English Essay

Nowadays, the government have built up more university for graduate to have their further studies. But then, students sometimes have problem while choosing university.There have many factors that make those students to decide which university they want to apply to. In order to solve this problem. students should consider the courses offered by the universities, facilities provided and fees that will be charge during the study period.

The courses offered by the current university are sometimes not relevant to the future jobs that will be offered to the graduate. For example, the courses that offered are agriculture research, jungle research and etc. Thus, the student will concern about their job application after they graduate from university if they take those courses.

With the mushrooming of small and private university,not all of them provide adequate facilities. The university will only show the well furnished hostel and better side of the university when they are being visited. The television, WIFI, fan, desk and chair are sometimes are not provided. Thus, the facilities are important while student choose the university.

At the another hand, the fees for the private university are sometimes too expensive. Student are can't effort the study fees for their courses. The courses which need alot of fee was the medicine, dentistry, forensic, law and etc.  Yet, the scholarship and loans are hardly to get nowadays because too many of graduate apply those loans and scholarship.Very often,they end up their studies because they unable to pay the studies fees.

In conclusion, student may think a lot when they are choosing the university. They have to consider about the courses offered, the facilities and the courses fees.

KIDNEY STONE

Definition

Kidney stones form in your kidneys. As stones move into your ureters — the thin tubes that allow urine to pass from your kidneys to your bladder — signs and symptoms can result. Signs and symptoms of kidney stones can include severe pain, nausea and vomiting.

Kidney stonesKidney stones (renal lithiasis) are small, hard deposits that form inside your kidneys. Kidney stones are made of mineral and acid salts. Kidney stones have many causes. In one common scenario, kidney stones form when the urine becomes concentrated, allowing minerals to crystallize and stick together.

Passing kidney stones can be painful. The pain of a kidney stone typically starts in your side or back, just below your ribs, and moves to your lower abdomen and groin. The pain may change as the kidney stone moves through your urinary tract.

Kidney stones usually cause no permanent damage. Apart from pain medication and drinking lots of water, treatment is often unnecessary. However, treatment may help prevent recurrent kidney stones in people with increased risk.

Symptoms

A kidney stone may or may not cause signs and symptoms until it has moved into the ureter — the tube connecting the kidney and bladder. At that point, these signs and symptoms may occur:

• Severe pain in the side and back, below the ribs
•  Pain that spreads to the lower abdomen and groin  
• Pain on urination
• Pink, red or brown urine
• Nausea and vomiting
• Persistent urge to urinate
• Fever and chills if an infection is present

When to see a doctor

Make an appointment with your doctor if you have any signs and symptoms that worry you.

Seek immediate medical attention if you experience:

• Pain so severe that you can't sit still or find a comfortable position
• Pain accompanied by nausea and vomiting
• Pain accompanied by fever and chills

Causes

Kidney stones form in your kidneys. As stones move into your ureters — the thin tubes that allow urine to pass from your kidneys to your bladder — signs and symptoms can result. Signs and symptoms of kidney stones can include severe pain, nausea and vomiting.

Kidney stones often have no definite, single cause. A number of factors, often in combination, create the conditions in which susceptible people develop kidney stones.

Kidney stones form when the components of urine — fluid and various minerals and acids — are out of balance. When this happens, your urine contains more crystal-forming substances, such as calcium, oxalate and uric acid, than the available fluid can dilute. At the same time, your urine may be short of substances that keep crystals from sticking together and becoming stones. This creates an environment in which kidney stones are more likely to form.

Types of kidney stones

Most kidney stones contain crystals of more than one type. Types of kidney stones include:

 Calcium stones. Most kidney stones are calcium stones, usually in the form of calcium oxalate. High oxalate levels can be found in some fruits and vegetables, as well as in nuts and chocolate. Your liver also produces oxalate. Dietary factors, high doses of vitamin D, intestinal bypass surgery and several different metabolic disorders can increase the concentration of calcium or oxalate in urine. Calcium stones may also occur in the form of calcium phosphate.

Struvite stones. Struvite stones form in response to an infection, such as a urinary tract infection. Struvite stones can grow quickly and become quite large.

Uric acid stones. Uric acid stones can form in people who are dehydrated, those who eat a high-protein diet and those with gout. Certain genetic factors and disorders of the blood-producing tissues also may predispose you to uric acid stones.

Cystine stones. These stones represent only a small percentage of kidney stones. They form in people with a hereditary disorder that causes the kidneys to excrete excessive amounts of certain amino acids (cystinuria).

Other stones. Other, rarer types of kidney stones can occur.

Knowing your type of kidney stone helps to understand what might have caused the stone to form and may give clues as to what you can do to reduce your risk of getting additional kidney stones.

Risk factors

Factors that increase your risk of developing kidney stones include:

Family or personal history of kidney stones. If someone in your family has kidney stones, you're more likely to develop stones, too. And if you've already had one or more kidney stones, you're at increased risk of developing another.

