The Lazada GSS Sales will start from 6 June and end on 8 June 2017. 

Lazada GSS Sales X Blackmores Health Supplement Surpirse Box

A huge Lazada GSS Sales x Blackmore Health Supplement arrived at my house and I was excited to find out what are the items in the box. Here I am revealing partial items in my Lazada GSS Sales Surprise Box.

First is the important supplement, Fish Oil 1000mg 120s as it contains Omega which is for preventing and managing heart disease. Some use it to lower blood pressure.

Next I have the Blackmores Bio C 1000MG 30S which is equally essential for growth and repair of tissues. Lots of people will use it to combat against common cold and flu too.

And you might be concerned with the expiry date. My products expired in mid and end of 2018. So there is sufficient time for me to finish consuming all the items. In fact, these supply meant for a month of consumption. If I consume diligently, I will finish them all within a month.

The Lazada GSS Sales has up to 90% off and flash deals every 2 hours. So don’t miss out the super attractive sales.

Promotion

At this Lazada GSS Sales, besides up to 90% off and there is also flash deals every 2 hours.

To save more use our unique Voucher Code: GSSMICH18 to get the 18% off, capped at $8 for new customers with no minimum spend required. The promotion period is from 6 to 8 June 2017.

More Lazada Surprises

If you have purchased the Surprise Box during Lazada GSS Sale, remember to do an unboxing video and upload it on social media with the hashtag #lazadasurprises. Winners will be chosen and prizes are guaranteed to be attractive!

NAHMJ Verdict

For a better health and more saving that up to 90% off, get on to Lazada GSS Sales. And don’t forget to voucher code GSSMICH18 for your purchases to save even more. Remember the sales last only 3 days, during 6 to 8 June 

Lazada

German e-commerce company

Website: http://ho.lazada.sg/SHPfig

The post Up to 90% Off At Lazada GSS Sales x Blackmores Health Supplement GSS Surprise Box Campaign – Singapore appeared first on NAHMJ.

The owner of Breathya who was asthmatic experience Halotherapy in Europe and was cured of his chronic illness. Hence he is a firm believer of this alternative treatment since it was drugless. 

Halotherapy is suitable for all ages, both adult and children who are suffering from conditions such as asthma, bronchitis, allergies, cold/flu, ear infections, eczema, psoriasis, sinus, smoker’s cough, stress, fatigue, amongst many others. Alternatively, it could be for relieving stress.

Halotherapy is a 100% natural, drugless and risk-free therapy treatment. There are 2 treatment rooms at Breathya; each is covered with salt. During the session, the micro particle salt is dispered in the room throughout the salt and recipients are to breath them in. These high concentrated negative ion salt will neutralise the harmful positive ions that are present in our airway and skin. The result of the treatment was relaxing and one will feel that the mucus in the airway were cleared. Adult will receive 60 minutes session while children will be doing 45 minutes of Halotherapy.

Apparently, multiple research in Europe were conducted to confirm the efficiency and effectiveness and the result was promising. It was shown that improvement rate was 75% for severe asthma cases, 85% for mild & moderate asthma cases and 97% for Chronic bronchitis & bronchiectasis cases. This result was published in Journal of Aerosol Medicine, 1955.

In a nutshell, the benefits in a glance are

1. Anti bacterial & Anti inflammatory
2. Loosens & clears mucus from the airways removing airflow obstructions
3. Reduces bronchial hyper responsiveness
4. Improves lung function
5. Reduces immune system sensitivity
6. Increases resistance to respiratory tract diseases
7. Improves microcirculation of skin
8. Restores pH value of the skin
9. Helps clear catrrh & congestion of the sinuses.

The therapy is not suitable for thsoe who have high blood pressure, Cancer, Kidney diseases, Severe Cardiac diseases, Tuberculosis, Hyperthyrodism, Cirrhosis and when individual having infections that are accompained by fever. And do remember to wear white or light coloured clothing for the therapy as after the therapy, one will be covered in a layer of white powder.

Furthermore, extremely minute of salt is absorbed into the body during treatment. Finally, in order to gain maximum benefits from Halotherapy, one isn’t enough. 

Promotion Code

For those who loves to try Breathya, here is a great news, quote BRMichelle15 for 15% discount.

NAHMJ Verdict

Experiencing a session of Halotherapy at Breathya personally and I thought it was pretty relaxing after the session. One will lay or sit comfortably on an inclined chair in a dim room with soothing music and inhaling salt.

Personally, I would prefer if Breathya could offer customer a robe to change so that our clothing won’t be stained with salt. In addition, if bathing facilities offered that would be perfect. Though one won’t feel sticky right after the session but once getting into the sun, this may not be the case soon. 

