a chapter of mylife 5.0

miserable

unmanageable

i saw my book

feelingless

i wanted to read

i don't know

i can't

what a feeling

i hate

where the spirit

have you ever feel the same

=_=

ya Allah...T_T

DA'WAH THE 1ST, BUT STUDYING NOT THE 2ND ^_^

 بسم الله الرحمن الرحيم

 you said....................

 but, during exam.........................do not be like this!(for me actually T_T )

 RENEW(TAJDIDKAN) THE NIAT ONLY FOR ALLAH AND THE DEEN(ISLAM), insha-Allah, KULLU KHEIR, HAMASAH WILL COME!

studying is also a branch of da'wah, keep study because :

keep it up with doa  & selawat ^_^

 selamat beramal~ 

wallahu Taala a'lam~

 









Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

PENULISAN QOLBU-HATI 5

 بسم الله الرحمن الرحيم

Doktor ni org yg dapat mengkaji ciptaan Allah paling tinggi.
sebab tu kalau saya kata dr yg belajaR kajian Allah, tetapi masih buta hattinya, adalah org yg paling buta!~DR MUHAYA~

Rujuk Surah Fussilat:ayat 53

"Kami akan memperlihatkan kepada mereka tanda2 kekuasaan kami disegenap ufuk dan pada diri mereka sendiri,sehingga jelaslah bai mereka bahawa Al-Quran itu adalah benar. Dan apakah Tuhanmu tidak cukup(bg kamu) bahawa sesungguhnya Dia menyaksikan segala sesuatu?

 

~KENA MUHASABAH BALIK~

Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

MODERN DOCS

By Datuk Dr LEE YAN SAN

Changing trends of medical practice in Malaysia. 

AFTER graduating in medicine from Australia, I started medical practice at the beginning of 1969. I have witnessed vast changes in medical practice. I came home to Malaysia at the end of 1971 before completing my postgraduate training in teaching hospitals in Sydney when my father took ill.
Back home, I joined the government service in Taiping Hospital and then University Hospital in KL for nearly five years. Then I went for post-graduate studies in Edinburgh before returning to Malaysia to start my own private practice.
I have therefore been through and seen the changes of medical practice in Malaysia for over 40 years. Recently, there have been many changes affecting medical practice and therefore I feel this will be an interesting topic, which I am qualified to write on, especially being a past president of the Malaysian Medical Association (MMA) and a council member of the Malaysian medical Council (MMC).

In the past, the doctor could just concentrate on his role as a healer. A doctor now has got to be a good administrator as well . – AFPRelaxnews

Medical practice is also now greatly influenced by new laws governing the way doctors should practise their profession.

Clinical practice to investigative practice

Doctors are now depending more on machines and are no longer are as good in diagnosing using clinical acumen, with the help of basic clinical examination tools.
I predict that in the not too distant future, stethoscopes may even become obsolete!
Clinical practice to investigative practice must be the most obvious change in medical practice. The actual practice of medicine has changed tremendously, and doctors are now depending more and more on gadgets and procedures rather than their clinical acumen.
In the past, without the easy access to such modern diagnostic tools, doctors had to be trained to rely mainly on their clinical skills to diagnose diseases. Experience and knowledge are important.
Unfortunately, these days, doctors no longer bother to go through basic examinations to come up with a diagnosis, as it takes more time and effort. All they need to do is to order a non-invasive brain CT or MRI scan to make the diagnosis. Some young doctors, through force of habit, do not even bother to listen to the lungs of patients complaining of chest symptoms, but just send them for a chest x-ray.
In the past, doctors were also trained to accurately diagnose heart defects purely by listening for typical heart murmurs, but now, with new gadgets such as the echo-cardiogram, this is no longer routinely practised.
But is it all good? Depending on gadgets may not create any problem if you are practising in places with such equipment available to you, but certainly, the doctor will be at a great disadvantage if such equipment are not available. This also increases cost, which may not be necessary.

Changes in medical training

Medical teaching and clinical training have changed greatly due to the vast increase of medical schools, with insufficient number of teaching hospitals and qualified teachers, which are of real concern.
Nowadays, due to the large number of medical schools, both locally and overseas, there are too many medical graduates produced annually, leading to insufficient facilities and patients to train them adequately. Some housemen do not even have the opportunity to learn to deal with emergencies.
The housemen will therefore not get sufficient experience and training as the hospitals and consultants are not able to cope with such large numbers.
The Government must seriously look into the declining standards in the training of housemen as the quality of medical care in the future depends on them. Internship is crucial to allow graduates to put medical training into practice under the supervision of senior doctors.
There is concern that many graduates from medical schools with inadequate teaching facilities will not have adequate core knowledge to treat patients.

