Dieting vs Food Temptation

After more than 3 years,I have decided to gain some weight.

Definitely not until 90kg like before.

Around

 70 kg from 60.1kg in a month is just fine.

Had so much fine eating.

Laksa 👎🏿

Looks like visceras but it's chicken.🤮

My favorite, chicken rice.

Wan Tan Mee

Hokkien Mee

Okay,this and meal before this is 👆 kinda greedy.

Terrible combo with a protein shake,but better than tasteless chicken breast.

No idea what shit is this.

Ice Kacang with choki choki.

An inherited habit from Bangladesh.

Bah Kuh Teh ,kinda bad combo but I'm always hungry.

😋

Folate Deficiency

Causes:
-Inadequate intake
-Elderly -Alcohol
-coeliac disease -Tropical sprue -Pregnancy -Haemolysis -Myelofibrosis -Malignancy -Crohn’s disease
-Liver failure
-Heart failure
-Methotrexate
-Trimetroprim
-Anti-Epileptics such as valproate, phenytoin

Symptoms of folate deficiency
-Anaemia
Additional symptoms in people with anaemia caused by a folate deficiency can include:
-Symptoms related to anaemia
-Reduced sense of taste
-Diarrhoea
-Numbness and tingling in the feet and hands
-Muscle weakness
-Depression

Sickle Cell Disease

Why does it's painful in SCD
Pain is the hallmark of a SCD, arising as sickle cells impede blood flow.
Red cells are approximately 8 micro metre wide.Their size and shape enable them to squeeze through capillaries which normally only minimal anisocytosis(variation in size) and poikilocytosis(variation in shape) can passes.Anything abnormal, it will fail to negotiate tight capillaries.

Causes of painful fingers in SCD?
Dactylitis which means is inflammation of an entire digit (a finger or toe) .Often active finger will undergoes the swelling and it's painful.
It is a common early manifestation and the reason is same as the cause of the pain.

Reason of abdominal pain in SCD
The cause of abdominal pain often associated with splenic sequestration and is also common.
Splenic sequestration happens when a lot of sickled red blood cells become trapped in the spleen. The spleen can enlarge, get damaged, and not work as it should.
Severe form causes autosplenectomy (disease damages the spleen to such an extent that it becomes shrunken and non-functional) but in milder forms,it causes splenic sequestration.

People who remove their spleen should be vaccinated against pneumococcal ,meningococcal and haemophilus.This is because infection by encapsulated bacteria tend to happens due to splenic's decreased ability to clear circulating antigen.

Hyperparathyroidism

What is Hyperparathyroidism
Hyperparathyroidism is an increase in parathyroid hormone (PTH) levels in the blood.
 This occurs either from a disorder within the parathyroid glands (primary hyperparathyroidism) or disorder outside the parathyroid glands (secondary hyperparathyroidism) resulting in them making too much PTH.

Symptoms
Symptoms may be so mild and nonspecific that they don't seem at all related to parathyroid function, or they may be severe. The range of signs and symptoms include:

Fragile bones that easily fracture (osteoporosis)
Kidney stones
Excessive urination
Abdominal pain
Tiring easily or weakness
Depression or forgetfulness
Bone and joint pain
Frequent complaints of illness with no apparent cause
Nausea, vomiting or loss of appetite

Vitamin K

Vitamin K
Used mainly in clotting and anticoagulation activities.

Vitamin K deficiency occurs in several situation
1.Fat malabsorption syndrome.
(a disorders in which the small intestine can't absorb enough of certain nutrients and fluids. Nutrients that the small intestine often has trouble absorbing can be macronutrients (proteins, carbohydrates, and fats), micronutrients (vitamins and minerals), or both.) 2.After destruction of Vit K- synthesizing gut flora by antibiotic.

3.Following birth of newborns.Liver reserves small amount,the gut flora has not developed,level of Vit K in breast milk is small.

4.Diffuse liver disease.

Consequences
In adult,it causes bleeding diathesis.
It means unusual susceptibility to bleed (hemorrhage) mostly due to hypocoagulability (a condition of irregular and slow blood clotting), in turn caused by a coagulopathy (a defect in the system of coagulation). This result in
a)Hematomas(solid swellings of clotted blood within the tissues)

b) hematuria (blood in urine)

c)melena(black tarry stools, which usually occurs as a result of upper gastrointestinal bleeding)

d)ecchymoses(discoloration of the skin resulting from bleeding underneath, typically caused by bruising)

e)Bleeding from the gums.

