Sunday, 2 April 2017

Diabetic Coma

The Malaysian cuisine is delicious and is easily available just about everywhere one walks. Malaysians generally eat well, are well-fed and eat three main meals a day. There is so much food and many food choices today as compared to the 1950s and 1960s. The cuisines today are varied and exquisite, from spicy to bland, from slow-cook to fast food, from pounded to blended, from sauteed to deep fry. The culinary magic is among Malaysia's strong points that supports its tourism industry and hospitality industry. People are eating all the time and everywhere. All these are possible because Malaysia is a hot pot of many ethnicity from the globe. There may not be Vikings and Inuits in Malaysia, but there are Malays, Chinese, Indians, Mongols, Thais, Filipinos, Indonesians, Nepalese, Uyghurs, Japanese, Koreans, etc in Malaysia. They have contributed much to Malaysia's unique international cuisine. Malaysians are mostly obese. Diabetes is common in Malaysia.

Diabetes is Malaysia's biggest health problem, apart from overweight and obesity. Malaysians are not scared of diabetes. They just dislike it and let it take its course. They toy around trying to find a traditional cure for their diabetes. No amount of doctors' advice will ever change them (hard core). They trust and prefer the methods of their ancestors when dealing with diabetes. They do not like Western medicine and do not heed the dangers of diabetes. They will come to hospital at the last minute, but still, they will not comply with medical advice. Nothing will change them. Thus, we see a number of diabetic complications.

Up in the male surgical ward, there were men with amputated limbs. There was a man whose rotten leg stump was placed in a bamboo; it was stinking badly. Over in the ladies ward at another hospital, there was a woman who had undergone wound debridement; she was moaning in pain and wanted to go home, but she died in hospital. In a few homes, family members with severe neuropathy were playing with their own poop and had to be chained. There are many horror stories of Malaysian diabetics.

There is a group of diabetic patients who have made the hospital their second home. They suffer from pre-diabetic coma. Diabetes is reversible, and so is diabetic coma. Diabetic coma is a medical emergency and patients need to be brought to hospital immediately. Semi-conscious patients are brought to hospital Accident & Emergency (A&E) Department by their caregivers, family members, relatives or friends.

Often, the national identity card (MyKad) and hospital registration card (HUSM RN) are the two documents used to identify local patients. If the patient is registered at the hospital where he/she is currently being admitted, doctors have access to the patient's file, medical history and medical status of the last hospital visit to the Diabetes Clinic. Weight and blood pressure (BP) readings should be in the patient's folder. Obesity and hypertension can be made out.

Unconscious or comatose patients can't speak for themselves; doctors will need to work on their medical status and underlying causes. For diabetics, there are four possible causes of coma or unconsciousness:

(1) Hypoglycaemia causes altered consciousness - inability to focus, giddiness, dizziness, etc. This could be due to inappropriate injection of insulin (insulin overdose).
(2) Hyperglycaemia - dangerously high glucose levels in blood. This could be due to skipping insulin doses or skipping insulin altogether, and preferring to try traditional herbal medicine instead (which usually don't work in diabetes).
(3) Dehydration - not consuming sufficient fluids or loss of fluids - vomiting, diarrhoea, drugs, medications, herbal prep etc.
(4) Alcohol consumption worsens pre-existing dehydration in diabetics.

There will be biochemical and pathological changes in the body in diabetic coma:

(1) Acid-base imbalance: Metabolic acidosis; diabetic ketoacidosis (DKA)
(2) Fluid imbalances: Hypovolaemia; edema
(3) Electrolyte imbalances: Hyperkalaemia
(4) Kidney problems: Anuria/oliguria; ketonuria; kidneys cannot filter blood properly
(5) Respiratory system: Acetone breath
(6) Blood: Ketonemia; hyperglycaemia;
(7) Blood lipids: Lipaemia; hypercholesterolaemia; hypertriglyceridaemia; increased fatty acids
(8) Liver: Fatty liver (30%-40% of liver is fatty)

There are Standard Operating Procedures (SOP) for Diabetic Coma under Intensive Care Medicine. Treatment of diabetic coma will depend on the status of the patient:

(1) Hyperglycaemia: infuse insulin
(2) Hypoglycaemia: infuse glucagon
(3) Acidosis: infuse alkali
(4) Hypovolaemia: infuse saline
(5) Lipaemia: apheresis
(6) Fatigue:
(7) Pain:
(8) Fever/infection(s):
(9) Neurology:
(10) Heart:
(11) Blood: dialysis

There will be medical and ethical issues to deal with once the patient pulls through after dialysis, before he/she exits the Intensive Care Unit (ICU) to the open ward. Some patients die soon after dialysis due to cardiogenic shock. This is often stated as "badan reject dialisis" among family members present outside the ICU.

