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Article 1 : Is It Safe to do any surgery after stenting?http://www.medscape.com/viewarticle/812181?t=1 Safety of Noncardiac Surgery After Stenting www.medscape.com. For patients undergoing noncardiac surgery who previously received either a bare-metal and drug-eluting stent, there is a high risk of MACE, but the risk levels off at six months. WHAT IS MACE ? MAJOR ADVERSE CARDIOVASCULAR EVENTS. IN DETAIL: BIRMINGHAM, AL — For patients undergoing noncardiac surgery within two years of receiving a coronary stent, only those undergoing emergency surgery and those with advanced heart disease were at an increased risk of major adverse cardiovascular events (MACE), according to the results of a new study. In contrast, those who had a stent implanted at least six months before undergoing noncardiac surgery were not at an increased risk of MACE, nor did the type of stent used influence the risk of adverse events, report investigators. "The main thing we found is that surgery happened very often in that first year after a coronary stent," said lead investigator Dr Mary Hawn (University of Alabama, Birmingham). "Whether it was a bare-metal stent or a drug-eluting stent [DES], the rate of adverse events wasn't different by the type of stent implanted, either overall or by when the stent was implanted. The guidelines would suggest that six weeks after a bare-metal stent, the risk goes down, and after one year for a drug-eluting stent the risk goes down, but we found that both stents were associated with a high risk early on, and by about six months the risk seemed to hit baseline." The study, a large, national, retrospective analysis of nearly 42 000 patients, is published online October 7, 2013 in the Journal of the American Medical Association. Wait One Year Before Surgery After Receiving DES Speaking with heartwire , Hawn said the potential risk of MACE among stented patients undergoing surgery within the first year after stent implantation has been an issue among cardiologists and surgeons and was thought to be related to stopping dual antiplatelet therapy. In 2007, the clinical guidelines were revised to recommend that patients who receive a DES continue with dual antiplatelet therapy for at least one year and that surgery should be delayed, if at all possible, within this first year. If surgery couldn't be delayed, then it should continue without the patient stopping dual antiplatelet therapy. "However, this is really based on limited data, including case reports, and there really hasn't been a large or national study looking at the true rate of cardiovascular events," said Hawn. "So we undertook this study to get a better estimate of the real risk, when the risk was the highest, and what other factors contributed to that risk." The researchers conducted a retrospective cohort analysis of 41 989 patients in the Veterans Affairs (VA) and Centers for Medicare and Medicaid Services (CMS) systems undergoing noncardiac surgery within two years of receiving a stent. Between 2000 and 2010, there were 124 844 stents implanted and of these treated patients, 22.5% underwent noncardiac surgery within the first two years. For the 28 029 patients who underwent surgery, there were 41 989 surgeries performed. Within the first 30 days after surgery, there were 1170 nonfatal MIs or nonfatal coronary revascularizations, 141 fatal MIs or fatal coronary revascularizations, and 669 deaths. For those who had surgery within the first six weeks of stent implantation, the MACE rate was 11.6%. For those who had surgery from six weeks to less than six months after receiving the stent, the MACE rate was 6.4%. Between six months and less than one year and between one and two years, the MACE rates were 4.2% and 3.5%, respectively. The risk of MACE was also significantly higher among patients treated with a bare-metal stent vs those treated with a DES (5.1% vs 4.3%, p<0.001). However, in a multivariate, risk-adjusted model, only admission for emergency surgery, a history of MI in the six months preceding surgery, and a revised cardiac index >2 were significantly associated with an increased risk of MACE. After six months, Hawn said it didn't matter what type of stent was implanted. Instead, the patient's risk, their MI history, and whether or not they were undergoing an emergent procedure were more important variables. For surgeons, when assessing whether or not it is safe to operate on a patient who has received a coronary stent, the timing of when they received the stent isn't as important as these other factors. "Our paper is obviously limited in that patients weren't randomized by the type of stent, so there is some decision-making in terms of the type of stent going in," Hawn told heartwire . "Still, the risk with a bare-metal stent remains elevated longer than just in the first six weeks. We need to keep that in the back of our mind. For patients who've been revascularized, if they've had a recent MI, they're going to be at a higher risk for longer than six weeks." And for those with a bare-metal stent, the results suggest that operating within the first year can be safe, said Hawn. Surgery After Six Months Appears Safe
ArtAssist® device model AA-1000 increases arterial blood flow to the limbs of patients with arterial obstruction. This is achieved by rapid compression of the soft tissues of the foot, ankle and calf. The ArtAssist® device rapidly empties the veins and reduces venous pressure. The reduced venous pressure results in an increased driving pressure to greatly improve arterial blood flow.
For the medical treatment of non-surgical patients with PAD
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Connect the power cord to the side of the control unit.
Connect cuff tubing to the side panel of the ArtAssist® device.
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Indications for Use
For improving blood circulation in the limbs in non-surgical
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Acute Deep Venous Thrombosis (DVT), suspected or diagnosed
Increased pain with ArtAssist® device operating or with worsening skin tissue condition
During episodes of inflammatory phlebitis or pulmonary embolism
When increased venous or lymphatic return is undesirable including presumptive evidence of congestive heart failure
Contraindications for Use
US pat. no. 5,218,954. Israel pat. no. 106,258. RSA pat. no. 93/4841. Other US and foreign pat.’s pending.
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L 5.67 Rev. New, 04/02/13
DO NOT WAIT FOR CHEST PAINS.
HEART ATTACK CAN BE PREVENTED, REVERSED AND ELIMINATED WITHOUT SURGERY. START NOW.
FDA warning: Stress test linked to Heart Attack and death.
November 20, 2013
FDA: Stress Test Agents Linked to Possible Heart Attack, Death
FDA: Stress Test Agents Linked to Possible Heart Attack, Death
FDA: Stress Test Agents Linked to Possible Heart Attack, Death
The FDA is warning healthcare professionals of the rare but serious risk of heart attack and death associated with the use of Lexiscan (regadenoson; Astellas) and Adenoscan (adenosine; Hospira), two cardiac nuclear stress test agents.
RELATED: Diagnostic Agents Resource Center
Lexiscan and Adenoscan are both approved for use in radionuclide myocardial perfusion imaging for patients unable to undergo adequate exercise stress. These agents dilate the arteries of the heart and increase blood flow to help identify any obstructions.
However, Lexiscan and Adenoscan can cause blood to flow specifically to the healthier, unblocked arteries, which can reduce blood flow in the obstructed artery. This reduced flow can lead to a potentially fatal heart attack.
The FDA reported that some adverse events occurred in patients with signs or symptoms of acute myocardial ischemia.
Cardiac resuscitation equipment and trained staff should be available before administering Lexiscan or Adenoscan. Healthcare professionals should avoid using these drugs in patients with signs or symptoms of unstable angina or cardiovascular instability, as they may be at greater risk for serious cardiovascular events.
The Warnings & Precautions section of both drug labels already contain information about the possible risk of heart attack and death.
Due to the recent reports of serious adverse events, the FDA has approved changes to the drug labels to include updated recommendations for use.
For more information call (800) 332-1088 or read the FDA Safety Announcement.
It is also known as Silent heart attack.
How to Recognize a "Painless" Heart Attack
by: Junji Takano
When people suddenly experience severe chest pain, the first thing that comes to mind is heart attack, which is medically known as myocardial infarction.
However, there's a dangerous type of heart attack that is not accompanied with any pain and is unnoticeable. This condition is known as "painless heart attack".
