卵巢癌 | 难缠的妇女杀手 怎发现？怎治疗？

卵巢癌 | 难缠的妇女杀手 怎发现？怎治疗？

May 29, 2023

相比更高发的乳腺癌，卵巢癌被大家较少关注。可怕的是，卵巢癌早期几乎没有症状，半数以上的卵巢癌患者确诊时已处于晚期！12年生存率仅20%！我国女性55岁以后卵巢癌发病率最高，到底该如何对抗这个难缠的妇女杀手？

卵巢是连接子宫两端的器官，具有储存卵子供生殖和产生女性激素的双重功能。女性激素在青春期协助乳房、阴道、子宫、输卵管和身材的发育，并调节月经周期。当卵巢细胞发生病变，在卵巢各部位长出恶性肿瘤，就被称为——
卵巢癌 (Ovarian cancer)。

根据大马 2012年至2016 年国家癌症登记（NCR），恶性卵巢肿瘤在女性最常见癌症排名第四，在总体最常见癌症排名第十。根据大马癌症注册局，卵巢癌占据女性癌症案例的 5%。根据世界卫生组织的数据，马来西亚在2021年共记录了 48,639 例新的癌症病例。预计到 2040 年，发病率将翻倍。每年大约有 500 名马来西亚妇女被诊断为卵巢癌。

令人震惊的是，马来天后级女星艾蒂芭诺（Adibah Noor）于2022 年惊传卵巢癌末期逝世，终生未婚无生育，享年 51 岁，令人深感惋惜。根据马来媒体报导，她早在 50 岁时发现自己患有卵巢癌，并已进入第四期，但一直没有对外宣布消息。

她的离去，无疑给女性健康敲响了警钟！

女性该如何对抗这个难缠的妇女杀手？

1. 卵巢癌的可怕之处？

不幸的是，卵巢癌的大多数症状并没有非常明显。这类的女性患者在早期的时候一般无症状。 但可怕的是，一旦女性被诊断出卵巢癌，多数已经是晚期了。

此外，不同于宫颈癌的宫颈抹片检查（Pap smear），目前没有特定的筛查工具或测试来查出卵巢癌。

这也是为什么医生经常重复劝告大家：当身体有任何异常症状，或某种症状有持续经常出现，及早和医生报告是非常重要的。

2. 50岁女性属于卵巢癌的高风险群吗？

所有女性都有患上卵巢癌的风险，无论你处在哪一年龄层的阶段。然而，在55岁至64岁之间的女性中，她们患癌风险的确是最高的。

3. 确诊卵巢癌第四期，意味着？

卵巢癌一共分为四期，第四期的卵巢癌意味着疾病已经远端扩散到肝脏，或转移到腹腔外部的器官。

【卵巢癌的四期】

一期
：癌症限制于一个或两个卵巢；

二期
：癌症在一个卵巢或两个卵巢以外，不过没有扩散到盆骨以外，如：子宫、胆囊、大肠；

三期
：一个或两个卵巢的癌症扩散到盆骨以外的腹腔（还未到肝脏）或到附近淋巴结；

四期
：癌症已扩散到身体其他部位，如：肝脏、肺和脑。

4. 卵巢癌主要常见发生在未生育女性身上吗？

未生育与特定的生殖恶性肿瘤，包括乳腺癌、卵巢癌和子宫癌的风险增加有关。

卵巢癌或与女性排卵次数和激素水平有关。

5. 孕妇是否更容易患卵巢癌？

怀孕本身不会导致癌症，怀孕并不会增加患癌症的风险。

6. 卵巢癌可治愈吗？

是的，卵巢癌是可以治愈的。如果疾病在早期被检测发现到，并且癌细胞仅限于卵巢部位，相信高达90%的患者可以被治愈。

根据数据显示，大约20%的晚期卵巢癌患者在治疗后能够存活12年以上，并有效地被治愈。

7. 女性应采取哪些预防方法？

想要预防或大大降低卵巢癌风险的有效方法：一切始于你要先了解卵巢癌的风险因素。 Columbia Asia 医院 – Bukit Rimau分院的
Dr Loo Suat Chin 妇产专科顾问医生
介绍，其中不可变的卵巢癌高风险因素，主要是
年龄
 或
家族遗传
。

然而，以下风险因素却是可改变的：

●生活习惯●

保持健康的体重（BMI: 19至25）

戒烟

考虑母乳喂养宝宝

日常生活增添更多生活情趣

保持健康饮食（摄取各种水果、蔬菜、谷物和豆类，减少红肉和加工肉食品的摄入）

避免使用含有滑石粉的个人护理产品

药物选择

避孕措施（口服避孕药/避孕注射

●手术治疗●

输卵管和卵巢切除术（对于高风险的BRCA基因突变的人来说，这是一种常规治疗）

输卵管结扎（Tubal ligation）

子宫切除术（Hysterectomy）、输卵管卵巢切除术（Salpingo-oophorectomy）

●早期检测●

经阴道超声检查（Transvaginal scan）

CA 125（卵巢癌肿瘤标志物）

Dr. Loo Suat Chin

Consultant Obstetrician & Gynecologist

Columbia Asia Hospital – Bukit Rimau
MBBS (India), MRCOG (UK)

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卵巢癌 | 难缠的妇女杀手 怎发现？怎治疗？- 健康时尚杂志GoodHealth Magazine, March 2023

这篇文章首次刊登在《健康时尚杂志GoodHealth Magazine》, March 2023 Vol 131 issue

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枕头如何危害婴儿

枕头如何危害婴儿

October 22, 2020

父母应不应该让婴儿使用枕头？曾发生致命事件，涉及因使用枕头而使头部抬高的婴儿。 那么，这种看似无害的床上用品与新生婴儿之间有什么联系呢？ Columbia Asia Hospital – Petaling Jaya的儿科专科医生，沈至恒医生为家长们解答。

“犹记得我在政府医院工作的时候，在做巡房时，我会看到不少父母会为宝宝在医院里准备枕头，很多是少于一岁的宝宝，甚至还有一些是新生儿。我问了问我的医生下属们，他们的意见是什么，大家都支支吾吾。一个看似简单的问题，医生们都不清不楚，更何况是父母了，很多时候又是人云亦云。今天就讲讲这个问题，希望大家以后不会人云亦云。”

宝宝需要用枕头吗？

新生宝宝是不需要枕头的。

为什么宝宝不需要枕头？

因为新生宝宝的脊椎骨，尤其是靠近颈椎的部位是直的，宝宝平躺的时候，后背和后脑勺是在同一个平面。

因此，如果给宝宝睡枕头，会使他的头部高过身体，他的颈部会形成一个弯曲，使得他的下巴更靠近胸口，进而限制宝宝的呼吸，甚至造成呼吸道紧闭，还会有危险。如此还会影响宝宝骨骼、脊椎的生长发育。

大量的医学研究表明，枕头是造成婴儿窒息猝死的重要因素，也是医学上讲的婴儿猝死综合征 (Sudden Infant Death Syndrome, SIDS)。

那么何时需要枕头？

美国儿科权威机构，美国儿科学会建议一岁以上才给宝宝用枕头，如果可以的话延迟到18 个月更好。

这主要是关乎到宝宝的安全，同时降低婴儿猝死综合征 (SIDS)的风险，因为有临床数据显示枕头、毯子或者毛绒物都会提高SIDS 的机率。

功能性枕头有用吗？会不会让宝宝的头型更漂亮？

市面上有许多商家打着“让宝宝头型更漂亮”的旗号来宣传他们的产品，其实这些具有“定型”、“防偏头”的婴儿枕头，并不能让宝宝拥有更好的头型，反而会束缚宝宝，像“紧箍咒”一样限制宝宝的睡姿。

宝宝的头壳缝大约到了2岁才会互相接合，而且宝宝也用很多时间活动，喝奶等。这都会让头骨很好的发育。

这些所谓的“让宝宝头型更漂亮”枕头更可能造成头型扁平，因为宝宝头部的活动空间太局限了。
Photo credit: Freepik.com

Dr. Sam Zhi Heng

Consultant Pediatrician

Columbia Asia Hospital - Petaling Jaya
MBBS (UM), M. Paeds (UM)

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新冠防控10贴士，大马民众务必把健康提醒记在心

新冠防控10贴士，大马民众务必把健康提醒记在心

September 23, 2021

当前，大马国内的 COVID-19 新冠肺炎疫情持续扩散蔓延，关于新冠肺炎的预防，由内科和肾脏科专科医生郑燊权再次梳理了疫情防控10贴士，为大家进行解读和提醒，希望大众可以将这些健康提醒记在心里！

“一开始人们对冠状病毒的认知非常少，直到如今已掌握了初步症状，可惜对其医治方式和疫苗还处在研究阶段。由于冠状病毒已经证实是通过飞沫传染，所以大马卫生部警告大众遵守SOP限制人与人的接触，阻止疫情蔓延。也希望，在延缓疫情的同时，医治方式和疫苗可以取得突破。”

新冠疫情简介：

大马人已知的新冠肺炎（COVID-19）自 2019 年 12 月在中国武汉开始爆发，疫情迅速在中国各地扩散，可是由于新冠病毒传播率极强，在短短的四个月里，病毒已经传遍全球。至今，全球已有确诊病例 3420万宗，死亡案例高达 102万宗，欧美数国疫情尤其严重。

中国在防疫工作上采取了果断的封城措施，防疫效果在两个月后非常显著，各国争相效仿；马来西亚政府也在3月18日颁布了行动管制令，全马沉浸在一股全民一心，共同抗疫的气氛中。前线工作者，奋力筑起了一道防疫线；人民们配合遵守呆在家里一起防疫。每天看着诺希山卫生总监报告的死亡人数，大家也注意到了多数死亡案例都属于高风险族群，哪些又是高风险族群呢？美国疾病管制与预防中心已列出了以下几组高风险族群：

· 65岁或以上的年长者

· 糖尿病患者

· 高血压患者

· 肾脏疾病患者

· 肝脏病患者

· 心脏疾病患者

· 哮喘病或呼吸疾病患者

· 长期使用控制免疫力失调药物的病人

· 其他造成免疫力下降的疾病例如癌症患者、爱滋病患者

注意！

郑燊权医生：以上高风险族群已被证实感染新冠肺炎并发症的机率较高，死亡率也比普通患者来得严重。

疫情防控10贴士

在医生的角度看来：“防范永远都胜于治疗”，以下有10条防控贴士让大家参考参考:

1. 呆在家里，减少外出。

尽可能让较健康的家庭成员出外购买食物与日用品。如果迫不得已需要外出购物，尽量预先编排好详细的购物单，以便减少在外面逗留的购物时间。也应该尽量购买足够一星期的用量，这样就可以减少需要外出的机会。

2. 常洗手。

需时常保持手的卫生，因为我们的双手是最有可能接触患者的飞沫。研究也显示了新冠病毒可以在物体表面上存活数小时，甚至数天。可是，只是戴口罩，却无法完全防止这些沾在手上的病毒。最关键的是——“勤洗手”，才可以把这些沾在手上的病毒去除。例如：肥皂洗手可以达到非常好的清除手上病毒的效果。如果出门在外，无法第一时间找到肥皂，我们也可以使用含酒精的洗手液清洗我们的双手。

3. 保持社交距离。

时时刻刻谨记人与人之间保持一米的距离，尤其当碰到发烧咳嗽伤风的病患。一米的距离足以防止飞沫的传染。

4. 避免触碰自己的口鼻眼。

必须时刻谨记，时刻提醒自己和家人，这些病毒可以通过口、鼻、眼睛的管道感染我们。

5. 保持家居环境的整洁。

因为病毒可以在环境中生存一段时间，因此必须保持良好的家居环境卫生，以减低传播机会。

6. 确保有足够的药物储备。

慢性疾病患者如糖尿病、高血压患者须确保自己的药物充足。可以向自己复诊的医生查询，很多诊所和医院都开始设立邮寄药物服务和“drive through”的服务，这些都可以减少出外的机率。

7. 时刻和医生保持联系。

与你长期复诊的医院和诊所的医生沟通，以了解是否适合延后复诊的预约日子。很多慢性疾病患，都会避免去诊所和医院这一类的高风险区，担心受感染，有些甚至不去例行检查。这些行为都是不对的，因为有些疾病非常不稳定，例如第四和第五期的肾脏衰竭、心脏衰竭等较严重的慢性疾病，都需要定期的检查和护理以避免并发症。往往这些并发症都很严重，也会造成死亡。所以最好的方式还是和您的医生沟通，如果病情稳定适合延迟检查日子，那么当然最好。可是如果医生觉得需要定期检查，您应该做好防范措施去复诊。

8. 在家里观察和检测自己的疾病。

有些疾病例如糖尿病和高血压，可以利用家里的血糖测试器和血压测量器来观察自己的血压和血糖。保持良好的血压和血糖指数，可以让自己更健康，以抵抗病毒。

9. 维持健康的生活作息。

在行动管制令期间，需要维持良好的生活作息。饮食需均衡，别暴饮暴食。如血压高、肾衰竭患者需减少盐分摄取；肾衰竭，心脏病患者需注意喝水的分量，不应喝超过医生建议的分量；糖尿病患者需酌量摄取糖分和碳水化合物。大家也应该有充足的睡眠与休息。空闲时，在家里做一些简单的运动，保持身心健康。

10. 了解新冠病毒感染的征兆，及时求医。

一旦出现发烧、喉咙痛、咳嗽、呼吸困难的征兆时，可向邻近的诊所或医院就医。记得向医护人员提高相关的资料，包括：14天以内接触的人，是否接触过确诊病患，是否有出国旅游，自身的病例和正在服用的药物等等。