Families can expect patients to pull through by two weeks hospitalisation at ICU and the open ward. Patients are able to sit up in bed and eat hospital food. But families often prefer to supply home food to newly recovered patients (as a gesture of caring). Salty food and certain fruits will set off the biochemical imbalances again. Care has to be accorded to observe that families comply with doctors' strict orders for proper patient care and rapid recovery while still in hospital. But families tend to think that they know better than doctors and choose to disobey.

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Friday, 31 March 2017

ESWL for kidney stones

Kidney stones
Kidney stones are known as renal stones or renal calculi (single renal calculus). There are many causes of renal stones - dietary, hereditary (genetic), idiopathic (unknown).

Passing stones in urine
Tiny kidney stones can exit via urine. However, kidney stones are actively growing crystals in the kidneys and these can grow to be quite big if not removed. When these big kidneys stones (like staghorns) try to exit the kidneys into the ureters, they will get lodged, bruise and tear the ureters, causing pain and blood in urine.

Bladder stones
Bladder stones form in the urinary bladder. The bladder is a big elastic pouch - ie, it expands with urine, bladder stone or both. Bladder stones can become as big as a softball or hockey ball.

Blood in urine
The presence of blood in urine is known as hematuria. Passing stones in urine can cause hematuria. Bloody urine is worrying as it can mean an active infection or kidney stones.


Kidney stones and bladder stones occur commonly in Malaysian families. We have long hot weather and people tend not to drink sufficient water. They prefer to ignore the dangers of dehydration and possible kidney stone formation.

Malaysia is famous for its thick sweet milk tea (teh tarik or chai), which is consumed in the morning, afternoon and evening. It is taken with roti canai or plain dry biscuits (biskut Marie or biskut Cap Ping Pong). Teh tarik and roti canai are Indian cuisine, which Malaysians have adopted and blended into Malaysian cuisine.

Scenario 1: There was a big elderly man who liked thick sweet milk tea so much that he must consume it daily. He had a bladder stone for a long time before he decided to have it removed. When the bladder stone was removed, it was a big chalk-white ball - as big as a softball (bigger than a hockey ball). He kept the bladder stone as a souvenir! His unusual souvenir became an attraction for the village elderly.

Scenario 2: A young working girl liked thick sweet milk tea and often consumed it daily. She had little kidney stones which exited in her urine. However, one day, an usually large elongated kidney stone tried to exit her body, but got stuck half-way out at the orifice. She was in so much pain. She was rushed to the hospital in an ambulance, where the stone was pulled out without anaesthesia! She screamed! Hospitalisation was necessary to monitor her condition and she was discharged after two days. She switched jobs and became a successful entrepreneur. However, she has short stature and features of a kidney stone sufferer.

Scenario 3: A father of seven worked as a field supervisor for his college students. He refused to drink water when he was doing field work as there were no proper public toilets. He would only drink water at home. After working 30+ years, he developed kidney stones and suffered excruciating pain, which was relief with traditional ointment. He lived in a hot house and sweated profusely. No amount of water seemed to be able to replace his water loss. He refused intravenous saline and glucose infusions. He could not open his dry eyes and therefore could not see his food nor his children around him. He eventually died of severe dehydration - just skin and bones.


Stones can form often when we don't drink sufficient water or eat certain food. There are many causes of kidney-related problems (also known as renal problems).

Kidney stone and pain
Kidney stones are also known as renal calculi (single calculus). They can form in the kidney and if they break off, the broken pieces can travel down the ureters (urine tubes) and lodge there. Whether the stones are lodged in the kidneys or the ureter, they will give rise to pain, sometimes very severe pain. Kidney stones cause excruciating pain known as renal colic.

Patients with renal stones suffer excruciating pain, which makes them unable to enjoy daily activities and sports. Life can be dreary for kidney sufferers. Some choose to ignore little pain or experience no pain.

