5 Steps to Controlling Your Asthma

What happens during an asthma attack?

People with asthma have acute episodes when the air passages
in their lungs become more narrow, and breathing becomes
more difficult. These problems are caused by an
oversensitivity of the lungs and airways.

Lungs and airways overreact to certain triggers and become
inflamed and clogged. Breathing becomes harder and may hurt.
There may be coughing. There may be a wheezing or whistling
sound, which is typical of asthma.

Controlling Your Asthma

You can help get your asthma under control and keep it under
control if you do these 5 simple steps: 


1) Talk openly with your doctor.

Tell your doctor what you want to be able to do that you
can't do now because of your asthma. Additionally, tell your
doctor your concerns about your asthma, your medicines, and
your health.

It's also important to talk to your doctor about ALL the
medicines you take--for asthma and for other problems--to be
sure they will not interact violently. Be sure to mention
eye drops, aspirin, and other medicines you take without a
prescription. 



2) Ask your doctor for a written treatment plan. Then be
sure to follow it!

A written treatment plan will tell you when to take each of
your asthma medicines and how much to take. If you have
trouble reading small print, ask for your treatment plan
(and other handouts) in larger type.

3) Watch for early symptoms and respond quickly!

Most asthma attacks start slowly. You can learn to recognize
when an attack is coming if you keep track of the symptoms
you have, how bad they are, and when you have them.

Your doctor also may want you to use a "peak flow meter,"
which is a small plastic device that you blow in, to
measures how well you are breathing.

If you respond quickly to the first signs that your asthma
is getting worse, you can prevent serious asthma attacks.

4) Stay away from things that make your asthma worse.
Tobacco smoke, dust and viruses can make asthma worse. So
can other things you may breathe in, such as pollen. Talk to
your doctor about what makes your asthma worse and what to
do about them. Ask about getting a flu shot and a vaccine to
prevent pneumonia and other respratory illnesses.

5) See your doctor at least every 6 months.

You may need to go more often, especially if your asthma is
not under control. Regular visits will let your doctor
check your progress and, if needed, change your treatment
plan.

The bottom line is action. You can sit back just waiting
for your asthma to get better, and continue to suffer
needlessly...or...you can take action as listed above

Once you do, you will be on the way to getting your asthma
under control, and taking back your life!

English - Writting

         Nowadays, there are many students having problem in deciding which universities they want to apply to. In order to solve this problem, student should consider the course offered by the universities, facilities provided and fees that will be charged during the study period.
The course offered by the current universities are sometimes not relevant to the future jobs that will be offered to the graduates. Some universities only acquire students that get credit in all basic subject in their SPM examination. And to get the choosen course, they must fulfill all the term and condition in the selected course. For some students, they realy hoping to get the course, but their SPM result not so good. So they didn’t get the course they want to. This problem can cause demoralization to the students to choose for their enthusiasm in the subject and course.
          The other factors on the facilities aspect include transportation, residence or hostel, library, information and technology sources (IT cafe), cafeteria, sports ground and many more. For transportation and hostel, the location should be more stategic and near to the class and for outskirts, transportation should be provide for students to go out during break or those who want to return to their hometown. Library is the main sources for study and very important for the students to get and find information for their study. If there’s no library, the students for sure will have a difficulty in their study because they didn’t have any sources to guide them with their learning. While internet sources such as IT cafe give an additional element in their study. For fees, students should aware of the price they charged. Ask and seek for the confirmation of the fees and make a clear understanding before accept for the proposal.
        In conclusion for this problem, students should be more prepared before applying for universities they choose and be more alert for all the aspects involving the factors that they should consider before applying any course in the universities.

Diarrhea

What is diarrhea?

Diarrhea is loose, watery stools. A person with diarrhea typically passes stool more than three times a day. People with diarrhea may pass more than a quart of stool a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own without special treatment. Prolonged diarrhea persisting for more than 2 days may be a sign of a more serious problem and poses the risk of dehydration. Chronic diarrhea may be a feature of a chronic disease.

Diarrhea can cause dehydration, which means the body lacks enough fluid to function properly. Dehydration is particularly dangerous in children and older people, and it must be treated promptly to avoid serious health problems.
People of all ages can get diarrhea and the average adult has a bout of acute diarrhea about four times a year. In the United States, each child will have had seven to 15 episodes of diarrhea by age 5.

What causes diarrhea?

Acute diarrhea is usually related to a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to functional disorders such as irritable bowel syndrome or inflammatory bowel disease.
A few of the more common causes of diarrhea include the following:

• Bacterial infections. Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits include Campylobacter, Salmonella, Shigella, and Escherichia coli (E. coli).
• Viral infections. Many viruses cause diarrhea, including rotavirus, Norwalk virus, cytomegalovirus, herpes simplex virus, and viral hepatitis.
• Food intolerances. Some people are unable to digest food components such as artificial sweeteners and lactose—the sugar found in milk.
• Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium.
• Reaction to medicines. Antibiotics, blood pressure medications, cancer drugs, and antacids containing magnesium can all cause diarrhea.
• Intestinal diseases. Inflammatory bowel disease, colitis, Crohn’s disease, and celiac disease often lead to diarrhea.
• Functional bowel disorders. Diarrhea can be a symptom of irritable bowel syndrome.

Some people develop diarrhea after stomach surgery or removal of the gallbladder. The reason may be a change in how quickly food moves through the digestive system after stomach surgery or an increase in bile in the colon after gallbladder surgery.
People who visit foreign countries are at risk for traveler’s diarrhea, which is caused by eating food or drinking water contaminated with bacteria, viruses, or parasites. Traveler’s diarrhea can be a problem for people visiting developing countries. Visitors to the United States, Canada, most European countries, Japan, Australia, and New Zealand do not face much risk for traveler’s diarrhea.

In many cases, the cause of diarrhea cannot be found. As long as diarrhea goes away on its own, an extensive search for the cause is not usually necessary.

What are the symptoms of diarrhea?

Diarrhea may be accompanied by cramping, abdominal pain, bloating, nausea, or an urgent need to use the bathroom. Depending on the cause, a person may have a fever or bloody stools.

