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Things to Know Before Acupuncture

Acupuncture, the practice of inserting needles into the body for therapeutic purposes, has a long history that dates back over 4,000 years. This science of healing originated from ancient Chinese medicine and has been developed and passed down to this day.   Currently, acupuncture has been widely accepted in the medical community across more than 140 countries. The World Health Organization (WHO) has recognized the efficacy of acupuncture since 1979.   In November 1996, the National Institutes of Health (NIH) in the United States acknowledged that acupuncture is a "reasonable option" for treating various diseases.   Generally, doctors will insert the needles for about 20-30 minutes before removing them. Treatment is usually done once a day, every day or every other day, for about 7-10 sessions, depending on the type and severity of the disease.   In addition, there are other forms of acupuncture treatment, such as ear acupuncture, tapping the skin with needles, moxibustion, and cupping therapy.   Treatment Preparations Before receiving acupuncture treatment, patients should prepare themselves by:   1. Being mentally prepared for the treatment Acupuncture is a "surgical" type of treatment that requires cooperation from the patient. If the patient is anxious or moves around too much, especially children, the acupuncturist may not be able to perform the procedure properly and the treatment outcome may not be as effective or even dangerous.   Patients should come to the treatment with confidence and not with fear or anxiety.   2. Wearing appropriate clothing In acupuncture, the needle insertion points may sometimes be located under the patient's clothing, such as under a shirt. Therefore, patients should wear clothing that is separated into parts, such as a separate top and bottom. The clothing should not be too tight, so that the patient can easily fold up their sleeves or pant legs. The clothing should be loose or wide enough to be folded up above the elbows or knees if needed. In cases where the needles need to be inserted in the shoulder or neck area, a shirt with a wide collar should be chosen.     3. Eat moderately Generally, patients who receive acupuncture should eat about 1-2 hours before and should not eat too much. If they have just eaten a lot or eaten too much, food will remain in the stomach for a long time. When they receive acupuncture, which requires lying down for a long time, up to 20 minutes, it may cause discomfort, especially when lying face down, and patients may not tolerate it. If the needle needs to be inserted in the abdominal area, if the stomach is filled with a lot of gas, it may be dangerous to insert the needle into the abdominal cavity or stomach easily.   On the other hand, patients should not receive treatment when they are extremely hungry, as they may easily experience "fainting" when the needle is stimulated. This is because the body may lack energy to use for metabolism while the nervous system and hormones are being stimulated by acupuncture.   4. Clean your body thoroughly Acupuncture is a procedure that involves using a sharp object to puncture through the skin into the body. Therefore, patients should have a clean body to reduce the risk of infection as much as possible before receiving acupuncture. If possible, patients should take a bath or shower before receiving acupuncture, especially if they need to receive treatment on the head. At the very least, they should not let the part of the body where the needle needs to be inserted be too dirty. Patients who need to receive acupuncture on the head should have their hair cut as short as possible. In addition, they should not use hair gel or cream that is sticky or oily. If they don't use it, it's best for the convenience of the acupuncturist.   Female patients who are menstruating can receive acupuncture treatment without any danger. Not getting acupuncture during this time is probably more of a matter of discomfort or embarrassment than anything else.   5. Calm body and mind during treatment When the doctor inserts the needle into the skin, the patient may feel a slight pain similar to an ant bite. When the doctor reaches the acupuncture point, the patient may feel numbness, heaviness, or slight tingling. As the doctor begins to stimulate the needle by gently twisting or moving it up and down, the patient may feel a stronger numbness, heaviness, or tingling. Sometimes, these sensations may spread along the meridian lines. If these sensations occur, the treatment usually has a good effect.   In the case of electroacupuncture, the patient will feel a mild muscular twitching in the area where the needle is inserted, following the rhythm of the electrical current.   Generally, during acupuncture treatment, the patient should not feel excessive pain or numbness. If the patient feels severe pain, excessive numbness, or a feeling like an electric shock, they should immediately inform the doctor because the needle may have pierced a blood vessel or nerve, or the needle may be in the wrong position, or the electrical current may not be appropriate.   During treatment, if any abnormal symptoms or discomfort occur, such as chest tightness, difficulty breathing, numbness in the hands, or dizziness, the patient should immediately inform the treating doctor or assistant.   While having acupuncture needles in the body, one should sit or lie still and avoid moving too much, as the parts of the body with needles may dislodge or break the needles. However, small movements are still permissible. Other parts of the body without needles can move freely as desired.   During the acupuncture treatment, patients should remain calm and relaxed, perhaps closing their eyes and breathing slowly and steadily to help maintain a consistent rhythm, which can help calm the mind.   While being stimulated by acupuncture, some patients may feel drowsy because the insertion of the needles can trigger the release of endorphins. These substances are similar in effect to morphine, helping to alleviate pain and soothe the nerves, and over time, some patients may find that they can fall asleep more easily or more deeply, and their mood may become brighter and more cheerful than before.   6. Post-treatment Practices After the acupuncture needles have been stimulated for the specified duration of about 20-30 minutes, the physician will remove the needles. Sometimes, a small amount of blood may come out from the point where the needle was inserted, similar to when receiving an injection. This is because the needle may have pricked a small capillary blood vessel. By using a cotton swab to apply pressure for a moment, the bleeding will stop on its own.   After the completion of the treatment, there are generally no specific restrictions imposed. Patients can eat, bathe, and carry out their daily activities as usual, except for cases where the needle is placed on the earlobe and extra caution is needed when bathing to prevent the earlobe from getting wet.   In general, after being treated with acupuncture needles, patients do not need to go back and rest at home, but can drive or return to work as usual. However, some individuals may experience slight fatigue or weakness after the needle insertion. But after taking some rest, these symptoms will disappear.   7. Other Treatments Combined with Acupuncture Patients who receive acupuncture treatment may already have existing conditions, such as diabetes, high blood pressure, heart disease, high cholesterol, or emphysema, which usually require them to take medications or undergo other treatments such as physical therapy.   In general, acupuncture treatment can be combined with medication or other therapies without any specific restrictions.   8. Prohibitions for acupuncture   8.1 Patients who are excessively anxious and fearful of treatment, even though they have tried their best, may not be able to control their emotions.   8.2 Patients who are exhausted after heavy exercise.   8.3 Pregnant women, especially those in the later stages of pregnancy, as these patients often cannot lie down or sit for long periods of time. Sleeping on their back may compress the uterus and the fetus, which could cause compression of the large veins in the abdominal cavity and result in hypotension. The prone position is also not suitable for pregnant women, as it may compress the fetus and cause discomfort for the mother.   Furthermore, severe needle insertion can stimulate the fetus to contract excessively, leading to a risk of miscarriage.   8.4 Patients with abnormalities related to blood clotting, such as hemophilia, may experience difficulty stopping bleeding once it starts. If treatment is necessary, extra caution must be taken. Needle insertion or acupuncture must be done gently to avoid piercing large blood vessels. After the needle is removed, pressure must be applied to prevent bleeding for a longer period than usual for the average patient.   8.5 Infants or young children, as well as patients with mental illness or dementia who cannot cooperate with treatment, require special consideration.   8.6 Patients with pacemakers installed in their bodies due to heart disease should not receive electric needle stimulation because it may interfere with the pacemaker's function and cause dangerous irregular heartbeats. However, in this case, needle stimulation can still be performed using a manual rotation method.   The aforementioned "prohibitions" are not absolute prohibitions. For example, needle insertion may be possible in patients with mental illness if the reasons why it may be dangerous are understood and caution is taken. Therefore, it is possible to perform acupuncture on these patients with caution.  