慢性病人如何抗疫？

以上10点只针对高风险族群的基本防控新冠病毒贴士，还有部分的慢性疾病患者需更加小心提防，比如说洗肾病患，他们还是需要每星期去洗肾中心进行三次血液透析治疗，他们不能只呆在家里，所以他们的风险也比别人高，必需时时刻刻注意自己的健康，如果出现新冠病毒征兆，应通知洗肾中心，以便洗肾中心可以准备隔离。亲戚朋友也不应该到洗肾中心探望病人，造成不必要的拥挤。洗肾病患也应该注意饮食，不应喝过量的水和吃含盐较高的食物。

哮喘病患者，也需多加小心。病患需熟悉哮喘行动计划（Asthmaaction plan）。基本上这是一些哮喘患者应懂的急救须知。远离能够引发哮喘的诱发因素例如地毯，宠物毛发和化学物等。如果哮喘患者对清洁用品敏感，可以让其他家庭成员帮忙打扫家居。至于那些长期服用抑制免疫系统药物的病人，如器官移植病人、红斑狼疮患者都应继续服用药物，不可因担心新冠病毒而擅自停止服用药物。

医生有话说：

对抗疫情是一条非常漫长的道路。即使没有行动管制令的约束，我们都必须做足防范措施，并且谨记维持自身的良好卫生习惯，避免感染病毒。病毒虽无情，唯团结一心，我们必能战胜它！

Dr. Tee Shin Kuan

Consultant Internal Medicine Physician & Nephrologist

Columbia Asia Hospital – Tebrau
MBBS (UM), MRCP (UK)

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新冠防控10贴士，大马民众务必把健康提醒记在心 - 健康时尚杂志

这篇文章首次刊登在《健康时尚杂志/GoodHealth Magazine》

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10 Important Blood/Urine Tests

10 Important Blood/Urine Tests

October 11, 2021

Here are the 10 important blood and urine tests to take during
health screening
:

1. Full blood count

There are many components included in this full blood count.

Some important to know are: Hemoglobin, Red blood cells, White blood cell and Platelets.

These tests may detect some abnormalities in body such as Anemia, Infection, Bone marrow problems or Cancer.

2. Lipid profile

This test consists of Total Cholesterol, Triglycerides, High Density Lipoprotein (HDL) and Low-density Lipoprotein (LDL).

It is important to know our risk factor for heart disease.

3. Liver Function tests

This test also has many components such as Albumin, Globulin, Total Protein, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), Gamma glutamyl transferase (GGT).

As its name suggests, this test is to know if our liver is functioning normally.

Some conditions that can be noted included poor nutrition status, liver damage due to toxin, infections etc, heart disease, bile duct blockage, bone disease or alcoholic liver disease.

4. Renal Profile (Kidney function tests)

This includes Urea, Creatinine, Sodium and Potassium.

It is important to know if our kidney is filtering out metabolism waste from our body.

Some conditions can cause abnormal renal profile readings such as dehydration, infection, heart disease, diabetes, drugs or toxins.

5. Fasting Blood Sugar and HbA1c

These tests are used for diagnosis and monitoring during treatment of Diabetes Mellitus.

These are also able to detect early abnormalities of blood sugar (Pre-diabetes state).

6. Cardiac Enzymes

This test is useful if there is a suspicious of heart disease.

Depends on the symptoms, doctor will choose which cardiac enzyme that needs to be checked.

This test can diagnose a significant ‘heart attack’ which causing damage to heart muscle.

7. Thyroid Function Test

This test is important to diagnose thyroid diseases, such as Grave’s disease (a common cause of hyperthyroidism), Hashimoto’s disease (a cause of hypothyroidism).

Other conditions are inflammation or infection of the thyroid gland.

8. Erythrocytes Sedimentation Rate (ESR)

ESR will increase (high) if there is an inflammation in the body. However, it cannot specify which part of body that has an inflammation process. A very high ESR level (>100 mm/hr) can indicate severe illness or cancer.

9. Viral test

Few important viral tests are virus hepatitis B, hepatitis C and HIV.

Hepatitis B is important because it can cause prolonged/chronic infection in the liver which may cause liver damage and liver cancer. However, it can be prevented with vaccine of hepatitis B.

Hepatitis C also can cause prolonged liver infection and now there are very good antiviral to cure this disease.

HIV disease if detect early can have better control and outcome of this disease.

10. Urine Full Examination and Microscopy Examination (UFEME)

This is a urine test that is very important to be done.

It can detect early
kidney disease
, urinary tract infection, stone in urinary tract or cancer.

In conclusion, not all the above blood tests need to be done at fasting state. Only fasting blood sugar and lipids profile need a minimal 8 hours fasting. Please book your health screening as soon as you can to get a better health outcome in case of diseases. We offer wide range of
health screening packages
 across our hospitals in Malaysia which includes basic health tests, blood and urine tests and more. Please book your health screening as soon as you can to get a better health outcome in case of diseases.

Dr. Sudarwin Tjanaka

Consultant Internal Medicine Physician

Columbia Asia Hospital – Setapak
MD (Indonesia), MMed (Internal Medicine) (UKM), CMIA (NIOSH)

Make an Appointment

PDF and Online Articles:

10 Important Blood/Urine Tests – Natural Health, Vol. 124, November/December 2021.

This article first appeared in Natural Health, Vol. 124, November/December 2021.

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这10种血液检查很重要！竟然能查出这么多毛病？

这10种血液检查很重要！竟然能查出这么多毛病？

October 11, 2021

每一次做身体检查，最重要的就是“抽血”环节，有时候还要验尿……逐一数出10种常见的血液与尿液检查项目有哪些？通过血液检查和尿检，又能够查出多少毛病？

1. 全血细胞计数(Full blood count)

顾名思义，就是统计单位体积血液中各种血细胞的数量，又被称为血常规检查。全血细胞计数是检查血液中组成血细胞的各种成分，包括：血红蛋白(Hemoglobin)、红细胞(Red blood cells)、白细胞(White blood cell)和血小板(Platelets)。医生可以通过血常规检查，了解您的血液细胞的信息，一看这个检查结果可能会观察到身体出现异常症状，如有无贫血、有无感染、有无骨髓或是癌症等等。

2. 血脂检查(Lipid profile)

主要是看你的血液中所含的脂肪量，包括测量血清中的总胆固醇、甘油三酯、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)的各项指数。然后通过获得的结果，医生才可以知晓你是否患有心脏疾病的高危族群。

*为了确保数据的准确性，通常要求要最少8小时的禁食(包括任何食物，以及除了水以外的任何液体)。

3. 肝功能检查(Liver Function tests)

顾名思义，这项检查是通过验血测量血液中的酶和蛋白质指数，医生可以根据结果来诊断肝脏是否正常运作。目前肝功能常规检查项目包括：如白蛋白、球蛋白、总蛋白、门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)等等。通过各项指标，医生可以监测是否有肝脏疾病或肝损伤，包括：有无营养不良、可能毒素引起的肝损伤、有无感染、心脏病、胆道阻塞、骨骼疾病或饮酒引起的酒精性肝病等等。

4. 肾功能检查(Renal Profile)

肾功能检查的指标是血肌酐、尿素氮、钠和钾。重要的是要让医生诊断是否存在肾脏疾病，确保肾脏是否正常运作来过滤体内的代谢废物。举例：当人体出现脱水、感染，患有心脏病、糖尿病，或者服用药物、毒素都会对肾脏造成损害，均可影响肾功能，主要表现为肾功能检查指标的异常。

5. 空腹血糖(Fasting Blood Sugar)/HbA1c

这个检查能够检测血糖的早期异常(前期糖尿病征兆)，或作为糖尿病治疗期间的诊断和监测。为了确保数据的准确性，通常要求要最少8小时的禁食(包括任何食物，以及除了水以外的任何液体)。

6. 心肌酶(Cardiac Enzymes)

如果医生怀疑你患有心脏病，那么这个检测非常重要。医生会根据病人的临床症状而选择进行哪一类型的心肌酶检查。根据有关检测结果，医生可以诊断出你是否出现心肌损伤，如严重的“心脏病发作”引起的损伤。

7. 甲状腺功能测试(Thyroid Function Test)

不管是甲状腺功能亢进还是低下，统统都可从血液检验中测检出来，这是医生诊断甲状腺疾病很重要的指标，例如格雷夫氏病(甲状腺功能亢进的常见因素)、桥本氏病(甲状腺功能衰退的主要原因)。其他情况有可能是甲状腺发炎或受到感染。

8. 红细胞沉降率(ESR)

红细胞沉降率(Erythrocyte sedimentation rate, ESR)简称血沉，是一个很常见的血液测试，估计身体炎症的水平。如果身体有炎症，ESR数据会增加或提高。虽然它不能说明身体的哪个部位有炎症过程。但是一旦出现非常高的ESR指数(>100毫米/小时)，通常代表着严重疾病或癌症。

9. 病毒检测

每一年体检最不能缺少的几项至关重要的病毒检测，如：B型肝炎病毒、C型肝炎和HIV艾滋病毒。

- B型病毒性肝炎：因为它会导致肝脏受到急性/慢性感染，从而导致肝损伤和诱发肝癌。及早接种疫苗，才能安全有效地预防B肝的感染。如果发现是携带者，及早进行治疗，这样才能有效控制病情的发展。

- C型肝炎：可能导致长期性的肝脏感染，现在有很好的抗病毒药物可以治愈这种疾病。

- HIV艾滋病：如果及早发现患有HIV疾病，可以更好地控制和治疗。

10. 尿液检查和显微镜检查(UFEME)

这是一项非常重要的尿检，医生可以根据检测数据来诊断你是否有任何的早期肾病、尿道感染、尿道结石或癌症等等征兆。

Dr. Sudarwin Tjanaka

Consultant Internal Medicine Physician

Columbia Asia Hospital – Setapak
MD (Indonesia), MMed (Internal Medicine) (UKM), CMIA (NIOSH)

Make an Appointment

PDF and Online Articles:

这10种血液检查很重要！竟然能查出这么多毛病？- 健康时尚杂志

这篇文章首次刊登在《健康时尚杂志/GoodHealth Magazine》

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10 Khasiat Luar Biasa Minyak Zaitun, Termasuk Turunkan Berat Badan

November 11, 2020

MINYAK
 zaitun adalah lemak yang diperoleh hasil daripada perahan buah zaitun
(olea europaea)
 yang banyak terdapat di rantau Mediterranean seperti di Sepanyol, Turki, Itali, Tunisia dan Morocco. Jom baca selanjutnya dan sama-sama ambil tahu tentang penyakit autoimun ini.

Disebabkan mengandungi khasiat yang tinggi, minyak zaitun telah digunakan secara meluas dalam bidang kecantikan, perubatan termasuk kulinari.

Pakar Pemakanan, Hospital Columbia Asia, Iskandar Puteri Johor, Yap Pau Lin berkata, minyak zaitun mengandungi lemak mono tidak tepu (MUFA) yang menyihatkan, di samping lemak tepu dan juga lemak poli tidak tepu (PUFA) termasuk omega 3 dan omega 6.

Ia juga terkandung bahan antioksida seperti hydroxytyrosol, oleocanthal, squalene dan beta karotin selain vitamin E tokoferol dan juga vitamin K.

Justeru, kata Pau Lin, orang ramai perlu belajar mengenali sama ada minyak zaitun yang dibeli adalah asli atau berbentuk tiruan.

Jika memilih minyak zaitun yang diimport dari luar negara, pastikan dahulu ketulenan logo pengesahan produk tersebut. Antaranya tercatat:

International Olive Council (IOC)

California Olive Oil Council (COOC)

Certified Australian Extra Virgin Olive Oil

Australia Olive Oil Association (AOOA)

Protected Destination of Origin-Europe

Ujar pakar itu lagi, harga yang mahal tidak semestinya memberi jaminan bahawa minyak zaitun itu berkualiti tinggi.

Katanya, umum perlu memahami bahawa harga sesuatu jenama itu kadang-kadang terlalu tinggi disebabkan pihak pengeluar mengambil kira cara pemprosesan minyak zaitun, kaedah ekstrak dan kos pengimportan.

Kata Pau Lin, secara keseluruhannya, minyak zaitun dibahagikan kepada lima jenis iaitu extra virgin, virgin olive, pure olive, extra light/light dan pomace (gred paling rendah).

“Daripada semua itu, extra virgin merupakan gred minyak zaitun yang paling tinggi dan mahal. Ia mengandungi kandungan antioksidan yang paling tinggi untuk melindungi sel-sel badan daripada dirosakkan. Namun, ia tidak sesuai untuk dimasak pada suhu lebih daripada 160 darjah selsius,“ ujarnya.

Pun demikian, Pau Lin memberitahu, pengambilan minyak zaitun asli yang telah diproses pada suhu tinggi atau terkandung bahan kimia tidak dicadangkan walaupun dijual pada harga yang melambung. Seperkara lagi, jangan keterlaluan menggunakan minyak zaitun kerana ia tetap mengandungi lemak.

MINYAK zaitun adalah lemak yang diperoleh hasil daripada perahan buah zaitun.

Menurut laman
SehatQ
, minyak zaitun sarat dengan pelbagai manfaat untuk kesihatan tubuh badan. Antaranya 10 manfaat paling signifikan adalah:

1. Melindungi organ jantung

Diet Mediterranean lazimnya mencampurkan minyak zaitun dalam setiap hidangan bagi mengurangkan risiko penyakit jantung.

