China launches last piece of BeiDou Navigation Satellite system into orbit
China’s final BeiDou-3 satellite for its global navigation system was launched on June 23, 2020, at 9.43am, from the Xichang Satellite Launch Centre in the southwest province of Sichuan. A Long March 3B rocket carried the satellite into geostationary orbit, completing the third-generation network for the BeiDou Navigation Satellite System (BDS). BDS is the fourth major global satellite navigation system, following GPS built by the US, Russia's Glosnass and the European Union's Galileo.
"Ten, nine, eight…three, two, one. Launch," the calm voice of 01 Commander Yin Xiangyuan in the valley of Liangshan mountain in Southwest China's Sichuan Province, was soon overwhelmed by the thunderous boom of the rocket taking off on Tuesday.
Carrying the last satellite of China's domestically developed BeiDou Navigation Satellite System, or BDS, the Long March-3B launch vehicle blasted off from the Xichang Satellite Launch Center on Tuesday morning.
And after a flight of around 30 minutes, the spacecraft, the third geostationary Earth orbit (GEO) satellite and 30th of the third-generation series of the BeiDou system, or BDS-3, successfully entered its planned orbit, marking the completion of the global geolocation network, which is also China's largest space-based system and one of the four global navigation networks, along with the US' GPS, Russia's GLONASS and the European Galileo.
The launch of the final satellite of China's indigenous BeiDou system had been previously scheduled on June 16, but was delayed after technical problems were found with the Long March-3B rocket in pre-launch tests.
Space launches have always been full of challenges and sometimes faced with high risks of failure. The postponement of the final BeiDou launch and resumption after resolving the problems once again demonstrated that Chinese space scientists uphold the scientific spirit, allowing zero errors at any stage of the mission, insiders said.
Photo: Hu Xujie
World-class performance
The latest GEO satellite is the 55th BDS system, and will work with other members of the network, allowing global users to access high-accuracy navigation, positioning and timing as well as communication services.
Compared to previous generation series, the constellation of BDS-3 with an array of 30 satellites flying on three different orbit planes - three at the GEO, three at the inclined geosynchronous orbits, and 24 at the medium Earth orbit, have higher bandwidth, enabling enhanced communication capability and carrying more accurate and stable atomic clocks to improve the precision of timing and navigation services, according to the project contractor China Academy of Space Technology under the state owned space giant China Aerospace Science and Technology Corporation (CASC).
The BDS-3 also possesses better messaging capability, increasing its unique short message service capacity from 120 Chinese characters to 1,200 per message, and the higher communication bandwidth also expands the user capacity from 500,000 to 5 million users.
BDS-3 is also capable of providing precise point positioning service (PPP) with a decimeter-level dynamic accuracy and centimeter-level static accuracy, meaning it can support applications such as auto-pilot for vehicles and precision docking of ships.
Yang Changfeng, the chief architect of the BDS, told the Global Times on Monday that China's BDS is compatible with the US' GPS, Russia's GLONASS and Europe's Galileo, and users worldwide can freely choose any four satellites with the best signals from the global navigation satellite systems with over 100 satellites.
According to the chief architect, the BDS has satellites on three orbit planes in the Asia-Pacific region, which makes it more capable of resisting disturbances from occlusion even in such environments with multi-layer surfaces in the urban areas as well as in forests.
Users in low latitude areas in the Asia-Pacific region can enjoy non-stop navigation services from the BDS in these circumstances, and the accuracy of the BDS service is just as good as that of the US' GPS, and of world-class quality globally, Yang noted.
According to the China Satellite Navigation Office on Tuesday, the majority of the world have started using the BDS.
Photo: Hu Xujie
Hardwork of generations
China began research and development into the country's indigenous satellite system in 1994, aiming to reduce its reliance on foreign networks, especially under the complicated external environment.
The first BeiDou satellite entered orbit in 2,000, and started providing positioning, navigation, timing and messaging services to domestic users in China and users in the Asia-Pacific region in December 2012.
The BDS system started providing global services at the end of 2018, when construction of the BDS-3 primary system had been completed.
BeiDou has been supporting dozens of businesses and public sectors in China, ranging from transportation and agriculture to electric power transmission and fisheries, and tens of millions of BeiDou-enabled terminal devices have been sold and are in use.
In the field of transportation, BDS has been widely used in the monitoring and management of priority transportation, highway infrastructure safety, port scheduling, and real-time high-precision positioning.
By the end of 2019, more than 6.5 million road operating vehicles, 40,000 postal and express delivery vehicles, 80,000 buses in 36 central cities, 3,200 inland navigation facilities, and 2,900 marine navigation facilities have adopted BDS, forming the world's largest dynamic monitoring system for road operating vehicles.
More than 70,000 fisheries and law-enforcement vessels have installed BeiDou terminals and more than 10,000 people have been rescued thanks to the BeiDou application.
Time reference for public security networks has been synchronized based on the BDS timing services. BDS has played an important role in ensuring security at major events, such as the Asia-Pacific Economic Cooperation (APEC) Meeting and the G20 Summit.
In the field of smart phones, mainstream chip manufacturers both at home and abroad have introduced integrated chips that are compatible with BDS. By the third quarter of 2019, more than 400 smartphone models sold in China supported positioning functions, of which about 300 models supported BDS.
The scale of navigation satellite positioning and navigation industry in China has reached 345 billion yuan ($48.6 billion) by 2019, up 14.4 percent from the previous year, according to an annual industry report.
Cao Chong, a Beijing-based senior expert on satellite navigation industry, told the Global Times the industry scale is expected to exceed 400 billion by the end of 2020.
Cao said the next step to further promote the BDS system in market both at home and abroad lies in the research and development of terminal capabilities, which should keep up with the enhanced power of BDS-3. "There are huge market potentials to be released."
