STORY TO BE TOLD

Malaysian calories
Tell Me About . . . . by Dr Y.L.M

Counting calories in Malaysian food.

I LOVE to have nasi lemak for breakfast every morning. My work schedule has been very hectic recently, and I often leave the office after eight pm every night. So I end up having tea and dinner around the office. Eating out so much has to be bad for me. Are Malaysian foods especially high in calories?

A typical Malaysian breakfast doesn’t just consist of nasi lemak. You have plenty of other food on the side, am I right? You probably have a fried chicken on top of the nasi lemak, anchovies, and cucumbers, and you will also order a teh tarik.

A plate of nasi lemak typically offers up to about 650 calories of energy.

So the nasi lemak itself is 644 calories (which is equivalent to three bowls of plain white rice). You added the piece of fried chicken, which is 290 calories. Your teh tarik is 83 calories, worse if you like it with plenty of sugar.

The grand total equals 1017 calories, and that is just for breakfast alone. And you wonder why Malaysians put on weight so easily.

Will it be better if I eat roti canai instead? Or a boiled egg and bread?

You don’t eat roti canai alone. You eat it with a generous helping of dhal or curry, right? And possibly with a generous cup of teh tarik to help you wash it down.

Roti canai and dhal is approximately 360 calories. If you make it a roti telur, it will be 414 calories. And that’s just one roti canai. You are very likely to have two.

You are better off eating two plain half-boiled eggs to go with plain bread (without butter or kaya). This will be 227 calories.

How many calories do I need a day?

As an adult, you roughly need to eat about: your weight in kg multiplied by 30 calories. So let’s say you weigh 60kg. You will need 60x30 = 1,800 calories a day.

You can imagine that if you take 1017 calories for breakfast alone, you will have to eat roughly 800 calories for the rest of the day just to maintain your weight if you don’t exercise or attempt to lose weight by other means.

Is exercise the only way to lose weight?

To lose weight, the simple objective is to ensure your output is more than your input. This means that the amount of calories you take per day will be less than what you require a day (around 1,800 calories for a 60kg person) plus any weight loss methods you employ.

So if you wish to lose about 0.5kg per week and you don’t wish to exercise, you will need to reduce your calorie intake by 550 calories per day to make your intake 1,250 calories per day from its requirement of 1,800 calories per day.

At the end of one month, you should have lost 2kg.

If you want to speed up the process, you should add exercise on top of that.

But maybe that’s just all the curries and coconuts and carbohydrates I eat. If I were to just take plain noodles, what would happen? I love noodles and I don’t think I can do without them.

When it comes to noodles, bear in mind these figures:

> plate of wantan mee is around 409 calories.

> plate of mee goreng mamak is 660 calories.

> bowl of mee (soup) is 381 calories.

So you can see it’s the preparation of the noodles that counts. The more oil that is used in its preparation (fried), the higher the calorie count.

Am I better off eating plain rice then?

Once again, you don’t just eat plain rice. You eat rice with a helping of at least two or three dishes on the side. This is our typical nasi campur.

One nasi campur with three dish helpings (e.g: vegetable, egg, chicken) is around 620 calories.

So how can I lose weight?

You can do so by practising self-discipline. In Malaysia, eating is a social event, and when you go to breakfast or lunch with your friends and you see them ordering plenty of delicious dishes, this is when you have to exercise self-control.

Here are some tips:

1. Exercise at least five times a week for 30 minutes every session. This will help increase your metabolism and burn fat. The more you exercise, the more weight you will lose. But if you haven’t exercised for a long time, you might want to start slow, otherwise you risk exhaustion.

2. Try eating less for each meal, but take more “mini” meals per day. Try halving your rice portions.

3. Drink plain water or green tea. Avoid sugary drinks. This will really cut down your “unseen” calorie intake.

4. Try to avoid eating and drinking more than 500 calories per meal, which means you really, really have to watch what you eat.

Playing 3D games on Nintendo may harm the eyes of young children.

Health warning: Nintendo's 3D games bad for young kids

The launch of Nintendo's long-awaited 3D version of its best-selling DS games console has been overshadowed by a health warning.

The Japanese computer giant has said children under the age of six should not use the device in 3D mode as it may harm their eyesight, Daily Mail of UK reported.

The Nintendo 3DS represents a major breakthrough as it will be the first hand-held games console to offer 3D images of both games and films without the need for glasses.

The European launch will take place in Amsterdam in January with the first consoles due to go on sale in UK shops in March. The device will go on sale in Japan in February and is due for release in the U.S. the following month.

This is a second LCD screen that sits over the main viewing panel that consists of a layer of material with a series of precision slits, allowing each eye to see a different set of pixels, so creating a sense of 3D depth.

It works well providing the user sits in a fixed point in front of the image but does not work when viewed from an angle.

A slider at the side of the device lets users choose the intensity of the 3D display, from an extreme "in your face" experience to a more subtle effect.

The 3DS is vital for the future of Nintendo, which disappointed many children around the world after it was unable to launch the product in time for Christmas.

The failure to go on sale in the crucial trading period wiped tens of millions of pounds off the company's stock market value.

However, there are new reasons to worry about its prospects after it emerged Nintendo has published an official safety alert on a Japanese website.

Game site Kotaku.com translated the page and reports that it warns that 3-D viewing causes quicker eye fatigue than standard screen viewing.

It suggests that players of all ages should take a break at least every 30 minutes in order to avoid eye fatigue.

Nintendo states: "If your physical condition worsens or you become ill, please stop playing at once."

The company goes on to warn that since the vision of young children is still in developmental stages, it recommends those under six should not use the console's 3D screen effect.

The warning follows comments made by Nintendo of America president Reggie Fils-Aime, who said: "We will recommend that very young children not look at 3-D images.

"That's because, (in) young children, the muscles for the eyes are not fully formed."

The concern appears to be that playing the game for long periods could harm the ability of children to focus, which may mean they require glasses in later life.

Many contributors to the Kotaku website suggested it would be difficult for parents to stop young children watching in 3D and Nintendo could face lawsuits in the future.

One warned: "As a child, your eyes, and your ability to force yourself to go cross-eyed or wide-eyed is very weak. Playing extensively could damage your ability to focus properly."

However, there is a parental control system involving a PIN number that will allow adults to turn off the 3D function.
Other contributors praised Nintendo for flagging up the issue.

One said: "I like how they are so responsible and warn people about the real side effects of the 3D gimmick.

"Many small kids will probably jump on it like wild animals because they simply do not know that it could harm their eyes."

The Nintendo 3D technology is different to that employed by the manufacturers of 3D televisions.

Essentially, the screen is made up with a large number of angled vertical ridges. The left eye sees one set of images and the right eye another set at the same time, fooling the brain into believing it is in 3D.

A similar system is used by some in-car DVD players to allow children sitting each side of the back seat to watch two different films through one screen at the same time.

With 3D televisions, the hi-tech glasses flash open and shut alternately over the left and right eye to create the illusion of 3D.

While the technology is different, the Nintendo warning echoes a similar alert issued by Samsung in April over viewing its 3D televisions.

Its advice included warnings to children, pregnant women, the elderly and those suffering from serious medical conditions.

The catch-all alert also included those with a history of epilepsy and strokes or even those who had been drinking.

It highlighted a number of alarming side effects including confusion, nausea, convulsions, altered vision, light-headedness, dizziness, involuntary movements such as eye or muscle twitching and cramps. - www.dailymail.co.uk

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What causes inflammation in our bodies?
By Dr C.S. FOO

Inflammation in the body’s tissues spell trouble, especially if it goes on for a long time.

A SNIPER’S bullet that tears through the chest, and a massive heart attack, have two things in common – searing pain and the possibility of death. If that is overly dramatic, let us review today what is slowly cooking us to death.

The three assassins that are stealthily killing us day by day are sugar, oxygen, and inflammation, like a sweet on fire! Arguably, this column is not meant for serious scientists, but I am very passionate about science, as the insight of our insides opens the gate to so many possibilities in the prevention of chronic ailments.

The path of preventive medicine has always fascinated me as we are gatekeepers, ushering a person on a journey that may change destiny. A practitioner is also a map maker drawing up directions, but alas, the directions are often too confusing, difficult to follow, and worse, downright misleading. It had never occurred to me that a simple mind made complex (by too many textbooks) can regain wisdom from simplicity, and that was when my lenses changed from microscopic to wide angled, as the deceptive trio was unmasked.

