Cuti-cuti Malaysiaku

Saya telah menghabiskan hujung tahun 2008 ini dengan 'bercuti-cuti Malaysia'..Nak tahu ke/di mana saya telah pergi/berada di sepanjang musim cuti persekolahan November/Disember lalu? Berikut adalah jawapannya :

15 Nov - 25 Nov 2008 Redh A House, Ampang
26 Nov - 28 Nov 2008 The Best Western Suria Beach Resort, Cherating
29 Nov - 30 Nov 2008 Vistana Hotel, Kuantan
01 Dec - 05 Dec 2008 Bayview Hotel, George Town
06 Dec - 11 Dec 2008 Redh A House, Ampang

12 Dec - 15 Dec 2008 Sofitel Palm Resort, Senai
16 Dec - 22 Dec 2008 Redh A House, Ampang
23 Dec - 24 Dec 2008 Hotel Seri Malaysia, Bagan Lalang
25 Dec - 31 Dec 2008 Redh A House, Ampang

Nak tahu apa yang menarik tentang program percutian kami pada kali ini..?

Pertamanya, kerana saya telah mengambil peluang untuk betul-betul 'bercuti' pada hujung tahun ini demi 'meraikan' suami saya yang akan menamatkan 32 tahun perkhidmatan separa kerajaannya pada penghujung tahun 2009 nanti. Yang keduanya kerana sebenarnya percutian kami hanyalah sekadar mengikuti suami saya yang bertugas di luar daerah samada kerana menghadiri mesyuarat, berkursus atau berseminar ataupun kerana memenuhi undangan 'talk'. Jadi sebetulnya yang bercuti -cuti itu hanyalah saya dan anggota rombongan saya yang terbuka kepada anak-anak yang bercuti sekolah/ipt/lain sedangkan suami saya bekerja. Yang ketiganya, untuk musim cuti sekolah kali ini, tiada satu pun pemergian keluar daerah suami saya yang tidak disertai oleh kami, semestinya saya dan WAAlim sedangkan WAAli hanya mengikuti 'ekspedisi' kami ke Cherating sahaja.

Di pantai timur, sambil mendengar deburan ombak menghempas pantai, walaupun air lautnya kelihatan tenang sahaja tetapi nampak lebih banyak daripada biasa, seperti biasa kami menjalani aktiviti berendam di 'swimming pool' selain melepak dan berkubang di bilik tidur. Vision Four pula menayangkan tiga empat buah filem yang sama bersileh ganti dalam tiga empat hari kami di sana. Salah satu tajuk yang masih saya ingat ialah V For Vandetta, WAAlim yang tolong ingatkan saya nama Vandetta tu. Menarik juga filemnya, kami pun menonton berulang kali juga kerana bukannya ada aktiviti lain yang hendak dibuat di samping pada satu-satu masa bukan dapat tengok sampai habis pun satu-satu filem samada tengok di awalnya sahaja ataupun di tengah-tengahnya sahaja ataupun di penghujungnya sahaja disebabkan kami berkejar juga dengan aktiviti-aktiviti berendam dan keluar makan-makan, lantaran jadual mesyuarat suami saya yang agak ketat dan saya pula tidak memandu. Budak-budak berdua ini pula hanya keluar berendam (bukan berenang..sebab tak reti..) setelah hampir tengah hari daripada pukul 12 lebih hingga pukul dua lebih memandangkan cuaca pagi musim tengkujuh yang sejuk dan tengah hari yang kurang bermatahari. Teruskan juga walaupun hujan turun merembas halus. Kedalaman kolam dewasa ialah 1.2m dan kolam kanak-kanak 0.6m - 0.9m. Saya mencuri-curi turun juga ke kolam renang selepas waktu tengahari itu semasa tetamu-tetamu lain berada di bilik/bilik seminar masing-masing, untuk melepaskan gian apatah lagi tatacara berpakaian yang tercatat di papan tanda kolam renang hanyalah 'tidak dibenarkan pakaian berwarna'. Dari kolam renang dewasa saya cepat-cepat beralih ke kolam renang kanak-kanak kerana merasa takut apabila air kolam itu seperti cuba mengapungkan badan saya. Satu atau dua jam juga saya berendam. Menarik di resort yang terletak berhampiran pantai ini ialah kerana kami juga boleh menggunakan kemudahan-kemudahan sauna dan gym juga beberapa kemudahan sukan 'indoor' seperti 'pool' dan 'table tennis', juga berbasikal, dengan jumlah caj sewaan tertentu tetapi entah macam mana WAAli boleh mendapat sebuah basikal tanpa membayar sewa? lalu keluar ke 'main road' dan membeli sedikit keropok lekor dan sata. Sedapnya saya dan dia meratah makanan yang masih panas-panas baru dimasak itu sedangkan WAAlim ketiduran keletihan..

Kuantan, kami hanya singgah sekejap sahaja di bandar ini dalam perjalanan balik ke Kuala Lumpur, tidak sampai 24 jam tetapi bermalam, sengaja kerana bilik hotel telah dibayar, rugilah kalau tidak dipergunakan dengan seoptimanya. Kami sampai di sini di sekitar waktu tengah hari. Selepas makan tengah hari, suami menghantar kami balik ke hotel sedangkan beliau diminta menggantikan seseorang ke majlis perasmian sebuah projek majikannya yang dijadualkan bermula di sekitar pukul dua petang. Kami pula menunggu di hotel untuk ikut beliau balik ke KL yang dijangka di sekitar pukul 5 atau 6 petangnya. Saya mengambil peluang membawa WAAlim ke kolam renang kanak-kanak sementara menunggu suami menyelesaikan tugasan tetapi apabila beliau datang semula ke hotel dia bertanya samada kami hendak bermalam di bandar ini atau terus balik dan bermalam di rumah. Kesudahannya, esok pagi barulah kami bertolak pulang tetapi terus ke khenduri perkahwinan anak seorang staf di Kuang. Kami sampai di rumah pukul 2 lebih petang.

Pada musim cuti sekolah hujung tahun ini juga suami saya perlu menghadiri kursus pra persaraan. Kami bertolak pukul 12 lebih tengah hari selepas tidak sampai 24 jam 'mendarat' di rumah pada hari sebelumnya. Kami diinapkan di sebuah hotel yang dilengkapi dengan 'rounding restaurant' di tingkat paling atas yang dipusingkan perlahan-lahan untuk menikmati pemandangan 'bay' sambil bersantai menyantap juadah hidangan selain 'gymnasium' di tingkat bawah yang menghadap kolam renang yang berkedalaman 1.2m yang mencerun pula ke kedalaman 3.5m, kolam kanak-kanak sedalam 0.6m dan kolam berjakuzi sedalam 0.9m. Ada spa dan 'Japanesse restaurant' juga. WAAlim yang tidak pandai berenang sebelum ini berpeluang mencuba beberapa kayuhan dengan disepara'instruct'kan dari jauh oleh seorang pemuda petugas kolam renang. Saya rasa wajah pemuda itu 'familiar' samada saya pernah mengenalinya dulu ataupun dia adalah seseorang yang pernah muncul di kaca TV atau majalah ataupun sebenarnya mungkin saya tidak pernah pun melihatnya di mana-mana tetapi hati saya agak kuat/berat mengatakan/merasakan wajahnya seperti suami kepada anak saudara kawan saya dulu-dulu, Hjh Maznah Kassim dari Tmn Free School. Seronoknya saya memerhati sambil mengawasi tubuh kecil anak saya ber'loklek' di dalam air, mula pandai untuk berenang dan menyelam. Semangat saya untuk meneruskan 'ekspedisi' ke destinasi seterusnya tambah berkobar lantaran ini. Saya juga tidak mahu melepaskan peluang untuk berendam di kolam berjakuzi dan dengan diam-diam melungsurkan badan saya ke dalamnya pada hari kedua walaupun tatacara berpakaian yang ditetapkan di papan tanda kolam renang agak ketat. Di hari ketiga, saya berjakuzi bersama seorang kawan, isteri kepada Hj. Wahab, kawan suami saya yang ikut berkursus tetapi kerana bersara pilihan. Sambil merasakan urutan semburan air kolam ke badan, beliau sempat menitipkan saya resepi masak tempoyak ikan patin yang tersangatlah 'simple'nya, sedikit cili padi ditumbuk dengan sedikit kunyit hidup, sekadar cukup kepedasan yang dikehendaki, boleh dicampur sedikit cili merah untuk mem'balance'kan kepedasan cili api tersebut, 2 sudu besar tempoyak yang agak baru, sedikit garam, daun kesom dan sejenis daun lagi yang saya sudah lupa apa dia, dijerang bersama seekor ikan patin sepanjang lebihkurang 6 inci sehingga mendidih, dibiarkan sekejap dan siap. Saya juga berpeluang menghadiri salah satu slot kursus pra persaraan walaupun memasukinya setengah atau satu jam lebih lewat daripada para peserta. Sebaik saja masuk ke bilik kursus, terus menatap VCD nyanyian kumpulan Far East dengan lagu Barzakh Menanti. Walaupun Ustaz pengendali meminta para audien menumpukan perhatian kepada senikatanya tetapi saya tidak berani dan asyik menundukkan kepala mengelak daripada terlalu menumpukan perhatian takut terbawa-bawa oleh perasaan. Di sini juga saya melihat suatu 'peringatan' semasa bersarapan, 'leftover' yang mencapai berat 100g akan dicaj RM10 untuk setiap 100g dan berikutnya. Dalam perjalanan balik saya membabai pulau ini di dalam hati buat kali kedua. Banyak perkara yang bermain di fikiran saya. Kami sampai di rumah di sekitar pukul 4 atau 4 lebih tetapi tidak dapat memasuki rumah kerana rumah berkunci dan WAM yang sepatutnya membukakan pintu untuk kami tiada di rumah pada ketika itu. Kami terus ke Carrefore berhampiran membeli beberapa barangan keperluan dan pulang semula selepas dua jam.

