we do have favourites when it comes to certain food or drinks, but as much as you like them, overdoing its consumption can only being harm. The lesson here is to take everything in moderation, bubble tea included!

Dr. Tan Wee Yong

Consultant Internal Medicine Physician and Neurologist

Columbia Asia Hospital – Petaling Jaya
MD (UKM), RCP (UK), MMed (Internal Medicine) (Singapore), Fellowship in Neurology (Malaysia) (Australia), CMIA (NIOSH)

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Boba Danger - The Star, 11 August 20199

This article first appeared in The Star, 11 August 2019

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Boleh menyusu jika tak mudarat [Press Clipping]

December 12, 2012

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12 December 2012


Bone Health Myths and Facts - Dr Harjeet Singh [BFM - Podcast]

December 06, 2011

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

How much calcium is enough or too much? When do you know you need supplements? Is osteoperosis strictly a female problem?

Dr. Harjeet Singh takes a good hard look at the myths and facts of bone health and sets the facts straight.

Listen to the podcast
here
.


Bongkar Penemuan Menakutkan

Bongkar Penemuan Menakutkan

August 16, 2021

BANYAK negara di Asia termasuk Malaysia tidak melakukan bedah siasat terhadap mayat pesakit Covid-19 yang meninggal dunia akibat jangkitan virus berkenaan.

Ini disebabkan kekangan prinsip agama, budaya dan menghormati perasaan keluarga mangsa.

Sebaliknya, berbeza di negara Barat yang kebanyakannya menjalankan proses terbabit, antaranya Jerman.

Pegawai Perubatan Columbia Asia Hospital, Dr S Malar Santhi berkata, di Jerman terdapat satu peruntukan undang-undang untuk prosedur bedah siasat iaitu Seksyen 25 (4), Akta Perlindungan Jangkitan Jerman atau Akta Perlindungan Penyakit Berjangkit Jerman.

Menurutnya, akta ini mewajibkan bedah siasat dilakukan terhadap individu yang meninggal dunia akibat penyakit berjangkit supaya penambahbaikan perkhidmatan kesihatan dapat diberikan kepada penduduk Jerman.

"Oleh itu, individu yang meninggal dunia akibat jangkitan Covid-19 tidak terkecuali melalui prosedur berkenaan.

"Walaupun data ini disimpan hanya untuk penggunaan perubatan klinikal, tetapi daripada kelulusan masyarakat yang beretika, maka data itu boleh dikumpulkan.
IMBASAN CT paru-paru pesakit Covid-19 selepas meninggal dunia.

"Ia supaya bidang perubatan dapat ditambah baik melalui apa dipelajari daripada prosedur bedah siasat itu," katanya yang berkongsi secara maya hasil kajian klinikal bedah siasat ke atas mayat pesakit Covid-19 di Jerman.

Perkongsian ini turut membongkar penemuan menakutkan hasil bedah siasat ke atas 12 mayat pesakit Covid-19 negara terbabit.

Beliau berkata, prosedur bedah siasat ini dilakukan oleh sekumpulan pakar perubatan di Jabatan Undang-Undang Pusat Perubatan Universiti Hamburg-Eppendorf Jerman.

"Semua pesakit disahkan positif Covid-19 sebelum meninggal dunia melalui ujian RT-PCR SARS-CoV-2, sama ada di hidung, mulut, tekak atau cecair badan yang lain seperti kahak daripada paru-paru dan sebagainya.

"Semua mayat pesakit Covid-19 ini berusia antara 53 hingga 87 tahun dengan 75 peratus daripada mereka adalah lelaki dan selebihnya wanita," katanya.

Dr S Malar berkata, berdasarkan hasil ujian bedah siasat mendapati dua daripada 12 pesakit meninggal dunia di luar hospital selepas bantuan pernafasan kecemasan (CPR) gagal dan ketika menerima rawatan di wad biasa hospital, masing-masing lima orang.

"Semua 12 pesakit ini mempunyai penyakit komorbid seperti penyakit jantung, asma, kencing manis, obesiti dan lain-lain.

"Sepuluh daripada 12 mayat ini melalui satu prosedur khas bedah siasat iaitu ujian imbasan tomografi berkomputer (imbasan CT) yang menyeluruh ke atas tubuh selepas meninggal dunia.

"Prosedur khas ini menggunakan teknologi pengimbas 'Multi Detector Philips Brillion 60 Slice'. Ujian imbasan CT itu dilakukan di kepala hingga ke separuh paha dengan perincian satu milimeter (mm).

"Ia membolehkan setiap satu mm sel dapat dikesan, diimbas dan dikaji untuk melihat sebarang perubahan yang terjadi selepas dijangkiti virus Covid-19,"katanya.

Selain itu, katanya, mayat turut melalui proses yang tisu daripada organ penting seperti jantung, paru-paru, hati, buah pinggang, limpa, pankreas, otak diambil dan dihantar ke makmal untuk ujian histopatologi.

"Ia bertujuan membolehkan pakar melihat sebarang perubahan dan bentuk tisu organ di bawah mikroskop.

"Prosedur seterusnya ialah ujian virologi iaitu mengambil sampel darah di jantung, paru-paru, hati, salur di kaki (saphenous vein) dan kemudian (sampel darah) dihantar ke makmal untuk melihat berapa banyak kandungan virus serta kepekatan virus pada organ berkenaan.

"Organ lain yang turut dikaji dalam bedah siasat itu ialah prostat, testis, ovari, usus kecil, salur karotid, tekak dan otot. Ini untuk melihat sama ada terdapat virus di organ berkenaan atau sebaliknya," katanya.

Menurut Dr S Malar, bedah siasat ujian imbasan CT menunjukkan paru-paru pesakit Covid-19 dalam keadaan sangat padat kerana mengandungi banyak virus dan sel darah putih (limfoist) yang melawan virus berada pada permukaan serta di dalam paru-paru.

"Ini menunjukkan satu 'peperangan' di antara virus dan 'tentera' daripada sistem imun badan berlaku pada permukaan paru-paru.

"Tujuh daripada 12 mayat yang melalui kajian klinikal bedah siasat ini ada darah beku pada kaki.

"Terdapat juga darah beku di saluran pernafasan dan saluran darah paru-paru (pulmonary embolism) yang ditemui pada empat daripada 12 mayat itu," katanya.

Beliau berkata, hasil bedah siasat ke atas enam daripada sembilan mayat lelaki pula menunjukkan adanya darah beku di kelenjar prostat yang boleh menjejaskan kesuburan.
KES jangkitan Covid-19 semakin meningkat di seluruh dunia.

"Enam daripada 12 mayat pesakit didapati mengalami keradangan di tekak (tekak menjadi kemerahan) dan terlalu banyak sel darah putih iaitu limfosit, penyebab keradangan (faringitis kronik).

"Sel darah putih dijumpai dekat jantung seorang daripada 12 pesakit yang menunjukkan keradangan turut berlaku di organ ini.

"Terdapat banyak virus (viremia) dijumpai pada organ enam daripada 12 mayat pesakit," katanya.

Katanya, sementara itu, lima daripada 12 mayat pesakit didapati mempunyai tahap kepekatan virus yang tinggi (
high viral RNA titus
) di hati, buah pinggang dan juga jantung.

"Malah, doktor menjumpai virus Covid-19 di otak dan salur darah kaki empat daripada 12 pesakit.

"Semua penemuan ini adalah hasil pemeriksaan seperti ujian darah dan histopatologi, bukannya menggunakan mata kasar," katanya.

Jelas Dr S Malar, hasil ujian bedah siasat terhadap semua mayat pesakit ini, turut menunjukkan tahap kepekatan virus Covid-19 di paru-paru mereka begitu tinggi.

Beliau berkata, inilah penyebab utama kematian pesakit Covid-19.

"Apabila virus Covid-19 memenuhi paru-paru menyebabkan organ ini bertukar menjadi kemerahan dan beratnya bertambah sehingga maksimum 3.42 kilogram (kg).

"Sedangkan berat paru-paru normal bagi lelaki ialah kira-kira 840 gram (gm), manakala wanita pula 630 gm.

"Berat paru-paru mayat pesakit Covid-19 meningkat lebih empat kali ganda, menunjukkan sel dan virus sangat tinggi di dalam organ ini," katanya.
PESAKIT Covid-19 diberikan bantuan oksigen kerana sukar bernafas.

Dr S Malar berkata, melalui ujian histopatologi pula mendapati terdapat kerosakan tisu di paru-paru, banyak saluran darah kecil di permukaan organ itu pecah, selain virus dan limfosid.

