I’m Skinny but I’m Fat

I’m Skinny but I’m Fat

July 04, 2019

Huh? It certainly is strange to hear two opposing adjectives to describe one person. How can you be fat when you don’t look fat? Apparently, being skinny fat is even more dangerous than being overweight! If this sounds a bit too much to digest, let Consultant Internal Medicine Physician, Dr. T Kalaiselvam A/L Thevandran from
Columbia Asia Hospital – Klang
 shed some light on the matter.

Tools that can be useful for finding out skinny fat are caliper measurements, Bioelectrical Impedance Analysis (BIA), and clinical tests.

In general, some symptoms or signs that very suggestive of skinny fat:

Feeling dizzy or light-headed after mild exercise

Lack of resistance exercises for many years

Flabby arms

Weak muscles

Increased Body fat percentage more than recommended.

Excess belly fat

Unhealthy eating habits with a neutral weight

Family history of Diabetes, Hypertension, Ischaemic Heart Disease

Is the term “skinny fat” a real thing?
Yes, skinny fat is a real, remarkably common phenomenon and can be deadly even. It describes lean individuals (BMI < 25kg/m2) with a dangerously high percentage of body fat compared to lean muscle mass. Many terms had been coined with skinny fat like Thin Outside Fat Inside (TOFI), Metabolically-Obese Normal-Weight (MONW), Normal Weight Obesity (NWO) and Sarcopenic Obesity (SO). In a recent research study, it was estimated that 14% of the men and 12% of the women scanned with a BMI 20–25 kg/m 2 were classified as TOFI. Being lean doesn't mean you're healthy.

What does “skinny fat” look like?
Phenotypically, they look lean and healthy, but when we check them out they have high levels of body fat and inflammation. This ectomorph body build has hidden high levels of body fat. They appear thin and flabby.

How do we know whether we’re considered “skinny fat”? What can we do to find out? What are the symptoms?
Weight is not the main measurement to use when determining the presence of skinny fat. The best way to tell if a body has excess fat stores on a smaller frame is to have their body composition checked out.

Once you’re able to get reliable information about your body fat percentage, you can compare it against the recommended percent body fat ranges. The recommended ranges for healthy men are between 10-20% body fat, and for women, the ranges are 18-28%. If your body fat exceeds these ranges, but you have a normal weight when you stand on the scale, you may be skinny fat.

Who does this usually affect? Is it common?
All age groups in both genders are affected and it is common.

Why do people who are “skinny fat” end up that way?
Most skinny fat people are the way they are because they don’t lift heavy weights or do any resistant exercise. Skinny fat people have low muscle mass. Their fat percentage is high compared to their muscle mass.

If someone is slim (means have low-fat percentage), you would be able to see their abs and their bodies wouldn't be flabby (especially their upper arms, thighs, and bellies).

Is it a dangerous issue? Are there any health risks?
Yes, skinny fat does lead to adverse clinical outcomes. The medical term for ‘skinny fat’ is technically MONW or “metabolically obese, normal weight” and “Sarcopenic obesity”. Skinny fat people are often a normal weight (or underweight!) but because of their sedentariness, lack of muscle, or poor diet, they have a high percentage of body fat.

Often, skinny fat people are at risk of certain medical issues as listed:

Raised blood sugar, leading to insulin resistance or diabetes.

Increased inflammatory markers in the body, which is linked to an increased risk of certain cancers, heart disease, arthritis, psoriasis, and depression.

Elevated blood pressure, which puts you at an amplified risk of stroke and dementia.

High triglycerides, which can root to heart disease.

Vitamin deficiencies that can lead to conditions such as chronic fatigue, anemia, and more

Digestive issues like IBS or acid reflux.

A study in the Journal of the American Medical Association (JAMA) showed that 1 in 4 skinny people have prediabetes and are ‘metabolically obese.’ This study also found that if you are ‘skinny fat’ at the time you are diagnosed with diabetes, then your risk of death is double that of someone who is an overweight diabetic.

If the answer is yes, how do we combat that “skinny fat”?
If you’re officially a part of the skinny fat club, what can you do about it? The good news is, your health is in your hands! It’s up to you to make a few lifestyle changes to go from skinny fat to strong, healthy, and balanced. Do these things to start making the transformation from skinny fat to healthy.

Exercise Often (Including Strength Training)
Being skinny fat, you need to switch from a sedentary lifestyle to one that includes both cardiovascular exercise and strength training. Building muscle is crucial to moving back the negative health effects of being skinny fat. Strength training can be done with weights or with your own bodyweight alone; there’s no fancy equipment required. Centres for Disease Control and Prevention, CDC recommends 150 minutes of cardiovascular activity for a week, and you may start strength training 2-3 times per week. Putting on muscle will re-balance your body composition, making you healthy and strong.

Apart from gym workups, a simple taking more steps can be a good starter. Get a pedometer and aim for an initial goal of more than 5,000 steps daily and then ultimately, at least 8-10,000 steps daily. This will simultaneously allow you to increase endurance and strength.

Manage Your Food Choices
Ensure that you’re
eating healthy
 with foods that nourish your body and muscles. Make sure you’re eating a vegetable-rich diet and include clean sources of protein (like lean chicken breast, salmon, and occasionally red meat) as well as healthy fats (olive oil, avocados, nuts) and fruits, legumes, and whole grains. Importantly, lowering carbs is vital to lower fat.

Manage Stress
Stress management is vital for general overall health. Studies show that chronic stress predisposes onto visceral fat which is harmful. Make meditation a daily practice, take time to unplug from devices, try yoga, and practice deep breathing when faced with difficult situations. The most important thing to remember is that your health is more internal than external.

Regular checks and tests
Take charge of your health and get all your numbers checked, not just your weight. The important numbers to know for your health are your body composition (the ratio of muscle to fat), your blood pressure, your blood sugar, and your cholesterol (including the “good cholesterol,” the “bad cholesterol,” and your triglycerides). Getting these numbers in the normal range is so much more important than any number on the scale.

What Not to Do

Don’t starve with very low-calorie diets.
When a person is looking to increase their muscle mass, calorie restricting is the last thing they want to do. Human bodies need those calories for energy, and a lot of energy goes into beefing up muscle mass.

Don’t overdo the cardio.
When a person puts themselves through an intense cardio session, especially when they don’t have the calories to burn, their bodies will start consuming muscle. This is the last thing they want to happen when trying to rid themselves of skinny fat.

Dr. Kalaiselvam Thevandran

Consultant Internal Medicine and Nephrology

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

Make an Appointment

PDF and Online Articles:

I’m Skinny but I’m Fat – Female Magazine, Issue June 2019

This article first appeared in Female Magazine, Issue June 2019

Looking for
Internal Medicine
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


The Importance of Healthy Bones - Dr Harjeet Singh [BFM - Podcast]

July 13, 2011

Consultant Orthopaedic Surgeon Dr. Harjeet Singh expounds the importance of keeping our bones healthy and strong, and ways on how to best do this.

He also touches on the occurence of bone fractures, and how to deal with the problem should it befall you.

Listen to the podcast
here
.


Influenza... Fakta Yang Perlu Anda Tahu Mengenai Virus Ini

February 03, 2020

Tahap pemulihan mangsa Influenza berbeza antara satu individu dengan individu yang lain.

JUMLAH kes influenza di beberapa negeri mencatatkan peningkatan dengan kebanyakannya melibatkan pelajar sekolah dan kanak-kanak.

Walaupun Influenza ini menjadi sebutan setiap hari, namun ada juga yang masih belum tahu apa sebenarnya penyakit ini.

Menurut Pakar Perubatan Dalaman & Neurologi, Columbia Asia Hospital Setapak, Dr Tan Wee Yong, Influenza adalah penyakit yang sebabkan oleh virus yang dikenali sebagai Influenza.

"Virus influenza yang paling biasa adalah virus influenza A dan Influenza B. Ia adalah penyakit berjangkit yang disebarkan melalui titisan udara sama ada melalui percakapan, bersin dan batuk.

"Dipercayai virus ini boleh disebarkan sejauh kira-kira dua meter," kongsinya kepada mStar.

Selsema Influenza berbeza dengan selsema biasa.

Kenali gejala Influenza

Orang yang dijangkiti akan mengalami demam tinggi, batuk, sakit otot dan kelesuan yang teruk. Kebanyakan pesakit akan mengalami kekurangan air dalam badan.

Kumpulan yang paling mudah terjejas

Orang tua berusia lebih 65 tahun, orang dengan penyakit kronik, wanita hamil dan kanak-kanak kurang daripada lima tahun. Kumpulan ini mempunyai imuniti yang kurang.

Mencegah jangkitan Influenza

Cara terbaik untuk mencegah adalah untuk mendapatkan vaksin. Disarankan supaya mengamalkan kebersihan peribadi yang asas seperti mencuci tangan lebih kerap ketika berada di luar dan pakai topeng muka di tempat terbuka serta sesak atau ketika menggunakan pengangkutan awam.

Perkara perlu dibuat sekiranya Terjejas oleh virus influenza

Doktor akan memberi ubat anti virus dan rawatan simptomatik lain seperti paracetamol, ubat batuk dan antihistamin. Pesakit disarankan menghabiskan ubat antiviral yang diberi.

Ciri-ciri dijangkiti virus influenza

Pegawai kesihatan turut membuat pemantauan kesihatan terhadap pelajar-pelajar sekolah.

Oleh kerana ciri-ciri selesema dan selesema biasa hampir sama, satu-satunya cara yang tepat untuk mendiagnosis adalah melakukan swab hidung untuk menguji virus selesema.

Anda dicadangkan untuk mengambil lebih banyak cecair, mengelakkan aktiviti berat dan isolasi daripada orang lain.

Tempoh pulih

Pemulihan biasanya berbeza bagi setiap individu. Biasanya ia mengambil masa seminggu untuk pulih, tetapi anda mungkin masih merasa lemah sehingga beberapa minggu.

Punca kes meningkat di Malaysia

Malaysia terletak di khatulistiwa, oleh itu tiada musim Influenza yang jelas di Malaysia, sekaligus bermakna negara ini akan terdapat virus influenza sepanjang tahun. Dipercayai akhir tahun adalah musim kemuncak rakyat Malaysia melancong dan melawat negara lain dan pada masa berkenaan akan membawa virus ini masuk ke Malaysia.

Dr. Tan Wee Yong

Consultant Internal Medicine Physician and Neurologist

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

Make an Appointment

PDF and Online Articles:

Influenza... Fakta yang perlu anda tahu mengenai virus ini- mStar, 19 Januari 2020

Artikel ini disiarkan oleh mStar, 19 Januari 2020

Looking for
Internal Medicine
 and
Neurology
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Influenza: No Vaccine Now What？

Influenza: No Vaccine Now What？

March 16, 2020

Influenza vaccine is updated yearly some time in August and September. This is comforting to know as according to Columbia Asia Hospital - Setapak Consultant Internal Medicine Physician and Neurologist, Dr. Tan Wee Yong, the best way to prevent contracting influenza is to take the influenza vaccine yearly.

However, currently it has been a challenge to keep up with vaccine requests from the public in light of the climbing number of influenza cases in the country. So what does one do in the mean time? “You can boost your own immune system by drinking lots of water, and eating more fruits and vegetables,” says Dr Lee, “…but the most important and obvious thing to do is to strengthen your personal hygiene habits.”

It may seem like furious OCD behavior but this is a time when the cliché ‘better be safe than sorry’ can be stressed upon with conviction. “Wash basins are not available everywhere but you still have to have clean hands all the time if that is possible. So apart from applying the handwashing technique of scrubbing your palms, back of your palms, interlacing your fingers, scrubbing them clean -- make it a habit of carrying a small bottle of hand sanitizer wherever you go and use it frequently,” advises Dr. Tan. He also calls for members of the public to start wearing a proper mask. “Imagine you are on board a train crammed with other passengers. You need to be aware of the risk you are taking every time you inhale in that environment.”

Influenza is a highly contagious disease transmitted by air droplets by people who talk, sneeze and cough. Did you know that an infected person can spread it to another person who is standing six feet away? That’s how easily this current situation can get out of hand.

Taking precautions goes both ways. As much as you don’t want to contract influenza from others, others do not want to contract it from you either. Regardless of whether one carries the influenza virus or not, if you need to cough or sneeze, there are ethics to be adhered to such as covering your mouth and turning your head away from people.

