Tahniah 'Jantung' Malaysia!

Sehingga 3 kali saya membaca artikel berita yang sama dan saya berasa begitu kagum dengan pencapaian pakar-pakar jantung dalam negara kita. Apa yang saya maksudkan disini, ialah pengenalan prosedur penukaran injap jantung yang rosak dengan injap gantian secara kateter - Tran- Catheter Aortic Valve Implantation (TAVI). Malaysia menjadi negara pertama di Asia yang memiliki kepakaran dalam mengendalikan prosedur menakjubkan ini. Dengan prosedur ini, rakyat Malaysia yang memiliki indikasi untuk pembedahan jantung tidak lagi perlu dilakukan secara terbuka begitu juga untuk pembedahan coronary by-pass (pintasan koronari). Oleh itu saya ingin berkongsi artikel berita ini untuk bacaan semua.

Institut Jantung Negara (IJN) menjadi hospital pertama di Asia memperkenalkan prosedur ‘Penukaran Injap Jantung Rosak dengan Injap Gantian Melalui Kateter’ bagi pesakit jantung berisiko tinggi dan lanjut usia.

Prosedur TAVI atau Tran-catheter Aortic Valve Implantation (TAVI) itu berjaya dilakukan ke atas tiga pesakit warga emas dengan salah seorang daripada mereka ialah Sasterawan Negara, Datuk Shahnon Ahmad.

Dua lelaki tersebut menerima injap jantung gantian pada 25 November lalu manakala Shahnon, 76 tahun menerima injap jantung gantian pada keesokan harinya.

Prosedur TAVI yang dilakukan oleh sekumpulan pakar bedah dan jantung IJN itu diketuai oleh Ketua Jabatan Kardiologi dan Pakar Jantung, Datuk Dr. Rosli Mohd. Ali.

Ia mengambil masa kurang daripada dua jam bagi seorang pesakit untuk dimasukkan injap jantung gantian bagi mengganti injap jantung yang telah rosak.

Terdapat dua kaedah iaitu dengan membuat tebukan kecil di pangkal paha atau di bawah tulang bahu pesakit berkenaan.

Menerusi tebukan tersebut injap jantung gantian berukuran 23 milimeter akan dimasukkan ke dalam salur darah melalui kateter untuk menggantikan injap jantung yang rosak supaya kembali normal.

Dengan adanya prosedur TAVI, pesakit jantung berisiko tinggi tidak perlu lagi menjalani pembedahan jantung terbuka atau pembedahan pintasan koronari yang lazimnya dilakukan terhadap pesakit jantung di negara ini.

Ketua Pegawai Eksekutif (CEO) yang juga Pengarah Perubatan (IJN) Datuk Seri Dr. Robaayah Zambahari sewaktu mengumumkan kejayaan tersebut berkata, prosedur itu telah berjaya dilakukan terhadap tiga pesakit tersebut dan kesihatan mereka kembali pulih.

Beliau berkata, pesakit pertama berusia 73 tahun manakala pesakit kedua berusia 77 tahun yang berisiko tinggi jika melakukan pembedahan jantung terbuka.

Menurut beliau, prosedur TAVI bagi setiap pesakit berlangsung kurang daripada dua jam dan mereka boleh berjalan semula dalam tempoh 48 jam.

Jelasnya, ketiga pesakit tersebut telah kembali sihat dan dibenarkan pulang lima hingga enam hari selepas melalui prosedur tersebut.

‘‘Prosedur ini tidak ditawarkan kepada semua pesakit jantung. Kaedah ini hanya ditawarkan kepada pesakit jantung berisiko tinggi yang mengidap darah tinggi, kencing manis atau lelah yang lanjut usia. Ia sangat sesuai dan selamat bagi pesakit jantung yang berumur 70-an hingga 80-an.