Minyak zaitun bertindak melindungi organ jantung dengan menurunkan tekanan darah, mencegah penggumpalan darah, melindungi dinding pembuluh darah, menurunkan radang dan menjaga kadar kolesterol dalam tubuh badan manusia.

2. Mengatasi penyakit Alzheimer dan diabetes

Minyak zaitun mampu menghilangkan plak beta-amyloid yang dipercayai boleh memicu penyakit Alzheimer. Praktis dalam Diet Mediterranean juga dikatakan boleh mencegah diabetes tahap dua. Namun, kedua-duanya masih belum dibuktikan secara saintifik.

3. Mencegah strok

Berdasarkan penyelidikan, menikmati minyak zaitun dengan kerap dapat merendahkan risiko strok. Sekali lagi, ia masih memerlukan kajian lebih terperinci.

4. Menurunkan berat badan

Minyak zaitun merupakan salah satu daftar makanan sihat yang boleh dikonsumsi untuk menjaga kesihatan dan menurunkan berat badan.

5. Memiliki kadar antiradang yang tinggi

Kandungan (antiradang) dalam minyak zaitun dikatakan menyamai ubat antiradang ibuprofren. Sumber semula jadi minyak itu dipercayai boleh meringankan radang sendi (rheumatoid arthritis).

6. Mencegah pankreatitis akut (keradangan pankreas)

Keradangan pankreas atau pankreatitis akut mudah meragut nyawa manusia dengan mudah. Kandungan asam oleat dan
hydroxytyrosol
 dalam minyak zaitun mampu menghindarkan sesiapa daripada penyakit itu.

7. Mengurangi risiko depresi (stres)

Dibandingkan dengan individu yang menggunakan lemak trans, mereka yang mengambil minyak zaitun akan mengalami masalah depresi yang lebih rendah iaitu sebanyak 48 peratus.

8. Bersifat antibakteria

Minyak zaitun boleh membunuh bakteria H.pylori. Mereka yang menikmati 30 gram minyak zaitun extra virgin setiap hari, dapat merawat 10 hingga 40 peratus jangkitan H.pylori selama kira-kira dua minggu.

9. Tinggi antioksidan

Minyak zaitun yang terkandung vitamin K dan E bantu cegah seseorang menghidap penyakit kronik kerana mempunyai antioksidan yang tinggi.

10. Mencegah penyakit radang usus besar (ulcerative colitis)

Kita boleh mencegah radang pada usus besar jika makan dua hingga tiga sudu minyak zaitun setiap hari.

Berdasarkan perspektif Islam, minyak zaitun daripada buah zaitun memang terbukti hebat. Dalam al-Quran, buah itu disebut sebanyak tujuh kali bersama dengan buah lain iaitu kurma, delima, anggur dan buah tin. Kesemuanya memiliki ‘kuasa‘ hebat untuk kesihatan.

Diriwayatkan oleh Ibnu Umar RA, Rasulullah SAW pernah bersabda:
“Minumlah minyak zaitun dan berminyak dengannya kerana sesungguhnya ia adalah dari pohon yang diberkati.“
 (Hadis Riwayat Al-Baihaqi dan Ibnu Majah).

Yap Pau Lin

Dietitian

Columbia Asia Hospital – Iskandar Puteri

PDF and Online Articles:

Khasiat Luar Biasa Minyak Zaitun – Sinar Harian, 1 November 2020.

10 Khasiat Luar Biasa Minyak Zaitun, Termasuk Turunkan Berat Badan - SinarPlus, 1 November 2020.

10 Khasiat Luar Biasa Minyak Zaitun, Termasuk Turunkan Berat Badan – Edisi Viral, 1 November 2020.

Artikel ini disiarkan oleh SinarPlus, 1 November 2020.

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10 Tips to Manage Wounds After Surgery

10 Tips to Manage Wounds After Surgery

October 11, 2021

After surgery, you will need to take care of the surgical incision as it heals. Your doctor used either stitches, staples, tissue glue, or tape strips to close the surgical incision. You will need to keep the area clean, change the dressing and watch for signs of infection. Doing so not only lowers the risk of infection, it can help you avoid pain/discomfort, and limits scarring.

The following are 10 tips on taking care of your surgical incisions:

1. Avoid friction and trauma to your incision.

Do not wear tight clothing against the incision. It is best to avoid movements that affects the area surrounding your wound. That way, you'll lower your risk of pulling the wound apart.

2. Keep your incision covered with clean and dry dressings.

Change the dressing according to your doctor's instructions.

3. Showering is preferable to bathing.

Soaking the wound will soften the scar tissue and can cause the wound to re-open. You can splash the wound but do not rub the wound area as this will cause pain and delay the healing process.

4. Some waterproof dressing can be left in place while you take a bath or shower.

Other dressings that is not waterproof will need to be removed before having a bath or shower.

5. Do not use skin cleansers, alcohol, peroxide, iodine, or soaps with antibacterial chemicals.

6. Pat the wound dry gently with a clean towel after bathing or showering.

You may apply an antibacterial ointment to protect the incision from infection.

7. If the surgery was performed on your face, do not wear make-up over the scar until it has fully healed.

8. Eat a balanced diet, high in protein, which keeps your skin strong and helps wounds heal.

9. If you smoke, quit! Smoking is bad for blood flow and ultimately, skin healing.

10. All wounds leave a scar.

Scars are sensitive to the sun and can get darkened. For the first 6 months after your operation, keep scars covered or apply sunscreen. Lotions and skin softeners are also helpful to soften scars. Some scars fade over time and some do not.

If you are experiencing the following changes, you should consult to your doctor or a
general surgeon
 for further investigation.

a wound that is more red, swollen or hot

a wound that has green or yellow discharge

a wound that smells bad

bleeding that does not stop after applying pressure

pain that is getting worse

a feeling of hardness or fullness around the wound

an incision that opens

a fever over 37.8°C

Dr. Kerwin Teoh

Consultant General Surgeon

Columbia Asia Hospital – Iskandar Puteri
MBBS (IMU), MRCS (Ireland), M. Med. Surgery (USM), AM (Malaysia)

Make an Appointment

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手术后伤口护理一定不能懒！护理需要注意哪些细节？

手术后伤口护理一定不能懒！护理需要注意哪些细节？

October 11, 2021

不管是普通外科手术、整形手术或是剖腹手术，术后的伤口护理也是十分重要。如术后没有做好护理，容易引发感染，影响伤口的愈合，或者出现疤痕增生。这篇文章将由普外科医生在这里私人提醒手术后伤口护理的10项注意细节，帮助大家建立科学的伤口护理观念。

很多人都只关心手术后的各种身体恢复问题。事实上，任何手术我们都说七分靠手术，三分靠护理。好的术后护理，对术后效果有着很大的影响作用。例如预防术后感染，保持伤口清洁，最重要的一定要遵照医嘱定时服药以预防感染！请牢记：手术后伤口护理一定不能懒！

“不管您的医生使用缝线、订书钉、组织胶或胶带条来闭合手术切口。谨记！在手术后，手术切口愈合的护理一定不能少。您需要保持伤口部位的清洁，按照医嘱定时更换敷料，并注意可能出现的感染迹象。这样做不仅可以降低感染的风险，还可以帮助您避免疼痛/不适，并减少疤痕的形成。” ——张智评医生

术后伤口护理10大注意细节

以下是普外科医生私人提供的术后伤口护理10大注意细节：

1. 避免伤口摩擦和外伤

不要在切口处穿紧身衣服。一般建议在伤口未愈合前，最好避免进行一些可能拉扯伤口范围部位的运动。这样才能降低伤口裂开或被拉扯的风险。

2. 定时更换敷料

根据伤口类型不同，换药的方式也不同，切记不要偷懒！请根据医生的指示来更换敷料，用干净、干燥的敷料敷盖在您的伤口/切口。

3.尽量不要浸泡伤口

淋浴优于泡澡，尽量不要浸泡伤口，这样做会软化疤痕组织，并可能导致伤口/切口重新打开。淋浴时，您可以轻轻喷洒在伤口部位进行清洁，但不要摩擦伤口部位，因为这会引起疼痛并延迟愈合过程。

4. 选用防水敷料

不妨选用一些防水敷料外层，洗澡或淋浴时可以进行替换，能防止水分侵入，这样就可以安心淋浴或洗澡。否则在洗澡前一定要去除、更換不防水的敷料。

5. 淋浴后，应尽量保持伤口干燥

在重新敷上敷料之前，将切口风干或用干净的纱布垫或干净的洗澡巾轻轻拍干伤口。不要大力擦洗或摩擦伤口。您也可以使用抗菌药膏来保护切口免受感染。

6. 不要使用化学物品

一般上建议不要使用含有刺激性的皮肤清洁剂、酒精、过氧化物、碘或含有抗菌化学物质的肥皂等等。这些有可能会损坏伤口组织，并减慢愈合速度。

7. 不要涂抹化妆品

如果在脸部动手术，避免化妆品对于脸部伤口的刺激，一般建议等伤口完全愈合之后方可进行日常化妆。

8. 均衡饮食

一般建议选择均衡饮食，适当增加高蛋白的摄取量，有助于增强皮肤的体制，有助于伤口的愈合。

9. 如果你吸烟，请戒烟！

吸烟不利于体内的血液循环，最终不利于伤口自行愈合。

10. 好好防晒

好好防晒不管是伤口，或是手术切口，都会在皮肤上留下一道疤痕。这些刚愈合的伤口疤痕很娇嫩，对阳光很敏感，如果被紫外线照射，很容易发生色素沉淀，疤痕表层可能会变黑。一般来说手术后的首6个月伤口要进行防晒，首选以物理防晒，用衣物或胶布贴遮挡疤痕，或者等伤口较为稳定选择涂抹防晒霜的化学防晒方式。不过，有些疤痕会随着时间而渐渐消失，有些则不会；适当使用乳液和皮肤柔软剂，有助于淡化、软化疤痕。

如果看到伤口出现以下变化，请立即咨询您的医生：

伤口更红、更肿或更热

伤口出现绿色或黄色分泌物

伤口伴随着难闻的气味

伤口加压后流血不止

疼痛感加剧

伤口周围感觉硬硬或饱胀感

伤口/切口裂开

发烧超过37.8°C

Dr. Kerwin Teoh

Consultant General Surgeon

Columbia Asia Hospital – Iskandar Puteri
MBBS (IMU), MRCS (Ireland), M. Med. Surgery (USM), AM (Malaysia)

Make an Appointment

PDF and Online Articles:

手术后伤口护理一定不能懒！护理需要注意哪些细节？- 健康时尚杂志

这篇文章首次刊登在《健康时尚杂志/GoodHealth Magazine》

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10 Ways To Keep Kidneys Healthy

10 Ways To Keep Kidneys Healthy

January 18, 2023

What is so important about kidneys that you must keep them healthy?

Kidneys regulate water
 for your body to work well. It must contain just the right amount of water. One of the vital jobs of the kidneys is to remove excess water from the body or to retain water when the body needs more.
Kidneys help to balance the body’s minerals.
 Many substances in the blood and other body fluids must be kept at the correct level for the body to function correctly. For example, sodium (salt) and potassium are minerals that come from food, are essential for good health, and must be at certain normal levels. When the kidneys work correctly, extra minerals, such as sodium and potassium, leave your body in the urine. The kidneys also regulate other minerals, such as calcium and phosphate (necessary for bone strength, growth, and other functions).
Kidneys remove waste products from your body,
 like urea and creatinine. While meat is broken down into urea and other wastes, creatinine is a waste product of the muscles. As kidney function decreases, urea and creatinine in the blood increase. The creatinine level in the blood is a useful measure of kidney function and is measured by a simple blood test.
Kidneys produce hormones.
 Normal kidneys also make essential chemicals in your body called hormones. These hormones circulate in the bloodstream like “messengers” and regulate blood pressure, red blood cell production, and the calcium balance in your body.

What advice or tips should a person follow to keep kidneys healthy?

Drink Water

Proper hydration is vital to kidney health. When the body doesn’t get enough water, the kidneys get dry, causing them to absorb toxins rather than expel them. Insufficient hydration causes water retention because the kidneys cannot remove the liquids they usually would. Doctors recommend drinking between six to eight glasses of water daily. However, remember that daily intake may need to be increased in conditions like hot weather or when performing strenuous physical activities.

Put Down the Salt

This seasoning is at the top of the list of foods to avoid with kidney disease. Salt is added to processed foods, and many people pick up a fork when shaking salt onto every item on their plate. Keeping sodium intake to less than 2,300 milligrams daily is a great way to improve kidney health.

Exercise

Running a marathon or becoming a Crossfit champion isn’t necessary to enhance kidney function. Simply taking an after-dinner walk is a sensible start to being more active. Look for ways to increase movement every day. As it becomes more natural to be mobile, consider trying more strenuous workouts. Riding a bike, swimming, dancing, and yoga are all wonderful for kidney health.

Quit Smoking

It’s impossible to overstate how crucial giving up tobacco is to promote healthier kidneys. Smoking impairs blood flow to all organs and may interfere with the efficacy of blood pressure medications. Kicking the habit may not be easy, but it is the healthiest choice for everyone.

Cut Back on Alcohol

It’s best to refrain from alcohol except on special occasions. People who want to drink more often are advised to restrict intake to one drink a day for women and one to two drinks a day for men.

See Your Doctor

Routine medical appointments give your doctor a chance to perform potentially life-saving screenings. Pay attention to annual check-ups and be vigilant about additional appointments if your kidney disease risk factors are high.

