Ambil Ikut Keperluan

Ambil Ikut Keperluan

October 18, 2019

Kesibukan menguruskan keperluan anak dan kerjaya membuatkan ramai wanita memilih bijirin segera sebagai sarapan ringkas di rumah sebelum keluar menempuh kesesakan trafik untuk ke pejabat setiap hari.
Berbeza dengan nasi lemak, roti canai dan pelbagai sajian berat yang popular dalam kalangan masyarakat Malaysia, bijirin segera mendapat tempat di hati ramai ibu berikutan dianggap lebih sihat dan berkhasiat.

Mungkin kerana pengaruh iklan di televisyen, radio, akhbar dan majalah, ramai di antara kita beranggapan bijirin segera mampu menepati keperluan diet harian bagi setiap individu.
Ironinya bijirin segera bukanlah pilihan sajian terbaik untuk orang dewasa, apalagi mereka yang banyak menghabiskan masa menghadap komputer atau bermesyuarat sepanjang hari.

Kata pakar pemakanan, Siti Sarah Mohd Juzup, ada pelbagai jenis bijirin segera di pasaran kini yang boleh dipilih mengikut keperluan diet, berdasarkan label produk.

“Bagaimanapun, kita perlu tahu kebanyakan bijirin segera memang ditambah gula untuk membekalkan tenaga segera. Jadi, kalau kita perlukan tenaga segera, bijirin jenis ini adalah pilihan sesuai,” katanya.

Jelas Siti Sarah, kebanyakan bijirin segera kini dihasilkan mengikut keperluan dua kelompok berbeza iaitu kanak-kanak dan orang dewasa.

“Bijirin kanak-kanak ditambah gula kerana mereka aktif. Bagaimanapun, pengambilan bijirin untuk golongan ini masih tertakluk kepada saiz hidangan yang dicadangkan.

“Untuk orang dewasa, kita boleh lihat pelbagai jenama baharu dan lama di pasaran dengan resipi berbeza bagi memenuhi keperluan setiap individu.

“Jadi, bandingkan produk A, B atau C dan pilih produk bijirin yang paling sedikit kandungan gula. Pertimbangkan juga isi kandungan produk sama ada mengandungi bijirin penuh atau bijirin segera yang siap diproses.

“Ini kerana bijirin yang bagus dan sihat sepatutnya mengandungi tiga komponen utama iaitu endosperma, bran serta germa. Di dalam tiga komponen inilah terkandungnya vitamin, mineral dan serat diperlukan tubuh,” katanya.

Masih Boleh Nikmati Bijirin Segera

Menurut Siti Sarah, walaupun bijirin segera mengandungi lebih gula, ia masih boleh dinikmati orang dewasa bersama susu sebagaimana kanak-kanak.

“Apa yang penting, kekalkan gaya hidup aktif. Kemudian, pastikan jumlah yang diambil setiap kali mengikut kadar atau saiz hidangan dicadangkan pengeluar produk. Ini biasanya tertulis pada kotak.

“Cuma pengguna yang tidak peka dengan label pada bungkusan makanan. Ramai yang suka tuang bijirin segera dalam mangkuk mengikut selera sendiri. Mereka tidak sukat, apalagi timbang.

“Selepas habis semangkuk dan masih lapar, mereka tuang sekali lagi dan sambung makan. Sebenarnya, ada sukatan dan tidak boleh lebih. Kalau diambil berlebihan, ia akan memudaratkan kesihatan,” katanya.

Menjelaskan mengenai kaedah pengambilan bijirin, kata Siti Sarah, ia boleh dipelbagaikan mengikut tahap keperluan nutrisi, selera dan cita rasa rakyat Malaysia.

“Kita di sini mungkin jarang makan bijirin. Tetapi, tidak ada masalah jika hendak bersarapan dengan bijirin ringkas. Selain susu, pastikan ada buah-buahan dan sayuran.

“Untuk hidangan tengah hari, kita boleh tukar kepada nasi beras perang untuk mendapatkan khasiat bijirin penuh. Bagi yang tidak biasa dengan rasanya, mereka boleh campurkan sedikit beras perang dalam sajian nasi putih sebagai permulaan.

“Letak jagung dalam nasi juga tiada masalah. Itu cara mudah untuk menambah bijirin dalam sajian. Selebihnya, ikut cadangan diet suku-suku-separuh. Suku bahagian nasi (karbohidrat), suku lagi protein dan separuh adalah sayur-sayuran serta buah-buahan,” katanya.
Manfaat Bijirin Penuh

Dengan pelbagai serat, mineral dan nutrien yang terkandung dalam bijirin penuh, pastinya ia memberi pelbagai manfaat untuk kesihatan. Antaranya:

Membantu melawan kanser

Mengurangkan tahap kolesterol

Menurunkan paras gula dalam darah

Mengurangkan risiko penyakit kardiovaskular

Mengurangkan risiko penambahan berat badan berlebihan

Menggalakkan kesihatan usus

Tip Penting

Periksa label makanan bagi memastikan bijirin penuh adalah ramuan utama dalam sumber yang anda pilih.

Berhati-hati dengan label mengelirukan pada makanan seperti multi-grain (pelbagai bijirin), 100 peratus gandum, organik, bijirin sebenar dan sebagainya.

- Bagi yang dilabel pelbagai bijirin, ia mungkin mengandungi gabungan gandum, sekoi, barli, flaks dan tidak semestinya bijirin penuh.

- 100 peratus gandum pula mengandungi gandum sahaja dan tidak semestinya bijirin penuh.

Siti Sarah

Dietitian

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

PDF and Online Articles:

Ambil Ikut Keperluan – Harian Metro, 4 Oktober 2019

Artikel ini disiarkan oleh Harian Metro, 4 Oktober 2019

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Anaemia

Anaemia

February 20, 2013

Anaemia is referred to as a condition where the blood level is not enough. Generally, it means the red blood cell content is low. Patients with anaemia will experience lethargy, malaise, reduced effort tolerance and breathlessness. Sometimes it presents with atypical complaints resembling coronary heart disease. I have seen a patient admitted for diagnosis of acute coronary heart disease, found to be severely anaemic and recovers completely after correction of anaemia.

The major cause of anaemia is iron deficiency. Other less common are folate and vitamin B12 deficiency. Haemolytic anaemia occurs when there is increased lysis or destruction of red blood cells. This may occur as a primary disorder or secondary to SLE (systemic lupus erythematosis), drug induced or enzyme disorder like G6PD deficiency. Anaemia may also result from bone marrow infiltration like leukaemia and suppression by drugs like chemotherapy for cancer. Hereditary causes are haemoglobinopathy like thalassaemia and sickle cell anaemia. Very often, anaemia is diagnosed incidentally when patient comes for a medical check-up.

Medical history to be obtained from an anaemic patient are menorrhagia or excessive blood loss during menses, any bleeding haemorrhoids, any passage of black tarry stool indicating blood in stool. History of analgesic abuse is relevant as it can cause erosive gastritis and peptic ulcer. Chronic alcoholics may get folate deficiency anaemia. Clinical examination of an anaemic patient includes a digital examination of the rectum to look for melaenic stool (black tarry).

Preliminary blood tests to be done are full blood count, peripheral blood film, iron studies, blood level of folate and vitamin B12.Once the cause is determined, further test may be needed. It is important not to attribute iron deficiency to dietary insufficiency. Living standard in Malaysia is such that there is hardly any malnourishment except perhaps among the orang asli children who have worm infestation. The main cause of iron deficiency is blood loss like excessive loss in menses, bleeding haemorrhoids and chronic loss from the gastrointestinal tract like peptic ulcer, stomach cancer and colonic cancer. Thus an OGDS (oral gastroduodenoscope) and colonoscopy are warranted. The underlying cause will be dealt with accordingly like surgery for cancer and medication for ulcers.Iron deficiency is easily corrected by oral iron supplements. Blind treatment without determining the cause is unacceptable standard of practice.

Vitamin B12 deficiency occurs when patient develops an antibody which destroys the intrinsic factor which is required for vitamin B12 absorption. This is known as pernicious anaemia. Other causes of vitB12 deficiency are bacterial infection of the intestines where the bacteria utilises all the vitB12 and disease of the terminal ileum (that part of the small bowel where absorption takes place. Treatment of pernicious anaemia is monthly injection of vitB12 for life.

Other rare causes of anaemia need more extensive investigation which may include bone marrow study and is best handled by a haematologist.
Dr. Ng Butt Chin

Consultant Physician


Anaesthesia – Is it safe?

Anaesthesia – Is it safe?

December 18, 2011

Traditionally Anaesthesia meant General Anaesthesia. Not too long ago, this was the only available option for patients going for an operation. The patients used to be paralysed and then a tube will be put in for breathing. The machine will be doing the breathing for the patient. Patient will be unconscious and unaware. The gases used back then can cause injury to the liver that patients are usually advised not to have General Anaesthesia more than once in 3 months.

Things have changed. The gases that are used nowadays do not cause liver injury. In fact they are very short acting that patient can wake within minutes of finishing operation. Drugs that we use to paralyse also has evolved that they have become shorter acting in nature with minimal residual effects. All this translates to a shorter recovery time and safer anaesthesia practice. Short procedures can be done as Day Care whereby you come fasting in the morning, have the operation done and go home the same day. Columbia Asia strongly believes in this concept and reducing cost by reducing length of stay (LOS).

Nowadays we are moving towards less paralysing and allowing more patients to breathe spontaneously during operation. We facilitate this by using new device for airway such as Laryngeal Mask Airway. This will also cause less sore throat to the patients post operation.

Some operations involving lower half of body can be done under regional anaesthesia, for example Caesarean Section, Operations for Urinary problems and any operations involving lower limbs. Regional Anaesthesia can be either a Spinal, Epidural or combined.

Epidural is also used widely now to relieve pain during labor. It is safe with no side effects to the baby. All this means anaesthetist must now must communicate the best suited anaesthesia for the type of patient and type of operation so maximal satisfaction can be achieved with least side effect or residual effects. We also have to gear towards getting you home as quickly as possible.

All in a day’s work!
Dr. Mohamed Asri B Kader Ibrahim

Consultant Anaesthetist

Columbia Asia Hospital- Bukit Rimau


Andropause

Andropause

June 16, 2020

1.	What is andropause?

Andropause is a condition caused by a decrease in the male hormone known as testosterone.

2.	What causes it?

It is often affiliated with a decreased level of testosterone or hypogonadism; a diminished functional activity of the gonads, involving the testes/ovaries, that may result in diminished production of sex hormones.

3.	Who usually experiences andropause?

Male menopause or andropause usually affects males in their 50s.