Di rumah esoknya, tidak banyak perkara yang telah saya buat tetapi suami saya ke Ulu Langat untuk merebus ketupat peringkat daerah/zon rukun tetangga bersama dua lagi AJK RT taman kami. Malamnya, kami ke dataran RT kerana jamuan pra-sambutan hari raya Aidil Adha diadakan.

Pagi Ahad, kami ke Pasar Pohon Celagi untuk membeli barangan basah untuk keperluan minggu berikutnya juga untuk sambutan hari raya keesokannya. Malamnya, kami ke Seafood Terminal di Sri Ukay yang berkonsepkan '3 in 1' iaitu sebuah alat memasak 3 tingkat yang berfungsi untuk stim (paling atas), grill (tengah) dan steam boat (paling bawah), kerana anak sulong kami hendak belanja kami makan. Sambil gelak-gelak saya berbisik kepada suami, bukan 3 dalam 1 tetapi empat sebab kepanasan turut menjalar ke dalam kain yang saya pakai. Caj ikut kepala dan kami boleh makan sebanyak mana yang kami suka tetapi setiap 'leftover' yang mencapai berat 100g akan dicaj RM8 per 100g dan berikutnya. Sebelumnya, petang, anak perempuan sulong kami telah membawa sebuah mangkuk tingkat berisi kek lapis batik (yang disediakan oleh adik ipar bongsunya, Afifah), ayam masak merah (yang disediakan oleh adik ipar bujangnya, Fadhil), rendang daging (yang disediakan oleh ibu mertuanya), kuah kacang (yang disediakan oleh suaminya), kuah lodeh (yang disediakannya olehnya sendiri) dan juga ketupat (yang disediakan oleh mereka sekeluarga) memadailah untuk kami sekeluarga bersarapan di pagi Aidil Adha. Nasib baik!

Pada pagi hari raya, selepas bersembahyang dan bersarapan, suami saya ke surau seperti tahun-tahun sebelumnya untuk melapah lembu korban. Tengah hari saya mula memasak nasi bukhara seperti yang diminta oleh suami saya tetapi malangnya nasi mentah dan tidak mahu masak-masak sehinggalah ke petang. Walau bagaimana pun, hasil masakan saya itu dapat dimakan juga akhirnya selepas saya dan anak dara kami KW berhempas pulas selama beberapa jam dalam kerisauan. Seekor ayam organik HPA yang dibeli semalam lunyai di dalam periuk nasi berkenaan. Hari itu pula dipenuhi dengan hujan. Sebenarnya saya telah mengulangi kejadian di pagi 1 Syawal yang lalu di mana sambal nasi lemak yang saya masak tidak mahu menjadi sedari 5 pagi saya menumis sehingga ke 7 pagi, rasanya tetap pahit-pahit tetapi bila dimakan pada waktu tengahari dalam perjalanan balik ke Kelantan, di sebuah masjid dalam daerah Merapoh, okey pula rasanya..entahlah!

Dua hari berikutnya aktiviti saya dipenuhi dengan mendobi; membasuh dan menjemur pakaian walaupun keadaan cuaca kurang memberangsangkan. Hari ketiga, sambil meneruskan kerja mendobi, saya menolongtengokkan 3 cucu perempuan kami yang dijaga oleh dua bapa saudara mereka. Mereka tidak ke taska seperti biasa kerana taska bercuti umum di peringkat negeri lantaran Harijadi Sultan. Esoknya kami hendak bergerak ke negeri Johor pula.

Pada percutian kali ini juga kami dapat menikmati bilik paling luas yang pernah kami inap dengan 'room rate' yang agak rendah, mungkin juga disebabkan penganjur seminar berkenaan membuat 'group booking'? Bilik berhadapan dengan kolam renang yang juga agak luas dengan kedalaman 1.2m di samping kolam kanak-kanak sedalam 0.3m. Saya agak hampa dengan kecetekan kolam kanak-kanak ini lantaran saya sedang bersemangat untuk memberi peluang kepada anak saya yang sedang belajar berenang walaupun ianya dilengkapi dengan air pancur dan kedalaman beransur seperti di pinggiran pantai, sesuai untuk kanak-kanak yang berusia lebih muda. Kehampaan saya ini diperitkan lagi apabila saya terpandang seorang wanita tempatan/Asia Tenggara yang dengan bebasnya melenggeng di tepi kolam renang itu dengan sut baju mandi ala-ala bra sukan dan seluar dalam, sedangkan suaminya yang berbangsa Eropah itu bermandi manda dengan berseluar pendek. Alangkah mudahnya bangsa dari rantau kita ini mengikut sahaja rencah budaya yang bukan daripada cara gaya hidup tempatan kita. Cara gaya itulah pula yang akan diperkembangkan dalam masyarakat kita sehingga tata kehidupan kita yang murni menjadi porak peranda. Dan alangkah sedihnya juga kerana kita seperti dipencilkan di negara kita sendiri lantaran kita tidak mengikut tata gaya berpakaian kolam renang seperti mereka. Mujorlah juga keperitan ini sedikit diubati dengan kemeriahan di kolam renang pada petang Sabtu itu dengan ramainya kanak-kanak tempatan/Melayu juga ibubapa mereka yang ber'swimming suit' Muslim/Muslimah. Hotel resort ini juga mempunyai kemudahan 'sport house' yang dilengkapi gelanggang 'bowling', 'squash', 'table tennis', 'snooker', 'gym' dan kolam renang 'olimpik' dengan kedalaman 1.2m-1.5m dan sebuah lagi kolam renang kanak-kanak dengan kedalaman 0.5m, juga padang golf. Saya juga berkesempatan berkenalan dan beramah mesra dengan dua orang isteri, Khairani dan Nurul, yang lebih muda daripada saya, yang juga mengikuti suami mereka berseminar yang sama tetapi daripada sebuah perbadanan, bersama anak-anak mereka. Di sini juga saya dipanggil 'makcik' oleh seorang petugas hotel resort yang genit yang mungkin sebaya dengan salah seorang daripada anak-anak kami yang membuatkan saya agak kehairanan di samping merasa agak terganggu bila diingatkan masa bersarapan yang masih tinggal 20 minit lagi dan ditunggu untuk dikemas meja oleh seorang petugas yang lain dan pintu tempat mengambil makanan telah ditutup 15 minit lebih awal daripada waktu yang diperuntukkan untuk bersarapan tamat. Entahlah, mungkin mereka merasakan saya yang tidak 'sofisticated' ini tidak layak untuk berada di tempat sedemikian seperti mereka. Ataukah mereka sendiri yang merasa tersindir..

Sepulang dari Johor, seperti dijanjikan, 3 hari seterusnya saya sekali lagi menolong menengokkan 3 puteri kepada puteri sulong kami yang terbang ke Langkawi kerana mesyuarat kerja, tetapi saya turut dibantu oleh 2 lagi anak lelaki kami, mujorlah.

Pada hari Sabtu, saya dan suami berkunjung ke klinik gigi kerana saya telah mengalami bengkak-bengkak gusi sejak beberapa hari lalu dan selepas pemeriksaan dibuat, temujanji seterusnya untuk kami berdua ditetapkan, 23 hb jam 2.00 petang (suami) dan 24 hb jam 3.30 petang (saya) yang kemudiannya diubah (untuk saya sahaja) kepada 5.30 petang hari yang sama. Suami saya pula mengambil cuti tahunan daripada 22 hb hingga ke hujungnya.