New laws governing doctors

Malaysia used to have only the Medical Act 1971 to govern the medical profession. There are now new laws governing medical practice in place.
The scenario in private practice has changed drastically. Until recently, to start a private clinic, a doctor did not need to have a business license as medical practice was not considered a business and doctors were trusted to do the right thing, and that was looking after the health of the community. To start a clinic, a doctor only needed to register with the MMC to make certain they are qualified to practise as a doctor. They did not even need an annual practising certificate.
The main routine work was to keep decent medical records, a precise record of drugs stocked, and maintain an accurate financial account for the Inland Revenue Board.
Today, it is not easy to set up a private practice, especially a general practice. In the past, the doctor could just concentrate on his role as a healer. A doctor now has got to be a good administrator as well. Doctors now have to handle various issues such as rental, building requirements, and so on. The doctor has to answer to various government agencies that include the local council, the labour department, the statistic department, the fire and building departments, the pharmaceutical department, and if you happen to own an x-ray machine, the physics department as well, just to name a few.
More recently, the Private Health Care & Facilities Act was enacted. The Act dictates in great detail what doctors must do and should have in their clinics, many of which are unrealistic, and quite unnecessary.
Doctors in this country are practically accused of being greedy, immature, unscrupulous, and unethical, with the threat of heavy fines and jail terms if they don’t toe the line.
I hope to see the Government giving private doctors some breathing room. Some “black sheep” in the profession have caused mistrust, and this has led the Health Ministry to think that the private sector needs to be supervised in a stricter way. Doctors are all against those unscrupulous doctors who tarnish the reputation of their profession. Those doctors have no regards for ethics or law, but the rest of the medical practitioners should not be made to suffer because of them.
Surely it is more economical, more efficient, and fairer for the authorities to try and weed out the black sheep and deal drastically with them.
The Medical Act is already there and sufficient to control the doctors and to punish any in a fair way. If not, new amendments to the Medical Act can see to that.
Already, many general practitioners in solo practice are not doing well, so much so that doctors nowadays prefer to specialise, which is another new trend. This is an unhealthy trend as family (general) practice still plays a very big role in the healthcare of our country, and the authorities should do all they can to encourage it and not cause it to be less attractive by imposing too many rules.

Increase in the number of specialists

Forty years or more ago, there were hardly any specialists in private practice. The family doctor had to refer his patients to government hospitals if they needed specialist care. Now, one big change is the vast increase in the number of specialists in private practice.
Nowadays, specialists tend to specialise only in a particular and limited field. In the past, we had only general physicians and general surgeons. Medical knowledge and treatment procedures have advanced so much that it takes many years of training just to become such a specialist.
For example, for Internal Medicine alone, there are no longer general physicians who are trained to handle a wide variety of diseases. Instead, there are now physicians specialising only on certain parts of the human anatomy, such as cardiologists, gastroenterologists, renal physicians, dermatologists, neurologists, and endocrinologists, just to name a few. Surgery also follows this trend.

Changing scene in private hospitals

As mentioned earlier, the private healthcare scene has changed greatly. Because of this, cost of treatment has also escalated steeply.
In the past, doctors were in control in most of what they did when practising in private hospitals, but now, due to the commercialisation of private hospitals, which started about 20 years ago, doctors are no longer in control and have little say in the daily running of the hospital.
In the past, it was the medical superintendent, a doctor, who saw to the whole running of the hospital. Now, hospitals are run like a business concern, often by a group of businessmen who are not doctors. The administrators make the final decision. Doctors are just employees to make money for the hospitals, unlike in the past.
Private hospital practice is now getting more and more commercialised and less personal in many ways, including the doctor-patient relationship. This is due to the involvement of Managed Care Organisations (MCO). Cost of private healthcare has increased tremendously, partly due to this trend. It is really sad to see such penetration of commerce into the province of medical practice. In 1999, the Government was even considering privatising public hospitals. The plan was fortunately put on hold after the MMA protested. Privatisation will be disastrous for the poor, especially if the country does not have a suitable national health insurance scheme in place.
Managed care was first introduced in the US to cope with increasing healthcare costs more than 40 years ago. Now it no longer serves such a purpose, and has in fact become a big source of commercialisation of medical care, causing marked increase in healthcare costs.

Increasing drug prices

The tremendous rise in drug cost has affected medical practice to a great extent. In the past, medicines were very cheap, costing less than 10 sen per tablet, and many doctors practising in private clinics were able to even absorb the cost of medicine in their fees.
Now the price of medicine has escalated by leaps and bounds. In fact, some regularly used routine medicines such as those for diabetes, high blood pressure, or lowering cholesterol drugs, which you need to take regularly, cost up to RM5 to RM7 a tablet, which is a 50-fold increase! The cost of medicine now forms the main proportion of the total cost in a doctor’s bill.

