Category: Wordpress

Motion sickness is an unpleasant condition or feeling sick when subjected to motion such as travel by car, boat, plane or train. It is characterized by symptoms of dizziness, nausea and fatigue.

 

The most common symptoms experienced in motion sickness are:

• Nausea
• Vomiting
• Dizziness
• Vertigo
• Abdominal discomfort
• Headache
• Fatigue
• Pale face and cold sweats
• Hypersalivation
• Hyperventilation

Symptoms gradually improve within 15 minutes of the motion stopping, when stomach motility has returned to normal.

Do’s and Don’t’s when you are travelling to avoid motion sickness:

DO’S

• minimise motion – sit in the front of a car or in the middle of a boat
• look straight ahead at a fixed point, such as the horizon
• breathe fresh air if possible – for example, by opening a car window
• close your eyes and breathe slowly while focusing on your breathing
• distract children by talking, listening to music or singing songs
• break up long journeys to get some fresh air, drink water or take a walk
• try ginger, which you can take as a tablet, biscuit or tea

DONT’S

• do not read, watch films or use electronic devices
• do not look at moving objects, such as passing cars or rolling waves
• do not eat heavy meals, spicy foods or drink alcohol shortly before or during travel
• do not go on fairground rides if they make you feel unwell

TIPS TO AVOID MOTION SICKNESS

1. Behavioural Therapy:

-reducing head movement

-gazing at the horizon

-lying down and controlled, regular breathing

-If there are no windows or it is dark, then closing the eyes or trying to sleep may help. Closing the eyes -prevents the conflict that occurs between what is visually perceived and what is sensed by the inner ear

2. Natural Remedies

Some people feel like they get relief with these:

-Raw ginger. There’s some scientific proof that this root, long used as a folk remedy to fight nausea, is effective. But it may act as a blood thinner. Talk to your doctor first before you use it.

-Mint. Eating peppermint is thought to calm the body. At the very least, the aroma may soothe you.

3. Pharmacological Therapy:

If you’re still bothered by motion sickness, you can talk to your doctor about these:

To prevent motion sickness symptoms, oral medications should be taken at least 30-60 minutes before travel to allow adequate absorption time.

Antihistamines are the most commonly used medication for preventing and treating motion sickness, and work by reducing the stimulation to the inner ear. Antihistamines include:

• Promethazine hydrochloride (e.g. Phenergan)
• Cinnarizine (e.g. Stugeron)
• Prochlorperazine
• Meclozine + Pyridoxine (e.g Veloxin)

 

 

Sources

https://emedicine.medscape.com/article/2060606-treatment

https://www.mims.com/malaysia

https://emedicine.medscape.com/article/2060606-medication

You may be eating and exercising according to your healthcare team’s recommendations while faithfully taking your medications.

But how do you know if you are doing the right thing when it comes to self-monitoring of your blood glucose.

The answer is pretty simple: Regularly monitor your blood glucose level and keep a record of your progress.

 

Self-monitoring

Self-monitoring lets you:

–Check the impact of different treatment elements on your blood glucose and make adjustments, if necessary.

-Knowing the results early will allow you to take quick actions in restoring your blood glucose level to within a healthy range.

-Identify, quickly treat and prevent hypoglycemia or hyperglycemia.

Also, self-monitoring allows your healthcare team to measure the progression of your diabetes and adjust your medications accordingly. This is why you should self-monitor even when you show no signs of illness, and keep a record of the results.

When should you monitor your blood glucose?

Self-monitoring of blood glucose (SMBG) is the method of choice in assessing blood glucose control and prevent hypoglycaemia.

Self-Monitoring of Blood Glucose data can be used to adjust food intake, exercise, or pharmacological therapy to achieve pre-defined goals. The need for and frequency of SMBG should be re-evaluated at follow-up visits.

Self-Monitoring of Blood Glucose can be done using Glucose Meter.

 

How do You Measure Your Blood glucose?

The first step is to meet with a health professional. After identifying your characteristics and needs, she will recommend a glucose meter, which you can buy at a pharmacy, along with all the other materials necessary for self-monitoring: lancets (needles), a lancing device (to take blood), test strips and tissues. 