Myocardial infarction is a heart disease that needs to be treated as early as possible to prevent further complications and sudden death. If it won't be possible for you to identify heart attacks if it occurs without pain, then the condition may eventually become irreversible. Therefore, being able to recognize signs and symptoms of painless heart attack is crucial!
Fortunately, there's one "signature" symptom that occurs in the body when heart attack occurs, which can help you identify it even in the absence of pain. This knowledge is vital as it can possibly save lives.
Heart Attack on a Woman
In this article, we'll let you know how to recognize a painless heart attack and why it occurs, plus information on other diseases that can cause chest pain symptoms.
## Sudden Sweating for No Reason = A Sign of Heart Attack
When heart attack occurs, the pumping function of the heart is reduced drastically, and the amount of blood sent to the whole body decreases. Because of this, blood vessels around the body contracts and blood will flow preferentially to more important organs such as the heart or brain.
Aside from the blood vessels, the sweat glands will also shrink. At this point, the body is experiencing pathological stress, and sweating may occur even in the absence of heat and movement. This is known as cold sweat (diaphoresis).
Cold sweat can be a sign of heart attack
Dizziness, fatigue, and facial paleness, are other symptoms that may indicate that blood circulation is insufficient and can be a sign of heart attack, too.
How can a heart attack become painless? Sensory nerves can get damaged and prevent pain signals from being relayed to the brain. Diabetes and aging are the major factors that can cause abnormalities of the sensory function.
Currently, the survival rate of heart attack patients who are quickly brought in for treatment is more than 90%. This shows how important it is to seek medical attention within 2 hours after the onset of heart attack.
For elderly people and diabetics in particular, it is crucial not to miss any symptoms of the body especially when cold sweat occurs suddenly with no apparent reason.
## Is the "Chest pain" I'm experiencing something to be worried about?
It doesn't always mean that a severe chest pain indicates a heart disease like myocardial infarction. Sometimes, chest pain may indicate gastroesophageal reflux disease(GERD)or (NERD)Non erosive , wherein the gastric acid flows back into the esophagus. This is more commonly known as acid reflux or heartburn. Because the severe pain is felt around the heart area, it is commonly mistaken to angina pectoris or heart attack.
Still, chest pain can be caused by many other diseases aside from heartburn.
Although chest pain can be difficult to identify even for doctors, one guide that can help tell whether the chest pain is life-threatening or not is by pressing your finger on the painful site.
If you can locate the painful area with your finger...then it is most likely a sign of muscle pain, neuralgia, or inflammation of some sort in the chest area.
On the other hand, if you are unable to locate the painful site...then the chest pain may be caused by life-threatening conditions such as myocardial infarction or heart attack, angina, aortic dissection, and pulmonary thromboembolism. It is recommended that you seek medical attention immediately as soon as these symptoms appear.
I seek Public awareness on alternative treatment for No.1 killer (Heart Attack).
Heart attack is still the No 1 killer in Malaysia and it is caused by Coronary Artery Disease.
What is coronary artery: Coronary arteries are small arteries 2 to 3mm diameter in size, supplying blood to the heart Muscles. There are normally right and left coronary arteries . The left main artery branches into two, so we roughly say that we have three branches of coronary arteries.
What is Angina: Angina is chest pain due to narrowness of the coronary arteries and partial lack of blood supply to heart muscle. Stable angina when the patient can predict the chest pains on performing a certain amount of exertion. Unstable angina is when the patient cannot predict the chest pains. It can come at any time with or without exertions. It is more serious than the former.
What is acute myocardial Infarction: When one of the coronary arteries is totally blocked, there will be severe chest pains, cold sweating, cold and clammy hands and legs, vomiting, giddiness , fainting and patient can become unconscious. Rarely there may be all the above symptoms without chest pains and it is called Silent Heart attack. A portion of the heart muscle may be damaged or become dead due to total occlusion of the artery, that is called infarct.
What is the treatment for CAD?
Normally CAD patients are treated in hospital by invasive therapies such as Angioplasty, stenting and Heart Bypass surgery depending upon the severity of narrowness or blockage of arteries. It is lifesaving in ICU (Intensive Care Unit) for severe cases.
Is there any Non Invasive therapy apart from invasive surgical therapy for CAD?
The Public should be made aware that there is an alternative form of therapy that is approved by the Food and Drug Administration of America (FDA) for the treatment of Coronary Artery Disease without the need for surgery. The Alternative therapy is known as ECP (External Counter Pulsation). It is a non-invasive therapy using computerized external air pumps to improve the circulation of the heart. This machine is controlled by a sophisticated computer device to pump the lower legs, thighs, and hips through air pressure cuffs sequentially during the resting period of the heart. The maneuver is non-invasive, painless, and needle-less. Patients only require outpatient treatment and the process has no side effects. The cost of treatment is extremely low compared to Angioplasty, Stenting and Bypass open heart surgery.
ECP therapy has been approved by the US FDA since the 1960’s. It has been used in USA for many years. In Malaysia we have been practicing it since 2002. The Ministry of Health has recently classified ECP as the Medical equipment for the treatment of Angina (Chest pains), Acute Myocardial Infarction (Heart attack), Cardiogenic shock (Patient faint and shock due to heart attack), and Congestive heart failure (Patient suffering from weakness of heart pumping, with swelling of legs and body, short of breath on slight exertion). All these signs and symptoms appears due to lack of blood supply to the heart muscles by the narrowness or partial closure or complete obstruction of Coronary Arteries.
There are growing number of ECP centres in Malaysia and at present it is about 15 ECP centres around in KB, JB, Kuala Lipis, Kuala Lumpur , PJ and Kelana Jaya etc.. .
The sad truth is that Malaysian ECP centres are regarded as “second hand workshops” for patients with Coronary Artery Diseases because most of our patients have already gone through Angioplasty, Stenting and Bypass surgery done at hospitals by the famous Cardiologists for the initial attack. Unfortunately, sooner or later these patients will be required to repeat such therapies again and again. Eventually, if they are asked to repeat the same procedures later they will look around for an alternative therapy. Patients usually come to know about ECP therapy through word of mouth from close friends.
The surgical methods like Angioplasty, Stenting and Bypass heart surgery are not a permanent cure as they require repetitive surgeries. Such therapies are not free from side effects as well. These include brain damage, stroke, blood vessels damage, kidney damage and even death on the table. ECP therapy is free from such side effects. The public is not aware of this ECP therapy so they go for the above invasive therapies first.
Coronary artery disease is a progressive disease and it is not stopped easily. It may be enhanced by smoking, high blood cholesterol, high blood pressure, stress and uncontrolled diabetes mellitus.
Over 100 research papers have demonstrated its overwhelming effectiveness and unquestioned safety in improving blood flow in patients with heart disease. Some experts are calling for the ECP procedure to become the first-line therapy for heart disease, long before surgery or other invasive procedures are used. I totally agree with them since I found 80 to 90% of my patients improve and recover from CAD by using ECP therapy.
In the USA, ECP is covered by Insurance and there is no reason for the same to be introduced in Malaysia.
For maximum effectiveness, it is highly recommended to do ECP therapy 35 times in 35 days, one hour daily for coronary artery diseases. The cost is roughly about RM10, 000 for full treatment. The positive effects of ECP therapy can last up to five years.
ECP therapy involves the use of ECG (Electrocardiogram) and Plethysmograph (PPG). It must be supervised by trained Licensed Physicians who are well versed with ECG, PPG , ECP and heart conditions to avoid negative side effects. In the wrong hands it could cause more damage to the heart rather than healing the heart. Please be informed that ECP therapy is not categorized under Traditional and complementary (T/CM) . The Ministry of Health has already classified that ECP device as the medical device for the treatment of coronary artery disease in accordance with medical device definition as specified in Section 2, of the Medical Device Act (Act 737).
