Archive for August, 2009


All about anaemia

While the causes of anaemia may be varied, the condition can be treated easily with proper diagnosis.

BLOOD is made up of fluid (plasma) and cells, that is, red blood cells which transport oxygen; white blood cells which help protect the body against infection; and platelets which help the blood to clot. Most blood cells, including the red blood cells, are produced from the stem cells in the bone marrow which is the red spongy material found in the cavities of the long bones of the body.

Red blood cells contain haemoglobin which is a red, iron-rich protein that gives the red colour to blood. Haemoglobin, which is made up of two proteins called alpha and beta chain globins, enables the red blood cells to transport oxygen from the lungs to all parts of the body and to transport carbon dioxide from other parts of the body to the lungs where it is got rid off during exhalation.

Essential mineral: Without enough iron, the body cannot produce enough haemoglobin for the red blood cells.

The body uses iron, folate and vitamin B12 found in the food we eat, to produce red blood cells. The number of red blood cells in circulation is maintained through the control of their formation and not their life-span. A feedback mechanism controls the production. It is not until the cells have been removed from the marrow that new cells will develop to replace them.

Erythropoietin, a hormone produced in the kidneys, plays an important role in the development of new red blood cells and the production of haemoglobin.

The red blood cells circulate in the bloodstream for about 120 days before they are broken down in the spleen. If the haemoglobin or number of red blood cells is low, the oxygen-carrying capacity of the blood is reduced and anaemia develops. Anaemia is a general name given to a variety of disorders affecting the red blood cells.

Haemoglobin is measured in grams per 100 millilitres (1 decilitre or dl). The normal level in females is between 11.5 and 15.5gm per dl. A woman is considered to be anaemic if the haemoglobin is below 11.5gm per dl.

Types of anaemia

Iron deficiency anaemia is the most common type of anaemia. It affects about 30% of the world’s population. It is due to a shortage of iron, which is needed by the bone marrow to produce haemoglobin. Without enough iron, the body cannot produce enough haemoglobin for the red blood cells. This results in iron deficiency anaemia. Apart from food, the body can get iron from the red blood cells that die.

The iron in the dead cells is recycled to produce new cells. If blood is lost, iron is also lost. This occurs if women have heavy periods or when there is a chronic blood loss from some part of the body.

Vitamin deficiency anaemia occurs when there is a shortage of folate and/or vitamin B12. The dietary requirements of folate are much more than that of vitamin B12. When the diet is short of these and other important nutrients, there is a decrease in the production of red blood cells. This can also occur if absorption of nutrients is affected by a variety of gut conditions. The bone marrow produces large, abnormal red blood cells called megaloblasts.

Hemolytic anaemia occurs as a result of an inherited or acquired condition in which the red blood cells are destroyed faster than their replacement by the bone marrow. Haemolysis is a term used to describe the breaking up of red blood cells and results in the release of haemoglobin into the plasma.

Aplastic anaemia is a life-threatening condition. It is due to a decrease or failure of the bone marrow to produce sufficient numbers of red blood cells, white blood cells and platelets. Sometimes the cause is unknown but at other times, it could be due to chemotherapy, radiotherapy, toxins and lupus.

Anaemia can also be caused by liver disease, cancer, HIV/AIDS and chronic inflammatory conditions like rheumatoid arthritis which interfere with the production of red blood cells, resulting in chronic anaemia. Kidney failure and chemotherapy can cause a shortage of erythropoietin, resulting in anaemia.

On rare occasions, no cause of anaemia can be identified.

Anaemia in pregnancy

Many women are anaemic during pregnancy. A recent study by the Anaemia Working Group found that about one-third of pregnant Malaysian women are anaemic.

Anaemia occurs because there is increased demand for iron and vitamins in pregnancy. The mother has to produce more red blood cells for herself and the foetus. More plasma is also produced.

The blood volume increases by about 50% during pregnancy with a disproportionate increase in plasma. This leads to a dilution of the blood with the haemoglobin falling. The haemoglobin is at its lowest level between 24 and 30 weeks of pregnancy.

Other causes of anaemia include:

> Poor diet: If the diet is low in iron and vitamins, especially folic acid, there is a risk of anaemia as these are the raw materials needed to produce sufficient numbers of red blood cells.

> Family history: Some women whose family members have anaemia because of inherited genes are at increased risk.

> Alcoholism: Chronic drinking increases the risk because alcohol interferes with the absorption of folic acid.

> Vegetarians who have a strict diet may not get enough iron or vitamin B12 in their food.

> Chronic conditions like kidney or liver failure, and cancer increases the risk. Chronic blood loss from some parts of the body due to ulcers, haemorrhoids, etc, may lead to iron deficiency anaemia.

> Intestinal conditions like Crohn’s disease: Intestinal polyps and even intestinal surgery can result in nutritional deficiencies because of poorer absorption.

