RMT Family Medicine

Multiple Sclerosis Diagnosing

2009-03-31T12:20:00.000-07:00

Posted by:Dr.Iliana

The underlying autoimmune process in MS causes demyelination of white matter in brain and spinal cord, resulting in episodes of variable focal neurological symptoms.

Remember the essence of modified McDonald’s Criteria used for MS diagnosis – dissemination in space (two or more focal neurological symptoms) and time (two or more episodes of symptoms) without a better neurological explanation.

Most common presenting symptoms of MS;

Motor symptom	lower extremities paraparesis with spasm, indicating UMNL aka upper motor neuron lesion (exception in patient with concomitant cerebellar involvement, which cause muscular hypotonia).
Sensory symptom	Hypoesthesia-numbness and paresthesia-tingling sensation
Optic nerve involvement	Decreased visual acuity-blurred vision and diplopia-doubling of vision, or optic neuritis- unilateral eye pain which increases with eyeball movement, often accompanied by decreased visual acuity
Cerebellar sign	Loss of balance (the pathognomonic scanning speech is seldom meet)

Apart from above stated common symptoms, most of MS patient also experienced nonspecific generalized symptoms such as;

Increased fatigability, typically in mid afternoon

Depression

Heat insensitivity, which is provoked or worsened when exposed to heat, e.g. a hot shower

NB – Patient with MS tend to neglect or forget their symptom (especially the presenting ones), as most of the them are temporary. Therefore it’s crucial to ask thoroughly about other common neurological symptoms. A simple question like “Have you ever experienced blurring of vision or unexplained weakness and numbness in your leg/hand before? ” would remind the patient about their previous symptoms .

When should we suspect MS?

(NB – MS is relatively rare in Malaysia and other South East Asian countries)

Onset of symptoms in patient aged 20-50 years old;

onset earlier than 20 years is more typical for hereditary diseases e.g. spinocerebellar atrophy, while in patient older than 50 years such symptom are more frequently caused by TIA aka transient ischemic attack, or reversible ischemia.

Symptoms and signs indicating the involvement of central nervous system

(i.e. any part of the brain or spinal cord);

Optic-spinal form of MS aka OSMS is more often encountered in South East Asian region than prototypic/classical MS which is typical in western countries

Two or more episodes lasting at least 24 hours and occurring at least one month apart;

usually symptom develops progressively during few days, stabilized than regress spontaneously or due to corticosteroid administration – NB – regression maybe complete or partial according to course of the disease, note that in primary progressive type there might be no regression of the symptom at all

Further Management

Refer patient to neurologist – this is the best part being a family med specialist - we diagnose and let others manage (kidding =p)

Treating Common Problems

2009-03-20T02:11:00.000-07:00

Firstly, I would like to apologize for being in hiatus.
I will try to make it up on the past few weeks I had left.
I hope everyone is in their best condition right now as there have been four cases reported on ( Rubella ).

Continuing on our topic on Prophet's Medicine, this post will guide you on among the common problem and diseases we need to maturely treat.

Treating Tonsillitis & Administration of Medication Orally.

Sahihah narrated that the Prophet (PBUH) said that;

Cupping and marine costus are among your best remedies; and do not torture your children by pressing their uvula to cure tonsillitis.

Bleeding of nose can caused due to ( tonsillitis ) or headache, at most people that isn't in the state of trauma.
Abu Ubaidah once said that this is a blood-related throat irritation. Roughly, it is an ulcer that appears between the ear and the throat that normally attacked young boys.

Aloes are widely known for their benefits. Among them is to cure tonsillitis, in this case.
Scrub aloes through the nose externally where composed of bloods related phlegm accumulates in the body/nose. it will tighten up the uvula and pulls it up to the proper anatomical position. Doing this when the person is laying on his back and his shoulders are elevated so that the head lay back. In this position, medication would reach the head and disease is extracted by sneezing.