Be Warned! ECP is essentially a Medical Device. United States Federal law restricts this device for use on or by the order of a Licensed Physician and the same applies to Malaysia.
For more information, please refer to the following websites: http://www.academycmt.com ,
DR. HJ. MUHAMMAD EBRAHIM SULAIMAN
MBBS, DTM&H (UK), FAAFP (USA), ECPT (USA).
The above article was sent to online MMG (Malaysian Medical Gazette). But the reply was negative as below.
Dear Dr Ebrahim,
Once again we applaud your enthusiasm. After a review by the Editorial Board, I regret to inform you that your article will not be published in our Gazette at this moment. We wish you well in your efforts. Thank you.
***The Malaysian Medical Gazette reserves all rights regarding publication.***
Dr Hidayah Ismawi
The Malaysian Medical Gazette
Commentaries: The Author of the article was applauded but the article was rejected: Let us read Al-Quran karim.
Sura yasin 36: verse 7.
laqad- haqqal- qawlu- ala- aktharihim - fahum- laa- yu'minuna. (Meaning:)
Certainly- the truth- word -upon- most of them- so they- do not- believe.
“The word of chastisement (Criticize severely, to restrain, refine, purify) , has already proved true , it has become due , for most of them, for they in other words, most them , will not believe.”
You see for example: The idolators, hypocrites, unbelievers will not believe in “Laa Ilaa Ha Illalah!. There is no God Except Allah!” when Prophet Muhammad (SAW) preached them.
Now as well, it is the same for introduction of any truth e.g like evolution of Proven ECP therapy to restrain from, invasive therapies , from their greediness , pride and to look forward for the benefit of mankind.
They will not believe or accept it as they are selfish.
Dear Sir ,
I would like to share this article about the results of scientific research that External counterpulsation (ECP) is a circulation assist device that may remove the cholesterol thickening of the inner lining of the heart arteries. And improve endothelial dysfunction by increasing shear stress (Force of the blood flow).
ECP therapy may reduce the cholesterol deposition and thickening of the Heart arteries in 7 weeks.
The cholesterol deposition and thickening inside the heart arteries causes narrowness of the lumen of the arteries and reduce blood flow and cause heart attack.
Those who are prescribed to take anti-cholesterol drugs for life time may seek ECPT for 7 weeks. The doubling of the shear force(force of blood flow) removes the cholesterol thickening in side the arteries.
Seven weeks exposure of ECP therapy causes cells lining of arteries (vascular endothelial cells and vascular smooth muscle cells to relatively high physiological shear stress has antiproliferative and vasoprotective effects) to reduce and disappear by the doubling of shear stress .
The present study hypothesizes that EECP inhibits intimal hyperplasia and atherogenesis by modifying shear stress–responsive gene expression. Reference: American heart Association Journal: Full text circulation.
For detail scientific information with pictures please ref:
Dr Hj Mohd Ebrahim Sulaiman. Kuala Lumpur
In animal studies, the inner lining thickening (Intimal hyperplasia) was observed in the coronary arteries of the high-cholesterol diet group, whereas in animals receiving EECP, (the intima-to-media area ratio), Cholesterol thickening was significantly decreased by 41.59%.
Picture below shows. Scanning electron micrographic characteristics of the porcine LADs(Left Anteria descending artery) (magnification ×500). A, Representative micrograph of normal control group. B, Representative micrograph of CHOL group. The luminal surface was covered with many adherent cells; serious endothelial cell disarrangement and desquamation were observed. C, Representative micrograph of CHOL+EECP group. Less cellular adherence could be observed. VECs (vascular Endothelial cells) aligned parallel to the direction of blood flow.
A . Normal inner lining
B. Inner ling thickened by cholesterol
C. Cholesterol thickening reduced.
In cholesteral group the intimal thickness inside the artery is cleaned by ECPT and the calibre is bigger in size.
Effect of EECP on the histomorphology and intimal hyperplasia of LADs of hypercholesterolemic pigs.
The Initimal thickening is markedly reduced and lumen is dilated more than the control group. On the right side of the picture.
Wall shear stress is probably the most important local factor able to influence atherogenesis. In large arteries, the magnitude of shear stress is in the range of 10 to 70 dyne/cm2. Arterial level shear stress (>15 dyne/cm2) induces endothelial quiescence and an atheroprotective gene expression profile, whereas low shear stress (<4 dyne/cm2), which is prevalent at atherosclerosis-prone sites, stimulates an atherogenic phenotype. Shear stress regulates endothelial structure and function by regulating the expression of mechanosensitive genes. VECs subjected to a long duration of laminar shear stress at the relatively high levels have a lower rate of DNA synthesis than those under static conditions. In animals with vessel grafts or stented vessels, increased local shear stress induces regression of intimal hyperplasia. In humans, it has also been demonstrated that augmentation of wall shear stress inhibits neointimal hyperplasia after stent implantation.The systolic deflation/diastolic inflation sequence of EECP leads to systolic unloading and diastolic augmentation, resulting in increased blood flow in a pulsatile manner. In the present study, the data showed that during EECP, the peak diastolic arterial wall shear stress increased >2-fold. EECP has the definite effect of elevating arterial wall shear stress in vivo, whereas most drugs have failed to demonstrate such beneficial hemodynamic effects.
Acute increase in shear stress can cause acute robust NO production, which plays a critical role in vessel relaxation, whereas chronic NO production due to the increased laminal shear stress may serve as an antiatherogenic and anti-inflammatory molecule. It is well known that regular physical exercise improves endothelial function by increasing blood flow and shear stress, which in turn enhances the eNOS/NO pathway.24 In this aspect, the mechanism of EECP is similar to physical exercise. Because most cardiac patients cannot exercise sufficiently to achieve a similar degree of increase in arterial shear stress, EECP can help to provide a vascular protective benefit similar to that of vigorous exercise.
It is well known that regular physical exercise improves endothelial function by increasing blood flow and shear stress, which in turn enhances the eNOS/NO pathway. In this aspect, the mechanism of EECP is similar to physical exercise. Because most cardiac patients cannot exercise sufficiently to achieve a similar degree of increase in arterial shear stress, EECP can help to provide a vascular protective benefit similar to that of vigorous exercise.
Conclusions.— EECP reduces hypercholesterolemia-induced endothelial damage, arrests vascular smooth muscle cell proliferation and migration, decreases proliferating cell nuclear antigen proliferative index, suppresses extracellular matrix formation, and eventually inhibits intimal hyperplasia and the development of atherosclerosis by increasing the arterial wall shear stress, which in turn activates the endothelial NO synthase/NO pathway and probably suppresses extracellular signal-regulated kinases 1/2 overactivation.
In conclusion, the present study demonstrates a correlation between EECP-mediated increased shear stress and the inhibition of intimal hyperplasia, supporting the antiatherogenic effect of chronic exposure to shear stress, and suggests that EECP should be considered a therapeutic strategy for the treatment of atherosclerotic occlusive disease. By receiving EECP therapy, the intima-to-media area ratio (cholesterol thickening) was significantly decreased by 41.59% is amazing.
• Molecular Cardiology: : American heart Association Journal: Full text: circulation.
• www. circ.ahajournals.org/content/116/5/526.full.
By Dr Mohd Ebrahim Sulaiman, Kuala Lumpur.
Scientists Expose A 30 Year Government Vaccination Cover-up.