4.	What are its effects/symptoms?

Its effects are quite similar to females who are going through their menopausal period. A male who is undergoing andropause will lose his erectile function as it naturally becomes weaker with a decrease in muscle mass index. This results in sexual deprivation as it lowers the sex drive. He will also experience mood swings and gain excess fat usually around the belly area and chest.

5.	Is andropause curable? If so, what are the treatment options?

Naturally, everyone will have to go through the process despite having led a healthy lifestyle and following health regiments by the book. However, you may prolong andropause (depending on each man’s individual body and hormone level) by opting for testosterone replacement. A striking difference can be seen among males in European countries who take up replacement therapy, usually to keep the sex drive going, compared to Malaysian males who seem to be more accepting of themselves going through andropause when the time comes. This could also be due to a lack of awareness of the replacement treatment, or they just don’t care and accept their condition as is!

6.	How is the replacement therapy carried out?

At Columbia Asia Hospital-Cheras, the treatment is carried out via injection usually once in every three months.

7.	Does this therapy cause any side effects?

About 10 to 15 years ago, the public was so afraid of taking the injection since it may cause prostate cancer as prostate cancer is associated with an increased level of testosterone. However, recent studies have shown that if one takes the injections and monitors their prostate-specific antigen level on a regular basis, the risk of one having prostate cancer is less 0.5 per cent.

8.	What can you do to avoid andropause?

It a normal process and bound to happen to every male. But as mentioned above, you can prolong it from happening early by taking the replacement therapy. I would also strongly advise any man aged 50 and above with andropause symptoms to check on their testosterone level and seek treatment if need be.

Dr. Thana Balan V. Sivaratnam

Consultant Urologist

Columbia Asia Hospital – Cheras
MBBS (India), MS (General Surgery) (UKM), FRCS (Urology)(Glasgow), Fellowship in Urology (MY)

Make an Appointment

PDF and Online Articles:

Male "Menopause" – New Straits Times, 23 July 2020

This article first appeared in New Straits Times, 23 July 2020

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Anesthesia? What is it all about?

Anesthesia? What is it all about?

September 06, 2016

Photocredit: playtech.ro

What is anesthesia?
Photocredit: musc.libguides.com

Anesthesia is a way to control pain during a surgery or procedure by using medicine called anesthetics.

Anesthesia is used to:

Relax you.

Block pain.

Make you sleepy or forgetful.

Make you unconscious for your surgery.

Brief history of Anesthesia
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Anesthesia dates back to the mid-1800s. Before the discovery of anesthesia over a century ago, few surgeries could be performed. Even a condition, which by current standards is easily treated, was usually fatal.

In 1842, Dr. Crawford Long of Georgia used ether to perform the first painless surgery. Dr. Horace Wells demonstrated painless dentistry under nitrous oxide in 1844. In 1846, Dr. William Morton of Massachusetts General Hospital achieved anesthesia with ether.

After World War II ended in 1945, major developments in the field of anesthesiology opened new avenues of medical and surgical care that were previously unthinkable.

What are the types of anesthesia?

LOCAL ANESTHESIA
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Local anesthesia
 numbs a small part of the body for minor procedures. For example, you may get a shot of medicine directly into the surgical area to block pain. You may stay awake during the procedure.
REGIONAL ANESTHESIA
Photocredit: en.wikipedia.org
Regional anesthesia
 blocks pain to a larger part of your body. You may also get medicine to help you relax or sleep.
EPIDURAL AND SPINAL ANESTHESIA
Photocredit : en.wikipedia.org

This is a shot of anesthetic near the spinal cord and the nerves that connect to it. It blocks pain from an entire region of the body, such as the abdomen, hips, or legs.
GENERAL ANESTHESIA
Photocredit : healthydietbase.com

General anesthesia affects your brain and the rest of your body. You may get some anesthetics through a vein (intravenously) and you may breathe in some anesthetics. With general anesthesia, you're unconscious and you don't feel pain during the surgery.

What determines the type of anesthesia used?

The type of anesthesia used depends on several things:

Your general health status.
 This includes other surgeries you have had and the health problems you have. Tell your Anesthetist if you or any family members have had a serious reaction to anesthetics or other medicines.

The type of surgery.
 For example, you may need general anesthesia to ensure your comfort and safety during certain types of surgery.

The results of tests,
 such as blood tests or an electrocardiogram (ECG).

Your doctor may prefer one type of anesthesia over another for your surgery. In some cases, your doctor may let you choose which type to have. Sometimes, such as in an emergency, you don't get to choose.

What are the risks and complications of anesthesia?

All anesthesias have some risk, depending on patient’s pre-existing medical condition. For example:

General anesthesia may induce cardiovascular related problems, sore throat, or vomiting can occur.

With high doses of local anesthesia, the anesthetic can go into the rest of the body and affect your brain or heart.

After spinal anesthesia some people get headaches.

Your risk depends on the type of anesthesia you get, your age, your health, and how you respond to the medicines used. Some health problems, such as heart or lung disease, increase your chances of problems from anesthesia. Taking certain medicines, smoking, drinking alcohol, and using illegal drugs can also increase your chance of problems.

Your Anesthetist will talk with you about the best type for you and will review risks, benefits, and other choices.

How can you prepare for anesthesia?

Your Anesthetist will let you know what to do the night before and the day of the procedure. Here are some tips to help you prepare:

Know when to stop eating and drinking.
 If you take any medicines regularly, ask your doctor or nurse about changes to your medicine routine for the day before or the day of your surgery.

Try to stay calm.
 Many people are nervous before they have anesthesia and surgery. Mental relaxation methods, such as guided imagery or meditation, can help you relax. And some medicines can help you relax.

Plan ahead for going home.
 Ask a friend or a family member to drive you home. Don't plan to drive yourself.

If your child is having surgery or a procedure, you can help him or her prepare. Let your child know what to expect. Be honest if he or she might feel pain. Be sure to tell your child that you will be close by.

What happens while you're under anesthesia and when you recover?

Before and during surgery, an anesthesia specialist will take charge of your comfort and safety. He or she will give you the anesthesia and closely monitor you. This means he or she will check your blood pressure, breathing, heart rate, and other vital body functions throughout the surgery. During surgery, the anesthesia specialist also will continue to give anesthesia to keep you free of pain.

How quickly the anesthesia wears off depends on the anesthetics and other medicines used and on your response to the medicines.

After surgery, you will be taken to the recovery room. A nurse will check your vital signs and any bandages and ask about how much pain you have. If you are in pain, don't be afraid to say so.

Some effects of anesthesia may last for many hours after surgery.

You may have some numbness or less feeling in part of your body if you had local or regional anesthesia.

Your muscle control and coordination may be affected.

You may have nausea and vomiting. Most of the time, this can be treated and doesn't last long.

You may feel cold and may shiver when you first wake up.

For minor surgeries, you may go home the same day. If surgery is more complicated, you may have to move to a hospital room to continue your recovery. If you stay in the hospital, your doctor or nurse will visit you to check on your recovery and answer any questions you have.

Dr Anand Chandrasegaran

Consultant Anesthesiologist
Columbia Asia Hospital - Taiping
Newspaper:

Hurts so good: An overview of the wonderful world of anaesthesia – New Straits Times Online, 18 October 2016

Medical Anesthesia – New Straits Times, 18 October 2016

Click for Online Article:

New Straits Times Online, 18 October 2016
.


Ankle Sprain

Ankle Sprain

May 25, 2011

What do roller skating, ice skating, futsal and even high heel use have in common? No takers?

Well, these are all common causes of outer ankle sprain!!

Ankle ligament injury is common. Almost 25000 people experience it daily! Many of us have found this fact out the more painful way.

These injuries often occur due to a combination of causes,; from poor footwear, poor foot dynamics to plain bad luck. It happens when the foot twists, rolls or turns beyond its normal limits. The ligaments are effective restraints but with excessive force this may partially or totally tear. Often, an awkwardly placed foot when running, stepping up or down, or even a simple task as getting out of bed may cause an ankle sprain. The injury also occurs during stepping on irregular surfaces especially when this happens unexpectedly, as seen when stepping into a hole. Some athletic events such as basketball and netball involve close body jumps where there is always a risk of planting your foot awkwardly and injuring the ankle.

The foot usually rolls inwards – inversion which is the more common form of ankle sprain seen.
How do you know that you have a sprain?

Firstly the abnormal movement has to be one than can cause a sprain. The most common one would be that of a plantar flexed foot being awkwardly planted with a subsequent movement of the foot.

If you find you ankle swelling up especially the part over the outer part, congratulations you’ve probably sprained it or worse. Movements are usually painful.
When to worry?

Most mild ankle sprains don’t require an immediate trip to the doctor. Please worry (don’t panic) if:

The pain is poorly controlled by the RICE Protocol ( please see RICE and Use of Cold and Hot in Injury) and over the counter medications.

You are unable to comfortably walk for more than 4 steps or you experience severe pain when pressing over the medial or lateral malleolus, the bony bulges on each side of the ankle – this requires an radiograph to rule out a fracture.

You cannot move the injured ankle comfortably.

The foot or ankle is misshapen beyond normal swelling.

You experience loss of feeling in the foot or toes.

You are not fairly improved by a few days.

Why worry?

Most ankle sprains can be treated conservatively but this has to be done right from the word go. The more severe sprains may require the use of a specific ankle brace which allows the injured ligament to heal in its best possible position. It is also necessary to rule out the more serious injury too. This will often require the input of your Orthopedic or Sports Surgeon. Most Important of all…….. Take home message numero uno…….

Please visit your Orthopedic Surgeon if you are unsure about the severity of your injury.
Dr. Harjeet Singh a/l Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital- Bukit Rimau


Anxiety: Bane of Mums-to-be’s Wellbeing

Anxiety: Bane of Mums-to-be’s Wellbeing

May 30, 2023

Most women look forward to being pregnant, but carrying a baby in the womb can also bring about various emotions, including anxiety.

In this sense, there are differences between anxiety attacks and panic attacks, according to Vera Pillai, a clinical psychologist for Columbia Asia Hospital – Bintulu and Miri.

“Firstly, while both are what we refer to as anxiety in general, anxiety attack is not an official diagnosis; rather, it’s a colloquial term used to describe a gradual build-up of anxious thoughts that become intense over time,” she tells thesundaypost in Miri.

She says in an anxiety attack, one would feel tensed, agitated and restless, and also find it difficult to concentrate and sleep. This usually lasts for days, which is a longer duration than panic attacks.

“Panic attack is usually unpredictable, involving a sudden feeling of intense fear and dread. It comes with shortness of breath, heart palpitation, dizziness, chest tightness or sweating.

