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Thursday, April 30, 2009

New treatment for eczema sufferers

For years eczema sufferers has to deal with this menacing condition which restrict ones lifestyle.
It has caused much inconvenience and many lose hope after multiple visit to the GP and various dermatologist. For those who isn't familiar with this condition, eczema is a form of dermatitis, or inflammation of the epidermis. It is often characterized by episodic occurrence of inflammation, flaking, itchiness, edema, similar to a urticaria rash, except that this is prolonged and recurrent.
This menacing condition often cause disfigurement and discolouration to the skin after chronic attacks. Until today, nobody actually know the cause the this condition. Genetic plays a role in susceptibility and increasing the chance of suffering from this condition which seemed to get triggered off by anything under the sun. Nobody actually knows the etiology of the triggering factor, whether its dust, food, chemicals found in soap and washing powder..etc.
Eczema lesion occurs extensively characterized by raised, reddish, allergic like lesion at the initial stage. Unfortunately, the practice of treatment of such condition isn't permanent. Very often the doctors will prescribe antihistamine tablets to control the itchiness, at times steroids pills were prescribe to prevent recurrence. Most popular method of treatment is by dispensing creams that contains steroids that reverse the cascades of events that result in this condition, the release of histamine. Histamine is a chemical contained in mast cells that circulates in the blood system and upon certain condition, ranging from mosquito bite to more serious condition such as administration of drug which an individual may be allergic to. This would result in the release of histamine that is responsible for features of allergic, urticaria rashes, inflammation.etc.
It is the responsibility of doctor to inform the patient on prolonged use of steroid based drugs, whether in the form of creams or edibles. Since steroids works fast on reversing the inflammation, the side effect outweighs the benefit of long term usage, since eczema is a episodic condition. Hyperpigmentation, thinning of the skin due to loss of fat cells, decreased local immunity against infection are the result of prolonged usage. As the gentleman shown above with a dark patch as a result of chronic use of steroid creams. No doubt it reverses the symptom fast and effectively, but what if there are other alternative available?
Thinning of skin would result in increased possibility of disfigurement as shown above, where this man has multiple dark patches and 2 ulcers as a result of scratching.
The opposite leg of the same gentleman. As you can see, eczema is a term used to describe both extensive as well as local chronic episodic inflammation.
Extensive rashes normally occur on the same site as before. Note the inflammation that reoccurs on the dark patch.
Hence, as i mentioned earlier, prolonged use of steroids would result in more complication rather than alleviation of symptoms.
However, recently there are 2 products which is available in the market today which revolutionized the management of eczema.
The first product which is steroid free tacrolimus, marketed as Protopic ointment.

With the absence of steroid, it has been clinically proven that Protopic can be use in a prolonged manner without causing side effects. Initially, it reverses the inflammation, and secondly, it repairs the damaged skin with its ointment formulation. It is safe to be used in children as young as 2 years old and can be used anywhere in the body, including the face.
Below are some case studies photos of patient with eczema being treated only with Protopic.

Baseline
One week after treatment. Notice the marked improvement
Protopic being applied twice a day for 4 weeks. Complete resolution
Below is another case studies with photos where patient developed eczema over the back of the knee area.
Baseline-before treatment
Protopic applied twice on a daily basis for 4 weeks
The first non steroidal product that not only alleviate the acute symptom, but repairs the damaged skin due to prolonged use of steroids.
Studies has indicated that up to 4 years of data confirms that steroid free Protopic is safe and effective- no other topical immunomodulator(TIM) has much safety and efficacy data.
It rapidly clears within 1 week, and again may i remind you that Protopic doesn't have any systemic immunosuppression.
Now for the second product, is from the company Stiefel, with their product for treatment of eczema, Physiogel AI Cream.

This is the only cream that contains PEA*!(N-Palmitoylethanolamide)You may ask, what is PEA,? Well, it is an endogenous substance found in the stratum granulosum (a layer of the skin) that has anti- inflammatory and anti-pruritic properties.
Recent research demonstrated that the human organism produces high quantities of PEA during the inflammation process and PEA binds to CB2-receptors present on immune cells and human mast cells. This leads to a reduced degranulation of mast cells, hence decrease release of histamine, cytokine and interleukin 4,6,8.
PEA binds to CB2-receptors present on cutaneous nerve fibre, hence decreasing transmission of pruritis and burning to the central nervous system.
Body's own endogenous fatty acid with anti-inflammatory properties, found to be deficient in atopic skin
+
DMS repair Technology-Lamellar structure at skin surface temperature
= Anti irritant repair cream




Outstanding Symptom Relief

Proven efective in the daily management of atopic dermatitis symptoms, including itching, dryness, and erythema.
Itching- Reduced in 79.3% patient
dryness- Reduced in 82.4% of patients
Erythema- Reduced in 74.3% of patients

I understand that there are many people who are suffering form any form of eczema constantly search the internet for solution for this condition. I sincerely hope you would enquire from your local doctor regarding this product as its not available in any pharmacy.
This treatment without its side effect is far diferent from the conventional method where steroids are constantly prescribed resulting in worsening of the skin.
Now that such revolutionary product is available in the market, get it now.

