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Abdominal Obesity
Tuesday, May 30, 2006

One patient of mine, Mr. Y, in his 4o's, an executive, living a sedentary lifestyle, has high waist circumference. Is this okey or is it dangerous? When we visit our doctor we are often told to watch our weight. Why is that so?As people age, the fat tends to distribute more on the abdominal area. Studies show that this is because of the influence of genes and hormones. We call this condition abdominal obesity which is an independent predictor of risk factors and morbidity. It is associated with increased risk for serious diseases like cardiovascular disease, hypertension, type 2 diabetes, coronary artery disease, dyslipidemia, etc.

What do we do to prevent all this? We should watch our weight to prevent gaining fat especially if we don't have much daily activities. We do this by undereating to decrease insulin resistance and daily exercise to increase insulin sensitivity
posted by Amelyn R. Rafael,MD @ 3:48 PM   0 comments
Jam Sweet Jam
Sunday, May 28, 2006

Just the other day, one of our doctor friends got sick and was confined in the hospital. Me and my husband visited her and stayed for several hours in the hospital. When finally she looked stable and okey we decided to leave. It was already dinner time. After a long busy day in our clinic and with no afternoon snacks we really felt hungry on our way home. The thought of having dinner in a famous restaurant is very inviting......so we gave it a go!

In the photo above is calamares. I certainly love this dish. Even my kids love it. Other restaurants refer to it as crispy fried squids. Its very easy to cook. I prepare it at home once in a while as an alternative to adobong pusit.


Kare-kare was one of our orders. I also love this dish but I haven't cooked it even once at home. Every now and then I surf the net trying to look for a simple way to prepare it. But I just couldn't find one. My husband sometimes pressure me to prepare it at home. I hope one day I can. Its a stew with a variety of vegetables swimming in a rich nutty sauce and served with bagoong! Hmmmm..................yummy!
posted by Amelyn R. Rafael,MD @ 11:14 AM   1 comments
Diabetes
Thursday, May 25, 2006

In the photo is Mr. Z., our diabetic patient for 6 years. Recently he has been on 4-drug theraphy for his diabetes but his blood sugar remained high at 200mg/dl. Dr. Rafael, my husband, convinced him to have regular insulin injections for his diabetes. He used Humapen ergo, an insulin device with a very fine needle, making insulin delivery very convenient and painless. They started on the abdominal area above the umbilicus. He then advised the patient to have his succeeding injections in this area one-finger length from the previous injection. This will be followed by other injection sites like below the umbilicus, both anterior thighs, both posterior thighs, then lastly the arms.

Everytime we eat, the food is broken down into several organic compounds for the body's use. One of these compounds is glucose which is utilized as source of energy. In order for glucose to enter the cells and be utilized as energy source, it needs insulin. Insulin is produced by the beta cells of the pancreas. Individuals with type 1 diabetes produce no insulin hence glucose cannot enter the cells. Insulin is then given regularly to diabetic patients to control their blood sugar levels. It needs to be injected into the fat under the skin so that it can be brought into the bloodstream and be utilized by the body.

Do we need to inject everyday? Yes, in order to control blood sugar levels. Otherwise this condition will lead to complications like heart disease, kidney problems, blindness, nerve damage, etc.
posted by Amelyn R. Rafael,MD @ 3:32 PM   2 comments
Hypertension
Tuesday, May 23, 2006
This is Mrs. X. She came to our clinic just the other day complaining of dizziness. Her blood pressure reading is 160/100. Is she really hypertensive? Its difficult to say unless she comes back for follow up for another blood pressure reading and for a hypertensive work-up. The problem is that she only visits a doctor whenever she is dizzy and she hops from one doctor to another. The big question is: Is the dizziness due to hypertension or the hypertension due to the dizziness? Just like the question about the chicken and the egg.

Hypertension is a very common condition. Here in our locality we don't end the day without a hypertensive patient. Most of the time its not even their chief complaint. They would appreciate it much more if you just concern yourself with their chief complaint than dealing with their hypertension. I remember one old man in his late 50's telling me that if I want him to be strong I won't give him antihypertensive medication. Quite strange really. No matter what you tell them. They are like walking time bombs ready to explode anytime.