Renal pain will cause patients to go to hospital to seek treatment and relief. Some will go to hospital only when nothing else seems to work at home. Some will call up friends to find help. Some will wait for someone to come by and visit them at home while stuck in bed. Patients are at a loss as to what they can do for themselves.

All of a sudden, relatives and close ones find themselves in charge of a patient with kidney problems, and often times, a kidney stone sufferer with the stone not yet removed. They don't know what to do either. All they can do is watch someone in pain till help comes along.

Chemistry of kidney stones
Kidney stones are chemical precipitates. As precipitates they can therefore be dissolved chemically. Some stones are easily dissolved. However, some stones maybe harder to dissolve.

Lemon peels contain huge amounts of oxalates. The oxalates turn into crystals within our body and interrupt calcium absorption to a large extent. The unabsorbed calcium solidifies within the kidneys and gallbladder in the form of stones (calcium oxalate stones).


Kidney stones are detected by x-ray, IVP, ultrasound, and CT scan.

AXR = abdominal x-ray (x-ray of the abdomen)
KUB = kidney, ureter, bladder
IVP = intravenous pyelogram
CT = computed tomography
Renal profile

Abdominal x-ray
Kidney stones are opaque and can be seen on x-ray of the abdomen (known as AXR). X-ray of the kidney, ureter, bladder is known as KUB. 

A dye or contrast media is used to detect structures of the KUB. It detects problems of the urinary tract due to kidney stones etc.

Kidney ultrasound
Kidney stones can be detected by ultrasound of the abdomen - KUB. The patient must drink sufficient water an hour prior to the procedure and have his/her bladder full for this procedure. The patient then lies on the stomach and the KUB region is scanned.

Abdominal CT
CT of the abdomen and pelvis helps to detect cause of pain due to kidney and bladder stones.

Renal profile
This looks for abnormality of serum calcium and serum phosphate as well as altered kidney function.

The Urine Dipstick Test looks for possible infection of the renal system.
Urine FEME looks for microscopic evidences such as casts (epithelial cells), crystals, yeasts, red blood cells, white blood cells, pus and other (if any).


1. Cystone
2. Tamsulosin
3. ESWL = Extracorporeal Shockwave Lithotripsy

An Ayurvedic herbal prep which can help to dissolve kidney stones rapidly is Cystone. It is sold at local pharmacies. There are wonder stories about using Cystone for getting rid of kidney stones from patients who suffered years from kidney stones. Patients pass out sandy urine for a few days and the kidney stone is gone for good.

Tamsulosin is used to assist kidney stones exit in urine in difficult cases. It is also used in men with enlarged prostate gland as in prostate cancer, where urination is problematic.

Larger kidney stones must be removed in the renal clinic or surgery. Large kidney stones can be removed by blasting the kidney stones as in the procedure extracorporeal shockwave lithotripsy (ESWL). ESWL is a mechanical means to break up kidney stones. This procedure is an outpatient procedure and the patient goes home after the procedure, unless there are other complications and need for extended stay. Patients may need some form of anaesthesia. The patient lies on a waterbed and laser light is passed through the kidney stone to break it up. The fine broken stone pieces will pass out in the urine. If a piece of kidney stone is too big and trapped in the ureter, it will need to be pushed back up into the kidney for further ESWL, until it is sufficiently small and safe to pass through the ureter and out into urine.


Will kidney stones recur? It depends. If the diet is unchanged and patients continue to consume little water (remains dehydrated), then kidney stones may return. Adding more fruits and vegetables to the diet will help patients to stave off kidney stones .... hopefully for good.

Patient education
For patients who have hypertension, have kidney problems (eg kidney stones), and live in hot climate, some dietary modifications are necessary and consuming plenty of fluids will help. Personal education and willingness to make changes are of prime importance in patients with kidney problems. No amount of advice will help them unless patients themselves choose to change - ie, consume sufficient water daily, reduce salty food consumption, eat more fruits and vegetables daily, and stay out of the sun.


Conditions at home
Most patients cannot afford the luxury of this life and do not have air-conditioning at home. They live in extremely hot houses without shirts on (for men) and just wrapped in sarongs (kemban for women). Sometimes old houses suffer from severe heat due to the nature of roofs that are installed. Previously people used attap roof for kampung houses. Nowadays people use Addex roof for kampung houses. Attap is cooler but has lost favour among villagers. Addex is preferred today, but it is not as good as attap. As such patients have no means to make their living quarters cool and conducive for safe living.