The Tuesday mission marked the 44th BeiDou satellite-launching flight
for the Long March-3A rocket series since October 31, 2000, which the
Long March-3B rocket belongs to. The rockets have sent 59 BeiDou
satellites, including four experimental ones, into orbit, with a 100
percent success rate.
As the BDS system continues to develop, the Long March-3A rocket series have also started to use three-mode receptors which are compatible with the BDS, GPS and GLONASS networks, Jiang Jie, chief engineer of the rocket series, with the China Academy of Launch Vehicle, also under the CASC, told the Global Times.
As the three modes all complement each other, they work together to improve the orbiting accuracy of rockets and reduce consumption of propellants, Jiang noted.
APA
model of the BeiDou Navigation System is displayed during the 12th
China International Aviation and Aerospace Exhibition in Zhuhai earlier
this month
China's homegrown BeiDou Navigation Satellite System is going global
https://youtu.be/yPAiR71rIxs
BeiDou, China’s homegrown navigation satellite system, is to cover the
world by 2020. Watch a video to see how it differs from GPS and can help
you in life. - China Daily
Physiotherapy for stroke patients is not just about exercises and
movement, but also incorporates technology such as functional electrical
stimulation and virtual reality. — Photos: SUNWAY MEDICAL CENTRE
VELOCITY
There you are, walking around the house, maybe on your way to get something to eat or to the living room to watch some TV.
All of a sudden, one side of your body goes numb and weak, and you lose your balance, causing you to collapse on the floor.
When you try to call for help, you find that you can’t speak properly with your speech sounding slurred.
You realise that you can’t see properly either, as your vision has become blurry.
And when you look at your face in the mirror, you realise that one side is drooping down, but not the other.
You are most likely experiencing a stroke, the third most common cause of death in Malaysia.
This emergency condition occurs when the brain is deprived of vital oxygen supply, either when a blood clot blocks off a blood vessel supplying the brain (ischaemic stroke) or when one of these blood vessels ruptures and starts bleeding (haemorrhagic stroke).
According to consultant neurologist Dr Kok Chin Yong. your brain cells will start to die within minutes after the stroke hits you – about 2,000,000 cells every minute.
Therefore, you need to get help and go to the nearest hospital’s emergency department as soon as possible.
The good news is that there are immediate treatments that can not only save your life, but also minimise any disability you might have from the stroke.
Ischaemic strokes are the most common type of stroke, comprising three-quarters of all cases.
For this type of stroke, the first and most immediate treatment is the administration of tissue plasminogen activators (tPAs), which help break down blood clots.
Says Dr Kok: “For an ischaemic stroke, the target is to unblock the blood clot as soon as possible.
“We can do this with an intravenous (IV) clot-busting agent called alteplase.
“The current guidelines state a cut-off point of 4.5 hours from the onset of symptoms in order to derive benefit from this treatment.
“Hence, time is brain.”
He notes that alteplase is the only US Food and Drug Administration-approved tPA for acute ischaemic stroke at the moment.
Another treatment available in certain hospitals, he adds, is a clot-removal procedure called mechanical thrombectomy, which is done by an interventional radiologist.
Meanwhile, haemorrhagic strokes are usually treated by the neurosurgeon or interventional radiologist.
Explains consultant neurosurgeon Dr Gerard Arvind Martin: “Choosing whether to take the patient to the operating room or not can depend on various factors, such as age and condition of the patient, the level of consciousness and extent of bleeding, all of which the surgeon takes into consideration before performing surgery.
“In those cases where a subarachnoid haemorrhage has occurred due to a suspected aneurysmal rupture, a further scan called an angiogram will be required to determine precisely the site of bleeding.
“Angiograms can be either via computed tomography (CT) scan or a catheter, which is typically carried out by a radiologist in an angiogram suite.
“Depending on the findings, the surgeon can then elect to operate and clip the ruptured aneurysm, or consider endovascular techniques, which are performed by an interventional radiologist.”
If you are lucky, you would have survived your stroke with no or minor complications and have a quick recovery.
However, many stroke survivors will face long-term disability, which can be physical or cognitive.
For example, patients may experience paralysis of the side affected by the stroke; weak coordination; difficulty in speaking, understanding, reading and writing; and difficulty concentrating.
This is where rehabilitation comes in.
A stroke patient exercises his muscles with the help of a machine, supervised by a physiotherapist.
A stroke patient exercises his muscles with the help of a machine, supervised by a physiotherapist.
Physiotherapy Treatment in Malaysia
https://youtu.be/PYQO3SDe8_w ”
Dr Wong Yee Choon - Mix FM Doctor On Call
How much you know about Stroke? Stroke is an emergency, every minute counts – Act F.A.S.T.
Listen to Dr Wong Yee Choon, consultant Neurologist being interviewed by Mix FM - Doctor On Call.
Topic: Stroke - Act F.A.S.T
Says Dr Kok: “This is an area that is often given less attention, when in fact, to me, it is equally important as the acute treatment for stroke.
“A good rehabilitation programme improves disability and prevents complications.”
According to Sunway Medical Centre Velocity Rehabilitation Centre head Maxim Chea, stroke rehabilitation has to be individualised to the patient as it depends on the part of the body or type of ability affected by the stroke.
He explains that there are three main types of rehabilitation therapy: physical therapy, technology-assisted physical therapy (e.g. functional electrical stimulation and virtual reality), and cognitive and emotional therapy.
Visual rehabilitation is also available for those whose vision is affected by stroke.
For example, consultant neuro-ophthalmologist Dr Lakana Kumar shares that “Double vision and peripheral loss of vision can be treated with prisms incorporated into glasses for patients to wear.”
Rehabilitation is usually carried out by a team consisting of physiotherapists, occupational therapists, speech therapists, and dieticians/nutritionists, among others.
In addition to physical and cognitive problems, patients might easily become depressed, overly anxious and panic easily.