Destinasi terakhir kami, tidak sampai 24 jam kami di sana. Sampai +-8.40malam selepas melalui Ampang-Sepang-Banting-Kanchong-Pantai Morib-Sg Pelek-Bagan Lalang, melalui jarak 139.6 km, selepas bertolak dari rumah pada jam 5.40 petang. Rasanya, suami saya sudah mula merasa pelik apabila kami sudah agak lama berada di perjalanan yang sepatutnya tidaklah terlalu lama tetapi masih belum sampai-sampai, malahan tidak jumpa/nampak tanda arah ke Pantai Bagan Lalang manakala sudah 2 kali kami berhenti bertanya arah jalan. Apatah lagi jawapan daripada lelaki China dengan wajah yang berkerut dan lelaki Melayu di bengkel di simpang jalan tadi mengatakan jauh atas lagi dan masa yang perlu diambil lebihkurang 40 minit lagi. Suami saya memberhentikan kereta 1 atau 2 km selepas simpang itu dan makan di sebuah kedai makan pada waktu maghrib itu. Saya lihat label nama di kedai ukiran batu bersebelahan menunjukkan kami sedang berada di Kanchong. Rasanya suami saya sengaja berhenti di sini untuk berfikir semula dan juga mengelak daripada memandu di waktu remang senja/Maghrib kerana memandu di waktu sebegini adalah merbahaya dan macam-macam perkara buruk boleh terjadi. Logik, disebabkan masa, suasana dan pencahayaan yang sedang bertukar boleh mempengaruhi hati dan fikiran kita dan juga gangguan-gangguan halus tatkala syaitan sedang berkeliaran. Kemudiannya, setelah menghampiri Pantai Morib dan baru menjumpai label arah ke Pantai Bagan Lalang, Sg. Pelek dan Sepang, barulah kami menyedari bahawa kami telah tersilap mengambil jalan 'long cut'. Apabila saya berkata, "kita telah sesat", suami saya menidakkannya sebaliknya mengatakan, "Allah nak beri kita kemudahan". "Macam mana tu?", saya bertanya. Katanya, "sebab dengan itu kita boleh solat jamak dan qasar". Suami saya dijemput membuat penyampaian di salah sebuah slot kursus pada pagi esoknya. Kami juga tidak berpeluang menghadiri satu slot kursus (opsyenal) pada malam ketibaan dan merasa agak rugi kerana penyampainya adalah seseorang yang didatangkan dari luar negara. Kami diberi bilik yang agak besar juga dengan sebuah katil 'double' dan sebuah lagi katil 'single', juga set sofa 2+1+1. Pada paginya, sementara suami saya memenuhi slot muhasabahnya, saya menemani dan mengawasi WAAlim di kolam renang. Kedalaman di bawah paras mata punggungnya sesuai untuknya mencuba beberapa kayuhan. Selepas satu jam kami bersiap untuk pulang dengan saya tidak mandi pagi kerana suami saya terpaksa berkejar untuk menghadiri mesyuarat pada pukul 2 petang di ibu pejabat. Perjalanan balik yang bermula +-12 tengah hari itu hanya mengambil masa 1 1/2 jam berbanding pergi (3 jam) kerana kami mengambil jalan Bagan Lalang-Sg Pelek-Sepang-Ampang, dengan jarak +-89.6 km. Bermakna kami telah membuat lebihkurang dua pertiga bulatan untuk sampai ke Sg. Pelek dan menggenapkan sepertiga bulatan lagi daripada Sg. Pelek ke Ampang. Kami berhenti makan tengahari pada +- 1.30 di sebuah restoran berhampiran taman perumahan kami kerana saya keberatan untuk memasak hidangan tengahari..dan suami saya kata saya 'agah'..

Aktiviti kami seterusnya selepas itu ialah membeli pakaian sekolah WAAlim, yang kami laksanakan pada 25 hb. Sebenarnya suami saya yang menguruskan kesemua pembelian pakaian sekolah agama, sekolah kebangsaan dan kasut-kasut untuk kedua-dua sekolah berkenaan memandangkan saya berada di sebuah salon untuk memotong rambut lantaran tidak tertahan lagi dengan masalah kegatalan di kulit kepala yang telah saya alami sejak sekian lama. Pembelian buku-buku untuk kedua-dua sekolah telah suami saya uruskan sebelumnya, rasanya pada pagi sebelum kami bertolak ke Bagan Lalang.

Kami juga berkesempatan menghadiri ceramah sempena sambutan Maal Hijrah di peringkat RT taman kami pada malam 30 hb. (2 Muharram 1403 H) dengan tajuk Penjernihan Jiwa Sebagai Prasyarat Kecemerlangan Diri. Pada malam 31 hb (3 Muharram 1403 H) pula, kami ke Masjid Puterajaya untuk mendengar sedikit taklimat berkenaan Palestin dan Keganasan Zionis. Seperti sedia dimaklumi, sebenarnya tentera Israel telah melancarkan serangan terbesar sejak 60 tahun ke bumi Palestin bermula Sabtu 27 hb. Disember 2008. Seusai program kami menuju ke kereta untuk bergerak pulang tetapi jalan masuk ke bulatan Dataran Putrajaya telah ditutup kerana kesesakan lantaran ramainya orang datang untuk menyaksikan percikan bebunga api detik 12 malam. Terpaksalah kami menyusuri jalan keluar yang lain.

Di perjalanan-perjalanan kami ini, saya teringatkan sebuah lagu lama nyanyian Orkes El-Suraya ..

Berjalanlah di muka bumiii
lihat gunung-gunung yg menjulang tinggiii
lautan dalammm bermacam ragam isinya
tak terduuga manusiaa

Betaapaaa Tuuuhann jadiiikan
aalam yg peenuuuh keeeinndaahan
betaapaaa tuuuhann jadiiikan
aalam yg peenuuh keeinndaahan

..dan kenangan-kenangan semasa saya masih bergelar seorang pelajar di pulau mutiara. Agaknya saya sudah banyak lalai di tahun-tahun kebelakangan ini..?

Erti 16 Dec Kepada Saya..

Apa erti 16 Dec kepada saya..?

Pada 16 Dec 2007, telah tercipta satu sejarah di kampung saya, apabila pada kali pertama banjir terbesar sejak sekian lama menenggelamkan puncak banggol di mana bertemunya empat arah jalan..dari arah jalan ke pekan, dari arah jalan ke lebuhraya, dari arah jalan ke sekolah rendah kebangsaan dan dari arah jalan ke masjid/rumah ibu saya di mana air bercantum daripada empat penjuru..

Di sekitar tarikh itu, 15-16 Dec, saya mengalami cirit birit selama lebih kurang 24 jam manakala suami saya menghadiri mesyuarat 2 hari di Bangkok..

Di sekitar tarikh itu juga, cucu kedua kami diserang virus chicken pox, selama lebih kurang dua minggu, diikuti anak bongsu kami di penghujung Dec/awal Jan.. mengakibatkan orientasi masuk sekolah/darjah satunya tergendala.. dan diakhiri dengan saya sendiri bermula pada pertengahan Januari 2008..lalu kami tidak dapat menghantar adik bongsu saya ke lapangan terbang untuk terbang ke luar negara sepulang dari bercuti belajar selama lebih kurang sebulan..

Pada malam sebelum 1 Dec 2004, suami saya diserang sakit jantung..pada awal dinihari 5 Dec 2004 kami menyambut kehadiran cucu pertama..pada awal pagi 26 Dec 2004 kejadian tsunami melanda negara-negara Indonesia, Thailand, Afrika, Burma, .. termasuk Malaysia mentraumakan ramai manusia..pada usia saya menyekitari 40 tahun..

Pada 16 Dec 2001, jatuhnya 1 Syawal pada tarikh ini, di mana Aidilfitri pada tahun itu disambut dengan kehadiran cahayamata 'bongsulong' yang baru berusia 44 hari.. sambil saya tersenyum duduk di sofa di samping suami sementara disalami oleh 3 puteri dan 3 putera kekanda-kekanda WA Alim..pada usia saya mencecah 37 tahun..

Sms baru diterima :

Congratulations & a glorious annivesary year of 44. May Allah guide and bless u with happiness. Thanks 4 all your support & patience all these years. Together we seek repetence from Allah.

Sender:
WASH

Sent:
09:58:05am
16-12-2008

Iya, 16 Dec adalah tarikh lahir saya sebagaimana tercatat di atas kad pengenalan dan surat beranak saya tetapi ..

Sebenarnya saya dilahirkan bukan pada tarikh ini kerana ibu bapa saya telah mendaftar lewat kelahiran saya. Begitu juga dengan 4 daripada adik beradik saya yang lain bermula daripada anak ketiga (Sept 1959) hingga ke anak ketujuh (July 1966). Alasannya kerana abang saya (anak kedua) yang dilahirkan di hujung tahun (Oct 1953), terlalu kecil untuk masuk sekolah pada waktu itu..?