Breathya

1 Marine Parade Central #03-09 Parkway Centre, Singapore 449408
Tel: +65 62065060 / 63230408

Website: http://www.breathya.com/
FB: https://www.facebook.com/BreathyaSG/

Opening Hours

Tuesdays – Sundays  1000 to 2000

Getting There

By Bus:

• Blk 43 along Marine Parade Road (Bus Stop 92049)   15, 31, 36, 43, 47, 48, 134, 135, 196, 196e, 197, 401, 853, 966

• Opp Parkway Parade along Marine Parade Road (Bus Stop 92041)   15, 31, 36, 43, 48, 134, 135, 196, 196e, 197, 853, 966

• Opp Roxy Square along East Coast Road (Bus Stop 92111)   10, 10e, 12, 14, 14e, 32, 40, 47

• Roxy Square along East Coast Road (Bus Stop 92119)   10, 10e, 12, 14, 14e, 32, 40

*Disclaimer: This was a media invite.

The post Breathya, Drugless Respiratory Care Centre – Marine Parade, Singapore appeared first on NAHMJ.

I was amazed to find out how versatile the Gavia Natural Sweetener is. Unlike most sugar replacement as the chemical structure is not stable, Gavia could be used in Bakes. Be it in Brownies, Tarts or even Muffin. The best part is that the bakes tasted as close as those making using with sugar.

And of course, without doubt, it is in non-bake goodies such the Strawberry Yogurt Cheesecake too.

Not forgetting in the drinks too.

What Is Gavia Natural Sweetener?

Made from Stevia plant extract and Erthritol, Gavia Natural Sweetener is an all-natural, zero calorie and zero glycaemic product. For centuries, Guarani people in South American uses Stevia to sweeten their tea and food. This amazing plant was spread to Japan and they too use it for many decades.

Research showed that the Stevia extract does not elevate blood sugar level and blood pressure hence it is suitable for individual with diabetes as well. Per Geuns JM publication in Phytochemistry, Stevia has a very low acute toxicity, and no allergic reactions to it seem to exist. Globally established that stevia sweeteners are safe for people of all ages at an Acceptable Daily Intake (ADI) of 4 mg/kg body weight.

Price & Promotion

Each pack of 150g Gavia Natural Sweetener is at $7.25. Quote “gavia20happy” to enjoy 20% off from the retail price when order via Gavia online store.

Gavia Natural Sweetener

Website: http://gaviasweet.com/

Reference

1. Geuns JM. Stevioside. Phytochemistry. 2007;64:913–21.
2. Kirtida R. Tandel. Sugar substitutes: Health controversy over perceived benefits. J Pharmacol Pharmacother. 2011 Oct-Dec; 2(4): 236–243.

The post Gavia Natural Sweetener – A Sugar Replacement Alternative appeared first on NAHMJ.

The media event was kickoff with the back stage tour and followed by an open speech by WTA President Micky Lawler.

Next, Ms. Kathleen Stroia, Senior Vice President, WTA Sports Sciences & Medicine & Transitions shared with the media the importance of nutrition for tennis players and the benefits of USANA Health supplements for the players. She was one of the key decision maker to approve the USANA Health supplements for the WTA tennis players.

USANA, a leading global vitamin and health supplement manufacturer, and the official health supplement supplier of the WTA since 2006, provides nutritional assistance to athletes through a range of high quality USANA products. There are currently over 225 WTA players benefiting from USANA supplements. And 8 out of 10 top players are taking the supplements.

In 2014, the WTA and USANA came together to spearhead Aces for Humanity, a joint initiative that supports the USANA True Health Foundation, raising money to support the non-profit philanthropy. At the BNP Paribas WTA Finals Singapore presented by SC Global, WTA will unveil a cheque donation of $25,000.

Kristina Mladenovic is the USANA ambassador who is also taking the supplements. Her favourite product is the Recovery Shake. Finally, up close with Kristina Mladenovic for a photo session. She is playing double with Caroline Garcia in the WTA Finals 2016.

Lastly, the night was ended with an exciting match with Madison Keys, singles rank is 7, playing against Angelique Kerber, singles rank is 1. Keng Hean of USANA tossed the coin for the match. The match was won by Germany borned Angelique Kerber, 28, who is residing in Poland currently.

The post USANA Health Sciences Promotes Sports Nutrition At BNP Paribas WTA Finals Singapore 2016 appeared first on NAHMJ.

USANA, the “Official Health Supplement Supplier of the WTA”, have been partnering with the WTA since 2006. This partnership allows the tennis players to have access to the highest quality, science-based nutritional supplements that help them maintain top form throughout their professional careers. 