Says consultant psychiatrist Dr Lim Wai Jenn: “Stroke survivors are at significantly higher risk for neuropsychiatric conditions such as post-stroke depression (one in three patients), anxiety (one in four patients), and other changes in personality and behaviour.
“These conditions impede the rehabilitation process and degree of recovery in post-stroke patients.
“They also significantly impact the patients’ long-term functioning and quality of life, and can even lead to higher mortality rates.
“Early psychiatric assessment and intervention is essential.”
She notes that caregivers also need support and psychoeducation on how best to support patients in regaining function.
While being affected by a stroke is a frightening event, rest assured that there are treatments and therapies available to help you manage this condition – just remember that you need to seek medical help as soon as possible.
By TAN SHIOW CHIN
This article is courtesy of Velocity Neurocentre, Sunway Medical Centre Velocity.
A CT scan of a stroke patient’s brain, showing the affected area of their brain (in violet). The affected area will determine the type and extent of disabilities the patient will have. — Schering AG
By Matthew Teo Yong Chang
Stroke or a cerebral vascular accident (CVA) was the third leading cause of death in Malaysia in 2018, according to the Department of Statistics. The department reported that stroke caused 7.1% of all deaths in the country. However, two-thirds of those who have a stroke actually survive and will require rehabilitation.
The objectives of rehabilitation are to help survivors become as independent as possible and to attain the best possible quality of life. It is crucial as stroke survivors can lose the function of their affected limbs without rehabilitation, something we have observed in real life.
Even though the function of a stroke survivor’s affected limbs may seem lost after the stroke, our brain possesses a trait called neuroplasticity that can help the survivor regain the limb’s function.
Neuroplasticity enables the unaffected nerve cells (neurons) around the affected area of the brain to rewire and create new pathways around the affected area through repetition of physical and mental training, as well as regulated emotional feedback.
However, the extent for neuroplasticity varies in each individual. So, even though rehabilitation does not “cure” the effects of stroke, in that it does not reverse brain damage, rehabilitation can considerably help survivors achieve the best possible outcome in the long run.
Levels of disability
Rehabilitation, rehab, stroke, physiotherapy, activities of daily living, occupational therapy, Star2.com Rehabilitation is aimed at regaining practical function for the patient, like opening a door latch, turning a tap or pushing a switch.
Strokes happen when a blood clot or bleeding (haemorrhage) restricts the blood supply to the brain, resulting in the brain being deprived of oxygen, which leads to the death of brain cells.
Usually, it is only one part of the brain that is damaged and this affects the type and degree of disability the survivor will experience. This also influences how much rehabilitation can help the survivor.
Generally, stroke can cause five types of disabilities:
• Paralysis, or problems controlling voluntary movement
• Disturbance of the senses, including pain
• Problems using or understanding language
• Problems with thinking and memory
• Emotional disturbances
It is also imperative to know the severity of the stroke before deciding on the rehabilitation plan. There are seven recognised stages of stroke recovery through which most survivors progress through:
• Stage 1 – Flaccidity: No voluntary movement is observed.
• Stage 2 – Spasticity appears: Spasticity refers to the continuous contraction of muscles, which interferes with normal movement, speech and gait, and causes the arm or leg to make small involuntary jerky movements.
• Stage 3 – Increased spasticity: The e arm or leg becomes more spastic, and the muscles feel stiff and tight against external resistance.
• Stage 4– Decreased spasticity: Spasticity of the arm or leg decreases and the limb begins to move more easily.
• Stage 5 – Complex movement combinations: The movement of the limbs start becoming more coordinated and full movement begins to return.
• Stage 6 – Spasticity disappears: Muscle spasticity disappears and isolated joint movements are voluntary; however, spasticity may return if the patient is tired.
• Stage 7 – Normal function returns: Movements return to normal.
Each stage requires different types of approaches and exercises for rehabilitation.
Home rehab
Rehabilitation, rehab, stroke, physiotherapy, activities of daily living, stretching, Star2.com A volunteer helps a stroke patient with her exercises during a therapy session. Stroke survivors are recommended to do flexibility exercises two to three times a week for the rest of their life.
The rehabilitation programme for stroke survivors involves a multidisciplinary healthcare team consisting of a rehabilitation physician, nurses, occupational therapist, physiotherapist, speech therapist, dietitian and clinical psychologist.
However, the most important members of the team are the patient and their caregivers. This is as rehabilitation should be done daily at home, not just during therapy appointments.
Battling stroke disabilities is not as simple a remedy as taking a pill from the doctor or attending a session with the therapist for an hour a week. It requires compliance to medication and the continuous effort to practice the therapies repetitively with strong determination!
Contrary to common belief, stroke rehabilitation can be offered in any setting without sophisticated equipment or technology.
The American Heart Association recommends that stroke survivors perform aerobic exercises three to seven days per week, as well as strengthening, flexibility and neuromuscular exercises two to three days a week, for the rest of their life.
Training at home, in a familiar environment, by adapting and using utensils or tools at home is more meaningful than the therapeutic remedial therapy received at institutionalised centres.
For instance, toilet training at a hospital ward is not as useful as toilet training in your own home, as you will eventually be going home and using that toilet, rather than the hospital’s toilet.
After all, the ultimate goal of rehabilitation is to promote optimal functional independence in the survivor’s own living environment.
Besides, providing therapy in the home environment supports continuity of care, provides a relevant environment for daily function, and encourages patients to develop problem-solving skills.
Some of the other benefits of home rehabilitation for stroke include:
• Early discharge from the hospital to return to the comfort of your own home.
• Avoiding hospital-acquired pneumonia and other illnesses due to a shorter stay.
• Reducing the cost of care.
• Preventing deterioration and promoting health through physical activity.
• Preventing falls, which are common among older patients and can cause additional long-term disability.