Diarrhea in Children

Children can have acute and chronic forms of diarrhea. Causes include bacteria, viruses, parasites, medications, functional bowel disorders, and food sensitivities. Infection with the rotavirus is the most common cause of acute childhood diarrhea. Rotavirus diarrhea usually resolves in 3 to 9 days. Children who are 6 to 32 weeks old can be vaccinated against the virus with a vaccine called Rotateq.
If your child has diarrhea, do not hesitate to call the doctor for advice. Diarrhea is especially dangerous in newborns and infants, leading to dehydration in just a day or two. A child can die from dehydration within a few days. The main treatment for diarrhea in children is rehydration to replace lost fluid quickly.
Take your child to the doctor if there is no improvement after 24 hours or if any of the following symptoms appear:

• stools containing blood or pus
• black stools
• a temperature above 102 degrees
• signs of dehydration

Medications to treat diarrhea in adults can be dangerous for children and should only be given with a doctor’s guidance.

Dehydration

Diarrhea can cause dehydration, which means the body has lost too much fluid and too many electrolytes and can’t function properly. Dehydration is particularly dangerous in children and in older adults and must be treated promptly to avoid serious health problems.
Signs of dehydration include

• thirst
• less frequent urination
• dry skin
• fatigue
• light-headedness
• dark-colored urine

Signs of dehydration in children include

• dry mouth and tongue
• no tears when crying
• no wet diapers for 3 hours or more
• sunken abdomen, eyes, or cheeks
• high fever
• listlessness or irritability
• skin that does not flatten when pinched and released

If you suspect that you or your child is dehydrated, call the doctor immediately. Severe dehydration may require hospitalization.

Preventing Dehydration

The fluid and electrolytes lost during diarrhea need to be replaced promptly because the body cannot function without them. Electrolytes are the salts and minerals that affect the amount of water in your body, muscle activity, and other important functions.
Although water is extremely important in preventing dehydration, it does not contain electrolytes. Broth and soups that contain sodium, and fruit juices, soft fruits, or vegetables that contain potassium, help restore electrolyte levels. Over-the-counter rehydration solutions such as Pedialyte, Ceralyte, and Infalyte are also good electrolyte sources and are especially recommended for use in children.

When should a doctor be consulted?

Diarrhea is not usually harmful, but it can become dangerous or signal a more serious problem. You should see the doctor if you experience any of the following:

• diarrhea for more than 3 days
• severe pain in the abdomen or rectum
• a fever of 102 degrees or higher
• blood in your stool or black, tarry stools
• signs of dehydration

How is the cause of diarrhea diagnosed?

Diagnostic tests to find the cause of diarrhea may include the following:

• Medical history and physical examination. The doctor will ask you about your eating habits and medication use and will examine you for signs of illness.
• Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection.
• Blood tests. Blood tests can be helpful in ruling out certain diseases.
• Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask you to avoid lactose, carbohydrates, wheat, or other foods to see whether the diarrhea responds to a change in diet.
• Sigmoidoscopy. For this test, the doctor uses a special instrument to look at the inside of the rectum and lower part of the colon.
• Colonoscopy. This test is similar to a sigmoidoscopy, but it allows the doctor to view the entire colon.
• Imaging tests. These tests can rule out structural abnormalities as the cause of diarrhea.

How is diarrhea treated?

In most cases of diarrhea, replacing lost fluid to prevent dehydration is the only treatment necessary. Medicines that stop diarrhea may be helpful, but they are not recommended for people whose diarrhea is caused by a bacterial infection or parasite. If you stop the diarrhea before having purged the bacteria or parasite, you will trap the organism in the intestines and prolong the problem. Rather, doctors usually prescribe antibiotics as a first-line treatment. Viral infections are either treated with medication or left to run their course, depending on the severity and type of virus.

Tips About Food

Until diarrhea subsides, try to avoid caffeine, milk products, and foods that are greasy, high in fiber, or very sweet. These foods tend to aggravate diarrhea.
As you improve, you can add soft, bland foods to your diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the pediatrician may also recommend a bland diet. Once the diarrhea has stopped, the pediatrician will likely encourage children to return to a normal and healthy diet if it can be tolerated.

Preventing Traveler’s Diarrhea

Traveler’s diarrhea happens when you consume food or water contaminated with bacteria, viruses, or parasites. You can take the following precautions to prevent traveler’s diarrhea when you travel outside of the United States:

• Do not drink tap water or use it to brush your teeth.
• Do not drink unpasteurized milk or dairy products.
• Do not use ice made from tap water.
• Avoid all raw fruits and vegetables, including lettuce and fruit salads, unless they can be peeled and you peel them yourself.
• Do not eat raw or rare meat and fish.
• Do not eat meat or shellfish that is not hot when served.
• Do not eat food from street vendors.

You can safely drink bottled water—if you are the one to break the seal—along with carbonated soft drinks, and hot drinks such as coffee or tea.
Depending on where you are going and how long you will stay, your doctor may recommend that you take antibiotics before leaving to protect you from possible infection.
 

Hope through Research

The Division of Digestive Diseases and Nutrition at the National Institute of Diabetes and Digestive and Kidney Diseases supports basic and clinical research into gastrointestinal conditions, including diarrhea. Among other areas, researchers are studying how the processes of absorption and secretion in the digestive tract affect the content and consistency of stool, the relationship between diarrhea and Helicobactor pylori, motility in chronic diarrhea, and chemical compounds that may be useful in treating diarrhea.

Points to Remember

• Diarrhea is a common problem that usually resolves on its own.
• Diarrhea is dangerous if a person becomes dehydrated.
• Causes include viral, bacterial, parasitic infections, food intolerance, reactions to medicine, intestinal diseases, and functional bowel disorders.
• Treatment involves replacing lost fluid and electrolytes. Depending on the cause of the problem, a person might also need medication to stop the diarrhea or treat an infection. Children may need an oral rehydration solution to replace lost fluid and electrolytes.
• Call the doctor if the person with diarrhea has severe pain in the abdomen or rectum, a fever of 102 degrees or higher, blood in the stool, signs of dehydration, or diarrhea for more than 3 days.

DEMENTIA

Definition..

Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.

Alternative Names..

Chronic brain syndrome; Lewy body dementia; DLB; Vascular dementia; Mild cognitive impairment; MCI

Causes, Incidence, And Risk Factors...