‘‘IJN bangga kerana mencatatkan sejarah menjadi hospital pertama di Asia memperkenalkan prosedur tersebut terhadap pesakit berisiko tinggi. Kejayaan ini dilakukan secara berkumpulan oleh mereka yang terlibat dalam prosedur tersebut,’’ katanya.

Beliau berkata demikian pada sidang media di IJN di sini hari ini.

Turut hadir sekumpulan doktor pakar yang terlibat melakukan prosedur TAVI iaitu Datuk Dr. Rosli Mohd Ali, Dr. Shaiful Azmi, Datuk Dr. Mohd Azhari Yakub, Dr. Jeswan Dillon, Datuk Dr. Mohamed Hassan Mohamad Ariff, Dr. Sharifah Suraya Syed Mohd.Tahir dan Dr. Ganesh Manoharan.

Mengulas lanjut kejayaan tersebut, Dr. Robaayah berkata, prosedur TAVI diperkenalkan buat pertama kalinya di Amerika Syarikat (AS) pada 2002.

Sementara itu, Dr. Rosli berkata, pada pertengahan Januari depan beliau dan kumpulannya akan melakukan prosedur TAVI terhadap empat lagi pesakit jantung yang lanjut usia dan berisiko tinggi.

‘‘Kaedah ini sangat selamat serta menjimatkan masa. Kita menyasarkan untuk melakukan prosedur tersebut terhadap 20 pesakit jantung IJN yang berisiko tinggi dalam masa setahun.

‘‘Kejayaan prosedur ini 98 hingga 99 peratus,’’ katanya.

Katanya, kos bagi setiap prosedur dianggarkan RM140,000,00 termasuk harga injap jantung gantian yang berharga RM112,000.

Beliau berkata, kajian untuk menggunakan prosedur tersebut bagi pesakit IJN telah dibuat sejak lebih setahun yang lalu.

Leia Mais…

DM and Pregnancy

Diabetes mellitus, a clinical syndrome characterized by deficiency of or insensitivity to insulin and exposure of organs to chronic hyperglycemia, is the most common medical complication of pregnancy.

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with first recognition during pregnancy.

Hyperglycemia around the time of conception and early organogenesis results in the developing embryo having a 6-fold increase in midline birth defects. Ketoacidosis is an immediate threat to life and is the leading cause of perinatal morbidity in diabetic pregnancies today.

Complications of GDM include fetal macrosomia, which is associated with increased rates of secondary complications such as operative delivery, shoulder dystocia, and birth trauma. In addition, neonatal complications attributed to gestational diabetes include respiratory distress syndrome (RDS), hypocalcemia, hyperbilirubinemia, and hypoglycemia.

Before the introduction of insulin in 1922, patients often died during the course of their pregnancy. Twenty years ago it was not uncommon to deliver an unexplained stillbirth from a mother with type 1 diabetes mellitus. In an effort to prevent fetal death, deliveries were often performed early.

Today, this tragedy is rare.

With therapy beginning prior to conception and continuing throughout pregnancy, including nutrition therapy, insulin when necessary, and eventual antepartum fetal surveillance, there is a marked decline in overall morbidity and mortality. Two decades ago, most diabetics required prolonged hospitalization, but today the majority is managed with only brief hospitalizations. This is partly due to the technologic improvements in home reflectance glucose monitors and the beneficial impact they have had in management of the diabetic during pregnancy.

Currently, the major challenges of caring for diabetics in pregnancy are first, to enhance preconceptual glucose control and reduce the risk of associated congenital malformations, second to adequately screen pregnant women, and third, to detail the full impact of milder glucose elevations, not only on maternal risk for developing diabetes, but also on immediate and long-term consequences to the fetus/child.

What risks does pregestational diabetes pose to the baby?
Poorly controlled pregestational diabetes poses a number of risks to the baby. These risks can be greatly reduced with good blood sugar control starting before pregnancy.

