Health Information | Health Care

Eat right to maintain healthy bones

2009-05-14T01:16:00.000+08:00

By DR MILTON LUM

KEEPING healthy with a positive lifestyle has a significant impact on health. As bone mass peaks in our 30s, the higher the bone mineral density (BMD) attained at this time, the less likely is the risk of osteoporotic fractures. So we should try to get as high a BMD as we possibly can in the first three decades of our lives.

Many women have no hesitation about taking a healthy diet when pregnant but may not do so after the baby is born. They can do themselves a lot of good if they continue taking a healthy diet, whether pregnant or not.

Lifestyle changes will lower their risk of health problems as they get older. The perimenopause is a good time to pay more attention to health if one has not been doing so.

It is essential to remember that prevention is better than treatment – it is easier to prevent loss of bone density than to restore it once it is lost.

Healthy diet

A balanced diet high in grains, fruits and vegetables, with adequate water, vitamins and minerals but low in fat contributes to good bone health. The intake of sweet and fatty food should be limited. Fat intake should be less than 30% of daily calorie requirement.

Women at the perimenopause and beyond should pay attention to their diet as cardiovascular disease and osteoporosis are affected by diet.

There is a positive relationship between calcium consumption and bone mass at all ages. When calcium intake is consistently high in childhood and adolescence, bone mass achieved in the 30s would be higher. An increased calcium intake enhances the effects of other treatments like vitamin D and hormone therapy.

The recommended daily consumption of elemental calcium varies at different ages. It is important that these levels be achieved so that there is maximum impact on bone health. The recommended intakes are:

* Infant – 300mg in breast-fed and 400mg in bottle-fed

* Children – 500mg (one to three years), 600mg (four to six) and 700mg (seven to 10)

* Adolescents (10 to 18) – 1,000mg

* Adults – 800mg (up to 49) and 1,000mg (above 50)

* Pregnant and during breast- feeding – 1,000mg.

Calcium is found in leafy green vegetables, calcium-rich dairy products, tofu, dhal, mussels, ikan bilis, sardine, baked beans, and calcium-fortified foods and juices. If this is insufficient, calcium supplements (calcium carbonate, citrate, calcium lactate and calcium gluconate) may be used.

Calcium absorption is increased by vitamin D, which can be found with 15 minutes or more of daily exposure to the sun and in fortified foods like milk, tuna and liver or vitamin D supplements. If one does not go outdoors, is immobile or has a deficient diet, a daily intake of 800IU of vitamin D supplement is necessary. This is particularly relevant to women, as a recent study found that 49% of postmenopausal Malaysian women were vitamin D-deficient. An adequate intake of protein and energy is important particularly in children and senior citizens.

Exercise

Physical inactivity is a risk factor for many conditions. Exercise can help one lose weight and protects against cardiovascular disease and prevents osteoporosis as it maximises peak bone mass, decreases age-related bone loss as well as maintains muscle strength and balance.

If one is not used to strenuous activity, it would be prudent to check with the doctor before commencing an exercise programme, especially if one is above 40 years or overweight.

In a good workout, one needs to exercise at the target heart rate for at least 30 minutes three times a week. The doctor will be able to provide advice on the target heart rate, which is dependent on age.

If there is difficulty in fitting exercise into one’s schedule, there are things that can be done to be more active, such as walking (rather than driving) and taking the stairs (instead of the lift).

Excessive dieting and a low body weight (body mass index less than 19kg per sqm) are associated with low bone mass and increased risk of fracture. Weight gain is not due to menopause. As one ages, metabolism slows so that the body takes a longer time to burn up the food taken. This means that taking the same amount of food like what one did when younger would increase the weight.

It would be best not to exceed the weight for one’s height. If one has to lose weight, discuss the matter with the doctor and dietitian. A healthy rate of weight loss is 0.5 to 1kg per week. Do not go on crash diets.

Alcohol exerts a greater impact on women than men as their bodies contain less water to dilute the alcohol and the enzyme that digests alcohol is less in women. Alcohol interferes with calcium absorption and bone growth. A drink or two a day may be all right. Larger amounts have been associated with many health problems.

Preventing falls

It is important to eliminate factors in the environment that can result in falls, thereby reducing the risk of fractures. Various conditions can increase the chances of falling. They include poor eyesight and/or balance, decreased muscle strength, excessive alcohol intake, diseases of the nervous system, muscles and the skeleton, certain medicines like anti-hypertensives, sedatives, and home conditions like slippery floors, steps and poor lighting. In general, falls can be avoided by regular exercise, reducing alcohol intake, avoiding sedatives and correcting eyesight problems.

There is ample evidence that hip protectors reduce the risk of hip fractures due to falls. To avoid falls indoors, keep rooms free of clutter, keep floors smooth but not slippery, install grab bars and use a rubber bath mat in the tub or shower. To avoid falls outdoors, wear rubber-soled shoes, avoid walking on slippery surfaces and use a walker or cane for added stability.

Hormone therapy, bisphosphonates and other medicines have proven effective in the prevention of osteoporosis. A healthy lifestyle and regular clinical examinations are important in maintaining health. Routine examinations can detect problems early and give the patient and doctor an opportunity to discuss ways to avoid problems later in life.

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.

Maternal and neonatal health

2009-04-02T18:36:00.000+08:00

Kasmiah Mustapha

2009/03/30

A child born into poverty is almost 14 times more likely to die in his first month.

The financial crisis has taken its toll on women, with many dying from complications of pregnancy and childbirth.

Women in the world’s poorest countries do not have access to medical attention during pregnancy.

WHILE pregnant women in Malaysia have easy access to medical attention during their pregnancy and childbirth, those in other parts of the world may not be so lucky.

For hundreds of thousands of women living in poverty, pregnancies can result in death.

Some 500,000 women worldwide die from complications of pregnancy and childbirth each year, while it is estimated that 20 million suffer pregnancy-related illness after birth.

Women in the world’s poorest countries are 300 times more likely to succumb to complications in their pregnancies while a child born into poverty is almost 14 times more likely to die in his first month than if he were born in a developed economy.
Malaysian women’s lifetime risk of maternal death is 1 in 560 compared with one in seven in Niger. In the Philippines it’s 1 in 140, 1 in 97 in Indonesia and 1 in 500 in Thailand.

It is expected the financial crisis that has resulted in some 100 million people being back in poverty will further increase the death toll of pregnant women.

More are expected to die this year compared with last year as the economic downturn derails development gains and jeopardises progress on the challenges that remain.

The World Bank and World Health Organisation had warned that between 1.4 and 2.8 million children are expected to die before 2015 if the current economic crisis persists, without efforts to support or strengthen primary healthcare.

According to the United Nations Children Fund (Unicef), this year’s World Health Day themed “Save lives, make hospitals safe in emergencies” underscores the importance of investing in health systems that will be able to serve people despite emergencies and crises brought about by an economic downturn.

This was revealed in Unicef’s State of the World’s Children 2009 report released recently.

Themed “Maternal and Newborn Death”, it highlighted the dismal global progress in meeting the target of the fifth Millennium Development Goal, which called for a 75 per cent reduction in maternal deaths from 1990 to 2005.

Unicef representative to Malaysia and special representative to Brunei Youssouf Oomar said that at least 80 per cent of these deaths are preventable and it is unacceptable that women and infants are denied their rights to life because of poverty.

“The survival of women in childbirth reflects the overall development of a country and whether or not the health services are functioning. It is telling when mothers die during pregnancy and childbirth.

“Behind these deaths is a failure to assure women’s rights, their low status and lack of power, poor access to information and care, restricted mobility, early age of marriage and the low political priority and resources given to their health,” said Youssouf in a statement.

These factors, combined with a lack of access to family planning services, a shortage of trained health workers, weak health systems and HIV infection made young women vulnerable.

In the report, Unicef had recommended essential services be provided through health systems that integrate a continuum of home, community, outreach and facility-based care that would reduce maternal mortality.

As the health and survival of mothers and their newborns are linked, many of the interventions that save the mothers’ lives would also benefit their infants.

Globally, a woman dies from complications of pregnancy and childbirth every minute.

Africa and Asia accounts for 95 per cent of the world’s maternal deaths, with particularly high burdens in sub-Saharan Africa — 50 per cent of the global total — and South Asia (35 per cent).

The State of the World’s Children 2009 focuses on maternal and neonatal health and identifies the interventions and actions that must be scaled up to save lives.

Of global maternal deaths, two-thirds occur in India, Nigeria, Afghanistan, Ethiopia, Bangladesh, Indonesia, Pakistan and Niger.

Most maternal deaths are related to obstetric complications — including post-partum haemorrhage, infections, eclampsia and prolonged or obstructed

labour — and complications of abortion.

Nutritional status of Malaysian children

2009-03-18T02:04:00.000+08:00

NUTRI SCENE
By DR TEE E SIONG

There is a significant prevalence of undernutrition in our children. Conversely, the incidence of overweight is also on the increase.

THE World Health Organisation (WHO) has highlighted that children are a vulnerable group and their nutritional status is a sensitive indicator of community health and nutrition. The WHO has long emphasised the importance of assessing and monitoring the growth status of children. Several monographs on this topic have been published over the years. I have also highlighted the development of a growth reference by WHO for monitoring growth of children and other groups.

The National Plan of Action for Nutrition (NPAN) II of Malaysia has also identified continuous assessment and monitoring of the nutrition situation as one of its strategies. NPAN II is the blueprint of nutrition programmes in the country and this strategy has been recognised as vital to achieving the goal of improving nutritional status of Malaysians.

