高血压定义· 上压逾140 下压逾90

根据世界卫生组织定义，高血压指人体在休息的状态下，经多次量度，血压高于140（上压）/90（下压）mmHg。民众可按以下轻微至严重程度区分：

正常血压：上压低于120mmHg；下压低于80mmHg

血压正常至高：上压120-139mmHg；下压80-89mmHg

血压高（轻微）：上压140-159mmHg；下压90-99mmHg

血压高（中等）：上压160-179mmHg；下压100-109mmHg

血压高（严重）：上压180mmHg或以上；下压110mmHg或以上

幽门螺旋菌

幽门螺旋菌会复发吗？

问：我于两年前曾接受幽门螺旋菌治疗。可是最近有胃痛，容易闷胀，大便不成形和胃灼热。曾经做血液检验，化验结果有螺旋菌。

因此，我再去医院做尿素呼气试验，但结果是阴性（Negative），医生给我得喜胃通（Dexilant）服用。

答：胃痛，容易闷胀和胃灼热是胃炎（gastritis）或消化性溃疡（pepticulcer disease）相当典型的症状。血液化验（从所附的报告是检测IgG抗体）IgG抗体呈阳性，只表示曾经感染螺旋菌，而不代表现在还感染螺旋菌。然而碳十三尿素呼气检验（urease breatht e s t）则可以告诉我们现在是否感染螺旋菌（可以是之前的螺旋菌治疗无效，抑或是新的螺旋菌重新感染）。

得喜胃通是一种抑酸作用相当强的质子泵抑制剂（proton pump inhibitor），它能减少胃酸分泌，因此有助胃炎或胃溃疡的愈合，从而减少胃痛易闷。

如果有需要可以促胃肠动力药（prokineticdrugs）增加胃肠的蠕动，帮助减轻闷胀症状。

抗酸药（antacids）则可中和胃酸，舒缓胃灼热症状。

此外，也要养成定时定量有规律的饮食习惯，同时减少饮用浓茶和咖啡。如果长期吸烟与饮酒，更要努力减少或戒除。

如果由于其他疾病而正服用药物如阿司匹林制剂（aspirin）、类固醇（steroids）或一些镇痛药如非类固醇消炎药物（NSAIDs）而引起，就有必要向医生查询，是否有替代药物或是在医生的建议下调整剂量。

虽然螺旋菌会导致胃炎和消化性溃疡，但它只是消化性溃疡许多病因的其一。因此没有螺旋菌并不表示没有胃炎或消化性溃疡，甚至胃癌。如果症状没有好转，或者反反覆覆的好转与复发，那么就一定要进行胃镜检查。

问：幽门螺旋菌有可能复发吗？该如何治疗？

答：一般上，在确诊感染螺旋菌后，医生都会用抗生素给予治疗。然而，大约一成的螺旋菌带有抗药性，因此这治疗并不能把螺旋菌给根除，在这情况下，医生就会用第二线甚至第三线的抗生素，希望能把螺旋菌赶尽杀绝。

然而有时候，螺旋菌的确给根除了，但病患却非常不幸的再次感染上新的螺旋菌，因此需要重复治疗。

另外，来信提到其中一个症状是大便不成形。

这通常跟胃炎或消化性溃疡无关，反而可能是结肠或直肠癌的症状，如果症状持续超过数周就不可掉以轻心，必须进行大肠镜检查加以确诊。

***温馨提醒：文章与广告内提及产品、服务及个案仅供参考，不能作为看诊依据，必要仍须以医生的意见为主。

文章来源：

星洲日报‧2017.07.08

Nose Bleeding in Toddlers

1) Cold Compression with ice
2) Oxymetazoline
3) Do not give ibuprofen
4) Investigate cause of nose bleeding
For more information, please whatapps to 017-2822923 Klinik Medilove Kepong

Palate Abnormality - Torus Palatinus

Torus Palatinus

It is not a cancer 

It is caused by bony growth and bony protrusion on the palate.

It appear during the after puberty and may disappear in the old age due to resorption of bone.