Ceritanya, abang saya yang semasa itu berada di darjah satu, terpaksa dibangunkan seawal pukul 4 lebih pagi, dimandikan dan diletakkan di dalam tempayan hijau, sebuah tempayan yang bermulut besar di rumah pusaka keluarga kami kerana kesejukan sementara menunggu di 'kekkong' oleh bapa saudara kami, Abah Daud, ke stesen keretapi untuk menaiki keretapi yang biasanya tiba pada pukul 5 lebih pagi. Di stesen, beliau ditunggu oleh datuk kami sebelah ibu, Che Tok Jusoh, dari kampung sebelah, yang menemani cucu tirinya yang sebaya dengan abang saya untuk menaiki keretapi ke pekan yang berjarak lebih kurang 2 batu dari kampung kami. Mereka berdua belajar di sekolah rendah yang sama. Pada masa itu, rasanya masih belum wujud sekolah rendah di kampung kami. Che, akan menunggu di sekolah/pekan hingga tamat waktu persekolahan dan membawa mereka berdua pulang ke kampung dengan menaiki keretapi juga..? (Al Fatihah untuk kedua-dua mereka, Allahyarham Che Tok Jusoh dan Allahyarham Abah Daud..)

[Agaknya, disebabkan kesulitan-kesulitan yang dialami pada masa itulah, terwujudnya sebuah sekolah rendah di kampung kami atas inisiatif datuk kami (Che Tok Jusoh, Tok Penghulu), bapa saudara kami (Pak Cik Ya, Pengerusi PIBG) dan seorang lagi bapa saudara kami (Pak Su Tar, Guru) yang mendapat latihan perguruan. Kesemua maklumat penubuhan sekolah rendah di kampung kami ini boleh dilawati di laman web sekolah berkenaan! Al Fatihah untuk Allahyarham Pak Cik Ya juga].

Oleh sebab itu, kami 5 beradik tidak mengetahui dengan tepat tarikh lahir kami yang sebenar.. walau bagaimana pun secara congakan berdasarkan ingatan ibu tentang jarak umur di antara setiap kami berapa tahun dan berapa bulan, saya mengagak bahawa saya dilahirkan di sekitar Feb tahun itu.. walaupun ada di antara adik beradik kami beralih tahun kelahiran disebabkan kelewatan ini..? (Kalau saya pilih 16 Feb sebagai tarikh lahir saya boleh..?)

Hm..

Walau bagaimana pun saya tidak terkilan..memang keadaan hidup pada masa itu dan takdir telah menentukan..lagipun kami dari generasi lalu tidak biasa dengan sambutan-sambutan harijadi ni..tak kisah pun!

Chickenpox

Herpes Zoster

A highly contagious viral disease, chickenpox is common but mild in children; it is more severe in adults. Infection is easily spread via airborne droplets that are exhaled or expelled (eg. when coughing or sneezing), causing outbreaks in places where there are close person-to-person contacts. Epidemics are thus common in schools, military camps, dormitories, and crowded areas. A single attack gives a person lifelong immunity. However, the virus may remain dormant in the nerve tissues and reappear later in life as shingles. (See SHINGLES page 478)

Symptoms

• Fever and malaise (headache, backache, sore throat, weakness, etc), runny nose which precedes the rash.
• Rash, which start as small, very itchy red bumps on the upper arms and armpits, behind the ears, and on the torso (chest, abdomen, and back). The bumps turn into fluid-filled blisters and after several days, dry up, crust over, and finally fall off on their own. Duration of illness is about 2 weeks.
• Severe itch.

Complications

• Secondary bacterial infection.
• Pneumonia (lung infection), which is common in adults.
• Encephalitis (inflammation of the brain), in rare cases.
• If a pregnant woman gets infected a few days before delivery, the newborn could get a severe form of the disease.

Cause

• Infection by the Varicella zoster virus. A person is highly infectious about two days before the rash appears and about a week after, or when all blisters have crusted over.

Chickenpox is transmitted via:

• Airborne nose and mouth secretions expelled when an infected person exhales, coughs, or sneezes.
• Direct contact with ruptured blisters.

What you can do

• Take a complete rest until all blisters have dried up. Full recovery comes a week to 10 days after the rash breaks out.
• Do not burst the blisters, scratch, or peel off the scabs to avoid spreading the viral infection, as well as to prevent secondary bacterial infection and scarring. Trim a child's fingernails or put mittens on his hands to keep him from scratching.
• Take antifever medicine for the fever; this will also take care of the aches.
• Consult a doctor if you think you or your child has the symptoms and have not had the disease.

What your doctor can do for you

• Prescribe antiviral tablets for an adults. (Children usually need only rest.) To be effective, however, the treatment must be started very soon after the rash appears (at least within 24-48 hours).
• Prescribe antibiotics, if there is secondary infection.
• Treat the complications.
  

For products see Skin anti-itch agents & antihistamines page 491

This article is reffered to Malayssia Healthcare Guide-The family health guide, MIMS, 2nd edition, 1997, page 269

Tonsillitis

Sore throat

The tonsils are lymph nodes at the back of the throat that serve as the first line of defense against germs entering the body through the nose and mouth. Tonsillitis occurs when the tonsils themselves get infected by the micro-organisms they filter. The disorder is common in childhood but rare in adults, who usually experience sore throats or pharyngitis instead. Some children get recurring attacks.

Symptoms

• Swollen tonsils on either side, which sometimes have white spots on them.
• Flu-like symptoms, fever, headache : Tiredness, weakness, loss of appetite.
• Pain when swallowing.
• Earache.
• Foul-smelling breath.

In children (in come cases):

• Abdominal pain.
• Cough.
• Vomiting.
• Swellings on either side of the neck due to enlarged lymph nodes (other then the tonsils).

Complications

• Quinsy (an abscess on the tonsil).
• Rheumatic heart disease, due to an untreated bacterial infection.
• Kidney damage due to an untreated bacterial infection.

Cause

Viral (more common) or bacterial infection on the tonsils.

What you can do

• Nothing. The disorder goes away on its own in a few days.
• Stop smoking.
• Drink plenty of fluids.
• Gargle with mouthwashes or warm salt water.
• Suck antiseptic lozenges or cough drops.
• Take simple painkillers or antifever medicine. However, give a child paracetamol, not aspirin. Aspirin puts him at a risk of contracting Reye's syndrome, a rare life-threatening disease which affects the brain and liver.
• Consult a doctor if symptoms persist for more than 2 days, you run a high fever, or pus can be seen on the tonsils.

What your doctor can do

• Determine the cause of the infection.
• Prescribe antibiotics for bacterial infection.
• Treat the complications.
• Perform tonsillectomy (surgical removal of the tonsils), in rare cases.

Prevention tips

At the first sign of a sore throat, suck antiseptic lozenges.

For products see Sore throat page 511, Oral hygiene page 435

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 530.

Constipation

The frequency of moving stool varies from individual to individual, ranging from three times a day to twice a week. Constipation happens when this function is unduly delayed from the normal pattern. Occasional constipation is not serious but a long-standing disruption of this pattern, and changes in the appearance and consistency of the stool may be signs of a more serious disorder (eg intestinal cancer, hypothyroidism).

Symptoms

• Delay or difficulty in bowel movement.
• Pellet-like stool (small, dry, and hard).
• Pain, which may come and go in waves.
• Flatulence (excessive gas in the bowels) and frequent passing of air.
• Abdominal distension and discomfort.

Common causes

• Change of diet.
• Insufficient fluid and fibre in the diet.
• Too little exercise, causing the colon contractions that push the stool down to weaken.
• Ignoring the urge to pass stool when busy.
• Haemorrhoids (piles) or anal tissues (tears in the skin arround the anus), which cause pain when passing stool. (See PILES page 452).
• Certain drugs and minerals (eg painkillers, iron tablets) and cough mixture with codeine.
• Pregnancy, in which the fetus pushes down on the bowel.
• Illness which causes loss of fluids, alters the diet, or hinders a person's mobility (eg paralysis).
• In bottle-fed infants, feeding formulas that are too strong.
• Aging process. The abdominal muscles gradually weaken with age.

What you can do

• Eat plenty of fibre daily (eg four servings of cereals, fruits, and vegetables).
• Drink 6-8 glasses of fluids a day.
• Eat at regular hours.
• Exercise everyday. Walk briskly for at least half an hour.
• Consult a doctor if the measures listed above fail.

What your doctor can do for you

• Rule out haemorrhoids, anal tissues, and the more serious causes of constipation (eg colon or rectal cancer).
• Emphasize exercise and dietary strategy.
• Prescribe a laxative.
• Prescribe suppositories or an enema (passing fluid into the rectum through a tube inserted into the anus to induce bowel movement).
• Treat the complications.

Prevention tips

• Take plenty of fluids and fresh fruits and vegetables daily.
• Exercise regularly.
• Keep regular hours for your meals.
• Follow a regular pattern for bowel movement. Do not ignore the urge to pass stool.

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 280-281.