Tuesday, April 28, 2009

Dermatix,for scar reduction.

For those unlucky individual who have the tendency to develop hypertrophied scar or keloid after a cut, it use to be a nightmare while seeking treatment from the plastic surgeon. The regular steroid injection would be something that you won't be looking forward to. Today i met up with Mr. Sri Naga Leong, the first person who got me Botox after returning to Malaysia.
He left Allergan several years ago and now working for Pharmalink. Since he has got cosmetic knowledge in his resume, so, he was placed in charged of the beauty products for Cosmetic Physicians, Dermatologist, and Plastic Surgeons.
He introduce a new range of cosmetic product which i will do a write up after getting familiariazed with it. More than that, he brought a new product for the keloid prone customers.
Ladies and gentleman, may i introduce to you, Dermatix. A clear gel to be applied on surgical scars when the skin are healing. It is used for the treatment and prevention od keloids and hyperthrophied scars , after the wound has healed and the skin surface is intact.
Each box contains a tube that carries 15g of gel.
Adviced to apply on a healing wound twice a day to create a more similar colour and contour between the old skin and the newly formed skin.
Just to enlighten fellow readers on stages of keloid.
A photographic evidence of the usefullness of the product.
Not even a scar or mark after removal of the mole!
A keloid that developed after a cystectomy was the revised by surgical removal of the keloid supplemented with Dermatix.
This write ups of this product appeared in September 2002, Journal of Cosmetic Dermatology.
A true bonafide medically graded exclusively available at the nearest clinic.

Reason why I shouldn't worry

I was down when i wrote the previous post. It felt like the burden fell on my shoulder. The crisis will be over, the question is when.
After a few kind words from fellow bloggers from their comments, (thanks Ahmike & Irene) it made me think twice. I should be positive minded and be glad with what i have. There are people who are doing much worst then me.
My cousin sister who came for a blood test a few days ago received a worrying results. Personally, i told her to repeat the test in 3 weeks times, but i am worried for her as well.
Her tumour marker Ca19.9 which is specific for Pancreatic Carcinoma is high. I pray it could be due to some other reasons, but the next test in three weeks time i reveal the truth.
She just got married, and at the prime of her life. I should be worried for her.
The worst part of being a doctor is informing the patient that they have a grave disease, cancer, hepatitis B, HIV+, bad prognosis.etc.....
I would usually call up the patient a few days after seeing them in the clinic to ask them how they are doing, but such grave diseases, how can i call them up and ask them how are they feeling.
I have not developed the skill to break bad news to patients, and i believe there won't be any book, or guide on " How to tell patient that they are dying".
I guess the best i can do is to help them whenever i can, offer them time to talk to whenever they feel like talking.
I realized that once a person knows that they days are numbered, they start to reflect back on what they have done, or rather what they have not done. Sharing they emotion is the least i can do, and i am glad i am able to listen to the patient without being judgemental.
Being a doctor is a life long learning experience, and i agree with the saying, being a doctor is not a profession, its a way of life. ( read it from somewhere long time ago)

Monday, April 27, 2009

I am worried

I don't know what made me want to write this down, perhaps its a thought that needs to be remembered. The economic turmoil is getting bad. The is no sign of improvement. Companies closing down, declaring bankruptcy.....The phrase companies closing down.... I am worried for my wife, and both my children. The strain has been heavy to bare, especially she works for an Italian company that is not doing well Globally, and is in the process of shutting down its factories one by one.
She seemed unhappy these days, mind seemed to always seemed occupied. And yet, she tries hard to put a brave front. Hiding all the worries behind her mask. Her persistent headache is a dead giveaway. That is why every Sunday whenever we go out, we leave the problems behind rather than letting it lurks along us like a shadow. We don't want our troubles to be known to our children. To take away the children's laughter is th worst thing a parents can do to their children. They have always been the source of happiness for both of us. I pray to the Lord for guidance. Lord, i am worried.

Another Sunday Gone, another week begins...

Time really flies.It was hardly a few days ago i posted the blog on my weekends. Well, longs hours in the clinic really drains me off my energy, and the only thing that keeps me going on is the very much anticipated weekends, my family day.
I woke up quite early at 7am on Sunday morning. Aha! I was surprised that Isabelle and Natalie both are wake as well!