In those days way back before our great grandfather was born, children suffered from tonsillitis had to be treated by pressing the uvula and sometimes affixing an object to the uvula.
This practise is disallowed by Prophet (PBUH) strictly.

Treating Disease of Heart.

Dates (Kurma) especially from Madinah gives great qualities and very effective in treating heart ailments.

Using seven dates is known through relevation.

Prophet had once said that;

Whoever eat dates from the area of Al-Aliah when he gets up in the morning then no poison or magic would harm that day.

Dates; a type of fruit widely known for its nutritional and medicinal value. Physiologically, dates do not produce harmful waste or excretements like any other types of foods. It preserves the bodily waste from being spoiled and from rotting, especially for those who are used to eating dried dates. Now, that's a bonus!

As said before, dates has a spiritual and material significance.
Allah SWT has created seven heavens, seven earths, seven days in a week and made the creation of mankind pass through seven stages.
Plus, Tawaf is made seven circumambulations, and the Sa'i is also seven trips between Safa and Marwah. Besides that, the Jamrat are stoned with seven pebbles each and the Takbir during 'Eid prayer is made seven times.

In addition, Prophet (PBUH) reminded;

Command him to pray upon reaching the age of seven.

These statements coming from The Prophet are certainly true and divinely revealed, deserve to be believed, without any hesitation or denial.

Guidance on Food and Drink contaminated by Flies.

Sahihan narrated that Messenger of Allah SWT said;

If a housefly falls in the drink of anyone of you, he should dip it (in the drink), for one of its wings has a disease and the other has the cure for the disease.

This is to confirm your disbelieves to some of you in this matter.
In this case, Allah SWT reminded us to not waste the food or drinks that had been intruded by the flies. There is always a silver lining behind every cloud, isn't it?

This Hadith comes in two areas of interest, Fiqh and medicinal.
In Fiqh part, Hadith states that when a flyfalls in water or fluids, it does not make it impure. The Prophet ordered when the fly falls on hot food, dip it. thus killing the fly. Logically thinking, if the fly's death inside the food will lost it's purity, surely The Prophet would have ask us to throw the food away. On the contrarary, we are asked to salvage the food.

Bees, hornets, spiders and their familes are treated the same way as the houseflies of which they have no blood and do not cause impureness of the food.

A for medicinal value, purpose of dipping the fly is to extract the cure from its wing just as the poison was extracted from the other wing that fell on the food.

Houseflies do carry poisonous materials as evidenced by the effect of their bite, such as rashes and infections. This poison is the fly's weapon to defense itself. The Prophet (PBUH) ordered that we neutralize the poisonous substance produced by the fly with the cure Allah SWT has kept on its other wing.

If the head of houseflies is amputated, the body is used to scrub the tumor that appears in the eyelid, and it will cure it, Allah's willing.

Dietetic table of № 10

2009-03-15T13:51:00.000-07:00

Posted By Dr.Zharif From RMTCardiology

Dietetic table of № 10

Indication: diseases of cardiovascular system with Heart Failure NYHA I -II[a] degree.

Aim:

1. improvement in the blood circulation,

2. functions of cardiovascular system, liver and kidneys,

3. the normalization of exchange of substances,

4. protection of cardiovascular system and organs of digestion.

General characteristic: -

1. small reduction in the caloricity due to the fats and partly carbohydrates.

2. limitation of a quantity of sodium of chloride,

3. the decrease of the consumption of liquids.

4. The content of the substances, which excite cardiovascular and nervous system, which irritate the liver and nights, is limited superfluously burdening gastrointestinal tract, that facilitate meteorism.

5. increased the content of potassium, magnesium, lipotropic substances, products, which render the alkalizing action (milk, vegetables, fruits). Culinary working is performed with that moderated by mechanical .