Hot stuff: High glycaemic foods are pro-inflammatory in nature.

The mere mention of the word stress conjures up less than friendly images of the tyranny within. Our body is continuously bombarded by three types of stresses, namely glycaemic stress, oxidative stress, and inflammatory stress. These three assassins work in concert to corrode the pillars supporting true health.

Glycaemic (sugar) stress is the chronic effects of feeding the body with too much sugar. In its simplest form, glucose is paramount for energy production, without which there would be no life. Yet it is a highly toxic molecule when in excess. The reason for this dilemma is obvious – we eat too much!

“But I don’t take sugar” is a common defence. Bear in mind that all carhohydrates turn to sugar, albeit at different rates. It is no secret that our favourite foods are generally high glycaemic, shooting up our blood sugar rapidly, and crashing down rapidly like a roller coaster, with the unused sugar turning into fat around the belly.

A protruding waistline is an incubator for many diseases. The Metabolic Syndrome harbours the sinister ambitions of diabetes, hypertension, heart disease, stroke and obesity.

Oxidative stress (free radical burden) is the pressure on our bodies caused by excessive errant oxygen molecules known as free radicals, which literally steal our health and youth by the seconds. The demands of modern society, bludgeoning influx of toxic foods, environmental poisoning, compounded by unhealthy lifestyle habits, add up the load of free radicals, thereby inducing a significant oxidative stress. This state is not ameliorated by the imbalanced nutrition stemming from poor food choices.

Acute inflammation

Some fertile areas of the body that do not get too much sun are like a damp, tropical rainforest, perfect for mushrooming fungi of all sorts. A yeast infection at the underarm can be an incessant nuisance, resulting in uncontrollable scratching due to itchy skin inflammation.

Among the foliage, bacteria finds the abode an ideal breeding ground and causes trouble when it invades the skin. A boil in the armpit is more than just a painful embarrassment.

The marvellous story of the body’s ministry of defence goes something like this. Under the skin are stationed sentries (macrophages), which are roused by the intrusion of a foreign invader. They quickly send out SOS signals (cytokines) that open up the blood vessels and mobilise an army of specialised white blood soldier cells (neutrophils) that creep along the engorged arteries.

Fluid and cells pour onto the site of infection, the latter gobbling up the bacteria like hungry wolves or delivering knockout punches to everything in their path. In the indiscriminate search and destroy mission, the white blood cells spray round after round of ammunition that annihilate not only the intruders but innocent bystanders as well.

The collateral tissue damage leads to painful pus formation, which either “ripens” and discharges to the exterior or is ultimately released by the doctor’s knife.

Fortunately, once the threat is neutralised, the inflammation mode is turned off and the cinders finally extinguish, leading to resolution.

The preceding sequence of events was first described by Aulus Cornelius Celsus, a Roman medical writer from the 1st century AD, who described the stages of dolor (pain), calor (heat), rubor (redness) and tumour (swelling).

Next time, when a “bag” of pus appears, refrain from complaints and be appreciative that our protectors have done a good job. Imagine the devastating peril should the inflammation spread beyond the boundaries (septicaemia) to infect the entire host.

Not all acute inflammation are infective in nature. Bronchitis, asthma and sinusitis invoke a different form of inflammation. An offending trigger sets off a cascade of immune reactions that congest and clog the airways.

Acute inflammation can also be brought on by injury, errors in metabolism (e.g. gout), auto-immune diseases (e.g. rheumatoid arthritis, lupus, etc, when the immune system turns on the host), and so on.

Chronic inflammation – the secret killer

Both glycaemic and oxidative stress have been dealt with in detail in past articles. The final link to chronic degenerative diseases is chronic inflammation.

Unlike the distress of acute inflammation, this is a much more sinister situation as there are no immediate symptoms. A state of inflammation that does not switch off is deemed chronic. Potent inflammatory mediators are released and the cycle is self propagating in a vicious manner.

We issue our own licence to eat rather indiscriminately. As our palate is the master of our stomach, gustatory pleasure is of prime importance, and needless to say, our high glycaemic favourites are pro-inflammatory in nature. The expanded waistline, a.k.a. visceral fat, is like a rumbling volcano spewing hot stuff (inflammatory mediators) that can trigger inflammation.

When the human cells are attacked by free radicals or external threats, be it poisoning, injury, or damage, a master switch (nuclear factor kappa beta) within the cells is thrown, like an alarm system, which then instructs the cells’s DNA to send signals to manufacture pro-inflammatory proteins, which in turn propagate more inflammation.

As the bell is constantly ringing, inflammation becomes chronic and prolonged as the body is fooled into believing that the threat is persistent.

When immune cells are erroneously turned on, they revolt by attacking the host, resulting in a bizarre potpourri of conditions, collectively known as auto-immune diseases. Rheumatoid arthritis and lupus commonly cause painful joint inflammation, but the process can affect multiple organs.

Multiple sclerosis, with consequent paralysis, occurs when nerves are inflamed. Psoriasis is a disfiguring inflammatory skin disorder. Even Alzheimer’s disease has underlying inflammation.

It seems almost every chronic condition is stamped by inflammation. Certainly the body’s discharge pipes, namely the intestines, are not spared. Crohn’s and ulcerative colitis are notorious troublemakers.

The heart is on fire

About a decade ago, there were scientific rumblings that heart disease is associated with inflammation. This was first proposed by a German pathologist, Dr Rudolph Virchow, in the mid 1800s, and as usual, his theory was sidelined into the archives.

Today, the concept is re-emerging from the closet. Being conquered by naivety and a subscriber of scepticism for a greater part of life, my eyebrows raised to my scalp line when I first heard that heart disease was due to inflammation. I thought it was just a plumbing problem, now they tell me that the heart is on fire!

For years, it was taught that having high cholesterol equates to heart disease, and yet 50% of heart attacks have normal cholesterol counts, which begs for the search of some other underlying mechanism.

In an article printed in a respected peer-reviewed journal, the Archives Of Internal Medicine (April 11, 2005), a meta-analysis (review) of 100 clinical trials involving 250,000 individuals found that a group of cholesterol busters lowered death due to heart attack by 23%, as compared to omega 3 fish oil, which outperformed drugs by a whopping 32%. This led the researchers to infer that fish oil offered cardioprotection through an alternative mechanism, likely an anti-inflammatory pathway, as fish oils do not affect cholesterol levels.

It is curious to note that the same cholesterol drugs are feverishly being studied at this very moment to determine if they have anti-inflammatory properties apart from lowering cholesterol. The one with this additional feature would beat the pack.

As the fire of inflammation burns within the artery walls, as in the case of progressive heart disease, an inflammatory substance called C-reactive protein is released and its presence has been used to gauge the extent of inflammation within the blood vessels. This test can be easily requested in a routine blood analysis.

I have never been excited in my entire professional career until now (ironically, just as I am contemplating early retirement) when finally the pieces of the jigsaw puzzle come together to become a complete picture. Many modern day diseases are man-made and are preventable. The roots are now bared and need our outmost attention.

We have spent too much time and money treating the foliage. Nurturing the roots pays long-term dividends, and if we do not start now, then when?

Dr C.S. Foo is a medical practitioner. For more information, e-mail starhealth@thestar.com.my.

Nagging is bad for health

It is a complaint heard in households across the country, usually muttered under the breath: "All this nagging will be the death of me."

Now, all those browbeaten husbands and wives have the proof to support their claims.

Research has shown a partner’s "excessive demands" can significantly increase a person’s risk of suffering angina - a painful condition that can be a precursor to heart attacks.

"Serious worries from significant others seem to be important risk factors," said the report’s authors, from Copenhagen University in Denmark.

In a six-year study of 4,500 men and women aged 40 and 50, demands from a partner increased the risk almost fourfold, while stress from children and other loved-ones almost doubled the risk.

Commenting on the report, Cathy Ross, a nurse at the British Heart Foundation, said: "There is evidence stress may be linked to an increased risk of heart disease but the mechanism of how this happens is not clearly understood."

The study is in the Journal of Epidemiology and Community Health.
Source: mirror.co.uk

Published Dec 27 2010

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Types of headaches

ACCORDING to the International Classification of Headache Disorders (created by the International Headache Society), a gold standard for describing headaches, there are 14 major groups of headaches which are divided into primary headaches, secondary headaches, and cranial neuralgias, primary facial pain and other headaches.