As Pei Ling is still asleep, i don't blame her, she wakes up 2-3 times to feed the Natalie, and Isabelle is down with gingivitis. Hmmm, could it be my fault as i was the one who is in charge of Isabelle brushing her teeth.
These two were playing around for a while, until i look at the clock on the wall.
9.45am!!! hey, what about breakfast!!! He had our breakfast at home. Then Pei Ling and Natalie went back to wonderland. I pity Isabelle for now knowing what to, so, i allowed her to watch the movie that i was watching last night.
"Please use the headphones, mummy and Natalie are asleep now.
"Ok, daddy......" So the grabbed the over sized headphones and place on her head after I've adjusted for her.
Looking at Natalie sleeping peacefully while Isabelle enjoying the movie while the room was in total silence is a rare moment! I've decided to check my mail, and thought of updating my blog.
So many mail, comments from bloggers to be moderated, while "some" to be "deleted"
Out of the sudden, Isabelle said out loud, "Daddy, the Ironman is sooooo coooool!!!!!'
"What are you doing, daddy?..."Go watch your movie,Isabelle!"
After the movie got over, and Pei Ling got herself and Natalie ready. Isabelle took a quick bath then went downstairs at the front door waiting me to open it. :D
I placed Isabelle onto her child sit, and buckled her up, and did Natalie on her baby sit.

"Where are we going , daddy????......." "We're going for lunch...what do you want to eat? "PIZZA!!!!" -------- "AGAIN!!!?"
"Yes. Pizza is my favourite!!!...giving me a gleeful smile.

We wanted to do our groceries in Tesco, and to get our monthly 5 packets of 10kg rice for donation to an orphanage. But before all that, all of us need to satisfy our gastronemic urges first.
We reach Tesco and went straight to Pizza Hut. The service wasn't great. The is a notice asking us to wait while the staff will take us to our sits. Yeah, after 10 minutes of not being noticed by the workers there, we walked in, and just sat on the table we desired.

Isabelle clearly made her point that she can't wait any longer!

Pei Ling grabbed a piece of paper that has puzzles in it and gave them to her just to distract her mind.
After about 10 minutes upon ordering our food, Isabelle wanted the soup. And she showed us her new method of soup drinking!
"Isabelle, what are you doing?" " This is a new way of drinking soup, daddy!"

Natalie was watching her sister drinking soup her "new" way... she propably thought, "my sister is a weirdo!"
Right after paying the bill, off we go the the first floor. Wow.. packed,leh? Our shopping list include 5 packets of 10 kg rice for the orphanage, sparkling juice for granddad 80th birthday, toiletries, diapers, sausages, . Since the stroller was being use to push Natalie around, Isabelle settles for the shopping trolley.

Heights of laziness!!!

As i had mentioned before in my previous post, she loves to travel, but hates walking.!!! Apalah!
The worse part is that she kept on directing me where to go! All I did was asked her to talk to "the hand"..
Ok, first item in the shopping list, get the rice for the orphanage.
Got them!
Next, the most frequent visited venue for the past 2 months,
Yup, you got it right.IKANO. to get Natalie's baby food and some sparkling juice for granddad's 80th Birthday.
Natalie loves this place! Looking at the bustling crowds, the music playing on the loudspeakers this is more like it. We stepped into cold storage to search for the sparkling juice, non alcohol of course.
We set our eyes on the array of displayed variety of Sparkling juice got us confused!

If you can't find Isabelle, not need to be alarmed. She has got to on a trolley since too lazy to walk. Hmm.. let me see.... there you are!

Ok, next destination would be grandpa's place for dinner!
My grandfather has been living in this temple located next to Sungai Gombak, so whenever there's heavy rain that doesn;t seem to stop for day, flood is unevitable.

Sunset

Grandpa's residence.

The old lantern the hangs before the entrance through the front door.
We had dinner since one of my uncle had prepred the meal, so why waste money when you cna eat for free??
Immediately after dinner, i stopped by the orphanage to pass the 5 bags of rice. Then off we go to Cineleisure. My Sony Ericsson W910i has been under their care for the past 3 weeks, and each weeks we were told of different stories! I just got fed up. Just get a new one,lah!

Another one of the most frequently visited area every weekends. We walked straight to Sony Ericsson as i had a;ready made my up my mind on the phone that i want to get.

Another walkman phone with 4 gigabytes and Wifi , the W705.
I brought my old memory card to transfer all the contacts in to the new phone.

The sales person who attended to us is quite new, while the other experienced guy was attending to other customers. It took him a while before getting all the data fully tranferred.

The colour of the phone is actually quite beautiful actually.

That was my first Sony Ericsson Model being displayed.

Slim, powerful, large memory space, equipped with Wifi. I am going to have some fun with this phone.

Basic features needs to be availble. Using photo of Natalie as the wallpaper.

The menu looks entirely different from W910i.
Well after the purchase, i guess we'll call it night. Sleep early for start a brand new week.
Not after taking a few photos of Natalie of course!




Today Natalie must be pretty happy to go out shopping, eh?