World Diabetes Day 2017 Campaign : HbA1c

HbA1c

Glycated hemoglobin (HbA1c), also called A1C, is a test measuring of the amount of glucose attached to the hemoglobin (Hb) in red blood cells. The higher the glucose levels over the previous 2-3 months, the higher the A1C.

In Pantai Premier Pathology, our HbA1c is measured by a High Performance Liquid Chromatography (HPLC) method, which is a NGSP-certified method and Gold Standard in HbA1c testing. This HPLC method is traceable to DCCT reference, providing us the true HbA1c value but not a calculated HbA1c value. The results generated by this HPLC method are free from interference by haemoglobin variants, and not affected by HbC, HbS, HbE or HbD trait.

The American Diabetes Association (ADA) recommends using HbA1c to diagnose diabetes using a NGSP-certified method of a cutoff of HbA1c ≥6.5%. Point of Care (POC) assay methods are not recommended for diagnosis.¹

Using A1c as a Screening Test for Diabetes
Measurement of glycated haemoglobin levels revealed that A1c assay showed the least variance in normal subjects compared to plasma glucose levels. OGTT is the “gold standard” for diagnosing diabetes, it is known to be poorly reproducible and is cumbersome to perform. Using A1c level to diagnose diabetes is convenient since therapeutic decisions are also based on this value, regardless of the findings of the OGTT.²

Diagnostic Values for Pre-diabetes and Type 2 Diabetes Mellitus Based on A1c²:
Normal : <5.6% (38 mmol/mol)
Pre-diabetes: 5.6-6.2% (38-44 mmol/mol)
Diabetes: ≥6.3% (45 mmol/mol)

Recommendation
Screening for diabetes using fasting plasma glucose (FPG) or A1c should be performed annually in
those with risk factors and those >30 years.²

References:
1. ADA position statement on the United kingdom prospective Diabetes Study
2. MOH. (2015).Clinical Practice Guidelines on Management of Type 2 Diabetes Mellitus (5th ed.)

World Diabetes Day 2017 Campaign : Prediabetes

Malaysian Menopause Society Conference 2017 – “Clinical Update on Menopause”

Malaysian Menopause Society Conference 2017

“Clinical Update on Menopause”

 

Date: 25th & 26th March 2017

Venue: Hotel Pullman Kuala Lumpur Bangsar

 

Please download the booklet here.

A guide to understand your blood test report

A guide to understand your blood test report

Have you gone for a medical check-up before? If yes, do you understand what does the blood report tells you?

Basically, your test results will be interpreted together with your personal medical history. All these information are essential in diagnosing a disease or even to check for your health condition. Below are some of the most commonly requested blood test and the descriptions:

No. Blood test profile Description
1. Full Blood Count (FBC)

The test might include:

  • Total Red Blood cell
  • Total White Blood Cell
  • Differential Count
  • Haemoglobin
  • Haematological Indices (MCH, MCV, MCHC, PCV)
  • Platelet Count
FBC measures the amount of different types of blood cells. An FBC test alone cannot provide a definitive diagnosis of a condition but it helps to give important “clues” about possible problems. For example;

  • A low platelet count might be caused by a viral infection or an autoimmune condition where the immune system attacks healthy tissue.
  • A high platelet count might indicate inflammatory conditions, infection or a problem with the bone marrow.
2. Erythrocyte Sedimentation Rate (ESR) ESR is often used to aid diagnosis in conditions associated with inflammation such as arthritis, endocarditis, Crohn’s disease and etc.It is used together with some other tests to confirm presence of infection in your body.
3. Blood Glucose Monitoring your blood sugar level by regular blood glucose tests is very important especially for diabetic patients. If the blood glucose levels become too high, a range of serious complications may appear such as kidney related diseases or nerve damage.It is important for you not to eat for at least 10 hours before the test so that your blood sugar level would not increase during the test.
4. Lipid Profile

The test might include:

  • Total Cholesterol
  • HDL-Cholesterol
  • LDL-Cholesterol
  • Triglycerides
  • Cholesterol/HDL Ratio
This test is to provide a picture whether you are at risk of developing cardiovascular diseases (CVD) such as stroke or heart attack.High cholesterol level can effect on your health because it increases your risk of having heart attack, stroke or etc.

Same as blood glucose test, this test also requires fasting before blood sampling.

5. Thyroid Function testThe test involves:

  • Thyroid Stimulating Hormone (TSH)
  • Free T4 (FT4)
  • Free T3 (FT3)
Lower or higher-than-average levels of these hormones means that you have thyroid problems or at risk of developing one in the future.