• Birth defects: Women with poorly controlled diabetes in the early weeks of pregnancy are 3 to 4 times more likely than nondiabetic women to have a baby with a serious birth defect. These include heart defects or neural tube defects (NTDs), birth defects of the brain or spinal cord.
• Miscarriage: High blood sugar levels around the time of conception may increase the risk of miscarriage.
• Premature birth (before 37 completed weeks of pregnancy): Premature babies are at increased risk of health problems in the newborn period as well as lasting disabilities.
• Macrosomia: Women with poorly controlled diabetes are at increased risk of having a very large baby (10 pounds or more). Macrosomia is the medical term for this. These babies grow so large because some of the extra sugar in the mother's blood crosses the placenta and goes to the fetus. The fetus then produces extra insulin, which helps it process the sugar and store it as fat. The fat tends to accumulate around the shoulders and trunk, sometimes making these babies difficult to deliver vaginally and putting them at risk for injuries during delivery.
• Stillbirth: Though stillbirth is rare, the risk is increased with poorly controlled diabetes.
• Newborn complications: These include breathing problems, low blood sugar levels and jaundice (yellowing of the skin). These complications can be treated, but it's better to prevent them by controlling blood sugar levels during pregnancy.
• Obesity and diabetes: Babies of women with poorly controlled diabetes may be at increased risk of developing obesity and diabetes as young adults.

What risks does gestational diabetes pose to the baby?
Babies of women with gestational diabetes usually face fewer risks than those of women with pregestational diabetes. Babies of women with gestational diabetes usually do not have an increased risk of birth defects. However, some women with gestational diabetes may have had unrecognized diabetes that began before pregnancy. These women may have had high blood sugar in the early weeks of pregnancy, which increases the risk of birth defects.

Like pregestational diabetes, poorly controlled gestational diabetes increases the risk of macrosomia, stillbirth and newborn complications, as well as obesity and diabetes in young adulthood.

Does diabetes cause other pregnancy complications?
Women with diabetes (pregestational and gestational) are likely to have an uncomplicated pregnancy and a healthy baby, as long as blood sugar levels are well controlled. However, women with poorly controlled diabetes are at increased risk of certain pregnancy complications. These include:

• Preeclampsia: This disorder is characterized by High Blood Pressure and protein in the urine. Severe cases can cause seizures and other problems in the mother and poor growth and premature birth in the baby.
• Polyhydramnios: Too much amniotic fluid (polyhydramnios) can increase the risk of preterm labor and delivery.
• Cesarean delivery: When the baby grows too large, a cesarean delivery often is recommended.

What causes gestational diabetes?
Gestational diabetes occurs when pregnancy hormones or other factors interfere with the body's ability to use its insulin. An affected woman usually has no symptoms. This form of diabetes usually develops during the second half of pregnancy and goes away after delivery.

Who is at risk of gestational diabetes?
Women with certain risk factors are more likely to develop gestational diabetes. These risk factors include:

• Had gestational diabetes in a previous pregnancy
• Age over 30
• Overweight and/or excessive weight gain during pregnancy
• Had a very large (over 91/2 pounds) or stillborn baby in a previous pregnancy
• African-American, Native American, Asian, Hispanic, Pacific Island ancestry

However, even women who don't have any risk factors can develop gestational diabetes. For this reason, health care providers screen most pregnant women for the disorder. According to the American Diabetes Association (ADA), women under age 25 who have no other risk factors may not require screening because they have a very low risk of the disorder.

Leia Mais…

Amalan Tradisi Ada Juga Faedahnya...

PETUA-PETUA TRADISIONAL…

Mengurangkan masalah darah tinggi.

Ambil pucuk betik jantan direbus dan dibuat kerabu ia juga bolih direbus dan dimakan bersama sambal belacan.Ianya pahit sikit tapi baik untuk yang sakit darah tinggi.Insyaallah, semoga ianya berjaya.

Hilangkan sakit kepala.

Ambil beberapa biji limau nipis, potong dan gosokan di seluruh bahagian kepala , biarkan selama 1/2 jam...InsyaAllah hilang sakit kepala.

