Monday, February 28, 2011

Demam Denggi Malay Leaflet

Leaflet Kempen Bahaya  Denggi ni saya ambil di pejabat kesihatan Kota Bharu

Tuesday, February 22, 2011

insulin treatment in Type 2 diabetes - Part 2

Insulin Type

Manufactured insulin can be either synthetic (human) or animal in origin, and falls into five main categories

  • rapid-acting
  • short-acting
  • intermediate acting (also called isophane insulin)
  • fixed mixtures (of rapid - or short-acting and intermediate-acting insulin)
  • long-acting

Indications for insulin treatment

Strong indications for insulin therapy include:

  • symptoms of hyperglycaemia such as polyuria, thirst, 
    recurrent fungal infections (especially genital thrush) or bacterial infections (especially urine infections
  • pregnancy or planning pregnancy
  • oral hypoglycaemic treatments not tolerated/ contra-indicated
  • weight loss without dieting in someone of low or normal weight.
Possible indications for insulin therapy include:
  •  unsatisfactory glycaemic control, even with the maximum tolerated dose of oral hypoglycaemic agents (OHAs) (HbA1c higher than 7 per cent, self blood glucose monitoring results higher than 7 mmols/litre before meals or 9 mmols/litre two hours after meals) 
  • personal preference
  • painful neuropathy
  • foot ulceration and infection.

Monday, February 21, 2011

insulin treatment in Type 2 diabetes - Part 1


How Insulin Works
Put simply, insulin unlocks the ‘doors’ of cells to let the glucose in and it also suppresses liver glucose production. People with Type 2 diabetes may need supplementary injected insulin if they are insulin deficient and/or insulin resistant as a result of obesity or taking certain drugs, such as steroids, and where diet, physical activity and oral hypoglycaemic agents (OHAs) are no longer sufficiently effective in lowering blood glucose

Normal basal insulin secretion

The liver releases glucose at a relatively constant rate all the time, with a slight dip during the night and a surge before dawn.A steady release of insulin is therefore
needed to maintain normal blood glucose levels.

Normal meal-time insulin

As well as this 24-hour background insulin secretion, there is a burst of insulin at every meal -often called the meal-time bolus.Whenever glucose is released into the bloodstream from food, a matching release of insulin is required for up to two hours in order to move the
glucose into the cells. How long this increased insulin level is needed depends on the type of carbohydrate, its glycaemic index, and the fat content of the meal.
mechanism of insulin secretion

                          Normal Basal and Meal time insulin produced by pancreas

Friday, February 18, 2011



The wound care guidelines have been developed by clinicians who are treating patients with wounds. They reflect current research and evidence based expert opinion.

The guidelines are intended for use as a resource for wound management and should be available to all medical,nursing and therapist caring for patients with wounds in Bolton Primary Care NHS Trust and Bolton Hospitals NHS Trust,Bolton Hospice and The Beaumont Hospital. Evidence based recommendations are included and a formulary of wound care products is included to promote rational prescribing.
These guidelines have been produced for use by any member of the healthcare team.

They are not intended as a substitute for professional judgement but are in support of the practitioner making an informed decision relating to the management of the patient,in accordance with individual professional competence.

Click at the book to download

Android Insulin Dose Calculator

Discover more Android apps

Tuesday, February 15, 2011

Ceftobiprole medocaril (Ortho-McNeil)

                         Fifth-Generation Cephalosporin

Another drug in development is ceftobiprole, which is in the midst of phase III trials for cSSSIs. Ceftobiprole is the first fifth-generation cephalosporin and also the first cephalosporin with activity against methicillin resistant Staph aureus (MRSA), according to Mark Kosinski, DPM, a Professor in the Department of Medicine at the New York College of Podiatric Medicine. Unlike other cephalosporins, ceftobiprole is designed to have a high affinity for PBP2a and therefore will be active against MRSA, adds Dr.Kosinski. As far as advantages go, he says the antibiotic offers gram-positive and gram-negative coverage, and also has a low potential to spur in vitro resistance.