6. Meat and fish they boil.

7. Food is prepared without the salt.

8. The temperature of food is usual.

9. Feed mode: 5 times a day by relatively uniform portions.

Chemical composition and energy-value (daily ration):

· the proteins 90[g] (55- 60% animals)

· the fats 70[g] (25 30% plant)

· the carbohydrates 350-400 g

· Energy-value 2500-2600 kcal.

· the common salt 6-7[g]

· the liquid 1,2[l]

Can

Can’t

• bread is wheaten from the flour the 1st and 2nd types, yesterday's baking or slightly dried slightly; dietetic salt-free bread, pastry and sponge cake;

• any vegetarian soups with different groats, milk soups;

• the nonfatty types of beef, veal, meat and trimming pork, rabbit, hen, turkey. they boil meat after cleaning from the tendons and fascias, and then bake or brown, dishes from the chopped or lump boiled meat, flood from the boiled meat, limited - doctoral and dietetic sausages, the nonfatty forms of fish - boiled or with subsequent roasting, dish from boiled sea products;

• milk, sour-milk beverages and cottage cheese;

• egg – 1per day, soft-boiled, the steam and baked omelettes, protein omelettes, in the dishes • dish from different groats; boiled macaroni articles;

• vegetables in the boiled and baked form potatoes, cauliflower, carrot, beet, summer squashes, pumpkin, tomatoes, lettuce, cucumbers, the cabbage and green peas – limited green bow, dill, parsley - in the dishes;

• lettuces from the fresh vegetables (ground carrot, tomatoes, cucumbers), vinaigrettes with vegetable oil, vegetable roe, lettuces are fruit, with sea products, fish the boiled flood

• fresh bread, article made of the rich test and puff-pastry Guest, pancakes, fritter;

• soups from the bean, meat, fish and fungus bouillon;

• the fatty forms of the meat of goose, weft, the liver, kidney, the brains, smoked foods, sausage articles, meat canned foods, fish, bird;

• kidney, smoked foods, sausage;

• salt, the fatty forms of fish, roe, canned foods, salt and fatty cheeses;

• bean;

• the eggs hard-boiled, fried;

• the salt, and sour vegetables; fruits with rough cellulose tissue, spinach, sorrel, horseradish, radish, garlic, turnip-shaped bow, fungi;

• chocolate, strong tea, coffee and coco

Exemplary menu of diet N 10.

• the 1st breakfast: egg soft-boiled, porridge is oat milk, tea.

• the 2nd breakfast: apples are baked with the sugar.

• Dinner: soup is pearl-barley with the vegetables on vegetable oil (1/2 portions), meat boiled with the carrot puree, compote from the dried fruit.

• Dishes: the broth of sweetbrier.

• Supper: pudding is curd (1/2 portions), boiled fish with the potatoes boiled, tea.

• On the night: kefir

Ref: RmtCardiology

list of medical abbreviation in Malaysia

2009-03-05T13:07:00.000-08:00

Posted by:Dr.zharif
Source from:Aizzuddin Yusof

Hospital list of medical abbreviation in Malaysia

click the picture above to download it

This is what we all search long time ago..
Now we try to share it with you all...
Mostly hospital in Malaysia use this abbreviation.
So try to use this abbreviation in ur patient case or study k
Try to adapt with it for better future understanding during working in Malaysia.
Good luck

click here for download the file

Remedies and Guidance of Natural Medicines

2009-02-26T22:24:00.000-08:00

By: Dr.Layla

On the previous post, we had wrote about fever, diarrhea and the benefits of honey. A simple topic we would begin posting here. And for today, the theme is about the possibilities of these ailments and illness could occur and their treatment.

4. Remedy for Dropsy & Constipation

Dropsy, is known as the harmful cold elements that penetrates the external organs and causing it to swell. In short, they are a sort of edema. Dropsy is usually symptomatic of an ailment in the liver due to congestion of the liver.

Three types of dropsy;

body tissues
body cavities (ascites)
in an organ

During the ancient times of our Prophet, this disease requires mild laxatives and diuret ic medicines that could help rid of the extra body fluids. These essence exist in the milk and urine of camels. Camels milk is mild laxative, diuretic and cleanses and remove obstructions, plus it soothes the body.