> Other conditions: Infections, blood disorders, autoimmune disorders, exposure to toxins, and the use and abuse of certain medicines can affect red blood cell production.

If the anaemia is severe, it may interfere with the ability to carry out daily activities. One may be too tired or even exhausted to work or play. If untreated or inadequately treated, anaemia can lead to rapid or irregular heartbeat. The heart has to pump more blood to compensate for the shortage of oxygen. This can result in a heart attack or stroke.

The rapid loss of a large volume of blood can result in acute anaemia and may be potentially fatal, unless there is blood transfusion. This can happen during childbirth.

If anaemia caused by vitamin B12 deficiency is not treated, it can result in nerve damage and decreased mental function because vitamin B12 is important not only for healthy red blood cells but also optimal nerve and brain function.

The symptoms of anaemia include tiredness, breathlessness, rapid heartbeat (palpitations), dizziness, and headache and chest pain if the anaemia is severe. Apart from these symptoms, anaemia is usually diagnosed during ante-natal blood tests which are usually done at the initial consultation and, if necessary, in the second half of pregnancy. A full blood count measures the haemoglobin level and the levels of the different cells in the blood. Some of the blood may be examined under the microscope to evaluate the size, shape and colour of the red blood cells. This evaluation may indicate a diagnosis.

Blood estimations of iron, folate and vitamin B12 will help confirm deficiencies of these compounds. If inherited conditions are suspected, tests like haemoglobin electrophoresis will be carried out.

Additional tests may be done to determine the underlying cause of the anaemia. For example, iron deficiency can be due to peptic ulcers, benign colon polyps, haemorrhoids or other conditions, in which case, appropriate tests will need to be carried out.

If there is a family history of inherited anaemia, a discussion with the doctor and possibly a medical geneticist would be helpful as they can help advise on your risk and the risk of transmitting the condition to your children.

Management and prevention

The treatment depends on the cause. With adequate treatment, most anaemias can be cured. Iron deficiency anaemia will be gone once the iron stores are replenished and any source of blood loss stopped. Folate and vitamin B12 deficiencies are often successfully treated with supplements. Anaemia caused by chronic conditions, hemolytic anaemia and aplastic anaemia can be managed, if not corrected. Inherited anaemias are not curable but the symptoms can be relieved with treatment.

Many types of anaemia can be prevented. Iron deficiency and vitamin deficiency anaemia can be avoided by eating adequate amounts of a healthy diet.

It is important to eat plenty of iron-rich foods. Adequate iron is also important for vegetarians. Food rich in iron include lamb, beef, pork, beans, peas, whole grain breads, dark green leafy vegetables, dried fruit, nuts and seeds.

Food that contains vitamin C helps increase iron absorption. They include raw vegetables, potatoes, lime and oranges. Foods rich in folic acid includes fresh fruits and vegetables, citrus fruits, meat, dairy products and beans.

Vitamin B12 is found abundantly in meat and diary products.

The diet can be supplemented with iron, vitamins and folic acid.

Source: Dr Milton Lum

The Health Ministry has been monitoring the H1N1 situation over the last few months and we acknowledge the significant community transmission of the virus in the country. The number of patients requiring hospital care has increased, including ICU admissions.

With the evolution of the pandemic, the ministry has also adjusted its management guidelines to keep in tandem with the situation. There should also be coverage for those with influenza-like illness who do not have co-morbidities (risk factors) as they make up 20% to 25% of all H1N1 hospital admissions. Nonetheless, we recognise that more than 90% of patients infected with H1N1 will have a mild and self-limiting disease lasting one to three days. Treatment with influenza anti-virals for these individuals may not be necessary.

Hence, to balance the concerns of widespread overuse and the need to get treatment to a proportion of those with no co-morbidities, the ministry recommends using clinical assessment to assist decision making, with fever being a good indicator of disease activity.

Our current updated guidelines recommend the usage of influenza anti-virals for the following:

> All patients admitted for influenza-related complications. H1N1 confirmation is not required for commencement of therapy in these cases.

> All patients with high risk co-morbidities who present with influenza-like illness (ILI).

> All patients with ILI (but do not have co-morbidities) who present with fever of 38°C after 48 hours of fever. However, any patient with ILI who is experiencing rapidly progressive symptoms in the first two days of illness may also be started on therapy. This will be the clinical purview of the attending doctor.

Rapid influenza diagnostic testing is not a requirement for commencement of therapy but, if available, may be used to assist in clinical assessment, which remains the crux of clinical decision-making.

The ministry will continue to monitor the situation on the ground, including reviewing all mortalities and identifying potential areas of weakness. We believe there is still much to learn from this pandemic, which is still evolving.