Asthma

Also see Allergy page 197

During an asthma attack, the muscles in the walls of the small airways contract (bronchopasm), the linings of the small airways become inflammed, and excessive mucus is produced in the small airways. All three reactions combine to narrow the airways, thus limiting the passage of air, especially during breathing out. The disorder usually begins in childhood, with about half the children outgrowing it.

Symptoms

• Chest tightness.
• Breathing difficulty; laboured breathing in episodes. (Symptoms are worse at night.)
• Wheezing (a whistling sound while breathing).
• Coughing, with or without thick sputum.
• During severe attacks, cyanosis (bluish discoloration) around the lips, sweating, and a fast pulse rate.
• In infants, fast breathing, with the lower ribs being drawn in.

Complications

• Pneumothorax (collapsed lung due to an air leak).
• Acute respiratory failure.
• Death.

Common causes
Asthma is the result of a hypersensitivity reaction to stimuli, inflammation and constriction of the air passages. It is a condition due to both hereditary and environmental factors. An asthma attack may be provoked by:

• Allergens (eg. animal dander, dust, certain food and medicines, mites, mold spores, pollen, etc).
• Viral or bacteria infections (eg. bronchitis, common cold, coughs, sinusitis).
• Environmental irritations (eg. exhaust gases, hair spray, perfumes tobacco smoke).
• Emotional stress (eg. excitement, upheaval).
• Strenuous exercise.

What you can do

• Consult a doctor the first time you start wheezing, or if the condition does not respond to the prescribed treatment.
• Take the medication prescribed by the doctor (eg bronchodilator). Inhaled bronchodilators are usually recommended. Wait 15-20 minutes after an inhaled dose. Rrepeat if necessary.
• Take your peak expiration flow rate.

Call your doctor or go to the hospital if:
. you or your child is not getting better after following the doctor's instructions.
. you or your child is unable to talk because of breathing difficulty.
. you or your child requires inhaled bronchodilator very often (eg more than 3-4 hourly).
. your child looks exhausted.

• Try to be calm and call for help if you cannot cope. See HELPLINES.
• Rush the nearest hospital's emergency room if you have an accute attack.

The bystander:

• Sit the person upright and make him lean forward, with both arms resting on the table.
• Rush the person to the nearest hospital's emergency room if an acute attack does not respond to the prescribed medication.

What your doctor can do for you

• Administer oxygen.
• Administer a bronchodilator via nebulisation.
• Administer oral or intravenous steroids.
• Treat an accompanying chest infection with antibiotics.
• Prescribe long-term anti-inflammatory treatment.
• Teach you how to manage acute attacks, and how to use certain devices (eg inhaler, turbuhaler, rotahaler, diskhaler) to ensure optimum benefit from them.
• Teach you how to use a peak flow meter to monitor your asthma.

Prevention tips

• Know what triggers the asthma attack. If possible, avoid the factors that trigger the disease. (Keep your home free of dust, animal hair, mites, etc.; and stay away from irritations such as cigarette smoke, exhaust fumes, etc).
• Stop smoking.
• Take the medications prescribed by the doctor to reduce the frequency and severity of subsequent attacks.
• Exercise regularly to improve lung and heart function.

Helplines
Persatuan Asma Malaysia 03-757 6641

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 223-224

Eczema

Skin rash

Also see Allergy page 197

Eczema is a skin rash or inflammation characterised by blistering, cracking, itching, oozing, redness, or scaling. The skin often becomes thick and discolored due to constant scratching. Eczema is common, recurrent, and sometimes persistent, but it is not contagious. Most affected children outgrow the condition by puberty.

Symptoms

• Swelling and redness.
• Itchy rash, which is sometimes intense.
• Blisters (small bumps filled with fluid) that may ooze due to scratching.
• Crusty, dry and cracked, leathery, scaly, thickened, or weeping areas of skin.
• Pain, soreness, discomfort.

Complications

• Secondary bacterial infection.

Cause
There are many types of eczema. They are due to combination of endogenous (internal) and external factors.

• Allergy - allergic contact eczema.
• Skin irritation - irritant contact eczema.
• Photosensitive eczema - sunlight-induced.

What you can do

• Seek treatment early.
• Avoid scratching as much as possible, as it can lead to bacterial infection.
• Apply cream, lotion, or moisturizer to prevent dryness.
• Apply soothing ointment on the affected area to ease irritation and cover with dressing to prevent scratching.
• Wear cotton clothes. Do not use wool and synthetic fabrics as this tend to irritate the skin.
• Take antihistamine (anti-allergy medicine). Take sedative antihistamines at night and non-sedative in the day or at work.
• Consult a doctor if the condition shows signs of spreading or is distressful, or if there is an infection.

What your doctor can do for you

• Conduct skin allergy tests.
• Prescribe hydrocortisone (anti inflammatory cream) or other creams.
• Prescribe antibiotics for bacterial infection.
• Diagnose the type of eczema, help to identify the cause.
• Prescribe oral histamines.

Prevention tips

• Try to determine the substances that cause allergic reactions or skin irritation in you and avoid them as best as you can.

For products see Skin antiseptics & disinfectants page 498, Skin anti-itch agents & antihistamines page 491

This article is reffered to Malaysia Healthcare Guide - The family health guide, MIMS, 2nd edition, 1997, page 342-343

That You Will Love

Psoriasis

Psoriasis is a skin disorder characterised by thick, red patches of skin that are covered by white or silvery scales. It usually appears between the ages of 20 and 30, and it tends to run in families. It is not infectious although the patient can go into remission by treatment on spontaneously. Psoriasis, even in mild causes severe embarassment, shame and social isolation. Psoriasis, cannot kill easily but ruins people's lives.

Symptoms

• Raised red patches of skin, covered with dry white or silvery scales. The patches usually appear on the elbows, knees, nails (fingers and toes) scalp, and trunk.
• Itch, in some cases.
• Pitted, cracked, or deformed nails; loose nails.
• Profuse shedding of dead skin (looks like dandruff when on the scalp), in severe cases.
• Cracked painful skin, blisters on the palms and soles.

Complications

• Arthritis (inflammation of the joints), in severe cases.
• Impaired use of hands or feet.
• Depression due to social isolation and anxiety.

Cause
Not yet fully known, but is associated with:

• The overproduction of new skin cells (10 times as fast as normal), leading to the buildup of live cells (the cause of thickened patches) and profuse shedding of the outer skin layer.
• A combination of factors have been implicated including hereditary factors, stress, after physical illness or infection.
• Immunologic.

What you can do

• Sunbathe for 15-30 minutes daily, but not to the point of being sunburnt. A sun (ultraviolet) lamp is an alternative.
• Apply petroleum jelly to the affected areas.
• Avoid ingestion of alcohol.
• Avoid or learn to manage stress.
• Proper stress management and follow a healthy lifestyle. Keep a healthy body weight.
• Consult a doctor if you suspect psoriasis. He will help you control the disorder.

What your doctor can do for you

• Explain the condition; counsel.
• Recommend cream, ointment, or other treatment to clear the psorisis (eg coal targel).
• Prescribe anti-inflammatory medicine for arthritis.
• Recommend ultraviolet treatment.

Helplines
Psoriasis Association of Malaysia 03-254 6160

For other products see Skin medicated soaps/cleansing agents/gloves page 501

PRODUCT GUIDE
BE-PROSALIC K H Hoe
Ointment 15 g, 450 g (871164A)
Contains Betamethasone dipropionate 0.064%, salicylic acid 3%.
Uses Relief of skin inflammations, eg psoriasis, dermatitis & seborrheic dermatitis.
How to use Wash & dry the affected area. Apply the ointment sparingly to the affected areas & rub-in twice daily, or as prescribed by the doctor.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused ointment after healing is complete. Caution in use if to be applied to large areas, particularly in children. Avoid prolonged use & contact with eyes. Burning sensation, irritation, skin eruptions, dryness & changes in skin color may occur.

BEPROGEL K H Hoe
Topical solution 0.5 mg x 30 ml [913399A]
Contains Betamethasone dipropionate 0.064%
Uses Treatment of skin inflamation, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Wash & dry the affected area. Apply the topical solution sparingly to the affected areas & rub-in once or twice daily, or as prescribed by your doctor.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused solution after healing is complete. Caution in use if to be applied to large areas, particularly in children & in occlusive dressing. Avoid prolonged use.

BEPROGENT K H Hoe
Cream 1.5 g, 450 g (871377A)
Ointment 450 g (871378A)
Contains Per g Betamethasone dipropionate 0.64 mg, gentamicin sulphate 1.7 mg
Uses Treatment of eczema, dermatitis, seborrheic dermatitis & psoriasis aggravated by secondary bacterial infection.
How to use Apply the cream or ointment to the affected area twice daily.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused cream/ointment after healing is complete. Caution in use if to be applied to large areas, particularly in children & in occlusive dressing. Avoid prolonged use & contact with eyes. Deafness, burning sensation, irritation, skin eruptions, dryness & change in skin color may occur.