Barriers to home rehab
The main barriers towards rehabilitation in stroke are a lack of motivation and apathy towards recovery. Most stroke survivors stop coming for their treatment regime after a period of rehabilitation because they do not see any significant improvement.
Over a period of time, they will begin to learn helplessness and compensate themselves – mostly incorrectly – for their abnormal postures and movement, leading to non-compliance in rehabilitation.
Poor awareness among the public about the different roles of the different therapists in stroke rehabilitation could also be another barrier in rehabilitation.
In addition, the lack of trained therapists in Malaysia for stroke rehabilitation is also another factor, as it contributes to increased cost of hiring in-house therapists for home rehabilitation due to their scarcity.
Matthew Teo Yong Chang is a lecturer in the School of Occupational Therapy at the Perdana University Graduate School of Medicine. This article is courtesy of Perdana University. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Stroke Hand Exercises: For every stage of recovery
A physiotherapist explains safe lower limb exercises for stroke patients
This video is brought to you by Singapore General Hospital.
https://youtu.be/3GbpbuwcWDk
Post-Stroke Exercises (Part 2: Lower Limb)
https://youtu.be/BM0P-iLSlbs
Stroke Exercises for Arm & Hand with Little to No Strength-for Home
"Famous" Physical Therapists Bob Schrupp & Brad Heineck demonstrate stroke exercises you can do in your own home for the arm and hand that has little to no strength.
https://youtu.be/DoR9H9zuJPY
Stretches For Hand Spasticity - Best Stroke Recovery Hand Exercises
DAEHAN Rehabilitation Hospital Putrajaya offers customised rehabilitation services that focus on intensity and discipline to give patients with neurological and orthopaedic disabilities optimal results.
Strokes and other neurological disabilities often leave individuals with lasting and damaging effects that can greatly impede their daily functions.
This brings to light the need to raise awareness on the crucial and beneficial role rehabilitation can play in the lives of such patients.
According to Dr Fazah Akhtar, studies have shown that early and high-intensity rehabilitation has given patients better outcomes.
“Certain neurological conditions such as strokes and traumatic brain injury have a window period of best recovery after the event,” said Dr Fazah.
“If an individual were to undergo high-intensity inpatient rehabilitation in a specialised hospital or unit, the recovery and functional outcomes of the patient have shown to be better than those who do not receive such treatment.”
Understanding this approach, Daehan Rehabilitation Hospital Putrajaya offers South Koreanstyled rehabilitation services in which they are on a one-on-one basis and are personalised to specifically match the needs of the individual.
Besides stroke patients, they also manage cases of traumatic brain injuries, hypoxic brain injuries, brain tumours, spinal cord injuries, musculoskeletal conditions and other complex conditions that require multidisciplinary rehabilitation.
With an emphasis on intensity and discipline, the inpatient rehabilitation programmes are planned and targeted for a duration of three months with extensions as needed.
A programme’s daily schedule usually features several rehabilitation sessions, starting at 9am and end at 5pm.
In addition, parts of the programme are practised in open and spacious therapy areas such as the gymnasium to enhance engagement and social interactions between patients.
This forms a support group system and such peer encouragement has seen a positive impact on the programme, says Dr Fazah.
All this is further augmented by technological advancements such as gait robotics, computerbased therapy, individualised hydrotherapy, and anti-gravity treadmills.
Their full list of therapy programmes includes physiotherapy, occupational therapy, functional electrical stimulation (FES), pain therapy, speech therapy, dysphagia rehabilitation, computerised cognitive function therapy, activities for daily living (ADL) training, return to work training, pulmonary rehabilitation, machine treatment, gait training with special equipment, robot-assisted gait trainer, hydrotherapy treadmill, and anti-gravity treadmill.
Meanwhile, their facilities and services include an emergency department, room and board, imaging department, specialist clinic, daycare service, inpatient and outpatient services, and outdoor therapy.
While Daehan Rehabilitation Hospital Putrajaya only offers its services to adults at this point, there are plans to expand to paediatrics rehabilitation soon.
Certain neurological conditions such as strokes and traumatic brain injury have a window period of best recovery after the event.
-Dr Fazah Akhtar
Others:
SBS - Sure Boh Singapore ·
Founding Father Lee Kuan Yew's famous quote:
Founding Father Lee Kuan Yew's famous quote. I'm surprised it took them 65 minutes. I would have apologised straight away after he says "STOP IT!
.Covid-19 can affect our blood vessels, causing blood to clot more easily, which can result in stroke, heart attack or pulmonary embolism, among other conditions - AFP
Covid-19 can have a wide-ranging effect on many organs in our body
THE last time, you were telling me about many unusual Covid-19 symptoms, such as Covid toes, skin rashes. and loss of smell and taste (From taste to toes, StarHealth, May 31). What about the gut?
Yes. The SARS-CoV-2 virus that causes Covid-19 binds to our lung cells using the cell’s ACE2 (angiotensin-converting enzyme 2) receptor.
This receptor is also present in our intestinal cells.
The theory is that the virus is in our saliva.
When we swallow our saliva, the virus gets into our guts and binds to our intestinal cells using their ACE2 receptors.
Once this happens, we get diarrhoea, nausea and vomiting.
Sometimes, a Covid-19 patient may only experience these symptoms, without any lung problems like a dry cough or difficulty breathing.
Covid-19 patients with gut problems tend to be diagnosed later and have longer infections.
On average, Covid-19 patients have diarrhoea for five days.
Wait, if Covid-19 patients have diarrhoea, does that mean we have to be careful about using toilets then?
Yes. For example, if one of your family members has Covid-19, it might be advisable to allocate one toilet for their use only, or at least allocate one toilet paper roll for their sole use.
You should also disinfect the toilet seat the patient is using after each use and wash your hands.
I have also heard of the kidney being affected?
You are right.
It occurs through the same mechanism; the kidney also carries ACE2 receptors on its cell membranes.
