A Chinese Remedy for Balding Heads

This is a remedy for regrowing hair and keeping it black. I learned it from my late Chinese father-in-law.

Ingredients
5 oranges
coconut oil

Utensils
fire
lesung

Methods

(i) Prepare the orange charcoal-coconut oil mixture

Light a small fire and place the oranges on the fire. Let the oranges cook till they become charcoal. Take the orange charcoal and pound till fine. Add coconut oil to the pounded orange charcoal and mix thoroughly.

(ii) To apply the orange charcoal-coconut oil mixture

Wet the hair and apply the orange charcoal-coconut oil mixture. Rub in till the mixture covers the entire scalp. Wrap the head with a towel and leave it on overnight.

(iii) Rinsing

Next morning, remove the towel and wash the hair thoroughly. Remove all traces of the orange charcoal-coconut oil mixture.

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Additional note #1:

Application of a hair cream, Brylcream, makes the hair black. Brylcream is made from coconut oil.

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Additional note #2:

Urang aring is a plant found in Malaysia. It is used to make the hair black. (Refer to my post on Urang aring in this blog and photos by Dq Farm in Facebook).

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Additional note #3:

Vitamin B shampoo helps with hair regrowth. It is used to help hair regrowth in children who lost their hair as a result of scalp infection, eg in tinea capititis.

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Breast Cancer

Risk for breast cancer
- genetic predisposition
- family history

Breast cancer
- types of breast cancer
- breast cancer cells

Hormones
- made by endocrine system
- female hormones are estrogen and progesterone
- breast cancer cells have hormone receptors (ER, PR)
- hormones can stop breast cancer cells from multiplying
- male hormones are androgens
- male hormones are made by the adrenal glands which are located at the top of kidneys

Menopause
- is the end of reproductive period in women
- women can't reproduce anymore
- women can't have babies anymore
- women are regarded as infertile

Aromatization
- male hormones are converted into female hormones by chemical aromatization
- aromatization occurs throughout the body in fatty tissue (including breast tissue)
- aromatization is more pronounced in women after menopause

Hormone receptors
- hormone-receptor positive:
  -- the breast cancer cells have a significant number of either ER or PR,
  -- and will respond to endocrine therapy
- endocrine receptor (estrogen or progesterone receptor)
  -- estrogen receptor (ER)
  -- progesterone receptor (PR)
  -- ER/PR = estrogen receptor/progesterone receptor
- endocrine receptor (estrogen or progesterone receptor) positive

Carcinoma
- breast carcinoma
- invasive breast carcinoma
- tumour (American, tumor)

Biomarker testing
- ER positive
- PR positive
- HER2 positive
- ER/PR/Her-2
- ER/PR/Her2
- Triple negative: not positive to receptors for estrogen, progesterone or HER2
- Triple positive: positive for estrogen receptors, progesterone receptors and HER2

Overproduction of HER2/neu protein in breast cancer
- protein
- breast cancer protein
- HER2, Her2 or Her-2
- HER2 positive
- DNA
- DNA amplification
- FISH = fluorescent in situ hybridization
  -- a technique used to assess Her2 DNA amplification

Treatment
- surgical treatment
- radiation treatment
- chemotherapy
- drug treatment
- endocrine therapy
- other medications

Surgical treatment
- the ovaries maybe removed in breast cancer as they are a source of hormones

Chemotherapy
- taxanes are used to treat breast cancer
- has a lot of side effects

Drug treatment
- Tamoxifen
  -- blocks ER
  -- is the gold standard of hormone therapy for breast cancer treatment
  -- is marketed as Nolvadex
  -- is an antiestrogen drug pill; it blocks estrogen
  -- has been used for more than 30 years (since 1984)
  -- is used to treat advanced breast cancer (metastatic or stage IV)
  -- is used to treat early breast cancer (stage I and II) after surgery in high risk patients
  -- is used to treat locally advanced cancer (stage III) after surgery in high risk patients
  -- is used in premenopausal and postmenopausal women with breast cancer
  -- is used to treat males with breast cancer
- Aromatase inhibitors
  -- eg Arimidex, Femara
  -- stop estrogen production in post-menopausal women
  -- stop the enzyme that catalyses aromatization of hormones
  -- stop the aromatization of androgens to estrogens
  -- stop the growth of breast cancer
- Herceptin
   -- reduces occurrence of HER2-positive breast cancers
   -- is given after surgical treatment, along with adjuvant chemotherapy in metastatic breast cancer
   -- has less side effects compared to chemotherapy (no nausea or hair loss)
   -- poses risk of heart and lung damage
   -- scientists are still working out how long patients should take Herceptin
- Tykerb is given for metastatic cancer if Herceptin fails
- Kadcyla is given after Herceptin and taxanes
- Perjeta (i.v.) is for late stage HER2-positive breast cancer
- Perjeta when given combined with Herceptin extends life