Mercury is used as preservatives in vaccines, amalgam of the tooth fillings, is also contaminated and found in Fish (seafood) .Some self claimed learned persons have bravely declared in news papers /medias, in the past that Heavy metal like mercury has no harm to body and chelation therapy has no place in Medicine. Eventually the truth has prevailed. if any one say something truth it is always ,
"First it is ridiculed by those ignorant of its potential.
Next it is subverted by those threatened by its potential.
Finally , it is considered self evident." Now they agree Autism is caused by vaccinations.
Scientists Expose A 30 Year Government Vaccination Cover-up.
Research by the University of British Columbia's (UBC) Department of Ophthalmology, Visual Sciences, Experimental Medicine and Neuroscience has exposed 30 years of corruption and lies concerning government vaccination policy. An extensive investigation into the inner workings of the U.K.'s nationali...
The preservatives for most of the vaccines are mercury causing Autism in children. Chelation and hyperbaric oxygen therapy are good for autism. Chelation remove heavy metals and oxygen detox and repair the brain damage. When some idiots hea...See More
"Courts quietly confirm MMR Vaccine causes Autism"
Courts quietly confirm MMR Vaccine causes Autism Monday, August 5, 2013 After decades of passionate debate, parents probably missed the repeated admissions by drug companies and governments alike that vaccines do in fact cause autism. For concerned parents seeking the truth, it’s worth remembering that the exact same people who own the world’s drug companies also own America’s news outlets. Finding propaganda-free information has been difficult, until now. Dr. Andrew Wakefield At the center of the fifteen-year controversy is Dr. Andrew Wakefield of Austin, Texas. It was Dr. Wakefield that first publicized the link between stomach disorders and autism, and taking the findings one step further, the link between stomach disorders, autism and the Measles Mumps Rubella (MMR) vaccine. Courts quietly confirm MMR Vaccine causes AutismFor that discovery way back in 1996, and a subsequent research paper published by the doctor in 1998, Andrew Wakefield has found himself the victim of a world-wide smear campaign by drug corporations, governments and media companies. And while Dr. Wakefield has been persecuted and prosecuted to the extent of being unable to legally practice medicine because of his discovery, he has instead become a best-selling author, the founder of the Strategic Autism Initiative, and the Director of the Autism Media Channel. But in recent months, courts, governments and vaccine manufacturers have quietly conceded the fact that the Measles Mumps Rubella (MMR) vaccine most likely does cause autism and stomach diseases. Pharmaceutical companies have even gone so far as to pay out massive monetary awards, totaling in the millions, to the victims in an attempt to compensate them for damages and to buy their silence. Grassroots outcry It was a regular reader named Kathleen that brought this ongoing story to our attention here at Whiteout Press. When asked what her connection to the vaccine-autism battle was, the young reader replied, “I just researched it for a school project a while back and then I stayed on top of it, until I couldn’t stand it anymore. I’m not a parent, nor do I belong to any organization – a mere outside observer.” This reader isn’t alone. The news that vaccines cause autism has spread across the US despite a coordinated media black-out. She takes her concerns one step further explaining, “All I want is to see this information where the public can access it. I’ve looked everywhere, and no one gives this dire Wakefield situation even ONE small mention.” She goes on to give us another motivation for her activism, “In Washington State, where I’m from, vaccines have become mandatory for school children, which is very frightening!” Landmark rulings In December 2012, two landmark decisions were announced that confirmed Dr. Wakefield’s original concern that there is a link between the MMR vaccine, autism and stomach disorders. The news went mostly unreported, but independent outlets like The Liberty Beacon finally began publishing the groundbreaking news. The website wrote last month, ‘In a recently published December 13, 2012 vaccine court ruling, hundreds of thousands of dollars were awarded to Ryan Mojabi, whose parents described how “MMR vaccinations” caused a “severe and debilitating injury to his brain, diagnosed as Autism Spectrum Disorder (‘ASD’).”’ The Liberty Beacon went on to describe the second court ruling that month, as well as similar previous verdicts writing, ‘Later the same month, the government suffered a second major defeat when young Emily Moller from Houston won compensation following vaccine-related brain injury that, once again, involved MMR and resulted in autism. The cases follow similar successful petitions in the Italian and US courts (including Hannah Poling, Bailey Banks, Misty Hyatt, Kienan Freeman, Valentino Bocca, and Julia Grimes) in which the governments conceded or the court ruled that vaccines had caused brain injury. In turn, this injury led to an ASD diagnosis. MMR vaccine was the common denominator in these cases.’ The report echoes the exact same sentiment that our reader conveyed – Dr. Wakefield has had his career and reputation destroyed over the past 15 years, but has just been vindicated. The account reports, ‘While repeated studies from around the world confirmed Wakefield’s bowel disease in autistic children and his position that safety studies of the MMR are inadequate, Dr. Wakefield ’s career has been destroyed by false allegations. Despite this he continues to work tirelessly to help solve the autism catastrophe.’ The article from The Liberty Beacon closes with a direct quote from Dr. Wakefield himself to the independent grassroots outlet, “There can be very little doubt that vaccines can and do cause autism. In these children, the evidence for an adverse reaction involving brain injury following the MMR that progresses to an autism diagnosis is compelling. It’s now a question of the body count. The parents’ story was right all along. Governments must stop playing with words while children continue to be damaged. My hope is that recognition of the intestinal disease in these children will lead to the relief of their suffering. This is long, long overdue.” Wakefield attacked again Since the world has slowly become aware of the dangers of the MMR vaccine, parents around the globe have refused to get their children vaccinated. Earlier this year, the UK government singled out Dr. Wakefield and blamed him for the rising number of measles outbreaks in the country. In an April 2013 interview, he responded publicly. The website TheRefusers.com published both the video, as well as the written transcript, of Dr. Wakefield’s public response. Below are some excerpts of the doctor’s remarks: “The important thing to say is that back in 1996-1997 I was made aware of children developing autism, regressive autism, following exposure in many cases to the measles mumps rubella vaccine. Such was my concern about the safety of that vaccine that I went back and reviewed every safety study, every pre-licensing study of the MMR vaccine and other measles-containing vaccines before they were put into children and after. And I was appalled with the quality of that science. It really was totally below par and that has been reiterated by other authoritative sources since. All I could do as a parent was to say, ‘what would I do for my child?’ That was the only honest answer I could give. My position on that has not changed. So, what happened subsequently? At that time the single measles vaccines were available freely on the National Health Service. Otherwise, I would not have suggested that option. So parents, if they were legitimately concerned about the safety of MMR could go and get the single vaccines. Six months later, the British government unilaterally withdrew the importation license for the single vaccines, therefore depriving parents of having these on the NHS; depriving parents who had legitimate concerns about the safety of MMR from a choice; denying them the opportunity to protect their children in the way that they saw fit. The news shouldn’t be left wing or right wing, conservative or liberal. It should be the news. It should be independent – Whiteout Press And I was astonished by this and I said to Dr Elizabeth Miller of the Health Protection Agency, ‘why would you do this, if your principal concern is to protect children from serious infectious disease? Why would you remove an option from parents who are legitimately concerned about the safety of MMR?’ And her answer was extraordinary. She said to me, ‘if we allow parents the option of single vaccines, it would destroy our MMR program.’ In other words, her principal concern seemed to be full protection of the MMR program and not protection of children.” Dr. Wakefield himself reiterates the final conclusion of the courts in various countries, but censored by the world’s media outlets saying: “Now this question has been answered not by me, but by the courts, by the vaccine courts in Italy and in the United States of America where it appears that many children over the last thirty years have been awarded millions of dollars for the fact that they have been brain-damaged by MMR vaccine and other vaccines and that brain damage has led to autism. That is a fact.” Source: Whiteout Press Read More: Scientists Expose A 30 Year Government Vaccination Cover-up CDC Admits 98 Million Americans Received Polio Vaccine Contaminated With Cancer Virus Bayer and US Government Knowingly Gave HIV to Thousands of Children Vaccine Court Awards Millions to Two Children With Autism Boy Recovers From Autism By Removing Dairy & Gluten. Strong Evidence Links Vaccines to Autism Supreme Court Rules Drug Companies Exempt From Lawsuits Read More: http://www.whydontyoutrythis.com/2013/08/courts-quietly-confirm-mmr-vaccine-causes-autism.html | Follow us on Facebook: http://www.facebook.com/whydontyoutrythis
Read page 18 and 19
MALAYSIA 15-31 MARCH 2014
15-31 MARCH 2014 MALAYSIA FOCUS 18
Alternative treatment for
coronary artery disease
Dr. Mohd Ebrahim Sulaiman
External counterpulsation (ECP), also known
as enhanced ECP therapy, provides a
unique opportunity to save countless of lives
and billions of dollars, but it is generally being
overlooked by the medical community. [J Am
Coll Cardiol 2007;50(16):1523-31]
Heart attack is still the number one killer in
Malaysia and it is caused by coronary artery disease
(CAD). CAD is costly and deadly, and it is
not seasonal like dengue. In the US, heart attacks
claim more lives each year, one every 45
seconds, compared with all other diseases.