"Penemuan lain ke atas tujuh daripada 12 mayat pesakit pula mendapati, sebenarnya pesakit mengalami gejala tromboembolisme iaitu ada darah beku yang menyebabkan saluran darah pecah.

"Tiga daripada 12 mayat pula menunjukkan saluran berhampiran paru-paru pecah disebabkan oleh darah beku pada saluran ini.

"Lapan daripada 12 mayat pula didapati paru-parunya hancur dan rosak disebabkan keradangan yang teruk," katanya.

Katanya, kesimpulan daripada ujian klinikal bedah siasat itu menunjukkan punca utama kematian disebabkan jangkitan Covid-19 tertumpu di paru-paru kerana berlaku keradangan sangat teruk dan darah beku di organ ini.

Di samping itu, organ lain yang terkesan adalah jantung, kelenjar prostat, buah pinggang, hati dan otak.

"Kena ingat, 80 peratus pesakit Covid-19 mengalami jangkitan ringan.

"Sebanyak 15 hingga 20 peratus akan menjadi kritikal, tetapi selamat. Empat peratus masuk ICU dan bertarung nyawa. Sementara, satu peratus meninggal dunia," katanya.

Dr. Malar Santhi A/P Santherasegapan

Medical Officer

Columbia Asia Hospital - Cheras
M.D (CSMU), IES (London), MBA (Hons, UTM)

PDF and Online Articles:

Bongkar Penemuan Menakutkan – Harian Metro, 1 Ogos 2021

Artikel ini disiarkan oleh Harian Metro, 1 Ogos 2021.

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Breakfast Grille, Columbia Asia [BFM - Podcast]

April 27, 2009

A Healthy Business - Richard Evans, Chairman, Columbia Asia Group of Companies.

Listen to the podcast
here
.


Breaking down the Influenza

Breaking down the Influenza

February 27, 2020

Influenza, also known as 'the flu' is one of the most common infectious diseases that is highly contagious due to airborne transmission. Classically, this infection occurs as seasonal epidemics whereby incidences are usually higher in certain regions. Generally, in the Northern hemisphere it occurs in early fall, peaks in mid-February and ends in late spring in the following year. However, in tropical areas such as Malaysia, it occurs throughout the year.

Virus Travels Wide

Whenever an infected person coughs or sneezes, the virus spreads through airborne droplets that can travel up to six feet. Apart from being airborne, it can also spread by direct contact (touch), as the virus can survive up to 48 hours on surfaces.

There are actually four types of influenza that exist but the types that are most commonly causing epidemics are Type A and B. On top of that, Influenza A has further sub-types or strains whilst influenza B has none.

Telltale Signs

An influenza infection manifests itself via an acute febrile illness with variable degrees of associated systemic symptoms. Mainly, it involves the nose and throat, possibly spreading to the lungs, causing acute respiratory illness.

The mildest form of outcome would be mild fatigue while extreme cases result in respiratory failure and death. The presenting signs and symptoms of Influenza infection overlaps with other upper respiratory infections. Even a dengue patient can display similar symptoms especially in the early stages of the disease.

Common systemic symptoms observed in influenza infection includes:

Fever - often high grade ?Sore throat

Headache - frontal or retro orbital

Body weakness and fatigue

Severe aches and pains in joints and muscles (especially the back and around the eyes)

Nasal discharge

Cough - often dry

Red and/or watery eyes

Vomiting and diarrhea - especially in children

Most patients will recover between three to four days, but malaise and lethargy can sometime last up to two weeks.

Influenza And The Common Cold

Apart from the clinical symptoms, flu is also known to cause significant morbidity and mortality. For instance, contributing to human suffering and loss of workdays. Certain groups of people have a higher risk of complications from the flu such as the elderly (above 65), young children (below five), pregnant women and people with chronic medical conditions as well as weakened immune systems.

Some of us might confuse between the term common cold and flu. The common cold is usually a mild infection caused by respiratory viruses other than influenza. Symptoms are usually milder with low grade fever associated with runny or stuffy nose without body ache or weakness. In addition to that cold doesn't require specific treatments with anti-viral medication. It is also not known to cause any severe complications.

Normally, an infected person wil exhibit influenza symptoms two days after exposure but theoretically this can range from one to four days. It is possible that the exposure can come from an infected person who is well and asymptomatic since the airborne transmission usually starts a day before the patient develops any symptoms.

Confirming Diagnosis

To diagnose any disease, doctors normally will do a thorough check of the patient's medical history and carry out a full physical examination. This is to ascertain the possible diseases that the person may have. Similarly, in influenza infection, the same steps are done. If it strongly suggests an influenza infection, the next step is to do a confirmatory test. The test will be performed by taking samples from the nose or throat and checking for the presence of either Influenza A or B. Additionally, a patient who is suspected of having infection in the lungs, a chest radiograph (CXR) will be performed.

The most potent weapon to combat the influenza infection is by preventing the disease itself and the mainstay of prevention remains to be influenza vaccination. Vaccine will become effective after 10 to 14 days of its administration. Thus, exposure within those periods might still risk infection. It is suggested to vaccinate yearly as the vaccine components change in order to keep up with the evolving strains of the virus.

Women And Children

In children, influenza vaccination is recommended from the age of six months and above, especially children with medical conditions that increase risks of severe complications. This includes preterm babies, and those with chronic diseases of the lung or heart. If a household has a child below six months, other family members should vaccinate to reduce the risk of influenza infection.

Vaccination is also safe for pregnant women regardless of trimester In fact, it is recommended as their newborns too will be protected against influenza in the first few months of life.

Help is Here

Generally, viral illnesses are self-limiting which means it will resolve on its own. However, antiviral usage is sometimes indicated in patients who have been diagnosed with influenza either clinically or via lab testing. It will reduce the duration and severity of the influenza infection.

For maximum effectiveness, the anti-viral treatment should start during the first 48 hours of symptoms and administered twice daily for five days. Antibiotics are not required for a viral infection such as Influenza unless the treating doctor is suspecting a secondary infection by bacteria.

Other than anti-viral treatments, below are measures to expedite recovery:

Bed rest

Drink enough fluids to avoid dehydration.

Avoid physical exertion.

Take fever-reducing medicine such as Paracetamol

Practice cough etiquette when you sneeze or cough by covering your mouth with a tissue. Throw the tissue immediately to prevent transmission.

During the flu season, vaccines and anti-viral medications can be limited. When there is a surge in the number of flu cases in our vicinity, it is imperative that we take the following measures to reduce risks of infection:-

Wash hands often and/or using alcohol-based hand sanitizer.

Avoid meeting people who have the flu. Avoid crowds.

Wear a facial mask in public areas.

Avoid sharing others' personal equipment such as towels and utensils.

Ensure air circulation is good at home and work.

Clean exposed surfaces such as tabletops, regularly.

Dr. Muhammad Bin Shahruddin

Consultant Internal Medicine Physician

Columbia Asia Hospital – Puchong
Bachelor Of Medicine & Bachelor Of Surgery (MBBS), Doctor of Internal Medicine (UKM), CIMA (NIOSH)

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PDF and Online Articles:

Breaking Down the Influenza – Health & Wellness, 1 February 2020

This article first appeared in Health & Wellness, 1 February 2020

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Breast Health Tips

Breast Health Tips

January 19, 2017

Breast health tips as suggested by Her World magazine in its January issue, on things to do monthly in 2017. October is breast cancer awareness month and what better way to celebrate than by taking care of your bosom.
Newspaper:

Breast Health Tips – Her World Magazine, Issue January 2017


Bromhidrosis - Excessive Sweating, Strong Odour [Press Clipping]

April 01, 2014

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Natural Health,

April 2014

Natural Health,

April 2014

Natural Health,

April 2014

Natural Health,

April 2014

Natural Health,

April 2014

Natural Health,

April 2014

Natural Health,

April 2014


Buah Pinggang Boleh Rosak

Buah Pinggang Boleh Rosak

November 04, 2020

Angkara tamak, segelintir pengusaha kilang makanan tergamak menjalankan operasi dalam premis kotor.

Lebih menjijikkan, ada yang menggunakan air daripada tandas untuk mencuci serta memproses makanan.

Di sebalik bungkusan makanan yang bersih dijual di pasaran, ada yang sebenarnya dihasilkan oleh kilang kotor selain pengendali makanan tidak diberi suntikan tifoid. Bagaimanakah hak pengguna?

Ikuti wawancara bersama Pegawai Perubatan Hospital Columbia Asia, Dr. Malar Santhi dan wartawan Nor Asyikin Mat Hayin bagi mengupas isu ini.

Jenis-jenis kuman dalam makanan tercemar dan risiko pada manusia. Klasiflkasikan jenis dan mudaratnya?

