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Pancreatic Cancer

6/8/2017

2 Comments

 
Cancer of the pancreas always present in the late stages because he does not have any symptoms in the beginning. What are the causes and symptoms to look out for ? Is treatment possible for pancreatic cancer ?
2 Comments

Manage Stress Well

27/7/2017

1 Comment

 
Stress

Everyone will experience stress which is part of our life. The amount of stress one feels depends on how you manage you work, lifestyle, meet demands, cope with life events and interact with people. A certain amount of stress is important as it motivates us and make us improve. Good stress management results in a healthier and happy life. 

Stress management is about taking charge of your emotions, thoughts , lifestyle and learning better coping strategies for daily events and stressors. Stressors are circumstances that cause stress.  Examples of stressors are meeting sales target, meeting datelines, changing jobs, divorce, losing a loved one. Different people copes differently to stressors and each individual has their own way of coping with them depending on their skills, experience and knowledge. 
​

Identifying causes of stress

To better cope with stress, we need to know what causes stress. Not only negative life events cause stress, positive events can also cause stress. Some examples of stressors in life are: 
  • Biological causes: Pregnancy, illness 
  • Economical causes: Retrenchment,Unemployment, Bills, Debts 
  • Personal causes: Death, Accident and injury 
  • Social or relationship causes: Breakups, divorces , relocation, switch jobs , new job

You can start a stress journal to note down what causes the stress, how you felt emotionally and physically and how did you resolve the stress. This will act as a good pointer to identify your common stressors and learn which is the best way from experience to cope with them.

Read more:
 http://www.medthical.com/manage-stress-well.html​
1 Comment

What is Ebola?

27/7/2017

1 Comment

 
Ebola virus disease is previously known as Ebola hemorrhagic disease. It is a very severe disease with mortality up to 90%. Ebola first appeared in 1976 mainly in Nzara, Sudan, and in Yambuku, Democratic Republic of Congo. It started from the village near the Ebola River and hence it got its name Ebola.

Ebola virus comprises of 5 distinct species: Bundibugyo ebolavirus (BDBV), Zaire ebolavirus (EBOV), Reston ebolavirus (RESTV), Sudan ebolavirus (SUDV) and Taï Forest ebolavirus (TAFV). BDBV, EBOV and SUDV have been associated with the outbreaks in Africa.
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Where does Ebola come from? 

Fruit bats of the Pteropodidae family are natural hosts of the Ebola virus. Hunters in Africa hunt down wild infected “bushmeat” which include infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines. When these bushmeat is not properly cooked or if the hunters get into contact with body secretions and fluids of infected animals, they can get infected. Then from there, the infected person can spread to another person by direct contact. 

Read more: ​http://www.medthical.com/ebola.html
1 Comment

What is Biotin?

27/7/2017

1 Comment

 
Biotin is a vitamin found in a number of foods. It has enzymes that help to digest fats, carbohydrates and others. It is taken as supplement for patients with biotin deficiency.

Biotin deficiency patients usually present with scaly rash on face (eyes, mouth and nose area), thinning of hair, fatigue, depression, tingling feelings in arms and legs and also sometimes hallucinations.

Biotin deficiency may occur in patients who have rapid weight loss, malnutrition, those on long term tube feeding, some diabetes patients and also during pregnancy states.

Benefits

Biotin supplements is usually taken by people who have symptoms as a result of biotin deficiency.

There is insufficient evidence to prove that biotin helps in hair loss, diabetes, brittle nail condition and diabetic neuropathy.

Possible side effects 

Biotin is generally safe when taken orally and also when given as injections in some medically indicated cases. It is also safe in pregnant/lactating women as they may have mild biotin deficiency.

Also those patients who have kidney failure on dialysis may need slightly higher dose of biotin.

Drug-drug interactions 

Currently there are no evidence based studies to prove any significant drug-drug interactions with biotin.

Dosage

Please follow the instructions given by your doctor and if in doubt if you require this supplement please consult your doctor first. There is currently no guidelines on daily dose of biotin supplements for people without any clinical indications. Below is the biotin requirements for our daily life according to our age and conditions, we can usually get enough biotin from our food. 