Designing homes
Thus, house design is of great importance in hot countries of the Equator, like Malaysia. Not all house designs and building materials are suitable for hot weather. Some form of natural ventilation and affordable means of cooling houses are needed. Architects and engineers have thus to come up with better house designs so that kidney problems can be reduced among poor people living in the Equator.

Global warming
Malaysia is hot (31C) at midday and cooler (24C) at night.  Reducing exposure to the sun and heat maybe helpful for those with kidney problems. Drinking plain water before leaving home/office should help. Refusing to drink sufficient fluid in order to avoid having to go to toilet is a big reason why many refuse to drink sufficient fluid daily. Thus, these people fall victim to kidney problems, including kidney stones. As global warming heightens and the kidney stone belt widens, we can expect to see more patients with kidney problems.

External links:,p07709/

Monday, 20 March 2017

Immune Health

What constitutes innate immunity?

What determines immunity?

Can immunity be developed?

Can immunity be improved? How?

Can immunity be transferred?

Can immunity be acquired?

What is not immunity?

How can immunity be compromised? What can be done?

Is there just one immunity for everything that can harm us, or are there many different immunity profiles for different things that can harm us?

Can immunity be modulated? How

How does immunity work? Can it be turned on and off? Does it sleep?

What things govern immunity?

Does immunity matter?

Do we all have immunity?

Is immunity permanent?

Why do the young and elderly get sick easily?

Is poor immunity detrimental to one's health?

Should immunity always be high even when nothing bad is around?

External links:

Tuesday, 14 March 2017

Technical report

A. Hits

The # of hits for this website on 14 March 2017 is 445,458. This is good for a website that has been in existence for 7 years.

B. "404" Error Code

I also received a message from Google Analytics that there are errors in this website, which returned Increase in "404" on searches or search links. This means that the link-to pages, images or objects have been removed, omitted or deleted.

                   Increase in “404” pages on

I have downloaded from Google Analytics, a list of this website searches that returned "404" and I will try and remedy that.

C. I have not added AMP (Accelerated Mobile Pages) to this website. Will work on this.

D. I have redirected this website to https to make it more secure.

E. Feedback

For those who wrote comments, thank you for your kind effort.

For those who liked this website as the images loaded very fast, I also want to thank you for even noticing it. I have picked and used a template that loads images very fast. These templates come free and anyone can use them. I have only tried one sample of these fast templates for this website. They don't look nice as they are meant for speed - ie, fast loading.

However, the images also loaded doubly fast as I have converted the original high resolution images to web images for even faster loading. To do this, I have used Zoner Photo Studio version 15. However, Zoner has updated their software to version 18, which also has the photo optimization for web images, but has removed other useful features such as annotation etc, which I particularly liked. As many useful features have been removed from recent versions, I am unable to annotate images/photos after version 15.

The photos/images that I have used in this website are mostly my own. The rest are from various Internet pages and I have indicated their sources in the caption, or somewhere on the respective pages.

If there are topics that you would like to see at this website, you can email to me and I will see what I can do. This website is meant for general reading and knowledge, with some relevance to medicine and health. It does not provide medical advice and patients must depend on their doctors' advice.

This website is meant for those who want to search for new things, review old things, and maybe also look into health issues about the future of things. I write on topics which people tend to overlook, but I think are important to our health. Medical students may find the pages useful. Parents may get some ideas about what we teach at the university in this digital era.

I cannot advocate the use of traditional medicine (herbs, herbals and herbal medicine) on this website, but I provide information about them here for general knowledge. There is more information from the Ministry of Health Malaysia web pages and individual websites. I taught about them long ago, but just for ethical consideration in our Ethics & Behavioural Science Block.

14 March 2017

Monday, 13 March 2017

Academic Scholarship

It is nice and feels great to be in academia. However, academia demands a high level of time, energy, dedication and passion. There is one thing that kills academia, and that is cheating.

In academic indulgence, scholarship, research, writing and publication, there is a lot of room for cheating. There are many ways in which university lecturers have used to cheat their way to the top. I have seen too many times and thus this warrants a write-up first-hand.