Being an adult. Kidney stones are most common in adults age 40 and older, though kidney stones may occur at any age.

Being a man. Men are more likely to develop kidney stones.

Dehydration. Not drinking enough water each day can increase your risk of kidney stones. People who live in warm climates and those who sweat a lot may need to drink more water than others.

Certain diets. Eating a diet that's high-protein, high-sodium and high-sugar may increase your risk of some types of kidney stones.

Being obese. High body mass index (BMI), increased waist size and weight gain have been linked to an increased risk of kidney stones.

Digestive diseases and surgery. Gastric bypass surgery, inflammatory bowel disease or chronic diarrhea can cause changes in the digestive process that affect your absorption of calcium and increase the levels of stone-forming substances in your urine.

Other medical conditions. Diseases and conditions that may increase your risk of kidney stones include renal tubular acidosis, cystinuria, hyperparathyroidism and certain urinary tract infections.

Preparing for your appointment

You're likely to start by first seeing your family doctor or a general practitioner if you think you have a kidney stone. Small kidney stones can be treated by your family doctor. But if you have a large kidney stone and experience severe pain or kidney problems, your doctor may refer you to a doctor who treats problems in the urinary tract (urologist).

Because appointments can be brief, and because there's often a lot to cover, it's a good idea to be well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.

Write down key personal information, including major stresses or recent life changes.

Make a list of all medications, as well as any vitamins or supplements, that you're taking.

Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Tests and diagnosis

If your doctor suspects you have a kidney stone, you may undergo tests and procedures to diagnose your condition, such as:

Blood tests. Blood tests may reveal excess calcium or uric acid in your blood. Blood tests allow your doctor to check for other medical conditions and to monitor the health of your kidneys.

Urine tests. Tests of your urine, such as the 24-hour urine collection, may show that you're excreting too many stone-forming minerals or too few stone-inhibiting substances.

Imaging tests. Imaging tests may show kidney stones in your urinary tract. Imaging tests may include computerized tomography (CT) or, less commonly, X-ray.

Analysis of passed stones. You may be asked to urinate through a strainer designed to catch any stones you pass. That way, any stones can be collected for laboratory testing. A laboratory analysis will reveal the makeup of your kidney stones. Your doctor uses this information to determine what's causing your kidney stones and to formulate a plan to prevent future kidney stones.

Treatments and drugs

The parathyroid glands, which lie behind the thyroid, manufacture the hormone parathyroid, which plays a role in regulating your body's level of the minerals calcium and phosphorus.

Parathyroid glandsTreatment for kidney stones varies, depending on the type of stone and the cause.

Treatment for small stones with minimal symptoms

Most kidney stones won't require invasive treatment. You may be able to pass a small stone by:

Drinking water. Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system.

Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve).

Treatment for larger stones and those that cause symptoms

Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more invasive treatment. Procedures include:

Prevention


Lifestyle changes

You may reduce your risk of kidney stones if you:

Drink water throughout the day. Drink more water throughout the day. For people with a history of kidney stones, doctors usually recommend passing about 2.6 quarts (2.5 liters) of urine a day. Your doctor may ask that you measure your urine output to ensure that you're drinking enough water. People who live in hot, dry climates and those who exercise frequently may need to drink even more water to produce enough urine.

Eat fewer oxalate-rich foods. If you tend to form calcium oxalate stones, your doctor may recommend restricting foods rich in oxalates. These include rhubarb, beets, okra, spinach, Swiss chard, sweet potatoes, tea, chocolate and soy products.

Choose a diet low in salt and animal protein. Reduce the amount of salt you eat and choose nonanimal protein sources, such as nuts and legumes. This may help reduce your chance of developing kidney stones.

Continue eating calcium-rich foods, but use caution with calcium supplements. The calcium in the food you eat doesn't have an effect on your risk of kidney stones. Continue eating calcium-rich foods unless your doctor advises otherwise. Ask your doctor before taking calcium supplements, though, as these have been linked to an increased risk of kidney stones. You may reduce the risk by taking supplements with meals.

Ask your doctor for a referral to a dietitian who can help you plan meals that will help reduce your risk of kidney stones.

Medications

Medications can control the level of acidity or alkalinity in your urine and may be helpful in people who form certain kinds of stones. The type of medication your doctor prescribes will depend on the kind of kidney stones you have:

Calcium stones. To help prevent calcium stones from forming, your doctor may prescribe a thiazide diuretic or a phosphate-containing preparation.

Uric acid stones. Your doctor may prescribe allopurinol (Zyloprim, Aloprim) to reduce uric acid levels in your blood and urine and a medicine to keep your urine alkaline. In some cases, allopurinol and an alkalinizing agent may dissolve the uric acid stones.