The Top 8 Singles players and Top 8 Doubles teams are coming to Singapore to contest in the season ending tournament for a record US$7 million in prize money. The final is scheduled on 27 October. 

To participate in this USANA Giveaway Contest, readers have to first follow @usanasingapore and @NAHMJ. Next, re-post the giveaway contest Instagram post. Tag @usanasingapore and @NAHMJ. Then, use the hasgtag #imSMART, #MySmartShake, #ChampionsChooseUSANA and tell us why you should be the winner. The 2 most creative Instagram comment win the goodie bag that includes 1 athlete myhealthpak, 1 ticket to the WTA match, and 1 passes for the Racquet Club. The closing date of our first USANA Giveaway Contest is on 21 Oct 2016, 2359hr. Winners will be announced on our Instagram account.

This giveaway contest is closed. Winners were announced on my Instagram.

Who Is USANA?

USANA is a Utah-based company that produces the highest quality nutritional health supplement. Its plants are FDA approved and it is on New York Stock Exchange as USNA. Myron Wrentz who has double PhD in immunology and microbiology founded USANA in 1992. It’s sales channel is through Multi-Level Marketing.

Dr Oz Show featured USANA products and the athletes of Women’s Tennis Association (WTA) uses the nutritional supplement too.

What is MyHealthPak?

The MyHealthPak system provides a completely customised selection of USANA Nutritionals. This allows customers to select a complete and balanced spectrum of nutrients to meet their personal dietary needs. A month’s supply of individual morning and evening supplement packs each containing up to eight USANA supplements.

The individual packs:

• Eliminate the need for multiple supplement bottles
• Make it easy for customers to consistently take the full dose of supplements they’ve selected every day
• Are easy to transport, so customers can take their supplements with them while they are traveling or on the go

USANA

391B Orchard Road Ngee Ann City Tower B #19-01/02, Singapore 238874
Tel: +65 6820 8828

Website: http://www.usana.com/
FB: https://www.facebook.com/OfficialUSANASingapore/

*Photo Credits: USANA

The post USANA Giveaway Contest To Meet & Greet WTA Players Cum WTA Finals (Closed) appeared first on NAHMJ.

Enzyplex

How many of us often tend to over eat especially when eating too fast? And as such indigestion resulted. Then we feel bloated in the stomach. There are many remedies out there and today we are looking at using Enzyplex to ease indigestion.

What is Enzplex? The manufacturer of Enzplex is United Pharm. One could aid digestion with Enzplex as it is a formula of digestive enzymes. Digestive enzymes are substance that help to break down the food for the body to absorb.

It not only aid digestion but also improve metabolism. Enzyplex is also useful in reliefing bloating, belching, flatulence, abdominal discomfort or feeling of fullness.

Enzplex is available in 2 sizes. The big bottle contains 100 tablets while the small bottle contains 30 tablets.

The pills are elongated and teal in colour. I tried and find it pretty easy to swallow. Adult could take 1 – 2 tab 3 times a day with or after meal.

For those who are keen to know that formula of Enzplex, here it is. Each tablet contains Amylase 10k units, Protease 9,000 units, Lipase 240 units, Desoxycholic Acid 30 mg, Dimethylpolysiloxane 25 mg, Vitamin B1 10 mg, Vitamin B2 5 mg, Vitamin B6 5 mg, Vitamin B12 5 mcg, Nicacinamide 10mg, Calcium Panthothenate 5 mg.

Exclusive Promotion For NAHMJ Readers

Good news for NAHMJ readers. There are 2 exclusive promotions; purchase Enzyplex at a 10% discount and redeem free Enveron Vitamin C.

10% Discount For Enzyplex

Simply enter ENZYPLEXMICH to enjoy 10% OFF Enzyplex Digestive Enzymes at Guardian E-store via http://bit.ly/Enzyplex. Promotion is valid from 11-31 August 2016.

First select the required size.

Then you will see the next page and then look for the Promo code field on the right, under the Summary Section. Click the drop down arrow and the field will appear. Then enter ENZYPLEXMICH.

Followed by check out to purchase your product at a 10% discount.

Redeem Free Enervon With Vitamin C, 10S

Head over to bit.ly/RedeemEnervon to redeem your FREE Enervon with Vitamin C 10s today! While stocks last!

The post [Promo Code] Aid Digestion With Enzyplex appeared first on NAHMJ.

We need both macro-nutrients and micro-nutrients. Some may not understand the terms. Macro nutrients are Carbohydrates, Proteins and Fats while micro-nutrients are the vitamins and mineral. In this product, the focus is bridging the macro-nutrients gap and at the same time to eat clean.

