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Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Medical eBook

Pediatric Protocol for Malaysian Hospital 2nd Edition

By Hussain Imam Hj. Muhammad Ismail, Ng Hoong Phak, Terrence Thomas

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Harrison's Principles of Internal Medicine, 16th edition

Harrison's

16th Edition, PDF format
By Dennis L. Kasper, & Eugene Braunwald, Stephen Hauser, Dan Longo, J. Larry Jameson, Anthony S. Fauci,
Publisher:McGraw-Hill Professional
ISBN : 0071445544

Publishing April 2006, three brand new stand-alone guides join the Harrison's Family.

These new guides contain the unparalleled expertise and authority found in the respective sections of Harrison 's Principles of Internal Medicine, 16th edition, plus plenty of new material in a brand new portable format to expedite access to the guidance you need for patient care.

  • Contain a wealth of pathophysiological drawings, clinical photographs, algorithms, tables and detailed treatment strategies
  • Incorporate significant new developments that have emerged in these rapidly evolving medical fields since the publication of Harrison's 16th Edition
  • Put laboratory values of clinical importance at your fingertips
  • Offer helpful Q&A refreshers for exam review

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Bailey & Love's Short Practice of Surgery 24th Edition

Bailey & Love

Edited by
R.C.G.Russell
Norman S Williams
Christopher J.K Bulstrode
Format : pdb

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To read download Isilo (pdb reader):

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PDA with windows operating system

Nelson Textbook of Pediatrics 17th edition

Medical eBook

From Book News, Inc.
Edited by Behrman (pediatrics, Stanford U. School of Medicine), Kliegman (pediatrics, Medical College of Wisconsin), and Jenson (pediatrics, Eastern Virginia Medical School), this general medical school textbook seeks to be comprehensive in its treatment of the medical problems faced by children. In addition to the standard information on diseases and disorders, organized by bodily system, the editors include sections on psychological disorders, social issues, children with special health needs, nutrition, development, and environmental health hazards.

Format : pdb

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Diet during Pregnancy

Getting pregnant, an important moment every wife been waiting for in her life. Pregnancy is a beautiful, memorable moments that will carve in the memory of each woman. Many people wonder “what should I do?” “How should I eat?” “Are these foods safe for my babies?” Many of the women will turn to the elderly who experienced it before. However the correct info is vital to ensure the baby growing well and healthy. Note: FOOD EATEN DURING THE FIRST 3 MONTHS OF PREGNANCY AFFECT THE OUTCOME OF BABY AS THE DEVELOPMENT OF ORGAN IS MOSTLY DONE AT THAT TIME!!

What is the food requirement for a pregnant woman?

Many people believe that during pregnancy the need of food is double the amount as compared to usual food habit eaten by the mother. However this is not entirely true. During pregnancy, it’s important to eat a variety of healthy foods. Eating at least three meals a day and healthy snacks is probably the best way to consume a greater variety of foods. It is true that the amount should be increased but the amount is not necessarily double the usual amount and the variety of healthy food is more important rather than the amount. However try to aim more than minimum requirements in each category in food pyramid. Food Pyramid for Asian!!

Generally a pregnant woman needs 1,800 to 2,800 calories daily. During pregnancy the amount of proteins, carbohydrate, minerals and vitamins are vital for fetal wellbeing. There are few important nutrients should be taken adequately during pregnancy which includes:

1. Folic Acid

2. Iron, Vitamin B12

3. Calcium

4. Protein

5. Carbohydrate

6. Vitamin C

Folic acid is important for development of nervous system especially in early pregnancy. So any pregnant mother should make sure they have adequate amount of folic acid by taking folic acid supplement. Studies shown that 600 microgram of folic acid significantly reduces risk of nervous system malformation particularly neural tube defect (incomplete closure of spine), or anencephaly (absence of brain).