The drug is parenteral only at this point, has good tissue penetration and has been shown to be active against Pseudomonas aeruginosa, according to Dr. Kosinski, a member of the Infectious Diseases Society of America.

Read More at Drugs development-technology

Monday, February 14, 2011

Versatile Wound Care Option - Dermacyn


Dermacyn™ Wound Care (Oculus Innovative Sciences). One newly developed modality may prove to be a worthwhile adjunct in facilitating good wound care. According to the
company, clinicians may employ Dermacyn, a super-oxidized and non-toxic water product, to help debride and clean acute and chronic dermal lesions, such as stage I to IV pressure ulcers, diabetic ulcers and post-surgical wounds.

Matthew Regulski, DPM, the Director of the Wound Center of Ocean County, N.J., uses Dermacyn for “any type of wound” at his facility. Those wounds include arterial wounds, venous wounds, immunopathic wounds and inflammatory wounds. Dr. Regulski’s staff pre-treats the wound with a Dermacyn soak for 10 minutes prior to debridement. He notes he will also use the product in conjunction with grafts, human growth factors and autologous platelet gels. In addition, Dr. Regulski uses the product in pulse lavage and with products like Versajet (Smith and Nephew) and VAC Therapy (KCI).

Calling Dermacyn “quite revolutionary,” Dr. Regulski cites a number of advantages. He notes it destroys bacteria, resistant strains, viruses, fungi and spores, and also can inhibit the release of histamine from mast cells and pro-inflammatory cytokines like TNF-alpha, IFN-gamma and interleukins. With Dermacyn, one can sterilize a wound in as few as three applications and Dr. Regulski adds that its sterilization properties are so effective that he now uses very little silver or cadexomer dressings. Dr. Regulski adds that Dermacyn is non-cytotoxic and non-genotoxic, and his patients have not had oral, ocular or skin irritations.

Saturday, February 12, 2011

Demam Denggi Kawalan dan Pencegahan



Pengawasan vektor
a. Jentik-jentik
b. Nyamuk dewasa

Kawalan ketika berlaku wabak

Pengawasan vektor (nyamukAedes) Sasaran utama usaha pengawalan ditujukan terhadap vektor penyakit, terutamanya Aedes aegypti kerana nyamuk ini merupakan satu-satunya komponen dalam kitaran transmisi virus yang boleh dikawal secara efektif dengan kaedah yang tersedia pada masa ini. Pengawasan vektor bertujuan untuk mengawasi jumlah dan juga paras kepadatan nyamukAedes. Langkah ini akan memberikan penunjuk tentang kejayaan usaha pengawalan vektor dan juga boleh membantu menentukan masa yang tepat untuk memulakan, menggiatkan ataupun menghentikan usaha pengawalan. PengawasanAedes boleh dilakukan terhadap peringkat jentik-jentik atau nyamuk dewasa.

1.Pengawasan jentik-jentik

Apabila melakukan tinjauan untuk mengkaji jumlah jentik-jentik, setiap
rumah akan diperiksa. Pemeriksaan dilakukan pada sekurang-kurangnya 50
buah rumah di kampung yang besar atau di bandar. Di setiap rumah semua bekas
di dalam dan di luar rumah diperiksa sama ada terdapat air dan jentik-jentik
atau tidak. Terdapat beberapa jenis indeks yang digunakan untuk menentukan kepadatan jentik-jentik:

a. Indeks Premis ( Indeks Rumah) = Bilangan rumah positif dengan jentik- jentik / Bilangan rumah yang diperiksa x 100 = % rumah positif untuk jentik-jentik.

b. Indeks Bekas = Bilangan bekas positif dengan jentik- jentik / Bilangan bekas yang diperiksa x 100 = % positif untuk jentik-jentik

c. Indeks Breteau = Bilangan bekas positif dengan jentik-
jentik / Bilangan rumah yang diperiksa x100 = Bilangan bekas positif / 100 rumah.

d. Indeks kepadatan jentik-jentik  = Bilangan jentik-jentik dari semua
rumah / Bilangan rumah yang diperiksa  = Purata bilangan jentik-jentik / rumah.

e. Indeks Stegomyia  = Bilangan bekas positif dengan jentik- jentik / Bilangan penduduk di kawasan tinjauan x1000 = Bilangan bekas positif / 1000

Takungan seperti deram, tempayan, kolam simen dan lain-lain.