“Some people believe in air purifiers to keep influenza at bay but there has not been much evidence of that. The disease is spread by droplet from a person to a person, even in clean air surroundings,” says Dr Lee.

In some people, the risk of infection is much higher. Because of their low immunity than the average person, children under five and adults above 65 as well as pregnant women and those with chronic diseases may get a more serious infection. “Those in the high risk group may take a longer time to recover compared to others. They may also get a secondary infection which will require additional treatment including oxygen support and antibiotics,” says Dr Lee.
Photo Credit: Freepik.com

Dr. Tan Wee Yong

Consultant Internal Medicine Physician and Neurologist

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

Make an Appointment

PDF and Online Articles:

小心另一波流感 – Nan Yang, 8 March 2020

流感10知/陈伟阳医生 – Nan Yang, 8 March 2020

This article first appeared in Nan Yang, 8 March 2020

Looking for
Internal Medicine
 and
Neurology
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Injury Management in Sports

Injury Management in Sports

November 22, 2017

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

After just five weeks of the 2017-2018 season, Premiership Rugby clubs are already dealing with depleted squads due to early-season injuries. We discuss if rugby is facing an injury crisis, whether painkillers in sport is a career necessity, and the role of inflammation in healing.

Produced by: Tina Carmillia

Presented by: Meera Sivasothy

Dr. Harjeet Singh Puran Singh

Consultant Orthopedic Surgeon

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

Make an Appointment

Podcast:

Listen to the podcast here

Looking for
Orthopedic
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Injury Prevention and Treatment in Racquet-Based Sports - Dr Harjeet Singh [BFM - Podcast]

September 20, 2011

As much a part of our national identity as our food and culture, children can be seen playing badminton over house gates everywhere around Malaysia. But how much damage might our bodies be sustaining with badminton and other racquet sports? Dr. Harjeet Singh, consultant orthopaedic surgeon and sports enthusiast, tells us more.

Listen to the podcast
here
.


The Injury Prone Athlete - Dr Harjeet Singh [BFM - Podcast]

September 05, 2014

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

The news that Rafael Nadal will not be defending his US Open Grand Slam title due to a wrist injury marks the most recent injury-blighted chapter of Nadal's stellar career. Dr. Harjeet Singh examines why some athletes are more prone to injury and how this can be avoided.

Listen to the podcast
here
.


Integrated Medical Fitness - Dr Harjeet Singh [BFM - Podcast]

August 14, 2013

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon.

How can doctors, trainers and physiotherapists come together to better manage injuries and other conditions? Dr. Harjeet Singh lays out a roadmap.

Listen to the podcast
here
.


Intra-Articular Injection in the Treatment of Knee Osteoarthritis

September 25, 2020

Knee osteoarthritis (OA), is a degenerative joint disease, typically the result of wear and tear and progressive loss of articular cartilage. OA is common in elderly persons and a major cause for disability. The intensity of the clinical symptoms may vary with everyone, but it typically becomes more severe and debilitating over time. The rate of severity and progression varies for each individual, and so their clinical symptoms and knee pain. The prevalence of knee OA will continue to increase as life expectancy, and obesity rises. Studies have found that the majority of the OA patients were asymptomatic, although with radiographic findings.

Did you know

Pain is the hallmark symptom of osteoarthritis

RISK FACTORS FOR KNEE OA

Modifiable

Non-modifiable

Occupation - prolonged standing and repetitive knee bending

Weight

Health - metabolic syndrome

Muscle weakness or imbalance

Articular trauma

Age

Genetics

Gender - females more common than males

Race

The treatment for OA can be classified from the conservative approach to ultimately surgical treatment options. Intra-articular (IA) treatment for osteoarthritis (OA) is a non-surgical treatment option. This non-surgical intervention does not alter the underlying disease process but may substantially diminish pain and disability. Intra-articular injections may be useful for symptomatic knee osteoarthritis, especially where there is a considerable inflammatory component. The different intraarticular injection is corticosteroids, viscosupplements and blood-derived products.

The delivery of the corticosteroid directly into the knee may reduce local inflammation associated with osteoarthritis and minimize the systemic effects of the steroid. Whereas the other injectable option, the hyaluronic acid (HA) injections is a glycosaminoglycan that is found throughout the human body and is an important component of synovial fluid and articular cartilage. HA injection into the joint acts as a lubricant and may help to increase the natural production of HA in the joint.

Osteoarthritis is the most common type of arthritis, and generally, the chances of developing osteoarthritis rises after age 45 with the knee being one of the most affected areas. The most common cause of osteoarthritis of the knee is age, and Malaysia is fast developing into an ageing society. InfoMed sat down with Dr Ang Hock Leong, Consultant Orthopedic and Joint Replacement Surgeon, Columbia Asia Hospital - Klang to understand the medical options available for the treatment of osteoarthritis, precisely the non-surgical option.

COMMON ADVERSE EFFECTS OF IA CORTICOSTEROID INJECTION AND IA HA INJECTION

Intra-Articular Corticosteroid Injection

Intra-Articular HA Injection

Infections

Allergic reaction

Pain and swelling

Skin discoloration at the site of injection

Elevated blood sugar

Fever

Muscle pain

Injection site pain

Trouble walking

Chills

Headache

CLINICAL SYMPTOMS OF KNEE OSTEOARTHRITIS - KNEE PAIN

Worsening overtime

Worse with prolonged activity

Worse with inactivity

Worse with repetitive bending or stairs

Better with rest

Better with ice or anti-inflammatory medication

Knee stiffness

Knee swelling

Decreased ambulatory (walkabout) capacity

Did you know

Studies have shown multiple times injections of steroids which are powerful anti-inflammatory drugs, in the long term can cause further cartilage to thin out.

An Interview with Dr. Ang Hock Leong, Consultant Orthopedic, Trauma & Joint Replacement Surgeon - Klang

Who are the best candidates for intra-articular injection?

Dr Ang:
 Mild to moderate knee osteoarthritis usually respond well with hyaluronic acid (HA), platelet-rich plasma (PRP), or combination of both.

How long does an intra-articular injection last?

Dr Ang:
 Studies have shown that HA and PRP can last more than six months. In my practice, most patients do it annually.

Does this procedure require hospitalization?

Dr Ang:
 It is usually done as an outpatient or daycare procedure.

Is there any post-injection physiotherapy requirement?

Dr Ang:
 Usually, there will be slight swelling post-injection, and patients are advised to do regular cold pack and elevation for the first few days. Physiotherapy is helpful for osteoarthritis in terms of pain relief, reduce stiffness and thigh muscle strengthening.

Intra-articular injection is a steroid. Any side-effects?

Dr Ang:
 Intra-articular steroid injection can provide an excellent anti-inflammatory effect. It is usually done for acute exacerbation of osteoarthritis or inflammatory arthritis like rheumatoid arthritis and gouty arthritis. Since it is injected into joint space, systemic absorption into the bloodstream is minimal to cause systemic side effects. However, studies have shown multiple times injections of steroid in the long term can cause further cartilage thin out.

Is age a factor in considering intra-articular injection as an alternative to TKR?

Dr Ang:
 Yes. For a patient who is too young for TKR, or elderly who has multiple medical co-morbidities who is unfit for surgery.

Older adults often have complex and multiple disorders. As a surgeon, how do you view your challenges in improving the quality of life of older people?

Dr Ang:
 TKR is proven to improve the quality of life of knee osteoarthritis patient. However, every surgery carries certain risks and possible complications, especially in elderly who has multiple medical co-morbidities. Recent medical advancement has allowed pretty decent control over multiple chronic disorders, improvements in surgical techniques, advancement in materials, and instruments have lead to shorter operation time, less bleeding, lower infection rates. Better implant design improves longevity and addresses osteoporotic bone in elderly. In general, post-operation recovery is faster, and shorter rehabilitation process has reduced other risks like deep vein thrombosis, improve surgical outcomes and implant longevity, and subsequently better quality of life. In my practice, if medical co-morbidities are reasonably controlled, and surgical benefits outweigh the risks, surgery is still my preferred choice of treatment.

Are there any restrictions for doing an intra-articular injection?

Dr Ang:
 Generally, if there is active knee infection, the injection should not be given. In my practice, do not give HA/PRP during acute exacerbation of arthritis except steroid to avoid excessive swelling and pain. The injection should not also be given if the patient is allergic to the component of HA /PRP.

Are the options and the personal goals of the patient discussed in arriving at the best treatment?

Dr Ang:
 Good clinical practice should always explore patient expectations before the commencement of any treatment plan. Current evidence does not suggest intra-articular injection as a cure for knee osteoarthritis. It is merely an adjunctive to ease symptoms and functions. There are still non-invasive and non-pharmacological options available like weight reduction, activities modification, low impact exercises, applying topical NSAIDs, rest, walking aid and oral pain killer during bad days etc., and of course a more proven treatment method, TKR.

In my practice, patients are always informed regarding the effectiveness of intra-articular injection, which may not last long, or it may not be effective at all before they consented for the procedure. Available options are always discussed at the same time.

Can you tell us about platelet-rich plasma use in intra-articular injection?

Dr Ang:
 Platelet-rich plasma or PRP, a mixture of high concentration of platelet and associated growth factors, derived from the centrifugal separation of patient own whole blood or other persons whole blood. It is injected into the knee joint in the hope of promoting healing in wear and tear joint. More and more studies have shown promising outcomes of PRP, especially in younger patients. However, further studies still needed to determine the details like optimum preparation methods, volumes, concentration etc.

The key symptom of knee osteoarthritis is pain. What are the options available with intra-articular injection in minimizing this pain?

Dr Ang:
 Hyaluronic acid (HA), is the natural collagen in our connective tissue. The function is providing cushioning, lubricating and viscous effects in knee joints. HA injection or viscosupplementation is to replace or supplement the progressive loss of HA in osteoarthritis knee. It can be avian derived or produced via bacteria fermentation. The higher molecular weight variant (more than 1 million Dalton) is shown to be more effective. It is also shown to be more effective when used in combination with intra-articular steroid.

Intra-articular steroid injection is very effective in treating the pain during acute exacerbation of osteoarthritis or inflammatory arthritis like rheumatoid and gouty arthritis.

Intra-articular stem cell injection. The mesenchymal stem cell is used in intra-articular knee injection with the hope that stem cell will proliferate and differentiate into cartilage to replace and repair the damaged host cartilage. These cells are usually sourced from patient own bone marrow aspirates, adipose tissue, or peripheral blood. Although many active studies are ongoing, there is still no strong evidence to suggest the stem cells as a cure to osteoarthritis. In fact, there is still a lot of debate going on regarding its efficacy, cell harvesting, processing, characterization and delivery.

In intra-articular injection, are there any risks that might overshadow their potential benefits?

Dr Ang:
 Although it is a minimally invasive outpatient procedure, but a small risk of introducing infection into the joint cavity still possible. It may cause skin redness, skin irritation over the injection site, especially avian derived HA if the patient is allergic to avian products.

What about the recovery and regain process after the intra-articular injection?

Dr Ang:
 Most patients will have some knee swelling post-injection which may last a few days, but they are generally able to walk independently immediately after injection. They are advised to use a cold pack and elevate the knee when at rest. It is not advisable to receive this treatment too near to their planned trip or vacation.

What are the current challenges in intra-articular injection for the treatment of knee osteoarthritis?

Dr Ang:
 Efficacy of intra-articular injection is not consistent, and a lot of time is short-lived. We do not know exactly which patient will respond well even though they are in the same stage of the disease. We also do not know how long it will last. Intra-articular injections are still not a cure to osteoarthritis as none of them have shown to replace or to regenerate cartilage especially in advance stage of osteoarthritis and also in the elderly who usually do worse when it comes to tissue regeneration capacity.

Photo credit: Freepik.com

Dr. Ang Hock Leong

Consultant Orthopedic, Trauma & Joint Replacement Surgeon

Columbia Asia Hospital – Klang
MBBCh BAO (Ireland), MS (Orthopedics) (UKM), Fellowship in Adult Joint Reconstruction (Singapore)

Make an Appointment

PDF and Online Articles:

Intra-Articular Injection in the Treatment of Knee Osteoarthritis – InfoMed Malaysia, Issue 34, Jul - Sep 2020.