Penggunaan air paip tandas dalam memproses makanan bukan sahaja mendedahkan kepada risiko jangkitan, malah boleh menyebabkan pelbagai masalah kesihatan lain.

Ini kerana makanan boleh rosak disebabkan tindak balas pelbagai jenis kuman seperti bakteria E Coli, Shigella, Salmonella, Clostridium Perfringes, Staphyloccocus dan banyak lagi.

Kesan daripada kuman, bakteria dan virus ini boleh menyebabkan demam serta cirit-birit iaitu gejala keracunan makanan.

Keracunan makanan yang teruk boleh menyebabkan kegagalan fungsi buah pinggang seterusnya mengakibatkan kematian.

Apa yang agak membimbangkan ialah risiko komplikasi kesihatan seperti jangkitan kulat sama ada pada kulit dan paru-paru.

Ini kerana, pili air dan sistem paip tandas lebih mudah ditumbuhi kulat berbanding paip di kawasan lain.

Air tandas atau
seewage water
  biasanya tinggi kandungan campuran bahan kimia seperti ammonia dan nitrogen.

Selain itu, air paip dari tandas juga berkemungkinan mengandungi bahan logam berat yang boleh mengancam kesihatan.

Pekerja pula warga asing tanpa suntikan vaksin kepialu (tifoid). Bagaimana tanpa suntikan ini boleh memudaratkan orang ramai?

Suntikan vaksin tifoid bertujuan mengelakkan pengendali makanan daripada menjadi pembawa jangkitan tifoid, sekali gus mencegah penularan kepada orang awam melalui makanan atau minuman.

Oleh itu, semua pengendali makanan sama ada tempatan atau warga asing diwajibkan mengambil suntikan vaksin berkenaan.

Secara tidak langsung, pengendali atau pengusaha makanan yang mengambil suntikan ini boleh dianggap sebagai golongan yang mementingkan kebersihan dan kualiti makanan.

Bagi pengendali makanan yang tidak mengambil suntikan itu. kita bukan sahaja bimbang tahap kebersihan dan status jangkitan tifoidnya.

Kita juga khuatir dengan tahap kesihatan keseluruhannya termasuk kesihatan mental, kebersihan badan dan sebagainya.

Sumber air tandas untuk hasilkan roti dan mi. Penduduk sekitar Kuala Lumpur makan roti serta mi tandas. Kesan kesihatan jangka pendek dan juga tidak memperbaharui lesen kesihatan?

Kesan jangka pendek boleh dialami ramai penduduk di kawasan sekitar kilang roti dan mi terbabit.

Antara gejala yang mereka hidap ialah ketidakselesaan perut, masalah pencernaan, alahan cirit-birit, muntah dan demam.

Sekiranya jangkitan ini menjadi kritikal, ia boleh menyebabkan komplikasi seperti kerosakan buah pinggang dan kegagalan organ dalaman yang lain.

Ini secara tidak langsung meningkatkan kos perubatan dalam tempoh jangka panjang.

Umum mengetahui bahawa roti adalah makanan disukai ramai daripada kanak-kanak hingga golongan dewasa.

Sekiranya pengguna terbeli roti yang dihasilkan kilang roti kotor, maka kesihatan mereka bakal terancam.

Pengendali makanan yang tidak mengambil suntikan vaksin tifoid boleh menjangkiti pengguna dan menjadi pembawa penyakit demam kepialu.

Individu yang dijangkiti kuman tifoid boleh menjangkiti orang lain melalui najisnya sekiranya tidak mencuci tangan dengan betul selepas membuang air besar.

Apabila mereka mengendalikan makanan tanpa memakai sarung tangan, kuman ini boleh ‘berpindah’ pada makanan.

Keracunan makanan yang teruk boleh mengakibatkan kematian

Bagaimana mahu memastikan bekalan makanan dari kilang baik untuk kesihatan pengguna?

Pihak berkuasa perlu lebih agresif dan tegas dalam melaksanakan pemantauan berkala secara kerap. Ini kerana kita tidak boleh mengharapkan semua pengusaha dan peniaga bersikap jujur terhadap pengguna.

Di samping itu, perlu ada pemantauan secara mengejut di premis kilang atau kedai.

Pihak berkuasa perlu menetapkan peraturan ketat untuk pengeluaran dan memperbaharui lesen perniagaan bagi pengusaha serta peniaga.

Maksudnya, jika pengendali makanan tidak mengambil suntikan tifoid, maka lesen premis perniagaan tidak layak dikeluarkan.

Pemborong, peruncit dan sebagainya juga wajar dikenakan tindakan supaya tidak menyalahkan pengeluar sahaja, Pemborong dan peruncit perlu bertanggungjawab memastikan produk dijual di premis mereka berlesen serta betul.

Pandangan Dr, bagaimana dengan kesedaran orang ramai mengenai kepentingan penyediaan makanan bersih dan berkualiti. Contoh, ada yang merokok sambil memasak burger?

Kesedaran orang ramai mengenai kepentingan penyediaan makanan bersih dan berkualiti pada tahap sederhana serta perlu diperkasakan lagi.

‘Budaya’ merokok sambil memasak burger juga sudah menjadi perkara biasa yang sukar diubah.

Namun, saya berpendapat, kita jangan berputus asa dan terus mendidik masyarakat.

Sementara itu. pihak berkuasa perlu tegas dan mengenakan syarat yang ketat sebelum lesen perniagaan dikeluarkan.

Pada masa yang sama, meletakkan syarat wajib, contoh, individu perlu mengambil kursus mengendalikan makanan terlebih dahulu sebelum lesen perniagaan diluluskan.

Program sebegini boleh dianjurkan oleh kerajaan atau pertubuhan bukan kerajaan (NGO).

Ulasan mengenai industri makanan Malaysia berkualiti atau sebaliknya. Bagaimana mahu memastikan kelestariannya?

Pendapat peribadi saya ialah, kualiti industri makanan di Malaysia agak baik dan permintaan juga tinggi.

Malah Malaysia yang digelar syurga makanan turut menjadi destinasi kunjungan pelancong luar.

Saya pernah pergi ke beberapa lokasi 'makanan tepi jalan' di Malaysia dan mendapati ramai peniaga mengikut peraturan ditetapkan, seperti memakai topi, menggunakan sarung tangan dan sebagainya.

Cuma disebabkan ada satu atau dua pengusaha yang tidak mengikut peraturan (premis kotor), menyebabkan pengusaha lain mendapat tempiasnya.

Hakikatnya, peniaga tidak beretika sebegini wujud hampir dalam semua industri dan juga wujud hampir di semua negara.
Foto Kredit: Freepik.com

Dr. Malar Santhi A/P Santherasegapan

Medical Officer

Columbia Asia Hospital - Cheras
M.D (CSMU), IES (London), MBA (Hons, UTM)

PDF and Online Articles:

Buah Pinggang Boleh Rosak – Harian Metro, 27 September 2020.

Artikel ini disiarkan oleh Harian Metro, 27 September 2020.

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Buasir Pada Bulan Puasa

Buasir Pada Bulan Puasa

June 02, 2021

Pejam celik, sudah tiga minggu kita menjalani ibadah puasa di bulan Ramadan. Mungkin ada sebahagian dari anda yang meraih manfaat untuk tubuh badan disebabkan berpuasa. Contohnya anda mungkin mengalami penurunan berat badan yang ketara atau perubahan fizikal yang positif!

Walau bagaimanapun, sekiranya diet anda kurang air atau pengambilan serat tidak mencukupi, anda mungkin akan mengalami sembelit.

Ada juga antara kita yang mengalami tanda-tanda buasir seperti sakit di bahagian dubur, kegatalan, pembengkakan atau najis berdarah. Selalunya tanda-tanda ini datang selepas seseorang itu mengalami masalah sembelit yang berpanjangan.

Mungkin ramai yang tidak mahu berjumpa doktor disebabkan pandemik COVID-19 yang berlaku sekarang atau mungkin juga ada yang segan untuk berkongsi hal masalah buasir dengan doktor kerana ianya suatu masalah di tempat sulit.

Saya kongsikan di sini tips untuk mengelakkan buasir di bulan puasa. Saya harap perkongsian saya ini mampu membantu anda menangani masalah buasir sekiranya anda belum berjumpa doktor.

Pertama sekali, apa itu buasir?

Buasir adalah pembengkakan salur darah pada lapisan kusyen di bahagian anus dan rektum usus. Lapisan kusyen ini biasanya bertindak membantu proses perkumuhan iaitu proses buang air besar.

