Liver Cancer

Also called: Hepatocellular carcinoma

Your liver is the largest organ inside your body. It filters harmful substances from the blood, digests fats from food and stores the sugar that your body uses for energy. Primary liver cancer starts in the liver. Metastatic liver cancer starts somewhere else and spreads to your liver.

• Risk factors for primary liver cancer include
• Having hepatitis
• Having cirrhosis, or scarring of liver
• Being male
• Low weight at birth

Symptoms can include a lump or pain on the right side of your abdomen and yellowing of the skin. However, you may not have symptoms and the cancer may not be found until it is advanced. This makes it harder to treat. Treatment options include surgery, radiation, chemotherapy or liver transplantation.

Hepatitis B

Also called: HBV

Hepatitis B is one type of hepatitis – a liver disease- caused by the hepatitis B virus (HBV). Hepatitis B spreads by contact with an infected person's blood, semen or other body fluid. An infected woman can give hepatitis B to her baby at birth.

If you get HBV, you may feel as if you have the flu, or you may have no symptoms at all. A blood test can tell if you have it. HBV usually gets better on its own after a few months. If it does not get better, it is called chronic HBV, which lasts a lifetime. Chronic HBV can lead to scarring of the liver, liver failure or liver cancer.

There is a vaccine for HBV. It requires three shots. All babies should get the vaccine, but older children and adults can get it too. If you travel to countries where Hepatitis B is common, you should get the vaccine.

Hepatitis A

Also called: HAV

Hepatitis A is one type of hepatitis - a liver disease - caused by the hepatitis A virus (HAV). The disease is spread primarily through food or water contaminated by stool from an infected person. You can get HAV from

• Eating food prepared by someone with HAV who did not wash their hands after using the bathroom
• Having anal/oral sex with someone with HAV
• Not washing your hands after changing a diaper
• Drinking contaminated water

HAV can cause swelling of the liver, but it rarely causes lasting damage. You may feel as if you have the flu, or you may have no symptoms at all. It usually gets better on its own after several weeks.

The hepatitis A vaccine can prevent HAV. Healthy habits also make a difference. Wash your hands thoroughly before preparing food, after using the toilet or after changing a diaper. International travelers should be careful about drinking tap water.

Hepatitis

Also called: Viral hepatitis

Your liver helps your body digest food, store energy and remove poisons. Hepatitis is a swelling of the liver that makes it stop working well. It can lead to scarring, called cirrhosis, or to cancer.

Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; for example, hepatitis A, hepatitis B or hepatitis C. Drug or alcohol use can also lead to hepatitis. In other cases, your body mistakenly attacks its own tissues. You can help prevent some viral forms by getting a vaccine. Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime.

Some people who have hepatitis have no symptoms. Others may have

• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Dark-colored urine and pale bowel movements
• Stomach pain
• Jaundice, yellowing of skin and eyes

Hepatitis C

Also called: HCV

Hepatitis C is one type of hepatitis - a liver disease - caused by the hepatitis C virus (HCV). It usually spreads through contact with infected blood. It can also spread through sex with an infected person and from mother to baby during childbirth.

Most people who are infected with hepatitis C don't have any symptoms for years. A blood test can tell if you have it. Usually, hepatitis C does not get better by itself. 

The infection can last a lifetime and may lead to scarring of the liver or liver cancer. Medicines sometimes help, but side effects can be a problem. Serious cases may need a liver transplant. There is no vaccine for HCV.

AIDS and Infections

Also called: AIDS-related opportunistic infections, OIs

Having AIDS weakens your body's immune system. Your immune system normally fights germs that enter your body. When AIDS makes it weak, it can't fight germs well. This can lead to serious infections that don't often affect healthy people. These are called opportunistic infections (OIs).

There are many types of OIs. Tuberculosis and a serious related disease, mycobacterium avium complex (MAC) are bacterial infections. Viral infections include cytomegalovirus (CMV) and hepatitis C. Fungi cause thrush (candidiasis), cryptococcal meningitis, pneumocystis carinii pneumonia (PCP) and histoplasmosis, and parasites cause crypto (cryptosporidiosis) and toxo (toxoplasmosis).

Having AIDS can make any infection harder to treat. People with AIDS are also more likely to suffer complications of common illnesses such as the flu.

