Chronic Kidney Disease
Discussant: Josephine Go Yap, M.D.
Chronic Kidney failure is the slow deterioration of the kidneys due to uncontrolled ailments like diabetes, hypertension, chronic infection due to obstructions, tumors, chronic glomerular diseases and polycystic illnesses. Acute Kidney failure, on the other hand, is the sudden onset of declining or shutting down of kidney function because of severe dehydration, bleeding, severe infection, trauma and drug use.
Signs and symptoms of kidney failure include loss of weight, anemia, rise in creatinine and BUN, swelling of the face, body, and lower extremities, loss of appetite, high blood pressure, presence of blood and protein in the urine, nausea and vomiting, and difficulty in breathing.
Dialysis is a treatment addressing kidney failure. Hemodialysis removes waste in the blood using an artificial kidney called the dialyzer. Peritoneal dialysis removes waste product and excess water using the thin lining in the abdomen.
To retard the progression of kidney failure, the following are recommended:
n Optimum blood sugar control
n Well-controlled blood pressures
n Acknowledge enlarged prostate glands, stones, tumors
n Treat urinary tract infection
n Low protein and low salt diet
n Consult doctors for proper treatment
Medical Forum No. 200
Discussant: Johnny Lokin, M.D.
Stroke is one of the leading causes of death and disability worldwide, affecting some 22 million people and a mortality rate of five to six million annually. It is also the most significant cause of disability for people in 60-year-old age bracket.
There are three types of strokes. Transient Ischemic Attack (TIA) or mini stroke happens when an artery leading to or inside the brain becomes blocked for a short period of time. Blood flow to an area of the brain slows down or stops. Symptoms include numbness, trouble speaking, loss of vision and loss of balance or coordination. Ischemic Stroke occurs when a blood clot blocks an artery, cutting off the flow of oxygen-rich blood to a part of the brain. Hemorrhagic Stroke is caused by the bursting of a blood vessel in the brain that spills blood into the brain tissues.
Ischemic Stroke can either be triggered by embolism or thrombosis. In an embolic stroke, a blood clot or plaque fragment forms somewhere in the body and moves through the blood stream reaching certain areas of the brain. In a thrombotic stroke, a blood clot does not travel but forms inside an artery which supplies blood to the brain.
Hemorrhagic Stroke can either be Intracerebral or Subarachnoid. The former is caused by a bursting blood vessel that bleeds into the brain. The latter is caused by a blood vessel that bursts near the surface of the brain and blood spills into the area around the brain.
Diagnostic technology for stroke victims include Cranial CT Scan, Cranial MRI, Angiography/Arteriography, Transcranial Doppler Ultrasound.
Medical Forum No. 201
The Role of Chinese Medicine in Immunology and Cancer
Discussant: Dr. Godfrey Chi-Fung Chan
Traditional Chinese medicine plays a role in caring for those suffering from cancer as well as in addressing the area of immunology.
Dr. Godfrey Chi-Fung Chan of the Queen Mary Hospital, University of Hong Kong discussed the details of Chinese medicine in relation to cancer and immunology.
Medical Forum No. 202
Complication of Osteoporosis
Discussant: Nelson Lim, M.D.
Specialty: Reconstructive Microsurgery
Osteoporosis literally means porous bone. It is a disease of progressive bone loss associated with an increased risk for fractures. It often develops unnoticed over many years with no symptoms or discomfort until a fracture occurs. The disease causes loss of height and a severely rounded upper back or dowager’s hump.
Major causes of osteoporosis include aging, heredity, nutrition and lifestyle, medications and other illnesses. It is diagnosed via skeletal x-rays, bone densitometry or dexa scan, and complete medical history and physical examination.
Complications and consequences of osteoporosis include death; fragility fracture; psychological distress; back, hip, wrist pain; prolonged immobility, which may lead to bedsores, DVT, PE, CHF, pneumonia, refracture; loss of height; deformities; disability or loss of function.
Treatments range from regular weight bearing exercises, nutrition therapy of adequate protein, calcium, and Vitamin D. Available medications include estrogen replacement, selective estrogen receptor modulators, bone forming drugs.
Osteoporosis may also be prevented through regular weight bearing exercises, exposure to sunlight, and a well-balanced diet that includes foods rich in calcium, protein, and Vitamin D.
Medical Forum No. 203
Discussant: Jennifer Chua, M.D.
Specialty: Infectious Diseases
Adult vaccination or immunization is often not given importance as child immunization. While it is a fact that most immunizations will occur during childhood, there is a need to follow up booster vaccinations in adult life to help the body’s immune system build up a defense against certain illnesses and diseases.
Some of the immunizations given during childhood and even during adulthood need to be updated as efficacy fades. This means that booster shots are necessary. The tetanus and diphtheria shots should be boosted every 10 years. Also, immunizations such as the MMR, Hepatitis A and B may need to be given a booster sometime during adulthood.
Aging also naturally weakens the immune system, making it necessary for adults to receive common immunizations like the flu shot and pneumococcus vaccination for pneumonia.
Women, until the age of 26, should receive the Human Papillomarvirus (HPV) vaccine, to help protect against cervical cancer.
Medical Forum No. 204
Kidney Stones in Adults
Discussant: Alberto Chua, M.D.
A kidney stone is a hard mass developed from crystals that separate from the urine within the urinary tract. The most common type of stone is calcium combined with oxalate or phosphate. There is also the struvite or infection stone and the less common uric acid stone.
About 2.3% of the population has kidney stones and occur more frequently in men. The prevalence of kidney stones in men rises in their forties and continues into their seventies, while in women the prevalence peaks in their fifties.
Causes of kidney stones include: family history, certain foods for people who are susceptible to formation of kidney stones, kidney disorders, urninary tract infections, hyperparathyroidism, renal tubular acidosis and hypercalciuria, excess intake of vitamin D, gout, disorder of uric acid metabolism, intestinal bypass operation or ostomy surgery, and intake of diuretics or water pills.
Kidney stones often do not cause any symptoms, but when a stone blocks the flow of urine, sharp cramping pain at the back and side or lower abdomen occurs. Other symptoms include nausea and vomiting, blood in the urine, frequent urination and burning sensation during urination. Fever and chills accompany any of these symptoms when infection is present.
Diagnosis of kidney stones can be done through x-ray and ultrasound, blood and urine tests, and CT Scan or an intravenous pyelogram (IVP).Capsule.jpg - Lowering of the time capsule. From left, TYKFI Trustee and former Prime Minister Cesar E.A. Virata, TYK Trustee Tan Hui Bin, Former Manila Congresswoman Sandy Ocampo, TYK Trustee Carmen K. Tan, TYK Chairman & President Dr. Lucio C. Tan, and Manila Mayor Alfredo Lim.