Struvite stones. To prevent struvite stones, your doctor may recommend strategies to keep your urine free of bacteria that cause infection. Long-term use of antibiotics in small doses may be useful to achieve this goal.

Cystine stones. Cystine stones can be difficult to treat. Your doctor may prescribe certain medications to alkalinize the urine or to bind the cystine in the urine in addition to recommending an extremely high urine output.

Using sound waves to break up stones. A procedure called extracorporeal shock wave lithotripsy uses sound waves to create strong vibrations called shock waves that break the stones into tiny pieces that are then passed in your urine. The procedure creates a loud noise and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable. The specifics of your procedure may vary depending on the type of equipment your doctor uses.

Extracorporeal shock wave lithotripsy can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.

Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy involves surgically removing a kidney stone through a small incision in your back. This surgery may be recommended if extracorporeal shock wave lithotripsy has been unsuccessful or if your stone is very large.

Using a scope to remove stones. To remove a stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter. Your doctor maneuvers the ureteroscope to the stone. Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine.

Parathyroid gland surgery. Some calcium stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone, your body's level of calcium can become too high, resulting in excessive excretion of calcium in your urine. This is sometimes caused by a small benign tumor in one of your four parathyroid glands. A surgeon can remove the tumor or the parathyroid glands.

THE SKIN

Quick! What's the body's biggest organ?
You might be surprised to find out it's the skin, which you might not think of as an organ. No matter how you think of it, your skin is very important. It covers and protects everything inside your body. Without skin, people's muscles, bones, and organs would be hanging out all over the place. Skin holds everything together. It also:

• protects our bodies
• helps keep our bodies at just the right temperature
• allows us to have the sense of touch

Don't Miss Your Epidermis

The skin is made up of three layers, each with its own important parts. The layer on the outside is called the epidermis (say: eh-pih-dur-mis). The epidermis is the part of your skin you can see.

Look down at your hands for a minute. Even though you can't see anything happening, your epidermis is hard at work. At the bottom of the epidermis, new skin cells are forming.
When the cells are ready, they start moving toward the top of your epidermis. This trip takes about 2 weeks to a month. As newer cells continue to move up, older cells near the top die and rise to the surface of your skin. What you see on your hands (and everywhere else on your body) are really dead skin cells.

Bye-Bye Skin Cells

These old cells are tough and strong, just right for covering your body and protecting it. But they only stick around for a little while. Soon, they'll flake off. Though you can't see it happening, every minute of the day we lose about 30,000 to 40,000 dead skin cells off the surface of our skin.
So just in the time it took you to read this far, you've probably lost about 40,000 cells. That's almost 9 pounds (4 kilograms) of cells every year! But don't think your skin might wear out someday. Your epidermis is always making new skin cells that rise to the top to replace the old ones. Most of the cells in your epidermis (95%) work to make new skin cells.
And what about the other 5%? They make a substance called melanin (say: mel-uh-nun). Melanin gives skin its color. The darker your skin is, the more melanin you have. When you go out into the sun, these cells make extra melanin to protect you from getting burned by the sun's ultraviolet, or UV, rays.
That's why your skin gets tan if you spend a lot of time in the sun. But even though melanin is mighty, it can't shield you all by itself. You'll want to wear sunscreen and protective clothing, such as a hat, to prevent painful sunburns. Protecting your skin now also can help prevent skin cancer when you get older.

The Dermis Is Under the Epidermis

The next layer down is the dermis (say: dur-mis). You can't see your dermis because it's hidden under your epidermis. The dermis contains nerve endings, blood vessels, oil glands, and sweat glands. It also contains collagen and elastin, which are tough and stretchy.
The nerve endings in your dermis tell you how things feel when you touch them. They work with your brain and nervous system, so that your brain gets the message about what you're touching. Is it the soft fur of a cat or the rough surface of your skateboard?
Sometimes what you feel is dangerous, so the nerve endings work with your muscles to keep you from getting hurt. If you touch something hot, the nerve endings in your dermis respond right away: "Ouch! That's hot!" The nerves quickly send this message to the brain or spinal cord, which then immediately commands the muscles to take your hand away. This all happens in a split second, without you ever thinking about it.

Dermis = Lots of Blood Vessels

Your dermis is also full of tiny blood vessels. These keep your skin cells healthy by bringing them the oxygen and nutrients they need and by taking away waste. These blood vessels are hard to see in kids, but you might get a better look if you check out your grandparents' skin. As the dermis gets older, it gets thinner and easier to see through.
The dermis is home to the oil glands, too. These are also called sebaceous (say: sih-bay-shus) glands, and they are always producing sebum (say: see-bum). Sebum is your skin's own natural oil. It rises to the surface of your epidermis to keep your skin lubricated and protected. It also makes your skin waterproof — as long as sebum's on the scene, your skin won't absorb water and get soggy.
You also have sweat glands on your epidermis. Even though you can't feel it, you actually sweat a tiny bit all the time. The sweat comes up through pores (say: pors), tiny holes in the skin that allow it to escape. When the sebum meets the sweat, they form a protective film that's a bit sticky.
An easy way to see this film in action is to pick up a pin with your fingers. Then wash your hands well with soap and water and dry them off completely. Now try to pick up that pin again. It won't be so easy because your sticky layer is gone! Don't worry — it will be back soon, as your sebaceous and sweat glands create more sticky stuff.