This strategy has identified the need for a national nutrition survey to be conducted periodically in the country. Furthermore, it has identified growth monitoring of pre-school and school children as essential activities to be carried out.

Let us take a look at the nutritional status of Malaysian children. I will be relying mostly on the report of the National Health and Morbidity Survey (NHMS) III, conducted in 2006.

National health and morbidity surveys

National Health and Morbidity Surveys (NHMS) have been conducted over the past three decades. The first was in 1986, a subsequent one in 1996 and the third was carried out in 2006. These are nationwide surveys of various aspects of health, carried out on representatively sampled subjects from all parts of the country.

These are massive surveys, involving large sample sizes. For example, in the 2006 survey, over 56,000 subjects were interviewed. The efforts of these surveys are indeed commendable as they have made available data that is useful in determining the national health burden. Such data is absolutely essential in health policy and programme planning. Repeated surveys over the years now enable us to understand the trend of various disease prevalences.

The NHMS III report was released in early 2008. The report covers findings from 18 research topics, ranging from general topics such as health expenditure and health utilisation to specific subjects such as sexual behaviour and psychiatric morbidity. I am pleased to note that the authorities have encourage the wide dissemination of the findings of this study.

There were no nutrition status measurements in previous national and health morbidity surveys. Weight and height measurements of subjects were only included in the second NHMS, and only for adults.

In the most recent survey of 2006, weight and height measurements were taken of all subjects. This is certainly a most welcome move as we now have a representatively sampled data of growth status of Malaysians. I have extracted data for children and discuss these in the following sections.

Reporting nutritional status of children

NHMS III included assessment of the nutritional status of children (aged 0 to below 18 years) in a nationally representative sample. A total of 21,249 children were assessed using weight and stature (length or height) measurements.

These weight and height measurements of the subjects were then compared with a set of growth reference prepared by the the United States Centre for Disease Control (CDC). The growth achievements of the subjects were calculated as a number of standard deviations (or z scores) away from the median of the reference. In the next step, the nutritional status of the children were classified according to z scores for weight for age (WAZ), height for age (HAZ) and weight for height (WHZ) as recommended by WHO (1995). These are standardised parameters used by nutritionists to indicate undernutrition or overnutrition in a community.

Undernutrition amongst children

When children are below -2SD of the WAZ, they are considered underweight. These children have lower weight achievement for that particular age. The NHMS III findings showed that the national prevalence of underweight children was 13.2%, the level being higher in boys (14.5%) compared to girls (12.0%). The report also showed that more children in rural areas (16.0%) were underweight compared to those in urban areas (11.4%).

Stunting is another common malnutrition problem and implies long-term undernutrition and poor health. Stunted children are those with HAZ below -2SD. In the NHMS III study, stunting was the most important undernutrition problem encountered. The prevalence of stunting was found in 15.8% of the children, with a slightly higher prevalence among boys (16.6%) than girls (15.0%). The percentage of children who were stunted in the rural areas (19.4%) was clearly higher than children in urban areas (13.6%).

Children with WHZ below -2SD are said to be wasted. This is the third form of undernutrition commonly encountered and suggests recent or continuing current weight loss. The prevalence of wasting was found in 10.4% of the children, with a similar prevalence among boys (10.6%) and girls (10.2%). The prevalence of wasting was slightly higher in urban compared with rural areas at 11.0% and 9.5% respectively.

Overweight is an increasing problem

On the other extreme of the malnutrition scale is overnutrition. Children with WAZ above +2SD were classified as overweight. These children have gained more weight than is appropriate for their age. The NHMS III found that 5.4% of the children were overweight, with a slightly higher prevalence among boys at 6.0% than girls at 4.7%. The proportion of overweight children was higher in urban areas at 6.3% than in rural areas at 4.0%.

Which age groups are most affected?

Let us examine more closely the data and determine which age groups are most affected. For the problem of underweight, the highest prevalence was found amongst those one to three years old (19.8%). The next highest group was found in children four to six years old (16.4%). Infants, on the other hand, had the lowest prevalence (7.1%).

In the case of stunting, the group most affected were those in the 16-18 years group (23.7%). This is followed young children, ie those one to three years (17.2%) and four to six years (16.7%). Again, infants were the least affected (9.0%).

Wasting was found to be most common amongst infants (15.2%) and those in the one to three years old group (15.1%). Children in the 10-13 years group were the least affected (4.5%).

As for the problem of overweight, younger children were again most affected. Findings showed that 6.8% of children in the seven to nine years old group were overweight, followed by 6.4% in the four to six years old group. The children least affected by overweight were those in the one to three years group (3.2%).

It is quite clear that younger children, particularly those in the one to six years old group were the most affected with nutritional problems, both undernutrition and overnutrition. This is not surprising at all as these are the most vulnerable groups where growth and development are rapid.

Are Malaysian children growing right?

The NHMS III findings showed that the great majority (over 80%) of Malaysian children have satisfactory nutritional status. Nonetheless, a significant proportion of the children were found to be undernourished as about 15% of them were found to be underweight, stunted or wasted. Stunting appeared to be the most important undernutrition problem.

These are average figures for the whole country. One can expect significant differences in percentage of undernourished children in different parts of the country. Just as an illustration of this difference according to location, the survey findings clearly showed that the three types of undernutrition reported were more prevalent in rural areas. These findings are as expected as socio-economic conditions of rural groups may be a handicap for optimal growth achievement.

On the other hand, the problem of overweight was of a lower magnitude, as it affected only 5% of the children studied. This is a significant figure and must not be overlooked. Other studies in the country, amongst various age groups in selected parts of the country, have indicated higher prevalences. In the case of overweight, the reverse is true; more urban children are affected, compared to those in rural areas. This finding is in line with the commonly accepted understanding that overweight is very much influenced by the environment. Urban children are generally less physical active and at the same time, have a higher food intake.

It can also be noted that there are gender differences in these parameters of malnutrition. Findings showed that there are more malnourished boys than girls in all the three parameters discussed. While only marginally more boys were wasted, it is clear that more boys were stunted and underweight.

All these findings, including differences in geographical locations, between gender, different socio-economic groups and ethnicity are extremely important and useful in formulating intervention programmes.

I would just like to end by highlighting the reference used for the analysis of the weight and height measurements. As I indicated above, the CDC reference was used as that was perhaps the most comprehensive database available at that time. It would be very useful to reanalyse the available data with the WHO growth reference released in 2008.

NutriScene is a fortnightly column by Dr Tee E Siong, who pens his thoughts as a nutritionist with over 30 years of experience in the research and public health arena. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

Nutrition Month Malaysia 2009 will focus on promoting healthy eating among children. Join in the fun and educational NMM carnival at the Mid Valley Exhibition Centre on April 4 and 5 from 10 am onwards.

Depression is hard on the heart

2009-03-13T19:32:00.000+08:00

WASHINGTON: Severe depression may silently break a seemingly healthy woman's heart. Doctors have long known that depression is common after a heart attack or stroke, and worsens those people's outcomes.

Monday, Columbia University researchers reported new evidence that depression can lead to heart disease in the first place.

The scientists tracked 63,000 women from the long-running Nurses' Health Study between 1992 and 2004.

None had signs of heart disease when the study began, but nearly 8 percent had evidence of serious depression.

The depressed women were more than twice as likely to experience sudden cardiac death - death typically caused by an irregular heartbeat, concluded the 12-year study, published Monday in the Journal of the American College of Cardiology.

They also had a smaller increased risk of death from other forms of heart disease. The big surprise: Sudden cardiac death seemed more closely linked with antidepressant use than with the depression symptoms the women reported.

That might simply mean that women who used antidepressants were, appropriately, the most seriously depressed, cautioned lead researcher Dr. William Whang.

But he said the finding merited more research.

Studies of the newer antidepressants most often used today so far haven't signaled a risk of irregular heartbeat, and some even have suggested protection, noted Dr. Redford Williams of Duke University, a specialist in how psychosocial factors affect health.

The drug question aside, Williams said the work adds to growing evidence that depression is an independent risk factor for heart disease - on top of the classic risks of high blood pressure, diabetes, high cholesterol and smoking.

The predominantly white Nurses' Health Study may underestimate it, Williams said.

"If anything, the impact in African-American women is probably greater," he said, adding that it's time for the next step: A study testing whether properly treating depression lowers the risk.

Why might depression have that effect?

The study found that the more severe the women's reported depression symptoms, the more likely she was to have traditional heart risk factors.

Also, stresses like depression have been linked to such physical effects as a higher resting heart rate.

Perhaps a more straightforward reason: Depression can make people do a worse job taking care of themselves. Indeed, the American Heart Association last year recommended that everyone who already has heart disease be regularly screened for depression - because depressed patients may skip their medications, sit indoors instead of exercising, and eat particularly poorly.

Check your eyes for glaucoma

2009-03-09T07:36:00.000+08:00

2009/03/08

If you are 40 years and above, go check your eyes for glaucoma as the effects of the disease, which can even be eventual blindness, can be kept at bay with early treatment, reports ANNIE FREEDA CRUEZ.

SOME 78,000 Malaysians have gone blind due to various diseases with 1.8 per cent of them due to glaucoma.

Many are not even aware they have an eye problem until their vision is extensively compromised, said Malaysians Medical Association Opthalmological Society chairman Professor Dr Che Muhaya Mohamed.

"Why wait till you lose your vision? Go for regular eye checks as early detection can prevent blindness," she said in conjunction with World Glaucoma Day.