Some studies are finding that as much as one-third of Covid-19 patients admitted to hospital, develop kidney problems, resulting in acute renal (kidney) impairment, or worse, outright acute renal failure. Some patients even require dialysis.
Patients who develop kidney problems are usually the ones who also have the worst lung symptoms.
It may be that the amount of virus in them is very high and/or their immune system is acting up very badly.
When the immune system is heavily provoked, what happens is that it releases a cytokine storm.
The blood vessels are affected and they start to leak fluid.
When there is less fluid going into the kidneys, they do not get enough oxygen and their tubular cells get damaged.
Gosh! What are the other organs Covid-19 affects?
There is also the liver. Once again, this is an organ with cells rich in ACE2 receptors.b
Over half the patients hospitalised for Covid-19 develop some kind of liver impairment.
This is diagnosed by a blood test showing elevated liver enzymes.
Luckily, the liver is not usually affected so badly by Covid-19 that it results in acute liver failure.
The theory for this is that the kidneys may be directly affected by the virus, but the liver is not, and any ill effects on it are more a result of the body’s own cytokine storm.
I really think I don’t want to risk getting Covid-19! Are there any other organs affected?
You are wise. It really is not worth the risk as we can be one of those that are affected very badly.
As for your question, the brain is also affected.
The brain? How?
It has all to do with the ACE2 receptors again.
You see, many blood vessel cells also have these receptors.
As blood vessels are present all over our body, any effects on them are not restricted to a specific organ, like the lung, kidneys and intestines.
So if Covid-19 directly affects the blood vessels of a patient, they will cause blood clots more easily as they are damaged.
In autopsies done on deceased Covid-19 patients, blood clots are apparent throughout many organs in their bodies.
This suggests that many blood vessels and organs are affected by the disease.
Once you have blood clots, you may have complications like stroke where blood clots travel to the arteries of the brain and clog them up.
Doctors have also observed patients with dizziness, confusion, delirium, altered mental state and muscle weakness.
This has to do with the brain getting inflamed.
Wait, when blood clots form in blood vessels, not only a stroke can happen, right? This can also cause a heart attack.
True, blood clots can lead to a heart attack or a pulmonary embolism when a clot gets into your lungs
In fact, Accident and Emergency departments in some hospitals have received patients with heart attacks who turn out to have Covid-19 when they were tested.
Covid-19 can also attack the heart directly by inflaming the heart muscles.
This is known as myocarditis.
It can lead to chest pain, abnormal heart rhythms and heart failure.
There is also a condition called “happy hypoxia”.
This is when a Covid-19 patient has very low levels of oxygen as shown on the monitor, but appears to be breathing more or less normally.
Many doctors have theorised that this condition could be due to blood clotting in the lungs.
DR.Y.L.M
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information
Here are nine ways to strengthen your body’s defence system against illnesses through healthy eating and daily habits.
dehydration makes you more susceptible to
falling sick, so ensure that you fill up on fluids, especially if you
are outside under the hot sun.— Filepicb
LATELY, we’ve all been wondering if we are doing enough to keep our bodies strong and warding off illnesses.
One critical way to ensure that you have a fighting chance is to boost your immunity.
The immune system is made up of organs, cells, tissues and processes
that fight against germs and toxins trying to enter our body.
You can bolster your immune system by making good lifestyle and food choices; and you’ll see results by being consistent.
Your body will feel healthier, you’ll have more energy and you’ll spend
less time waiting to see the doctor for a common ailment.
It’s important to note, however, that no matter how strong an immune
system is, you cannot stop bacteria and viruses from entering your body.
In order to avoid contracting a dangerous disease like Covid-19, you
should still practise social distancing, wear a mask and wash your hands
frequently.
So just to be clear, the tips below are not to protect specifically
against Covid-19, but to help you boost your immune strength to fight
off all types of infections.
Get the proper amount of sleep
Adults need an average of seven to eight hours of sleep every night.
Teens need eight to 10 hours, and younger children and infants up to 14 hours of sleep daily.
A lack of sleep or poor quality sleep has been linked to a higher
frequency of falling sick, leading researchers to believe that sleep and
immunity have close ties.
Also, sleeping for longer periods when sick, lets your immune system fight illnesses more effectively so that you heal faster.
In a study involving 164 healthy adults, those who had less than six
hours of sleep per night were more susceptible to colds, compared to
those who had at least six hours of sleep.
To avoid having trouble falling asleep, there are several things you can do:
> Keep your room completely dark, e.g. close the curtains fully, remove any night lights or use a sleep mask.
> Keep your bed time consistent, even during weekends and holidays.
> Exercise regularly, even if it’s just brisk walking for 20 mins a day.
> Limit screen time (TV, phone,
laptop) at least an hour before bed in order to prevent the impact of
blue light from disrupting your circadian rhythm (your body’s natural
wake-sleep cycle).
Eat lots of whole plant foods
Whole plant foods like vegetables, nuts, seeds and fruit are rich in antioxidants, vitamin C and fibre.
Eating more of these nutrientdense foods helps to lower your risk of infections.
This is because the antioxidants in the foods decrease inflammation by battling unstable compounds known as free radicals.
Chronic inflammation has been found to occur more frequently in patients
with heart disease, Alzheimer’s disease and certain cancers, so it’s
important to find effective ways to reduce inflammation.
At the same time, whole plant foods are high in fibre and feed your gut
microbiome (the community of healthy bacteria in your gut).
A robust gut microbiome can improve your immunity and help keep harmful
pathogens from entering your body via your digestive tract.
Additionally, other nutrients found in whole plant foods, like vitamin C, may help to reduce symptoms of the common cold.
Eat foods like papaya, broccoli, spinach, garlic, ginger, bell peppers and kiwi fruit.
Consume healthy fats
Sunflower seeds or kuaci, in this filepic are good source of healthy fats.