Endocrine therapy
- is also known as hormone therapy, hormonal therapy or hormone treatment
- is used in diabetes, menopause, and breast cancer treatment
- comes last, after surgical treatment, chemotherapy, and radiation treatment are completed
- adds, blocks or removes hormones
- is used to curb the growth of breast cancer, stop their spread, and recurrence
- blocks estrogen receptors and effects of estrogen, prevents recurrence of breast cancer
- is used to top up hormones in diabetes and menopause (low hormone levels)
- is used to block the body's natural hormones from reaching cancer cells in the body
- is used to slow down or stop cancer growth in prostate cancer and breast cancer
- side effects include infertility, blood clots, stroke, etc

Breast cancer biomarker status (ER/PR/HER2)

1. 75% of breast cancers are ER-positive. These cancers grow with more estrogen. Estrogen comes from food sources (estrogenic foods) - soybean milk (air soya, susu kacang soya), ubi keledek.
2. 65% of ER-positives are also PR-positive. These cancers grow with more progesterone.
3. 60% of breast cancers which are ER/PR-positive will respond to endocrine therapy.
4. 20%-25% breast cancers are HER2/neu positive. These are aggressive breast cancers and they grow very fast.

External links
http://pathology.jhu.edu/breast/biomarker-testing.php
http://www.webmd.com/breast-cancer/breast-cancer-types-er-positive-her2-positive
http://www.webmd.com/breast-cancer/breast-cancer-hormone-therapy-directory

Hospital Shah Alam

Address:

No 2 Persiaran Kayangan

Seksyen 7 

40400 Shah Alam

Selangor

Approval by Ministry of Health Malaysia: 2006

Expected date of completion: 2-3 years (2008-2009)

No. of beds: 300

Cost: RM300million

Ranking: 12th public hospital in Selangor

Specialist sections:

1. Paediatric 

2. Orthopaedic 

3. ENT (ear, nose and throat) 

4. Obstetrics and Gynaecology 

5. Physiology 

6. Anaesthesiology 

Acreage: 12 hectares

Coordinates:  3°4'18"N   101°29'23"E

Map (Jan-May 2014)
http://wikimapia.org/7115034/Hospital-Shah-Alam

Nearest landmarks
Police Station Section 7
Klinik Komuniti Seksyen 7 Shah Alam
I-City
UiTM Shah Alam entrance/exit main gate

Roads
Persiaran Kayangan meets with Persiaran Bestari and Persiaran Permai.

Reason for building this hospital
Relieve congestion at existing Hospital Tengku Ampuan Rahimah in Klang

In the news:
Public Hospital for Shah Alam (Thursday, 15 March 2007)  http://www.thestar.com.my/story.aspx/?file=%2f2007%2f3%2f15%2fnation%2f17146222&sec=nation

Hospital Putrajaya

Status
Teaching hospital

Website
http://www.hpj.gov.my/portalv11/index.php/en/

Facebook
https://www.facebook.com/HospitalPutrajaya

Clinical Research Centre (Clinical trials)
http://www.hpj.gov.my/portalv11/index.php/en/clinical-research-centre

Diabetes Resource Centre
http://www.hpj.gov.my/portalv11/index.php/en/diabetes-resource-centre

Cancer Care
http://www.hpj.gov.my/portalv11/index.php/en/penyayang-penyakit-kanser
http://www.penyayang.org.my/

Pharmacy SMS Take-n-go
http://www.hpj.gov.my/portalv11/index.php/en/pharmacy-sms-take-n-go

Pharmacy Home Delivery via Poslaju
http://www.hpj.gov.my/portalv11/index.php/en/ubat-melalui-pos-ump-1-malaysia

Hypertension worsens vision

.facebook.com/faridah.abdulrashid

External links
http://www.healthcentral.com/high-blood-pressure/c/question/619793/54291
http://www.highbloodpressuremed.com/4-ways-to-avoid-high-blood-pressure-in-menopausal-women.html
http://www.ehow.com/facts_5606362_blood-pressure_s-effect-eye-pressure.html
http://edition.cnn.com/HEALTH/library/high-blood-pressure/HI00062.html
http://www.glaucoma-association.com/other-eye-conditions/ocular-hypertension.html
http://www.nhlbi.nih.gov/hbp/hbp/effect/eyes.htm
http://ezinearticles.com/?How-Does-High-Blood-Pressure-Effect-Eyesight?&id=3949533

Glucose in Urine

Is glucose present in normal urine?

