Cardiologist Malaysia

08/03/2026

In 2025

This is my talk regarding cardio renal syndrome (heart failure and kidney failure) at Sin Chew JIt Poh

Cardio-renal syndrome（心肾综合征） 是指心脏与肾脏功能之间存在密切相互影响的一种病理状态，其中一个器官的急性或慢性功能障碍会导致另一个器官功能的恶化。它体现了心脏与肾脏之间复杂的双向病理生理联系。

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📘 中文解释如下：

心肾综合征（Cardio-renal Syndrome, CRS）

心肾综合征是指心脏与肾脏功能相互影响、相互恶化的一种临床综合征。具体表现为：
• 心脏疾病导致肾功能恶化
• 或肾脏疾病导致心功能受损
• 或两者共同受损，互为因果，形成恶性循环。

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🔎 心肾综合征的分类（根据ADQI共识）：
1. Ⅰ型（急性心肾综合征）
急性心力衰竭导致急性肾损伤。
2. Ⅱ型（慢性心肾综合征）
慢性心功能不全导致慢性肾功能恶化。
3. Ⅲ型（急性肾心综合征）
急性肾损伤引发心功能不全（如心力衰竭、心律失常）。
4. Ⅳ型（慢性肾心综合征）
慢性肾脏病引起心脏结构或功能异常（如左心室肥厚、心衰）。
5. Ⅴ型（系统性心肾综合征）
由系统性疾病（如糖尿病、败血症、红斑狼疮等）同时引起心肾损害。

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🚨 临床意义：

心肾综合征患者预后差，死亡率高，治疗复杂，管理重点在于：
• 控制体液状态
• 管理血压
• 减少神经激素活性（如RAAS系统）
• 早期识别和干预双器官功能衰竭

大马肾脏科学会主席林仕军教授和你聊心脏与肾脏的牵连也可去医识力臉书追踪每日的健康资讯：https://www.facebook.com/easily.sinchew更别忘了按赞及订阅医识力频道，让《医识力》把健康送到家！ #医识力 #林仕军 #心脏 ...

08/03/2026

低蛋白饮食：护肾，还是伤身？
"Low Protein Diet: Protecting the Kidneys or Harming the Body?

Debunking Nutrition Myths in Elderly Kidney Disease," features Professor Dr. Lim Soo Kun, Chairman of the Malaysian Society of Nephrology.

The lecture addresses the "protein paradox" faced by elderly patients with Chronic Kidney Disease (CKD): the struggle to balance reducing kidney strain while avoiding muscle loss (sarcopenia).

Core Summary of the Talk
1. The Protein "Double-Edged Sword"
* The Kidney Perspective: High protein intake increases nitrogenous waste, which the kidneys must filter. For diseased kidneys, this accelerates decline.
* The Elderly Health Perspective: Seniors naturally lose muscle mass. Insufficient protein leads to sarcopenia, weakness, and a compromised immune system, which can be more fatal than the kidney disease itself.

2. Key Nutritional Principles Shared by Prof. Lim
* Tailored Low-Protein Diet (LPD):
For non-dialysis CKD Stage 3-5 patients, the recommendation is typically 0.6–0.8g of protein per kg of body weight per day. This is "low," not "zero" protein.
* High-Biological Value (HBV) Protein:
Quality matters more than quantity. Prof. Lim emphasizes sourcing protein from high-quality origins like fish, lean meat, eggs, and dairy to ensure all essential amino acids are consumed despite the lower volume.
* The Role of Keto-analogues:
In very low-protein diets (0.3–0.4g/kg), keto-analogues are often prescribed. These supplements "recycle" nitrogenous waste in the body and convert it into essential amino acids, protecting the kidneys while preventing malnutrition.
* Total Calorie Intake is Crucial:
A common mistake is cutting protein but not eating enough calories overall. If the body lacks energy, it will burn its own muscle for fuel, creating more waste and worsening kidney health.