Glaucoma is a group of eye diseases that cause progressive damage of the optic nerve at the point where it leaves the eye to carry visual information to the brain.
If left untreated, most types of glaucoma (without warning or obvious symptoms to the patient) progress towards gradually worsening visual damage and may lead to blindness.

Visual damage is mostly irreversible, and this has led to glaucoma being described as the "silent blinding disease" or the "sneak thief of sight".

Glaucoma is the second most common cause of blindness worldwide. It is estimated that 4.5 million persons globally are blind due to glaucoma and that this number will rise to 11.2 million by 2020.

The most common form of glaucoma, primary open-angle glaucoma, develops gradually, giving no warning signs.

Glaucoma is not just one disease, but a group of them.

The common feature of these diseases is damage to the optic nerve, usually accompanied by an abnormally high pressure inside your eyeball.

The optic nerve is a bundle of more than a million nerve fibres at the back of your eye.

It's like an electric cable made up of thousands of individual wires carrying the images from the retina to your brain.

Blind spots develop in your visual field when the optic nerve deteriorates, usually starting with your peripheral (side) vision.

If left untreated, glaucoma may lead to blindness in both eyes.

"If detected and treated early, glaucoma need not cause even moderate vision loss," said Dr Che Muhaya.

With technological advancements, glaucoma can now be easily diagnosed and treated.

It was once believed that the cause of most or all glaucoma was high pressure within the eye, known as intraocular pressure (IOP).

It has now been now established that even people without an abnormally high IOP may suffer from glaucoma.

IOP is considered today as a "risk factor" for glaucoma, together with other factors such as racial ancestry, family history, high myopia and age.

Dr Che Muhaya said since glaucoma may not have any early symptoms, the first step in preventing it is to know the primary risk factors, which include increasing age, high eye pressure, family history of glaucoma, African and Chinese ancestry, near-sightedness and high blood pressure.

"The consequences of vision loss due to irreversible optic nerve damage can affect a person's ability to drive and perform daily activities due to sensitivity to light."

There is no cure for glaucoma as yet, and vision loss is irreversible.

However, Dr Che Muhaya said, medication or surgery can halt or slow down any further vision loss.

"Therefore, early detection is essential to limiting visual impairment and preventing the progression towards severe visual handicap or blindness."

Omega 3 rangsang perkembangan minda bayi

2009-03-03T08:36:00.000+08:00

Kasih sayang, pemakanan berkhasiat dan genetik juga faktor penting melahirkan anak pintar

KEPINTARAN dan perkembangan minda bayi boleh dirangsang sejak dalam kandungan. Stimulasi terhadap bayi termasuk membacakannya buku boleh dilakukan apabila kandungan memasuki usia empat bulan.

Rangsangan berterusan, kasih sayang, pemakanan berkhasiat dan genetik adakan faktor gabungan bagi melahirkan anak pintar.

Perunding Pediatrik, Pusat Perubatan Kampung Baru, Dr Khairul Azman Mohd Khalid, berkata menerusi teknik imbasan otak terkini, dakwaan penyelidik sejak 20 tahun lalu iaitu persekitaran bayi memberi kesan dramatik kepada perkembangan otaknya sudah terbukti.

Selama berdekad-dekad saintis dan penyelidik seluruh dunia cuba memahami perkembangan janin dalam rahim. Sekitar 1970an, saintis begitu teruja apabila mendapati janin di dalam rahim peka terhadap persekitarannya.

Sekitar 1980 pula, saintis mula menemui bukti janin boleh mendengar, merasa, melihat dan menikmati pengalaman baru pada penghujung usia kehamilan.

Semua penemuan itu disahkan beberapa penyelidik terkemuka seperti Dr Glenn Doman dan Dr M Shichida. Penyelidikan lima dekad oleh Shichida pula mendapati ketika janin membesar di dalam rahim, dia menerima rangsangan daripada persekitaran di luar rahim menerusi ibunya.

Semua rangsangan ini membentuk pengalaman baru kepada janin yang membantu pertumbuhan otak.

Bagaimanapun kata Dr Khairul Azman, melahirkan anak pintar tidak cukup sekadar mempertaruhkan faktor genetik dan kekerapan rangsangan pada janin tetapi juga banyak faktor lain perlu digabungkan.

“Melahirkan anak pintar bermula pada peringkat pemilihan jodoh. Kepintaran anak diwarisi menerusi genetik. Ibu yang pintar tetapi ayah kurang pintar memberi peluang anak mewarisi 50 peratus kepintaran. Tetapi kalau kedua-duanya bijak, peluang mendapat anak bijak lebih besar,” katanya.

Kecerdikan ibu bapa tidak semestinya bergantung kepada segulung ijazah walaupun pada umumnya semua lepasan universiti itu bijak pandai belaka. Kecerdikan mungkin boleh diukur pada bakat dan kemahirannya dalam bidang seni, pertukangan atau kejuruteraan.

Faktor genetik itu pula perlu digabungkan dengan kesihatan ibu yang baik. Justeru pemilihan makanan berkhasiat, pengambilan vitamin dan zat galian yang betul dan mencukupi sepanjang tempoh kehamilan juga penting.

Pemakanan untuk anak yang bijak dan sihat

“Jangan ambil ubat-ubatan herba atau apa saja ubat yang kononnya memudahkan bersalin dan mengurangkan kesakitan bersalin. Ia sebenarnya tidak banyak membantu,” katanya.

Pengambilan minyak ikan Omega 3. Ia adalah makanan terbaik untuk perkembangan otak bayi. Kandungan EPA dan DHA yang boleh ditemui dalam minyak ikan diperlukan untuk perkembangan yang sihat.

“Minyak ini juga komponen terpenting dalam pembentukan sistem saraf dan retina. Kekurangan satu atau kedua-duanya dikaitkan dengan kelahiran bayi pra matang atau bayi lahir dengan berat badan bawah paras normal,” katanya.

Minyak ikan juga penting untuk ibu. Pada peringkat ketiga kehamilan, ibu akan memindahkan kebanyakan simpanan DHA kepada janin, yang diperlukan untuk pembentukan sistem saraf dan otak bayi. Justeru keperluan kepada Omega 3 sangat penting kerana bayi hanya boleh mendapatkan khasiat ini melalui ibu. Kesihatan ibu boleh terancam jika tidak mendapatkan bekalan secukupnya.

Kekurangan EPA dan DHA boleh menyebabkan ibu hamil mengalami masalah tekanan darah tinggi (yang akan dihadapi pada waktu kehamilan saja). Ketika hamil juga ibu akan kehilangan tiga peratus jisim otaknya disebabkan kekurangan EPA dan DHA. Sesetengah saintis percaya keadaan ini membawa kepada masalah tekanan perasaan selepas bersalin seperti gila meroyan.

Satu lagi pemakanan terbaik untuk bayi adalah susu ibu. Sebaik-baiknya berikan anak anda susu badan sehingga dia berusia dua tahun atau sehingga dia berusia enam bulan. Bayi yang menyusu badan dikatakan lebih cerdik berbanding bayi tidak menyusu badan.

Ketika bayi mencecah usia enam bulan, perkenalkan makanan tambahan seperti bubur nasi. Bagaimanapun ini tidak bermaksud ibu boleh menghentikan pemberian susu badan.

“Ibu tidak bekerjaya berpotensi tinggi mendapatkan anak bijak menerusi sentuhan dan belaian berterusan berbanding anak yang diletakkan di pusat jagaan atau ditinggalkan dengan pembantu rumah,” katanya.

Sepanjang kehamilan juga kata Dr Khairul Azman, penting bagi orang Islam berdoa untuk memastikan keselamatan dan kepintaran anak yang bakal dilahirkan.

Pembinaan kepintaran bayi selepas dilahirkan

Tiga tahun pertama adalah tahap usia anak paling penting. Ketika ini otaknya sibuk membina sistem jaringan. Aktiviti otak menghasilkan rangkaian elektrikal kecil dikenali sebagai ‘synapses’ (sinaps - pertemuan neuron dengan organ efektor).

Jumlah rangsangan yang diterima bayi memiliki kesan langsung pada jumlah sinaps yang terbentuk. Rangsangan berterusan akan memperkemaskan hubungan itu dan menjadikannya kekal.

Perkembangan otak pada ketika ini berlaku sekali saja seumur hidup dan ibu bapa berpeluang membantu anak merangsang pembentukan litar otaknya.

Bagaimana merangsang bayi

1. Kasih sayang - Anak yang diletakkan di pusat jagaan punya banyak rangsangan tetapi kurang kasih sayang! Anak tidak pernah cuba untuk memanipulasikan ibu bapanya jauh sekali mengawal anda. Kasih sayang adalah keperluan biologi anak. Kasih sayang menghasilkan kekuatan dalaman padanya dan meningkatkan pembangunan otak.

2. Bercakaplah dengan bayi anda - Bercakap dengan pelbagai nada, pelbagai bahasa, tatabahasa dan hasilkan banyak mimik muka. Suara anda adalah irama paling merdu dan menjadi pujaannya (kerana dia sudah mendengar suara itu sejak dalam rahim).

3. Bertindak balas - Jangan mengelak dengan sebarang permintaannya. Ini bagi memberitahu dia boleh berkomunikasi dengan orang lain dan memberikan kekuatan rasa percaya dan emosi yang stabil. Jangan biarkan dia menangis terlalu lama. Bertindak balas apabila dia menangis kerana menerusi tangisan anda berupaya menterjemahkan permintaannya.