The Third Layer Is Subcutaneous Fat

The third and bottom layer of the skin is called the subcutaneous (say: sub-kyoo-tay-nee-us) layer. It is made mostly of fat and helps your body stay warm and absorb shocks, like if you bang into something or fall down. The subcutaneous layer also helps hold your skin to all the tissues underneath it.
This layer is where you'll find the start of hair, too. Each hair on your body grows out of a tiny tube in the skin called a follicle (say: fah-lih-kul). Every follicle has its roots way down in the subcutaneous layer and continues up through the dermis.
You have hair follicles all over your body, except on your lips, the palms of your hands, and the soles of your feet. And you have more hair follicles in some places than in others — there are more than 100,000 follicles on your head alone!
Your hair follicles rely on your sebaceous glands to bring on the shine. Connected to each follicle in the dermis layer is a tiny sebaceous gland that releases sebum onto the hair. This lightly coats the hair with oil, giving it some shine and a little waterproofing.

Skin Can Warm and Cool You

Your skin can help if you're feeling too hot or too cold. Your blood vessels, hair, and sweat glands cooperate to keep your body at just the right temperature. If you were to run around in the heat, you could get overheated. If you play outside when it's cold, your inner temperature could drop. Either way, your skin can help.
Your body is pretty smart. It knows how to keep your temperature right around 98.6° Fahrenheit (37° Celsius) to keep you and your cells healthy. Your skin can respond to messages sent out by your hypothalamus (say: hy-po-thal-uh-mus), the brain's inner thermometer. If you've been running around on a hot day, your blood vessels get the signal from the hypothalamus to release some of your body's heat. They do this by bringing warm blood closer to the surface of your skin. That's why you sometimes get a red face when you run around.
To cool you down, sweat glands also swing into action by making lots of sweat to release body heat into the air. The hotter you are, the more sweat your glands make! Once the sweat hits the air, it evaporates (this means that it changes from a liquid to a vapor) off your skin, and you cool down.
What about when you're ice-skating or sledding? When you're cold, your blood vessels keep your body from losing heat by narrowing as much as possible and keeping the warm blood away from the skin's surface. You might notice tiny bumps on your skin. Most kids call these goosebumps, but the fancy name for them is the pilomotor (say: py-lo-mo-ter) reflex. The reflex makes special tiny muscles called the erector pili (say: ee-rek-tur pie-lie) muscles pull on your hairs so they stand up very straight.

Keep It Clean!

Unlike other organs (like your lungs, heart, and brain), your skin likes a good washing. When you wash your skin, use water and a mild soap. And don't forget to cover scrapes and cuts with gauze or a bandage. This keeps the dirt out and helps prevent infections. It's just one way to be kind to the skin you're in!

OBESITY

Definition


Obesity is defined as having an excessive amount of body fat. Obesity is more than just a cosmetic concern, though. It increases your risk of diseases and health problems such as diabetes and high blood pressure.

Doctors often use a formula based on your height and weight — called the body mass index (BMI) — to determine if you are obese. Adults with a BMI of 30 or higher are considered obese. Extreme obesity, also called severe obesity or morbid obesity, occurs when you have a BMI of 40 or more. With morbid obesity, you are especially likely to have serious health problems.


BMI Weight status

Below 18.5 Underweight

18.5 — 24.9 Normal

25.0 — 29.9 Overweight

30.0 and higher Obese


Today, about one in three American adults is considered to be obese, but obesity is also becoming an increasing health problem globally. The good news is that even modest weight loss can improve or prevent the health problems associated with obesity.

Symptoms

Symptoms associated with obesity can include:

• Difficulty sleeping 
• Snoring
• Sleep apnea
• Pain in your back or joints
• Excessive sweating
• Always feeling hot
• Rashes or infection in folds of your skin
• Feeling out of breath with minor exertion
• Daytime sleepiness or fatigue
• Depression

When to see a doctor

If you have symptoms associated with obesity such as the ones above, see your doctor or health care provider. You and your doctor can discuss your weight-loss options. Even modest weight loss can improve or prevent problems related to obesity. Weight loss is usually possible through dietary changes, increased physical activity and behavior changes. In some cases, prescription medications or weight-loss surgery may be options.