Private doctor income

The changing trend of medical practice in Malaysia has affected the doctor’s income in private practice. Group practice is now more popular than solo practice. The general practitioner’s ability to earn a decent living is very much affected. This is due to the vast increase in overhead expenses, yet their charges have not significantly increased over the years.
Inflation has seen rising costs of materials, rental, electricity, and drugs, and this has affected the general medical practice.
Salaries for clinic assistants and nurses have also risen. Expenses now also include contribution to SOCSO and EPF, which have also risen. Rental and other bills such as water, electricity, and repairs have also increased.
In spite of all these, a doctor’s consultation fee has hardly increased. Consultations charged by doctors are now much lower than any other profession, including taking your pets to a vet surgeon, or your electrical appliances for repair!
Other professions, except doctors in general practice, have increased their income substantially. Even TV and car repair men are charging more than 10 times the previous rates. Food price certainly has increased tremendously. For example, a plate of char koay teow, which used to cost 30 sen, is now over RM5; thus an increase of nearly 20 times.
The great increase in the number of general practitioners has also affected their income. Even the increase in the number of specialists in private practice have also contributed to this due to patients going directly to see a specialist instead of their general practitioner first.
The Government’s effort to increase the doctor-population ratio unfortunately did not take into consideration the distribution of doctors, which tend to be concentrated in urban areas. There are already too many doctors in the urban area, and the Government’s effort to attain so many doctors in so short a time is affecting the quality of medical practice in urban areas.
The Government must be realistic in its target so as not to compromise quality.

Defensive medical practice

The practice of medicine is also heading towards defensive medicine due to more lawsuits and complaints. This has caused a marked increase in premium for medical insurance due to increasing claims and liabilities.
It can also make even the best doctors become too careful for fear of making mistakes. This will eventually also lead to increased investigations, referrals, etc, to avoid taking any risk, and thus will affect the quality of patient care. Because of this, medical insurance premiums will continue to rise steeply due to increased claims and liabilities.
Unfortunately, even the most careful doctor can make mistakes. There is too much expectation of doctors in general. Patients and even doctors themselves have created an impossible expectation of perfection, which makes it impossible and difficult for doctors to admit to mistakes and thus learn from them.
Society demands a perfect outcome from doctors. Even an isolated case of a mistake by a doctor will be sensationalised by the press. Other professionals do not face such expectations from the public.
Everyone is always so quick to blame doctors whenever there is a mistake. This is even so when the error was not directly due to doctors but their auxiliary staff.
In the US, nothing less than a perfect outcome is acceptable to consumers. It was reported that in 1993, an estimated 84% of US physicians practise defensive medicine to protect themselves from potential lawsuits. This also accounts for more problems arising from unnecessary tests, x-rays, and procedures, which in the long run will be even more harmful. For example, normal vaginal delivery has been replaced with caesarean sections at the slightest indication of difficulties.
Every procedure or treatment carries a certain amount of acceptable risk. Doctors should take every care to do his best in the performance of his duties to avoid being accused of negligence. It is important for doctors to have good communication with his patients.

Looking towards the future

The practice of medicine has certainly changed substantially. However, doctors should not abandon the old ways of spending more time with their patients; take more time to examine their patients, and take good history. Although the use of the latest equipment may be necessary, doctors should avoid being too dependent on them.
Doctors should make every effort to find ways to resist commercialisation of medical practice.
Before implementing any new rules affecting doctors, the authorities should seek the opinion of doctors who are well informed and knowledgeable of their own profession for discussions. This is in the best interest of the public as well as the medical profession.
There has been increasing pressure for doctors to adopt business strategies, which is in direct conflict with our professional ideals. Doctors must be trained and persuaded to resist such trends. Medical ethics must never be compromised and is a priority for doctors.
Hopefully in more years to come, we can still be respected as compassionate healers and not businessmen. Only those who have the passion to heal should become doctors.


 SUMBER



Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

SYNDROME HUNTER

SYNDROME HUNTER

sumber: http://www.hmetro.com.my/articles/Mestipekagejalaawal/Article/artikelMA

Mesti peka gejala awal

OLEH NORLAILA HAMIMA JAMALUDDIN
norlaila@hmetro.com.my

SAKIT... pesakit Sindrom Hunter menerima rawatan.

TIDAK NORMAL... dua budak yang menghidap penyakit Sindrom Hunter.

“MASA dia terbaring kerana demam, seluruh muka serta badannya nampak biru dan bengkak; terdetik dalam hati kami — adakah masa untuk Iman (Mohd Nur Aiman) ‘pergi’ sudah sampai. Namun apabila bengkaknya surut, dia boleh bangun dan tersenyum, kami menarik nafas lega. Allah masih beri kami masa untuk bersamanya.

“Walaupun badannya semakin lemah, pertuturan menjadi kurang jelas dan banyak kemahirannya mulai hilang, dia gagahkan diri untuk bergerak dan bermain dengan adiknya, Irfan (Mohd Nur Irfan). Semangat itu memberi kekuatan kepada kami untuk terus berbakti menjaganya sebaik mungkin selagi hayatnya masih ada,” kata Mardzita Mohamed Talip, 36.

Dalam pertemuan tidak dirancang di Institut Pediatrik Hospital Kuala Lumpur (HKL), Mardzita berkata masalah kesihatan Iman mula disedari ketika berumur tiga tahun apabila pergerakan anaknya dilihat semakin perlahan, pertumbuhan fizikal terbantut, badannya menjadi bongkok dan struktur mukanya juga berubah.