Most types of dementia are nonreversible (degenerative). Nonreversible means the changes in the brain that are causing the dementia cannot be stopped or turned back. Alzheimer's disease is the most common type of dementia.
Lewy body disease is a leading cause of dementia in elderly adults. People with this condition have abnormal protein structures in certain areas of the brain.
Dementia also can be due to many small strokes. This is called vascular dementia.
The following medical conditions also can lead to dementia:

• Parkinson's disease
• Multiple sclerosis
• Huntington's disease
• Pick's disease
• Progressive supranuclear palsy
• Infections that can affect the brain, such as HIV/AIDS and Lyme disease

Some causes of dementia may be stopped or reversed if they are found soon enough, including:

• Brain tumors
• Changes in blood sugar, sodium, and calcium levels (see: Dementia due to metabolic causes)
• Low vitamin B12 levels
• Normal pressure hydrocephalus
• Use of certain medications, including cimetadine and some cholesterol-lowering medications
• Chronic alcohol abuse

Dementia usually occurs in older age. It is rare in people under age 60. The risk for dementia increases as a person gets older.

Symptoms...

Dementia symptoms include difficulty with many areas of mental function, including:

• Language
• Memory
• Perception
• Emotional behavior or personality
• Cognitive skills (such as calculation, abstract thinking, or judgment)

Common Eye Disorders

Anatomy of eye

This guide was created to help you learn the type of eye disorder you may have and what should be done about it. But these guidelines are only an overview and definitely should not replace a consultation with your own eye doctor.
Typically, common eye disorders can be broken down into major eye symptoms, making it easier to sort them out and come up with specific guidelines. Major categories include:

• Redness
• Itching
• Swelling
• Burning
• Trauma
• Pain
• Blur (decrease in vision)
• Spots, flashes and floaters

What if Your Eyes Are Red and Irritated?

Eyes can turn red for many reasons, including infection, inflammation, allergy, broken blood vessels and trauma. If the white of your eye (sclera) looks red or pink, you might have one of the following conditions:

Pink eye

•   If you have kids, you almost certainly know about an eye infection known as pink eye. Adults can get it, too. If the redness is from a form of pink eye known as conjunctivitis, you will also have other symptoms such as itching, burning or stinging, discharge, swelling, watering — or a combination of the above. Some forms of pinkeye are contagious, and some are not. Allergic conjunctivitis, for example, is not contagious. But viral and bacterial forms of pink eyes are contagious. So it's best to see your eye doctor or family doctor for diagnosis and possible treatment.
  
  
  • Quick Tip: Until you know more about what may be causing your problem, you should avoid rubbing your eyes. Make sure you wash your hands often. For relief, use cool, wet compresses on the outside of your closed eyelids. 

Eye Allergies

• Allergies can be seasonal (spring and fall), or they can happen when something irritating (allergen) invades your eyes, like cat dander or fumes. You may have an eye allergy if your eyes rapidly become red, watery and puffy. How your eyes are affected may depend on the time of year and type of plants you have in the area where you live. We Minnesotans tend to have lots of seasonal allergy problems in the spring and fall. But many people can also have year-round allergies because of dust mites, molds, etc.
  
  
  • Quick Tip: Try cold, wet compresses on the outside of your closed eyelids. You may also find relief if you take an over-the-counter antihistamine orally. If the allergy continues to annoy you, you may need to see your eye doctor for a prescription to help you deal with symptoms.

 Broken Blood Vessel (subconjunctival hemorrhage)

• Tiny blood vessels in the white of the eye can break from straining, lifting, rubbing or for no reason at all. Called subconjunctival hemorrhages, they are usually harmless and ordinarily aren't considered an emergency.   

•    Quick Tip: To be on the safe side, you should see your eye doctor within a day or two after noticing symptoms to make sure there's no underlying cause for the broken vessel. Otherwise, there really is no treatment other than time for most of these blood leaks. But  always tell  patients to make up a really good story, because everyone will ask them what happened! 

Eye Trauma

•   Getting hit in the eye can certainly cause redness, along with pain and blurred vision. The eye may be scratched or gouged, but there also could be hidden damage inside the eye, such as a detached retina, that can be very serious and must be treated. Unless the hit is very light, an eye doctor should treat eye traumas right away.

• Quick Tip: For some immediate relief, put a very cold compress or ice pack on the injured eye. Avoid rubbing it. If you can't reach your eye doctor, go to an emergency room or urgent care center for help.

Itching and Itchy Eyes

• Almost all eye itching is caused by some sort of allergy. Very often, mild itching can be helped with over-the-counter lubricating eye drops. I'd avoid the ones that take away redness (decongestants), as they can be addictive. You can also use cold compresses or ice packs to help with itchy eyes.
• More severe itching may need extra help, such as oral antihistamines or prescription eye drops. Although itchy eyes are not an emergency, you still may need to consult your eye doctor for advice or a prescription.
• If your eyelids are red and inflamed, you could have blepharitis. Make sure you visit your eye doctor to determine the cause and appropriate treatment.

 

• Quick Tip: Try to avoid rubbing your eyes! Rubbing releases chemicals called histamines that actually make the itching worse

Blurred Vision

• If you have blurred vision that happens suddenly and persists, consider this an emergency. See your eye doctor, or visit an emergency room/urgent care center.
• If one eye becomes blurry or goes dark suddenly, like a curtain coming down, this is an emergency and should be checked out by your eye doctor or an emergency room/urgent care center. This could indicate a retinal problem, like a detachment, or even a stroke.
• If you have some minor blurring that comes and goes, this could mean tiredness, dryness or eye strain. Keep in mind that many eye conditions can cause some vision blur, including pink eye, allergies, dry eyes and even a lot of near vision work. Most of these would not be emergency situations.

• Quick Tip: For mild blurry vision, try resting your eyes. If the blurry vision persists, make an appointment for an eye exam.

Puffy Eyes

• Unusual puffiness around the eyes often is a sign of an allergy. Of course, trauma such as getting hit in the eye also can cause eyes to swell. 

• Quick Tip: If swollen eyes are caused by an allergy, you may have to take an over-the-counter decongestant orally to alleviate symptoms.

Eye Burning

• Eye burning can be caused by allergy, dryness, tiredness, vision stress (like computer work) or a combination of the above. See your eye doctor if the burning persists, but this symptom is not usually an emergency.

 

• Quick Tip: Usually, burning can be helped with over-the-counter lubricating eye drops and rest. You can also use cool, moist compresses.