For more information, please whatapps to 017-2822923 Klinik Medilove Kepong

Colorectal Cancer - CEA, M2-PK, Colonoscpoy

Colorectal Cancer

For more information, please whatapps to 017-2822923 Klinik Medilove Kepong

Thalassemia

Thalassemia

Thalassemia - Genetic Disease of Hb synthesis with underproduction or no production of one globin chain.

Beta thalassemia means less beta chain production (minor) or abscence (major)

Hb electrophoresis: HbA2, HbF, Hb Electrophoresis

Sign & Symptoms of beta-thalassemia major (Cooley's Anemia) :

• severe anemia in 1st year 
• failure to thrive 
• extramedullary hemopoiesis : RBCs made outside the marrow - skull bossing, hepatosplenomegaly
• life long blood transfusion needed 
• iron overload leading to endocrine failure: pituitary, thyroid, pancreas-DM, liver disease

Diagnosis:

• Hypochromic Microcytic Cells
• +target cells
• +nucleated RBCs
• raised HbF

Treatment

• Promote fitness
• Healthy diet - folate 
• Folate Supplements
• Life Long Transfusion 2-4 weekly to keep Hb>9g/dl 
• Iron-chelators to prevent iron overload - oral deferiprone + desferrioxamine s/c twice weekly 
• Vitamin C to increase urinary excretion of iron 
• Splenectomy after age 5 due to risk of transmission

Prevention

• Genetic Couselling 
• Antenatal Diagnosis 

Thalassemia Trait 
- person who carry the gene of thalassemia 
- not much of health issue except mild anemia 
- promote fitness and take folic acid 

For more information, please whatapps to 017-2822923 Klinik Medilove Kepong

Helicobacter Pylori / Peptic Ulcer Disease

Helicobacter Pylori / Peptic Ulcer Disease 

Helicobacter Pylori in the stomach and upper part of duodenum can cause peptic ulcer.
It attack the stomach lining and cause ulcer in the stomach.

Symptoms:
Patient might not have symptoms or might have heartburn, abdominal pain 

Transmission:

• Faecal-Oral 
• Oral-Oral

Diagnosis by:

• Urea Breath Test
• H pylori antibody - Blood
• OGDS scope

Treatment:

• Triple Regimen (Amoxicillin + Omeprazole + Clarithromycin) for 14 days 
• Repeat Urea Breath Test after 4 weeks once complete Triple Regimen 

Complications:

• Chronic gastritis 
• Atrophic gastritis 
• Stomach ulcer
• Stomach cancer 

For more information, please whatapps to 017-2822923 Klinik Medilove Kepong

Blood Test - High Cholesterol

High Cholesterol Level 

Cholesterol found in the lipid (fat) in your blood.

High Cholesterol can build up fatty material at the blood vessel (Atherosclerosis)

↓

Difficult for blood to flow through

↓

Not enough Oxygen to heart / brain : Heart Attack / Stroke

Causes:

• Unhealthy lifestyle - inactivity and diet factors
• Inherited / Genetic - liver produce excess cholesterol

Risk Factors:

• High Fat Diet - saturated fat (animal fat) , trans fat (bakery)
• Obesity 
• Lack of exercise
• Smoking
• Diabetes

High Cholesterol has no symptoms - can only be found from blood test

LDL - Bad Cholesterol     - transport cholesterol throughout the body , build up in the wall of                                                   arteries 

HDL - Good Cholesterol  - pick up excess cholesterol back to liver 

Lifestyle modifications / changes

Food 

• Healthier Fat: avoid red meat & full diary milk fat, choose low fat diary & plant oil: olive oil & canola oil 
• Avoid Trans Fat : in fast food / fried food / snacks / cookies
• Omega 3 Fatty Acid : - salmon , walnuts , almonds 
• Fibers : oat brans , vegetables and fruits 

Exercise

• minimum 1 week 3 times 
• 1 time 30 minutes of aerobic exercise

Smoking & Alcohol

• Quit Smoking

Obesity

• Weight Reduction

For more information, please whatapps to 017-2822923 Klinik Medilove Kepong