CAD is a national healthcare issue, a national
economic issue and a national bioethical issue.
As such, all healthcare personnel, doctors and
the public should be aware of the latest ECP technology
for the prevention and treatment of CAD.
What is ECP?
ECP is a non-invasive therapy using computerized
external air pumps and cuffs to improve
blood circulation. The machine is controlled by
a sophisticated computer to pump blood in the
lower legs, thighs and hips through air pressure
cuffs, which sequentially synchronized pumping
during the resting period of the heart. The
therapy is non-invasive and painless, and does
not require drugs or needles. Patients only need
outpatient treatment and the process has no
side effects. ECP may be as effective as surgery,
with less likelihood of adverse events.
How does ECP work?
The principle is similar to pressing a long, soft
balloon filled with fluid at one end. The opposite
end expands slightly due to the fluid pushed
there. Imagine that our cardiovascular system is
like a long, soft balloon filled with blood. The
heart pumps hard so that blood can reach the
15-31 MARCH 2014 MALAYSIA FOCUS 19
whole body. The ECP machine squeezes blood
from the lower part of the body back to the heart
in the opposite direction. The dormant coronary
collateral arteries, which are unused smaller
branches of arteries supplying heart muscles,
become larger and start functioning, thus supplying
the blocked area. The process is also
known as natural bypass.
Patients need to undergo ECP therapy 1
hour a day for 35 days. ECP therapy can be repeated
many times as treatment and preventive
measure as it is a form of cardiovascular exercise.
Patients are encouraged to attend every
scheduled treatment, but if they miss a day it
will not have a negative outcome on the overall
treatment. Another treatment is added until they
reach the 35 completed sessions. [Am J Ther
ECP therapy was approved by the US FDA
in 1995 for the treatment of CAD and angina,
cardiogenic shock, and for use during a heart
attack. In 2002, the FDA approved ECP therapy
as a treatment for congestive heart failure.
ECP therapy has undergone clinical trials at
leading universities and has been subjected to
over a hundred scientific studies published in
medical journals worldwide. [J Am Coll Cardiol
1999;33(7):1833-40, Am J Cardiol 1992;70:859-
62, J Card Fail 2005;11(3):240-5, Clin Cardiol
2001;24(6):435-42, Cardiology 1996;87(4):271-
5, J Am Coll Cardiol 2007;50(16):1523-31]
Some patients who cannot undergo ECP
therapy include pregnant women, those with a
severe aneurysm in the aorta requiring surgical
repair, and patients with active blood clots in the
arteries of the lower limbs.
Disclaimer: The views expressed in this article are those of the
author and do not necessarily represent the views of, and should
not be attributed to Medical Tribune and MIMS Medica.
New Heart Studies Question the Value Of Opening Arteries
By GINA KOLATA
Published: March 21, 2004
A new and emerging understanding of how heart attacks occur indicates that increasingly popular aggressive treatments may be doing little or nothing to prevent them.
The artery-opening methods, like bypass surgery and stents, the widely used wire cages that hold plaque against an artery wall, can alleviate crushing chest pain. Stents can also rescue someone in the midst of a heart attack by destroying an obstruction and holding the closed artery open.
But the new model of heart disease shows that the vast majority of heart attacks do not originate with obstructions that narrow arteries.
Instead, recent and continuing studies show that a more powerful way to prevent heart attacks in patients at high risk is to adhere rigorously to what can seem like boring old advice -- giving up smoking, for example, and taking drugs to get blood pressure under control, drive cholesterol levels down and prevent blood clotting.
Researchers estimate that just one of those tactics, lowering cholesterol to what guidelines suggest, can reduce the risk of heart attack by a third but is followed by only 20 percent of heart patients.
''It's amazing and it's completely backwards in terms of prioritization,'' said Dr. David Brown, an interventional cardiologist at Beth Israel Medical Center in New York.
Heart experts say they understand why the disconnect occurred: they, too, at first found it hard to believe what research was telling them. For years, they were wedded to the wrong model of heart disease.
''There has been a culture in cardiology that the narrowings were the problem and that if you fix them the patient does better,'' said Dr. David Waters, a cardiologist at the University of California at San Francisco.
The old idea was this: Coronary disease is akin to sludge building up in a pipe. Plaque accumulates slowly, over decades, and once it is there it is pretty much there for good. Every year, the narrowing grows more severe until one day no blood can get through and the patient has a heart attack. Bypass surgery or angioplasty -- opening arteries by pushing plaque back with a tiny balloon and then, often, holding it there with a stent -- can open up a narrowed artery before it closes completely. And so, it was assumed, heart attacks could be averted.
But, researchers say, most heart attacks do not occur because an artery is narrowed by plaque. Instead, they say, heart attacks occur when an area of plaque bursts, a clot forms over the area and blood flow is abruptly blocked. In 75 to 80 percent of cases, the plaque that erupts was not obstructing an artery and would not be stented or bypassed. The dangerous plaque is soft and fragile, produces no symptoms and would not be seen as an obstruction to blood flow.
That is why, heart experts say, so many heart attacks are unexpected -- a person will be out jogging one day, feeling fine, and struck with a heart attack the next. If a narrowed artery were the culprit, exercise would have caused severe chest pain.
Heart patients may have hundreds of vulnerable plaques, so preventing heart attacks means going after all their arteries, not one narrowed section, by attacking the disease itself. That is what happens when patients take drugs to aggressively lower their cholesterol levels, to get their blood pressure under control and to prevent blood clots.
Yet, researchers say, old notions persist.
''There is just this embedded belief that fixing an artery is a good thing,'' said Dr. Eric Topol, an interventional cardiologist at the Cleveland Clinic in Ohio.
In particular, Dr. Topol said, more and more people with no symptoms are now getting stents. According to an analysis by Merrill Lynch, based on sales figures, there will be more than a million stent operations this year, nearly double the number performed five years ago.
Some doctors still adhere to the old model. Others say that they know it no longer holds but that they sometimes end up opening blocked arteries anyway, even when patients have no symptoms.