Mencampurkan Abate ke dalam semua bekas yang digunakan untuk menyimpan air. mencampur garam atau minyak tanah ke dalam perangakap semut yang terdapat di dalam rumah.

Membersihkan rumput, lalang dan semak di tanah-tanah lapang akan
memusnahkan tempat nyamuk menetap dan berehat. Kaedah-kaedah ini
bersama-sama dengan kaedah yang lain akan membuat alam sekitar tidak sesuai
untuk pembiakan nyamuk Aedes aegypti dan Aedes albopictus..

Langkah-langkah yang perlu
diambil semasa aktiviti
a. Semburan kabus 'thermal'
b. Semburan kabus 'ultra low volume'

Kawalan jangka panjang
a. Kawalan biologi
b. Pendidikan kesihatan
c. Penggunaan vaksin
d. undang-undang

a. Kawalan Biologi

Merupakan kawalan nyamuk melalui musuh alamiah seperti haiwan pemangsa, parasit dan patogen. Haiwan pemangsa biasanya lebih besar dari mangsa yang sering dimakan. Pemangsa seperti ikan Gambusia, Claris fuscus, Macropodusdan Tilapia nilotica  telah untuk digunakan untuk memakan  jentik-jentik bagi nyamuk Aedes.

Jentik-jentik dari spesis nyamuk Toxorhynchites boleh juga digunakan  untuk mengawal jentik-jentik nyamuk Aedes di dalam bekas-bekas takungan air. NyamukToxorhynchi tes merupakan nyamuk yang berukuran besar tetapi tidak pernah menggigit dan menghisap darah manusia. Bakteria seperti Bacillus thuringiensis,  Bacillius israelensisdan Bacillus  sphaericus boleh juga digunakan untuk  mengawal nyamukAedes. Lain-lain  contoh kawalan biologi adalah seperti menggunakan cacing gelang dan kulat seperti Coelomomyces.

b. Pendidikan Kesihatan Masyarakat

Pendidikan kesihatan memainkan peranan yang penting dalam pengawalan penyakit Demam Denggi oleh kerana ia berkaitan rapat dengan kehidupan domestik manusia. Pendidikan ini meliputi mengenai penyakit Demam Denggi dan komplikasinya, cara-cara jangkitan dan pengawalan tempat pembiakan nyamuk. Pendidikan kesihatan harus dimulakan daripada peringkat sekolah dan menengah supaya kanak-kanak mendapat pendidikan tentang tabiat kesihatan umum yang boleh membawa kepada kesedaran bagi pencegahan tempat pembiakan nyamuk dan seterusnya mengurangkan masalah Demam Denggi. Pendidikan orang dewasa boleh dilakukan melalui ceramah, pameran, risalah dan juga perbincangan melalui radio, televisyen dan suratkhabar

c. Penggunaan vaksin

Sehingga kehari ini masih tiada lagi vaksin yang benar-benar berkesan dihasilkan untuk membunuh virus Denggi. Walau bagaimanapun penyelidikan terhadap vaksin-vaksin ini masih dijalankan di Thailand dan di Amerika Syarikat untuk memastikan ia
benar-benar berkesan dan tidak merbahaya kepada manusia.