Buasir mula terjadi apabila kita ada masalah sembelit. Sembelit akan membuat kita duduk lama di mangkuk tandas sambal meneran. Ini akan meningkatkan tekanan kepada dinding kusyen yang disebutkan tadi, lantas menyebabkan pembengkakan.

Pesakit biasanya akan mengalami masalah pendarahan, kegatalan, pengeluaran mukus atau lendir. Jika masalah ini berterusan, maka akan terjadi pembengkakan pada dubur. Pesakit akan berasa sakit di kawasan tersebut.

Lima Tip Tangani Buasir

Lebihkan serat

Sebelum anda berjumpa doktor, saya cadangkan anda mengubah gaya hidup anda supaya lebih sihat. Banyakkan memakan makanan berserat tinggi. Sebaik-baiknya badan kita memerlukan kira kira 20 hingga 30g serat sehari. Banyakkan juga minum air kosong iaitu enam hingga lapan sehari atau lebih dari 1.8 liter sehari. Elakkan duduk lama di mangkuk tandas serta banyakkan bersenam kerana ia boleh membantu melancarkan pergerakan usus.

Hati-hati bila beraktiviti atau bersukan

Elakkan aktiviti yang boleh meningkat risiko buasir seperti duduk terlalu lama apabila memancing atau bekerja di depan komputer. Contoh aktiviti sukan yang boleh mengakibatkan peningkatan tekanan pada dubur ialah angkat berat, mengayuh basikal dan mendaki.

Kurangkan Masa di Tandas

Elakkan duduk di mangkuk tandas sambil membuang air besar lebih dari lima minit. Meneran atau duduk terlalu lama di mangkuk tandas akan meningkatkan tekanan (
pressure
) pada dubur yang boleh menyebabkan pembengkakan buasir.

Banyakkan Minum Air

Minumlah air sebanyak enam hingga lapan gelas sehari. Amalkan meminum satu gelas air ketika berbuka, setelah solat Maghrib, selepas Isyak, selepas solat Tarawih, sebelum tidur dan ketika bersahur.

Anda juga boleh dapatkan ubat pelawas seperti laktulos atau fiber tambahan yang didapati di farmasi atau pasar raya
(over-the-counter)
. Sekiranya usaha ini tidak berjaya atau masalah berterusan selepas seminggu, saya cadangkan anda membuat temu janji bersama doktor anda untuk pemeriksaan lanjut.

Kebiasaannya doktor akan melakukan pemeriksaan pada dubur anda untuk memastikan penyebab masalah anda. Selain buasir, penyakit seperti
anal fissure
 (luka pada anus),
absess
 (nanah), kanser dan
rectal prolapse
 juga boleh berlaku.

Dr. Abang Mohammad Affendi Bin Abang Yusop

Consultant General Surgeon

Columbia Asia Hospital – Bintulu
MD (UNIMAS), MS (UKM)

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PDF and Online Articles:

Buasir Pada Bulan Puasa – Getaran, 8 Mei 2021

Artikel ini disiarkan oleh Getaran, 8 Mei 2021.

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Buat 6 Perkara Ini Kalau Doktor Suruh Kawal Kencing Manis Semasa Hamil

January 15, 2019

Kencing manis semasa hamil atau
gestational diabetes (GDM
) sering dihidapi wanita hamil. Kadangkala buntu juga bila bacaan gula dalam darah sentiasa tinggi sedangkan anda sudah berusaha mengawalnya.

Menurut Dr Norintan Zainal Abidin Shah, Pakar Perbidanan & Sakit Puan Columbia Asia Seremban, glukosa atau glukos adalah bahan yang menjadi sumber tenaga bagi kehidupan sehari-hari. Namun jika tahap glukos dalam darah berlebihan, ia boleh memberi kesan buruk kepada organ-organ dalam tubuh kita seperti merosakkan lapisan retina di bahagian mata sehingga boleh menyebabkan buta.
Tahap glukos yang tinggi semasa hamil pula akan menyebabkan pelbagai masalah di dalam janin misalnya, masalah jantung pada bayi dalam kandungan.
PERLU SENAMAN SEDERHANA

Tahap glukos dikawal oleh insulin. Insulin merupakan hormon yang dihasilkan oleh pankreas supaya tahap glukos terkawal dan tidak kekal tinggi.
 Di kalangan wanita yang hamil pula, hormon-hormon yang dihasilkan ketika hamil akan berlawan dengan insulin. Ini menyebabkan paras glukos wanita hamil mudah meningkat naik.
 Setelah bayi dilahirkan dan uri dikeluarkan, tahap glukos akan kembali normal semula.

Inilah yang dikenali sebagai
gestational diabetes mellitues (GDM)
atau masalah kencing manis ketika hamil.
 Pesakit GDM selalunya mengamalkan pemakanan yang seimbang tetapi tidak melakukan senaman, tahap gula atau glukos selalunya akan kekal tinggi.

Senaman yang dimaksudkan adalah
senaman sederhana seperti berjalan kaki selama 30 hingga 45 minit setiap hari
. Ramai yang bertanya, setelah melakukan kerja-kerja rumah, maka perlukah melakukan aktiviti berjalan kaki ini? Jawapannya adalah, ya!
5 TIP KAWAL SELERA

Soalan-soalan yang juga sering ditanya ialah bagaimana caranya untuk mengawal pemakanan ketika mengalami gestational diabetes ini? Bagaimana cara untuk mengekang selera?

Terdapat pelbagai tips yang boleh dicuba tetapi langkah yang pertama adalah untuk berjumpa dengan pakar pemakanan di hospital. Setelah mendapat taklimat tentang diet/pemakanan daripada beliau, anda bolehlah mencuba tip di bawah.

Jangan simpan makanan yang tidak boleh dimakan di dalam rumah.
 Misalnya, jika anda tidak dibenarkan minum minuman bergula, jangan beli atau simpan apa-apa minuman berkarbonat misalnya di rumah. Semua ahli keluarga yang lain termasuklah suami hendaklah bekerjasama dalam hal ini.

Ganti beras/mi/mihun/pasta/roti biasa dengan bahan-bahan karbohidrat berserat tinggi (
complex carbohydrates)
. Beras putih boleh digantikan dengan beras perang. Roti putih boleh digantikan dengan roti
“grain bread”
atau
 “wholemeal”
. Mihun dari beras merah ada dijual di pasaran. Pasta yang diperbuat dari wholemeal flour juga mudah didapati daripada pasaran.

Makan dalam kuantiti kecil tapi kerap.
 Waktu makan utama iaitu sarapan, makan tengah hari dan makan malam dikekalkan tapi ambil snek antara waktu makan utama. Antara masa sarapan dan makan tengah hari ambil
snek pagi.
 Di antara makan tengah hari dan makan malam pula ambil
 snek petang.

Bagi sarapan, makan tengah hari dan malam;
amalkan diet yang disarankan oleh pakar pemakanan anda.

Kegagalan diet yang disarankan oleh pakar pemakanan akan berlaku jika diet dan jenis makanan tidak menepati selera seseorang pesakit itu. Justeru Dr Norintan mencadangkan supaya
makan makanan yang anda suka
. Misalnya, jika sarapan yang dicadangkan ialah sandwic telur tetapi anda tidak suka makan ini bolehlah tukar kepada sekeping capati atau secawan mihun goreng. Tapi pastikan kuantiti yang bersesuaian.

Dr Norintan merayu kepada semua wanita yang mempunyai tahap glukos yang tinggi dan
wanita yang mengalami kencing manis supaya tidak hamil sebelum tahap glukos & selera dapat dikawal.
 Katanya,
tahap glukos yang tinggi dan tidak terkawal boleh menyebabkan masalah jantung di dalam janin yang di kandung.

Dr. Norintan Zainal Abidin Shah

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Seremban

PDF and Online Articles:

Buat 6 Perkara Ini Kalau Doktor Suruh Kawal Kencing Manis Semasa Hamil - Majalah Pa&Ma, 15 Januari 2019

AArtikel ini disiarkan oleh Majalah Pa&Ma, 15 Januari 2019

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Bukan sekadar deman biasa [Press Clipping]

June 02, 2013

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Metro Ahad,

2 Jun 2013


Bukan Wanita Berkahwin Sahaja Hadapi Risiko Peranakan Jatuh... Jaga Berat Badan, Elak Sembelit

July 24, 2020

ORGAN peranakan wanita terdiri dari rahim, pundi kencing dan usus besar yang disokong oleh ligamen serta otot yang dikenali sebagai otot pelvis.

Kejadian rahim jatuh berlaku apabila otot pelvis menjadi lemah disebabkan keregangan berlebihan.