Eye Pain

• Eye pain can be sharp or dull, internal or external, constant or intermittent, stabbing or throbbing. As a general rule, if you have eye pain along with redness, you should consider this an emergency and either see your eye doctor or go to an emergency room or urgent care center right away.
• Constant eye pain, especially when moving your eyes or gently pushing on your eyes, can sometimes indicate an inflammation of some of the inner eye parts. This means you should try and see your eye doctor as soon as possible for diagnosis and treatment.
• I often help people with rheumatoid arthritis or fibromyalgia (chronic pain throughout the body) who are having related eye pain. Eye pain sometimes is caused by dry eyes, which needs to be treated with over-the-counter or prescription medication. Occasionally, eye pain is caused by something serious, like uveitis. This is an inflammation of the inner eye tissues, like the iris. Again, this type of condition should be treated as soon as possible.
• Eye pain with blurred vision should be considered an emergency and should be investigated as soon as possible by your eye doctor or by the emergency room/urgent care center.

 

• Quick Tip: If your eye pain is dull like a headache in your eye, but there is no redness or blurred vision, this could be caused by overuse, eye strain or even sinus problems. I suggest seeing your doctor only if it doesn't clear up with rest or perhaps some Tylenol or Advil.

Spots, Flashes and Floaters

• Many spots and floaters are normal. As you age and experience all of life's bumps and movements, bits and pieces of your retinas break loose and float in the inner liquid of the eyes (the vitreous). Most of these floaters are harmless ... just annoying. You tend to see them against a lighted background, sky or white wall.
• However, some flashes and floaters can let you know something is happening to your retina (the inner back tissue of the eyeball). You can have vitreous detachments and/or detached retinas, which must be diagnosed and treated.
• As a general rule, if you have a few little dots, threads or "bugs" that come and go depending on how tired you are or what kind of lighting you're in, these are normal floaters. But if you suddenly see flashes of light, clouds of floaters, swirly mists or a curtain over part of your vision, it's best to see your eye doctor or an emergency room/urgent care center. They'll dilate your pupils to see what's going on inside your eyes and make sure it gets treated if need be.
• Most retinal detachments can be helped if treated soon. If retinal detachments are ignored, however, they can lead to a loss of vision or even blindness.

 

• Quick Tip: Most vitreous detachments creating spots and floaters just need to be watched. But you have no way of knowing whether you have a vitreous detachment or a far more serious retinal detachment. So in either case, make sure you see a doctor.

Foreign Object (Something in the Eye)

• Getting something in your eye seems like it should be an emergency, and it often is. Whether your eye is invaded by a piece of metal, a thorn or sticker or a sharp object, it's critical that you see an eye doctor or an emergency room/urgent care center right away.
• Don't rub your eye or attempt to remove whatever is in there. You could cause more damage. Loosely tape a paper cup (or eye shield if you have one) over your eye and seek help.

 

• Quick Tip: Let's also be practical. Not everything that gets in your eye is serious. We all have little bits of something in our eyes at times. If you know it's just a piece of dust that's irritating your eye, you can try rinsing it with saline solution or using lubricating eye drops. If you are able, try turning your eyelid inside out to see if you can dislodge the particle. If none of these home remedies works, then it's off to the doctor.

WAY TO LOSE 2 POUNS OF FATS

2 of The Best Weight Loss Tips


Have a Salad or Soup For Dinner With At Least 20 Grams of Protein Added

For the purposes of this article, I’m just going to focus on dinner. I will just take for granted that you are doing the right things for breakfast and lunch. So, for dinner, all you need to do is make some homemade vegetable soup or a vegetable salad. You can even have both, if you like. Just make sure to add at least 20 grams of protein to the meal.

Some fine choices of protein include a can of black beans, salmon, lean meat, tuna, or chicken.

Just keep the thought in your head that it’s not a real meal until protein gets thrown into the mix.

Substitute Stevia in Water for Sodas, Coffees, and Diet Sodas

You need to give up the unhealthy drinks. By doing this, you can eliminate thousands of empty calories per month. And the best way to do that is by starting to drink water with a couple of Stevia packets added. If you need caffeine, you can add a caffeine pill to your water. This should help you get rid of the coffee.

You’ll get slimmer much quicker just by quitting the sodas and coffees.

So, if you want to lose 2 pounds fast, follow those 2 simple and easy weight loss tips.

Big Weight Loss – For Big Bellies

Looking for big weight loss? Well today’s your lucky day, because I’m going to show you how to make that happen – safely and effectively.

This little article will take you no more than a few minutes to read. But those few minutes could change your life.

Keep reading to learn how to get a firmer butt, flatter stomach, and sexier body.

Big Weight Loss – Now!

Eat a bowl of vegetable and lentil soup before two meals a day.

Make sure this soup is not from a can. Make it from scratch. I think you’ll find that one big batch will last for more than a few days, and it’s easy to make.

Lentils are full of fiber of protein. And also one of the best foods for weight loss you can eat. It costs next to nothing, too.

If you’re going to be eating lunch at work, pack the soup in a plastic container and bring it with you. Just do this.

If you commit to this for at least two weeks, I think you’ll like what you see when you jump on the scale and look in the mirror.

Snacks

Yogurts are great for protein and apples are packed with fiber. Just make sure the yogurt you eat contains eighty calories or less. Wal Mart sells their yogurt for less than 35 cents each. My personal favorite is strawberry banana, in case you were wondering.

During commercial breaks, jump on a mini-trampoline.

Almost anyone can do this exercise and it works every part of the body. That’s why it’s my favorite. If your legs and butt are riddled with cellulite, it’ll help that, too.

Try to do these short spurts of exercise for at least twenty minutes every day. That’s only about 7 commercial breaks a day for three minutes at a time.

You can do this.

Get all three of these things right, and you’ll notice some big weight loss.

Health Care Systems of Malaysia

Malaysia is fortunate to have a very comprehensive range of the health services. The Malaysian government is very much committed to its principles of a universal access to high-quality health care in which the local Ministry of Health offers thru wide varieties of nationwide networks of clinics and hospitals. However, in spite of the dedication of the local government of Malaysia to provide the best possible health care, there are still some problems that are unsolved, and one of those is the unavailability of quality health care centers in remove areas. When patients are transferred from a specific health center to a more probable hospital, doing so not only incurs some inconveniences on the part of the patient and the family, but also adds costs to the health care systems. In order to deal with the issue, a tool has been designed called the tele primary care. This method helps the doctors on remote areas to discuss problem cases by tele-consultations with specialists and doctors on hospitals.