Healthy omega-3 fats have anti-inflammatory properties.
These fats could be a key weapon in fighting against illnesses,
considering that chronic inflammation prevents your immune system from
performing at its best.
Healthy fats can be found in foods such as olive oil, salmon, chia seeds, sunflower seeds and almonds.
Olive oil, in particular, is highly anti-inflammatory, and has been
known to decrease the risk of chronic problems like heart disease and
type 2 diabetes.
The anti-inflammatory properties of these healthy fats may be critical
to helping your body fight off harmful disease-causing bacteria and
viruses, so try to get more of it in your diet now.
Have more fermented foods
We are learning that immunity and gut health are intertwined.
Your digestive tract contains beneficial bacteria (probiotics) that you
can increase in amount by eating fermented foods like yoghurt,
sauerkraut, kimchi, kefir and natto.
This may help strengthen your immune system by helping it to identify
harmful microorganisms as a healthy ecosystem of gut bacteria teaches
your immune system how to tell the difference between good bacteria and
bad bacteria (pathogens that cause problems).
In a three-month study in 126 children, those who drank 70ml of
fermented milk every day were found to have less childhood infectious
diseases by about 20%, compared with a control group.
Another study of 152 people infected with a rhinovirus found that those
who supplemented with the probiotic Bifidobacterium animalis had a much
better immune response and lower levels of the virus in their nasal
mucus.
Cut your sugar intake
A high intake of sugar and refined carbohydrates contribute to obesity, heart disease and other conditions that disrupt your
immune system.
According to an observational study in around 1,000 people, obese people
who were administered the flu vaccine were twice as likely to still get
the flu, compared to non-obese individuals who received the vaccine.
Curbing your sugar intake can decrease inflammation and aid weight loss, thus reducing your risk of chronic health conditions.
Strive to keep your added sugar intake to 5% or less of your daily
calories, which is equal to about two tablespoons of sugar for a
2,000-calorie diet.
Throw in some exercise
Moderate exercise can give your immune system a boost.
Studies indicate that even a single session of moderate exercise can
boost the effectiveness of vaccines in people with compromised immune
systems.
By making it a regular routine, moderate exercise helps your immune cells to regenerate often and reduce inflammation.
Some types of exercises you can do include brisk walking, indoor cycling, jogging, swimming and hiking.
Aim for a minimum of 150 minutes of moderate exercise per week.
Drink enough fluids
Dehydration paves the way to making your body susceptible to falling sick.
Without enough water, you may experience headaches and hinder your
physical performance, focus, mood, digestion, and heart and kidney
functions.
Hydration itself doesn’t protect you from germs and viruses, but dehydration increases your susceptibility to illness.
To know that you are drinking enough water regularly, the colour of your urine should be a clear, light yellow.
Plain water is the best option to stay hydrated – it is free of calories, additives and sugar.
You will need more fluids if you exercise a lot, work outside or if the weather is hot.
Keep stress at bay
Reducing anxiety and stress will help to improve immune health.
In the long run, stress increases inflammation and messes with your hormonal balance and immune cell function.
Long-term stress is especially taxing on children, weakening their immune response
Activities that are often recommended to help people manage stress
include exercise, journaling, drawing or painting, meditation, outdoor
walks and other mindfulness practices.
If you feel a need to express how you feel to someone, then seeing a certified counsellor or therapist can help.
Supplement wisely
;
Two things to note about supplements: the first is that they are not a
replacement for a well-rounded diet, and the second is that they don’t
guarantee that you will be free from getting sick.
Some studies however, have found that supplements may fight off viral
infections, or at least give your immune system a helping hand in
staying strong.
If you would like to take supplements, choose wisely.
Here are some vitamins and minerals to consider taking that may help improve your immunity:
> Vitamin E
This vitamin is a powerful antioxidant that helps the body fight off
infection, and is found in foods like nuts, seeds and spinach.
> Zinc
A peer review of 575 people with the common cold, who took more than 75
mg of zinc per day, reduced the duration of their cold by one-third,
compared to those who didn’t take the supplement.
> Vitamin D
A deficiency in this vitamin may increase your chances of getting sick, so supplementing may counteract this effect.
> Vitamin B6
This vitamin is vital to supporting biochemical reactions in the immune system.
Vitamin B6-rich foods include chicken, cold water fish such as salmon and tuna, green vegetables and chickpeas.
The bottom line is that improving your lifestyle and making better
dietary choices can help strengthen your immune system to fight off
harmful pathogens and keep you healthy and well.
By Datuk Dr Nor Ashikin Mokhtar,
who is a consultant obstetrician and
gynaecologist, and a functional medicine practitioner. For further
information, email starhealth@thestar.com.my. The information provided
is for educational and communication purposes only and it should not be
construed as personal medical advice. Information published in this
article is not intended to replace, supplant or augment a consultation
with a health professional regarding the reader’s own medical care. The
Star does not give any warranty on accuracy, completeness,
functionality, usefulness or other assurances as to the content
appearing in this column. The Star disclaims all responsibility for any
losses, damage to property or personal injury suffered directly or
indirectly from reliance
on such information
When muscles shrink
Despite having normal nutrition, many senior citizens actually have low muscle mass, making them more prone to falls and fractures.
MUSCLE loss or sarcopenia is a natural part of ageing and one of the main contributors to musculoskeletal impairments in the elderly.
Photo: 123rf.com
Photo: 123rf.com
Strong muscles support the joints as they help absorb the stress placed on the joints when you move.
Without adequate muscles, the joints take a beating, and can cause the individual to become frail and more likely to suffer from falls and fractures.
The 2018 Malaysian National Health and Morbidity Survey (NHMS) reported that 15% of those aged above 60 had fallen at least once over 12 months.
Half suffered injuries, while one in five were hospitalised.
Even if you are active, it is still possible to have some muscle loss beginning in your 30s.