“For reference, I will use the term ‘anxiety’ to include general anxiety, antenatal anxiety, postnatal anxiety, anxiety attacks and panic attacks,” she adds.
Is antenatal anxiety normal?

According to Vera, anxiety affects one out of four pregnant women in Malaysia, indicating that this condition is quite common among mothers-to-be.

“To be responsible for a new life and ensure that the baby’s growth is safe, well and healthy, it’s not an easy task.

“Factoring in with a family history of depression or anxiety, intimate partner victimisation, substance abuse, complications during pregnancy, past miscarriages, disharmony in family relationship – any of these can easily overturn the joy and excitement of approaching labour, and replace it with endless worrying.

“So, if you’re experiencing anxiety as a pregnant woman, know this – you are not alone,” she assures.
How anxiety affects labour

Vera says with the mind being at one with the body, anxiety will bring about changes to a pregnant woman’s body, which may harm the foetus.

Blood flow to the foetus is reduced when the mother is experiencing high anxiety. This can lead to a low birth weight and premature labour, says the psychologist.

“For some, it may increase the labour length, and the need for epidural analgesia. It will also release less oxytocin, a crucial hormone to stimulate uterine contractions in labour and childbirth.”

Moreover, Vera says during pregnancy, the baby is exposed to the mother’s experiences such as sounds, breath and food.

“This also includes the mother’s feelings. Feelings of anxiety can increase particular hormones in the mother that can influence the baby’s development of the brain and the body.”

Seeking professional help

Worrying over one’s new motherhood phase in life is normal, says Vera.

“Emotion-filled anxiety serves to prepare us for what may come, especially when the mind knows that we are about to experience many new changes.

“However, if mothers-to-be start to feel like they are losing control, do seek psychotherapy treatment from clinical psychologists to help learn ways to control your feelings and thoughts.

“I have yet to come across anyone who regrets seeking help for their mental health.

“On the contrary, many patients look back and regret not getting themselves treated sooner.

“The intensity of worry very likely increases as pregnant women approach their labour.

“It takes time to address the root of our worries; thus. it is best to get psychotherapy treatment once anxiety is detected.”

Anxiety medication during pregnancy

For many women, taking anti-anxiety medication during pregnancy may not be an option, says Vera, adding that there is still little information about the safety of such medication for the baby.

“Thus, it is important for pregnant women to talk to their psychiatrist before medicines are prescribed.

“Fortunately, they can opt for other options during pregnancy such as psychotherapy treatment like Cognitive Behavioural Therapy (CBT). This addresses unhelpful thoughts, heavy emotions, and provides anxiety management strategies.
Ways to cope

Learn relaxation skills, Vera advocates.

Exercises such as diaphragmatic breathing, meditation, grounding and mindfulness can help ease the mind from many worries, and can also help calm the body, she adds.

“Get enough sleep. Find out what works best for your sleep such as a pregnancy pillow, a quiet room, or a calming bed routine.

“Consider putting your thoughts and emotions on paper by setting aside 15 minutes at the end of the day to write. Setting this time would help your brain understand that it has a specific time to think about these concerns, so you won’t catch yourself worrying throughout the day.”

Pregnant women can also consider psychotherapy, says Vera, adding that they can identify and learn ways to manage their thoughts and their worries about their pregnancy or anticipated motherhood.

A partner’s help during labour

Partners should stay calm and encourage the mother-to-be to take deep breaths. As best as their can, remain calm and provide gestures of care such as holding hands or a gentle grip on the hands, to help her feel calm.

The partner can also offer assurances by telling the mother-to-be affirmative words such as ‘I am here with you’, ‘you’re doing well’, or ‘I’m so proud of you’, to remind her of the support for each other, and that she is not alone.

“Give her time; don’t rush to calm her down by saying something like, ‘just stop it’.

“She needs time to calm down while the partner offer assurances,” says Vera.

What NOT to say to an anxious mother

“Avoid problem-solving. You can try and offer solutions once the mother is calm. In moments of anxiety attacks or panic attacks, emotions are intense where it is hard for our minds to make rational decisions.

“Avoid asking ‘what’s wrong’ or ‘what’s happening’. Rather, focus on calming her emotions.

“Avoid judgmental comments. A mother goes through a lot of changes in her body. She goes through a lot of worries, even if it is not her first pregnancy or childbirth,” says Vera.

She also reminds people surrounding an expecting mother to stay away from comments like ‘you’re thinking too much’, ‘you’re overreacting’, ‘X has it worse than you’, ‘yot again’.

“Rather, remind her of your support for her.”

Bonding difficulties between mum, baby

“Yes. Postnatal anxiety (anxiety after birth), when severe, can often bring about response of strong avoidance of the fear trigger – in this case, the new baby.

“It is important for newborn babies to bond with their mothers,” stresses Vera.

For such cases, the psychologist highly recommends mothers to seek psychotherapy services to address the root of their fears and help ease their relationship with their newborn babies.

Having their partner’s support in seeking for professional help is essential to help mothers in their anxiety treatment and recovery process.

“The partner can offer support and be a listening ear to understand her thoughts and feelings.

“As some mothers are also overwhelmed with household chores, offer to take turns handling some chores. The partner can slowly be involved in handling the baby such as being with the mother during feeding sessions, or helping to bathe the baby.

Vera says she has seen quite a few cases of mothers refusing to leave the hospital or their homes after giving birth.

“Leaving the hospital means becoming independent when it comes to caring for the baby.

“Leaving the home means exposing the baby to the outside world, risking diseases. These reasons could be signs of postnatal anxiety or depression.”

In view of this, Vera advises mothers going through such situation to consult a clinical psychologist to further understand and at the same time, gain the appropriate treatment via therapy as well as familial support.

“That would be the key to overcoming fears of being a mother,” she stresses further.

Ms. Vera Pillai

Clinical Psychologist (Visiting)

Columbia Asia Hospital – Miri
M.Clin.Psy (CP1-0315)

PDF and Online Articles:

Anxiety: Bane of mums-to-be’s wellbeing - The Borneo Post, 4 June 2023

This article first appeared in The Borneo Post, 4 June 2023.

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Are Your Gadgets Making You Sick?

Are Your Gadgets Making You Sick?

March 27, 2017

Ever wondered how gadgets affect our health? Do you own a smartphone, TV, laptop, or tablet? Chances are, you spend more time on your gadgets than you do on sleep. According to an Ofcom study, in a day, the average adult spends 8 hours and 41 minutes on their gadgets, compared to 8 hours and 21 minutes on sleep. This proves that most of us spend half of our waking hours staring at a screen, rather than engaging in healthy activities that benefit our bodies. While personal devices have undoubtedly improved our lives, over reliance and addiction comes with negative health consequences.

Are Your Gadgets Making You Sick? – Her World, Issue March 2017
.


Ask the Doctor: Kidney Diseases

Ask the Doctor: Kidney Diseases

April 06, 2020

In conjunction with World Kidney Day on March 12, this month we will be exploring the topic of kidney health. To explain more about the kidney disease situation in Malaysia, we speak to Columbia Asia Hospital – Klang Consultant Internal Medicine Physician & Nephrologist, Dr. T Kalaiselvam A/L Thevandran.

1. People talk about heart health, eye health, bone health but rarely speak of kidney health. In your opinion, what is the best way to increase more awareness about kidney health among the public?

“In my opinion, we should exercise specific measures to raise awareness of kidney health. These measures should highlight the Chronic Kidney Disease (CKD) burden and encourage the general public, more so the government, to invest in taking action for better prevention and early detection.

“Currently, one in three people in our world population, which is an estimated 850 million people, is at an increased risk of CKD. In fact, although an estimated figure, 10 per cent of people worldwide have CKD. Estimates suggest nine out of 10 are unaware of their condition.”

2. What is the number one kidney disease that Malaysians should be concerned about, and why?

“That would definitely be Diabetes Mellitus. In Malaysia, our local data in 2016 reveals that diabetes mellitus is the most common primary renal disease amounting up to 65 per cent of End-Stage Renal Disease (ESRD) cases.”

3. As Malaysians, how do our lifestyle and culture affect our kidney health?

“Let’s look at the numbers. Data from the National Health and Morbidity Survey (NHMS, 2011) shows a four-time increase in Diabetes Mellitus cases from 8.3 to 31.2 per cent since 1996. Meanwhile, according to the Malaysian Society of Nephrology, its 2017 registry showed that the number of dialysis patients had doubled. Subsequently, the rate of renal transplantation decreased per 1000 dialysis patients from 2007 till 2016.

“This data implies that our lifestyle and culture affect kidney health. Healthy lifestyles comprising a healthy diet and exercises, as well as avoiding nephrotoxins such as traditional or dietary supplements and painkillers, is crucial to prevent kidney diseases. With Malaysia’s Ministry of Finance imposing sugar tax as of July last year, this will eventually lead to Malaysians consuming less sugar. However, more needs to be done to increase awareness of kidney health and promote kidney transplants in our country.”

4. Does gender, race, age or pregnancy have anything to do with the prevalence of certain types of kidney diseases? How so?

“Yes. Gender, race, age and pregnancy are related to kidney diseases. Regarding gender, women are more likely to develop CKD compared to men. According to a study by the Institute of Health Metrics and Evaluation, the average prevalence of CKD in women is 14 per cent as opposed to 12 per cent in men. This is likely due to women’s longer life expectancy.

“In contrast, males are more likely to develop ESRD compared to women. The Malaysian Society of Nephrology Renal Registry 2015 reports 56 per cent of males against 44 per cent of females, were new dialysis patients. The fact is, kidney function declines faster in men than women, possibly owing to the unhealthier lifestyles of men and the damaging effects of testosterone. Women’s estrogens have a protective effect on the kidneys.

“Relating to race, generally, colored skin including Asians, are at an increased risk of getting kidney diseases. African Americans are three times more likely to get CKD while Hispanics are 1.5 times more likely to have kidney failure compared to Caucasian Americans. Researchers do not fully understand why minorities are at a higher risk of getting kidney diseases. However, minorities have a much higher rate of high blood pressure, diabetes, obesity and heart diseases, all of which increase the risk of kidney diseases. Minimal access to healthcare may also play a role.

“Sadly, kidney diseases can develop at any time and any age, but those over the age of 60 are more likely to develop kidney diseases. As people age, so do their kidneys. Many people don't realize that as we age, we lose kidney function. According to recent estimates from researchers at Johns Hopkins University, more than 50 percent of seniors over the age of 75 are believed to have a kidney disease. Kidney diseases have also been found to be more prevalent in those over the age of 60 when compared to the rest of the general population.