Biotin: Adequate Intake (AI) per day according to age group

 0-6 months: 5 micrograms/day

7-12 months: 6 mcg/day

1-3 years: 8 mcg/day

4-8 years: 12 mcg/day

9-13 years: 20 mcg/day

14-18 years: 25 mcg/day

19 years and up: 30 mcg/day

Pregnant women: 30 mcg/day

Breastfeeding women: 35 mcg/day
1 Comment

Singapore Community Health Assist Scheme

27/7/2017

1 Comment

 
Community Health Assist Scheme (CHAS) is a scheme by the Ministry of Health (MOH) that enables Singapore Citizens from lower- and middle- income households to receive subsidies for medical and dental care at participating General Practitioner (GP) and dental clinics near their homes.

Singapore Citizens who qualify for CHAS will receive an individual blue or orange Health Assist card. Health Assist cardholders will also enjoy subsidised referrals to Specialist Outpatient Clinics (SOCs) located at Public Hospitals or National Dental Centre when required.

Clinics registered under the scheme have partnered with MOH to provide common medical treatments and selected dental services for this group of patients. The scheme will also cover treatment for the 15 chronic conditions currently covered under the Chronic Disease Management Programme. The 15 conditions areDiabetes, Hypertension, Lipid Disorders, Stroke, Asthma, Chronic Obstructive Pulmonary Disease, Major Depression, Schizophrenia, Dementia, Bipolar Disorder, Osteoarthritis, Benign Prostatic Hyperplasia, Anxiety, Parkinson’s Disease and Nephritis/Nephrosis.

Enhancements to the scheme
From 1 Jan 2014, the following enhancements to the Community Health Assistance Scheme (CHAS) took effect:

- The previous qualifying age for CHAS (40 years old and above) has been removed.

- The Annual Value of residence criterion for households without income has been raised from $13,000 to $21,000.

- Eligible Health Assist cardholders can enjoy subsidies for recommended screenings under the Health Promotion Board’s Integrated Screening Programme.

- The coverage for the number of chronic conditions covered under CHAS has been increased. The 5 new conditions are Osteoarthritis, Benign Prostatic Hyperplasia, Anxiety, Parkinson’s Disease and Nephritis/Nephrosis.
1 Comment

What is Bacteria Vaginosis?

27/7/2017

0 Comments

 
Bacteria Vaginosis is usually not considered a sexually transmitted disease although it occurs more often in sexually active women than non-sexually active women.

Bacteria Vaginosis is a condition as a result of the replacement of the usual lactobacilli in the vagina with high concentrations of anaerobic bacteria such as Gardnerella Vaginalis, Mycoplasma Hominis, Mobiluncus Species and prevotella species. This results in a rise in PH from the usual 4.5 to as high as 7.0.
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Possible complications of Bacteria Vaginosis

It has been associated with pregnancy related complications such as preterm labor, late miscarriages, premature rupture of membranes and post-delivery endometritis.

It is also associated with pelvic inflammatory disease, vaginal cellulitis post-surgery and endometritis.

Currently there has been more evidence suggesting that Bacteria Vaginosis (lack of lactobacilli) has been associated with an increased risk of HIV contraction with a HIV partner during heterosexual intercourse.

Clinical symptoms and signs of Bacteria Vaginosis

Most people with bacteria vaginosis have no symptoms. If they do have symptoms they may present with an unpleasant fishy smelly thin white homogenous vaginal discharge.

Read more: 
http://www.medthical.com/bacteria-vaginosis.html
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Importance of Exercising

27/7/2017

2 Comments

 
Exercise Right 

Exercise and lead a healthy life to reduce risk of coronary heart diseases, diabetes, hypertension, stroke, osteoporosis, some cancers and so on. Staying healthy is not just about dieting and eating right, physical activity is also important to maintain a healthy body, boost energy, improves quality sleep and improve good mental health. 

Regular exercise also helps us burn off those extra calories, keep a healthy BMI, reduce bad cholesterol, increase good cholesterol and lower our blood pressure.  
Types of exercise

Aerobic exercise: often known as cardio exercise like running, dancing, biking, swimming, badminton are some examples. These exercises involve your total body movement where you move fast, heart rate goes up and you will breathe harder. Should you have joint problems, swimming is a better alternative. 

Strength training: These exercises tones up our muscles to develop stronger muscles and bones. It also increases your metabolic rate when you gain muscle and this helps to burn more calories. It also improves neural functioning and reaction time hence reduce risk of injury. You can use weights, resistance bands or own body weight (in yoga) to train. It is advisable to do it 2-3 times a week and let your muscle recover in between. 

Stretching: These exercises help remove tension and stiffness in our joints and muscles and improve flexibility. Always do stretching before and after aerobic exercise.  