Food that rich in folic acid:

1. Fortified breakfast cereals

2. Fortified whole-grain breads

3. Leafy green vegetables

4. Dried peas and beans

5. Citrus fruits and juices, such as oranges and grapefruits

6. Bananas

7. Cantaloupe

8. Tomatoes

On the other hand, iron also important as it is one of the component used to build red blood cells (cells that is responsible to carry oxygen) in an individuals. For mother iron is essential as during the pregnancy maternal blood will be diluted (blood volume expands) and if your iron demands are not met, mother will develops iron deficiency anemia (a condition where lack of red blood cells manifest by easy fatigability, dizziness, prone to infection). During fetal life iron is vital especially during 7-8 weeks of pregnancy onwards where the bone marrow starts to actively produce red blood cells and this is when oxygen. When the pregnancy reach term (37-42 weeks of pregnancy) mother should remember that she will deliver the baby soon and she will lose average of 250-500mL of blood. When this occurred, it will be major problem for the mother if she has underlying anemia (lack of red blood cells) and it is one of leading cause of maternal death during pregnancy. So pregnant mother, please take note to top-up your iron intake during pregnancy. Note: Iron supplement given by health clinic (particularly ferrous sulphate) may leads to constipation, but DO NOT STOP MEDICATION BY YOURSELF!! Try to ask you doctor for newer generation of iron supplement such as ferrous fumarate.

Food that rich in iron:

1. Red meat

2. Spinach

3. Fish

4. Tofu

5. Dried fruits such as raisins and prunes

6. Nuts

7. Whole grain, fortified breads and cereals

Vitamin B-12 also plays an important role in red blood cells synthesis and formation of nervous system. Lack of vitamin B-12 may leads to megaloblastic anemia (lack of red blood cells with large size of red blood cell) and demyelination of nervous system (loss of nerve covering).

Other than that, Calcium is responsible for formation of strong bones and teeth. When you’re pregnant and breast-feeding, you need 1,000 to 1,500 mg a day. That’s about 40 percent more than most adult women require. Several forms of calcium supplements are available namely calcium carbonate or calcium citrate. Never take oyster shell or bone meal calcium also known as dolomite and calcium appetite because it may be contaminated with lead and other harmful chemicals that is harmful to your baby.

Food that rich in calcium:

1. Milk

2. Cheese

3. Yogurt

4. Salmon

5. Spinach

6. Broccoli

7. Dried beans

8. Papaya

9. Orange

10. Fruit juices, breakfast cereals

Protein and carbohydrate also plays important role in pregnancy as it provides energy source for cell formation, tissue growth and brain development. Apart from that protein and carbohydrate also provide energy for synthesis of fetal organ and for mother it is also essential as the basal metabolism increased during pregnancy state.

Vitamin C is also important for iron absorption for both mother and fetal. Usually it will be prescribed together with iron supplement to prevent iron deficiency anemia. Foods that are rich in Vitamin C include mango, kiwi and oranges.

Vitamin A also useful to ensure baby healthy skin, eyesight and bone growth. However NEVER TAKE VITAMIN A EXCESSIVELY as it might cause defects in baby’s bone, heart, nervous system, head and face. Studies suggested that Vitamin A should not be taken more than 5000IU.

What to eat if morning sickness occurred?

If morning sickness makes this impossible, try eating a series of snacks or small meals throughout the day. Remember that you can get servings from several food groups at once if you eat them in combination. A slice of cheese pizza, for example, would count toward servings in the grain (crust), vegetable (tomato sauce) and dairy (cheese) groups.

What if I am vegetarian?

For a vegetarian, aim for non-dairy source available for each nutrient requirement based on food pyramid (above). If you’re a vegetarian, you can continue to follow your diet during pregnancy and have a healthy baby. But you’ll need to plan and review your food intake. Eating variety of food is the key to maintain adequate nutrients intake per day. Usually vegetarians are having problem to consume enough zinc, vitamin B-12, iron, calcium and folic acid. To overcome these problems, try to practice this tips:

1. Eat at least four servings of calcium-rich foods each day. Nondairy sources include broccoli, kale, dried beans, and calcium-fortified juices, cereals and soy products.