Monitor Sugar Intake

People with diabetes are highly likely to develop kidney disease and are recommended to limit their consumption of sweets, sodas, and alcohol.

Keep A Tab on Blood Pressure

Consistently high blood pressure causes the kidneys to work overtime. Monitor blood pressure regularly, and stick to any recommended medications prescribed by a doctor.

Choose a Healthy Diet

Select lean proteins and plenty of fresh fruit and vegetables for most meals. Consuming green, leafy vegetables keeps body weight in check while providing critical nutrients that every system in the body requires for optimal functionality.

Limit NSAIDs

Regularly taking ibuprofen, naproxen, and similar over-the-counter pain relief remedies strain the kidneys. Ask a doctor about healthier alternatives for everyday pain management

What are the signs of healthy kidneys?

No Changes in the Frequency of Urination

One of the early signs of kidney disease is having to urinate more often. This is because damaged kidneys can cause one to feel the urgent need to urinate, even if they just went. Therefore, if you have not been experiencing an increased frequency of having to urinate, especially at night, then you likely have healthy kidneys. Consistency is a good sign, so keep an eye out for changes to your daily urination habits.

Healthy Urine

Healthy urine is directly related to healthy kidneys. Healthy urine is based on color, consistency, and frequency. When kidney damage occurs, changes to the urine can include a consistent foamy or blood in the urine. Therefore, if you or a loved one starts experiencing these symptoms, it is crucial to seek a kidney specialist immediately. Again, consistency is critical, so make sure to stay aware of any changes in the color of your urine. The darker the color becomes, the more necessary it is to talk with your doctor about the possible reasons.

Proper Sleeping Patterns

Another sign of healthy kidneys is proper sleeping habits. Since kidneys can directly impact sleeping habits, one of the first things kidney damage affects is sleep quality. This is because healthy kidneys filter out toxins and impurities through the urine, and when they can longer do that, it can impact your sleep quality. In addition to lack of quality sleep, unhealthy kidneys have also been linked to other sleeping issues, like sleep apnea. Many reasons, like stress, anxiety, and other outside factors, can cause your sleep to be disrupted. Still, if you consistently have trouble sleeping for no logical reason, your kidneys could be to blame. Be sure to look at the other signs and see if a pattern is forming that points towards kidney disease.

No Signs of Puffiness or Swelling

When your kidneys are not properly functioning, they can severely impact your look. Although you may not feel damage to your kidneys happening, you will notice that areas of your body will become puffy or swollen. Mainly, it would help if you looked out for puffiness in your eyes and swelling in your lower body. A malfunctioning kidney can leak protein into your urine and cause your body to retain more sodium.

No Muscle Cramping

While occasional muscle cramping is common, frequent muscle cramping can be a sign of damaged kidneys. This is caused by electrolyte imbalances that lead to issues such as low calcium levels. Your kidneys play a vital role in keeping your body free from toxins; without it, you will feel the physical side effects. These side effects can be aesthetic, such as puffiness and swelling, or they can be internal, like muscle cramping. Ensuring you have a healthy kidney will make the rest of your body function properly and help you be productive and efficient.

Your Skin is Clear and Healthy

The kidney function impacts a lot of other areas of the body. Those with kidney disease may have dry or itchy skin due to the inability of their blood to have the proper nutrition and minerals. If your skin is clear, then that is a good sign you have a healthy kidney.

Key Renal Malaysia’s statistics:
Malaysia is the Second-Fastest Rising Kidney Failures Globally.

Malaysia reported a 13 percent annual increase in treated kidney failure cases in the last decade, the second-highest rise in the incidence rate worldwide.

According to the United States Renal Data System annual data report for 2018, the incidence rate of treated end-stage renal disease (ESRD) in Malaysia rose an average of 13.2 percent per year from 2003 to 2016, the second country in the list to record a high increase, after Thailand at 19.4 percent.

Malaysia with highest Diabetes Mellitus related End Stage Renal Disease globally.

The most significant average yearly increase in diabetes related ESRD incidence rates from 2003 to 2016 also occurred in Malaysia and Jalisco, where incidence rates of treated ESRD due to diabetes increased an average of 9.5 and 7.8 patients per million general population (PMP) per year, respectively, over the 14 years.

The Malaysian Dialysis and Transplant Registry reported that
8,431 new patients received dialysis in 2018
; by the
end of 2018, there were 44,136 patients on dialysis.
 End-stage kidney disease (ESKD) patients are
estimated to reach 106,000 in 2040.

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 Board Certified Nephrologist (Malaysia)

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PDF and Online Articles:

10 Ways To Keep Kidneys Healthy – Natural Health, 18 January 2023

This article first appeared in Natural Health, 18 January 2023.

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15 Risiko Kehamilan Wanita Obes Turut Jejaskan Bayi

November 16, 2018

Berat badan memainkan peranan penting dalam kehamilan. Obesiti atau kegemukan akan mengundang pelbagai risiko yang tidak baik kepada diri dan kandungan.

Menurut Dr Sharina Mohd Razali, Pakar Perbidanan & Sakit Puan Hospital Columbia Asia Bukit Rimau, wanita obes yang merancang untuk hamil boleh berjumpa pakar sakit puan atau
primary care physician
 untuk mendapatkan nasihat yang tepat berkenaan berat badan optimum dan cara hidup sihat yang perlu diamalkan.

Kajian yang dibuat di Sweden mendapati penurunan berat badan sekurangnya 4.5kg boleh menurunkan risiko mendapat kencing manis semasa hamil sebanyak 40% pada kandungan yang seterusnya.

Berat optimum yang perlu dicapai adalah BMI yang normal (BMI 18-24.9) BMI adalah berat dibahagi dengan ketinggian kuasa dua .

BMI yang lebih daripada 25 adalah dalam kategori berat badan berlebihan dan BMI lebih daripada 30 ke atas adalah ‘obes’. Terdapat tiga kategori obesiti iaitu Kelas 1 (BMI 30-34.9), Kelas 2 (BMI 35-39.9) dan Kelas 3 atau
morbid obese
(BMI lebih 40).
PERSEDIAAN UNTUK HAMIL

Selain mencapai berat badan optimum dan mengikuti saranan pakar, wanita obes yang ingin hamil juga perlu melakukan beberapa perkara sebelum kehamilan agar kesihatan ibu dan kandungan berada di tahap yang optimum.

Mengambil asid folik 5mg
 atau lebih setiap hari sekurang-kurangnya sebulan sebelum kehamilan dan diteruskan sehingga trimester pertama.

Mengambil Vitamin D
 sekurang-kurangnya 10microgram sehari sepanjang kehamilan dan diteruskan sehingga selepas kelahiran bayi dan sepanjang tempoh penyusuan susu ibu.

Menurunkan berat badan.
 Wanita disarankan menurunkan sekurang-kurangnya 5-7% dari berat asal untuk memastikan proses kehamilan yang sihat dan kurang berisiko.

BAHAYA OBESITI SEMASA HAMIL

Obesiti berbahaya kerana boleh mengundang pelbagai risiko buruk kepada kedua-dua ibu dan bayi. Justeru ia perlu dicegah bagi mengelakkan berlakunya komplikasi.
RISIKO KEPADA IBU

Keguguran secara berulang
(recurrent miscarriages)

Diabetes semasa mengandung
(gestational diabetes)

Praeklampsia iaitu tekanan darah tinggi semasa mengandung yang merbahaya dan boleh mengakibatkan sawan, strok dan kegagalan organ-organ lain.

Venous thromboembolism
 iaitu darah beku pada salur darah yang bolehmengakibatkan kegagalan fungsi pernafasan dan membawa maut

Kelahiran secara induksi.

Kelahiran secara pembedahan
Caesarean.

Komplikasi bius.

Jangkitan pada luka pembedahan caesarean atau episiotomi.

Kesukaran memulakan penyusuan susu ibu.

RISIKO KEPADA BAYI

Stillbirth
 atau bayi meninggal dalam kandungan.

Kecacatan kongenital seperti
spina bifida
dan jantung berlubang

Kelahiran secara pramatang.

Macrosomia
iaitu bayi bersaiz besar.

Kematian neonatal.

Risiko bayi menjadi kanak-kanak obes dan mendapat penyakit metabolik.

Dr. Sharina Binti Mohd Razali

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Bukit Rumau
Artikel ini disiarkan oleh Majalah Pa&Ma, 16 November 2018
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15 Risiko Kehamilan Wanita Obes Turut Jejaskan Bayi - Majalah Pa&Ma, 16 November 2018


4 Real Things We Learned From Breast Cancer Awareness Month

November 13, 2019

October: the month of goblins and boobies. Not to say they go together, but shouldn’t they be given equal attention? It’s so discouraging to see that we have no problem stocking Halloween decorations into our carts but buying a pink ribbon in support of breast cancer seems to cost our lives. Come on, it’s breast cancer awareness month. An illness that has taken away multiple lives of women – mothers, daughters, aunts and spouses. It knows no boundaries and it gives no mercy to no one. Did you know that about one in 19 women are Malaysia are at risk? That’s quite a lot!

Don’t let it be a hankering when you lose your two globes. It won’t take much time and effort to love them, just some attention monthly to make sure they’re healthy and their normal selves. Starting with the breast self-examination, it’s a small step you can take right? Now take off your clothes and let your juggies run lose. We’re here to teach you how to check them correctly.

How to Self-Check Your Tits

Step 1: Visual Examination

Stand in front of a mirror with your shoulders straight and your arms on your hips. Observe your boobs to check whether there’s a change in size, shape or colour. Next, raise your hands and look for the same changes.
Step 2: Physical Examination

Using the pads of your three fingers, move in a pattern that covers the entire area and armpit. It can be done in a circular motion, up-down vertically in rows or a compass manner. And when you’re done, pinch your nipples for any breast discharges.

As for the pressure:
Light pressure:
 when you’re feeling the skin and tissue just beneath
Medium pressure:
 for the tissues in the middle of your breasts.
Firm pressure:
 when you’re reaching the deep tissues at the back, press hard and you should be able to feel down to your ribcage.

Multiple Positions to Check:

In Front Of A Mirror

Lather your fingers with lotion to help your fingers glide more smoothly over the skin. After checking around the boobs, don’t forget to raise your hands and examine the sides and armpits.
When In the Shower

Most girls prefer to do this in the shower when boobies are wet and slippery. The steps are the same as the other self-exam types and you can either do this sitting or standing.
When Laying Down

Breast tissues spread out evenly along the chest wall, which makes it easier to spot any lumps. When you’re checking your right breast, put your hand behind your head and use your left hand to check your breast. As you’re ready to check the other side, do the same but with opposite hands. In short: check your left side with your right hand and right side with your left hand! Got it?

When to Make a Visit to the Doctors:

Dimpling, puckering or bulging of the skin

the appearance of your skin is similar to the texture of an orange peel.

it’s often associated with inflammatory breast cancer.

A nipple that has changed position or an inverted nipple

unless you’re born with it, this is usually one of the symptoms.

instead of pointing outwards, the nipple is pulled the breast.

Nipple discharge

milky discharge is common when you’re breastfeeding but this should turn the red light if you’re not.

This can be in watery, milky, yellow fluid or blood form.

Changes in size & shape of the breast

If you notice your breasts swelling at times other than your menstrual cycle, or if only one breast is swollen, consult your doctor!

In cases of normal swelling, both breasts remain symmetrical. It won’t suddenly be larger or more swollen than the other.

Peeling, scaling, or flaking skin

Don’t immediately scream breast cancer when you notice these symptoms. It can simply be a characteristic of atopic dermatitis, eczema, or other skin conditions.

Have your doctor run a few tests to rule out these diseases.

Skin rash on the breasts

In cases of inflammatory breast cancer (IBC), skin rash or redness is an early symptom.

IBC doesn’t usually cause lumps, but your breasts may become swollen, warm and appear red.

What’s Next?

Don’t panic if you felt a lump (but don’t go without having it check out either just because we said so!). Pick up the phone to make an appointment with your gynaecologist or a breast specialist. They will most likely have you do an ultrasound or mammogram depending on your age.

While you're anxiously waiting for the day of your appointment, heed advice from a professional instead of Googling your symptoms and thinking it to be cancerous. We've managed to sit down with Dr Kiran, a general surgeon who specializes in breast surgery from Columbia Asia Hospital Klang, to discuss about the most commonly asked questions about breast cancer.
Most Commonly Asked Questions

Breasts come in all shape and sizes. How do you know whether they’re normal?

Breasts come in a wide range of shapes and sizes. No two people have breasts that look exactly the same. It depends on our genetic influence, weight, age and other factors such as pregnancy and breast-feeding. We should be concerned if there is a sudden change in the size or shape of our breasts or even sudden change in the appearance of the nipple or skin overlying the breast.
At what age should girls start performing breast exams?

Once a girl hits puberty, she should be encouraged to perform breast self-examination (BSE) regularly. Although there is no evidence on the effectiveness of BSE and it does not have a meaningful impact on breast cancer survival rates, the practice of BSE has been seen to empower women and encourage them to take responsibility of their own health.
How often should you get a breast examination?

Breast examination can be divided into 2 – breast self-examination (BSE) and clinical breast examination (CBE). BSE is usually performed by the woman herself. CBE, on the other hand, is an examination performed by health care providers. There are no specific guidelines recommending the frequency of breast examinations but women are encouraged to perform BSE monthly. There is insufficient evidence to support routine CBE in population-based screening. However, CBE plays an important role especially in women who fear mammograms or those who have limited access to mammography.