Normal urine contains no glucose because the kidneys are able to reclaim all of the filtered glucose back into the bloodstream.

What does glucose in urine mean?

'Glucose in urine' is glycosuria or glucosuria, and refers to the excretion of glucose into the urine.

What are the causes of glucose present in urine?

Glycosuria can be due to:
1. Diabetes mellitus (most common)
2. Intrinsic problem with glucose reabsorption in kidneys (rare)

Glycosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus. Excess glucose in the blood spills over and exits in urine.

Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys themselves, a condition termed renal glycosuria.

What causes osmotic diuresis?

Glucose is an osmotic molecule - it attracts water. Glycosuria leads to excessive water loss into the urine with resultant dehydration, a process called osmotic diuresis.

Explain the filtration of glucose in the kidney.

Blood is filtered by millions of nephrons, the functional units that comprise the kidneys. In each nephron, blood flows from the arteriole into the glomerulus, a tuft of leaky capillaries. The Bowman's capsule surrounds each glomerulus, and collects the filtrate that the glomerulus forms.

The filtrate contains waste products (e.g. urea), electrolytes (e.g. sodium, potassium, chloride), amino acids, and glucose.

Explain the reabsorption of glucose in the kidney.

The filtrate passes into the renal tubules of the kidney. In the first part of the renal tubule, the proximal tubule, glucose is reabsorbed from the filtrate, across the tubular epithelium and into the bloodstream.

The proximal tubule can only reabsorb a limited amount of glucose. When the blood glucose level exceeds about 8.9-10.0 mmol/L (160 – 180 mg/dL), the proximal tubule becomes overwhelmed and begins to excrete glucose in the urine.

What happens when blood glucose exceeds the renal threshold for glucose?

Glucose will be excreted into urine; glucose appears in urine; glucose can be detected in urine.

What is the renal threshold of glucose?

The point at which high glucose exceeds the renal threshold of glucose (RTG) causes it to overflow into urine.

The average renal threshold of glucose is 8.9-10.0 mmol/L (160-180 mg/dL).

It varies in individuals and in different physiological states; it is lowered in pregnancy and in children.

What is the renal threshold for glucose in children and pregnant women?

Children and pregnant women, may have a low RTG (less than ~7 mmol/L or 126 mg/dL glucose in blood to have glucosuria).

What are the other conditions where glucosuria may occur?

Glucosuria can occur temporarily from:

1. emotional stress or pain, 
2. hyperthyroidism, 
3. alimentary hyperglycemia, and 
4. meningitis.

What is renal glycosuria?

If the RTG is so low that even normal blood glucose levels produce the condition, it is referred to as renal glycosuria.

What is the urine dipstick test?

The urine dipstick test is a convenient urine test where a reagent test strip is used and dipped in freshly voided urine for the detection of pH, specific gravity (S.G.), protein, ketone, glucose, hemoglobin, red blood cells (rbc), white blood cells (wbc), and others.

Different dipsticks test for different things or combinations in urine.

The urine dipstick test is often used for OSCEs, a type of practical examination format that is used in medical schools.

What is the relationship between glucose detected by dipstick and blood/plasma glucose levels?

External links:
http://wiki.answers.com/Q/How_do_you_lower_blood_glucose#slide=4
http://www.elmhurst.edu/~chm/vchembook/624diabetes.html
http://en.wikipedia.org/wiki/Glycosuria

Blood Glucose: Fasting vs. Random

Synonyms:
Random Blood Glucose (RBG)
Random Blood Sugar (RBS)
Random glucose
Random sugar
Blood sugar
Blood glucose


Introduction

A blood glucose test measures the amount of a type of sugar, called glucose, in your blood.

The random glucose test is blood glucose level determined on a non fasting sample, taken randomly from a non fasting subject. This test is also called random blood glucose (RBG).