Terdapat pelbagai jenis kejatuhan rahim dan umumnya ia bergantung kepada organ yang terlibat.
 Menurut Pakar Obstetrik & Ginekologi Hospital Columbia Asia Iskandar Puteri, Dr Salmi Daraup, tiga bahagian utama yang kerap berlaku.

Peranakan jatuh hanya boleh diketahui selepas menjalani rawatan kesihatan seperti pap smear.

"Bahagian atas yang paling biasa berlaku. Sekiranya ia membabitkan bahagian atas faraj, rahim akan jatuh ke bahagian faraj dan rahim turun sedikit, biasanya ini tidak mendatangkan sebarang gejala (asymptomatic) dan hanya dapat dikesan semasa rutin membuat pap smear.

"Rahim yang jatuh sehingga ke pangkal rahim boleh dilihat di muka pintu faraj. Pada ketika ini pesakit mungkin mengalami simptom seperti kerap buang air kecil. Akhir sekali, keseluruhan rahim jatuh terkeluar daripada faraj iaitu procidentia. Selalunya pesakit akan berasa sesuatu terkeluar dari celah alat sulitnya.

"Manakala bahagian hadapan melibatkan pundi kencing (cystocele) atau pundi dan salur kencing (cystourethrocele) jatuh ke dalam faraj dan ketiga adalah bahagian belakang faraj yang melibatkan sebahagian daripada usus kecil yang jatuh di antara faraj dan bahagian akhir usus besar (rektum) yang dikenali sebagai rectocele," kongsinya kepada mStar.

Punca peranakan jatuh

Antara sebab yang menyebabkan peranakan jatuh ialah kehamilan dan kaedah bersalin yang memerlukan bantuan seperti forceps.

Selain dari itu, berat badan berlebihan serta faktor usia lanjut juga merupakan salah satu sebab terutamanya selepas menopaus.

Lain-lain sebab termasuk sembelit, batuk berterusan atau sering mengangkat sesuatu yang berat di mana keadaan ini boleh menyebabkan kelemahan pada otot pelvis dan ligamen.
Merokok juga antara faktor kemungkinan boleh menyebabkan peranakan jatuh.

Tanda-tanda peranakan jatuh

Anda mungkin tidak mempunyai gejala sama sekali dan hanya mengetahui bahawa anda mengalami peranakan jatuh selepas pemeriksaan kesihatan seperti 'pap smear' oleh pakar perubatan.

Kesukaran mengawal kencing, kerap kencing atau kencing tidak puas sekiranya melibatkan pundi kencing.

Suatu lagi gejala peranakan jatuh ialah sembelit serta rasa tidak puas buang air besar sehingga kadangkala terpaksa memasukkan jari untuk mengeluarkan najis jika melibatkan usus besar.

Jika melibatkan rahim, wanita akan merasa tidak selesa seolah-olah ada sesuatu yang terkeluar dari alat sulit.

Dalam keadaan procidentia ini, keseluruhan rahim berada di luar faraj, boleh menyebabkan luka, pendarahan dan jangkitan kuman.

Kaedah pencegahan dan rawatan

Secara amnya, pencegahan dan rawatan individu bergantung kepada pelbagai faktor seperti usia, simptom, jenis peranakan jatuh, perancangan reproduktif dan seksual, tahap kesihatan serta kesannya kepada kehidupan pesakit dalam jangka masa panjang.

Salah satu cara pencegahan ialah mengamalkan gaya hidup sihat seperti berhenti merokok, diet, bersenam dan mengelakkan sembelit serta aktiviti yang boleh menjadikan keadaan lebih teruk seperti mengangkat berat.
Senaman Kegel boleh menguatkan otor-otot pelvis yang lemah.

Senaman Kegel juga dapat menguatkan semula otot-otot pelvis yang lemah.

Untuk pesakit yang tidak sesuai menjalani pembedahan seperti wanita muda yang masih mahu hamil dan melahirkan anak atau wanita berusia yang tidak sihat untuk menjalani pembedahan, pesari faraj iaitu alat berupa gelang yang terdapat dalam beberapa saiz boleh digunakan untuk mengekang rahim daripada jatuh.

Alat ini hendaklah diganti setiap tiga bulan dan hendaklah dimasukkan oleh pakar perubatan.

Pembedahan untuk peranakan jatuh adalah pilihan terakhir sekiranya rawatan lain tidak berjaya untuk menyokong organ pelvis sebagai bantuan meredakan gejala ini.

Terdapat beberapa jenis pembedahan untuk masalah ini yang selalunya bergantung kepada betapa seriusnya penyakit dan gejala wanita tersebut.

Dr. Salmi Daraup

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Iskandar Puteri
MBBS (IIUM), Doctor of OBS & GYN (UKM)

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Bukan Wanita Berkahwin Sahaja Hadapi Risiko Peranakan Jatuh... Jaga Berat Badan, Elak Sembelit - mStar, 4 Julai 2020

Artikel ini disiarkan oleh mStar, 4 Julai 2020

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Butter Cream Chicken

Butter Cream Chicken

October 18, 2016

Columbia Asia Extended Care Hospital – Shah Alam (CAHEC-SA)provides rehabilitation services to patients who require long-term nursing care. To achieve good ratings in satisfying inpatient meals, preparing the meals is a challenging task for Kitchen Executive, Al Malek, and his Food Service team. Encik Malek joined the hospital in 2013. Previously he was working in the hotel industry for more than 15 years.

Q: What is the biggest challenge in preparing inpatient meals in CAHEC-SA?

Malek:
The biggest challenge is to satisfy the special demands of long-stay patients without compromising their diet requirements. Long-stay patients want their hospital food to taste like home-cooked food. Occasionally they will bring their own ingredients from home for us to cook for them. But before that, we will always check with respective doctors about the patients’ diet requirements before giving in to their demands.
Q: Why did you choose to share your ‘butter cream chicken’ recipe with us?

Malek:
‘Butter Cream Chicken’ is a delicious and easy recipe to prepare. I adjusted this particular recipe to come up with a healthier version.
Q: Any special cooking instructions to prepare the dish?

Malek:
 The sauce is the most important part of the dish. For healthier cooking, the chicken can be baked or grilled without any flour. Just marinate the chicken with salt and coarse pepper before you cook it. For those who prefer ‘crunchy’ fried chicken, you need to coat the chicken with bread crumbs before deep or shallow frying.

RECIPE

Butter Cream chicken
Ingredients
Chicken

2 pieces Boneless chicken breast (approximate 250gram)

2 tablespoons Rice flour

2 tablespoons Tapioca flour

Salt, to taste

Pepper, to taste

Cooking oil (for pan-fry)

Sauce

2 Eye bird chili, chopped (optional)

1 stem Curry leaf

3 cloves Garlic, chopped

1 tablespoon Cooking oil

2 tablespoons Soft margarine/unsalted butter

1 cup Low fat milk

1 tablespoon Wheat flour

Salt, to taste

Method

Mix rice flour, tapioca flour, salt and pepper. Coat chicken with the mixture and pan fry till fragrant. Keep aside.

Heat cooking oil with margarine/butter. Add eye bird chili, curry leaf and garlic. Sauté till fragrant. Add wheat flour and stir well. Add low fat milk and season with salt.

Nutrient Content:

Calorie (kcal) -
541

Protein (gm) -
33

Fat (gm) -
35

Carbohydrates (gm) -
22

Sodium (mg) -
275

Recipe prepared by:
Al Malek Idris

Kitchen Executive
Columbia Asia Extended Care - Shah Alam


Your Meal's Been Hacked - Banana Leaf Rice

May 15, 2016

We hate to break it to you, but relying on food stalls and eating out all the time in Malaysia might not be the smartest move when it comes to your health. Try out this healthier alternative to Malaysia’s most popular dish – Banana Leaf Rice, specially prepared by Chef Mohd. Naim Suhaimi from Columbia Asia Hospital – Bukit Rimau and walk away a healthier, fitter man.

Your Meal's Been Hacked - Banana Leaf Rice – Men’s Health , May 2016
.


Tak Sampai 6 Bulan Lepas Caesar Mengandung Balik Rahim Ibu Terkoyak Boleh Berlaku

July 16, 2019

Hamil lagi selepas bersalin ceaserean sebelum tempoh dua tahun seperti disarankan? Mama jangan panik, baca dulu apa yang dikatakan doktor ini.

Lazimnya bagi ibu yang bersalin secara pembedahan caesarean, doktor akan menyarankan waktu selamat untuk hamil semula ialah selepas dua tahun. Tapi bagaimana kalau anda hamil lagi sebelum waktu itu….?