* One should also remember that a negative examination does not exclude the presence of breast cancer.
When is the best time to do it?

The best time to do a monthly BSE is about 3 to 5 days after our period starts as our breasts are not as tender or lumpy at this time. It should be performed at the same time every month so that it becomes a routine. For those who have undergone menopause, breast exam can be done on the same day every month.
How do I differentiate a breast gland from a lump?

Breasts contain tissues of varying consistency - including fatty, glandular and connective tissue. Breast related symptoms, such as tenderness or lumpiness, changes with our menstrual cycle. It is difficult to differentiate breast lumps from lumpy glandular breast tissue especially during breast self-examination. If there is any suspicion, do consult your doctor for further examination/ investigation.
Do all lumps translate to breast cancer?

Although breast cancer is the most common cancer found in women, most breast lumps detected during breast self-examination (BSE) or clinical breast examination (CBE) are benign in nature (non-cancerous). In fact, more than 80% of them are benign. Cancerous breast lumps tend to feel hard and irregular shaped, while many benign breast lumps are smooth or rubbery to touch.
Do breast implants raise your breast cancer risk?

There is a possible association between breast implants and the development of breast-implant associated anaplastic large cell lymphoma (BIA-ALCL), an uncommon cancer of the immune system. However, further research is required to understand better the relationship between this condition and breast implants. If you have breast implants, do visit your doctor for routine checkups and report any signs or symptoms promptly. If you are considering breast implants, discuss risks and benefits with your doctor.
What can one do to lower the chances of getting breast cancer?

In terms of reducing the chances of developing breast cancer, we should address our risk factors. Risk factors simply mean factors that increase our chance of developing breast cancer; which can be divided into two types: non-modifiable and modifiable risk factors.

Non-modifiable risk factors are factors that cannot be changed – it includes gender, family history of breast cancer and being a carrier of the BRCA1 and BRCA2 gene mutation. Hitting puberty early (<12 years old) and menopause later in life (>55 years old) increases the risk of developing breast cancer.

Modifiable risks come down to lifestyle choices such as sedentary habits, alcohol consumption, smoking and even long term intake of exogenous hormones in the form of oral contraceptive pills or hormone replacement therapy. Not bearing children, full-term pregnancy after the age of 30 as well as no breastfeeding increases the risk further.

Non-modifiable risks cannot be changed. However, the risk may be lowered for some patients; for example, prophylactic mastectomy can be performed to lower breast cancer risk in BRCA gene mutation carriers. In terms of modifiable risk factors, leading a healthy lifestyle, regular exercise and maintaining a healthy weight will not only reduce the risk of breast cancer but also reduces the risk of recurrence in survivors.
What are the things we keep doing that increases the risk of breast cancer?

Most of us are aware that excessive alcohol consumption, smoking and leading a sedentary lifestyle increases the risk of not only breast cancer but various other cancers. Hence, limiting the amount of alcohol consumption and cessation of smoking is important. Lead a healthy lifestyle, ladies!

Dr. Kiran Kaur D/O Amer Singh

Consultant General Surgeon

Columbia Asia Hospital – Klang
BSc (Hons) (Biomedicine) (UPM), MD (UPM), M Surgery (UM), Special Interest In Breast Surgery

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PDF and Online Articles:

4 Real Things We Learned From Breast Cancer Awareness Month – CLEO, 25 October 2019

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5 Common Eye Diseases In Adults

5 Common Eye Diseases In Adults

February 26, 2021

Adults may be affected with many different types of eye problems. The more common ophthalmic problems are cataracts, dry eyes, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy.

It is important to be aware of these conditions and to seek treatment early as timely intervention and preventive measures may help prevent loss of sight and the associated negative impact on quality of life that the visual impairment brings.

1. Cataract

A cataract is a clouding of the eye’s natural lens. Although it is common to have cataracts as we age, it is also more often seen in people who smoke, those who do not protect their eyes from the sun, diabetics and those with family history of cataracts. Trauma to the eyes and head may also cause cataracts.

Symptoms:

Blurry or dim vision

Glare

Difficulty in night vision

Seeing halos around lights

Need for frequent changes in glasses

As the cataract worsens it severely affects the vision and surgery would be necessary to remove the cloudy lens and replace it with a new one. Most cataract surgeries are daycare procedures performed under local anaesthesia. With modern techniques, the end results are usually excellent.

2. Dry Eyes

Tears function to lubricate our eyes and stops the surface from drying. Dry eyes occur if tears are not produced in the correct amounts or if it does not stay on the surface of the eye long enough. Dryness can range from mild afflictions to sometimes severe dryness that can damage the surface of the eyeball. Dry eye can affect anyone of any age but is more common as we get older. Dry eye is common in postmenopausal women and in people with systemic conditions such as certain types of arthritis.

Symptoms:

Grittiness or itchiness of the eyes

Pain and tearing in more severe cases

Increased sensitivity to light

Redness

Discharge or stringy mucous

Blurring of vision

There is no cure for dry eyes, but its symptoms can be alleviated. Treatment include artificial tears, punctal plugs, warm compresses and newer therapies such as thermal pulsations and intense-pulsed light therapy.

3. Age related macular degeneration

Age-related macular degeneration (ARMD) is a condition affecting older people, and it involves the loss of the person’s central field of vision. Globally, ARMD ranks third as a cause of blindness after cataract and glaucoma. Age is the biggest risk factor for developing ARMD. Family history, high blood pressure and smoking are other risk factors.

Symptoms:

Maybe asymptomatic in the early stages

Gradual or sudden blurring of vision

Visual distortion especially straight lines

Difficulty in recognising faces or central scotomas

People with macular degenerations can be treated with supplements, photodynamic therapy and anti-angiogenic drug injections.

4. Glaucoma

Glaucoma refers to a group of diseases that causes damage to the optic nerve with associated visual field loss. An elevated intraocular pressure is one of the primary risk factors for glaucoma. Advanced glaucoma leads to severe vision impairment and even blindness. Glaucoma is one of the leading causes of irreversible blindness. Risk factors for glaucoma include age, family history of glaucoma, chronic usage of steroid medications, diabetes, hypertension and short-sightedness.

Symptoms:

Called the ‘Silent thief of sight’, most people with open angle glaucoma usually do not have any symptoms until the disease is at an advanced stage. The disease starts affecting the peripheral vision and then progresses gradually to involve the central vision.

Acute angle closure causes sudden eye pain, blurring of vision, eye redness, haloes, headaches, nausea and vomiting.

Although there are different types of medication that are used in the treatment of glaucoma, surgery maybe indicated in the cases which deteriorate despite optimal medical treatment. Early diagnosis and treatment can help to prevent worsening of the condition.

5. Diabetic Retinopathy

Diabetic retinopathy is a specific complication of diabetes mellitus. Diabetic retinopathy develops with time and is associated with poor control of blood sugar, blood pressure, and blood lipids. It causes abnormal changes in the retinal blood vessels causing leakages, swelling of the retina and bleeding.

Symptoms:

Maybe asymptomatic in the early stages

Blurring of vision that maybe gradual or rapidly worsening

Fluctuation in visual acuity

Distortion of central vision

Floaters

Flashes of light

Treatment of diabetic retinopathy consists of strict control of blood sugars, laser photocoagulation, anti-vascular endothelial growth factors (anti-VEGF) injections and surgery.

EYECARE TIP

Get your eyes checked if you have any of the symptoms mentioned above it is important to consult an ophthalmologist as soon as possible.

If you have significant medical or family history such as diabetes or glaucoma, it is advisable to see an ophthalmologist at least yearly.

Stopping by and getting your eyes checked in eye screening booths in malls and events can also help to detect eye problems early.

Dr. Palanyraj Naicker

Consultant Ophthalmologist

Columbia Asia Hospital - Cheras
MBBS (India), M Ophthalmology (UM))

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PDF and Online Articles:

5 Common Eye Diseases In Adults – Natural Health

This article first appeared in Natural Health.

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6 Cara Kawal Bacaan Gula Normal Buat Ibu Hamil Yang GDM, Bolehlah Cuba Makan Kuih Raya Nanti!

June 02, 2021

Kencing manis semasa hamil atau
gestational diabetes
 (GDM) sering dihidapi wanita hamil. Bila raya ni, mesti ada yang teringin makan kuih raya kan? Kami kongsikan cara anda kekalkan bacaan gula normal untuk elak GDM.

Kadangkala buntu juga bila bacaan gula dalam darah sentiasa tinggi sedangkan anda sudah berusaha mengawalnya.

Glukosa atau glukos adalah bahan yang menjadi sumber tenaga bagi kehidupan sehari-hari. Namun jika tahap glukos dalam darah berlebihan, ia boleh memberi kesan buruk.

Terutama kepada organ-organ dalam tubuh kita seperti merosakkan lapisan retina di bahagian mata sehingga boleh menyebabkan buta.

Bacaan gula normal ibu hamil boleh dikawal dengan cara ini

Menurut Pakar Perbidanan & Sakit Puan Columbia Asia Seremban, Dr Norintan Zainal Abidin Shah, tahap glukos yang tinggi semasa hamil pula akan menyebabkan pelbagai masalah di dalam janin misalnya, masalah jantung pada bayi dalam kandungan.

Jadi ini enam cara yang dikongsikan doktor ini mungkin boleh kekalkan bacaan gula normal buat ibu hamil terutama yang menghidap GDM.

1. Senaman Ringan

Tahap glukos dikawal oleh insulin. Insulin merupakan hormon yang dihasilkan oleh pankreas supaya tahap glukos terkawal dan tidak kekal tinggi serta pastikan bacaan gula normal ibu hamil.

Dalam kalangan wanita yang hamil pula, hormon-hormon yang dihasilkan ketika hamil akan berlawan dengan insulin. Ini menyebabkan paras glukos wanita hamil mudah meningkat naik.

Setelah bayi dilahirkan dan uri dikeluarkan, tahap glukos akan kembali normal semula. Inilah yang dikenali sebagai
gestational diabetes mellitues
 (GDM) atau masalah kencing manis ketika hamil.

Pesakit GDM selalunya mengamalkan pemakanan yang seimbang tetapi tidak melakukan senaman, tahap gula atau glukos selalunya akan kekal tinggi.

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

2. Elak simpan makanan ringan di rumah

Misalnya, jika anda tidak dibenarkan minum minuman bergula, jangan beli atau simpan apa-apa minuman berkarbonat misalnya di rumah.

Semua ahli keluarga yang lain termasuklah suami hendaklah bekerjasama dalam hal ini.

3. Makan makanan berserat tinggi

Ganti beras, mi, mihun, pasta, roti biasa dengan bahan-bahan karbohidrat berserat tinggi. Beras putih boleh digantikan dengan beras perang.

Roti putih boleh digantikan dengan roti
wholemeal
. Mihun dari beras merah ada dijual di pasaran. Pasta yang diperbuat dari
wholemeal flour
 juga mudah didapati daripada pasaran.

4. Makan dalam kuantiti kecil tapi kerap

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

5. Amalkan diet disaran pakar pemakanan

Bagi sarapan, makan tengah hari dan malam; amalkan diet yang disarankan oleh pakar pemakanan anda. Hafal piramid makanan dan pastikan anda ikut.

Ia penting bagi memastikan anda makan ikut kuantiti yang sepatutnya. Hamil bukan bermakna anda perlu makan untuk dua orang, ia adalah tanggapan yang salah sama sekali.

6. Makan makanan yang anda suka tetapi pada kuantiti bersesuaian

Kegagalan diet yang disarankan oleh pakar pemakanan akan berlaku jika diet dan jenis makanan tidak menepati selera seseorang pesakit itu.

Jadi, makanan makanan yang anda suka. Misalnya, jika sarapan yang dicadangkan ialah sandwich telur tetapi anda tidak suka makan ini bolehlah tukar kepada sekeping capati atau secawan mihun goreng. Tapi pastikan kuantiti yang bersesuaian.

Pastikan makanan yang diambil adalah bersesuaian dengan kuantiti walaupun ia adalah makanan yang anda suka. Pastikan ia tidak berlebihan kerana ia mungkin boleh menganggu usaha untuk mengekalkan bacaan gula normal si ibu hamil.

Dr. Norintan Binti Zainal Shah

Consultant Obstetrician & Gynecologist

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

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6 Cara Kawal Bacaan Gula Normal Buat Ibu Hamil Yang GDM, Bolehlah Cuba Makan Kuih Raya Nanti! – Oh! Semput, 10 Mei 2021

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6 Effective Ways To Prevent Bone Density Loss

April 19, 2018

our bones may seem like hard and lifeless pieces of mass made up of collagen and calcium, but in truth, bones are living, growing tissues with blood supply and with an active metabolism. Just like how our skin cells go through a renewal process, our bones too go through a process called resorption, where old bone is broken down and new bone is formed. Bone density loss happens when more bone is broken down than is added to the skeleton.

Age is one of the factors that determine the speed at which your bone breaks down and new bone is formed. Bone formation is most active during childhood and teenage years, and then most people reach peak bone density at around age 30. After that bone resorption gradually exceeds new bone formation, which explains why many women are faced with brittle bones as they age. However, a diagnosis of osteoporosis might indicate that you’ve actually had low bone density all your life!