As we now aren't living in the places that have camels, be it Russia or even in Malaysia, there are always other alternatives of choosing laxatives around. It is more commonly known as drugs that induce the bowel system treating constipation.

Enemas having lubricant and stimulants are used to evacuate the colon and rectal for bowel examinations. But an excessive of these saline laxatives can cause diarrhea and dehydration.

Our Prophet uses Senna to cure constipation is his days. Senna, a plant grows in the Western Arabia is a hot and dry plant, giving mild medication but there's always a side effect of everything. Senna can be treated for;

bile and black bile ailments ( secretion humor by kidneys or the spleen that can cause sadness and melancholy to someone)
strengthen the heart
relaxing muscles
helps against lice, headache, mange, pustules, rashes & epilepsy
improves the hair

Ar-Razi also said that Senna and fumitory help extract mature humours (bodily waste) and helps against leprosy and rashes, when one takes four to seven measures or each remedy. Senna taken by blending its powder with honey with help the laxative action in our body.

5. Treating Migraine and Headaches

When headaches attack you, it is as if there's a hammer that is constantly pounding your head while you were at first in a content condition and never thought it would strike you anytime, anywhere.

Headaches that attacks one side of the head is generally called migraine. Various conditions caused this headaches that can attack just anyone, whether the young aged from 10 years old and above and also the senior and senile communities. It usually starts when head becomes hot due to pressure of a septic vapor that accumulates near the head but fails to find its way out of the body. Moisture, when heats up needs space to expand and this applies to the vapor and caused headaches to the entire head. And will leads to dizziness.

There are just so much or specific causes of headaches and migraines.

Four essential conditions (coldness, hotness, dryness and wetness) predominates our body.
Ulcers of stomach because nervus cephalicus and the stomach relates.
Thick flatulence can accumulate in the stomach and ascend to the head.
Tumor in gastric veins cause pain in the head, because head and stomach are connected.
Stomach, when it is full of food, can provoke headaches as the food remains undigested.
Occurs after sexual intercourse because the body will then be weakened and lack of oxygen.
Occur after vomiting due to excessive dryness.
Due to hot weather and air that is too dry for certain people who are new upon adapting at that kind of area.
Can caused by cold weather when the vapor accumulates in the head is unable to decompose.
Not having enough sleep, insomnia.
Putting pressure on the head, for example carrying heavy objects on the head most of the time.
Excessive talking that can weakens the mind.
Excessive sports activity and movement.
Sadness, depression, obsession even for a small thing, evil thoughts.
Excessive hunger expecially when excess gaseous materials accumulates too much in the stomach.
Tumor at the cerebral lining.
Intense heat from the body.

Weaker side of the brain accepting septic materials and this cause the migraine to be accompanied with the pulsation of the arteries. In this case, to relieve the pain, one ties a bandage so that the pulsation of the arteries is stopped and the pain is lessened.

Sahih states that the Prophet (PBUH) said during the illness that preceded his death used to tie a piece of clothes around his head.

Headaches can also be cured by vomiting, eating, being calm and idle and many more.

6. Henna Usage

In the above case, henna can help soothes the pain. Crushed henna blended with vinegar and then apply to the forehead can relieve the pain attacking the head. It also soothes the nerves when use as bandage. For example, for hot tumors and inflammations.

Henna helps stomatitis, an inflammation of mucous membrane of the mouth that always appear in child's oral cavity.

When symptom of small pox starts to break out, henna is applied at the bottom of the feet so that the eyes will be immune from the sores that accompany small pox.

Leaves of the henna that are submerged in fresh water and then squeezed and to be drank in forty days, can prevent leprosy.

Also. henna is used as oinment at fingers where it polishes and strengthens them. Besides, it is also benefits against chronic mange, helps the hair to grow stronger and strengthens the head. Finally, it also helps against blisters and pustules that seems to normally appear at leg and feet.

