Flat Stomach Exercises

HOW TO SURVIVE THE ECONOMIC CRISIS

2010-01-10T19:17:00.000-08:00

"Reduce spending by using your money to buy only necessities"

Make a budget

The best way to control your spending and avoid debt is by keeping track of what you are spending on. Start by creating a budget for yourself. List down all your income and expenses. Besides your main expenses, make sure not to overlook small or irregular expenses.

Making a budget can help you manage your money more wisely. Try to think critically about the money spent and whether or not it was a necessary expense. See what you can cut out or spend less on. Review your budget regularly to make sure it is still in line with your needs. If necessary, talk to a professional who can develop a better budget plan for you.

Spend less and save more

Reduce spending by using your money to buy only necessities and limit unnecessary expenses such as entertainment and expensive gifts.

Eating out are probably one of your biggest expenses. Learn how to prepare your own meals. You can opt for more economical meals or bring your lunch to work. Besides saving money, making your own food can be healthier too. When buying groceries, prepare a shopping list so that you are not tempted to buy unnecessary items.

Sell luxuries as you may not have the funds to enjoy these things during the economic crisis. If you have two or more cars in the household, consider selling one of the cars. You can also save on fuel if you keep the car that uses the least amount of fuel.

Exercise at home or at parks instead of signing up for fitness classes. Get your hair cut less often and consider going to a less expensive hair saloon. Wash your own car, repair household items, learn some useful DIY skills and do chores that you regularly pay others to do. Do not waste money on electricity. Turn switches off when you are not using lights or other appliances.

Put spare change into a jar and you will watch your savings grow to hundreds of ringgit a year, which you can deposit into your savings account.

Get out of Debt

Debt can be overwhelming when you do not have a clear idea of how much in debt you really are. Gather your bills and make a simple list of all the debts you have. Note down the particulars, including name of the creditor and your total balance.

Then pay off as much debts as possible, especially unsecured debts such as credit card balances. While having a credit card that you pay off in full each month is acceptable, having an outstanding balance that you have to pay interest is a disaster.

If possible, get rid of the credit cards as soon as you pay them off or keep only one for emergency use. Having too many credit cards can increase the temptation of overspending.

HEALTH TIPS FOR SENIORS

2010-01-10T18:55:00.000-08:00

Aging is a natural process and doesn't have to leave you feeling overwhelmed. A positive approach is very important to the aging process. Practicing good health can make you feel more comfortable as you greet the changes that come with aging.

"You dehydrate faster now than when you were younger"

Getting the proper nutrition and staying active are some ways to enhance your potential for successful aging and ensure you enjoy your golden years.

Nutrition

Proper nutrition and good eating habits are some of the key components for healthy aging. Good nutrition can prevent or delay the onset of many chronic illnesses such as osteoporosis, diabetes and heart disease.

Nutritional needs of older people differ from those who are younger. As you age, your body's metabolism may be less efficient or slower. Also, there may be less absorption and greater excretion of nutrients. Hence, you need to eat more nutrient-dense food. Nutrient-dense food are those that provide substantial amounts of vitamins and minerals and relatively few calories such as whole-grains, vegetables and fruits.

Another important part of good nutrition is getting adequate hydration. You dehydrate faster now than when you were younger and as you get older, you have lower levels of saliva and digestive juices. Water makes swallowing food easier, aids digestion and prevents constipation. Aging bodies also hold less water and some medications may cause water loss.

Drink six to eight glasses of fluid daily, depending on your height and weight as bigger people require more fluid. Water can come from drinking water, fruit juices, milk and soups. Try to limit the amount of caffeinated drinks such as coffee and tea as they can cause you to lose body water. Have a drink available around mealtimes and take water breaks throughout the day.

People often wonder whether it is necessary to take vitamin and mineral supplements. Unless directed by your doctor, vitamin and mineral supplements are rarely necessary if you eat enough food to meet your energy needs. It is also important that you do not use supplements in place of food or in extremely high amounts.

Be sure to check with your doctor or dietitian before starting any dietary supplements or when you have specific health problems or changes.

Physical Activity

Exercise is important for all age groups, particularly for the elderly. Many older people do not exercise as they think of it as a chore, boring or disappointed by the lack of immediate results. Regular physical activity not only make you look and feel better, it can help your body function more effectively in many ways, protect you from chronic illnesses and lower your chances of injury.

There are many types or exercise that you can do to enhance your level of physical activity. Choosing a type of exercise that is fun and enjoyable will enrich all aspects of your life and easily maintained over the long term.

Walking is a great way to exercise. If you find it boring, walk together with a partner and carry on a conversation while you're walking. You can also try different exercise programs such as joining swimming or tai chi classes and taking up a hobby like gardening. Try to work on making exercise a regular part of your day and build on your daily routine.

However, before starting an unfamiliar activity or new exercise program, you should always get help from your doctor to decide which type of exercise suits you best and discuss on any special conditions you might have. It is also important that if you feel pain or discomfort, you should stop the activity, take a break and consult your doctor.

Disclaimer:
While every effort has been made to ensure accuracy of facts, the articles and information above must never be construed as giving professional health advice and as such Kurnia does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in the above article. Kurnia cannot be held responsible for any losses, injury or death resulting from the use of the above information.

TIPS ON FILLING VEHICLE

2009-10-19T16:53:00.000-07:00

Nowadays, car owners have become increasingly concerned about saving fuel. Here are some simple tips on filling your vehicle.

"Do not overfill or top off your vehicle tank"

Fill up early in the morning when the day's temperature is at its lowest. Fuel is denser when temperatures are cooler. Filling up when the air is cooler also reduces fuel evaporation.

When you are filling up, do not squeeze the trigger of the nozzle to a fast mode. If you are pumping on a fast rate, some of the fuel that goes to your tank becomes vapour. Pumping on low speed minimizes the vapours that are created.

Watch where you fill up. If there is a fuel tanker pumping into the storage tanks, steer clear of it. When the tanker fills fuel into the containers below the station, the sediment get stirred up. This sediment gets sucked into the vehicles that fill up first, and can cause a decrease in fuel efficiency.

Tighten the cap. Keep your fuel cap tight all the time when you are not filling up. Fuel will evaporate from the tank if it has an escape so make sure you twist the cap back.

Do not overfill or top off your vehicle tank. Overfilling results in sloshing over and out of tank. Never fill fuel past the first "click" of fuel nozzle. When you hear that first click of the fuel nozzle it’s time to stop.

While the savings may not amount to much each time you fill up, over time you should start to see a difference.

VITAMINS

2009-08-19T01:28:00.000-07:00

Vitamins are vital to metabolic processes such as bone formation, blood-clotting and tissue repair. Vitamins A, D, E and K are fat-soluble, and can be stored in the body. Water-soluble vitamins - the B group and vitamin C - cannot be stored, and must be eaten regularly.

"Small amounts of iodine are vital for making thyroid hormones, and a lack of iodine causes thyroid overactivity"

Vitamin	RDA*	Good Sources	Function in body
A Retinol	0.8-1 mg	Egg yolks; fish oils; offal. Made by body from carotene in green, yellow and orange vegetables.	Growth; immunity; maintains health of mucous membranes; vision (especially in dim light).
B1 Thiamine	1-1.4 mg	Beans; fortified cereals; fortified flour; nuts and seeds; pork; brown rice; wheat germ.	Carbohydrate metabolism; maintains health of muscular and nervous systems.
B2 Riboflavin	1.2-1.6 mg	Avocados; fortified cereals; dairy products; eggs; nuts offal; wheat germ; yeast.	Cellular respiration; tissue maintenance and repair.
B3 Niacin	13-18 mg; excess harmful	Fish; fortified cereals (not natural maize) and flour; liver; meat; peanuts; yeast; wholegrains.	Carbohydrate metabolism; maintains health of skin, nerves and digestive system.
B5 Pantothenic acid	4-7 mg	Fish; legumes; poultry; wholegrains; yogurt. Also made by intestinal bacteria.	Carbohydrate, fat and protein metabolism; maintains health of nervous system.
B6 Pyridoxine	2 mg	Bananas; fish; meat; potatoes. Also made by intestinal bacteria	Protein metabolism; red blood cell and antibody formation.
B9 Folic acid	0.2-0.4 mg	Meat, orange juice; pulses; green vegetables; wheat germ; wholemeal flour; yeast.	DNA production; cell division (with B12) - including red and white blood cell formation.
B12 Cobalamin	0.003 mg	Fortified cereals; cheese; eggs; fish; meat; oysters.	DNA production; maintains health of nervous system; helps functioning of folic acid.
Biotin (B group; not numbered)	0.1-0.3 mg	Egg yolks; nuts; offal; soy products; wheat germ; yeast. Also made by intestinal bacteria.	Fat metabolism.
C Ascorbic acid	60 mg (100mg for smokers)	Fruits and vegetables, especially raw blackcurrants, citrus fruit, tomatoes, peppers and potatoes.	Antioxidant (protects against disease); maintains health of connective tissue and cell walls.
D Calciferol	0.01mg	Mainly sunlight on skin. Also full-fat dairy products; eggs; liver; fortified margarine; oily fish.	Facilitates absorption of calcium and phosphorus from intestines and bone growth.
E Tocopherol	8-10 mg	Butter; cereals; eggs; fortified margarine; nuts and seeds; wheat germ; vegetable oils.	Antioxidant (protects against disease). Thought to protect cell membranes.
K Menaquinone/ phylloquinone	0.07-0.14 mg	Leafy green vegetables. Also made by intestinal bacteria.	Facilitates blood-clotting.

* Recommended daily amount for adults.

Iodine
Small amounts of iodine are vital for making thyroid hormones, and a lack of iodine causes thyroid overactivity. In places where the diet is lacking in iodine - because there is little seafood or the soil (and thus food and water) contains no iodine - people can develop a swollen thyroid gland, known as a goiter.

WAYS TO KEEP HEALTHY AND VITAL

2009-08-19T01:26:00.000-07:00

Health is something most people take for granted. To those who are ill, health is seen as a crown worn by those who are healthy. Many illnesses that we experience now are actually the cumulative effects of the unhealthy habits that have been acquired over the years as a reflection of our lifestyle.

"Get at least 20-30 minutes of exercise everyday"

Some of us fall ill not due to our own actions but because of genetic predispositions. This is unavoidable, but many people this category do lead healthy lives by knowing and actively modifying their risk factors.

Although studies shown that morbidity and mortality rates from infectious diseases in developing countries like Malaysia have reduced, diseases of lifestyle are now killing us Malaysians. Even our children are at risk for developing cardiovascular diseases such as obesity and asthma. This has become more apparent with the advent of the IT era because people are encouraged to rely so much on modern technology that we hardly find ourselves 'sweating' after completing a manual task. Even our children lead lives as computer game addicts and 'couch potatoes'! Other obvious risk factors include overeating, smoking and over dependence on medicinal drug supplements.

Unfortunately, many people these days choose the easy way out when it comes to health. They would rather diet and take slimming pills then exercise. Disorders that can develop due to this sedentary lifestyle include chronic fatigue, shortness of breath, obesity, stomach discomforts, headaches, anxiety, muscular weakness and atrophy, high blood pressure, arteriosclerosis and coronary heart disease.

Knowledge on these diseases however, are not enough to motivate an individual to make long-term positive behavioral changes. Skills for successful and healthy living must be taught to the young and reinforced periodically so that the individuals will be empowered to change their lifestyles positively. Pharmacists can encourage changes by advising individuals to be aware of risk factors that can affect their health in the long run. Advocating regular exercise combined with healthy eating habits and having a positive attitude in life is a good start for a vital and healthy life, regardless of age.

Tips on staying vital and healthy:

Get a balanced diet. Eat more fresh vegetables, fruits, soups and wholegrain products such as bread and pasta. Take less preserved foods that come in cans or packs- chances are they might be overloaded with sugar or salt.

Instead of eating three big meals in a day, keep it to five or six smaller snacks a day.

Get at least 20-30 minutes of exercise everyday. Do this by walking, jogging, cycling or even dancing to fast pace music of your choice. Housework does not count.

Arm yourself against snack attacks with ready-to- eat, tummy filling snacks such as cold vegetable juice, raw veggies or fresh fruit. Nibble them to keep your mind off sugary snacks when you're bored, angry, frustrated or feeling blue and want to soothe your mind with a treat.

Instead of deep-frying, try to cook your food by steaming, roasting or grilling. There's less oil involved this way.

Learn the difference between physical hunger and mental hunger. Only eat when you need to.

Do not smoke. If you already do, lower the number of cigarettes you smoke or stop altogether.

Instead of driving, why don't you walk or cycle? It could be more fun and you need not worry about traffic.

No booze please. Alcoholic beverages increase your caloric consumption and can boost your appetite.

Drink lots of water especially in our hot Malaysian weather.

Don't overeat. Keep your mind on your food because having distractions such as watching TV will encourage you to overeat. Don't overdo it at buffets either!

When exercising, bring your children or family along. This would make it more enjoyable.

Stay busy. Watching TV or playing computer games all day isn't going to help you stay healthy.

Eat most of your calories early in the day. As they say, breakfast like a king, lunch like a prince and dine like a poor man.

If you decide to take extra vitamin supplements, please get advice from the pharmacist or doctor first. You might end up consuming too much or having something that isn't suitable for you.

Get regular medical checkups. Prevention or early knowledge safeguards you from any diseases that may be untreatable if left undiagnosed for too long (especially if you have a family history of a disease or illness).

Do not be fooled into taking up a fad diet program. Here are ways to spot them:

	It focuses on one or a limited variety of food and cuts out entire food groups.
	It incorporates special dieting foods, pills or formula.
	It makes recommendations on vague studies and research.
	It claims that exercise or increase in physical activity is not necessary.

Give yourself a treat once in a while as an incentive. You might lose interest to live healthily if you don't. Good luck!

GETTING A GOOD NIGHT'S SLEEP

2009-08-19T01:24:00.000-07:00

Going to sleep is one of the most wonderful sensation a person can have. However, it is estimated that millions of people around the world suffer from insomnia and have trouble getting quality night sleep. This is the beginning of sleep-anxiety where the mere worrying about getting enough sleep will keep you awake all night. Left untreated, these sleep disorders can turn into long-term problems that will adversely affect the quality of your life.

"You should have your dinner at least 3 hours before bedtime because a digesting stomach will not let you sleep."

Why do we need sleep?
It is yet to be discovered the full benefits of sleep. It is generally thought however, that sleep is a regenerating process that restores the body's energy supplies. Most repair work is also done during sleep where damages or torn body tissues are rebuilt. Mental energy is also restored, hence the saying that if you sleep on a problem, you will find a solution when you wake up. When deprived of sleep, you become moody and less coordinated, make more mistakes and is more prone to illnesses.

What is Insomnia?

Insomnia is inadequate or poor quality sleep due to one or more of the following:

	Difficulty in falling asleep
	Waking up frequently during the night with difficulty returning to sleep
	Waking up too early in the morning
	Unrefreshing sleep

It may cause problems during the day, such as tiredness, lack of energy, difficulty concentrating and irritability.

Types of Insomnia

Transient - lasts from one night to a few days

Intermittent - lasts a few days to a few weeks

Chronic - lasts a few weeks to a few months

What causes Insomnia?
Transient and intermittent insomnia generally occur in people who are temporarily experiencing one or more of the following: stress, environmental noise, extreme temperatures, varying bedtimes, changing work shifts, and the side effects of medication.

Chronic insomnia is more complex and may be due to a combination of factors including underlying physical or mental disorders. One of the most common causes of chronic insomnia is depression. Other underlying causes include heart problems, breathing disorders, kidney disease, asthma, Parkinson's disease and arthritis. Chronic insomnia may also be due to behavioral factors including the misuse of caffeine, cigarettes, alcohol or other substances, disrupted sleep/wake cycles, excessive napping in the daytime, and chronic stress.

Some behaviors may prolong existing insomnia, and may be responsible for causing the sleep problem in the first place: expecting and worrying about difficulty sleeping, taking excessive amounts of caffeine, consuming alcohol or smoking before bedtime, excessive napping in the daytime, and irregular or continually disrupted sleep/wake schedules. Stopping these behaviors may eliminate the insomnia altogether.

What is the treatment?
Transient and intermittent insomnia may not require treatment since they last only a few days at a time. However, for some people who experience daytime sleepiness and impaired performance as a result of transient insomnia, the use of short-acting sleeping pills may improve sleep and alertness the following day. As with any medication, there are potential side effects.

Treatment for diagnosed chronic insomnia includes identifying behaviors that may worsen insomnia. by stopping or reducing them. Sleeping pills may be used (although the long-term use of sleeping pills for chronic insomnia is controversial) with behavioral techniques such as relaxation therapy, sleep restriction therapy and reconditioning to improve sleep. Contact your family doctor for further advice.

	Food A diet that promotes health naturally promotes good sleep. Replace instant foods such as canned foods and preserved items with fresh wholesome foods. Instant foods additives such as sugar, salt, coloring and flavorings stimulate the body into hyperactivity. Insomnia sufferers should take more Vitamin B found in whole meal breads and brown rice because it is known to alleviate symptoms. You should also have your dinner at least 3 hours before bedtime because a digesting stomach will not let you sleep.
	Exercise Sleep is a body's natural response to tiredness. By building exercise into your daily routine, you help yourself sleep better because it releases tension in the muscles and nerves. Avoid exercising late in the evening or at night however, because raised adrenaline will keep you awake throughout the night. If it is the only time you can exercise, choose deep relaxation exercises such as yoga or t'ai chi.
	Environment If you live in a city and you find the environment too noisy, opt to move to a quieter area or sleep in a room with less exposure to noise. Use curtains to block out the noise or light from windows and close your room door if it helps.
	Sleeping Habits Modern living plays a big part in meddling with our sleeping schedules. Due to work and our need for entertainment, most people have irregular sleeping habits. Sleep researchers suggest waking up at the same time each day regardless of how many hours you got to sleep the night before. Replacing sleep debts on weekends also do not work- you just end up more tired than before!
	Emotional Distress When your mind is not in peace, it is next to impossible to sleep. Anxiety, resentment, jealousy, guilt and grief are negative feelings that can ruin sleep. If you suffer from depression, you are likely to suffer from insomnia. Advising an insomniac to leave all their troubles before going to bed is easier said than done. Learning how to do this takes practice and a commitment to improve one's waking life. Re-orientate your long-term plans and always reassure yourself that things are never as bad as they seem.
	Substance Abuse Relying on quick fixes to banish stress can be another sleep hazard. It is ironic how we load ourselves up with cigarettes and coffee in the daytime to keep us awake and turning to alcohol and sedatives to go to sleep at night. Notorious sleep- thieves such as caffeine and smoking keeps you awake, edgy and anxious by triggering adrenaline and stimulating the nervous system.
	Illness and Medication Having illnesses such as breathing problems and pain can affect the quality of your sleep. Medications such as those used for arthritis can actually cause insomnia in some people. Find out the side effects of the medication or drug that you are using and whether there are alternative medication that you can take for your condition.

When to seek help?
It's important to ask for help if you are having sleep problems. You should consider getting medical advice if your sleep has been disturbed at least several times over the past month, or if sleep problems interfere with the way you feel or function during the day. Your doctor will evaluate your general health and ask about your usual sleep habits. Sometimes all that is needed is helpful advice.

SAVE HOLIDAYS

2009-08-19T01:19:00.000-07:00

As the holiday season approaches, many travel far and wide, leaving their homes unoccupied for days or weeks. Undesirably the holiday season also sets forth a high record of road-accidents and misdemeanors such as house break-ins and thefts.

"Check your maps before you begin your journey so you could understand the routes and tour confidently"

As the unforeseen may happen whilst on the road, our Kurnia Auto Assist roadside service comes as a handy reinforcement -offering towing and workshop services in times of need.

Concurrently, the holiday period is a good time to consider attaining some forms of protection ranging from home to travel insurance that would safeguard you from any personal or property losses that may incur beyond your will.

For example, your long awaited plan for a holiday has finally set forth. After travelling for 14 hours, you finally touch down. Tired and worn out from the long journey, you waited patiently for your baggage to arrive, only to find that it has been mistakenly flown to another destination. There was nothing you could do but to purchase the necessities to last you the night as you wait for your luggage to be re-routed.

In this situation, despite the anger and frustration, you could at least have some assurance that the unnecessary costs incurred are covered by your travel insurance. Throughout your frequent rounds of travel, you would never thought the day would come when this could happen to you. Wouldn't it be good to know that you have your insurance to stand by you?

Not wanting to face more surprises upon returning home from your holiday, it is best to adopt some theft prevention measures to safeguard your home and property before you leave. As bothersome as they may seem, you would never know if that small effort could save you from all the troubles that arise. Keeping all this in mind, you should be able to enjoy your much anticipated holiday with a peaceful mind!

Out and About

While you and your loved ones are out and about, it is imperative to keep in mind that tourists to thieves are like flowers to bees.

Often lost or distracted, weighed down with bags, or carrying cameras, plane tickets, money, and other valuables, unsuspecting travellers are easy criminal targets. Although many believe that the best advise would be to blend in with the crowd, there are also some preventive measures that always come in handy.

	Don't display expensive jewellery and other items that might draw attention. Watch out for your cameras, handbags, and other small items especially in very crowded places.
	Check your maps before you begin your journey so you could understand the routes and tour confidently.
	Stick to well lit, well-travelled streets at all times - no shortcuts.
	Always lock your car even when you are driving. Carjacking is known to occur while the victim stops at traffic lights.
	Keep valuables out of sight, preferably locked in the trunk. Don't advertise that you're a tourist by leaving maps and guidebooks on the seat or dashboard.

Travelling safely with your family also means sticking together and keeping an eye on your children at all times. Make sure they know where you're staying (name and address), and teach them what to do if they get lost or separated.

Agreeing on a meeting place in case of separation helps too. And by all means, make sure your kids know not to accept rides or favours from strangers.

Make your family vacation a memorable one for all the right reasons.

IMPROVING YOUR LIFE AT WORK

2009-08-19T01:17:00.000-07:00

Feeling a little down at work? Think you are not going anywhere or getting anything accomplished? Read on and find out how you can improve your working life for the better!

