What is dementia...

Dementia is a disease where brain cell die in an abnormal way. it is  a term used to describe progressive degenerative brain disease.it is not part of normal ageing.the memory, thinking, behaviour & emotions are affected in dementia. it occurs in people of all cultures & educational background. Although there is no cure for dementia, treatments are available to manage the symptoms.
Symptoms of dementia..each person will experience dementia in his or her own way. symptoms may include:  forgetting dates.. repeatedly misplacing items.. repeating questions.. frequently leaving gas stoves on or water taps running difficulty in finding the right words to express oneself.. difficulty understanding what people are saying.. difficulty in performing previously routine tasks.. getting lost in previously familiar surroundings.. having trouble driving.. problems making financial decisions.. mood changes, including agitation & depression.. personality changes like behaving in appropriately in social situation in the early stage, it may be difficult to tell if there is really something wrong. it is common for people affected by Alzheimer's disease..One of the causes of dementia..to deny that they are having problems.family members may suspect that something is wrong. it is important to get help as soon as possible as medications can have a more beneficial effect when started at an early stage of the disease. in the middle stage, supervision on certain daily activities is needed. mood & personality changes may become more prominent & problematic. for example, they may frequently become agitated in the middle of the night or wander off & become lost. or they may lose their inhibitions, undress in public or make inappropriate sexual advances, The late stage of the illness is marked by severe cognitive decline. the impaired person is apathetic, disoriented, & unable to find their way around the house. the person may also become incontinent & lose all intelligible speech. eventually in the late stage, those affected are unable to care for themselves & need help with all aspects of daily life.

What are the causes of dementia...Alzheimer's...disease

There are a number of disease which cause the symptoms of dementia. All of them cause the death of brain cells. There are many factor which may have an effect on the risk of developing dementia, including age, genes, alcohol & head injury. the two most common cause of dementia are Alzheimer's disease & vascular dementia.  Alzheimer's disease is the most common cause of dementia & accounts for 50% To 60% of all cases, it destroys brain cell & nerves disrupting the neurochemicals which carry messages in the brain, particularly those responsible for storing memories. The average duration of the disease usually progresses over a span of eight years from the onset of symptoms. Approximately 10 million people worldwide are affected by Alzheimer's disease. it is a leading cause of death behind cardiovascular disease & cancer. in Singapore, there were about 3,200 persons with Alzheimer's disease in the year 2000. The number expected to more than triple to 10,500 over the next 30 years.most of the people who are affected are over 65, & the chance of developing the disease increases with age. however, in rare cases, Alzheimer's disease can strike people at earlier ages in their 40's & 50's. The other person affected by Alzheimer's disease is the caregiver. Actually, the stress of caring for someone with Alzheimer's disease often affects the whole family. family & caregivers experience emotion distress like anger, isolation, anxiety, sleep problems, & depression. there is increased burden & overall distress, as the disease progresses & eventually leaves patients completely dependent upon other. while caring for an Alzheimer's patient may be challenging & difficult, help is available to ease the burden. physicians, mental health professionals, caregiver support groups & Alzheimer's association can provide much needed advice & guidance. no known cure for the disease exists, but there are newly available therapies indicated specifically for Alzheimer's dementia that slow down symptomatic decline & enhance cognition, activities of daily living & global functioning.

Vascular...dementia

Vascular dementia, formally know as multi-infarct dementia, accounts for about 30% of all cases of dementia. Vascular dementia occurs where blood vessels in the brain are damaged & the supply of oxygen to the brain is reduced. when oxygen supply fails in the brain, a series of mini strokes..infarcts..occur, causing the death of brain cells. The mini strokes that cause vascular dementia are often so small that they cause no immediate symptoms. sometimes, they may cause some temporary confusion. However, the damage by new mini strokes accumulates over time, resulting in vascular dementia. vascular dementia & Alzheimer's disease can also occur together, acting in combination to cause dementia. with vascular dementia, mental decline is likely to have a clear start date & symptoms tend to progress in a series of steps following each attack, suggesting that small strokes have been occurring.

What is Dementia...? what can families do to help a person with dementia..