All is not lost. There are steps that you can take starting now to prevent bone density loss. Dr Sidik Che Kob, Consultant Orthopaedic, Trauma & Arthroscopy Sports Surgeon from Columbia Asia Hospital – Klang, shares practical tips on how to strengthen your bones.
1. Rethink your diet

Get started on a calcium-rich diet that includes salmon, sardines, dark leafy greens, broccoli, almonds, dried figs, fortified tofu and soy milk. Taking calcium supplements with vitamin D may be beneficial too.
2. Exercise, exercise, exercise

To boost bone strength, try exercises that compress the bone. For example, running, jogging, high-impact aerobics, repetitive stair-climbing, dancing and playing tennis.
3. Go easy on the drinkss

If you consume more than 3 ounces of alcohol a day (that’s roughly six drinks), you could experience more bone loss than those with minimal alcohol intake.
4. Stop smoking already!

Smoking increases the risk of osteoporosis because it reduces blood flow to the bones, slows down the production of bone-forming cells and impairs calcium absorption.
5. Regularly check your bone density

See your physician about a bone density screening. A simple X-ray test called the DXA test, measures bone mineral density and helps determine risks of osteoporosis and fractures.
6. Seek early treatment

Consider osteoporosis treatments such as hormone therapy to increase waning estrogen levels. Low estrogen levels are linked to bone loss. This can cause hip and spine fractures.
This article first appeared in Women’s Weekly, 28 March 2018
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6 Effective Ways To Prevent Bone Density Loss – Women’s Weekly, 28 March 2018


7 Perkara Tentang Penyakit Autoimun

7 Perkara Tentang Penyakit Autoimun

November 11, 2020

Tahukah anda, penyakit autoimun adalah penyakit di mana sistem imun tubuh seseorang menyerang sel atau tisunya sendiri.

Dengar macam pelik kan?

Tapi inilah yang terjadi kerana sistem imun badan gagal membezakan sel atau tisu badan dan menganggap sel tersebut adalah sel asing.

Disebabkan kegagalan fungsi tersebut, maka sistem imun badan boleh menyerang pelbagai organ dan tisu dalam tubuh.

Kenapa pula sistem imun ni menyerang tubuh kita sendiri sedangkan ia patut melindungi kita?

Jom baca selanjutnya dan sama-sama ambil tahu tentang penyakit autoimun ini.

Penyakit Autoimun: Punca, Simptom, Rawatan & Komplikasi

1. Apakah Penyakit Autoimun?

Di Malaysia, mungkin penyakit autoimun ini masih belum diketahui ramai dan mungkin kurang kesedaran terhadap kewujudannya.

Secara umumnya, penyakit autoimun ini adalah satu kondisi di mana badan manusia itu menghasilkan antibodi sendiri (sistem imun) yang menyerang sel-sel badan atau organ manusia itu sendiri.

Bagaimana ia boleh berlaku?

Jelas Pakar Perundingan Perubatan Hospital Columbia Asia Puchong, Dr. Muhammad Bin Shahruddin;
“Sepatutnya sistem keimunan dan antibodi kita ini adalah untuk menyerang penyakit seperti contohnya bakteria, fungus dan virus dari luar. Tetapi dalam kes penyakit autoimun ini, badan kita menghasilkan antibodi yang sama dan menyerang organ dalam diri sendiri. Ini kerana sistem imun badan tidak dapat membezakan sel atau tisu badan sendiri dan menganggapnya sebagai sel atau tisu asing."

2. Simptom / Tanda Penyakit Autoimun

Menurut Dr Muhammad lagi, simptom-simptom penyakit autoimun pada awalnya tidak spesifik dan tidak jelas.

Ia bermula dengan rasa rasa letih, lemah badan dan sakit otot, diikuti dengan demam yang berterusan hingga seinggu atau 2 minggu.

Ini diikuti dengan rasa sakit, bengkak, sukar untuk bergerak apabila bangun tidur dan keguguran rambut yang berlebihan.

Menurut Portal MyHealth, tanda-tanda lain juga termasuk:

Sakit sendi, sakit otot atau kelemahan otot

Susut berat badan

Ruam yang berulang, amat sensitif pada cahaya matahari, ruam berbentuk rama-rama pada hidung dan pipi

Sukar untuk memberikan perhatian atau tumpuan

Rasa letih, berat badan bertambah atau tidak tahan sejuk

Rambut gugur ataupun keputihan pada kulit

Kekeringna pada bahagian mata, mulut dan kulit

Kebas pada bahagian tangan dan kaki

Kerap mengalami keguguran

3. Jenis-jenis Penyakit Autoimun

Menurut sumber, terdapat lebih 80 jenis penyakit autoimun yang telah dikenalpasti oleh pakar.

Namun, hanya beberapa penyakit sahaja yang mungkin kita familiar atau pernah dengar; contohnya Lupus, radang usus, psiorasis, artritis reumatoid, Diabetes Type 1, Multiple Sclerosis, dan Celiac Disease.

Berikut dijelaskan serba-sedikit tentang penyakit autoimun yang popular.

i) Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus (SLE) adalah penyakit autoimun yang paling dikenali.

Ia adalah sejenis penyakit kronik di mana tubuh badan pesakit menghasilkan protein darah dengan banyak.

Protein darah yang dipanggil antibodi ini dengan sendirinya memberi tindak balas terhadap tisu seseorang.

Kesan dari penyakit ini amat berat kerana melibatkan banyak organ, manakala gejala-gejala yang timbul pula adalah tidak spesifik.

ii) Psoriasis

Psoriasis pula adalah penyakit autoimun yang menyerang kulit.

Penyakit ini mempengaruhi sel kulit hingga sel kulit baru menjadi matang terlalu cepat padahal sel-sel yang sudah tua tidak gugur sehingga menyebabkan terjadi penimbunan sel-sel di permukaan kulit.

Pesakit yang mengalami psoriasis akan menunjukkan tanda pada kulit yang terinflamasi, mempunyai tompokan, atau bersisik terutamanya pada bahagian kulit kepala, lutut, punggung dan pergelangan tangan.

iii) Penyakit Tiroid<

Penyakit tiroid berpunca daripada sistem antibodi yang menyerang organ tiroid dan lebih banyak menyerang wanita.

Dua jenis tiroid ini adalah

Grave’s Disease
 – berlaku apabila hormon tiroid berlebihan manakala Hashimoto disease berlaku apabila hormon tiroid terlalu rendah.

Hashimoto Disease
 – kelenjar tiroid kurang aktif (hipotiroid) sehingga tidak menghasilkan cukup hormon tiroid

iv) Rheumatoid Arthritis (RA)

Rheumatoid arthritis (RA) melibatkan masalah sistem muskuloskeletal di mana berlakunya keradangan pada sendi-sendi.

Pesakit RA akan mengalami sendi-sendi yang menjadi bengkak, sakit dan kaku yang biasanya lebih ketara pada waktu pagi.

Jika dibiarkan penyakit ini berterusan dan tidak dirawat, sendi-sendi boleh menjadi rosak dan hilang keupayaan.

Ia bukan penyakit keturunan dan selalunya lebih kerap dihidapi oleh kaum wanita berbanding lelaki dengan nisbah 3:1.

Walaupun rheumatoid arthritis boleh bermula pada bila-bila masa, ia lebih kerap bermula dalam lingkungan umur 35 hingga 45 tahun.

v) Celiac Disease

Celiac Disease ini mungkin kita biasa dengar berlaku pada kanak-kanak yang melibatkan gangguan pertumbuhan dan perkembangan.

Ia adalah penyakit autoimun yang menyerang usus kecil sebagai respon dari intoleransi terhadap produk gluten iaitu bahan yang terdapat dalam gandum.

Pesakit Celiac akan mengalami gangguan penyerapan makanan sehingga pesakit tidak mendapatkan gizi yang cukup.

Gejala-gejala lain adalah seperti penurunan berat badan, ketidakselesaan perut, kembung, cirit dan Anemia.

vi) Multiple Sclerosis (MS)

Menurut
The Malaysian Medical Gazette
, Multiple Sclerosis (MS) ialah sejenis episod serangan terhadap saraf optik, saraf tunjang dan otak yang dipercayai berpunca oleh gangguan pada respon imun terhadap badan.

Penghidap penyakit MS mungkin mengalami kelemahan, paraparesis (kelumpuhan separa pada anggota bawah), paresthesias (sensasi tidak normal, biasanya seperti dicucuk pin dan jarum), hilang penglihatan, diplopia (penglihatan berganda), terketar-ketar, terhuyung-hayang, atau hilang fungsi pundi kencing.

4. Punca

Sehingga kini punca penyakit autoimun masih belum diketahui punca sebenarnya yang tepat.

Walau bagaimanapun, pakar mengatakan bahawa secara umumnya ia boleh disebabkan oleh faktor-faktor berikut:-

Sejarah keluarga yang mempunyai penyakit autoimun

Jantina dan status hormon (75% penyakit autoimun berlaku di kalangan wanita)

Jangkitan virus atau bakteria

Pendedahan kepada persekitaran dan bahan kimia toksik

Tekanan (stres) dan trauma

Tabiat merokok

Kekurangan nutrisi

5. Adakah Penyakit Autoimun Merbahaya?

Kesan penyakit autoimun pada tubuh boleh membuatkan pesakit berasa tidak dapat melakukan aktiviti harian.

Namun ia juga bergantung pada tubuh badan masing-masing kerana setiap orang mempunyai tahap kesihatan yang berbeza.

Bagi sesetengah orang, kesakitan yang dialami mungkin pada tahap yang masih terkawal manakala tahap yang kronik boleh membawa maut.

6. Adakah Ia Boleh Dirawat?

Rawatan pesakit adalah bergantung kepada jenis dan gejala yang dialami.

Walaupun belum ada rawatan yang betul-betul menjamin semua jenis penyakit autoimun boleh disembuhkan sepenuhnya, namun dengan diagnosis awal serta rutin rawatan, ia dapat membantu pesakit menguruskan simptom yang dialaminya.

7. Ia Menyerang Sesiapa Saja

Walaupun kedengaran asing bagi sesetengah kita, namun penting untuk kita fahami bahawa ia boleh menyerang sesiapa saja, bahkan selebriti popular.

Antara selebriti yang pernah dikhabarkan bertarung dengan penyakit ini ialah Selena Gomez, Kim Kardashian, Lady Gaga, dan Anita Baharom, iaitu salah seorang selebriti tanah air.

Pengiran Muda Abdul Azim, 38, Putera Sultan Brunei yang mangkat pada pagi 24 Oktober 2020 turut menghidap penyakit autoimun yang menyebabkan keradangan pada pembuluh darah hingga menyebabkan kegagalan organ dan menyebabkan jangkitan berterusan.

Pentingnya Kesedaran Awam

Sebagai orang awam, kesedaran penyakit ini adalah penting supaya seseorang tidak mengabaikan simptom-simptom yang berlaku dan segera melakukan pemeriksaan jika ada sesuatu yang mengganggu aktiviti harian anda.

Dengan membangkitkan kesedaran ramai tentang penyakit ini, semoga pesakit yang didiagnos juga sentiasa bersemangat dan mendapat sokongan daripada orang di sekeliling mereka.

Dr. Muhammad Bin Shahruddin

Consultant Internal Medicine Physician

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

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PDF and Online Articles:

7 Perkara Tentang Penyakit Autoimun (SLE / Lupus, Tiroid, Psoriaris) – Harian Post, 29 Oktober 2020

Artikel ini disiarkan oleh Harian Post, 29 Oktober 2020.

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70 and Still Running

70 and Still Running

January 27, 2016

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Elite senior marathoners may be giving their younger counterparts a run for their money. A new study published in American Journal of Physiology examines if their impressive fitness has anything to do with their muscles not ageing. Consultant Orthopaedic Surgeon, Dr Harjeet Singh, shares how older persons can continue to remain active without injuries.