4. Sentuh bayi anda - Penyelidik mendapati bayi yang lahir kurang matang tetapi diurut akan membesar dengan cepat, kurang menangis dan akan dikeluarkan dari hospital lebih awal.

5. Berikan pengalaman baru - Bawa dia bersiar-siar, membeli belah dan beri dia nikmati pengalaman baru.

6. Bacakan buku - Walaupun bayi tidak akan mengikuti cerita yang anda bacakan, dia akan tertarik dengan gambar ditunjukkan dan suara anda yang pelbagai nada ketika bercerita.

7. Biarkan dia menjelajah suhu berlainan dan tekstur berbeza. Berikan dia ruang untuk meneroka secara sendirian.

8. Mainkan muzik - Muzik Mozart didapati boleh merangsang sesetengah nueron dalam otak yang kemudiannya digunakan untuk matematik.

9. Apabila anda rasa marah atau geram kerana bayi anda kerap menjatuhkan barang perhiasan atau buku atau menumpahkan makanan ke lantai, sebenarnya dia cuba mengetahui bagaimana dunia ini berfungsi.

Fakta

Tumbesaran

* Bayi punya keperluan biologi dan keinginan untuk belajar.

* Asas jaringan sinaps otak hampir sempurna selepas pembentukan otak secara berterusan.

* Lagi banyak rangsangan pengalaman diberikan, lagi banyak jaringan dibina untuk keperluan pembelajaran pada masa hadapan.

* Bayi suka pada imej kontras. Bayi yang berusia 0-setahun sukakan warna merah, hitam dan putih.

* Rangsangan visual boleh menghasilkan lebih peluang untuk dia belajar menerusi kepekaan, penumpuan dan kecurigaannya.

* Tidak perlu membeli banyak permainan jika tidak digunakan kerana ‘toy’ bayi yang terbaik adalah anda selaku ibu bapanya. Justeru manafaatkan setiap saat untuk berinteraksi dengannya.

Pemakanan

a) Peringkat tiga bulan pertama kandungan - keutamaan hanya pada pengambilan asid folik sama ada menerusi sayur-sayuran atau dalam bentuk tablet. Pemakanan ibu pada peringkat ini untuk memastikan perkembangan organ janin yang sempurna. Pada peringkat ini pemakanan tambahan yang lain belum diperlukan.

b) Peringkat kedua dan ketiga kehamilan - pengambilan asid folik ditambah dengan pengambilan zat besi, B kompleks, dan omega 3.

Kepentingan Asid Lemak Omega 3 Dalam Pengambilan Makanan Seharian

2009-03-03T07:54:00.000+08:00

1)   Apa itu lemak?

Lemak merupakan salah satu zat makanan yang diperlukan oleh tubuh kita. Dalam sehari, kita disarankan mengambil 20 hingga 30% lemak daripada jumlah keseluruhan makanan.

Sehingga kini, ramai yang beranggapan lemak adalah bahan yang memburukkan kesihatan. Hakikatnya, ia adalah bahan penting yang membolehkan kita hidup sejahtera kerana sumber tersebut penting utk memberi tenaga, melembapkan kulit, membolehkan organ dalam badan berfungi dengan baik, memberi kesedapan kepada makanan dan juga memberikan tekstur yang menarik kepada makanan.

Namun, jangan sampai keterlaluan kita mengambil lemak, kerana makanan yang mengandungi jenis lemak yang tidak baik akan membunuh kita secara perlahan-lahan iaitu dengan mendapat penyakit jantung dan sebagainya.

Adalah amat penting, kita mengetahui lemak yang baik dan lemak yang tidak baik. Lemak makanan terdiri dari 2 jenis asid lemak iaitu asid lemak tepu dan asid lemak tak tepu. Asid lemak tepu adalah kurang baik kepada kesihatan iaitu dapat meningkatkan aras kolesterol dalam darah (merangsang pengahsilan kolesterol daripada hati). Contoh asid lemak tepu ialah santan kelapa, ia merupakan penyumbang utama lemak tepu dalam diet harian kita. Oleh itu, perlu dihadkan pengambilan santan kepada 2 sudu besar untuk 3 kali seminggu sahaja. Contoh asid lemak tepu yang lain ialah kaki ayam, lembu, kambing dll. Krimer, susu krimer manis, minyak sapi, sosej, burger, kulit ayam, lemak daging, marjerin & mentega.

Oleh itu, asid lemak jenis kedua yang lebih baik adalah jenis asid lemak tidak tepu. Di dalam asid lemak tak tepu terdapat 2 jenis iaitu asid lemak mono tak tepu dan asid lemak poli tak tepu. Asid lemak yang akan kita bincangkan pada hari ini ialah asid lemak poli tak tepu iaitu Omega 3 dan Omega 6. kedua-dua w3 dan w6 ini adalah asid lemak yang diperlukan oleh badan kita kerana , asid lemak ini tidak boleh dibentuk oleh badan, perlu diambil dari makanan. Namun demikian, asid lemak w6 senang diperolehi dalam makanan dan tidak kritikal untuk badan. Jika kita mengamalkan pemakanan yang seimbang, keperluan w6 sudah mencukupi.
Oleh itu, hanya asid lemak w3 sahaja yang akan dikongsi bersama dengan pendengar sekelian.

2) Apakah asid lemak Omega 3?

Asid lemak yang baik untuk badan kita.
Omega 3 dikenali sebagai asid lemak perlu (EFA) kerana asid lemak ini adalah kritikal untuk kesihatan yang baik. Oleh kerana badan kita tidak boleh membuat omega 3 nya sendiri, maka omega 3 mestilah diperolehi daripada makanan.

Struktur kimia Omega 3 = terdapat ikatan berganda pada karbon yang ke 3
(sebab itulah asid lemak ini dikenali sebagai omega 3)

Manakala dalam Omega 3 ini pula terdapat 3 komponen asid lemak yang utama yang dikenali sebagai
i) ALA (Alpha linolenic acid)
ii) EPA (Eicosapentanoik acid) dan
iii) DHA (Docosahexanoic acid)

untuk senang diingat sebut ALA , EPA dan DHA

Apabila seseorang makan makanan yang mengandungi w3 ini, ALA iaitu alpha linolenic acid akan dimetabolisme kepada rantai panjang EPA dan DHA. Jadi hasil akhir ini barulah boleh digunakan oleh badan kita. Kebanyakan w3 ini adalah tinggi kandungannya di dalam otak, dan penting untuk fungsi mata (retina) dan kognitif otak, (otak kanan, beri idea, manakala otak kiri, membuat penilaian).

3) Kenapa asid lemak Omega 3 ini penting kepada kehidupan seharian?

Kajian klinikal telah membuktikan bahawa w3 boleh menurunkan risiko penyakit berikut:

1.   penyakit jantung/ kardiovaskular (EPA)
merendahkan tahap kolesterol dan menstabilkan degupan jantung yang tidak tetap
(aritmia)
2.   serangan jantung/ kematian mengejut akibat penyakit jantung (sudden cardiac death)/ strok
3.   hipertriglyceridaemia (kandungan trigliserida yang tinggi dlm darah)
4.   hipertensi / penyakit darah tinggi (EPA)
5.   artritis reumatoid
Mencegah radang sendi/ mengurangkan aktiviti keradangan dalam rheumatoid
arthritis (sakit sendi) – sendi berasa sakit, kejang dan bengkak
adalah penyakit sistem imun yang menyakitkan, menyebabkan ketidakselesaan
dan bengkak pada sendi, saraf, otot, pembuluh darah dan tisu perantara dalam
badan.
6.   osteoatrhritis
penyakit sendi degeneratif yang terhasil daripada proses haus dan lusuh sendi
7.   dementia / nyanyuk atau penyakit Alzheimer
mengurangkan risiko dalam kalangan warga emas
8.   kanser kolon/ usus/ payu dara
boleh mengurangkan risiko penyakit
9.   pertumbuhan awal kanak-kanak
EPA dan DHA juga amat penting dalam dan merupakan komponen penting untuk
penglihatan (mata) dan fungsi kognitif otak.
Bahan ini diletakkan dalam susu kanak-kanak, diperkayakan dengan EPA & DHA

4) Berapakah saranan asid lemak Omega 3 yang diperlukan oleh rakyat Malaysia?

Mengikut Jawatankuasa Pemakanan, KKM dalam Panduan Saranan Pengambilan Makanan Malaysia pada tahun 2005, telah menyarankan dalam diet seharian kita perlulah mengandungi 0.3% hingga 1.2% asid lemak w3.
Minimum perlu diambil dalam makanan – 0.3%, maksimum 1.2%.
Ini bermakna, sekiranya dalam sehari, orang dewasa yang memerlukan 2000 kcal tenaga, maka, 2000 kcal x 0.3% bahagi dengan 9gm lemak, anda perlu minimum sebanyak 670 mg w3 dalam sehari. Untuk kuantiti maksimum, 2000 kcal x 1.2% , nilai sebanyak 2220 mg w3 dalam sehari.

Oleh itu, julat saranan untuk 2000 kcal/hari adalah 670 mg hingga 2220 mg w3 dalam sehari perlu diambil dari makanan.

5) Apakah contoh makanan di Malaysia yang mengandungi asid lemak Omega 3?