USANA MySmart Shake

In the USANA MySmart Shake, it consists of all the required macro-nutrients at the amount we required. It is made using only natural sources with no added sugar. In this product, USANA eliminates simple processed sugar, instead it consists of complex Cabohydrate. For the Protiens option, there are Whey and Soy available. Lastly, it uses coconut oil as it is rich in Medium Chain Triglycerides since it is beneficial for sport performance, weight loss and promote a greater sense of satiety. And this product is gluten free.

As the USANA MySmart Shake focus only on the macro-nutrients, you will need to supplement the diet with vegetables and fruits or with some USANA micro-nutrients products.

How to Make An USANA MySmart Shake?

It is extremely easy to consume the USANA MySMart Shake. As all you need to do is to mix all required ingredients and shake it up.

Step 1 – Choose a Proteins Base

The base consists of the bulk of macro-nutrients available as Whey Proteins ($65) or Soy Proteins ($65) in mild vanilla flavours. Depending on your lifestyle, chose accordingly.

Using the plastic scoop provided, add 1 spoonful to a shaker.

Step 2 – Choose a Flavour Optimiser

There are 4 flavours to choose from for the Flavour Optimiser ($10/7sticks). Flavours available are Banana, Orange, Cappuccino and Chocolate. Likewise, add the entire flavour stick into the shaker.

Alternatively, replace the flavour sticks with fruit juice.

Step 3 – Choose a Booster

Choose either MySmart Fibergy Plus Booster ($46) to introduce more fibre or MySmart Shake Protiens Plus Whey Booster ($35) to build more muscle mass.

Another optional choice is add a dose of the USANA Probiotic powder.

Step 4 – Shake it up

The last step is to add Soy or Milk or Fruit Juice (if flavours sticks is not added) and shake it up to mix well. Now try to consume.

Alternate Method

Use USANA MySmart Shake to make a Smoothie by blending your favourite fruits and the various ingredients in the USANA MySmart Shake.

Recipe

1 scoop   Whey Proteins or Soy Proteins
1/2 scoop   MySmart Fibergy Plus Booster
1 stick   USANA Probiotic powder
Favourite fruits cut into small chunk
1 large cup   Soy Milk
1 large cup   Ice

1. Add all the above ingredients into the blender
2. Blend all the ingredients (If you find that it is too thick, add more Soy Milk)
3. Serve in a cup and enjoy

The result is a fruity smoothies.

How to Use the USANA MySmart Shake?

Use USANA MySmart Shake as replacement meal for those who are seeking weight lose. One could replace up to 2 meals per day.

To detox, replace all 3 meals with USANA MySmart Shake for a day. Add 2 – 3 teaspoon of Fibergy Plus Booster.

If one is planning to maintain healthy muscle mass, supplement your diet with 2 USANA MySmart Shake per day. Adding 2 teaspoon of Protein Plus Booster is a must.

Lastly, which is the most crucial for most of us is to rebalance our diet. Replace one meal in a day withUSANA MySmart Shake and add 1 tablespoon of both Protein Plus Booster and Fibergy Plus Booster.

For more information on USANA MySmart Shake, visit https://mysmartshake.usana.com/

Who is USANA?

USANA is a Utah-based company that produces the highest quality nutritional health supplement. Its plants are FDA approved and it is on New York Stock Exchange as USNA. Myron Wrentz who has double PhD in immunology and microbiology founded USANA in 1992. It’s sales channel is through Multi-Level Marketing.

Dr Oz Show featured USANA products and the athletes of Women’s Tennis Association (WTA) uses the nutritional supplement too.

NAHMJ Verdict

We tried the MySmart Shake and could attest its convenience and taste. And with fibregy that is rich in fibre helps in bowel movement too. We know of a successful testimonial who uses the product to achieve weight lost. The lost was visible around the belly and arms too. This was within 2 weeks.

In addition, as USANA products are scientific based proven, NAHMJ is confident in using them.

This product is the turn to for foodies who need to either reduce or maintain weight.

USANA

391B Orchard Road Ngee Ann City Tower B #19-01/02, Singapore 238874
Tel: +65 6820 8828

Website: http://www.usana.com/
FB: https://www.facebook.com/OfficialUSANASingapore/

The post USANA MySmart Shake, Foodies’ Secret Weapon appeared first on NAHMJ.

Bonsoy

Bonsoy is a non dairy organic soymilk which is lactose free with barley. The name comes from French and it means wonderful soybean. All the soyabeans used in making the product, Bonsoy, are whole and organically grown with non-genetically modified soybeans plant and are free from pesticides, herbicides and fungicides.