Malah ketika ini Iman yang asalnya ‘banyak mulut’, masih tidak pandai memberitahu mahu buang air walaupun diajar berulang kali.

“Pada awalnya Iman sering selesema dan hidung berair. Apabila dibawa ke hospital, doktor beritahu dia juga dapat jangkitan telinga yang menyebabkan pendengarannya terjejas. Memang doktor mengesyaki ada sesuatu yang tidak kena tetapi gagal mengesahkan masalah Iman.

“Kemudian kami berjumpa pakar kanak-kanak dan apabila melihat keadaan fizikal Iman terutama pusatnya yang tersembul, doktor kata dia mungkin menghidap Sindrom Hunter. Itu kali pertama saya dengar nama penyakit ini. Namun untuk pengesahan, doktor minta contoh air kencing dan darah saya, suami dan Irfan untuk diuji di HKL.

“Keputusannya, sah Iman menghidap Sindrom Hunter. Untuk mengetahui tahap berapa, sampel air kencing dan darah kami dihantar ke Australia. Ketika memberitahu keputusan ujian kepada suami (Mohd Shapini Hashim, 42) saya tidak boleh bercakap, terlalu sebak.

“Kami sama-sama menangis selepas berbincang mengenai penyakit Iman, apatah lagi apabila doktor memberitahu umur pesakit Sindrom Hunter biasanya tidak melebihi 10 tahun,” katanya sambil mengesat air mata.

Menurut doktor, jika penyakit Iman dapat dikesan sebelum berumur dua tahun, dia boleh diberi rawatan pemindahan sumsum tulang yang dapat mengurangkan kesan Sindrom Hunter.

Jika selepas dua tahun, pembedahan pemindahan sumsum tulang masih boleh dilakukan jika pesakit belum mengalami gangguan otak.

“Pemindahan sumsum tulang tidak lagi sesuai untuk Iman kerana dia alami gangguan otak. Doktor berkata antara tanda gangguan otak itu ialah kebolehan percakapan dan pemahamannya semakin hilang, pembelajarannya menjadi sangat perlahan dan dia tidak tahu membezakan warna — semuanya ada pada Iman,” katanya.

Hati ibu mana tidak sedih melihat anak yang comel dan cergas tiba-tiba berubah wajah dan tidak mampu berlari lincah seperti dulu. Walaupun masih boleh berjalan perlahan-lahan tetapi selepas beberapa langkah dia minta didukung kerana penat dan sendi kakinya yang lemah membuatkan dia tidak mampu berdiri lama.

Satu demi satu masalah kesihatan berlaku pada Iman. Bermula dengan jangkitan telinga, tonsil bengkak dan sendi kejang, kini dia disahkan mengalami masalah jantung di mana dua injap jantungnya bocor.

Selain itu saluran pernafasannya semakin sempit, membuatkan dia sering sesak nafas dan cepat penat.

Lebih memilukan apabila diberitahu kini saraf tunjang Iman mula mengalami masalah dan dia boleh pengsan, lumpuh seluruh badan atau meninggal dunia secara tiba-tiba jika keadaan semakin teruk.

“Setahun saya berendam air mata, tetapi kami yakin setiap dugaan itu ada hikmahnya. Iman adalah hadiah yang sangat istimewa buat kami dan kerana dengan kehadirannya, hidup kami sekeluarga dilimpahi kasih sayang. Malah, penjaga Iman juga menganggapnya sebagai anak dan kerap meminta kami membenarkan Iman bermalam di rumahnya.

“Kami tidak mampu mendapatkan rawatan penggantian enzim yang mencecah RM1 juta setahun. Walaupun doktor kata hayatnya tidak panjang tetapi selagi dia bertahan, selagi itu kami cuba sedaya upaya menjaganya dengan baik. Kami hantar dia ke prasekolah pendidikan khas sejak Iman berumur lima tahun dan daftarkan dia untuk masuk tahun satu.

“Kami reda dengan takdir Allah dan bersedia menghadapi sebarang kemungkinan. Cuma sesekali apabila saya melihat dia mencium adik dan ayah yang tidur sebagai menyatakan rasa sayang (kerana tidak pandai bercakap), air mata saya mengalir laju,” katanya.


Penyakit genetik

Menurut Perunding Paediatrik Pusat Perubatan Kelana Jaya, Dr Syed Nazir MS Kadir, Sindrom Hunter atau mukopolisakaridosis Jenis II (MPS jenis 2) ialah penyakit genetik yang sangat jarang berlaku.

Ia disebabkan kekurangan atau ketiadaan enzim yang dipanggil iduronate-2-sulfatase (I2S) dalam badan.

Nama sindrom ini diambil sempena nama doktor di Scotland, Charles A Hunter (1873-1955) yang mula menerangkan penyakit ini pada 1917.

Makanan yang kita ambil perlu melalui banyak proses untuk dipecahkan kepada molekul kompleks sebelum ia boleh digunakan oleh badan.