Minimum Enam Bulan

Menurut Dr Norintan Zainal Shah, Pakar Perbidanan & Sakit Puan, Hospital Columbia Asia Seremban, ibu tidak perlu panik kerana terdapat kajian yang menunjukkan jarak minimum untuk hamil selepas kelahiran adalah enam bulan sahaja. Sebagai contoh, sekiranya ibu hamil setelah anak pertama berusia sepuluh bulan, risiko dinding rahim terkoyak adalah amat rendah.

Risiko Uterine Rupture

Masalah dinding rahim terkoyak ini dinamakan sebagai uterine rupture selalunya berlaku sewaktu kontraksi ketika hendak bersalin. Ia dilaporkan berlaku kurang dari 1% bagi ibu yang mempunyai satu pembedahan caesarean sebelumnya.

Percubaan untuk bersalin secara normal selepas adanya pembedahan caesarean dikenali sebagai TOS atau (Trial of Scar). Bersalin secara normal melalui faraj selepas adanya pembedahan caesarean dikenali pula sebagai VBAC (Vaginal Birth After Caesarean Section).

Masih Berpeluang Bersalin Normal

Jika wanita ingin melalui pembedahan caesarean bagi kandungan kedua, ini dikenali sebagai Elective Repeat Cesaerean Section ( ERCS). Bagi pesakit yang pernah mengalami pembedahan caesarean dan inginkan VBAC bagi kandungan keduanya, doktor hendaklah memberitahu bahawa VBAC lebih selamat daripada ERCS.

Ini bererti, pesakit yang berjaya melalui TOS tanpa berlakunya dinding rahim terkoyak dan bersalin melalui VBAC, mereka tidak banyak mengalami masalah. Jika ada 10 orang wanita yang melalui TOS, lapan daripadanya akan berjaya bersalin secara normal.

Amat penting bagi ibu untuk memahami bahawa dinding rahim terkoyak berisiko kepada wanita yang melalui proses TOS. Walau pun ibu terbabit dipantau di hospital yang mempunyai perkhidmatan doktor pakar perbidanan dan pakar bius, serta perkhidmatan tabung darah, hal ini boleh berlaku!

Kesan Dinding Rahim Terkoyak

Tumpah darah dari rahim ibu sehingga ibu
memerlukan transfusi darah.

Ibu melahirkan bayi secara
emergency caesarean section.

Anak yang dilahirkan boleh mengalami
masalah kekurangan darah dan oksigen
 sehingga boleh menyebabkan kecacatan otak dan maut.

Rahim yang mengalami koyak kadang kala tidak dapat diselamatkan dan perlu dibuang.

Kesan sampingan bius penuh ketika menjalankan caesarean secara kecemasan juga tinggi. Doktor bius akan memberi penerangan sebelum ibu dibedah.

Kehilangan darah yang banyak
 boleh berisiko menyebabkan masalah DIVC (Disseminated Intravascular Coagulation) di mana darah terus menerus mengalir keluar dari badan kerana darah tidak dapat membeku. Keadaan ini boleh menyebabkan maut.

Dr Norintan menasihatkan agar ibu yang hamil semula dalam jarak kurang dari enam bulan segera merujuk kepada pakar sakit puan & perbidanan supaya rekod pembedahan yang pertama boleh diperiksa atau disemak sebelum ibu boleh melalui TOS. Risiko dinding rahim terkoyak amat tinggi (jika ia berlaku).

Dr. Norintan Binti Zainal Shah

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Seremban
MBBCh BAO (Ireland), LRCP & SI (Ireland), MMed (Obs & Gyn) (USM)

Make an Appointment

PDF and Online Articles:

Tak Sampai 6 Bulan Lepas Caesar Mengandung Balik Rahim Ibu Terkoyak Boleh Berlaku, 12 Julai 2019

Artikel ini disiarkan oleh Majalah Pa&Ma, 12 Julai 2019

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饭后运动, 会得阑尾炎?

饭后运动, 会得阑尾炎?

September 14, 2022

父母从小就会警告你：刚吃饱饭不能跑跳，否则会得盲肠炎！要去医院割阑尾！直到长大后才发现“阑尾炎”，也是父母俗称的盲肠炎，和饭后剧烈运动没有任何关系。

大部份人俗称的“盲肠炎”，其实指的就是阑尾炎(Appendicitis)，不过大部分人分不清楚盲肠及阑尾分别属于两个不同部位，正确的发病位置是在阑尾，只是大多数民众习惯以盲肠炎来称呼。阑尾是一段细长弯曲的盲管，位于小肠与大肠连接处的位置，根部连于盲肠的后内侧壁（如下图），大小因人而异。

阑尾为什么爱发炎？

阑尾发炎是因为粪石掉进阑尾洞里。（小编提醒：所谓粪石，就是由于食物残渣在肠道停留太久，水分被吸干，变成干燥、坚硬的粪块。而当它们掉进阑尾时，阑尾的恶梦就来临了。）

饭后运动是诱发阑尾炎的原因吗？

不是。

饭后多久可以运动？

既然饭后运动不会诱发阑尾炎，所以并没有限制饭后多久才可以运动。

如何判断自己患了阑尾炎？

如果出现明显的右下腹疼痛，你就要警惕自己是不是患了阑尾炎，尽快到医院去看医生做检查。临床症状一般是右下腹疼痛，并且多半伴随着食欲不振、发烧等症状。

阑尾痛是什么感觉？

这是一种内脏痛，是一种隐隐作痛，一般先从中上腹痛开始，慢慢转移到右下腹痛。通常不是剧烈痛感，但如果阑尾充满脓液，痛感就可能会持续性剧烈疼痛。

阑尾炎易患人群有哪些？

阑尾炎可发生在任何年龄，我国阑尾炎的高发年龄段是10～30岁。通常在2岁以下婴幼儿，或70岁以上年长者则比较少见。

阑尾炎是急诊吗？会致命吗？

阑尾炎是一种很普遍的腹部急诊情况，因为它一旦严重时，可能会在 6 小时内出现阑尾化脓穿孔，会导致阑尾中的脓性物质扩散进入到腹腔中，更严重者会出现败血症，最后导致死亡。

Dr. Chan Chong Jin

Consultant General Surgeon

Columbia Asia Hospital - Seremban

MBBS (UM), FRCS (Edinburgh), FRCSI (Ireland), MS (General Surgery)(UM)

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饭后运动，会得阑尾炎？真相是这样…… - 健康时尚杂志

这篇文章首次刊登在《健康时尚杂志/GoodHealth Magazine》

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Can What You Eat Cause Cancer?

Can What You Eat Cause Cancer?

March 22, 2023

The word "cancer" strikes fear in all of us. When we hear of a loved one or friend being diagnosed with the disease, we often wonder about their diet and whether there's a link.

While the reality is that cancer can affect anyone, there are many who believe certain foods cause cancer or increase the risk of getting the disease. While some of these beliefs may be true, others are not backed by science.

Instant Noodles

Among the most vilified foods are instant noodles, a staple in many Malaysian households. But does consuming instant noodles on a regular basis raise one's cancer risk?

Columbia Asia dietitian Kong Woan Fei says there are more than 20 types of food additives in a bowl of instant noodles to make it chewy, cook quickly, and be flavourful. This does not yet include the chemical flavour enhancers, colourants and seasoning agents that come with instant noodles.

Kong explains that although epidemiological evidence in humans is still lacking in terms of linking these food additives as carcinogenic, it is certainly not worth consuming so many chemicals for the sake of convenience.

Soy-Based Products

Soy products have also been frequently associated with an increased risk of reproductive cancers in females.

Kong says, in fact, soy is recommended for cancer prevention.

Phytoestrogen chemicals (isoflavones, saponins, phytates, phytosterols and protease inhibitors) that are found in soy can decrease the risk of breast, colon, prostate and endometrial cancers.

BBQ Food

Oily foods that have been cooked at high temperatures through methods such as roasting or grilling will produce polycyclic aromatic hydrocarbons (PAH), explains Kong.

"Many factors will affect PAH levels in food such as cooking methods, smoking temperature, fat content in the food or the cooking surface, but PAH is carcinogenic and can cause cancer."

Long term exposure in large amounts brings great risks to consumers, she says, but adds that we can reduce these risks by preventing food from having direct exposure to the source of fire.

This includes wrapping food in aluminium foil first, lowering the heat or removing fatty layers of food before cooking.
Fast Food

Vegetables that contain asparagine (an amino acid), like potatoes, when cooked at high temperatures, will produce acrylamide. French fries are one of the major food sources of acrylamide, says Kong.

Acrylamide has been found to be carcinogenic in animal studies.