The good news is that you can help prevent infections by taking your AIDS medicines. Other things that can help include practicing safe sex, washing your hands well and often and cooking your food well.

Smallpox

Smallpox is a disease caused by the Variola major virus. Some experts say that over the centuries it has killed more people than all other infectious diseases combined. Worldwide immunization stopped the spread of smallpox three decades ago. The last case was reported in 1977. Two research labs still house small amounts of the virus. Experts fear bioterrorists could use the virus to spread disease.

Smallpox spreads very easily from person to person. Symptoms are flu-like and include high fever, fatigue and headache and backache, followed by a rash with flat red sores.

The U.S. stopped routine smallpox vaccinations in 1972. Military and other high-risk groups continue to get the vaccine. The U.S. has increased its supply of the vaccine in recent years. The vaccine makes some people sick, so doctors save it for those at highest risk of disease.

Viral Infections

Viruses are capsules with genetic material inside. They are very tiny, much smaller than bacteria. Viruses cause familiar infectious diseases such as the common cold, flu and warts. They also cause severe illnesses such as AIDS, smallpox and hemorrhagic fevers.

Viruses are like hijackers. They invade living, normal cells and use those cells to multiply and produce other viruses like themselves. This eventually kills the cells, which can make you sick.

Viral infections are hard to treat because viruses live inside your body's cells. They are "protected" from medicines, which usually move through your bloodstream. Antibiotics do not work for viral infections. There are a few antiviral medicines available. Vaccines can help prevent you from getting many viral diseases.

Hemorrhagic Fevers

Also called: VHFs

Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses. These include the Ebola and Marburg viruses and Lassa fever virus. VHFs have common features: they affect many organs, they damage the blood vessels and they affect the body's ability to regulate itself. Some VHFs cause mild disease, but some, like Ebola or Marburg, cause severe disease and death.

VHFs are found around the world. Specific diseases are usually limited to areas where the animals that carry them live. For example, Lassa fever is limited to rural areas of West Africa where rats and mice carry the virus.

The risk for travelers is low, but you should avoid visiting areas where there are disease outbreaks. Because there are no effective treatments for some of these viral infections, there is concern about their use in bioterrorism.

Dengue

Also called: Break-bone fever, Dengue fever

Dengue is an infectious disease caused by a virus. You can get it if an infected mosquito bites you. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States.

Symptoms include a high fever, headaches, joint and muscle pain, vomiting and a rash. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. Sometimes dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening.

To lower your risk when traveling in dengue-prone countries

• Wear insect repellent with DEET
• Wear clothes that cover your arms, legs and feet
• Close unscreened doors and windows

Prevent H1N1

Practice good hygiene to prevent the spread of the virus.

Influenza A (H1N1) FAQ

What is the A (H1N1) influenza?

It is a respiratory disease of pigs caused by type A strains of the influenza virus. It regularly causes high flu outbreaks in pigs but with low death rates. There are four main sub-types of the virus, but the most recent isolated influenza viruses from pigs have been H1N1 viruses.

How does it spread?

Influenza A (H1N1) viruses do not typically infect humans though they do occur through close proximity or contact with infected pigs or contaminated areas. Cases of human-to-human spread have been documented.

What are the symptoms?

The symptoms are similar to those of regular flu:
- Fever
- Lethargy
- Runny nose
- Cough
- Sore throat
- Lack of appetite
- Vomiting and diarrhoea in some cases.

How common is the A (H1N1) flu infection in humans?

In the past reports of about one human A(H1N1) flu virus infection had been received every one to two years in the United States. From December 2005 till February 2009, 12 cases have been reported.

Has this strain of flu been seen before?

No. Flu mutates constantly, so it is common for new strains to emerge. Pigs can also be infected with both human and avian influenza, and the current circulating A (H1N1) flu strain appears to contain genetic elements from all three.

Can the A (H1N1) flu be treated with antiviral drugs and flu vaccine?

The A (H1N1) flu is resistant to two common drugs – Amantadine and Rimantadine. The A (H1N1) flu viruses are very different from human H1N1 viruses. Therefore, vaccines for human seasonal flu would not provide protection. However, a “seed vaccine” has been specifically tailored to this swine flu and will be manufactured if officials deem it necessary.

Can people catch A (H1N1) flu by eating pork?