This article first appeared in InfoMed Malaysia, Issue 34, Jul - Sep 2020.

Looking for
Orthopedic
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Irregular Bowel Movements

Irregular Bowel Movements

November 22, 2018

Constipation is common in childhood. Parents often become very worried about their child’s bowel habit. The main thing to realise is that every child is different. Normal can vary quite a bit. It is a change in what is normal for your child that suggests a problem. The frequency of bowel movements is not very important. What is important is that the stools are soft, well-formed and passed easily.

Babies will open their bowels anything from several times per day to once every few days. As your baby grows up, into a toddler and then a young child, you may see further changes in the stool frequency and consistency, often dependent on what they are eating. Anything from three times a day to once every other day is common and normal.

Constipation in children or babies can mean any, or all, of the following:

Difficulty or straining when passing stools.

Pain when passing stools, sometimes with a streak of blood on the toilet paper, due to a small tear in the skin of the anus.

Passing stools less often than normal. Generally, this is less than three proper stools per week.

Stools that are hard and perhaps very large, or pellet-like and small, like rabbit droppings.

Your child may be constipated because they are not eating enough high fibre foods or drinking enough water. When paired with good hydration, fibre keeps your digestive tract moving along as it should. This prevents and can even treat constipation.

Children between the ages of 1 and 18 should be getting between 14 and 31 grammes of fibre a day. Foods which are high in fibre are fruit, vegetables, cereals and wholemeal bread.

The list below can give you some ideas of what your child should eat to increase her fibre intake:

Whole-wheat and whole-grain bread has an average of 2g of fibre per slice.

High-fibre cereals like raisin bran-type cereals, contain about 5g of fibre per bowl.

Each medium banana or orange contains 3.1g of fibre, which makes it a great afternoon snack.

One small apple contains 3.6g of fibre.

One medium baked sweet potato with peel contains 3.8g of fibre.

Dried (or semi-dried) apricots or raisins for snacks.

Parent should encourage children to drink plenty of water.

However, some children get into the habit of only drinking squash, fizzy drinks or milk to quench their thirst.

These may fill them up and make them less likely to eat proper meals with food that contains plenty of fibre. Try to limit these kinds of drinks and give them water as the main drink.

If you think your child may be constipated, take him to the doctor. The treatment for constipation depends on your child’s age. The longer your child is constipated, the more difficult it can be for them to get back to normal, so make sure you get help early.

Answers provided by Dr Lim Kok Chong, consultant paediatrician, Columbia Asia Hospital — Bukit Rimau.
Published in New Straits Times, 20 November 2018

Worm Infections – New Straits Time, 20 November 2018


Irritable Bowel Syndrome in Children (Part 1)

May 30, 2023

Irritable bowel syndrome or IBS, is a chronic inflammation of the gut. It causes abdominal pain, diarrhoea, and bloody stools. It usually starts in childhood before the age of 16.

For kids, IBS can reduce their quality of life, preventing them from enjoying or participating in daily activities like learning and playing.

We sat down with Dr Jayagauri A/P Balakrishnan, Consultant Pediatrician at Columbia Asia Hospital - Petaling Jaya, to learn more about IBS in children and what parents can do if their kids have this condition.

Q1: What are some of the most common symptoms of IBS?

There are 3 subtypes in childhood IBS: Crohn’s disease (CD), ulcerative colitis (UC) and IBD unclassified (IBD-U). These diseases are not contagious and sometimes it’s hard to differentiate between them.

But we have found some common symptoms of irritable bowel syndrome (IBS) include:

Abdominal pain or discomfort (with varying intensity)

Changes in bowel movements (diarrhoea or constipation)

Mucus or blood in the stool

Fatigue

Joint pain: 7 to 20 percent of people with IBS suffer from arthritis, typically the large joints of the lower extremities.

Anxiety and depression

IBS symptoms can vary from person to person. Some may experience only a few of these symptoms, while others may experience several and the severity also varies over time.

Q2: What are some of the causes of IBS in children?

The cause of irritable bowel syndrome (IBS) in children is unclear and can have various causes.

Some of the factors or triggers that may contribute to IBS in children include:

Genetics

Certain genes that you were born with may make it more likely that you will get IBS. So, if one or both of your parents has IBS or if your child has a family history of IBS, then chances are they will inherit the condition.

Inappropriate Immune Response

This can take the form of either hyper or hypo-immunity. When a person’s immune system reacts inappropriately which causes inflammation of the intestine leading to the gastrointestinal symptoms listed previously.

Abnormal Gastrointestinal Motility

Muscles which control movement of food through the digestive system may contract too strongly or weakly, leading to IBS symptoms.

Microbiome Imbalance

Imbalance of the gut microbiome can also be blamed for IBS. This happens when the good and bad bacteria in the gut are not balanced.

Environment

Environmental factors also cause IBS symptoms. Things that you are exposed to, such as food (highly processed food) can trigger IBS symptoms. In some children the common food triggers are dairy, gluten, and high-fat foods.

Psychological Factors

Sometimes the triggers can be entirely in the mind. Stressful situations and anxiety attacks can worsen IBS symptoms especially in children.

Medications

Certain types of drugs and medical treatments can unfortunately cause IBS symptoms. For instance, taking antibiotics multiple times early in life increases the risk of IBS. Repetitive infections and exposure to toxins also known to increase the risk of IBS.

Q3: How is IBS diagnosed in children?

Doctors diagnose IBS by looking at medical history, studying the symptoms, carrying out physical examinations and other tests.

Some of the tests that doctors may use to diagnose IBS in children include:

Blood Tests:
 inflammation, haemoglobin, low blood protein, etc.

Stool Tests:
 blood, infections, inflammation markers

Breath Tests:
 bacterial overgrowth in the small intestine

Imaging Tests:
 ultrasound, barium meal, MRI, capsule endoscopy.

Endoscopy:
 intestinal examination and biopsy.

To diagnose IBS in children, doctors usually consider the symptoms the child is experiencing and the results of any tests they may undergo.

The healthcare provider will carefully evaluate the child and use their professional judgment to make the diagnosis.

Q4: How do you treat children with IBS?

The treatment of IBS in children is based on the severity of their symptoms, their age, and their individual needs. It is complex and should involve a multi-disciplinary team.

The goal of treatment includes:

to relieve symptoms and improve the child’s quality of life and maintaining the patient’s remission for long period of time

healing the intestine and preventing complications

to maintain normal growth and development

restoring quality of life

To accomplish these goals involves the implementation of the following steps:

Medications

Certain medications can help manage specific symptoms of IBS. Medication also helps control the swelling and irritation (ulcers).

 There are several types of medications used and chosen based on where the disease is located and the severity of the irritation.

Doctors may also prescribe probiotics, which are live bacteria that promote gut health.

Nutritional Management

Dietary changes may help to alleviate IBS symptoms.

Avoid foods that may trigger symptoms, such as high-fat foods or dairy products. Increasing fibre intake and drinking plenty of fluids.

Poor diet can cause poor growth and poor weight gain.

This is why it’s important that an IBS team includes dieticians who can plan an individual nutritional plan catered to your child’s specific needs.

Stress Management

Stress and anxiety can exacerbate IBS symptoms, so stress reduction techniques such as relaxation exercises, biofeedback, or counselling may be recommended.

Surgery

Surgery is an important part of effective treatment for some patients when medicine alone cannot control the symptoms or reverse the bowel damage.

Q5: How can parents help manage their child’s symptoms at home?

Depending on the symptoms, a doctor may prescribe different treatments for each child. This includes lifestyle changes and how to manage their condition at-home.

However, here are some general steps that parents can take to support their child’s if they have IBS:

Consistent Routine

Children often benefit from a regular routine that includes consistent sleep, meal, and activity times. This helps stabilise their mood, energy levels, and overall health.

Good Nutrition

A healthy and balanced diet can help reduce inflammation, boost immunity, and support overall health. Encourage your child to eat a variety of fruits, vegetables, whole grains, lean protein, and healthy fats. Limit foods which can exacerbate symptoms.

Hydration

Help your child stay hydrated which can help reduce symptoms like constipation. Encourage your child to drink plenty of water and limit sugary drinks.

Manage Stress

Encourage your child to engage in stress-reducing activities such as mindfulness, deep breathing exercises, or yoga. Make time for fun and relaxation activities.

Doctor’s Visit

If your child is experiencing significant symptoms, it’s important to call and discuss them with their healthcare provider.

Dr. Jayagauri A/P Balakrishnan

Consultant Pediatrician

Columbia Asia Hospital - Petaling Jaya
MD (Russia), M Pediatric (UM)

Make an Appointment

PDF and Online Articles:

Doctor Tells All on Irritable Bowel Syndrome in Children (Part 1 of 2)

This article first appeared in Motherhood.com.my, 29 May 2023.

Look for
Pediatric
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Irritable Bowel Syndrome in Children (Part 2)

May 30, 2023

Irritable bowel syndrome (IBS) in children can cause all sorts of bowel issues. For children, this condition can severely reduce their quality of life.

We sat down with Consultant Pediatrician at Columbia Asia Hospital - Petaling Jaya, Dr. Jayagauri A/P Balakrishnan, to learn more about this disease. Read Part 1 of our conversation
here
.

In the first half of our chat, we covered some important topics about irritable bowel syndrome in children. These include symptoms, causes, tests, treatments and at-home management.

In Part 2, we will cover everything else that you need to know, including complications, parental support, differences between adult and children, takeaways, and resources.

Q1: What are the long-term complications associated with childhood IBS?

IBS is generally not associated with serious long-term health complications, but it can have a significant impact on a child’s quality of life.

Children with IBS may experience the following long-term complications:

Poor growth:
 malnutrition, possible delayed puberty.

Chronic pain:
 abdominal pain interfering with day-to-day life.

Medication associated:
 Immunosuppression, increase in opportunistic infection (e.g., TB reactivation).

Strictures:
 Narrowing of the intestine obstruction of the bowel causing reduced food intake, severe nausea and vomiting and pain after eating.

Non-digestive complications:
 Eye inflammation, joint pain or swelling (arthritis), skin sores, liver disease.

Malignancy:
 Colorectal carcinoma and medication-induced lymphoma

Psychological impact:
 anxiety, depression, and other mental health problems particularly during the adolescent period.

It’s important to note that these long-term complications are not inevitable for all children with IBS.

With appropriate management and treatment, many children with IBS can lead normal, healthy lives.

Q2: How can parents and caregivers support children with IBS?

Parents and caregivers can play a critical role in supporting children with irritable bowel syndrome (IBS) in several ways:

Pediatric Consultation

Work closely with your child’s healthcare provider, be sure to follow the healthcare provider’s recommendations regarding medication, diet, and lifestyle changes.

Be Informed

Learn as much as possible about your child’s condition and treatment options. This can help you understand your child’s symptoms, anticipate potential triggers, and be better prepared to help them manage their symptoms.

Communicate

Encourage your child to talk about their symptoms and how they’re feeling. Create a safe and supportive environment where they feel comfortable discussing their concerns.

Emotional Support

Stress can trigger or worsen IBS symptoms, so it’s important to help your child manage stress. Encourage relaxation techniques, and find activities that help your child relax and feel good.

Healthy Lifestyle

Encourage your child to eat a healthy and balanced diet, get regular exercise. Healthy lifestyle helps manage IBS symptoms and improve overall health.

Q3: How does IBS in children differ from in adults?

Some of the key differences between IBS in children and adults include:

Symptoms

Children with IBS may experience symptoms differently than adults. While adults with IBS commonly report abdominal pain and altered bowel movements, children may have more other symptoms such as nausea, vomiting, and poor appetite. Many of the symptoms in children may overlap with other digestive illness thus diagnosing IBS in children can be challenging. A doctor may need to rule out other conditions before making a diagnosis of IBS in children.

Treatment

Many of the treatment options for IBS are similar for both adults and children, but some medications may not be appropriate for children due to the side effects. Plus, dietary and lifestyle changes may be more challenging to implement in children. However, this may be difficult for picky eaters who have food preferences or have difficulty adhering to strict dietary restrictions.

Quality of Life

IBS can have a significant impact on a child’s quality of life, including school attendance, social activities, and academic performance. It’s important to consider these factors when treating a child with IBS. In terms of unique challenges in treating children with IBS, doctors need to take into account the developmental stage of the child, as well as their individual needs and preferences. Children may require more support from their caregivers to manage symptoms and stick to treatment plans.