Bonsoy is pasteurized at 130°C to ensure that all bacteria are killed and also to remove trypsin protein inhibitor that cause indigestion. Uniquely in Bonsoy, it contains Job’s Tear (Pearl Barley) which is rich in calcium, phosphorus, iron and Vitamins B1 and B2. It is also anti-cancer (with Gemanium and Coixol) and aid in digestion, improve blood circulation, prevent myocardinal, atherosclerosis and high blood pressure.

This soymilk does not has additional refined sugar added to sweeten it, instead it is sweetened with the natural tapioca syrup. There is no artificial additives, preservatives, colours, chemicals, flavour, oils and kombu added.

There is a long list of health benefits that are attached with soybeans and soymilk. In case you are wondering how benefitting is the soymilk. Here are some.

1. It has anti-oxidant effect from Saponin and vitamin E to slow the aging process and prevent arteriosclerosis.
2. There is no cholesterol content and instead it helps to lower cholesterol due to the presence of soy protein, glycine and the peptides produced during digestion of the soybeans.
3. Due to relatvie amount of lecithin and colin, collectively known as lin lipid, which will prevents hyperlipemia and controls the increase of lipid in the liver by burning excess body fat. Hence prevent fatty liver.
4. More benefits such as strengthen bones and moderate menopausal disorder and may prevent both breast and prostate cancer by Isoflavones.

Nutrition Facts of Bonsoy (For serving size 200ml)

Energy: 482kJ, Protein: 8.2g, Total Fat: 4.4g (Saturated Fat: 0.6g, Trans Fat: 0g),
Cholesterol: 0mg, Total Carbohydrate: 11g (Sugars 4.4g), Sodium: 94mg, Potassium:
375mg, Calcium: 51mg.

Laksa Recipe

Bonsoy is a very versatile product which can be used as a replacement of coconut milk and milk for those who are lactose intolerant. In case you are wondering how you could make use of the soymilk beside drinking it as it is. The most common way is to cook Laksa and Curry. Below is the recipe for the Laksa which I tried. It was so good till I have 2 helping.

Ingredients:

Brown rice udon
Fresh glass prawn
Egg
Fish cake
Bean sprout

For the gravy

Tau Pok
Laksa leaves
Laksa paste
Bonsoy
Hiflo water (preferably)
Nature’s Glory Dashi powder
Nature’s Glory kombu powder

Preparing the Gravy

1. Fry the laksa paste until fragrant
2. Add Hiflo water and bonsoy in the same proportion (if you want thicker gravy, add
   lesser water) and bring it to boil in moderate fire
3. Add 1 tsp each of Nature’s Glory Dashi powder and kombu powder to enhance the taste
4. Put in the Tau Pok and boil for 5mins. Turn off fire, set aside

Preparing to serve

1. Boil the fresh prawn and de-shell.
2. Boil the egg to hard-boiled egg, de-shell and slice them
3. Cook the beansprout by boiling
4. Slice the or shred the fish cake
5. Chopped the laksa leaves
6. Now prepare the brown rice udon by putting it into the boiling water and let it cook for 10 mins (do not overcook). Drain and rinse with cold water
7. Finally, place the udon and all the prepared ingredients such as the prawn, egg, fish cake, beansprout and chopped laksa leaves. Then pour in piping hot Laksa gravy.

Now enjoy the bowl of freshly prepared Laksa cooked with Bonsoy.

About Nature’s Glory

Nature’s Glory started in 1991 with a philosophy that Man should be in harmony with Nature. As such, it offers a range of products that truly display this philosophy and to meet their objective.

What make Nature’s Glory unique? The team at Nature’s Glory carry out their own QA test to ensure the products meet the International Organic standards set by Japan, Europe, US and Australia. They air flown the fresh produce on a weekly basis, only top grade quality products were imported, the fresh produce are sourced only from Trusted farms, only Non-genetic modified products are on the shelves, lastly only no radiation Japan products were carried.

Nature’s Glory 

315 Outram Road #01-09 Tan Boon Liat Building, Singapore 169074
Tel: +65  6256 0104

Website: http://www.natures-glory.com/
FB: https://www.facebook.com/NaturesGlorySg/?fref=ts

Opening Hours

Monday  0930 to 1430; Tuesday – Saturday  0930 to 1830; Closed on Sundays and Public Holidays

Getting There

By Bus:

• alight aft Furama RiverFront along Outram Road   5, 16, 75, 123, 175, 195, 970

• alight at Blk 28 along Zion Road   5, 16, 75, 123, 175, 195, 970

By MRT:

• North-East line – Outram Park station

• East-West line – Outram Park or Tiong Bahru station

The post Bonsoy, Organic Soymilk By Nature’s Glory – Outram Park, Singapore appeared first on NAHMJ.