When lecturers first get research students at their door, the student is almost always in a self-pity state. It is derogatory to get a begging student, doesn't matter whether it is a male or female. I have often accepted them, but I find that these beggar students are not worth my hard work of toil looking and supervising them.

A sad and begging student is a falsehood of everything that academia needs. I should turned away all research students who come into this category. They may succeed in obtaining their postgraduate degree, but they are undeserving and often ungrateful souls. I don't ever want them back with me or working with me.


Here are some instances I can cite and you can judge how former students and lecturers cheat. Cheating is big time at university.

Scenario 1

A beggar student with a low CGPA comes to your door - begging to be your postgraduate student. He gets accepted for begging hard. He turns out to be aligned to other researchers with even bigger grants. So he is just registered under you, but actually works for somebody else on the faculty.

Scenario 2

A beggar student with a reasonably good CGPA comes to your door, begging to be your postgraduate student. She gets accepted for begging hard. She turns out to be inclined to make better friends with your head of department. After graduation, she continues her research with your head of department, while you are oblivious to their research. Somehow, technology shows their publication, which you found by surprise. Of course your name is not on any of their research while the research involves learning off your back.

Scenario 3

This is like from rags to riches. An average student barely makes through the grades and graduates. She become a research assistant. Then she found herself a lecturer job by befriending a head department whom she met earlier during her struggling days. She gets promoted and landed a job as a research director. Good job but a sick attitude. How in the world can one appreciate an almost dropout student to easily become a research director?

Scenario 4

A medical lecturer tired to overpower her subordinate and tries to take away his research to call it her own. He defends himself and refuses to give it all up for her. He transfers. She has another plan - to take up his residual research and make it big and as if her own. Since she is head, it is big time for her. She is acknowledged, but for what? People must be blind not to see how a medical lecturer with just an average pass in MMed can be a director of a specialised field of research that someone else did before her.

Scenario 5

This one is what I call a killing. You have a medical lecturer as your head of department. She only has an MRCP but no PhD. You have a PhD and lots of other skills that all tertiary academics should have. Of course and in due time, the head of department will make a sure kill - kill you in your sleep, kill you till you cannot claim your academic freedom, kill you and make sure you don't get your academic promotions.

Scenario 6

This one is an old man who refuses to quit. Yes, the retirement age has been increased to 60, so many lecturers stay on till bald and forgetful. However, they are meaner. They have a hand in every university affair and decision that you can't even have a breathing space. Sometimes you just wish that old man will wither and just die, so lecturers can live, wish and work well in the university.

There is so much madness in academia. It feels great to survive torture, but it feels even greater to win battles against such cheaters and nerds.

Friday, 12 August 2016

Pancreatic Cancer

English: Pancreatic cancer
Malay: Kanser pankreas
Indonesian: Kanker pankreas

Q1. What is pancreatic cancer?

Q2. Who gets pancreatic cancer?

  • Some people are more prone than others to get pancreatic cancer. 
  • There are multiple risk factors associated with pancreatic cancer; it does not necessarily mean that if someone has any of these risk factors they will get pancreatic cancer. These risks factors have only a weak link to pancreatic cancer.
  • Sometimes there are none of the risk factors in pancreatic cancer patients.

Q3. Why does pancreatic cancer occur in some patients and not others? What causes pancreatic cancer?

  • Multiple risk factors are linked to pancreatic cancer.
  • Genetics. Approximately 5% to 10% of pancreatic cancer patients have an immediate family member who also has pancreatic cancer. It should not mean that pancreatic cancer runs in families. Although genes have been associated with increased risk of pancreatic cancer, nevertheless, no pancreatic cancer gene has been identified. 
  • Diabetes. Pancreatic cancer is linked to diabetes, but not all diabetics have pancreatic cancer. 
  • Smoking. Smoking is linked to pancreatic cancer, but not all smokers have pancreatic cancer.
  • Obesity. Pancreatic cancer patients are obese initially and lose weight constantly. 
  • Ethnicity. Over 80% of pancreatic cancers develop between the ages of 60 and 80 years, in African-American Black population.

Q4. How does pancreatic cancer develop?