Causes

Although there are genetic and hormonal influences on body weight, the bottom line is that obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat. Obesity usually results from a combination of causes and contributing factors, including:

Inactivity. If you're not very active, you don't burn as many calories. Unfortunately, today most adults spend most of their day sitting, whether at home, at work or during leisure activities. With a sedentary lifestyle, you can easily take in more calories every day than you burn off through exercise or normal daily activities. Watching too much television is one of the biggest contributors to a sedentary lifestyle and weight gain.

Unhealthy diet and eating habits. Having a diet that's high in calories, eating fast food, skipping breakfast, eating most of your calories at night, consuming high-calorie drinks and eating oversized portions all contribute to weight gain.

Pregnancy. During pregnancy a woman's weight necessarily increases. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women.

Lack of sleep. Getting less than seven hours of sleep a night can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.

Certain medications. Some medications can lead to weight gain if you don't compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.

Medical problems. Obesity can sometimes be traced to a medical cause, such as Prader-Willi syndrome, Cushing's syndrome, polycystic ovary syndrome, and other diseases and conditions. Some medical problems, such as arthritis, can lead to decreased activity, which may result in weight gain. A low metabolism is unlikely to cause obesity, as is having low thyroid function.

Risk factors

Factors that may increase your risk of obesity include:

Genetics. Your genes may affect the amount of body fat you store and where that fat is distributed. Genetics also may play a role in how efficiently your body converts food into energy and how your body burns calories during exercise.

Family history. Obesity tends to run in families. That's not just because of genetics. Family members tend to have similar eating, lifestyle and activity habits. If one or both of your parents are obese, your risk of being obese is increased.

Age. Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. This lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs and can make it harder to keep off excess weight. If you don't decrease your caloric intake as you age, you'll likely gain weight.

Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to a weight gain of as much as several pounds a week for several months, which can sometimes lead to obesity.

Social and economic issues. Certain social and economic issues may be linked to obesity. You may lack access to safe areas to exercise, you may not have been taught healthy ways of cooking, or you may not have the financial means to buy fresh fruits and vegetables or foods that aren't processed and packaged. In addition, some studies show that your social networks influence your weight — you're more likely to become obese if you have obese friends or relatives.

Even if you have one or more of these risk factors, it doesn't mean that you're destined to become obese. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.

Complications

If you're obese, you're more likely to develop a number of potentially serious health problems, including:

• Blood (fat) lipid abnormalities
• Cancer, including cancer of the uterus, cervix, ovaries, breast, colon, rectum and prostate
• Depression
• Gallbladder disease
• Gynecological problems, such as infertility and irregular periods
• Heart disease
• High blood pressure
• Metabolic syndrome
• Nonalcoholic fatty liver disease
• Osteoarthritis
• Skin problems, such as intertrigo and impaired wound healing
• Sleep apnea
• Stroke
• Type 2 diabetes

What you can do


Being an active participant in your care can help your efforts to overcome obesity. One way to do this is by preparing for your appointment. Think about your needs and goals for treatment. Also, write down a list of questions to ask. These questions may include:


Why can't I get over obesity on my own?

What other health problems might I have?

What are the treatment options for obesity and my other health problems?

Is weight-loss surgery an option for me?

Will counseling help?

Are there weight-loss medications that might help?

How long will treatment take?

What can I do to help myself?

Are there any brochures or other printed material that I can take home with me?

What Web sites do you recommend visiting?

In addition to your prepared questions, don't hesitate to ask questions at any time during your appointment.


What to expect from your doctor

During your appointment, your doctor or other health provider is likely to ask you a number of questions about your eating, activity, mood and thoughts, and any symptoms you might have. You may be asked such questions as:

What do you eat in a typical day

How much activity do you get in a typical day?

During what periods of your life did you gain weight?

What are the factors that you believe affect your weight?

How is your daily life affected by your obesity?

How is your mood affected by your weight?

What diets or treatments have you tried to lose weight?

What other medical conditions, if any, do you have?

Do you have any family members with weight problems?

What are your weight-loss goals?

Are you ready to make changes in your lifestyle to lose weight?

What do you think might prevent you from losing weight?

How committed are you to losing weight?

What medications or over-the-counter herbs and supplements do you take?

What you can do in the meantime

If you have several days or weeks before your scheduled appointment, you can start making some changes on your own to your eating and activity levels as you begin the journey to lose weight.

Start making healthy changes in your diet, such as eating more fruits, vegetables and whole grains and reducing portion sizes. Eat breakfast.

Track how much you're eating or drinking each day so you get a sense of how many calories you're consuming. It's easy to underestimate how many calories you actually consume every day.

Begin increasing your activity level. If possible, take some walks. Otherwise, simply try to get up and move around your home more frequently. Start gradually if you aren't in good shape or aren't used to exercising. If you have any health conditions, or if you're a man over age 40 or a woman over age 50, talk to your doctor before you start a new exercise program.