The Malaysian government is continually striving to make the healthcare system better but there is still a dearth of medical expertise in the country and their high concentration in the urban areas. The current efforts in the past few years have certainly made developments for the health care system in Malaysia.
The Evolution of Healthcare in Malaysia

The health care in Malaysia has notably undergone some radical transformations. The earliest pre-colonial medical cares were confined mostly on those traditional remedies that are evident today on local Chinese, Malays, and some other ethnic group populations. However, with the birth of colonialism, more modern and westernized medical practices are then slowly introduced to this country. Since its independence way back August of 1957, the different systems of medical care were then transferred from British colonial rules to meet the growing needs of proper health care in Malaysia.



At present, Malaysia is divided into two sectors—the public sectors and the private sectors. Doctor are generally required to render three years of serving in public hospitals throughout the whole nation, making it a point to provide adequate coverage of the medical needs of the general population. Foreign doctors are also encouraged to share their expertise in Malaysia.



Over the years, Malaysia has been continuously vigilant about their health care system. For emigrants who are planning to stay in Malaysia, the health care system of this Asian Dragon is one thing to be worried about. The presence of so many medical schools in this nation is enough to attest that Malaysia is really serious with their aim in providing quality health care not only to its residents but to its tourists, emigrants, and visitors as well.

One of the flagship projects of the Malaysian government in the past decade has been medical tourism. This provides for affordable costs for procedures and accommodations for this particular market segment.



Some Medical Issues in Malaysia

Very common among Asian countries are over-prescription of some doctors who think of nothing but how to gain much money from their patients. This particular is actually very rampant not only in Malaysia, but also in some neighboring Asian countries. Although there are some reductions of over-prescription cases, the problem still remains up to this day. Emigrants are warned about these issues as there are possibilities that they might come across with this. Additionally, problems about selling fake drugs have been recorded, according to major pharmaceutical firms in Malaysia but these problems have long been solved. Again, everybody should be cautious about it because safety and health are very important things.



The medical society of Malaysia also recommends all travelers, tourists, emigrants, and the likes to visit their personal physicians or travel health clinics at least four to eight weeks prior to departure. Vaccinations on the following possible medical problems should be properly done:

Hepatitis- recommended for all the travelers

Typhoid- recommended for the travelers who may drink or eat outside major hotels and restaurants

Yellow Fever- required for every traveler that is more than a year old of age upon arrival. Not recommended otherwise

Japanese Encephalitis- for long term traveler on rural areas, or those who may possibly be engaged in unprotected and extensive outdoor activities on rural areas

Hepatitis B- for travelers who have direct contacts with local residents. This is very important especially if the visit is more than six months.

SEXUAL CHILD ABUSE

What is sexual child abuse?

 -  Sexual abuse is the third most frequently reported form of child mistreatment (10% of all cases). 

 -  Sexual abuse is that of a child involved in sexual activity for which consent cannot be given, is outside of the victim's developmental age, is unable to comprehend, and/or "violates the law or social taboos of society." Examples include fondling and any form of genital, anal, or oral-genital contact with a child that are unwarranted.

  - These acts may occur whether the child is clothed or unclothed. Non-touching child sexual abuse would include exhibitionism, voyeurism, and the involvement of a child in prostitution or pornography.

What causes child abuse deaths?

   -  Caused by accidents due to lack of supervision or abandonment or from the failure to seek medical attention for an injury, illness, or condition.

   -  Fatal injuries from mistreatment can and do result from many different acts. Children may die from severe head trauma (injury), shaken baby syndrome, trauma to the abdomen or chest, scalding, burns, drowning, suffocation, poisoning, starvation, etc

How is child abuse treated?

• The safety of the abused child and any other potential victim of abuse in the household is paramount. Removal of the victim and placement in protective custody in a group home or foster care is often necessary.
  
  
• Effective counseling for the child, family, and the abuser is essential to deal with the associated emotional and psychological stress and trauma.
  
  
• In the event of neglect, establishing realistic expectations of the child's needs and capabilities is required.
  
  
• Parental high-risk behaviors such as substance/alcohol abuse must be addressed.
  
  
• Law-enforcement evaluation is performed, followed by the filing of charges, court appearance, and (if found guilty) sentencing as indicated.
  
  
• Pedophiles (people who have sexually abused children) often require intense psychological and pharmacological therapy prior to release into the community because of the high rate of repeat offenders.

How can child abuse be prevented?

• A support-group structure is needed to reinforce parenting skills and closely monitor the child's well-being.
  
  
• Visiting home nurse or social-worker visits are also required to observe and evaluate the progress of the child and his/her caretaking situation.
  
  
• The support-group structure and visiting home nurse or social-worker visits are not mutually exclusive. Many studies have demonstrated that the two measures must be coupled together for the best possible outcome.
  
  
• Children's school programs regarding "good touch...bad touch" can provide children with a forum in which to role-play and learn to avoid potentially harmful scenarios.
  
  
• Parents should make sure that their child's daycare center is licensed and has an open-door policy regarding parental visitation.
  
  
• Public-awareness programs regarding child abuse and neglect can be informative.
  
  
• Developing free and anonymous support systems (for example, "hot lines") encourages the reporting of potential instances of child abuse.

What more can be done to prevent child neglect?

• proper use of car seats and seat belts;
  
  
• consistent use of helmets for bicycling, skateboarding, and skiing/snowboarding;
  
  
• pool and water safety;
  
  
• firearm safety;
  
  
• preventing community violence; and
  
  
• poisoning prevention.

HEALTH AND AGING PROCESS

The aging process is for the greater part no mystery anymore. It consists for a great part of daily damages done on the macroscopic, tissue, cellular and genetic levels. These add up as the years are passing. These damages have specific causes like oxidating agents, sun beams, mechanical wear and tear, psychological stress, lack of some nutritional components and too much of others, like fat.



Another component of aging is the reduction of the telomere chains at the chromosome ends, as each cell division occurs. However, the body has means to repair these ends again, with an enzyme called telomerase. The rapidity of the aging process depends on lack of efficiency in this repair process. The above mention aging causes also slow down this repair process.


The factors causing aging, also causes other diseases like cancer and coronary heart disease. Both aging and these diseases can in great extend be prevented with the knowledge possessed today, and the damages can in great extend be reversed. The components to achieve this are:

-Adequate dayly food containing whole cereals, peas, beans, vegetables, fruit, fish, mushroms, fouls and seafood, and with just a moderate amount of red meat.