Enzim khusus diperlukan untuk setiap proses ini, dan kekurangan atau ketiadaannya akan menyebabkan pelbagai masalah akibat pengumpulan molekul makanan yang kompleks.

Pengumpulan molekul yang kompleks ini boleh memberi kesan buruk kepada sel dan tisu tertentu. Pada kanak-kanak yang mengalami Sindrom Hunter, pengumpulan molekul ini menyebabkan kerosakan kekal yang berlaku secara berterusan dan memberi kesan kepada rupa, perkembangan mental, fungsi organ dan kebolehan fizikal.

“Sindrom Hunter muncul pada kanak-kanak seawal usia dua tahun dan biasanya ia berlaku pada kanak-kanak lelaki. Sehingga kini tiada rawatan untuk menyembuhkan Sindrom Hunter dan rawatan yang ada hanya membabitkan pengurusan gejala serta komplikasi.

Maknanya pesakit akan diberikan rawatan berdasarkan gejala dan masalah kesihatan yang diakibatkan oleh sindrom ini.

“Apabila pengumpulan molekul kompleks ini semakin banyak di seluruh badan, tanda Sindrom Hunter jadi lebih jelas. Bagi sesetengah pesakit ia menyebabkan perubahan fizikal pada ciri muka dan saiz kepala (jadi besar).

“Dalam kes lain mungkin membabitkan otak yang menyebabkan perkembangan pesakit menjadi perlahan. Kesan Sindrom Hunter berbeza bagi setiap pesakit daripada segi kesan atau kadar kemaraan penyakit.

“Bagaimanapun secara umumnya Sindrom Hunter selalunya teruk, memberi kesan berterusan dan membuatkan pesakit tidak panjang umur,” katanya.


Bagaimana penyakit ini diwarisi?

Sindrom Hunter ialah penyakit yang diwariskan melalui gen-X resesif, bermakna wanita akan menjadi pembawa dan mewariskannya kepada anak-anak tetapi mereka tidak mengalami sebarang gejala.

Wanita yang menjadi pembawa gen-X resesif mempunyai empat kebarangkalian iaitu 25 peratus anak lelaki normal, 25 peratus anak lelaki Sindrom Hunter, 25 peratus anak perempuan normal dan 25 peratus anak perempuan normal tetapi menjadi pembawa gen ini.

Sindrom Hunter disebabkan kecacatan kromosom dan untuk menjadi pesakit, seorang anak perlu mewarisi kromosom yang cacat ini. Biasanya sindrom ini berlaku pada lelaki kerana lelaki mempunyai satu kromosom X dan satu kromosom Y (XY).

Manakala wanita mempunyai dua kromosom X (XX), dan jika salah satu kromosom ini cacat, kromosom yang elok masih boleh berfungsi dengan baik dan menutup kelemahan kromosom yang cacat tadi.

Oleh kerana Sindrom Hunter adalah penyakit yang jarang berlaku, dianggarkan cuma ada 2,000 pesakit di seluruh dunia dengan taburan 500 di Amerika Syarikat, Kanada (30), Ireland (6) manakala New Zealand, Arab Saudi dan Chile mempunyai satu kes masing-masing. Jumlah sebenar pesakit di Malaysia tidak diketahui.


Tanda dan gejala

Gejala Sindrom Hunter tidak kelihatan ketika lahir, tetapi ia semakin jelas selepas umur setahun. Antara gejala awal yang biasanya muncul ialah perut buncit, jangkitan telinga, selesema dan hidung berair.

Oleh kerana ia gejala yang sangat biasa, doktor tidak dapat mengenal pasti sindrom ini dengan segera. Bagaimanapun, apabila molekul kompleks semakin banyak dalam badan, gejala lebih jelas boleh dilihat seperti ciri muka yang kasar (dahi lebar dan jendul, hidung besar dan penyek, lidah dan kepala besar, perut buncit) serta kerap mendapat jangkitan telinga dan saluran pernafasan. Ciri ini menyebabkan semua kanak-kanak Sindrom Hunter mempunyai wajah lebih kurang sama.

Sindrom Hunter boleh dibahagi kepada dua jenis iaitu MPS IIA dan MPS IIB, dan gejalanya berbeza mengikut jenis. MPS IIA (kemunculan awal) lebih kerap berlaku dan lebih teruk, gejala hanya muncul selepas dua hingga empat tahun.

Jenis ini juga boleh menjejaskan perkembangan otak (terencat otak) apabila pesakit semakin besar dan biasanya umur pesakit tidak melebihi belasan tahun.

