internet addiction: Healthy or not

http://www.thestar.com.my/News/Nation/2014/01/10/Internet-addiction-taking-toll-on-health/
73% of Malaysian adults who took part in the 2013 AIA Healthy Living Index survey admitted that their online activities and social networking were getting addictive, putting Malaysia with the highest addiction rates in the Asia-Pacific region. As a result, they leads more sedentary lifestyle, less sleep and more health problem.

There is 7 benefits of exercise :-
controls weight-physical activity burn calories
Combats health condition and disease- cheapest way to boost good cholesterol (HDL) and decrease TG. It also prevent type 2 diabetes
Improves mood - increase endorphin (happy substance ) in the brain and make you happy
Boost energy- improve muscle strngth and endurance
Promotes better sleep- it make you fall to sleep easily but remember not to exercise near bed time
Prevent sexual dysfunction- men exercise tend to have less problem on erectile dysfunction
Fun and healthy way to spent time- can closer relationship with friends
7 reasons why you should do exercise

Sleep is important for health
Many people do not know inadequate sleep and rest leads to more problem.
Health-Normally people will get sick like flu easily when they do not have adequate sleep.
Study shows that a link between insufficient sleep and some serious health problems, such as heart disease, heart attacks, diabetes, and obesity.
Better sex-. According to a poll conducted by the National Sleep Foundation, up to 26% of people say that their sex lives tend to suffer because they're just too tired. There's evidence that in men, impaired sleep can be associated with lower testosterone levels
Less pain- studies found links between threshold of pain and sleep loss
Lower accident- US found 1 out of 5 aciidents from drowsy driving.

With the above reasons , I don’t see why you should not stop your internet addicts.

Alzheimer’s disease

http://news.sinchew.com.my/node/337060


When people getting older and older, they tends to have memory loss which may affect their personal life . Lots of people tends to use Alzheimer’s disease to refer to memory loss.
Actually the correct term for memory loss and thinking skills which disturb daily living is dementia. Alzheimer’s disease is just part of the type of dementia. It is the main contributor for dementia.
What is Alzheimer’s disease?
Alzheimer’s disease is the commonest form of dementia. It is the degenerative brain disorder. It worsen as it progress. It is common among people over 65 years of age.

What is the symptom of Alzhimer’s disease?
Early symptom of Alzheimer’s disease are memory problems however decline in other aspects of cognition, such as word-finding, vision issues, and impaired reasoning or judgment, may also signal the very early stages of Alzheimer’s disease.

As Alzheimer’s disease progresses, memory loss worsens, and changes in other cognitive abilities are evident. Problems can include, for example, getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, using poor judgment, and having some mood and personality changes.

What causes Alzheimer’s disease
It is likely that the causes include some mix of genetic, environmental, and lifestyle factors.


How to diagnose Alzheimer’s disease?
Alzheimer’s disease may diagnose like checking memory and ability to carry out normal activity plus doing urine test and blood test with brain CT to rule out other possible causes of memory problem.

Commit suicide and depression

http://www.thestar.com.my/News/Nation/2013/11/28/Doctor-commits-suicide-after-killing-son.aspx
 Psychological problem like depression is become a common problem in urban world.

What is depression?
Depression is a state of low mood that can affect person's thoughts, behavior, feelings and sense of well-being.

How common is the depression ?
Depression in Malaysia is about 11-12 % among rural area. It is much higher in city.

What is the presentation of depression?
If you got depression, you will got difficulty of sleep or excessive sleep, poor appetite, feeling hopeless,low mood, lost of interest, reduce body weight and later with feeling worthless to live or even suicidal idea eventually commit suicide.

What to do if I got the symptom?
You should seek treatment from doctor if urgent need psychiatric attention.

Is there a treatment for depression?
There is  treatment for depression . Medication group like  selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors(SNRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) works well as antidepressent.

What is the risk factor for diabetes ?

http://www.bernama.com/bernama/v7/newsindex.php?id=992117

As mentioned in this article , diabetes among young people is on the rising trend. Have you wondered why our during 1986 era diabetes over 30 in malaysia is only around 4% and now is about 12 %.

What is the risk factor for diabetes?
Is the family history contributing to diabetes?

Before the question is answer, I will give a brief account for diabetis.
Diabetes means sugar in urine. In the modern era, doctor identify diabetes by high sugar in blood because sugar in urine is less accurate( need higher sugar in blood to be identified).

Diabetis may cause disease to the heart, brain, kidney, nerve and even dead if poorly controlled. In fact more than 60% of dialysis patients is due to diabetes!