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90%染疫孩童遭家人传染 5岁以下不擅表达 诊断添难度

90%染疫孩童遭家人传染 5岁以下不擅表达 诊断添难度

September 24, 2021

医句话： COVID-19的感染症状有咳嗽、发烧、呼吸困难、腹泻、肌肉疼痛、疲劳、呕吐、腹痛、伤风、结膜炎、红斑或红疹等，然而，儿童群体并不像大人那样懂得精准表达自己，尤其是5岁以下的小朋友，这为诊断添加了难度。

“COVID-19在2019年杪爆发，截至2021年7月13日为止，全球有逾1亿8800万宗确诊病例，造成超过405万人死亡，全球修正死亡率为2.9%。去年12月，我曾在社交媒体上写过一篇文章，当时的全球确诊人数有1400万人，死亡人数超过40万人，然而经过7个月的时间，确诊人数和死亡数字呈急速增加，而COVID-19在马来西亚的死亡率更是高达3%，这是一个很可怕的数据。

COVID-19的感染症状有咳嗽、发烧、呼吸困难、腹泻、肌肉疼痛、疲劳、呕吐、腹痛、伤风、结膜炎和红斑或红疹等，然而，儿童群体并不像大人那样懂得精准地表达自己，尤其是5岁以下的小朋友。

小孩不说 靠医生经验“说话”

如果小朋友感染了COVID-19，首先因为他们不会表达自己的感受，所以在诊断方面也会比较复杂一些。在临床上，要选择比较有经验的医生；其次，医生需要对孩子的一些表现，例如活跃程度、或从胃口好不好等来作出诊断，以确定小朋友是不是需要对COVID-19病毒进行筛检。

在病毒大流行期间，很多人都知道感染者在咳嗽、打喷嚏、说话、唱歌或深呼吸时，会从口或鼻中释放出微小的液态颗粒（small liquid particles）。液态颗粒从较大的呼吸滴液（droplets）到较小的气溶胶（aerosols），气溶胶可以长时间在空气中生存。

我常常会在医院观察人群，发现很多人会不知觉的用手去触碰口罩看看有没有太松或太紧，而且还会在不洗手的情况下，用手触摸自己的眼睛、鼻子或口部，接触被病毒污染的表面（fomite），结果因而受到感染。

至于空气会不会传播病毒？答案是会的，只要在封闭的空间里，病毒在空气中的含量会变得很高，接着病毒就会通过空气传播，就比如在工作空间感染了病毒，而确诊者不知道自己被感染，回到家里和家人一起时，就会提高传染给家人或小朋友的几率，这就是我们所谓的空气传播。

父母为主要照护者须自律

我需要特别强调一点，往往父母都是孩子的主要照护者，如果家长没有照顾自己的卫生和安全，那小朋友被感染的风险也会大大增加，无论是在马来西亚或者全世界的数据，有90%的染疫孩童都是由家人传染。

根据卫生部的数据，截至2021年6月，已经有8万2341名18岁以下的患者确诊，而当中有33%是介于13到18岁；31%是介于7岁到12岁；而小于4岁的则占了24%。截至今年6月，已经有15名儿童因为感染COVID-19不幸逝世。

儿童患上重症和死亡的人数，相较于成人的比例是比较低的，但是在7月，有很多医生都接到儿童进入重症和死亡的消息，几乎整个儿童病房都是需要插管和呼吸器治疗，这一点是大家不容忽视的。

蛋白质制造抗体蛋白重要元素

没有最好的疫苗，接种疫苗就是最好的疫苗，我想请所有的成人都去接种疫苗，因为注射疫苗可以帮助自己和家人，可以挽救和你接触过的人的生命。 在这个大流行期间，很多家长都会问我，该给孩子吃什么以增强孩子的免疫力，其实很简单，就是确保孩子在食物中，摄取均衡的营养，特别是足够的蛋白质。其次是充足的睡眠以及适量的运动。

蛋白质促进身体健康成长，组织肌肉及各个重要器官的基本要素，更是制造抗体蛋白（antibody）的重要元素，另外，也别忽略了微量元素和矿物质特别是铁、碘、叶酸、锌、维生素A和D。维生素D在免疫系统中扮演着重要元素，主要来源是适量的阳光照射以及从海鱼、鱼肝油、鸡蛋和奶制品中摄取。

刷屏迟睡影响免疫力

充分的睡眠对身体健康和免疫功能也是极为重要，但由于疫情的关系，很多家长都放任孩子玩手机或看电视，可能会造成孩子该睡的时候不肯睡。

根据睡眠基金会（sleep foundation）的建议，1岁以下的婴儿一天大概需要15个小时的睡眠时间；而1至5岁的儿童则需要12个小时的睡眠时间；到了6到12岁的儿童则需10个小时的睡眠时间。

世界卫生组织（WHO）也建议5到17岁的儿童，一天应该要有60分钟做中等至剧烈的运动。

在疫情期间，很多人都觉得连门都不敢出，甭说去外面做运动，我的建议是，在许可的情况下，在家里做做运动让自己出身汗也好。

耐心平和讲解 消除孩童不安

在疫情笼罩下，有很多关于COVID-19的传闻，而身为父母，到底该如何向孩子正确地讲解COVID-19呢？其实孩子是知道周围在发生着什么事，例如孩子会察觉父母每天呆在家没有出去工作、他们也没有得出去商场或公园玩等，所以讲解对孩子来说是很重要的。

让孩子了解我们现在的情况，要知道孩子不像成人一样会表达自己，尤其是小过7岁的孩子，他们不会告诉大人他们的焦虑与不安，所以这个时候，家长解说时就要有耐心，语调平和，用句简单直白，消除他们的不安及焦虑。

一般上我会建议父母拿一张图片，用最浅白的句子跟孩子解释什么是COVID-19病毒，如果感染了它会对我们造成怎样的影响。

当然，在父母和孩子对话之间，身为父母也要确定孩子有在听，同时也要聆听孩子的话；还有最重要的是，大人跟大人之间的沟通，要尽量避免责备和导致污名化（stigmatization）的语言，因为不要忘记，孩子也在听着。父母也要时常注意孩子在电视上及网站上看到和听到的内容，不要只顾着居家工作，在父母居家工作的同时，孩子也可能玩着手机或者看电视。

以绘本取代电子产品

父母应该帮助孩子适应新常态，关注孩童的营养、睡眠和运动或户外活动；杜绝睡前的屏幕活动（electronic curfew）、减少孩子对电子产品的接触时间，尤其是2岁以下的孩童，电子产品会影响他们的语言能力，可以用绘本取代电子产品，增加亲子活动。

父母在教导孩子的时候，往往会用苛责的语气，例如小孩子常常不肯洗手，其实应该用温柔而坚定的语气，告诉孩子在新常态下，不洗手可能会造成什么样的后果。

同样的，由于孩子没有社交活动，就连学校或幼儿园都不可以去，这段时间父母应该观察孩子是否出现压力情绪或行为变化征兆，如过度担心或悲伤、不健康的饮食习惯、失眠或嗜睡、难集中注意力等。如果孩子出现这些症状，就要好好地跟孩子沟通。”

Dr. Sam Zhi Heng

Consultant Pediatrician

Columbia Asia Hospital - Petaling Jaya
MBBS (UM), M. Paeds (UM)

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PDF and Online Articles:

90%染疫孩童遭家人传染 5岁以下不擅表达 诊断添难度 - 医识力, 星洲网

90%染疫孩童遭家人传染 5岁以下不擅表达 诊断添难度 - 医识力, 星洲日报

这篇文章首次刊登在2021年8月28日的《医识力, 星洲网》

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A Diet For Healthy Blood

A Diet For Healthy Blood

July 13, 2017

The lifespan of a normal blood cell is about 120 days. The red blood cell is completely replaced in four to six weeks while white plasma is replaced within 24 hours. Chief Medical Officer, Columbia Asia Hospital - Petaling Jaya, Dr. Jonathan S. Nair, shares about the types of blood and its functions; as well as food that encourages a healthy blood production.
Newspaper:

Be in Diet Tentukan Darah Sihat - KOSMO!, Issue 5 July 2017

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Diet Tentukan Darah Sihat - KOSMO!, Issue 5 July 2017
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A Mindful Ramadan

A Mindful Ramadan

June 01, 2018

HEAR IT FROM THE EXPERTS TIPS TO HAVE A HEALTHY AND BALANCED RAMADAN

The Holy Month of Ramadan is a special time in Islam for reflection, spirituality and togetherness. Ramadan truly breaks borders and get the heart of all the Muslims around the world closer together. The holiest month of Ramadan is observed wit fasting, charity and offering prayers.

The holy month of Ramadan is now here and you have already changed your lifestyle. Fasting during the long hot and humid days can be easier with a little awareness.

Fasting for a whole day during a hot day may lead you to feel weak, lazy and dizzy in the absence of proper care. Many people face this during the last few days of Ramadan. A little awareness in your Ramadan diet will keep you healthy and energetic. We have shared in this edition of Make A Difference Magazine some useful tips to for you to use in Ramadan.

Make sure that you sleep for a good number of hours during Ramadan. This will compensate your lack of a complete diet. Avoid high-sugar diet and food that are too oily. Wholesome healthy foods for both the meals; Suhoor and Iftaar will serve you as a boost of energy. A healthy body will help you a lot in maintaining your emotional and spiritual health. Hence, never skip your breakfast before sunrise as it is very important to stay fit.

On behalf of Columbia Asia Group of Hospitals, we wish you a Ramadan Mubarak!

Make A Difference e-Magazine – Issue 1, Ramadan edition


Abdominoplasty

Abdominoplasty

June 21, 2012

An abdominoplasty (also know as a Tummy Tuck) is a popular form of cosmetic surgery for people wishing to regain a flatter abdomen.

Abdominoplasty is designed to flatten the abdomen by removing excess skin and fat and to tighten the muscles of the abdominal wall. It is an excellent procedure to correct excess abdominal skin and repair muscle laxity following childbirth, prior surgery, or as a result of significant fluctuations in weight.
How is abdominoplasty performed?

A full abdominoplasty is performed under general anaesthesia. The procedure takes 3 to 6 hours, depending on the individual patient.

The doctor will make a horizontal incision in the area immediately above the pubic bone. The length and shape of the incision will be determined by the degree of correction necessary. Excess skin is removed and the weakened abdominal muscles are sutured together resulting in a smooth, tight abdominal wall. If necessary, liposuction may be used to achieve the desired correction. A small incision around the navel will be necessary to re-position the belly button.
Who is a good candidate for an abdominoplasty?

You may be considered a good candidate for an abdominoplasty if you are physically healthy and your weight is stable. Patients considering abdominoplasty should have realistic expectations regarding the outcome of their surgery.
Recovery

After your surgery, the doctor will apply a dressing to your incision. You will wear a removable compression garment in order to minimize swelling while supporting your abdomen as you recover for the first few weeks. The doctor may also place a temporary drain tube under the skin to drain any excess fluids that would otherwise collect around your incision. Typically patients can return to work after about one to two weeks. However, strenuous activity must be avoided for four to six weeks. After this time, you should be standing tall and confident with your new slimmer profile. Your scars will take approximately three to twelve months to fade and flatten.
Dr. A. ANANDA DORAI

Consultant Plastic Reconstructive Aesthetic Surgeon

Columbia Asia Hospital - Bukit Rimau


About Ovarian Cancer

About Ovarian Cancer

April 30, 2020

In 2018, a woman in Connecticut had undergone a removal of a tumor from her ovary that weighed 60kg! The symptom she had was merely a rapid increase in body weight over a few months. Luckily, the tumor was not malignant. She survived the operation and did not need any further treatment after the surgery.

However, had the growth been malignant, it would have proven how discreet its progression had been; in reference to the silent killer – the ovarian cancer.

This type of cancer is the fourth most common cancer among women in Peninsular Malaysia. According to the Malaysian National Cancer Registry 2012-2016, ovarian cancer makes up 5.5% of female cancer cases with a 1.6% lifetime risk in the general population.

Introduction of Ovarian cancer

Ovaries are the female reproductive organs that produce eggs as well as female hormones, estrogen and progesterone. Ovarian cancer is the cancer arising from different types of cell within the ovaries.

The majority of ovarian tumors or growth are benign (not cancerous) especially in the reproductive age group. For malignant/cancerous ovarian tumors, a germ cell tumor is more common in those younger than 30 years old, and epithelial ovarian cancer is more common in women above 40 years old.

Factors determining risks

Evidently, the risk factors of ovarian cancer are related to two major categories, namely ovulation and family history.

Studies have shown that the early onset of menses, late menopause, first childbirth at age 35 and older, the use of androgen or fertility drugs as well as obesity with a body mass index of at least 30 kg/m2, increase the risks of ovarian cancer. Furthermore, postmenopausal women using estrogen monotherapy for at least five to 10 years have a higher risk of developing ovarian cancer.

Women younger than 25 years old at pregnancy and first childbirth and are breastfeeding, carried a 30 to 60 per cent lower risk. Additionally, women who have been taking Oral Contraceptive Pills for more than five years have a significantly lower risk of ovarian cancer.

The link to colorectal cancer

About 15 per cent of ovarian cancers are genetically related. If a first-degree relative (parent, sibling or child) develops ovarian cancer before age 50, the risk increases six to 10-fold. If two or more close relatives are affected, the lifetime risk rises by 40 per cent. Those with a family history of colorectal cancer has a higher risk of ovarian cancer. This familial risk is associated with gene mutation.

As for other cancers, the risk of ovarian cancer increases with age. It is most prevalent in the eighth decade of life. Risk also increases among those with a personal history of breast cancer.
Vigilance is prevention

There is no sure way to prevent ovarian cancer but be on the lookout for possible symptoms as well as genetic counselling for those with a family history of cancers may help. Maintaining a healthy body weight and a well-balanced diet as well as leading a healthy lifestyle, can decrease the risk. To date, there are no reliable screening tests for ovarian cancer for the general population.

Like many cancers, ovarian cancer may not produce symptoms in the early stages. However, at an advanced stage, the common symptoms include abdominal bloating or a feeling of pressure or abdominal/pelvic pain, early satiety, unexplained weight gain/loss or abnormal vaginal bleeding.

Procedures of diagnose

As for the diagnosis, most ovarian cancers are diagnosed in its advanced stage. Even in more advanced cancers, symptoms and signs are vague and nonspecific. To come to a diagnosis, the following can be expected:

A pelvic examination; the first step in evaluating a patient with a known or suspected diagnosis of ovarian cancer.

Ultrasound; this uses sound waves to create an image of internal organs, including the ovaries, uterus and cervix.

Computerized Tomography (CT) scan; this helps diagnose ovarian, fallopian tube or peritoneal cancer.

Magnetic resonance imaging (MRI); to ddetect tumors or recurrences in other areas of the body, such as the head.

Positron emission tomography (PET) scan; this is an imaging test that helps reveal how your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity. This scan can sometimes detect a disease before it shows up on other imaging tests.

The fight against ovarian cancer

Cancer treatment is particularly challenging because most cases are detected at an advanced stage due to absence of symptoms in earlier stages.

The mainstay of treatment is surgery; to locate and remove visible signs of cancer in a process called debulking surgery.

Chemotherapy; to deliver high doses of chemotherapy drug combinations to the tumors, while reducing damage to the rest of your body.

Radiotherapy; to deliver of high dose radiation to kill the cancer cells.

Targeted therapy; to block the enzyme poly ADP-ribose polymerase (PARP) from identifying damaged DNA inside cancer cells. PARP inhibitors may stop cancer cells from repairing themselves.