Antara tanda dan gejalanya ialah:

Perkembangan kemahiran terjejas (biasanya antara umur satu setengah hingga tiga tahun)

Ciri muka yang kasar, bibir tebal, lidah dan hidung menjadi besar

Hidung besar dan penyek

Tangan dan jari bengkok

Lidah terjulur keluar

Saiz atau bentuk tulang menjadi tidak normal

Organ dalaman seperti hati dan limpa membesar menyebabkan perut buncit

Alami kesukaran pernafasan, termasuk apnea tidur (pernafasan terhenti ketika tidur)

Alami gangguan jantung seperti injap jantung menebal, tekanan darah tinggi dan saluran darah ke jantung tersumbat

Penglihatan hilang secara perlahan-lahan akibat kerosakan sel yang menangkap cahaya dan pengumpulan molekul kompleks pada otak menyebabkan tekanan pada saraf optik dan mata

Lesi pada kulit di belakang dan atas lengan


MPS IIB pula lebih ringan dan gejalanya yang kurang teruk biasanya muncul apabila pesakit besar. Jenis ini biasanya dikesan selepas berumur 10 tahun dan ada kalanya tidak disedari hinggalah pesakit dewasa. Perkembangan intelek dan sosial hampir normal dan pesakit boleh hidup sehingga melebihi 50 tahun.

Antara gejala MPS IIB ialah:

Saiz atau bentuk tulang yang tidak normal tetapi tidak seteruk MPS IIA

Pertumbuhan terbantut

Penglihatan kurang jelas

Sendi tegang (sakit sendi)

Hilang pendengaran

Sering alami masalah sakit pada pergelangan tangan

Alami masalah apnea tidur


Bagaimana penyakit ini menjejaskan pertumbuhan dan perkembangan pesakit?
Pengumpulan molekul kompleks dalam sel lama kelamaan memberi kesan kepada organ seperti:

Dinding jantung dan injap menjadi tebal hingga memperlahankan denyutan

Dinding saluran pernafasan juga menjadi tebal dan menyempitkan laluan udara. Akibatnya pesakit kerap mengalami masalah pernafasan, terutama ketika tidur. Malah kapasiti paru-paru juga terhad

Oleh kerana hati dan limpa membesar ia menolak bahagian abdomen, menyebabkan perut pesakit kelihatan buncit

Semua sendi besar (pergelangan tangan, siku, bahu, pinggul dan lutut) terjejas dan menjadi tegang serta mengehadkan pergerakan, termasuk berjalan. Sendi jari juga terbabit dan menyukarkan pesakit menulis dan mengutip benda kecil.

Perkembangan tulang yang terjejas menyebabkan pesakit bantut

Pengumpulan molekul kompleks pada otak mengakibatkan otak terencat


Pengesanan dan rawatan

Oleh kerana Sindrom Hunter jarang berlaku, pengesanan dari awal mungkin sukar. Ibu bapa perlu peka pada perubahan ciri muka anak dan untuk pengesahan, lakukan ujian darah, air kencing atau tisu.

Ada kala masalah kesihatan lain muncul dulu yang membolehkan doktor mengesan penyakit ini. Contohnya jika pesakit kerap mengalami jangkitan paru-paru, ujian sinar-X akan menunjukkan bentuk tulang vertebra dan rusuk yang tidak normal.

Rawatan yang ada ialah terapi penggantian enzim tetapi kosnya sangat mahal sehingga mencecah RM1 juta setahun bagi setiap pesakit. Oleh itu rawatan yang biasa diberikan ialah menguruskan gejala dan memberi kelegaan kepada pesakit.

Selain itu pemindahan sumsum tulang dikatakan antara rawatan yang dapat membantu pesakit.

Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

HUKM~btui KA NAK JADI doktor ni???

semasa ana mengikuti kursus arab ni...pada tanggal 18jun kalau tak salah...kami telah di bawa bergerak ke HUKM~hospital UKM...di sana semasa sesi taklimat yang berlangsung di dalam dewan kuliah perubatan, kami telah di conduct oleh 2 orang doktor yang bertauliah...

kedua-dua mereka adalah lepasan luar negara...

SATU SOALAN cepu emas telah di tanya kepada kami...

~KENAPA ANDA SEMUA nak JADI DOKTOR????~

rasa2 semua orang yang mahu menjadi doktor sure kena jawab soalan ni...ana sendiri ternanti-nanti jawapan yang ana harap sama dan serupa macam jawapan ana....

bila mikrofon 2 di pas2....ada ja yang jawab:

1. saya telah dilahirkan untuk menjadi doktor....

2. saya ni orang yang belas kasihan...xsanggup saya tengok orang derita

3. saya ni suka sangat tolong orang..jadi kerjaya sebagai doktor adalah tepat

4. doctor can make money!!!

namun, in my opinion....kita kena berbalik kepada matlamat atau tujuan asal kita hidup di dunia ni....

first, kita hidup ni tujuan dia sebagai hamBA Allah...(Surah Az-Zariyat:56)

jadi, dalam kita hidup ni, kita kena sentiasa ingat bahawa kita ni sebagai hamba Allah...jadi2 apa lagi tujuan kita adalah beribadat kepada Allah...iaitu sentiasa mencari keredhaan-Nya yg SATU.....

keduanya, tujuan kita hidup di dunia ni lagi adalah kerana kita ni KHALIFAH Allah....rasanya semua orang arif tentang ini cuma terlepas pandang sahaja...jadi, sebagai khalifah...kita telah ditanggungjawabkan untuk berdakwah....AMAR MAKRUF NAHI MUNKAR~

jadi relation dengan tujuan jadi doktor ni sebenarnya ada kaitannya dengan dakwah ni....sebab bila seseorang 2 sakit tau apa mereka akan kembali kepada Tuhan-Nya...ini memang sesuatu yang SOH...memang fitrah manusia begitu...masih ingat lagi PELAJARAN SYARIAH ISLAMIAH yg diajar di TINGKATaN 4....??

