Friday, September 25, 2009

Endometriosis

Endometriosis is a condition in which the tissue (named “endometrium”), that is normally lining the womb, grows outside the womb and attaches to other organs. Mostly organs in the pelvic area including ovaries, outer surface of womb, bowels, and bladders, are affected; but endometriosis has also been found in the lungs, the brain and even on arms and thighs. The condition afflicts over 70 million women and girls throughout the world, knowing no racial or socio-economic barriers, and affecting women ranging from adolescence to post-menopause.
During the menstrual cycle the thickness of the endometrium increases in readiness for the fertilized egg. If pregnancy does not occur the lining is shed as a 'period'. Similarly, in each menstrual cycle, endometrium that grows outside of the womb, is also built up and then breaks down and bleeds in the same way as the lining of the womb. Such internal bleeding may lead to inflammation, pain, and formation of scar tissues in organs outside of the womb.
Endometriosis is not an infection, not contagious, and not cancer either. Of the theories, the most widely accepted is retrograde menstruation. According to this theory some of the menstrual blood flows backwards down into the pelvis.
The considerations about what type of treatment should depend on age, severity of the symptoms, desire to have children, and severity of the condition. Painkillers, like aspirin, may help relieving the pain. Hormonal treatment designed to interfere with ovulation generally provides effective pain relief, but the recurrence rate following cessation of therapy is high, and this type of treatment will contradict with the woman’s pregnancy. Surgical treatment provides pain relief, improves pregnancy rates, and is the preferred initial treatment for infertility caused by endometriosis. Removal of the womb, ovaries, and all growths is a radical surgery for patients with intractable pain, if childbearing is no longer desired. Complementary therapies, such as acupuncture, aromatherapy, herbal therapy, and nutrition have not been clinically proven to treat endometriosis. However, many women do have improvement of their symptoms whilst using such therapies. It is probably wise to seek help from a qualified practitioner and not self medicate.

Monday, September 21, 2009

Treatments for Bed-wetting

Bed-wetting is normal and very common among preschoolers, affecting 40 percent of children at age 3, occurring in 20 percent of 5-year-olds, 10 percent of 6-year-olds, and 3 percent of 12-year-olds.
It is a complex neurodevelopmental process for the bladder to send the signal, for the brain to receive it and for the child to respond by awakening and using the toilet. For the child who wets the bed, parents need to remain supportive and encouraging. They should be sensitive to the child's embarrassment or discomfort over this problem. A child who sleep-wets is likely to stop eventually. The purpose of a treatment program is to make this happen sooner. There are different approaches, both medical and behavioral, to bedwetting. Behavioral approach stresses changes in behavior, such as having the children take responsibility by helping with the wet sheets, and having them read a picture book about bed-wetting each night to reinforce staying dry. Medical approach uses medicine(s) to reduce the number of wet nights, but there was some evidence that this was not sustained after treatment stopped.

Wednesday, September 16, 2009

Kidney Failure

Kidneys are a pair of bean-shaped organs that lie on either side of your spine in the lower middle of your back. The main function of the kidneys is to remove waste products and excess water from the blood. Good kidney’s functions allow us to continue to consume a variety of foods, drugs, vitamins and supplements, additives, and excess fluids without worry that toxic by-products will build up to harmful levels. The kidney also plays a major role in regulating levels of various minerals such as calcium, sodium, and potassium in the blood. If the kidney fails to function, this can ultimately result in death.
Kidney failure occurs when the kidneys partly or completely lose their ability to carry out normal functions. This failure is caused by a number of conditions including diabetes, hypertension, glomerulonephritis, and cystic kidney disease.
When someone’s kidney failure becomes permanent called End-stage renal disease (ESRD), he/she requires either dialysis or a kidney transplant to maintain life. Hemodialyis is one kind of dialysis where the blood is filtered through a machine that acts like an artificial kidney and returned back into the body. This procedure needs to be performed in a designated dialysis centre. It is usually needed about 3 times per week, with each episode taking about 3-4 hours. Haemodialysis in Singapore can cost about 2,500 to 3500 Singapore Dollar per month.
Another kind of dialysis is Peritoneal dialysis, where the blood is cleaned without being removed from the body. A solution (mainly made up of salts and sugars) is injected into the abdomen that encourages filtration such that the waste is transferred from the blood to the solution. There are 2 types of Peritoneal Dialysis - continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). CAPD needs to be done 3 to 5 times every day, but does not require a machine. In Singapore, this can cost around 1500 Singapore dollar per month. APD uses an automated cycler machine to perform 3 to 5 exchanges during the night while the patient is asleep. This can cost around 2,000 Singapore dollar per month.
Each treatment option has its own advantages and disadvantages, which vary with the condition of the patient and presence of underlying diseases. Hence, it is important for every patient that develops ESRD to discuss the various treatment options with his/her doctor before starting treatment.

Saturday, September 5, 2009


Diagram di atas menunjukkan hasil pengukuran tekanan darah pasien dengan kondisi tekanan darah tinggi yang memonitor tekanan darahnya sehari-hari. Pasien ini diharuskan dokter minum obat tekanan darah tinggi setiap hari. Selain itu, pasien ini mengukur tekanan darahnya setiap hari meggunakan alat pengukur tekanan darah digital dengan teknologi telemedicine. Dengan teknologi ini, setiap kali, hasil ukuran tekanan darahnya dikirim oleh alat pengukur tekanan darah tersebut secara otomatis ke website dimana dokter yang merawat pasien juga bisa memonitor tekanan darah pasien secara berkala dan memberikan saran-saran kesehatan berkenaan dengan perawatan kondisi tekanan darah tinggi pasien.
Di awal program pengukuran tekanan darah pasien dengan teknologi telemedicine (di bulan November 2008), tekanan darah pasien nampak naik turun, dan cenderung tinggi. Tercatat 8 kali pengukuran tekanan darah atas (Sistolik) dan / atau tekanan darah bawah (Diastolik) yang melebihi batas normal. Tekanan darah atas (Sistolik) dan tekanan darah bawah (Diastolik) nampak naik-turun, tidak stabil, dan cenderung meninggi. Sembilan bulan berikutnya (di bulan Agustus 2009), ukuran tekanan darah pasien tersebut, baik tekanan darah atas (Sistolik) maupun tekanan darah bawah (Diastolik), menurun, lebih rendah dari tahun lalu, menjadi dalam batas normal, dan stabil. Hal ini menunjukkan bahwa tekanan darah pasien menjadi lebih terkontrol.

Thursday, September 3, 2009

Self Monitoring Blood Pressure

One of the greatest problems in treating high blood pressure is patient’s self compliance to the prescribed medication and medical advice. The treatment is for long term, mostly for long life, and may be associated with side effects, without having significant symptoms, and therefore does not experience a decisive improvement of symptoms through the treatment.
This requires the patient’s involvement in his/her own treatment in related to the selection of anti-hypertensives drug(s) used, the patient’s commitment to change lifestyle, and the patient’s participation in controlling his or her blood pressure (BP).
Self BP measurement is recommended by the European Society of Hypertension as a very sensitive method of adjusting treatment. Hence, telemetric BP monitoring opens up new possibilities of improving patient compliance in the treatment of hypertension. It improves the relationship of the patients to their own disease – and thus the basis for treatment.
A clinical study reveals that telemetric BP monitoring is a useful way of involving patients communicatively in their treatment through self-measuring BP. It opens up the possibility of interaction between physician and the patients. This produces an unusually high rate of BP normalisation.
 

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