Menghilangkan kolestrol dalam darah.

Ambil limau nipis belah dua tapi jangan sampai terputus sambil memotong anda kenalah membaca selawat x 3 dan masukkan dlm air panas sampai limau itu kuning dan minum amalkan setiap hari insyaallah menjadi.....

Mengawal kencing manis.

Bagi yang mengidap Kencing Manis diperingkat permulaan , ambil akar semalu dan jemurkan sehingga kering.Kemudian rebus dan airnya diminum Amalkan selama dua minggu setiap pagi..Insyallah..

Menurunkan darah tinggi.

Cara untuk menurunkan darah tinggi ialah dengan cara ambil pucuk limau puruk rebus hingga mendidih dan airnya dibuat minum tiap-tiap hari ,insyaallah dengan cara ini dapat menurunkan darah tinggi dengan izin Allah . Selamat mencuba.

Rambut gugur.

Untuk mereka yang bermasalah tentang keguguran rambut.Caranya ialah dengan mengambil 5 hingga 6 helai daun Pinang Muda ( Pucuknya ), kemudian dipecah-pecahkan dan ramas sehingga mengeluarkan buih.Kemudian sapukan sehingga rata dirambut dan kulit kepala,biarkan 15 minit dan bilas dengan air bersih.Amalkan setiap selepas mandi.Lihatlah perbedaannya dalam tempoh 1 minggu.Akar rambut akan menjadi kukuh dan kelihatan sihat bersinar.

Leia Mais…

Recommended Books For 2nd and 3rd Course Medic

List of books recommended for medical students ( 3rd course):


1.PHARMACOLOGY (Lippincott's Illustrated Reviews)

"Banyak ilustrasi yang memudahkan pemahaman kita..tapi isi kandungan buku ini terlalu panjang untuk satu topik.."














2.Oxford Handbook of Clinical Medicine (OHCM)

"Buku ini sangat bermanfaat, lengkap dan mudah dibawa ke mana-mana...ramai pelajar perubatan di Malaysia menggunakan buku yang sama" Ahmad Ramdan Zainordin

"Best2 mmg bergune..beli la.." Iliana Mohamad@kak yana














3.PATHOLOGY (Jaypee by Harsh Mohan)

"Buku yang tebal dan besar..banyak lukisan slaid pathology yang bermanfaat..juga boleh digunakan untuk semua cabang pathology seperti Pathological Anatomy dan Pathological Physiology..bagus2.." Annie Alfred







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For 3rd year medical students in Volgograd State Medical University, other books can be obtained from the library and lecture materials as well and they are quite enough to comprehend your studies during the semesters. One of the most beneficial book that you must borrow or buy is:



PHARMACOLOGY (Kharkevitch)

"Very2 good and excellent book.." munirah

"Buku ini sangat berguna selain isi yang lengkap dan sangat mudah untuk memahaminya..ilustrasi juga menarik dan bermanfaat..mesti dapatkannya segera" Ahmad Ramdan Zainordin















List of books recommended for medical students (2nd course):



1. Atlas of Histology with Functional Correlations (By Victor P. Eroschenko)

"Very comprehensive book and many lecturers used it including Prof. Marina Kapitanova..must get one.."



















2. Essentials of Medical Physiology (Jaypee)


















For 2nd year medical students in Volgograd State Medical University, other books for your studies can be obtained from the library and of course, lecture materials too. Don't miss your lecture...


May your holidays be a such 'Happy Ending' and good luck for your next journey towards excellence.

"Maka sesungguhnya bersama kesulitan ada kemudahan. Sesungguhnya bersama kesulitan ada kemudahan. Maka apabila engkau telah selesai (dari suatu urusan), tetaplah bekerja keras (untuk urusan yang lain). Dan hanya kepada Tuhanmulah engkau berharap" as-Syarh:5-8

Leia Mais…

Internship for Medical Graduates

Pursuant to the Medical Act 1971, ‘internship’ is a period of structured supervised practical training AFTER graduation.