You will then learn how to measure your blood glucose properly:

1. Wash your hands with soapy water and dry them well.
2. Insert the test strip into the glucose meter.
3. Insert the lancet into the lancing device.
4. Prick the end of a finger (on the side).
5. Gently squeeze the end of your finger, if necessary.
6. Apply the blood to the test strip.
7. Wait a few seconds (the time varies by type of meter).
8. Read and write down the result in a logbook or store it in the glucose meter.

According to the Malaysian Clinical Guidelines on Management of Type 2 Diabetes Mellitus (2009), the following practice is recommended.

Timing and Frequency of Self-Monitoring of Blood Glucose:

	Breakfast	Lunch	Dinner
Diet Only	Check before and after meal	Check after meal	Check after meal
On oral medication     only	Check before and after meal	Check after meal	Check after meal
On insulin	Check before  and after meal	Check before and after meal	Check before and after meal

 *Blood Glucose should be monitor just BEFORE the meal or 2 hours AFTER meal.

 

Your blood glucose target
Before Meal Post-Prandial (After Meal)	4.4 – 7.0 mmol/L      4.4 – 8.5 mmol/L

 

Example of Self-Monitoring of Blood Glucose Log Book:

 

 

Some Tips for SMBG:

To minimize or prevent diabetes-related complications, always check blood glucose levels as directed by your primary care provider and learn the factors that may alter or affect those levels, such as eating certain foods, taking certain medications, stress, illness, and physical activity.

Although patients commonly check blood glucose levels several times a day (ie, before meals, 2 hours after meals, or at bedtime), if you are uncertain, ask your primary health care provider how many times you should check your blood glucose level each day.

Select a finger from which to obtain a blood sample, and use a lancet device on the side of the finger to obtain a sample. Always prick the side of the fingertip since that area is less sensitive than the flat side of the fingertip and is less likely to bruise. Try to alternate fingers each time a test is performed.

Test strips are for single use and unique for each meter. Test strips must be kept in the original canister, as any moisture can affect the integrity of the strip, and the containers should be kept closed. Check for expiration date.

Exercise, food, medications, and stress can affect your blood glucose level. If you notice any abnormal reading during SMBG, write down the possible factor that may contribute to the abnormal reading e.g.  consumption of certain brand of milk or bread.

Monitoring by your healthcare team:

Your healthcare team monitors the progress of your diabetes management efforts by measuring the following:

-Blood glucose level.Check with your healthcare professional whether you need to fast before they measure your blood glucose level.

-Urine testing.This is to determine whether your kidneys are functioning properly.

-HbA1c refers to the protein in your red blood cells, haemoglobin, which are bonded to glucose to give what we call “glycated haemoglobin”.  By determining your HbA1c value (measured in %), your healthcare team will get a good idea of your blood glucose level over the last 2 or 3 months.

* This is why you cannot fool your healthcare team by starting to manage your diet only a few weeks before your medical appointment 🙂 *

-Blood pressure. This is to gauge whether your cardiovascular system is in good order.

-Blood lipid level.By measuring the amount of cholesterol and triglycerides in your blood, your healthcare team would have a good gauge of your risk of heart disease, which is usually increased in diabetics, especially those with weight problems.

THANK YOU FOR READING =)

Breast cancer is cancer that forms in the cells of the breasts. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

In addition to chemotherapy and hormone therapy, there are newer, more effective treatments that can attack specific breast cancer cells without harming normal cells. Currently, these targeted methods are commonly used in combination with standard chemotherapy drugs. However, targeted drugs often have less severe side effects than standard chemotherapy drugs.

How do breast cancer targeted therapies work?
Breast cancer targeted therapy uses drugs that block the growth of breast cancer cells in specific ways. For example, targeted therapy may block the action of an abnormal protein (such as HER2) that stimulates the growth of breast cancer cells.