BEPROSOL K H Hoe
Ointment 15 g (940218A)
Contains Betamethasone dipropionate 0.064%
Uses Treatment of skin inflammation, eg eczema, dermatitis, seborheic dermatitis & psoriasis.
How to use Wash & dry affected area. Apply the ointment sparingly to the affected area once or twice daily, or as prescribed by your doctor.
Precaution For external use only. If symptoms persist, consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unused ointment after healing is complete. Caution in use if to be applied to large areas. Avoid prolonged use.
Warning Do not use in chicken pox, acne, viral, bacteria or fungal skin infections, on the eye or occlusive dressing.

BEPROSONE K H Hoe
Cream 15 g, 450 g (870597A)
Ointment 450 g (870596A)
Contains Betamethasone dipropionate 0.064%
Uses Treatment of skin inflammation, eg eczema, dermatitis & psoriasis.
How to use Apply the cream/ointment to the affected area as prescribed by your doctor.
Precaution Caution in use in applying to large skin areas, particularly in children & in occlusive dressing. Burning sensation, skin irritation, dryness, changing in skin color & skin eruptions may occur.

BETNOVATE
Glaxo Wellcome
Cream 5 g x 12's, 15 g x 12's, 100 g [860146A]
Ointment 5 g x 12's, 15 g x 12's, 100 g [870601A]
Contains Betamethasone valerate 0.1%
Uses Treatment of eczema, psoriasis, seborrheic dermatitis & other skin inflammations not due to virus, bacteria or fungi.
How to use Apply a small amount of cream or ointment to the affected area 2 or 3 times daily until there is an improvement.
Special Instruction occlusion may be applied, using a plastic film in severe cases.
Precaution Avoid prolonged use, especially in infants & children. Thinning of the skin may occur.
Warning Do not use in acne, chickenpox & mouth ulcers, viral, fungal or bacterial skin infections.

Keep all medicines safely out of reach of children.

BETNOVATE SCALP APPLICATION
Glaxo Wellcome
Scalp application 30 mL [870598A]
Contains Betamethasone valerate 0.1%
Uses Treatment of hair scalp infections eg psoriasis & severe dandruff.
How to use Apply a small amount to the scalp night & morning until there is an improvement.
Precaution Avoid contact with the eyes or use near an open flame. Avoid prolonged use.
Warning Do not use if there is scalp infection.

BETNOVATE-N
Glaxo Wellcome
Cream 5 g x 12's, 15 g x 12's, 100 g [871159A]
Ointment 5 g x 12's, 15 g x 12's, 100 g [871152A]
Contains Betamethasone 0.1%, neomycin sulphate 0.5%
Uses Treatment of eczema, psoriasis. Also helps relief insect bites, sunburn, prickly heat, itching arround the skin of the anus & external ear infections.
How to use Apply a small amount of cream or ointment to the affected area 2 or 3 times a day until there is an improvement.
Special Instruction Occlusive may be applied , using a plastic film in severe cases.
Precaution Avoid prolonged use, especially in infants & children. Thinning of the skin may occur.
Warning Do not use in acne, chickenpox & mouth ulcers, bacterial, viral or fungal skin infections. Do not use if you have a perforated or injured ear drum.

CELESTODERM-V
Schering Plough
Cream 15 g, 450 g [870619A]
Contains Betamethasone valerate 0.1%
Uses Relief of skin inflammations, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Apply a thin film of cream to the affected area 1-3 times a day.
Precaution For external use only. Avoid contact with eyes or mucous membranes, prolonged use or occlusive dressing, particularly in infants & children. Disconue use if irritation or rash occurs & consult your doctor.
Warning Do not use for bacterial, viral or fungal skin infections.

CELESTODERM-V WITH GARAMYCIN
Schering Plough
Cream 15 g, 450 g [871375A]
Contains Per g Betamethasone valerate 1 mg, gentamycin sulphate 1 mg
Uses Treatment of skin inflammations or allergy, eg eczema, pruritus (severe itch), dermatitis, seborrheic dermatitis & psoriasis.
How to use Apply a small amount of cream to the affected area twice daily, or as prescribed by the doctor.
Precaution For external use only. Avoid contact with eyes or mucous membranes. Caution in use when applying to large surface areas or under occlusive dressing.
Warning Do not use in bacterial, viral or fungal skin infections.

CELESTODERM-V WITH NEOMYCIN
Schering Plough
Cream 15 g [871173A]
Contains Per g Betamethasone valerate 1 mg, neomycin sulphate 5 mg
Uses Relief of skin inflammations eg psoriasis, eczema, dermatitis & seborrheic dermatitis.
How to use Apply a thin film of cream to the affected area 2 or 3 times a day.
Precaution For external us only. Avoid contact with eyes or mucous membranes, open wounds or damaged skin, prolonged use or occlusive dressing, particularly in infants & children. Irritation, burning sensation, dryness or deafness may occur.
Warning Do not use for bacterial, fungal or viral skin infections.

CLODERM SCALP APPLICATION
K H Hoe
Scalp application 30 mL [930240A]
Contains Clobetasol propionate 0.05%
Uses Treatment of hair scalp inflammation, eg psoriasis & eczema.
How to use Wash & dry the affected area. Apply the scalp application sparingly to the affected area & rub-in twice daily, or as prescribed by your doctor.
Precaution If symptoms persist, consult your doctor. This medicament is to be used for your present condition only. Do not allow use by other person & discard unused scalp application after healing is complete. Caution in use in children, large surface areas & long-term treatment. Avoid contact with eyes. Burning sensation, irritation, dryness, skin eruptions & changes in skin color may occur.
Warning Do not use in children below 1 yr, infection of scalp & dermatitis.

DAIVONEX Leo
Ointment 50 ug/g x 30 g [921382A]
Contains Calcipotriol
Uses Treatment of psoriasis vulgaris.
How to use Apply the ointment to the affected area twice daily, up to a maximum of 100 g weekly.
Precaution Avoid contact with the face since it may cause facial irritation. Wash hands carefully after application.

DERMOVATE
Glaxo Wellcome
Cream 5 g x 12's, 15 g x 12's, 100 g [870583A]
Ointment 5 g x 12's, 15 g x 12's, 100 g [870584A]
Contains Clobetasol propionate 0.05%
Uses Treatment of psoriasis, eczemas & other conditions which do not respond to less active steroids.
How to use Apply the cream or ointment sparingly to the affected area once or twice daily until there is an improvement.
Special Instruction Occlusion may be applied, using a plastic film in severe cases.
Precaution Avoid prolonged use, especially in infants & children. Thinning of the skin may occur.
Warning Do not use in acne & mouth ulcers, in children under 1 yr & in nappy rash, chickenpox & fungal, viral or bacterial skin infections.

DIPROCEL, DIPROGENTA, DIPROSALIC, DIPROSONE
All by Schering Plough, see page 466

EGOPSORYL TA Ego
Cream 30 g, 500 g [913162X]
Contains Sulphur 0.5%, coal tar 1%, phenol 0.5%
Uses Control of general psoriasis & psoriasis of the scalp. Chronic dermatitis.
How to use Apply 2-4 times daily. As the condition improves, reduce the number of times of application gradually.
Special Instruction Do not stop application suddenly. For enhanced effect, apply petroleum jelly over Egopsoryl TA.
Precaution For external use only. Irritation, acne-like eruptions on the skin & sensitivity to light may occur. Discontinue use if irritation occurs.
Warning Do not use on acutely inflammed or weeping skin. Do not use for a long time without consulting a doctor. If you are using another medication inform your doctor.

ESPERSON Hoechst
Ointment 0.25% x 30 g [870492]
Contains Desoximetasone
Uses Treatment of eczema, psoriasis, severe skin infections, burns, sunburn, insect bites & stings.
How to use Apply the ointment to the affected skin areas & if possible, rubbed in slightly 2 0r 3 times a day at the beginning of treatment. If there is improvement, the frequency of applications may be reduced. To prevent the disease to recur, treatment should be continued for some time even after the complete disappearance of symptoms.
Precaution Caution in use for infants & small children; long-term treatment & application to large area or near eyes.
Acne, changes in skin pigmentation may occur.

FLUCIDERM K H Hoe
Cream 15 g [913400A]
Contains Fluocinolone acetonide 0.025%
Uses Treatment of skin inflammation, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Wash & dry the affected area. Apply the cream sparingly to the affected areas & rub-in once or twice daily, or as prescribed by your doctor.
Precaution For external use only. Avoid contact with eyes. Caution in use in large areas or occlusive dressing. If symptoms persist consult your doctor. This medicament is to be used only for your present condition. Do not allow use by other person & discard unsed cream after healing is complete. Caution in use in children & in large areas of the skin. Burning sensation, dryness of skin, changes in skin color & skin eruptions may occur.
Warning Do not use in acne, chickenpox, viral, bacterial or fungal skin infections.