Primary headaches

Primary headaches are those not caused by underlying health problems and form the most common types of headaches experienced. They are:

> Migraine – characterised by moderate to severe pain. About 60% of migraineurs experience pain on one side of the head, while the rest, both sides. A migraine in an adult can last from four to 72 hours, but frequency varies in different people. During a migraine, other symptoms like nausea and sensitivity to light and sound may arise.

> Tension-type headache – the most common form of primary headache usually associated with a dull pain, tightness, or pressure in the forehead and scalp or at the back of the neck. A single attack can last from 30 minutes to a whole week.

> Cluster headache and other trigeminal autonomic cephalalgias (TACs) – characterised by severe, penetrating pain in and around one eye or on one side of the head. A series of these headaches occurs in clusters of attacks, giving rise to its name. The pain usually increases within five to 10 minutes to a peak that may last from 15 minutes to three hours.

> Other primary headaches – mainly short-lasting headaches with characteristic signs and symptoms. Examples include headaches caused by coughing or sneezing, or prolonged exercise.

Secondary headaches

A secondary headache is one that is a symptom of another disease or condition:

> Headache attributed to head and neck trauma.

> Headache attributed to cranial or cervical vascular disorder.

> Headache attributed to non-vascular intracranial disorder.

> Headache attributed to a substance or its withdrawal – this includes medication-overuse headache.

> Headache attributed to infection.

> Headache attributed to disorders of homeostasis (certain processes keep physiological conditions relatively stable, or in a state of homeostasis. Disorders that disrupt these processes are known to cause headaches. They include problems with the thyroid gland and oxygen deficiency in high altitudes).

> Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures.

> Headache attributed to psychiatric disorder.

Other headaches

(Neuralgia is severe pain caused by damaged nerves.)

> Cranial neuralgias and central causes of facial pain.

> Other headaches, cranial neuralgia, and central or primary facial pain.

> Source: WHO and ‘Mayo Clinic On Headache’

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Acute kidney failure needs prompt treatment
The Doctor Says by Dr MILTON LUM

Kidney (renal) failure occurs when the kidneys are unable to perform their functions, leading to accumulation of toxic substances in the body, and consequent harm to health.

THE kidneys are two bean-shaped organs located on either side of the spine, in the space behind the abdominal cavity, which also contains the stomach, intestines, liver, spleen, and female genital organs.

The kidneys get its blood supply from the aorta through the renal arteries, which become progressively smaller in size. The smallest blood vessels, called arterioles, form groups of microscopic vessels called capillaries, each group of which is called a glomerulus. The blood leaves each glomerulus through an arteriole, which joins a small vein. The small veins join to form a large vein, which transports blood out of the kidney.

Each kidney has about a mil-lion nephrons, which are microscopic units that filter blood, producing urine in the process. Each nephron comprises a glomerulus and a tiny tubule that drains fluid from the glomerulus. The fluid becomes urine by the time it reaches a collecting duct.

When there is loss of kidney function, dialysis is required. In haemodialysis, the body’s waste products are removed by circulating blood through an artificial kidney machine.

There are numerous collecting ducts that lead to cup-like structures (calyces). Each kidney has many calyces, which all drain into a single large chamber-like structure (renal pelvis) from which the urine drains into another tube-like structure (ureter).

The two ureters from both kidneys join the bladder, from which the urine leaves the body through the urethra via the vulva in females and the penis in males.

The kidneys continuously produce urine, which is composed of excess water, salts, and waste products. Urine does not usually contain organisms or substances like glucose, proteins, ketones, blood etc.

The kidneys’ main function is to filter blood to get rid of waste products, toxins, and excess water and electrolytes from the body, whilst reabsorbing useful chemicals.

Many medicines are excreted by the kidneys. The kidneys help in the regulation of blood pressure and also produce hormones which help regulate the production of red blood cells, and the growth and maintenance of bones.

The kidneys enable a person to consume various food, medicines, fluids and substances without toxic by-products reaching harmful levels in the body.

The functions of both kidneys can be performed sufficiently by one kidney. That is why it is possible for a person to donate a kidney to another person.

Kidney (renal) failure occurs when the kidneys are unable to perform their functions, leading to accumulation of toxic substances in the body, and consequent harm to health.

Renal failure can be acute or chronic. The former occurs rapidly, and the latter, gradually over many years, during which the kidneys are destroyed slowly.

It is estimated that about 5% of hospitalised patients develop acute renal failure, with a higher incidence in patients in the intensive care unit.

Causes

The causes of acute renal failure are usually categorised into:

> Pre-renal: causes that affect the blood flow to the kidneys.

> Post-renal: causes that affect the flow of urine out of the kidneys.

> Renal: causes in the kidney itself that affect blood filtration and urine formation.

Pre-renal causes account for more than half of the causes of acute renal failure. The causes include dehydration, from vomiting, diarrhea, blood loss and diuretics; and reduced blood flow to the kidneys, from bleeding, severe injuries or burns, infections of the blood (septicaemia), heart attack or heart failure, blockage or narrowing of blood vessel supplying the kidneys and liver failure, which affects hormones regulating blood flow and pressure to the kidneys.

As the kidneys are not damaged by the pre-renal causes, the situation can be reversed with appropriate treatment. However, delayed or inadequate treatment can lead to permanent renal damage.

Post-renal causes are the least common causes of acute renal failure. The causes include obstruction of the ureters by stones or cancer of the urinary tract or adjacent structures; and obstruction at the bladder by stones, enlarged prostate in men, blood clots, bladder cancer and neurological conditions affecting the bladder’s ability to contract.

The situation is remedied by removal of the blockage, with the kidneys usually recovering its function within a week or two provided there is no infection. However, delayed or inadequate treatment can lead to permanent kidney damage.

Renal causes account for a quarter to half of all causes of acute renal failure. They may affect filtration, blood supply within the kidney, and the handling of salt and water. Although there are several renal conditions, the most common is acute tubular necrosis, a condition in which the tubules are damaged, leading to impairment of the kidney’s filtration function. The causes of this condition include shock, medicines, especially antibiotics, chemotherapeutic agents and poisons.

Glomerulonephritis is a condition in which the glomeruli are damaged by various causes, one of the most common being a streptococcal bacterial infection of the throat.

Acute interstitial nephritis is a condition in which there is inflammation of kidney tissue that deals with salt and water balance. The causes include medicines like antibiotics, painkillers and diuretics.

Clinical features

There may be no symptoms, especially in the early stages of acute renal failure or the symptoms may be non-specific. The symptoms include decreased passage of urine, swelling of the body, abdominal discomfort, lethargy, fatigue, poor concentration and confusion. Fits and coma may occur in severe acute renal failure.

The findings on physical examination are usually few.

A diagnosis is often made from laboratory investigations of the blood or urine. These tests may be done because the patient is generally unwell or hospitalised for another reason, or as part of screening tests.

The blood levels of urea and creatinine are raised when the causes are pre-renal. The serum electrolyte levels may be very high or low when there are filtration problems. A low haemoglobin count is present when there is severe renal failure or it is prolonged.

There may be inappropriate excretion of protein and other substances in the urine. The urine may be darkened by creatinine and other substances.

Microscopic examination of the urine may reveal blood, pus and casts, which are solid materials. The retention of urine in the bladder after passing urine is indicative of a post-renal cause, which is usually an enlarged prostate in men.

An ultrasound examination of the kidneys and bladder may reveal evidence of specific causes of the renal failure. Sometimes, a kidney biopsy may be done to obtain tissue samples of the kidneys for microscopic examination.

Management

The management of acute renal failure depends on the cause and its severity. The condition is usually managed by a kidney specialist (nephrologist) or a physician, if there is no nephrologist available.

The objectives of management are to identify and remove the cause of the failure, and to determine the extent to which the body is affected by the failure.

Dehydration will be corrected with intravenous fluids. If the body’s excess fluids are not adequately removed by the kidneys, fluid intake should be limited. If the blood flow to the kidneys is reduced, measures will be taken to improve cardiac function and increase blood pressure. Electrolyte abnormalities will be corrected so that other bodily functions will not be impaired.

A review of the patient’s medicines and food intake will be made. The compounds that are harmful to the kidneys will be removed or their dosages reduced.