Dr. David Hillis, an interventional cardiologist at the University of Texas Southwestern Medical Center in Dallas, explained: ''If you're an invasive cardiologist and Joe Smith, the local internist, is sending you patients, and if you tell them they don't need the procedure, pretty soon Joe Smith doesn't send patients anymore. Sometimes you can talk yourself into doing it even though in your heart of hearts you don't think it's right.''
Dr. Topol said a patient typically goes to a cardiologist with a vague complaint like indigestion or shortness of breath, or because a scan of the heart indicated calcium deposits -- a sign of atherosclerosis, or buildup of plaque. The cardiologist puts the patient in the cardiac catheterization room, examining the arteries with an angiogram. Since most people who are middle-aged and older have atherosclerosis, the angiogram will more often than not show a narrowing. Inevitably, the patient gets a stent.
''It's this train where you can't get off at any station along the way,'' Dr. Topol said. ''Once you get on the train, you're getting the stents. Once you get in the cath lab, it's pretty likely that something will get done.''
New Heart Studies Question the Value Of Opening Arteries
Published: March 21, 2004
(Page 2 of 2)
One reason for the enthusiastic opening of blocked arteries is that it feels like the right thing to do, Dr. Hillis said. ''I think it is ingrained in the American psyche that the worth of medical care is directly related to how aggressive it is,'' he said. ''Americans want a full-court press.''
Dr. Hillis said he tried to explain the evidence to patients, to little avail. ''You end up reaching a level of frustration,'' he said. ''I think they have talked to someone along the line who convinced them that this procedure will save their life. They are told if you don't have it done you are, quote, a walking time bomb.''
Researchers are also finding that plaque, and heart attack risk, can change very quickly -- within a month, according to a recent study -- by something as simple as intense cholesterol lowering.
''The results are now snowballing,'' said Dr. Peter Libby of Harvard Medical School. ''The disease is more mutable than we had thought.''
The changing picture of what works to prevent heart attacks, and why, emerged only after years of research that was initially met with disbelief.
Early attempts to show that opening a narrowed artery saves lives or prevents heart attacks were unsuccessful. The only exception was bypass surgery, which was found to extend the lives of some patients with severe illness but not to prevent heart attacks. It is unclear why those patients lived longer; some think the treatment prevented their heart rhythms from going awry, while others say that the detour created by a bypass might be giving blood an alternate route when a clot formed somewhere else in the artery.
Some early studies indicated what was really happening, but were widely dismissed. As long ago as 1986, Dr. Greg Brown of the University of Washington at Seattle published a paper showing that heart attacks occurred in areas of coronary arteries where there was too little plaque to be stented or bypassed. Many cardiologists derided him.
Around the same time, Dr. Steven Nissen of the Cleveland Clinic started looking directly at patients' coronary arteries with a miniature ultrasound camera that he threaded into blood vessels. He found that the arteries were riddled with plaque, but almost none of it was obstructing blood vessels. Soon he began proposing that the problem was not the plaque that produced narrowings but the hundreds of other areas that were ready to burst. Cardiologists were skeptical.
In 1999, Dr. Waters of the University of California got a similar reaction to his study of patients who had been referred for angioplasty, although they did not have severe symptoms like chest pain. The patients were randomly assigned to angioplasty followed by a doctor's usual care, or to aggressive cholesterol-lowering drugs but no angioplasty. The patients whose cholesterol was aggressively lowered had fewer heart attacks and fewer hospitalizations for sudden onset of chest pain.
The study ''caused an uproar,'' Dr. Waters said. ''We were saying that atherosclerosis is a systemic disease. It occurs throughout all the coronary arteries. If you fix one segment, a year later it will be another segment that pops and gives you a heart attack, so systemic therapy, with statins or antiplatelet drugs, has the potential to do a lot more.'' But, he added, ''there is a tradition in cardiology that doesn't want to hear that.''
Even more disquieting, Dr. Topol said, is that stenting can actually cause minor heart attacks in about 4 percent of patients. That can add up to a lot of people suffering heart damage from a procedure meant to prevent it.
''It has not been a welcome thought,'' Dr. Topol said.
Stent makers say they do not mislead doctors or patients. Their new stents, coated with drugs to prevent scar tissue from growing back in the immediate area, are increasingly popular among cardiologists, and sales are exploding. But there is not yet any evidence that they change the course of heart disease.
''It's really not about preventing heart attacks per se,'' said Paul LaViolette, a senior vice president at Boston Scientific, a stent manufacturer. ''The obvious purpose of the procedure is palliation and symptom relief. It's a quality-of-life gain.''
Photos: Dr. Steven Nissen's findings about the narrowing of coronary arteries and plaque's role in heart disease were initially met with skepticism. (Photo by Associated Press); Dr. Eric Topol, an interventional cardiologist at the Cleveland Clinic, questions the ''embedded belief that fixing an artery is a good thing.'' (Photo by Roger Mastroianni for The New York Times)(pg. 21) Graph: ''Heart Procedures'' The use of aggressive treatments for clogged arteries is rising rapidly. Annual procedures in the U.S., in millions. Graph tracks the annual procedures in the U.S. for STENTS (Wire cage implanted to keep artery open) and ANGIOPLASTY (Balloon inserted in artery) since 1997. (Source by Merrill Lynch)(pg. 21)
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Veterans should not be neglected.
I recently had the honor of treating a 70 year old Malay army Veteran at my clinic for coronary heart disease. He is a retired Lieutenant Colonel in the Royal Malaysian Armed Forces. He came in his wheel chair, pushed by his wife and a friend. Due to his severe shortness of breath, the doctor on duty had to put him on oxygen inhalation and External Counter-Pulsation therapy (ECP) ref:1.
7 years ago he had mild chest pains and was admitted into a government hospital. He was diagnosed with a mild myocardial infarct and had a coronary stent put in. He also had diabetes mellitus, hypertension and gout. In addition, he had also been smoking for many years during his youth but had stopped.
Two weeks ago he was admitted into a well known government hospital after complaining of chest pains. The doctors there performed 6 angiograms and angioplasties – three in the hand (radial artery) and three in the groin (femoral artery). Unfortunately the procedure was not successful. He was later discharged on medication as his condition worsened - he experienced breathing difficulties, was unable to walk even three steps, was always gasping for breath and could only sleep in a sitting position. His face and limbs were swollen (oedema) due to heart failure. His kidney function was severely impaired probably due to the side effects of PTCA/PCI (Percutaneous Coronary Intervention). He was lucky because historically some patients also experienced aneurysms of the lower abdominal aorta, stroke and suffered brain damage after such a procedure.
Percutaneous coronary intervention (PCI), commonly known as coronary angioplasty or simply angioplasty, is a non-surgical procedure used to treat the stenotic (narrowed) coronary arteries of the heart found in coronary heart disease. These stenotic segments are due to the buildup of the cholesterol-laden plaques that form due to atherosclerosis. PCI is usually performed by an interventional cardiologist, though it was developed and originally performed by interventional radiologists.
The artery-opening procedure alleviates chest pain far more quickly than medical therapy, but has not been shown to prolong life. The "vast majority of heart attacks do not originate with obstructions that narrow arteries” ref:2
After listening to his story and looking at his (then) present condition, I felt deeply saddened and disappointed at his predicament and how our government is treating this man whom had once served to defend our country.
After completion of 15 days ECP therapy, the patient whom earlier could not even walk can now climb stairs and walk for 15 minutes without rest. He can breathe better and sleep comfortably lying down. I have treated other patients like him who failed the various methods of surgical intervention such as angioplasty, stenting, and bypass surgery. These patients were told by the cardiologists that there is no other medication or surgery that can help them except for a heart transplant.