H-S-C K H Hoe
Ointment 450 g [871319A]
Contains Per g Hydrocortisone 10 mg, salicylic acid 20 mg, strong coal tar solution 30 mg
Uses Treatment of psoriasis.
How to use Apply the ointment thinly to the affected area once or twice daily depending on the seriousness of the condition. When use in scalp disorders, a small amount of ointment should be rubbed gently into the roots of the hair.
Precaution Avoid prolonged use or occlusive dressing, or when using on large areas especially in children. Caution in use when exposed to sunlight. For external use only. Not for use on the eyes. Burning sensation, dryness, change in skin color & skin eruptions may occur.
Warning If you are sensitive to sunlight, consult your doctor first before using this medicament.

K H HOE HYDROCORTISONE
K H Hoe
Cream 450 g [870471A]
Ointment 450 g [870472A]
Contains Hydrocortisone 1 %
Uses Treatment of skin inflammations, eg eczema, dermatitis & psoriasis.
How to use Apply thinly the cream or ointment to the affected area 1-4 times a day, depending on the seriousness of the condition. Occlusive dressing may be used when treating psoriasis.
Precaution For external use only. Avoid prolonged use or contact with eyes. Caution in use when applying an occlusive dressing, in children. Burning sensation, dryness of skin, changes in skin color & skin eruprions may occur.

NERISONE Schering AG
Cream 10 g, 50 x 10 g [900556A]
Fatty ointment 10 g, 50 x 10 g [900558A]
Ointment 10 g, 50 x 10 g [900557A]
Contains Diflucortolone valerate 0.1%
Uses Skin infections, eg in dermatitis, eczema, psoriasis, burns, sunburns & insect bites.
How to use Apply the cream or ointment thinly to the affected area 2-3 times daily.
Special Instruction Use the cream for weeping skin conditions; ointment for skin that is neither weeping nor very dry; fatty ointment for very dry conditions.
Precaution Avoid application to large areas of the skin or for prolonged periods. Avoid contact with the eyes.
Warning Do not use if you have viral diseases, eg chickenpox, shingles.

NEUTROGENA T/GEL SHAMPOO
Neutrogena
Shampoo 4.4 fl oz, 8.5 fl oz [911817X]
Contains Solubilized coal tar extract 2%
Uses Helps control psoriasis, seborrheic dermatitis & dandruff.
How to use Wet hair thoroughly. Massage liberal amount into the scalp. Leave lather on scalp for several minutes. Rinse well & repeat.
Precaution For external use only. Do not apply to inflammed or broken skin. If irritation develops, discontinue use & consult your doctor. Discoloration of gray, blonde, bleached or tinted hair may occur.

PINETARSOL BATH OIL
Ego
Bath oil 200 ml [912398X]
Contains Pine tar 2.3%
Uses Dry, itchy, inflammed, or flaky skin conditions. Supplementary relief of the symptoms of dry skin, eczema & psoriasis.
How to use Adults Bath Add 10-15 mL to a lukewarm water & bathe for 5-10 minutes daily, more often in severe cases. Shower Wet skin, then smooth a small amount onto the skin. Leave on for 2-3 minutes, then rinse off. Pat skin dry. Patients in bed, elderly patients Add 3 ml to a basin of water & wash skin gently. Pat skin dry. Infants Add 3 ml to a baby's bath. Pat skin gently dry. Do not rub.
Precaution For external use only. Avoid contact with eyes. Skin irritation may occur.

PINETARSOL/PINETARSOL GEL
Ego
Gel 100 g [912381X]
Solution 200 mL, 5 L [912380X]
Contains Gel Pine tar 1.6%, glycerin 5% Solution Pine tar 2.3%, triethanolamine lauryl sulphate 6%
Uses Relief of itch & inflammation associated with dermatitis, psoriasis & eczema, chicken pox, heat rash & eruptions in the napkin area of various origins.
How to use Gel : Use as an alternative for shower use & patients in bed. Apply to wet skin & gently smooth over affected area. Leave on for 2-3 minutes & rinse. Pat skin dry.
Solution : Bath Add 15-30 ml to a lukewarm bath (3 ml to a baby's bath) & bathe for 5-10 minutes daily, more often in severe cases. Pat skin dry. Shower Wet skin & spray on a small amount. Leave for a few minutes, then rinse. Pat skin dry. Patients in bed Add 15 ml to 3 L of water & sponge freely. Pat skin dry.
Avoid using with Soap on inflammed areas skin. Precaution For external use only. Avoid contact with the eyes & nostrils. Skin irritation & acne-like eruptions may occur.

PSORIGEL Galderma
Gel 4 oz [920445X]
Contains Coal tar solution 8.8% (equivalent to 1.75% coal tar)
Uses Controls skin itching, flaking & scaling associated with psoriasis.
How to use Apply to the affected areas 1-4 times daily or as directed by a doctor. Rub in well, let dry & remove any excess by patting with tissue paper.
Avoid using with Utltraviolet radiation treatment, other medicines for treating psoriasis. Precaution For external use only. Avoid contact with eyes. Upon contact, flush eyes with water. Do not use this medicament in or arround the rectum, the genital area or groin except on medical advise. Do not use on highly inflammed or broken skin. Avoid exposure to direct sunlight after applying this medicament. If undue irritation develops, discontinue use & consult your doctor/pharmacist.

SEBITAR Ego
Liquid 250 mL [912421X]
Contains Pine tar 1%, coal tar 0.2%, salicylic acid 2%, undecylenamide 1%
Uses Relief of itch, inflammation & flaking skin conditions associated with dandruff, seborrhea, eczema & psoriasis of the scalp.
How to use Wet hair, apply to the affected area & massage well. Apply to the remainder of the scalp & hair & work into a lather. Leave for 5 minutes, rinse thoroughly.
Precaution For external use only. Avoid contact with eyes, nostrils & broken skin. Skin irritation & acne-like eruptions may occur.

TRAMSONE K H Hoe
Cream 15 g [913401A]
Contains Triamcinolone acetonide 0.1%
Uses Treatment of skin inflammations, eg eczema, dermatitis, seborrheic dermatitis & psoriasis.
How to use Wash & dry affected area. Apply the cream sparingly to the affected area & rub-in once or twice daily as prescribed by your doctor.
Precaution If symptoms persist, consult your doctor. This medicine is to be used for your present conditon only. Do not allow use by other person & discard unused cream after healing is complete. Avoid contact with eyes. Caution in use in children & if to be applied to large areas or when under occlusive dressing. Burning sensation, dryness & skin eruptions may occur.
Warning Do not use in skin viral infection, eg chickenpox, acne & skin tuberculosis.

Are you in the habit of eating fast? If you are, you may tend to overeat! This is because your body takes 20 minutes to tell your mind that it's satisfied. Try to chew your food well, eat slowly and enjoy every bite. This way, your body will have time to tell your brain that you've had enough!

This article is reffered to Malaysia Healthcare Guide - The family health guide MIMS 2nd edition 1997 page 464-468

Diabetes

Diabetes mellitus ia a condition which results from a lack of insulin. Insulin is a hormone produced by the pancreas. It is needed for the assimilation of glucose, amino acids and fatty acids by the body for energy or storage. Defiency of or ineffectiveness of insulin results in high glucose level in the blood. The disease cannot be cured but it can be controlled by lifelong treatment. There are two major types of diabetes mellitus. Type I (insulin-dependent) occurs mostly in young people and requires regular insulin injections. Type II (non-insulin dependent) occurs mainly in older people: some can be controlled with proper diet and exercise alone; and others may need antidiabetes medication. Some may also need insulin injections. Most of those who suffer from non-insulin dependent diabetes are overweight or obese. Diabetes tends to run in families.

Symptoms

• Constant thirst.
• Polyuria or frequent urination. Getting up frequently to pass urine at night.
• Frequent hunger, strong appetite.
• Weight loss despite a hearty appetite.
• Tiredness, weakness.
• Tingling sensation and numbness in the hands and feet.
• Blurred vision.
• Recurrent skin infections.
• Itching in the private parts.

Complications

• Severe hyperglycemia (too much glucose in the blood) with too much acid in the body, can cause confusion and loss of consciousness. (See LOSS OF CONCIOUSNESS page 415.)
• High blood pressure, heart disease, stroke, and kidney damage.
• Blindness (due to retinal damage), cataracts, and other eye disorders.
• Poor healing of wounds.
• Gangrene (tissue death) due to cut off of blood supply. This usually occurs in the toes and feet.
• Infection, in particular skin, and soft tissue, vaginal infection.
• Numbness, due to nerve damage with loss of sensation especially the feet.