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Acupuncture

Acupuncture is a form of medical treatment based on traditional Chinese medicine. It is believed to have three main therapeutic effects:   1. Correcting obstructions in the flow of Qi, or vital energy, through the meridians of the body. 2. Balancing the functions of various organs in the body. 3. Stimulating the immune system to eliminate harmful factors from the body. 4. Suppressing pain. 5. Alleviating tension in the muscles.   Duration of acupuncture treatment:   Doctors will use small needles, ranging in size from 0.18-0.30 mm, to puncture various points on the body and stimulate them by rotating the needle manually or by using a low voltage electrical device. The procedure takes about 30 minutes, after which the needles are removed.   Diseases that can be treated with acupuncture:   The World Health Organization (WHO) identifies many different diseases and conditions that can be treated with acupuncture. The most common ones include:   Hemiplegia, facial paralysis, and limb weakness Headache Insomnia, stress, and anxiety Constipation Diseases of the respiratory system, such as cough and asthma, as well as facial pain, trigeminal neuralgia, hemifacial spasm, locked jaw, and drooling Musculoskeletal disorders, such as cervical spondylosis, frozen shoulder, sciatica, carpal tunnel syndrome, numbness and tingling in the extremities, back pain, knee pain, knee swelling, and knee osteoarthritis Pain due to cancer, tumors, and surgical wounds Nausea, vomiting, inability to eat Diabetes and complications, darkening and discoloration of the feet, numbness in hands and feet High blood pressure, high blood lipids Weight loss, postpartum weight loss, reducing fat in specific areas such as thighs, calves, upper arms, and abdomen Weight gain, for thin people or chronic patients Health maintenance for students, working age adults, and the elderly Geriatric diseases such as tremors, Parkinson's disease, dementia, and Alzheimer's disease Obstetric and gynecological diseases such as menstrual pain, irregular periods, and uncertain periods Menopause Sexual dysfunction Allergies Removal of stretch marks, sagging under the chin, flabby arms, freckles, wrinkles, acne, hair loss, and varicose veins Quitting addictive substances such as alcohol, cigarettes, and drugs Gastrointestinal and intestinal diseases such as chronic stomach pain and irritable bowel syndrome Other diseases which will be considered on a case-by-case basis by a doctor   Prohibitions on Acupuncture   Acupuncture should not be performed on the following patients:   1.Pregnant women, especially in the late stages of pregnancy. 2.Patients with abnormalities related to blood coagulation, such as hemophilia. 3.Cancer patients who have not received treatment. 4.Diseases that require surgical treatment.   Duration of Acupuncture   Acupuncture should be performed at least twice a week, continuously for at least 10 times, depending on the physician's assessment. Chronic diseases may require longer treatment periods. Each treatment session takes approximately 20-30 minutes.  