Family history do contribute to diabetes - If your sibling or parents got diabetes , you got higher risk of getting diabetes.

Race affect your changes of getting diabetes. Asian , hispanic , afro. Indian is the highest risk among Malaysian to get diabetes

Do lifestyle affect diabetes?
Yes, the less active the more risk to get diabetes. Activity uses up glucose as energy and makes your cells more sensitive to insulin

Is increased sugar intake increase risk of diabetes?
Increased sugar have been linked to overweight and obesity but recent study found that an additional 150 calories from sugar per person per day – the equivalent of just one 12-ounce soda drink – increased the prevalence of diabetes by 1% in that population

Is diabetes during pregnancy increased riskof diabetes?
Yes , the women who have diabetes during pregnancy have higher risk of getting diabetes in later life.

Disclaimer
All advice and information on this news is given in good faith and is based on sources believed to be reliable and accurate at the time of release on the article. I do not accept legal liability or responsibility for the content of the advice or information or any consequences arising from its use.
The information provided on this news is provided for information purposes only. If you are a patient reading the news, you should seek assistance from a health care professional when interpreting these materials and applying them to your individual circumstances.

Is the ECG stress test able to detect symptoms before sudden death happened ?

http://www.malaysia-chronicle.com/index.php?option=com_k2&view=item&id=183571:25-year-old-woman-dies-after-running-10km-marathon&Itemid=4#axzz2jmTSqt87

A 10 km run which killed a 25 year old young lady make you wonder whether you should participate in the upcoming Penang bridge run which range from 10 km to 42 km. Is the stress test a must prior to participation ? Is the stress test can avoid such issue happening to you and your loved one.

The answer is yes and no !

Yes, For people with chest pain, a positive result can determine whether the problem is heart-related. Stress tests can also evaluate heart risk before a surgery or after a heart attack. Stress tests can effectively show whether the heart's arteries are 70% narrowed or more. Most of the patients got heart attack when artery to the heart is 70-75% blocked
But heart attacks can arise from arteries that are less than 50% blocked ! The answer is no as it wont detect 50% blockage.

Stress test is only 60% accurate meaning they miss 40% of the diagnosis ! Women got less accuracy compared to man as smaller branch of artery are affected when woman got heart disease. Breast tissue can trigger false negative.

The false positive and false negative bring potential problem as it give extra security or more invasive procedures and the unnecessary use of medications.

U.S. Preventive Service Task Force does not recommend treadmill testing for those with a low risk.

2nd question will arise after reading this is why 50% or lower plaque will cause heart attack ?
The heart attack occurred when vulnerable plaque rupture. Vulnerable plaque rupture causing thrombosis of artery . A small plaque with thin core is easily rupture then the big plaque with thick core. Small vulnerable plaque is higher risk compared to big plaque.


What is the definite strategy of  detecting ischemic heart disease?
The gold standard is angiogram ( invasive procedure where a thin tube is inserted into the artery of the heart) . The procedure is needed when symptom suggestive of heart disease and risk of heart disease is present . The risk of heart disease are high blood pressure, fa,mily history of sudden death , diabetes, obesity and high cholesterol.

Back to the above news, is the patient died of heart disease?
The answer is yes but not heart attack (coronary artery blockage). The cause of death for young athletes is mainly hypertrophic cardiomyopathy. Hypertrophic cardiomyopathy is a congenital condition in which a portion of heart muscle is thickened . It can be detected by ECG but definite test would be echocardiogram and cardiac MRI.

Disclaimer
All advice and information on this news is given in good faith and is based on sources believed to be reliable and accurate at the time of release on the article. I do not accept legal liability or responsibility for the content of the advice or information or any consequences arising from its use.
The information provided on this news is provided for information purposes only. If you are a patient reading the news, you should seek assistance from a health care professional when interpreting these materials and applying them to your individual circumstances.

dengue fever

Dengue fever

http://www.bharian.com.my/bharian/articles/Kesdenggimembimbangkan/Article/

Our local paper (http://www.bharian.com.my/bharian/articles/Kesdenggimembimbangkan/Article/)

showed that increasing number of reported dengue cases which lead me to discuss about dengue in details. 

Dengue fever is a common topical illness including Malaysia. It is caused by dengue virus.

Dengue is transmitted by mosquito within the genus Aedes, principally Aedes aegypti. The virus has four different types which is DEN I , II , III and IV. Infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications which is dengue hemorrhagic fever.