If there is no response to the management measures and renal function does not return to normal, renal dialysis will be carried out. There are two types of dialysis, i.e. through the blood vessels (haemodialysis) or through the abdominal cavity (peritoneal dialysis). The body’s waste products are removed by circulating the blood through an artificial kidney machine in the former, and through a catheter inserted into the abdominal cavity in the latter.

The majority of patients do not require dialysis if the cause is identified and removed or treated. This is particularly so if the cause is not due to kidney damage, when there is usually restoration of normal renal function.

However, there are instances where there may be residual kidney damage resulting in only partial restoration of function. Although such patients may not need dialysis, many have to take medicines to handle the loss of function.

Prevention

Several measures can be taken to prevent acute renal failure. Adequate fluid consumption will ensure proper functioning of the kidneys. The avoidance of medicines that can damage the kidneys would be very helpful. This is one of the reasons why doctors hold the view that self-medication should be done only with the advice of the doctor.

When one is unsure or does not know the side-effects of medicines, it is prudent to seek advice from the doctor or the pharmacist.

Annual medical examinations will provide information about the health status of the kidneys and urinary tract.

Patients at increased risk of chronic renal disease should be aware of the need for early medical attention, particularly when they have urinary symptoms or notice changes in the urine. They also have need for more frequent medical check-ups and tests of renal function.

Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.

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Kidney matters
THE DOCTOR SAYS
By Dr MILTON LUM

The kidneys play a pivotal role in maintaining blood pressure, and blood pressure, in turn, affects the health of the kidneys.

THE leading cause of death in Malaysia is coronary heart disease. According to the Statistics Department, it constituted 12.9% of medically certified deaths in 2008, with pneumonia second at 7.0%, and strokes (cerebrovascular disease) third at 6.6%.

Data from the Health Ministry reveal that heart diseases and diseases of the pulmonary circulation were the most common causes of death in its hospitals at 16.09% in 2009, with septicaemia second at 13.82%, and cerebrovascular disease fifth at 8.43%.

High blood pressure (hypertension) is a common medical condition in Malaysia. According to the National Health and Morbidity Survey (NHMS) 2006, the prevalence was 32.2% of the population aged 18 years and above.

The disturbing finding was that only 35.8% of those with hypertension were aware of their condition, and of these, 87.7% were then currently on treatment. Of those who were aware of their hypertension and were receiving treatment, only 26.3% were found to have their hypertension controlled. The overall control of hypertension was a shocking 8.2%.

Hypertension is the most important modifiable risk factor for coronary heart disease, cerebrovascular disease, kidney failure (end-stage renal disease) and peripheral vascular disease. As such, the identification and treatment of patients with hypertension, together with the promotion of a healthy lifestyle, will assist in decreasing the prevalence of the condition.

Hypertension is either primary (essential) or secondary. The former comprises 90% or more of all cases whilst the latter comprises the rest. The majority of the secondary causes of hypertension are due to conditions in the kidneys (renal).

The kidneys play a pivotal role in maintaining blood pressure within a healthy range, and blood pressure, in turn, also affects the state of health of the kidneys.

Regulation of blood pressure

The regulation of blood pressure is complex. Although blood pressure is a product of heart (cardiac) output and peripheral vascular resistance, both are affected by multiple factors. The factors that affect cardiac output include sodium intake, renal function, and hormones.

The factors that affect peripheral vascular resistance include the sympathetic nervous system, humoral factors, and local autoregulation. The humoral factors are mediated by compounds that constrict or dilate the blood vessels, e.g. angiotensin, prostaglandins, etc.

Autoregulation is mediated by contraction and expansion of the volume in the blood vessels, which is regulated by the kidneys, and transfer of fluids across the blood capillaries.

The interactions between cardiac output and peripheral vascular resistance maintain a set blood pressure for a person. Changes in the various factors that affect cardiac output and peripheral vascular resistance would lead to the development of hypertension. Changes in blood viscosity, blood velocity, vascular wall thickness and circulating blood volume can all lead to the development of hypertension.

Hypertension

When blood pressure remains high over a period of time, it is called hypertension. Many people consider that a blood pressure below 140/90 mm Hg is normal. However, experts recommend that normal blood pressure with respect to cardiovascular risk be set at 120/80 mm Hg or less. Blood pressure of 120-139/80-99 mm Hg is considered as pre-hypertension, a category of individuals who are at risk of progressing to hypertension and in whom lifestyle modifications are essential preventive measures.

Hypertension and kidney disease

Hypertension results in the heart having to work hard, and also causes damage to blood vessels all over the body. Should the blood vessels in the kidney be damaged, its function of removal of waste materials and excess fluid from the body will be affected.

The extra fluid in the blood vessels would then increase the blood pressure further, with the vicious cycle continuing if untreated or inadequately treated.

Although hypertension is treated when it is diagnosed, the incidence of end-stage renal disease has not decreased. There are several reasons for this and they include the nature of hypertensive disease, failure to reduce the blood pressure to a level that provides protection, poor compliance with treatment prescribed, and the concomitant presence of diabetes.

Pressure in the glomeruli in the kidneys in hypertension leads to the development of sclerosis and impairment of renal function.

The likelihood of developing end-stage renal disease is increased in patients with diabetic nephropathy and hypertension. The increased glomerular pressure results in the presence of albumin in the urine in microscopic amounts (microalbuminuria).

The renin angiotensin system in the kidneys is involved in the development of hypertension. The consumption of angiotensin converting enzyme (ACE) inhibitors, which reduces glomerular pressure, has been shown to slow down the progression to end-stage renal disease in diabetic nephropathy, even if there is no hypertension. However, this beneficial impact of the ACE inhibitors is less clear in patients who are not diabetic.

The NHMS 2006 reported that the overall control of hypertension was a shocking 8.2%. The survey also reported that overall prevalence of diabetes mellitus (known and newly diagnosed) was 11.6%, with the national prevalence of known and newly diagnosed diabetes among adults above 30 years having risen from 8.3% in NHMS in 1996 to 14.9% in NHMS 2006.

The 16th report of the Malaysian Dialysis and Transplant Registry 2008 reported that a total of 18,856 patients were reported to the registry as being on renal dialysis at the end of 2008, with a prevalence rate of 626 per million per year. These facts do not augur well for the nation’s health.

Hypertension is common in those with renal disease, with the majority of patients with end-stage renal disease having hypertension. This has been mainly attributed to volume expansion and the activation of the rennin angiotensin system in the kidneys.

Management

Damage to the kidneys may be without symptoms and is often detected through medical examinations and laboratory investigations, which would provide information about renal function. An elevation of the serum creatinine would indicate that the main function of the kidneys, i.e. glomerular filtration, is impaired.

The presence of protein in the urine (proteinuria) is another indicator of impaired renal function. However, proteinuria is also present in other conditions, e.g. heart disease, damaged blood vessels.

Microalbuminuria is an early indicator of diabetic nephropathy and those with increased risk of cardiovascular morbidity and mortality.

It is currently recommended that diabetics be screened for microalbuminuria. Such screening in hypertensives who do not have diabetes has not been established.

There are occasions when hypertension is due to renal artery stenosis. If the clinical features suggest this condition and if a corrective procedure is considered, imaging studies like computed tomography (CT) angiography and magnetic resonance angiography (MRA) would be performed. Both imaging studies are not without risk.

The risk of CT angiography is that of dye nephropathy, especially in diabetics with chronic renal disease. The risk of MRA is that of nephrogenic systemic fibrosis due to the gadolinium used in the MRA.

Additional tests may be done depending on the clinical situation.

Medicines would be required in most patients to control the hypertension. There are two groups of medicines that lower blood pressure and have a protective effect on the kidneys in diabetics, i.e. ACE inhibitors and angiotensin receptor blockers (ARBs). Both ACE inhibitors and the ARBs also reduce proteinuria and reduce the progression to end-stage renal disease in non-diabetics.

Controlling blood pressure

The recommendation of the National Heart, Lung, and Blood Institute (NHLBI) in the United States is that people with kidney disease should use whatever treatment necessary, including lifestyle changes and medicines, to keep their blood pressure below 130/80.

It has been calculated that a blood pressure reduction of 2mm Hg reduces the risk of stroke by 15% and the risk of coronary artery disease by 6% in a given population.

The NHLBI recommends lifestyle changes to control the blood pressure:

> Maintenance of the body weight at a level close to normal. Choose fruits, vegetables, grains, and low-fat dairy foods.