Tests and diagnosis

If your doctor believes you are overweight or obese, he or she will typically review your health history in detail, perform a physical exam and recommend some tests. These can help confirm the diagnosis, check to see what may be contributing to your weight problem and also check for any related complications.

These exams and tests generally include:

Taking your healthy history. Your doctor reviews your weight history, weight-loss efforts, exercise habits, eating patterns, what other conditions you've had, medications, stress levels and other issues about your health. Your doctor also may review your family's health history to see if you may be predisposed to certain conditions.

Assessing other health problems. If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure or binge eating disorder.

Calculating your BMI. Your doctor will check your body mass index (BMI) to determine your level of obesity. Your BMI also helps determine what other health problems you may face and what treatment may be appropriate.

Measuring your waist circumference. Fat stored around your waist, sometimes called visceral fat or abdominal fat, may further increase your risk of diseases such as diabetes and heart disease. Women with a waist measurement of more than 35 inches and men with a waist measurement of more than 40 inches may have more health risks than people with smaller waist measurements.

A general physical exam. This includes measuring your height, checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.

Laboratory tests. What tests you have depend on your health and risk factors. They may include a complete blood count (CBC), a check of cholesterol and other blood fats, liver function tests, fasting glucose, a thyroid test, and others depending on your health situation. Your doctor also may recommend certain heart tests, such as an electrocardiogram.

Gathering all this information helps you and your doctor determine how much weight you need to lose and what health conditions or risks you have. And this will shape what treatment options are right for you.

Treatments and drugs

The goal of obesity treatment is to achieve and maintain a healthier weight to reduce your risk of serious health problems and enhance your quality of life. You may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help you understand and make changes in your eating and activity habits. Together, you can determine a healthy goal weight and how to achieve it. Your initial goal may be to lose 5 to 10 percent of your body weight within six months.

You can start feeling better and seeing improvements in your health with just minor weight loss, though — 5 to 15 percent of your total weight. That means that if you weigh 200 pounds (91 kilograms) and are obese by BMI standards, you would need to lose only about 10 to 30 pounds (4.5 to 13.6 kilograms) to start seeing benefits.

Specific treatment methods

There are many ways to treat obesity and reach a healthier weight. The treatment methods that are right for you depend on your level of obesity, your overall health, and your willingness to participate in your weight-loss plan. Think of your treatment plan as a way to make changes that you can stick with for a lifetime, so that you keep the weight off.

Treatment methods include:

Dietary changes

Exercise and activity

Behavior change

Prescription weight-loss medications

Weight-loss surgery

Achieving a healthy weight is usually done by making changes in your lifestyle — dietary changes, increased activity and behavior change. Prescription medication or weight-loss surgery is typically used in addition to lifestyle changes in more serious cases.

Dietary changes

Reducing your daily calorie intake and eating healthier are vital to overcoming obesity. Slow and steady weight loss of 1 or 2 pounds (1/2 to 1 kilogram) a week is considered the safest way to lose weight and the best way to keep it off permanently. Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term. There are a number of different dietary strategies to choose from, all of which can lower your calorie intake.

Dietary ways to overcome obesity include:

Reducing your calorie intake. The key to weight loss is reducing how many calories you consume. You and your health care providers can review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. You may be eating larger portions than you thought, or realize that your diet includes lots of fast food, sweets or sugary drinks. You and your doctor can decide how many calories you need to take in each day to achieve weight loss, but a typical amount is 1,000 to 1,600 calories.

Feeling full on less. The concept of energy density can help you satisfy your hunger with fewer calories. All foods have a certain number of calories within a given amount (volume). Some foods, such as desserts, candies and processed foods, are high in energy density. This means that a small volume of that food has a large number of calories. In contrast, other foods, such as fruits and vegetables, have low energy density. These foods provide a larger portion size with a fewer number of calories. By eating larger portions of foods less packed with calories, you squelch hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.

Adopting a healthy eating plan, such as the Mayo Clinic Healthy Weight Pyramid. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole grains. Also emphasize plant sources of protein, such as beans, lentils and soy, choose lean meats, and try to include seafood twice a week. Limit salt and added sugar. Stick with low-fat dairy products. And make sure fats come from healthier sources, such as nuts and olive, canola and nut oils. When you adopt an overall healthier diet, rather than trying a crash diet, you're more likely to follow it for the long term. The Mayo Clinic Healthy Weight Pyramid is one way to adopt a healthy, lifelong eating plan. This means no severe restrictions on the foods you eat and no extreme hunger. The base of the pyramid focuses on generous amounts of healthy foods that contain a small number of calories in a large volume of food, particularly fruits and vegetables. Healthy choices in moderate amounts make up the rest of the pyramid, which focuses on whole-grain carbohydrates, lean sources of protein such as legumes, fish and low-fat dairy, and heart-healthy unsaturated fats.