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Gastrointestinal endoscopy

Gastrointestinal endoscopy   Gastrointestinal endoscopy is a medical procedure that uses an endoscope, a flexible tube that can be bent and maneuvered, with a diameter of approximately 1 cm and a length of 100 cm. The endoscope has a lens at the tip that magnifies the image, and on the other end, it is connected to a light source, which transmits the image to a monitor. This procedure is recommended for individuals who experience difficulty swallowing, have a sensation of something sticking in their throat or chest, experience pain when swallowing, vomit blood or black stools, vomit frequently after meals, have recurring abdominal pain or discomfort, and have taken medication to treat gastritis, but the symptoms persist or have lost weight, or have frequent diarrhea.   The process of gastrointestinal endoscopy involves several steps:   The patient is given a local anesthetic spray in the throat area. In some cases, the patient may be given a sedative injection to reduce discomfort during the procedure. The patient lies on their left side during the procedure. The doctor inserts the endoscope through the mouth and instructs the patient to relax to make the procedure easier.   Benefits of gastrointestinal endoscopy include:   Diagnosis of diseases in the esophagus, stomach, and small intestine, such as inflammation, ulcers, tumors, or organ compression. Treatment by inserting tools or devices through the endoscope, such as a tool to remove polyps, a device to cut off bleeding vessels in the stomach, a device to inject or band varices in the esophagus, or a device to stretch a narrow esophagus.   Side Effects 1.In the case of food debris in the stomach, there may be regurgitation of food debris into the lungs, which can cause pneumonia and make the test results ineffective. 2.After the test, there may be soreness in the throat area. 3.There may be chest pain, abdominal discomfort, and difficulty breathing. 4.Note that the spitting saliva may contain a small amount of blood.   Preparation for the Test   1.It is recommended to fast for 6-8 hours before the test to empty the stomach of food debris, in order to prevent regurgitation of food debris into the lungs, which can cause pneumonia and to ensure accurate test results. 2.If you have removable dentures, they should be removed before the test. 3.It is recommended to have a relative or friend accompany you. 4.If you have any medical conditions or allergies to medications, inform the doctor.   Thorough translation: Post-Endoscopy Care   1.Rest and observe for any abnormal symptoms for about 1-2 hours. 2.Do not drink any water until the numbness in the throat has disappeared. Once the numbness has subsided, try sipping water. If there is no discomfort, it is safe to drink water. 3.There may be some discomfort in the throat after the procedure.   With best wishes from the Gastrointestinal Center.

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The new strain of influenza H1N1 2009