> Limitation of the daily salt (sodium) intake to 2,000mg or lower if there is high blood pressure. Read nutrition labels on packaged foods to inform oneself of how much sodium there is in one serving. Keep a sodium diary.

> Getting plenty of exercise, i.e. at least 30 minutes of moderate activity on most days of the week.

> Avoidance of excessive alcohol consumption. The limit for men is two drinks (two 360ml servings of beer, two 150ml servings of wine or two 45ml servings of “hard” liquor) a day. The limit for women is no more than a single serving a day because metabolic differences make women more susceptible to the effects of alcohol.

> Limitation of caffeine intake.

> Cessation or reduction of smoking and avoidance of illicit drugs are also essential preventive measures.

Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.

Kidney matters

More on: http://thestar.com.my/health/

Credits to and source taken from: http://thestar.com.my/health/

How to Avoid Feeling Sleepy After Lunch

After having a fantastic lunch, you head back to your office and resume your work. A few minutes later, your eyelids begin to droop and you yawn like a hippo. It’s a classic case of post-lunch sleepiness or drowsiness, also known as afternoon slump or afternoon apathy syndrome. During this time, your body shifts its attention from your work to digesting your lunch, which makes you lose your focus and commit mistakes. This phenomenon is natural, but you can do a lot of things to reduce its effects. The following tips should make you feel less sleepy when afternoon arrives.

1. Heavy lunch = heavy drowsiness: Instead of eating a heavy lunch that your body will have to break down more aggressively, start with a heavy breakfast, and then split your lunch into two light meals. This will reduce the focus of your body on digestion and keep you attentive to your work. Your lunch should contain protein and dietary fiber from foods such as poultry, lean meat, tuna, seafoods, nuts, and beans.

2. Exercise: Not enough oxygen circulates through your system when you’re unfit. Daily exercise makes your body more active, which reduces the effects of after-lunch sleepiness. If you don’t have time to exercise in the morning, try to walk as much as you can going to work, or take the stairs instead of the elevator.

exercising

3. Start with strenuous activities in the morning: Since post-lunch sleepiness strikes in the afternoon, plan your work such that you will do strenuous activities in the morning, and easier activities in the afternoon. Schedule presentations, meetings, and other important activities before lunch, and easier tasks like sorting papers and sending e-mails afterwards. This way, you’ll accomplish everything without compromising your work.

4. Brighten up your office space: Your workspace greatly contributes to your afternoon drowsiness. Bare or unorganized cubicles encourage boredom and remind you of the monotony of your job. Brighten up your workspace with pictures of your friends or family, flowers, or anything that may provide you with visual satisfaction. Full-spectrum fluorescent tubes are also better than white fluorescent tubes because they simulate sunlight and stimulate livelier response from people.

napping at work

5. Take a nap: Drowsiness means your body is telling you to sleep. What better way to get rid of your sleepiness than to actually take a short one? A short nap during the day will freshen you up and increase your productivity — that’s why some even call it a “power nap.” In order for a nap to work effectively, however, your head must rest on something, like a back of a chair or a desk.

6. Meditate for five minutes: Scientists believe that meditation rejuvenates the body. When the afternoon slump strikes, quit forcing yourself to do your tasks and just meditate for five minutes. Meditation doesn’t merely consist of closing your eyes and bowing your head, since these activities will just lull you to sleep more. Meditation means relaxing yourself and doing some breathing exercises to circulate fresh air into your system. Listen to positive, motivating music to help you get back to work with more enthusiasm.

7. Get up and take a walk: It’s extremely hard to do anything even remotely physically demanding when sleepiness sets in, but you have to will yourself to get up from your chair and wake up. Take a break and walk around the office or outside for a couple of minutes. Running up and down the stairs for two minutes also boosts your blood circulation, helping you to breath easier.

8. Wash your face: Your body needs outside stimulus to keep its focus during the post-lunch slump. When your face starts to feel numb because of drowsiness, go to the restroom and splash water on your face. Brush your hair, massage your face, or reapply makeup if you want. Once you see yourself looking better, you’ll also feel better, and it’s easier to get back to work.

washing the face

9. Find something funny: If you’re using a computer, a quick search for a short funny article or a picture online can quickly snap you out of your sleepiness. On the other hand, if your job doesn’t involve computers, you may want to tell your coworker a joke or ask him for a joke to solicit laughter. Humor gets rid of drowsiness like magic.

10. Chat with others: Oftentimes, feeling sleepy is also a consequence of being alone in a cubicle for a long time. To counter it, you must try to see other people and chat with them. As long as your conversation is work-related, your boss won’t see any harm in it.

chatting

11. Develop a sleep routine: Cutting down on your sleep to complete your tasks will lead to sleep deprivation. The effects of sleep deprivation have been compared to being intoxicated, including committing mistakes and acting irrationally. Catching up on your sleep during weekends also doesn’t work. Instead, develop a sleep routine by going to bed and waking up around the same time each day.

drinking coffee

12. Coffee: Coffee’s effect on sleep is debatable. For some people, coffee helps them get rid of their drowsiness and stay awake for an extended amount of time. Others though feel that coffee dehydrates them or disrupts their sleep at night, contributing to the cycle of sleep deprivation. Be sure that your body reacts favorably to coffee, so that your post-lunch sleepiness problem will not get worse.

13. Coffee substitutes: Instead of grabbing a bite of sugary snacks during the afternoon when feeling drowsy, try these other options:

* Baked potato: Baked potato gives your blood sugar a quick boost for an energy surge. Make sure that the cream is low-fat to keep it healthy. Eat spicy baked potatoes to help knock the sleep out of you.

* A glass of water: Fatigue is sometimes caused by dehydration, which is often exacerbated by drinking too much coffee. Instead of coffee, drink a fresh glass of water to give your body plenty of liquids for the rest of the day. Juicy fruits like watermelon can also rehydrate and fill you up with essential vitamins and fibers.

* Dried dates: Dates are traditionally used in the Sahara as energy meals for camels. They can boost your energy level, and they’re rich with minerals too, including potassium. Eat a bunch of dried dates during the post-lunch slump to bring some life back into your body.

Most of these techniques are just temporary solutions to afternoon drowsiness. Nothing beats regular exercise and a balanced, nutritious diet in keeping your body healthy and lively. If you treat your body properly, it will work like a well-oiled machine whether day, night, or afternoon.

source taken from: http://lifehackery.com/

Too little sleep may make you fat
Too little sleep may increases the chance of becoming obese, a study suggests

People burn fewer calories asleep, so it might seem to be counterintuitive that more sleep prevents weight gain.

But it was found people who slept four hours or less per night were 73% more likely to be obese, possibly because of effects on appetite hormones.

The Columbia University study was presented to the North American Association for the Study of Obesity annual meeting in Las Vegas.

Sleep deprivation

A team from the Mailman School of Public Health and the Obesity Research Center at Columbia analysed data on 18,000 people aged between 32 and 59 who participated in the National Health and Nutrition Examination Survey during the 1980s.

While those who had less than four hours sleep were most at risk, people who got only five hours of sleep were 50% more likely to be obese than those who were getting a full night's rest.

Those who got six hours of sleep were 23% more likely to be substantially overweight.

Dr James Gangwisch, who led the research team, admitted: "The results are somewhat counterintuitive, since people who sleep less are naturally burning more calories."

"But we think it has more to do with what happens to your body when you deprive it of sleep as opposed to the amount of physical activity that you get."

And Dr Stephen Heymsfield, who also worked on the study, said it was not as simple as saying that if people were awake for longer, they were likely to eat more.

"There's growing scientific evidence that there's a link between sleep and the various neural pathways that regulate food intake."

Prehistoric cause?

He said previous research had shown sleep deprivation was linked to a decrease in levels of the hormone leptin, which regulates appetite and weight and tells the brain how much energy is available in the body.

However, levels of the hormone grehlin, which makes people want to eat, have also been seen to increase in people who are sleep-deprived.

Dr Gangwisch suggested the reason for this effect could hark back to prehistoric times.

"The metabolic regulatory system may have evolved to motivate humans to store fat during summer months when the nights are shorter and food is plentiful, which was a survival mechanism for the body to prepare for the dark winter months when food would not be as plentiful.

"As a result, sleeping less could serve as a trigger to the body to increase food intake and store fat."