d. undang-undang

Di Malaysia Akta Pemusnah Serangga Pembawa Penyakit telah disahkan pada tahun 1975. Akta ini memberi kuasa kepada Pegawai Kesihatan dan Inspektor Kesihatan untuk memasuki rumah dan memeriksa rumah tersebut sama ada terdapat pembiakan nyamuk atau tidak. Jika terdapat pembiakan nyamuk ditemui, amaran dan arahan akan diberikan kepada pemilik atau penghuni rumah untuk memusnahkan tempat pembiakan tersebut. DENDA akan dikenakan jika arahan ini  tidak dipatuhi. Pemeriksaan rumah kemudian diulangi setelah tempoh masa tertentu dan sekiranya arahan tidak dipatuhi, pemilik atau penghuni boleh didenda atau diperintahkan hadir di mahkamah. Denda maksimum pada kali pertama adalahRM100. Jika mahkamah mendapati pemilik atau penghuni bersalah pada kali pertama,denda maksimum RM1000 atau penjara maksimum 3 bulan atau kedua-duanya sekali. Pada kesalahan kedua, denda maksimum sebanyak RM 2000 atau hukum penjara maksimum 1 tahun ataukedua-duanya sekali.

Friday, February 4, 2011

Familial hypercholesterolaemia (FH)


Schoolgirl dropped dead on sports field after GP missed vital signs of heart condition 


 An 11-year-old schoolgirl who told friends 'Oh God I feel like I'm going to die, I love you all' before she collapsed and died, was suffering from a treatable hereditary disease.Rianna Wingett was suffering from hypercholesterolaemia (FH) - where the body cannot filter out the bad cholesterol causing arteries to narrow.

This brought on a fatal heart attack after she ran two laps of her school's sports field in Hornchurch, Essex.Her mother Amanda was diagnosed with the same cholesterol condition when she was 18-years-old but didn't realise it was hereditary.

Mrs Wingett said: 'I know it's sometimes hard to know your family history but I urge anyone to suspects they have FH to go and get tested.'And any parent with FH must get their children tested as soon as possible.'

The condition is caused by a genetic defect and means the body cannot remove LDL cholesterol leaving suffers susceptible to heart attacks and heart disease due to narrowed arteries.Symptoms of the condition can included fatty skin deposits on the elbows, knees, buttocks, tendons and around the cornea of the eye, and chest pains.
A post mortem examination revealed Rianna had extremely high cholesterol levels of 20 - 30mmol (millimoles per litre) - at 7.5mmol doctors normally put patients on medication because they are deemed to be at high risk of heart attacks.Her arteries had been so badly clogged they were just the size of a pinhole and her heart was struggling to pump blood around her body.

Her mother added she did not realise her daughter, a keen horse rider, had the deadly condition because she was so fit and healthy.

Dr Jonathan Morell, a GP from the Heart UK charity, said: 'It's important not to blame the CP. Ninety-nine percent of doctors wouldn't have picked up on the signs, but that's what we are trying to address.Almost one in 500 people are thought to suffer from the condition and 70 per cent no not have any symptoms. Those with FH can be successfully treated with medication.

Read more:
Familial hypercholesterolaemia (FH)

Inherited risk

Some families have a much stronger inherited risk of developing cardiovascular disease.
This may be because of problems with their heart rhythms, heart muscle function or risk
factors for cardiovascular disease (things that increase your chance of getting heart disease,such as high blood cholesterol). There is treatment for nearly all of these problems.
If you or a family member are diagnosed with cardiovascular disease (such as having had
a heart attack or stroke) before the age of 60, it is very important that you ask your doctor
to measure your risk factors. The rest of your family (especially your brothers, sisters and
children) also need to have their risk factors measured.This information sheet describes one special case of inherited risk inherited high blood cholesterol, called familial hypercholesterolaemia (FH).

What is FH?

FH is one of the most common, potentially fatal inherited conditions. FH is when your body
does not remove enough cholesterol from your blood. This causes high blood cholesterol
levels and early heart disease in some families. About one in every 500 Australians is
affected. The good news is that FH can be successfully treated.

Why do people get FH?