We continue to be flexible in our strategies in dealing with this pandemic and will not hesitate to make changes in our approach to safeguard the health and well-being of our people.

By:

TAN SRI DR ISMAIL MERICAN,
Director General of Health.

The A (HINI) flu is a viral disease that is amenable to treatment if anti-virals are administered early. However, I feel that the recommendations for treatment by the Health Ministry are too tight.

A number of households within the past two weeks, especially those that are in contact with the public such as medical personnel, students and teachers, have had members of the family down with flu.

Any flu-like illness, especially among those already vaccinated with flu vaccine, within the last two weeks is most probably HINI unless proven otherwise.

The disease has become too widespread to be contained, and steps taken to prevent the spread may prove ineffective. Hence, the next option is to deal with the situation in the most appropriate manner. And that is to administer treatment to the appropriate group early.

Those who get the infection will become immune, and when enough of the population has acquired the infection and become immune, then we get herd immunity and the disease can be contained.

Looking at the symptoms, they are fairly consistent. Most of them start with sore throat and dry cough associated with fatigue and cold intolerance for a few days followed by cyclical fever which usually occurs in the evening. Watery runny nose occurs about one day after the onset of fever and is usually transient unless there is a secondary bacterial infection.

Some patients may have diarrhoea at this stage. Some have milder disease with low grade fever. Note that there is no bone or joint pain or severe headache as opposed to dengue, and that in dengue, there is usually no symptoms of runny nose.

While a nasal swab is helpful with the diagnosis, it has a high false negative rate, hence patients may be wrongly diagnosed. Therefore, clinical judgement is more important.

As we are all aware, the disease does not only cause fatality among the immuno-suppresed, but also healthy individuals, and if we follow closely, we will see that some of those who died had received outpatient treatment for flu prior to their death.

The current recommendation for treatment with anti-virals (http://h1n1.moh.gov.my/caseManagement.php) is too rigid and may be too late because the anti-viral is most effective if given within 48 hours of the onset of symptoms. Often, those who came early for treatment with flu-like illnesses were sent home with antibiotics which gave a false sense of security not only to the patient but also to the doctor.

According to the Health Ministry’s recommendations, if patients have no risk factor, they have to become moderately ill before they can be admitted and receive treatment with anti-virals. By that time it may be too late or the anti-viral may not be as effective or they may already be dead!

A few fatal cases were in fact relatively well at presentation but deteriorated very fast. Within hours the patient succumbed to the illness.

Patients who have high grade fever and are unwell for more than one day associated with flu-like illness should be given the option of receiving treatment with anti-virals.

The British Medical Journal research is correct to say that many people with swine flu only get mild symptoms, and they may find bed rest and over-the-counter flu remedies work for them.

“But for those who experience severe symptoms, the best scientific advice tells us that anti-virals should still be taken as soon as possible — and to suggest otherwise is potentially dangerous”.

No doubt, there are concerns about side effects and resistance to anti-virals, but at this point in time, it is not justified whatsoever to let them run the risk of fatal complications since more than 10% of mortality were from among previously healthy individuals. I repeat, the mistake is withholding anti-viral treatment for patients who deserve it. We have to be less stringent in our criteria to treat.


BENTUK badan atau postur memang berkait rapat dengan masalah sistem otot dan tulang atau sistem musculoskeletal Anda mungkin pernah mengalami sakit leher apabila bangun dari tidur, sakit bahagian belakang selepas anda duduk lama di depan komputer atau selepas melakukan kerja-kerja harian seperti menyapu, memasak atau memandu kereta.

Anda mungkin mengalami sakit bahu selepas melakukan aktiviti sukan seperti bermain golf. Anda juga boleh mengalami sakit di semua sendi anggota badan sebaik sahaja menamatkan hari bekerja seperti sakit sendi siku, sakit bahagian ibu jari seperti sindrom De Quarvain, sakit sendi lutut, sakit kaki dan sakit bahagian badan yang lain.

Sakit sistem musculoskeletal ini biasanya disebabkan oleh postur badan yang tidak normal yang berpunca daripada:

> Kecederaan atau penyakit seperti kelumpuhan, patah tulang, penyakit sistem otot seperti Myasthenia Gravis, penyakit sistem saraf seperti poliomyelitis dan sebagainya.

> Tabiat dan gaya badan (ergonomik) yang tidak baik semasa melakukan fungsi harian seperti duduk, berdiri dan mengangkat yang tidak betul dan dilakukan secara berterusan.

> Bentuk fizikal dan berat badan yang tidak normal seperti berat badan berlebihan atau gemuk.

> Fesyen dan pemakaian kasut yang tidak baik seperti memakai kasut bertumit tinggi, pakaian yang ketat dan tidak selesa yang boleh menyebabkan anda terpaksa mengubah bentuk dan gaya badan bagi menyesuaikan diri dengan fesyen yang dipakai.