It assumes a recent meal and therefore has higher reference values than the fasting glucose test. The fasting glucose test is called fasting blood glucose (FBG) or fasting plasma glucose (FPG) since plasma is usually used for the determination of glucose, whether random or fasting.

Regulation of blood glucose

Glucose comes from carbohydrate foods (eg rice, pasta, bread, roti canai, mee goreng, pisang goreng, ubi, karipap, nasi lemak, etc). It is the main source of energy used by the body, and lasts 4 hours after normal food intake.

Glucose levels in the blood is controlled by insulin. Insulin is a hormone that helps the body's cells use the glucose found in the blood. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises, for example, after you have eaten (postprandial).

Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high (hyperglycaemia). Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. These are referred to as complications of hyperglycemia, which occurs in long-standing diabetes or chronic diabetes.

Types of glucose determinations

There are several different types of blood glucose tests or glucose determinations. There are reasons why some tests are chosen over others. Some tests require fasting blood samples, while others do not and patients do not need to fast (as for random blood glucose).

1. Fasting blood sugar (FBS)
2. 2-hour postprandial (2HPP) blood sugar
3. Random blood sugar (RBS)
4. Oral glucose tolerance test (OGTT)
5. Glycohemoglobin A1c (HbA1c, A1c, A1C)

Why is blood glucose determined?

Blood glucose tests are done to:

1. Check for pre-diabetes and diabetes.
2. Monitor treatment of diabetes.
3. Check for diabetes that occurs during pregnancy (gestational diabetes).
4. Determine if an abnormally low blood sugar level (hypoglycemia) is present. A test to measure blood levels of insulin and a protein called C-peptide may be done along with a blood glucose test to determine the cause of hypoglycemia. To learn more, see the topic C-Peptide.

What is fasting blood glucose?

Fasting blood sugar (FBS) measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for pre-diabetes and diabetes.

What is 2HPP?

2-hour postprandial blood sugar measures blood glucose exactly 2 hours after you start eating a meal. This is not a test used to diagnose diabetes. It is part of a modified OGTT (see OGTT).

What are Normal Blood Glucose Levels?

The amount of glucose in your blood changes throughout the day and night. Your levels will change depending upon when, what and how much you have eaten, and whether or not you have exercised.

Normal Blood Sugars

A normal fasting (no food for eight hours) blood sugar level is between 70 and 99 mg/dL.
A normal blood sugar level two hours after eating is less than 140 mg/dL.

Reference values

The reference values for a "normal" random glucose test in an average adult are 79 - 140 mg/dl (4.4 - 7.8 mmol/L), between 140 - 200 mg/dl is considered pre-diabetes, and > 200 mg/dl is considered diabetes according to ADA guidelines (patients should visit the doctor or a clinic for additional tests. However, a random glucose of > 200 mg/dl does not necessarily mean patients are diabetic).

Conversion units for glucose

http://www.soc-bdr.org/conversion_glucose_mg_dl_to_mmol_l/index_en.html

What is hypoglycemia?

Hypoglycemia is low levels of glucose in blood.

A test to measure blood levels of insulin and a protein called C-peptide may be done along with a blood glucose test to determine the cause of hypoglycemia.

What to do when your blood glucose is too low.

You can eat 3 dried dates and drink some water to bring up your blood glucose levels. You can also drink glucose solution.

What is random blood glucose?

This test is also called a casual blood glucose test, but this term is hardly used.

Random blood sugar (RBS) measures blood glucose regardless of when you last ate.

Blood sample is taken randomly (untimed) from a non fasting patient. The patient does not have to fast when coming to the clinic or hospital.

Since blood glucose levels fluctuates throughout the day, several random measurements may be taken throughout the day.

Random testing is useful because glucose levels in healthy people do not vary widely throughout the day.

Blood glucose levels that vary widely may mean a problem.

What is pre-diabetes?

Pre-diabetes is a condition before full-fledged diabetes occurs. It is a temporary and transient period. It is a reversible condition and diabetes will disappear.

Patients who are diagnosed with pre-diabetes are at high risk of developing diabetes. You can prevent or delay diabetes by increasing physical activity, eating healthy foods, and maintaining or losing weight or obtaining normal weight.

What is impaired fasting glucose?

In pre-diabetes, patients have impaired fasting glucose levels. This means the cells in the body have become resistant and the cells can no longer take up glucose (glucose uptake becomes nil).

Pre-diabetes is also called impaired fasting glucose (IFG).