“Moving on, it would not be wrong to say that a woman with kidney disease face a significant dilemma in her pregnancy that affects her kidney health. Pregnancy can occur at all CKD stages and in kidney transplant recipients too. Pregnant women with CKD are at a higher risk of complications such as preeclampsia, restricted growth of the fetus, early delivery and the worsening of the CKD. If you are worried about this, do consult a nephrologist during pre-pregnancy as it is vital to assess the timing of pregnancy and check-ups regarding clinical matters, investigations and medications. Equally important is the continuous multidisciplinary care from both nephrologist and obstetrician. This is important throughout the duration of the pregnancy.”

5. What are the tell-tale signs of unhealthy kidneys and at which point should we be worried and seek medical help?

“What we all should know is that kidney disease is a silent disease. Did you know that early CKD has no symptoms even? You can lose up to 90 per cent of your kidney functions without even knowing it. So we need to arm ourselves with knowledge about the early warning signs, namely frothy urine, fatigue, difficulty concentrating, trouble sleeping, poor appetite, muscle cramps, swollen feet or ankles, puffiness around the eyes in the morning, dry and scaly skin as well as frequent urination, especially late at night.

“Symptoms that are more severe could signal kidney failure. These would be nausea, vomiting, loss of appetite, changes in urine output, fluid retention, anemia which is a decrease in red blood cells, decreased sex drive, sudden rise in potassium levels or hyperkalemia and inflammation of the pericardium which is the fluid-filled sac that covers the heart. You should consult medical help as early as possible if ever you experience the symptoms above.”

Dr. T Kalaiselvam A/L Thevandran

Consultant Internal Medicine Physician & Nephrologist

Columbia Asia Hospital - Klang
BSc (Medical Science)(UPM), MD (UPM), MRCP (UK), ISN - ANIO Nephropathology Certificate (USA), MSN Broad Certified Nephrologist (Malaysia)

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Autism -- What You Need To Know

Autism -- What You Need To Know

April 02, 2020

Dr Sharifah Aida Alhabshi is a pediatrician at Columbia Asia Hospital – Petaling Jaya with a special interest in child-learning difficulties and child psychology. In conjunction with World Autism Day, we speak to her about the basics of Autism Spectrum Disorder.

How would you describe autism?

Autism, also termed ASD for A utism Spectrum Disorder , is a condition whereby there is a breakdown in communication regardless of mediums, namely words, facial expressions or gestures. While a non- autistic child can receive, process and understand information, the autistic child struggles to understand simple concepts. This is because the brain of an autistic child experiences delays when processing information. Clearly, ASD is a delicate and complex condition. Not only is it challenging for the autistic child to understand others but it is just as challenging for others to understand the child.

At the onset, what are signs that indicate an autistic child or infant?

Early signs include displaying reluctance to make eye contact, non-responsive when someone calls his or her name, inability to share focus with another individual, lacking skills in pretend/imitation play and struggling with non-verbal communication. Other signs can include hyperactivity, impulsiveness and aggressiveness. However, many new parents tend to think that these behaviours are the norm among young children and thus, would not consider it to be any cause for concern.

How early can autism be diagnosed in children?

Signs of autism can be seen when the child is as young as 12 to 16 months. Healthcare experts who are trained in this field will recognize the signs even earlier. However, for parents who are not aware of the subject of ASD, they will not recognize these signs. They will only suspect something is amiss when their child does start speaking when other toddlers have started speaking. This usually happens when the child is around three-years old and older which explains why most autistic children go undiagnosed until after the age of three.

What are some of the behaviors and characteristics that the autistic child displays?

Autism comes in many degrees. On one spectrum, some autistic children are not able to make themselves comprehensible to others and will need constant monitoring and care. On the other spectrum, some autistic children are able to care for themselves and grow into adults who are self-reliant to the point of gaining employment.

Although the brain is slow in responding to information, the senses are heightened more than the average person’s. They may have skills that develop unevenly. For example, they could have trouble communicating but be unusually good at memorizing dialogues or painting.

Also because of these same heightened senses, sounds that are normal to us like the whirring of a fan for instance, may be processed as a piercing scream to the autistic child. How do we react when we hear a piercing scream? We may become distressed, confused, curious and defensive. For the autistic child, all that is manifested into tantrums and meltdowns. On the other hand, there are also autistic children whose character is overly friendly that they can just randomly hug a stranger.

In general, what are the basics of caring for a child who has ASD?

Set routines. Autistic children seem to be at ease when there are routines set in place. Don’t make sudden changes to their routines especially dietary changes as this can affect them physically and mentally.

Also, identify signals that are tuned in to his or her emotions. What are the triggers that cause him or her to react differently? What upsets them and what calms them down? When you have established these signals, you will create a nurturing environment for your child. A strong network of support is very important.

*If you suspect your child may be autistic, seek professional advice immediately. Early detection and intervention can result in better outcomes for you and your child.

Dr Sharifah Aida Alhabshi

Consultant Pediatrician

Columbia Asia Hospital – Petaling Jaya
MBChB(UK), M.Med(Pediatric)(UM)

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PDF and Online Articles:

Autism: What you need to know? - BabyTalk

This article first appeared in BabyTalk Malaysia.

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Avoiding Injuries for 'Weekend Warriors'

February 12, 2012

Injuries can occur from inadequate preparation of muscles and tendons of our body for occasional strenuous activities - the so-called 'weekend warriors'. These injuries can be so disabling that they can either disturb normal weekday activities or completely disrupt them. Worse still, the sufferer may end up admitted to a hospital due to the injury. This will subsequently affect his or her sports activities, productivity and, if prolonged, quality of life.
Futsal is one the common games that may inflict injuries especially among weekend warriors.

So, what are the common injuries among these unfortunate 'I-wanna-be-active-but-with-little-time-for-it' individuals?

Tendinitis
 - which means inflammation of tendons (the structure which connects muscles to bones). The areas which are prone to this conditions are the heel, elbow, shoulder and knee regions.

Sprain
 - where tissues (such as the muscles or ligaments) are bruised but not torn - most commonly affects the ankle but they may also involve the knee, shoulder and back.

Ligaments tears
 - the knee and ankles are most commonly affected by this injury. Complete ligament tears will result in instability in the joints affected, hence will commonly result in permanent pain and instability (sensation that the affected joint 'gives way' during activities) unless they are treated, most commonly through reconstructive surgery where the torn ligament will be replaced by a 'substitute' ligament. Tears may also involve the tendons (e.g. the Achilles tendon at the back of the heel) and meniscus (the 'impact absorption tissue' in the knee).

Cartilage injury
 - cartilage is the lubricating surface in our joints that functions to provide a smooth and congruent movement during activities. Injury to the cartilage can occur during a fall, during an awkward landing from jumping maneuvers, and also from direct hit to the joint (e.g. from a violent tackle during a soccer game). Again, the knees and ankles are the most commonly affected areas. Cartilage injuries are difficult, cumbersome and also expensive to treat, with relatively poor results (compared to other types of injuries) and subsequent sequelae of joint damage and disabling pain.

How do we (as weekend warriors) avoid getting these injuries?

Do a proper warm up and stretching routines before starting any strenuous exercises. These two routines are invaluable in avoiding unexpected injuries. Warm ups increases the heart rate gradually and thus will lead to steady increase in blood supply to the muscles. Stretching will prepare the muscles for fast, alternating contraction and relaxation that usually occurs during exercises and thus minimizes the risk of muscle sprain and tears.

Increase the frequency of exercises that include weekdays
 as well. As the activities get more frequent and evenly spaced, the body can withstand more strenuous activities with minimal risk of injuries.

Avoid high-risk sports
 such as contact sports, high-impact sports (where jumping is done repeatedly), and also pivoting sports where sudden change in directions are needed such as soccer, futsal, basketball and racket games. Swimming and static cycling are two examples of low-risk activities that can be done safely and at the same time allows us to maintain fitness as well as strength.

In situations where high-risk sports cannot be avoided, frequent muscle toning and strengthening exercises will help in avoiding injuries. Strong and well-toned surrounding muscles will ensure a more stable joint and thus minimize risk of injuries to that particular joint.

For runners, good shoes with proper arch support and soft heels will help to reduce the impact on the joints of the lower limbs and also protect the ankles from abnormal loading that frequently causes ligament sprains.

Dr. Mohd Nizlan Mohd Nasir

Consultant Orthopedic and Arthroscopic Surgeon

Columbia Asia Hospital-Setapak


Awas Bakteria Dalam Peti Sejuk

Awas Bakteria Dalam Peti Sejuk

August 20, 2020

Ada beranggapan peti sejuk adalah tempat penyimpanan makanan paling selamat dan tidak mendatangkan bahaya terhadap kesihatan pengguna.

Lebih-lebih lagi apabila ada yang menyangka makanan yang disimpan dalam peti sejuk tidak akan basi sama sekali.

Hakikat itu tidak benar kerana peti sejuk juga boleh menjadi ‘lubuk’ pembiakan bakteria sekaligus merosakkan makanan dan berpotensi menjadi punca jangkitan kuman kepada pengguna.

Pegawai Perubatan Columbia Asia Hospital - Cheras, Dr S Malar Santhi berkata, kuman masih boleh membiak di dalam peti sejuk tetapi suhu yang rendah dapat memperlahankan proses pembiakan pelbagai bakteria, sekaligus melambatkan makanan menjadi basi.

Beliau berkata, terdapat dua jenis kuman yang membiak di dalam peti sejuk. Pertama ialah bersifat patogen iaitu agen penyebab jangkitan penyakit kepada manusia.

“Contoh bakteria ini ialah Salmonella yang selalunya ada pada telur dan susu.

“Bakteria ‘Clostridium perfringes’ pula terdapat pada lasagna dan lauk pauk serta ‘Campylobacter’ (daging, ayam dan ikan).

“Kedua adalah kuman seperti Pseudomonas dan kulat seperti Aspergilus yang menyebabkan bau serta rasa makanan berubah, namun ia tidak menyebabkan jangkitan atau penyakit. Kuman seperti ini dikenali sebagai bakteria pembusuk.

“Lazimnya, walaupun termakan makanan yang berubah bau dan rasa, ia tidak akan menyebabkan penyakit, tetapi memberi rasa tidak enak atau kurang bersih, ”katanya.

Katanya, dua risiko penyakit boleh berlaku kepada pengguna disebabkan bakteria dalam peti sejuk ialah keracunan makanan dan jangkitan pada usus.

Menyentuh jangkitan bakteria dalam peti sejuk boleh membawa maut atau tidak, Dr S Malar berkata, perkara itu boleh terjadi sekiranya makanan yang disimpan dalam peti sejuk tercemar dengan jangkitan bakteria merbahaya seperti E Coli dan Toxoplasmosis.