"Don't be distracted by gossip"

Dress the part
While some jobs require different standards of dressing, one constant remains- be well groomed. If you think no one notices that you wore the same clothes as yesterday or you walk around in slippers because its comfortable, well, think again. As said by many employers, if you want to be perceived as professional, look the part.

Ethics
Yes, dressing matters. But it's how you present yourself as a person that is really crucial. Are you reliable? Responsible? Honest? All the skill in the world won't make up for someone who's lacking these essentials. Remember, employers are always looking out for clues on what kind of employee you are, especially in the early days. Watch out for: arriving late, letting your personal life overshadow your work life, taking long lunches and being hung-over on a regular basis.

Being heard
There are brash, aggressive people at the work place. If you are not one of them, getting heard may be a nerve wrecking experience. However, the last thing you want your boss to think is that you have no ideas, or worse, don't care. Check the following tips for some hints on making yourself heard at meetings:

	Do some homework- being prepared bolsters your confidence. If you are giving a presentation, rehearse the night before on what you are going to say.
	Be on time, or better yet, be early. No harm having a few extra minutes to calm yourself down, is there?
	Speak up in the early stages of the meeting before you lose your nerve. Take a few breaths if your voice is shaking.
	At the meeting's conclusion, summarise your ideas and email them to your boss, especially if you didn't get the opportunity to present them fully at the meeting.
	Don't start your ideas with negative disclaimers such as "This may not be possible to achieve, but�". If you don't have the confidence in your own ideas, why should anyone else?

Entering the political arena
When you first started working, you thought that all you'd be doing is work, right? Well, it probably didn't take you long to find out that office politics takes up most of your time too. We spend more time with our colleagues than we do with our family and friends. Sometimes a psychology degree comes in handy when handling these kinds of situations.

Don't be distracted by gossip- you can listen but don't gripe about your situation either as it may be used against you later. If you have become a target of office bullying, stand up for yourself even if you are being threatened. Often, confronting someone will embarrass them into behaving more reasonably. Deliver your self-defense with a little finesse and don't lower yourself to their level. Approach them by asking if there's anything that can be done to improve your working relationship. If they're not receptive, consider asking the powers-that-be for advice.

Sorting things out
According to a survey conducted by various managers in different fields, their top complaint was: lack of organisation. It may look like something easy for them to say but you have to remember that they didn't start out at the top either. Employers want workers they can rely on which can be tricky if you are constantly trying to locate that file you misplaced.

	If you get your work done, a cluttered work space shouldn't be a problem. But organisation goes beyond a tidy desk. It's about the way your execute your tasks so that you meet goals and deadlines.
	Don't go on holiday before tying up loose ends- plan ahead if you know you will be going on holiday for whatever length of time. If it's not possible to finish work, hand over the responsibilities to another colleague or subordinate. Make sure you give them ample instructions on what to do and ensure that it doesn't bog down their schedule either.
	Don't take on too much work- don't be too enthusiastic when taking on new projects or responsibilities when you already have your hands full of work. Its far better to under-promise than to over-deliver.
	At the meeting's conclusion, summarise your ideas and email them to your boss, especially if you didn't get the opportunity to present them fully at the meeting.

If your disorganisation is due to the lack of structure, take notes from people who seem to be on top of everything. Workplaces are so busy that no matter how well you know your clutter, you risk disaster if you don't have any real system in place. Not everyone is clean and tidy, but sorting yourself out, even if it means coming to work on the weekend to sort through paperwork may be worth the effort- and the important people will notice.

It's not all about you
Many people, especially the young ones, have an idealistic view of the workplace and what duties would be. But when they get there, they are often asked to do things outside their role and some employee's don't like that. But that's not realistic behavior. Be ready to get your hands dirty and do things for team gain. A manager would be more impressed with your ability to be flexible than your refusal to do anything not in your job description.

Impatience
You are itching for new responsibilities, more office space, new challenges and most likely- more cash, but are you ready to move? No matter how talented you may be, don't have an unrealistic career view. Firstly, you become frustrated with your current role as you dream about the next stop. Secondly, it's hard for an employer to hire someone who changes positions or jobs every 12 months or less. They wouldn't want to hire someone who's leave so soon.

Everyone moves ahead at different speeds, depending on the industry and your company. You could get a senior position at a smaller firm or take on a more junior role at a larger, more prestigious one, both at the same skill level. Although you may be further up the ladder at the first one, but you'd probably get better training and opportunities at the larger company.

Therefore...
When you first started work, you were brimming with enthusiasm. Every opportunity had such delicious potential. But these days, things look different. Relax! Everyone gets demotivated at some point or another. Problem is, no one likes the indifference- especially your employer, So rather than let this career crisis become a lifelong event, take a long look at what could be bothering you

Always have discussions with your boss to reassess tasks and discuss solutions for difficulties at work. If you think your job isn't contributing to your career objectives, think about the reasons why. If it's a promotion you want, ask your employer if this is realistic. If not, discuss what you need to achieve to make it happen. Alternatively, if you are looking for a change in direction, see a recruitment firm or career counselor to discuss your options. Staying in an unsatisfactory environment for too long can affect the ability to sell yourself to another employer because you lose confidence in yourself.

Be patient, be prepared to learn and above all, accept that you don't know everything!

High Cholesterol Level Risk

2009-07-07T17:05:00.000-07:00

A lot of people don’t take the risks of high cholesterol very seriously. After all, one out of five people have high cholesterol. Could something so common really be a serious health risk? Unfortunately, yes. Cholesterol is a direct contributor to cardiovascular disease, which can lead to strokes and heart attacks.

“Despite all of the amazing medicines and treatments we have, cardiovascular disease is still the number one cause of death and illness in our society”, says Laurence S Sperling MD, director of preventive cardiology at the Emory University School of Medicine, Atlanta, USA.

The World Health Organization estimates that almost 20% of all strokes and over 50% of all heart attacks can be linked to high cholesterol. But if you’ve been diagnosed with high cholesterol, don’t despair. The good news is that high cholesterol is one risk factor for strokes and heart attacks that you can change. You just need to take action now, before your high cholesterol results in more serious disease.

All About High Cholesterol Rick Numbers

When it comes to high cholesterol risks, it’s tough to keep the details straight. We might have a vague idea of whether our cholesterol is good or bad., but we forget the actual numbers by the time we get to the parking lot outside our doctor’s office. So it may be worth reviewing the basics.

Cholesterol is a fat-like substance circulating in your blood. Some of your cholesterol comes from the foods you eat. But the bulk of it is actually made in your own body, specifically in the liver. Cholesterol does have some good uses. It helps produce new cells and some hormones. But an excess of it in the bloodstream can lead to trouble.

There are two types of cholesterol: LDL and HDL

LDL is also called ‘bad cholesterol’. LDL can clog your arteries, increasing the risk of heart attack and stroke. Most people should aim for a level of less than 3.5 mmol/L. However, people who already have heart disease may need to aim for under 3 mmol/L.

HDL is ‘good cholesterol’. This type of cholesterol attaches to bad cholesterol and brings it to the liver, where it’s filtered out of the body. So HDL cholesterol reduces the amount of bad cholesterol in your system. You should aim for 3 mmol/L or higher.

Triglycerides are not cholesterol but another type of fat floating in your blood. Just as with bad cholesterol, having a high level of triglycerides increases your risk of cardiovascular problems. Aim for a level of less than 2 mmol/L.

So although we all talk about high cholesterol risks, the term is a little misleading. What we really mean is high levels of LDL and triglycerides and a low level of HDL.

What about total cholesterol, which is the sum of your LDL and HDL? While anything under 5.2 mmol/L is still considered the target, most expert don’t focus on the number. It doesn’t mean all that much.

How Harmful Is High Cholesterol?

Everyone has cholesterol in their blood. But if your levels of LDL is too high, the excess can accumulate on the walls of your arteries. This buildup of cholesterol and other substances - called plaque - can narrow the artery like a clogged drain. It can also lead to arteriosclerosis, or hardening of the arteries, which turns the normally flexible tissue into more brittle.

Plaques can form anywhere. If they form in the carotid artery in the neck, it’s carotid artery disease. When they form in the coronary arteries - which supply the heart muscle with blood - it’s called coronary artery disease. Like any organ, the heart needs a good supply of blood to work. If it doesn’t get that blood, you could get angina, which causes a squeezing pain in the chest and other symptoms.

There are other high cholesterol risks. If these plaques break open, they can form a clot. If a clot lodges in an artery and completely chokes off the blood supply, the cells don’t get the nutrients and oxygen they need and die. If clot gets to the brain and blocks blood flow, it can cause a stroke. If a clot lodges in the coronary arteries, it can cause a heart attack.

Are We Aware Of High Cholesterol Levels?

Experts say that people don’t take high cholesterol risks seriously enough. According to the CDC, in 2005 almost a quarter of American adults said they hadn’t had their cholesterol checked in the last five years.

One problem is that high cholesterol doesn’t cause symptoms that make people pay attention.

“People naturally respond more to medical conditions that cause symptoms”, says Nathan D Wong, PhD, fellow of the American College of Cardiology and director of the Heart Disease Prevention Program at the University of California, Irvine. SInce you won’t feel your rising cholesterol levels, you won’t go to the doctor about it.

By the same token, people may be less likely to stick to treatment for high cholesterol than they would be for a painful condition.

“People on cholesterol-lowering medicine don’t feel any better”, says Sperling. “It’s not like taking a painkiller for an aching knee, where you know it’s working”. As a result, people may be less likely to follow their treatment plan over the long term, Sperling says.

Also, high cholesterol risks are usually not immediate. The damage accumulates over years and decades - high cholesterol in your 20s and 30s can take its toll in your 50s and 60s. Because the effects take time, many people don’t feel real urgency in treating it. They feel they can just deal with it later.

“Unfortunately, I think that many people are too casual about their high cholesterol”, says Adolph Hutter MD, a cardiologist at Massachusetts General Hospital and a professor of medicine at Harvard Medical School. “They ignore it for years and it only gets their attention when they actually develop vascular disease”.

How To Lower High Cholesterol Risks

There are many good treatments for heart disease, arteriosclerosis and other serious conditions caused by high cholesterol. But it’s terrible shame to let things get that far when making changes now could prevent these life threatening illnesses. Reducing your high cholesterol risks is a crucial step.

So what should you do? First, go to the doctor. “It’s very important for all adults to get their cholesterol tested”, says Wong. Every adult over 20 should have a cholesterol test at least once every five years.

Also keep track of your cholesterol levels yourself. Write down your current numbers and, if they’re high, what numbers you should be striving for.

If you do have high cholesterol, get serious. Talk with your doctor about what your goals should be and how you should achieve them. Make sure you understand what lifestyle changes you need to make. If you already have heart disease or other risk factors like diabetes, you need to be even more careful.

There are products available in the market to help reduce high cholesterol. One of the most effective and clinically proven is Proactol. It is 100% natural, 100% green (suitable for vegetarian) and certified organic. Proactol is clinically proven to lower blood cholesterol by binding 28% of dietary fat intake, and used as a treatment for obesity. It is backed by many medical experts including Dr. Joerg Gruenwald, a leading scientific director of Phytopharm Consulting, and the author of the international reference work for botanical medicines Physican Desk Reference for Herbal Medicines.

“Coronary heart disease and diabetes are all too often found in people with high cholesterol, excess weight, unhealthy eating habits and lack of exercise. However, it is especially this high risk group that finds it difficult to take charge of their weight and eating habits. It is therefore encouraging to see that a product like P

Cholesterol Questions To Ask Your Doctor

2009-07-07T17:00:00.000-07:00

Many people have questions for their doctors about tests, drug treatments, risk factors and lifestyle changes. Below are examples of common questions.For a printable version to take to your doctor's office, click the link in the right column of this page.

About Blood Cholesterol

What do my cholesterol numbers mean?

What is my cholesterol goal?

How long will it take to reach my cholesterol goals?

How often should I have my levels checked?

How does exercise affect my cholesterol levels?

How does smoking affect my cholesterol levels?

What type of foods should I eat?

Do I need to lose weight, and if so, how much?

Will I need cholesterol-lowering medicine?

About Drug Treatment

What kind of medicine should I take?

Can I take the generic form of the medicine?

What should I know about the medicine?

What are the side effects?

How do I know if it’s working?

How can I remember when to take the medicine?

What if I forget to take a medicine?

Should I avoid any foods or other medicines?

Can I drink alcohol?

How long will I need to take my medicine?

Why Is Cholesterol Important?

2009-07-07T16:58:00.000-07:00

Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease.

How Does Cholesterol Cause Heart Disease?

When there is too much cholesterol (a fat-like substance) in your blood, it builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. The blood carries oxygen to the heart, and if enough blood and oxygen cannot reach your heart, you may suffer chest pain. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack.

High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.

What Do Your Cholesterol Numbers Mean?

Everyone age 20 and older should have their cholesterol measured at least once every 5 years. It is best to have a blood test called a "lipoprotein profile" to find out your cholesterol numbers. This blood test is done after a 9- to 12-hour fast and gives information about your:

Total cholesterol
LDL (bad) cholesterol--the main source of cholesterol buildup and blockage in the arteries
HDL (good) cholesterol--helps keep cholesterol from building up in the arteries
Triglycerides--another form of fat in your blood

If it is not possible to get a lipoprotein profile done, knowing your total cholesterol and HDL cholesterol can give you a general idea about your cholesterol levels. If your total cholesterol is 200 mg/dL* or more or if your HDL is less than 40 mg/dL, you will need to have a lipoprotein profile done. See how your cholesterol numbers compare to the tables below.

Total Cholesterol Level	Category
Less than 200 mg/dL	Desirable
200-239 mg/dL	Borderline High
240 mg/dL and above	High

* Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

LDL Cholesterol Level	LDL-Cholesterol Category
Less than 100 mg/dL	Optimal
100-129 mg/dL	Near optimal/above optimal
130-159 mg/dL	Borderline high
160-189 mg/dL	High
190 mg/dL and above	Very high

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.

Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

What Affects Cholesterol Levels?

A variety of things can affect cholesterol levels. These are things you can do something about:

Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level.
Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL and total cholesterol levels, as well as raise your HDL and lower your triglyceride levels.
Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL (bad) cholesterol and raise HDL (good) cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.

Things you cannot do anything about also can affect cholesterol levels. These include:

Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise.
Heredity. Your genes partly determine how much cholesterol your body makes. High blood cholesterol can run in families.

What Is Your Risk of Developing Heart Disease or Having a Heart Attack?

In general, the higher your LDL level and the more risk factors you have (other than LDL), the greater your chances of developing heart disease or having a heart attack. Some people are at high risk for a heart attack because they already have heart disease. Other people are at high risk for developing heart disease because they have diabetes (which is a strong risk factor) or a combination of risk factors for heart disease. Follow these steps to find out your risk for developing heart disease.

Step 1: Check the table below to see how many of the listed risk factors you have; these are the risk factors that affect your LDL goal.

Major Risk Factors That Affect Your LDL Goal

Cigarette smoking
High blood pressure (140/90 mmHg or higher or on blood pressure medication)
Low HDL cholesterol (less than 40 mg/dL)*
Family history of early heart disease (heart disease in father or brother before age 55; heart disease in mother or sister before age 65)
Age (men 45 years or older; women 55 years or older)

* If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count.

Even though obesity and physical inactivity are not counted in this list, they are conditions that need to be corrected.

Step 2: How many major risk factors do you have? If you have 2 or more risk factors in the table above, use the attached risk scoring tables (which include your cholesterol levels) to find your risk score. Risk score refers to the chance of having a heart attack in the next 10 years, given as a percentage. My risk score is ________%.

Step 3: Use your medical history, number of risk factors, and risk score to find your risk of developing heart disease or having a heart attack in the table below.

If You Have	You Are in Category
Heart disease, diabetes, or risk score more than 20%*	I. High Risk
2 or more risk factors and risk score 10-20%	II. Next Highest Risk
2 or more risk factors and risk score less than 10%	III. Moderate Risk
0 or 1 risk factor	IV. Low-to-Moderate Risk

* Means that more than 20 of 100 people in this category will have a heart attack within 10 years.

My risk category is ______________________.

Treating High Cholesterol

The main goal of cholesterol-lowering treatment is to lower your LDL level enough to reduce your risk of developing heart disease or having a heart attack. The higher your risk, the lower your LDL goal will be. To find your LDL goal, see the boxes below for your risk category. There are two main ways to lower your cholesterol:

Therapeutic Lifestyle Changes (TLC)--includes a cholesterol-lowering diet (called the TLC diet), physical activity, and weight management. TLC is for anyone whose LDL is above goal.
Drug Treatment--if cholesterol-lowering drugs are needed, they are used together with TLC treatment to help lower your LDL.

If you are in...

Category I, Highest Risk, your LDL goal is less than 100 mg/dL. you will need to begin the TLC diet to reduce your high risk even if your LDL is below 100 mg/dL. If your LDL is 100 or above, you will need to start drug treatment at the same time as the TLC diet. If your LDL is below 100 mg/dL, you may also need to start drug treatment together with the TLC diet if your doctor finds our risk is very high, for example if you had a recent heart attack or have both heart disease and diabetes.
Category II, Next Highest Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin treatment with the TLC diet. If your LDL is 130 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart healthy diet for all Americans, which allows a little more saturated fat and cholesterol than the TLC diet.
Category III, Moderate Risk, your LDL goal is less than 130 mg/dL. If your LDL is 130 mg/dL or above, you will need to begin the TLC diet. If your LDL is 160 mg/dL or more after you have tried the TLC diet for 3 months, you may need drug treatment along with the TLC diet. If your LDL is less than 130 mg/dL, you will need to follow the heart healthy diet for all Americans.
Category IV, Low-to-Moderate Risk, your LDL goal is less than 160 mg/dL. If your LDL is 160 mg/dL or above, you will need to begin the TLC diet. If your LDL is still 160 mg/dL or more after 3 months on the TLC diet, you may need drug treatment along with the TLC diet to lower your LDL, especially if your LDL is 190 mg/dL or more. If your LDL is less than 160 mg/dL, you will need to follow the heart healthy diet for all Americans.

To reduce your risk for heart disease or keep it low, it is very important to control any other risk factors you may have such as high blood pressure and smoking.

Lowering Cholesterol With Therapeutic Lifestyle Changes (TLC)

TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are:

The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power.
Weight Management. Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women).
Physical Activity. Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement.

Foods low in saturated fat include fat-free or 1percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products.

Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.

Drug Treatment

Even if you begin drug treatment to lower your cholesterol, you will need to continue your treatment with lifestyle changes. This will keep the dose of medicine as low as possible, and lower your risk in other ways as well. There are several types of drugs available for cholesterol lowering including statins, bile acid sequestrants, nicotinic acid, fibric acids, and cholesterol absorption inhibitors. Your doctor can help decide which type of drug is best for you. The statin drugs are very effective in lowering LDL levels and are safe for most people. Bile acid sequestrants also lower LDL and can be used alone or in combination with statin drugs. Nicotinic acid lowers LDL and triglycerides and raises HDL. Fibric acids lower LDL somewhat but are used mainly to treat high triglyceride and low HDL levels. Cholesterol absorption inhibitorrs lower LDL and can be used alone or in combination with statin drugs.

Once your LDL goal has been reached, your doctor may prescribe treatment for high triglycerides and/or a low HDL level, if present. The treatment includes losing weight if needed, increasing physical activity, quitting smoking, and possibly taking a drug.

High Blood CholesterolHigh Blood Cholesterol: What You Need To Know

2009-07-07T16:51:00.000-07:00

What Is Cholesterol?

To understand high blood cholesterol (ko-LES-ter-ol), it is important to know more about cholesterol.

Cholesterol is a waxy, fat-like substance that is found in all cells of the body. Your body needs some cholesterol to work the right way. Your body makes all the cholesterol it needs.
Cholesterol is also found in some of the foods you eat.
Your body uses cholesterol to make hormones, vitamin D, and substances that help you digest foods.

Blood is watery, and cholesterol is fatty. Just like oil and water, the two do not mix. To travel in the bloodstream, cholesterol is carried in small packages called lipoproteins (lip-o-PRO-teens). The small packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body. It is important to have healthy levels of both:

Low-density lipoprotein (LDL) cholesterol is sometimes called bad cholesterol.
- High LDL cholesterol leads to a buildup of cholesterol in arteries. The higher the LDL level in your blood, the greater chance you have of getting heart disease.
High-density lipoprotein (HDL) cholesterol is sometimes called good cholesterol.
- HDL carries cholesterol from other parts of your body back to your liver. The liver removes the cholesterol from your body. The higher your HDL cholesterol level, the lower your chance of getting heart disease.

What Is High Blood Cholesterol?

Too much cholesterol in the blood, or high blood cholesterol, can be serious. People with high blood cholesterol have a greater chance of getting heart disease. High blood cholesterol on its own does not cause symptoms, so many people are unaware that their cholesterol level is too high.

Cholesterol can build up in the walls of your arteries (blood vessels that carry blood from the heart to other parts of the body). This buildup of cholesterol is called plaque (plak). Over time, plaque can cause narrowing of the arteries. This is called atherosclerosis (ath-er-o-skler-O-sis), or hardening of the arteries.

The illustration shows a normal artery with normal blood flow (figure A) and an artery containing plaque buildup (figure B).

Special arteries, called coronary arteries, bring blood to the heart. Narrowing of your coronary arteries due to plaque can stop or slow down the flow of blood to your heart. When the arteries narrow, the amount of oxygen-rich blood is decreased. This is called coronary heart disease (CHD). Large plaque areas can lead to chest pain called angina (an-JI-nuh or AN-juh-nuh). Angina happens when the heart does not receive enough oxygen-rich blood. Angina is a common symptom of CHD.

Some plaques have a thin covering and can burst (rupture), releasing cholesterol and fat into the bloodstream. The release of cholesterol and fat may cause your blood to clot. A clot can block the flow of blood. This blockage can cause angina or a heart attack.

Lowering your cholesterol level decreases your chance for having a plaque burst and cause a heart attack. Lowering cholesterol may also slow down, reduce, or even stop plaque from building up.

Plaque and resulting health problems can also occur in arteries elsewhere in the body.

