Tuesday, February 24, 2009

More going to govt hospitals


IPOH: There has been an increase in the number of people seeking treatment at government hospitals and clinics over the last six months.
Deputy Minister of Health Datuk Dr Abdul Latiff Ahmad attributes this to the global economic slowdown. The concern over money had affected the public's capacity to seek treatment at private hospitals.

"Patients only need pay RM1 to consult a doctor and seek treatment at government hospitals. Although they have to wait to see the doctors, more of them are visiting government hospitals and clinics now," he said after opening the 3rd Perak Health Conference here yesterday.

The conference, themed "Bridging Public Health Practice and Clinical Medicine", was organised by the Perak Health Department and the Malaysian Public Health Specialists Association (Perak).

Also present were Health Ministry director-general Tan Sri Dr Mohd Ismail Merican and Perak Health Department director Datuk Dr Ahmad Razin Ahmad Mahir.
Asked if the government healthcare sector would be able to cope with the rising number of patients, Dr Abdul Latiff said the situation was manageable with extended hours at several clinics nationwide. These clinics are open until 9.30pm.

He said he had told hospital staff to be "flexible" when collecting payments for hospitalisation and surgeries from the lower income group.

"Patients with financial difficulties can raise the matter with the hospital directors or social medical officers," he said, pointing out that the officers had been vested with powers to reduce or cancel the charges.

Sunday, February 22, 2009

Pin-hole surgery for fast recovery


Dr Yap demonstrating the pin-hole surgery procedure. 

With lower cost and less risk, pin-hole surgery is the choice of treatment for hole-in-the-heart patients, writes KASMIAH MUSTAPHA. 

THESE days, in less than an hour, a heart patient’s life can be changed forever.

Through a simple and non-invasive procedure, patients will be able to lead normal lives without having to deal with the effects of a major surgery.

For those who suffer from hole in the heart, a catheter-based procedure has proven to be successful and less risky than open-heart surgery. 

The shorter recovery time and lower costs make it a more preferable treatment choice, not only among patients, but doctors as well.
Pin-hole surgery (or the transcatheter closure procedure) was introduced more than 10 years ago. It is considered the most successful technique in atrial septal defect (ASD) closure to date.

Prince Court Medical Centre consultant interventional cardiologist Dr Yap Yee Guan says the procedure avoids the need for open heart surgery to close a hole.

“In the last five to six years, this procedure has gained wide adoption across the world. The fact that it is a simple procedure which leaves no scarring, with lower costs and faster recovery, makes it the perfect choice for patients.”

ASD is the one of the most common types of congenital heart defect, in which the wall that separates the upper heart chambers (atria) does not close completely. 

There are three common types of ASD, depending on their position in the atrial septum. These are the secundum, ostium primum and sinus venosum.

Dr Yap says pin-hole surgery is more commonly used for people who suffer from secundum ASD.

This condition is due to the failure of that part of the atrial septum to close completely during the development of the heart. 

This leads to the opening, or a hole, in the wall between the right and left atrium.

“Usually the size of the hole will be between 3mm and 4cm. If the hole is too small, it can close up within the first year of the baby’s life. But for about 50 per cent of cases, surgery is the only way to close the hole.”

With a 90 per cent success rate, pin-hole surgery is used for the majority of secundum ASD closure, although in some cases, open-heart surgery is still the only option.

“Open-heart surgery still plays a role, although it is becoming less favourable now. For patients with a hole of more than 3.2cm, the catheter procedure may not work. The device will be too small to close the hole. So open-heart surgery is the the only way.”

The hole will cause blood to flow between two and three times more than usual into the right atrium and right ventricle of the heart, as well as into the lungs.

Eventually, this will cause enlargement of the right atrium and the right ventricle, and irregular heartbeat or rhythm as the atrium stretches and enlarges with the extra blood. This will result in a fast heartbeat, resulting in dizziness, fainting or chest discomfort. 

It can also cause strokes, as a blood clot in a vein or in the right side of the heart can pass through the ASD and enter the blood stream, where it can block an artery supplying blood to the brain.