No. The A (H1N1) influenza viruses are not transmitted by food. Eating properly handled and cooked pork and pork products is safe. Cooking pork to an internal temperature of 70ºC and above kills the swine flu virus.

How long is someone with the A (H1N1) flu considered contagious?

People with the A (H1N1) influenza virus infection should be considered potentially contagious as long as they are symptomatic; possibly for up to seven days following the onset of the illness. Children, especially younger children, might potentially be contagious for longer periods.

What can I do to protect myself from the A (H1N1) flu?

There is no vaccine available right now to protect against the A (H1N1) flu.

However, you can help prevent the spread of germs that cause respiratory illnesses like influenza by:

- Covering your nose and mouth with a disposable tissue or handkerchief when you cough or sneeze. Throw the tissue in the waste basket after you use it.

- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also helpful

- Try to avoid close contact with sick people. - If you get sick with influenza, stay at home and limit contact with others to keep from infecting them.

- Avoid touching your eyes, nose or mouth.

- Consult your nearest healthcare facility if you think you have any of the symptoms.

What precautions are in place in Malaysia?

- The Health Ministry’s operations room in Putrajaya has started a 24-hour monitoring of the situation. The public can call 03-8881 0200/300 for enquiries.

- Those returning from Latin American countries and found to have flu-like symptoms will be quarantined.

- Health Ministry officials are conducting health screenings on passengers arriving from the United States.

- Thermal scanners will be placed at international airports to speed up the screening process for A (H1N1) flu.

- Public and private medical practitioners have been instructed to report to the district health office any patient with influenza-like illnesses or severe pneumonia symptoms and who had travelled to the affected countries after April 17.

- Travel Advisory from the foreign ministry

Where can I get more information?

For more information, go to the Health Ministry (www.moh.gov.my) or call the Ministry's hotline at (03) 8881-0200/300.

Case Definitions for Infection with Novel Influenza A (H1N1) Virus

A confirmed case of novel influenza A (H1N1) virus infection is defined as a person with an influenza-like illness with laboratory confirmed novel influenza A (H1N1) virus infection by one or more of the following tests:

• real-time RT-PCR
• viral culture

Medical care for patients with novel influenza A (H1N1) virus

Not all patients with suspected novel influenza (H1N1) infection need to be seen by a health care provider.For most people, the illness appears to be mild and self-limiting. Cases have been confirmed in all age groups, but children and younger people seem to be much more likely to be affected, whereas fewer cases have been confirmed to date in older adults.

For a minority of people, influenza A(H1N1) has caused severe illness with complications. In many, but not all, of these cases underlying risk factors (co-morbidities # ) have been identified that are likely to have contributed to the severity of the condition.

Complications of Influenza:

The following are the recognized complications of influenza. At times these complications, such as an exacerbation of chronic airways disease, may be the presenting symptom. Respiratory complications are the most common ones (especially secondary infections). Cardiac events following influenza are not uncommon.

Complications of influenza	Major clinical category
Respiratory	Pneumonia: primary viral, secondary bacterial, combined Upper respiratory: otitis media, sinusitis, conjunctivitis Acute laryngotracheo-bronchitis (croup) Bronchiolitis Complication of pre-existing disease
Cardiovascular	Myocarditis Pericarditis
Muscular	Rhabdomyositis Rhabdomyolysis with myoglobinuria and renal failure
Neurological	Encephalitis Reye’s syndrome Guillain-Barré syndrome Transverse myelitis
Systemic	Toxic shock syndrome Sudden death

# Co-morbidities / Risk factors:

Patients who are considered vulnerable to severe outcomes and should be a focus of early identification, assessment and treatment, include the following:

• Chronic respiratory conditions, including asthma, COPD, Obstructive sleep apnoea
• Pregnant women, esp. in second or third trimester
• Morbid obesity
• Other possible predisposing conditions, such as chronic cardiac disease (not simple hypertension), and chronic illnesses including diabetes mellitus, renal failure, haemoglobinopathies, immunosuppression (including cancer, HIV/AIDS, chemotherapy, long term steroids).
• Adults > 65 years of age esp. those with other chronic diseases
• Children under the age of 5 years, esp. those below the age of 2 years

As more epidemiologic and clinical data become available, these risk groups might be revised.