Dr David Haslam, chairman of the National Obesity Forum, said: "This is counterintuitive. But I think the key to it is that, if you're not sleeping, you're quite likely to be snacking in front of the computer or the TV.

"Being stressed, which can affect sleep patterns, is also known to affect hormone levels."

But Dr Haslam said: "This is very interesting because it flies in the face of what you would expect."

By Meadow Milano, eHow Contributing Writer

Lumps in a man's breast are not common. Hormones or, less frequently, cancer may fuel them. Male breast cancer is rare, however it does occur. Male breast lumps are more common in the adolescent years.

Types

1. Benign lumps in a man's breast are called gynecomastia. It occurs when hormone levels are not balanced. Liver tumors or disruptions of a man's endocrine system can cause gynecomastia. Male breast cancer also can present with a breast lump.

Features

2. Lumps in a man's breast, whether they are benign and hormonal in nature, or malignant due to carcinoma, present very similarly. It is difficult to differentiate them simply by palpation, or feel.
Prevention/Solution
3. A man cannot prevent lumps in his breast, however, after diagnosis, he can receive appropriate treatment to manage the condition. Frequently, with male breast cancer, surgical intervention is the favored option. Mastectomy is performed not only on women, but it also is the treatment of choice for male breast cancer.

Misconceptions

4. It is a common misconception that men do not get breast cancer. Although the incidence of breast cancer is much higher in women, it is still diagnosed in men.

Warning

5. When a man discovers a lump in his breast, it is vital that he get prompt medical evaluation and treatment. Just like in women, early detection of breast cancer is key in the man's prognosis.

source taken from: http://www.ehow.com/

What Are the Causes of Breast Pain in a Man?
By David Harris , eHow Contributing Writer

Though most people associate breast pain with women, men can also experience pain in the nipple or breast.

Gynecomastia

1. One common cause of breast pain in men is called gynecomastia, which is a harmless swelling in the breast. Puberty, hormone therapy and some medications can cause the condition, which usually resolves on its own.

Runner's Nipple

2. Another condition is called runner's nipple which appears as a red, cracked or sore nipple. Runner's nipple is irritation caused by the clothes rubbing against the skin. Wearing loose clothes, applying Vaseline or putting bandages over nipples can help.

Cysts

3. If you notice a lump, that may or may not be painful, see your doctor. It is mostly likely a benign cyst.

Breast Cancer

4. Breast cancer, however rare, can occur in men. Symptoms include a painless lump under the nipple, skin changes and discharge from the nipple.

Considerations

5. A painless lump does not always signify cancer. Fibroadenomas are benign tumors that can occur in men, as well as women.

source taken from: http://www.ehow.com/

Causes of Pain in Breasts
By Marcia Frost, eHow Contributing Writer

It is not unusual for a woman to have pain in her breasts. Some women even experience this symptom frequently to a varying degree. For the vast majority, the cause of breast pain is nothing to be concerned about. Breast cancer is rarely painful, but there are a number of other conditions that can cause breast tenderness.

Hormones

1. A change in a woman's hormone levels can cause breast pain. This tenderness most often comes before a menstrual period as hormonal changes cause painful cysts to form. These usually disappear during the monthly cycle. Other hormonal changes can also cause pain in the breasts. This is quite common during both puberty and menopause.

Pregnancy

2. Pain in the breasts is one of the first symptoms of pregnancy. This occurs mostly in the first trimester as the body prepares itself for pregnancy. The pain will occur again at the end of the pregnancy as the breasts prepare to lactate. As they fill with milk, they become very tender, something which continues after birth until a woman nurses (or allows the milk in the breasts to dry up if not breastfeeding).
Infection
3. An infection in the breast is a possible cause of pain. Symptoms of an infection include swelling and redness. Discharge and tenderness are also possible, sometimes accompanied by fever. Breast infections are more common surrounding childbirth. A visit to a health professional is necessary for a suspected breast infection as antibiotics are needed to treat the infection.

Injury

4. An injury to the breast, ribcage or surrounding muscles can cause pain in the breast. This can occur from an accident or something as simple as wearing an improperly fitted bra during exercise. If injury is causing the breast pain, it needs to heal. A doctor may prescribe anti-inflammatory medication to help reduce the swelling and pain.
Fibrocystic Breast Changes
5. Fibrocystic breast changes are a non-cancerous (benign) condition that many women have. It causes painful lumps to appear throughout the breasts. These lumps are often very painful. They will, however, change in size and discomfort throughout the monthly cycle. While fibrocystic disease is not breast cancer, there is a slightly higher risk of developing breast cancer if you have this condition.

Considerations

6. Malignant tumors rarely cause pain in the breasts, but no pain or lump should be ignored. Regular breast cancer screening---self-exams, mammography and annual exams---is important for early detection of breast cancer. If any unusual changes occur to the breast between routine screenings, a health professional should be notified to see if further testing is necessary.

source taken from: http://www.ehow.com/

By an eHow Contributing Writer

Breast cancer refers to cancers that originate in the tissue (sarcomas) or glands/ducts (adenocarcinomas) of the breast. Although breast cancer is most commonly diagnosed in females, it can affect males as well. Breast cancer is usually characterized by a lump in the breast, although inflammatory breast cancer can appear as a breast infection with reddened skin and no lump, and some early stage breast cancers are asymptomatic. Leg pain is generally not a symptom of breast cancer, unless the cancer has metastasized (spread) to the bone. However, leg pain is a common result of breast cancer treatment.

Symptoms

1. The symptoms of breast cancer are different for each person, and many patients have no symptoms at all. When symptoms do exist, a woman typically finds a lump in her breast, although the skin may also appear swollen or otherwise changed. Again, leg pain is not a symptom or common result of Stage I, II, or III breast cancer. Leg pain experienced prior to treatment may be a sign of bone metastasizes, or may be unrelated to the breast cancer.

Leg Pain

2. Medications used to fight primary breast cancer often cause leg pain. However, leg pain can also be a sign that the cancer has metastasized to the bones of the legs. Metastasizes occurs only in Stave IV breast cancer, and once metastasizes has occurred, the cancer is no longer curable although the metastasizes and the resulting pain are treatable. It is important to discuss any leg pain with your doctor, because although it is a common and normal result of breast cancer treatment, metastasizes should still be ruled out.

Non-metastatic Bone Pain

3. Chemotherapy used in the treatment of breast cancer can impact nerves, ligaments, joints or muscles. This impact can cause pain in the arms, as well as in the hips and the legs. Typically, the pain begins during a chemotherapy session and gets progressively worse with each treatment. This leg or hip pain may last for one year or longer after treatment ceases. NSAIDS (pain relief medications such as Tylenol and other over-the-counter non-steroid medications) may ease the pain, or your doctor may prescribe a stronger anti-pain medication, including various opiates or tricyclic antidepressant. This pain will eventually go away on its own, but it takes time.

Tamoxifen, one drug used to fight primary breast cancer, is specifically identified as causing pain in the hips and legs. Pain caused by tamoxifen can resemble the stiffness and aches caused by arthritis.

Treatment

4. In addition to painkillers, certain other treatments are recommended to help with leg pain caused by breast cancer treatment. Physical therapy is often recommended; swimming and yoga especially may help build strength and reduce pain.

Metastatic Bone Pain

5. Pain in the bones of the leg may indicate that the cancer has metastasized to the bone. The bone is a common site for breast cancer metastases. Certain treatments, including laser beam radiation therapy and tamoxifen, are used to treat bone metastases. Although metastatic breast cancer is not curable, new drugs including bisphosphonates such as Zometa and Aredia, have greatly improved survival time for patients diagnosed with metastases in the bone. These bisphosphonates help to slow the growth of the cancer, reduce bone destruction, and keep blood calcium levels normal.
source taken from: http://www.ehow.com/

About Breast Cancer & Neck Pain
By an eHow Contributing Writer

reast cancer refers to cancer that originates in the duct or glands of the breast (where it is called adenocarcinomas) or the breast tissue (sarcomas). Breast cancer can affect both males and females, although primarily the latter. The cancer may be asymptomatic or may cause a lump to appear in the breast, or effect skin changes in the breast or nipple. Neck pain is not a normal symptom of breast cancer. However, bone pain, including that in the bones of the neck, may occur as a result of breast cancer treatment or bone metastasis (the spread of the primary cancer to the bones of the neck).