Hypertension is a silent killer just like diabetes. Most of the time it is asymptomatic. You don't have to watch out for nape pain, dizziness, and headache to tell you that your blood pressure is rising. These symptoms usually don't occur unless you are already in the advanced stage. So what are you waiting for? Go to your physician and have your blood pressure reading checked!
posted by Amelyn R. Rafael,MD @ 3:20 PM   4 comments
Peanuts
Saturday, May 20, 2006
Peanut is actually a legume seed related to peas and other beans. It is a ground plant with the pod originating from the stem. Because of its heavy weight it bends down towards the ground, burrows, and mature.

Peanuts are available all year round. It is a very healthy food and rich in protein hence a good source of energy. It is also high in fats. Almost 1/2 of its fat content is in the form of monounsaturated fats. This monounsaturated fats is in the form of oleic acid, the type found in olive oil which has high health promoting effects. It also contains high amount of magnesium, folate, niacin, Vitamin E, fiber, copper, and arginine. All of which play a role in decreasing cardiovascular disease. Its high niacin content also protects us against age-related decline in brain functioning and intellectual activity. Studies also show that it can help prevent ocurrence of gallstones.

Peanut is also rich in antioxidants which serves as protection from cell damage. This phenolic antioxidant called resveratrol is the same antioxidant found in red grapes which helps in the prevention of arterial plaque formation.

See there are so many benefits from eating peanuts or peanut butter which is everybody's favorite sandwhich filling. An ounce of this nut a day decreases heart disease risk and improves levels of blood lipids. It is very easy to love peanuts. Once you start munching them, it is very hard to stop!
posted by Amelyn R. Rafael,MD @ 1:53 PM   0 comments
Covelandia du Labrador
Wednesday, May 17, 2006










My kids just love swimming very much so that before the summer vacation ends and before the rainy season begins we decided to go swimming again. Since May 14 was Mother's Day, we thought it was a perfect day for our plan. And it really was! This time we decided to go to Tobuan, Labrador, Pangasinan to see for ourselves what our friends have been telling us about Covelandia du Labrador Family Beach Resort. True enough......it's really amazing!

The entrance fee is very reasonable at Php 150 per head for adults and Php 100 per head for kids. Since we plannned to stay there the whole day we rented a cottage for Php 700. They also have picnic tables that can be rented for a lesser price. If you plan to go overnight they have hotel rooms also at very affordable prices. They have function rooms for parties and lectures. For entertainment they have basketball court, tennis court, and ping-pong table that could be rented at Php 100 per hour.

In the left photo is the adult pool with the slides above it. The right photo is the kiddie pool. On the right side of the kiddie pool are the cottages fronting the beach area. Food can be cooked in the cottage area. Each cottage is provided with barbeque grill and there are kitchen sinks constructed near the cottages. Allowing food to be brought inside the resort is the main difference with other family resorts that we have visited. Although all families enjoy cooking their own food, this is also the means by which the pools can get dirty. There aren't so much guard around to prevent food from being brought into the pool area so that some of kids throw in some bits of food in the pool while they are playing and eating at the same time. I can say that during our stay there the kiddie pool is dirty.

After having enjoyed swimming in the pool and in the beach, at around 1:00 pm I decided to shower. While inside the shower area suddenly there was no water coming out of the shower! I stayed inside for at least an hour waiting for the water but there was only water coming out of the faucet. I looked around and saw a plastic cup which I used to pour water to my soap-filled body. It took me so long inside the shower room that my husband was too worried while waiting at the cottage. Can't the management inform their visitors that water is not available at certain hours of the day? Yes the place look so great but I think there is a need for more manpower in order to maintain cleanliness.... and please have enough water!
posted by Amelyn R. Rafael,MD @ 9:27 AM   2 comments
Medical Mission: Operation Tuli
Tuesday, May 16, 2006
Outside the Philippines, circumcision is done during infancy. They say it has the benefit of preventing urinary tract infection as the child grows older. Here in the Philippines, it is usually done during the summer vacation when children are mostly at home and having great time going to beaches with family and friends.A boy who has to undergo circumcision must be screened first by the doctor to see whether the prepuce has already separated from the penis. If so, he is then scheduled for the procedure. In private clinics, the price for circumcision range from 300 to 800 pesos depending on the expertise of the physician.After the procedure the child is prescribed an antibiotic and analgesic to be taken for several days and advised to watch out for bleeding. Ideally there should not be bleeding after the procedure.