The extra blood being pumped to the lungs will also increase the pressure in the pulmonary arteries.

Over time, high pressure can damage the arteries and the small blood vessels in the lungs. 

Dr Yap says secundum ASD is more difficult to detect as it is non-symptomatic. 

The only way it can be diagnosed earlier is if doctors detect a murmur, which is an indication of a hole in the heart.

“If it is not detected earlier, babies can grow up without knowing they have this condition. When they reach adulthood they will have symptoms such as shortness of breath, palpitations, fatigue and fainting.

“But since these symptoms can also mean other things, they would ignore them. Doctors too will sometimes misdiagnose them.

“Eventually, at a late stage, high blood pressure can develop in the lungs, as well as other complications. The person can die prematurely. Sadly, as secundum ASD is difficult to detect, there can be many who have this condition and never realise it.

“So doctors need to be more alert and carry out a thorough examination if patients complain about any of the symptoms.

“They need to refer the patients to a cardiologist who can run an EEG and ultrasound tests. By doing this we can treat the condition earlier and, with the catheter-based procedure, the treatment is easier.”

Dr Yap, who has performed this procedure since 2004 when he was working in the United Kingdom, says pin-hole surgery can be done in 30 minutes and has changed the management of ASD surgery completely. 

The patient can leave the hospital the next day, although he needs to avoid strenuous activities for a month. 

He also needs to take blood-thinning medication to ensure there are no blood clots as the heart slowly forms a membrane around the device.

“After the hole is closed, the enlargement on right side of the heart will get smaller and go back to normal size. The patient will be able to lead a normal life.”

As part of its corporate social responsibility programme, Prince Court has sponsored the treatment of four secundum ASD patients.

How the procedure is carried out

Pin-hole surgery, or transcathether closure of atrial septal defect, involves implantation of the amplatzer — an umbrella-like device — into the hole. 

The amplatzer will be screwed onto a catheter, which will then be inserted into the veins and arteries in the groin.

These veins are directly attached to the heart, and this is the standard access technique used in all patients. 

Once the catheter reaches the hole, the amplatzer will open up like an umbrella. It will be pulled back against the septum wall, securing its position on to the wall.

With most of the devices used at present, half of the device is connected to one side of the atrial septum, and the second half attached to the other portion, closing the hole between the two atria.

Within six to eight weeks, the device acts as a “skeleton” or a “framework”, normal tissue to grow in and over the defect.

The entire procedure is performed under general anaesthesia, and the actual implantation of the device is performed using transoesophageal echocardiographic guidance (ultrasound pictures using a probe introduced into the oesophagus for improved imaging of the heart structures). —

Source: tchin.org/resource_room/c_art  

Thursday, February 12, 2009

Ungku Aziz reveals secrets to success


KUALA LUMPUR: What are Royal Professor Ungku Abdul Aziz's secrets to success? One of them is to read nine books.
This includes
1 Harvey Diamond's Fit for Life
2 Not Fat for Life,
3 Edward De Bono's Thinking Course,
4 Tony Buzan's Mind Map,
5 Head First
6 The 36 Strategies of the Chinese: Adapting An Ancient Chinese Wisdom to the
Business World by Wee Chow Hou and Lan Luh Luh.

Others are
7 Jim Collins' Level 5 Leadership,
8 Sun Tzu's Art of War,
9 Nicollo Machiavelli's The Prince on the Art of Power and Leader's Window by J.D.W. Beck and N.M Yeager.

The 87-year-old voracious reader said the books provide an insight on how to be good and successful leaders.

Citing an example, he said Edward De Bono's Thinking Course promotes lateral thinking.
"The book teaches you to think differently," he said in his lecture "Quest For Success" as part of the Merdeka Award Lecture Series. He was a recipient of the award last year, in the education and community category.

Ungku Aziz said a good leader would have intelligence, credibility, humility, courage, and discipline.

He also said a good leader would be able to spot opportunities during crisis.

"Every crisis opens up opportunities," he said.

Later, when taking questions from the floor, Ungku Aziz said successful people were those who had resolve because their minds were strong and were resolute in reaching their goals.