Indonesian elephant fossil opens window to past

2009-06-23T17:20:00.000-07:00

Scientists arrange the bones of an estimated 200,000 year-old giant elephant at Geology Museum in Bandung, West Java, Indonesia, Thursday, June 18, 2009. Indonesian scientists are reconstructing the largest, most complete skeleton of an ancient elephant ever found in the tropics, a finding that may offer new clues into the largely mysterious origins of its modern Asian cousin. Based on the fossil, the ancient elephant stood four meters (13-feet) tall, was five meters (16-feet) long and weighed more than 10 tons, considerably larger than the great Asian mammals now on Earth. (AP Photo/Dita Alangkara)

BANDUNG, Indonesia (AP): Indonesian scientists are reconstructing the largest, most complete skeleton of a prehistoric giant elephant ever found in the tropics, a finding that may offer new clues into the largely mysterious origins of its modern Asian cousin.

The prehistoric elephant is believed to have been submerged in quicksand shortly after dying on a riverbed in Java around 200,000 years ago. Its bones--almost perfectly preserved--were discovered by chance in March.

The animal stood four meters (13-feet) tall, was five meters (16-feet) long and weighed more than 10 tons. It was considerably larger than the great Asian mammals now on Earth, and closely resembled the woolly mammoth of the same period in terms of size.

Animal fossils are rare in the humid, hot climate of the equator because decomposition occurs extremely quickly.

A team of seven paleontologists from the Geology Museum in Bandung, West Java, set the bones in plaster for the trip back to their office after a monthlong excavation and the laborious process of piecing them together then began.

"We believe from the shape of its teeth that it was a very primitive elephant," but little else has been verified, said paleontologist Fachroel Aziz, who is heading a 12-strong skeletal reconstruction team.

Scientists agree it is the first time an entire prehistoric elephant skeleton has been unearthed since vertebrate fossil findings began to be recorded in Indonesia in 1863.

"It is very uncommon to discover a fossil like this in a tropical region like Indonesia," said Edi Sunardi, an independent expert at Indonesia's Pajajaran University in Bandung, West Java. "It apparently was covered by volcanic sediment that protected it from high temperatures, erosion and decay."

"From its feet to its skull, from the trunk to its tail bone, it's all complete," he said.

A piece of the 2.5-meter (8.2-foot) tusk of the extinct species was discovered five years ago by a geologist on a mapping project in the hilly village of Sungun, Central Java. The bigger find came three months ago when an old sand quarry collapsed during annual monsoon rains.

The next challenge will be removing the delicate bones from their molds and joining them into a stable, upright structure, a process that experts said is already being hampered by a lack of funding, inadequate tools and poor expertise.

Indonesia, an emerging and impoverished democracy of 235 million people, cannot afford to allocate more than a token sum to its aging museums, even for projects that have the potential to advance knowledge about the origin of key native species.

Gert van den Berg, a researcher at Australia's Wollongong University who helped dig up the skeleton, said tests are under way to determine its precise age and species, but that it will certainly answer lingering questions about the morphology of Asian elephants.

"This is the first time that an individual skeleton has been found that is so complete," Van den Berg said. Around 90 percent of the skeleton has been collected, including the skull and vertebrate which he said can provide details "about when the modern elephants evolved into what they are now."

About 2,000 old elephant remains have been found across the island nation over the past 150 years, but never in such good condition, said Aziz, describing how this elephant probably slipped into a pit of quicksand and was quickly buried.

"We want to exhibit it publicly because this is a spectacular discovery," he said. (By NINIEK KARMINI/Associated Press Writer)

Michael Jackson auction called off: official

2009-06-23T17:17:00.002-07:00

LOS ANGELES: A huge sale of items belonging to former "King of Pop" Michael Jackson due to take place next week has been cancelled, the auction house organizing the sell-off confirmed Tuesday.

Martin Nolan, executive director of Julien's Auctions, told AFP that the hotly anticipated sale had been scrapped after a settlement had been reached with the eccentric pop star's legal team.

Jackson's management company had been attempting to halt the April 22-25 auction despite earlier approving the sale and co-operating with Julien's.

"I can tell you that both parties today agreed not to move forward with the auction on April 22," Nolan told AFP. "The collection will stay together to be returned to Michael Jackson and MJJ Productions."

The terms of the settlement were not disclosed but Nolan said both parties were happy with the deal.

More than 1,300 items--including a customized Rolls Royce limousine and dozens of Jackson's concert costumes--had been due to go under the hammer in Beverly Hills in an auction expected to raise millions.

Items up for sale had been taken from Jackson's sprawling Neverland Ranch in California, which the singer left and has never returned to following his acquittal on child abuse charges in 2005.

All the auction lots were on display Tuesday at a public exhibition ahead of the sale which had sparked worldwide interest from memorabilia collectors and Jackson fans.

Jackson's production company MJJ Productions had contracted Julien's to arrange an auction of Neverland items last year before suddenly seeking to halt the sale in a lawsuit filed in Los Angeles last month.

A judge said the sale could ahead at a hearing on April 3, although Jackson's lawyers had been due to argue for an injunction at a further hearing scheduled for Wednesday in Los Angeles.

Nolan said he believed that the reaction of Jackson's fans following news of the auction had made the singer think twice about going ahead with the sale.

"There was such a sentimental reaction from fans all over the world about the dispersal of the collection from Neverland that it made Michael aware of the level of the loyalty of the fans," Nolan told AFP.

Nolan said while he expected prospective buyers would be disappointed by the cancellation "there's going to be rejoicing as well because at the end of the day there was a touch of sadness about the dispersal of Neverland."

"But now it's going to stay together and there will eventually be a permanent museum," he said. Nolan would not speculate on where any future Jackson museum was likely to be placed.

Jackson, who dominated the pop world with hit albums like "Thriller" and "Bad" in the 1980s, has virtually vanished from public view since being cleared at his "Trial of the Century" in California four years ago.

Jackson is currently preparing for a series of comeback concerts in London in July. Tickets sold out within hours when they went on sale. (AFP)

Malaysia pushing for WHO to adopt exit screening

2009-06-23T17:17:00.001-07:00

PUTRAJAYA: Malaysia is pushing for the World Health Organisation (WHO) to adopt a requirement for affected countries to implement exit screening to stop the spread of the new Influenza A disease, following concerns that a second wave of the H1N1 disease can be more deadly.

Health Minister Datuk Seri Liow Tiong Lai said currently WHO did not make exit screening mandatory to contain the spread of the disease and this had created tremendous pressure on other countries that were not affected by the outbreak to remain so.

WHO is not recommending travel restrictions following the outbreak, but has advised individuals who are ill to delay their travel plans and returning travellers who fall ill, to seek appropriate medical care.

The issue of exit screening was first brought up during the Asean Plus Three Health Ministers Meeting in Bangkok last week, but some countries were against making it mandatory as it would have an impact on travel and trade, especially at a time when many countries are facing an economic downturn, with huge costs involved.

"If we can have travellers from affected countries screened before they are allowed to travel out, this will help us to contain the spread of such virus to other places," he told Bernama here before leaving for the 62nd WHO General Assembly in Geneva, Switzerland.

However, while on transit in London, Liow confirmed Malaysia's first confirmed case of influenza A(H1N1) case involving a 21-year-old student who returned to Malaysia two days ago and is now quarantined at the Sungai Buloh Hospital.

The WHO general assembly, scheduled for May 18-22, will discuss a number of public health issues, including pandemic influenza preparedness, sharing of information on the influenza virus and access to vaccines and other benefits.

Liow said Malaysia and some other countries would push for WHO to adopt exit screening as a compulsory measure in the case of any outbreak in any country.

"We are pushing for this during the WHO general assembly in Geneva this weekend. Even at the Asean Plus Three Health Ministers Meeting in Bangkok (last week), not all countries agreed to it. But we hope WHO will pay attention to this," he said.

Apart from that, Liow said Malaysia would get the latest information on the H1N1 virus from WHO, as well as on the development of new vaccines while looking into stockpiling more anti-viral drugs for the country.

"We would like to bring to WHO's attention on the need for equal distribution of anti-viral drugs as well as other stockpiles as we are worried about the second wave of attack," he said.

Experts have said that the Influenza A(H1NI) outbreak is similar to the 1918 influenza pandemic as the viruses are similar and mutated. The 1918 influenza pandemic, which killed tens of millions of people, began mild and returned within six months in a much more lethal form.

"We've got to be prepared for this second, or even possible third wave while the government has decided to take all the precautionary measures as a long-term or permanent solution to the influenza outbreak," Liow said.

WHO said the new H1N1 flu virus could still mutate into a more virulent form and spark an influenza pandemic that could be expected to circle the globe up to three times.

The world health body has warned that the impact of any pandemic would vary, as a virus that causes only mild illness in countries with a strong healthcare system can become "devastating" in those with a weak healthcare system, shortage of drugs and poorly equipped hospitals.

According to WHO, the H1N1 viral infection, commonly referred to as swine flu, "appears to be more contagious than seasonal influenza and nearly the world's whole population lacks immunity to the new disease."

So far, the virus shows no signs of sustained person-to-person spread outside North America.

Some 6,497 people have been infected in 33 countries, according to WHO's tally on Friday with the hardest hit being Mexico with 60 deaths so far. (By ALAN TING/Bernama)

3 to 6 Months

2009-06-23T17:09:00.000-07:00

3 TO 6 MONTHS

What a time of wonder these first few months are! From a sleeping and eating machine to a smiling, responsive infant, your baby will grow by leaps and bounds in many ways, including physically.
HOW MUCH SHOULD MY BABY GROW?

After losing some of his birth weight during the first few days of life, your baby will be starting to grow steadily. By the middle of his first month, he will probably be gaining about 300gm to 600gm per month.
After the first month, weight gain may average 0.9kg to 1.2 kg and length may increase 2.5cm to 3.75cm per month. These are just averages; as long as your baby is staying on his own growth curve, you should have no concerns about his progress. Your paediatrician will measure his weight, length, and head circumference and plot your baby's own growth path on a chart, so any growth problems can be spotted early.

THE SENSES: SIGHT
By the end of this period, your infant's distance vision should improve dramatically. He'll be able to recognise you as you enter a room, well before you have picked him up. You'll catch him gazing out a window or at a picture on the other side of the room. Human faces are still one of his favourite things to look at, especially his parents' and his own.

THE SENSES: HEARING
Your baby loves to hear your voice. So talk, babble, sing and coo away during these first few months. Take special advantage of your baby's own 'talking' to have a `conversation'. If you hear him make a sound, repeat it and wait for him to make another. You are teaching your baby valuable lessons about tone, pacing and taking turns when talking to someone else.
Besides voices, your infant will enjoy listening to music (try out a variety and see which one he likes best). He'll be fascinated by the routine sounds of life as well. Keep him nearby as you rattle pans while making dinner, for instance.

THE SENSES: TOUCH
Between one and three months, your baby is depending on you to bring touch to him. Infants know they are loved and cared
for when they are held, caressed, massaged and kissed.

LEARNING AND PLAY
Your 1-3 month old is more alert and aware of his surroundings than he was as a newborn. He already recognises his parents' voices and faces, and he might be ready to respond to them with smiles. Your baby is ready to be an active participant in play.

WHAT WILL MY BABY LEARN?
Your baby will carefully watch your facial expressions and listen to your voice. By listening to you, he is learning the importance of speech before he understands or repeats any words himself. He'll also learn during this period that he has the ability to vocalise, too; make sure to answer his coos and gurgles with your own sounds, and he will be more willing to express himself.
Now that your baby's hands are open (and he's discovered them), he'll begin to use them to learn about the world. He'll play with his fingers, bring his hands to his mouth, and try to swing at things within view. In this way, he is learning hand-eye coordination. When lying down, he'll stretch out his arms and legs - soon he will learn to grasp and kick!
You will learn to recognise when your baby is alert and ready to learn and play, and when he'd rather be left alone. Sometimes your baby will need to protect himself from overstimulation by 'shutting down' for a bit.

WHAT SHOULD I DO?
Remember that play is not just 'play' to babies and children. Play is how they learn, so be enthusiastic when your baby shows interest in playing. Take every opportunity to interact with him - provided he's in the mood. Don't overstimulate him with too many activities at once, and let him tell you when he's bored.
Your baby will enjoy listening to music, the sounds his toys make, and your singing - and he won't care whether or not you 're any good. His eyesight is improving, so he'll be fascinated by brightly coloured pictures in books and the mobile above his crib. And he won't be able to take his eyes off himself if he has an unbreakable crib mirror.
As your baby's hands open, offer him a rattle to hold, and watch his search for the source of the rattle 's sounds. Give him safe objects of different textures, shapes, sizes, colours, and weights to hold. Dangle objects above your baby and let him swat at them.
To get his hands moving, clap them together. Move his legs like a bicycle with your hands. These body games will help him learn to control his movements.
Once your baby can hold his head up, introduce these classic games, or make up your own:
Elevator: Lie on your back and lift your baby up over you. Say, 'I'm going to kiss you! ' while you lower him down and give him a kiss.
Bouncing rides: Place your baby on your lap and hold him under his arms. Move forward until you 're at the edge of the seat, then raise and lower your heels to give him a gentle bounce. Reciting rhymes while you do this will add to the fun and encourage language development.

MOVEMENT AND COORDINATION
Your infant is now on his way toward more voluntary movement as some of the initial reflexes noticeable after birth begin to disappear. By the end of the second month, most infants should be able to lift their heads 45 degrees off the crib mattress while lying on their stomachs; some may even be able to lift up further. By the end of this period, he should be able to bring his head up and look around.
You'll notice increasing neck strength as you hold your baby, too; he'll be able to control his head more and more on his own, although he'll still depend on you to watch that he has proper head support. While it will still be difficult for him to lift his head while lying flat on his back, you'll notice that his neck is less floppy if you lift him by the arms. Baby's legs will gradually straighten out, and his leg strength will become more apparent with each kick. Although his kicks may still be mostly reflexive, he may soon be strong enough to push himself over from his front to his back with his leg. This is why you should never leave your baby unattended on a changing table, bed, or other high surface. You never know when your baby will decide that he wants to roll over!
Your infant will grow increasingly aware of his own hands during this period. Although he has been able to grasp your finger or a light object reflexively since birth, during these months he'll learn how to control that grasp: how to open and shut his hand and how to bring a hand (or an object it is holding) to his mouth. He can swipe his hands at objects hung above him. He can shake a rattle or other toy placed in his hand - and drop it when he loses interest in it. He may continually attempt to get his own hand into his mouth during these months, but may fall short of this goal until about the fourth month. Then he'll get that thumb where he wants it and will be able to keep it there!

COMMUNICATION
Your baby will recognise Mummy and Daddy, laugh, squeal and smile spontaneously. His personality begins to become evident. Crying will continue to be your baby's primary means of communication for many months. Aside from letting you know that he needs something (and perhaps even what he needs by the way he cries), your baby may cry when he is overwhelmed by all the sights and sounds of the world. sometimes he may cry for no apparent reason at all.
Your baby will respond to the sound of your voice by becoming quiet, smiling or getting excited, and moving his arms and legs. He will begin smiling regularly at you at this point. He probably won't smile and be friendly to strangers, but he may warm up to them with coos and baby talk - or at least a curious stare.
Babies this age discover that they have the ability to vocalise; soon you'll have a cooing and gurgling machine! Some babies begin to repeat some vowel sounds, like'ah-ah' or'ooh-ooh' at about two months. Your baby will 'talk' to you with a variety of sounds; he'll also smile at you and wait for your response, and respond to your smiles with his own. His arms and legs will move, and his hands will open up. He may even mimic your facial expressions.

SLEEP
Now your baby will probably begin to stay awake longer during the day and sleep more at night than he did when he was born. Since your baby is more alert and aware of his surroundings during the daylight hours, he will be more inclined to sleep during the night, especially if you fight the urge to play or talk to him during night-time feedings or diaper changes.
Your baby is adapting to the sleep-wake cycle that his parents favour, and his stomach is growing and holding more breast milk or formula. That means he might even be sleeping up to seven or eight hours without waking up because of hunger. At about three months, if you feed your infant and put him to bed at 10pm, you may find yourself actually sleeping until dawn! Again, not all infants keep to the same timetable.

Newborn

2009-06-23T17:07:00.000-07:00

0 TO 3 MONTHS
`It's a boy!'
`It's a girl!'
Once that's been established and fingers and toes have been counted, what's the next thing you'll find out about your newborn? Probably weight and length. When sending out your birth announcements, you'll probably include both of these measurements. Why all this interest in your baby's size? Because it's a concrete way to begin tracking your baby's growth from the first day forward.
HOW MUCH SHOULD MY BABY WEIGH?
Just like adults, newborns come in all shapes and sizes. The majority of babies born full-term (40 weeks) weigh from just over 3.41 kg to almost 5.02kg, and they are between 47.5cm and 52.5cm long. At one time we used to put a premium on `big' babies, but within this wide range of newborn weights and lengths, it's the baby's overall health that matters most.
Your newborn will most likely gain weight at an average of 200gm per week, and grow about 2.5cm to 3.75cm during his first month. Most newborns go through a period of rapid growth (a growth 'spurt') when they are seven to 10 days old, and again between three and six weeks.
Don't be worried if your full-term baby goes home weighing slightly less than he did when he was born. While it's disappointing for parents to see their newborns' weight drop, it's perfectly normal. Nearly all newborns lose a portion of their birth weight because of fluid loss and because they do not need much milk during the first few days of life.
By day 14 or before, your baby should be back to his birth weight. If you are concerned about what seems to be an excessive weight loss after the first few days of your baby's life, check with your paediatrician.
MOVEMENT AND COORDINATIONAlthough it may seem to the parents and siblings of a newborn baby that his activities are limited to sleeping, eating, and crying, that little body is capable of a myriad of movements. Research has shown that babies can not only make associations between sound and other senses, but can also be taught to respond in different ways to the same sound and, if permitted, will exert some control in choosing sounds they want to hear. One of your newborn's most important movements is his rooting reflex. Newborns get hungry, but they don't yet have the ability to look actively for food. The rooting reflex prompts a baby to turn in the direction of his mother's nipple. If you gently stroke the cheek of a newborn with your hand, he will turn in that direction, mouth open, ready to suck. This reflex generally lasts a few months, until the baby becomes proficient at simply turning his mouth to where his next meal is coming from. Your newborn's sucking is also a survival reflex. When his mother's nipple is placed in his mouth, he will automatically suck. The purpose of the rooting and sucking reflexes is obvious: they help your newborn get the nourishment he needs. These reflexes soon become voluntary or directed movements, and in a few months you may even find your infant trying to console himself by sucking his own hand.
Although it may seem to the parents and siblings of a newborn baby that his activities are limited to sleeping, eating, and crying, that little body is capable of a myriad of movements. Research has shown that babies can not only make associations between sound and other senses, but can also be taught to respond in different ways to the same sound and, if permitted, will exert some control in choosing sounds they want to hear.
One of your newborn's most important movements is his rooting reflex. Newborns get hungry, but they don't yet have the ability to look actively for food. The rooting reflex prompts a baby to turn in the direction of his mother's nipple. If you gently stroke the cheek of a newborn with your hand, he will turn in that direction, mouth open, ready to suck. This reflex generally lasts a few months, until the baby becomes proficient at simply turning his mouth to where his next meal is coming from.
Your newborn's sucking is also a survival reflex. When his mother's nipple is placed in his mouth, he will automatically suck. The purpose of the rooting and sucking reflexes is obvious: they help your newborn get the nourishment he needs. These reflexes soon become voluntary or directed movements, and in a few months you may even find your infant trying to console himself by sucking his own hand.
The Moro reflex shows itself when your newborn is startled by a loud noise or feels he is about to fall or be dropped. Sometimes new parents notice this reflex if they place their baby in the bassinet or crib too quickly. Your newborn will react by throwing out his arms and legs, arching his neck, then curling in again with a cry. This reflex quickly disappears, usually by the third month.
You may be able to see the tonic neck reflex at work in your infant. If you turn your baby's head to one side, you may notice him straightening the arm and leg on that side of his body, while curling the opposite arm and leg. This reflex will probably disappear by the middle of his first year.
Stroking your newborn's palms and feet, also called the grasp reflex, may elicit other reflexes. Put your finger directly in your baby's hand, and he may grasp it quite tightly - tightly enough perhaps to support his full body weight in the first days after birth. Touch the sole of your newborn's foot and look for a similar response: a flexing of the foot, with tightly clenched or flared toes. These reflexes also slowly disappear over the course of the first year of your baby's life.
WHAT CAN I DO?
Motor skills develop naturally under most circumstances. Your job during this stage is to make your baby feel safe and secure. Make sure that his head and neck are supported. Never leave him unattended, especially on high surfaces such as a changing table or bed. You can encourage movement through play by gently 'cycling' his arms or legs as he lies on his back, or you can let him kick at your hands or a toy that squeaks. The movement your newborn like best is YOUR movement, so hold him often.
THE SENSES
Your newborn may seem to do little more during the first weeks of life than eat, sleep and cry. But in reality, all of his senses are functioning already, taking in the sights, sounds, and smells of this new world he's entered. It's hard for us to know exactly what a newborn is feeling, but if you pay close attention to his responses to light, noise, and touch, you can see his complex senses begin to come alive.
THE SENSES: SIGHT
A newborn's sight is perfectly set to see the most important things in the world to him - his parents' faces. New babies can see best at a distance of only 20cm to 35cm, bringing his eyes in focus when he's gazing up from the arms of Mom or Dad. Your newborn can see things further away, but it is harder for him to focus on distant objects. Still, the light shining in from a faraway window may catch his eye, and he may stare at another family member moving around the room.
His colour preference is black, white and red in contrast to bright colours.
After human faces, brightness and movement are the things he likes to look at best. Even a crude line drawing of two eyes, a nose, and a mouth may keep his attention if held close enough. Although his sight is functioning, it still needs some fine-tuning, especially when it comes to focusing far off. His eyes may even seem to cross or diverge (go 'wail-eyed') briefly. This is usually just a sign that your newborn's eye muscles need to strengthen and mature a bit during the next few months.
THE SENSES: TASTE AND SMELL
We assume newborns can smell because we know they can taste, and these are the two most closely related of the human senses. Research with new babies shows they prefer sweet tastes from birth and will choose to suck on bottles of heavily sweetened water, but will turn away or cry if given something bitter or sour to taste.
Think of the world of smells an ordinary day affords your newborn: your clothes, dinner cooking on the stove, flowers in the yard. At least you don't have to worry too much about your baby's taste buds at this point. Breast milk will satisfy him completely!
THE SENSES: TOUCH
As it is to most humans, touch is extremely important to your newborn. Through touch, he learns a lot about the world around him. At first, he is looking only for comfort. Having come from a warm and enveloping fluid before birth, he'll be faced with feeling cold for the first time, brushing up against the hardness of the crib, feeling the scratch of a rough seam inside his clothes. He'll be looking to his parents to provide the soft touch he needs: silky blankets, comforting hugs, and loving caresses upon his head. With almost every touch your newborn is learning about life, so provide him with lots of tender kisses and he'll find the world a soothing place to be.
HOW DOES MY BABY COMMUNICATE?
Your baby is born with the ability to cry, which is how he will do most of his communicating for a while. Your baby's cries generally tell you that something is wrong in his world: his belly is empty, his bottom is wet, his feet are cold, he's tired, he needs to be held and cuddled. Soon you will be able to recognise which need your baby is expressing and respond accordingly. In fact, sometimes what a baby needs can be identified by his cry - for example, the 'I'm hungry' cry may be short and low-pitched, while 'I'm upset' may sound choppy.
Your baby may also cry when he is overwhelmed by all of the sights and sounds of the world. Sometimes he may cry for no apparent reason at all. Don't be too upset when your baby cries and you aren't able to console him immediately: crying is one of his ways of shutting out stimuli when he's overloaded.
A newborn can differentiate between the sound of a human voice and other sounds. Try to pay attention to how he responds to your voice. He already associates your voice with care: food, warmth, touch. If he's crying in his bassinet, see how quickly your approaching voice quiets him. See how closely he listens when you are talking to him in loving tones. He may not yet coordinate looking and listening, but even if he stares into the distance, he Il be paying close attention to your voice as you speak. He may subtly adjust his body position or facial expression, or even move his arms and legs in time with your speech.
Sometime during your newborn's first month, you may get a glimpse of his first smile and perhaps hear his first laugh or giggle. What welcome additions these are to his communication repertoire!
SLEEP
`Does your baby sleep through the night?' is one of the questions new parents faces the most. And the bleary-eyed mums and dads of newborns almost always answer: 'No'
Newborn babies don't know the difference between day and night yet - and their tiny stomachs don't hold enough breast milk or formula to keep them satisfied for very long. They need food every few hours, no matter what time of day or night it is.
A newborn may sleep as much as 16 hours a day (or even more), often in stretches of three to four hours at a time. And like the sleep all of us experience, babies have different phases of sleep: drowsiness, REM (rapid eye movement) sleep, light sleep, deep sleep, and very deep sleep. As babies grow, their periods of wakefulness increase.
At first, these short stretches of three to four hours of sleep may be frustrating for you as they interfere with your sleep pattern. Have patience - this will change as your baby grows and begins to adapt to the rhythms of life outside the womb. At first, though, the need to feed will outweigh the need to sleep. Many paediatricians recommend that a parent shouldn't let a newborn sleep too long without feeding. In practical terms, that means offering a feeding to your baby every 2 to 3 hours or so.
SLEEP SAFETY
Keep sleep safety in mind. Do not place anything in the crib or bassinet that may interfere with baby's breathing; this includes plush toys. Avoid objects with cords or ties and objects with any kind of sharp edge or corner. Make sure the crib you are using is up to today's safety standards.
The American Academy of Paediatrics recommends that healthy infants be placed on their backs or sides to sleep, not on their stomachs. Recent studies suggest that the back or side position for sleep might be safer. These studies noted that babies sleeping on their backs or sides have a somewhat lower risk of sudden infant death syndrome (SIDS) than babies who sleep on their stomachs do. The thought is that babies sleeping on their stomachs may have a greater tendency toward sleep obstruction and rebreathing their own carbon dioxide.
There are some exceptions to this recommendation, including: those with certain deformities of the head that make them more likely; to develop airway blockage when lying on their backs; Your paediatrician can best advise you on the right sleep position for your new baby.