Thymus, DiGeorge Syndrome and Thymus Thump

The thymus gland plays an important role in the development of a normal, healthy immune system.
 The function of the thymus gland is to generate mature T lymphocytes (white blood cels that help the immune system fight off illness). Do adults need thymus gland?
The thymus gland, located behind your sternum and between your lungs, is only active until puberty
The thymus is special in that, unlike most organs, it is at its largest in children. Once you reach puberty, the thymus starts to slowly shrink and become replaced by fat. By age 75, the thymus is little more than fatty tissue. Fortunately, the thymus produces all of your T cells by the time you reach puberty

What and where is the thymus gland?
The thymus gland, located behind your sternum and between your lungs, is only active until puberty. After puberty, the thymus starts to slowly shrink and become replaced by fat.

What are the symptoms of an enlarged thymus?
Tumors in the thymus can press on nearby structures, causing symptoms such as:
Shortness of breath.
Cough (which may bring up bloody sputum)
Chest pain.
Trouble swallowing.
Loss of appetite.
Weight loss.

What is DiGeorge Syndrome.
Children born without the thymus.

What is Thymus Thump
The Thymus Thump (also known as the happiness point) can help to neutralize negative energy, exude calm, revamp positive energy, support healing and vibrant health, and boost your immune system. A simple but very effective energy technique involves tapping, thumping or scratching on the thymus point.

Vitamin B12

Vitamin B12 does a lot of things for your body. It helps make your DNA and your red blood cells, for example.

Since your body doesn't make vitamin B12, you have to get it from animal-based foods or from supplements. And you should do that on a regular basis, because your body doesn’t store vitamin B12 for a long time.

Causes:
-Inadequate intake
-Vegan
-Pernicious anaemia
-Gastrectomy
-Bacterial overgrowth
-Crohn’s disease -Terminal ileum resection
-Coeliac disease
-Tropical sprue
-HIV
-Metformin(Diabetes med)
-Proton pump inhibitor (gastritis med)
-Pancreatic deficiency

Symptoms of Vitamin B12 Deficiency

If you have vitamin B12 deficiency, you could become anemic. A mild deficiency may cause no symptoms. But if untreated, it may lead to symptoms such as: -Weakness, tiredness, or lightheadedness -Heart palpitations and shortness of breath -Pale skin -A smooth tongue -Constipation, diarrhea, loss of appetite, or gas -Nerve problems like numbness or tingling, muscle weakness, and problems walking -Vision loss -Mental problems like depression, memory loss, or behavioral changes

What are the complication of B12 deficiency?

Megaloblastosis can cause multi system effect notably cardiomyopathy and neurological disease examples such as subacute combined degeneration of cord, peripheral neuropathy and dementia.

Is there a risk in administering a blood transfusion in the setting of B12 deficiency?

In mixed anaemia with severe B12 deficiency,B12 should always be replaced before transfusion because transfusion can precipitate heart failure.

Seizure

Type of Seizures?
Seizures are classified into two groups.

Generalized seizures affect both sides of the brain.
*Absence seizures, sometimes called petit mal seizures, can cause rapid blinking or a few seconds of staring into space. *Tonic-clonic seizures, also called grand mal seizures, can make a person
-Cry out.
-Lose consciousness.
-Fall to the ground.
-Have muscle jerks or spasms.

Focal seizures are located in just one area of the brain. These seizures are also called partial seizures. *Simple focal seizures affect a small part of the brain. These seizures can cause twitching or a change in sensation, such as a strange taste or smell. *Complex focal seizures can make a person with epilepsy confused or dazed. The person will be unable to respond to questions or direction for up to a few minutes. *Secondary generalized seizures begin in one part of the brain, but then spread to both sides of the brain. In other words, the person first has a focal seizure, followed by a generalized seizure.

What you shouldn't do?

Do not hold the person down or try to stop his or her movements.

Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.

Do not try to give mouth-to-mouth breaths (like CPR). People usually start breathing again on their own after a seizure.

Do not offer the person water or food until he or she is fully alert.

Dear God,

I can't say it in words,
Can you please listen through my heart,
Tell me that your plans are better than my dreams?
God.