2. Add more energy-rich foods to your diet. This is particularly important if you’re having trouble gaining enough weight. Good sources include nuts, nut butters, seeds and dried fruit.

3. Seek advice on supplements. Many vegetarians need a vitamin B-12 supplement. A prenatal vitamin that supplements other nutritional needs. Consult your healthcare provider for further details.

What food to avoid during pregnancy?

1. Undercooked poultry and ground meat – raw undercooked poultry and ground meat is a source of bacterial which are responsible for food poisoning. Salmonella and listeria particularly dangerous bacterium during pregnancy. It may cause dissemination to baby’s circulation and may leads to meningitis (infection in a layer covering the brain) eventually miscarriage of the baby.

2. Raw undercooked seafood

Frozen and fresh fish should be cooked properly especially during pregnancy as it almost always contaminated by bacterial and viral. When you cook seafood, 10 minutes rule should be applied. This involves measuring thickest part of the seafood and cooking at least 10 minutes per inch thickness at 450°F. For example cooking shrimps and other shellfish will take around 3-6 minutes. Fish such as tilefish, shark, and swordfish should be avoided as it contains large amount of chemical contamination such as mercury.

3. Raw fruits and vegetables should be avoided and if consumed it should be washed thoroughly to prevent pesticide poisoning

4. Fizzy drinks and coffee

Heartburn and indigestion pain is common during pregnancy. It is because the increase of intra-abdominal pressure. The consumption of fizzy drinks aggravates this condition so it is wise to limit fizzy drinks consumption. On the other hand fizzy drinks and coffee if taken in large amount (300 mg or three 5 oz. cups of coffee) may cause preterm delivery, low birth weight and even worse miscarriage.

5. Stay away from alcohol

Drinking alcohol during pregnancy is dangerous during pregnancy. During intoxication the mother may vomit until severely dehydrated. Dehydration is dangerous during pregnancy as the fluid requirements is more during pregnancy. On the other hand heavy alcohol consumption may leads to fetal alcohol syndrome. This syndrome characterized by facial anomalies, cardiac defect, limbs abnormalities, delayed motor development and mental deficiency. Avoid drinking more than 40 units a week.

6. Stay away from cigarette smoke

Cigarette smoking or exposure to its smoke may cause the noxious chemical enters the baby’s circulation during pregnancy. The exposure may leads to miscarriage, low birth weight baby, and even worse may leads to delivery of handicapped baby.

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Level

Equivalent to 1 serving (Note: In pregnancy aim to eat more than minimum requirement per day)

Number of Servings

1

· 1 slice of wholemeal bread

· ½ cup cooked rice

· ½ cup soaked bihun, mee or pasta

· ½ side-plate-sized capati

· 1 cup plain rice porridge

· ½ cup ready-to-eat breakfast cereal

· 1 medium-sized potato

· 3 plain biscuits

8-12

2

Fruits

· ½ medium-sized guava

· 1 small to medium whole orange, pear or apple

· 1 medium-sized banana

· 1 slice papaya, pineapple, watermelon

Vegetables

· ½ cup cooked dark green leafy vegetables with edible stems

· ½ cup cooked fruit or root vegetables

3-5

3

· 1 medium-sized chicken drumstick

· 1 medium-sized ikan kembong

· 2 matchbox-sized lean meat

· 5 dessert spoon headless ikan bilis

2-3

4

· 1 glass of milk

· 1 cup yoghurt

· 1 slice cheese

1-2

5

· Limit this type of food intake

Small Quantity


Source: Malaysian Dietary Guidelines,
National Coordinating Committee on Food and Nutrition,
Ministry of Health, Malaysia 1999


Acne, a nightmare for any young generation nowadays. From smooth and beautiful facial skin turns into dirty spots that tarnish the beauty that suppose to be owned by any individual.