-Just a moderate amount of fat and most of the fat supply comming from sources like olive, fish, nuts, sun-flower, etc. Then you will get a good balance between mono-unsaturated fat (olive), poly-unsaturated fat of the omaga-3-type (fish) and poly-unsaturated fat of the omega-6-type.



-Just a very moderate amount of butter, soya oil, corn oil and palm oil. A high consumption of these fat sources gives you too much saturated fat and poly-unsaturated omega-6-fat.


-Just a very moderate amount of sugar, refined flour or refined cereals.


-Supplements of specific nutritional components like vitamins, minerals, lecitin and some essential fatty acids.


-Adequate training, that both gives both a muscular load, work up your condition and stretches out your body. To stretch out, yoga-exercizes are ideal.


-Adequate rest and stress-reduction. Daily meditation is a method of achieving this. Natural relaxing agents or spesific tools for meditation or relaxation may also be useful.


-Supplements of specific anti-aging agents like anti-oxidants or human growth hormone.


-Use of spesific anti-aging agents to apply upon the skin surface.


-To protect the skin against excessive sun exposure.


The amount one needs of nutritional supplements, like vitamins and minerals, differs very much according to a person`s health condition, work load and exposure to environmental stress. A person having a poor digestion, doing high performance sport or being exposed to a high amount of environmental stressors, may need more than an person in an average situation.

TUBERCULOSIS ( TB )

What is tuberculosis?

     - Tuberculosis (TB) is an infectious disease caused by bacteria whose scientific name is    Mycobacterium tuberculosis

     -  TB most commonly affects the lungs but also can involve almost any organ of the body. 

     -   Many years ago, this disease was referred to as "consumption" because without effective treatment, these patients often would waste away. 

     -    Today, of course, tuberculosis usually can be treated successfully with antibiotics.

How does a person get TB?

      -  Person can become infected with tuberculosis bacteria when he or she inhales minute particles of infected sputum from the air. 

       -  The bacteria get into the air when someone who has a tuberculosis lung infection coughs, sneezes, shouts, or spits (which is common in some cultures).

       -  Tuberculosis is spread (transmitted) primarily from person to person by breathing infected air during close contact.

What happens to the body when a person gets TB?

        -  When the inhaled tuberculosis bacteria enter the lungs, they can multiply and cause a local lung infection (pneumonia).
        -   The local lymph nodes associated with the lungs may also become involved with the infection and usually become enlarged.
         -   The hilar lymph nodes (the lymph nodes adjacent to the heart in the central part of the chest) are often involved.

How common is TB, and who gets it?

Anyone can get TB, but certain people are at higher risk, including

• people who live with individuals who have an active TB infection,
  
  
• poor or homeless people,
  
  
• foreign-born people from countries that have a high prevalence of TB,
  
  
• nursing-home residents and prison inmates,
  
  
• alcoholics and intravenous drug users,
  
  
• people with diabetes, certain cancers, and HIV infection (the AIDS virus),
  
  
• health-care workers. 

Symptoms of tuberculosis?

      - The usual symptoms that occur with an active TB infection are a generalized tiredness or weakness, weight loss, fever, and night sweats.
      -  If the infection in the lung worsens, then further symptoms can include coughing, chest pain, coughing up of sputum (material from the lungs) and/or blood, and shortness of breath.
      -  If the infection spreads beyond the lungs, the symptoms will depend upon the organs involved.

How does a doctor diagnose tuberculosis?

       -  TB can be diagnosed in several different ways, including chest X-rays, analysis of sputum, and skin tests
       -  Several types of skin tests are used to screen for TB infection.
       -  These so-called tuberculin skin tests include the Tine test and the Mantoux test, also known as the PPD (purified protein derivative) test.

 

Obesity now a major health concern in Malaysia

BENTONG - Malaysians' penchant for skipping breakfast and eating late, especially at night, coupled with a sedentary lifestyle is ruining their figure and health.

Health Minister Datuk Seri Liow Tiong Lai said obesity is becoming the major health issue with the number of obese people almost tripling in the past 15 years from four per cent in 1996 to 14 per cent in 2010.


And since obesity is the gateway to other chronic diseases such as high blood pressure, heart and kidney problems, he said the risk of more Malaysians developing these diseases will become greater in future.

Liow said the ministry would soon mount a health campaign aimed at educating the public on how to prevent these chronic diseases.


He said the ministry would seek help from non-governmental organisations to reach out to the people especially in villages and rural areas.



"The problem with us is that Malaysians just love to eat especially late night suppers and we don't exercise.


"Unlike our forefathers who woke up early and had an early and heavy breakfast and light dinner, we wake up late and often miss breakfast and even lunch. But we make it up by having a heavy late dinner.


"Our forefathers did physical work and sweated it out, but we work in an office and rarely exercise. That is why obesity is becoming a problem, even among children," he said after distributing Mandarin oranges and angpows to patients during a visit to Bentong Hospital here yesterday.


Liow, who is also Bentong MP, said the ministry was worried over the rise in the number of patients with chronic diseases, especially in rural areas.



"When the haemodialysis machines at the hospital here were increased from four to 14, the number of patients also grew from six to 55 now.

"Considering that Bentong is a small town with only a population of 140,000, the number of kidney patients is high compared to the national average of 70:100,000 population."

Earlier, Liow witnessed the handing over of three new haemodialysis machines from Radicare (M) Sdn Bh chief operating officer Halwah Abdul Manap to hospital director Datuk Dr Chandra Sekanan Raman.
Liow also announced that the ministry would consider sending more medical specialists especially trauma specialists to the hospital since it handled a lot of trauma and accident cases due to its proximty to Karak Highway.



He also visited the hospital's new four-storey building which is due for completion in 2012 which will house the patients' wards, emergency clinic and mortuary.

Suicide in Youth

According to the Surgeon General, a youth commits suicide every two hours in our country. In 1997, more adolescents died from suicide than AIDS, cancer, heart disease, birth defects and lung disease. Suicide claims more adolescents than any disease or natural cause. Adolescents now commit suicide at a higher rate than the national average of all ages. The rate of adolescent suicide in adolescent males has tripled between 1960 and 1980. Suicide rates for adolescent females have increased between two to three fold. There have been striking increases in suicidal behaviors among African American males, Native American males and children under 14. Much of the increase can be accounted for by deaths due to guns. 