Your Pregnancy

2009-06-23T17:05:00.000-07:00

WHAT YOUR BABY WILL NEED AT THE HOSPITAL
Undershirt
An outfit such as a stretch suit, nightgown, or sweater set
A pair of socks or booties
Receiving blanket, cap and heavier blanket or bunting, if the weather is cold
Diapers and wipes (some hospitals provide an initial supply of these)
Safety pins or velcro attaching strips, and rubber or nylon pants (if you are using cloth diapers)
Infant car seat
Diaper bag
SAFETY ITEMS FOR YOUR BABY
Night lights or soft lighting
Baby monitor
Baby nail clippers/scissors manicure set
THINGS YOU'LL NEED TO TRANSPORT YOUR BABY
Car seat - you will need to find out the specifications for a car seat that will fit in your car. All car seats are not made alike
Stroller
Backpacks and soft carriers
Diaper bag - since this is something you will be carrying around for about three years, choose one that is comfortable and durable for you
ITEMS FOR YOUR BABY'S ROOM
Crib and crib linens
Play pen or portable crib
Changing table
Dresser
Glider or rocking chair
Clothes hamper
SUGGESTED ITEMS FOR YOUR HOME
Diapers or cloth diapers
Receiving Blankets
Clothing
Breast pump - if you plan to breastfeed.
Bottles - be sure to get the correct size of nipples, such as preemie, or newborn
Rectal or digital ear thermometer
Bathtubs
Washcloths and baby wipes
Diaper rash ointment and/or petroleum jelly
Hooded Towels
Diaper disposal system - good to have, but not necessary
Burp Cloths and waterproof lap pads
Bulb syringe - for suctioning baby's nasal passages if necessary. Your baby's doctor will tell you if, when, and how to do this
THINGS YOU'LL NEED AS YOUR BABY GETS OLDER
Outlet protectors
Toys
Books
Walker
High Chair
Gates

Getting some sleep

2009-06-23T17:02:00.000-07:00

A look at ways to manage insomnia.
THE body rests and recovers from previous activities during sleep. Normal sleep comprises cycles of non-rapid eye movement (NREM) and rapid eye movement (REM). NREM sleep is followed by REM sleep, which occurs four to five times during the usual eight-hour sleep period.
The first REM period of the night may be last less than 10 minutes, while the last may exceed an hour. The NREM and REM cycles vary in length from 70 to 100 minutes initially, to 90 to 120 minutes later in the night.
Restful: Normal adults need six to 10 hours of sleep.
During the first third of the night, deep NREM sleep predominates, while REM sleep predominates in the last third of the night. REM sleep takes up 20% to 25% of total sleep time.
Insomnia
Insomnia refers to the disturbance of a normal sleep pattern. The different types of insomnia are:
·Difficulty getting to sleep (sleep onset insomnia) which is most common in young people.
·Waking up in the night which is most common in older people.
·Waking up early in the morning, which is least common.
·Not feeling refreshed after sleeping, leading to irritability, tiredness and difficulty concentrating during the day.
·Waking up due to disturbances such as noise or pain.
The duration of insomnia varies. It may be:
·Transient, lasting two to three days
·Short-term, lasting more than a few days, but less than three weeks
·Chronic, that is, it occurs on most nights for three weeks or more.
Everyone has experienced insomnia. It is generally accepted that about one-third of the population has insomnia.
How much sleep?
The need for sleep varies with age. A newborn may sleep 16 to 20 hours, and an infant 12 to 14 hours. Toddlers may sleep 10 hours or more. Primary schoolchildren need nine to 10 hours of sleep, while normal adults need six to 10 hours of sleep.
It takes an adult about 10 to 20 minutes to fall asleep. Most of those who have less than five to six hours of sleep are probably not getting enough sleep.
After a good sleep, a person would feel refreshed on waking and can stay alert throughout the day, without the need for naps or sleeping in on weekends.
Symptoms and causes
The symptoms of insomnia vary. They include lying awake for a long period at night prior to sleeping, waking up several times at night, waking up early in the morning and not being able to go back to sleep, feeling tired and not refreshed, inability to function properly during the day, and feeling irritable.
The causes of insomnia:
·Physiological: working at night, light, noise, snoring, partner’s movements, and jet lag.
·Medical: pain or discomfort caused by arthritis, headaches, back pain, menopausal hot flushes, gastrointestinal disorders and pruritus (excessive itching).
·Psychological and psychiatric: examination stress, work worries, relationship problems, anxiety, depression, bereavement and dementia.
·Sleep disorders: sleep apnoea and sleep walking.
·Medicines: antidepressants, appetite suppressants, beta-blockers, corticosteroids and decongestants.
·Alcohol.
Management
Consult a doctor. He will look into the history of your condition and conduct a physical examination. The doctor will enquire about your sleeping routines, previous and current medical conditions, psychological or psychiatric conditions, if any, consumption of caffeine, medicines and alcohol, substance abuse including narcotic drugs, diet and exercise. The cause may be detected through this approach in many instances.
If the cause is not obvious, the doctor will ask for a sleep diary to be kept. This involves recording the time when one goes to sleep, when one wakes up in the morning and when one wakes up at night.
A referral to a specialist may be necessary if the cause is still not obvious. Laboratory tests and polysomnography may be carried out. The latter is used in the diagnosis of sleep apnoea and sleep disorders. This involves recording many parameters when one is asleep, including brain electrical activity; movements of the eye, jaw and leg muscles; and heart and lung functions. The doctor will discuss with the patient prior to any videotaping which may be considered necessary.
Once a diagnosis of the underlying condition has been made, the cause will be treated. For example, if the cause is anxiety or depression, the problem will go away once it is treated.
General measures which do not involve the use of medicines are preferred. It may involve counselling if the insomnia is due to stress or bereavement. Cognitive behavioural therapy which involves changes in thinking and behavioural patterns is useful. Measures like limiting caffeine or alcohol intake, exercise and keeping to a regular sleep routine are helpful.
Sleeping pills may be considered by the doctor for severe or short-term insomnia if general measures do not work. Doctors are usually reluctant to prescribe sleeping pills as they relieve the symptoms but do not address the underlying cause. An individual can also become dependent on sleeping pills, which are not without side effects.
Many of the sleeping pills available belong to a group of medicines called benzodiazepines which require a doctor’s prescription. Benzodiazepines are anxiolytics and hypnotics, that is, they reduce anxiety and promote calmness and sleep. Benzodiazepines can lead to dependence and side effects like a hangover and drowsiness during the day. This can lead to accidents when driving. Examples of benzodiazepines include lormetazepam and temazepam.
The short-acting “Z-pills” that is, zopiclone and zolpidem, act on the same receptors as benzodiazepines but are not classified as such because their molecular structures are different. They were initially thought to be less addictive and habit forming than benzodiazepines but this view has changed with reports of addiction in the past few years. The side effects are similar to benzodiazepines.
The lowest possible dose of sleeping pills should be taken for the shortest possible time. One should only take them under medical supervision. There is no place for self-medication. Do not stop intake abruptly as this may cause withdrawal effects. The doctor’s advice is crucial here.
Melatonin is a hormone that is involved in the regulation of the sleep cycle or circadian rhythm. It is a short-term medicine for insomnia and cannot be consumed for more than three weeks. Although side effects are uncommon, they include dizziness, migraines, irritability, constipation and abdominal discomfort.
Getting good sleep
Getting a good night’s sleep is vital. This can be achieved by various means:
·Having a routine facilitates sound sleep. This means going to bed and getting up at about the same time every day. It is important to relax before getting into bed as activity just before bedtime may keep one awake.
·Having an early dinner helps. The digestive system goes to sleep at about 7 o’clock. A light dinner is helpful.
·Avoid caffeine after lunch as caffeine keeps one awake.
·Avoid alcohol as its breakdown produces chemicals that stimulate the individual. It also increases the likelihood of snoring as it relaxes the muscles. This leads to lighter and less refreshing sleep.
·Avoid naps. The afternoon nap may keep one awake at night.
·Avoid light. This is because melatonin, the hormone that helps a person sleep, is produced in the dark.
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.

Influenza A (H1N1) FAQ

2009-05-11T21:15:00.000-07:00

Foreign tourists wearing protective masks stand in the main Zocalo plaza in downtown Mexico City, Monday. (AP Photo/Enric Marti)

What is the A (H1N1) influenza?

It is a respiratory disease of pigs caused by type A strains of the influenza virus. It regularly causes high flu outbreaks in pigs but with low death rates. There are four main sub-types of the virus, but the most recent isolated influenza viruses from pigs have been H1N1 viruses.

How does it spread?

Influenza A (H1N1) viruses do not typically infect humans though they do occur through close proximity or contact with infected pigs or contaminated areas. Cases of human-to-human spread have been documented.

Click on thumbnail for larger image.

What are the symptoms?

The symptoms are similar to those of regular flu:
- Fever
- Lethargy
- Runny nose
- Cough
- Sore throat
- Lack of appetite
- Vomiting and diarrhoea in some cases.

How common is the A (H1N1) flu infection in humans?

In the past reports of about one human A(H1N1) flu virus infection had been received every one to two years in the United States. From December 2005 till February 2009, 12 cases have been reported.

Has this strain of flu been seen before?

No. Flu mutates constantly, so it is common for new strains to emerge. Pigs can also be infected with both human and avian influenza, and the current circulating A (H1N1) flu strain appears to contain genetic elements from all three.

Can the A (H1N1) flu be treated with antiviral drugs and flu vaccine?

The A (H1N1) flu is resistant to two common drugs – Amantadine and Rimantadine. The A (H1N1) flu viruses are very different from human H1N1 viruses. Therefore, vaccines for human seasonal flu would not provide protection. However, a “seed vaccine” has been specifically tailored to this swine flu and will be manufactured if officials deem it necessary.

Can people catch A (H1N1) flu by eating pork?

No. The A (H1N1) influenza viruses are not transmitted by food. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 70ºC and above kills the swine flu virus.

How long is someone with the A (H1N1) flu considered contagious?

People with the A (H1N1) influenza virus infection should be considered potentially contagious as long as they are symptomatic; possibly for up to seven days following the onset of the illness. Children, especially younger children, might potentially be contagious for longer periods.

What can I do to protect myself from the A (H1N1) flu?

There is no vaccine available right now to protect against the A (H1N1) flu.

However, you can help prevent the spread of germs that cause respiratory illnesses like influenza by:

- Covering your nose and mouth with a disposable tissue or handkerchief when you cough or sneeze. Throw the tissue in the waste basket after you use it.

- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also helpful

- Try to avoid close contact with sick people. - If you get sick with influenza, stay at home and limit contact with others to keep from infecting them.

- Avoid touching your eyes, nose or mouth.

- Consult your nearest healthcare facility if you think you have any of the symptoms.

Which countries have had cases of the A (H1N1) flu?

The World Health Organisation (WHO) has confirmed human cases of the A (H1N1) flu in Mexico, the United States, Canada and Spain. Only Mexico has reported deaths from the new strain.

Are there any travel restrictions or advisories for Malaysians?

The Health Ministry on April 27 advised Malaysians against travelling to certain places in the United States, Mexico and Canada which have been affected by the swine flu.

What precautions are in place in Malaysia?

- The Health Ministry’s operations room in Putrajaya has started a 24-hour monitoring of the situation. The public can call 03-8881 0200/300 for enquiries.

- Those returning from Latin American countries and found to have flu-like symptoms will be quarantined.

- Health Ministry officials are conducting health screenings on passengers arriving from the United States.

- Thermal scanners will be placed at international airports to speed up the screening process for A (H1N1) flu.

- Public and private medical practitioners have been instructed to report to the district health office any patient with influenza-like illnesses or severe pneumonia symptoms and who had travelled to the affected countries after April 17.

- Owners of the 797 pig farms nationwide have been ordered to immediately contact the nearest Veterinary Services Department office or the Animal Disease Control Centre if their workers or animals show symptoms linked to the A (H1N1) flu.

WHAT YOU NEED TO KNOW ABOUT SWINE FLU

2009-05-11T21:11:00.000-07:00

Recently, swine influenza or "swine flu" has been in the headlines every time we read the news. World Health Organization (WHO) has raised the influenza pandemic warning to Phase 5. It means that there is human-to-human transmission at least two countries in one WHO region.

"Swine flu viruses are NOT transmitted by food"

How it started?
Pigs can get influenza (flu), but usually resulting in low death rates. However, swine flu viruses are different from human flu viruses. Swine flu does not often infect humans but this recent outbreak is caused by a new swine flu virus that has spread from person to person, who has no direct contact with pigs.

How do people catch the swine flu?
Swine flu viruses can be spread via contact with infected pigs or contaminated areas. Cases of human-to-human spread have been documented.

Apparently, the new swine flu virus spreads like regular flu from an infected person. It can also become airborne if an infected person cough or sneeze without covering his / her nose and mouth.

What are the symptoms of swine flu?

They are same as those of regular flu:

-	Fever
-	Lethargy
-	Runny nose
-	Cough
-	Sore throat
-	Lack of appetite
-	Vomiting and diarrhoea in some cases.

Can swine flu be treated with antiviral drugs and flu vaccine?
Since the H1N1 swine flu viruses aren't the same as human H1N1 viruses, vaccines for human seasonal flu would not provide any protection. The swine flu is resistant to two common drugs – Amantadine and Rimantadine.

In that case, how is swine flu treated?
Currently in Malaysia, there is no case reported yet. However in the U.S., tests show that the Tamiflu and Relenza is effective in preventing or treating swine flu, as recommended by their Centers for Disease Control and Prevention.

However, many of the first people in the U.S. with lab-confirmed swine flu has recovered without treatment.

Can people be affected by eating pork?
Swine flu viruses are NOT transmitted by food. It is safe to consume properly handled and cooked pork and pork products. The swine flu virus will be killed when pork is cooked to an internal temperature of 70ºC and above.

What can I do to protect myself from the swine flu?

-	Make sure you cover your nose and mouth with a disposable tissue or handkerchief when you cough or sneeze.
-	Wash your hands regularly with soap and water or an alcohol-based hand cleaner, especially after you cough or sneeze.
-	Avoid close contact with sick people.
-	Avoid touching your eyes, nose or mouth.
-	Go to the nearest hospital / clinic if you have any of the symptoms.

Should I avoid overseas travel?
The Health Ministry on April 27 advised Malaysians against traveling to certain places in the United States, Mexico and Canada which have been affected by the swine flu.

What are the precautions being done currently in Malaysia?

-	The Health Ministry’s operations room in Putrajaya has started a 24-hour monitoring of the situation. The public can call 03-8881 0200/300 for enquiries.
-	Those returning from Latin American countries and found to have flu-like symptoms will be quarantined.
-	Health Ministry officials are conducting health screenings on passengers arriving from the United States.
-	Thermal scanners will be placed at international airports to speed up the screening process for swine flu.
-	Public and private medical practitioners have been instructed to report to the district health office any patient with influenza-like illnesses or severe pneumonia symptoms and who had traveled to the affected countries after April 17.
-	Owners of the 797 pig farms nationwide have been ordered to immediately contact the nearest Veterinary Services Department office or the Animal Disease Control Centre if their workers or animals show symptoms linked to the swine flu.

Where can I get more information?
For more information, please visit Health Ministry (www.moh.gov.my) or call the Ministry's hotline at (03) 8881-0200/300.

Useful Links:

World Health Organization

Centers for Disease Control and Prevention

Homeland Security Department

WHO swine flu page

HEALTH TIPS FOR SENIORS

2009-05-11T21:09:00.000-07:00

"You dehydrate faster now than when you were younger"

Getting the proper nutrition and staying active are some ways to enhance your potential for successful aging and ensure you enjoy your golden years.

Nutrition

Be sure to check with your doctor or dietitian before starting any dietary supplements or when you have specific health problems or changes.

Physical Activity

DRESSED FOR SUCCESS

2009-05-11T21:08:00.000-07:00

In today's lifestyle, the whole point of dressing for work, even for men, has taken on a whole new meaning. To be professional, both men and women can opt for style and comfort, without compromising one or the other.

"Many employees agree that an employee who feels comfortable with what they wear will be more focused in their work"

Although the classic suit has not gone out of style, looking professional has over the years become more stylish, personable and versatile. This change in fashion is not merely a thirst for fashion, but a need for overcoming the hot and humid Asian weather. Wearing thick jackets for the women or suits for the men does not seem practical at all here.

Depending on the type of industry you work in, work wear can range from casual to smart business casuals or formal all the way. Perhaps when needed, a suit or jacket for meetings is encouraged. Some companies encourage casual Fridays although torn jeans and baggy t-shirts are not a good idea. Smart casuals or official company t-shirts are the norm. Dressing down does not mean coming to the office decked in your slippers and shorts, but rather, something that looks smart and makes you feel comfortable is the ideal combination to dressing down.

Many employees agree that an employee who feels comfortable with what they wear will be more focused in their work. On the other hand, if an employee feels trapped and hot in an uncomfortable suit or jacket, they are bound to find it hard to relax and get down to work.

Create a winning wardrobe. A successful business casual look pairs items from traditional career wardrobe (jacket, button down shirts, blouses, classic shirts, etc) with comfortable classics (khakis, skirts, dress pants) to create a winning wardrobe. Use pieces from an existing wardrobe to mix and match with casual clothing.

Develop savvy (knowledge). You have to read more about what business dress and business casual means. There are many books and magazines on the topic, fashion articles in the newspapers, fashion segments on television, and answers are to be found all over the Web.

Window-shop. Go to the stores and window-shop to get a sense of the latest styles. Observe what the mannequins wear, particularly, at stores catering to business clothes.

Window-shopping also permits you to observe what others are purchasing, and gives you an insight into what your office wardrobe, similar to other employees in your own organisation, are likely to set you back (financially) by.

Casual does not mean sloppy. Clothing should be clean, ironed and without holes or worn areas. All work wear should be handled specially such as sending them for dry cleaning. This way, they not only last longer, they will definitely save you money on having to buy new clothes to replace worn ones.

Keep the focus on the quality of work, not your fashion statement. Leave at home anything that you might wear to the gym or beach. Avoid clothing that are too revealing and remember that fads are usually inappropriate. T-shirts with messages or logos on them other than your company is probably not a good idea. Choose colours that not only compliment you, but those that are able to create a professional, updated and stylish impression.