Some patients were covertly told by their cardiologists to look for ECP therapy. They are told that their hearts are ‘not amenable to surgery but ECP might help’. If it is true that some cardiologists DO admit to the efficacy of ECP, why don’t our hospitals keep ECP machines and help these patients?
There is no doubt that ECP therapy, approved by the United States Food and Drug Administration, is useful and ultimately beneficial in treating such patients. For them, ECP is their ‘new heart’. ECP is their new hope. They must adhere to prolonged ECP therapy to improve their quality of life.
While I agree that heart hospitals are for heart disease, I do not agree that ECP therapy should be flagged off just because these same hospitals have reached their wits end doing what they can for the patients. It is unfair to throw out these hopeful patients. PCI and surgery may not be a final gold standard for treatment of heart diseases.
Unfortunately patients with such severe diseases lack the financial strength to pay for the ECP therapy because whatever little they had had been drained off after spending on the conventional surgical interventions.
No doubt, Veterans are treated for free in the Government hospitals. But ECP therapy is not provided to them in the hospitals. The question is why not? There are many ECP centers in USA and ECP therapy is even covered by the Insurance companies. Why not do the same in Malaysia?
My patient the Veteran had to look for funds through many channels to finance his life with ECP therapy in the private sectors. I was told that the Veterans department hesitated to support him. Even Baitumal, with their millions of ringgit of zakat money collected in the bank had refused to help. I don’t understand why our Malaysian veterans are being neglected by these departments. In the United States and even in the poorest of countries like Myanmar, veterans are respected and treated well.
Having listened to my patient’s story, I felt compelled to write this article with the hopes that perhaps someone in authority, someone with a sense of humanity who is in power, will do what needs to be done in helping our heart patients, particularly our retired army officers. I myself am doing whatever I can to help these patients lead the remainder of their lives with the same dignity and quality of life they had before being struck by heart disease.
Please do not neglect the Malaysian army veterans by kicking them out from the system. Help them to Go for ECP therapy.
For any questions please do not hesitate to contact me h/p 0122400623
2.Kolata, Gina. "New Heart Studies Question the Value Of Opening Arteries" The New York Times, March 21, 2004. Retrieved January 29, 2011.
What is the meaning of Coronary heart disease (Blocked arteries of the heart) not amenable to surgery.
When the cardiologist/cardiac Surgeons find that the patient’s heart condition is so bad that surgical intervention like angiogram, angioplasty, stentings are unsuccessful and Bypass surgery is not recommended due to high risk factors they commonly write the Medical report “patient’s heart is not amenable to surgery”. They usually tell the patient that nothing can be done except to transplant a heart. Some cardiologists recommend their patients to go for ECP therapy verbally. Our medical centre accept such severe cases with stage IV Congestive heart failure, associated with side effects as result of surgical intervention like enlarged heart, pleural effusion, ascites , kidney failures, aortic aneurysm of the lower abdominal aorta and brain damage etc..
Alhamdullilah! Such cases recover after ECP therapy.. My message to the public is that ECP therapy can save the patients who need heart transplant and were regarded as hopeless and told them that there is no more medicine and no more surgery for you..Such patients who were suffering short of breath can climb stairs, can walk, and sleep better after ECP therapy. There is Hope..
I am happy. Two cardiologists from two different hospitals advised two different patients to seek ECP therapy because patient's heart conditions are not amenable to surgery. Patients searched and found our clinic and came for ECP Therapy. They are improving . Alhamdullilah!
Case reports in Face book: Ismail Ahmad Sdra Samat Moain, mualnaya saya kena penyakit paru2 berair kerana jantung lemah. Ian bepanjangan hingga masuk ke UMMC berkali2. saya terpaksa menjalani ENGIOGRAPH/ENGIOPLASTY tetapi tak dapat masukkan "baloon" dan "STENT". Kawan recommend rawatan ini dan ALHAMDULILLAH, kini saya lebih sihat dari sebelumnya dan pernafasan bertambah baik dan sesak2 nafas boleh katakan tidak mengganggu pergerakan saya. ALLAH yang memberi kesembuhan, saya hanya berusaha.
May 6 at 6:56pm · Like · 1
Samat Moain In sha Allah tuan akan sembuh. Saya sentiasa mendoakan semoga segala permohonan baik tuan akan diperkenankan ALLAH SWT.
May 6 at 8:04pm · Like
Dr-Ebrahim Hnin Alhamdullilah. Lft colonel ismail Ahamad is recovering from congestive cardiac failure. What Hospitals cannot do, ECP can do. But many doctors and public are still unaware of ECP therapy. http://pub.mims.com/.../Medical_Tribune_March_2014_MY2.pdf
Yesterday at 2:15am · Like
Mohamed Ghazali Muslan Tabahkan hati dan kuatkan semangat menghadapi ujian Allah. Semoga cepat sembuh dan mohon Allah permudahkan semua urusan.
ECP therapy can save hopeless heart failure patient.
If your Heart specialists says you are not amenable for surgery , no more medicines for you?
No more hope for you. You still have hope if you seek ECP therapy.
Case presentation: One (veteran) 61 yrs old patient failed six attempts of angioplasty done on the same day in a famous hospital. Three attempts at radial artery hand and three at Femoral artery thigh. The side effect he got is Kidney damage. Heart failure.He can't even walk three steps, after 15days treatment by ECPT, now can climb stairs. Improved by ECP therapy.
Another patient 78 yrs also failed angioplasty. His cardiologist told him, Bypass surgery is also very risky for him. Several sessions of ESMR (Extracorporeal Shock wave Myocardial Revascularisation) failed on him. His cardiologists advised him to do ECP therapy. Well, He is a nice cardiologist , ethical, honest , educated, at least he wanted his patient to survive. he did not say there is nothing can be done on you. He did not say there is no other option for you. He did not say You must look for heart transplant. The side effects from repeated Angiogram he got is aneurysm of the abdominal aorta. The dimaeter of the aneurysm of the aorta is 28 mm , so we can still do ECPT.
Another patient 65 yr old, came for ECPT he was also told nothing can be done on you. He needs heart transplant. he could not walk for three steps. Now he could climb stairs.
Those who are waiting for heart transplant please do not lose hope. We have ECP therapy especially good for heart disease unamenable for surgery. If your Cardiologist gave up for surgery and maximum medication also did not work on such cases, ECPT may be very helpful.
Alhamdullilah! ECP therapy can save patients who are not amenable to surgical procedures.
RAWATAN EXTERNAL COUNTER PULSATION THERAPI (12 photos)
1. Control Unit Untuk Rawatan ECP.
1. Control Unit Untuk Rawatan ECP.
2. Katil dan Peralatan Untuk Rawatan ECP.
4. Persediaan Untuk Rawatan ECP.
5. Persediaan Sebelum Rawatan ECP.
6. Dipakaikan Peralatan Rawatan ECP.
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Dr-Ebrahim Hnin shared Ismail Ahmad's album.
Please share this.Facebook: Dr-Ebrahim Hnin
Mr Parl Singh is a retired RMAF officer. Please read his write up.
I am heart patient suffering from CAD-3 vessel disease and my ejection fraction is about 28% planned for Medical therapy but due to poor target for Coronary Artery Bypass Graft at IJN.At IJN they told me angioplasty and Bypass could not be preformed on me due to my heart condition, only heart transplant could be performed unless a I get a donor.At present I am surviving on Medicine prescription by IJN.About 9 months ago I could not even walk due breathless problem. My son introduced me to senior doctor who was also practising alternative therepy for heart patient.He suggest that I should do ECP(EXTERNAL COUNTER PULSATION THERAPY).This treatment is for people like me who cannot go through bypass surgery.I was told to do this therapy for 35 times daily for 1 hour a day.I had no choise with my detoriating heart condition and I took up this therapy and after about 15 session I found my heart condition improved And now I can climb up staircase and no more breathless problem my ejection fraction also improved and I thank the almight,my son and the doctor.This message is for all those people who are having any kind of heart condition and it is also recommend for everyone who is above 30 to get into this programme to avoid any furture heart complications or anybody having family history of heart condition.I will be glad to be of assistance.