3. Addressing Common Myths
* Soy and Kidney Disease: Modern medical views have shifted; moderate intake of plant-based proteins (like soy) is generally considered safe and even beneficial for some patients.
* Dialysis vs. Pre-Dialysis: Prof. Lim clarifies that once a patient starts dialysis, the rules change—they actually need more protein to replace what is lost during the filtration process.

Key Takeaway for Caregivers
The "over-restriction" of food is a major risk for elderly patients. Prof. Lim advises against "blindly dieting" and emphasizes regular monitoring of Serum Albumin levels to ensure the patient remains well-nourished while managing their kidney health.
Prof. Lim addressed by encouraging patients to work closely with renal dietitians.

破解老年肾病营养迷思
这场讲座的核心在于解决老年肾病患者在“保护肾功能”与“预防肌少症”之间的两难困境。

1. 核心矛盾：蛋白质的“双刃剑”效应
💪🏼护肾视角： 肾脏功能减退时，代谢蛋白质产生的含氮废物会加重肾脏负担，因此传统建议是实行“低蛋白饮食”以延缓洗肾。
😢长者健康视角： 老年人本身面临肌肉流失（肌少症）的风险，蛋白质摄取不足会导致体力衰退、免疫力下降，甚至增加死亡风险。
2. 讲座重点摘要
👍🏼量身定制的低蛋白饮食：
林教授强调“低蛋白”不等于“无蛋白”。对于尚未洗肾的慢性肾病（CKD）3-5期患者，通常建议蛋白质摄取量控制在 0.6-0.8克/公斤体重/天。
* 优质蛋白的选择：
重点在于摄取“高生物价蛋白质”（High Biological Value），如鱼、肉、蛋、奶，以确保即便在量少的情况下也能获得人体必需的氨基酸。
💊酮酸（Keto-analogues）的辅助：
在极低蛋白饮食（0.3-0.4克/公斤）的情况下，通常需要配合补充“酮酸药物”，它能转废为宝（吸收含氮废物转化为必需氨基酸），在保护肾脏的同时防止营养不良。
🍚热量摄取必须充足：
这是许多患者的误区。如果只减少蛋白质但总热量不足，身体会分解自身肌肉来供能，反而产生更多含氮废物并导致肌少症。
3. 针对老年患者的特别建议
🤐避免“过度戒口”： 林教授常提醒，过度恐慌导致的营养不良对长者的危害有时比肾病本身更严重。
👨‍⚕️定期监测： 需要定期检查血清白蛋白（Albumin）等指标，确保营养状态达标。
4. 互动问答焦点
讲座中林教授通常会针对以下常见迷思进行解答：
🫘 “吃豆制品会伤肾吗？”（现代观点认为适量植物蛋白也是可以接受的）。
🛌“洗肾后还需要限蛋白吗？”（不，洗肾后反而需要增加蛋白质摄取，以补偿透析过程中的流失）。

视频链接：

长者需要高蛋白，还是该限制蛋白质？吃多怕伤肾，吃少又担心肌少症——这正是许多老年慢性肾病患者与家属最焦虑的两难。这场由大马肾脏科学会主席林仕军教授主讲的讲座，将带你了解肾病患者的正确饮食原则。你也可透...