Section 13(2) of the Medical Act 1971 dictates that fresh medical graduates shall undergo further training for the purpose of obtaining experience as a house officer which includes four months posting in Surgery, orthopaedics, medicine, paediatrics, obstetrics & gynaecology and A&E.

The noble aim of internship training is to provide fresh graduates with an educationally sound experience that professionalizes new medical graduates not only with appropriate knowledge, skills and experience but above all attitudes.

Currently, there are 38 hospitals (click here for the list)approved by the Board for the purpose of houseman training.

Pursuant to the Medical Act 1971 , the Medical Qualifying Board , has determined that:

a. The Committee for the Houseman Training has the right to determine your discipline placement;

b. You will be allowed to proceed to the next discipline if your supervisor is satisfied with your knowledge, skills, competency and attitude in that particular discipline;

c. The Committee has the right to determine the duration of your extension period;

d. If you do not satisfactorily complete any or all of the internship training requirements, you will not be eligible for full registration;

e. The total duration of your internship training should not exceed SIX years. If you are unable to complete within the said period, you will not be eligible for full registration. For that matter, you need to appeal to the Board through the Committee.

Leia Mais…

KEDUDUKAN PENGISIAN PEGAWAI PERUBATAN LATIHAN SISWAZAH SEHINGGA 31 JANUARI 2009

Negeri	Bil.	Hospital	Bil. Jawatan
Perlis	1.	Hospital Tuanku Fauziah, Kangar	47
Kedah	2.	Hospital Sultanah Bahiyah, Alor Star	71
	3.	Hospital Sultan Abdul Halim, Sungai Petani	49
	4.	Hospital Kulim	36
Pulau Pinang	5.	Hospital Pulau Pinang	90
	6.	Hospital Seberang Jaya	39
Perak	7.	Hospital Taiping	58
	8.	Hospital Raja Permaisuri Bainun, Ipoh	95
	9.	Hospital Teluk Intan	55
	10.	Hospital Seri Manjung-Lumut	35
W.Persekutuan	11.	Hospital Kuala Lumpur	179
	12.	Hospital Putrajaya	31
Selangor	13.	Hospital Tengku Ampuan Rahimah, Klang	88
	14.	Hospital Selayang	53
	15.	Hospital Kajang	37
	16.	Hospital Serdang	40
	17.	Hospital Ampang	28
	18.	Hospital Sungai Buloh	46
N.Sembilan	19.	Hospital Tuanku Jaafar, Seremban	82
	20.	Hospital Tuanku Ampuan Najihah, Kuala Pilah	40
Melaka	21.	Hospital Melaka	78
Johor	22.	Hospital Pakar Sultanah Fatimah, Muar	52
	23.	Hospital Sultanah Aminah, Johor Bahru	98
	24.	Hospital Batu Pahat	37
	25.	Hospital Sultan Ismail, Pandan, Johor Bahru	44
Pahang	26.	Hospital Tengku Ampuan Afzan, Kuantan	68
	27.	Hospital Sultan Haji Ahmad Shah, Temerloh	38
Terengganu	28.	Hospital Sultanah Nur Zahirah, Kuala Terengganu	76
Kelantan	29.	Hospital Raja Perempuan Zainab II, Kota Bharu	80
Sarawak	30.	Hospital Umum Sarawak	57
	31.	Hospital Sibu	51
	32.	Hospital Miri	36
Sabah	33.	Hospital Queen Elizabeth	80
	34.	Hospital Tawau	25
	35.	Hospital Duchess of Kent, Sandakan	38
Pusat Pengajian Tinggi	36.	Pusat Perubatan Universiti Malaya (PPUM)	82
	37.	Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)	72
	38.	Hospital Universiti Sains Malaysia (HUSM)	63
JUMLAH			2274

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