Following a very low calorie liquid diet if medically recommended. These mainly liquid diets are meant to provide rapid weight loss over the short term. They provide only about 600 to 800 calories a day. Your doctor may recommend a very low calorie diet if you need to lose weight quickly before a medical procedure or if you have serious health problems. Don't try it on your own. You need close monitoring by your health care providers to avoid complications. You also may need to take vitamin or nutritional supplements. While you may be able to lose weight quickly on a very low calorie diet, you're also likely to regain it quickly once you stop the diet. To prevent weight regain after a very low calorie diet, you must make changes in your overall diet, activity level and behavior.

Meal replacements. These plans suggest that you replace one or two meals with their products — such as low-calorie shakes or meal bars — and eat healthy snacks and a healthy, balanced third meal that's low in fat and calories. In the short term, this type of diet can help you lose weight, and they may be a good option if they help you control portion size, limit calories and encourage healthy eating. Keep in mind that these diets likely won't teach you how to change your overall lifestyle, though. So while they may work for some, you might find it hard to maintain your weight loss over the long term.

TONSILITIS

Tonsils and Tonsillitis

Tonsils are clumps of tissue on both sides of the throat that help fight infections.
Tonsils may swell when they become infected (tonsillitis). If you look down your child's throat with a flashlight, the tonsils may be red and swollen or have a white or yellow coating on them. Other symptoms of tonsillitis can include:

• sore throat
• pain or discomfort when swallowing
• fever
• swollen glands (lymph nodes) in the neck

Enlarged tonsils without any symptoms are common among kids. Left alone, enlarged tonsils may eventually shrink on their own over the course of several years.
Don't rely on your own guesses, though — it can be hard to judge whether tonsils are infected. If you suspect tonsillitis, contact your doctor. Recurrent sore throats and infections should also be evaluated by the doctor, who may order a throat culture to check for strep throat.

About Tonsillectomy

Doctors might recommend surgical removal of the tonsils, called a tonsillectomy, for a child who has one or more of the following:

• persistent or recurrent tonsillitis or strep infections
• swollen tonsils that make it hard to breathe, particularly during sleep
• difficulty eating meat or chewy foods
• sleep difficulty that might be affecting the child's daily activities
• snoring and obstructive sleep apnea (when someone stops breathing for a few seconds at a time during sleep because enlarged tonsils are partially blocking the airway)

Surgery, no matter how common or simple the procedure, is often frightening for kids and parents. You can help prepare your child for surgery by talking about what to expect. During the tonsillectomy:

• Your child will receive general anesthesia. This means the surgery will be performed in an operating room so that an anesthesiologist can monitor your child.
• The operation will take about 20 to 30 minutes.
• The surgeon can get to the tonsils through your child's open mouth — there's no need to cut through skin.

Your child will wake up in the recovery area. Expect to spend about 5 hours or a bit longer at the hospital. Most kids go home on the same day, though some may require observation overnight. In general, kids under 3 years old and those with chronic disease will usually stay overnight for observation.
Rarely, children may show signs of bleeding, which would require a return to the operating room.
Depending on the surgical technique, the typical recuperation after a tonsillectomy may take several days to a week or more. Expect some pain and discomfort due to the exposure of the throat muscles after the tonsils are removed. This can affect your child's ability to eat and drink and return to normal activities.
Intracapsular tonsillectomy, a variation on traditional tonsillectomy techniques, is surgery in which all involved tonsil tissue is removed but a small layer of tonsil tissue is left in place to protect the underlying throat muscles. As a result, the recovery is much faster because most kids experience less pain, don't need as much strong pain medication, and are more willing to eat and drink. Additionally, the risk of bleeding after surgery is significantly less than with a traditional tonsillectomy. Since residual tonsil tissue remains, there is a very slight chance that it can re-enlarge or become infected and require more tonsil surgery, but this occurs in less than 1% of children undergoing intracapsular tonsillectomy.

Health Care Systems of Malaysia

Malaysia is fortunate to have a very comprehensive range of the health services.

The Malaysian government is very much committed to its principles of a universal access to high-quality health care in which the local Ministry of Health offers thru wide varieties of nationwide networks of clinics and hospitals.

However, in spite of the dedication of the local government of Malaysia to provide the best possible health care, there are still some problems that are unsolved, and one of those is the unavailability of quality health care centers in remove areas.

When patients are transferred from a specific health center to a more probable hospital, doing so not only incurs some inconveniences on the part of the patient and the family, but also adds costs to the health care systems.

 In order to deal with the issue, a tool has been designed called the tele primary care.

This method helps the doctors on remote areas to discuss problem cases by tele-consultations with specialists and doctors on hospitals.

The Malaysian government is continually striving to make the healthcare system better but there is still a dearth of medical expertise in the country and their high concentration in the urban areas.