In Singapore, the Human Organ Transplant Act (HOTA) has allowed for the kidneys, liver, heart and cornea to be recovered in the event of death from any cause for the purpose of transplantation since 1 November 2009. And only patient with brain dead are illegible for this purpose. There is a good medical reason for this which we will discuss later. This topic arises my awareness due to my Dad who was in a dilemma on whether to opt out a not. His worry is mainly whether he will experience pain while his organs were removed. Moreover he heard stories of patients in US who were pronounced brain death were back to life. Is this a myth? Are our various concerns or rather worries unduly? I felt the need to understand more about this topic and so my search began.

What is Brain Death?

Brain Death is defined as the irreversible cessation of brain function. And so what does this mean to someone who is not medically trained in anyway. In simple term, the brain has stop functioning and is no longer sending signal to other part of the body. As such, the body stop functioning and the patient is dead.

Some possible causes of brain death include:

• Trauma to the brain (i.e. severe head injury)
• Cerebrovascular injury (i.e. stroke)
• Brain tumor

Criteria for Brain Death?

Per JAMA (The Journal of the American Medical Association) published in March 18, 2009—Vol 301, No. 11, the clinical criteria are defined as:

• No response to any stimulus—no movement, withdrawal, grimace, or blinking
• No breathing efforts when taken off the ventilator (the apnea test)
• Pupils dilated and not responsive to light
• No gag reflex, no corneal reflex (blinking when the surface of the eye is touched), and absence of other specific reflexes

The above mentioned is pretty similar to the criteria for pronouncing a cardiac death.

There is a list of test (examination-based clinical criteria) the physician will perform. First the pyhsician will check to see if the patient flinches in response to something that can cause pain, like pinching the skin. Next shines a light in the eyes to check for pupil dilation and  tickled the vocal chord to check for  coughing or gagging response.

And JAMA has listed some other tests that the doctors may be used along with the examination-based clinical criteria. Not all tests need to be used to declare brain death. It differs from country.

• Computed tomography (CT) scans of the brain may show abnormalities such as bleeding (hemorrhage), massive stroke, brain injury, or severe brain swelling (edema).
• Electroencephalography (EEG) records electrical brain activity. If brain death is present, the EEG will show no activity.
• Cerebral radionuclide injection shows no uptake of the radioactive material in the brain when a person is brain dead.

If you are interested to know the list of possible clinical examination that may perform, there is a list published in Indian J Crit Care Med. 2009 Jan-Mar for the purpose of educating the physicians in India on determining Brain Death. Click here to read on.

Coma Versus Brain Death

The general public are confused with Coma and Brain Death. We tend to lump them together and believe that they are referring the same.

Clinically, there is a list of criteria to diagnose one as in Coma versus Brain Death. In short the patient who is in Coma is with body function but is unconscious. The most obvious observation is hair and nail growth. And the patient will continue to produce urine and bowel.

Why Only Brain Death Patients Are Able To Donate Their Organ?

The heart has the ability to beat independently of the brain when oxygen is presence. When the breathing machine is not on, the heart will eventually stop beating too as the oxygen in the body will deplete since the patient no longer breathe on their own.

With the breathing machine, oxygen is provided to the organs until they were recovered for transplant. The machine is not keeping the patient alive, but merely keeping the organs viable.

Discussion

From the death criteria of brain death versus cardiac dead, they are very similar. Basically, as long as the patient no longer can breath on their own, pupil no longer response to light, these are sign of death. In addition, a comprehensive testing were carried out by doctor before determining brain death. We have to remember that coma and brain death are totally different. Life exist in the former but not the latter. There is lots of myth and incorrect understanding about brain death in the general public. Therefore I see that there is a gap in education as well.

References

Live On Support Organ Donation. Found in https://www.liveon.sg/content/moh_liveon/en/index.html

Understanding HOTA. Found in https://www.liveon.sg/content/moh_liveon/en/faq.html

Ajay Kumar Goila and Mridula Pawar. The diagnosis of brain death. Indian J Crit Care Med. 2009 Jan-Mar; 13(1): 7–11.

Streba I¹, Damian S, Ioan B. Medical and ethical dilemma in brain death. Rev Med Chir Soc Med Nat Iasi. 2012 Jul-Sep;116(3):731-8.

Taylor RM¹. Reexamining the definition and criteria of death. Semin Neurol. 1997;17(3):265-70.