For about 1 in 5 women with breast cancer, the cancer cells have too much of a growth-promoting protein known as HER2/neu (or just HER2) on their surface. These cancers, known as HER2-positive breast cancers, tend to grow and spread more aggressively. First line therapy is Injection Perjeta (Pertuzumab) and Injection Herceptin (Trastuzumab). While for second line therapy is Injection Kadcyla (Ado-Trastuzumab Emtansine).

A number of drugs have been developed that target this protein. The therapies are:

• Pertuzumab (Perjeta): This monoclonal antibody can be given with trastuzumab and chemotherapy, either before surgery to treat early-stage breast cancer, or to treat advanced breast cancer. This drug is given intravenously (IV).

• Trastuzumab (Herceptin): This is a monoclonal antibody, which is a man-made version of a very specific immune system protein. It is often given along with chemotherapy, but it might also be used alone (especially if chemo alone has already been tried).

Trastuzumab can be used to treat both early- and late-stage breast cancer. When started before or after surgery to treat early breast cancer, this drug is usually given for a total of 6 months to a year. For advanced breast cancer, treatment is often given for as long as the drug is helpful. This drug is given intravenously (IV). Common side effect of this therapy are body pain, weakness, and nausea.

• Ado-trastuzumab emtansine (Kadcyla, also known as TDM-1): This is a monoclonal antibody attached to a chemotherapy drug. It is used by itself to treat advanced breast cancer in women who have already been treated with trastuzumab and chemotherapy. This drug is also given intravenously (IV).

There are some common side effects due to this chemotherapy.

• Bone Pain
• Heart Health
• Hair Loss
• Fatigue
• Menopausal Symptoms
• Skin Changes
• Nausea
• Neutropenia
• Neuropathy

“Nothing is impossible, with Prayers, Love and Hope”

Thank You 🙂

Apakah itu Fitosterol?

 

Fitosterol adalah terdiri daripada sterol atau stanol yang terdapat di dalam semua tumbuhan secara semula jadi. Ianya boleh didapati di dalam minyak sayur-sayuran seperti minyak soya, canola dan jagung dan juga hadir dalam kekacang, bijian dan bijirin tetapi dalam kuantiti yang kecil.

 

Apakah manfaat daripada pengambilan  Fitosterol?

Lebih daripada 20 kajian saintifik telah menunjukkan bahawa pengambilan Fitosterol boleh menurunkan tahap LDL-kolesterol dengan efektif.

Kajian menunjukkan bahawa pengambilan sebanyak 2 gram Fitosterol menurunkan sebanyak 5-10%  tahap LDL-kolesterol dan dalam beberapa minggu sahaja.

Menurut kajian Thomsen et al (2004); sejumlah 138 pesakit yang mempunyai kandungan tinggi kolesterol di dalam darah, telah mengambil susu rendah lemak yang mengandungi 1.2 gram dan 1.6 gram Fitosterol untuk empat (4) minggu. Mereka didapati berjaya menurunkan tahap LDL kolesterol mereka sebanyak 7-9%.

 

Bagaimana Fitosterol bertindak dalam badan kita?

Fitosterol mempunyai struktur dan tindakan yang hampir sama dengan kolesterol. Justeru itu, Fitosterol didapati berhasil mengurangkan penyerapan kolesterol di dalam usus kita dan meningkatkan perkumuhan dari badan kita. Dengan itulah, Fitosterol dapat mengurangkan tahap jumlah kolesterol dan LDL-kolesterol.

 

Adakah Fitosterol selamat?

Secara amnya, Fitosterol adalah selamat untuk pengambilan kerana banyak kajian saintifik telah dilakukan ke atasnya dan telah diluluskan untuk penggunaan dalam makanan.

Walaubagaimanapun, ada satu kerisauan dengan penggunaan Fitosterol iaitu ianya mungkin akan mengurangkan penyerapan vitamin-vitamin yang larut dalam lemak terutama beta-karotene yang penting untuk penghasilan vitamin A.

Namun begitu, kita boleh mengatasinya dengan pengambilan diet seimbang yang kaya dengan sayur-sayuran dan juga buah-buahan.