Stomach Cancer

Also called: Gastric cancer

Stomach cancer mostly affects older people – two-thirds of people who have it are over age 65. Your risk of getting it is also higher if you

• Have had a Helicobacter pylori infection

• Have had stomach inflammation

• Are a man

• Eat lots of salted, smoked, or pickled foods

• Smoke cigarettes

• Have a family history of stomach cancer

It is hard to diagnose stomach cancer in its early stages. Indigestion and stomach discomfort can be symptoms of early cancer, but other problems can cause the same symptoms. In advanced cases, there may be blood in your stool, vomiting, unexplained weight loss, jaundice or trouble swallowing.

Because it is often found late, it can be hard to treat stomach cancer. Treatment options include surgery, chemotherapy, radiation or a combination.

Intestinal Cancer

Also called: Duodenal cancer, Ileal cancer, Jejunal cancer, Small intestine cancer

Your small intestine is part of your digestive system. It is a long tube that connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet or having Crohn's disease, celiac disease, or a history of colonic polyps can increase your risk.

Abdominal pain or lumps, weight loss for no reason or blood in the stool can be symptoms. Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and show whether it has spread.

Surgery is the most common treatment. Additional options include chemotherapy, radiation or a combination.

Cancer

Also called: Carcinoma, Malignancy, Neoplasms, Tumor

Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms new cells as you need them, replacing old cells that die. Sometimes this process goes wrong. New cells grow even when you don't need them, and old cells don't die when they should. These extra cells can form a mass called a tumor. Tumors can be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors can invade nearby tissues. They can also break away and spread to other parts of the body.

Most cancers are named for where they start. For example, lung cancer starts in the lung, and breast cancer starts in the breast. The spread of cancer from one part of the body to another is called metastasis. Symptoms and treatment depend on the cancer type and how advanced it is. Treatment plans may include surgery,radiation and/or chemotherapy.

Lung Cancer

Also called: Bronchogenic carcinoma

Lung cancer is one of the most common cancers in the world. It is a leading cause of cancer death in men and women in the United States. Cigarette smoking causes most lung cancers. The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. High levels of pollution, radiation and asbestos exposure may also increase risk.

Common symptoms of lung cancer include

• A cough that doesn't go away and gets worse over time

• Constant chest pain

• Coughing up blood

• Shortness of breath, wheezing, or hoarseness

• Repeated problems with pneumonia or bronchitis

• Swelling of the neck and face

• Loss of appetite or weight loss

• Fatigue

There are many types of lung cancer. Each type of lung cancer grows and spreads in different ways and is treated differently. Treatment also depends on the stage, or how advanced it is. Treatment may include chemotherapy, radiation and surgery.

Lung Diseases

When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.

The term lung disease refers to many disorders affecting the lungs, such as asthma, chronic obstructive pulmonary disease, infections like influenza, pneumonia andtuberculosis, lung cancer, and many other breathing problems.

H1N1 Flu (Swine Flu)

Also called: Swine flu

Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.

There are antiviral medicines you can take to prevent or treat swine flu. There is a vaccine available to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by

• Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.

• Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners.

• Avoiding touching your eyes, nose or mouth. Germs spread this way.

• Trying to avoid close contact with sick people.

• Staying home from work or school if you are sick.

Bird Flu

Also called: Avian flu, Avian influenza, H5N1

Birds, just like people, get the flu. Bird flu viruses infect birds, including chickens, other poultry and wild birds such as ducks. Most bird flu viruses can only infect other birds. However, bird flu can pose health risks to people. The first case of a bird flu virus infecting a person directly, H5N1, was in Hong Kong in 1997. Since then, the bird flu virus has spread to birds in countries in Asia, Africa and Europe.

Human infection is still very rare, but the virus that causes the infection in birds might change, or mutate, to more easily infect humans. This could lead to a pandemic, or a worldwide outbreak of the illness.

During an outbreak of bird flu, people who have contact with infected birds can become sick. It may also be possible to catch bird flu by eating poultry that is not well cooked or through contact with a person who has it. Bird flu can make people very sick or even cause death. There is currently no vaccine.

Asthma in Children

Also called: Childhood asthma

Asthma is a chronic disease that causes the airways - the tubes that carry air in and out of your lungs - to become sore and swollen. In the United States, about 20 million people have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night.