  • A high TSH level with a low FT4 level: Hypothyroidism (under-active thyroid).
  • A low TSH level with a high FT4 level and a high FT3 level: Hyperthyroidism (over-active thyroid).
  • Abnormal TSH levels together with normal FT4 levels indicate you may be at risk of developing a thyroid disorder.
  • A low TSH levels together with a low FT4 levels can indicate a disorder of the pituitary gland

 

6. Liver Function TestThe test mainly includes:

  • Total Protein
  • Albumin
  • Globulin
  • A/G Ratio
  • Total Bilirubin
  • Alkaline Phosphatase
  • Alanine Transaminase (SGPT)
  • Aspartate Transaminase (SGOT)
  • Gamma-Glutamyl Transferase (GGT)

 

All these indicators are enzymes and proteins that will be elevated due to the damaged of the liver. This profile can help to diagnose certain liver conditions, including:

  • Hepatitis
  • Cirrhosis
  • Alcohol-related liver diseases
7. Renal ProfileThis test might include:

  • Urea
  • Creatinine
  • Glucose
  • Sodium
  • Potassium
  • Chloride
A renal profile is a diagnostic test that is designed to collect information about kidney function. Any abnormalities will be compared to your medical history.

The test profile here shows just a basic blood profile and might vary depending on the doctor’s request. The results need to be counter check with medical history and physical examinations in order to get a clearer picture of one’s health conditions.

(Source: www.nhs.uk, www.btf-thyroid.org, www.wisegeek.com)

Dr. Zaidi Zakaria

Head of Medical Services,

Pantai Hospital Ampang.

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How to lead a stress free life

“If you ask what the single most important key to longevity is, I would have to say it is avoiding worry, stress and tension. And if you didn’t ask me, I’d still have to say it.”

– George F. Burns-

What is stress?

Stress is a worried or nervous feeling that stops you relaxing, caused, for example, by pressure at work or financial or personal problems. Stress is a common problem that affects almost all of us at some point in our lives.  Stress is your body’s way of responding to any kind of demand. It can be caused by both good and bad experiences. When people feel stressed by something going on around them, their bodies react by releasing chemicals into the blood. These chemicals give people more energy and strength, which can be a good thing if their stress is caused by physical danger. But this can also be a bad thing, if their stress is in response to something emotional and there is no outlet for this extra energy and strength. This will discuss different causes of stress, how stress affects you, the difference between ‘good’ or ‘positive’ stress and ‘bad’ or ‘negative’ stress, and some common facts about how stress affects people today.

What Causes Stress?

Many different things can cause stress from physical (such as fear of something dangerous) to emotional (such as worry over your family or job.). Identifying what may be causing you stress is often the first step in learning how to better deal with your stress.

How Does Stress Affects You?

Stress can affect both your body and your mind. People under large amounts of stress can become tired, sick, and unable to concentrate or think clearly. Sometimes, they even suffer mental breakdowns.

Simple tips on reducing stress:

1. Let go of the need to feel in control.

A lot of our stress comes from feeling the need to be in control of events that are sometimes out of our control. Let go of the need to be in control all the time. This will take so much unnecessary stress out of your life.

2. Go for a walk.

If you feel you are stressed out, go for a walk out in nature. This will help clear your mind and reconnect with yourself.

3. Work on letting go of attachments to things.

For so many of us, stress is the result of having attachments to things. A lot of times these things are material objects, e.g., if you spill something on your new outfit, let it go! Is a trip to the dry cleaners really worth killing brain cells over?

4. Avoid getting into arguments.

Why get into an argument if it’s going to stress you out all day? Avoid getting in arguments if you can. This one tip will reduce so much unnecessary stress in your life.

5. Take a different route to work with less traffic.

Who cares if it takes a few minutes longer? For many of us traffic equals stress, so if adding a few extra minutes to your commute means less stress then find a new route to work!

6. Find humor in everything.

Charlie Chaplin said, “A day without laughter is a day wasted.” If you find yourself in a stressful situation, there is always a way to find some type of humor in it.

7. Cultivate a positive attitude.

A positive attitude will not only make you happier, but it also help you deal with stressful events.

If you change the way you look at things, the things you look at change.” – Wayne Dyer

8. Smile.

If you find yourself getting stressed out over something just smile! It will help you to change your perspective on the event, and become happier!

9. Listen to music.

Find some type of music you like that helps you relax. Just sit back, tune in, and relax!

10. Practice meditation.

Countless studies have shown meditation to be one of the greatest tools to combat stress. Find some time everyday to do just a minute of meditation. You’ll become happier, more focused, and you’ll also help prevent health future problems that are brought on by stress.