Overall, a multidisciplinary approach that includes healthcare providers, parents/caregivers, and schools can be effective in managing IBS in children.

Q4: What should parents keep in mind if their child is diagnosed with IBS?

If your child has been diagnosed with irritable bowel syndrome (IBS), here are some key takeaways for parents to keep in mind:

Educate yourself about IBS:
 this can help you better understand your child’s condition and provide better support.

Work with a healthcare professional:
 It’s important to work closely with your child’s healthcare professional to develop an appropriate treatment plan that works best for your child.

Encourage healthy eating habits:
 Encourage your child to eat a balanced diet that includes plenty of fruits, vegetables, whole grains, and lean proteins. Avoid foods that are known to trigger IBS symptoms.

Help your child manage stress:
 Stress can trigger or worsen IBS symptoms, so it’s important to help your child manage stress in healthy ways.

Communicate with your child:
 Talk to your child and encourage your child to talk about their symptoms and how they are feeling. This can help you provide better support and help them manage their condition more effectively.

Q5: What are some resources on IBS for parents?

There are many resources available to help parents learn more about irritable bowel syndrome (IBS), including:

Online Resources

There are many online resources available, such as the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which provides information on IBS symptoms, causes, and treatment options.

Healthcare Professionals

One of the most important resources for parents of children with IBS is their child’s healthcare professional. Pediatricians, gastroenterologists, and other healthcare professionals can provide information, advice, and treatment options tailored to your child’s specific needs.

Books and Articles

HThere are many books and articles written by healthcare professionals and patient advocates that provide information on IBS.

Support Groups

Joining a support group for parents of children with IBS can be a great resource for learning more about the condition, sharing experiences, and finding emotional support. The IBS Association and IFFGD both offer support groups for parents and caregivers of children with IBS.

Dr. Jayagauri A/P Balakrishnan

Consultant Pediatrician

Columbia Asia Hospital - Petaling Jaya
MD (Russia), M Pediatric (UM)

Make an Appointment

PDF and Online Articles:

Doctor Tells All on Irritable Bowel Syndrome in Children (Part 2 of 2)

This article first appeared in Motherhood.com.my, 29 May 2023.

Look for
Pediatric
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


生痔疮一定要开刀？

生痔疮一定要开刀？

November 03, 2020

生痔疮一定要开刀?

“先进激光镭射微创治疗”替你让你无需开刀也能去除痔疮

痔疮 . 不是一个可以高谈阔论的话题？

谈及 “痔疮” ，或许多数人会觉得这是个隐私的话题而避而不谈。因为痔疮似乎是一个禁忌，不是一个可以公开讨论的话题。

你知道吗?其实痔疮是一种非常普遍的疾病!整个社会有将近一半以上的男性和女性患有或患有过痔疮。或许，现在你身边就有人默默的承受着痔疮带来的痛苦与烦恼。

多数人在患上痔疮后，都会因为觉得羞耻而不咨询专业医生，最后选择自己治疗。迫于无奈下，到药剂行购买痔疮膏成了看似唯一的办法，即使患者心里明白，痔疮膏并不能永久性的改善疼痛感，更不能从根本解决痔疮问题。当情况愈来愈严重时，例如痔疮出血后，患者才会 “被迫” 到医院寻求帮助。

永久去除痔疮 只能手术割除？

提到 “永久去除痔疮”，不知大家脑海里是否浮现出电视节目中的演员，在动手术割除痔疮后坐在游泳圈上减轻痛楚的画面？

去除痔疮的传统手术疗法的确会造成一定的痛楚。Columbia Asia Hospital 现已提供最先进的“激光镭射微创治疗”，让痔疮患者无需通过手术开刀，也能解决烦恼！

激光镭射微创治疗

Columbia Asia Hospital 为了痔疮患者从德国引进了先进的激光镭射仪器。加上医院专业且具经验的医疗团 队，能够以更较小的侵入性干预让患者与痔疮说再见! 这台看似不起眼的仪器，能够精准放射出激光，通过一个小于 2 毫米的刺孔，阻断痔疮静脉血供，让痔疮 组织萎缩并到最后完全消失。

为何推荐激光治疗除痔疮?

通过激光来使突出肛门的痔疮组织萎缩，全程不需要开刀切除任何身体组织。跟传统手术开刀手法相比之下，激光疗法不仅疗程后痛处较少，手术后感染的风险的大大减低。患者也能够很快恢复正常生活，5 至 7 天就能痊愈。激光疗法也不会伤到括约肌而引起日后排便的困难。总结来说，使用激光疗法去除痔疮的患者痛楚少、痊愈快、风险低!

Columbia Asia Hospital 医生让你更了解痔疮

痔疮的形成是由于静脉长时期受压力，导致肛门附近的血液循环受阻或淋到周围的组织变弱，引起血管肿 胀及血管组织突出。

任何年龄层都有可能患有痔疮，尤其是长时间久坐或久站的人群，例如德士司机、朝九晚五的上班族等。 另外，喜食辛辣刺激食物、酗酒人士、孕妇、老年人等相对而言痔疮发病率也较高。此外，痔疮也有可能会遗传!

一般上，大家通常会从便秘、排便时疼痛、排出血便以及肛门有软块或疼痛肿胀等症状察觉出自己患有痔疮。

Columbia Asia Hospital 所提供的“激光镭射痔疮疗法”，将会由专业又亲切友善的 Dr. Zulkarnain Hasan 以 及 Dr Kerwin Teoh Tze Phin 负责进行。医生在进行疗法之前，都会与患者进行详细的讲解，确保患者了解 整个疗程!

Dr. Zulkarnain Hasan

Consultant General Surgeon

Columbia Asia Hospital - Iskandar Puteri
MD (USM), AFRCS (Ire), M.Med. Surgery (USM)

Make an Appointment

Dr Kerwin Teoh Tze Phin

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:

生痔疮一定要开刀? “先进激光镭射微创治疗”替你让你无需开刀也能去除痔疮

这篇文章首次刊登在 2020 年 9 月 8 日的”JOHOR NOW 就在柔佛”

Looking for
General Surgery
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Is Tap Water Ruining My Skin?

Is Tap Water Ruining My Skin?

August 30, 2017

Photo credit:
www.thesun.co.uk

“Is Tap Water Ruining My Skin?” Do you wonder about this each time you rinse your face? Read on to find out the answers.

Is Tap Water Ruining My Skin? – Her World, Issue August 2017


Jangan mandi malam [Press Clipping]

Jangan mandi malam [Press Clipping]

July 05, 2014

See our Press Clipping:

Berita Harian,

5 July 2014

Berita Harian,

5 July 2014


Jantung Terhenti Mengejut

Jantung Terhenti Mengejut

February 28, 2020

Selain sakit jantung yang sering dikaitkan sebagai ‘pembunuh senyap’, jantung terhenti mengejut atau sudden cardiac arrest (SCA) sebenarnya lebih berbahaya.

Kebiasaannya situasi itu berlaku secara tiba-tiba, tanpa amaran. Mangsa akan terus tumbang, tiada nadi, gagal bernafas dan meninggal dunia dalam beberapa minit jika tidak dirawat serta-merta.

Jika dibandingkan dengan serangan jantung, dalam kebanyakan kes mangsa masih boleh diselamatkan kerana terdapat pelbagai tanda awal untuk mengenal pasti penyakit itu termasuk sakit di bahagian dada, sukar untuk bernafas, berpeluh dan pening.

Berbeza dengan SCA yang boleh menimpa siapa sahaja termasuk individu yang sihat, cergas dan bebas daripada penyakit jantung.

Pakar Perunding Kardiologi Intervensi, Hospital Columbia Asia, Petaling Jaya, Dr Nandakumar Ramakrishnan, berkata SCA adalah keadaan di mana jantung seseorang itu terhenti secara tiba-tiba.

Bagi memahami SCA, kita perlu mengetahui bagaimana jantung berfungsi. Jantung mempunyai sistem elektrik yang mengawal nadi dan irama denyutan jantung. Ia berfungsi untuk mengepam jantung secara teratur.

Gangguan arimitmia

“Bagaimanapun, apabila berlaku gangguan terhadap sistem elektrik jantung, ia menyebabkan denyutan jantung menjadi tidak seragam dikenali sebagai aritmia,” katanya.

Mengulas lanjut, Dr Nandakumar berkata, gangguan aritmia ini menyebabkan jantung berdenyut dalam keadaan yang pelbagai sama ada terlalu cepat, perlahan mahupun tidak seragam.

“Ada aritmia yang menyebabkan jantung berhenti mengepam darah ke dalam badan sekali gus mengakibatkan berlakunya SCA.

“Contoh aritmia jenis ini termasuk ventricular fibrillation (VF) atau pulseless ventricular tachycardia (VT).

“Jika ini berlaku, darah akan berhenti mengalir ke otak dan organ lain yang penting sekali gus menyebabkan mangsa tidak mampu bernafas dan tidak sedarkan diri,” katanya.

Dr Nandakumar berkata, terdapat beberapa punca yang boleh menyebabkan serangan SCA.

Individu yang diserang sakit jantung boleh mengalami SCA. Sekiranya serangan jantung dihidapi agak teruk disebabkan arteri koronari tersumbat, ia boleh mencetuskan aritmia yang menyebabkan SCA.

“Selain itu, mereka yang menghadapi masalah cardiomyopathy iaitu jantung lemah atau bengkak dan kecacatan pada struktur jantung sejak lahir (congenital heart disease) turut boleh menjadi punca SCA,” katanya.

Beliau berkata, ia turut berpunca daripada masalah penyalahgunaan dadah.

Walaupun sukar untuk mengesan SCA berikutan tiada tanda-tanda yang jelas, kadangkala terdapat simptom untuk mengenal pasti kehadirannya.

Ia termasuk sakit dada, sukar bernafas, berasa lemah, denyutan jantung yang laju, sakit kepala dan hampir pengsan.

Photo Credit: Freepik.com

Buat pemeriksaan berkala

Justeru, sebagai langkah berjaga-jaga, Dr Nandakumar menggalakkan masyarakat membuat pemeriksaan berkala khususnya mereka yang berpotensi menghidap SCA.

“Mereka perlu mengetahui sejarah keluarga. Risiko lebih tinggi sekiranya ada dalam kalangan ahli keluarga menghidap sakit jantung mahu pun meninggal dunia pada usia muda tanpa sebab.”

“Selain itu, amalkan hidup sihat dan lakukan pemeriksaan rutin seperti ujian kolesterol, tekanan darah dan paras gula.”

“Individu berisiko termasuk mereka yang merokok, obesiti, mengamalkan gaya hidup tidak aktif dan mengalami tekanan darah tinggi atau pernah mengalami serangan jantung.”

“Golongan itu disarankan merujuk kepada pakar kardiologi bagi menjalani ujian termasuk elektrokardiogram (ECG), echocardiogram, menjalani prosedur angiogram dan imbasan Magnetic Resonance Imaging (MRI)," katanya.

Nandakumar turut berkata, kesedaran mengenai bahaya SCA perlu dipertingkatkan dalam kalangan masyarakat memandangkan ia boleh menyebabkan kematian jika tidak diberikan rawatan kecemasan dalam tempoh beberapa minit sahaja.

“Apabila jantung terhenti dan tidak ada bantuan kecemasan dalam kadar segera, ia menyebabkan oksigen tidak sampai ke otak.”

“Jika tidak dirawat dalam beberapa minit, mangsa meninggal dunia serta-merta.”

“Justeru, rawatan kecemasan yang boleh diberikan adalah memberikan tekanan kepada dada mangsa, bantuan pernafasan kecemasan (CPR) atau menggunakan alat defibrilator,” katanya.”

Kaedah rawatan

Menyentuh mengenai kaedah rawatan bagi pesakit yang disahkan menghidap SCA, mereka dinasihatkan untuk menjalani pembedahan kecil dengan memasang Implantable Cardioverter Defibrillator (ICD).

“ICD adalah alat kecil yang diletakkan di bawah kulit di dada.”

“Fungsinya untuk memantau dan mengawal aritmia berbahaya dengan memberi kejutan elektrik ketika berlaku gangguan pada jantung.”