Pay attention to the fit of your clothing. Men's pants should break just above the shoe. Shirt-sleeves should reach just beyond the wrist (closer to the thumb) and show a bit of the cuff when wearing a jacket. Shirts should be buttoned comfortably without pinching or leaving gaps.

Women who wear skirts to work should make sure that it's never too short. Unless you have super long legs, most skirts should preferably be 2 or 3 inches above your knee and no shorter. Pants should also be not too tight nor too baggy and should break above the ankle. Capri's or shorts should be saved for the weekends. Blouses or shirts should fit properly and not be too low cut or revealing.

Dress to the occasion. Wear what fits according to your day's schedule. If you have a meeting scheduled with clients, you may wish to dress more traditionally. Perhaps keeping an extra jacket in the office for unexpected meetings is a good idea. Shoes worn to the office should be kept as simple as possible. Low heeled pumps or sandals for the ladies and black or brown leather shoes should generally suit most dress codes for both the men and ladies.

Consult a personal shopper. When all else fails, don't feel embarrassed to enlist the help of an expert. Most popular and better-known clothing stores have "personal shoppers" or trained salespeople who are there to advise you. They will gladly help you choose and plan for a business wardrobe, paying particular attention to what is appropriate in your locale or region of the country. Make sure you explain a little about the background of your company and what is the general attire of your co-workers to the "personal shopper'.

Trust your instincts. Male or female, reluctant shopper or not, experts say no matter what's appropriate, your chosen attire needs to fit well and you need to feel comfortable in it. If it doesn't, you need to keep looking. Shop around and try some stuff on. Use the mirror in the changing room to see what looks good to you and what feels appropriate on you. When you are finally satisfied, head to the cash register, settle your bill, and walk out.

Conclusion? Buy clothes based on what you look good and feel comfortable in, not just what is fashionable for work.

HANDLING YOUR FIRST JOB

2009-05-11T21:06:00.000-07:00

You've spent approximately the last sixteen years sitting in a classroom absorbing bits of knowledge. Every now and then you were tested to see how well you remembered that information. Occasionally, you had to write a research paper; sometimes quite an extensive one. Suddenly you are out of the safe haven of the classroom and thrust into the harsh reality of your first job. Deadlines are "tomorrow, at the latest." There are no formal exams, but you are being tested, everyday. The results come, not in report cards, but in performance reviews.

"Learn what you need to know and don't pretend to know what you don't know"

When you start a new job you're generally not in the company of others who are also new. You're the new kid on the block coming into a situation where relationships have already been formed. You're the only one who can't find the restroom, doesn't know where the supply room and mailroom are located, doesn't yet realize that the custodian wields all the real power, and doesn't know not to talk to the boss until she's had her first cup of coffee.

Your first day

First of all, congratulations on getting your first job! Feeling jittery? Here's what you can expect (and not expect) during the first few days of your first job in the real world.

You will usually be required to attend a formal or informal orientation. This is where you will be introduced to the company, the building and employee policies.

	You may be asked to fill out paperwork for health insurance, life insurance and other employee benefits. Ask questions about your options; the human resources department or the person who hired you will have the answers.
	You may be asked to take a medical or physical exam. Some companies require you to do it before your first day.
	You will fill out tax forms.
	You will meet your fellow workers and various departments.
	You will be assigned to a work area, station or office.

Your first week

The first week on the job is your time to orient yourself. Find out who the key players are, and socialize with co-workers during lunch or after work. Find out what tools you need to do your job, and ask how you can get them. Ask questions! Introduce yourself to as many people as you can. It might help to identify the best workers- they serve as good role models and offer advice for your own success.

Also pay close attention to the corporate culture by learning how things work within your company. Are relationships formal or friendly? Does everyone arrive early and stay late? Are lunch hours short or non-existent?

Now it's time to dig in and do your job. To make a good impression, keep the following tips in mind.

	Always arrive on time, if not earlier. Stick to your lunch hour.
	Dress appropriately. Take your cue from your coworkers.
	Always listen and observe before jumping into anything.
	Be a team player. Pitch in to help out fellow workers whenever possible. Don't adopt a "that's not my job" attitude.
	Follow through on assignments and take pride in your accomplishments.
	Be willing to take on challenging assignments.
	Be responsible, on time and dependable. Remember deadlines.
	Mind your manners.
	Do not take time off until you have earned the right to do so.
	Stay away from office gossip. Avoid contributing to it and being a target of one.
	Learn what you need to know and don't pretend to know what you don't know.
	Be wary of the office troublemaker. You'll soon know who they are.

That first week of a new job can be physically and emotionally exhausting. After you've been working awhile, you'll find you are being judged primarily by your job performance. You may think it's a money thing for your employer and that is, of course, true; but it isn't the only reason. By keeping up the good work, you'll find it working in your favour- this could mean advancing within the company or getting a good reference when you seek your next job. Remember, you are an important spoke in the wheel that makes the organisation run.

Health Health Home Medical Products Medical Claim Health Articles Panel Hospital / Clinic Locator Hospital Events BMI Calculator Specified Illness De

2009-05-11T21:05:00.000-07:00

Before embarking on a journey, it is our duty to ensure that we bring along all the essential documents besides other necessities. Here is a checklist of important items for your holidays or business trips, whether it is across lands or down by the beach.

"Certain countries have restrictions on the amount of currency you may bring in or out of the country"

	International passport of at least six month's validity date.

	Visa if required for travel to a particular country. Check with your travel agent or directly with the embassy or high ommission of the country concerned.

	Vaccination Some countries require a valid certification of inoculation against certain disease for instance, African countries like Cameroon requires a show of a certification of inoculation against yellow fever. Check with the relevant high commission or embassy for details.

	Medical clearance form A form filled up by a doctor verifying your fitness for travel. This is required if you are pregnant, asthmatic, carrying contagious disease, suffering from any ailment or when you require special medical assistance. This form is available at the airline ticketing office. The form is to be submitted to the ticketing office and verified by the airline doctor before the ticketing office confirms your fitness to travel.

	Customs Check with your travel agent or airline on things that can be brought in or out of a designated country and what are the duty free allowances. These items need to be declared and examined by custom officers at the airport custom checkpoints.

	Currency Certain countries have restrictions on the amount of currency you may bring in or out of the country. Check with your travel agent before you embark on your trip.

	Map or brochures These are handy as they provide information about your destination, places of interest, customs, restaurants, dos and don'ts, as well as providing directions for you to move around on your own.

	Multi-vitamins and medication Fill them in a daily dose pill box so you don't forget to take them. You don't want to ruin a perfect holiday by falling sick. If you need to bring some medication, do get a letter from your doctor explaining your health condition and the required medication.

	First aid kit It is recommended to pack a first aid kit with items such as band aids, disinfectants, pain killer and influenza medicines. It may be difficult to find medicine when you're traveling.

	Travel insurance This may be the last thing you want to think about but it is better to be prepared for any contingencies such as delays, lost baggage, accidents or sickness, and travel with a peace of mind. Check out Kurnia Care Tavel Insurance and Traveller's Personal Accident Insurance.

TRAVEL FOR THE BUDGET CONSCIOUS

2009-05-11T21:03:00.000-07:00

Unless you are rich and famous, travelling abroad or locally can be a very expensive venture. Planning a holiday is difficult, especially if, for example, you are a student on a budget or someone who plans to travel with a large family. First thing you should always do: plan early. Read on for more tips on how to save money while on holiday.

"Decide on the purpose of your trip"

Book early
Decide early now on how, where and when you want to travel. Scout around for packages that meet your criteria and book one. By booking your holiday early, you not only allow airlines to identify forward booking, you also allow them to initiate tactical offers like early-bird specials. Waiting could cost you money.

Examine the package
Check the terms and conditions. For example, certain deals are only valid for up to a certain date (6 months usually). When prices are low, something has to give. The cheaper the fare, the more stringent the conditions. Also, look at what is included and compare them with other offers. A cheap deal may mean staying in a three star hotel in a seedy part of town. Although that may be okay with some people, it might not be suitable for a family with young children. It's an unhealthy trend when a holiday package focuses on price. If the content of a holiday package is bad, then it is not much of a holiday. Never discount a package just because it is expensive.

Do your research and consult your travel agent
Decide on the purpose of your trip. Are you looking for a leisurely holiday at the beach or a cultural/ historical one in an old city? What is your budget? Do you want a FIT (Free and Independent Traveler) holiday or are you okay with traveling in a big group? Will you be traveling with senior citizens or young children? If it is a family outing, check whether the hotel has facilities that cater to children. Discuss these issues with your travel agent so that it is easier to fulfill your needs and meet your expectations.

Take note of off-peak periods
Demand exceeds supply during the peak periods, and naturally, airfares and room rates go sky high. If you want to travel cheap, take advantage of the lull between peak periods, or the "shoulder periods". For example, if you visit Australia in winter, you will not have to fight for flights and rooms. If you are going local, bear in mind that Malaysia is popular with overseas holidaymakers during the months of June to September. School holidays are also a big no-no if you want to travel cheap.

Look for options
While South Korea has been positioned as a skiing destination in winter, it is not the only such destination. To avoid the crowd and exorbitant prices, you could go elsewhere such as the mountain areas in China or India. Places that are really popular are usually chock full of tourists and barely enough room to enjoy yourself.

Make use of the Internet
The Internet is a treasure throve of information. If you want to check the quality of a hotel noted in your tour package, you could do so if the hotel has a website online. Some resorts even have logs made by visitors; so read what they have to say. FIT travelers also plan their holidays, booking plans, rooms and flights through the Internet. Going to travel websites may also be useful because many of them offer traveling tips or warnings from people who have traveled to a certain destination. If you have the time, surf around and find out the best price and deals and make comparisons.

GETTING A GOOD NIGHT'S SLEEP

2009-05-11T21:01:00.000-07:00

"You should have your dinner at least 3 hours before bedtime because a digesting stomach will not let you sleep."

What is Insomnia?

Insomnia is inadequate or poor quality sleep due to one or more of the following:

	Difficulty in falling asleep
	Waking up frequently during the night with difficulty returning to sleep
	Waking up too early in the morning
	Unrefreshing sleep

It may cause problems during the day, such as tiredness, lack of energy, difficulty concentrating and irritability.

Types of Insomnia

Transient - lasts from one night to a few days

Intermittent - lasts a few days to a few weeks

Chronic - lasts a few weeks to a few months

	Food A diet that promotes health naturally promotes good sleep. Replace instant foods such as canned foods and preserved items with fresh wholesome foods. Instant foods additives such as sugar, salt, coloring and flavorings stimulate the body into hyperactivity. Insomnia sufferers should take more Vitamin B found in whole meal breads and brown rice because it is known to alleviate symptoms. You should also have your dinner at least 3 hours before bedtime because a digesting stomach will not let you sleep.
	Exercise Sleep is a body's natural response to tiredness. By building exercise into your daily routine, you help yourself sleep better because it releases tension in the muscles and nerves. Avoid exercising late in the evening or at night however, because raised adrenaline will keep you awake throughout the night. If it is the only time you can exercise, choose deep relaxation exercises such as yoga or t'ai chi.
	Environment If you live in a city and you find the environment too noisy, opt to move to a quieter area or sleep in a room with less exposure to noise. Use curtains to block out the noise or light from windows and close your room door if it helps.
	Sleeping Habits Modern living plays a big part in meddling with our sleeping schedules. Due to work and our need for entertainment, most people have irregular sleeping habits. Sleep researchers suggest waking up at the same time each day regardless of how many hours you got to sleep the night before. Replacing sleep debts on weekends also do not work- you just end up more tired than before!
	Emotional Distress When your mind is not in peace, it is next to impossible to sleep. Anxiety, resentment, jealousy, guilt and grief are negative feelings that can ruin sleep. If you suffer from depression, you are likely to suffer from insomnia. Advising an insomniac to leave all their troubles before going to bed is easier said than done. Learning how to do this takes practice and a commitment to improve one's waking life. Re-orientate your long-term plans and always reassure yourself that things are never as bad as they seem.
	Substance Abuse Relying on quick fixes to banish stress can be another sleep hazard. It is ironic how we load ourselves up with cigarettes and coffee in the daytime to keep us awake and turning to alcohol and sedatives to go to sleep at night. Notorious sleep- thieves such as caffeine and smoking keeps you awake, edgy and anxious by triggering adrenaline and stimulating the nervous system.
	Illness and Medication Having illnesses such as breathing problems and pain can affect the quality of your sleep. Medications such as those used for arthritis can actually cause insomnia in some people. Find out the side effects of the medication or drug that you are using and whether there are alternative medication that you can take for your condition.

EATING RIGHT: BE ON THE RIGHT TRACK OF DIET DURING THIS RAMADAN

2009-04-01T17:47:00.000-07:00

Ramadan is the ninth month of the Islamic calendar and Muslims fast daily from dawn to dusk throughout the month. During this fasting period, health problems may emerge as a result of excessive food intake and unbalanced diet. Food abstinence will also slow down your metabolism in a response to conserve energy.

"Eat slow digesting food and fiber-rich food"

Below are some simple guidelines to ensure your diet remains balanced and healthy during this Ramadan.

Maintain a well-balanced diet

It is important to eat a wide variety of food to make sure that you get all the nutrients needed. To do so, consume the right proportions from various food groups such as meat, vegetables, beans, fruits, bread / cereal, milk and dairy products.

Meat is a good source of protein and minerals. Vegetables and beans are relatively low in calories and contribute to our daily fiber intake. Dairy products are good sources of protein and calcium which are essential for maintenance of body tissues while bread / cereal are a good source of energy, provide minerals and dietary fiber. Due to the long hours of fasting, you should also eat slow digesting food and fiber-rich food in order to have a sustained amount of energy throughout the day. These include wheat, oats, beans, grains and seeds.

Chew your food slowly and do not over eat as this will burden the digestive system and makes you feel sluggish.

Avoid unhealthy food

Avoid eating very spicy food or fried food that may cause indigestion and health problems. Take less salty food as they will lead to dehydration. Also, reduce intake of sweet and sugary food as such food will turn into fat and causes weight gain that may lead to other health problems. Although it may be difficult to completely avoid these unhealthy food, it is wise to eat them in moderation.

Drink sufficient fluid

It is essential to have sufficient intake of fluids daily to avoid dehydration. Water is one of the best sources of fluid for your body. Other fluids such as milk and juices can contribute to your daily fluid intake. Drinking juices also help to maintain water and mineral balance in your body and the sugars they contain are sufficient to give energy. However, limit your intake of caffeinated drinks such as coffee and tea that causes dehydration.

Exercise

During the fasting period, it may be difficult to pursue your regular exercise, however it is not necessary that you stop completely. Physical activities help to boost energy and accelerates metabolic rate. It is good to at least perform some kind of light exercise and movement that will not lead to excessive sweating and dehydration, such as stretching or walking in order to maintain your body weight and reduce stress.

Intake of a balanced diet is critical to maintain good health and with the right approach, you can attain the full benefits of Ramadan.

HAND, FOOT AND MOUTH DISEASE

2009-04-01T17:45:00.000-07:00

Hand, Foot and Mouth Disease (HFMD) is a common illness of infants and children featuring mouth sores, fever and rash caused by a virus. It is usually a mild, self-limiting illness but can be more serious in some children. Let's read on to understand more and know how you can prevent and control the spread of this disease.

"A person is most contagious during the first week of the illness"

HFMD most often occurs in children under 10 years old but can also occur in older children and adults. It is caused by a number of enteroviruses in the family Picornaviridae. One such virus is enterovirus 71. HFMD is not to be confused with foot-and-mouth disease, which is a disease affecting sheep, cattle and swine which is unrelated to HFMD.

Symptoms of HFMD

HFMD begins with a mild fever, poor appetite, feeling sick and frequently a sore throat. One or 2 days after the fever begins, painful sores develop in the mouth. They begin as small red spots that blister and then often become ulcers. They are usually located on the tongue, gums and inside of the cheeks. The skin rash develops over 1 to 2 days with flat or raised red spots, some with blisters on the palms of the hand and the soles of the feet. A person with HFMD may have only the rash or the mouth ulcers.

The usual period from infection to onset of symptoms ("incubation period") is 3 to 7 days. Fever is often the first symptom of HFMD followed by blister/rash.

Is HFMD contagious?

Yes, HFMD is moderately contagious. It is usually spread by person to person contact with nose and throat discharges, saliva, fluid from blisters or the stool of infected persons. A person is most contagious during the first week of the illness. HFMD is not transmitted to or from pets or other animals.

Treatment

There is no specific treatment available for this infection. Treatment given is usually to provide relief from fever, aches or pain from the sores.

Prevent and control the spread of this disease by:

	Practising good hand washing techniques, especially after using the toilet, changing diapers or handling other stool-soiled material.
	Cleaning and disinfecting contaminated items and surfaces using diluted solution of chlorine-containing bleach.
	Daily examine children for HFMD.
	Covering the mouth and nose when coughing or sneezing.
	Washing toys and other surfaces that have saliva on them.
	Excluding children with HFMD from schools or childcare facilities until the child feels well.

CHRONIC LIFESTYLE DISEASES

2009-04-01T17:44:00.000-07:00

Critics say little is being done to tackle Asia's biggest killers such as cancer, diabetes, respiratory and heart disease. It is predicted that globally, deaths from Chronic 'Lifestyle Diseases' will increase by 77% between 1990 and 2020 and that most of these deaths will occur in the developing regions of the world. The causes of this dramatic health shift are mainly from sedentary jobs, poor diet, smoking and alcohol. These conditions not only cause enormous human suffering, they threaten the economies of many countries as they impact on the older and experienced members of the workforce.

"Eat more fruits and vegetables"

Definition of Chronic 'Lifestyle Diseases'

Chronic diseases of lifestyle are a group of diseases that share similar risk factors as a result of exposure, over many decades, to unhealthy diets, smoking, lack of exercise and possibly stress.

The major risk factors include high blood pressure, tobacco addiction, high blood cholesterol, diabetes and obesity. These results in various disease processes such as strokes, heart attacks, tobacco- and nutrition-induced cancers, chronic bronchitis, emphysema and many others that culminate in high mortality and morbidity rates.

Internationally, these diseases are also called 'noncommunicable diseases' or 'degenerative diseases'.

Extent of Chronic 'Lifestyle Diseases'

Many of the chronic disease risks, and the diseases themselves, overlap.

	Heart attacks and strokes kill about 12 million people every year.
	3.9 million people die annually from hypertensive and other heart conditions.
	An estimated 177 million people are affected by diabetes, the majority by type 2 diabetes. Two-thirds live in the developing world.
	More than one billion adults worldwide are overweight, and at least 300 million of these are clinically obese.
	Up to 80% of cases of coronary heart disease, 90% of type 2 diabetes cases, and one-third of cancers is because of unhealthy diet, less physical activity and smoking.

The Causes of Chronic 'Lifestyle Diseases'

	People worldwide are consuming more foods that are energy-dense - high in sugar and/or saturated fats - or excessively salty.
	Nutrition transition and increasingly sedentary behaviour is occurring at a much faster pace in developing countries than was the case for developed.
	Chronic diseases are becoming increasingly prevalent in many of the poorest developing countries.

How to Overcome Chronic 'Lifestyle Diseases'

Established scientific evidence suggests there are major health benefits in:

	Eating more fruits and vegetables, as well as nuts and whole grains.
	Daily physical activity can also help reduce osteoporosis and falls among older people.
	Moving from saturated animal fats to unsaturated vegetable oil-based fats.
	Cutting the amount of fatty, salty and sugary foods in the diet.
	Maintaining a normal body weight.
	Stop smoking.
	Optimal and healthier diet is very important.
	Well established, daily moderate-intensity physical activity is an important determinant for good health because it helps lower blood pressure, reduces body fat and improves glucose metabolism.

QUIT SMOKING

2009-04-01T17:43:00.000-07:00

Smoking is a major public health problem. It affects a person's health in many serious ways, having both immediate and long term ill effects on your quality of life.

"Smoking raises your risk of certain cancers"

Effects of smoking

Cigarette smoke is a complex mixture of chemicals produced by the burning of tobacco and the additives. Smoking raises blood pressure and heart rate. This puts you at a much higher risk of having a heart attack and can cause strokes. In chronic smokers this can cause heart disease.

Smoking also raises your risk of certain cancers. These can be lung cancer, stomach cancer, throat cancer, oral cancer and many more.

Effects on Pregnant Women

Smoking during pregnancy is a risky move. It can cause serious health problems for both mothers and babies.

Sudden Infant Death Syndrome: Women who smoke during pregnancy expose their babies to Sudden Infant Death Syndrome as these babies are more likely to die from the harmful effects of smoking.

Stillbirth: Smoking has repeatedly been associated with risk of stillbirth. Smoking cigarettes or breathing in somebody else's smoke reduces the amount of oxygen in your blood stream. Your baby gets its oxygen supply from your blood, so less oxygen in your blood deprives your baby of oxygen essential for growth and development.

Low birth weight of the baby: The more a pregnant woman smokes, the greater her risk of having a low birth weight baby. Low birth weight can lead to many complications. Being born too small is the major cause of infant illness and newborn death.

Respiratory Infections: Your baby is more likely to have asthma and other respiratory diseases if you expose your baby to smoking or second hand smoke.

Premature birth: Smoking during pregnancy can lead to premature birth. The child can have underdeveloped bone structure and maturity level mentally. The baby can be deformed, with retarded brain functions and have problems during their learning period. It can also result in death of the newborn.

Miscarriage: It is known that mothers who smoke are at a greater risk of miscarriage if they continue to smoke during pregnancy. Since passive smoke is also dangerous, make sure no one in your household smokes during the pregnancy.

Methods to quit

Most people who quit smoking use a combination of quit methods. You will need to find the combination of methods that works best for you. Here are some quit methods.

Cold Turkey
Cold turkey is the term used to describe quitting smoking with no help from quit aids of any sort. With this method, individuals abruptly stop smoking cigarettes. It is simple, self-managed and low cost. Withdrawal symptoms may be severe for some people, especially if they have been smoking a brand of cigarette with a high nicotine level.

Gradual Reduction
A slow gradual reduction in the number of cigarettes you smoke over time is a method that you may try. Try smoking only half the cigarette, waiting an hour longer each day before lighting up your first cigarette or smoking only during odd or even hours.