The current efforts in the past few years have certainly made developments for the health care system in Malaysia.

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HEALTH TEST EVERY WOMEN NEED

No matter your current health status, if you’re a woman, you’re going to need to undergo some standard testing regularly, to make sure that any changes in your health are identified early, when they can best be treated; undergoing regular health tests and screenings also makes sure you stay healthy if you already are.


There are several tests women should undergo regularly, both to prevent disease and catch diseases early enough that treatment can be provided to effect the best cure. Let’s take a look at the top ones.

Testing for a proper weight and body mass index

If you are overweight or obese, this can contribute to or even cause a number of other health factors in and of itself, so maintaining a normal weight is going to help you forestall or prevent health problems you might otherwise have. Ideally, most women should opt for a body mass index of under 25; your doctor can help you determine what your own best body mass index is. (In certain cases, very muscular or athletic women are going to have body mass indexes of over 25, but still will be perfectly healthy and of a good weight, so have your doctor help you determine what your own best body mass index should be based upon your own lifestyle and body type.)

Cholesterol

If you are age 45 or over, you should be getting your cholesterol checked regularly. If you have diabetes, if you have high blood pressure, if you smoke, or if you have heart disease, you should probably get your cholesterol checked earlier than that. This is a simple test that requires just a simple pinprick of blood.

High blood pressure

Known as the “silent killer,” high blood pressure is so deadly because it’s usually asymptomatic. Get your blood pressure checked regularly by your doctor and/or by going to one of many free locations available, such as your local pharmacy or drugstore.

Diabetes

You are at risk for diabetes if you are significantly overweight or obese. In addition, if you have high blood pressure or high cholesterol, you should also be tested for diabetes regularly. Caught early, type 2 diabetes may be able to be controlled with dietary changes and in some cases medications. If necessary, insulin injections can also be given to control blood sugar. (Type 1 diabetes is caused by the destruction of cells in the pancreas that produce insulin, and must always be controlled with insulin injections.) Left uncontrolled, though, diabetes is deadly.

Breast Cancer

Beginning at about age 40, you should have a mammogram every one to two years. If your family has a history of breast cancer, your doctor may advise you to take mammograms earlier. Breast self exams, too, may be used to check for lumps or any changes in breast tissue. Report any changes to your doctor to have them checked out further.

Cervical cancer

Between the ages of about 21 and 65, you should get a Pap smear every one to three years if you’ve ever been sexually active.

Colon cancer
Colon cancer is one of those cancers that can be completely cured with little to no discomfort if caught early. Doctors can remove precancerous lesions or polyps right away, and nothing further should need to be done. By contrast, colon cancer can be deadly if not caught early enough, and treatment is devastatingly unpleasant even if you can be cured. For most people, having regular screening tests after the age of 50 is enough, but if you have a history of colon cancer in your family, ask your doctor if you should start screening before that age.

Skin cancer
If you’re a so called “Ssun worshiper,” you are at particularly high risk for skin cancer. Make sure your doctor checks out any moles or spots you have at every checkup for changes, and report any changes you see. If a mole begins to bleed, itch or hurt, make sure you see your doctor right away. Caught early, skin cancer is one of the most curable types, but once it spreads, it can be difficult to cure and may even be deadly.

And to help prevent skin cancer, use sunscreen when you are out in the sun and avoid being a “sun worshiper.” If an appeal to vanity works for you, you should know that sun exposure also causes wrinkles and sagging skin at an early age, too. So stay out of the sun or use sunscreen to both look and feel better.

Depression

Not just something you can “snap out of,” depression is a major medical condition that can certainly impact your life negatively, and even threaten it. If you have depression, don’t simply ignore it. Talk to your doctor and seek treatment; in the vast majority of cases, depression can be treated with talk therapy and/or medication.

Sexually transmitted diseases, including HIV

If you are sexually active and nonmonogamous (or your partner is), make sure you get checked often for sexually transmitted diseases, including HIV. Many sexually transmitted diseases are curable, and therapies for even incurable diseases like HIV have greatly improved. If you must be sexually active, and you and/or your partner are not monogamous, make sure you use barrier protection like condoms. This can at least help prevent the acquisition of sexually transmitted diseases, but will not entirely prevent it even so. Remember that the only safe sex is monogamous sex between two partners who are not infected with a sexually transmitted disease, or abstinence.

Osteoporosis

You can get osteoporosis if you’ve reached menopause, especially if you are at risk; osteoporosis is a thinning of the bones, and can occur more often in small boned women, women who smoke, and women with a family history of osteoporosis. Talk with your doctor about getting a bone density test if you are at risk or if you are approaching menopause. New medications on the market can help rebuild bone density even if you’ve already lost it. And if you’re not yet menopausal, you can help ensure bone health by doing weight-bearing exercise and following a good nutritious diet, including one that has enough vitamin D, calcium and magnesium.