For more detail Please see my Face book:
parl singh. Further recommendation from Dato Parl Singh.
Very good write up and proper detailed information.I am the living proof who had benefited from ECP.Thanks to my son who brought me to see Dr Ebrahim when I hardly could walk a few steps and breathless.I had to go through a plan whereby I do 35 times ECP daily one(1) hour and I started to see the difference on the 15th time and after that and until today I don't have breathless problem.I know can climb staircase until 3 storey without sort of breath.If anyone of you have heart problem and you want to avoid surgery this is another alternative and it strongly recognised in USA and Europe.All medicine have side effects and if you take them it only can solve your problem on for a while.People who are over the age of 35 should try this alternative therepy whether you have heart problem or not but it is strongly recommended to people who have family history of heart disease.
What should be the stratergy to draw attention of the authorites. What does "its the crying baby that gets the milk" mean?
The saying could be taken to mean that if you want something, you have to speak up about it. !
I advise senior Veterans with heart failure not amenable to Angioplasty and Bypass heart surgery and are on waiting list for Heart Transplant should apply to the DG DS Hisham Abdullah , Minister of health @kvssubra, and PM or Army General to pay for the ECP therapy. ECP therapy improved their heart conditions and they can live a comfortable life. They could not even walk for three steps due to short of breath, but after ECP therapy they can climb stairs w/o short of breath. In USA ECP therapy is paid by insurance and the health departments. ECP therapy is like a new heart for these patients. ECP is recommended to do 35 times initially and to maintain regularly once or twice a week similar to Renal Haemodialysis to prolong their lives. I will keep on trying by various means to draw the attention of the relevant authorities. Noor Hisham Abdullah @kvssubra @HishammuddinH20. Let as act like crying babies to get more attention.
Comment from my friend Dr Zainal Abideen
Dr-Ebrahim Hnin Veterans who served the country for many years should not be neglected.
Yesterday at 12:52pm · Edited · Like ·
Zainal Abidin Abdullah: A good DG will hear and try to understand and do something better for human kind.A bad DG will keep the lettewr in dust bin and make something only for himself .
Yesterday at 3:48pm · Like
Dr-Ebrahim Hnin Dear Tuan Dr Zainal , Our new DG Health is OK. I am sure he will do something soon. He expressed thumb up to me. Please collect all the data of your success at your Kuala Lipis klinik Hijrah and submit to DG . I wish the cardiologists change their mind and advise hopeless cases who require heart transplant to go for ECP. Some wrote " heart is not amenable to surgery- ECP may help. At least that advice is better than telling them to wait for heart transplant or go home and die. If the cardiologist knowingly hide about ECP to the patient he is dishonest to his patient. If the cardiologist is ignorant about ECP therapy he is negligent or incompetent. Both are regarded as an offense . I have army veterans doing ECP most of them were brought in by friends. Some of them asked their cardiologist about ECP and they were told that don't waste you time and money. They shall have to pay for their slander and sins.I agree that Heart hospital is for Heart disease. But Heart hospitals cannot treat all heart cases. There is a limit for them..Last week one patient 85 years old Chinese male whose heart is not amenable to Angioplasty and Bypass surgery , who also did not benefit from series of ESMR (Extracorporeal Shock way Myocardial Vascularisation ) therapy his Aorta and Kidneys were damaged by repeated instrumentations, at last found our ECP centre. With ECP therapy he is dramatically improved with in a week. Please advise Heart hospitals to provide ECP therapy or refer them to the ECP centres to save life. Veterans can collect medicines from hospital FOC. But for ECP they cannot afford to pay from their own pocket.. In USA Health Department and Insurance pay for ECP therapy. I know that you have helped the veterans as I did. I request Govt or Ministry of Health to pay them for the ECP therapy. Any way we shall try with patience and constancy. .May Allah help them. Hisham Abdullah @Hisham Abdullah @DGHisham @HishammuddinH2O @DefenceHQ @MalaysiaGov @IJNDotComDotMy www.academycmt.com/Morerecentarticles.html#artilce13
Books now available.
Author: Dr Mohd Ebrahim Sulaiman
Call 03 21632469
Kamal book store in front of GHKL 03 40210575
In USA the treatment is called P-Shot(Priapus shot).
In Malaysia we call J-Shot (Jantan Shot).
what is it? Ref: https://m.youtube.com/watch?feature=youtu.be&v=5T_Kou0D9Y0
we take patient's blood and extract stem cells (PRP)
by special centrifuge with refrigerator at 4* centigrade.
We inject the stem-cells (PRP) into the Penis.
We use local anaesthesia to prevent pain for painless injection.
It is very safe because the procedure is under very strict sterilisation used with high tech equipment.
The procedure takes about 45 minutes.
Patient can go home after the procedure.
The next injection may be after 6 weeks if necessary.
The effect of the injection may last for about 18 months.
Each procedure cost in USA about USD$2000
In Malaysia about RM2,000 to RM3,000.
Call now 0321632469 for more......
All joint pains, due to Osteoarthritis or sports injury or accidents, are treated by PRPstemcells extracted from the patient"s blood and injected in to the joints.
step one Prolotherapy - Proliferative therapy.
step two Ozone injection
step three PRP stemcells injection.
step four injection of fat cells from patient.
step five injection of Bone marrow aspiration from the patient, into the joints
The whole procedure takes about 60 minutes.
Local Anaesthesia and Entonox inhalation is used to prevent pain for painless procedure.
The cost depends upon the combination of procedures.
Please call 0321632469 for more......
NOW we have ECP technology for children.
To improve circulation of the Brain, Heart, kidneys and other organs of the body.
please see pictures.
Deputy Minister Of health YB Datuk Seri Hilmi bin Yahaya appreciating Positve Negative EECP technology at our counter.
WE ARE PIONEER IN ECP/EECP for Coronary Heart disease in Malaysia since 2002.Super External Counter Pulsation (SECP)/PNEECP is positive/negative pressure ECP.
It differs from other EECP machines and applicable to adult and children. The child mode is included to suit the heart rate of 160 per minute. After application of positive pressure to body the suction or vacuum pressure is the ideal technology superior to normal EECP machines. Normal ECP/EECP machines will stop at the heart rate of 120 / minute.
Super External Counter Pulsation (SECP) therapy is the treatment for coronary heart disease without surgery and is approved by the Food and Drug Administration (FDA) of the United States of America. Your doctor may or may not know what is ECP therapy (ECPT), therefore you should read in Internet and be aware of ECPT, so that you can ask for this treatment in early cases of angina pectoris to avoid invasive therapies like angiogram, angioplasty, and stenting or bypass therapy
SECP is a non-invasive therapy designed to increase circulation, cardiac output, and coronary artery perfusion in patients suffering from coronary heart disease, specifically stable angina pectoris, unstable angina pectoris, acute myocardial infarction, cardiogenic shock and congestive heart failure. Look for a doctor who is trained and knows what SECP is and get a second opinion if you are asked to do invasive procedures. See SECP picture in our catalogue and in the recent articles section.
Click to search SECP http://secp.com.my/secp/:
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