Nicotine Replacement Therapy (NRT)
NRT refers to a number of quitting aids that ease withdrawal symptoms by delivering nicotine to your body in amounts you can regulate. There are several forms of nicotine replacement available such as patches, gums, lozenges, nasal spray and inhalers. Over time, you can reduce the nicotine dose, thus weaning your body from the addiction.

Using these products helps reduce the cravings for cigarettes and the withdrawal symptoms associated with quitting. NRT is much safer than smoking but if you have a medical condition, any health worries or are pregnant, it is important that you consult your doctor first.

Atropine and Scopolamine Combination Therapy
Some smoking cessation clinics offer a program using shots of the drugs atropine and scopolamine. You might want to talk to your physician or doctor before using this therapy as they may not be suitable for everyone. If you have chronic medical problems, take certain medications or are pregnant, then you shouldn’t use this therapy.

Hypnosis and acupuncture
Not everyone wants to take medicines to help them quit smoking. Techniques such as hypnosis and acupuncture may help some smokers to quit.

Quitting smoking can be really hard, but it is one of the best things you can do for your health!

HOW TO PREVENT DENGUE FEVER

2009-04-01T17:41:00.000-07:00

Dengue fever has become a major public health concern in recent decades. With dengue cases on the rise in the country, it is important to know more about dengue fever and how to protect yourself against aedes mosquitoes.

"Dengue is only spread through the bite of an infected mosquito."

What is Dengue fever and how is it transmitted?

Dengue fever is one of the most common mosquito-borne viral disease of humans. Dengue fever mostly occurs in the tropical and sub-tropical areas of the world. Outbreaks of dengue fever usually occur in the rainy season.

Dengue viruses are transmitted to humans through the bites of a striped Aedes aegypti mosquito that has previously bitten an infected person. Dengue does not spread directly from person to person. It is only spread through the bite of an infected mosquito.

The disease itself is rarely fatal, but a more serious complication, Dengue Hemorrhagic Fever is far more dangerous. Dengue Hemorrhagic Fever is a more severe and potentially deadly form of the disease in which bleeding and sometimes shock occurs. It can be fatal if unrecognised and not properly treated.

What are the signs and symptoms?

After being bitten by a mosquito carrying the virus, the incubation period ranges from three to fifteen (usually five to eight) days before the signs and symptoms of dengue appear. The signs and symptoms may vary, depending on the form of the disease.

Dengue fever signs and symptoms typically include high fever, severe headache, chills, red eyes and pain behind the eyes, severe muscle and joint pain, nausea and vomiting, backache and rash. Most people who develop dengue fever recover completely within two weeks. However, some may go through several weeks of feeling tired and/or depressed.

Symptoms of Dengue Hemorrhagic Fever initially may be indistinguishable from dengue fever, but the hemorrhagic form of dengue fever is more severe and is associated with loss of appetite, vomiting, high fever, headache and abdominal pain, progressing to faintness and generalized bleeding. Circulatory failure and shock may occur, which if untreated, can result in death.

What is the treatment?

There is no specific medication for treatment of a dengue infection. Consult your doctor immediately if you suspect that you have symptoms suggestive of dengue, especially if you have been in an area where dengue is known to occur. Rest and fluid intake for adequate hydration are important to help alleviate the illness.

Dengue Hemorrhagic Fever may be effectively treated by fluid replacement therapy if an early clinical diagnosis is made. Hospitalisation is frequently required in order to adequately manage Dengue Hemorrhagic Fever.

Prevention and Control

At present, there is no vaccine for preventing dengue. Therefore, the best preventive measure is to combat the mosquitoes.

	Removal of stagnant water is the best way to mosquito elimination. Items that collect rainwater or are used to store water should be covered or properly discarded.
	Get rid of sources or areas where mosquitoes breed, such as standing water in flower pots, tins, bottles or discarded tires. Mosquitoes breed easily in any source of standing water.
	Appropriate insecticides, such as larvicide's can be added to water containers. The insecticides can prevent mosquitoes breeding for several weeks. However, they must be re-applied as per directions.
	Always clean and check drains to ensure they are not blocked especially during the rainy season.
	Top up uneven surfaces of the floor to prevent water from accumulating.

In addition to the above, here are some ways to help prevent the mosquitoes being attracted to human prey.

	Wear loose, light coloured clothing that covers the whole body, as mosquitoes are attracted to dark colours and find it difficult to bite through loose clothes than tight fitting clothes.
	Apply mosquito repellents.
	Sleep under mosquito nets or in a room which has mosquito screens on the doors and windows. Stay in air-conditioned rooms whenever possible as mosquitoes are unlikely to bite in an air-conditioned room.
	Use mosquito coils and electric vapour mats to help prevent mosquitoes from entering the room.
	Avoid outdoor activities during morning and late afternoon. Aedes mosquitoes usually bite during the day, especially 2 hours after sunrise and several hours before sunset.

HEALTHY EATING DURING THE FESTIVE SEASON

2009-04-01T17:40:00.000-07:00

With the festive season just around the corner, there is no chance of sticking to a healthy diet, especially if you go on a holiday and your normal routines of exercise and mealtimes are changed. Every party and get-together seems to revolve around food and it is difficult to resist overindulging on all the delicious treats and mouth-watering food.

"Drink plenty of water"

Here are some tips to help you stay healthy during the festive season.

Avoid Over-Eating
One of the risks during the festive season is over-eating. To avoid over-eating, eat slowly and concentrate on enjoying food. By eating slowing, we allow the stomach to signal the brain when we have eaten enough. These signals tell us that we should stop eating. If you eat too fast, you would have eaten too much before your body is able to signal you to stop eating.

When eating at a social event, enjoy the food in moderation. Take a small amount of what you really want so that you are satisfied but make sure you keep within the guidelines of healthy eating.

If there is going to be a buffet, make sure you limit the intake and try not to eat deep fried food, batter food, cheese and nuts as they are all high in fat. Fill up your plate with low calorie food such as vegetables, fruits or bread based snacks. Choose a few of your favourites in sensible amounts, rather than a pile of everything offered. Sit down far away from the buffet table and resist the temptation to go back for seconds.

Chat and mingle around at a party. It you are bored, you are more likely to hang around the food table and over-eat.

Drink plenty of water
It is hard to avoid sweet and 'heaty' food during festive season because that's what normally every one gets served during household visitations. So have them in small quantities and remember to keep drinking lots of water. This guarantees that you remain properly hydrated, especially during hot weather.

Do not starve
Do not binge and starve. Skipping meals will lead to snacking on high fat food. Have your regular healthy meals and stop eating when you feel full. Never starve yourself all day in order to indulge in a special dinner as you'll be more likely to over-eat.

Exercise
Keeping up an exercise routine can be really challenging during the festive season or holiday break. When you finish your meal, it is really tempting to fall asleep. Try to have some form of light exercise or take a walk. This will boost your metabolism and work off a few extra calories.

Remember that the festive season are not only about food, but a time to reunite and spending quality time together with your family, relatives and friends. Enjoy the occasional small indulgence and have fun during this festive season.

WHAT YOU NEED TO KNOW ABOUT THALASSEMIA

2009-04-01T17:33:00.000-07:00

Thalassemia is an inherited blood disorder that causes the body to produce less hemoglobin. Hemoglobin is the substance in the red blood cells, which carries oxygen to all parts of the body.

"It is wise that you and your partner have testing done to determine the risk of passing on the disorder to a child"
Hemoglobin is made up of two kinds of protein chains called alpha globin chains and beta globin chains. Individuals with thalassemia do not produce enough of either of these two protein chains and as a result, the red blood cells do not form properly and cannot carry sufficient oxygen throughout the body.

Thalassemia is inherited, that is, they are passed on from parents to their children through genes. The two main types of thalassemia are called alpha thalassemia and beta thalassemia.

Alpha Thalassemia
Four genes are needed to make enough alpha globin protein chains. Alpha thalassemia occurs when one or more of the four genes are missing or damaged.

A person who has one gene missing or damaged is called a silent carrier. This form of alpha thalassemia does not cause any major changes in the hemoglobin or any health problems. Affected individuals generally have no symptoms, but they are carrier of the disease and they can pass on the genetic abnormality to their children.

If two genes are missing or damaged, the condition is called alpha thalassemia minor, also called alpha thalassemia trait. People who have the alpha thalassemia trait usually have no significant health problems except mild anemia, which can cause slight fatigue.

If three genes are missing or damaged, it will result in hemoglobin H disease. The condition causes abnormalities in red blood cells and rapid destruction of these cells. Most affected individuals have mild to moderate anemia and should receive regular medical care.

The most severe form of alpha thalassemia is known as alpha thalassemia major or hydrops fetalis. In this condition, all four genes are missing or damaged. Affected fetuses are usually miscarried, stillborn or die shortly after birth.

BetaThalassemia
Two genes are involved in making the beta globin protein chains. Beta thalassemia occurs when one or both of the two genes are variant.

Beta thalassemia minor, also called beta thalassemia trait occurs when one of the two genes are affected. A person with this condition will usually experience no health problems other than a possible mild anemia.

If both genes are affected, a person may have beta thalassemia intermedia or beta thalassemia major, also called Cooley's anemia. People with beta thalassemia intermedia have mild to moderate anemia. Beta thalassemia major is the most severe form of beta thalassemia in which the complete lack of beta protein in the hemoglobin causes a life-threatening anemia that requires regular blood transfusions and extensive medical care.

Prevention
Thalassemia is an inherited disease that cannot be prevented. However, blood tests and family genetic studies can show whether an individual has thalassemia or is a carrier. It is wise that you and your partner have testing done to determine your hemoglobin status if you're thinking of having children. This will help determine your risk of passing on the disorder to a child.

BUST THAT STRESS

2009-04-01T17:28:00.000-07:00

"Making sleep a priority is one major way to reduce stress"

Stress is a condition where our body goes into a "state of emergency" during a crisis situation, with stress hormone pour into the bloodstream with lightning speed, respiration and muscle reaction increase, the heart beats faster, fat reserves and sugar become activated. In order to maximise the energy to handle the state of emergency, body functions such as digestion and reproduction are deactivated and immune system start to slow down.

Our body can accomplish most astonishing feats during this acute state. However, what happens if this state is maintained permanently? Tension pent-up may cause damage to our body such as high blood pressure, sleeplessness, poor concentration, nervousness, headaches, fatigue and a host of related sickness. Too much stress can seriously affect our physical and mental well-being. Here are some strategies to help you relieve stress.

	Maintaining a healthy and well-balanced diet is vital to keeping one's stress level at a minimum. Stress reduces the effectiveness of the digestive system and leads to nutritional deficiencies. Taking healthy food and nutritional supplement are able to supply the body with vitamins and nutrients, thus enhancing the body's ability to function properly. Avoid sugar, carbohydrates, caffeine and alcohol in your diet.

	Exercise is widely recognised as beneficial in reducing stress. Relax your body and mind to break down accumulated tension. Try some sports that combine social activities such as tennis and golf. Jogging, swimming, biking and aerobics can improve the cardiovascular system. If you do not feel like doing outdoor activities, moving about or just walking is also useful to help improve blood flow to your brain, increasing one's daily energy supply.

	Relax by doing some stretching, listening to soft music, reading a good book or taking a hot bath. These periods of relaxation should be taken throughout the day and will relieve the up tight feeling that turn frowns into smiles. Give your brain something to do besides worrying over your problems. During work, get up and stretch periodically if your job requires that you sit for extended periods.

	Making sleep a priority is one major way to reduce stress. Have a good sleep by taking a warm bath or drinking a hot drink such as milk before going to bed. Avoid large meals, mint and spices before bed. Try to stop thinking about things that bother you for the day or after. You can keep a notebook & pen by your bed, write down anything important that you think about prior to falling asleep. You won't forget, since you wrote it down.

	Share your problems, concerns and worries with a friend, family member, teacher or counsellor. They may be able to help you solve your problems. If you feel your problem is serious, you might seek for professional help such as seeing a psychiatrist or social worker. Knowing when to ask for help may avoid more serious problems later.

	Schedule your time for both work and recreation. Play can be just as important as your work. Release your pressure and take a break from your daily routine to just relax and have fun.

	Schedule your tasks. Trying to take care of everything at once can seem overwhelming and as a result, you may not accomplish anything. Instead, make a list of what tasks you have to do, set priority to each task and do them one at a time, checking them off as they're completed. Concentrate on the work at hand and on the immediate step you need to take to complete it.

	Make new friends and enjoy new activities by offering your services to a neighbourhood or volunteer organisations. Sitting alone can make you feel frustrated, bored, sad and lonely. Instead of feeling sorry for yourself, get involved. Help yourself by helping other people and get involved with the people around you.

	Yoga is a moving meditation, a system for unifying the body, mind and spirit. The combined practice of Yoga postures, meditation and breathing exercises help reduce stress and anxiety levels so your mind and body can overcome any physiological or mental effects a person may encounter throughout life. To practice yoga, seek for a yoga teacher if you are unable to teach or treat yourself.

Your health and safety in pregnancy

2009-03-03T18:12:00.000-08:00

Is there any reason I shouldn't work while I'm pregnant?

If you're having a low-risk, normal pregnancy, you can certainly continue working. But of course you must make sure that the kind of work you do and your working conditions will not put your health or your baby's health at risk.

In many countries women's health and employment rights are protected by law during pregnancy and afterwards. In the UK for instance, women have the right to a risk assessment in pregnancy to make sure their work will not harm them and their employers are legally required to provide a safe work environment for them. If this is not possible, the employer is required to transfer or suspend her on full pay.

Unfortunately for us, maternity benefits and legal protection are not as clear cut nor as extensive in Malaysia. The Employment Act 1955 provides:
• a minimum of 60 consecutive days of maternity leave, and further states that employment cannot be terminated while a woman is on maternity leave
• a minimum maternity allowance of RM6 a day
• that if an eligible employee dies from any cause during the confinement period, her maternity allowance is paid to her nominee.

However, if your monthly income is more than RM1,500, you are not covered by the Act. You will have to rely on your employment contract or employee handbook. Check to see if there are any maternity benefits or additional privileges during pregnancy. You could also check with your trade union representative.

So what can I do to take care of myself while I am pregnant at work?

Health and safety issues are not just about obvious physical problems, but also things like mental and physical fatigue, movements and postures, travelling and noise. So any concerns you have about your work should be brought up with your boss.

Even if your job requires minimal standing and nothing more risky than lifting a telephone, you may find some simple measures will make you feel more comfortable. You could try:

• Taking breaks. Put your feet up if you've been standing, or stand and walk around every two hours if you've been sitting. This will help decrease swelling in your feet and ankles, and it should keep you more comfortable. Throw in a few stretching exercises to protect your back.

• Resting when you can. The more strenuous your job, the more you may want to reduce physical activity outside work.

• Wearing comfortable shoes and loose clothing.

• Taking time to eat regular meals. Add fibre to your diet to ease constipation.

• Choose lunches that are balanced and nutritious. Consider packing your lunch from home so you can avoid the risks of eating at dirty hawker stalls (including food poisoning).

Can I work right up to my due date?

You are legally allowed to work for as long as you want -- it is your choice when to start maternity leave.
Towards the end of your pregnancy, you may find yourself feeling tired very quickly, so take it as easy as possible. And don't be a hero -- if you can afford to start your maternity leave a week or two before your due date, consider using it to rest, prepare and indulge yourself. Remember that this may be the last quality time you have for yourself for a long time to come...

Are jobs that require a lot of physical activity dangerous?

A demanding job may become too difficult and even dangerous towards the end of pregnancy. If you have a strenuous job, talk to your doctor about it. If your doctor thinks you must reduce your activities, speak to your employer about a suitable alternative. If this is not possible, consider getting your doctor to write a letter to your employer stating that you need to take sick leave for an extended period.

Is there any risk associated with working at a computer?

There's no evidence that working at a computer causes any harm to your developing baby.

If I have any possible pregnancy complications, should I stop working?

Talk it over with your doctor, as it will depend on your condition. But you may be advised to stop if you've previously given birth to more than one premature baby, have either diabetes or high blood pressure, have a history of miscarriage, or are expecting twins.

Caffeine and pregnancy: what's safe?

2009-03-03T18:10:00.000-08:00

Do I have to give up caffeine now that I'm pregnant?

You don't have to give up caffeine, but you may want to cut down.

If you have too much caffeine your baby could have a lower birth weight than he should (CARE 2008). A low birth weight increases the risk of your baby having some health problems when he's born and in the future. There is also a possibility that high levels of caffeine could cause miscarriage (FSA n.d. b). One study suggested that even low levels of caffeine could be linked to miscarriage (Weng et al 2008).

Guidelines issued by the Food Standards Agency recommend that pregnant women have no more than 200mg of caffeine a day (FSA n.d. a). This is equivalent to two mugs of instant coffee or four cups of tea or five cans of cola per day (FSA n.d. a).

What exactly does caffeine do to my body?

Caffeine is a stimulant; it increases your heart rate and metabolism, which in turn affects your developing baby (OTIS 2006). But while unremitting stress isn't healthy, brief bouts of fetal stress, such as that your baby would feel after you drink a cup of coffee, shouldn't cause him any harm. It's akin to your dashing to the bus, another situation that briefly boosts your heart rate and metabolism.

Anyone who drinks coffee regularly knows that it can be addictive and that large amounts can also cause insomnia, nervousness, and headaches (Chawla et al 2006). It's also a diuretic, which causes your body to lose water and other fluids, all of which you need to maintain a healthy pregnancy.

Tea and coffee can also hamper your body's ability to absorb iron if you drink it with a meal or within half an hour of a meal (FSA n.d. b).

Which foods and beverages contain caffeine?

Caffeine can be found in coffee, tea, colas, and chocolate. Some over-the-counter drugs, including headache and cold tablets, stay-awake medications, and allergy remedies also contain caffeine. Always seek your pharmacist's advice before you buy over-the counter remedies, and don't forget to mention that you are pregnant.

Even the amount of caffeine in coffee and tea can vary widely depending on whether the coffee grounds or tea leaves are brewed or instant, weak or strong. Colas and other drinks vary in caffeine content, too. See the list below for average caffeine amounts in some common foods and beverages (FSA n.d. b). You might be surprised how easily you can get a large dose of caffeine.
• 1 mug of instant coffee = 100mg
• 1 cup of instant coffee = 75mg
• 1 cup of brewed coffee = 100mg
• 1 cup of tea = 50mg
• 1 can of cola = 40mg
• 1 can of "energy" drink = 80mg
• 1 x 50g bar of plain chocolate = up to 50mg
• 1 x 50g bar of milk chocolate = up to 25mg

I'd like to kick the caffeine habit - just to be safe. Any tips?

You may find your taste buds do the cutting back for you. Many women find their fondness for a cup of coffee evaporates during the first trimester when their sense of taste changes and nausea can strike.

Otherwise, to reduce the caffeine in homemade hot beverages, brew them for a shorter time. If you love a soothing cup of Earl Grey, steeping your tea bag for just one minute instead of five reduces the caffeine by as much as half. Many tea companies now offer decaffeinated black or green teas.

Although herb teas often have no caffeine, make sure you read the ingredients list. You'll want to avoid large amounts of caffeine as well as certain herbs and additives that may not be safe during pregnancy. (Read more on the safety of herbs in pregnancy.)

If you're a devoted coffee or cola fan, caffeine withdrawal isn't easy. To minimise symptoms, which include headaches, fatigue, weakness and drowsiness, ease off gradually (Chawla et al 2006). Cut back by half a cup of the beverage each day. You can also try switching from freshly brewed to instant coffee.

If coffee fills an emotional need, such as your private coffee break, or it's an early morning ritual or the perfect end to a meal, you could switch to a cup of decaffeinated coffee or tea. If you're hankering for an ice-cold cola, reach for the caffeine-free version at least some of the time or, better yet, try a glass of mineral water with a dash of lime cordial.

We are trying to get pregnant and my doctor told me to start taking folic acid. How much should I be taking?

2009-03-03T18:08:00.000-08:00

It's a good idea to start taking extra folic acid before conception. This essential nutrient, one of the B group of vitamins, reduces the risk of neural tube defects such as spina bifida in a developing baby. Spina bifida is a serious congenital condition, which occurs when the tube around the central nervous system (the neural tube) fails to close completely.
The neural tube develops during the first few weeks of pregnancy. At this stage, you may not even know that you are pregnant, which is why taking folic acid now is a good idea. The neural tube grows to form the baby's brain and spinal cord; the long bundle of nerves which runs inside the backbone to connect the brain with the rest of the body. When you are pregnant, you need extra folic acid, especially in the early weeks of pregnancy when your baby's body is being formed.

Although neural tube defects are very rare, the Department of Health recommends taking a 400 (mcg) microgram supplement of folic acid daily from the time of conception until the 12th week of pregnancy.

If you are not pregnant, you usually need to buy the supplement. Ask the pharmacist for advice on which supplements contain the recommended amount. Women who have previously had a baby with a neural tube defect or are on drug therapy for epilepsy are often prescribed higher doses of 5 milligrams (mg) per day; speak to your GP for guidance before becoming pregnant again.

As well as taking a supplement, you should also increase the amount of naturally occurring folates in your diet. Foods rich in folates include dark green leafy vegetables such as sprouts, spinach, and broccoli; other vegetables such as peas, cabbage, cauliflower, potatoes and green beans; baked beans; fruits (especially citrus fruits); dried beans; yeast extract and milk. Some types of bread and breakfast cereals are fortified with folic acid (check the nutritional information chart on the packaging);.

Like many vitamins, folates can be easily destroyed by cooking. Try steaming, microwaving or stir-frying vegetables which have high levels of folates, or cook them in the minimum amount of water.

Exercises recommended throughout pregnancy

2009-03-03T18:04:00.000-08:00

Why is exercise recommended during pregnancy?

Exercise does wonders for you during pregnancy. It helps prepare you for childbirth by strengthening your muscles and building endurance, and makes getting your body back in shape once the baby's born much easier. Staying active during pregnancy doesn't necessarily mean going for the burn. Your body releases a hormone called relaxin during pregnancy which loosens your joints in preparation for delivery, so you need to take care with the choice of exercise and pay attention to technique. It's important to find exercises that won't injure you or harm the baby.
Ideal exercise gets your heart pumping, keeps you supple, manages weight gain, and prepares your muscles for the hard work of labour and delivery -- without causing undue physical stress for you or your baby. Many activities such as running and weight training are fine in the beginning, but you may need to modify your regime as you grow bigger. You'll be better off avoiding activities that could put you at risk of slips and falls, such as cycling, rollerblading, horseriding and skiing, although people who take part in these sports competitively often continue well into their pregnancy.
The following exercises are fairly safe for expectant mothers, although some of them may not work for you during the last few months of your pregnancy. To be safe, consult your doctor before embarking on any of these activities.