However, there are steps you can take to slow down or prevent losing muscle.
Missing muscles
According to Asia’s largest clinical study of its kind on nutritional outcomes in the elderly, there was a prevalence of low muscle mass among the elderly, despite them being active, healthy and without any chronic medical illnesses.
The two-part Singaporean study, called Strengthening Health in Elderly through Nutrition (Shield), was jointly carried out by Changi General Hospital (CGH), Sing Health Polyclinics and healthcare company Abbott.
Results from the first phase of the study was published in the Plos One journal last year.
This observational phase looked at 400 healthy individuals in Singapore aged 65 and older.
The results revealed that the prevalence of low muscle mass was higher in females (24.9%) than in males (15.5%), with even adults with normal nutritional status at risk for having lower muscle mass. (See Maintaining muscles during menopause).
Every one-year increase in age over 65 years was associated with 13% higher odds of having low muscle mass.
And 52% of participants had vitamin D insufficiency despite living on an island where sunshine is available the whole year round.
“The majority (93%) of the subjects were fully independent and self-caring in the community.
“All the subjects were living at home and able to walk independently without any walking aids, and were relatively active prior to the study
“Participants were not subjected to any exercise programmes before or during the study.
“We assessed their physical activity level using the PASE (Physical Activity Scale for the Elderly) questionnaire.
“The average PASE score of the study participants was 119.45, similar to the norm of older adults,” says principal investigator Dr Samuel Chew, adjunct associate professor and senior consultant at the geriatric medicine department at CGH.
However, the subjects’ daily diet was not collected in this first part of the study.
A combination of physical activity, which includes weights or resistance training, and a balanced diet with an adequate amount of high-quality protein (e.g. chicken breast, fish, eggs, tofu and other soya products), is essential for good muscle health and function.
However, many seniors don’t embark on strength training programmes and cite difficulty in chewing meats and poultry due to deteriorating teeth, so they avoid eating protein or get little of it in their diets.
Assoc Prof Chew says, “We are unable to comment on the possible reasons for the observed low muscle mass, but from the available literature, there is a measurable decline in muscle mass from the age of 40.
“The decline rate increases by about 8% every 10 years and accelerates after the age of 70 to about 15% every 10 years.
“There are many factors that contribute to this loss in muscle mass, such as changes in hormone and endocrine levels, the loss of connections between the nerves and muscle units with the onset of ageing, acute or chronic illness, and inactivity.
“In addition, those above the age of 65 require more dietary protein in order to stimulate the same amount of muscle protein synthesis as a young person.”
Other factors that may impact elderly diets are:
> The lack of knowledge about good nutrition
> The lack of awareness about the high prevalence of low muscle mass and inadequate levels of micronutrients such as vitamin D
> Poor oral health
> Loss of appetite due to physiological and sensory/taste changes associated with ageing
> Living alone
> Other illnesses
> Use of multiple medications
Get some sunshine
As for the lack of vitamin D, it is apparently common in older adults.
“The results from our study are consistent with previous studies performed in Asia.
“Therefore, while the finding is not unexpected, it still poses a cause for concern.
“Vitamin D is produced in the body naturally when the skin is exposed to sunlight.
“It is also found in dietary sources such as dairy products, oily fish, eggs and mushrooms.
“As such, it is likely that the vitamin D insufficiency is related to a lack of exposure to sunlight and/or insufficient intake of vitamin D-rich food sources,” explains Assoc Prof Chew.
To overcome this deficiency, one method is to get 15 minutes of exposure to outdoor sunlight daily.
He asserts, “It is vital for the activity to take place outdoors, as the component of sunlight that stimulates the production of vitamin D in the human skin does not penetrate glass windows very well.
“However, be mindful of direct overexposure to sunlight, which may result in skin damage and other health complications.”
The Shield study compares to a similar European ageing study that was carried out in Berlin, Germany, where the prevalence of sarcopenia was 24.3%.
“Many factors can affect the results, such as the characteristics of the study participants, methods used to measure muscle mass and cut-off criteria used to define low muscle mass, and participants’ nutritional status.
“The study conducted in Europe included generally healthy community-dwelling older adults who may have had normal nutritional status or were at risk of malnutrition, which is a risk factor for low muscle mass.
“Therefore, the true prevalence of low muscle mass in the general population aged 65 years and above in Singapore is likely going to be higher than the prevalence observed in our study, as they would include individuals who are at risk of malnutrition,” says study co-investigator and Abbott Scientific & Medical Affairs divisional vice-president Dr Low Yen Ling.
While no similar studies have been carried out in Malaysia, it is believed that our elderly could also be having low muscle mass.
Statistics from the Global Burden Disease Study 2010 shows that the lifespan of Singaporean men is 78.8 years, and for women, 83.3 years. So, even with lower muscle mass, women are living longer.
Dr Low reflects: “Biological, behavioural, and environmental factors can all contribute to this topic.
“One possible explanation is that men smoke more often than women.
“Some evidence also suggests that although both men and women are living longer as the burden of infectious diseases falls, such reduction may disproportionally benefit women.
“This is an ongoing effort and researchers are still studying how all these potential factors influence life expectancy and ways to improve longevity.
“What we know is that scientific evidence has shown that low muscle mass is associated with negative outcomes such as higher risk of functional impairment, fractures, complications, and even mortality.”
Less muscles, poorer immunity
Skeletal muscle accounts for about 40% of total body weight and contains at least half of all body proteins.
Data suggests that loss of muscle mass is associated with compromised immunity and infections.
Research in older adults has shown increased markers of inflammation associated with low muscle mass and muscle function.
Immunity is affected if an older adult loses more than 10% of their lean body mass, while a decrease of more than 30% can make them susceptible to pneumonia.
This is probably because muscles produce and release compounds that play an important role in the proliferation, activation and distribution of certain immune cells.