However, there is no consistent evidence in humans that links acrylamide with cancer risks.

"A good step is to shorten your cooking time to avoid browning. This will also reduce the acrylamide level in some foods."

Currently, acrylamide has not been found in food that has been cooked below 120°C . Further studies are needed to confirm the exact cooking temperature at which acrylamide will be present in food.
Diet and Cancer Prevention

THE general advice is to have at least five servings of fruits and vegetables per day (at least 400g of a variety of non-starchy vegetables and fruits)

Kong says the beneficial effects are not due to any single type of fruit or vegetable, so variety is important.

Many studies have investigated the role of whole grains in preventing specific cancers, such as gastrointestinal cancer.

"The protective role against cancer offered by whole grains is not clearly understood. Still, it is advisable to include whole grains in your daily meals," says Kong.

The Malaysia Dietary Guideline recommends choosing at least half of your grain intake from whole grains.

Kong Woan Fei

Dietitian

PDF and Online Articles:

Can What You Eat Cause Cancer? - New Straits Times, 16 March 2023

This article first appeared in New Straits Times, 16 March 2023.

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Cancer Screening Guide

Cancer Screening Guide

March 03, 2021

Which Cancer Screening?

Monitoring the state of your health is necessary especially if you fall into the criteria that put you at risk of cancer. Furthermore, there are cancers that display no symptoms. These silent killers can only be detected if you get yourself screened regularly.

Isn’t a basic health screening enough?

While screenings are encouraged, it can sometimes be confusing to decide which type of screening to get, as there are plenty on offer. Some are packaged with tests you don’t need or missing the ones that you do need. For example, apart from checking blood sugar, cholesterol, bone density and the likes, a basic package may also include tumour markers at the most, but tumor markers alone are not enough to diagnose cancer. In fact, tumor markers can also show up in non-cancerous environments. Hence, you will need more specific screenings to detect cancer especially if you are at a high risk of getting a particular type of cancer.

Evidently, screenings can detect cancer growth at its earliest stage when the malignancy is minor and has not yet metastasized to other parts of the body. At this stage, there is a high possibility of you surviving cancer. However, there is no one-size-fits-all cancer screening. The screening you need very much depends on several factors comprising age, gender, family history and lifestyle. Read on for an idea of what to look for when deciding on a cancer screening package.

Most common cancer among females below 40

At below 40 years old, it is more the women who need to be vigilant because cancers such as cervical cancer happens mostly in this age group. In fact, it is the third most common cancer in Malaysia among females. The good news is, it is the easiest gynaecological cancer to prevent with regular Pap smears and HPV vaccinations.

“It is recommended for every woman to be vaccinated before they are sexually active. From that point on, Pap smear screening is recommended consecutively for two years and then every three years depending on the Pap smear results,” says Dr Manohari Ghandi Kijassingam, a medical officer at Columbia Asia Hospital – Bukit Rimau. She says that in Malaysia, the Human Papillomavirus or HPV immunisation programme has already been implemented as a modality for primary prevention. However, cervical screening programmes should be continued as HPV vaccination is expected to prevent only 71 per cent of cervical cancer.

At its early stage, the five-year survival rate for people with cervical cancer is 92 per cent. Once it has spread to the surrounding tissues, the five-year survival rate drastically decreases to 14 per cent.

After 40 cancer concerns

For women above 40, breast screenings will have to be an annual affair. This is especially vital if you have a family history of breast cancer. In fact, some women with a strong family history of breast cancer sign up for breast screenings at a much earlier age.

“Mammography is the most common screening test for breast cancer. Also, magnetic resonance imaging or better known as MRI, may be used to screen women who are at a high risk of getting breast cancer,” says Dr Manohari. She adds that in 2012, the Malaysia’s Ministry of Health implemented a nationwide mammogram screening for high-risk women through primary health care facilities. “Whether a woman should be screened for breast cancer and which screening test to be done, depends on their personal background such as age, lifestyle and family history.”

When a patient’s breast cancer is detected at its earliest stage with no signs that it has spread outside the breast, it can be treated with curative intent.
At this stage, the five-year survival rate is at a 100 per cent advantage. As for non-detected breast cancer cases, the five-year survival rate falls to below 22 per cent.

Men, ageing and prostate cancer risks

The older men get, the higher the risk of prostate cancer. Thus, if you are male, you would need to be extra vigilant as you enter your 50s. Speak with a doctor to find out if you are in the high-risk group. Be upfront and share your family history. If you are high risk, you may need to get a prostate cancer screening yearly and as early as 40 years old. Otherwise, you only need to be re-tested every two to three years.

When prostate cancer is detected early, patients may have a five-year survival rate of an assuring 100 per cent. Once the cancer has spread beyond its localised area, this rate will drop to 30 per cent.

Screening for colorectal cancer

Colorectal cancer has become the second most common cancer among the Malaysian population after cancer of the breast and the most common cancer among males (MNCR Report 2007-2011). Tests are used to screen for different types of colorectal cancer when a person does not have symptoms. It should be done every five to 10 years, depending on your risks. “Studies show that some screening tests for colorectal cancer help find cancer at an early stage and may decrease the number of deaths from the disease,” says Dr Manohari. “Among the types of tests used to screen for colorectal cancer are fecal occult blood test, sigmoidoscopy and colonoscopy.”

The five-year survival rate among patients with localised early stage colorectal cancer is 90 per cent but if undetected and untreated, this number drops to 14 per cent.

Lung cancer tests even after quitting cigarettes

A lung cancer screening should also be considered after 40 years of age, even if you have quit smoking. Lung cancer is overall the third commonest cancer in Malaysia and the most common cause of cancer deaths accounting for 19.8 per cent of all medically certified cancer-related mortality in this country. “Cigarette smoking is a major aetiological risk factor. Some 92 per cent of Malaysian male lung cancer patients have a significant smoking history,” says Dr Manohari.

Screening with chest X-rays and/or sputum cytology do not decrease the risk of dying from lung cancer. Screening tests for lung cancer are still being studied in clinical trials. If you are at risk of lung cancer, you should be tested every year.

The five-year survival rate of lung cancer that is detected early is 56 per cent but when the cancer has spread to other organs, the five-year survival rate is only five per cent.

Before cancer happens

To know if you are at risk of any cancer types, please see a qualified medical practitioner. Given that cancers are survivable if found early, it makes perfect sense to get yourself screened regularly. It may save your life.

“In the meantime, keep up with the regular exercises, an intake of balanced meals, a healthy diet and good lifestyle choices so you can ensure great overall health,” stresses Dr Manohari. “A healthy lifestyle can decrease the overall susceptibility of the development of cancer.”

Dr. Manohari A/P Gandhi Kijassingam

Medical Offer

Columbia Asia Hospital - Bukit Rimau

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Cancer Screening - What You Need to Know Before You Start

July 06, 2015

Cancer is a leading cause of concern for us as we plan our futures. It is now almost a household word, most of us having in some way or other been affected by this dreaded disease. The fear is not misplaced.

Cancer is the leading cause of death in a number of developed countries with populations similar to ours including Singapore and Hong Kong. In Malaysia, since 2012, the ministry of health has noted that cancer is the second commonest cause of death in private hospitals, responsible for a quarter of total deaths per year. Cancer treatment outcomes in Malaysia are not great, largely due to the late presentation of the disease. And yet, in developed countries like Singapore, the United States and Europe, cancer cure rates are improving yearly. The difference is diagnosis at an earlier stage. The Japanese for example, have struggled with stomach cancer for decades, but treatment outcomes are extremely good as the tumors are diagnosed early following nationwide endoscopic screening.

Cancer prevention is the best way to reduce the threat of cancer. There are several modifiable risk factors which when addressed, can sharply decrease the likelihood of getting cancer. Chief among these are smoking and obesity. Efforts to educate and spur those at risk to action are on-going. These must be emphasized and inculcated into the way we think. A healthy life style is not an event, it is a habit. Nevertheless, despite our best efforts, there remain a large number of us who will be affected by this disease on account of "unmodifiable" (read genetic) factors.

Clearly the key to successful outcomes with cancer is early diagnosis. The problem with cancer is that in most cases, in early stages of the disease, one is not sick. There are no symptoms. The only way to detect these tumors early is to perform screening tests before the symptoms develop while one is apparently healthy.

Cancer screening tests are misunderstood. Except in a few types of cancer, you cannot screen for cancer using a blood test alone. This simply does not work. For example, the carcino embryonic antigen (CEA) often used to screen for colon cancer is not accurate enough to detect early colorectal cancer. This means that a negative result does not mean that you do not have the disease. Clearly, if you are concerned about having cancer, you need better accuracy.