Neck Pain

1. Pain in the bones of the neck that occurs prior to treatment may be associated with metastases to the neck. The bones are a common site of metastases for Stage IV breast cancer, and metastases to the neck bone would cause pain there. Pain that occurs after treatment begins may also be symptomatic of bone metastases, but it may be caused by the breast cancer treatments as well. Certain chemotherapy agents and other drugs used to fight primary breast cancer may cause side effects--including bone, muscle and joint aches--which may affect the neck.

Non-Metastatic Causes of Neck Pain

2. Chemotherapy agents can cause pain in the nerves, joins, muscles or ligaments. While these chemotherapy drugs usually cause pain in the lower body, including the hips and legs, they may cause pain in the bones and ligaments of the neck. Pain associated with chemotherapy usually begins during chemotherapy sessions and becomes progressively worse. It may linger for up to a year after treatment ends.

Another drug used in the treatment of breast cancer, called tamoxifen, is known to cause stiffness in the bones and joints. Again, it primarily causes the problem in the lower body, but may cause a stiff neck as well. This pain is usually similar to arthritis pain.

Treatment for Non-Metastatic Neck Pain

3. Non-metastatic neck pain is usually treated by managing the pain with painkillers and/or by building muscle strength via physical therapy that builds muscles without being strenuous on the body. Pain medications include NSAIDs (non steroidal anti-inflammatory drugs) or stronger pain medications like opiates and tricyclyc antidepressants. Yoga and swimming are recommended forms of exercise to deal with neck pain caused by breast cancer treatment, and heat and massage can also help alleviate the pain. These treatments generally help with the symptoms of the pain, but do not cure the pain entirely--only time can fully cure neck pain associated with breast cancer treatment.

Metastatic Neck Pain

4. Pain in the bones of the neck may be a sign that the cancer has metastasized to the bone. Along with the lungs and liver, bone metastasis is common with Stage IV breast cancer. Bone metastasis can cause pain in the bones, and bone fractures. In fact, it is estimated that approximately half of all cancer-caused bone fractures occur as a result of bone metastasis, with breast cancer as the primary variety.

Treatment for Metastatic Neck Pain

5. Metastatic breast cancer is incurable, but its progression can be slowed or managed, and the symptoms, including neck pain, can be treated Laser-beam radiation on the affected bones has been proven effective at reducing pain in approximately 85 percent of patients with bone metastasis. Bisphosponates, a new drug, show promise in helping to keep calcium levels normal; slow or stop the destruction of bone by cancer cells; and extend survival time. Tamoxifen is another drug used to help reduce the spread of cancer cells in the bones. NSAIDs or other pain relievers are also used to manage neck pain or other pain associated with bone metastasis.

source taken from: http://www.ehow.com/

By an eHow Contributing Writer

Breast cancer is a cancer that originates in the tissue (sarcoma) or glands/ducts of the breast (adreoncarcinoma). It is far more common in women then men, and is often diagnosed by the presence of a lump found during a mammogram or breast exam. If found early, breast cancer is relatively treatable using a combination of surgery, radiation and chemotherapy. However, metastatic or Stage IV breast cancer is not a curable disease, and metastases often occur in the bones, liver or lungs. Although it can't be cured, new developments have helped to improve quality of life and increase longevity for patients with metastatic breast cancer.

Bone Metastasis

1. Bone metastases is common in Stage IV breast cancer. Often, bone metastases is symptomatic and is accompanied by bone pain at the site of the metastasis. Although the metastasis and the cancer are not curable, advances in medicine, including the use of radiation therapy, tamoxifen and bisphosphonates have improved the quality of life for patients with bone metastasis and have improved prognosis and 5 year survival rates for affected patients. Systemic therapies, including chemotherapy and hormone therapy, have also helped in the treatment of bone metastasis caused by breast cancer.
Chemotherapy
2. Chemotherapy can help shrink tumors and reduce pain associated with metastatic cancer. While chemotherapy will not cure the cancer in the bone or eliminate it completely, it can help reduce the amount of cancer cells present, which alleviates pain and extends lifespans. Common side effects include loss of appetite, baldness, nausea and mouth sores.

Bisphosphonates

3. Bisphosphonates are a relatively new class of drugs that have made a difference in the treatment of bone metastasis caused by breast cancer. Bisphosphonates help to treat weakness in the bones caused by metastases. Bisphosphonates work in four ways: they slow damage to the bone caused by cancer, they help maintain normal calcium levels in the blood, they reduce bone pain and they lower the risk of bone fractures caused by metastases.

Radiopharmaceuticals

4. Radiopharmaceuticals refers to a group of drugs, given intravenously, that have radioactive elements. The drugs target and settle in spots where cancer has formed in the bone and help to eliminate some of these metastatic cancer cells. This reduces pain and is far more precise and effective than the use of external radiation beams. A single injection of a radiopharmaceutical drug can reduce or eliminate bone pain for up to a year after it is administered. This type of treatment works best for bone metastases that stimulates the bone cells to form new bone areas in the body.

Hormone therapy

5. Some breast cancers are hormone receptive, which means estrogen aids the growth of the cancer. Hormone receptive cancers can be slowed by blocking access to estrogen. Removing the ovaries or providing hormone blocking drugs can thus slow the metastatic process.

source taken from: http://www.ehow.com/

What Is the Average Life Span of a Stage IV Breast Cancer Patient?
By Apryl Beverly, eHow Contributing Writer

When doctors diagnose breast cancer, they assign a number one through four--with four being the worst stage. Five percent of women in the United States suffer from breast cancer, which typically has a five-year survival rate. Patients with stage IV breast cancer have a 20 percent chance of living five years with the disease. Those living with stage I breast cancer have a 98 percent chance of living five years.

Stages

1. The first and second stages are known as early stage breast cancer and the third and fourth stages are referred to as late stage breast cancer. Late stage breast cancer attacks not only the breasts, but also other parts of the body such as the lungs, brain, bone and liver.

Treatment

2. Stage IV breast cancer is incurable. However, early detection combines with aggressive, quick and comprehensive treatment can help patients live for several years with stage IV breast cancer. Chemotherapy, radiation and targeted therapy are commonly used to treat late stage breast cancer.

Pregnancy

3. Pregnant women with breast cancer have a limited life span. Most studies predict that approximately 10 percent of them will be alive in five years (if they are diagnosed with late stage breast cancer).

Late Stage Survival

4. While still considered late-stage breast cancer, stage III is less severe in that it typically has not spread to other organs. This means it is easier to treat. The five-year survival rate for stage III ranges from 55 to 65 percent.

Cure

5. Stage IV cancer is incurable. However, you can live for several years with stage IV cancer if your oncologist administers proper treatment.

source taken from: http://www.ehow.com/

What Are the Treatments for Stage IV Breast Cancer?
By an eHow Contributing Writer

Stage IV breast cancer means breast cancer that has metastasized, or spread, beyond the breast to distinct areas of the body. The lungs, liver and bones are common sites of breast metastases. Treatment depends upon whether the cancer is hormone receptive, the site of the metastases and the individual patient. These treatments will not save your life, but they can extend the length and quality of life.

Hormone Therapy

1. Hormone receptive breast cancer depends on estrogen to grow and prosper. Estrogen blockers slow or stop the growth and spread of cancer. Tamoxifen is the most commonly prescribed estrogen blocker. It is taken in pill form, and in most cases can be taken for as long as the cancer responds to the treatment.

Targeted Therapy

2. Other targeted therapies are designed to slow or stop the growth of cancer cells by interfering with other essential components, in addition to estrogen, that the cancer needs to survive and grow. Bevacizumab, for example, blocks the supply of blood to the cancer cells. Trastuzumab blocks HER-2 positive cancer cells from growing.

Chemotherapy and Radiation

3. Chemotherapy and radiation may also be administered to stop the growth of cancer cells and/or slow the spread of the cancer. Radiation may be applied to only the breasts or to other areas of metastases to kill the cancer cells in other parts of the body. Chemotherapy is usually systemic--it goes through the whole body to kill cancer cells. Chemotherapy can be administered intravenously (through a needle in the vein) or in pill form.

How to Create a Diet to Prevent Anemia
By an eHow Contributing Writer

People who eat balanced diets will rarely have problems with anemia. However, vegetarians, pregnant women and people with a history of blood problems need to take special care to create a diet to prevent anemia.