~ilmu tanpa amal ibarat pohon x berbuah~

jadi, melalui kerjaya doktor ni la kita dapat menyebarkan dakwah2 islam ni....insya-Allah...kalau doktor suruh makan SE MUT yang kununnya boleh jadi ubat...PATIENT 2 akan makan...huhu...so...gunakan teknik dakwah yang terbaik....al-IHSAN wal mauiZAtuL hasanah.....

pendekatan yang baik mampu menarik hati orang untuk kembali kepada Tuhan-Nya yang menciptakan....selain itu juga, ana sendiri mendapat maklumat dari USRAh dengan bakaL2 doktor, mereka mengkhabarkan para YAHUDI dan nASRANI sememangnya menyedari akan hikmahnya menjadi doktor ni...iaitu untuk mendoktrin umat manusia ni ke arah kehancuran!kebinasaan!dan kesesatan serta menghancurkan ISLAM yang TERCINTA....

oleh itu, sebagai umat yang ada kesedaran ini marilah kita sama2 ubah dan TAJDIDkan niat kita....iaitu untuk mencapai KEREDHAAN ALLAH...

kerja untuk mencari rezeki 2 tak perlu difikirkan sangat....kerana Allah telah berjanji....REZKI itu Hanya DARI-NYA...dan jika kita memberi dengan pinjaman yang baik...Allah akan memberi dengan GANJARAN yang LEBIH lagi....(surah at-Taghabun:17)

"Jika kamu meminjamkan kepada Allah dengan pinjaman yang baik, niscaya Dia akan melipatgandakan (balasan) untukmu dan mengampuni kamu. Dan Allah Maha Mensyukuri dan Maha Penyantun.

~wallahua'lam~

Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

PASUM in memory~

Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

ammiah VS fusHAh!!!

Apa VS2 ni???

nk tgk WWF ka??

nak lawan Masak ka???

nak lawan makan ka???

no!!no!!!

sebenarnya nak berkongsi perkataan+vocab bahasa Arab...tapi cuma bole tulih dalam bahasa melayu ja la kut....pandai2 la eja sendiri dalam JAWI no...

FUSHAH: aidhan=juga

AMMIAH: bardu=juga

FUSHAH: kholamun=pen

AMMIAH: alam=pen

FUSHAH: aabun=ayah

AMMNIAH: baba=ayah

FUSHAH: ummun=emak

AMMIAH: mama=emak

FUSHAH: jamilah=cantik

AMMIAH: gamilah=cantik

FUSHAH: na'am=ya

AMMIAH: aiwah=ya

FUSHAH: jiddan=sangat2

AMMIAH: awi2=sangat2

FUSHAH: asif=maaf

AMMIAH: ma'alisyh=maaf

sebenarnya banyak lagi. ana pun baru duk belajar2 la ni...mari la kita sama2 belajar bahasa arab...best nya...!!!

menarik kan....huhu

kalau sapa nak tau banyak lagi tanya org yg duk mesir nu k...nasiruddin ble gak

http://almomentum.blogspot.com/

tapi kan yg sure nya, ejaan ada ja lebih kurang sama dengan fushah nya perkataan, cuma sebutan jadi len...

1. sin terbuka > jadi ta'

contohnya: salathah(3) > jadi talata

2. jim jadi > ga

contohnya: jamil(cantik) > jadi Gamil

3. zal jadi > dal

contohnya: zikrun(ingt) jadi > dikr

4. dhot jadi > zho

contohnya: dhobit(officer) jadi > zhobit

5. khauf jadi > hamzah@aalif

contohnya: Qul(cakap) jadi > UL

6. hamzah@aalif jadi > ya'

contohnya: naeem(tidoQ) jadi > nayeem

rasa2 yg tue ja kut ilmu yang ana bole kongsi...insya-Allah...nnti klu da pa2 lagi kita share lagi...

wallahua'lam...wassalam

Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^

AKhirNya...~fuh~

alhamdulillahirabbilalaamin...fuh...lega tui bla akhirnya dpt gak tulih blog yg x seberapa ni. Harap2 bole la share2 ilmu skit2...penat tui nk wat blog kn kucing...huhu..mula2 ana wat gna emel yahoo...elok siap tempalte dh abih cun...kra nk posting la ni, dia wat hal plak...xle publish...mau xtension ana...aduiii la....tp bila dpt support dr k.sarah+kak2 lain srh wat blog alang2 duk saja(tunggu result), tulih la pa yg bole...hua...past dia xle publish ana pn maleh nk layan dak..delete semu akaun goggle...huhu...ingt nk wat akaun wordpress plak...tp cam payah ja...mmg letih la dunia teknologi ni....tp BEST!!!...huhu..akhirnya...alhamdulillah..FINISH!!!...ni x tau nk tulih gapo gi..mungkin bila ana dh cri ilmu skit2 ana share k...wat ms ni usha Ja dlu gambaq kucing 2...real cat...^_^....