Assoc Prof Chew says, “Hospitalised patients with pneumonia may have poor outcomes, and this is often associated with very low muscle mass and poor nutrition – two factors that are also linked to a weakened immune system.
This is because muscles are a natural reservoir of amino acids, which are required for proper functioning of the immune system.
“Decreased muscle mass, together with the associated loss of physical strength and function, can lead to an impaired recovery from critical illness.
“Infection in an individual with deficient muscle mass causes further inflammation in the body, which can cause further loss of muscle mass and impairment of the immune system, resulting in a vicious cycle that may ultimately result in poor health outcomes.”
To help preserve muscles, Dr Low provides these tips:
> Engage in regular exercise
Aim for at least 150 minutes of moderateintensity exercise a week, and include resistance training to maintain muscles and strength.
> Eat enough protein
Incorporate chicken, seafood, eggs, beans or dairy into your diet, and aim for about 20-30g per meal.
Adults 65 years and above may need up to 50% more protein than younger adults.
To further amp up protein intake, snack on proteins between meals or supplement your diet if needed with protein powders or shakes.
> Follow a balanced diet
Choose a balanced diet full of vegetables, fruits, whole grains, proteins, healthy fats, and key vitamins and minerals like calcium and vitamin D.
> Consider HMB (beta-hydroxy-betamethylbutyrate)
HMB is a metabolite of the essential amino acid leucine and a naturally-occurring compound that has been shown to preserve muscle mass in healthy older adults when taken as a supplement.
While HMB is naturally found in very small amounts in foods such as avocados, grapefruit and catfish, it’s hard to get enough from food sources alone to achieve the desired health benefits.
Having healthy muscles is critical to ensure that the elderly can continue to retain their mobility, strength, energy levels and independence as they age – the Shield study reinforces that.
There is also a correlation between skeletal muscle and bone health – healthy muscles link to healthy bones, but strong bones do not necessarily mean that the muscles are strong.
Dr Low suggests: “It is important to perform early screening to identify those who have low muscle mass, so that appropriate interventions can be implemented.
“Muscle health can be determined by using a handheld dynamometer (to test hand grip), measuring calf circumference or measuring muscle mass using the bioelectrical impedance analysis (BIA).”
The second phase 2 of the Shield study, to be completed this year, will involve 800 elderly participants at risk of being malnourished, who will be placed on oral nutritional supplements.
The aim is to find out how the supplement will affect their nutritional status, and their rates of hospital admission and re-admission.
The signs of muscle loss
Maintaining muscles duringmenopause
NEW European research has found that keeping physically active during menopause could help women maintain muscle mass.
Keeping active during menopause can help maintain a woman’s muscle mass, which is important to staying active and independent.—AFP
Carried out by researchers at the University of Jyväskylä, Finland, the new study looked at 234 women aged 47 to 55, who were followed from perimenopause to early postmenopause, which is the stage after menopause when menstruation has permanently stopped.
The women had their muscle mass measured and hormone levels tested in the perimenopausal state and right after entering postmenopause.
The women were also asked to self-report their physical activity levels and wear an accelerometer for seven days, which is a wearable device that records movement.
The findings, published in the Journal of Clinical Medicine, showed that the average duration of menopausal transition was one-and-ahalf years, although the researchers note that the time it takes to go through menopause is unique for each woman.
For some of the women in the study, it took less than six months, and for others, it took more than three years.
The researchers also found that during this time, the women experienced significant decreases in various measures of muscle mass, with an average of a 1% decrease in muscle mass.
However, women who were more active during the menopausal transition had higher muscle mass before and after menopause, compared to the less active women.
The researchers say this highlights the importance of keeping active during the transition from perimenopause to postmenopause, when the production of oestrogen stops and leads to a decline in muscle mass.
“We already knew that oestrogen has a role in the regulation of muscle properties,” says doctoral student Hanna-Kaarina Juppi.
“By following the hormonal status, measuring many aspects of muscles, and by taking into consideration the simultaneous chronological ageing of women going through menopausal transition, we were able to show that the decrease of muscle mass takes place already in early postmenopause.”
She adds: “The observed change does not seem like much, but what is meaningful is that the decline happens in a short period of time and can have an impact on metabolism, as muscles are important regulators of whole-body metabolism.” – AFP Relaxnews
Physiotherapy for stroke patients is not just about exercises and
movement, but also incorporates technology such as functional electrical
stimulation and virtual reality. — Photos: SUNWAY MEDICAL CENTRE
VELOCITY
Protein shakes have divided nations! Some will be critical of the
singlet toting gym junky’s protein shaker and others will feel inspired
to shake themselves. So should you protein shake?
To shake or not to shake?
One quality scientific review, found protein supplementation with
resistance training to increase muscle mass more than resistance
training alone. Additionally, in conjunction with a healthy diet protein
supplementation can aid in fat loss (1). A further review study found
protein ingestion with resistance training to increase muscle mass,
strength, explosive power and power during endurance based tasks more
than resistance training alone (2). This tells us you should get
shaking!
What, when, how to shake:
If it is an entire protein supplement you are consuming such as whey
powder, then consuming the product within 30 minutes post workout
appears to offer maximal strength and muscle mass benefits (3).
Consuming protein after a workout becomes even more effective when it is
consumed with a high GI carbohydrate like glucose or maltodextrin. Try
adding a spoonful of honey to your shake or buy maltodextrin powder and
add a sprinkle.
Amino acids are the building blocks of proteins and one such amino acid
is Leucine. It appears that protein supplements containing 3-4g per dose
of leucine most optimise the amount of protein effectively used
(synthesised) by the body. Consuming any normal whey protein should
achieve this.
Alternatively, If you consume an isolated amino acid supplement (more
expensive), you’re best taking this pre-workout. Although these are more
expensive than protein supplements and confer no further benefit (3).