Walking

One of the best cardiovascular exercises for pregnant women, walking keeps you fit without jarring your knees and ankles. It is safe throughout the nine months of pregnancy and can be built into your day-to-day schedule.

Swimming

Healthcare providers and fitness experts hail swimming as the best and safest exercise for pregnant women. Swimming is ideal because it exercises both large muscle groups (arms and legs), provides good cardiovascular benefits, and allows pregnant women to feel weightless despite the extra weight of pregnancy.

Aquanatal classes

Many women find aquanatal classes enjoyable during pregnancy. Exercising while standing in water is gentle on joints and can help lessen swelling in legs, which is a common symptom in late pregnancy. However, it is difficult to find such a class in Malaysia, so you may have to stick with doing laps at the nearest pool.

Yoga and stretches

Yoga and stretching can help maintain muscle tone and keep you flexible with little if any impact on your joints. However, you may have to augment a yoga regime by walking a few times a week to give your heart a workout. Be careful not to overdo the stretching. You will be more supple as a result of the effects of relaxin, which causes your ligaments to be more pliable. Don't hold the stretches for too long or try to develop your flexibility too much.

Pilates

Pilates is a form of exercise which combines flexibility and strength training with body awareness, breathing and relaxation. The exercises are based on certain movement patterns performed with your tummy and pelvic floor muscles -- known in Pilates as the "stable core" or base. These muscles are also known as deep stabilising muscles. Because Pilates targets the tummy and pelvic floor muscles and these muscles can weaken during pregnancy, Pilates exercises can be useful. Many Pilates exercies are performed on a "hands and knees" position, and this is an ideal position for pregnancy. It helps to take a lot of stress off your back and pelvis and towards the end of your pregnancy can help to position your baby ready for delivery.

Weight training

If weight training is already part of your exercise routine, there's no reason to stop, although you will need to avoid using heavy weights and assuming certain positions. If you take the necessary precautions and have good technique, weight training is a great way to tone and strengthen your muscles. Avoid overheating and fatigue, and gradually taper off as the pregnancy advances.

Dance

You can get your heart pumping by dancing to your favourite tunes in the comfort and privacy of your living room, but steer clear of dance movements which call for you to leap, jump, or twirl or wiggle your hips. Remember -- technique is important. Avoid sudden changes of direction. If you sign up for a class, you can lose yourself in music, stay fit, and meet others.

Low-impact aerobics and Fitball

One good thing about an aerobics class is that it's a consistent time slot when you know you'll get some exercise. If you sign up for a class specifically designed for pregnant women, you'll get to enjoy the camaraderie of others just like you, and can feel reassured that each movement has been deemed safe for you and the baby.

Pregnancy exercise guide

2009-03-03T18:02:00.000-08:00

Does exercise help during pregnancy?

Because exercise promotes muscle tone, strength and endurance, it can help you carry the weight you gain during pregnancy, prepare you for the physical stress of labour, and make it easier to get back into shape after the baby is born. Being active during your pregnancy can also reduce the physical discomforts of backache, constipation, fatigue and swelling; can improve your mood and self-image; and can even help you sleep more soundly.

What are the benefits of exercise in pregnancy?

Why exercise? It's may be hard enough just to get dressed every day if you're feeling bloated and sick to your stomach, but believe it or not, a little effort can leave you feeling energised and perhaps a bit like your pre-pregnancy self. Because exercise promotes muscle tone, strength and endurance, it can help you carry the weight you gain during pregnancy, prepare you for the physical stress of labour, and make getting back into shape after the baby is born much easier. Before beginning any exercise programme, make sure you follow safety guidelines, especially now that you're pregnant.
Exercising now will:
Give you more energy
Pregnancy can rob you of energy, but regular bouts of exercise, such as brisk walking, will make you feel able to tackle your daily tasks. Exercise strengthens your cardiovascular system, so you don't tire as easily. With muscles that are strong and toned, you need less effort to engage in any activity, be it shopping for food or sitting through meetings at the office.

Help prepare you for the rigours of childbirth
It makes perfect sense: the better shape you're in, the stronger you'll be to cope with labour and the delivery. Giving birth is akin to running a marathon -- it requires stamina, determination and focus. Keeping physically active during pregnancy is good preparation for the hard work of labour. The UK’s Royal College of Obstetricians and Gynaecologists (RCOG) states that weight-bearing exercise throughout pregnancy can reduce the length of labour and decrease delivery complications. Additionally, some research has shown that fetuses of women who exercised during labour may tolerate labour better than those of the non-exercisers.

Reduce pregnancy discomfort
Exercise stretches and strengthens your muscles, which helps your body cope better with the aches and pains of pregnancy. Stretches ease back pain, walking improves your circulation, and swimming can strengthen your abdominal muscles.

Fend off the pregnancy blues
Pregnancy is a nine-month rehearsal for a big event -- childbirth -- and, after the initial excitement of telling everyone is over, you're left with a lot of waiting. By the sixth or seventh month, pregnancy can become downright tedious. And boredom may result from the increased weight gains and tiredness restricting your social activities. Finding a new activity appropriate for pregnant women may be one answer. "The best thing I can do at the moment to get some relief from feeling as big as a house is to do aquarobics... I find the relaxation session at the end -- when we float to music -- very therapeutic. It also gets you out of the house," says Kim.

Help you sleep better
When you're carrying all that extra weight in front of you, finding a comfortable position to sleep in at night can be a real challenge. Exercise will help you work off any excess energy, and will tire you enough to lull you into a deeper, more restful slumber.

Reduce stress and lift your spirits
Pregnancy and having a child is a life-changing, momentous event which can leave you feeling ecstatic yet overwhelmed and anxious at the same time. One good way to shake the blues is by dancing to the beat of a happy tune. One study found that exercise can boost your levels of serotonin, a brain chemical linked to mood, putting you in better spirits. When you're feeling a little blue, try putting on your favourite CD and kicking up your heels in the living room, or sign up for a low-impact aerobics class. Make sure you follow low-impact aerobics and let your teacher know that you are pregnant.

Improve your self-image
Face it: your body's not the svelte thing it used to be, and although you know it's for a good cause, watching the scale creep its way up to numbers you've never seen before can be disheartening. Staying active can make you feel less frumpy. It can also help you shed weight faster postnatally.

Help you get your body back faster postnatally
This alone is reason enough for many women to embark on a pregnancy exercise regime. As Angela puts it, "I am ready to get back to an active lifestyle and reclaim my body!" If you've managed to maintain your strength and muscle tone all through your pregnancy by staying fit, your body will have an easier time bouncing back after you give birth.

Nausea and vomiting in pregnancy (morning sickness)

2009-03-03T17:58:00.000-08:00

What is pregnancy sickness?

No-one knows why the first sign of pregnancy for many mums-to-be is an early morning dash to the bathroom. With around eight out of 10 pregnant women feeling sick, and half of them actually vomiting, many women spend the early weeks of pregnancy feeling awful rather than "blooming".

Pregnancy sickness is the commonest medical condition of early pregnancy, but how badly affected you may be varies widely from woman to woman. You may get the odd bout of mild queasiness when you first wake up, or find that certain smells trigger your nausea throughout the day, or you may have to endure weeks or even months of feeling or being sick morning, noon and night.

"Morning sickness" is misnamed. It may be worse in the morning, but most sufferers get it throughout the day and into the evening. Pregnancy sickness can take over your life for a time. If you get it badly you may find yourself unable to work, to care for your toddler or other children, to cook, shop or run your home. When you should be feeling happy and excited about your pregnancy you may feel miserable and ill, and your relationships with your husband, family and friends may become strained.

Women with unrelenting pregnancy sickness often feel that nobody really understands what they are going through. Not surprisingly, this can lead to depression. Talking to a fellow sufferer can help you feel less alone. Organisations such as the Ibu Resource Group can help you find a pregnancy support group in your area.

The most severe form of pregnancy sickness is called hyperemesis gravidarum (literally "excessive vomiting in pregnancy"). If you are vomiting many times a day, are unable to eat and drink without vomiting, and if you are losing weight then you probably have hyperemesis. Unlike normal pregnancy sickness, hyperemesis can affect your health and that of your baby, so talk to your doctor as soon as you can.

Why am I feeling sick?

Although it won't help your nausea, feeling sick is actually a good sign that your pregnancy hormone levels are high. The cause of pregnancy sickness is unknown, but it is thought to be connected to the hormone human chorionic gonadotrophin (HCG). This is produced in large quantities until your placenta takes over the job of maintaining and nourishing your baby at around 12 to 14 weeks. Other hormones such as oestrogen and the thyroid hormone thyroxine are also thought to be responsible.
If you also suffer from travel sickness, your symptoms may be linked to a disorder in the balancing mechanism in your inner ear. Other, rare, causes of pregnancy sickness include a disturbance to one of the brain's "feel good" chemicals, serotonin, or a digestive infection called helicobacter pylori.

If you are tired, hungry, or stressed the nausea may be worse, and if you are expecting twins or triplets you will have higher levels of pregnancy hormones, and may get more severe sickness.

An evolutionary theory is that a pregnant woman's increased sense of smell and nausea is a protective measure, making her less likely to be harmed by poisons or toxins in the environment.

Whatever the cause, it can be a shock for a previously healthy woman to find herself overwhelmed by pregnancy sickness. No-one understands why some women get it and others escape, but seeing your pregnant friends "blooming" can feel horribly unfair. It may help to remember that nothing you have done is causing your symptoms.

Some doctors still believe that pregnancy sickness is a psychological condition, but a recent review of studies found no evidence for this.

How long will it last?

Pregnancy sickness usually starts at around five or six weeks of pregnancy and improves for most women by 14 weeks. Some women find it persists until16 weeks, whereas others experience varying degrees of nausea or vomiting for the whole nine months until the birth. Fortunately, this is unusual, especially if you get help early on.

If you have pain, a fever or a headache, or if you get nausea and vomiting for the first time after nine weeks of pregnancy, see your doctor as you may be suffering from another condition.

Will it affect my baby?

Pregnancy sickness won't threaten your baby's well-being as long as you're able to keep some food down, and drink plenty of fluids.

Eat a balanced diet if you can, but if you are feeling very sick, eat whatever you can cope with. Your baby can catch up on his nutrients later on in your pregnancy when you're feeling better.

Your food choices may be odd for a while - you might only be able to manage potatoes and water for a month - but try not to worry about it, and catch up on the healthy eating later. Your liver stores many of the nutrients your baby will need to develop normally, so it won't matter too much if you are not eating. It's important that you take a folic acid supplement though, as this will help your baby's spine and nervous system develop. Take it at the time of day when you're most likely to keep it down.

If you are vomiting many times a day, are unable to eat and drink without vomiting, and are losing weight, see your doctor early on or you may become dehydrated. There are treatments that can help you at home, or you may need to be admitted to hospital.

Getting help and support

You may find that a combination of dietary changes, self help and natural remedies mean you can tolerate your sickness until it eases off. If nothing works, and you are still suffering, see your doctor as early as possible. Treatment becomes more difficult the longer you leave it. He can discuss other ways of coping, including medication.

Tell your husband, your family and your friends how you're feeling, and what you need, as they may not know how to help you. There's no need to feel guilty about asking for help with practical things like shopping, cooking and chores - you're ill! You may have to tell the people you work with about your pregnancy (and your sickness) earlier than you wanted, to get the support you need.

If you had pregnancy sickness with your first baby, there are things you can do to prevent or lessen it second time around. Again it's important to start early.

It can sometimes be hard to get help for pregnancy sickness. Pregnancy books and magazines often skim over the issue, as do medical textbooks, and you may find that your doctor doesn't have all the information you need. The internet can be invaluable. There are many useful websites with information for women and health professionals on this subject.

Diet for a healthy pregnancy

2009-03-03T17:51:00.000-08:00

Fine-tune your diet - even if you already eat well

Now that you're a mum-to-be, it's important to try and increase your intake of certain vitamins and minerals (such as folic acid and iron). You may also need to slightly increase your calorie intake as your pregnancy progresses.
If your diet is poor to begin with, it is even more important to make the transition to eating nutritious, well-balanced meals. Limit junk food, as it offers little more than empty calories, which means calories with few or no nutrients.
Your body becomes more efficient when you're expecting a baby and makes even better use of the energy you obtain from the food you eat. The average woman does not need any extra calories for the first six months of pregnancy and only about 200 extra calories per day for the last three months.

Two hundred calories is equivalent to:
• two slices of wholemeal toast and margarine/butter
• one popiah roll (not fried)
• plain thosai (without gravy or curry)
• one slice of cheese on toast
Your own appetite is the best indication of how much food you need to eat. You may find your appetite fluctuates during the course of your pregnancy:
• In the first few weeks your appetite may fall away dramatically and you may not feel like eating proper meals, especially if you suffer from nausea or sickness.
• During the middle part of your pregnancy your appetite may be the same as before you were pregnant or slightly increased.
• Towards the end of your pregnancy your appetite will probably increase, but if you suffer from heartburn or a full feeling after eating you may find it helpful to have small frequent meals.
The best rule to remember is to eat when you are hungry. Don't worry about your changing appetite as long as you are following the advice given about the type of food you need to eat and you are gaining weight at the appropriate rate, which your doctor or obstetrician will monitor.

Eat the right kinds of fish

Experts generally recommend that pregnant women and children under 16 don't eat shark, swordfish or marlin, as it may contain potentially unsafe levels of naturally occurring mercury. Also avoid bottom feeders, such as catfish, as they may ingest more pollutants.

They also advise that pregnant and breastfeeding women, and those who intend to become pregnant, should eat no more than four medium-size cans of tuna, or two fresh tuna steaks per week. This advice is based on two medium-size cans with a drained weight of 140g per can and fresh tuna steaks weighing about 140g when cooked or 170g raw. Also consider sardines, anchovies and mackerel (commonly grilled in an ikan bakar dish) as these smaller fishes are also high in oil)

Fish contains proteins, minerals, vitamin D and omega-3 fatty acids, which your baby will miss out on if you give it up altogether. Find out more about the benefits of fish for your developing baby and how to get the right balance of fish in your diet.

Some foods are no-nos

During pregnancy you should try to avoid:
• Raw seafood, such as oysters or sushi that has not been frozen before making.
• The cockles found in laksa and char kway teow are supposed to be boiled before they are added to these dishes, but you may want to ask the hawker to leave them out as you can't know how thoroughly they were cooked.

• Steamboat ingredients that are not cooked through - make sure the broth is brought to boil every time new ingredients are added, especially shellfish, meats and eggs.

• Cheeses with a white, "mouldy" rind, such as Brie and Camembert, and blue-veined cheeses like Stilton. All these cheeses could contain listeria, a bacteria that could harm your baby.

• Pate, raw or undercooked meat, poultry and eggs (cook all meat until there are no pink bits left and eggs till they are hard). All are possible sources of bacteria that can harm your unborn child.

• Liver and liver products (pate, liver sausage) should be avoided, too, because they may contain large amounts of the retinol form of vitamin A, too much of which could be bad for your developing baby.

• It is recommended that some women avoid peanuts and foods that contain them. If you, your husband, or any of your other children (if you have any) have a history of allergies such as hayfever, asthma, or eczema, avoiding peanuts during pregnancy and breastfeeding may reduce your baby's chances of developing a potentially serious peanut allergy.

• Many women choose to avoid or cut down on alcoholic drinks during pregnancy, too. Drinking too much alcohol can cause physical defects, learning disabilities, and emotional problems in children, so many experts recommend that you give up alcohol completely while you are pregnant.

If you decide to drink alcohol during your pregnancy, it is recommended by experts that you drink no more than one or two units of alcohol, no more than once or twice a week, and don't get drunk.

• You might want to cut down on caffeine, too. This may be easy for women who are suddenly revolted by the stuff during their first trimester, but that doesn't happen for everyone. Why is caffeine a potential problem? Research has linked consuming more than 300mg of caffeine a day with an increased risk of miscarriage and low birth weight, and one study has linked even low levels of caffeine to miscarriage. To be on the safe side stick to no more that three mugs of instant coffee, three cups of brewed coffee, six cups of tea or eight cans of cola per day. Or, you may want to be more cautious and cut down further on caffeine, or switch to non-decaffeinated hot drinks and colas, instead.

Take a suitable prenatal vitamin-mineral supplement

In an ideal world - free of morning sickness or food aversions - a well-balanced diet would be all an expectant mum ever needed. But in the real world, a prenatalvitamin-mineral supplement may be good insurance to help you meet your nutritional needs. Ask your doctor whether you should take a vitamin supplement.

Folic acid is one supplement that is particularly important to take before you conceive -- and for the first three months or so of pregnancy. A lack of this B vitamin has been linked with neural tube birth defects such as spina bifida. Not surprisingly, Positive Parenting, the expert education programme initiated by the Malaysian Paediatric Association, stresses that a folic acid supplement is absolutely necessary to prevent birth defects - you can get a prescription from your doctor.

Some experts recommend that you take a supplement containing 10 mcg of Vitamin D every day. If you are Asian, if you keep well-covered and don't get much sunlight on your skin then you may be at greater risk of Vitamin D deficiency - see your doctor for individual advice.

Later on in your pregnancy some women may need to take an iron supplement. Your iron levels will be checked periodically during your pregnancy, and your doctor will advise you about your individual needs.

If you are a strict vegetarian, have a medical condition such as diabetes, gestational diabetes, pre-eclampsia, or anaemia, or if you have a history of low-birthweight babies, do talk with your doctor about any special supplements you might need.

Remember, though, that more is not always better: Vitamin A supplements which contain retinol, the animal form of vitamin A, can be toxic to unborn babies in large quantities. The plant-based carotene type of vitamin A is safe in pregnancy. Megadoses of most vitamins and minerals could be harmful to your developing baby.

Don't go on a diet

Dieting during pregnancy is potentially hazardous to you and your developing baby. Some diets can leave you low on iron, folic acid, and other important vitamins and minerals. Remember, weight gain is one of the most positive signs of a healthy pregnancy.

Women who eat well and gain an appropriate amount of weight are more likely to have healthy babies. So if you're eating fresh, wholesome foods and gaining weight, relax: you're supposed to be getting bigger!

If you are overweight, you can improve your diet, cut out junk food and get some exercise (see your doctor first). Research has shown that in these circumstances it is safe to not gain any weight or even to lose weight during your pregnancy, as your body's fat reserves will provide your baby with enough calories.

Gain weight gradually

Weight gain varies amongst individuals and depends on many factors. Although you will be weighed at each visit to your doctor, remember that there is no evidence that a specific weight gain has any effect on your baby's health.

Average weight gain during pregnancy seems to be between 8 kilos / 18 pounds and 15 kilos / 32 pounds. Concentrate on eating a healthy diet: plenty of carbohydrates, lots of fruits and vegetables, reasonable amounts of protein, and just a little in the way of fats and sugars.

When you put on weight may be as important as the total amount. Most women gain the least weight during the first trimester and steadily increase, with the greatest amount being put on over the course of the third trimester when the baby is growing the most.

Eat small meals every few hours

Even if you're not hungry, chances are your baby is, so try to eat every four hours. And if morning (or all-day) sickness, food aversions, heartburn, or indigestion make eating a chore, you may find that eating five or six small meals, rather than the usual three larger ones, is easier on your body.

Remember, your developing baby needs regular sustenance, so try not to miss meals.

Occasional treats are OK

You don't have to give up all your favourite foods just because you're pregnant. But processed foods and snacks and sugar-packed desserts shouldn't be the mainstay of your diet, either. So as far as snacks are concerned, try a banana rather than luxury ice cream, or a frozen fruit sorbet instead of cendol. But don't feel guilty if you fancy the occasional biscuit. Enjoy every bite!

Sex during pregnancy

2009-03-03T17:46:00.000-08:00

Can I have sex while I'm pregnant?

Absolutely. With a normal pregnancy, you can keep doing it right up until your waters break. Do check with your doctor first if you're having any problems with your pregnancy, such as placenta praevia or bleeding or if you have a history of miscarriages.

Will sex harm the baby?

You won't hurt the baby by making love, even with your husband on top. The thick mucus plug cervix helps guard against infection. The amniotic sac and the strong muscles of the uterus also protect your baby. Though your fetus may thrash around a bit after orgasm, it's because of your pounding heart, not because he knows what's happening or feels pain. There are some important circumstances, however, in which you may be advised not to have intercourse.

Will it feel as good?

Even better for some women, not as good for others. Increased blood flow to the pelvic area can cause engorgement of the genitals and heighten the sensation. But the same engorgement gives other women an uncomfortable feeling of fullness after intercourse ends. Also, some women feel abdominal cramps during or after intercourse.

I haven't really been in the mood since I got pregnant. Is this normal?

Yes. The big changes in your body are bound to change your sex life. Some women, finally free from worries about conception and contraception, feel sexier than ever. But others are just too tired or nauseated to make love, especially in the first trimester. The second trimester is often marked by a resurging libido. Your desire may wane again in the third trimester as birth, labour and your belly loom large, or you may simply feel unattractive.

Will my husband's sex drive change?

Most men find their pregnant wife attractive. But a husband's desire may be dampened by concerns for the health of the mother and baby, apprehension about the burdens of parenthood, fear that sex can hurt the baby or even self-consciousness about making love
in the presence of their unborn child.

Is oral sex safe?

Yes, normal oral sex won't harm you or your baby and many consider it a good solution if intercourse is deemed too risky.

Which positions are the most comfortable?