"At the same time, humility is important, too.

"I'm happiest when I go to a kampung and people tell me 'you macam itu universiti punya' (you look like the person from the university)," he said to laughter from the floor.

Tuesday, February 3, 2009

Stress, not just genetics add years to face: study

Wrinkles are not due to genetics alone but also to stressful environmental factors, such as a divorce, abnormal weight loss and use of antidepressants, according to a study published Tuesday.
The study found that twins who had been divorced looked nearly two years older than their identical siblings who were married, widowed or single. Researchers found that antidepressant use and weight gain were also factors in perceived age difference.

In sets of twins younger than 40, the heavier twin seemed older, while in sets of twins more than 40 years old, the heavier twin seemed younger.

"The presence of stress could be one of the common denominators in those twins who appeared older," said Guyuron.

Continued relaxation of the facial muscles due to antidepressant use could explain sagging, and losing abnormal amounts of weight has harmful effects on health and appearance, the researchers found.

The study was published in the web-based version of "Plastic and Reconstructive Surgery," the ASPS medical journal.

Monday, February 2, 2009

Budaya Shisha Yang Merosakkan

" Assalamualaikum

Baru sebentar tadi ana balik dari makan malam bersama keluarga tersayang. Sang isteri yang agak keletihan mengemas rumah kerana bersepah dikerjakan tiga orang mujadeen cilik. Seperti biasa kalau nak keluar makan pun hanya disekitar rumah sahaja. Dekat dan cepat.

Cuma agak mengecewakan restoran tersebut ada menyediakan hidangan hookah atau lebih dikenali sebagai shisha. Walaupun ini bukan kali pertama ana makan di restoran yang menyediakan shisha tetapi perasaan pada malam ini berlainan sedikit kerana melihat gelagat anak-anak kecil yang amat tertarik dengan shisha tersebut.

Aduhai... bukankah kerajaan melarang mana-mana perokok merokok di tempat-tempat awam? Suatu ketika dulu operasi menyaman golongan perokok rancak dijalankan. Hatta yang sedang menunggu teksi di perhentian pun disamannya. Kini undang-undang itu bak ditelan zaman. Perokok bebas merokok di mana sahaja. Dan yang terbaru sejak akhir-akhir ini budaya menghisap shisha semakin popular!!!

Shisha atau juga dikenali dengan nama "hookah" merupakan sejenis peralatan paip air yang menegak, lazimnya digunakan untuk menghisap tembakau yang berperisa. Bayaran yang biasa dikenakan ialah antara RM10 hingga RM15 untuk satu sesi shisha. Menghisap shisha yang kian menjadi kegilaan khususnya muda-mudi Melayu, telah diamalkan di Timur Tengah ratusan tahun lamanya. Sebelum kemunculan tembakau, bahan yang sering digunakan di dalam shisha ialah candu dan hashish.

Rasanya sudah tiba masanya kita memandang serius gejala yang merosakkan ini. Ana amat merasa bimbang apabila masyarakat seolah-olah menerima trend menghisap shisha. Yang lebih menyedihkan lagi anak-anak muda remaja dan belia berlumba-lumba memulakan perniagaan kecil-kecilan (sambil menumpang di restoran2) seolah-olah ia direstui oleh semua orang.

Kalau kita boleh berkempen untuk saudara kita di Palestin. Mangapa tidak untuk kita berkempen menyedarkan kepada masyarakat sekeliling betapa bahayanya shisha. Benar kita perlu sentiasa berjuang untuk bumi Palestin. Tetapi tidak harus lupa juga kepada penyediaan generasi akan datang untuk meneruskan perjuangan yang kita junjung sekarang. Tapi awal-awal lagi tunas Islam di cemari dengan rokok dan shisha, apa yang kita harapkan lagi.

Mungkin dikalangan kita beranggapan shisha dan rokok itu sama sahaja. Hisap dan keluarnya asap jua. Tapi jangan lupa. kaedah mengisap shisha juga sama denga menghisap dam (yang menggunakan candu). Mana mungkin orang kebanyakkan seperti kita semua boleh membezakan orang yang sedang menghisap shisha tersebut menggunakan tembakau atau candu sebagai intinya?