“ICD perlu ada dalam badan pesakit SCA seumur hidup memandangkan terdapat risiko berlakunya gangguan berulang,”katanya.”

Pesakit dinasihatkan menjalani electrophysiology study dan radiofrequency ablation untuk mengurangkan atau membetulkan gangguan elektrik pada jantung.

Dr. Nandakumar A/L Ramakrishnan

Consultant Cardiologist

Columbia Asia Hospital – Petaling Jaya
MBBS (India), MRCP(Edinburgh), Fellowship in Cardiology IJN (Malaysia)

Make an Appointment

PDF and Online Articles:

Jantung Terhenti Mengejut – Berita Harian Online, 22 Februari 2020

Jantung Terhenti Mengejut – Berita Harian, 22 Februari 2020

Artikel ini disiarkan oleh Berita Harian, 22 Februari 2020

Looking for
Cardiology
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Joint Pain - Dr Harjeet Singh [BFM - Podcast]

February 26, 2014

Dr. Harjeet Singh, Consultant Orthopaedic Surgeon

Joint pain is one of the most common discomforts adults feel in daily life. Dr. Harjeet Singh, consultant orthopaedic surgeon, explains when one would need to see a doctor and what it might indicate.

Listen to the podcast
here
.


Kaedah Puasa Penghidap Barah

Kaedah Puasa Penghidap Barah

May 28, 2020

Pesakit barah memerlukan pola pemakanan seimbang yang di lengkapi nutrien mencukupi, tinggi kalori dan protein. Ia penting untuk menyembuhkan tisu yang rosak selepas menjalani rawatan dan meningkatkan sistem ketahanan badan pesakit. Pesakit barah yang berpuasa pada Ramadan perlu mengekalkan amalan ini bagi mengelakkan masalah kekurangan nutrisi penting yang akan meningkatkan risiko kekurangan zat makanan iaitu malnutrisi. Pusat Rawatan Kanser Amerika Syarikat melaporkan, hampir 65 hingga 70 peratus pesakit barah mengalami malnutrisi. Barah berkaitan malnutrisi akan menyebabkan pesakit berasa letih. lemah dan gagal mencapai matlamat rawatan yang diberikan.

Pakar Dietitian Columbia Asia Hospital - Cheras, Nor Alifah Mokhtar berkata, ada beberapa jenis makanan yang boleh diambil pesakit barah ketika berpuasa. Menurutnya, pesakit dinasihati tidak meninggalkan sahur kerana ia dapat membantu memberikan tenaga sepanjang berpuasa. Waktu bersahur paling digalakkan ialah 30 minit sebelum imsak.

“Mereka perlu mengutamakan pengambilan karbohidrat kompleks dan tinggi serat seperti nasi beras perang, oat dan roti atau biskut mil penuh. Ini kerana makanan itu lebih mengenyangkan dan dapat membekalkan tenaga bagi tempoh yang lebih lama serta mengurangkan rasa lapar ketika berpuasa,” katanya.

Nor Alifah berkata, pesakit barah memerlukan sumber protein yang tinggi dan mereka hendaklah memastikan mengambil sumber itu dalam setiap hidangan.

“Protein amat penting untuk membaiki tisu yang rosak dan memberi kekuatan bagi meningkatkan sistem ketahanan badan dalam melawan jangkitan kuman. Protein turut melambatkan proses pencernaan kerana strukturnya lebih kompleks. Contoh makanan tinggi protein seperti ikan, ayam, daging, telur, kekacang, susu dan produk tenusu,” katanya.

Beliau berkata, pesakit disarankan memulakan berbuka dengan makan tiga butir kurma dan minum segelas air kosong.

“Kurma mengandungi gula ringkas fruktosa yang memberikan tenaga segera dan mengembalikan kecergasan badan dengan cepat. Kurma juga kaya dengan sumber mineral seperti potassium, fosforus, kalsium, sodium dan zat besi. Selain itu. makanan ini mengandungi serat yang membantu proses penghadaman,” katanya.

Jelasnya, pesakit boleh mengembalikan tenaga sepanjang berpuasa dengan mengambil makanan yang sihat dan seimbang.

“Caranya ialah mengamalkan pinggan sihat iaitu Suku Suku Separuh. la merangkumi suku pinggan untuk bijirin (nasi, mi dan roti), suku pinggan bagi protein (ikan, ayam, telur dan tofu) dan separuh pinggan adalah buah-buahan serta sayur-sayuran. Selain memilih sajian berasaskan bijiran penuh, pesakit harus memperbanyakkan pengambilan buah-buahan dan sayur-sayuran segar dalam menu harian. Ia (buah-buahan dan sayur-sayuran) membekalkan vitamin, mineral serta serat. Pastikan setiap hidangan mengandungi sekurang-kurangnya satu sajian berkenaan,” katanya.

Nor Alifah berkata, minuman manis seperti kordial boleh diganti dengan jus buah-buahan segar tanpa gula.Jadikan buah-buahan dan sayur-sayuran sebagai hidangan moreh berbanding kuih atau manisan yang tinggi kalori.

Menurutnya, pesakit barah perlu mengutamakan pengambilan air masak yang secukupnya iaitu sekurang-kurangnya lapan gelas sehari bagi meningkatkan kandungan air dalam badan.

“Selain itu, pengambilan cecair juga dapat ditingkatkan dalam bentuk minuman, sup, bubur, puding dan makanan yang mengandungi kandungan air yang tinggi seperti tembikai, timun serta tomato. Untuk moreh pula, pesakit dinasihati mengelak daripada mengambil makanan berat seperti nasi dan mi goreng kerana badan tidak memerlukan tenaga yang banyak pada waktu malam. Cukup sekadar menikmati snek ringkas seperti sandwich, biskut, roti dan kuih muih, tetapi kuantiti snek yang diambil tetap perlu dikawal.” katanya.

Beliau berkata, ada dua kategori pesakit barah yang tidak digalakkan berpuasa iaitu pesakit yang sedang menjalani rawatan radioterapi dan kemoterapi.

Katanya, ini kerana mereka berisiko mengalami kesan sampingan yang boleh mempengaruhi pengambilan makanan sekali gus menyebabkan masalah nutrisi.

“Kesan sampingan yang selalu dialami pesakit semasa dan selepas menerima rawatan (radioterapi dan kemoterapi) ialah hilang selera makan, loya, muntah, perubahan deria rasa, bau, sakit mulut, tekak serta cirit birit. Kesan sampingan ini akan mempengaruhi proses penghadaman dan penyerapan nutrien daripada makanan yang diambil. Kekurangan nutrien akan meningkatkan risiko malnutrisi,” katanya.

Nor Alifah berkata, seterusnya ialah pesakit yang mempunyai barah masih aktif atau merebak ke bahagian organ badan lain juga tidak disarankan berpuasa.

“Bagi pesakit barah, pengambilan makanan yang optimum adalah penting untuk meningkatkan keupayaan badan melawan penyakit berkenaan dan meningkatkan tindak balas dan penerimaan pesakit terhadap rawatan diberikan,” katanya.
Photo credit: Freepik.com

Nor Alifah Mokhtar

Dietitian

Columbia Asia Hospital - Cheras

PDF and Online Articles:

Kaedah Puasa Penghidap Barah - Harian Metro, 17 Mei 2020

Artikel ini disiarkan oleh Harian Metro, 17 Mei 2020

Follow us for latest Health Tips:


Kanser Hati Sukar Dikesan

Kanser Hati Sukar Dikesan

February 02, 2019

Photo credit : Harvard Health Publishing

Keluarga pesakit hepatitis kronik dinasihatkan jalani pemeriksaan

Peringkat awalnya kanser hati sukar dikesan dan amat penting bagi mereka yang berisiko menjalani ujian saringan terperinci bagi mengenal pasti jika ada tanda penyakit” Dr Khairul Izan.

Walaupun kanser hati sukar dikesan pada peringkat permulaan kecuali mereka yang berisiko menjalani ujian saringan secara menyeluruh, tanda awal boleh dilihat menerusi kesan muntah darah, sakti perut dan sakit bahagian abdomen. Tanda lain kanser yang dikenali sebagai hepatoma ini termasuk kekuningan pada mata dan kulit (jaundis), manakala gejala ketara tahap kritikal, pesakit koma disebabkan kegagalan fungsi hati atau hepatic encephalopathy.

Perunding Pembedahan Am, Hospital Columbia Asia Malaysia, Dr Khairul Izan Mohd Ghani @ Mamat, berkata muntah darah disebabkan oleh pendarahan varices pada saluran makan (Oesophagus). Katanya, keadaan itu juga berpunca daripada sirosis atau penyebaran hepatoma ke dalam saluran darah. Akibat pendarahan dalaman hepatoma pesakit akan mengalami sakit perut, pada masa sama tidak selesa pada bahagian abdomen (rusuk kanan).

“Kesan kesakitan disebabkan berlakunya pembesaran hepatoma dan memberi tekanan kepada struktur atau organ berdekatan.

“Manakala jaundis pada mata dan kulit akibat tahap bilirubin tinggi hingga menyebabkan pesakit koma disebabkan organ hati gagal berfungsi,” katanya kepada BH.
Jalani ujian darah

Dr Khairul Izan berkata, peringkat awalnya kanser hati sukar dikesan dan amat penting bagi mereka yang berisiko menjalani ujian saringan terperinci bagi mengenal pasti jika ada tanda penyakit. Katanya, simptom hanya dapat dirasai apabila kanser hepatoma sudah membesar.

“Mereka berisiko (penghidap hepatitis kronik dan sirosis hati daripada punca lain) dinasihat menjalani ujian saringan dengan ujian ultra bunyi dan ujian darah alpha feto protein (tumour marker). Seterusnya mereka dinasihat menjalani saringan CT scan atau Pengimbas Imej Magnetik (MRI) bertujuan sebagai pengesahan diagnosis hepatoma dan dijadikan rujukan perubatan kemudian,” katanya.

Dr Khairul Izan berkata, penghidap juga akan mengalami kesan keletihan teruk, hilang berat badan dan kerap demam. “Pesakit rasa pembengkakan hati di bahagian abdomen, sakit tulang akibat penyebaran kanser ke tulang dan Ascites (pengumpulan cecair akibat sirosis di bahagian abdomen,” katanya.

Katanya, punca utama hepatoma disebabkan jangkitan kronik Hepatitis B dan C, iaitu dianggarkan 80 peratus daripada keseluruhan kes hepatoma. “Hepatoma juga dikenal pasti penyebab kematian kepada 250,000 hingga sejuta individu setiap tahun di seluruh dunia. “Kajian menunjukkan hepatoma menduduki tangga ketiga kematian berpunca daripada kanser secara keseluruhannya,” katanya.

Katanya, Asia Timur seperti China, Taiwan dan Hong Kong, manakala Malaysia, Indonesia dan Thailand termasuk dalam kawasan pertengahan. “Malah, perangkaan National Cancer Registry, menunjukkan kanser hati dikesan pada 2.8 bagi setiap 100,000 penduduk di Semenanjung dan seorang daripada 10 kanser utama membabitkan lelaki. Dianggarkan 5.24 peratus daripada populasi negara ini menghidap Hepatitis B kronik dan dua peratus menghidap Hepatitis C kronik. Kedua-dua kategori ini berisiko mendapat hepatoma,” katanya.
Buang sebahagian hati

Dr Khairul Izan berkata, hepatoma boleh sembuh jika mendapat rawatan awal, namun sekiranya lewat, hanya rawatan palliatif sahaja diberikan bagi meringankan sakit. Rawatan lain termasuk menjalani prosedur pembedahan hepatektomi, iaitu membuang sebahagian hati yang diserang sel kanser. Kaedah ini mempunyai kadar sembuh yang tinggi bagi pesakit hepatoma, bergantung pada peringkat hepatoma dan keadaan keseluruhan pesakit serta kepakaran yang ada.

“Pemindahan hati perlu dipertimbangkan sekiranya dikesan ada tanda kanser hati berukuran kurang lima sentimeter. Radiofrequency ablation, iaitu penggunaan haba secara radio frekuensi terus kepada sel kanser di hati yang dijalankan pakar radiologi. Begitu juga suntikan ethanol secara terus kepada sel kanser yang dijalankan pakar radiologi. Suntikan kemoterapi kepada sel tumor melalui salur darah pesakit oleh pakar radiologi atau dikenali juga dengan istilah TACE (Transarterial chemoembolisation),” katanya.