The new strain of influenza H1N1 2009   Cause: The cause is a new strain of the influenza A virus, H1N1, which has never been seen before in humans or pigs. It is the result of a genetic mixture of the influenza virus of humans, pigs, and birds. The virus in the nasal droplets and saliva of patients can survive on hands for about 5 minutes but it can live on surfaces for at least 2 to 8 hours depending on the environmental conditions; low humidity, dry and cold air are favorable for the survival of this virus.   Transmission: The new strain of influenza A virus, H1N1, is found in the droplets of mucus and phlegm of infected patients. When patients cough or sneeze, the virus can spread to people within a range of 1 meter or about one arm's length. If patients use their hands to cover their nose and mouth when they cough or sneeze, the virus can remain on their hands and spread to objects, such as handkerchiefs, handrails, elevator buttons, telephones, computer keyboards, or when they touch their nose, eyes, or drink from the same glass as others. Patients can spread the virus most within the first 3 days of illness, and the risk of transmission decreases as symptoms improve. In most cases, the virus can be transmitted for no longer than 7 days.   Practicing behaviors to prevent infection:   Stay at least one arm's length away from the patient to avoid direct exposure to coughing or sneezing, or inhaling infectious particles. Do not share personal items, especially with the patient, such as hand towels, drinking glasses, straws, and use a communal spoon when eating with others. Frequently wash hands, particularly after touching surfaces or items that may be contaminated with pathogens, such as doorknobs, handrails, elevator buttons, telephones, and computer keyboards. Develop a habit of not touching the nose, mouth, eyes, or face if hands are not clean. If necessary, use a tissue rather than the hands to prevent transmission. Avoid crowded places, particularly during high transmission periods. If required, individuals at high risk of severe illness should take extra precautions, such as wearing a face mask and frequently using hand sanitizer. Maintain a healthy and robust immune system. Exercise regularly and get exposure to sunlight in the morning to obtain adequate vitamin D. Consume nutritious food, such as eggs, milk, vegetables, fruits high in vitamin C, such as guava. Drink sufficient clean water. Get adequate rest and sleep. Do not smoke, drink alcohol, or travel to crowded places or areas with poor air circulation.   Symptoms: After being infected for 1 to 4 days (average of 2 days), patients will begin to have a fever, headache, chills, body aches, cough, sore throat, stuffy nose, runny nose, fatigue, loss of appetite, and may experience nausea, vomiting, or diarrhea. The majority of patients (95%) have mild symptoms similar to seasonal influenza, but because this virus can cause pneumonia more than the seasonal strains, some patients (5%) may have severe symptoms.   The minority are severe cases: Patients with severe symptoms are mostly (70%) those with underlying medical conditions (such as lung disease, asthma, heart disease, kidney disease, diabetes, neurological and intellectual disabilities, etc.), pregnant women (who are at four times higher risk of severe illness than the general population), obese individuals, those with weakened immune systems (such as those with blood disorders, cancer, AIDS, immunosuppressive drug recipients, etc.), young children under 2 years old, and elderly individuals over 65 years old. However, there are still a small number (30%) of individuals who were previously healthy and have no clear risk factors that have died. The World Health Organization and many countries are accelerating research to find the cause.   Dangerous signs Danger signs include having a high fever that does not subside within 2 days (children may have seizures), coughing until chest pain, coughing up blood, or breathing rapidly, being short of breath, tired, not eating, not drinking, being very weak, sleeping excessively, vomiting or having severe diarrhea, showing signs of dehydration, and having a purplish skin color. Patients with these symptoms, especially those at high risk of severe illness, should go to the hospital immediately for treatment and anti-viral medication as soon as possible.   Treatment Patients in the high-risk group for severe illness include those with chronic diseases (such as lung disease, asthma, heart disease, kidney disease, diabetes, etc.), pregnant women, obese individuals, those with weakened immune systems (blood disorders, cancer, AIDS, patients taking immunosuppressant drugs, etc.), children under 2 years of age, and elderly individuals over 65 years of age. When they get sick with severe influenza, they may become seriously ill, so they should go to the hospital immediately for treatment when they begin to feel sick. The doctor will consider giving antiviral drugs as soon as possible, which will have a good treatment outcome.   Home care for non-severe illness   If the patient has mild symptoms such as a low-grade fever, not very hot, not too tired or weak, and can eat normally, they can be taken care of at home by following these guidelines:   The patient should stop going to school or work and stay at home for about 7 days after the onset of symptoms, or may be earlier, but must be at least 1 day after recovery to avoid the spread of the infection. The patient should take fever-reducing medication such as paracetamol (not aspirin) and symptom-relieving medication such as decongestants and mucus thinners as directed by a doctor or pharmacist. Influenza is caused by a virus and does not require antibiotics, except when bacterial infections occur, which require medication as prescribed by a doctor. Wipe the body with lukewarm clean water or plain water for a period of time, wiping the arms and legs backward to the torso. Emphasize wiping to reduce fever on the forehead, cheekbones, cramped legs, and joints. If the patient feels cold or shivers, stop wiping and cover them with a warm blanket immediately. Drink plenty of clean water and fruit juices, avoiding very cold water. Try to eat soft, mild-tasting food such as porridge, boiled rice, eggs, vegetables, and fruits enough. Rest a lot in a room with not too cold air and good ventilation.   Preventing the spread of infection to others in the household:   The patient should stay in a separate room and not leave the house until they have fully recovered for at least one day, in order to avoid spreading the infection. Food should be eaten separately from others. If symptoms have subsided, the patient can eat with others but should use a shared spoon each time. Personal items such as face towels, body towels, drinking glasses, and straws should not be shared with others. Cover mouth and nose with a tissue when coughing or sneezing, and then dispose of the tissue in a trash bin. Immediately clean hands with hand sanitizer or soap and water. When in close proximity to others, wear a mask and stay at least 1-2 meters away from others in the house. Caregivers of the patient should wear a mask when caring for the patient, and dispose of the mask in a trash bin after use. Immediately clean hands with hand sanitizer or soap and water.   Recommendations: There are recommendations for relatives or visitors of patients who have contracted the 2009 influenza A (H1N1) virus, as well as recommendations for patients when they return home. Additionally, there are recommendations for the general public on how to cope with the 2009 influenza A (H1N1) virus. These can be found here.   Recommendations for family members/visitors regarding the flu:   Limit visits to only necessary ones. Keep a record of the names of family members who visit and the date and time of their visit. People who have symptoms similar to the flu, sudden or chronic respiratory illnesses, heart disease, are pregnant, have weakened immune systems, or are over 65 years old are not allowed to visit patients in the Influenza Ward. Visitors must wear protective gear, such as a medical/surgical mask or a respirator mask, and gloves if they need to touch the patient's secretions. There are guidelines for practicing hand hygiene and personal hygiene strictly. For the Non-Influenza Ward, visitations should also be limited, and people with flu-like symptoms should not visit at all.   Recommendations for patients when returning home are as follows:   Practice good hand hygiene, especially during the disease's contact period. Always wear a mask covering your mouth and nose, except when eating or performing personal hygiene. Cover your mouth and nose when coughing or sneezing with tissue paper and then wash your hands. Avoid close contact with family members and refrain from going to crowded places. Stop working and studying until after the disease's contact period has passed, which is seven days after the onset of fever in adults or at least one day after fever subsides and 14 days in children from the onset of symptoms. If symptoms worsen, such as high fever lasting over 48 hours, severe coughing, chest pain, rapid breathing, fatigue, inability to eat, vomiting, or frequent bowel movements, seek medical attention immediately.   General Recommendations for the Public:   Cover your mouth and nose with a tissue or your own shirt sleeve when coughing or sneezing, and wear a face mask when you have a cold to prevent the spread of germs.   Wash your hands frequently with soap and water, or use hand sanitizer gel to clean your hands. Also, clean frequently touched surfaces and objects.   Avoid going to places where there is a high risk of getting infected, such as crowded places with poor ventilation, and if it is necessary to go to such places, take good precautions, especially by wearing a face mask.   Avoid traveling, going to school or work when you have a cold or fever, at least for one day until you recover completely, and during that time, avoid close contact or sharing personal items with others.   We sincerely hope this advice is helpful. - Vibhavadi Hospital.