> Lahir dengan kecacatan dan sebagainya.

Cara elak sakit belakang

Bagi mengelakkan anda mengalami sakit, anda perlu tahu untuk menilai postur badan yang normal dalam keadaan berdiri, duduk atau semasa melakukan kerja-kerja seharian. Sebagai asasnya postur badan akan menjadi normal jika sekiranya anda mampu membayangkan dan meletakkan anggota-anggota badan berada di tempatnya dengan kesan daya luaran yang minimum seperti daya graviti atau daya tindakbalas bumi.

Anda boleh melakukannya di hadapan cermin dan memastikan daya graviti berada di garisan tengah badan dan daya tindakbalas bumi berada di keseluruhan tapak kaki semasa melakukan aktiviti harian.

Garisan tulang belakang mestilah berada selari atau rapat kepada garisan tengah badan. Garisan tengah sendi hendaklah selari dengan bumi atau sedikit condong ke hadapan bagi membolehkan berat badan disebarkan sama rata keseluruhan permukaan sendi.

Garisan tengah kaki mestilah selari atau rapat dengan garisan tengah badan bagi membolehkan berat badan disebarkan secara sama rata keseluruhan bahagian anggota kaki iaitu sendi pinggul, tulang paha, sendi lutut, tulang kaki, sendi pergelangan kaki dan tapak kaki.

Lagi jauh garisan-garisan ini dari garisan tengah badan, akan lebih lagilah kesan daya-daya luaran akan bertindak ke atas sistem musculoskeletal ini dan akan menghasilkan sakit-sakit yang mungkin tidak akan dapat dilegakan dengan pengambilan ubat-ubat penahan sakit.

Kesan daya ini akan memberikan lagi kesan sakit apabila anda melakukan aktiviti harian anda dengan postur badan anda yang tidak betul.

Jadi langkah-langkah berikut boleh diambil untuk mengelakkan sakit di bahagian badan anda iaitu:

> Pastikan anda membayangkan diri anda tinggi semasa berdiri, duduk atau semasa aktiviti harian.

> Pastikan telinga, leher, bahu, pinggang, lutut dan pergelangan kaki berada di garisan tengah badan dengan mempraktikkannya di hadapan cermin. Gambarkan postur normal ini di kotak fikiran anda dan mempraktikkannya sebilangan masa dalam apa jua keadaan.

> Pastikan lengkungan normal pada tulang belakang atas dan tulang belakang bawah anda tidak terlalu bongkok, tonggek atau leper.

> Sentiasa melakukan senaman postur badan di bawah pengawasan ahli fisioterapi anda bagi mengekalkan sistem otot anda mengawal dan mengekalkan postur badan berada dalam keadaan yang normal.

> Lakukan aktiviti harian dengan gaya badan yang betul.

> Sentiasalah bangga dengan diri anda sendiri kerana kognitif dan keyakinan anda juga memainkan peranan penting dalam mengekalkan postur badan yang normal.

Justeru itu, anda sendiri boleh mengelakkan diri daripada mendapat kesakitan diseluruh badan jika sekiranya anda mengenali postur badan yang normal.

Let’s face it. When it comes to relationships, convincing a man to commit is usually harder than convincing a woman to commit—especially when we’re talking about marriage. To help explain why that is, I came up with six types of single women who—instead of encouraging guys to come closer—possess traits that encourage men to stay single. For those of you who identify with these types, I’ve included a few tips on how to change your ways—and attract that special someone you’ve been seeking.

1. The “Guy-Friend Girl”

You have friends of the opposite sex. There’s nothing wrong with that, except you may neglect opportunities to connect with other women. This is a red flag for men, because we identify the “guy-friend girl” as someone dependent on flirtation to maintain friendships. An inability to create genuine relationships with women indicates, to us, that you have an insatiable desire for attention from men—that you need them to boost your sense of self-worth. Why would a man even try to win over your affection, when attention from one man probably won’t be enough for you?

By bonding with women you can confide in, you’ll avoid being labeled this bachelorette type and free yourself from the endless cycle of petty flirtation.

2. The Intimidator

You may gain points for getting an MBA from Harvard, or for earning a six-figure salary. Sure, these show off your brain power and financial independence, but they may have also gone to your head. You’re uncompromising, and you lean towards forgiving yourself more than forgiving others. Don’t get me wrong: There’s no problem with having high standards for the man you want to marry. You, however, hold a degree in nitpicking and finding flaws. You tend to hide every ounce of vulnerability inside.

If you think you fit this bill, you may have missed the point of a lifelong partnership. Marriage is about two people growing together—not a woman owning a man. When men look for the one they want to marry, they aren’t searching for the thrill of capturing the domineering vixen who sneers at the simpletons daring to woo her.

Guys go for the girl who gives them the benefit of the doubt instead of instantly judging them. Sure, it’s fine to know what you want and to pat yourself on the back for your achievements. At the same time, you shouldn’t let your independence and success overinflate your ego.

3. The Materialist

How many handbags do you need? Let’s be honest: If you don’t comprehend the word “budget,” and if it takes hours for you to count your pairs of shoes, then you’re guaranteed to scare away any sensible bachelor. Your only hope? Players who want a trophy wife—or changing your perspective on life by concentrating on a new mantra: Living beyond your means is never cool. (Suze Orman can explain this better.)

We all want to enjoy the finer things in life, but hoisting your self-esteem onto a huge mound of credit-card debt is plain irresponsible. Sure, many men may like stylish women with refined taste, but overwhelming yourself with extravagance is a sure sign of an unfulfilled psyche and an unhealthy fixation on possessions.

4. The Family Downer

Sharing a round of laughs about your boyfriend’s quirky brother can be a bonding experience. On the other hand, flat-out criticizing or insulting a family member is a no-no. Call me what you will, but when it comes to commenting on my family, showing a little respect is a dating requirement.

Here’s how to keep your negative opinions about your potential in-laws at bay: Let him ridicule his family first. If he encourages you to join in, feel free to do so. Without this precursor, choose to vent your thoughts to someone who won’t divulge it to him.

5. The Clinger

Sure, sharing quality time with your partner should rank high on your list of fun activities. But craving too much couple time can make you look needy, and can even move your relationship into distress mode. Spending every second together goes beyond counterintuitive; it’s an indication of naivete. Even if you want the intimacy of constantly experiencing life together, it’s important to realize that constant coupledom is just a fantasy. You’ll never merge into one being, and you’ll both always be your own individual. Every happily married couple knows this well.

The “clinger” solution is simple: Understand that your mate has hobbies you don’t, and might never, have an affinity for—and vice versa. Fit in the occasional time away from each other. He’ll respect you for it. If you don’t, he might schedule a permanent break from you.

6. The Pet Fanatic

I have nothing against pets; in fact, I have a few of my own. Now that I’ve stated my disclaimer, let’s continue.

Caring for pets has been proven to enhance people’s lives, especially singles. Nevertheless, hoarding and obsessing over a dozen animals that turn your tiny apartment into a cesspool of fur and dander tells men that you’d rather hang out with pets than with humans.

Remember: No matter how many pets you have, they’re simply no substitute for the human interaction you crave. Yes, animals can help fill the void, but overindulging in pet ownership is the same as spraying yourself with man-repellant.

To help assess where you stand on this list of types, ask your friends for input. You’ll gain insight on how others view you—and on how to improve your chances of attracting a guy you can truly share your life with.

Michelle Dennis

Michelle Dennis

BALLARAT – Bukan sahaja aib tetapi padah menanti seorang guru wanita di Australia iaitu Michelle Dennis apabila dia dibicarakan di sebuah mahkamah di sini setelah skandal seksnya dengan dua pelajar terbongkar, lapor sebuah akhbar semalam.

Guru muzik berusia dalam lingkungan awal 30-an itu didakwa pada Oktober tahun lalu kerana melakukan seks dengan seorang remaja bawah 16 tahun sebanyak tiga kali selain dakwaan berkelakuan lucah.

Berikutan kes tersebut, kelayakan mengajarnya digantung oleh Jabatan Pendidikan Wilayah Victoria.

Kes terbaru itu disebut beberapa hari selepas guru ketagih seks itu dipecat daripada Sekolah Tinggi Ballarat setelah dia dituduh mengadakan hubungan seks sebanyak tiga kali dengan seorang lagi pelajarnya yang berusia 17 tahun.

Semua dakwaan terbaru itu terbongkar selepas seorang bekas pelajar sekolah berkenaan membuat laporan polis.

Source: AP

ke_01.1

PUNDI hempedu merupakan organ badan yang terdiri daripada karung kecil berbentuk buah pear yang terletak di bawah bahagian kanan hati. Jus hempedu yang dirembeskan oleh hati disimpan sehingga diperlukan oleh tubuh bagi penghadaman lemak.

ke_01.2Meskipun bahagian ini jarang diberi perhatian, namun kegagalan pundi hempedu berfungsi sebaiknya akan menyebabkan kemudaratan yang cukup berbahaya.

Menurut Pakar Pembedahan Hepatobiliari Klinikal Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), kesakitan yang dialami bukan sahaja melibatkan bahagian abdomen malah terasa sehingga ke tulang belikat.

INILAH fizikal batu hempedu yang dikeluarkan dari pundi hempedu yang gagal berfungsi dengan baik.

INILAH fizikal batu hempedu yang dikeluarkan dari pundi hempedu yang gagal berfungsi dengan baik.

Gejala yang sering dihadapi adalah radang pada pundi hempedu berkenaan. Ini berlaku apabila batu terbentuk di dalam pundi hempedu pesakit. Keadaan menjadi kritikal sekiranya batu tersebut tersekat dan menghalang jus hempedu daripada dirembes keluar.

Terdapat dua faktor utama terjadinya batu dalam pundi hempedu iaitu kolesterol dan kalsium bilirubinate yang tinggi dalam badan.

Batu hempedu terbentuk apabila kolesterol dan garam hempedu menjadi tepu. Ia akan membentuk kristal dan lama-kelamaan akan membesar lalu menjadi batu.

Kesakitan yang dialami oleh pesakit biasanya disebabkan batu tersebut bergesel pada dinding pundi hempedu. Seringkali terjadi apabila seseorang itu mengambil makanan berlemak, pundi hempedu akan mengecut untuk merembeskan jus hempedu ke dalam usus untuk ‘meleburkan’ lemak tersebut.

BATU hempedu ditarik keluar dengan menggunakan endoskopi.


Jika batu hempedu tersekat di pangkal pundi hempedu, ini membolehkan berlakunya radang pundi hempedu. Lebih parah jika serpihan batu hempedu tersumbat pada saluran hempedu yang menyambungkan pundi tersebut pada usus. Ia seterusnya akan menyebabkan jaundis.

Kerana itu, ramai antara pesakit yang mengalami penyakit kuning (jaundis) jika lambat menerima rawatan.

Batu hempedu terdiri daripada tiga jenis iaitu batu hempedu kolesterol, pigmen dan campuran kedua-duanya yang dapat diketahui melalui warna.

Batu kolesterol biasanya berlaku di kalangan masyarakat Barat, lembut serta berwarna kuning seolah-olah tanah liat.

Batu pigmen pula terdapat pada mereka yang menghidap penyakit berkaitan darah seperti anaemia hemolitik dan berwarna hitam serta agak keras.

Bagi batu bercampur pula, kriterianya mirip kedua-dua batu tadi. Jenis ini selalunya terdapat di kalangan masyarakat Asia yang disebabkan oleh jangkitan atau pemakanan yang mengandungi kolesterol dan kalsium tinggi.

Justeru, tidak kira besar atau kecil saiz batu hempedu, ia perlu dibuang dengan teliti bagi mengelakkannya tersumbat atau beralih dan terlekat pada salur hempedu.

Rawatan

Proses bagi membuang pundi hempedu beserta batu-batu hempedu di dalamnya boleh dilakukan menerusi kaedah kolesistektomi laparoskopik .

Di PPUKM, mereka menggunakan kolesistektomi laparoskopik iaitu dengan memasukkan kamera melalui luka di bahagian pusat dan tiga lagi luka kecil di bahagian atas abdomen untuk mengeluarkan pundi hempedu berkenaan.

Kaedah pembedahan lubang kekunci tersebut memiliki beberapa kelebihan iaitu ia lebih selamat, kurang meninggalkan kesan parut dan tempoh pemulihan yang lebih pantas.

Pencegahan

Corak dan gaya hidup adalah faktor utama dalam mencegah masalah pembentukan batu hempedu.

Ia melibatkan cara hidup kita, terutama melibatkan aspek pemakanan. Hanya itu caranya untuk mencegah kewujudan batu hempedu tepu kolesterol dalam pundi.

Makanan yang mengandungi kolesterol seperti makanan segera, berminyak dan berlemak adalah penyumbang utama dalam masalah pundi hempedu.

Disebabkan faktor tersebut, mengikut statistik, 15 hingga 20 peratus daripada populasi masyarakat akan mendapat masalah batu hempedu terutama di negara Barat.

Dalam pada itu, jus hempedu dihasilkan oleh hati dan jus hempedu yang dikeluarkan setiap hari boleh menampung keperluan badan.

Walaupun hempedu dibuang,  tiada kesan sampingan pada sistem tubuh manusia biarpun dengan ketiadaan organ tersebut.

Hajat seorang ibu untuk mengubati anak daranya supaya melupakan bekas kekasihnya dengan seorang bomoh berakhir dengan anaknya dijadi mangsa pemuas seks bomoh terbabit.

Kejadian tersebut didakwa bermula pada 3 Ogos lalu apabila mangsa yang berusia 21 tahun dibawa ibunya ke rumah ‘Pak Haji’ di sebuah kampung di Kota Lama Kiri.

Setibanya di rumah Pak Haji pada pukul 7.30 malam, wanita itu disuruh meninggalkan anak gadisnya selama tiga hari tiga malam kononnya bagi melakukan proses rawatan melupakan bekas kekasihnya.

Bagaimanapun,pada pukul 12.30 malam hari pertama, gadis itu mendakwa Pak Haji telah memaksanya mengadakan hubungan kelamin.

Pada mulanya mangsa sangsi dan menolak, namun Pak Haji memberi alasan, hubungan kelamin harus dilakukan kononnya untuk mengeluarkan air mani mangsa yang dikatakan ‘ubat mujarab’ bagi mangsa melupakan bekas kekasihnya.

Menurutnya, dalam keadaan terpaksa mangsa merelakan dirinya dinodai dan perlakuan sumbang ‘Pak Haji’ itu berulang pada malam ketiga dan keempat.

Sebelum dibenarkan pulang, mangsa pada pagi 6 Ogos diminta mandi dengan air limau kononnya sebagai upacara terakhir menamatkan sesi perubatan.

Sebaik pulang ke rumah, mangsa merasai dirinya tertipu dan menceritakan perkara itu kepada ibunya.

Gadis yang tidak bekerja itu kemudian membuat laporan di Balai Polis Kuala Kangsar.

Polis telah menahan suspek berumur 62 tahun pada 7 Ogos lalu dan dia kini direman untuk siasatan.

Kes tersebut disiasat mengikut Seksyen 376 Kanun Keseksaan kerana merogol dan menipu.

Difahamkan, ketika kejadian dua anak suspek masing-masing berusia 23 dan lapan tahun berada di rumah tetapi isterinya berada di Kuala Lumpur.

Source: Kosmo! Online.

Cinta Internet, gadis diperdaya

LAM menunjukkan laporan polis berhubung penipuan melalui Internet di pejabat MCA

LAM menunjukkan laporan polis berhubung penipuan melalui Internet di pejabat MCA

Helah seorang lelaki memikat seorang gadis melalui Internet membuahkan hasil apabila dia berjaya mendapatkan wang sebanyak RM19,879.29 daripada gadis terbabit setelah berpura-pura ingin mengahwininya.

Mangsa yang hanya mahu dikenali sebagai Lam, 39, memberitahu, dia mengenali lelaki yang bernama Raymond itu menerusi sebuah laman web yang dilayarinya dua bulan lalu.

“Bermula dengan satu pesanan darinya yang mengaku tinggal di United Kingdom, hampir setiap hari kami berhubung sehinggalah kami menjadi mesra,” ceritanya pada sidang akhbar di pejabat Pengerusi Biro Pengaduan Awam MCA, Michael Chong di Ampang K.Lumpur.

Menurutnya, kerana kasih, Raymond berjanji akan mengirimkan sebuah komputer riba, pemain digital MP3, sebentuk cincin dan banyak lagi menerusi kargo selepas berbual pada 26 Jun lepas.

Selang tiga hari kemudian, Lam telah dihubungi oleh seorang lelaki yang dikenali sebagai Keiran mendakwa mewakili sebuah syarikat kargo Skynet memintanya memasukkan RM16,379.29 sebagai cukai kastam ke atas barangan yang dikirim oleh Raymond.

Source: Kosmo Online

In this age of sex,lies and videoclips,nothing really comes as suprise anymore.But Jennifer,who appears to be just like any others 21 years old college student,says the kind of home videos some of her peer are making now would raise more than just a few eyebrows.

It seems almost every college student now knows of  someone who has filmed themselves having sex,or has seen those clips online.According to DSP Mahfuz Abd.Majid form Royal Malaysia Police’s Cyber and Multimedia Crime Investigation Division (CMCID), most of the reports they’ve received or leaked sex videos feature young people aged between 16 to 28.

If you checked the Internet, you will find more than just leaked videos. As many a new media proponent would argue, technology has changed mass media so much. For some, it’s no longer enough to just consume media content, you have to be an interactive producer of content as well; and it’s the same with pornography.

Home made porn videos, featuring youths joking around in local slang with their faces in full view, are made explicitly for all to see on the Internet; that is the erotic lure of new age porn.

After all, teenagers these days are comfortable being in front of the camera. They pose provocatively when they’re taking pictures (or more commonly known as cam-whoring these days), and explore risque topics over webcams.

It is an exhibitionist mindset, that seems to have emerged from the same self-indulgent, self-publishing, “attention-whoring” culture, with which many young people Facebook, Twitter and blog. For some, filming their sex acts is but an extension of this exhibitionist streak.

Possession and distribution of pornographic content, even if it is self-produced, is illegal.

Just for thrills
Farah, 19, is in a stable relationship, and she and her boyfriend film themselves having sex despite knowing the risks involved for the added thrill.

“There’s excitement when we are filming ourselves having sex. It enhances the experience. But a lot of it is for my boyfriend. He lives far away, so I let him have some videos of me on his cellphone to keep him hooked while I’m not around.

“It’s also for evaluation. I want to see how I look, so I can improve on my performance. I don’t sleep around, so I had to learn (about sex) from watching porn. I have a whole stack of DVDs of porn I downloaded from the Internet, and I have a membership with a sex chat service,” said Farah matter-of-factly.

The college student believes she isn’t doing anything wrong, although she sometimes feels guilty because of her religion. She thinks their sex clips are private, and her biggest worry is that her parents might discover them one day.

Jennifer is a lot more liberal in her sexual outlook; she admits to sleeping around and watching a lot of porn but draws the line at recording her sex acts.

She and her friends have “porn parties” where they watch their latest porno downloads, but she always has her guard up.

“I never do webcams. I never put my pictures or videos on my blog, even though some sex blogs are doing that now. That’s because these days, there’s no such thing as ‘I love you forever’. This guy I dated for two years suggested we film ourselves once.

“But for me, even if we’re married there’s no guarantee it won’t come back to haunt me. Who knows? I might marry a Datuk next time, or become someone famous. The most I’ve done is tape some stuff just for fun, which I deleted immediately after watching it once,” said Jennifer during an interview at a cafe in Kuala Lumpur, where she talked openly about her sex life within earshot of several patrons.

She, however, could not resist sharing her sexual experiences on a blog.

“My blog is completely anonymous, because I don’t want my family to know,” says Jennifer who couldn’t be persuaded to reveal her blog address.

Early exposures

Psychologist Associate Professor Dr Khaidzir Ismail from Universiti Kebangsaan Malaysia believes one of the main reasons why young girls seem more sexually daring to try things like videotaping, cyber sex and sex blogging, is increasingly early exposure to sex.

“Women naturally enjoy sex, they enjoy the intimacy. But when they’re sexually active from an early age, our research shows that they become habitual. They want more, and they explore more, branching into things like videotaping,” he said.

Twenty-year-old communications student Melissa is one of those “early adopters”, having watched porn as a secondary school student with classmates on her cellphone at the back of the classroom, and even along her college corridors “in broad daylight” using the campus’ free wireless broadband.

More and more youths are filming themselves having sex these days.

Melissa is used to filming her sexual encounters. She thinks taping sex has become so common some girls might feel pressured into doing it. She commented: “It’s so acceptable these days. If a guy takes out his cellphone halfway through sex, it’s hard to say no sometimes.”

Even though she knows several friends who’ve had their videos leaked, she remains unperturbed.

“My boyfriend has sex videos of me on his cellphone right now, and I have ex-boyfriends who still have videos of us having sex. But I’m more careful now after my friend’s video got leaked. If I’m breaking-up with anyone, I’ll make sure I delete my videos first,” said Melissa.


Not safe for life

AN indication of how prevalent filming sex has become is the increase in police reports and media coverage of leaked sex tapes and pictures in the last two to three years.

DSP Mahfuz said sometimes, leaked footage aren’t even the result of malice, but sheer carelessness.

“Sometimes the people who have the videos aren’t even thinking about publishing or distributing them. Maybe they sent their laptops for repair, lent someone their thumbdrive, or had their computers accessed over a network by someone else.

“We had a case involving a college student living with four other people. They accessed the Internet using the same hub, and one of her housemates used this to retrieve nude photos of her and used them against her,” he said.

Melissa knows all too well how such things never just stay hidden on the Internet, or in a spurned lover’s cellphone memory card, and how unpleasent the consequences are.

“My friend broke up with her boyfriend, so he sent naked pictures of her to all their friends in college using bluetooth. At first, I didn’t want to see them, but naturally everyone gets curious.

“At first she was like, ‘whatever’, but then people started to talk about it, and finally she just broke down. She stayed at home for about three months, not hanging out, not partying, nothing,” revealed Melissa.

Although Mahfuz says possessing and distributing any form of pornography, whether it’s self-produced or downloaded, is illegal, he reveals that the police “don’t go hunting for it (personal sex videos)”, and they usually investigate a case only when there’s a complaint.

Almost all the complainants of leaked pornographic materials have been girls. Although the guys are usually the ones who initiate the sex recordings, it is usually the girls who bear the worst of the social stigma and shame when these clips become public.

Incriminating pictures or videoclips will eventually find its way on the Internet even when you think they have been deleted.

But in terms of people who’ve had their sex tapes leaked without their permission, Mahfuz says the law is on their side.

“Usually if the victim can help narrow down the possible suspects who would leak their videos, we have more than a 50% chance of finding the person responsible. The victims can also get a court injunction prohibiting the videos from being published if they know someone already has them,” he said.

Jennifer offered some rather different words of consolation to those who’ve had their tapes leaked.

She said: “It’s not like it’ll be national news. There are so many sex tapes out there, you won’t even be able to find what you’re looking for.”

Then again, remember what happened to Hong Kong actor Edison Chen.

(All names have been changed.)

Source: rage.com.my