Makan ikan adalah salah satu amalan pemakanan yang baik untuk kesihatan. Bagaimanapun, tidak semua ikan memiliki manfaat yang sama. Di luar negara, memang diketahui ikan kod, salmon, mackerel, tuna mempunyai kandungan omega 3 yang tinggi. Tetapi ikan tersebut tidak dijual atau mahal untuk dibeli di Malaysia. Kajian oleh Dr. Ng dari Institut Penyelidikan Perubatan (IMR) di KL telah mennganalisis kandungan w3 dalam sesetengah makanan di Malaysia. Makanan yang dianalisis termasuk ikan, minyak, sayur-sayuran dan produk tenusu.

Perbandingan, saya berikan nilai w3 dalam contoh makanan:

Perbandingan, saya berikan nilai w3 dalam contoh makanan:

Minyak (6 gm/1 tsp)

Ikan (55 gm)

Sayur-sayuran

Produk tenusu (55gm) / 250ml – 1C

Minyak kacang soya

(400 mg w3 – 1 tsp)

Minyak sawit

(30 mg w3 – 1 tsp)

Ikan Mackerel (1450)

Ikan salmon (930)

Ikan jelawat (350)

Ketam (175)

Tuna/tongkol (170)

Sardin (165)

Siakap (130)

Belut (95)

Tilapia (20)

Haruan/Keli (20)

Tau-hoo (276) –

1 kpg

Fucok (126) – 1 kpg

Taugeh (77) – ½ C

Kekacang (75) –

½ C

- dal, hijau, merah

Sayur hijau (50)

- ½ C

Susu kcg soya (400)

Susu (omega3) (90)

Susu FCM (40)

Telur (omega3) (350)

Telur (60)

Ayam (50)

Daging (60)

Nama Saintifik : Euthynnus affinis
Nama umum : Mackerel, bonito, tuna, kawakawa
Nama tempatan : Tongkol, aya kurik

6) Apakah saranan / pilihan yang baik untuk mencapai asid lemak Omega3 yang
mencukupi dalam diet seharian?

Kesimpulannya, anda perlu mengambil sekurang-kurangnya:

a)   1 hidangan ikan (tongkol/sardin/ketam/jelawat)
b)   3 – 5 hidangan sayur-sayuran (sayur tauhoo/fucuk/taugeh/kekacang/sayur hijau)
Sarapan pagi – sayur (1/2 C)
Tengahari – ½ C
Malam – ½ C
c)   2 gelas susu sehari (susu kcg soya/ susu biasa)
d)   Kalau mempunyai wang lebih, boleh menggunakan :
Minyak sawit – menggoreng ikan, ayam dsbnya
Minyak kacang soya – menggoreng sedikit – tumis sayur

7) Bolehkah saya mengambil kapsul minyak ikan?

1 biji kapsul minyak ikan mengandungi 300mg w3/ 1gm kapsul.

Cuma perlu diambil oleh warga emas atau pesakit yang diketahui mengalami kekurangan dalam pengambilan omega3 seharian.
Biasanya, bila diambil minyak ikan ni, kita rasa kurang selesa kerana bau dan rasanya agak hanyir dan menjadikan perut rasa kurang enak. Kapsul tidak ada kesan sampingan.

Pengambilan makanan tambahan yang berlebihan pada individu yang sihat adalah membazir dan tidak membawa sebarang keuntungan/ kebaikan.

8) Kesimpulan

a)   Perlu mengetahui lemak yang baik dan kurang baik supaya kita pandai memilih makanan yang baik dan memberikan kesihatan yang sempurna.
b)   Seseorang itu akan sihat dan bertenaga bila mengamalkan diet yang seimbang. Diet seimbang perlulah mengandungi karbohidrat, lemak, protein, vitamin, zat-zat galian, serat dan air dalam kuantiti tertentu yang diperlukan oleh tubuh kita.

-   Nikmati pelbagai jenis makanan
-   Imbangkan pengambilan makanan yang dimakan dengan akitviti fizikal
-   Kurangkan pengambilan lemak tepu berbanding lemak tak tepu
-   Ambil makanan tinggi serat seperti sayur, buah & kekacang

Soalan tambahan

Perbezaan minyak sawit dan minyak isirung sawit

Minyak olein sawit	Minyak isirung sawit	Minyak PUFA lain - soya - jagung
SFA - 51%	86%	22%
MUFA - 40%	12%	22%
PUFA - 9%	2%	56%
- selamat digunakan menggoreng minyak banyak - menolak proses oksidasi semasa menggoreng - stabil semasa menggoreng - sifat separa pejal - boleh digunakan dalam pelbagai aplikasi makanan - SFA utama iaitu asid palmitik, cenderung menjadi neutral apabila pengambilan kolesterol adalah rendah	- tidak sesuai utk menggoreng kerana mempunyai rantaian asid lemak tepu yang pendek dan pengaruhnya ke atas makanan.	- sifat terlalu cair - perlu dihidrogen supaya menjadi separa pejal - mengandungi TFA ( 1 – 46% TFA) apabila dibuat marjerin - ikatan berganda dalam molekul asid lemak adalah lebih senang teroksida, dan pada suhu yang tinggi (180 -190 darjah celcius), kadar reaksi kimia akan menjadi lebih tinggi. - Tidak boleh digunakan utk menggoreng pada suhu yang tinggi - Cepat teroksida

Keeping healthy

2009-03-03T02:27:00.000+08:00

2009/02/09

Consuming foods rich in astaxanthin, besides exercise and a balanced diet, will increase your stress resistance and balance your mind, body and soul. YAM CHER SENG writes.

KEEPING healthy is an excellent resolution to fire up the year. Start by resolving to eat healthily and exercise. Make a commitment to shed those extra kilos and flatten that bulge.

Maintaining a healthy weight and regular exercise have been associated with more health benefits than anything else known to man. This combo can help you manage your current health condition such as obesity, and your cholesterol, blood sugar and blood pressure levels.

Given the hectic and stressful lifestyles nowadays, we need to invest in things or activities that are designed to bring balance to our body, mind and soul. Daily exercise allows one’s tension to dissipate.

Ensure each session lasts at least 40 minutes and maintain it thrice-weekly. Brisk walking is a good way to begin. Take the stairs instead of the elevator or escalator. Park your vehicle further away and walk the distance to your office. Alternatively, you can choose to hit the gym before or after work. Any form of exercise that gets you moving is a good start.
Consumption of astaxanthin has demonstrated marked improvement in the body’s capacity for physical activity. This is especially beneficial for those who seek more energy to exercise, particularly in strenuous sports.

Muscle endurance is greatly improved and recovery time shortened. Lactic acid build-up and oxidation are also reduced, resulting in less aches and pains normally associated with exercise.

Astaxanthin, a powerful natural antioxidant, also helps to accelerate body fat reduction when combined with exercise. It increases the uptake of fatty acids as an energy source during exercise.

Astaxanthin protects a lipid transport enzyme (CPT 1) that supplies lipids to the mitochondria for energy production against reactive oxygen species during intense physical activity.

Thus astaxanthin allows the continual transport of fats into the mitochondria for energy production.

Astaxanthin, a carotenoid pigment, can be found mainly in microalgae (Haematococcus pluvialis), yeast, salmon, shrimps, lobster, crabs and trout. A daily dose of 4mg to 12mg of astaxanthin is required, and supplementation is necessary as diet alone will not suffice.

When the going gets tough, we often neglect to do the obvious thing: eat a balanced diet.

Keeping the pantry and freezer stocked with healthy choices such as fruits, vegetables or wholegrain crackers will stop you from reaching for unhealthy snacks that are rich in refined carbohydrates such as chocolates and fat-laden fast food.

* GET a copy of Antioxidants to Your Rescue — The Facts & Benefits for Your Health. Email your name, new I/C number, address and contact number to csyam@streamyx.com. You can also participate in an online survey.

** The writer is a pharmacist who is actively involved in the dissemination of information on natural healthcare and holistic therapies. For more information, she can be contacted at csyam@streamyx.com

Local health portal: cekodok.com

2009-03-03T01:55:00.000+08:00

By : MEENA SREENIVASAN

2009/02/02

Kevin shows off his free health portal.

Health portal cekodok.com makes counting calories easy, writes MEENA SREENIVASAN.

YOU are on a strict diet but you cheated last night, polishing off a plate of nasi lemak followed by a glass of teh tarik for supper.

How do you know how many calories you have consumed so you can burn them off at the gym today? Easy. Just log on to cekodok.com.

Launched in November, cekodok.com is a free Malaysian food calorie database.

Not just a comprehensive calorie-counting tool for local food, the portal also gives information on calories for food eaten elsewhere in the world.
According to its founder, fitness and nutrition consultant Kevin Zahri: “We have developed a comprehensive calorie guide based on local foods. Future plans include more diet tools which are free, such as an interactive meal planner, fitness regimes, video guides and an e-Book, this month.

“Our objective is simple. We wish to provide people worldwide with free tools and information to improve their general health and well-being,” said Kevin, a Malaysian fitness celebrity.

He added that the portal aims to be a fun site.

With the help of sponsors, Kevin aims to organise free monthly public health and fitness awareness seminars.

Why the domain name cekodok.com for a health website?

“It’s short and catchy. I didn’t want something too generic. After all, the website is not about perfection, but more about balance in life.

“It’s okay to eat cekodok (fried banana balls), which is sweet and oily, as long as it’s in moderation. The cool thing about the website is that you are able to share the platform established in Malaysia with the rest of the world.”

How does it work?

cekodok.com categorises food based on description and calculates their calorific value.

“For example, there are different categories of food such as mamak food, rice or pasta, and the website lists the fat, carbohydrate and protein content.

“For example, when you eat a roti canai, you consume about 300 calories, but then again, it depends on how it’s prepared and cooked.”