Here are some time-tested positions and tips for making love while you're pregnant:
• Lie sideways. Having your husband on top demands increasingly creative gymnastics as your tummy swells. But lying partly sideways allows your husband to keep most of his weight off your uterus.
• Use the bed as a prop. Your bulge isn't an obstacle if you lie on your back at the side or foot of the bed with your knees bent, and your bottom and feet perched at the edge of the mattress. Your husband can either kneel or stand in front of you.
• Lie side-by-side in the spoons position, which allows for only shallow penetration. Deep thrusts can become uncomfortable as the months pass.
• Get on top of your husband. It puts no weight on your abdomen and allows you to control the depth of penetration.
• Enter from a sitting position, which also puts no weight on the uterus. Try sitting on your husband's lap as he sits on a [sturdy] chair.
Have faith - where there's a will, there's a way. With a little experimenting, you and your husband are sure to find a technique that works for you.

My home pregnancy test showed a faint line. Am I pregnant?

2009-03-03T17:44:00.000-08:00

Anna McGrail

Tests you can do at home are very sensitive and can pick up the presence of pregnancy hormones in your system even before you have missed a period.
For a home pregnancy test to give you a positive result, your body has to be making a detectable level of the hormone human chorionic gonadotrophin (hCG). However, not all pregnancy tests can detect the same amount of hCG; a sensitive test is one which turns positive even if a low amount of the hormone is present. The more sensitive a pregnancy test is, the earlier it will show a positive result.

If the test you're using is only faintly positive, it may not be very sensitive. If you still have the box, it should say somewhere what the test's sensitivity is; the lower the number, the better the test. For example, a test with a sensitivity of 20 IU/L (milliInternational Units per Litre) will tell if you're pregnant sooner than a test with a sensitivity of 50 IU/L. Read the side of the box to see what it says.

Many women get a faintly positive result if they're not as far along as they expected. If this turns out to be the case for you, taking another test in two or three days should give you more exact results. Most home urine tests should be positive by the time your period is due if your body is making the normal amount of hCG.

Pregnancies with complications also produce hCG but in lesser amounts, so that could be causing the faint line. If your test is faintly positive and then a few days later turns completely negative, you may have had a very early miscarriage.

Experts estimate that about 50 per cent of fertilised eggs don't make it, and a further 15 per cent of recognised pregnancies end in miscarriage, so unfortunately this is very common. It is only since pregnancy tests became so sensitive that people have realised how often early miscarriages can happen. In the past, these very early losses might not even have been noticed, and the woman would never have known she had been pregnant.

Home pregnancy tests

2009-03-03T17:39:00.000-08:00

What is a home pregnancy test?

A home pregnancy test measures the presence of the hormone human chorionic gonadotrophin (hCG) in your urine. This hormone is first secreted at the time the fertilised egg implants in the uterus (about six days after fertilisation) by the cells which go on to form the placenta. Levels of the hormone build up rapidly in your body in the first few days following implantation. Usually, home pregnancy tests should be able to pick up the hCG in your urine by the first day you miss your period. Levels of hCG peak between the 60th and 90th days of pregnancy (about the ninth week of pregnancy).

If you have a negative result when you first test, it may be that the levels of hCG have not yet reached a level where they can be detected by a test, even by the day your period is due, so you may want to wait a few days then test again.

Not all pregnancy tests are the same. Some are more sensitive and usually more expensive as a result. The more sensitive tests can detect pregnancy even if you have only a small amount of hCG in your system. Concentrations of hCG are reported in milliInternational Units (mIU) or amounts equal to 1/1000th of an IU per millilitre. A test with a sensitivity of 20 IU/L is more sensitive than one with 50 IU/L. You should be able to find this information on any pregnancy test box.

How do I use a home pregnancy test?

You can test any time of day, and as early as the first day of your missed period for most tests. More sensitive tests may be able to detect low levels of hCG a few days before your period is due but testing this early may give you an inaccurate result (see below). Avoid drinking too much fluid just before testing as this could dilute the pregnancy hormone in your urine. Over-the-counter medicines, such as paracetamol, should not affect the result, but fertility drugs containing hCG may do so.

First, read the directions carefully, because the instructions will vary with different brands. Some require you to urinate in a pot and then, using a dropper, place a small sample into a testing well. Others let you pee directly onto a stick. But, fundamentally, all pregnancy tests work the same way; they measure the amount of hCG in your body. What's different is how they display results (positive or negative). Some change the colour of the urine sample, others show pink or blue lines on the test strip, reveal a red plus or minus sign, or the actual words "pregnant" or "not pregnant", in a window.

How long does it take to see the results?

You can check the results in about five minutes; the longest five minutes ever. If you're testing in the bathroom, you may want to go to another part of the house and find something else to do. A watched pot never boils, and a watched pregnancy test is just excruciating.

Are home pregnancy tests accurate?

If you follow directions to the letter, home pregnancy tests are 97 per cent accurate. But mistakes do happen, which is why some kits come with two tests. There are several reasons why a home pregnancy test may be negative: you may not be pregnant, or your body may not be making a normal amount of hCG. If you test too early (before the first day of your missed period), you may get a false negative result because not enough of the hormone has built up in your system. If the test comes back negative but you still suspect you're pregnant, wait a few days, read the directions carefully, and try again. False positives, when the test says you're pregnant but you're not, are rare.

If you have irregular periods, it may be harder to calculate when your period is due. Allow for your longest cycle in recent months before testing. If you have recently stopped taking the contraceptive pill, you may not know how long your natural cycle is so you may end up testing either too soon or too late. If your test is negative in either of these situations, you should test again in three days.

BabyCenter tip: Perform the test first thing in the morning when your urine is most concentrated.

Where can I buy one?

Home pregnancy tests may be purchased without a prescription at most pharmacists. You can also buy them online by mail order.

How are home pregnancy tests different from ones performed by doctors?

Many clinics use home pregnancy tests to verify pregnancies, in which case, they're exactly the same. Occasionally, women are given blood tests, but they aren't all that different from home pregnancy tests, either. Both types look for hCG in your body. A blood test is much more sensitive than any over-the-counter kit, which means it can determine whether you're pregnant just six to eight days after you ovulate.

Early pregnancy

2009-03-03T17:36:00.000-08:00

Just pregnant? Congratulations! We've rounded up the most common early pregnancy issues and worries so that you can find what you need.
Some of these articles were written for our UK sister site, but we are working hard to make more of them local to your needs.

Top 10 signs of pregnancy

If you're extremely tuned in to your body's rhythms, you may begin to suspect you're pregnant soon after conception. But most women won't experience any early pregnancy symptoms until the fertilised egg attaches itself to the uterine wall, several days after conception. Others may notice no signs of pregnancy for weeks and begin to wonder "Am I pregnant?" only when they miss a period. Below is a list of some of the first signs of impending motherhood. You may experience all, some, or none of these symptoms of pregnancy:

1. Food cravings. Yes, it's a cliché, but food cravings sometimes can be a sign of pregnancy. Don't rely on them as a sure symptom (it may be all in your head, or even a sign that your body is low on a particular nutrient), but if cravings are accompanied by some of the other symptoms on this list, start counting the days from your last period.

2. Darkening of your areolas. If the skin around your nipples gets darker, you may have successfully conceived, though this may also signal a hormonal imbalance unrelated to pregnancy or be a leftover effect from a previous pregnancy.

3. Implantation bleeding or cramping. 3. About eight days after ovulation, you may experience implantation spotting, a slight staining of a pink or brown colour, as well as some cramping. This is caused by the egg burrowing into the endometrial lining. You might also see some spotting around the time you expect your period.

4. Frequent urination. Once the embryo implants and begins producing the hormone human chorionic gonadotropin (hCG), you may find yourself going to the bathroom more often.

5. Fatigue. Feeling tired? No, make that exhausted. High levels of the hormone progesterone can make you feel as if you've run a marathon when all you've done is put in a day at the office. Fatigue is a hallmark of early pregnancy, though probably not a surefire symptom on its own.

6. Tender, swollen breasts. If you're pregnant, your breasts will probably become increasingly tender to the touch, similar to the way they feel before your period, only more so. Once your body grows accustomed to the hormone surge, the pain will subside.

7. Altered sense of taste. You may notice that your sense of taste changes. Some women say they have a metallic taste in their mouth, others that they cannot stand the taste of coffee, tea, or a food they usually like.

8. Morning sickness. If you're lucky, morning sickness won't hit you until a few weeks after conception. (A lucky few escape it altogether.) But as early as a couple of days following conception, you may begin feeling nauseated and queasy. And not just in the morning, either -- pregnancy-related nausea can be a problem morning, noon, or night.

9. A missed period. If you're usually pretty regular and your period is late, it's worth trying a pregnancy test. A missed period is the surest sign of pregnancy in a woman of childbearing age who usually has regular periods.

And finally...

10. A positive home pregnancy test. If you've waited to test until at least the first day of a missed period and a blue line appears in the test window, you're most likely to be in the family way. Make an appointment with your doctor to confirm the good news, and head on over to our pregnancy area. Congratulations!

THE DANGER OF SLIMMING PILLS

2009-02-25T16:25:00.000-08:00

Recent news events have told us about women stricken with complications arising from taking slimming pills with unauthorized and dangerous substances. Many distributors of slimming products make unfounded claims in the effectiveness of their products making their product look seemingly innocent.

" There is no shortcut way in one's bid to lose weight"

Due to the lack of knowledge and ignorance on the side of users, many people are given misleading or incorrect information about the slimming product or pills that they are taking.

Slimming pills stimulate weight loss in a variety of ways. Slimming pills that suppress the appetite often contain adrenaline derivatives which cause harmful and unpleasant side effects such as palpitations, dry mouth, insomnia, restlessness and anxiety. These side effects may add to the existing problem of obesity and create medical complications.

Slimming pills that contain diuretics stimulate water-loss and are usually ineffective because of the body's natural tendency to replace lost fluids. If you take a pill that makes you lose say 1 pound of water, your weight will be reduced by the same amount, but the moment you drink liquids, the depleted quantity of water will be replaced and your weight will return to normal. Diuretics can be potentially harmful because they may also cause potassium depletion, which can lead to muscular weakness, including weakening of the heart muscle and mental confusion. Water depletion is also particularly dangerous if you are living in hot climates countries where dehydration may create numerous complications.

Slimming pills that contain laxatives may lead to severe diarrhea, dehydration from water loss, vitamin and mineral deficiencies. Pills containing harsh laxatives tend to destroy normal movement of the bowels. Taken over a long time, they prevent the ability to produce normal stools.

If you feel slimming pills are an option for you, speak to your doctor. You and your doctor should discuss the long term effects of a product in relation to your health before deciding if the pills are appropriate for you. Slimming pills are potentially very dangerous and should only be used with the recommendation of your doctor and taken as prescribed.This is true if you intend to use them for a long period of time.

The most healthy and effective way to control your weight is through long-term healthy eating and regular exercise.Your body requires certain quantities of vitamins and minerals daily for optimum health. The healthy diet should be based on lower calorie nutritious food such as vegetables, fruits, lean meat, poultry, fish, low fat dairy products and cereals.

Eating healthy to lose weight is a great idea but your weight loss plan will be far more effective if you add regular exercise to it. To keep your weight down in the long term, get at least 30 minutes of exercise everyday. There are lots of ways to increase the amount of activity you do. Aerobics classes, running, brisk walking, swimming and cycling will all improve your fitness levels. Choose activities that suit your lifestyle and that you find enjoyable. You are then more likely to build it into your routine and continue to exercise. Alternatively, you could join a fitness class to make physical activity a regular habit. As you exercise more often, you will be able to increase the length and intensity of your workout.

Do not lose weight rapidly. Remember that there is no shortcut way in one's bid to lose weight.

Diabetes: the heart and blood vessels

2009-02-25T16:24:00.001-08:00

Maintaining blood sugar levels is not what concerns a cardiologist primarily. This is the province of the endocrinologist. Cardiologists are more concerned about the effects of chronically elevated blood sugar.

When the pancreas malfunctions, there is insulin deficiency, and blood sugar rises, sometimes severely. These issues are very well studied, and has been addressed with the use of insulin injections (discovered by Dr F. Banting and Charles Best in 1921) and also the drugs that work primarily in stimulating the pancreas to produce extra insulin, like glibenclamide.



In the 21st century, we have obesity by the ton, forgive my pun. Obese people can have high levels of insulin and yet high levels of blood sugar. This paradox was initially puzzling but we now know that the potbelly produces substances that cause the body cells not to respond to insulin. In our language, obesity causes insulin resistance.

This truncal obesity, together with hypertension, insulin resistance, high triglyceride and low HDL-cholesterol, form a syndrome that we call the "metabolic syndrome", truncal obesity being the main component of this cardio-damaging disease.

The potbelly is a very active organ (not as docile as it may seem), producing hormones and chemicals that cause insulin resistance, diabetes and hypertension and these two in combination severely aggravate heart disease.

Persistent high insulin levels, as often occurs with insulin resistance, changes excess blood sugars into fats, and this further aggravates the potbelly.

Hence, a potbelly begets a potbelly. What�s worse, the persistent high blood sugar causes the blood, blood cells and also the artery wall cells, including the heart, kidney and brain arteries, to be sticky. This promotes blockages in the artery wall.

Therefore, although pancreatic malfunction causes one type of diabetes, obesity and potbelly, very much a 21st century disease, causes another type of diabetes, which comes with hypertension. This latter variety is highly cardiac and blood vessel damaging.

To reiterate, obesity causes insulin resistance and fat metabolism disorder, which in turn causes hypertension and diabetes mellitus (metabolic syndrome), which in turn causes coronary artery disease. When we should be sitting on our fat, we are allowing the fat belly to sit on us and cause us all these problems. Now this bothers cardiologists, a lot.

Complications of diabetes

The saying is true that no one actually dies from diabetes itself anymore. The pre-insulin days where patients waste away from severe high blood sugar and diabetic coma is nowadays a rarity with the advent of insulin. That's why, I guess, Dr Banting and Best won the Nobel prize for Physiology in 1925.

Patients with diabetes nowadays develop kidney, eyes, brain and nerves, and heart and blood vessel complications. In fact all the diabetic complications are blood vessel related. Small blood vessel damage leads to eye problems, kidney disease, kidney failure and nerve damage. Bigger blood vessel damage leads to strokes, CAD with heart attacks and poor limb circulation resulting in amputation for some.

Eventually diabetes translates to cardiac and vascular disorders as blood vessel walls thicken and get clogged up with sluggish circulation and damaged blood vessel wall cells.

Yes, main target organs can be damaged, resulting in complications like kidney failure and renal dialysis, blindness, strokes, heart attacks, angina attacks, angioplasties, bypass surgery, limb gangrene, poor healing wounds and limb amputations.

What is also important to emphasise is that once you are afflicted with diabetes, your risk for every medical illness becomes worse. Even common cough and colds take longer to recover in diabetics, and is more likely to be complicated.

The bbcnews.com recently reported that obese people suffer more complications following motor vehicle accidents. It is as if diabetes weakens your whole body. All cardiac procedures carry a higher risk of complications and the outcomes tend to be worse, in the short and long term, be it angioplasties, or bypass surgery.

Management of diabetes

For those who are already diabetic, please realise that your life is in your hands. Proper treatment by qualified medical practitioners can do much to delay or even avoid complications.

A careless attitude and non-compliance to medical treatment invariably results in worse outcome and target organ failure.

The drugs for the insulin deficient type of diabetes is a little different from the drugs used for the obesity, potbelly type of diabetes. There are very good drugs for both types as our understanding of the disease has improved tremendously.

We have drugs that will help the pancreas to produce more insulin, like the sulphonyl ureas, and insulin injections (for the insulin deficient kind) and drugs that sensitise the cells and tissues to insulin, like the biguanides and "glitazones" (for the insulin resistant kind).

Soon we will have a nasal spray insulin for easier administration. There is also an anti-obesity drug about to be launched that promises to make subjects lose weight and lessen the risk of heart disease, acting through a new body system called the Endocanabinoid system. Interesting. Help for the potbellies is on the way.

Prevention is better than cure

But drug treatment for diabetes, though good, is not the best strategy, both for the patient and for the nation. It is much, much better that diabetes, especially the metabolic syndrome (potbelly type), is prevented.

Potbelly is invariably the result of eating the wrong food and a sedentary lifestyle. This is the age of computers and the remote control. We want instant gratification, without ever having to move from our seat in front of the big, flat screen. We do not exercise enough. We love the elevator, even to go up one to two floors, rather than use the staircase.

Cycling to work has been suggested as a way to overcome this problem. Well, let us see how many will follow. We love junk food. Fast food, almost synonymous with junk food, is springing up all over the place. French fries are many a child�s regular diet. Add to it salt and a sugar-rich carbonated drink, you have the classical diabetic, hypertensive diet.

We have identified some of the problems. Prevention then is relatively easy, but involves sacrifice. Promoting a low salt diet (3 gms a day), with avoidance of carbonated drink would be a good start.

Fruits and vegetables are healthy and should be encouraged. White meat is preferred. Except for service lifts, and lifts for the handicapped and infirm, lifts should go to every third floor. Remote controls for TVs and radios should be banned. Regularly walk 15km a week. Have regular check-ups. All males above 40 years and all females above 50 years should go for a medical checkup.

DIABETES AND THE HEART

2009-02-25T16:21:00.000-08:00

Almost 15-20% of our population, including those in the rural areas of Malaysia, suffer from diabetes mellitus. And approximately 30-40% of our heart patients have diabetes as well.

"Once you are afflicted with diabetes, your risk for every medical illness becomes worse"

Diabetics do worse in all measures of heart disease outcomes, be it angioplasty outcomes, bypass surgery outcomes, heart attacks outcomes and even plain angina attack outcomes. That is why cardiologists spend a lot of their time understanding diabetes. We will try and understand how diabetes is the bad-tempered close relative of CAD.

Diabetes mellitus

Diabetes is "kencing manis", or sweet urine, giving us our first impression that diabetes is a condition of too much sugar in the urine. There is too much sugar in the blood, causing the excess sugar to overflow into the urine.

Well this impression is largely correct. But the reverse must also quickly be mentioned, so as to correct a very large and present misconception, and that is, if there is no sugar in the urine, I do not have diabetes. Well this is not true. Back in the 60s and early 70s, we used to use urine sugar as a way of testing for diabetes. You remember the Benedict's solution as a way of testing for sugar in the urine? This has been found to be unreliable and largely abandoned, although being a cheap test, some clinics continue to use it as a rough guide to diabetes follow-up.

Sugar is a simple molecule, circulating freely in the blood circulation, reaching all organs, and helping all cells to function. It is the energy-providing, life-sustaining molecule that all cells require.

Diabetes occurs when there is too much sugar in the blood stream and yet this high blood sugar level somehow cannot get into the cells where it is required. As we often say, it is almost like the saying "water, water everywhere, but not a drop to drink".

Now to the science of diabetes through the eyes of a cardiologist - the pancreas is a leaf-shaped organ situated at the back of the abdomen, lying stretched across the spine. This organ is mainly responsible for the regulation and maintenance of blood sugar levels within a narrow range of about 4-6 mmols/litre.

Too low a level will make the cells malfunction, just as would too high a blood sugar level. Depending on which cells or organs are affected most, hypoglycaemia (low sugar level) it may present as lethargy and tiredness on the one hand, or violence and aggression on the other.

Of course, extreme hypoglycaemia can result in coma. Hypoglycaemia is a much lesser medical issue then hyperglycaemia (high blood sugar), and is usually the result of drug treatment for hyperglycaemia.

The pancreas produces insulin, a hormone that is required for the proper maintenance of blood sugar levels. It basically facilitates the movement of sugar from the blood stream into cells and tissues for their energy-requiring functions. Sugar in the cells is broken down to produce energy to drive the cell's function.

Insulin production is increased in response to high circulating blood sugar level, as will occur after meals containing carbohydrates/sugar.

The increased outpouring of insulin after a meal causes the sugar in the blood stream to move into cells and tissues (eg muscle cells, brain cells and heart muscle cells) so that these cells can use the sugar to produce energy for their important functions.

Excess sugar is stored in the liver with the help of insulin. In the event of low sugar levels in the blood, the pancreas also produces another hormone, called glucagon, which functions to facilitate the movement of sugar out of the liver cells where sugar is stored and to the blood stream to normalise the blood sugar level. So like all body systems, there is always a "yin-yang" balancing to maintain body equilibrium.

Britney Spears Has a Budget — $130,000 on Plastic Surgery

2009-02-09T19:26:00.000-08:00

The following article is reprinted from Make Me Heal 's Celebrity Plastic Surgery News. The article, along with photos can be found at the following link:Is Britney Spears’s Latest Weight Loss From Plastic Surgery?.

Tabloids have been reporting that between appearances on the TV show How I Met Your Mother, Britney Spears has lost anywhere from 15-30 pounds in only a few short weeks. Make Me Heal decided to take a look at the evidence of the entertainer’s rapid weight loss and weigh in on the possibility that plastic surgery is behind her makeover.

The former teen idol was well known for her incredible body and when she lost it to pregnancy, critics were harsh on the 26-year old mother. Make Me Heal has previously reported on Britney Spears penchant for plastic surgery, from her rhinoplasty to her breast augmentations to her various liposuction treatments (see Make Me Heal’s stories on Britney Spears’s nose job and Britney Spears’s breast implants and Britney Spears’s liposuctions). In the past, Britney’s rumored weight loss has been attributed to Lipodissolve, a type of mesotherapy procedure. Mesotherapy is a procedure that is popular in Europe that is aimed at reducing fat and improving the appearance of cellulite through a series of injections with micro needles. She has also been rumored to have used laser liposuction procedures such as Smartlipo as well as more invasive lipo procedures.

It is hard to tell from Britney’s appearance on television, but recent pictures of Britney in a bikini do appear to show the pop star restored to her pre-baby glory days, making Make Me Heal think that it is possible that the star may have gotten a cosmetic surgery procedure to speed up her weight loss. After any liposuction procedure, whether it is tumescent liposuction or minimally invasive laser/infrared light liposuction alternatives (i.e. Smartlipo, SmoothShapes, Velasmooth, Velashape, CoolLipo), the area usually swells or otherwise appears inflamed. In Britney’s case, however, there doesn’t appear to be any signs of recent work in Britney’s pictures.

Plastic surgeon Dr. John Di Saia says, “It seems more likely to me that she starved herself or used stimulants. The swelling from lipo would still be there. I’d wager she’s had lipo in the past though.”

Whatever the reason for Britney’s recent weight loss, Britney must be looking good enough for television as there are already rumors that she will have yet another appearance on the popular sitcom How I Met Your Mother.