Cause

• Not fully known yet. However, it is beliaved to be due to:
• Heredity.
• An autoimmune disorder. The body's defences attack and destroy the cells in the pancreas that produce insulin.
• A viral infection that damages the pancreas which may than set off an autoimmune process.
• Lack of exercise, poor dietary habits and obesity.

What you can do

• Consult a doctor if you think you have diabetes.
• Stick to a lifelong low-sugar, low-fat, high fibre diet. If overweight, lose weight. Contol your intake of refined sugar. Spread out intake of food over the day. (Diet and weight management are often enough to keep non-insulin dependent diabetes in check and may prevent diabetes-prone people from developing diabetes.)
• Exercise regularly.
• Regularly look over your body, especially the feet, for wounds or infection; never walk bare foot. Wash your feet daily, dry them thoroughly, and apply talcum powder. Take extra care when cutting your fingernails and toenails. Shave with care.
• Practice good hygiene.
• Maintain good dental health.
• Take prescribed medicine religiously. Never stop medication without consulting your doctor.
• Monitor your blood or urine sugar regularly.
• Have regular medical checkups.

What your doctor can do for you

• Take blood tests initially to confirm the presence of diabetes and subsequently to check whether blood sugar is under control.
• Recommend an appropriate diet regimen and exercise.
• Prescribe anti-diabetes tablets or insulin injections if necessary. Teach you how and where to inject insulin on yourself.
• Teach you how to monitor the glucose level in your blood.
• Watch out for the development of complications and treat them.

If you are or suspect you may be pregnant, take extreme care about any medicine you take, particularly during the first 12 weeks - consult your doctor or pharmacist.

Injection sites for insulin:

1. Abdomen - fast absorption 2. Arm - intermediate absorption 3. Thigh - slow absorption 4. Buttock - slow absorption 5. One hand's width from shoulder, elbow, hip and knee 6. Skin 7. Subcutaneous tissue 8. Muscle 9. Inject insul;in into subcutaneous tissue into the fat (between skin & muscle layer)

Foot care for diabetics:

1. Dry the feet well especially between toes to prevent fungal growth.
2. Examine the feet daily for any blister, sore, scratch, skin discolouration, calluses or ingrown toenails. See a doctor immediately if any of these symptoms appear.
3. Change socks or stockings daily. Cotton or wool socks are better as nylon can cause perspiration.
4. Wear soft leather shoes to allow the skin to breathe.
5. Wash feet daily with luke warm water & mild soap.
6. Cut your nails straight across. Gently file rough edges.
7. Keep the skin, heels & soles supple by applying lanolin, but do not apply between toes. If you tend to perspire, dust feet with foot powder or baby powder.
8. Examine your shoes everyday for cracks, pebles, nails & any roughness which may cause skin irritation.
9. Do not walk barefoot either indoors or outdoors. Wear comfortable shoes, slippers or sandals that fit well.
DON'T: a. Soak feet in hot water or use hot water bottle for the feet. b. Use com plasters & other commercial foot preparations.

Recommended exercises for diabetics:

1. Tiptoe exercise: Hold on to a chair. Raise & lower yourself on your toes alternately. Repeat 20 times. 2. Leg swing: Hold on to a table & stand with one leg slightly raised on a thick book. Swing the other leg to & fro 10 times. Repeat the same procedure on the other leg 10 times. 3. Calf stretch: Lean with palms of your hands against the wall. Keep your feet some distance away and flat on the floor. Bend your arms 10 times keeping your back and knees straight without raising the heel. Sustain the stretch for 10 seconds. 4. Knee bend: Hold on to a chair & do deep knee bends keeping your back straight. Repeat 10 times (start with 5 times & increase gradually). 5. Daily walk: Take a walk daily of 1/2 - 1 hour. Try to increase duration every week. 6. Ball roll: Sit on a straight backed chair, with your foot on a rubber ball. Grip the ball with your toes, then relax your hold. Repeat a few times for each foot.

Prevention tips

• Avoid refined sugar, honey and excessive intake of sweets and simple carbohydrates, fats and salt.
• If overweight, reduce weight.
• Exercise regularly. Aerobic exercise (eg. cycling, jogging, vigorous sports, swimming, brisk walking), decreases the risk of heart disease, helps control your weight, and helps the body to maximise the effects of insulin.
• If you have a family history of diabetes and you are over 40 years, have your blood checked for sugar 2 hours after a good meal. You should repeat this every year or two as many people have diabetes for years without feeling unwell.

Helplines
Malaysian Diabetes Association 03-750 2385

This article is reffered to Malaysia Healtcare Guide - The family health guide MIMS 2nd edition 1997 page 323-325

Headache

Also see Facial neuralgia page 355, Jaw joint pain page 413

Just about three out of four persons suffer from headache each year. Headache is seldom a symptom of an underlying brain disease, even when the pain is intense. The two main types of headache are migrane and tension headache which are described in the following pages.

Headache-migraine
Migraine

Migrane, a common and painful headache that typically occurs on one side of head, often begins at puberty or early adulthood, runs in families and tends to recur. More women than men suffer from migraines (about 75% of the cases), usually before menstruation, with the attacks tapering off after menopause.

Symptoms
Migraine without aura:

• Pain, usually felt on one side of the head. It gradually builds up to full throbing intensity and is aggravated by movement, light or noise.
• Nausea.
• Vomiting.

Migraine with aura:

• An aura (unusual sensation) coming about 20 minutes before the headache. The symptoms may include nausea, vomiting, enlarging blind spots, flashing or zigzagging light, strange noises or smells, and numbness in one side of the body.
• Same symptoms as common migraine, but the onset of pain is more abrupt.
• Sensitivity to light.
• In rare cases, paralysis on one side of the body.

Cause
Not yet fully known, but attributed by many experts to chemical inflammation of the dural blood vessels, which stimulate the nerve endings. Factors that trigger the condition include:

• Stress (eg. anger, changes in climate, distress, overexertion, shock).
• Certain kinds of beverages, food, and food additives (eg. alcohol, chicken liver, citrus fruits, monosodium glutamate, nitrites, red wines).
• Head injury.
• Sensory stimulation (eg. bright light, blaring sounds).
• Overexertion.
• Hunger
• Hormonal imbalance, oral contraceptives.

What you can do

• Lie down and sleep or rest in a dark, quiet room.
• Apply an ice pack to the painful area.
• Take a cold shower.
• Take simple painkilllers.
• Try to identify the factors that trigger the headache and avoid them.
• Consult a doctor if the pain is unbearable or if the recommended measures offer no relief.

What your doctor can do

• Rule out serious underlying causes of headaches.
• Prescribe stronger painkillers.
• Prescribe prophylactic (preventive) medicine for migrane.
• Prescribe medicine to stop the migraine.

Prevention tips

• Avoid the factors that can trigger the headache.

Helplines
Headache Society of Malaysia 03-757 6588

For other products see Painkillers & antifever medicines page 439


Headache-tension headache
Tension headache, Neck ache
A tension headache, unlike a migraine, is characterised by generalized pain, a feeling of fullness or pressure over the top of the head or at back of the neck. It can occur everyday, is not associated with vomiting and is not aggravated by movement. The disorder is the most common type of headache, affecting people of all ages.

Symptoms

• Dull, sometimes intense pain over the top of the head, the temples, or at the back of the neck.
• Sore scalp and neck muscles.

Cause
Not yet fully known. Factors that trigger the condition include:

• Stress (eg. anger, changes in climate, distress, overexertion, shock).
• Poor posture; not moving for a long period.
• Depression.
• Lack of sleep.
• Eye strain.

What you can do

• Apply an ice pack to the head.
• Take a hot or cold shower.
• Massage head, neck, and shoulders.
• Do stretching and other relaxation exercises.
• Discontinue or minimize your intake of caffeine (eg. coffee, tea).
• Avoid the glare of strong sunlight. Wear sunglasses if you have to stay outdoors.
• Take simple painkillers.
• Consult a doctor if:

1. The headache is continuous or recurs frequently.
2. The headache is accompanied by fever and stiff neck (may be meningitis), numbness or weakness in the limbs and visual or speech disorders (may be a stroke).
3. Slight exertion brings on an attack.

What your doctor can do

• Rule out serious underlying causes of headaches.
• Prescribe muscle relaxants.
• Prescribe stronger painkillers.

Prevention tips

• Relax. Learn relaxation techniques and meditation. Do stretching and relaxation exercises in between extended periods of work or sitting.
• Exercise regularly.
• Avoid or minimize stress.
• Try to get enough sleep.
• Minimize your intake of caffeine (eg. coffee, tea).
• Avoid excessive sunlight by staying indoors on bright, sunny days or wearing sunglasses outdoors.

For products see Painkillers & antifever medicines page 439

This article is reffered to Malaysia Healthcare-The family health guide MIMS 2nd edition 1997 page 392-394.