So what actually is acne?? Acne is derived from greek word “acme” or “a prime of life”. It is actually a lesion in the sebaceous gland (a.k.a. sebum gland or oily gland) of hair follicle. The common sites of acne are face, earlobe, back, chest, and anogenital area. However the facial acne is particularly a nuisance for an individual as it is the most visible one.

Even though sebaceous gland is responsible for acne, it also holds certain functions. It functions to secrete sebum which composed from triglyceride, fatty acid, wax esters, and sterols. This sebum is responsible to lubricate the skin, prevent crack of the skin and to cool down skin during hot weather.

How does sebaceous gland causing acne?? The changes happen during acne started with increase in sebum secretions. Then the keratin lining of sebaceous duct will get thickened and forms comedones or black spots (or white spots). The change of colour of comedone is due to melanin. As the sebum secretions increase in amount, a bacteria known as Propionibacterium acnes proliferates inside the sebum. After that, inflammation will occur around the sebaceous gland and produce acne. Basically, the main culprit that is causing acne is increase in sebum secretion.

Acne1

So what causing the increase in sebum secretions?? There are few causes of increase sebum secretions includes hormonal factor, fluid retention, dietary habit, season changes, exogenous factor, and medications.

Hormonal factor plays an important role in sebum secretions as increase in androgen (male hormone) will cause increase in sebaceous glands size which in turn increase the amount of its secretions. This explains why the male adolescent is more common to get acne compared to adolescent girls.

Fluid retention particularly during premenstrual period leads to increase hydration and swelling of sebaceous duct. This explains why there is exacerbation of acne during the premenstrual period. Apart from that sweating also makes acne worse due to same mechanism.

Dietary habits of eating chocolate, nuts, fizzy drinks or coffee worsen acne problems. However the exact mechanism on how these foods causing acne has yet to be determined.

Acne often improves with natural sunlight and it is worse during winter. The Ultraviolet light said to improves acne however the efficacy of the UV light treatment is unpredictable. Exogenous exposure to oils (particularly common in cooks in hot kitchen) has known to worsen acne. Exogenous exposure to coal tar, dicophane (DDT), and polychlorinated biphenols also has known to worsen acne.

Some medications also can worsen acne. These medications include corticosteroids (both systemic and topical), androgen and combined oral contraceptive pills (COCP). Consult with the doctor who prescribed the medication if acne problems arise from usage of these medications.

So what should we do if we have acne?? Relax, acne is usually resolved spontaneously and it is not infectious. There are few methods to hasten the resolution of acne which includes conservative method, topical cream, and medications.

The conservative method is done by applying hot wet soft cloth on the face (simple alternative to facial sauna), followed by gentle rubbing in a plain soap, or diluted Savlon solution (an antiseptic solution). This will cause dissolution of comedone however they (particularly savlon solution) may cause considerable skin scaling and dryness. NEVER PINCH THE ACNE!! Pinching the acne will expose the acne to secondary infection and it is responsible for ugly scar on the skin.

Topical cream for acne is widely available nowadays. It is up to the consumer to choose which one is the most suitable. The best topical cream for acne should contain Benzoyl peroxide in concentrations of 1–10%, salicylic acid and vitamin A solution. So try to find out the best solution for your acne problem. Note: Benzoyl Peroxide may irritates the skin depends on your type of skin (for example oxy: picture below)

oxy

If both conservative method and topical cream are unsuccessful, consult your doctor for antibiotic. Commonly prescribed antibiotic for acne is tetracycline. However the treatment needs time, sometimes need months to take effect. Other alternative for tetracycline are erythromycin and co-trimoxazole.

Newly available treatments are UV light therapy, antiandrogen, and synthetic retinoids. However the efficacy of these treatments has yet to be determined.

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