Suicidal behavior is the end result of a complex interaction of psychiatric, social and familial factors. There are far more suicidal attempts and gestures than actual completed suicides. One epidemiological study estimated that there were 23 suicidal gestures and attempts for every completed suicide. However, it is important to pay close attention to those who make attempts. 10% of those who attempted suicide went on to a later completed suicide. A suicide has a powerful effect on the individual’s family, school and community. We must deal with it as a public health crisis in our schools, clinics and doctors’ offices. 

Social changes that might be related to the rise in adolescent suicide include an increased incidence of childhood depression, decreased family stability, and increased access to firearms. 

Suicidal behaviors are often associated with depression. However, depression by itself is seldom sufficient. Other co-existing disorders, such as attention deficit hyperactivity disorder, substance abuse or anxiety can increase the risk of suicide. Recent stressful events, can trigger suicidal behavior, particularly in an impulsive youth. Girls may be more likely to make suicidal attempts, but boys are more likely to make a truly lethal suicide attempt. 

Risk factors for suicide include:

 

• Previous suicide attempts
• Close family member who has committed suicide.
• Past psychiatric hospitalization
• Recent losses: This may include the death of a relative, a family divorce, or a breakup with a girlfriend.
• Social isolation: The individual does not have social alternatives or skills to find alternatives to suicide
• Drug or alcohol abuse: Drugs decrease impulse control making impulsive suicide more likely. Additionally, some individuals try to self-medicate their depression with drugs or alcohol.
• Exposure to violence in the home or the social environment: The individual sees violent behavior as a viable solution to life problems.
• Handguns in the home, especially if loaded.

Some research suggests that there are two general types of suicidal youth. The first group is chronically or severely depressed or has Anorexia Nervosa.  Their suicidal behavior is often planned and thought out. The second type is the individual who shows impulsive suicidal behavior. He or she often has behavior consistent with conduct disorder and may or may not be severely depressed. This second type of individual often also engages in impulsive aggression directed toward others. 

Adolescents often will try to support a suicidal friend by themselves. They may feel bound to secrecy, or feel that adults are not to be trusted. This may delay needed treatment. If the student does commit suicide, the friends will feel a tremendous burden of guilt and failure. It is important to make students understand that one must report suicidal statements to a responsible adult. Ideally, a teenage friend should listen to the suicidal youth in an empathic way, but then insist on getting the youth immediate adult help. 

Warning Signs:

• Suicidal talk
• Preoccupation with death and dying.
• Signs of depression
• Behavioral changes
• Giving away special possessions and making arrangements to take care of unfinished business.
• Difficulty with appetite and sleep
• Taking excessive risks
• Increased drug use 
• Loss of interest in usual activities

UNDERSTAND THE RISK FACTORS FOR TEEN SUICIDE

1. Previous suicide attempts/current suicidal thoughts
2. Drug or alcohol abuse
3. Access to firearms
4. Situational stress

KNOW THE WARNING SIGNS

Signs of depression in teens

1. Sad, anxious or “empty” mood
2. Declining school performance
3. Loss of pleasure/interest in social and sports activities
4. Sleeping too much or too little
5. Changes in weight or appetite

Signs of Bipolar Disorder in Teens

1. Difficulty sleeping
2. Excessive talkativeness, rapid speech, racing thoughts
3. Frequent mood changes (both up and down) and/or irritability
4. Risky behavior
5. Exaggerated ideas of ability and importance

TAKE ACTION

Three steps parents can take

1. Get your child help (medical or mental health professional)
2. Support your child (listen, avoid undue criticism, remain connected)
3. Become informed (library, local support group, Internet)

Three steps teens can take

1. Take your friend’s actions seriously
2. Encourage your friend to seek professional help, accompany if necessary
3. Talk to an adult you trust. Don’t be alone in helping your friend.

Intervention: 

 

Intervention can take many forms and should throughout the different stages in the process. Prevention includes education efforts to alert students and the community to the problem of teen suicidal behavior. Intervention with a suicidal student is aimed at protecting and helping the student who is currently in distress. Postvention occurs after there has been a suicide in the school community. It attempts to help those affected by the recent suicide. In all cases it is a good idea to have a clear plan in place in advance. It should involve staff members and administration. There should be clear protocols and clear lines of communication. Careful planning can make interventions more organized, and effective. 

Prevention often involves education. This may be done in a health class, by the school nurse, school psychologist, guidance counselor or outside speakers. Education should address the factors that make individuals more vulnerable to suicidal thoughts. These would include depression, family stress, loss, and drug abuse. Other interventions may also be helpful. Anything that decreases drug and alcohol abuse would be useful. A study by Rich et al found that 67% of completed youth suicides involved mixed substance abuse.  PTA meetings family spaghetti dinners can draw in parents so that they can be educated about depression and suicidal behavior. “Turn off the TV Week” campaigns can increase family communication if the family continues with the reduced TV viewing. Parents should be educated about the risk of unsecured firearms in the home. Peer mediation and peer counseling programs can make help more accessible. However, it is critical that students go to an adult if serious behaviors or suicidal issues emerge. Outside mental health professionals can discuss their programs so that students can see that these individuals are approachable.

Intervention with a suicidal student:  

Many schools have a written protocol for dealing with a student who shows signs of suicidal or other dangerous behavior. Some schools have automatic expulsion policies for students who engage in illegal or violent behavior. It is important to remember that teens who are violent or abuse drugs may be at increased risk for suicide. If someone is expelled, the school should attempt to help the parents arrange immediate, and possibly intensive psychiatric and behavioral intervention. 