“Pusat Kawalan Penyakit di Amerika Syarikat mengganggarkan lebih kurang 48 juta orang mendapat jangkitan berpunca daripada makanan dan hampir 3,000 meninggal dunia setiap tahun.

“Dianggarkan hampir 20 peratus jangkitan itu berkaitan dengan makanan daripada peti sejuk, sama ada di rumah pengguna, pusat komersial, restoran atau pasaraya, ”katanya.

Dr S Malar berkata, ramai tidak mengetahui bahawa ada beberapa jenis makanan yang sebenarnya menggalakkan pembiakan bakteria apabila disimpan dalam peti sejuk.

“Contohnya daging lembu, kambing, ayam dan ikan. Air daripada bahan mentah sebegini, jika mengalir serta terkena pada sayur atau buah, boleh menyebabkan pembiakan bakteria menerusi jangkitan silang, terutamanya apabila dimakan mentah atau separa masak.

“Oleh itu, bahan ini perlu disimpan menggunakan kaedah penyimpanan yang betul bagi mengelakkannya menjadi agen pencemar kepada makan lain yang terdapat dalam peti sejuk, ”katanya.

Katanya, pengguna juga perlu mengetahui cara penggunaan peti sejuk yang betul dan selamat.

“Pastikan suhu peti sejuk kurang daripada empat hingga lima darjah celcius.

“Bahagian sejuk beku untuk makanan basah, suhu disarankan ialah serendah negatif 18 darjah celcius atau paling kurang sifar darjah celsius, ”katanya.

Selain itu katanya, masyarakat perlu mengamalkan kaedah penjagaan peti sejuk yang betul supaya tidak memberi kesan terhadap kesihatan.

“Langkah pertama ialah kurangkan tindakan membuka dan tutup peti sejuk kerana boleh menyebabkan suhu menjadi tidak stabil.

“Seterusnya memastikan suhu dalam peti sejuk dikekalkan pada julat yang stabil, bukannya kerap menukar suhu menaik atau menurun.

“Tutup bekas makanan walaupun di dalam peti sejuk. Bekas makanan yang terbuka, memudahkan pembiakan bakteria kerana suhu lebih tidak stabil.

“Langkah terakhir ialah meletak makanan basah seperti ikan, ayam dan daging dalam bekas bertutup atau plastik. Ini kerana air daripada makanan ini boleh mencemarkan makanan lain, ”katanya.

Kajian ‘The Use and Performance of Household Refrigerators’ mendedahkan 65 peratus pengguna dari negara maju seperti Sweden tidak mengetahui etika dan suhu peti sejuk yang sesuai digunakan. Katanya lagi, peti sejuk perlu diselenggara bagi menggelakkan kerosakan yang boleh menjejaskan kestabilan suhu.

“Peti sejuk adalah peralatan elektrik yang penting di rumah dan pengguna kena tahu etika dan cara penggunaan selamat untuk mengelakkan penyakit berkaitan peti sejuk, ”katanya.

ADDITIONAL INFO

Definisi peti sejuk

Pembeku – Membekukan barangan yang disimpan dalam ruang kabinetnya.

Bukan pembeku – Peti sejuk yang ada di rumah dan peti sejuk kaca yang digunakan khusus untuk menyimpan pelbagai mimnunman dalam tin, kotak dan botol.

Cara menjaga peti sejuk

Membersih peti sejuk – Tutup suis plug, keluarkan semua barang dalam peti sejuk sebelum dicuci.

Menjaga penyejat – Jangan cungkil timbunan air di bahagian penyejat menggunakan objek tajam seperti pisau atau gunting kerana dikuatiri menyebabkan kebocoran di bahagian berkenaan (penyejat).

Kedudukan peti sejuk – Pastikan kedudukannya tidak terlalu rapat dengan dinding untuk pelepasan haba yang baik.

Menyimpan makanan – Pastikan makanan dan minuman yang panas serta suam berada berada pada suhu bilik sebelum disimpan dalam peti sejuk.

Kepentingan menyimpan makanan dalam peti sejuk dengan cara betul

Memastikan makanan tahan lebih lama.

Memastikan makanan dalam keadaan selamat hingga dimakan.

Mengekalkan rupa dan rasa makanan.

Mengekalkan keenakan makanan.

Mengekalkan kandungan nutrient

Photo credit: 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:

Awas Bakteria Dalam Peti Sejuk – Harian Metro, 9 Ogos 2020

Awas bahaya bakteria dalam peti sejuk - My KMU NeT, 23 Ogos 2020.

Artikel ini disiarkan oleh Harian Metro, 9 Ogos 2020

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Awas Penyakit Jantung Koronari Membunuh Secara Senyap... Ketahui Tanda-Tanda Dan Cara Mencegahnya

January 14, 2020

PENYAKIT jantung dianggap sebagai 'pembunuh senyap' tidak mengira latar belakang mangsanya.

Seperti semua sedia maklum, jantung adalah organ penting untuk badan yang mana ia berfungsi untuk mengepam darah yang membawa oksigen dan nutrien kepada semua organ dan anggota badan.

Menurut Pakar Perunding Kardiologi & Perubatan Dalaman, Penyakit Jantung Koronari Columbia Asia Hospital - Tebrau, Dr Benjamin Leo, penyakit jantung koronari berlaku akibat gangguan bekalan oksigen pada otot jantung.

Jelasnya, hal ini selalunya disebabkan kerosakan pada dinding saluran darah atau pengumpulan kolesterol pada dindingnya yang menyebabkan saluran darah menjadi sempit atau tersumbat.

"Apabila bekalan oksigen kepada otot jantung terjejas, ia akan kurang berfungsi dan menimbulkan perasaan atau simptom sakit jantung (angina).

"Jika tidak segera dirawat dan dibiarkan berterusan, otot jantung akan rosak dan mengakibatkan serangan jantung," kongsinya kepada mStar.

Tambah Dr Benjamin, penyakit jantung merupakan punca kematian paling tinggi di Malaysia iaitu sebanyak 13.9 peratus pada 2017.

"Kadar kematian ini meningkat 54 peratus berbanding 2007.

"Setiap hari di Malaysia, 37 pesakit meninggal dunia akibat penyakit jantung," ujarnya.

Simpton Atau Tanda-Tanda Sakit/Serangan Jantung.

Sakit dada yang mengencang atau menekan.

Sakit dada yang bertambah teruk ketika bekerja atau melakukan aktiviti.

Sakit dada yang berkurangan dan hilang ketika rehat. Sakit yang merebak ke bahagian rahang, leher atau lengan (selalunya lengan kiri).

Sakit ini boleh timbul di dalam beberapa minit sahaja.

Sakit ini boleh disertai dengan kesesakan nafas, rasa loya, berpeluh dingin atau pengsan.

Pesakit yang lebih berumur, yang mengidap penyakit kencing manis (diabetis) atau wanita kadang kadang tidak mengalami simptom kesakitan tetapi mengalami sesak nafas, mual, pengsan dan keletihan yang melebih.

Faktor-Faktor Risiko Penyakit Jantung Koronari

Faktor-faktor risiko penyakit jantung koronari boleh dibahagikan kepada dua:

(i) Faktor-faktor yang boleh diubah seperti:

Merokok

Obesiti

Kurang bersenam

Tekanan darah tinggi (hipertensi)

Kadar kolesterol dan lemak yang tinggi (hiperlipidaemia) Kencing manis

(ii) Faktor-faktor yang tidak boleh diubah seperti:

Umur (risiko sakit jantung meningkat dengan umur)

Sejarah sakit jantung dalam keluarga terdekat

Jantina (risiko serangan jantung lebih pada jantina lelaki)

Langkah-Langkah Pencegahan Penyakit Jantung

Jangan Merokok

Asap rokok mengandungi lebih 4000 jenis bahan kimia beracun antaranya nikotin, karbon monoksida dan tar.

Nikotin boleh merosakkan saluran darah dan mengganggu pengaliran darah.

Nikotin juga akan mengecutkan saluran darah serta mengurangan bekalan oksigen ke jantung dan seluruh badan.

Nikotin meningkatkan kadar denyutan jantung.

Karbon monoksida akan mengurangkan bekalan ke jantung dan seluruh badan.

Sajian dan diet

Pilih lebih banyak bijirin dan kekacang.

Makan lebih sayur sayuran dan buah buahan.

Pilih makanan yang rendah lemak dan kolesterol.

Pilih makanan yang sederhana kandungan gula dan garam.

Bersenam

Bersenam sekurang-kurangnya 3 kali seminggu.

Lakukan aktiviti fisikal seperti berjalan, berjoging, berenang, berbasikal, senamrobik dan bersukan.

Kawal berat badan untuk mencapai Indeks Jisim Badan yang betul.

Rawatan

Dapatkan pemeriksaan kesihatan secara berkala.

Disyorkan untuk dapatkan pemeriksaan kesihatan secara berjadual sekiranya anda berumur 35 tahun ke atas.

Bagi mereka yang berumur di bawah 35 tahun tetapi berisiko tinggi, adalah dinasihatkan untuk menjalani pemeriksaan saringan kesihatan.

Dapatkan pemeriksaan saringan untuk indeks jisim badan (Body Mass Index), glukos dan kolesterol darah, tekanan darah dan komposisi lemak badan.

Dr. Benjamin Leo Cheang Leng

Consultant Internal Medicine Physician & Interventional Cardiologist

Columbia Asia Hospital – Tebrau
MBBCh BAO (Ireland), MRCP (UK), Fellowship in Cardiology (Korea & Malaysia)

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PDF and Online Articles:

Awas Penyakit Jantung Koronari Membunuh Secara Senyap – mStar, 24 Disember 2019

Artikel ini disiarkan oleh mStar, 24 Disember 2019

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Awasi Lelehan Yang Luar Biasa

Awasi Lelehan Yang Luar Biasa

March 25, 2019

MASALAH keputihan ketika hamil antara keluhan yang sering dialami si ibu, namun perlukah masalah ini dikhuatiri?

Tahap peningkatan estrogen badan semasa hamil meningkatkan aliran darah ke kawasan pelvik dan merangsang membran mukus namun lelehan faraj yang tidak disenangi wanita ini tidak dicipta sia-sia kerana ia ada fungsinya yang tersendiri.

Ia bertindak sebagai pembersih semula jadi vagina, membantu mencegah jangkitan dengan membuang bakteria seterusnya menjaganya sentiasa berada pada paras pH yang normal dan membuang sel mati.