A pair of genes controls the removal of cholesterol from your blood. If one of these genes
is faulty, then the removal process only works half as well. This means that your blood
cholesterol rises to about twice its usual level, even if you follow a healthy balanced diet low in saturated fat and lead a healthy lifestyle. There is approximately a 50% chance that the faulty gene will be passed on to the children of people who have FH.

How do I know if I have FH?

Most people with FH don t know that they have it, because they don t feel any symptoms.
If you think that you may have or be at risk of FH, talk to your doctor. Your doctor can do tests to find out if you have FH. People who have FH have higher blood cholesterol levels from birth and can be diagnosed at any age. With an approximately 50% chance that FH will be passed from parent to child it is important that you are aware of your family history of FH and talk to your doctor about whether or not you need to be tested. FH does not depend on your body weight, if you are male or female, or fit or unfit. However,
people with FH will almost always have a high blood cholesterol level. Because there are lots of other things that can cause high blood cholesterol levels, your doctor will also consider other risk factors to find out if you have FH.Another indication that you might have FH is if you have lumps on the tendons on the back of your hands and heels. Sometimes people with FH get lumps of cholesterol in these areas.

What can be done about FH?

Families at high risk of early heart disease may not realise that it could be because they have FH, or that it can be treated. The treatment of FH is aimed at lowering blood cholesterol levels and reducing the risk of cardiovascular disease, such as heart attack and stroke. Treatment can be started after the onset of heart disease, but it is better to find out if you have FH before it causes any damage. The key is to identify families who have FH, and then identify the family members who have inherited FH. It is important for all people who have FH, including children, to follow a healthy lifestyle. This includes eating a healthy balanced diet low in saturated fat, being physically active and avoiding tobacco smoke. Smoking is especially dangerous if you have FH. Adults who have FH will benefit from taking cholesterol-lowering medicine. They also need to see their doctor regularly to check that their heart stays healthy.

Thursday, February 3, 2011

Cares4U Diabetes Center


Treatment service 
( click at picture to see more info of our treatment service)
                                        FIR Sauna

                        Maggot Debridement Theraphy


Surgical Debridement

                                  Ozone Theraphy


Maher Zain Insya'ALLAH Malay Version

Penawar HAti pembawa ketenangan

TekeZot saye!!  Maher zain Boleh Nyanyi and Buat Malay Version.
Semoga dapat lebih melekat di Hati orang Melayu Kite..

Tuesday, February 1, 2011

Tips for Dining Out With Diabetes


Tips to Lower Salt Intake When Dining Out

Eating less salt can substantially reduce the risk of health problems associated with high blood pressure, which is a risk factor for heart disease and stroke -- a cause of death for more than 2 out of every 3 people with diabetes


* Select fresh fruit or vegetables.
* Avoid soups and broths.
* Stay away from bread and rolls with salty, buttery crusts.


* Select fresh fruits and vegetables.
* Avoid pickles, canned or marinated vegetables, cured meats, seasoned croutons, cheeses, salted seeds.
* Order salad dressings on the side and use small amounts of them.

Main courses

* Select plain foods including broiled, grilled, or roasted meat, poultry, fish, or shellfish.
* Select plain vegetables, potatoes, and noodles.
* Ask the server about the low-salt menu choices and ask how the food is prepared.
* Request food to be cooked without salt or monosodium glutamate (MSG).
* Avoid restaurants that do not allow for special food preparation (such as buffet-style restaurants or diners).
* Avoid casseroles, mixed dishes, gravies, and sauces.
* At fast food restaurants, skip the special sauces, condiments, and cheese.
* Avoid salted condiments and garnishes such as olives and pickles.


* Select fresh fruits, ices, sherbet, gelatin, and plain cakes.

Controlling Portion Size at Restaurants

Servings at many restaurants are often big enough to provide lunch for two days. When eating out:

* Ask for half or smaller portions.
* Eyeball your appropriate portion, set the rest aside, and ask for a doggie bag right away.
* If you have dessert, share.

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