Symptom of dengue fever are fever, muscle pain, joint pain, headache and characteristic skin rash(redness). Dengue fever may presented with more severe presentation which is dengue haemorrhagic fever which if overlooked may progress to dengue shock syndrome.Incubation (disease stay inactive) period lasting 4-10 days.Acute fever phase lasting 2 to 7 days, a critical phase beginning around the time of defervescence (fever subsiding) and lasting 1 to 2 days, and a recovery phase lasting 2 to 3 days.

Dengue fever diagnosed with combination of disease symptom, history of recent fogging, physical examination of rash, bleeding tendency , postural drop blood pressure and confirm by dengue serology test and complete blood test.

Treatment involve fluid therapy which is IV drip and encourage orally, fever control with antipyrexia and proton pump inhibitor if gastrointestinal symptom presents. Severe hemorrhagic condition may need blood product transfusion.

FAQ:

Does antibiotic play any role in dengue fever ?

Antibiotic play no role in dengue fever unless there is bacteria infection associated with dengue fever.

Does dengue fever can cause mortality ?

Yes, it is dangerous if fluid replacement (IV drip) not given accordingly especially after fever subsided. Critical period normally is 2 days after fever subsided.

How long should I Stay in hospital ?

It may be lasted 7 to 9 days depending on which phase you are presented.

Can I have dengue fever by skin contact?

No, It is spread via mosquito bites.

Disclaimer

All advice and information on this news is given in good faith and is based on sources believed to be reliable and accurate at the time of release on the article. I do not accept legal liability or responsibility for the content of the advice or information or any consequences arising from its use.

The information provided on this news is provided for information purposes only. If you are a patient reading the news, you should seek assistance from a health care professional when interpreting these materials and applying them to your individual circumstances.

Phyton and snakes bites

 The NST news (http://www.nst.com.my/nation/general/python-caught-in-oil-palm-plantation-1.388026?cache=03D163D03edding-pred-1.1176%252F%253FpFpentwage63Dp%253A%252Fhe3D03Dn63Frea-rti3D19.3D163D03edding-pred-1.1176%252F%253FpFpentwage63Dp%253A%252Fhe3D03Dn63Frea-rti3D19.111w5ii%25%2F7.478218%2F7.478218)regarding  Phyton echoed me to give my patients education regarding the snake bite . Before I become the doctor , I always hear people said about when poisonous snake bite you. You need to tourniquet so that the venom (poison ) won’t reach the heart and kill you. Is it the myth or the facts ?
Let me explain to you regarding the type of snake and how they prey on their victim before I elaborate further.

Snake naturally can be divided into venomous or non venomous snake
-Non venomous snake kill his prey by swallowing alive or kill by constriction. Phyton is a constricting snake.

-Venomous snake  kill prey by injecting venom .
Venomous snake mainly can be divided into 3 types-
Type 1 - Elapidae - commonly family of the snake is Cobra.
They kill their prey by  injecting neurotoxin. Some may produce cytotoxin. Neurotoxin may paralyses our breathing muscle and eye muscle. Human bitten by this snake may died of breathing difficulty. Earliest symptom of neurotoxin is drooping of eye lid.
Cytotoxin is toxin that may destroy cell. Severe venom injection may end up victim loss their hand or leg.

Type 2-Viperidae- commonly type of the snake is viper (ular kapak).
Viper kill their prey by injecting  hemotoxin which may cause serious bleeding problem which may cause bleeding problem and died.

Type 3-Sea snake
Contain both neurotoxin and hemotoxin . One of the most poisonous snake type as may cause both type of problem.

FAQ
What should you do when snake bites you?
You should go to nearest hospital or clinic.

Can I suck out the venom after tourniquet the wound?
It is not encouraged to do so as any small ulcer or injury in mouth may let the venom enter your body and cause poison effect . It is better to have one person save the others that injured by snake than having 2 person in similar trouble.


What the hospital Doctor would do?
They need to admit you and monitoring for potential toxin effect by doing examination and close observation. Severe toxin effect which affect the clotting of blood or nervous system may warrant antivenom.

Why do not every patient receive antivenom?
Antivenom is made of horse serum which carry the risk of causing severe anaphylaxis (allergy) reaction to patient. The usage of it need to be justified. Do no harm is the motto of treatment to patient.

I think with this piece of news and info may help you in understanding snake bites better. Hope it will enlighten you on the study.

Dr Khoo Kah Fang
Tanjung medical Centre.

Disclaimer
All advice and information on this news is given in good faith and is based on sources believed to be reliable and accurate at the time of release on the article. I do not accept legal liability or responsibility for the content of the advice or information or any consequences arising from its use.
The information provided on this news is provided for information purposes only. If you are a patient reading the news, you should seek assistance from a health care professional when interpreting these materials and applying them to your individual circumstances.