Many things can cause asthma, including

• Allergens - mold, pollen, animals

• Irritants - cigarette smoke, air pollution

• Weather - cold air, changes in weather

• Exercise

• Infections - flu, common cold

When asthma symptoms become worse than usual, it is called an asthma attack. Asthma is treated with two kinds of medicines: quick-relief medicines to stop asthma symptoms and long-term control medicines to prevent symptoms.

Asthma

Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that you are allergic to or find irritating. When your airways react, they get narrower and your lungs get less air. This can cause wheezing, coughing, chest tightness and trouble breathing, especially early in the morning or at night.

When your asthma symptoms become worse than usual, it's called an asthma attack. In a severe asthma attack, the airways can close so much that your vital organs do not get enough oxygen. People can die from severe asthma attacks.

Asthma is treated with two kinds of medicines: quick-relief medicines to stop asthma symptoms and long-term control medicines to prevent symptoms.

Kidney anatomy

The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and stimulating red blood cell production.

Urine and Urination

Your kidneys form urine by filtering wastes and extra water from the bloodstream. The waste is called urea. It is carried in the bloodstream to the kidneys. From the kidneys, urine travels down two thin tubes called ureters to the bladder. The bladder stores urine until you are ready to go to the bathroom. It swells into a round shape when it is full and gets smaller when empty. If your urinary system is healthy, your bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours.

You may have problems with urination if you have

• Kidney failure

• Urinary tract infections

• Prostate enlargement

• Bladder control problems like incontinence or interstitial cystitis

• A blockage that prevents you from emptying your bladder

Some conditions may also cause you to have blood or protein to be in your urine. If you have a urinary problem, see your healthcare provider. Treatment depends on the cause.

Male urinary system

The urinary system is made up of the kidneys, ureters, urethra and bladder.

Prostate Diseases

The prostate is a gland. It helps make semen, the fluid that contains sperm. The prostate surrounds the tube that carries urine away from the bladder and out of the body. A young man's prostate is about the size of a walnut. It slowly grows larger with age. If it gets too large, it can cause problems. This is very common after age 50. The older men get, the more likely they are to have prostate trouble.

Some common problems are

• Prostatitis - an infection, usually caused by bacteria
• Benign prostatic hyperplasia, or BPH - an enlarged prostate, which may cause dribbling after urination or a need to go often, especially at night
• Prostate cancer - a common cancer that responds best to treatment when detected early

Kidney Stones

Also called: Nephrolithiasis

A kidney stone is a solid piece of material that forms in the kidney from substances in the urine. It may be as small as a grain of sand or as large as a pearl. Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not go away. It may get stuck in the urinary tract, block the flow of urine and cause great pain.

The following may be signs of kidney stones that need a doctor's help:

• Extreme pain in your back or side that will not go away
• Blood in your urine
• Fever and chills
• Vomiting
• Urine that smells bad or looks cloudy
• A burning feeling when you urinate

Kidney Diseases

Also called: Renal disease

Your kidneys are two bean-shaped organs, each about the size of your fists. They are located near the middle of your back, just below the rib cage. Inside each kidney about a million tiny structures called nephrons filter blood. They remove waste products and extra water, which become urine. The urine flows through tubes called ureters to your bladder, which stores the urine until you go to the bathroom.

Damage to the nephrons results in kidney disease. This damage may leave kidneys unable to remove wastes. Usually the damage occurs slowly over years. There are no obvious symptoms, so you don't know it is happening.

Many things can cause kidney disease. You are at risk if you have

• Diabetes
• High blood pressure
• A close family member with kidney disease

Your doctor can run tests to find out if you have kidney disease. If your kidneys fail completely, a kidneys transplant or dialysis can replace the work your kidneys normally do.

Kidney Cancer

Also called: Hypernephroma, Renal cancer

You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys. It happens most often in people over 40. Risk factors include smoking, having certain genetic conditions and misusing pain medicines for a long time.

Often, kidney cancer doesn't have early symptoms. However, see your health care provider if you notice

• Blood in your urine
• A lump in your abdomen
• Unexplained weight loss
• Pain in your side
• Loss of appetite

Treatment depends on your age, your overall health and how advanced the cancer is. It might include surgery, radiation, chemotherapy or biologic therapy. Biologic therapy boosts your body's own ability to fight cancer.