Beliau berkata, pencegahan lebih baik daripada merawat, hepatoma sering dikaitkan dengan pengambilan alkohol. “Justeru, ahli keluarga pesakit Hepatitis B atau C kronik, perlu menjalani saringan untuk penyakit Hepatitis B atau C itu,” katanya.
Kanser hati atau hepatoma

Penyebab kematian 250,000 hingga sejuta setahun.

Hepatoma menduduki tempat ketiga bagi kematian berpunca daripada kanser.

Sukar dikesan, pesakit hanya mengetahui selepas kanser berada pada tahap kritikal.

Penyakit kuning atau jaundis bagi orang dewasa antara simptom nyata.

Pesakit hepatoma dikesan berpunca daripada jangkitan Hepatitis B kronik.

China, Taiwan dan Hong Kong merekodkan kes hepatoma tertinggi di Asia.

Malaysia, Indonesia dan Thailand kawasan pertengahan penghidap hepatoma.

Dr. Khairul Izan Mohd Ghani

Consultant General Surgeon

Columbia Asia Hospital – Petaling Jaya

Make an Appointment

PDF and Online Articles:

Kanser Hati Sukar Dikesan – Berita Harian, 2 Februari 2019

Artikel ini disiarkan oleh Berita Harian, 2 Februari 2019

Looking for
Cardiology
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Kecederaan ketika bersukan [Press Clipping]

May 12, 2013

See our Press Clipping:

Mingguan Malaysia,

12 May 2013


Kecoh Tentang HFMD - Kenali Penyakit Ini Dan Cara Mencegahnya

June 10, 2022

“Masa tu anak saya asyik menangis,” kata Puan Aishah Aljuned, ibu kepada Amal yang berusia tiga tahun ketika anaknya dijangkiti Penyakit Tangan, Kaki dan Mulut (HFMD atau Hand, Foot and Mouth Disease).

“Dalam mulut dia terasa pedih disebabkan ulser. Walaupun lapar, susah dia nak kunyah makanan. Terpaksalah saya berikan dia bubur. Aiskrim pun saya bagi sebab kesian saya tengok dia, asyik merengek. Di punggung pula banyak lepuh, macam chicken pox. Kita sebagai ibu tengok dia pun, kita sedih.”

Ibu bapa pastinya terkesan melihat keadaan anak yang payah makan, lesu dan berasa gatal serta pedih khususnya di kawasan tangan, kaki and mulut.

Tambahan pula bila terbaca penyakit HFMD ini boleh mendatangkan kematian, pasti ibu bapa risau dan tidak keruan dibuatnya.

Namun, tahukah anda bahawa kematian disebabkan HFMD jarang sekali berlaku?

Mari kita dengarkan fakta dari Pakar Kanak-Kanak dari Hospital Columbia Asia – Cheras, Dr Kenneth Looi, tentang HFMD supaya tidak panik apabila ahli keluarga dijangkiti.

“Mula-mula tu ‘suspen’ juga”

“Penyakit HFMD ialah suatu penyakit berjangkit yang biasanya terjadi dalam kalangan bayi serta kanak-kanak,” kata Dr Kenneth.

“Jika tidak ditangani dengan baik, ia boleh merebak sehingga menjadi wabak walaupun kadar jangkitan di tahap sederhana. Dalam kes-kes yang amat serious, ia boleh mendatangkan maut tetapi ini sangat jarang berlaku. Sekiranya berlaku, ia adalah HFMD varian Enterovirus 71 atau EV71,” tambahnya.

Menurut Dr Kenneth, penyakit HFMD disebabkan jangkitan sistemik dengan Enterovirus manusia.

Enterovirus manusia terdiri dari satu genus dari kumpulan gene Picornavaridae. Antara ‘ahli keluarga’ gen enterovirus yang menjangkiti manusia termasuklah virus polio dan virus Coxsackie.

Sebuah badan kesihatan awam di Amerika Syarikat, Centre of Disease Control and Prevention, membayangkan ia sebagai suatu penyakit yang walaupun tidak ‘serius’ tetapi kadar jangkitannya sangat cepat.

Jika hilang kawalan dan menjadi wabak, ini yang akan mendatangkan lebih banyak masalah pada peringkat penjagaan kesihatan.

Isolasi satu tanggungjawab

Sekiranya ada kes HFMD di sekolah, besar kemungkinan ia akan merebak. Satu kes pun sudah cukup untuk sekolah mengambil tindakan menutup sekolah sekurang-kurangnya selama seminggu.

Menurut Dr Kenneth, simptom boleh bertahan sehingga tujuh atau 10 hari. Oleh sebab itu, ibu bapa yang bertanggungjawab akan mengasingkan anak mereka di rumah supaya tidak bercampur dengan kanak-kanak lain.

Puan Aishah berkongsi, “Mula-mula tu ‘suspen’ juga tapi di sekolah Amal tu, asalkan satu kes HFMD, sekolah akan ditutup selama seminggu. Kemudian bila semua sudah ok, datang pulak satu lagi kes HFMD. Sekali lagi sekolah tutup.

“Begitulah seterusnya. Tutup buka tutup buka. Sebagai ibu bapa, itu yang sebaiknya, asal kesihatan anak-anak didahulukan.”

“Doktor lihat ada cacar pada tangan anak saya”

Ulser HFMD kebiasaannya tumbuh di lelangit, lidah serta bahagian dalam pipi dan bibir (mukosa bukal).

Kadangkala ulser ini kecil dan tidak banyak. Kadangkala ulsernya besar sehingga menjadi stomatitis (radang di dalam mulut). Lebih banyak ulser, lebih pedih rasa sakitnya.

Kepala pening, badan lesu, rasa lemah dan senak di bahagian perut serta ruam gatal di tangan dan kaki.

“Di klinik, doktor cuma sekali lalu tengok tapak tangan Amal,” kata Puan Aishah. “Dia nampak ada beberapa ‘boils’. Dari situ doktor kata ini macam HFDM ni.”

“Memang salah satu gejala yang paling ketara penyakit HFMD ini adalah ulser di tapak tangan, tapak kaki dan dalam mulut, serta demam,” kata Dr Kenneth. Menurutnya gejala-gejala ini mungkin tidak akan kelihatan pada hari jangkitan tetapi pada hari berikutnya.

Umumnya kanak-kanak dalam lingkungan bawah lima tahun akan menunjukkan kesan HFMD yang lebih ketara berbanding kanak-kanak yang lebih tua. Ini kerana sakit ulser di mulut membuat mereka sangat tidak selesa dan susah untuk makan.

Air liur terkumpul di dalam mulut kerana kanak-kanak tersebut berasa sakit apabila menelan. Tabiat ini akan menyebabkan stomatitis atau gingivitis (penyakit gusi). Ramai pesakit HFMD dimasukkan ke hospital dan disambung dengan titisan IV sehinggalah mereka boleh menelan air dengan selesa.

Jangan dekat-dekat

“Walaupun penyakit ini umum terjadi di kalangan kanak-kanak berumur lima tahun kebawah, sesiapa sahaja boleh dijangkiti sebenarnya,” kata Dr Kenneth.

“Virus ini menjangkiti apabila pesakit berdekatan dengan orang lain. Oleh itu penyakit ini sering tersebar di sekolah-sekolah dan tadika. Jika ada adik-beradik lain di rumah, mereka pun mungkin turut dijangkiti.”

“Penyakit HFMD ialah suatu penyakit yang terhad rawatannya kerana kebiasaannya ia akan sembuh dengan sendirinya. Apa yang kita boleh lakukan ialah memberi bantuan untuk membuat pesakit lebih selesa.

“Jumpa dengan doktor atau ahli farmasi untuk mendapatkan ubat demam. Pastikan anak anda boleh minum dengan betul sekurang-kurangnya air suam atau susu supaya dia tidak mengalami dehidrasi, Minuman sejuk juga boleh mengurangkan rasa pedih ulser.

“Jika ke klinik, kemungkinan doktor akan mengesyorkan gel untuk ulser atau pun ubat semburan atau lozenge bagi mengurangkan rasa pedih ulser.

“Sekiranya ada tanda-tanda HFMD semakin serious, bawa pesakit berjumpa dengan pakar kanak-kanak dengan segera,” ujar Dr Kenneth lagi.

Tanda-tanda HFMD semakin serius

Sakit dada

Sakit tengkuk

Nanah atau bengkak di ulser atau lepuh

Dehidrasi

Mulut kering

Kurang/Tidak buang air kecil

Mata cengkung

Demam tinggi

Sawan

Sangat penat dan lesu

Kurangkan risiko jangkitan HFMD

Biasakan cuci tangan selalu dengan air dan sabun atau penyahkuman (sanitiser).

Cuci dan nyahkuman permukaan yang sering disentuh dan dikongsi seperti permainan kanak-kanak dan tombol pintu.

Jangan sentuh mata, hidung dan mulut.

Jangan hampiri mereka yang tidak sihat.

Jangan kongsi gelas atau cawan, sudu garfu, sapu tangan serta barangan peribadi seperti tuala dan berus-berus.

Dr. Kenneth Looi Chia Chuin

Consultant Pediatrician

Columbia Asia Hospital - Cheras

MBBS (IMU), MRCPCH (UK)

Make an Appointment

PDF and Online Articles:

Kecoh Tentang HFMD - Kenali Penyakit Ini Dan Cara Mencegahnya – Getaran, 4 Jun 2022

This article first appeared in Getaran, 4 Jun 2022

Looking for
Pediatrics
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Kegel Menguatkan Otot Lantai Pelvis, Buat Senaman Ini 3 Kali Sehari!

December 02, 2020

Kecantikan seorang wanita bukan sahaja terhad kepada luaran, rupa yang cantik atau badan yang langsing tetapi juga memerlukan kecantikan dalaman yang sihat. Bagi seorang wanita ia merupakan kebiasaan untuk seseorang itu menjalankan senaman yang kerap untuk otot- otot anggota atas, anggota bawah, belakang and abdomen tetapi kebanyakan wanita kerap mengabaikan kepentingan penjagaan otot lantai pelvik mereka.

Mengapa kekuatan otot lantai pelvik penting?

1. Menyokong organ-organ dalam pelvik dan memudahkan proses bersalin.

PFM dapat menyokong organ-organ dalam pelvik. Bagi wanita yang mengandung, ia dapat membantu untuk menampung berat bayi dalam rahim. Jika kerap melakukan senaman pelvik, ia akan memudahkan proses peneranan bayi keluar dari faraj.

2. Mengelak daripada gejala mudah terkencing dan organ prolaps.

Sekiranya anda sering mengalami gejala mudah terkencing ketika ketawa, mengangkat barang atau bangun dari tempat duduk, senaman PFM dapat membantu mengurangkan dari inkontinesia urin iaitu pengaliran air kencing atau najis yang tidak sengaja. Selain daripada itu, ia juga dapat mengelak daripada organ prolaps (Rahim - ‘cystocele’) yang melalui termasuk ke faraj (cystocele) dan rectocele (Rektum- ‘rectocele’) yang tertekan di dubur.

3. Meningkatkan keyakinan diri dan penting untuk fungsi seksual.

PFM dapat meningkatkan kualiti kehidupan seseorang malah boleh memberi kesan kepada hubungan seksual dengan pasangan.

4. Mengatasi masalah perbelanjaan kos rawatan yang tinggi termasuklah kos pembedahan.

Otot lantai pelvis yang kuat dapat mengatasi masalah seperti:

i) Infeksi salur kencing, ‘pruritus’ akibat dari kekerapan penggunaan tuala wanita dan lampin orang dewasa

ii) Mengambilan Ubat

iii) Rawatan pembedahan

Cara-cara menangani masalah kelemahan otot lantai pelvis

1. Senaman Kegel

i) Kempiskan perut dan lakukan proses ‘kemut-lepas-kemut’

ii) Lima kontraksi pantas

iii) Diikuti dengan kontraksi perlahan, kontrakkan PFM dan tahan untuk kiraan sepuluh, ulangi pergerakkan ini untuk
20 kali
.

iv) Adalah disarankan senaman di atas dilakukan sebanyak tiga sesi sehari untuk
mengekalkan
 kekuatan PFM

v) Bagi
menguatkan otot
 PFM yang lemah, pesakit disarankan untuk mengulangi kontraksi PFM perlahan sebanyak tiga sesi sehari dan setiap sesi
30 ulangan
.