Medicine of the Prophet (PBUH)

2009-02-26T01:20:00.000-08:00

By: Dr Layla

The book Healing with the Medicine of the Prophet (PBUH) written by Imam Ibn Qayyim Al-Jauziyah almost 650 years ago, which was a timely work research that is use for our generations whether the past, present and definitely the future.

Being a medical student that are currently learning Piragov's operations, Sechenov's medical procedures or even Edward Jenner's history of vaccine, we can never deny the treasure & guidance left by the Prophet according to Qur'an & Sunnah as his main reference in issues of health and medicines.

In this Family Medicine department arranged by the Russian Medical Team (RMT) members, we are proudly posting up chapters from the book as to share with all about the treatment of ailments and preventive remedies that are extremely useful towards better community.

As an introduction, Muslim narrated in his Sahih that the Prophet (PBUH) said ;

'Every illness has a cure, and when the proper cure is applied to the disease, it ends it, Allah willing'

We, as a future doctor, are well-known for taking the obligation to cure and medicate people no matter what colour or religions they are. Prophet's statement on role of a doctor, according to him, is a man whose hand He sent and cause the cure. This statement strengthen the sick person to seek for medication. Rather than despair, he will gain hopes that gives positive anticipation having the energy of the soul and the psyche to energize the body so the disease is more easily dissipated & defeated.

As I am writing this according to the book, certain topics that are familiar with our daily lives and things that we might not see in details but will soon discover in the coming posts, not only the surface but also deeply on what natural medicines actually benifits us.

May you have a clear picture on a simple words and mind spoken here.

1. Prophet's guidance concerning food and drink.

Prophet told us that every one-third of our stomach is for;

food
water
breathing

This is the best method of eating for the body and the heart. For example, when the stomach is full of foods, there are not enough space for drinking and breathing, thus bringing the laziness and fatigue in oneself. This will automatically on the plug of delaying obligations to Allah SWT.

2. Curing Fever

'Verily Fever - or severe fever - is a breath of the Hell Fire, so cool it using water'

so said the Prophet.

Fever that results from sunstroke, mostly in tropical and deserted areas requires the treatment of cold water, either by drinking or taking bath.
As fever causes rising temperatures of the body, it could spread to the heart and to the entire body via blood vessels and the soul, of course.

Technically, there are two types of fever;

accidental, resulting from tumors, sunstroke, movements or intense heat
resulting from ailments that usually start at particular organ and heats up the whole body.

Unknown by most of us, fever gives positive actions where it heats up and mature & septic harmful substances and cause various blockages to open easily for medicines to reach to the harmful area of the disease.

For a clear and light example, fever helps against facial paralysis, hemiplegia, spasms and ailments that result from thick substances or excesses.

Cold water, as the easiest relieve fever during summer and in hot areas is beneficial. Water would be the furthest from the rays of sun just before sunrise (at its coolest). Body is at its strongest after relaxation and sleep. Adding the strength of body and the strength of water in medical cases, will definitely decrease the temperature of the heatwave body.

3. Curing diarrhea

Honey washes away harmful substances that might collected in veins or intestines. There are many advantages of drinking or eating honey.

Amongst them;

dissolves excess moisture, especially those suffering from phlegm that is also accompanied by coughing and chilled condition.
softens the bowel movement and a good preserving agent.
cleanses the liver and chest, aids in producing urine.
honey that is consumed hot and mixed with rose oil cures animal bites and effects of opium.
honey mixed with water helps against bite or rabid dog and effects of eating poisonous mushrooms.
fresh meat that is kept in honey can preserves freshness for almost 3 months.
applying to someone that is infected with lice, it kills both lice and the eggs.
in beauty purpose, it softens the hair and allowing it to grow longer.
strengthen the weak eyesight
whitens the teeth, take care of the gums
opens orifice of veins along causing the menstruation flow easily.