If a caregiver suspects Alzheimer's disease, seek help from a doctor for assessment, selecting one who specialised in the elderly assessment clinics are available in Alexandra Hospital, Changi General Hospital, Institute of Mental Health, national University Hospital & Tan Tock Seng Hospital. Try to learn more about the disease, There are educational & training classes conducted by voluntary welfare organisations.

Community resources for caregivers..you can also find out about the specialised services available in the community, the Alzheimer's disease Association provides education & support services to people with dementia & their caregivers. Tsao Foundation provides training & workshop for caregivers. SAGE..

Singapore Action Group of Elders..offers a hot line to call for problems concerning the elderly. Day care centres catering specifically to dementia sufferers are also available to provide day activity programmes in the community. Examples would be apex harmony lodge, new horizon centre, sunlove day centre & swami home...Seeking professional advice...book an appointment for psychiatric consultation.

Prostate Cancer

The prostate, which forms part of the male reproductive system,is a walnut-sized gland located in front of the rectum and just below the bladder. it wraps around the urethra, the tube carrying urine from the bladder through the penis. The prostate requires mainly testosterone the male hormone to function properly. one of its function is to produce fluid for semen to transport sperm during ejaculation. When prostate cells grow abnormally the organ enlarges and pushes against the urethra and bladder, blocking the normal flow of urine. Cancer that begin in the prostate may remain in the prostate or spread to nearby lymph nodes. in some cases it can even spread to the bones, bladder, rectum and other organ. screening for prostate cancer is important.
since the disease rarely show any definitive signs in the early stages.as the disease progresses, however prostate cancer patients may find themselves having to urinate more frequently and urgently, but with less urine or even blood in the urine.

Getting a Grip on Pain

Pain is an uncomfortable sensation that tells you something 
may be wrong in your body. pain may be a normal sensation
triggered in the nervous system to alert you to possible 
acute injury and the need to take care of yourself. 
However if the pain is excessive or prolonged it can be harmful to you.
Everybody reacts to pain differently based on their physical condition past experiences emotion and attitudes.
Types of pain can be divided into: 
Acute pain has a short duration with an obvious cause. examples include acute post-operative pain,pain of physical injuries and pain during childbirth.
Acute pain usually responds well to simple painkillers or opioid medications.
Chronic Pain: 
Pain that lasts for more than 3 months and often continue beyond the expected time of healing. examples of chronic pain will include chronic low back and neck pain,arthritis and cancer pain. sometimes the reason for the chronic pain may not be clear. chronic pain is often associated with decreased function and 
quality of life.unlike acute pain medications along may not be effective in relieving chronic pain.treatment of chronic pain may also require other therapies like nerve blocks physical therapy and psychological therapy.
Controlling Your Pain is Important:
good pain control is important in both acute and chronic pain states. 
although acute pain is often transient good pain treatment allows you to be more comfortable help you to heal faster and avoid various complications.

Getting a Grip on Pain

Pain control is also important in chronic pain to prevent prolonged suffering, increase physical and mental function  and improve overall quality of life.
Reporting your pain:
Pain treatment begins with accurate reporting of the pain symptoms.                 You are the expert on your pain only you know how much pain you are feeling. 
Tell us how much it hurts by reporting the pain severity as a number based on a scale of 0-10 where 0 equals no pain and 10 is the worst pain imaginable rate your pain on the scales below.

Pain Treatment depends on the type of pain the cause of pain
the pain severity and associated medical illnesses.
it is common to combine a few types of pain treatment to increase
pain relief.talk to your doctor about the treatment options.
They will be able to give you more information.
The common pain treatment include Pain medications:
There are several groups of pain medication Simple painkillers.
Aspirin, paracetamol and the non-steroidal anti-inflammatory drugs (NSA IDS) These medication are usually given for mild to moderate pain. They are also administered together with opioid in patients with severe pain.

