harapan menggunung biar sampai jadi gunung.

Sunday, March 31, 2013


video paling kelakar... tergolek2 atas katil tgk diorg nanyi.. hahahaha... serius lawak, boleh la tgk time stress2.... kaka

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ade jugak yg jeles.. kahkakaka

Saturday, March 30, 2013


HELLO everyone. now i would like to share about the most well known disease.  This disease is very familiar in our country and it is recognize as a rich-disease. It is because most of the rich family has been attack by this disease in a mean time.(perhaps not)

Now I would like to share with all of you regarding the statistic of gout disease around the world. During 2004, about 30 %  of gout patient die in Thailand, 24 % in US, 17% in Mexico, 13% in Japan, 8% in Brazil and Korea.

Before I explain further, let me explain what is uric acid. Uric acid basically the end product of purine metabolism in the cell and tissue.  Purine can be found in all type of foods that we eat every day. Then, the consumption of purine will undergo metabolism that will produce uric acid.

What is gout disease actually. It is a state where recurrent inflammation happened due to deposition of urate crystal at any joint. Then it will cause painful attacks in the joints such as knee, ankle, foot and arm.  If left untreated, the attack will become more frequent, more prolonged and more generalized.

For over 2000 years ago, gout disease is a very well know disease and it is famous with name of king of the disease. It is because of the overindulgence of fatty food and alcohol. . That’s why I said early that this disease commonly happen in rich family because they eat plenty of foods.  Besides, animal also has tendency to get a gout disease which is a very well known not only by human but also animals can suffer from this disease.

One researcher  has found that about 80 % of patients will got an attack of gout at the big toe and 20% get an attack of gout disease at more than one joint, maybe at knee of arms.

Do you have any idea why I explain about uric acid just know? It is because due to increase in the level of uric acid in the body will lead the formation of gout disease. .  that’s the main reason why the gout disease occurs. Besides, consume food that contain high content of uric acid also will lead to this problems.  Besides, if the patient has a kidney problem, also lead to gout disease because the kidney unable to excrete out excess uric acid in body, thus cause accumulation of uric acid in the body.

Liver problem also can lead to this problem because when liver is damage, it cant metabolize uric acid in the body, thus also cause accumulation of uric acid, then lead to formation of monosodium urate crystal in the joints.  Then, a researcher have found that 1 out of 4 gout patients have a family history of gout disease, this means that the disease can be inherited by one generation to other generation. Other drugs such as diuretics drugs also can cause accumulation of uric acid in the body because this drugs can interfere with the normal excretion of uric acid.

The last factor that can cause gout disease is environmental factors such as stress, physical injury, unusual physical exercise, severe illness, surgery.

Example of food that contain high content of uric acid include sea foods, mushrooms, lentils, organ meats, spinach, oat, yeast product and many more.

Who is at risk of gout disease? It is you, me , teacher or who? It is men, women or child. Research have found that men has high content of uric acid compares to women. So men has high tendency to expose to this disease.  Men typically will be attack by gout disease at the age of 30-50 years old. Whereas women is after menopause.  It is because after menopause, level of uric acids in women tends to increase higher than men.  Then , a very few cases is reported about the gout attack among teenagers and children.  Besides, obese people also has high tendency to suffer from this disease.  Then also alcoholic people.

Now, how do we know that we got an attack of gout disease. The sign and symptoms of this disease is easily recognize because we can see and feel it clearly. An acute attack of gout disease often occurs night or early in the morning that will reach peak within a few hours. For example swelling at the affected area. This is the first symptom that present itself. You will feel like you feet would explode anytime.  This swelling may affect more than one joint. Then, the affected area will become redness, tenderness and warmth due to build-up of uric acid crystals in the joints.

Then of course you will feel intensely pain at the affected area. Even touched by a blanket or clothers, you can’t tolerate feel of pain.  Then you skin may become peel and itch because the swelling that occurs earlier. Once the swelling subsides, the skin will become dry.  The last one is the presence of nodules due to accumulation of monosodium urate (MSU) crystals. It is a white compound that forms after uric acid composite in the joints.

In the treatment of gout disease, there are three important steps. We have to follow this steps in order to reduce the attack of gout disease.

THE FIRST steps we have to reduce the pain and inflammation. To treat this we can useda NSAIDs drugs. For example ibuprofen, indomethacin and diclofenac.  The short half life drugs such as ibuprofen and indomethacin is commonly used because of its rapid action, but it must be used coutiosly  in patients with peptic ulcer gastric heamorrhage and renal insufficiency. 

Besides we also can used colchine when NSAIDs drugs is not effective even though it can cause diarrhea.  The if the pain does not reduce, we can used corticosteroid drugs by injected the drugs to the affected area to reduce the inflammation.

THE SECOND STEPS is by life style modification to reduce another attack of gout disease.  Patients can alter diet, reduce weight,  and reduce alcohol consumption

THIRD STEPS is by lowering the uric acid level in the body.  This steps used for a long term treatment. It can be used when no acute attack is occurs. Example of drugs is allopurinol and probenecid. Allopurinol can reduce the uric acid production in our body. It is most helpful in patients with a very high level of uric acid in the body or they have kidney failure. Probenecid is a uricosuric acid, it will increase the excretion of uric acid in the body. This drugs may not affective in kidney failure patients. 

As a conclusion, we can avoid this disease from attacking us. Once the symptoms is arises, we have to go straight away to the doctor. So that proper management could be assign.  No boby want to live in pain including me, because it can effect all things in our life right. So we have to take a proper action to reduce the pain such as apply an ice at the swelling joint.  A good gout treatment plan is needed to manage this disease properly.