Maximum Heart rate (MHR): it is a guide to gauge the intensity level of the exercise you are doing and how much you are pushing yourself. For vigorous intensity activity you should work till 80-85% of your MHR. As for moderate intensity activity you should aim towards 70-80% of your MHR. How to calculate maximum heart rate? MHR = 220 minus your age. 
How much to exercise?

For Children and Adolescents (6-17 years old):

  • 1 hour or more aerobic activity every day 

For adults 18-64 years old the recommended exercise regimes are: 

  • 150 minutes of moderate intensity aerobic exercise per week. When doing moderate intensity exercise, you have enough breath to talk but not sing. 150 minutes of exercise can be spread over 5 days with 30 minutes of exercise each time. 
OR
  • 75 minutes of vigorous intensity aerobic exercise per week. When doing vigorous intensity exercise, you will not be able to say more than a few words without pausing for a breath. 75 minutes can be spread over 3 days with 25 minutes of exercise each time. 
  • You will also benefit if you break up the 30 minutes segment daily into segments of 10-15 minutes. 
AND
  • Moderate to high intensity muscle strengthening activity at least 2 times a week for additional health benefits. 
Elderly > 65 years old 

  • Same as per adults 18-64 but must be tailored to own's means because elderly may have chronic medical conditions, joint issues and mobility issues. You can consult a sports physician/medical personnel on how to tailor exercise to stay fit and reduce risk of other diseases.

Pregnant and post-partum women

  • Maintaining your usual exercise regime is important for pregnant woman. Physical activity is safe and it DOES NOT cause early delivery, low birth rate, early pregnancy loss, impact fetal growth or impact's breast milk composition. 
  • 150 minutes of moderate intensity aerobic exercise per week. 150 minutes of exercise can be spread over 5 days with 30 minutes of exercise each time. It is okay to divide into 10-15 minutes segment of the 30 minutes exercise regime per day. 
  • Do not engage in activity that are high risks of abdomen injury or falls for example horse riding, soccer and basketball.


Getting Started to gear up and exercise

Start exercise by choosing exercises that you enjoy as that will make you more consistent. Always start slow and slowly build up according to your stamina and resistance.The body needs time to adjust and adapt especially when you have been living an inactive sedentary life for awhile. 


Be flexible if you do not have enough time, doing 10-15 minutes exercise 3 times a day is as good as a continuous 30 minutes moderate intensity workout. Always remember to warm up before and after exercise as it improves flexibility and prevent muscle pulls and strains. 


Lack of motivation to continue? Try joining activities/ class at gym, engage family and friends to join you to stir up your interest and motivation. Set goals to keep yourself focused and motivated. 


Exercise Caution

Always sick medical advice before starting any exercise regime if you have serious chronic medical conditions like diabetes, stroke or heart disease as your exercise need to be tailored to prevent any complications. 

Should you experience chest pain, shortness of breath, extreme break out of sweat, dizziness, fainting spells, fast erratic heart beat during exercise, stop immediately and sick medical attention. 

It is normal to feel muscle aches after exercise. Rest a day and you will realize that your stamina will slowly build up. ​
2 Comments

Japanese encephalitis

27/7/2017

4 Comments

 
Japanese encephalitis is a virus caused by the Japanese encephalitis virus. It is transmitted to human via the bite of the infected mosquito. It is does not spread from human to human.In many people it is just a mild disease with no symptoms . However in a small percentage of people (1 in 200) it can lead to serious complications of inflammation (encephalitis) and even death. 

Japanese encephalitis will normally present with fever, vomiting, headache and lethargy. In the case of encephalitis, the person will have severe headache, stiff neck , fever,confusion, seizures and even coma. This is a critical stage which can cause permanent brain damage and even death. 

A pregnant woman down with japanese encephalitis can also cause much harm to the unborn fetus. 

Japanese encephalitis is more prevalent in rural farming areas in South east Asia and Far east. It occurs especially during the rainy season when mosquito breed fast i.e. from may to September. 

Japanese encephalitis vaccine can help prevent this disease for travelers who go the affected areas for a long period of time. Prevention via immunization is not 100% foolproof. Mosquito repellents, try to stay indoors with mosquito net, avoid going out during sunset when mosquito activities are mot active are also ways to prevent mosquito bites which is the mode of transmission

Who should get Japanese encephalitis vaccine?