Hampir semua wanita mengalami lelehan faraj yang lebih daripada biasa semasa kehamilan. Ini berlaku disebabkan semasa kehamilan, serviks (leher rahim) dan dinding vagina menjadi semakin lembut dan lelehan meningkat untuk membantu mencegah jangkitan dari faraj ke rahim. Apabila melahirkan anak, biasanya masalah ini hilang sendiri.

Pakar Sakit Puan Hospital Columbia Asia Setapak, Dr Herbert Low berkata, meskipun masalah lelehan faraj ketika hamil kebanyakannya tidak perlu dikhuatiri dan sebahagian daripada perkara normal kehamilan, tetapi amat penting untuk si ibu memberitahu doktor jika lelehan itu menimbulkan ketidakselesaan.

Katanya, lelehan faraj dikatakan normal semasa hamil jika ia jernih atau berwarna putih tanpa menyebabkan rasa gatal atau tidak selesa.

Sebaliknya jika lelehan terlalu banyak hingga memerlukan ibu hamil menukar pad atau pelapik seluar dalam dengan kerap, gatal, berbau kurang menyenangkan atau bertukar warna, ia perlu diambil perhatian kerana mungkin itu tanda jangkitan.

“Jika lelehan vagina disebabkan jangkitan, risiko kelahiran pramatang serta air ketuban pecah lebih awal daripada sepatutnya.

“Oleh itu, sentiasa dapatkan nasihat perubatan di fasiliti kesihatan sekiranya anda mendapati lelehan vagina yang tidak normal. Jangkitan biasanya boleh dirawat oleh doktor dengan pemberian ubatan.

“Kebiasaannya, lelehan faraj yang tidak normal adalah disebabkan perubahan pada flora di bahagian itu. Flora faraj normal biasanya didominasi pelbagai spesis pembersihan semula jadi laktobasilus yang juga dikenali sebagai bakteria baik.

“Kewujudannya bertujuan sebagai perlindungan terakhir untuk mengelakkan berlakunya masalah jangkitan pada bahagian sulit dengan menghasilkan hidrogen peroksida dan asid laktik untuk menghalang pembiakan yis dan bakteria yang tidak diperlukan,” katanya.
Beberapa panduan boleh diikuti

Sentiasa memastikan bahagian faraj dalam keadaan bersih dan kering.

Elakkan penggunaan pembersih faraj yang mengganggu kestabilan pH atau menyebabkan kegatalan.

Gunakan pelapik seluar dalam pada saat yang diperlukan saja. Elakkan juga pemakaian seluar dalam yang ketat dan diperbuat daripada satin.

Jangan guna sebarang produk wangian seperti bedak atau ubat sembur pada bahagian faraj.

Elakkan pengambilan ubat secara berterusan tanpa nasihat doktor.

Kurangkan pengambilan makanan yang tinggi kandungan gulanya.

Amalkan gaya hidup sihat

Elakkan kehadiran benda asing di dalam faraj seperti kondom yang tertinggal selepas aktiviti seks.

Basuh bahagian sulit dengan air bersih dan buang air kecil selepas aktiviti seks.

Berjumpa pegawai perubatan dengan segera dan jalani pemeriksaan vagina jika ada tanda yang dinyatakan di atas.

Gejala keputihan

Keputihan atau lelehan lendir yang keluar daripada faraj wanita ada pelbagai sifatnya dan berbeza di antara wanita.

Biasanya berwarna jernih atau kelabu keputihan.

Jika keputihan tidak berubah warna kekuningan atau kehijauan bermakna tiada jangkitan.

Pangkal uterus juga mengeluarkan lendir dengan tujuan mencantumkan benih lelaki (sperma) dan perempuan (ovum) dalam proses persenyawaan.

Lendir dikeluarkan menghasilkan tenaga dan makanan kepada sperma bagi tempoh persenyawaan berlaku.

Jika anda aktif dalam melakukan hubungan kelamin, perlu jalani ujian lumuran pap dan pemeriksaan pelvis.

Keputihan atau lendir faraj berubah akibat perubahan hormon dan perubahan mental, jangkitan, ubatan dan penyakit dalaman. Wanita mempunyai kitaran haid yang dipengaruhi hormon.

Keputihan dianggap bermasalah seandainya ia keluar terlalu banyak, berbau busuk, hanyir dan menyebabkan bahagian sulit berasa gatal atau radang.

Penyakit lain dikaitkan dengan jangkitan

Kulat candidiasis (keputihan seperti kepingan susu basi)

Kuman tricomonas (lelehan keputihan atau tidak berwarna cair, banyak, berbuih)

Bakteria vaginosis (lelehan berbuih, berbau hanyir).

Kuman chlamydia (jarang menyebabkan lelehan).

Kuman gardneralla (lelehan cair berbau busuk)

Dr. Herbert Low Wea Haw

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Setapak

PDF and Online Articles:

Awasi Lelehan Yang Luar Biasa - Harian Metro, 25 March 2019

Awasi Lelehan Yang Luar Biasa - Harian Metro, 25 March 2019

Artikel ini disiarkan oleh Harian Metro, 25 March 2019

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Ayam Masak Jintan

Ayam Masak Jintan

September 17, 2015

A confinement diet is when traditional dishes are served to postnatal mothers for at least 30 to 40 days from the time she gives birth (depending on respective ethnic customs). A confinement diet aims to help the mother regain strength after delivery and to speed up her recovery process.

We interview Chef Faziludin Ibrahim bin Zainadin from Columbia Asia Hospital – Puchong for more information on confinement diets in the hospital. Chef Ibrahim joined Columbia Asia Hospital-Puchong in September 2009. He has 10 years’ experience in dietary services. He has worked in various hotels and restaurants before venturing into the healthcare industry.
Q: Is there any confinement food for mothers after childbirth at Columbia Asia hospital?

A:
 Yes, there is a confinement menu at Columbia Asia Hospital-Puchong. In this menu, ingredients include ginger and cumin that are traditionally believed to be good for the mother’s post-natal wellbeing.
Q: What will be the dish that you can recommend for lactating mothers?

A:
I would like to recommend chicken with fennel seeds (ayam masak jintan). This dish is suitable for all mothers, regardless of their ethnic customs.
Q: Can you suggest how to lessen the fat content in traditional confinement dishes?

A:
 First, use ayam kampong (free-range chicken) and remove all the skin. Use only the lean chicken parts like the breast. This will reduce the total fat content in the dish. Cooking utensils also matter. Use a non-stick pan which require very little cooking oil, yet is able to retain the moisture in the chicken meat.
Q: Snakehead fish (ikan haruan) is a type of fish with a strong fishy smell. How can we reduce this smell?

A:
 We can wash the fish in clean water with added salt, dried tamarind pieces (assam keping) and banana leaf. After that, soak the fish in plain yogurt for 20 minutes. Lastly, wash away all the yogurt from the fish.

RECIPE

Chicken with Fennel Seeds (Ayam Masak Jintan Manis)

Serves 1

Ingredients

200g chicken

200ml *fish stock

1 tablespoon cumin powder

1 tablespoon anise seed powder

1 small shallot, chopped

1 tablespoon ginger, chopped

½ tablespoon turmeric

1 piece dried tamarind piece (asam gelugor/keping)

2 tablespoons black pepper

2 tablespoons vegetable cooking oil

Salt

Preparation for Fish Stock:

Clean and then boil a whole fish (e.g. snakehead fish/ikan haruan) in 500ml water with ginger. Boil until the water decreases to 200ml.

Method

Heat the oil in a sauce pan. Sauté the shallots and ginger. Add the cumin powder, anise seed powder and black pepper until ingredients become turn brownish.

Add in chicken and turmeric. Mix well with all ingredients.

Add in the fish stock and boil the chicken until well-cooked.

Season with salt and add in the dried tamarind piece.

It is ready to be served!

Nutrient Content (per serving):

Calorie (kcal) -
599

Protein (g) -
50

Fat (g) -
36

Carbohydrates (g) -
22

Sodium (mg) -
263

Dietitian’s Note:

Fennel seeds are rich in vitamin C. Studies shown that it may increase milk supply. However, if the baby is allergic to plants in Apiaceae family e.g. carrots, the mothers should avoid consuming fennel excessively because of the possibility of a cross-allergenicity.

A balanced diet with adequate nutrition is important especially for lactating mothers. Every woman’s body and their labouring process is different. Therefore, mothers are not encouraged to consume herbs and traditional supplements excessively. If the mother decides to omit certain foods due to a food taboo, it is recommended for her to replace that with other foods in the same nutrient category.

Recipe prepared by:
Chef Faziludin Ibrahim bin Zainadin

Kitchen Coordinator
Columbia Asia Hospital - Puchong

Nutrients content reviewed by:
Kong Woan Fei

Dietitian
Columbia Asia


Bahana Tekanan Perasaan

Bahana Tekanan Perasaan

December 01, 2020

KEMARAHAN membuak secara tidak berkala (intermittent explosive disorder) atau tekanan perasaan boleh berlaku jika tidak memberikan perhatian awal dalam mengawal pengurusan marah dan kurang keyakinan diri dengan sempurna.

Lebih membimbangkan ialah ia boleh mendorong individu bertindak agresif hingga membunuh, meskipun berpunca daripada perkara kecil seperti ejek-mengejek.

Jika ia berlaku (membunuh), kemungkinan besar si pelaku menghidap masalah mental seperti penyakit bipolar membabitkan perubahan mood atau perasaan secara melampau dan bertindak agresif.

Pegawai Perubatan Hospital Columbia Asia Dr S Malar Santhi berkata, ada kemungkinan individu atau remaja yang mempunyai kecenderungan tingkah laku bertindak agresif ini, boleh dikenal pasti oleh orang terdekat seperti keluarga atau guru.

Menurutnya, satu daripada gejala yang boleh dikenal pasti dengan mudah ialah masalah kemarahan yang tidak normal.

"Sama ada individu ini mengalami kemarahan melampau dalam satu tempoh hingga tidak sedar tindakan yang dilakukannya.

"Biasanya individu ini mengatakan dia tidak dapat mengawal kemarahan dan tindakannya, seterusnya menyesali perbuatan yang dilakukan.
EJEK-MENGEJEK boleh mendorong individu bertindak agresif.

"Atau pun individu terbabit mengalami kemarahan melampau kerana kerap dibandingkan dengan rakan sebaya. Golongan ini (ada masalah kemarahan) mempunyai kecenderungan bertindak agresif sehingga membunuh," katanya.

Beliau berkata, selain itu, remaja yang mempunyai masalah keyakinan diri sentiasa menjauhkan diri daripada rakan sebaya, tidak ceria, tidak aktif dan sebagainya juga berkemungkinan mempunyai masalah kemurungan atau tekanan perasaan.