Fitosterol secara amnya tidak digalakkan untuk kanak-kanak dan juga wanita yang hamil atau yang sedang menyusukan bayi.

 

Apakah sumber makanan yang kaya dengan Fitosterol?

Walaupun Fitosterol terdapat secara semulaja di dalam makanan, ianya adalah agak mustahil untuk mendapatkan kuantiti yang mencukupi untuk mengurangkan kolesterol daripada makanan yang kita ambil seharian.

Fitosterol biasanya telah ditambahkan ke dalam pelbagai bahan makanan termasuklah susu (yang diperkaya) termasuk di Malaysia. Kebanyakan pihak berkuasa kesihatan menyarankan pengambilan Fitosterol sebanyak 2-3 gram sehari daripada pelbagai makanan yang telah diperkayakan untuk menurunkan tahap kolesterol dalam darah.

 

 

Disediakan oleh:

Eliza Wong Yen Sim

Pegawai Dietetik Hospital Sultan Ismail

 

Sumber:

Kementerian Kesihatan Malaysia

Malaysian Dietitians’ Association

Smoking cessation (also known as quitting) is the process of discontinuing tobacco smoking. Smoking cessation is encouraged to reduce the risk of developing disease caused by smoking and improve health in general.

Tobacco smoke contains nicotine, which is addictive. each puff of the smokes contain not only nicotine into the body but also along with 500 different toxic chemicals, exposing the respiratory tract to possible health hazards, which including chronic lung and airway disease, lung cancer, heart disease and etc. it also can bring harm to the foetus of pregnant smoker or passive smoker.

Treatment options

• Nicotine replacement therapy (NRT)  

Nicotine replacement therapy is to aim to control nicotine levels in the blood to prevent withdrawal while the patient is adjusting without cigarette smoking.

Nicotine replacement therapy may be in the form of patches and gums in malaysia. These agents should be used only as prescribed by a physician or pharmacist.

NRT Types	How to Use Them
Patch	Place on the skin on rotate application sites Gives a small and steady amount of nicotine
Gum	Chew to release nicotine Chew until you get a tingling feeling, then place between cheek and gums

• Nicotine-free therapy

Nicotine-free therapies are normally in capsule or tablets form. It is to aim to relieve nicotine withdrawal symptoms such as irritability, cigarette cravings, increased appetites, chest congestion and stomach disturbances.

Patient with heart disease, stroke and diabetes may benefit from nicotine-free therapy.

How to design a Personal Stop- Smoking Regimen

1. Organize a plan for quitting
2. Set a stop date
3. Involve other people for support
4. Plan short activities during these urges.
5. Avoid/change situations in which smoking was involved

If you do not smoke;

• Your risk of getting  LUNG CANCER and HEART ATTACK will REDUCE
• Your SMOKER’S COUGH will DISAPPEAR
• You will have MORE ENERY
• You will NO LONGR HARM THE HEALTH of your loved ones
• You will SAVE money 🙂

Always remember , STOP Smoking Before SMOKE stops YOU 🙂

Herb-drug interactions that patients need to know

What is a Herbal Supplement?

Herbal supplements are sold in many different forms – dried leaves for teas, powdered, as capsules or tablets, or in solution.

The use of herbal supplements has a long history – dating back thousands of years. Examples of important medicines extracted from botanicals include reserpine, morphine, penicillin, and vinca alkaloid anti-cancer drugs.

Today, herbal supplements and nutraceuticals can be purchased over-the-counter (OTC) and may be labeled “all-natural”, but that does not always mean they are safe. While these products are intended to boost health, and may make claims to that effect, robust clinical studies may be lacking.

Patients need to understand that herbal medications are not completely safe, and that these preparations, when taken with other drugs, can alter the way that the drug is processed and excreted by the body, enhance a drug’s side effects, or block the intended therapeutic effect of the drug.

1. Coenzyme Q10

Coenzyme Q10 protects the heart from damage from cancer medications. The use of coenzyme Q10 with warfarin decreases its blood thinning effects and may increase the risk for a blood clot.