Kevin said his interactive meal planner enables him to share it with others, who, in turn, will be able to share their secrets and tools with him.

Another useful instrument at cekodok.com is the Fitness Analysis. Based on your weight, age, height, sex and level of activity, you can calculate your BMR (basal metabolic rate) and the number of calories you need in a day. It also lists the number of calories you need to burn to lose weight.

“From your BMR, you can get your DCR (Daily Calorie Requirement); BMI (Body Mass Index) — whether you are obese, overweight, underweight or normal; and your activity factor.

“Then you will be able to calculate how many calories your body actually needs. With this information, you can have your recommended meal plan based on your goal — be it weight gain, weight loss or just maintaining your weight.”

Kevin hopes to include educational articles and short video clips on exercise and fitness.

“I also intend to come up with the second edition of my book Fitness 24/7 and the Malay version, Cergas 24/7, both launched last year.

“My goal is to attain international recognition and reach out to the Middle East and publish Fitness for Islam, a book about food, exercise and lifestyle.

Health treatments with traditional Chinese medicine

2009-03-03T01:40:00.000+08:00

By : SUZANNA PILLAY

2009/02/02

Li (left) with a patient.

An oncology centre complements Western treatments with traditional Chinese medicine. SUZANNA PILLAY writes.

Chinese herbs being prepared for a prescription.

Beneficial Chinese herbs used at the wellness centre.

CAN the integration of conventional Western therapy and traditional Chinese medicine (TCM) make a difference to cancer sufferers?

Renowned oncologist Professor Li Fu Min, who has been practising TCM for 39 years, believes it can.

A senior visiting consultant from the Immunology and Oncology Department of Singapore’s IAG Health Services Medical Centre, he said that in China, Chinese herbal medicine was frequently used in tandem with traditional Western treatments of chemotherapy, radiotherapy and surgery.

Li is head of internal medicine at the First Affiliated Hospital of Suzhou Traditional Chinese Medicine University and is also the recipient of China’s Ministry of Health National Award for contributions to the advancement of science and technology in the field of medicine and public health in 1996. He was recently in Kuala Lumpur on the invitation of the Integrated Wellness Centre (IWC).
The IWC is an integrated healthcare establishment that offers TCM. In January, it joined forces with the IAG to form Malaysia’s first TCM oncology centre at Starhill Gallery, Kuala Lumpur.

Li remembered someone in his care who had been undergoing conventional treatment and told he had six months to live.

He survived for four years by complementing his chemotherapy treatment with TCM.

Li said that taking the cue from China, there is an increased awareness of the beneficial effects of using TCM as a complement.

“TCM has yielded new methods of cancer prevention and treatment.

“Cancer cells grow and divide rapidly, and are invasive. While effective at killing cancer cells, traditional cancer treatments such as chemotherapy and radiotherapy can cause changes to normal body functions and the immune system,” he said.

“Anaemia, infections, nausea, vomiting, anorexia, stomatitis, and ulcers are just some examples.

“Other fast-dividing cells, like those responsible for hair growth, can also be affected by the treatment, resulting in hair loss,” he explained.

“After numerous rounds of chemotherapy, the drug loses its efficacy. What Chinese herbs do is to make the body more receptive to chemotherapy by restoring sensitivity and making treatment more effective.”

TCM concentrates on rebuilding the patient’s natural immune system to fight harmful cells and also aims to minimise pain and discomfort caused by the cancer, or the chemotherapy and radiotherapy.

“TCM practitioners believe that cancer is a lifestyle disease determined by habits, diet, exercise and smoking.

“Medicine is prescribed to patients only after the overall symptoms are ascertained.”

IWC chairman Ahmad Fizal Othman said that the IWC-IAG partnership would educate patients on the latest treatment methods and contribute to a positive patient experience.

IAG currently has patients from Malaysia, Indonesia, Vietnam, United States and Russia.

“Our clinic will also act as a follow-up centre for Malaysian cancer patients who are discharged from foreign hospitals.

“IWC is already collaborating with top oncologists who will jointly manage these patients from within Malaysia. A second medical centre is also being planned in Penang,” Ahmad Fizal said.

Eyes' Nutrients

2009-03-02T23:31:00.000+08:00

2009/01/20

Eat a variety of fruits and vegetables for good eye health.

YAM CHER SENG writes on substances that act like “sunglasses”, protecting the eyes from the oxidative effects of ultraviolet rays.

BLINDNESS and low vision increase significantly with age, particularly in those over the age of 65. A report published in the April 2004 issue of the Archives of Ophtalmology identified age-related macular degeneration, cataracts and diabetic retinopathy as the most common eye diseases in Americans aged 40 and above.

The eye is a complex organ that allows us to perform daily activities such as reading, writing, driving and working. The retina could be likened to the film of a camera. It is a membrane containing photoreceptor nerve cells that line the inside back wall of the eye.

The photoreceptor nerve cells change the light rays into electrical impulses and send them through the optic nerve to the brain where an image is perceived. The centre of the retina, called the macula, is very sensitive and responsible for sharp vision.

The retina and macula are highly susceptible to oxidative stress due to their high consumption of oxygen, high content of polyunsaturated fatty acids and exposure to light.
Age-related macular degeneration occurs when the cells of the macula become damaged. This disease blurs the sharp central vision you need for activities such as reading, sewing, and driving. This ageing disease is not painful and those with the condition will have enough side (or peripheral) vision to get around and be independent.

Besides ageing, obesity, post-menopause, smoking, inadequate nutrition, excessive exposure to sunlight (UV light) and genetics may have a role to play in contributing to age-related macular degeneration.

The evidence backing the effectiveness of long-term supplementation with antioxidants in halting its progression is dominated by one large trial known as Age-Related Eye Disease Study (AREDS), involving 3,600 participants.

The results were very encouraging. People at a high risk of developing advanced stages of age-related macular degeneration reduced their risk by 25 per cent with antioxidant supplements.

The AREDS study and other research have shown that antioxidants like vitamins A, C and E, and zinc, selenium, lutein and zeaxanthin may work against oxidation that causes macular degeneration and protect the eyes from further deterioration.

Zeaxanthin is the predominant pigment in the fovea, the region at the centre of the macula. The quantity of zeaxanthin gradually decreases and the quantity of lutein increases in the region surrounding the fovea, with lutein as the predominant pigment at the outermost periphery of the macula.

With particular focus on age-related macular degeneration, studies have shown that lutein and zeaxanthin are nutrients that act like a pair of “sunglasses”, protecting the eyes from the oxidative effects of ultraviolet and blue light. The more unfiltered sunlight reaches your retina, the more lutein and zeaxanthin are used up in defending your delicate retinal tissues.

According to a recent report, dietary consumption and absorption of lutein and zeaxanthin determine the density of the protective macular pigment at the back of the eyes.

There is also a growing body of evidence suggesting a connection between age-related macular degeneration and low levels of macular pigment. A dense macular pigment may protect against the condition.

Diet-wise, eat a variety of foods, especially fruits and vegetables. Food sources of lutein and zeaxanthin include corn, egg yolks and green vegetables and fruits such as broccoli, green beans, green peas, Brussels sprouts, cabbage, kale, collard greens, spinach, lettuce, kiwifruit and honeydew.

At the same time, wear ultraviolet and blue light protection glasses to help reduce stress in your eyes.

* The writer is a pharmacist actively involved in the dissemination of information on natural healthcare and holistic therapies. For more information, she can be contacted at csyam@streamyx.com

Health screenings: Early Detection of Diseases

2009-03-02T23:13:00.000+08:00

By : KASMIAH MUSTAPHA

2009/01/13

Obesity leads to heart disease, cancer, fatty liver, stroke and kidney disease.

Health screenings help with early detection of diseases but they should go hand-in-hand with managing our health better, writes KASMIAH MUSTAPHA.

Assessing stress levels to determine the heart’s condition.

Those at risk of diabetes should have a blood sugar level screening yearly.

THE next time you are at the doctor’s office, be sure to ask about health screening packages.

Today almost every medical centre offers medical packages tailored to an individual’s needs, age and gender. Basic health screening includes a complete physical examination, chest x-ray, urine and blood tests, and an electrocardiography (ECG) test.

With a simple blood or urine test, the doctor is able to detect whether you are at risk of kidney problems, cardiovascular diseases and even cancer. The test can also determine if you have a healthy liver or high blood sugar level.

Prevention is better than cure, both in managing our health as well as in reducing the financial burden of treating an affliction.
Treatment for chronic illnesses such as diabetes can be long and costly. To make matters worse, it can lead to other related diseases if diagnosed at a later stage. Early detection is crucial and one of the ways is through frequent health screenings.

Kelana Jaya Medical Centre consultant physician and gastroenterologist Dr Abdul Malik Jamal Buhari says a health screening should be done at least once in a lifetime, if you are not in the high-risk group. Those between 35 and 40 years of age should undergo it once a year or once in two years.

“If you are in the high-risk group, such as having a family history of heart problems or diabetes, do a blood test every three to four months. But even if you are not at risk, it is advisable to have a cholesterol and blood sugar level screening every year.

“If you do not wish to go for the more advanced packages, the basic is good enough to detect these diseases. You can opt for the complete screening later if you feel that you need to know more.”

The basic screening test includes a full blood count to detect the level of red and white blood cells, fasting blood glucose and fasting cholesterol levels, liver and kidney functions, and a urine test. A patient can opt for cancer marker tests and a HIV test.