Getting a Grip on Pain

Opioids: morphine, pethidine, fentanyl
These medication are administered for moderate to severe pain.
if can be administered through PCA (patient controlled analgesia)
Adjuvant medications: (anti-depressants,anti-convulsants)
These medications are useful in treating tingling and burning pain
and certain types of chronic pain.
Intervention's procedures Nerve block are commonly used in:
Acute post-operative pain treatment
The nerve block injects local anaesthetic medication to numb the pain transmitting nerves.
This can provide excellent pain relief after surgery.
Chronic pain
Nerve block are also commonly used in the treatment of chronic pain. medications that are commonly injected during these nerve block include local anaesthetic medications and or steroid medication. steroid medications help to reduce swelling and inflammation present at the painful sites or around pain transmitting nerves.
Complementary therapies
Complementary techniques are commonly used for the treatment of chronic pain and they include.
Physical therapy
Techniques such as application of heat or cold packs massage pressure or vibration therapy therapeutic exercises and graded mobilisation exercises.
Psychological therapy
Such as counselling relaxation techniques and stress management.

Getting a Grip on Pain

What you can do:
you need to report your pain accurately.
to rate your pain severity on a scale of 0-10.
need to take your medication.according to dose & 
schedule as prescribed by doctor.tell your doctor if the
medicine or treatment work or if you have developed
any side effects to the treatments.
What your is health care provider will do:
ask you about pain on a regular basis.
explain & provide the treatment option for pain control.
ask you if received the relief you expected 
from the medicine.suggest other ways to help you 
be more comfortable.
Thing to remember:
if you have pain ask for the medicine.don't save pain medicine until the pain get worse. medicine can help control your pain.
the staff will not think you are complaining if you ask
for medicine for your pain.
don't worry about becoming addicted to pain medicine

What is Gout ?

Gout is a joint condition and a type of arthritis. it attacks single joints, especially the big toe, if left untreated an acute attack will subside in week or two, but gout is prone to recurrence.
What are the risk factors of gout ? High blood uric acid levels, High blood pressure, Obesity, Alcohol consumption. What causes gout ? Gout is usually associated with an excessive intake of rich foods and alcohol. it is associated with high blood Ulric acid levels. both genetic and environmental factors appear to influence the incidence of gout. about a quarter of gout patients' relatives will also have high uric acid levels. What is uric acid ? Uric acid is a metabolite of purine. purine can be found in foods. high levels occur in the blood when the body produces too much uric acid and or the kidneys cannot eliminate enough of it uric acid levels will also increase if you are fasting. uric acid is not very soluble in water and can crystallise in the joints, casing inflammation and gout. What is the normal levels of blood uric acid ? Men...232..494..MMOL...3..9..8..3..mg/L Women...140..340..MMOL..2.3..5.7mg/L.
Gout is more likely to occur at uric acid levels greater than this. however, a person may have normal uric acid levels and still develop gout, . What are the consequences of high uric acid levels ?  Kidney or urinary tract stones, kidney damage.. What is the treatment for gout ? Low purin diet, Low purine diet with medication.

How should I control my diet.

Suitable foods..Fresh fruits and vegetable > except those listed below.
peanuts, milk and milk products, egg, in moderation, white bread, rice and plain noodles.
Foods to be taken in moderation....Meat, fish, poultry, scallop, lobster, mussel, oyster, crayfish.sunflower seeds.
dry lentils,chickpeas, peanuts, peas,oatmeal. fruits, banana, jack fruit. spinach, capsicum, sweetcorn, cauliflower, chives, parsley, bean sprouts, leeks, broccoli.
Foods highest in purine-Avoid....Yeast extracts e.g Marmite. Animal organs such as live, kidney, heat, brains. Small fish, e.g. sprat,ikan Billi's, sardine, herring,trout, tuna, canned fish, fish roe, dried mushrooms, broths, meat stocks, eg. chicken essence, bak kut teh, gravies, stock cubes, soy bean and related products eg. bean curd, bean paste, soya bean milk, tempeh.
In Addition...Please eat balanced meals that include a variety of food. decrease the amount of fat and oil used in your meals as the items will increase uric acid production. get most of your energy from starchy foods. use sugar in moderation especially if you are overweight. Avoid alcohol as it will increase uric acid production. if you wish to drink, please discuss alcohol consumption with your doctor. take prescribed medication according to your doctor's instruction. maintain your ideal body weight and be more active as far as possible. do not follow a crash diet even if you are very overweight, as it can bring on an attack of gout. avoid a high protein diet to lose weight as this may trigger or aggravate a gout attack. Drink 2-3 litres...10-15 glasses...of water daily. Do simple movements to prevent stiffness but do not over exercise or strain the affected joint. Proper dietary management with or without medication is essential to avoid further attacks and prevent complication.