In conclusion, get to and stay at a healthy weight, practise regular physical activities and consume a healthy well-balanced diet with plenty of fruits and vegetables. Knowing yourself, your family history and your risks, will go a long way in curtailing the incidence of ovarian cancer.

For further details, seek professional medical advice.

Dr. Khairiah Binti Seman

Consultant Obstetrician & Gynecologist

Columbia Asia Hospital - Klang
MBBS (Australia), MMed (Obs & Gyn)(USM)

Make an Appointment

PDF and Online Articles:

The Silent Killer: Ovarian Cancer - Natural Health, 8 June 2020

The Silent Killer: Ovarian Cancer - Natural Health, 8 June 2020

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

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In the Absence of the Influenza Vaccine

In the Absence of the Influenza Vaccine

April 07, 2020

It’s the flu season and odds are you already know someone who has tested positive for either Influenza A or B. Chances are you yourself have already contracted it. For most of us, it simply means some time off work or school to rest and recuperate, and then life goes back to normal. But, Influenza can be very serious and even deadly, if you have an underlying health condition such as asthma, diabetes, heart disease or kidney disease. It is a highly contagious illness that spreads mainly by droplets that are produced when an infected person coughs, sneezes or talks. These droplets can land in the mouths or noses of people standing nearby and possibly infect them. Symptoms of Influenza are similar to the common cold, only more severe. Symptoms include high fever, body aches and pains, a bad cough, runny nose and sore throat. Some may even experience vomiting or diarrhoea and extreme fatigue which may last for several weeks.

The single most effective way to prevent influenza is to get vaccinated annually. However, in addition to vaccination, or should the influenza vaccine not be accessible to you, what are the other things you can do to protect yourself?

Avoid the germs:

It’s not hard to catch the flu. A sick person just has to sneeze or cough within two meters distance from you and you are likely to catch it. You can also get the flu germs from touching contaminated surfaces. For example, when you touch a table in a restaurant that a person infected with Influenza was dining at before you. The flu germs can also be found on surfaces such as dining tables, cashier counters, doorknobs and even the handrail belt of an escalator. Germs can linger on these surfaces for up to eight hours. When you touch one of these surfaces and then touch your face, nose or mouth, you are transferring the virus into your body. So, practising good hygiene habits is a step towards building a barrier between you and the flu germs. Certain steps include:-

Washing your hands regularly with warm water and soap, especially after shaking hands or touching a seemingly germ-covered surface.

Alternatively, it’s strongly recommended to keep hand sanitizer with you when you are going out in public places where you may not have access to a sink to wash your hands.

Additionally, carry disinfectant wipes with you to clean surfaces such as your table at a restaurant before you touch it.

Resist the urge to touch your face, mouth and nose before washing your hands.

Avoid crowded areas:

When the flu season comes around, it’s best to refrain from going to public areas that are very crowded. This includes shopping malls, cinemas and indoor playgrounds. However, if you have to be in a crowd, do wear a mask to protect yourself, such as when you are on a bus or on a train commuter to and from work.

Avoid sharing:

Although sharing is caring and a great way to bond with family and friends, it’s also the fastest way to spread germs through saliva. If you are sharing a main dish, use a serving spoon. Don’t share your utensils, plates and glasses with others, and ensure all used dishes and utensils are washed with hot water and soap.

Maintain your immune system:

When your immune system is strong, you are less susceptible to infections. So, to boost your immune system, eat a well-balanced diet rich in vitamin C and Zinc. Maintain an active lifestyle with a regular exercise routine and get enough sleep.

If you’ve been unfortunate to catch the flu bug, a combination of natural remedies and medication may be helpful to manage your symptoms at home. Over-the-counter medication such as anti-histamines, lozenges and cough syrup can help relieve your symptoms. Pain relief medication can help manage headaches and body pain. Certain natural remedies, although may not cure you, will help to soothe your symptoms.

Stay hydrated:

It’s always important to drink plenty of water on a daily basis. It is even more important to stay hydrated when you are ill with the flu. Water helps to keep the mucous membranes in our nose, mouth and throat moist and this helps the body to get rid of any built up mucous or phlegm. Additionally, when you are experiencing a high fever, such as when you are ill with Influenza, you are losing water from the surface of your skin. Also, if you are experiencing diarrhoea, that is further fluid loss. A poor appetite also means that you are not eating or drinking enough. It’s important to stay hydrated during an illness. Examples of fluids you can consume to stay hydrated are:

Plain water

Coconut water

Sports drinks

Fresh juices

Broth

Soups

Water-rich fruits such as watermelon, oranges, cantaloupe, strawberries, grapes

To ensure you are drinking enough fluids, it’s important to keep an eye on your urine output. You will know if you are well-hydrated if you have to pass urine regularly and the colour of your urine is clear to a pale yellow.

Drink warm chicken broth:

The classic old wives’ cure for the common cold is chicken broth. Its beneficial effects are numerous. Firstly, it aids in hydration, which is a key factor to recovery, and secondly, the steam from the hot broth helps to loosen and relieve nasal and throat congestion. Thirdly, chicken broth, rich in protein and nutrients, also helps to boost the immune system.

Other natural remedies:

A warm water and salt gargle can help soothe the throat and clear excessive secretions. Breathing in steam from a pot of hot water can relieve congestion in the nose, throat and sinuses. As the flu virus survives longer in dry air, using a humidifier to add humidity in your home may help reduce the flu virus circulating in the air. It is a known fact that certain spices have anti-oxidant and bactericidal effect, such as turmeric, garlic, and cloves. Star anise which is the star-shaped spice, is one of the principal active ingredients in Oseltamivir, the anti-viral drug used to treat Influenza. Therefore, a herbal/spiced drink may help you fight off the flu virus, such as a green tea infused with star anise. Pure honey can be added to soothe the throat.

Foods to consume:

Both Zinc and Vitamin C help to shorten the length of illness and relieve symptoms by boosting the immune system. Therefore, consuming foods rich in vitamin C and Zinc is helpful. Foods that are high in Zinc include red meat, lentils, chickpeas, beans, nuts, dairy and eggs. Examples of Vitamin C rich food include citrus fruits, avocados, papaya, cantaloupe, broccoli, cauliflower and capsicum. Garlic also has anti-viral properties, so eating a meal rich in garlic can help support the immune system and combat infection. Ginger may help nausea that accompanies the flu and reduces the frequency of vomiting. It can either be added to a soup or a herbal drink. Oatmeal is another good option when ill with the flu. It is a great source of fiber, which keeps the stomach full and also has pre-biotic fiber which promotes a healthy gut.

Foods to avoid:

Certain foods can slow down the recovery from the flu. Avoid alcohol as it dehydrates the body and weakens the immune system. Processed food can be high in salt, which can dehydrate the body and greasy food can slow down digestion. Dairy products can be hard to digest when you are ill with the flu and should be avoided until flu symptoms resolve. Also avoid food with rough edges such as crackers and crisps as they can scratch the throat and worsen soreness that you may experience.

Most people who have Influenza have a mild illness and may not need to see a doctor. However, do see a doctor if :

You are over the age of 65 years old or younger than 12 months old

You are pregnant or recently delivered a baby in the last 2 weeks

You have an underlying chronic medical condition such as Diabetes, Kidney, Lung or Liver Disease

You have a high Body Mass Index (BMI) of more than 40

You are not able to eat or drink anything

You are having difficulty breathing

Photo credit: Freepik.com

Dr. Harpreet Kaur A/P Harnam Singh

Consultant Internal Medicine Physician

Columbia Asia Hospital - Tebrau
MBBS (IMU), MRCP (UK), AM (Malaysia)

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PDF and Online Articles:

In the Absence of the Influenza Vaccine – Natural Health, Issue March 2020

This article first appeared in Natural Health, Issue March 2020

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Active, healthy, injury-free [Press Clipping]

April 28, 2013

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Acute Kidney Injury

Acute Kidney Injury

March 29, 2013

Acute kidney injury (formerly known as acute renal failure) is defined as a syndrome arising from a rapid fall in GFR over hours to days. The criteria used is either urine output or serum creatinine.AKI may be staged from stage 1 to stage 3.Such staging is more for epidemiology than of any clinical significance.

Classification- AKI may be classified as prerenal ARF, ATN (acute tubular necrosis),intrinsic renal disease, post renal or obstructive uropathy.

Prerenal ARF is due to reduced renal perfusion causing a reduced GFR.It is important to understand that hypoperfusion is not equivalent to volume depletion. It is the effective arterial blood volume(EABV) that matters.EABV may be considered as analogous to BP which is a product of cardiac output and total peripheral vascular resistance.Thereforehypovolaemia indeed will lower the EABV.Causes of hypovolaemia are haemorrhage, severe vomiting, diarrhoea, burns, salt loosing nephritis and diureticoverusage.Reduced peripheral resistance which results from vasodilation causing an increased vascular capacitance as occurs in septic shock, anaphylaxis and hepatorenalsyndrome will cause a drop in EABV and renal hypoperfusion.Cardiac failure will cause a reduction in cardiac output and drop in systemic BP which compromises renal perfusion.

Intrinsic renal disease are caused by:-

Glomerulonephritis

Interstitial nephritis usually drug induced

vasculitis like SLE, polyarterits nodosa, wegenersgranulomatosis

ATN and prerenal ARF are just on opposite ends of a continuum of renal damage. All that causes prerenal ARF may cause ATN. Postrenal ARF or obstructive uropathy may occur from bladder outlet obstruction like prostrate hypertrophy or bilateral ureteric obstruction from renal calculi or malignant infiltration. Clinical approach to AKI. It is important to recognise the at risk groups of patients who are:-

Elderly patients

DM with established diabetic nephropathy

Patients on ARB, ACEI, NSAID.

Hypovolaemia

Multiple myeloma

Patients undergoing surgeries especially hepatobiliary, cardiac and vascular surgery like repair of abdominal aneurysm.

History taking must include drug history like NSAID, alternative or herbal medication, history of pre-existing renal disease like diabetic nephropathy. All medications that patient is on must be noted. Clinical evaluation of fluid status is important. Never miss a distended bladder. The most discerning indicator of hypovolaemia is a postural drop of 20 mmHg systolic pressure. One must not be rigid over the 20 mm figure. I have seen a patient who presented with typical complain of giddiness on getting up from bed. His postural drop was only 10 mm Hg.In this context, I am sure the 10 mm Hg is significant. Incidentally he was started on lasix 40 mg daily,micardis 40mg daily and coralan 5 mg daily about a month by his cardiologist. Blood must be sent for renal profile, full blood count, LFT, calcium, phosphate, uric acid andUFEME.Collagen screening and vasculitic screen like anti DsDNA, ANCA Ab,Anti GBM are not routine and only done on suspicion like active urinary sediments of proteinuria, haematuria and casts. During our undergraduate days, we were taught that analysing the urine for sodium concentration, osmolarity,urine/plasma creatinine ratio will determine if it is prerenal ARF or ATN.I personally never bother, because it does not assist in management. Attempt to do so will most likely result in conflicting figures. Because in reality, there is never a 100%prerenal ARF or a 100% ATN.Most are in between. Retrospectively if renal function returns after correction of hypovolaemia, it is prerenal ARF, if not it is established ATN.

A renal and bladder ultrasound is certainly advised as it is easily available and easy to do. It helps to rule out obstruction (Acute obstruction may not give hydronephrosis).A small and echogenic kidney indicate underlying chronic renal failure. Normal kidneys mean nothing.

I would put in a CBD to monitor strict I/O chart. The most important initial management is to correct hypovolaemia.For patients who are difficult to clinically judge volume status like elderly patients, haemodynamically unstable with hypotension and those whom I anticipate will need dialysis, I would promptly insert a triple lumened internal jugular catheter under ultrasound guidance. Boluses of fluid, 200 ml of N/SALINE would be a good choice is given. After every infusion, CVP is checked and patient clinically assessed. Once euvolaemia is achieved, a bolus of IV frusemide 80 mg is given to promote diuresis.Return of diuresis do not always mean recovery, it may just convert anoliguric ARF to a nonoliguric ARF which is much easier to handle. Fluid maintainanceamounts to urine output daily plus 500 ml insensible loss daily. Meanwhile all nephrotoxic drugs like ACEI, ARB, NSAID and aminoglycosides are omitted. If after rehydration, BP remains low as in cardiac failure or SIRS (systemic inflammatory response syndroms) from sepsis or pancreatitis etc, inotropic support is required. Such cases carry a high mortality as it indicates multiorgan failure.

When to refer to a nephrologist-

When the need for dialysis is imminent like severe acidosis PH<7.0, pulmonary oedema, hyperkalaemia, severe uraemia which is left to the discretion of the attending doctor to decide.

Suspicion of an underlying glomerulonephritis or vasculitis like active urinary sediments. Prompt treatment with steroids and immunosuppressive agent may abort a catastrophic rapidly progressive or crescenteric glomerulonephrits with irreversible loss of kidney function.

Dr. Ng Butt Chin

Consultant Physician


Alkaline Water : Beneficial or Bogus?

Alkaline Water : Beneficial or Bogus?

June 01, 2016

What is Alkaline Water and who benefits from drinking it? Let Dr Sivah Sandrasakre, Chief Medical Officer, Columbia Asia Hospital – Cheras with other experts weigh in on this.

HER WORLD Magazine, Issue June 2016
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All about Varicose Veins [Press Clipping]

May 14, 2014

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Natural Health,

14 May 2014

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14 May 2014