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Pregnancy Guide

Pregnancy Guide   All pregnant women should promptly seek antenatal care, preferably within the first trimester, that is, not later than 3 months after their last menstrual period, to ensure a normal pregnancy and a healthy and complete baby. Doctors will examine the woman's health for any complications that may be dangerous to the pregnancy, such as high blood pressure, diabetes, anemia, and infectious diseases.   Services that women will receive during antenatal care include:   Weight measurement, height measurement, blood pressure measurement, and urine examination. The doctor or nurse will take a medical history related to the woman's previous pregnancies, pregnancy-related symptoms, fetal movement, past medical history, family medical history, and allergies to drugs. This information will be useful for the obstetrician to provide appropriate care during pregnancy and delivery. The woman will receive a detailed physical examination by an obstetrician-gynecologist, including an estimation of the expected date of delivery, which is usually within 1-2 weeks of the estimated date. The obstetrician will provide advice on how to take care of oneself during pregnancy, prescribe necessary medications, and schedule the next check-up appointments. The next check-up appointments will be scheduled as follows: From the first antenatal visit to 7 months of pregnancy, the woman should have a check-up once a month. From 7 to 8 months of pregnancy, the woman should have a check-up every 2 weeks. During the last month of pregnancy, the woman should have a weekly check-up. If there are any abnormal findings during the pregnancy check-up, such as complications or underlying diseases, the doctor may require you to have more frequent check-ups than the recommended schedule.   Practices during pregnancy   Eating: You should consume nutritious foods, especially protein-rich foods such as meat, fish, milk, eggs, liver, and various beans. In addition, vegetables and fruits should also be consumed as they provide vitamins and minerals and prevent constipation. As for foods high in carbohydrates and fats, it is not necessary to consume a lot as it may cause excessive weight gain, complications, and difficult childbirth.   Rest and exercise: You should rest for at least 8 hours a day or more. Light exercises such as walking or doing household chores are good forms of exercise. Traveling or working outside the home is not dangerous during pregnancy unless it causes extreme fatigue. It is recommended to take a nap during the afternoon for about 15-30 minutes to prevent excessive fatigue.   Dental health: You should visit a dentist to have your teeth checked and treated because your teeth are more prone to decay during pregnancy. Tooth filling or extraction is not harmful to the baby in the womb if the dentist deems it necessary.   Hygiene: You should shower at least twice a day and wear clean clothes that are not too tight. If there is clear fluid coming out of your nipples, you should wash it off with water or mild soap every time you shower. For those with short or inverted nipples, you should pull on them every time to help them elongate and facilitate breastfeeding in the future.   Things you should avoid:   You should not eat spicy food or drink any kind of tea, coffee, or alcohol. You should not smoke. You should not exercise or do any heavy work that makes you feel excessively tired. You should not buy and take any medication without consulting a doctor. You should not wash your vagina with water or any kind of solution, except when ordered by a doctor. You can have sexual intercourse, except during the last month of pregnancy or in cases of abnormal conditions, such as bleeding or when ordered by a doctor. You should not have an X-ray, except when deemed necessary by a doctor.   Note: If you need to see another doctor for any reason, you should inform them that you are pregnant.   Common symptoms that you may experience during pregnancy   Morning sickness is a common symptom, especially in the first 3 months of pregnancy. You don't have to worry, and an easy way to alleviate this is to get enough rest, eat small, frequent meals, and avoid having an empty stomach. If you have severe symptoms, a doctor may prescribe medication, which is safe during pregnancy.   Abdominal bloating and discomfort can be caused by poor digestion. To alleviate this, it's recommended to eat easily digestible food and avoid gas-producing food like pickles, beans, and carbonated beverages. Light exercise, like walking, is also recommended to prevent constipation, which can be helped by drinking lots of water and consuming plenty of fruits and vegetables.   Headaches and dizziness can be alleviated by getting enough rest and avoiding being in poorly ventilated areas with a lot of people.   Back pain and cramps can be alleviated by getting enough rest, avoiding prolonged standing, heavy lifting, and wearing high heels. Warm compresses and massage with warm honey can also help to relieve the pain.   Vaginal discharge is normal if it's clear or white, but if it's mixed with blood or has a bad odor or itching, you should see a doctor.   Hemorrhoids is always found during pregnancy. It is important to be careful not to become constipated. Usually, hemorrhoids disappears on its own about 4-5 weeks after giving birth.   Varicose veins occur due to slow blood circulation. It is advisable not to stand or sit with your legs crossed for long periods of time. When lying down, elevate your feet. If the pain is severe, consult a doctor.   Stretch marks on the belly or chest are normal and cannot be prevented or treated. However, applying cream or coconut oil frequently can prevent itching.   Swelling is a normal symptom, especially in the weeks leading up to childbirth. Resting and elevating your feet will help reduce swelling, and mild pain around the ankle is also normal.   Insomnia, especially near childbirth, may occur due to discomfort caused by a growing fetus and difficulty breathing. This can be remedied by propping up the head.   Mood swings are common during pregnancy, and you may feel easily agitated, have trouble sleeping, and cry easily. Try to relax and don't have too much free time. This will help those around you, such as your spouse, feel more comfortable, and most importantly, when the baby is born, you will feel a warm feeling in your heart.   Abnormal symptoms that you should see a doctor before scheduling an appointment:   Severe nausea that prevents you from eating Feeling bloated or having frequent indigestion Frequent headaches or dizziness Rapid weight gain with swelling in the face and hands Fever or chills Decreased fetal movement in pregnant women Burning and frequent urination Presence of blood or discharge with odor and itching   When you experience labor pain: Labor pain is characterized by continuous and regular pain in the abdomen, with the first few contractions lasting longer. Subsequent contractions will become more frequent, usually every 5-10 minutes, and last for about 2-3 hours. Do not panic when the pain begins, and for women with a backache, labor may progress faster than those with abdominal pain. Therefore, if you are sure that you are in labor, go to the hospital immediately. However, this may depend on the distance and traffic, so it is best to go as soon as possible.   Best regards from Vibhavadi Hospital.