1. Calm the immediate crisis situation. Do not leave the suicidal student alone even for a minute. Ask whether he or she is in possession of any potentially dangerous objects or medications. If the student has dangerous items on his person, be calm and try to verbally persuade the student to give them to you. Do not engage in a physical struggle to get the items. Call administration or the designated crisis team. Escort the student away from other students to a safe place where the crisis team members can talk to him. Be sure that there is access to a telephone.
2. The crisis individuals then interview the student and determine the potential risk for suicide.
   1. If the student is holding on to dangerous items, it is the highest risk situation. Staff should call an ambulance and police and the student’s parents. Staff should try to calm the student and ask for the dangerous items.
   2. If the student has no dangerous objects, but appears to be an immediate suicide risk, it would be considered a high-risk situation. If the student is upset because of physical or sexual abuse, staff should notify the appropriate school personnel and contact Child Protective Services. If there is o evidence of abuse or neglect, staff should contact parents and ask them to come in to pick up their child. Staff should inform them fully about the situation and strongly encourage them to take their child to a mental health professional for an evaluation. The team should give the parents a list of telephone numbers of crisis clinics. If the school is unable to contact parents, and if Protective Services or the police cannot intervene, designated staff should take the student to a nearby emergency room.
   3. If the student has had suicidal thoughts but does not seem likely to hurt himself in the near future, the risk is more moderate. If abuse or neglect is involved, staff should proceed as in the high-risk process. If there is no evidence of abuse, the parents should still be called to come in. They should be encouraged to take their child for an immediate evaluation.
   4. Follow-Up: It is important to document all actions taken. The crisis team may meet after the incident to go over the situation.  Friends of the student should be given some limited information about what has transpired. Designated staff should follow up with the student and parents to determine whether the student is receiving appropriate mental health services. Show the student that there is ongoing care and concern in the school.

Postvention: 

An attempted or completed suicide can have a powerful effect on the staff and on the other students. There are conflicting reports on the incidence of a contagion effect creating more suicides. However, there is no doubt that individuals close to the dead student may have years of distress. One study found an increased incidence of major depression and posttraumatic stress disorder 1.5 to 3 years after the suicide. There have been clusters of suicides in adolescents. Some feel that media sensationalization or idealized obituaries of the deceased may contribute to this phenomenon. 

The school should have plans in place to deal with a suicide or other major crisis in the school community. The administration or the designated individual should try to get as much information as soon as possible. He or she should meet with teachers and staff to inform them of the suicide. The teachers or other staff should inform each class of students. It is important that all of the students hear the same thing. After they have been informed, they should have the opportunity to talk about it. Those who wish should be excused to talk to crisis counselors. The school should have extra counselors available for students and staff who need to talk. Students who appear to be the most severely affected may need parental notification and outside mental health referrals. Rumor control is important. There should be a designated person to deal with the media. Refusing to talk to the media takes away the chance to influence what information will be in the news. One should remind the media reporters that sensational reporting has the potential for increasing a contagion effect. They should ask the media to be careful in how they report the incident. Media should avoid repeated or sensationalistic coverage. They should not provide enough details of the suicide method to create a “how to” description. They should try not to glorify the individual or present the suicidal behavior as a legitimate strategy for coping with difficult situations. 

What can you say to support a student with suicidal thoughts and a low self-esteem?

• Listen actively. Teach problem-solving skills
• Encourage positive thinking. Instead of saying that he cannot do something, he should say that he will try.
• Help the student write a list of his or her good qualities.
• Give the student opportunities for success. Give as much praise as possible
• Help the student set up a step-by-step plan to achieve his goals.
• Talk to the family so that they can understand how the student is feeling.
• He or she might benefit from assertiveness training
• Helping others may raise one’s self-esteem.
• Get the student involved in positive activities in school or in the community.
• If appropriate, involve the student’s religious community.
• Make up a contract with rewards for positive and new behaviors.

5 ways-free strategies to help prevent heart disease

• You can prevent heart disease by following a heart-healthy lifestyle.
• Heart disease may be the leading cause of death for both men and women, but that doesn't mean you have to accept it as your fate. 
• Although you lack the power to change some risk factors — such as family history or age — there are some key heart disease prevention steps you can take.
• Take steps to avoid heart disease — don't smoke, get regular exercise and eat healthy foods. 
• Avoid heart problems in the future by adopting a healthy lifestyle today. 

Here are five heart disease prevention tips to get you started.


1. Don't smoke or use tobacco products

     - Smoking or using other tobacco products is one of the most significant risk factors for developing heart disease. When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.

    - Tobacco smoke contains more than 4,800 chemicals. Many of these can damage your heart and blood vessels, making them more vulnerable to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

    - In addition, the nicotine in cigarette smoke makes your heart work harder by narrowing your blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — only smoking while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.

    - Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't do either. Worse, this risk increases with age, especially over 35.

     - The good news, though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit
.

2. Get active

-   Regularly participating in moderately vigorous physical activity can reduce your risk of fatal heart disease.  And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.

-   Physical activity helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may also be a factor in heart disease.

-   Guidelines recommend that you get at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts of exercise offer heart benefits, so if you can't meet those guidelines, don't give up. You can even break up your workout time into 10-minute sessions and still get the same benefits

-   And remember that things like gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3.Eat a heart-healthy diet

-   Eating a special diet called the Dietary Approaches to Stop Hypertension (DASH) eating plan also can help protect your heart. Following the DASH diet means eating foods that are low in fat, cholesterol and salt

-  The diet is rich in fruits, vegetables, whole grains and low-fat dairy products that can help protect your heart. Legumes, low-fat sources of protein and certain types of fish also can reduce your risk of heart disease


-   Limiting certain fats you eat also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels.

-   Major sources of saturated fat include beef, butter, cheese, milk, and coconut and palm oils. There's growing evidence that trans fat may be worse than saturated fat because unlike saturated fat, it both raises your low-density lipoprotein (LDL), or "bad," cholesterol, and lowers your high-density lipoprotein (HDL), or "good," cholesterol.

-   Sources of trans fat include some deep-fried fast foods, bakery products, packaged snack foods, margarines and crackers. Look at the label for the term "partially hydrogenated" to avoid trans fat.

4. Maintain a healthy weight

-   As you put on weight in adulthood, your weight gain is mostly fat rather than muscle. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.

-  One way to see if your weight is healthy is to calculate your body mass index (BMI), which considers your height and weight in determining whether you have a healthy or unhealthy percentage of body fat.

-  Even small reductions in weight can be beneficial. Reducing your weight by just 10 percent can decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes

5. Get regular health screenings

-   High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

• Blood pressure. Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more frequent checks if your numbers aren't optimal or if you have other risk factors for heart disease. Optimal blood pressure is less than 120/80 millimeters of mercury 
• Cholesterol levels. Adults should have their cholesterol measured at least once every five years. You may need more frequent testing if your numbers aren't optimal or if you have other risk factors for heart disease. Some children may need their blood cholesterol tested if they have a strong family history of heart disease. 
 

Prevention pays :

       Heart disease is often avoidable. Following a heart-healthy lifestyle doesn't have to be complicated. Find ways to include heart-healthy habits into your lifestyle — and you may well enjoy a healthier life for years to come.