08/03/2026

Swallowing multiple magnets 🧲 can kill you

07/03/2026

The father of pacemaker

He grabbed the wrong part. The mistake started beating like a human heart.
Wilson Greatbatch reached into his component box without looking closely. His eyes were tired from hours hunched over the workbench. He needed a resistor. He grabbed one. The color bands looked right in the dim light.
They weren't.
It was 1956 at the University of Buffalo. Greatbatch was an electrical engineer trying to build a device that could record heart rhythms for medical research. Nothing ambitious. Just a recorder. A tool to help doctors hear what was happening inside the chest.
He soldered the wrong resistor into place—a 1-megaohm instead of the 10-kiloohm he needed. He connected the wires. He flipped the switch.
The circuit didn't record anything. Instead, it began to pulse.
Blip. One second of silence. Blip. One second of silence.
Greatbatch stared at the green line on his oscilloscope. The spike appeared, held for 1.8 milliseconds, then vanished. Exactly one second later, it returned. Perfect rhythm. Perfect timing.
He wasn't looking at a failed recorder. He was looking at something that commanded rhythm rather than captured it. The mistake was beating exactly like a living heart.
And in that moment, watching the green pulse on the screen, Greatbatch understood what he was holding.
"I stared at the thing in disbelief," he later wrote, "and then realized this was exactly what was needed to drive a heart."
He had seen the alternative firsthand. At Cornell's animal behavior farm where he worked, he'd witnessed what happened when hearts stopped maintaining their own rhythm. Heart block—a condition where the heart's electrical system fails—was a death sentence in the 1950s.
The only treatment was barbaric. External pacemakers the size of television sets, plugged into wall outlets, delivering electrical shocks through the skin. The voltage had to be high enough to pe*****te the chest, leaving burns that never fully healed. Patients screamed during the pulses. They couldn't leave the room because they were tethered to the wall by a power cord.
And when thunderstorms knocked out electricity, as they often did in rural areas, the machine stopped. The heart stopped. The patient died in the dark.
Greatbatch looked at his accidental circuit. It fit in the palm of his hand. A thought formed that would consume the next decade of his life: this doesn't need to be outside the body. This could go inside.
The medical establishment had a rule, and it was absolute: electronics do not belong inside the human body.
The reasoning was sound. The body is wet, salty, and corrosive. It destroys metal in weeks. It rejects foreign objects violently. Batteries of that era contained toxic chemicals. Placing one inside a chest cavity wasn't medicine—it was malpractice.
Every surgeon, every committee, every expert agreed: external machines were brutal, but they were safe compared to the madness of implanting electronics.
It was a good rule. Until it met a man who had heard a different truth in the pulse of an accidental circuit.
Greatbatch went home and looked at his bank account. He had $2,000 in savings. It was enough to buy a modest house or feed his family for years. It was his only safety net.
He didn't apply for grants. He didn't seek approval from institutions. He walked to his barn in Clarence, New York, cleared space on his workbench, and withdrew the money.
He told his wife Eleanor they would need to grow vegetables to stretch their budget. He quit his job. The safety net disappeared.
For the next two years, that barn became his laboratory. The challenge wasn't just making the circuit work—it was hiding it from the body's immune system.
He wrapped components in electrical tape. Body fluids seeped through within days. He tried epoxy resin. It cracked under the constant flexing of chest muscles. He tested rubbers and plastics. Each failure meant money spent, and the $2,000 was vanishing.
When he showed prototypes to doctors, they recoiled. "The battery will die, Wilson," they said. "Then you have to cut them open again. You'll kill someone."
Engineers were worse. They explained, patiently, that his idea violated basic principles. Corrosion. Biocompatibility. Battery life. Legal liability.
He kept working. The smell of solder smoke and epoxy filled the barn through winter. He heated the space with a wood stove, modified circuits to consume less power, experimented with new battery types.
Eleanor helped, taping transistors to the bedroom wall to test their durability with shock tests.
He found an ally in Dr. William Chardack, a surgeon at Buffalo's Veterans Administration Hospital desperate enough to try anything. Together with surgeon Andrew Gage, they tested the device in a dog.
May 7, 1958. The dog's heart started beating in rhythm with the device.
"Well, I'll be damned," Chardack exclaimed.
It worked for four hours before the body's fluids shorted the electronics.
Greatbatch tried again. He discovered a special epoxy used in boat hull construction. He remolded the device. This time it lasted days. Then weeks.
The medical community's pressure intensified. If the device failed after implantation, the surgeon would face manslaughter charges. Greatbatch argued the only alternative was watching patients die.
June 6, 1960. A 77-year-old man named Frank Henefelt lay dying from complete heart block at Millard Fillmore Hospital in Buffalo. His heart beat so slowly his brain was oxygen-starved. He suffered so many Stokes-Adams attacks—sudden blackouts—that he wore a football helmet to protect himself from falls. One fall had fractured his skull.
External pacemakers were failing. There were no options left.
The surgical team opened his chest. They stitched electrode leads directly to his heart muscle. They tucked Greatbatch's device—looking like a small hockey puck wrapped in epoxy, just two cubic inches—into his abdomen. They closed the incision.
The room fell silent. Everyone waited.
Lub-dub. Lub-dub.
They turned off the external machine. They unplugged the power cord from the wall.
The man's heart continued beating.
For the first time in human history, a machine completely inside a person's body was sustaining life.
Henefelt didn't die that day. He left the hospital. He lived a relatively active life. He survived for 18 months, eventually passing from unrelated causes.
The wrong resistor had become the implantable pacemaker.
Within years, the "reckless experiment" became standard medical practice. The device that experts insisted would kill patients began saving hundreds of thousands of lives.
Nine other patients received Greatbatch's hand-built pacemakers in 1960. One, a young factory worker not expected to survive, recovered, got a new job, joined a bowling league, and was still thriving when Greatbatch met him again 30 years later.
Greatbatch continued innovating. The biggest problem was battery life—patients needed surgery every two years just to replace batteries.
In the early 1970s, he developed a corrosion-free lithium-iodide battery that made pacemakers last over 10 years instead of 2. That battery design is still used in pacemakers today.
He held over 325 patents but licensed them generously, prioritizing widespread adoption over personal wealth. In 1970, he founded Wilson Greatbatch Ltd. (now Greatbatch Inc.), which became the world's largest manufacturer of implantable lithium batteries.
He remained, at heart, an engineer who solved problems—and a deeply religious man who believed his accidental discovery was divine intervention. "The Lord was working through me," he said.
Today, nearly one million pacemakers are implanted annually worldwide. More than 8 million lives have been saved since Greatbatch's invention. The life expectancy for people with pacemakers is nearly the same as the general population.
Millions of people walk the earth with a small device in their chest, keeping perfect time.
It exists because an engineer in a barn reached for the wrong component, recognized what he was hearing, and refused to accept that the rules were more important than the rhythm of a human heart.
Wilson Greatbatch died September 27, 2011, at age 92. His barn workshop in Clarence has been preserved as a museum—a testament to what one person with $2,000, a wood-heated barn, and an accidental discovery can achieve.