"Mereka juga boleh dikategorikan sebagai golongan yang mungkin boleh bertindak lebih agresif jika diejek atau diprovokosi

"Kajian Persatuan Psikologi Amerika (APA) mendapati remaja yang mempunyai masalah keluarga seperti ibu bapa sering bertengkar, bercerai atau masalah kewangan, mempunyai kecenderungan tinggi bertindak ganas dan agresif.

"Mereka perlu diberi tumpuan serta perhatian daripada awal sebelum masalah mental bermula," katanya.

Dr S Malar berkata, selain itu, penagih dadah atau individu ketagihan alkohol juga cenderung bertindak sedemikian.
TINDAKAN agresif seperti membunuh dirasakan penyelesaian masalah.

Mereka perlu dirujuk ke pusat rehabilitasi dan rawatan ketagihan seawal mungkin bagi mengelakkan kejadian tidak diingini berlaku.

Katanya, media elektronik atau media sosial yang memaparkan keganasan boleh memberi pengaruh besar terhadap sikap dan tingkah laku individu atau remaja.

"Walaupun mereka tidak bertindak segera selepas menonton aksi itu, tetapi mereka menyimpannya dalam ingatan.

"Apabila ada situasi yang mencetuskan kemarahan, mereka menggunakan keganasan sebagai penyelesaian masalah.

"Tambahan pula, remaja lebih cenderung meniru dan melakukan perkara yang dilihat berbanding mendengar nasihat," katanya.

Selain itu, beliau berkata, kurang kesedaran nilai moral dan harmoni juga antara sebab utama remaja bertindak sedemikian.
IBU bapa perlu mewujudkan hubungan akrab bersama anak-anak.

"Sekitar 1980-an hingga awal 2000, nilai moral serta harmoni sangat diterapkan dalam diri remaja melalui aktiviti badan beruniform seperti Pandu Puteri, Pengakap dan sebagainya.

"Namun sejak kebelakangan ini, penerapan nilai murni sukar dilaksanakan, impak daripada pengaruh media sosial tanpa sempadan," katanya.

Menurut Dr S Malar, peranan institusi kekeluargaan sangat penting untuk menghalang remaja bertindak ganas atau agresif sehingga boleh membunuh.

"Saya pasti remaja yang berfikiran waras tidak akan terfikir untuk membunuh, terutama rakan sendiri.

"Ahli keluarga perlu memainkan peranan dalam membina keyakinan diri anak-anak sejak kecil.

"Elakkan anak-anak daripada diejek dan dicemuh rakan-rakan," katanya.
IBU perlu menjadi pendengar setia masalah anak.

Jelasnya, ibu bapa perlu diberikan pendedahan mengenai perlindungan undang-undang seperti Sekysen 233 (1)(b) Akta Komunikasi dan Multimedia 1998 (Akta 588) yang mana memalukan orang lain dengan mengejek atau memberi komen terhadap bentuk dan saiz badan individu adalah kesalahan jenayah.

"Individu terbabit boleh didenda tidak lebih RM50,000 atau penjara tidak lebih setahun atau kedua-duanya, jika sabit kesalahan.

"Ibu bapa perlu cakna dengan undang-undang ini dan ia perlu diterapkan kepada anak-anak. Jangan terima serta tahan ejekan kerana ia boleh mengganggu kesihatan minda jangka panjang," katanya.

Beliau berkata, ibu bapa perlu menjadi rakan baik kepada anak sendiri.

Sentiasa dampingi mereka kerana mudah untuk mengesan sebarang perubahan sikap dan tingkah laku anak remaja.

"Ibu bapa jadi pendengar yang baik, tanya perasaan dan emosi anak-anak. Bincang masalah mereka secara matang serta didik cara untuk menangani masalah dihadapi.

"Perkara paling penting ialah ibu bapa perlu elak bertengkar di depan anak-anak. Sikap ibu bapa yang bercakap kasar atau nada tinggi di hadapan anak, boleh memberi impak negatif terhadap minda mereka," katanya.

Di samping itu, katanya, institusi keluarga perlu memastikan tiada tindakan agresif fizikal berlaku dalam keluarga.

Ibu bapa atau ahli keluarga yang bertindak ganas seperti memukul di hadapan anak-anak juga boleh memberi kesan tidak baik kepada mereka.

Mengenai rawatan yang diberikan kepada remaja bertindak agresif, ia bergantung kepada tahap masalah yang dikesan dan kesihatan individu secara menyeluruh.

"Mereka wajar dirujuk kepada pakar kesihatan keluarga atau pakar psikologi untuk mengenal pasti masalah, ujian pengesahan seperti ujian darah, air kencing, imbasan dan diagnosis.

"Jika dikesan ada masalah mental, maka doktor yang merawat akan berbincang mengenai jenis dan bentuk rawatan seperti terapi, kaunseling, senaman dan ubat jika perlu," 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:

Bahana Tekanan Perasaan - Harian Metro, 22 November 2020

Artikel ini disiarkan oleh Harian Metro, 22 November 2020

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Psychiatry
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Bahu Tersangkut Masa Bersalin Boleh Buat Bayi Cedera & Otak Kurang Oksigen

March 05, 2019

Bahu bayi tersangkut ketika kelahiran (shoulder dystocia) adalah antara masalah kecemasan yang boleh berlaku ketika proses kelahiran. Bayi patah tulang bahu, cedera saraf dan kurang oksigen antara risikonya.

Menurut Dr Sharina Mohd Razali, Pakar Perbidanan & Sakit Puan Columbia Asia Bukit Rimau, bahu bayi tersangkut ketika kelahiran ia adalah keadaan di mana kepala bayi yang telah lahir tetapi bahunya tersangkut pada tulang pubis ibu.

Sekiranya berlaku, doktor perlu melakukan langkah kecemasan tambahan
 (additional manouvres)
 untuk membantu melepaskan bahu bayi yang tersangkut pada tulang pubis tersebut.
RISIKO BAHU TERSANGKUT KEPADA BAYI

Kebanyakan masa bahu bayi boleh dilepaskan tanpa sebarang masalah tetapi dalam beberapa kes bahu tersangkut ini kadangkala boleh menyebabkan masalah kepada bayi seperti;

Patah tulang bahu.

Kecederaan pada saraf.

Kekurangan oksigen
(birth asphyxia)
.

Masalah ini boleh berlaku dalam 1 dalam 150 kelahiran (0.7%) dan lebih kerap berlaku pada ibu-ibu yang menghidap penyakit kencing manis semasa mengandung. Hakikatnya ia sangat sukar diramal.
7 KEADAAN MENINGKATKAN TERJADINYA BAHU BAYI TERSANGKUT SEMASA PROSES KELAHIRAN

Oleh sebab ia sukar diramal ketika hamil, ibu-ibu yang perlu memahami siapa yang berisiko tinggi untuk mengalami bahu bayi tersendat ketika kelahiran. Dengan ini perlu mengambil langkah awal serta persediaan mental dan fizikal.

Sejarah
 bahu bayi tersendat ketika kelahiran sebelumnya.

Ibu yang menghidap
 kencing manis.

Bayi yang besar
 dan ibu menghidap kencing manis.

Indeks jisim tubuh
(BMI) ibu lebih dari 30
.

Kelahiran secara paksa
(indius).

Proses bersalin yang sangat lama.

Kelahiran menggunakan

ventouse
atau forseps.

DALAM KECEMASAN, LANGKAH-LANGKAH INI AKAN DILAKUKAN

Bagi kes kecemasan di mana ia terjadi tanpa jangkaan atau dikenali sebagai
obstetric emergency
, pakar sakit puan dan bidan yang bertugas akan memberikan rawatan segera. Sekiranya berlaku bahu bayi tersendat semasa proses kelahiran,
red alert

akan dimulakan untuk mendapat bantuan dari pasukan perubatan.
Ibu akan diminta berhenti meneran
 untuk mengelakkan kecederaan lebih teruk pada bayi.
#1.
 Doktor akan menyuruh
 ibu membengkokkan paha dan lutut ke arah perut ibu
 bagi menambah ruang vagina supaya bahu bayi boleh dilepaskan dari tulang pubis ibu. Ini dipanggil
Mc Roberts manouvre.
#2.
 Sekiranya
manouvre
pertama gagal, langkah seterusnya ialah
doktor pakar akan menekan pada bahagian abdomen ibu
 iaitu pada atas tulang pubis bertujuan untuk menolak dan melepaskan bahu bayi yang tersangkut.
#3.
 Andai
manouvre
kedua gagal, doktor akan
 memasukkan tangan dalam vagina dan cuba menolak bahu bayi
 dan cuba melepaskan bahu bayi yang tersangkut.
Guntingan episiotomi akan dilakukan
 sekiranya belum dibuat
untuk memudahkan manouvre tersebut diatas.
#4.
 Akhir sekali sekiranya semua gagal
ibu mungkin akan disuruh menelangkupkan badan (o
n all four hands and legs
) kerana ini juga boleh membantu melepaskan bahu bayi.
IBU KENCING MANIS PASTIKAN GULA TERKAWAL

Masalah bahu bayi tersangkut ini sukar dielakkan kerana sukar diramal. Cara yang boleh dilakukan untuk mengelakkannya ialah dengan adalah ambil langkah berjaga-jaga jika ibu mempunyai risiko terutamanya ibu yang menghidap kencing manis.
Bersalin secara induksi boleh mengelakkan masalah ini.

Elakkan sama sekali kehamilan yang terlebih tempoh bagi ibu yang mempunyai kencing manis.
Doktor selalunya akan mencadangkan bersalin melalui pembedahan
caesarean
 jika berat bayi melebihi berat normal iaitu 4kg
. Walau bagaimana pun risiko bahu tersangkut masih boleh berlaku pada bayi yang mempunyai berat kurang dari 4kg lebih-lebih lagi jika ibu menghidap diabetes.

Dr. Sharina Binti Mohd Razali

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Bukit Rimau

PDF and Online Articles:

Bahu Tersangkut Masa Bersalin Boleh Buat Bayi Cedera & Otak Kurang Oksigen – Majalah Pa&Ma, 5 March 2019

Artikel ini disiarkan oleh Majalah Pa&Ma, 5 March 2019

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Baked Tilapia in Banana Leaves

Baked Tilapia in Banana Leaves

June 16, 2015

Malaysia is a multi-ethnic country. In Sarawak has more than 40 sub-ethnic groups with its own distinct language, culture and lifestyle. Melanau group (one of the Sarawak sub-ethnic group) has their unique traditional foods e.g. umai (raw fish salad). Traditionally, Melanau consume more fish compared with other sub-ethnic. This is because Malanau ancestors lived near the river and sea.