The fasting blood glucose test helps detect if the patient is diabetic. If the blood sugar level is more than seven mmol per litre, than he or she is a diabetic. However if the level is between five and seven mmol per litre, it is considered borderline diabetes, which needs to be monitored.

“The normal blood sugar level is below 5.6 mmol per litre. If the blood test is done randomly, without the person fasting for 10 hours before taking the test, the normal level is 7.8 mmol per litre.”

The blood test can also detect cholesterol levels — low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Total cholesterol level should not be more than 5.2 mmol per litre.

“However, we look at LDL and HDL levels individually to detect if the person is at risk. It’s best to have low LDL and high HDL.”

LDL — also known as “bad” cholesterol — can slowly build up in the inner walls of the arteries and form plaque (a thick, hard deposit that can clog arteries). This condition, known as atherosclerosis, can lead to a heart attack or stroke.

In contrast, the high level of HDL — “good” cholesterol — protects against heart disease. It is believed that HDL removes excess cholesterol from arterial plaque, slowing its build-up.

Dr Abdul Malik says the LDL level should be below 3.4 mmol per litre. For a diabetic, it must be below 2.6 mmol per litre. Those who have both diabetes and heart disease, or have suffered a heart attack, must ensure their LDL level is at or below 1.8 mmol per litre.

The liver function test detects levels of ALT and AST enzymes in the organ. High levels of these enzymes are proof of liver damage likely caused by fatty liver and hepatitis C, among others.

“We are seeing more cases of fatty liver now brought on by obesity, diabetes, hypertension and high cholesterol. The worrying fact is that many may not realise they have problems with the liver as there are no early symptoms and it is hard to detect.”

Fatty liver is one of the most common forms of liver disease and is known to lead to critical conditions. If steps are not taken to control the risks, it can lead to cirrhosis, which can be life-threatening.

Dr Abdul Malik says those who have fatty liver may suffer from cirrhosis in the next 10 to 20 years.

“The number of Malaysians who are obese and diabetic is increasing. If they don’t take care of their condition, they will eventually have fatty liver.”

A blood test can also be done to detect certain types of cancer such as breast, uterus, ovary, liver, pancreas, colon and stomach.

“The test is about 50 to 60 per cent accurate. But you need to discuss it with the doctor if you want it. It is the same with the HIV test. Doctors have to seek permission from the patient. It is unethical to do these tests without a patient’s consent.”

Some health screening packages include a stress test to assess the condition of the heart. It is also called the treadmill ECG to determine cardiovascular fitness levels and if there is adequate blood flow to the heart during increasing levels of activity while the patient is running on the treadmill.

While health screenings help with early detection and treatment, it is also important that the person changes his lifestyle even if the screening does not detect any abnormalities, says Dr Abdul Malik.

“Exercise and eating healthily are important to better health management.” he emphasised.

Take enough nutrients

2009-03-02T22:05:00.000+08:00

By : YAM CHER SENG

2009/01/05

Fresh vegetables boost the immune system.

Nutritious food is essential for a healthy body, writes YAM CHER SENG.

LOW immunity may lead to infections and a myriad of health problems. It will also hinder recovery from illnesses. Many conditions may be associated with poor immune functions, including urinary tract infections, vaginitis, colds and the flu.

Important nutrients that are beneficial to the immune system are beta-carotene, vitamins C and E, and minerals such as selenium and zinc. The best way to obtain these nutrients is to eat a variety of foods.

Nutritious food — such as fresh vegetables and fruits and whole grains, and an adequate amount of protein from seafood and lean meat — is the key to a healthy body. However, due to consumption of highly processed food, lack of control in one’s diet and unhealthy lifestyle practices, supplementation is advisable.

Apart from boosting the immune system, these nutrients are natural antioxidants that help neutralise free radicals (unstable oxygen molecules) in the body. These free radicals can be damaging to the immune system and may alter genetic material.
Hence the molecule with an unpaired electron is highly unstable. It would then seek another electron to regain its stability. Free radicals tend to react with other adjacent molecules to “steal” an extra electron.

In the body, free radicals are formed as by-products of oxidation. Other sources of free radicals are from environmental pollution, cigarette smoke, alcoholic drinks, ultra-violet light, physical and emotional stress and high intake of saturated fat. The danger arises when there is an “overload” of free radicals in the body.

Take beta-carotene as it is a good antioxidant.

Vitamin C is probably the best known of all vitamins. The basic function of vitamin C is to help with growth and repair of body tissues, and maintenance of healthy gums, blood vessels, bones and teeth.

Vitamin E is essential for maintaining a healthy immune system, heart, capillary walls and skin, and for reducing the severity of inflammations.Vitamin E works by preventing the damage of free radicals on fats in the body. It’s vital in safeguarding the protective fatty tissues that surround all major organs.

Zinc and selenium also play an important role in the defence against free radicals.

• The writer is a pharmacist actively involved in the dissemination of information on natural healthcare and holistic therapies. She can be contacted at csyam@streamyx.com

Need for healthy lifestyle

2009-03-02T21:55:00.000+08:00

By : KASMIAH MUSTAPHA

2009/01/05

A healthy diet is crucial to good health.

The sharp rise in the number of heart-related diseases, diabetes and obesity is alarming. But they all can be avoided if only we learn to stay healthy and eat right. KASMIAH MUSTAPHA reports.

Too much fatty food will cause obesity.

WE can no longer ignore the statistics and reports. The increasing rate of non-communicable diseases globally is alarming. And, sadly, most of the figures reported by the World Health Organisation (WHO) come from poor and developing countries, including Malaysia.

According to the world health body, globally, deaths from cancer will increase from 7.4 million in 2004 to 11.8 million in 2030, and deaths from cardiovascular diseases (CVD) will rise from 17.1 million to 23.4 million in the same period.

It is predicted that the four leading causes of death in the world in 2030 will be ischaemic heart disease, cerebrovascular disease (stroke), chronic obstructive pulmonary disease (COPD) and lower respiratory infections (mainly pneumonia).

Darul Ehsan Medical Centre consultant physician and cardiologist Col (R) Dr Abdul Rahman Mohd Ali says that much like other countries in the world, Malaysia is also grappling with these diseases. Cancer, obesity, diabetes and heart disease remain among the top health problems in the country.
“We are seeing more and more cases of cancer and we know that obesity, diabetes and heart diseases are related to each other. With the increasing number of people who are obese, it will mean more cases of diabetes and heart disease.”

Dr Abdul Rahman says to combat these killer diseases, the most important thing is to educate and continue to raise awareness of the risk factors.

“These are lifestyle diseases. Unless we make proactive efforts to change our lifestyles, there will be a rise in the number of new cases and deaths.

“Eat balanced meals. It is okay if you want to eat fast food once in a while, but limit your intake. Avoid food that contains colouring or preservatives. Stop smoking and exercise more. This will reduce our risk of getting these diseases.”

CANCER

WHO warned that cancer will surpass heart disease as the leading killer worldwide by 2010.

Cancer accounts for about one in eight deaths worldwide.

It estimated that there were some 12 million new cancer diagnoses worldwide last year, and more than seven million people will die from the disease. There may be between 20 million and 26 million new diagnoses by 2030 and 13 million to 17 million deaths.

Trends that will contribute to rising cancer cases and deaths include the ageing population in many countries, as cancer is more common in the elderly.

Lung cancer is still the No.1 killer among the types of cancer, with the increase in tobacco users. It caused more deaths than breast and prostate cancer put together. Every 30 seconds, someone somewhere in the world dies of lung cancer.

Dr Abdul Rahman says that surveillance and early detection have helped monitor cancer cases, and in some cases increased the survival rate.

“But it has not helped prevent new cancer cases because people are largely ignorant about their risks. They know smoking causes lung cancer but they refuse to quit or they expose themselves to second-hand smoking.

“They eat food high in trans-fatty acids, which is one of the factors that cause cancer. They also eat food that contains carcinogens such as preservatives and colouring, which increase the risks of cancer.”

OBESITY

The global obesity problem, now known as “globesity”, is worsening. According to WHO, there were 400 million obese people in 2005. By 2015, the number will rise to 700 million.

The rising number of obese people is attributed to the increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity. The obesity rate is increasing much faster in developing countries than in the developed world.

Obesity and overweight may lead to Type 2 diabetes, cardiovascular disease, hypertension and stroke, and cancer. The health consequences range from increased risk of premature death to serious chronic conditions that reduce the overall quality of life. Of special concern is the increasing incidence of child obesity.

Dr Abdul Rahman says the most worrying trend now is childhood obesity, as more children are exposed to fast food and unhealthy lifestyles.

“They are exposed to fast food, which is available 24 hours a day. They are eating more and exercising less.”

DIABETES

According to WHO, more than 180 million people worldwide have diabetes. This number is likely to more than double by 2030.

A complex interplay of genetic, social and environmental factors is the main cause of Type 2 diabetes. For low- and middle-income countries, economic advancement can lead to alterations to the living environment that result in changes in diet and physical activity within a generation or two.

Diabetes is often referred to as the silent killer. Since there are no symptoms at the early stage of the disease, early detection is impossible. Many will develop diabetes-related illnesses such as cardiovascular disease, kidney disease, stroke and eye disease, among others.

Diabetes is said to account for 3.8 million deaths per year, similar in magnitude to HIV/AIDS.

“It is another lifestyle disease. As we know, obesity is one of the reasons for diabetes. Those who are at risk of diabetes need to control their weight, stop smoking and eat healthy,” says Dr Abdul Rahman.