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Sinusitis in Children

Sinusitis in Children   What is sinusitis? Sinuses are air pockets in the facial bones, located around the nose. The normal function of sinuses is not fully understood, but they may: Lighten the skull Resonate sound Produce mucus and immune protection for the nasal cavity Regulate the temperature and humidity of air entering the body Normally, the mucus in the sinuses drains into the nasal cavity through small openings (ostia) in the sinus walls. This mucus is used to fight infections and clear foreign substances from the nasal cavity, down the throat, or out through the nose.   Causes of sinusitis: Sinusitis occurs when the sinuses become inflamed and swollen, for example, during a cold or sinus infection caused by allergies, or when there is a foreign substance blocking the ostia. This blockage can cause a buildup of mucus in the sinuses, allowing bacteria or viruses to grow and infect the sinuses, leading to pus formation and more swelling. This condition is known as "sinusitis."   Symptoms of Sinusitis There are various symptoms of sinusitis depending on which sinuses are inflamed and whether the condition is acute or chronic. The most common symptoms include nasal congestion, thick and discolored mucus, bad breath, headache, postnasal drip, frequent coughing, and sometimes nosebleeds, facial pain, toothache in the upper jaw, pressure in the sinuses, fatigue, and fever in acute cases.   Treatment for Sinusitis The main principles of treatment for sinusitis include three major approaches:   The use of antibiotics to kill the infectious agents causing the sinusitis. The reduction of inflammation in the sinuses to allow for proper drainage of mucus. Avoiding irritants that can cause inflammation in the sinuses.   Antibiotics The infectious agents that most commonly cause sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Antibiotics used to treat these infections include amoxicillin, amoxicillin/clavulanic acid, cefuroxime axetil, cefaclor, clarithromycin, and clindamycin. The choice of antibiotics will depend on the specific needs of the patient.   Antibiotics are typically prescribed for longer periods than those needed to treat respiratory infections, lasting up to 2-6 weeks, to ensure that the infection is completely eradicated and the sinuses have fully drained.   Reducing nasal swelling can be done by: Rinsing the nose with saline solution. Using nasal spray.   Rinsing the nose with saline solution can be done easily by:   Purchase 0.9% normal saline solution without added sugar or mix it yourself easily by using clean water (250 cc) and adding 1/2 teaspoon of clean salt. Pour the saline solution into a clean glass. Suck up the saline solution from the glass into a rubber bulb syringe or a 10 ml syringe. Spray the saline solution into the nasal passage while leaning forward, hold your breath while spraying the solution into the nose. Repeat until the saline solution is gone, practice once a day for 1-3 times. Sometimes, a doctor may prescribe nasal spray or rinse to be used according to their instructions.   Avoiding Triggers   Some patients with sinusitis (up to 50%) may experience symptoms of sinusitis due to nasal allergies, which can cause nasal swelling and subsequent infection. These patients should avoid allergens such as dust mites, according to their doctor's recommendations. Patients should avoid: Cigarette smoke Infections from people around them Being in crowded areas Swimming in non-standardized pools, etc. Following up with treatment is crucial. Patients should come for regular evaluation appointments as scheduled by their doctor.   Best regards, Pediatric Department, Vibhavadi Hospital.

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When to use anti-seizure medication

When to use anti-seizure medication   Anti-seizure medication is used in patients with epilepsy to prevent seizures. Epilepsy is a significant condition, and although it is found in approximately 1% of the Thai population or about 600,000 people nationwide, it can occur at any age, from newborns to the elderly. Reports show that each year, new patients with epilepsy under the age of 20 comprise up to 70%.   It is necessary to start anti-seizure medication when a seizure occurs or not. If a seizure has been diagnosed by examining the brain's electrical activity and diagnosed by a physician as epilepsy, it is necessary to start anti-seizure medication. Seizures can also occur for other reasons, with fever-induced seizures being common in children. These seizures are called febrile seizures. If the fever is reduced, the seizures will stop, so medication used will typically be for fever reduction, and frequent wiping with a wet cloth can also help reduce fever. Physicians may prescribe anti-seizure medication for some children with febrile seizures, but the medication is only used during the time the child has a seizure and is not required continuously throughout their life. Therefore, if you ask whether anti-seizure medication needs to be used every time a seizure occurs, it depends on the physician's diagnosis. Typically, the physician will consider the benefits of seizure control when deciding whether to start anti-seizure medication. If there is a high risk of severe side effects from the medication, it will not be used. However, if the patient does not receive medication and continues to have seizures, there is a risk of harm from the seizures and it can affect the patient's quality of life. In such cases, it is necessary to use the medication. In cases where it is necessary, medication is used when a patient has a seizure without any known cause or trigger, or when the patient experiences more than two seizures due to fever, or when further diagnosis through electroencephalogram (EEG) shows the presence of seizure activity. In such cases, medication may be necessary. "Patients with epilepsy must have regularity in taking medication, not forget or increase the dosage on their own. Measuring and dividing medication must be precise, as anti-seizure medication is a dangerous drug that affects the brain. If abnormal symptoms occur from taking the medication, medical consultation should be sought immediately."     What are the types of anti-seizure medications and how do they work? Anti-seizure medications can be classified into two groups: standard and new generation. Examples of standard anti-seizure medications are carbamazepine, phenytoin, phenobarbital, and sodium valproate, while examples of new generation anti-seizure medications include topiramate, levetiracetam, vigabatrin, and lamotrigine. These medications come in various forms such as tablets, capsules, and injections. Every medication has a mechanism of action that targets the brain areas that release seizure-causing electrical activity, preventing seizures. However, different types of medication are suited for different types of seizures, and doctors will choose the appropriate medication based on the type of seizure that is occurring. For example, medications may target seizures that are specific to certain areas of the brain or those that spread throughout the brain. Seizures may also be categorized as rigid, jerking, or a combination of both, or may be mild or severe. Therefore, patients or caregivers should provide accurate information to the doctor in order for the doctor to choose the appropriate medication. Typically, doctors will start with one type of medication and use the smallest effective dose to control seizures. If seizures cannot be controlled, the doctor may consider a medication that has been effective and has the fewest side effects to allow the patient to live a normal life. Most patients need to take anti-seizure medication for about two years or more to reduce the likelihood of recurrent seizures. If there are no seizures, the doctor may gradually reduce the medication until it is stopped. The process of reducing medication may take about 6-12 months. After that, the doctor will schedule follow-up appointments to monitor the patient and prevent seizure recurrence.   Source: Health Today Magazine.