Kerridge IH¹, Saul P, Lowe M, McPhee J, Williams D. Death, dying and donation: organ transplantation and the diagnosis of death. J Med Ethics. 2002 Apr;28(2):89-94.

Steven Laureys. Death, unconsciousness and the brain. Nature reviews Neuroscience (Impact Factor: 31.38). 12/2005; 6(11):899-909.

Jennett, B. & Plum, F. Persistent vegetative state after brain damage. A syndrome in search of a name. Lancet 1, 734–737 (1972).

Linda L. Emanuel, MD, PhD; Frank D. Ferris, MD; Charles F. von Gunten, MD, PhD; Joshua M. Hauser, MD; Jamie H. Von Roenn, MD. The Last Hours of Living: Practical Advice for Clinicians. Medscape Internal Medicine. March 24, 2015

Janet M. Torpy, MD et al. Brain Death. The Journal of the American Medical Association B.  March 18, 2009—Vol 301, No. 11.

Calixto Machado. Diagnosis of brain death. Neurol Int. 2010 Jun 21; 2(1): e2.

The post Brain Death – What Is It? appeared first on NAHMJ.

I remember sometimes in 2013, I got this cough which doesn’t stop. And I mean it. It will go on and on for minutes. At times, as a long as 5 minutes. These went on for as long as 2 months. Not only I could not talk but was out of breath. It hindered my work as I need to talk, talk at meetings, with my managers and peers and so on. It affected my quality of life, sleep and …  The list continues. I kept bugging my Family Physician to get it fixed. Nobody would want to end up in this manner. I hope it happens to no one and never.

What is Cough?

In the Murray & Nadel’s Textbook of Respiratory Medicine, it defines cough as “a series of respiratory maneuvers that leadds to a sudden explusion of air creating a characterist cough sound.”

Cough is not a diesease or illness but a symptom. This symptom could mean many other diseases depending on what other symptoms does the patient has.

It can be further classify to acute, sub-acute or chronic. Anything less than 3 weeks is considered acute, 3 – 8 weeks is sub-acute cough and > 8 weeks is chronic.

And you could be getting either a wet cough with phlegm or a dry cough (without phlegm).

What could it mean?

As per the many journal and medical website, it is always mentioned that cough is the most common symptoms that prompt patients to seek medical care. And it is no surprise since cough is such a nuisance that is disruptive to work and life.

Most importantly, what could it mean? And what are the causes?

Upper Respiratory Tract Infection / Post Infectious

When one is down with the common cold or flu, that is usually diagnose as Upper Respiratory Tract Infection. Other symptoms include sore throat, fever, running nose, and block nose.

Usually, when the patient recovers from the rest of the symptoms, cough persist for weeks. This is the Post Infectious phase but patient will soon recover.

Cough Characteristics: Either dry or wet cough is possible.

Lower Respiratory Tract Infection

When there is a secondary infection, the bacteria might gets further down the respiratory tract and may end up in the bronchi resulting in bronchitis. If worse, in the lung(s), that would mean pneumonia.

And when the patient is infected by Mycoplasma, Mycoplasma Pneumonia or also known as Atypical or Walking Pneumonia resulted. Such infection does not usually result in a full blown pneumonia. Usually, it is so mild till patient only has the flu-like symptoms. Patients would usually recover even without antibiotics. But with this infection, patients might cough up to a month. Usually the diagnosis of Mycoplasma Pneumonia is via a blood test.

Cough Characteristics: Initially a dry cough which after a few days turns to a wet cough with yellow, green, and/or red or rust-tinged mucus.

Postnasal drip

The Postnasal drip is now know as the the upper airway cough syndrome (UACS).

When mucus drip down to the throat (due to either allergies or a cold), it tickles the nerve endings and hence trigger cough. This type of cough is usually worse at night, especially upon lying down. One would feel the tickling feeling at the back of the throat. Itchy eyes and sneezing might accompanied if it is due to allergies.

Cough Characteristics: Can be either dry or wet cough.

Asthma

Most of us would imagine an Asthma flare up to be breathless, wheezing, the classic symptoms. Not many would associate this disease with cough or even only cough alone. In fact, cough is the most common symptom in asthma flare up and in particular in Cough Variant Asthma patient. This group of patient does not have that classic Asthma symptoms other than cough.

Cough Characteristics: A dry, non-productive cough.

COPD – Chronic Obstructive Pulmonary Disease

COPD is a lung disease with irreversible permanent lung tissue damages to almost the entire lower respiratory systems. The cause is usually due to cigarette smoking. Other symptoms may include  large amounts of mucus (a slimy substance), wheezing, shortness of breath, chest tightness, and other symptoms.