If left untreated IFG patients progress to become diabetic. At IFG stage, things are reversible. Pre-diabetes is reversible. Diabetes has no cure but it can be controlled.

How is pre-diabetes diagnosed?

Pre-diabetes is diagnosed by any one of the following:

1. A fasting blood glucose in between 100-125 mg/dL
2. An A1c between 5.7 - 6.4 percent
3. Any glucose value between 140 mg/dL and 199 mg/dL during a two-hour 75g oral glucose tolerance test. [The US uses 75g glucose load. We use 100g glucose load in Malaysia.]

What is an OGTT?

An oral glucose tolerance test (OGTT) is a series of blood glucose measurements taken after you drink a sweet liquid that contains glucose (eg 100g glucose mixed in a glass of water).

The OGTT is used to diagnose pre-diabetes and diabetes.

When is OGTT performed?

1. The OGTT is commonly used to diagnose diabetes that occurs during pregnancy (gestational diabetes or gestational diabetes mellitus, GDM). This test is not commonly used to diagnose diabetes in a person who is not pregnant. 
2. OGTT is also conducted with a hormone test (eg growth hormone, GH) in patients who have abnormally large features (gigantism, acromegaly). In acromegaly, OGTT is abnormal and glucose does not suppress the growth hormone levels.

What is a modified OGTT?

A modified OGTT is shorter and easier for doctors to do for their patients. 

A modified OGTT has only 2 values - before glucose intake and 2 hours after glucose intake (2HPP).

A 2HPP is part of a modified OGTT. 

How do you use glucose readings to diagnose diabetes?

Diabetes is diagnosed by ANY ONE of the following:

1. Two consecutive fasting blood glucose tests that are equal to or greater than 126 mg/dL
2. Any random blood glucose that is greater than 200 mg/dL
3. An A1c test that is equal to or greater than 6.5 percent. 
4. A two-hour oral glucose tolerance test with any value over 200 mg/dL
5. Sometimes you may have symptoms of fatigue, excessive urination or thirst, or unplanned weight loss. However, often people have no symptoms of high blood glucose and find a diabetes diagnosis surprising.

What is the criteria for diagnosing diabetes?

Criteria for Diagnosing Diabetes

(American Diabetes Association's criteria)

To be diagnosed with diabetes, you must meet one of the following criteria:

1. Have symptoms of diabetes (increased thirst, increased urination, and unexplained weight loss) and a blood sugar level equal to or greater than 200 milligrams per deciliter (mg/dL). The blood sugar test is done at any time, without regard for when you last ate (random plasma glucose test or random blood sugar test).
2. Have a fasting blood sugar level that is equal to or greater than 126 mg/dL. A fasting blood sugar test (fasting plasma glucose) is done after not eating or drinking anything but water for 8 hours.
3. Have a 2-hour oral glucose tolerance test (OGTT) result that is equal to or greater than 200 mg/dL. An OGTT is most commonly done to check for diabetes that occurs with pregnancy (gestational diabetes).
4. Have a hemoglobin A1c (HbA1c) that is 6.5% or higher.
5. The diagnosis of diabetes needs to be confirmed by repeating the same blood sugar test or doing a different test on another day.

What is A1c?

A1c is an easy blood test that gives a three month average of blood sugars. It indicates the amount of glycosylation that has occurred in the past 3 months. It tells the doctor whether patients controlled their diet or otherwise.

Glycohemoglobin A1c measures how much sugar (glucose) is stuck to red blood cells. 

This test can be used to diagnose diabetes.  

HbA1C or just A1C is an abbreviation for glycosylated hemoglobin. The blood levels of HbA1C can identify average blood glucose levels for an individual over approximately 120 days, the life span of a red blood cell.

It also shows how well your diabetes has been controlled in the last 2 to 3 months and whether your diabetes medicine needs to be changed.

What is normal A1c?

If patients controlled their blood glucose levels, HbA1c is less than 7%.
If patients did not control their blood glucose levels, HbA1c is greater than 7%.

What is eAG?

The result of your A1c test can be used to estimate your average blood sugar level. This is called your estimated average glucose, or eAG.


External links:
http://www.webmd.com/diabetes/blood-glucose
https://www.virginiamason.org/WhatareNormalBloodGlucoseLevels
http://en.wikipedia.org/wiki/Random_glucose_test
http://diabetescenter.blogspot.com/2008/07/renal-threshold-for-glucose.html