1. Those traveling to the Southeast Asia and Far East epidemic areas for more than one month

2. Travelers traveling to epidemic areas less than one month but will be spending more hours outdoors in the rural areas. 

3. Travelers travelling to areas with an active Japanese encephalitis outbreak. 

4. Laboratory workers who come into contact with the Japanese encephalitis virus. 

Read More
4 Comments

What is Cholera?

27/7/2017

1 Comment

 
Cholera is an infectious disease caused by Vibrio Cholerae. In some people, they may not have any symptoms. However in some people, it can cause vomiting and diarrhea leading to severe dehydration and possible death. 

Cholera can be contracted by consumption of contaminated water and food especially infected shellfish. Spread from person to person can occur also. 

Cholera still occur in parts of Africa, India and South America. With proper food handling, the risk of contracting cholera is still low. 


Prevention is the way to go

Cholera vaccine is not really necessary as prevention is the main stay to prevent from contracting cholera. Prevention involves proper personal, water and food hygiene. This is especially important in developing countries where sanitation is poor. Do not drink any untreated water and be very careful of what you eat. 

Cholera vaccine

So long as there is proper food and water hygiene, cholera vaccine is seldom needed. Unless you are an AID worker travelling to remote country where medical attention is hard to come by or if cholera is widespread over there. 

Prevention with proper personal, food and water hygiene is the mainstay. 

A Cholera oral vaccine called Dukoral is available. You should not consume any food or drink one hour before and after the oral vaccine. The vaccine comes in sachet form whereby you dissolve the content in water and consume it. 

It is best to complete the full vaccination one week before travelling to cholera area. It is not recommended for children below 2 years old as the efficacy is unknown. 

For children 2-6 years old: 3 doses spaced one week apart of each other no later than 6 weeks apart. A booster 6 months later if there is continued risk of cholera. 

For children above 6 years old and adults: 2 doses space one week apart no later than 6 weeks. A booster two years later to maintain protection. 

If the doses are taken more than 6 weeks apart, then the vaccination need to be restarted all over again. 

Do note that the vaccine does not convey full protection as it does not cover all strains of cholera. 

Contraindications to cholera vaccine

Those who have anaphylactic allergy reaction to the ingredients of vaccine such as formaldehyde should not take the vaccine. 

There is no data on the safety of cholera vaccine for pregnant and lactating women hence it should not be given to this group of patients. 

Possible side effects

1 in 100 people may have possible minor side effects like abdomen pain , nausea and diarrhea. These symptoms only last for a short period of time and can be treated symptomatically. Severe reaction is rare unless you have allergy to the vaccine. 
​
1 Comment

What is Hepatitis A?

27/7/2017

0 Comments

 

Hepatitis A is a serious liver infection caused by hepatitis A virus. It is found in the stools of people in  Hepatitis A. Hepatitis A is spread via fecal-oral route of ingestion of food or drinks contaminated with the fecal content containing with hepatitis A. Eating raw shellfish which is contaminated because of poor sewage system is also a way of transmission. It usually happen in places with poor sanitation and from people with poor personal hygiene.  

The incubation period from ingestion of contaminated food to the onset of symptoms is 28 days. 

The symptoms of hepatitis A include 
  • fever and lethargy
  • jaundice (yellow skin/eyes and tea colored urine)
  • abdomen discomfort
  • loss of appetite and vomiting 
  • severe abdomen pain in children 

Most people need to be hospitalized during acute hepatitis A. Most people recover within 2 months however some may have persistent illness for 6 months. It is a self limiting disease. However in elderly, there is a risk of developing into fulminant hepatitis (acute liver failure). There is no long term complications like association with liver cancer unlike hepatitis B and C.  

Treatment of Hepatitis A

As hepatitis A is a self-limiting disease hence there is no specific treatment. Treatment is only for symptomatic relief of symptoms and bed rest. The person with hepatitis A carries the virus and they can spread the virus to others hence they need to exercise proper personal hygiene. 

Patients who are dehydrated, with persistent vomiting and signs of impending liver failure need to be hospitalized for monitoring. 

Prevention of Hepatitis A 

One should observe good personal hygiene and avoid consuming raw seafood and water which could be contaminated with sewage. A better way or prevention is via immunization with hepatitis A vaccine. This is especially important for those who travel to hepatitis A endemic regions like southeast Asia, Caribbean, mexico, Africa, eastern Europe and south and central america.  

Who should get Hepatitis A vaccine? 

Read more: http://www.medthical.com/hepatitis-a-vaccine.html​
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