There are many effectiveness of honey that we can apply them in our lives.
Community that eats complex meals will have to have more complex cure like those in the city unlike those who lives in village and rural areas that eats simple dish and need not have to take extra medication.

All these Prophetic medicine is through guidance of the Qur'an and all success comes from Allah SWT.

Russian Dietetic table № 5(Stol 5)

2008-12-03T06:41:00.000-08:00

By:Dr.Zharif

Dietetic table of № 5

Indication:

Acute hepatitis and Cholecystitis in the stage of recovery;
Chronic hepatitis not in acute stage;
Liver cirrhosis without Liver insufficiency;
Chronic cholecystitis and Gallstone disease not in acute stage.

Purpose:

under the conditions of valuable nourishment for the liver,
the normalization of the liver and bile tracts functions and activity,
an improvement in the bile secretion.

It is assigned in all enumerated cases only of in the absence expressed diseases of stomach and bowels.

General characteristic: -

The physiologically normal content of proteins and carbohydrates with the small limitation of the fats, especially refractory.

Are excluded the products, rich in nitrogenous extractive substances, by purines, by cholesterol, by oxalic acid, by essential oils and by the oxidation products of fats, which appear with the frying.

The content of lipotropic substances, cellulose tissue, pectins, liquid is increased.

Dishes are prepared with boiled, baked, rarely - stewed.

Only sinewy meat and vegetables rich in cellulose tissue are rubbed: flour and vegetables not pasterization. Very cold dishes are excluded.

Consumption of food of 5 times in the day in the ground form.

Chemical composition energy-value (daily ration):

proteins until 150 (50% animals)

fats 80-100[g] (30% plant)

carbohydrates 350-400 g. (sugar until 80)

Energy-value 2800-3000 kcal.

common salt 10 g

liquid 1,5-2 l

vitamins A, C, B1, B2, B12, folic acid, pp., K.

Can eat

Can’t eat

• vegetarian fruit, milk soups,

• groats soups on the vegetable broth,

• boiled meat, the bird of non fatty types,

• boiled nonfatty fish,

• milk, fresh sour milk, kefir,

• acidophilic milk,

• cottage cheese until 200 into the day, the nonfatty cheese

• porridge and meal dishes (with exception of fancy bread),

• bread is white, black dry,

• egg - 1 during the day;

• cream, butter to 10[g];

• vegetable oil to 30[g];

• ripe fruits, berry (besides acid types) in the damp, baked, boiled form, bananas, grapes without the skin, watermelon, the persimmon

• vegetables and verdure in the boiled form and damp (especially carrot, beet),

• jam, honey, sugar (until 70 during the day),

• vegetable, fruit juices in a significant quantity,

• tea is weak with the milk,

• drying, blocks, a pastry of the type of pancake coils biscuits.

• alcoholic beverages,

• the liver, the brains, lard,

• bean, fungi, spinach, sorrel, bow,

• fancy bread, the fatty types of meat, fish, • fried, sharp, smoked products,

• the extractive substances of meat, fish,

• spice, vinegar, canned foods,

• ice cream, such as, the gassed beverages, • chocolate, creams.

Method taking menu of diet N 5.

• the 1st breakfast: cottage cheese with the sugar and the sour cream, porridge is oat milk, tea.

• the 2nd breakfast: apple biscuit.

• Dinner: soup from the composite vegetables is vegetarian on vegetable oil, hen boiled in milk sauce, fig boiled, compote from the dried fruit.

• (afternoon) snack :the broth of sweetbrier.

• Supper: fish about container with the sauce white on the vegetable broth, potato puree, curd/jam patty, curd tart, cheese-cake with the cottage cheese, tea.

• On the night - the kefir

Ref:

Russian Medical Portal
Russian Internal Medicine textbook
Hospital Therapy Cycle

P/s:who want original diet therapy in Russian for table no 5 contact Dr.Zharif=zharif_6023@yahoo.com