2. John’s Wort supplements

Supplements containing St. John’s Wort are commonly used to treat symptoms of depression. This should not be used concomitantly with other antidepressants, migraine medications, dextromethorphan, warfarin, birth control pills, and certain antiretroviral medications due to seriousness of drug interactions.

3. Ginseng

Ginseng is commonly used to improve the body’s resistance and vitality. There are four known types of ginseng, namely American, Korean, Siberian and Brazillian. Of these, “American ginseng” is known to decrease the effects of warfarin and should not be used together with other anticoagulants, though this cannot be conclusively said for the other three types. Different type of Ginseng have different interaction with Warfarin. Ginseng also has an effect in blood pressure and diabetic medications like insulin or oral hypoglycemics.

4. Ginkgo biloba

Ginkgo biloba is used to enhance memory, and in improving symptoms of Alzheimer’s and Parkinson’s diseases. It can decrease effects of certain HIV medications, and alter the actions of drugs metabolized by the liver.

5. Cranberry

Even the simple cranberry can have drug interactions.

Cranberries are a fruit chock full of vitamin C, and some people drink cranberry juice to help prevent urinary tract infections (UTI). Although data is conflicting, some studies have shown cranberry can reduce recurrent UTIs in pregnant women, the elderly and hospitalized patients; but it is not helpful to cure a UTI.

Cranberry may exert an increased effect on blood thinners (anticoagulants) like warfarin and lead to bruising or bleeding. If you take an oral blood thinner, check with your doctor before consuming unusual amounts of cranberry or cranberry juice. You may need to have your International Normalized Ratio (INR) or other blood clotting lab test checked more frequently.

6. Evening Primrose Oil

Evening primrose is a flowering plant known by other names such as Oenothera biennis, scabish, or king’s cureall.

Evening primrose oil provides fatty acids used by the body for growth. Evening primrose oil contains gammalinoleic acid that may slow blood clotting and increase the likelihood of bruising or bleeding. If you take drugs or herbs that may have blood thinner effects, check with your health care provider before using evening primrose oil

Use of evening primrose oil may increase the risk for seizures if you take anti-seizure medications or phenothiazine drugs.

7. Garlic

Garlic is a commonly used flavoring agent, food product and herbal supplement. There are many conditions garlic has been used for – to reduce cholesterol and triglycerides, to prevent cancer, to lower blood sugar levels, and to reduce menstrual pain, among other uses.

Garlic has been reported to moderately affect blood clotting and blood sugar levels and may affect people who take blood thinning agents like aspirin, warfarin, or clopidogrel (Plavix). Use of garlic supplements with HIV protease inhibitors (PI) may decrease the PI blood levels.

8. Green Tea

Green tea is a popular drink that originated in China and has been promoted for stomach disorders, to lower cholesterol, as an anti-cancer antioxidant, as a stimulant, and to lessen belly fat, among other uses.

In the U.S., it has gained recent popularity due to claims it can boost metabolism and aid in weight loss. Dried green tea leaves contain vitamin K, which can increase blood clotting. Large amounts of vitamin K may interfere with the activity of some blood thinners.

A substantial decrease in the INR (a measure of blood clotting) has been reported in a patient treated with warfarin after he began consuming large quantities (1/2 to 1 gallon daily) of green tea. Patients treated with warfarin should probably avoid large amounts of green tea as it can interfere with the blood-thinning capabilities of warfarin.

9. Ginger

Ginger is a commonly used flavoring agent, food product, and herbal supplement. Ginger has been used in the treatment and prevention of motion sickness, vertigo, to increase appetite, and to reduce stomach acidity. Ginger has also been used by some women under medical supervision to reduce severe nausea and vomiting in pregnancy.

It is known to inhibit thromboxane synthetase, which can prolong bleeding time and may cause interactions with anticoagulants like warfarin, aspirin, or other blood thinners.

 

There are many other herbs that can interact with medications.

“It is important that patients consult first with a physician before taking any herbal supplements, or inform their physician if they are taking herbal preparations if they are prescribed with medications.” 

Thank you for reading 🙂