Setiausaha Agung Persatuan Pengguna Islam Malaysia (PPIM), Datuk Dr Maamor Osman dalam temubual ;

"Menghisap shisha, katanya, mempunyai banyak persamaan dengan perbuatan menghisap rokok dan dalam masa yang sama, ada juga penggemar shisha perokok tegar.Di Malaysia, tambahnya, menghisap shisha ini lebih mirip kepada pengambilan dadah marijuana dengan menggunakan alat yang dipanggil "dapur".

"Persoalan yang perlu dirungkaikan ialah, sesuaikah menghisap shisha ini dengan sosio-budaya Malaysia?Kerajaan telah menetapkan dadah sebagai musuh utama negara. Justeru, kita tidak sepatutnya membiarkan budaya negatif ini timbul semula melalui inovasi shisha. Ia mungkin inovasi baru tetapi tetap sama (penggunaan tembakau),"

Budaya yang tak senonoh ini elok sangat kalau dicantas secepat mungkin. Kempen harus dilaksanakan. Banner mesti dinaikkan. Flyer juga harus disebarkan. Operasi terjah dan explain dari restoran ke restoran perlu dijalankan. Khutbah Jumaat juga boleh memainkan peranan. Insyallah. sekadar beberapa cadangan yang terlintas...

Ana merayu kepada antum semua untuk sama-sama memikirkan permasalahan ini dan yang terpenting sekali perlaksanaan harus meterialize. Yang jauh akan sentiasa diingati tetapi yang dekat jangan dilupakan.

"Ya Tuhan kami, jadikanlah kami berdua orang yang tunduk patuh kepada Engkau dan (jadikanlah) di antara anak cucu kami umat yang tunduk patuh kepada Engkau dan tunjukkanlah kepada kami cara-cara dan tempat-tempat ibadat haji kami, dan terimalah taubat kami. Sesungguhnya Engkaulah Yang Maha Penerima taubat lagi Maha Penyayang." Al Baqarah : 28

Oleh Hang_Kasturi
Sumber : TranungKite. Tempat mengutuk kerajaan dsb pailng popular

TV and video games increase teen depression risk: study

Spending more hours watching television or playing video games as a teenager may lead to depression in young adults, according to a study published Monday.
Researchers looked at the exposure to electronic media of 4,142 adolescents who were not depressed when the study began in 1995, before DVDs and the Internet were widely used.
The teens reported an average of 5.68 hours of media exposure per day, including 2.3 hours of television, 2.34 hours of radio, 0.62 hours of videocassettes and 0.41 hours of computer games.
Seven years later, when the participants were an average of 21.8 years old, 308 of them (7.4 percent) had developed symptoms consistent with depression.

"In the fully adjusted models, participants had significantly greater odds of developing depression by follow-up for each hour of daily television viewed," wrote the authors of the study published in the Archives of General Psychiatry journal.

"In addition, those reporting higher total media exposure had significantly greater odds of developing depression for each additional hour of daily use," said the study, led by Brian Primack of the University of Pittsburgh School of Medicine.

Young women were found to be less likely to develop symptoms of depression than young men when exposed to the same amount of electronic media.

Depression, the leading cause of non-fatal disability worldwide, commonly begins in adolescence or young adulthood, the article explained.

The authors noted that time spent engaging with electronic media may replace time that could be spent on social, athletic or intellectual activities that could guard against depression.

Messages transmitted through electronic media may encourage aggression, inspire fear or anxiety and hamper identity development, they added.

Being exposed to media at night may also disrupt sleep important for emotional and cognitive development.

"When high amounts of television or total exposure are present, a broader assessment of the adolescent's psychosocial functioning may be appropriate, including screening for current depressive symptoms and for the presence of additional risk factors," the authors said.

"If no other immediate intervention is indicated, encouraging patients to participate in activities that promote a sense of mastery and social connection may promote the development of protective factors against depression."

sumber : NST. Sok kaba bodo.