Learn to Create a Diet to Prevent Anemia

Step 1

Work eggs into your morning breakfast. You don't need to eat them every day, but three to four servings of eggs each week will help you get a host of vitamins that help prevent anemia, including about 10 percent of your daily value of vitamin B12 per egg.

Step 2

Eat red meat at least once a week if you've had problems with anemia in the past. Beef and other meats contain vitamin B12 and are excellent sources of iron, which is essential to prevent anemia.

Step 3

Create a few seafood meals to add more fish to your diet. Trout and salmon contain close to 100 percent of your daily value of vitamin B12. As an added benefit, fish contains omega-3 fatty acids, which is thought to be a natural treatment for attention deficit disorders.
4.
Step 4

Look for whole grain cereals that are fortified with vitamin B12 if you are a vegetarian. Also, some nutritional yeasts contain enough vitamins to make up for a lack of meat, fish and animal products in your diet. You can either cook with the yeast or use it as a condiment.

Step 5

Snack on fruits like raisins and dried figs to get a little bit of extra iron in your diet. Vegetarians may need to eat more iron-rich fruits than most people, since meat and animal products are the major sources of iron for many people.

Step 6

Talk to a dietitian if you want help to create a diet to prevent anemia. Your overall diet will have to be adjusted to account for the amount of physical exercise you get and your age.


Tips & Warnings

A glass of milk with dinner can help you get your vitamins on days that you aren't eating meat or fish.

Carefully read the ingredients of nutritional yeast to be sure it contains the vitamins you need. These yeasts are regulated as foods and are held to looser regulations than drugs and medications.

It can take several years of eating a vegetarian diet before vitamin storage is used up and anemia appears. Take early steps to create the proper nutritional diet.

Don't take iron supplements without consulting your doctor. Large amounts of iron can interfere with many other processes in your body.

source taken from: http://www.ehow.com/

Itchy eyes and sneezing aren't just for springtime

By Kaitlin Bell
Prevention Magazine
updated 8:57 a.m. ET April 29, 2010

Think allergies end in April or May? Guess again.

Those sneezy, itchy-eyed, congested months can last well into late fall, as different trees, then grasses and, finally, weeds bombard the air with pollen. If that weren't irritating enough, outdoor mold starts to release airborne spores starting in summer and continuing through fall, which can cause further irritation. In fact, reactions to mold (fungi that thrive in warm, moist, humid climates both outdoors and in) as well as ragweed may be even more of a problem in certain parts of the country this summer because of heavier-than-usual rainfall.

If you're sneezing like crazy, here's how to stay outside, active, and virtually symptom free — all allergy season long.

1. Rethink your exercise plan.
You breathe harder and suck in more air when you're exercising than when you're, say, watching TV.

The more air you inhale, the more airborne pollen and mold spores you suck in too. That's why it's important to take your workout indoors when your allergies are acting up or on days with very high pollen or mold counts.

Love walking or running outside? You don't have to give it up entirely, but try to minimize your exposure. To help ease symptoms, take a nondrowsy antihistamine before you exercise or plan to spend significant time outdoors. Pick a path that's less likely to expose you to allergens—walk on a school track, for example, instead of through your tree-lined neighborhood. And steer clear of major roads and highways. Chemical irritants from exhaust can worsen allergy symptoms, says Malcolm N. Blumenthal, MD, director of the Asthma and Allergy Program at the University of Minnesota Medical School in Minneapolis.

2. Watch for nonseasonal allergies.
The more allergens you're exposed to at a given time, the higher your allergenic load and the worse your symptoms.

If you're allergic to cats and dust mites in addition to pollen and mold, for example, visiting a cat-owning friend on a summer evening can make that load virtually unbearable.

Here are some tips to help you limit your exposure to these top offenders:

Here are some tips to help you limit your exposure to these top offenders:

* Dust mites. Cover flooring with washable throw rugs instead of carpets, which, like blankets, down comforters, and curtains, are favorite mite habitats. Launder rugs, bed linens and curtains in hot water (more than 130°F) to kill mites. Dust often with a damp cloth. Get zippered, allergyproof covers for your mattress and pillows.
* Dog and cat dander. If pet owners come to visit, be sure to vacuum couches or chairs they've used after they leave. Their clothes may carry their furry friends' dander, which can be deposited in your home and aggravate symptoms.
* Indoor mold. Get a dehumidifier to dry out your basement, and use exhaust fans in other areas prone to dampness and mold, such as the kitchen and bathroom. Wash bath mats often, and keep houseplants to a minimum (mold loves potting soil).

3. Be a clothes snob.
Shun synthetic materials for natural ones like cotton—your nose and eyes will thank you.

Who knew? When synthetic fabrics rub against one another, they create an electrical charge that attracts pollen, which, as it turns out, is also electrically charged, says Gailen D. Marshall, MD, PhD, director of clinical immunology and the division of allergy at the University of Mississippi. Natural fibers such as cotton also breathe better, so they stay drier and less hospitable to moisture-loving mold.

Toss just-washed clothes and bedding in the dryer—don't hang them outside on a clothing line. Avoid contacts when your eyes feel itchy, and feel free to splurge on a pair of jumbo sunglasses—they'll help shield your peepers from airborne irritants.

4. Get smart about gardening.
Got killer allergies? The best way to deal with yard work is to have someone else do it. Failing that...

Take an antihistamine or cromolyn sodium about half an hour before you head outdoors, and wear a pollen mask whenever you dig around in dirt, rake leaves, or mow the lawn—activities is all but guaranteed to stir up pollen and mold. Keep your lawn cut short, so it's less likely to sprout pollen-producing flowers or weeds. If you have a compost heap—a major mold breeding ground—consider getting rid of it or moving it far away from the house.

Finally, consider replacing plants that produce lots of offending pollen with more benign varieties. Rules of green thumb: Choose showy, flowering trees and shrubs such as apple and cherry trees and azaleas; they produce waxy pollen that's too heavy to ride the breeze. On the lawn, opt for nonpollinating ground cover such as myrtle or ivy rather than grass.

5. Give yourself a good scrubbing.
Showering more often may keep allergy invasions at bay.

While you're outside, pollen and mold spores can parachute onto your hair, eyebrows, eyelashes, and skin. To give them the boot and minimize your exposure, do the following once you cross the threshold: Wash your hands, rinse your eyes, and shower (before bed, or right away if you've done yard work).

Same goes for your pet. Even if you're not allergic to your pup, he can become an allergy magnet after running around outdoors. Brush off his fur before you give him free reign of the house again.

6. Consider a stronger treatment.
OTC meds like antihistamines and decongestants can significantly relieve symptoms, but if your nose is still running, it may be time for an upgrade.

If you've got a faucet for a nose and are constantly congested, ask your doctor about a steroid nasal spray, which relieves these symptoms better than an antihistamine, says David Shulan, MD, FAAAI, vice president of Certified Allergy & Asthma Consultants, a practice in Albany, NY. The catch: You need to use it on a regular basis, and it can take up to 2 weeks to have an effect. A spritz every once in a while is useless, Shulan says.

If pollen, ragweed, or dust mites are your main problem, think about getting allergy shots (immunotherapy). Injections of very small, safe amounts of the chemicals you're allergic to will help your immune system become resistant to the allergens, so your body doesn't launch a full-out attack every time you inhale a pollen particle. You get shots once or twice a week for several months in gradually increasing doses, and periodic maintenance shots after that for 3 to 5 years.

source taken from: http://today.msnbc.msn.com/

Heart Attack Warning Signs
Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Other signs may include breaking out in a cold sweat, nausea or lightheadedness

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don’t wait more than five minutes to call 9-1-1 or your emergency response number.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

A TIA, or transient ischemic attack, is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke. The usual TIA symptoms are the same as those of stroke, only temporary. The short duration of these symptoms and lack of permanent brain injury is the main difference between TIA and stroke.

Cardiac arrest strikes immediately and without warning. Here are the signs:

• Sudden loss of responsiveness (no response to tapping on shoulders).
• No normal breathing (the victim does not take a normal breath when you tilt the head up and check for at least five seconds).

If these signs of cardiac arrest are present, tell someone to call 9-1-1 or your emergency response number and get an AED (if one is available) and you begin CPR immediately.

If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is available) before you begin CPR.

Use an AED as soon as it arrives.