06/03/2026

🌸 Saturday Hualien English Heart-warming Talk 🌸
7 March 2026 (Sat) 🕡 6:30 AM – 8:00 AM (MY/TW time)

🕕 6:30 – 7:00 AM
🌿 Brother Joe Huang (Taiwan) ~ Dharma Insights

🕖 7:00 – 7:30 AM
🌿 Brother David Liu (Taiwan) ~ Q & A

🕢 7:30 – 8:00 AM
🌿 Brother Teck Wee (Malaysia) ~ HEPOP

🔗 Join via Zoom (click to enter directly)
👉 [https://us02web.zoom.us/j/3967875416?pwd=UQMn2sb1cQVW23a0r9mGJQXhtJLaRK.1]
🆔 Meeting ID: 396 787 5416
🔒 Passcode: 1013

🎥 Watch Live: 👉 [YouTube | Tzu Chi English LIVE](http://youtube.com/c/TzuChiEnglish-live)

💖 Let’s begin the weekend with Dharma, inspiration, and heartfelt sharing!
🙏🏼🙏🏼🙏🏼

Share your videos with friends, family, and the world

06/03/2026

Very good advice from an ex transgender ⚧️

加油 👏🏾 正能量

05/03/2026

How to prevent cancer?

Discover how nearly 40% of cancer cases could be prevented by avoiding key risk factors, according to new research from the WHO. Read more at straitstimes.com. Read more at straitstimes.com.

03/03/2026

ALBINO

Acceptance is the medicine 💊 for happiness

03/03/2026

谁是最爱你的人？
如果他们还在，你是幸运的人。

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

02/03/2026

Herbal infusion

02/03/2026

“医生我错了”

醫生又不是通靈，你不說，醫生怎知道你承受病痛和真實病情的差異