Category Archives: EZ 62 – Medical


by Dr Tan Kenny – Consultant Neurologist & Physician 

(Subspecialty in Parkinson’s Disease & Movement Disorders)

Having sudden facial or limb weakness and numbness?
Sudden slurred speech or drooling?
Sudden blurred vision?
Is that a concern?
What is going on with your body?

Stroke is preventable and treatable. It is important to recognise early stroke symptoms and BE FAST to act during the golden hour so that immediate emergency stroke treatment can be initiated to reduce brain injury.

Stroke occurs when there is reduced blood supply to the brain. In general, stroke can be classified based on the etiology of reduced blood supply, i.e. ischemic (blockage) and hemorrhagic (bleed). Ischemic stroke is the most common type of stroke. Symptoms suggestive of stroke include sudden poor balance, visual problems, face or limb weakness or numbness, speech difficulty. An easy acronym to remember is BE FAST (Balance Difficulties, Eyesight Changes, Face Weakness, Arm Weakness, Speech Difficulties, Time to call for help).

Around 2 million brain cells die every minute during acute stroke, increasing the risk of permanent brain damage, disability or death. Thus, it is pertinent to identify stroke early so that the necessary medical treatment can be implemented.

Upon reaching the hospital, the neurologist will initiate emergency stroke assessment to establish the diagnosis of ischemic stroke before initiating acute stroke treatment. One such treatment is thrombolytic therapy, i.e., administration of a ‘clot buster’ medication to dissolve blood clots that have blocked the arteries in the brain causing stroke, in the hopes of breaking the clot to reperfuse and return blood flow to the affected brain cells. To be effective, the therapy needs to be initiated as soon as possible within the golden hour (4.5 hours from the onset of symptoms), before permanent irreversible damage has occurred.

For ischemic stroke patients who arrive beyond the treatment window period (>4.5 hours) and not suitable for acute thrombolytic therapy, appropriate investigations and medical treatment to stabilise patient will be initiated i.e. blood thinners, blood pressure and blood sugar control. The first three months after a stroke are the most important for recovery as patients will see the most improvement. Thus, besides providing best medical treatment, patient will require neuro-rehabilitation i.e. physiotherapy, occupational therapy and speech therapy.

Stroke can be debilitating but the bright side is it can be prevented and may be attributed to modifiable and non-modifiable risk factors

In Malaysia, hypertension was the most common risk factor followed by diabetes mellitus. Modifiable risk factors are the focus of primary prevention and they include the following risk factors:

a) Lifestyle, i.e., smoking, unhealthy diet, lack of physical activity.

b) Metabolic, i.e., hypertension, diabetes, high cholesterol, obesity (measured by high body mass index or BMI)

c) Environmental, i.e., stress, air pollution.

Many are not aware that stroke can recur. The recurrence rates are 3-4% in the first month and 12% in the first year after a stroke. This emphasises the importance of secondary stroke prevention, and this may involve medical interventions including anti-platelet therapy, anti-hypertensive treatment, cholesterol and blood sugar control. Besides compliance to medication, lifestyle modification plays a vital role.

It is recommended to maintain an active lifestyle by exercising 30 mins daily or at least 150 mins per week, stop smoking, avoid heavy alcohol drinking and healthy diet. Mediterranean diet (low glycemic with high intake of vegetables) supplemented with nuts, diet high in fruits and leafy green vegetables are beneficial. It is also recommended to follow the Dietary Approaches to Stop Hypertension (DASH diet) to reduce blood pressure, emphasising on high consumption of fruits, vegetables, whole grains, low-fat dairy foods, legumes and nuts, and low intake of sodium, sweetened beverages, and red and processed meat.

In Malaysia, there is still lack of awareness in regards to recognition of stroke symptoms and the significance of time-sensitive stroke treatment. As a result, delay in early intervention may lead to prolonged hospital stay and increase of stroke-related morbidities and mortality. BE FAST to ensure better outcome as time loss is brain loss in acute stroke. Stroke strikes fast, so should you.

Dr Tan Kenny is a Consultant Neurologist and Physician at LohGuanLye Specialists Centre. He has vast experience in diagnosing and managing stroke, dementia, headaches, Parkinson’s and various other neurological conditions. He established the emergency neurology stroke service at LohGuanLye Specialists Centre and obtained the World Stroke Organization (WSO) Angels Award Platinum Status for the hospital’s stroke service. He is committed to creating awareness, education and holds the position as the Medical Advisor for the Penang Parkinson’s and Rehabilitation Association.


by Dr Mecherl Lim 

MD (MA) Naturopath (ND), Holistic Kinesiology

How a series of sleep loss impacts mental & physical wellbeing
Three consecutive nights of sleep loss can have a negative impact on our mental and physical health and cause both to greatly deteriorate. Sleep deprivation can lead to an increase in anger, frustration, anxiety and a weakened immune system and amongst others.

A new study published in Annals of Behavioural Science looked at the consequences of sleeping fewer than six hours for eight consecutive nights – six hours is the minimum duration of sleep that experts say is necessary to support optimal health in average adults.

Lead author Soomi Lee, Assistant Professor in the School of Aging Studies at the University of South Florida, found the biggest jump in symptoms appeared after just one night of sleep loss. In a study by the University, the number of mental of physical problems steadily got worse, peaking on day three. At that point, the research showed that the human body has gotten relatively used to repeated sleep loss. But all that changed on day six, when participants reported that the severity of physical symptoms was at its worst.

Many of us think that we can pay back our ‘sleep debt’ on weekends and be more productive during the week. However, results from this study shows that having just one night of sleep loss can significantly impair your daily mental abilities and functioning.

Data provided by the Midlife, included a study of nearly 2,000 middle-aged adults who were relatively healthy and well-educated. Among them, 42 percent had at least one night of sleep loss, sleeping one and a half hours than typical routines.

They recorded their mental and physical behaviours in a journal for eight consecutive days, allowing researchers to review, how SLEEP LOSS causes wear and tear on the body.

Participants reported a pile-up of angry, nervous, lonely, irritable and frustrated feelings as a result of sleep loss. They also experienced more physical symptoms, such as upper respiratory issues, aches and pain, gastrointestinal problems, and other health concerns.

These negative feelings and symptoms were continuously elevated throughout consecutive sleep loss days and did not return to baseline levels unless they had a night’s sleep of more than six hours.

About one third of adults sleep less than six hours per night. Once that becomes a habit, it’s increasingly difficult for your body to fully recover from lack of sleep, continuing the vicious cycle of worsening daily wellbeing, which could impact one professionally.

A previous study led by author Sommi found losing just 16 minutes of sleep could impact job performance. Her previous findings also showed that minor sleep loss can decrease daily mindfulness, which is a critical recourse for managing stress and maintaining healthy routines.

So, I would advise the best way to maintain a strong daily performance is to set aside more than SIX HOURS of SLEEP NIGHTLY.

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