The truth is better tests are available, there are many tests but the best test for you will depend on your risk for developing cancer. Risk assessment for developing cancer is based on a number of factors. Different cancers have different predispositions. Cancer is a genetic disease in the sense that gene mutations are the primary triggers. However, the mutations are just as likely to be somatic rather than germ line, which means you do not pass this risk down to your kids. Rather the effect of your environment has instigated the disease in you.

As such, start cancer screening with a visit with a consultant experienced in the diagnosis and treatment of cancer. This usually will comprise a detailed interview regarding lifestyle and family history. A suitable screening test can then be discussed. This may involve specific tests which need to be performed by trained professionals. This is currently the only way to get the desired outcome in the treatment of a disease as inevitable as cancer. The aim after all, is to provide peace of mind so that you may confidently plan your future without anxiety.
Cancer screening explained:

The process of screening for cancer comprises 3 steps:

Consultation, Physical Examination and preliminary tests.

The purpose of this is to bring you face to face with information you need before screening for cancer. This is because screening is not a straight forward exercise. There are caveats you must understand and accept before proceeding. We are estimating and evaluating risks that may have a serious effect on your health. A complete consultation allows your doctor to determine if you do indeed require formal cancer screening and it may be reassuring to you to find out that you really do not.

Risk assessment and Screening protocol

Risk factors for developing cancer are identified from large epidemiological studies. More often than not, they are based on populations different from ours. For example, the risk assessment tool available on the National Institutes of Health (NIH) website for risk of breast cancer is based on Caucasian patients and cannot be directly applied to a typical Malaysian population.
Source:
http://breast-cancer.ca/images/survivalstageschart.jpg

Chart Showing Improved Cancer Survival When Diagnosed at An Earlier Stage

Another contentious issue in risk assessment for cancer is that the risk is often relative. A smoker is often quoted to be 23 times more likely than a non-smoker to develop lung cancer. This sounds like a large number but the actual risk of a non-smoker is about 50 per 100 000 person-years. For a smoker? About 1200 per 100 000 person-years. The risk per year is still small but increases in time.

For these reasons, it is vital to have your risk assessed and explained to you by a professional before you embark on screening.

A variety of screening tests for the most common cancers have been identified. Each test comes with a degree of accuracy which has to be balanced with the degree of cost and risks. The aim is always to identify cancer while it is small and treatable which, if you did already have the disease, would lead to the best possible outcome.

Risk reduction advice and action

Professional advice regarding risk reduction is sometimes considered a no brainer - telling you to stop smoking to cut down your chances of dying of lung cancer is hardly rocket science. However you may want to know how to quit smoking, you may want to know that you have pharmacological options that have been proven to help you quit smoking. You may also want to know 10-15 percent of non-smoking persons diagnosed with lung cancer report exposure to second -hand smoke.

Sometimes, risk reduction may involve serious, drastic measures. A recent example is surgical removal of breasts followed by surgical breast reconstruction as in the case of Angelina Jolie, the well-known celebrity. Clearly this was decision that was made using the best available information in order to prevent what was almost a definite diagnosis of breast cancer in the future. Drastic, yes but the most effective way to prevent an almost certain threat to life.
Source:
http://www.ons.gov.uk/ons/resources/sbreastcancerimage2010_tcm77-280705.png

Chart Showing Mortality from Breast Cancer Dropping by Half After Breast Screening Commenced in UK

What about a full body scan?

Screening aims to reduce your chances of dying of cancer. However, it is impossible to screen for all possible sites of the disease. Today we have the means to look inside the human body entirely. We even have the means to look for the biological activity of cancer cells which is by itself like a fourth dimension in cancer diagnosis. This technology is known as Positron Emission Tomography (PET) and it involves using radioactive molecules which are metabolized by cancer cells differently compared to normal cells. When combined with Computerized Tomography (CT) scanning, the end result is as close to a whole body scan for finding cancer as can be. Unfortunately the technology is not yet perfect in that there is a risk of identifying lesions which mimic cancer but really are not. This may lead to unnecessary invasive procedures to clarify matters. Furthermore, the radioisotopes used in this procedure are prohibitively expensive. It is therefore unlikely that PET scans can be used for routine cancer screening at this time.

Screening for cancer needs to be individualized. A systematic effort to identify your risk of developing cancer, with specific tests focused on these risks will achieve the desired effect, which either an early diagnosis and hence, a better chance of cure or, quite simply, peace of mind.

For example, A 50 year old lady who smokes 1 packet of cigarettes a day for the last 20 years. She has a sibling who had breast cancer which was diagnosed at the age of 34. She is otherwise well. Her preliminary blood tests detected a blood hemoglobin level of 10.5 g%. No other abnormalities were detected.

This patient's present clinical condition and living environment puts her at risk for a number of common cancers. She is at risk of developing lung cancer, breast cancer and there is a chance that she may already have colonic cancer. It would be wise if she underwent a low dose CT Chest, Mammography and had a stool test for occult bleeding. These tests have a very high chance of detecting cancer (a positive stool for occult blood will require a colonoscopy to detect the underlying colorectal cancer). Similar tests done yearly will decrease her chances of dying from cancer related illness. This is not to say that these tests are completely foolproof as there is a small chance one can be affected in between testing or tests may be incorrectly interpreted, one may also be inflicted by a kind of cancer that these tests are not designed to diagnose. However, the chances of missing a cancer with these tests are much less than they would be with other kinds of tests. This is described as these tests having a high sensitivity for the kind of cancer tested for. With a regular follow up, it is likely that early symptoms of any cancer will be recognized sooner.

Some tests used for screening have risks of their own. For example, use of CT scans for screening comes with a small risk of developing cancer on account of radiation exposure. With modern multi-slice scanners this risk is decreasing. However, each of us will have to be convinced of the benefit of these tests in the long run as these are stacked against such risks.

Risk reduction advice for our patient would start with advice on the various methods available to assist one to stop smoking. This can include behavioral changes and nicotine replacement. Detailed genetic counselling and testing for mutations that are known to be associated with cancer is another option that can discussed. These tests are available but require professional interpretation. Our patient should be advised to keep her weight in a healthy range and would do well to take a diet rich in vegetables and fruits while avoiding red meats.

In another example, Mr. Y is a 42 year old man with no certain evidence of cancer in the family. However he suspects 2 of his elder brothers had bowel cancer as they had passed away due to abdominal symptoms before 40. Mr. Y has a good appetite and is overweight.

International guidelines are clear that if there is a history of colorectal cancer in one's immediate family, then you are at increased risk for the disease. However, in Mr. Y's case a doctor will have decide on the likelihood of his suspicion. If it seems very likely, then Mr. Y should undergo colonoscopy - an invasive procedure whereby a fiber-optic endoscope is passed along the length of the colon through the anus. This procedure will detect and can confirm any cancerous or 'precancerous' tumors in the colon with certainty. Another option could be a less invasive fecal occult blood test and sigmoidoscopy which may be the right option if the family history is in doubt.
Source:
http://cdn2.hubspot.net/hub/365322/file-678283347-png/colon-cancer-stage...

Illustration Explains the Evolution of Colorectal Cancer and Better Survival with Earlier Detection

As such it is clear that cancer screening in this case is not straight forward and to obtain the best result, an experienced clinical decision must be made so that early cancer is diagnosed without unnecessary added risks to Mr. Y.

Risk reduction for Mr. Y would emphasize on his increased risk for developing bowel cancer. Modifiable risk factors like obesity should be addressed- a suitable weight loss program can be suggested. A dietician may be able to help outline a diet which may help decrease the risk of cancer and lead to weight loss. If the colonoscopy shows evidence of precancerous tumors such as adenomas, endoscopic removal of these lesions may prevent cancer. Moreover, the option of starting aspirin, a cost effective, well known drug which has been shown to reduce cancer risks, can be discussed.

For Mr. Y, a proper cancer screening may be the difference between a life cut short by a unrelenting disease and a life lived to the fullest, complete and without regret.

References

National Comprehensive Cancer Network Clinical Oncology Guidelines (NCCN GuidelinesR)
http://www.nccn.org/professionals/physician_gls/f_guidelines.asp
 accessed May 20,2015

Health facts : Ministry of Health Malaysia Virtual Library
http://vlib.moh.gov.my/cms/content.jsp?id=com.tms.cms.section.Section_35...
 accessed May 20, 2015

Haritharan Thamutaram

Consultant General and Hepatobiliary Surgeon
Columbia Asia Hospital – Petaling Jaya

Cancer Screening : What You Need to Know Before you Start – The Star, 28 June 2015
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