Cough Characteristics: A cough with mucus.

GERD – Gastroesophageal Reflux Diseas

Lesser known is the Gastric Reflux. This is acutally the second most common cause for the chronic cough.

Several mechanisms may result in the cough caused by GERD. The explanation can get too technical. In short the gastric juice that gets into any part of the throat, the body is reacting to it with a cough since it is a considered as a foreign particle as the gastric juice is not suppose to appear in this area. At times, patients with GERD might not experience heartburn but only cough.

Cough Characteristics: Chronic hacking cough with mucus produced, particularly in the morning

ACE Inhibitors

The percentage varies from research to research. It is noted as high as 35% of patients on ACE Inhibitors begin to cough a few weeks into the medication.

Cough Characteristics: Dry Cough

Whooping cough (pertussis)

Pertusis is a contagious bacterial disease. This should be rare in most countries due to vaccines that was introduced in the 1940s. But according to CDC, US is reported seeing an increase in Pertussis cases since 2012.

Cough Characteristics: Intense severe hacking cough that may end up throwing up or turn red or blue with ending whooping sounds.

Other Less Common Causes

The other less common causes might be due to Heart diseases, Abnormal swallowing, Lung cancer and Stress.

When to worry?

When you cough for more than 8 weeks, coughing up blood, feeling breathless, chest tightness, having a persistent fever, wheeze, greenish or rusty mucus

Discussion

The symptoms of the various causes can prove too similar, to avoid incorrect self diagnose, seek prompt medical attention.

At the doctors office, when the cough is more than 8 weeks, a Chest X-Ray, blood test and detailed medical history will be taken for the evaluation of the diagnosis and coming up with the treatment plan for the patient.

References

V.Courtney Broaddus, Robert C Mason, Joel D Ernst, Talmadge E King Jr., Stephen C. Lazarus, John F. Murray, Jay A. Nadel, Arthur Slutsky, Michael Gotway. Murray & Nadel’s Textbook of Respiratory Medicine. 

Peter V Dicpinigaitis^1*, Gene L Colice², Mary Jo Goolsby³, Gary I Rogg¹, Sheldon L Spector⁴ and Birgit Winther⁵. Acute cough: a diagnostic and therapeutic challenge. Cough Journal

Overlack A. ACE inhibitor-induced cough and bronchospasm. Incidence, mechanisms and management. Drug Saf. 1996 Jul;15(1):72-8.

Dicpinigaitis PV¹. Angiotensin-converting enzyme inhibitor-induced cough: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):169S-173S.

Pertussis Outbreak Trends. Found in http://www.cdc.gov/pertussis/outbreaks/trends.html

Akio Niimi^* Cough and Asthma. Curr Respir Med Rev. 2011 Feb; 7(1): 47–54.

Irwin RS¹. Chronic cough due to gastroesophageal reflux disease: ACCP evidence-based clinical practice guidelines. Chest. 2006 Jan;129(1 Suppl):80S-94S.

Irwin RS¹, Madison JM. Anatomical diagnostic protocol in evaluating chronic cough with specific reference to gastroesophageal reflux disease. Am J Med. 2000 Mar 6;108 Suppl 4a:126S-130S.

Lazenby JP¹, Harding SM. Chronic cough, asthma, and gastroesophageal reflux. Curr Gastroenterol Rep. 2000 Jun;2(3):217-23.

Tokayer AZ¹. Gastroesophageal reflux disease and chronic cough. Lung. 2008;186 Suppl 1:S29-34. doi: 10.1007/s00408-007-9057-3. Epub 2008 Jan 24.

Sidney S. Braman, MD, FCCP. Postinfectious Cough ACCP Evidence-Based Clinical Practice Guidelines. CHEST 2006; 129:138S–146S

Mycoplasma pneumonia. Found in http://www.nlm.nih.gov/medlineplus/ency/article/000082.htm

Chronic Obstructive Pulmonary Disease (COPD). Found in http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022631/

JOSEPH J. BENICH III, MD, and PETER J. CAREK, MD, MS, Medical University of South Carolina, Charleston, South Carolina. Evaluation of the Patient with Chronic Cough.

A.H. Morice, G.A. Fontana, A.R.A. Sovijarvi, M. Pistolesi, K.F. Chung, J. Widdicombe, F. O9Connell, P. Geppetti, L. Gronke, J. De Jongste, M. Belvisi, P. Dicpinigaitis, A. Fischer, L. McGarvey, W.J. Fokkens, J. Kastelik. The diagnosis and management of chronic cough. Eur Respir J 2004; 24: 481–492

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