  • All cells contain DNA except mature red blood cells (mature erythrocytes). 
  • DNA can be damaged by constant exposure to radiation and by chemicals in the food we eat and the environment we live in. 
  • This damage is described as a mutation in the DNA. 
  • When the DNA has mutated, it produces certain proteins that can trigger new protein formation. 
  • These are abnormal proteins, which can trigger cells to proliferate. 
  • When cells proliferate at an uncontrollable rate, it can lead to a mass of cells that form a tumour. 
  • A tumour can be either benign or malignant. 
  • Tumours can spread (metastasize) via the lymphatic system (vessels that contain lymph) or the general circulatory system (vessels that contain blood). 
  • In this way, a single tumour cell can re-establish in another organ far away from the initial tumour site and start a new tumour growth. 
  • How fast or slow a tumour grows depends on what nutrients are supplied in the diet and what nutrients eventually reach the tumour. 
  • Tumours love loads of sugar in the food that we eat. 
  • Reducing sugar intake and making correct dietary adjustment to food intake can help in stopping tumour spread and get rid of the cancer itself.

Q5. What are the signs and symptoms of pancreatic cancer?

Q6. Pancreatic cancer investigations and diagnosis.

Q7. Conventional pancreatic cancer treatment:

Q8. What does the pancreatic cancer patient feel? Does the patient feel pain? Yes.

  • Pain is in the middle of the top segment of the abdomen. 
  • Patients take painkillers to cover pain and forgot that there is a cure for it.

Q9. Are there cures for pancreatic cancer? Yes.

  • There are two options. 
  • There is conventional treatment (surgery, radiotherapy and chemotherapy). 
  • There is an alternative DIY therapy, a self-taught, more herbal routine that has worked for patients. 
  • You can try the techniques of these successful patients or DIY (do it yourself). 
  • There is no one cure that will heal pancreatic cancer. 
  • There is no one pancreatic cancer that will respond well to all known therapies. 
  • There is always room for innovation and improvement for pancreatic cancer.

Q10. Are there effective cures for treating pancreatic cancer? Yes. You can read about some of these but be careful of what you decide:

Q11. Will pancreatic cancer go away for good? Yes and No.

  • If you look after yourself well after curing cancer, the cancer will stay away from you.
  • If you don't look after yourself after curing cancer, the cancer will return.
  • Stay on a right diet, live peacefully and happily, stick to your faith and live a life of no worries.

Q12. Will pancreatic cancer kill? Is it fatal? Yes and No.

  • Yes, if you do nothing about your pancreatic cancer. It will kill you because you did nothing and just ignored it and just took painkillers.
  • No, if you did something to stop it and reverse it. You need to learn how to by understanding your cancer, how it happened, its symptoms etc. Then read about how others have successfully managed to heal their pancreatic cancer. 
  • Even an elderly 74-year-old lady knows how to cure her pancreatic cancer. You decide what you want to do.

Q13. Are there pancreatic cancer survivors? How long can they survive? Yes.
  • In 2000, she had stage 4 pancreatic cancer and refused conventional treatment.
  • In 2003, an elderly 74-year-old lady created a record for herself. She cured herself of stage 4 pancreatic cancer with her own routine. She shares her experience and routines with other pancreatic cancer patients and the world.
  • In 2012, she had stage 4 pancreatic cancer and survived chemotherapy. She had her own natural DIY cure

Q14. What will happen to pancreatic cancer in the future?

  • The future of pancreatic cancer is now a living past. 
  • We already have cures for pancreatic cancer today. 
  • Conventional treatment cures 40% of pancreatic cancer cases. The remainder 60% of pancreatic cancer patients have can resort to alternative DIY routines as a form of therapy to cure themselves. DIY pancreatic cancer therapies will certainly need time, commitment and patience. Nothing comes easy. Perseverance usually gives the best results. As the Arabic saying goes: Haste makes waste. There is no cure if you are going to rush things.

Q15. What is the prognosis of pancreatic cancer? Bad and Good.

  • Depends on how you look at it. 
  • Any cancer diagnosis comes with a negative cloud and frightens patients as if it is the end of their world. This must stop. 
  • Patients must come to know that there are conventional treatment and alternative DIY cures for pancreatic cancer.
  • The prognosis of a metastatic pancreatic cancer 5-year survival rate is 2%.

Q16, Pancreatic cancer Q&A

Q17. Pancreatic cancer diary

Q18. Pancreatic cancer Patient's Guide.

Q19. Cancer Care therapy for pancreatic cancer

Q20. Eat the right food