Diarrhoea and Vomiting Advice

Drink lots of water and clear fluids such as barley water, glucose drink, boiled rice water and clear soup. Water intake is sufficient if the urine is clear and the tongue wet. if vomiting, take fluids slowly. in children, start with small sips and gradually increase the amount. if vomiting occurs, rest for a while and then try again. About 8 hours after vomiting has stopped, gradually return to soft diet. Avoid milk, cream and dairy products for the next few days. Consult a doctor if.....the diarrhoea or vomiting increases in frequency or amount. diarrhoea and vomiting does not improve after 24 hours. the stool has blood in it. there is decreased urination, dry mouth and lethargy.

What are the complication of DVT


DVT  is a serious condition because the blood clot that is formed in your leg can break loose and travel to your lungs. This will result in pulmonary embolism PE which is a blockage of the pulmonary artery pulmonary embolism can be life threatening. the symptoms for pulmonary embolism includes shortness of breath, chest pain, low blood pressure, rapid heart rate and confusion. Pulmonary embolism the blood clot from the leg vein travel to the heart and is lodged inside a blood vessel in the lungs, blocking blood supply this is a potentially fatal emergency. blood clot inside a lung blood vessel blocking the blood supply.

Deep Vein Thrombosis DVT Prophylaxis.




Deep vein thrombosis ( DVT ) is the formation of a blood clot in a deep vein, commonly located in the calf or thigh. DVT occurs when the blood clot either partially or completely blocks the flow of blood in the vein.
When the circulation of the blood slows down due to illness, injury, or immobility, there is a tendency for blood to accumulate or "Pool " A static pool of blood offers an ideal environment for clot formation and poses a potential risk for DVT. The risk of developing DVT during hospitalisation is 10 - 15 % in hip facture patients.
Who are at risk ?...Elderly person at 70 years old. Obese person  BMI 25. Bedridden persons. Patients with these conditions are at risk : Spinal cord injury - Cancer, stroke - Heart attack. Patients who have undergone abdominal or pelvic surgery and orthopaedic surgeries, particularly, hip fracture surgery, total hip or knee replacement. pregnant women. Women on oral contraceptives or hormone replacement therapy if DVT occurs, a person will experience pain in the leg. This will be accompanied by redness, tenderness and sudden swelling of the leg. the leg will also be warm.DVT is a serious condition because the blood clot that is formed in your leg can breaks loose and travel to your lungs. This will result in pulmonary embolism PE which is a blockage of the pulmonary artery. pulmonary embolism can be life threatening. The symptoms for pulmonary embolism includes shortness of breath, chest pain low blood pressure, rapid heart rate and confusion. How to prevent DVT can be prevented. if you are having a surgery that puts you at risk of developing DVT, you will be given mechanical prophylaxis and or chemical prophylaxis. Chemical prophylaxis- involves using medications to prevent the blood from clotting. Mechanical prophylaxis-involves using intermittent pneumatic compression devices that are placed on your legs. this device will in crease blood circulation in the deep veins and stimulates fibrinolysis-the body's natural method for preventing and breaking down clots. To use mechanical prophylaxis effectively to prevent DVT it is important to use the device continuously. Usually you will be started on the pneumatic compression device when you are admitted for the surgery. it is essential that you continue to use this device during and after the surgery. Do not remove the device by yourself. remind the nurses to put it back after it is disconnected ( eg. after a visit to the toilet). inform doctors or nurses if you experience any pain, redness, tenderness or swelling in your legs. Check with doctors or nurses on when you can remove the device. In addition to mechanical or chemical prophylaxis to prevent DVT you will also benefit from the following. Elevating your feet on a pillow when resting on the bed to promote blood flow. Try to move. if you are on bed rest because of surgery the sooner you get moving ( eg. sit out of bed, walking ) the less likely blood clots will develop. Drink lots of water.

Advice For Using Crutches.

You have been given crutches so that you will not bear weight on your injured leg while it is healing.
Do not wear slippers while using crutches. Wear comfortable low heel shoes
Do not place tips of the crutches too close to your feet when walking. 
It could result in a loss of balance.
Put your weight on the hand grips. lift your good leg and swing forward through the crutches placing your weight on your good leg. Take small steps each time.
Do not stand on your injured leg until your doctor give approval. 
Remove any loose rugs or mats from the floor and do not walk on wet or waxed floors. 
Be cautious when climbing stairs.
Consult a doctor if you experience a tingling sensation in your arms or hands

Diuretic and some psychiatric drugs.

Diuretic and some psychiatric drugs can prevent the body from losing heat quickly.
People who are obese or old have to be particularly careful not to dehydrate or overheat. old people may not be able to move about easily, turn on the fan or air-conditioner when the weather gets too hot, or drink as frequently as they should. but drinking enough water and sitting in cool environment are important in hot weather.
When training for a marathon be sure to practise outside to get used to weather conditions. running in the gym is vastly different from running in hot, humid weather. While proper hydration is crucial before marathons or any exercise, water may not be best as it doesn't help replace the salt lost through sweating as imbalance of salt leads to cramps or weakness of the arms. isotonic drink may be better.Avoid exercise when feeling unwell, as it can make you more likely to suffer from heat exhaustion. A quick way of cooling the body is to dip a sponge or towel in cold water and press it on the neck, armpits and groin area. if heat symptoms persist, seek medical attention immediately. Thirst is not as good an indicator of dehydration as the colour of the urine. A clear colour means the body is well hydrated. People suffering from multiple long term medical conditions such as hypertension and diabetes should get out of saunas, hot tubs or steam rooms when they feel giddy or faint, have a headache, nausea or cramps it's best to go with someone who is able to help you if you suddenly feel sick.

Call 995 for an ambulance.

The paramedics are trained to stabilise the patients condition with medication, and the ambulance is equipped with a defibrillator to resuscitate the patient should the heart stop en route.
Give clear instruction to the paramedics on finding the patients home, have someone wait at a visible location to guide the paramedics and hold the lift open if the patient live in a high- rise building, so as to save time. Ready the patients personal effects such as personal identification, medical benefit identification, insurance and other documents for admission. Have the patient seated in a location where he can be transferred easily to a stretcher. Give a clear account of what happened, let the paramedics know about any drug allergies or past medical history. Drive or take public transport to the hospital, even if the patient lives nearby. the patients condition may deteriorate en route, and it is safer to wait for an ambulance. ambulances also get priority on arriving at A & E. ignore the pain get anxious about time wasted when the paramedics perform an on-site ECG.

Preventing Malaria

Malaria is the world's most important parasitic disease, accounting for an estimated 3 million cases and 1.5 to 2.7 million deaths annually. many people acquire malaria during travel to tropical and subtropical countries. Malaria occurs in most parts of sub-Saharan Africa, south and southeast Asia, Mexico, Haiti, central and south America, papua new guinea and the Solomon islands.
The risk of acquiring malaria for travellers depends mainly on specific risk behaviour e.g. rural travel, night-time exposure, unscreened accommodation. travel to areas with drug-resistant malaria. time of travel high or low transmission season.

Symptoms of Malaria

Malaria is a disease that occurs when an infected anopheles mosquito bites a person and injects malaria parasites into the blood. Four species of malaria parasites can infect humans Plasmodium falciparum, P. vivax, p. ovale and p. malariae, plasmodium falciparum infection can result in rapid progression to life-threatening illness. about 1 to 2% of patients infected with falciparum malaria die. Symptoms of malaria are flu-like and may include fever, chills, sweats, muscle aches, headache and sometimes vomiting and diarrhoea. Patients with falciparum malaria may develop renal failure, convulsions and coma. infection with P. vivax and P. ovale may remain dormant in the liver for many months, causing a reappearance of symptoms months or even years later. The period between a mosquito bites and the onset of symptoms of malaria is usually 7 to 21 days but this interval may be longer when the traveller has taken incomplete or inadequate malaria prevention measures. if a traveller develops fever during or after travel to malarious areas, medical help must be sought immediately to exclude malaria as a cause. A blood sample should be checked for malaria parasites.

Protection against malaria

Travellers can protect themselves by using anti- mosquito measures and taking drugs to prevent malaria.
Preventing mosquito bites. any measures that reduces the exposure to the evening and night time feeding female anopheles mosquito is the best way to prevent infection. Measures to avoid mosquito bites include > Use long sleeved clothing and long pants preferably light coloured if you're outdoors at night. Apply insect repellent containing 20 to 30% Deet N,N- diethyl-m-toluade to exposed skin. use mosquito net over the bed if your bedroom is not air-conditioned or screened, for additional protection, treat the mosquito net with the insecticide permethrin. spray permethrin or similar insecticide or light a mosquito coil which give out pyrethrum in the living or sleeping areas. Using antimalarial drugs>>>>

Using Antimalarial Drugs

Traveller to areas where malaria occurs should consult their doctor before departure. Drugs to prevent malaria are usually prescribed for travellers to malarious areas. an exact itinerary is necessary to decide the degree of protection required. The common drugs recommended for the prevention of malaria in travellers include> Mefloquine, Doxycycline, Chloroquine. Strict adherence to the recommended doses and schedule of the antimalarial drug prescribed is necessary for effective protection.
Take the tablet at the same day each week or at the same time each day. Take tablets after meals.
Take the recommended doses 1 to 2 weeks before travel with the exception of doxycycline which is started 1 day before travel, throughout the trip and for 4 weeks after leaving the malarious area.
Do not stop the tablets after arriving home as it is essential to complete the full dosage.
Side effects of antimalarial drugs. all medicines have side effects. mild nausea, occasional vomiting and giddiness are not adequate reasons for stopping the antimalarial drug. The seriousness of malaria warrants tolerating temporary side effects. However, if serious side effects occurs, the traveller should seek medical help and stop taking the antimalarial drug.

Prostate Cancer

The prostate which forms part of the male reproductive system, is a walnut sized gland located in front of the rectum and just below the bladder. it wraps around the urethra, the tube carrying urine from the bladder through the penis. The prostate requires mainly testosterone the male hormone to function properly. one of its functions is to produce fluid for semen to transport sperm during ejaculation. When prostate cells grow abnormally, the organ enlarges and pushes against the urethra and bladder, blocking the normal flow of urine. Cancer that begins in the prostate may remain in the prostate or spread to nearby lymph nodes. in some cases, it can even spread to the bones, bladder, rectum and other organs. Screening for prostate cancer is important,since the disease rarely shows any definitive signs in the early stages, as the disease progresses, however, prostate cancer patients may find themselves having to urinate more frequently and urgently, but with less urine or even blood in the urine.

A prostate enlarged by a tumour- the red area - can block the flow of urine......

Healthy foods + fruits /.@ Prevent Cancer

Asvocado  :Are high in vitamins, dietary fibre, potassium, folic acid and copper.
Broccoli  : Contains isothiocyantes which have been shown to encourage the body's production of cancer - prevent enzymes.
Pumpkins  : Contains alpha - carotene, a strong antioxidant that boosts immunity.
Asparagus : Full of Prevent - cancer compounds like selenium as well as vitamins A & C.
Turmeric : Contains cur cumin extracts which help alleviate the side effects of radiotherapy and chemotherapy.
Potatoes : Provide fuel for the body and are rich in immunity - boosting vitamin C.
Red Beans : Have a high antioxidant rating and can protect cell from free radicals which cause cancer.
Apple : Contain flavanoids and polyphenols which help fight cancers.

Medical Centre for international travellers

Sspecialists at the Medical Centre for international Travellers > At Changi General Hospital will be pleased to provide you with : Pre-Travel Advice Care
Vaccinations that are required or recommended for the country of travel.

Malaria prophylaxis / Prevention and treatment of Traveller's Diarrhoea.
Basic items to be included in the Travel Medical kit.
Post - Travel Care> Treatment for travellers who return with the following medical complaints >
Fever/ Diarrhoea for more than 48 hours/ Jaundice/ Rashes/ Sexually Transmitted Diseases.

Protect Yourself Against AIDs and Other Sexully Transmitted Diseases

Avoid sexual contact with prostitutes and casual acquaintances. Remember, you cannot tell if someone is infected by their appearances.
Practise safe sex by using condoms correctly. Antibiotics do not prevent infection.
Remember to continue to take medication for malaria prophylaxis for as long as it is prescribed.
Consult your doctor immediately if you > feel unwell or have the following symptoms, fever, diarrhoea persisting for more than 48 hours, jaundice. dark urine, yellow skin or eyes, rashes.
Suspect that you have a sexually transmitted disease such as gonorrhoea, syphilis, genital herpes or AIDS.
Inform your doctor that you have been travelling abroad, including transit countries.

While.......you are abroad.

Be Careful of what you Eat Or Drink.> Follow the general rule >Boil it, Cooked it, Peel it......or forget it "
Drink water that has been boiled or purified with chlorine or iodine, or canned, bottled drink. Avoid tap water or ice cubes. Eat food that is  fully cooked and is still hot when served. Avoid seafood or meat that is raw or insufficiently cooked. Avoid cold dishes and salads. Eat only fruits and vegetables that you have peeled yourself. Avoid ice cream, puddings and anything prepared with unpasteurised milk.
Beware of Mosquitoes >Diseases like malaria, dengue fever, Japanese B Encephalitis are required if you are going to areas which have these infection. Always consult a doctor first if you plan to visit malaria endemic areas. pills for malaria prophylaxis may need to be taken. This medication should be consumed one week before departure, continued throughout the stay and for 30 days after returning to Singapore.
Protect Yourself Against Mosquito Bites.>Wear light coloured long-sleeved clothing and long pants when going out at night. Apply insect repellent containing 30% DEET /NN-diethyl-n-toluamide/ to exposed areas of the body. Sleep under a mosquito net, in an air-conditioned room or in a room where the windows are fitted with fine wire netting. Spray permethrin or similar insecticide in the room or burn pyrethroid mosquito coil before going to bed. Ultrasound devices are ineffective against mosquito bites.

Travelling...Healthy Tips for Travellers

Everyone enjoys a trip abroad but health problems can arise. These can range from a minor illness like Traveller' s diarrhoea" to more serious ones like cholera, typhoid, malaria, yellow fever & sexually transmitted diseases. illness & accidents spoil your holidays or business trips.

Prepare before you travel >Consult your doctor four to six weeks before departure about your fitness to travel and vaccination which may be required or recommended.
Prepare a Travel Medical Kit which may include >>insect repellent, Disinfectant, Plasters, bandages,
Suntan lotion ( at least sun protection factor 6 ) Chlorine tablets, Drugs like anti-diarrhoea pills, tablets for fever, colds, motion sickness, antibiotics for traveller's diarrhoea and painkillers. Thermometer, oral re- hydration salts, Regular medication for any chronic diseases e.g. diabetes and hypertension.
Do Not Plan to buy medicines abroad since the quality and combination of constituents may be an unpleasant surprise.

The Silent Killer

just as water mains needs a heat of pressure to pump water through pipe to all home so your heart pumps blood under pressue through blood vessels to all parts of the body. blood pressure changes from minute to minute, during exercise or anxiety blood pressure is higher this is called high blood pressure.

Cooling System For Vehicle.

To keep the engine at it most efficient operating temperature operating at all speeds and under all operating condition. the liquid is circulated around the cylinder to absorb heat from the cylinder wall faults. (1) low coolant level. (2) loose fan belt. (3) thermostat stuck closed. (4) defective water pump.

Get enough exercise

Swimming : this is a good all round exercise for full benefits swim fast enough to make you part slightly. cycling : another fun exercise cycle with family or friends with stationary bike. exercise time passes quickly if you read or watch tv at the same time jogging, brisk, walking, aerobic, dancing : anyone can do it no special skill are needed. get a pair of light flexible well padded shoes with heel and arch support and you're ready.

Influenza

Influenza it is the most common infection in Singapore. some people get the influenza more than twice a year. symptoms: tiredness aches all over head, neck or limbs. poor appetite fever which can go up to 39'c for two to three days watery, red eyes, harsh,dry cough. there is no cure for influenza is caused by virus and there on medicine to cure infection. prevent its spread avoid crowed places and swimming pools. cough or sneeze into tissue paper and flush them down the toilet and wash your hands with soap and water. after blowing your nose or coughing into your hands. don't spit or share your unwashed, eating utensil drinking glass and towels with other member of your family. may be now can cure.

Kidney disease

A number of kidney disease can by successfully treated when discovered & treated in it early stages but may be potentially fatal it neglected. kidney disease can attack anyone at any age. puffiness around the eyes particularly in children, gradual swelling of part of the body often the ankles, lower back pain just below the rib cage increased frequency of urination, colored urine pain or unusual sensation bloody or tea in colour. high blood pressure, diagnosis. see your doctor immediately if one or more of these warning signs occur. some kidney condition can be cured in other case treatment can relieve pain retard the disease prolong life.

Dengue fever

Dengue fever is a mosquito borne viral disease transmitted by the mosquito. there are (4) types of virus (1) eggs: after a blood meal a female mosquito will look for a suitable place to lay eggs on average, she can lay up to 300 eggs each time. (2) larva: this normally lasts for 4 to 5 days depending on the environmental condition.(3) pupa: it take 1 to 2 days for a pupa to develop into on adult mosquito. (4) adult: the adult mosquito can survive in the natural environment for 2 to 3 weeks.

Attitude it is your hands

You alone are responsible for your positive attitude. people are not born with a positive attitude. it has to be constantly nurtured and practised. start a day saying that it is going to be a fantastic day. give yourself positive self talk this affects your attitude.be a happy person and get healthy life style.

Risk of heart attack

The heart is an organ made of strong muscles.it receives a rich supply of blood from a network of coronary blood vessels around it. when a coronary blood vessel is so narrow that part of the heart is not getting enough blood. it cause heart pain or angina which lasts a few minutes. this is a tight constricting or crushing pain behind the breastbone. the pain may spread to the left or right side of the chest. up the neck and to the arm usually the left arm when a coronary blood vessel is completely blocked a part of the heart muscle is damaged. causing severe heart pain or heart attack.

Maybe it's a heart attack.
Severe chest pain and a combination of the following symptoms can mean a person is having an acute heart attack, said Associate professor Marcus ong, senior consultant, department of emergency medicine, Singapore General Hospital.
Severe chest pain is often described by patients as the worst pain of their lives and likened to something very heavy pressing on the chest. pain that appears to spread up to the neck or down to the left arm. breathlessness, sweating. feeling faint and or nausea. A history of heart problems.
Patient is elderly, smokes or suffers from diabetes, high blood pressure and high cholesterol.

Control Stress

Pressures demand and worries are facts of life a little stress can be good it keep you on your toes. but too much stress can over whelm you and give rise to mental and physical problems so keep stress to small doses within your control. protect against stress.(1) share your problem to doctor. (2) cultivate a happy family. (3) learn to relax your body and mind.

Don't smoke eat right foods

to relax take your Get enough exercise and sleep be willing to change, healthier,happier feel better get your healthy lifestyle.reduce your risk of heart attack,don't smoke and less salt eat less food with high cholesterol content, exercise regularly and lean medicines according to you doctor advice if you have high blood pressure or diabetes

Lifestyle and safe rules

See your doctor before starting if you're over 35 age have never exercised before or have special medical problems wait for 2 hours after a meal before you exercise warm up for 5 minutes before you start and cool down the same way after you finish,stretch exercises like those on the left are the best way.start slowly and increase the amount and duration of exercise gradually. do aerobic exercise at least 15 minutes each time a week until you perspire and breathe deeply without feeling breathless.

Healthy lifestyle

Healthy lifestyle some common illness:Practising good health habits & giving up harmful one (1) Eat a variety of foods no single food group supplies all the nutrients you need. (2)Eat fight for your level of activity an office manager or executive need less than an outdoor worker. (3) Eat right for your age 50 above as you grow older. you don't need as much food cut down. especially on fats, sugar, starches. choose daily from these 3 basic food group.(1)Protective food: apple,banana,carrot,vegetable,etc.(2)Energy providing food: bread,rice,potato,cracker,etc.(3)Body building food: chicken,egg,fish,meat,bean,etc