In the photo is my husband, Dr. Randy, performing circumcision. This is a medical mission conducted by our municipal mayor, Hon. Mojamito Libunao, aiming to circumcise all eligible boys living in San Fabian, Pangasinan. The project started April 29, 2006 and it is being done every Saturday. This is the third Saturday, May 13, and there are around 500 boys who were circumcised since the start of this mission. Quite a number huh!
posted by Amelyn R. Rafael,MD @ 10:27 AM   0 comments
Coffee, anyone?
Friday, May 12, 2006
There isn't a day that my husband does not drink coffee. He is really a coffee drinker averaging around 3 mugs per day. Our close friends and relatives know very well his love for coffee so that everytime they send us gifts it is always coffee. Even my children seem to be developing love for coffee. Whenever they see daddy's mug and smelled its fresh aroma, they rush in and see to it that they are able to sip and taste from daddy's high quality coffee.

A cup of coffee in the morning keeps us alert and improves our physical stamina. The caffeine stimulates our brain and nerve cells for us to keep going. It can even make us ignore fatigue and enhances our endurance.

Drinking coffee on a regular basis gives us lots of good benefits. There is evidence that it lessens the risk of developing type II diabetes because it is loaded with antioxidants next to fruits and vegetables. These antioxidants improve glucose metabolism and increase insulin sensitivity. They also lessen the risk of certain cancers, liver cirrhosis, heart problems, Parkinson's disease, and gallstones. They help lessen asthma attacks and may even stop a headache and boost our mood. One component of coffee helps prevent dental cavities from forming because of its antibacterial properties.

With all these health benefits from drinking coffee, can we say that it is a health food? Researchers say more studies are needed. Why not drink moderate amount of coffee everyday and enjoy its taste and aroma. Keep on sipping!
posted by Amelyn R. Rafael,MD @ 9:50 AM   2 comments
"Family Physicians: On the Road to Information Technology"
Monday, May 08, 2006


The title was the theme for yesterday's event: the 24th anniversary celebration and induction ceremony of the Philippine Academy of Family Physicians (PAFP) Pangasinan chapter to which my husband, Dr Rodolto T. Rafael, is the new president. It was held at Ethan's Place, Leisure Coast Resort, Dagupan City. They were inducted by the PAFP National President, Dr. Alejandro V. Pineda Jr., who was assisted by the National Executive Secretary, Dr. Policarpio Joves, and the Regional Director for Luzon, Dr. Wilfredo Simbul.

All the new set of officers were present. The affair was attended by members of the chapter together with their families. It was really a success.
posted by Amelyn R. Rafael,MD @ 2:27 PM   0 comments
The Physiology Society of the Philippines
Monday, May 01, 2006
The Physiology Society of the Philippines (PSP) recently conducted its 25th Annual convention last April 28-29, 2006 at the College of Medicine, UP Manila. The theme for this year is The Silver Lining in Physiology: A Journey of Discovery. It was a two-day convention culminating in the induction and fellowship night on the eve of April 29 at the Pan Pacific Hotel.

In the photo is Dr. Carmencita David-Padilla on her talk about the ABC's of stem cell research and its clinical applications. This was on the second day of the convention. According to her "Stem cell research can provide understanding fundamental events in embryonic development to explain the causes of birth defects, infertility, and pregnancy losses. Since stem cells offer the possibility of a renewable source of replacement cells and tissues, they can be used to produce different stem lines for therapeutic transplantation. Examples of which include the development of transplantable pancreatic tissue to treat diabetes, and the generation of replacement tissues for treating neurological conditions such as spinal cord injury, multiple sclerosis, and Parkinson's disease." Although its applications are still limited at present, stem cell theraphy holds great promise for the future.

I started teaching physiology at Lyceum Northwestern University in the year 1999. It was only in the year 2001 when I became a member of PSP. An organization of academicians, it is really an honor to be one of its members.
posted by Amelyn R. Rafael,MD @ 2:55 PM   0 comments
About Me

Name: Amelyn R. Rafael,MD
Home: San Fabian, Pangasinan, Philippines
About Me: Family Physician, and Associate Professor (Clinical Anatomy and Medical Physiology)
See my complete profile
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