Gambarajah 1:

Kontraksi otot lantai pelvis dengan pernafasan seperti biasa

Gambarajah 2:

Senaman lengkukan pinggang sambil kontraksi otot lantai pelvis dalam posisi baring.

Gambarajah 3:

Senaman lengkukan pinggang kontraksi otot lantai pelvis dalam posisi duduk.

Gambarajah 4:

Senaman kontraksi otot lantai pelvis dengan mengunakan bola dan angkat punggung

2. Bantuan peralatan perawatan sekiranya PFM terlalu lemah atau lansung tidak dapat melakukan kontraksi

i) EMS, electrical muscular stimulator

ii) Vibrance kegel device

3. Pakar perubatan

i) Mengambilan ubat

ii) Alat perawatan masalah PFM ditempatkan di faraj

iii) Pembedahan

Bagaimana cara mengenalpastikan keberkesanan senaman ‘Kegel’

Keberkesanan /kekuatan otot lantai pelvis boleh dikenalpasti apabila seseorang menjalankan senaman mengikut senaman yang ditetapkan untuk jangka masa selama sekurang-kurangnya 3 bulan.

1. Maklumbalas daripada pasangan seksual

2. Kawalan kencing lebih baik

3. Pegurangan penggunaan tuala wanita atau lampin orang dewasa

Otot lantai pelvis juga akan menjadi renggang dan lemah secara semulajadi bukan sahaja disebabkan oleh kekurangan senaman, ia juga akan berlaku apabila usia meningkat. Oleh itu, para wanita disarankan agar menjalankan senaman untuk menguatkan otot lantai pelvis sekerap tiga sesi sehari untuk mengekalkan serta menguatkan otot lantai pelvis bagi mengekalkan kejelitaan dalaman anda.

Lee Heng Ho

Physiotherapy Manager

Columbia Asia Hospital - Puchong

PDF and Online Articles:

Kegel Menguatkan Otot Lantai Pelvis, Buat Senaman Ini 3 Kali Sehari! – Mingguan Wanita, 18 November 2020

Artikel ini disiarkan oleh Mingguan Wanita, 18 November 2020

Follow us for latest Health Tips:


Kekal Aktif Walaupun Hamil

Kekal Aktif Walaupun Hamil

June 04, 2020

Mengandung bukan lagi alasan untuk tidak melakukan sebarang aktiviti.

Pasti ramai masih beranggapan wanita hamil tidak perlu bergerak aktif dengan alasan menjaga kandungan. Tidak dinafikan ramai akan bimbang tentang keadaan anda sekiranya melakukan senaman bila berbadan dua. Hakikatnya, senaman sangat membantu kandungan dan tubuh anda untuk gaya hidup yang lebih sihat ketika hamil. Ramai juga masih tidak tahu terdapat beberapa aktiviti yang digalakkan untuk anda lakukan ketika hamil.

Anda boleh lakukan senaman yang mudah dan ringkas malah tidak membebankan tubuh badan anda. Dengar kata tubuh, dan jika terasa letih, berehat seketika dan buat sekadar yang mampu. Jangan memaksa tubuh anda untuk melakukan aktiviti tersebut sehingga anda tercungap atau susah bernafas. Pilih senaman yang sesuai dengan kondisi tubuh badan anda.

"Secara umumnya sekiranya wanita hamil itu sihat, senaman semasa hamil adalah selamat dan tidak menambahkan risiko keguguran atau kelahiran pra-matang. Sungguhpun demikian, anda hendaklah merujuk kepada pakar sakit puan terlebih dahulu sebelum melakukan senaman yang bersesuaian" kata Dr Salmi Daraup, Pakar Obstetrik & Ginekologi daripada Hospital Columbia Asia Iskandar Puteri.

MANFAAT PADA TUBUH

Senaman yang bersesuaian semasa hamil boleh mengurangkan sakit belakang, melawaskan, mengurangkan risiko untuk menghidap kencing manis (gestational diabetes mellitus) dan pre-eclampsia, risiko berat badan yang berlebihan dan seterusnya menambah stamina. Bukan sahaja senaman dapat memudahkan proses kehamilan anda malah ia sangat membantu tubuh badan anda selepas hamil.

Idealnya, wanita hamil disarankan melakukan aktiviti senaman aerobik intensiti sederhana seperti brisk walking atau berkebun sekurangnya 150 minit seminggu. Wanita hamil dinasihatkan memulakan aktiviti senaman secara berperingkat dimulakan dengan brisk walking selama lima minit sehari dan menambahkan masa senaman anda secara berperingkat.

ELAKKAN INIKALA SEDANG HAMIL:

Senaman mudah cedera seperti bermain ski dan menunggang kuda.

Aktiviti yang perlu melompat dan berlari.

Aktiviti lasak seperti bermain bola tampar, bola keranjang dan bola sepak.

Bersenam di temp at yang panas seperti sauna dan tab panas.

Latihan intensiti tinggi seperti lompat bintang.

Senaman angkat berat seperti angkat dumbel.

Latihan yang melibatkan baring untuk jangka masa panjang seperti sit-up dan crunches.

Ini boleh menambahkan stamina dan melancarkan peredaran darah. Selain brisk walking, senaman yoga atau pilates yang bersesuaian dapat mengurangkan tekanan dan membaiki emosi anda. Penjagaan emosi wanita hamil memberi kesan pada tumbesaran bayi anda. Selain itu, sebahagian daripada senaman pernafasan juga boleh dipraktikkan ketika bersalin kelak. Latih did anda dengan kaedah pernafasan yang betul untuk wanita hamil sebagai persediaan awal ketika bersalin.
“Secara umumnya sekiranya wanita hamil itu sihat, senaman semasa hamil adalah selamat dan tidak menambahkan risiko keguguran atau kelahiran pra-matang.”

KETAHUI TEKNIK BERSESUAIAN

Teknik atau cara senaman anda turut dititikberatkan supaya tiada kesan sampingan terjadi pada kandungan anda. Senaman yang tidak bersesuaian boleh mengakibatkan beberapa kesan sampingan seperti risiko kecederaan kepada anggota badan atau kandungan. Risiko pendarahan dan kelahiran pra-matang mungkin berlaku sekiranya wanita hamil itu diagnosis sebagai placenta previa.

Sekiranya wanita hamil dikehendaki bed rest contohya seperti dalam situasi placenta previa, anda tidak digalakkan untuk bersenam. Anda turut dinasihatkan untuk menyelesaikan tempoh bed rest tersebut bagi mengelakkan risiko pendarahan atau kelahiran pramatang. Oleh itu, pakar sakit puan akan menyarankan beberapa langkah utk mengelakkan risiko deep vein thrombosis seperti pemakaian stoking DVT.

Apapun aktiviti yang mahu anda lakukan perlu dapatkan nasihat dan pandangan doktor pakar sakit puan terlebih dahulu. Anda perlu sentiasa berpada-pada dan tidak terlalu memaksa diri untuk melakukan senaman. Lakukan aktiviti sekadar yang mampu tetapi secara berterusan agar kandungan anda kekal sihat. Senaman yang dilakukan juga perlu seiring dengan penjagaan makanan anda.
Photo credit: Freepik.com

Dr. Salmi Daraup

Consultant Obstetrics & Gynecologist

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

Make an Appointment

PDF and Online Articles:

Hidangan Raya Pesakit Diabetes Perlu Berpada-pada – HerInspirasi.com, 1 Mei 2020

Artikel ini disiarkan oleh HerInspirasi.com, 1 Mei 2020

Looking for
Obstetrics & Gynecology
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Kenal Pasti Jangkitan UTI

Kenal Pasti Jangkitan UTI

April 23, 2019

RASA pedih dan seakan-akan tidak puas membuang air kecil antara situasi menakutkan dan merimaskan kebanyakan wanita hamil.

Keadaan ini antara gejala jangkitan saluran urinari (UTI) yang kerap berlaku kepada kebanyakan wanita malah wanita hamil turut berisiko mengalaminya.

Meskipun UTI boleh berlaku kepada semua jantina tanpa mengira usia, wanita lebih mudah mengalami jangkitan itu berbanding lelaki disebabkan struktur saluran urinari (uretra) wanita lebih pendek.

Struktur bukaan saluran urinari wanita juga lebih dekat dengan dubur dan memudahkan bakteria daripada najis menjangkiti saluran itu.

Pakar Perbidanan dan Sakit Puan Hospital Columbia Asia Cheras Dr Norshida Brahim berkata, UTI lebih biasa berlaku ketika hamil berikutan berlaku perubahan pada sistem imun menyebabkan jangkitan bakteria lebih mudah menyerang.

Katanya, sistem imun wanita ketika hamil biasanya lebih rendah dan lebih mudah terdedah kepada jangkitan termasuk UTI.

“Bagaimanapun, keadaan ini tidak perlu dikhuatiri kerana biasanya UTI boleh dirawat dengan pemberian antibiotik dan ubatan lain untuk pesakit.

“Cuma, wanita hamil sering menyalah anggap simpton dan gejala yang dialami adalah disebabkan bayi yang semakin membesar menekan pundi kencing hingga rasa ketidakselesaan semasa membuang air kecil.

“Sebab itu, amat penting ibu hamil memberitahu doktor ketika lawatan pemeriksaan sekiranya mereka merasakan ada kelainan yang berlaku ketika kencing. Biasanya fasiliti perubatan akan membuat ujian air kencing untuk mengenal pasti jangkitan,” katanya.

Dr Norshida berkata, walaupun penyakit ini tidak memberi kesan secara langsung terhadap bayi dalam kandungan, jika tidak dirawat segera menyebabkan risiko jangkitan merebak ke buah pinggang.

Katanya, jangkitan yang tidak dirawat juga menyebabkan kontraksi pramatang bagi ibu mengandung. Justeru, rawatan awal UTI boleh mengelakkan risiko pada bayi.

“Ada sesetengah ibu hamil merasakan gejala UTI yang dialami adalah perkara biasa semasa hamil dan melengahkan rawatan.

“Ada sesetengah kes tidak dirawat boleh menyebabkan ibu mengalami demam teruk, jadi saya nasihatkan agar semua ibu hamil tidak mengambil mudah jika terdapat tanda jangkitan,” katanya.

Menurutnya, UTI boleh dirawat secara selamat dengan antibiotik ketika kehamilan dan pakar perubatan biasanya menetapkan antara tiga ke tujuh hari pengambilan antibiotik yang selamat untuk ibu hamil serta bayi.

Berjumpa doktor jika anda mengalami demam, menggigil, sakit pada bawah perut, loya, muntah, kontraksi atau jika selepas mengambil ubat selama tiga hari, anda masih rasa pedih dan membakar ketika membuang air kecil.
Tanda Dan Gejala UTI

Rasa tidak selesa, pedih dan seperti terbakar ketika kencing.

Lebih kerap kencing daripada biasa.

Tiba-tiba ingin kencing (tidak boleh tahan).

Tiba-tiba ingin kencing (tidak boleh tahan).

Air kencing yang pekat atau berbau.

Rasa kurang sihat.

Kesakitan ketika hubungan seksual.

Cara Kurangkan Risiko Jangkitan
Amalan kebersihan diri yang baik.

1. Mandi setiap hari, basuh kemaluan dan pastikan anda bersihkan dari depan ke belakang selepas ke tandas. Kebanyakan UTI adalah disebabkan bakteria daripada punggung yang disebarkan secara tidak sengaja ke uretra (lubang kencing).

2. Jangan tahan kencing. Pergi ke tandas sebaik saja anda terasa ingin membuang air kecil.

3. Cuci kemaluan sebelum dan selepas melakukan hubungan seks. Ini membantu membuang bakteria di sekitar uretra.

4. Minum air kosong mencukupi. Ketika hamil, mungkin ada yang tiada selera atau mengalami alahan mengandung, namun pastikan anda minum air secukupnya.

5. Minum jus kranberi. Jus kranberi atau kapsul kranberi adalah kaedah semula jadi untuk meningkatkan daya tahan anda terhadap UTI.