aha....idea2...mungkin ada dalam kalanagan sahabat2 ni sama umo atau tua skit atau muda ka yg maybe baru abih exam kn....ana pn termasuk golongan ampa semu...huhu...ana baru ja abih exam PASUM tepat pada Pkui 11.30 d Dewan Peperiksaan UM...

kt MNa ana Blajaq???...huhu...PASUM...ramai org tak tau pa dia PASUM ni....'pejabat asas untuk makan'???

hahahah....xdak la....klu dlu ana sendiri pun xterpikiq nk masuk sna...ana even x tau pon apa 2 PASUM....rupa2 nya...

~Pusat Asasi Sains Universiti Malaya~

adoii la....wat sesapa yg xtau gi...2 la PASUM....bnyk la ana sembang2 dgn adik2 junior ana n sepupu....

"nnti nak sambung ngaji mna???"

mmg ble agak la jawpan depa,"first choice sure la uia..,"dengan gembira depa habaq kt ana...

huhu

mmg ramai la nk p sana...even ana dlu pon....tp bila Allah dh takdirkan dpt PASUM...ana pn dpt la merasai biahh@condition dia yg TRUE eva The bEst in my Life Maybe...

(sebenaqnya la kan...setiap tmpat ada keistimewaan dia tersendiri)

'Allah jadikan tempat2 bersejarah utk kita amik pngajaran darinya'

so, bkn ana nk BiaS promote UM ka apa....back to what i had said...every place has its own story...so make it nice....apa yg penting diri kita kna pandai bawak diri...

ok2..duk bleteq plak ana...huhu...

PAsUm ni ada tiga kos...

1.Asasi Sains Hayat

2.Asasi Sains Fizikal

3.Asasi Alam Bina....

~Asasi Sains Hayat~Blajaq sama ja n Lebih kurang Matrix...cuma sylibus dia plus Form 6 nya skit2 dan d susun ole pensyarah2 UM....qUite challenging la...especially math dia...ana maybe xtere...2 yg coment gitu...klu yg 4.00 tu insya-Allah depa petik jari dh dpt....tp pa pon kembali kepada Allah la...

'Allah beri apa yg kita perlu bkn apa Yg kita mahu'

tp kn...satu ja yg pening skit sai hayat ni...huhu...klu kt matrix KPM, depa blajaq bio, kimia, math...
klu PASUM Hayat...extra fiZik...pas 2 setiap subjek plak divide 2 lagi...

kra nya semu 8 subjek...fuh...letih deh...FJAXO111.FJAX0112,FJAX0113,FJAX0114,FKAX0111,FKAX0112,FKAX0113,FKAX0114,FQAH0111,FQAH0112,FQAH0113,FQAH0114,FMAX0111,FMAX0112,FMAX0113,FMAX0113,FMAX0114

da la lagi jati diri...MuET...

~Asasi Sains Fizikal plak~...

lebih kurang sama ja...cuma buang bio...n tambah subjek math engine+sains komputer...

~Asasi Alam Bina....hah...ni khas skit...klu matrix xdak ni...kepada sesiapa ja yg tangan2 seni suka conteng ka...wat sampah ka...baju xlipat ka...yg d kira seni...bole la masuk asasi ni....dia blajaq gak subjek2 sain cam kimia+fizik...math pn...tp yg asas ja..RoMMAte ana dlu alam bina...dia asyik kan wat project every weeks~kna kreatif~...letih ana tgk...huhu...

cam 2 la skit2 sai PASUM ni...dua sem ja...x lam...10 bulan ja..klu exam 2 wat la tutorial bnyk2...insya-Allah score...haha...ana pn maleh gak...last minute ja...adusss...

klu sapa2 nk tau apa2 sai PASUM ni bole ja contat ana kut emel ni...tau pn rmai ja kwn2 atau senior2 len bole tolong...search kt friendster bole...grop PUSAT ASASI UNIVERSITI MALAYA....km Sedia membantu!!!..^_^

Dalam Melangakah Terkadang Diri d ujI Dengan Ujian Yg terasa Berat HinGGa dri Terduduk&menaNgis..Perit Terasa tP KetahuiLAh&RenungilaH KembaLi ke Dalam dri....MungKin Dia HadirKan air MaTa Tika itu UTk menJahiT KemBali SejaDah iMan yg Kian TerKoyak LanTAraN Ada LanGkaH2 yg TerSasaR dr KeikHlasn..SeEMOga dri d TetapKan iman..D Setiap KepayahAn ada KemanisAn..^_^