CARDIOVASCULAR DISEASES

WHO estimated that by next year, cardiovascular disease will be the leading cause of death in developing countries. By 2015, almost 20 million people will die of CVDs, mainly of heart disease and stroke. It noted that 16.7 million or 29.2 per cent of total global deaths result from the various forms of CVD, many of which are preventable if patients eat well, exercise and quit smoking.

Some 80 per cent of the deaths worldwide were in developing, low- and middle-income countries. These countries also accounted for 86 per cent of the global CVD disease burden. It is estimated that by 2010, CVD will be the leading cause of death in developing countries.

A substantial number of these deaths can be attributed to tobacco smoking, which increases the risk of dying of coronary heart and cerebrovascular diseases. Major types of CVD include coronary (or ischaemic) heart disease, cerebrovascular disease, hypertension, heart failure and rheumatic heart disease.

“If you are diabetic and obese, you are predisposed to cardiovascular disease. These conditions lead to heart disease and stroke.

“Again, if you are smoking, you need to quit because it is still the independent risk factor of CVD,” says Dr Abdul Rahman.

Protect yourself against heart disease

2009-03-02T21:42:00.000+08:00

2009/01/13

Eat vegetables for good health.

Studies seem to show that coenzyme Q-10 is helpful in maintaining cardiovascular health, writes YAM CHER SENG.

A DISEASE of the heart and blood vessels is called cardiovascular disease (CVD). It’s a major cause of death in the world and accounts for nearly 30 per cent of deaths globally.

In the last 10 years (1996-2007), CVD has been the leading cause of hospital admissions and deaths in Malaysia. The National Health and Morbidity survey showed that more than 61 per cent of Malaysians had one risk factor for CVD or more.

According to the American Heart Association, several risk factors for CVD have been identified. Some of them can be modified, treated or controlled, and some can’t. The more risk factors you have, the greater the chances of developing coronary heart disease. Major risk factors that can’t be changed are age, gender and heredity.

Risk factors that you can modify, treat or control are tobacco smoke, high blood cholesterol, high blood pressure and physical inactivity. Diet-wise, a well-balanced meal with lots of fresh vegetables, fruits and whole grains is advised. Many people also complement their diet with additional nutrients and herbs such as red yeast rice, fish oil and guggulipid for better health.
Another nutrient of value is Coenzyme Q-10, a fat-soluble vitamin-like nutrient present in every cell of the body which is involved in the production of energy within the cell. It also functions as an antioxidant. It is naturally present in small amounts in a wide variety of foods but is particularly high in organ meats such as heart, liver and kidney, as well as in beef, soy oil, sardines, mackerel and peanuts.

Internationally, there have been numerous studies on the treatment of heart diseases with CoQ-10 and all the outcomes have been positive, with a remarkable safety record. Studies on this nutrient have been encouraging for chronic fatigue syndrome, cancer and immuno-compromised conditions. CoQ-10 deficiency may be caused by insufficient dietary CoQ-10, impairment in its biosynthesis, excessive utilisation of it by the body or any combination of the three.

Evidence shows that some commonly prescribed cholesterol medications can cause a depletion of Coenzyme Q-10 in the body. HMG-CoA reductase inhibitors used to treat elevated blood cholesterol levels by blocking cholesterol biosynthesis, also block CoQ-10 biosynthesis. The resulting lowering of blood CoQ-10 level is due to the partially shared biosynthetic pathway of CoQ-10 and cholesterol.

Ironically, Coenzyme Q-10 is essential to cardiovascular health. The highest concentrations are found in the heart where its action in the mitochondria is vital to the healthy functioning of the heart muscle tissue. A deficiency in Coenzyme Q-10 in the body may lead to tiredness and muscle fatigue.

When the CoQ-10 is diminished, the heart weakens and eventually results in congestive heart failure. Therefore, supplementing the diet with additional Coenzyme Q-10 has been found to help maintain the body’s levels of the nutrient, which is important, not only for heart health but also for maintaining healthy blood pressure, energy levels and general well-being.

If you are on medication, a Coenzyme Q-10 supplement is recommended to help replenish your “depleted stores”. Try to opt for 50mg of Coenzyme Q-10 in soy bean oil base, which enhances its absorption and acts as a carrier for the nutrient.

The writer is a pharmacist actively involved in the dissemination of information on natural healthcare and holistic therapies. For more information, she can be contacted at csyam@streamyx.com

Alternative treatment for hole-in-the-heart patients

2009-03-02T12:34:00.000+08:00

2009/02/16

Dr Yap demonstrating the pin-hole surgery procedure.

With lower cost and less risk, pin-hole surgery is the choice of treatment for hole-in-the-heart patients, writes KASMIAH MUSTAPHA.

THESE days, in less than an hour, a heart patient’s life can be changed forever.

Through a simple and non-invasive procedure, patients will be able to lead normal lives without having to deal with the effects of a major surgery.

For those who suffer from hole in the heart, a catheter-based procedure has proven to be successful and less risky than open-heart surgery.

The shorter recovery time and lower costs make it a more preferable treatment choice, not only among patients, but doctors as well.
Pin-hole surgery (or the transcatheter closure procedure) was introduced more than 10 years ago. It is considered the most successful technique in atrial septal defect (ASD) closure to date.

Prince Court Medical Centre consultant interventional cardiologist Dr Yap Yee Guan says the procedure avoids the need for open heart surgery to close a hole.

“In the last five to six years, this procedure has gained wide adoption across the world. The fact that it is a simple procedure which leaves no scarring, with lower costs and faster recovery, makes it the perfect choice for patients.”

ASD is the one of the most common types of congenital heart defect, in which the wall that separates the upper heart chambers (atria) does not close completely.

There are three common types of ASD, depending on their position in the atrial septum. These are the secundum, ostium primum and sinus venosum.

Dr Yap says pin-hole surgery is more commonly used for people who suffer from secundum ASD.

This condition is due to the failure of that part of the atrial septum to close completely during the development of the heart.

This leads to the opening, or a hole, in the wall between the right and left atrium.

“Usually the size of the hole will be between 3mm and 4cm. If the hole is too small, it can close up within the first year of the baby’s life. But for about 50 per cent of cases, surgery is the only way to close the hole.”

With a 90 per cent success rate, pin-hole surgery is used for the majority of secundum ASD closure, although in some cases, open-heart surgery is still the only option.

“Open-heart surgery still plays a role, although it is becoming less favourable now. For patients with a hole of more than 3.2cm, the catheter procedure may not work. The device will be too small to close the hole. So open-heart surgery is the the only way.”

The hole will cause blood to flow between two and three times more than usual into the right atrium and right ventricle of the heart, as well as into the lungs.

Eventually, this will cause enlargement of the right atrium and the right ventricle, and irregular heartbeat or rhythm as the atrium stretches and enlarges with the extra blood. This will result in a fast heartbeat, resulting in dizziness, fainting or chest discomfort.

It can also cause strokes, as a blood clot in a vein or in the right side of the heart can pass through the ASD and enter the blood stream, where it can block an artery supplying blood to the brain.

The extra blood being pumped to the lungs will also increase the pressure in the pulmonary arteries.

Over time, high pressure can damage the arteries and the small blood vessels in the lungs.

Dr Yap says secundum ASD is more difficult to detect as it is non-symptomatic.

The only way it can be diagnosed earlier is if doctors detect a murmur, which is an indication of a hole in the heart.

“If it is not detected earlier, babies can grow up without knowing they have this condition. When they reach adulthood they will have symptoms such as shortness of breath, palpitations, fatigue and fainting.

“But since these symptoms can also mean other things, they would ignore them. Doctors too will sometimes misdiagnose them.

“Eventually, at a late stage, high blood pressure can develop in the lungs, as well as other complications. The person can die prematurely. Sadly, as secundum ASD is difficult to detect, there can be many who have this condition and never realise it.

“So doctors need to be more alert and carry out a thorough examination if patients complain about any of the symptoms.

“They need to refer the patients to a cardiologist who can run an EEG and ultrasound tests. By doing this we can treat the condition earlier and, with the catheter-based procedure, the treatment is easier.”

Dr Yap, who has performed this procedure since 2004 when he was working in the United Kingdom, says pin-hole surgery can be done in 30 minutes and has changed the management of ASD surgery completely.

The patient can leave the hospital the next day, although he needs to avoid strenuous activities for a month.

He also needs to take blood-thinning medication to ensure there are no blood clots as the heart slowly forms a membrane around the device.

“After the hole is closed, the enlargement on right side of the heart will get smaller and go back to normal size. The patient will be able to lead a normal life.”

As part of its corporate social responsibility programme, Prince Court has sponsored the treatment of four secundum ASD patients.

How the procedure is carried out

Pin-hole surgery, or transcathether closure of atrial septal defect, involves implantation of the amplatzer — an umbrella-like device — into the hole.

The amplatzer will be screwed onto a catheter, which will then be inserted into the veins and arteries in the groin.

These veins are directly attached to the heart, and this is the standard access technique used in all patients.

Once the catheter reaches the hole, the amplatzer will open up like an umbrella. It will be pulled back against the septum wall, securing its position on to the wall.

With most of the devices used at present, half of the device is connected to one side of the atrial septum, and the second half attached to the other portion, closing the hole between the two atria.

Within six to eight weeks, the device acts as a “skeleton” or a “framework”, normal tissue to grow in and over the defect.

The entire procedure is performed under general anaesthesia, and the actual implantation of the device is performed using transoesophageal echocardiographic guidance (ultrasound pictures using a probe introduced into the oesophagus for improved imaging of the heart structures). — Source: tchin.org/resource_room/c_art