6. Elakkan memakai seluar dalam atau seluar yang ketat. Pakai seluar dalam daripada fabrik kapas agar pengudaraan yang baik.

Dr. Norshida Brahim

Consultant Obstetrics & Gynecologist

Columbia Asia Hospital – Cheras

PDF and Online Articles:

Kenal Pasti Jangkitan UTI - Harian Metro, 23 April 2019

Kenal Pasti Jangkitan UTI

Artikel ini disiarkan oleh Harian Metro, 23 April 2019

Follow us for latest Health Tips:


Kenali Jenis Bakteria Penyebab Keracunan Makanan, Ketahui Cara Mengelaknya

October 07, 2022

Makan itu satu nikmat yang tidak terkata, tetapi cara penyediaan yang tidak bersih boleh menyebabkan kemudaratan. Tiada yang nikmat bila perut mula sakit, mulut terasa loya, muntah-muntah dan badan terasa lemah lesu.

Ini bukan sahaja boleh berlaku di gerai atau restoran. Malahan, di dapur rumah juga ia boleh berlaku sekiranya tatatertib kebersihan tidak diberatkan.

Mungkin ada di antara anda yang tidak sedar bahawa terdapat beberapa jenis bakteria yang menjadi penyebab kepada keracunan makanan. Bakteria-bakteria ini tercetus daripada jenis makanan-makanan tertentu.

Pakar Pemakanan, Siti Sarah Juzup dari Hospital Columbia Asia, Setapak akan membawa anda mengenali bakteria-bakteria yang menjadi penyebab keracunan makanan.

Bahkan, Siti Sarah juga turut membantu untuk memberikan tip mengenai bagaimana kita mahu mengelak daripada diserang keracunan makanan dan diet yang diharuskan seandainya kita mengalami keracunan makanan.

Diet yang diharuskan ini termasuk mengelakkan beberapa jenis makanan atau minuman yang tertentu jika kita ingin pastikan kondisi kita sewaktu mengalami keracunan makanan itu tidak menjadi semakin teruk.

Kenali bakteria penyebab keracunan makanan

Salmonella

Selalunya salmonella berkaitan dengan produk haiwan seperti telur, ayam, ikan dan susu. Sayur mentah dan air juga boleh mengandungi salmonella. Salmonella boleh terdapat semasa mengendalikan makanan atau semasa kilang pemprosesan.
E.coli

E.coli selalu berkaitan dengan daging yang kurang masak. E.coli juga terdapat dalam pelbagai jenis makanan termasuk produk segar, daging, kekacang dan air. Simptom sekiranya termakan makanan yang tercemar dengan E.coli adalah loya, muntah, cirit-birit bergantung kepada jenis E.coli.

Shigella

Shigella boleh dipindahkan melalui pengendali makanan yang dijangkiti, dan seterusnya menjangkiti orang lain dan ianya disebabkan oleh amalan kebersihan yang kurang baik. Selain daripada manusia, serangga perosak seperti lalat juga boleh memindahkan bakteria ini. Simptomnya adalah kejang perut dan najis berdarah.
Botulism

Ini ialah salah satu bakteria yang menjadi penyebab keracunan makanan yang teruk. Botulism terdapat di dalam makanan bertin atau khinzir dan ham. Bakteria ini boleh menghasilkan neurotoksin yang boleh menyebabkan lumpuh. Simptom yang lain termasuk sakit badan, loya, muntah, lemah dan hilang kebolehan untuk menelan.
Listeria

Jangkitan bakteria ini berlaku dengan mengambil makanan yang tercemar dan tidak diproses dengan betul seperti makanan mentah atau diproses seperti sayur-sayuran,buah-buahan, daging, susu atau produk tenusu yg tidak dipasturkan.

Jangkitan listeria boleh menyebabkan cirit-birit dan demam. Jangkitan ini sangat berbahaya kepada wanita hamil dan boleh menyebabkan gugur, kelahiran pra-matang dan kematian kepada bayi yang baru lahir.

Cara-cara untuk mengelakkan keracunan makanan

Penyebab keracunan makanan adalah berbeza dan ini adalah sebahagian cadangan untuk mengelakkan keracunan makanan:

Basuh tangan anda dengan sabun dan air bersih sebelum dan selepas menyediakan makanan. Selain itu, anda juga perlu basuh tangan selepas mengendalikan pelbagai jenis makanan.

Pastikan makanan masak dengan betul dan tidak lagi mentah atau kemerah-merahan. Makanan mentah pula harus disimpan berasingan. Contohnya, jangan letak sebekas ayam mentah sebelah buahan-buahan.

Gunakan papan pemotong dan pisau yang berlainan untuk mengendalikan sayuran-sayuran dan makanan/daging mentah. Sekiranya memotong salad atas papan yang dipotong daging mentah, dikhuatiri bekas daging akan melekat ke salad yang bakal dimakan tanpa dimasak.

Suhu makanan panas hendaklah dikekalkan pada 60 darjah celcius ke atas dan makanan beku dalam -18 darjah celcius. Sentiasa pastikan peti sejuk anda berfungsi dengan baik supaya makanan di dalamnya selamat dimakan.

Pastikan semua makanan yang terdedah ditutup kemas. Jangan biarkan sebarang makanan pada suhu bilik selama lebih dari dua jam.

Diet yang harus sewaktu keracunan makanan

Semasa anda mengalami keracunan makanan, anda perlu minum banyak air untuk menggantikan elektrolit dan air yang hilang, contohnya minuman sukan. Selepas episod keracunan makanan, disyorkan pesakit untuk mengambil makanan yang mudah dihadam seperti nasi, pisang, sup kosong, ubi dan ayam panggang tanpa kulit.

Nasi dan pisang memberi faedah terutamanya kepada kanak-kanak yang mengalami cirit birit. Kandungan nutrien dan kanji amat sesuai bagi individu yang baru pulih dari keracunan makanan. Selepas satu atau dua hari, bolehlah mengambil makanan yang normal.

Makanan yang perlu dielakkan semasa mengalami simptom keracunan makanan adalah:

Minuman berkafein seperti teh dan kopi serta minuman berkarbonat.

Makanan yang tinggi kandungan lemak seperti makanan bergoreng, dan makanan berproses, contohnya makanan segera.

Makanan dan minuman yang mengandungi gula yang tinggi seperti kek, donut atau air manis.

Susu dan produk tenusu yang mengandungi laktosa seperti keju dan yogurt.

Makanan yang pedas, dan mengandungi cili atau herba yang berasa pedas.

Siti Sarah Binti Mohd Juzup

Dietitian

Columbia Asia Hospital – Setapak

Make an Appointment

PDF and Online Articles:

Kenali Jenis Bakteria Penyebab Keracunan Makanan, Ketahui Cara Mengelaknya – Getaran, 24 September 2022

Artikel ini disiarkan oleh Getaran, 24 September 2022.

Looking for
Dietetics and Nutrition
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips:


Kenali Jenis Makanan Bayi

Kenali Jenis Makanan Bayi

July 01, 2022

FASA yang cukup kritikal ialah dua tahun pertama bagi perkembangan nutrisi kanak-kanak kerana tempoh itu memberi kesan kepada tumbesaran otak serta fizikal lain si kecil anda.

Detik yang paling mengujakan untuk tempoh dua tahun terbabit ialah saat anak atau bayi diperkenalkan dengan makanan pejal pertama.

Menurut Pakar Dietetik Hospital Columbia Asia Klang, Teen May Yen, pendedahan dan kaedah ibu bapa dalam memperkenalkan makanan pertama untuk anak boleh memberi kesan kepada kehidupan pada fasa seterusnya.

"Sejak hari pertama iaitu usia bayi enam bulan sehinggalah ke usia dua tahun, jenis dan pilihan makanan diperkenalkan kepada anak dalam tempoh itu sangat penting.

"Makanan bersesuaian terutama dari sumber bahan yang segar dan sihat seperti protein, karbohidrat, serat dan juga lemak baik sangat penting untuk pertumbuhan mereka.

"Pilihan yang baik ialah kombinasi pelbagai jenis variasi makanan dalam diet bayi sehinggalah usia mereka dua tahun sangat penting.

"Kepelbagaian jenis makanan baik dan sihat diberikan pada kanak-kanak membantu membentuk tabiat baik terutama menangani isu seperti memilih makanan (picky eater) dan juga berkait dengan berat badan," katanya.

Tambah pakar itu, kesediaan bayi untuk menerima makanan pejal boleh dilihat pada keadaan atau gerakan bayi itu sendiri.

"Memang garis had umur disarankan pakar adalah enam bulan dan ibu bapa boleh lihat pola perlakuan anak mereka yang menunjukkan tanda-tanda bersedia untuk makan.

"Pertama, keadaan bayi dari bahagian kepala dan leher sudah stabil yang mana menunjukkan pergerakan seperti mengangkat kepala atau sudah pun dalam posisi duduk.

"Selain itu ada juga pergerakan mulut atau mengeluarkan air liur apabila melihat orang dewasa makan. Ini antara gerakan yang biasa dilihat pada bayi berusia sekitar enam bulan dan ke atas jika mereka bersedia untuk makan," katanya.

Kata May Yen, sebaik melihat reaksi itu ditunjukkan bayi mereka, ibu bapa perlu persiapkan makanan dalam tekstur yang sesuai dengan tahap atau perkembangan anak itu.

"Bagi makanan pejal yang pertama memang bermula dengan tekstur puri kerana usus bayi masih lembut selain masih belum tumbuh gigi.

"Bentuk puri membantu peralihan lebih baik dari susu iaitu diperoleh dalam bentuk cecair kepada makanan.

"Sebaiknya perkenalkan dengan satu menu dalam tempoh seminggu secara konsisten sebelum beralih kepada menu lain.

"Ini penting bagi mengenal pasti masalah alahan selain kecenderungan anak sama ada suka atau tidak makanan terbabit.

"Jika anak masih tidak suka, masih perlu ibu bapa terus memperkenalkan makanan yang tidak disukai bagi melatih untuk tidak bersikap memilih makanan.

"Kaedahnya dengan banyakkan bahagian makanan disukai dan diselit dengan bahagian tidak disukai sedikit. Lama-kelamaan anak boleh biasakan diri untuk makan apa juga jenis makanan," katanya.

May Yen tidak menafikan bayi berkemungkinan tidak menyukai hidangan sayur atau buah tertentu kerana tekstur dan rasa.

"Memang terdapat kajian mengatakan kanak-kanak tidak makan sayur kerana tekstur dan rasanya pahit.

"Tetapi jika didedahkan secara perlahan-lahan, tunas rasa bayi yang baru rasa sayur atau sumber lain termasuklah buah-buahan boleh menerima dengan baik," katanya.

Kata May Yen, sayur-sayuran dan buah-buahan sangat penting kerana sumber serat tinggi mencegah masalah sembelit dalam kalangan bayi serta kanak-kanak.

Dalam pada itu pakar dietetik itu juga tidak lupa menitipkan tip penting, termasuklah sikap ibu bapa dalam proses memperkenalkan makanan pejal terhadap anak mereka.

"Cuma dalam proses memperkenalkan makanan pejal ini ibu bapa perlu ada inisiatif dan konsisten.

"Maksudnya jika tiba satu tempoh yang ibu bapa sibuk dan mereka tidak sempat menyediakan makanan pejal untuk bayi, mereka hanya membekalkan susu kepada anak.

"Sebenarnya ini adalah salah dan ibu bapa tetap perlu menyediakan makanan pejal pada tempoh berkenaan. Andai tidak sempat menyediakan sendiri, gunakan produk makanan bayi sedia ada dalam pasaran.

"Selain itu, seiring dengan pemberian makanan pejal, jumlah susu diambil juga berkurangan. Sebaiknya patuhi jadual pemeriksaan anak bersama doktor sepanjang dua tahun supaya perkembangan anak termasuklah berat badan dapat dipantau dengan baik," katanya.

Teen May Yen

Dietitian

Columbia Asia Hospital - Klang

Make an Appointment

PDF and Online Articles:

Kenali Jenis Makanan Bayi - Harian Metro, 17 Jun 2022

Artikel ini disiarkan oleh Harian Metro, 17 Jun 2022.

Looking for
Dietetics & Nutrition
 in Columbia Asia?

Make an Appointment

Follow us for latest Health Tips: