Jumlah Anggaran kos perubatan di Malaysia

Kos perubatan di malaysia

Bismillahirahmanirahim, Pagi semalam saya diberitahu rakan karib ayah saya telah menemui Allah yang esa , pada waktu sekarang tiada yang boleh menafikan kematian , ada yang mati di usia muda dan ada yang di usia tua , tetapi sebagai hamba Allah kita tahu bahawa mati itu pasti , Cuma apa yang ingin saya kongsikan sini pada entry blog saya kali ini , apakah persediaan kita kepada perbelanjaan kesihatan yang akan kita laburkan suatu masa nanti.

Pengalaman saya apabila bekerja di bahagian kesihatan atau di hospital ini mendekatkan diri saya kepada penciptanya , kadang kadang kita tak sedar bertapa bernilainya satu anugerah yang di kurniakan allah yang dipanggil nikmat kesihatan .Kesihatan badan manusia adalah satu nikmat yang paling bernilai dan tidak dapat dijual ganti , bertapa bernilainya kesihatan ini saya rasa tuan tuan sendiri tahu. Kita lihat sahaja Steve Jobs seorang genius yang membina empayar Apple ,secara jujur kita katakan dia adalah jutawan dan kalau diikutkan secara fikiran kasar dia mampu membayar kesihatan ini ,tetapi penyakit yang dihidapi oleh beliau lagi hebat dan sukar diubati. Ini lah yang patut kita fikirkan pada masa ini kenapa kesihatan ini amat bernilai.

Duit dan kekayaan bukanlah segalanya mampu untuk membeli kesihatan tetapi dengan adanya kekuatan ekonomi seseorang individu itu ia mampu menyediakan rawatan yang terbaik buat diri mereka dan juga keluarga mereka itu sendiri. Selalu soalan ditanya oleh pesakit pesakit kepada saya berapakah anggaran kos perubatan dinegara Malaysia ini.

Disini saya tampilkan anggaran kos perubatan  yang boleh memberikan sedikit penerangan dan info apakah jumlah wang yang perlu kita laburkan untuk membeli kesihatan kita

• Tahukah anda jumlah anggaran sesuatu pembedahan jantung yang dilakukan di hospital pakar swasta anggaran adalah sekitar Rm 30,000 sehingga RM 50,000 ,dan setiap block atau sumbatan pada jantung anggaran dalam sekitar RM8000.
• Bagi rawatan ballon atau angioplasty dimana salur darah yang tersumbat dibesarkan dengan prosedur memasukkan belon ke bahagian yang tersumbat bernilai dalam anggaran  RM 16,000 sehingga RM25,000, serta pemasangan stent pula di sekitar RM5,000 sehingg RM13,000.
• Pembedahan pemindahan jantung pula dianggarkan sekitar RM 50,000 sehingga RM80,000
• Rawatan selepas serangan jantung juga memakan belanja atau kos yang besar dengan anggaran sekitar RM10,000 ke RM30,000.
• Bagi Rawatan Pulmonari Hipertensi atau tekanan darah tinggi ,perbelanjaan perubatan semakin meningkat dengan anggaran sekitar RM20,000 ke RM 40,000.
• Antara yang memberikan kesan kepada pesakit buah pinggang ialah kos dialysis yang semakin meningkat , disini ianya menyatakan anggaran kos sekitar RM1500 bagi setiap bulan yang dilakukan di pusat dialysis kebajikan , bagi saya anggaran itu pun sudah membebankan di mata kasar.
• Pemindahan pembedahan organ bagi buah pinggang adalah dianggarkan sekitar RM 100,000 dan bayaran perubatan yang perlu pesakit lakukan setiap bulan bagi ubat ubat yang diberi dianggar sekitar RM2000 ke RM3000 setiap bulan.
• Rawatan pembedahan bahagian otak pula ianya dianggarkan sekitar RM 25,000 ke RM 40,000.
• Stroke juga memakan perbelanjaan yang besar pada masa kini dengan anggaran perubatan ialah di sekitar RM 30,000 ke RM 60,000.
• Prosedur pembedahan yang melibatkan bahagian paru paru dianggarkan sekitar RM2000 ke RM8000.
• Kos pembedahan pemindahan hati boleh dikatakan antara kos peubatan yang tertinggi di malaysia iaitu dianggarkan sekitar RM300,000 ke RM400,000.
• Pembedahan tulang belakang pula anggaran di sekitar RM20,000 ke RM 30,000.
• Jika Dilihat pembedahan pemindahan sum sum tulang juga merupakan antara pembedahan yang memakan belanja yang besar dan dianggarkan sekitar RM350,000 kos dewasa dan dimana kos kanak kanak  adalah di sekitar RM120,000 ke RM150,000.
• Rawatan Kanser dan barah juga antara kos rawatan yang tertinggi dimalaysia yang dianggarkan sekitar RM3000 ke RM400000, bagi rawatan Chemotherapy satu sesi rawatan memakan belanja sekitar RM500 ke RM10000 dan rawatan radiasi terapi di sekitar RM1,200 ke RM2000 bagi satu sesi ,jika dikalikan 10 sesi ianya mampu menelan kos yang lebih tinggi.
• Pembedahan kecil dan general selalunya anggaran di sekitar RM1000 ke RM8000.

Jika kita melihat keratan akhbar yang dilaporkan pasti ianya meruntun perasaan kita dimana kita lihat sendiri kos yang perlu ditanggung bagi merawat sesuatu penyakit itu , Kita perhatikan kehidupan kita dan juga apakah kita betul betul menjaga kesihatan iaitu anugerah yang dikurniakan allah ini dengan sebaik baiknya , apa yang perlu kita perhalusi ialah kesihatan ini juga merupakan kekayaan dan juga merupakan pinjaman yang boleh ditarik pada bila bila masa , kenapa jika pagi kita ke tempat kerja dalam keadaan yang sihat tetapi jika diuji dengan berlakunya kemalangan maka kesihatan itu boleh hilang begitu sahaja , sebab itulah saya ingin katakan bahawa jaga pemakanan , lakukan senaman berkala, lakukan pemeriksaan rutin amalkan pemakanan sunnah insha Allah selebihnya tawakal kepadanya. Cuma apa yang paling penting untuk diri saya dan juga pembaca semua untuk menyediakan duit dalam jumlah yang besar adalah sesuatu yang mustahil , sediakan payung sebelum hujan dengan mendapatkan insurans kesihatan yang suatu masa nanti mampu membantu meringankan bebanan kita .wallahuaklam.

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Pulmonary Embolism treatment

Pulmonary Embolism treatment and prevention.

Bismillahirahmanirahim ,To continue this topic regarding PE  ,here I list out  the treatment and prevention method to avoid this problem is happen and become a problem.

TREATMENT AND DRUG

A pair of anticoagulants
- Fast-acting anticoagulant heparin is administered intravenously or under your skin (subcutaneously), which immediately helps prevent existing clots from enlarging and stops the formation of new ones.

anticoagulant warfarin, is a pill that given by mouth. Warfarin also helps stop clot formation, but because it works less quickly than heparin does, both drugs must be overlapped for at least five days, until the warfarin effect alone is enough to prevent clot formation.

WHEN PULMONARY EMBOLISM IS BECOME LIFE-THREATENING, ONE OF THE FOLLOWING THERAPIES MAY BE AN OPTION (DR Management)

Vein filter.

To attempt to block clots from being carried into the pulmonary artery, there may have a filter placed in the main vein (inferior vena cava) in abdomen leading from legs and pelvis to the right side of heart. This is done by inserting the filter on the tip of a catheter through a vein in groin or neck

- Clot-dissolving (thrombolytic) therapy.

Rather than simply preventing clot formation, medications such as urokinase and the tissue plasminogen activator alteplase actually dissolve clots. They work by activating an enzyme that breaks down blood clots and are sometimes popularly referred to as "clotbusters." . Therapy not siutable for pregnant lady, have had a recent stroke, have severe high blood pressure or have undergone surgery within the past 10 days. Thrombolytic medications increase risk of bleeding, especially from recent wounds, at needle puncture sites and in digestive tract, but bleeding can occur anywhere, including your gums when brushing teeth. Some bleeding may be fatal, especially if bleeding occurs in the brain.

WHAT IS THE BEST PREVENTION FOR THIS PROBLEM.

Preventive steps in the hospital
- Heparin or warfarin therapy.  Anticoagulants such as heparin and warfarin are given to people at risk of clots both before and after an operation as well as to people admitted to the hospital with a heart attack, stroke or complications of cancer.

- Graduated compression stockings. Compression stockings steadily squeeze your legs, helping your veins and leg muscles move blood more efficiently. Compression stockings used in combination with heparin are much more effective than is heparin alone.

- Use of pneumatic compression. This treatment uses thigh-high or calf-high cuffs that automatically inflate every few minutes to massage and squeeze the veins in your legs. Pneumatic compression can reduce the risk of blood clots.

-Physical activity. Moving as soon as possible after surgery can help prevent pulmonary embolism and hasten recovery overall.

-Take a walk. Move around the airplane cabin once an hour or so. If you're driving, stop every hour and walk around the car a couple of times or do a few deep knee bends.

-Exercise while you sit. Flex, extend and rotate your ankles or press your feet against the seat in front of you, or try rising up and down on your toes. And don't sit with your legs crossed for long periods of time.

-Wear support stockings. These help promote circulation and fluid movement. What's more, compression stockings no longer look like something that grandmother would wear — they're available in a range of stylish colors and textures.

-Drink plenty of fluids before and during the trip.Water is the best liquid for preventing dehydration, which can contribute to the development of blood clots. Avoid alcohol, which contributes to fluid loss.

What is the most important thing you need to understand is Talk to your doctor. If you're at high risk of blood clots and plan to fly six hours or more, your doctor may recommend taking heparin two to four hours before departure.wallahuaklam.

                

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Pulmonary Embolism Diagnosis

Pulmonary Embolism Diagnosis

Bismillahirahmanirahim , for today I want to continue the same topic regarding Pulmonary Embolism , here the info I want to share is about how to diagnosis the problem and what is the common procedure  to test and understand for prevention in this problem. To understand more you can read my previous topic regarding pulmonary embolism sign and symptom.

HISTORY AND PHYSICAL EXAMINATION

·         There always needs to be a high suspicion that PE may cause chest pain or SOB. Healthcare provider will take hx of the type of chest pain, including its onset and association symptoms that may direct diagnosis to PE. It may include asking about risk factors for developing DVT

·         Physical examination will concentrate on heart and lung, since chest pain and SOB may also be presenting complaints for heart attack, pneumonia, pneumothorax and aortic aneurysm, among others.

·         Chest examination often normal, but if there is some associated inflammation on the surface of the lung (pleura), a rub maybe heard during auscultation. When pleura become inflamed, as can occur in PE, a sharp pain can result that is worsened by breathing, so-called pleurisy or pleuritic chest pain

Physical examination may include looking for sign of DVT in extremity :

- warmth

- swelling

- redness

- tenderness

TESTS AND DIAGNOSIS

CHEST X-RAY

This noninvasive test shows images of heart and lungs on film. Although X-rays can't diagnose pulmonary embolism and may even appear normal when pulmonary embolism exists, they can rule out conditions that mimic the disease.

LUNG SCAN

This test, also called a ventilation-perfusion scan (V/Q scan), uses small amounts of radioactive tracers (radioisotopes) to study airflow (ventilation) and blood flow (perfusion) in lungs. The radioisotopes are attached to substances known as radiopharmaceuticals.

In the first part of the test, you inhale a small amount of radiopharmaceutical while a camera that's able to detect radioactive substances takes pictures of the movement of air in lungs. A small amount of a different radiopharmaceutical is then injected into a vein in arm, and pictures are taken of blood flow in the blood vessels of lungs. Comparing the results of the two studies helps provide a more accurate diagnosis of pulmonary embolism than does either study alone

CT SCAN

Contrast dye is injected into intravenous line in the arm while CT scan is being taken, and pulmonary arteries  can be visualized. There are risks with this test since some patients are allergic to the dye, and the contrast dye can be harsh on kidney function especially if pt’s kidney function is marginal.  It may be wise to limit exposure to pregnant pt. however, it still can be performed, preferably after the 3rd trimester. 

PULMONARY ANGIOGRAM

This test provides a clear picture of the blood flow in the arteries of lungs. It's the most accurate way to diagnose pulmonary embolism, but because it requires a high degree of skill to administer and carries potentially serious risks, it's usually performed when other tests fail to provide a definitive diagnosis

In a pulmonary angiogram, a flexible tube (catheter) is inserted into a large vein — usually in groin — and threaded through your heart into the pulmonary arteries. A special dye is then injected into the catheter, and X-rays are taken as the dye travels along the arteries in your lungs

TEST TO DETECT BLOOD CLOT

D-dimer blood test.

-Having high levels of the clot-dissolving substance D dimer in blood may suggest an increased likelihood of blood clots, although D-dimer levels may be elevated by other factors, including recent surgery. Drawing the blood takes just a few minutes, and the risks — which include slight bleeding or a small accumulation of blood at the puncture site — are minor.

Ultrasound.

- A noninvasive "sonar" test known as duplex venous ultrasonography uses high-frequency sound waves to check for blood clots in thigh veins. In this test, doctor uses a wand-shaped device called a transducer to direct the sound waves to the veins being tested. These waves are then reflected back to the transducer and translated into a moving image by a computer

Venography.

-A more complex and invasive procedure called venography can help reveal blockages caused by blood clots at any point in your arms or legs. During the test, a catheter is inserted into a vein in  foot or ankle. Because blood vessels aren't normally seen on X-rays, a contrast dye is injected into the vein to make it visible just before the X-rays are taken.

Magnetic resonance imaging (MRI).

-This test uses no X-rays. Instead, a computer creates tissue "slices" from data generated by a powerful magnetic field and radio waves. Because MRI is expensive, it's usually reserved for pregnant women and people whose kidneys may be harmed by dyes used in other tests.

Blood tests.

- If pt have a family history of blood clots, have had more than one episode of blood clots or have experienced clots for no known reason, doctor may order a series of blood tests to look for inherited defects in clotting system. If genetic abnormalities are found and you have a history of blood clots, doctor may recommend lifelong therapy with anticoagulants to prevent future clotting problems. Also, if genetic test results are abnormal, doctor may recommend that other members of family receive similar testing.

This info most of the method that practice by the Dr to detect and also to plan a best and suitable treatment base on the result of this test and diagnosis. wallahuaklam.

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Physiotherapy and Pulmonary embolism

PULMONARY EMBOLISM

Bismillahirahmanirahim , Today I have been asked by one of my patient , he is worried regarding his fracture can cause Pulmonary embolism , I have explain to him it is prevented case if we take it seriously and understand our body condition.

·         Pulmonary embolism is a condition that occurs when an artery in lung becomes blocked. In most cases, the blockage is caused by one or more blood clots that travel to lungs from another part of your body.

·         Most clots originate in legs, but they can also form in arm veins, the right side of your heart or even at the tip of a catheter placed in a vein.

·         In most cases, a pulmonary embolism isn't fatal. Still, pulmonary embolism is a leading cause of hospital deaths and an increasing threat to passengers on long airplane flights. when pulmonary embolism does occur, treatment with anti-clotting medications can greatly reduce the risk of death

CAUSES

·         Human body have two lungs, one on each side of heart. Blood is constantly being pumped from the right side of heart to the lungs and back to the left side of your heart. In lungs, blood picks up oxygen and releases carbon dioxide, a waste product of metabolism. Blood vessels called arteries take the oxygen-rich blood to tissues throughout body, and veins bring oxygen-poor blood back to the heart. Capillaries — the smallest blood vessels — connect the veins and arteries.

·         Clots that form in the veins throughout body can dislodge, travel through the bloodstream to the right side of the heart, and then enter the pulmonary arteries, where they may cause a blockage. A blockage can occur in any small artery. Most often, a number of clots will shower your lungs during an episode of pulmonary embolism; it's unusual for just one clot to take place

UNDERSTANDING BLOOD CLOT

·         A blood clot is a plug of platelets — colorless blood cells that repair injured blood vessels — enmeshed in a network of red blood cells and fibrin, a type of protein. Clots normally develop to help stop bleeding after being cut or injured, but sometimes clots form for no apparent reason

·         A blood clot that forms and remains in a vein is called a thrombus. A clot that travels to another part of your body is an embolus. Occasionally other substances, such as pieces of a tumor, globules of fat from fractured bones or air bubbles, may enter the bloodstream and become an embolus that blocks arteries

·         Most clots that cause problems originate in a vein in leg or pelvis. The affected vein may be near the surface of skin (superficial thrombosis) or deep within a muscle (deep vein thrombosis, or DVT). Clots in superficial veins usually aren't serious and often clear on their own. But clots in the deep veins may detach and migrate through  bloodstream to lungs

Illustration of Blood clot for example review

FACTOR INVOLVE IN CLOT FORMATION

SURGERY.

·         especially operations to replace major joints, such as the hip and knee.

LONG PERIODS OF INACTIVITY.

·          Inactivity caused by prolonged bed rest (exp after surgery, heart attack or serious injury) or long plane or car trips that decreases blood flow in veins, making clots more likely.