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What to know before giving birth

What to know before giving birth   Currently, the trend of women giving birth through cesarean section has increased by almost 50%, of which approximately 20% are necessary to use this method due to indications or reasons that prevent them from giving birth naturally. For example, if the mother or fetus has complications during pregnancy, and there are others who choose this method for various reasons.   In reality, nature has given women the ability to give birth naturally like other animals. However, there are various reasons that lead many people to decide to undergo a cesarean section, which include:   Indications that the fetus has problems during pregnancy, such as lack of oxygen, which may lead to death or disability if left untreated. In cases where the baby cannot turn their head or their size is too large to come out, a cesarean section may be necessary to help save their life or reduce the risk of disabilities that may occur later. Indications that the mother has dangerous complications, such as a larger-than-normal pelvis or inability to give birth naturally. In these cases, a cesarean section is necessary to save the lives of both the mother and the baby. These are the main reasons why doctors choose to use this method to assist in childbirth.   Postpartum Recovery Normally, the size of a natural birth wound and a surgical wound will differ. The wound from a natural birth is smaller, and only the area around the birth canal is sewn up. The level of pain and wound severity is less than a surgical wound, and the wound will heal within five days, while a surgical wound will take about 5-7 days. Therefore, the recovery of a mother who gives birth naturally is faster. However, due to modern medical technology, painkillers are less of a problem. When the pain decreases, the recovery of a mother who undergoes surgical delivery will also be faster.   Risks of Caesarean Section Infection from surgery still exists despite the effectiveness of antibiotics in killing germs. Therefore, it is necessary to be careful.   Problems with the estimated delivery date can occur naturally. However, in the case of surgery, it is necessary to accurately calculate the gestational age. If miscalculated, the child may be born prematurely and may have breathing problems due to underdeveloped lungs. Therefore, accuracy in calculating gestational age is crucial.   Nevertheless, it is important to be aware that nature is always the best. If there are no complications for the mother and the baby, natural birth may be a better option. As for pain, it is believed that everything depends on the "mind". It depends on how much you can endure, and once this significant period has passed, you will feel more love for your mother that cannot be expressed in words.   Thank you for the information from the Health Today magazine.