Our cook from Columbia Asia Hospital - Bintulu, Almelli would like to share one of her Melanau dish – Baked Tilapia in Banana Leaves. Traditionally, the dish shall be prepared by cooking fish in a bamboo and stuffed with water (Sarawak people called Pansoh). Almelli had simplified the cooking method to lets the beginner easier to handle this special dish.

RECIPE

Baked Tilapia in Banana Leaves

Serves 2

Ingredients

Tilapia fish fillet 500gm (or ikan keli, ikan patin and ikan sultan)

Banana leaves, cleaned 3-4 pieces

Marinate / Sauce:

Shallot, raw 15gm

Garlic, raw 15gm

Ginger, 20gm

Coriander, ground 2 tablespoons

Local basil leaves, fresh 50gm

Fish sauce 3 tablespoons

Coconut milk, fresh 100ml

Kaffir lime leaves 2-4 pieces

Hot pepper (chili padi) 10gm

Lime juice, fresh 1 tablespoon

Method

Blend all ingredients for marinate/sauce

Soak and marinate the fish fillet about 1 hour in deep bowl

Wrap the fish with banana leaves

Bake the fish on baking tray for 15 minutes

Heat the remaining sauce in thick pot without oil. Serve together with the baked fish and rice

Nutrient Content (per serving):

Calorie (kcal) -
663

Protein (g) -
50

Fat (g) -
10

Carbohydrates (g) -
19

Sodium (mg) -
4494

Healthy Eating Tips:

Replace fish sauce with sugar to balance sour and spicy flavor

Replace coconut milk with low fat milk

Recipe prepared by:
Almelli Binti Anthony Abet

Chef
Mohd Sharil

Kitchen Coordinator & Café Team
Columbia Asia Hospital - Bintulu


Balancing Act

Balancing Act

April 01, 2016

We're often told to keep up with healthy habits like drinking eight glasses of water, running to stay fit, and sleeping at least nine hours a day. Dr. Sivah Sandrasakre, Chief Medical Officer of Columbia Asia Hospital - Cheras, says on too much of a good thing can actually be bad for your health.

HER WORLD Magazine, Issue Apr 2016
.


The Basics of Autoimmune Arthritis

The Basics of Autoimmune Arthritis

May 19, 2020

What is autoimmune arthritis?

Autoimmune arthritis denotes various types of arthritis or inflammation of the joints caused by a person's immune system that attacks his/her own joints. This leads to an inflammation that can cause pain, stiffness and mobility problems as well as the destruction of the joints.

There are a few diseases categorised under autoimmune arthritis. The most common example is rheumatoid arthritis. Now, samples of less common types include psoriatic arthritis and systemic lupus erythematosus.

Who is at a high risk of developing autoimmune arthritis?

Women aged 55 and below with a smoking history are especially at high risk.

What’s the difference between normal arthritis and autoimmune arthritis?

We seldom use the term ‘normal arthritis’. It probably means arthritis related to other diseases. The common type is Osteoarthritis due to degenerative causes such as the ageing process or via injuries as well as gout due to a high content of uric acid.

How do you diagnosis autoimmune arthritis?

To diagnose autoimmune arthritis, we need to perform a detailed investigation of one’s health history and carry out a physical examination to look for signs of arthritis and other clues. Of course, there is also a blood investigation, specifically inflammatory markers, and followed by an antibody test like rheumatoid factor, antinuclear antibody or extractable nuclear antigen.
How do you treat autoimmune arthritis?

The treatment usually consists of four groups of medications:-

NSAIDs

Nonsteroidal anti-inflammatory drugs can relieve pain and reduce inflammation but only temporarily.

Steroids

Corticosteroid medications reduces inflammation and pain and slows down joint damage. Its function is similar to a pain killer but probably with less short-term side effects.

Disease-modifying antirheumatic drugs (DMARDs)

These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage.

Biological agents

These drugs can target parts of the immune system that trigger inflammation causing joint and tissue damage. However, these types of drugs also increases the risk of infections, hence we reserve these drug for patients who fail conventional disease-modifying antirheumatic drugs or have very aggressive RA.

Please describe dietary habits suitable for autoimmune arthritis patients

There has been no specific diets recommended for autoimmune arthritis patients as the cause is unknown. Nevertheless, we should consume a healthy diet which consist of 2/3 plant-based foods including fruits, vegetables and whole grains in order to have a healthy body to fight against this disease.

Prevention tips for autoimmune arthritis

Unfortunately, as the cause of the disease is unknown, we can't prevent autoimmune arthritis. We can only treat and suppress it when it occurs. The advice is to seek for doctors’ advice if you encounter any form of joint pain. The key point is to diagnose early and treat early, in order to prevent joint damage.

Dr. Kuan Woon Pang

Consultant Internal Medicine Physician & Rheumatologist

Columbia Asia Hospital – Bukit Rimau
MD (Canada), MRCP (UK)

Make an Appointment

PDF and Online Articles:

The Basics of Autoimmune Arthritis - Natural Health, 8 June 2020

The Basics of Autoimmune Arthritis - Natural Health, 8 June 2020

This article first appeared in Natural Health, 28 July 2020.

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 &
Rheumatology
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Basketball for Malaysians?

Basketball for Malaysians?

January 26, 2017

Photo credit:
spaldingequipment.com
Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Consultant Orthopaedic Surgeon Dr. Harjeet Singh returns for his monthly show on sports medicine and orthopaedics. This time, we find out why basketball never really took off in Malaysia and if it has anything to do with our height. Also, does your height actually affect your overall health and fitness?

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Be Fit Malaysians #1: Bike Sharing

Be Fit Malaysians #1: Bike Sharing

February 21, 2018

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

With the rise in bike-sharing services and the opening of more bike lanes in Klang Valley, more people can cycle to nearby locations without much hassle. But does one size fit all? Professional cyclists will tell you that you need the right bike setup for your physique, so, does the bike sharing model create healthier commuters, or will it create future injuries? Consultant orthopaedic surgeon Dr Harjeet Singh lends his medical opinion on the subject while athlete and indoor cycling instructor Kannan Murugasan shares his experience as an avid cyclist.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #10: Treatment or Training?

March 20, 2019

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Can conventional exercise equipment be used for medical rehabilitation? Consultant Orthopaedic Surgeon Dr Harjeet Singh and Technogym’s Lester Francis share how innovation has advanced medical rehab.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

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Podcast:

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #11: Training like an Athlete

April 30, 2019

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

What does it take to be an athlete? What happens inside our body when we undergo an extreme regimen? Dr Harjeet Singh is joined by sports therapist, Jorg Teichmann to discuss training like an athlete.

Produced by: Kelly Anissa

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

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Podcast:

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #12: Stem Cells for Cartilage Repair

June 26, 2019

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Damage and degeneration of the cartilage can cause excruciating pain and diminish your quality of life, especially when it occurs in the knee. But stem cell therapy research and trials have shown that stem cells are able to help with cartilage regeneration. To help us find out more about the research that is being done here in Malaysia are Dr Harjeet Singh, consultant orthopaedic surgeon, and Dato’ Dr Badrul Akmal Hisham Md Yusoff, senior lecturer and head of arthroscopy and sports trauma unit at UKM.

Produced by: Lim Sue Ann

Presented by: Tee Shiao Eek

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #2: Pilates and Pregnancy

March 21, 2018

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

A pregnant woman is often given great care and protection. She is often told she can’t do this, that or the other. But what can she actually do when it comes to her health and fitness?

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #3: Tennis Elbow

Be Fit Malaysians #3: Tennis Elbow

April 24, 2018

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Roger Federer is 36 years old and still dominates the world rankings in tennis, but he’s an anomaly in the tennis world. Novak Djokovic, Andy Murray, Rafael Nadal and Garbiñe Muguruza who all used to occupy the top spots in the sport are facing a series of troubling injuries and mid-match retirements. Is the long tennis season to blame as the injuries continue to mount? Or could it be technology’s fault?

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #4: Football Fever

Be Fit Malaysians #4: Football Fever

June 06, 2018

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

The 2018 FIFA World Cup will kick off on June 14th. The month-long tournament is the most prestigious football event and the most widely viewed sporting event in the world. A sports medicine specialist and a football coach square off on their idea of a complete footballer.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #5: Life After Being A National Athlete

July 12, 2018

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Being a professional athlete is something that many people aspire towards. It takes a lot of hard work and sacrifice to play at the highest level of any sport, but it can be quite rewarding. However, after the glitz and glamour, what’s life like upon retirement? Former national hockey player I Vikneswaran joins Dr Harjeet Singh for his monthly sports medicine segment to share his experience.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #6: The Role of The Team Doctor

September 19, 2018

Photo credit:
sportsoracle.com
Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Every month, Dr Harjeet Singh explores injury management and prevention in sports and exercise. The Asian Games in Indonesia just ended and Malaysia retained its 14th placing in the medals tally, with 7 gold, 13 silver and 16 bronze medals. We praise our athletes, and their coaches, and the sports ministry for a job well done but let’s turn our attention to the unsung heroes in their scrubs: The physicians. For a behind-the-scene perspective, we speak to Malaysia’s team doctor at the recent Asian Games, Consultant Sports Physician Dr Kamaljeet Singh.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #7: Medical Implications of Wearable Tech

October 31, 2018

Photo credit:
nutraingredients.com
Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Fitness trackers, smartwatches, and other wearable technology are the number one fitness trend for 2019, according to an annual survey of health and fitness professionals published in the November issue of American College of Sports Medicine’s Health & Fitness Journal. This month, Dr Harjeet Singh examines how this trend will affect the future of sports science and orthopaedic practice.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #8: Ringside Medicine

Be Fit Malaysians #8: Ringside Medicine

November 28, 2018

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Combat sports such as boxing, karate and taekwondo are the only types of sports that require athletes to strike their opponents to win the match. With more people dabbling in mixed martial arts, find out what is the physician's role in fighting sports when athletes often end matches with injuries from these direct strikes.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

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Orthopedic
 in Columbia Asia?

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Be Fit Malaysians #9: New Year New Start

January 23, 2019

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Get fit, stay healthy. That's probably one of the most common New Year's Resolutions. After almost a month into the new year, consultant orthopaedic surgeon Dr Harjeet Singh answers some of the most pressing questions about exercise and sports, and your fears and expectations.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

Columbia Asia Hospital - Bukit Rimau
MBBS (India), MS (Orthopedics) (UKM), MRCS (Edinburgh), Fellowship in Orthopedic Sports Medicine & Arthroscopy (Germany), CMIA (NIOSH)

Make an Appointment

Podcast:

Listen to the podcast here

Looking for
Orthopedic
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips: