Contact dermatitis...a suprising culprit , I've learned!

Salam & Hi,

I've been to family medicine posting for just a week and there are a lot of common-everday problems I saw at the outpatient clinic. It is interesting because these problems usually does not need admission and requires simpler management.

Here I would like to share a case that is quite common due to misunderstanding and white lie given by the advertising company regarding the everyday soap for bathing or hand washing.

Clinical Scenario:


Source of picture:Wikimedia Commons

A 51 years old senior police officer came with first onset of generalised pruritus (itchiness) for a month. It is more severe at his limbs and abdominal area. It also cause him to have dry skin.

On further questioning on possible allergen contact he denied any allergy towards food,dust,aerosol, current detergent,animals etc. He did not engaged in recent outdoor activites like swimming, travelling or jungle tracking. Moreover, his occupation nature requires him to be inside an air-conditioned room. However he mentioned that he had changed his bathing soap to a antimicrobial soap recently ( I won't mention the brand here...but, it is the commonest anti-microbial being advertised nationwide)

He did seek medical help from private clinic and was given topical cream. His problem relieved by the appliance of the cream temporarily but the symptom persist afterwards.

Other medical illness: sinusitis under medication. There is no chronic illness

He does not smoke or consume alcohol.No fever, loss of appetite or weight. There is no other significance found on other history asked.

On examination of his skin : There skin looks dry with scratch marks.There is no abnormality of the skin indicting skin infection or atopy.

Discussion:
What could be the possible cause of his problem????
* from history, he is not allergic to any possible allergen
* there is no sign of infection

However, the answer is : THE ANTI-MICROBIAL BATHING SOAP!!!

Reason: Anti microbial bathing soap have strong anti microbial properties but LACK of MOISTURIZER. It may not cause problem to younger people since the skin can still produce some naturel moisturizer itself. However, in older people,it will cause dryness of skin and eventually DERMATITIS!!

* Eventhough, Malaysia have high humidity index, our skin still need some moisturizer effect!

So, plan of management:
1. Stop using 'the soap'. Choose a normal soap with good moisturizer properties.
2. Give anti-histamine (Piritone)
3, Moisturizer aqueous to be applied to dry skin
4. Steroid(Hydrocortisone) cream to be applied at the MOST itchy part.
5. Do come back if the symptom persist after a week...(it may due to other cause)

Take home message:
* Choose your hygiene care product that suitable for your skin. If there is any signs of irritation i.e ithciness do change to another product.
* anti-microbial soap is not to be used regularly in people with dry skin type and elderly.

p/s: this case is quite common in primary health care due to lack of knowledge on this kind of matter.
other cause of contact dermatitis : sun light and specific allergens(metals, jewellery...etc)

Health screening at SMK Teknik Sepang.

Salam,

Alhmdulillah, I've passed my year 3 without problems & happilly appreciating my 2 months break. The 1st month of my break fills with a few activities spend at KL,Kelantan & Malacca.

The lastest activity done is becoming a volunteer for health screening booth set up by our UKM Medical Society (PERSIAP). We received the invitation from Science & Social Faculty of UKM for their event Hari Jantung Sedunia at that school on 27/04/2010.

The girls setting up the banner


What we did there? Basic health check up: Height,weight,body fat measurement,Blood pressure(BP) and blood type. At the end of session, everyone will be given counselling on their health check-up result.

For the first hour, I have to manage the counselling booth.I always wonder, what kind of problem they want to know? Porblems faced by these form 4 students(16 years old)
1. Most of them have low blood pressure.
2. Some are overweight or have low/normoweight but with high fat index.

Blood Pressure is tension exerted on walls of arteries(a type of blood vessel that brings blood from heart to body cells) by the strength of contraction of the the heart.

Masitah with her favourite elctronical BP set


Example of the normal reading 120/90. 120 is called the Systolic BP while 90 is the Diastolic BP. Systolic BP indicates the blood flow into your heart while Diastolic BP indicates the blood flow from heart to body.

Therefore, low blood pressure indicates low flow of blood to your body & other vital organs. It is normal to have low BP if you are atheletes & people who exercise regularly.They also have low risk for stroke,kidney disease and heart disease. Thus, low BP is acceptable as long as it is not low enough to cause symptoms(dizziness,fainting) and problems to the body(chest pain/heart attack when insufficient blood supply to heart).

Me & the adik-adik


Weight issues & high fat index can be manage with eating in a small amount 5 times per day and choose the food according to the food pyramid. Excercise is very important.For those who doesn't involve with sports, brisk walking for more than 45 minutes,3 times per week is good for health. However, for weight reduction, for effort in cutting the calories & increasing fequency of excercise should be done.

guy's booth


girl's booth


Wasalam (",)

We live to eat or we eat to live?

NASI TIMBEL KOMPLIT...Sundanese special cuisine i found in Bandung

Salam..

Alhamdulilah, i've finish my final exam.The result will come out in 2 weeks time.
Today i want to talk about FOOD & APPETITE

Appetite is one of the desire that human sometimes find it hard to control.
That's why we sometimes craved for certain kind of food..
The result is it can cause the imbalance between food intake and the energy expenditure.

Actually, there are guidelines in eating according to our prophet Muhammad(pbuh).
From one of his hadith it which i conclude that we only eat just to support the need of your body.Therefore the stomach is divided into 3 EQUAL parts:
1.for food
2.for water/drinks
3.for air


The hadith says...
Tak ada wadah yg lbh buruk yg dipenuhi oleh manusia selain perutnya. Dia sebenarnya hanya memerlukan beberapa suap untuk menopang hidupnya. Kerana itu, perut perlu dibahagi kepada 3 bhg; sepertiga untuk makana, sepertiga utk minuman & sepertiga utk udara (Hadith riwayat Tirmidzi, Ibnu Majah, Hakim & Ibnu Hibban)

During my 1st year,I learned about nutrition and food intake in detail.
There are a lot of diseases cause by imbalance intake of food.It is one of the most common environmental cause of disease .Rather than discussing on the effect i would like to share how to prevent it..

The answer is easy..CONTROL your APPETITE..FOLLOW the RULES:FOOD PYRAMID



Image source is from http://www.oakhills.k12.oh.us

SO, what does the serving means??
generally 1 serving of...
CARBOHYDRATE equals to:
1 slice of bread
1/2 C of cooked rice,noodle or pasta(including spaghetti)
3-4 small or 2 large crackers or biscuits
1 small potato
1 oz ready to eat cereals
(6-11 servings per day)

FRUIT&VEGETABLE equals to:
1 medium apple,orange or banana
3/4 C juice
1/2 C canned fruits
1 C leafy vegetables
1/2 C cooked or raw vegetables or legumes
(Fruits:2-4 servings,Vege: 3-5 servings)


PROTEIN equals to:
1 egg
4 oz tofu
2-3 oz cooked meat, poultry & fish
2 tbs of peanutbutter or seeds
(2-3 servings per day)

MILK/DAIRY PRODUCTS equals to:
1 C milk or yougurt
2 oz process cheese
(2-3 servings per day)

(Guide: oz=ounce, tbs=table spoon, C=cup)

However all of it still depends on amount of fat, sugar, additive substance(perasa)that should be use SPARINGLY..

I don't say you cannot eat chocolates, cakes, ice cream or other fatty yummy food.I like them too (",)
Just eat them in small amount and balance it with some simple exercise...Thus just
Thus, just follow the rules. EAT when you are hungry.STOP before satiety.

A healthy lifestyle keeps the disease away


P/s:
I always read people blogs and articles discussing about love, coupling,covering their aurah...i hope someone will discuss it deeper in Islamic view and invite me to view his/her opinion on NAFSU MAKAN...

ANy opinion??

Sources:
1. Praktek Kedokteran Nabi, Ibnu Qayyim Al-Jauziyah (indonesian translation)Publisher:Hikam Pustaka.

2. Understanding Nutrition,9th edition by Whitney & Rolfes,Publisher: Wadsworth

Coffee: Lift up your mood

During our last Community Research Program Discussion(CRP), we were asked to present a dummy research problem for our latest topic: Identify Research Problem.Most of my friends choose a bombastic topics like Down Syndrome, Kidney stone & Hypertension. However,I choose a simple topic of interest : COFFEE.

My tutor likes my idea and proudly to say,I receives his attention on it(he is a coffee consumer too). Why i choose this topic? It is because I always wonder why i easily get high (become extra happy, excited & more active) when i have only a cup of 3 in 1 coffee for breakfast.In the dummy research, i want to know about the amount of coffee that can contribute to anxiety and sleeping disturbance.

Isn't curiosity is the best policy in research??

In my family, coffee is always for the adults...tea will be served for all including us the kids. Moreover,i only prefer to drink plain water. So, i became the real consumer when i enter the medical school.It is for staying up at night..Sometimes,I take it in the morning for breakfast to prevent me from sleeping during the lecture or tutorial. Although, sometimes i do sleep with or without coffee.LOL (",)

What makes the coffee special??
1. caffeine ( a psychoactive drug)
2. the delicious aroma
3. there are many ways to have them with: chocolate, marshmallow, milk, caramel..etc
4. it is a social drink...during meetings,hangout(lepak) with friends, serving the guest of your house..

Ok..here are 10 facts that i found out while reading on about it for my dummy research;

1. Coffee is the most widely used psychoactive substance(mild antidepressant) that lift up your mood, alleviate depression and may cause euphoria.

2. People can get hooked to coffee and craved for it- coffee addiction

3. Morning cup of coffee often bring the smile to our face(happen to me all the time)

4.You'll get the same kick(effect) from the day after day if you took coffee every morning, no matter how addicted you are....no need to increase the dose to get the same effect.no resistance effect eh??Cool...

5. People who were given caffeinated coffee performed better in IQ test and less stressed.However...after your brain is forced to work,when the effect ware off it will get tired and you'll feel weak

6.Depending on your tolerance to coffee, excessive drink can cause anxiety,disturb your sleep and wreck your mood

7.If you get headache after suddenly stop consuming coffee(if you are a daily consumer) you may get headache as the withdrawal effect.Thus, we have to stop it little by little. How? decreasing the amount gradually before stopping.

8.Stomach problem people( having gastritis,peptic ulcer) should decrease their coffee intake.Make it as little as possible.

9.Coffee can interfere with some drugs interaction, so if you are a frequent coffee consumer,ask your doctor about it.

10.Smokers need to increase their intake to get the same effect as the non smokers

TO SUM UP:
The key of coffee magical effect is CAFFEINE. In small amount, it improve your mood and performance but heavy intake can disturb your sleep and decrease your mood.

Thus, life is about balance. TAKE IT MODERATELY, DRINK IT HEARTILY!

Hmm...which one i should choose, Carrebian nut or Choccocinno 3 in 1 coffee...


Refference:
Food your Miracle Medicine: Preventing and curing common health problems the natural way. Author:Jean Carper.Publisher: Harper