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Solving Allergy Problems

Solving Allergy Problems Currently, allergies are a widespread condition affecting people of all ages. In a survey conducted in Thai schools, it was found that the percentage of children with nasal allergies is as high as 30-40%. Moreover, there is a growing trend of children with allergies at a younger age. Some individuals display allergic symptoms just a few days after birth, such as food allergies and milk allergies. The severity of allergies in children these days is increasing because their immune system is not yet strong enough. However, sufficient knowledge and understanding combined with modern medical science can help parents manage or reduce the risk of their children having this condition more effectively.   Why are more and more children developing allergies? The cause may come from changes in the environment, as well as pollutants and additives in food, which alter children's immune systems. Studies have delved deeper into the mother's lifestyle and diet during pregnancy, as food and the environment can affect gene expression that is passed down to the child. Nowadays, we observe that allergies are becoming more severe over time. For example, there are cases of children who are severely allergic to cow's milk or wheat, which can cause them to go into shock. Such cases were once rare in Thai people, but now they are becoming more common in Thai children. Therefore, it is recommended that everyone return to a natural way of life and use less chemicals, reduce the use of food additives and pay more attention to the food you consume in order to reduce the risk of genetic or hereditary effects on the body, which may affect future offspring.   For expectant mothers, it is important to consume a balanced amount of all food groups. Do not overly emphasize any one particular food group, as commonly believed, such as drinking a lot of milk or eating a lot of eggs. For mothers who have a child with a food allergy, when asked about their medical history, it is often found that they have recently increased their consumption of that particular protein during pregnancy, which the body was not accustomed to receiving in such a large quantity. For example, the body is used to balancing the protein from three eggs per week, but cannot adjust to an excessive amount of protein from seven eggs per week, leading to negative consequences for the baby. Therefore, it is advisable to follow the middle path according to the teachings of Buddhism, as anything excessive, no matter how good it may seem, can still have negative or poisonous consequences. If an expectant mother is unsure how to balance her diet, she should consult with a physician and use her judgment when selecting information. Do not simply believe everything heard, but rather examine information from reliable sources and rely on scientific principles. For instance, some mothers have read advice to eat two raw eggs per day during pregnancy, which may have positive effects on the baby, but it is highly not recommended, as there may be issues with cleanliness and disease, and raw protein is more likely to cause an allergic reaction than cooked protein. In fact, babies born to mothers who consumed a lot of raw eggs during pregnancy often exhibit severe egg allergies. Therefore, before making a decision, it is important to carefully consider and study the information to derive the most benefits.   Choosing products for children with allergies, parents should train themselves to read product labels in detail. For example, if they want to choose lotion for a child with a cow's milk allergy, they should choose products specifically made for children with allergies and avoid lotions that contain milk because they may cause skin rashes for the child.   In the case where the child cannot speak yet, how can one know if the child's allergy is severe or not? In fact, children have their own way of communicating, and we must understand and communicate with them because children are straightforward and don't conceal things. In this regard, pediatricians are trained to observe children's body language until they become proficient. We can detect details even if the patient does not speak by using medical tools and questioning the parents.   For parents, if they want to know if their child's allergy is severe or not, a simple way to observe at home is to see if the allergy affects their eating, sleeping, learning, activities, or growth. If any of these change, such as weight gain or loss, restless sleep, lethargy, not playing or eating, it is considered severe and should be examined by a doctor.   But if parents are unsure, they should take their child to see a doctor to assess whether there is anything abnormal or not because sometimes symptoms can be hidden, such as tonsillitis, stuffy nose, runny nose, or sinusitis.   How can we tell if coughing, sneezing, and runny nose are symptoms of allergies? Nasal congestion and runny nose are common symptoms in children. To distinguish between the causes of these symptoms, we can observe the following criteria: if the symptoms are caused by an infection, the child will often have a fever and the mucus may be green. Other symptoms may include body aches, nausea, vomiting, or frequent coughing. On the other hand, if the symptoms are caused by allergies, there may be little or no fever, and the mucus will be clear. If the child frequently experiences itchy or sneezy fits that come and go, this may be more indicative of allergies, as infections generally do not cause itching. Additionally, if the child has mild allergies, the symptoms may only occur at certain times of day, such as in the morning or evening, whereas cold symptoms will often last all day. However, if the child has severe allergies, they may experience symptoms all day long.   This information was sourced from Health Today magazine.

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Medication for the elderly

Medication for the elderly The elderly are a population that uses more medication than other age groups due to the fact that these patients often have chronic diseases that require treatment by physicians. Many people have found that 90% of those over the age of 65 use at least one type of medication per week, and the number of medications used is related to increasing age. The resulting issues from medication use include adverse effects, drug interactions, and increased treatment costs. The use of medication in the elderly can easily lead to side effects due to changes in pharmacokinetics with age, such as decreased absorption and elimination of drugs from the body. In addition, the elderly who have visual and memory problems have a greater risk of taking medication incorrectly.   Certain medication groups carry a high risk for the elderly, including: Sedative and hypnotic drugs Antidepressants Non-steroidal anti-inflammatory drugs (NSAIDs) Antidiabetic medications Muscle relaxants Anticoagulants Antiemetic drugs Antihistamines   Group of medications commonly used in the elderly: Medications for chronic diseases such as blood pressure-lowering drugs, blood sugar level controlling drugs, and heart disease medications. Sleep and anxiety-relieving medications. Pain relievers and muscle relaxants. Vitamins, dietary supplements, and herbal remedies.   Factors that promote side effects from medication use in the elderly: Taking multiple medications at the same time can cause drug interactions or drug contraindications. For example, a patient with both high blood pressure and diabetes who takes a diuretic blood pressure medication may experience elevated blood sugar levels, making it difficult to treat diabetes. Additionally, in cases where elderly patients regularly take blood thinners and enjoy consuming Ginkgo biloba supplements, there is an increased risk of easy bleeding. Changes in pharmacokinetics and pharmacodynamics affect drug efficacy and elimination from the body. Patient behavior, such as: Self-medicating, is common in the elderly population in Thailand. It is easy for them to purchase medication from drugstores, and many seniors buy sets of medicine or counterfeit drugs, thinking they are safe because they are made from herbs. However, many of these drugs may contain androgen steroid mixtures that can cause long-term harm, such as osteoporosis, hypothyroidism, and high blood pressure. Lack of regular follow-up with physicians: Many elderly individuals do not like to see a doctor regularly due to various limitations, such as fear of bothering those close to them, fear of wasting time and money, and difficulty with transportation. As a result, it is common for relatives to request the same medications from the physician without the patient being present for follow-up treatment. Non-compliance with medication: Many patients take medication incorrectly for various reasons, such as: Difficulty in understanding how to use medication properly, such as taking medication too many times a day Stopping medication without informing their physician due to unwanted side effects Poor eyesight, forgetfulness, or misreading unclear labels on the medication Patients may also have misconceptions about medication, such as believing that taking more medication will speed up recovery, or taking too much medication can harm their liver and kidneys Accumulation of medication: Elderly patients with chronic illnesses often receive multiple medications, and when they don't finish their medication, they keep it for future use. When they become ill again, they choose to take the same medication that worked before. However, this can be dangerous if the medication has expired. The most commonly used medications by the elderly are sleeping pills and pain relievers, which do not treat the underlying cause of the disease but may temporarily alleviate symptoms. Therefore, medication use should be combined with treatment for the underlying causes of insomnia and pain, which should be under the care of a physician.   Thank you to Health Today Magazine for the information.

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