11. Just Breathe

Try to control your own heart beat when you are nervous and stressed. Breath as slow as you can. You can try this simple breathing exercise when you feel you are stressed:

    I.       5 seconds of inhale

 II.        3 seconds of holding your breath

III.       8 seconds of exhale

 

Cheong Kar Hui

Psychology Counselor

Pantai Hospital Ampang

(source : www.lifestressrelease.com, www.mindbodygreen.com)

War against Dengue

Malaysia is facing a dengue endemic with more than 48,000 people falling victim to the mosquito-borne disease this year alone. So far, there are at least 92 deaths urging the government to set up a national task force to tackle the problem.

What is Dengue Fever? 

Dengue is a viral infection transmitted by the bite of an infected female Aedes mosquito causes a severe flu-like illness. There are four distinct serotypes of the dengue virus (DEN 1, DEN 2, DEN 3 and DEN 4) that can cause dengue fever, all of which spread by a certain type of mosquito. In Malaysia, at present the serotype 2 has been more prevalent and virulent compared to the others and it can cause death. If you have suffered from dengue fever previously it is still possible to contract it again, because of the number of different types of viruses that can cause fever.

Once bitten it takes about four to ten days for the symptoms to show. The most common symptoms are high fever, severe headache, pain behind the eyes, nausea, vomiting, swollen glands, muscle and joint pain and in some cases a rash. The more severe forms of dengue are hemorrhagic fever and dengue shock syndrome. Here are a few simple and practical tips to keep dengue at bay:

  1. Removal of stagnant water is the best way to mosquito elimination. Items that collect rainwater or are used to store water should be covered or properly discarded.
  2. Get rid of sources or areas where mosquitoes breed, such as standing water in flower pots, tins, bottles or discarded tires. Mosquitoes breed easily in any source of standing water.
  3. Appropriate insecticides, such as larvicide’s can be added to water containers. The insecticides can prevent mosquitoes breeding for several weeks. However, they must be re-applied as per directions.
  4. Always clean and check drains to ensure they are not blocked especially during the rainy season.
  5. Top up uneven surfaces of the floor to prevent water from accumulating.

Dengue is a completely preventable, all you have to do is to take a few steps to keep yourself and your family safe.

(Souces: http://www.channelnewsasia.com, http://malaysia.kurnia.com, http://www.medicalnewstoday.com)

 

Liver Cancer

Liver Cancer: Because Each of Us Has Only One Liver

Liver Cancer is a cancer that form and originate on the surface or inside the liver. Liver is one of the most important components in the body that involved in blood filtration, converting nutrients and drugs absorbed from the digestive tract into ready-to-use chemicals. It performs regulation, synthesis and secretion of glucose, proteins and bile salts that contains cholesterol, phospholipids and bilirubin.

According to the latest WHO data published in April 2011 Liver Cancer deaths in Malaysia reached 1,154 cases or 1.13% of total deaths. As the largest solid organ in the human body, the liver basically an organ that does not complain very much until it is very, very late. Because of that, patients with liver cancer often see their doctors in late stages of the disease, where treatment options are limited.

The main cause of Liver Cancer is due to chronic Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infection. However, chemicals that cause cancer namely a carcinogen and high alcohol consumption will also contribute to Liver Cancer. Smoking, obesity and diabetes can give raise to the risk of developing Liver Cancer.

Worldwide, Liver Cancer affects more men than women at a ratio of 3:1. The symptoms are non-specific and can be caused by many health problems other than Liver Cancer. Plus, many people do not experience signs or symptoms in the early stage. As the cancer progress, some may or may not notice some of these symptoms:

  • Weight loss
  • An ongoing lack of appetite
  • Feeling very full even after a small meal
  • A hard lump on the right side just below the rib cage
  • Pain around the right shoulder blade
  • Yellow-green colour to the skin and eyes (jaundice)
  • Discomfort or pain in the upper abdomen on the right side
  • Unusual tiredness
  • Nausea

Blood screening which include the liver function test and tumour markers can detect the abnormalities of your liver. If the blood test shows abnormal results, further investigation is needed including ultrasounds, MRI, CT Scans or biopsies to determine the presence of tumour. If the cancer is diagnosed too late, the cancerous cell might spread to a large area of the liver, or develop at multiple sites. It also can grow too close to an important artery causing narrowing the lumen of the blood vessel.

Thus, prevention is vital important. The best way to prevent Liver Cancer is to get vaccinated. If you are already infected by HBV or HCV, then the best way is to get your liver monitored regularly. At the same time, reducing all other risk factors including smoking, alcohol intake, diabetes and obesity can reduce your chances of developing liver cancer.

Pantai Premier Pathology –  In support of Love Your Liver Campaign

(Source: Malaysia Liver Foundation, Malaysian Oncological Society, the Star Online and World Life Expectancy)