·         In recent years, attention has also focused on the increasing incidence of deep vein thrombosis and pulmonary embolism among otherwise healthy travelers on long plane trips. Cramped seats with little legroom have contributed to the problem - deep vein thrombosis and is sometimes referred as "economy class syndrome." Not everyone who has DVT goes on to develop pulmonary embolism, however. For many people, the DVT causes few symptoms and is diagnosed long after the episode has passed.

INCREASED LEVELS OF CLOTTING FACTORS IN THE BLOOD

·         -Some types of cancer, especially pancreatic, lung and ovarian cancers, cause increased blood levels of procoagulants — substances that contribute to blood clotting. The female hormone estrogen found in birth control pills and hormone therapy (HT) also increases the amount of clotting factors in the blood

CERTAIN MEDICAL CONDITIONS

·         -People who have cardiovascular disease associated with clot formation, such as heart attack (myocardial infarction) or stroke, are more likely to develop blood clots in their veins

INJURY TO THE VEINS.

·         -occur during certain surgical procedures, especially hip surgery or knee replacement. It may also result from direct injuries to the legs or from leg or pelvic fractures.

SIGNS AND SYMPTOMS

·         Common signs and symptoms include:

·         Sudden shortness of breath, either when in active or at rest.

·         Chest pain that often mimics a heart attack. The pain can occur anywhere in chest and may radiate to shoulder, arm, neck or jaw. It may be sharp and stabbing or aching and dull and may become worse when you breathe deeply (pleurisy), cough, eat and bend. The pain will get worse with exertion but won't go away when you rest.

·         cough that produces bloody or blood-streaked sputum.

·         Rapid heartbeat (tachycardia).

·         Pt may have stable vital signs (BP, HR, RR, SPO²) but frequently present with elevated HR. Severe PE can present with shock ( low BP) or cardiac arrest, particularly when large clot blocks blood outflow from Rt side of the heart to lungs. In many case, HR and RR elevated to compensate.

·         SPO² may decreased

OTHER SIGNS AND SYMPTOMS THAT CAN OCCUR WITH PE INCLUDE

·         Wheezing

·         Leg swelling

·         Clammy or bluish-colored skin

·         Excessive sweating

·         Anxiety

·         Weak pulse

·         Light headedness or fainting (syncope)

·         Fever

IN COME CASES, PE PRESENT WITH

·         Sudden death, where pt collapse, stops breathing and heart stop beating (cardiac arrest).

RISK FACTOR

1.       Inactivity - prolonged sitting in a cramped position during lengthy plane or car trips increase risk.

2.       Prolonged bed rest-Being confined to bed for an extended period after surgery, a heart attack, leg fracture or any serious illness makes it more vulnerable to blood clots.

3.       Certain surgical procedures-Especially likely to cause blood clots are hip, pelvic and knee surgeries as well as some obstetric or gynecologic procedures

4.       Some medical conditions- - Certain cancers, especially pancreatic, ovarian and lung cancers can increase levels of substances that help blood clot, and chemotherapy further increases the risk. Women with a history of breast cancer who are taking tamoxifen or raloxifene also are at risk. High blood pressure and cardiovascular disease make clot formation more likely, as does having an inflammatory bowel disease such as ulcerative colitis or Crohn's disease.

5.       Being overweight-- one theory links the formation of clots to leptin, a hormone produced by fat cells in the body. People who are overweight have more leptin- so may be more prone to develop clots

6.       Pacemakers or venous catheters-  Having a pacemaker or catheter — a soft, flexible tube — in a central vein makes the formation of clots more likely in that vein.

7.       Pregnancy and childbirth

- Some women who have pregnancy-related venous thromboembolism also have an inherited clotting disorder.

8.       Supplemental estrogen. - The estrogen in birth control and in hormone replacement therapy can increase clotting factors in blood, especially if smoking or overweight

9.       Family history.

- Having a personal or family history of venous thromboembolism increases the risk of blood clots.

10.   Smoking

tobacco use predisposes some people to blood clot formation, especially when combined with other risk factors.

COMPLICATION

High blood pressure in your lungs (pulmonary hypertension)

- occurs when a large number of clots obstruct blood flow in the blood vessels in lungs for months or years, making the right side of heart work hard against great resistance.

        - most common symptoms of pulmonary hypertension are breathlessness (dyspnea) when you exert yourself and general fatigue. Fainting, dizziness, swollen legs or ankles, and pressure or pain in chest also are common when pulmonary hypertension becomes severe.

Heart damage.

In a condition called cor pulmonale, the lower right pumping chamber of heart (right ventricle) becomes enlarged and eventually fails as a result of problems in your lungs.

So this is the info regarding a pulmonary embolisme , the cause , effect and what is the symptom of this problem I have explain in this blog , insha Allah for my next entry I will share with all og you how to diagnoses and prevention measurement for this problem .Wallahuaklam.

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Kaki bengkok (CTEV) pada Bayi

Masalah Kaki Bengkok (CTEV)

 Bismillahirahmanirahim , Semalam saya didatangi satu pasangan muda yang baru sahaja mendapat cahaya mata .tetapi apa yang saya lihat di wajah mereka tiada terpancar rasa gembira , Sehinggalah si bapa memberitahu bahawa anak lelaki mereka mempunyai kaki yang bengkok. Dalam istilah bahagian perubatan Keadaan bayi yang dilahirkan dengan kaki bengkok iaitu pergelangan kaki dan buku lalinya berpusing menghala ke dalam atau ke bawah ianya dikenali sebagai CTEV atau Congenital Talipes Equino Varus (Club Foot)  adalah kecacatan yang biasa berlaku pada seorang bayi dalam setiap 1,000 kelahiran di dunia.

Kaki Bayi yang ada masalah CTEV

Apakah itu Talipes ?

Untuk pengetahuan semua nama Talipes ini diambil daripada perkataan Latin iaitu Talus untuk buku lali dan Pes untuk kaki. Bahgian Istilah berkenaan merujuk kepada gaya berjalan bayi yang terjejas apabila terpaksa memijak dengan buku lali berikutan tapak kakinya berpusing.

Cara mereka berjalan jika tidak dirawat

Selain daripada itu Kecacatan sebegini juga digelar 'club foot' kerana keadaan kaki yang membengkok itu menyerupai bentuk pemukul golf (Club). Keadaan ini boleh berlaku sama ada pada sebelah kaki atau kedua-dua bahagian kaki bayi kerana faktor tisu yang menyambung otot kepada tulang atau tendon adalah lebih pendek daripada kebiasaanya.

Apakah Punca terjadinya masalah ini?

Antara yang boleh saya nyatakan disini punca yang mengakibatkan kaki bayi bengkok sejak dilahirkan masih tidak diketahui dan masih lagi menjadi misteri dalam bidang perubatan sehingga hari ini. Tetapi kajian perubatan membuktikan, ada kes kaki bayi mengalami Talipes disebabkan keadaan bayi itu yang mengalami masalah kesihatan  seperti membabitkan kelainan tulang  spina bifida iaitu kecacatan kelahiran yang berlaku apabila tisu di sekeliling saraf tunjang tidak tertutup dengan sepenuhnya.

Kecacatan Genetik antara punca masalah kesihatan lain yang boleh mencetus Talipes seperti penyakit sendi kaku (artrogryposis) dan Sindrom Edward atau Trisomy 18 iaitu gangguan genetik yang berlaku pada kromosom ke-18.

Selalunya kebiasaan bagi kes kes yang kecil adalah Kecacatan yang disebabkan kedudukan bayi berada di posisi salah ketika dalam kandungan sehingga menjejaskan pembentukan tulang pada kaki.
Antara info lain ialah selalunya

·         masalah kaki bengkok lebih mudah berlaku pada bayi lelaki.

·         Ada faktor Sejarah keluarga apabila ibu bapa atau adik-beradik lain pernah mengalami masalah kaki bengkok.

·         Bagi pasangan yang Merokok ketika hamil dan wanita yang ada sejarah keluarga mengalami masalah ini risikonya adalah lebih tinggi.

·         Kajian juga menunjukkan masalah ini boleh juga terjadi jika berlakunya kekurangan air ketuban ketika bayi dalam kandungan.

Apakah gejala dan symptom masalah ini?

Pengalaman saya sebagai fisioterapi selalunya posisi yang salah ketika dalam kandungan proses ini mudah diperbetulkan oleh ibu dan penjaga dengan belajar melalui urutan atau menggunakan alat sokongan untuk membetulkan kedudukan kaki.

Nasihat saya kepada ibu bapa ,Bayi yang mengalami masalah kaki bengkok ini  jika tidak dirawat dari peringkat awal akan berdepan pelbagai komplikasi ketika hendak belajar berdiri dan berjalan mengikut perkembangan tulang bayi selalunya kedudukan pergelangan kaki dan buku lali yang berpusing akan menyukarkan kanak-kanak dengan Talipes untuk berjalan dengan betul adalah disebabkan anak ini tidak memijak dengan tapak kaki.

Tetapi kanak-kanak terbabit akan berjalan menggunakan buku lali dengan tulang buku lali itu yang akan menekan ke lantai. Andaikata Jika perkara ini berterusan, kanak-kanak itu boleh mendapat masalah radang artritis, kecacatan kekal serta kecederaan buku lali yang berulang dan juga mengganggu perkembangan semula jadi otot di bahagian kaki terutama bahagian betis.

Bagaimanakah pakar melakukan pemeriksaan?

Apa yang dilakukan oleh pakar perubatan selalunya mereka akan mengenal pasti masalah kaki bengkok pada bayi hanya dengan memeriksa bentuk dan kedudukan kaki bayi yang baru dilahirkan. Ada waktunya pengunaan x ray juga digunakan bagi melihat tahap kecacatan yang berlaku kepada anak kecil ini.

Dengan kecanggihan alatan perubatan sekarang selalunya pakar perubatan dapat mendiagnosis kaki bengkok kini secara melakukan menerusi pemeriksaan bunyi ultrasound pada ketika kandungan berusia 18 hingga 20 minggu.

Apakah persedian dan cara yang boleh membantu ibu bapa?

Apa yang boleh saya nyatakan walaupun diagnosis mengesahkan bayi yang dikandung mengalami Talipes,tetapi tiada tindakan boleh dilakukan bagi membetulkan masalah itu ketika bayi masih lagi berada di dalam kandungan , namun ibu bapa boleh bersedia dengan membuat pilihan rawatan sebelum bayi dilahirkan dan  juga bersedia dengan informasi yang cukup bagi membantu selepas proses kelahiran nanti.

Kebanyakan keadaan ini selalunya pemulihan kaki bengkok boleh dilakukan sama ada dengan kaedah konservatif iaitu melakukan urutan dan juga renggangan dengan beberapa teknik fisioterapi , jika pemulihan ini tidak menunjukkan tanda kejayaan selalunya proses pembedahan akan dilakukan oleh pakar tulang bagi membetulkan kedudukan tulang kaki ini.

Apakah tempoh rawatan pada masalah talipes ini ?

 Apa yang selalu saya nasihatkan kepada ibu ayah bayi yang mengalami masalah ini masa rawatan adalah faktor yang memainkan peranan yang penting dalam membantu kita merawat kaki ini selalunya untuk kaki bengkok biasanya bermula pada minggu pertama atau kedua selepas bayi dilahirkan kerana pada masa itu tulang dan sendi bayi mudah dilenturkan dan berada dalam kedudukan yang boleh dibentuk.

Salah satu rawatan yang biasa dipakai dan juga boleh dikatakan agak mudah dan selamat ialah Teknik Ponseti , ia adalah merupakan salah satu  kaedah rawatan konservatif yang popular dijalankan terhadap bayi dengan masalah Talipes ini  kerana dikatakan menghasilkan keputusan lebih baik berbanding teknik lain.

Teknik Ponseti 

Dalam menggunakan  teknik ini, selalunya pakar ortopedik akan menggerakkan kaki bayi pada kedudukan betul dan mengapit kaki itu dengan pemegang khas (POP CAST)  supaya ia berada pada kedudukan tetap dan pegun bagi membantu merenggangkan tulang dan sendi secara semula jadi dan selalunya Rawatan ini dilakukan sekali atau dua kali seminggu dalam tempoh beberapa bulan sehingga ia menunjukkan perkembangan positif sebelum pembedahan kecil dilakukan bagi memanjangkan tendon Achilles bagi membetulkan kedudukan kaki kanak kanak  ini.

Apabila  kaki dibentukkan semula,peranan ibu bapa memainkan peranan yang penting dimana mereka  perlu membantu mengekalkan bentuk baru itu dengan melakukan senaman regangan yang akan diajar oleh fisioterapi dan juga mereka akan belajar memakaikan bayi dengan pendakap kaki dan pastikan pendakap itu dipakai selalu sehingga tulang kaki yang dibetulkan menjadi utuh dan kekal dalam bentuk yang baik.

Pendakap Yang perlu dipakaikan berterusan sehingga ditentukan pakar 

Untuk pemahaman semua kesan dari pemakaian pendakap kaki dalam teknik ini adalah penting supaya tulang kaki tidak bergerak semula ke bentuk asal yang bengkok

Satu lagi teknik rawatan yang dipanggil teknik French , apa yang dilakukan oleh pakar selalunya kaki bayi yang bengkok akan diregangkan ke bentuk normal sebelum dibalut dengan pita pelekat menerusi pendekatan rengangan fisioterapi. Namun kelemahan teknik ini ianya memerlukan komitmen masa lebih lama berbanding teknik Ponseti.

Teknik French digunakan

     Huraian disini selalunya kajian juga menunjukkan bayi yang dirawat dengan teknik Ponseti dan ibu bapa mereka berdisiplin dalam membuat rawatan secara konsisten akan dapat menghasilkan fungsi kaki dan hayunan langkah lebih baik buat anak anak mereka mengikut perkembangan tubuh badan bayi anak anak itu. 

Tetapi bagi sesetengah kes, ada masalah kaki bengkok ini  tidak dapat dibetulkan dengan teknik konservatif kerana tahap masalah yang serius dan ini memerlukan pembedahan yang besar dan selalunya Pakar bedah ortopedik boleh memanjangkan tisu yang terbentuk pendek ketika dilahirkan bagi mengembalikan kaki ke posisi dan bentuk yang betul. 

Pembedahan dilakukan 

 Contoh pemakaian alat khas bagi membetulkan kedudukan kaki selepas dibedah

Pakar bedah ortopedik ini  akan memakaikan pengapit khas selama beberapa bulan dahulu sebelum memakai pendakap kaki supaya kakinya tidak bengkok lagi. Walaupun pembedahan menjimatkan masa pemulihan kerana kaki yang bengkok dibetulkan segera, tetapi rakan saya iaitu pakar bedah orthopaedic ini memberitahu bahawa bayi masih memerlukan beberapa lagi pembedahan lanjutan bagi mendapatkan keputusan yang lebih baik dan juga bergantung kepada tahap kecacatan bentuk kaki itu. wallahuaklam.

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Effect of Steroid in human

The danger of taking steroids in the body.

Bismillahirahmanirahim for today I just remember to share the bad effect of this drug to our body. As we know  now in Malaysia it become a Phenomenon to be tough and look masculine as GYM had been give the service for the people who are like to build up their body . The men crave the perfect body with big muscles and stamina up and various attempts were made, including steroids by mouth or injection. I can say with steroids, men are more confident with her body shape and want the result become faster.

What we understand about the Steroid?

Steroids are organic compounds which do not hydrolyze sterol fatty. According to one of my colleagues , he is health and sports specialists, this is absolutely no way confirmed in the medical world. he is mention to me "Our bodies actually own internal steroids but  If you continue to take steroids external, the pure steroid in the body will decrease,".

The Effect of steroid ?

Last time when I learn at my college, we have learn that  Steroids have a negative effect in the short and long term, but in some medical condition this  Steroids are actually allowed for treatment, for example in relieving inflammation. Although it is only possible in a critical condition and prescribe by the specialist or Dr only. The use of steroids is allowed by Dr, according to Him, at most three times a year by injection , Steroids given if the inflammation is not compromised. If you exceed the dose, it will cause serious disruption to health.

For our understanding ,The use of steroids for body building is totally unfair. its only allowed for treatment available dose in certain medical condition. We need to remember  If violated, it will cause short-term effects of fragility. Long-term impact is more terrible, because it interferes with the body's health permanently.

As info there is many diseases and also problem  can be caused by long-term use of steroids. Starting from high blood pressure, diabetes mellitus, heart disease, stroke, and even death can result. Long-term effects can not be predicted when it will approach the body.

another info the bad side effect of steroid 

• Infection.
• Allergic reactions.
• Bleeding into the joint.
• Rupture of a tendon.
• Skin discoloration.
• Weakening of bone, ligaments, and tendons (from frequent, repeated injections into the same area)
  

As a physiotherapist I would like to mention , there is no recommended dose for the formation of steroids because of the way the body is absolutely not allowed. If you want to make up the body have to do regular exercise and balanced nutrition and get a natural supplement to assist your body to have in a good shape without abuse your health .wallahuaklam.

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