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Parkinson's Patient
Wednesday, June 28, 2006

Are you familiar with Parkinson's Disease? It is a motor system disorder common in people more than 50 years of age. Majority of these patients present with tremor, with trembling of hands, legs, arms, or face. There is also stiffness of the trunk and extremities. The movement is very slow with impairment of balance. It is usually very difficult for them to accomplish simple daily activities. Their symptoms become progressive over time and there is still no cure for this condition.

In the photo is our patient, Mr. XY, with Parkinson's Disease. He is now 78 years old and also a diabetic hypertensive patient. He was a scout ranger during his time belonging to the elite force of the Philippine Army. What bothers him most is his trembling hands. It is definitely uncontrollable and puts him easily into fatigue.
posted by Amelyn R. Rafael,MD @ 9:04 AM   0 comments
Medical Students
Saturday, June 24, 2006

I teach Physiology in the first year Medical course at Lyceum Northwestern University, here in Dagupan City, Pangasinan, Philippines. For this school year classes started just recently and my first meeting with the students is in the laboratory. That is the physiology lab in the picture with the students working on their first experiment. For this school year we only have 13 students, 4 of which are Thailanders and the rest Filipinos.

Gone were the days when screening of students who were entering the Medical course were very stiff. There were so many aspiring to become doctors then and competition is really tough. Nowadays, students entering Medicine are very few. In fact some Medical Schools here in the Philippines have already closed down because of their dwindling number. The reason probably is the difficult times, together with the never ending increase in the price of gasoline. Another reason maybe is that the practice of this profession here in the Philippines is not so profitable so that most doctors opted to become nurses and go in other countries like US and UK.
posted by Amelyn R. Rafael,MD @ 1:20 PM   0 comments
Are they good for the health?
Tuesday, June 20, 2006

What does a 12-ounce can of soda contain? From what I've read, it contains 150 calories, 50 gms sugar, 30 mg phosphoric acid, 35-38 mg caffeine, carbonated water, artificial color and flavors. They provide no nutritional benefits at all that's why we refer to them as "empty calories". Lots of people and even children drink them everyday but until now no studies were formally done to prove their effects to health.

The high sugar content of soda has been linked to an increased risk for diabetes. It also causes dental problems. The acid also destroys the tooth enamel leading to dental cavity formation. It also damages the lining of the stomach causing erosions or ulcerations. The phosphorus also deplete the bones of calcium making them weak and prone to fracture and osteoporosis.

Too much sugar is really bad for the health and sodas contain nothing more than sugar. Although none of those claims have yet been proven scientifically, why not stick to drinking water? After all they are free or if you need to buy them they are very cheap.
posted by Amelyn R. Rafael,MD @ 9:46 AM   0 comments
Depressed? or Just Dreaming?
Friday, June 16, 2006

This is Mrs. T, a 40 years old housewife with 2 children. She had miscarriage 4 months ago after which Dilatation and Curettage was done. Since then she started to hop from one doctor to another complaining of so many signs and symptoms like headache, dizziness, nervousness, inability to sleep, easy fatiguability, and weakness. She was already on antihypertensives, anti-vertigo, and multivitamins. She said that no amount of medication given to her by different doctors could improve her condition.

If you look at the patient she looks very much normal. She even looks healthier than her husband. Physical examination also revealed no pertinent findings. But if you talk and listen to her, most of her words reflect the negative feelings of what she have inside. She certainly have lost the drive to continue the race in her daily life. She is suffering from depression. A condition which is very common to the low-income population.
posted by Amelyn R. Rafael,MD @ 8:43 AM   0 comments
Ripe Papaya, Is It Healthful?
Tuesday, June 13, 2006

Every breakfast I make it a point that fruits are served to my family. And ripe papaya is really great for breakfast. They can be eaten alone or served with yogurt. They are available all-year round so that looking for them won't be a problem. They can be bought from the market or in groceries here in the Philippines.

Papaya contains papain enzyme that helps improve poor digestion so that they are excellent for people with bowel problems. It is also rich in beta-carotene which reduce the risk for cancer. It also helps restore the normal bacterial flora in the intestines for those people who had been in antibiotics for a prolonged period of time. It is an excellent source of Vitamin C and a good source of folate. So why not go natural?
posted by Amelyn R. Rafael,MD @ 10:33 AM   0 comments
New Drug for Children
Friday, June 09, 2006

The other night was the launching of another new drug for children with tuberculosis. It is called Rimcure Paed for the tablet containing Rifampicin, Isoniazid, and Pyrazinamide; and Rimactazid Paed for the tablets containing Rifampicin and Isoniazid for the maintainance phase of treatment. Yes! You have read the right thing....these are tablets for children. They are chewable and dissolve easily in water if the child is still unable to chew the medication. These are the first pediatric anti-TB fixed-dose combinations here in the Philippines.

Why the need for a fixed dose combination? When we say FDC, we don't need anymore to compute for the dose in order to deliver the correct dosage to a child patient with TB. We just weigh the patient and based on the weight the correct number of drugs is given to the patient. This has the advantage of reducing risk of developing drug resitant TB because monotheraphy is prevented, it simplifies prescription and administration of the drug and it will enhance patient compliance. With these we can be certain to a faster TB eradication.
posted by Amelyn R. Rafael,MD @ 10:07 AM   14 comments
What is ECG?
Monday, June 05, 2006

ECG or Electrocardiogram is a test done to record the electrical activity of the heart. It gives us information on how fast or how slow our heart is beating and whether it is beating regularly or not. It also tells us if there is enlargement or damage of the heart. It is usually done as routine examination to elderly patients and patients with symptoms of chest pain or palpitation.

The patient who will undergo ECG is asked to remove jewelry or anything on the body which is made up of metal such as belt, coins, etc. He is then ask to lie down and the skin where the leads will be placed are cleansed with wet cotton. The leads are then placed in position and the patient is asked to relax and avoid unnecessary movement. The result is then recorded in a ruled paper which is then read by a physician. The procedure is very much painless. Nothing is felt. There are only localized rashes on the skin where the leads were placed.
posted by Amelyn R. Rafael,MD @ 11:11 AM   0 comments
Asthma or Heart Failure?
Thursday, June 01, 2006

In the photo is Mr. R., 80 years old, who came in with difficulty of breathing. At first look you will think that he is suffering from asthma. Even the patient and his children thought so. But with proper history and physical examination, we found out that he is suffering from heart failure.

The patient was found out to have irregular heart beat four years ago. He was hypertensive since then, was given maintenance medications but was lost to follow up. Now he is having easy fatiguability and inability to lie down from sitting position. Lying down will make him dyspneic again.

What caused his heart to fail? His high blood pressure gradually exhausted his heart's strength causing it to become weak thus affecting its function. Normally, the heart should be able to pump efficiently. If not this will cause blood to back up into the circulatory system. This will then lead to more problems like swelling of the abdomen and edema in the legs, ankles, and feet.
posted by Amelyn R. Rafael,MD @ 3:00 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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