Our demanding life-style with its high-stress level, imbalanced diet and lack of exercise is a major contributing factor to the rise in heart diseases among Malaysians. To attend to the increasing need for medical treatment of cardiac diseases, KPJ Johor is able to offer you the best of cardiac diagnostic and treatment services.

The Cardiac Centre comprises the Cardiology and Cardiothoracic Units. It offers the following services

• Coronary angiogram
  An angiogram is an X-ray image of blood vessels after they are filled with a contrast material. A coronary angiogram is used for the evaluation or diagnostic procedure of coronary artery disease (CAD). It also can be used to identify the exact location and severity of CAD.
  
  
• Coronary angioplasty (PTCA)
  
  Balloon angioplasty angioplasty in which a balloon catheter is inflated inside an artery, stretching the intima and leaving a ragged interior surface after deflation, which triggers a healing response and breaking up of plaque.
  
  PTCA is to enlarge the lumen of a sclerotic coronary artery by using a type of stent in which the stent will be inflated in the narrowed vessel.
  
  This provides an alternative to cardiac bypass surgery for selected patients with ischemic heart disease.
  
  
• PTMC (Percutaneous Transluminal Mitral Commisurotomy)
  PTMC is a semi-invasive procedure where a balloon is used to dilate the already narrowed mitral valve.
  
  
• Open Heart Surgery
  Coronary Artery Surgery, Valve Surgery and Surgery for Congenital Heart Disease
  Closed Heart Surgery
  Thoracic Surgery
  
  

Other Support Facilities and Services are:

• Well-equipped Catheterization Laboratory (Cath Lab).
  
• Cardiac Operation theatre
• Fully equipped Cardiac Intensive Care Unit (CICU)
• Comprehensive Physiotherapy Department providing pre/post cardiac surgery rehabilitation
• Echocardiogram
• IABP (Intra Aortic Balloon Pump)

KPJ Johor operates a 1.5Tesla Toshiba MRI scanner. It is also one of the quietest in its class.MRI utilizes strong magnetic fields combined with radio frequency energy to generate images of the body's internal structures.It is particularly useful for soft tissues such as the brain,spinal cord and joints.It is also very useful in the detection of early stroke.MRI does not utilize radiation.

KPJ Johor performs CT scanning with a Toshiba Aquiliion 64. This is a "64 slice" CT scanner with additional features that facilitate scanning of the heart in what is known as "Coronary CT angiography"- a faster, less invasive way to examine the coronary arteries for certain individuals.
The features that allow the Toshiba Aquilion 64 to scan a rapidly beating human heart makes the scanning of all other body structures much faster and easier compared to other older scanners.
Each scan "slice" is only 0.5mm thick and this allows for very high resolution images to be generated. Advanced computing hardware and software allows for rapid processing of the massive amounts of data produced during a scan. The end result – dramatic high resolution images in any direction including 3D views to give more assistance for doctors to plan your healthcare needs.

In an effort to speed up service, improve convenience, as well as to comply with environmental protection obligations we are in the process of implementing a Picture Archiving & Communication System (PACS).
This system will transmit everything from your doctor's request form, the scan images and the radiologist's report on line, making everything available to as many people that require them anywhere within the hospital at anytime. This will speed up your healthcare as well as eliminate the paper, film, chemicals and labor associated with having a more traditional examination.

Screening mammography has been shown internationally to reduce breast cancer related deaths by around 20 %, as such many advanced countries have introduced mass public screening mammography programs for their mature female citizens. In the absence of such public programs here, the responsible Malaysian woman must take personal initiative to ensure their health in this respect. KPJ Johor has made substantial investments in equipment and manpower to provide an effective mammography service.

At KPJ Johor mammography is performed using a Toshiba mammography unit in tandem with a Kodak computed radiography imaging system. This allows us to produce digital images akin to digital photographs. This approach drastically reduces repeat examinations and its associated additional radiation, discomfort and inconvenience. It also allows for sophisticated image enhancement and manipulation that increases the diagnostic value of the image.

The easy availability of in house specialists means that additional investigations such as ultrasound, biopsies, localizations, etc can be arranged rapidly if required.

Introduction
Fertility problems affect one in five couples and can cause undue stress and anxiety. Many fertility problems can now be overcome with the advances in medical science.

We in KPJ Johor Fertility Centre aim to provide a range of fertility treatments and special expertise to assist couples in the best possible way to achieve a pregnancy. Our laboratory is equipped with the most advance equipment and we provide state-of-the art technologies to give all couple the best chance of achieving a pregnancy.

Why Choose KPJ Johor Fertility?
We at KPJ Johor Fertility Centre fully understand the needs of individual couples facing fertility treatment and seek to respond in a warm, caring, professional and supportive manner. Our Centre is operated and managed by expertise from Singapore under IVF Consultancy Sdn Bhd. We have proven track records of achieving several first successful pregnancies using the latest techniques in assisted reproductive procedures in Singapore and the Philippines.

Services Offered By KPJ Johor Fertility Centre
Outpatients Laboratory Services:
- Basic seminal analysis (BSA)
- Complex seminal analysis (CSA)
- Fertility hormone tests
- Sperm enhancement procedures
- Sperm fertilizing potential test

Clinical Services:
- Fertility screening
- Ovulation induction and cycle monitoring
- Intra uterine insemination
- In Vitro Fertilization (IVF)
- Intra cytoplasmic sperm injection (ICSI)
- Surgical sperm retrieval
- Assisted hatching
- Embryo freezing & replacement of frozen embryos
- Eggs/Sperm/Embryo banking
- Pre Gentic Diagnostic ( PGD )

Who Needs Assisted Conception Treatment?
Women with the following problems:
- Ovulatory problems
- Polycystic ovaries
- Tubal disease or blockage
- Hostile cervical mucus Endometriosis

Men with the following problems:
- Abnormal sperm parameters
- Azoospermia due to absent vas or blockage
- Sperm antibodies
- Couples with Unexplained Infertility

Factors Affecting Outcome Of Treatment
Couples need to be aware of certain factors affecting the success of fertility treatment namely:

Woman's Age- It have been well documented that the chances of achieving pregnancy decreases with age. It is also recognized that the chances of miscarriage increases with the women's age.

Number of eggs retrieved/embryos transferred - The chances of success are directly affected by the number of embryos available for transfer. Therefore, more eggs retrieved will give rise to more embryos and better choice of selecting better embryos for transfer

Duration of Infertility - Statistics have shown that the chances of succes in pregnancy is inversely related to the duration of infertility.

Complications Or Art Treatment
- Ovarian Hyperstimulation Syndrome (OHSS)
- Ectopic Pregnancy
- Multiple Pregnancy

Reasons For Cancellation During Treatment
Although uncommon, IVF treatment cycle may be cancelled due to the following reasons:
- Failure to respond to medications
- Excessive response to medications
- The doctor may feel that it is unsafe to continue the treatment
- There may be illness in either of both partners
- Hormones level too low
- Presence of ovarian cyst
- No eggs at retrieval
- No fertilization or embryo transfer

Counselling
It is the policy of KPJ Johor Fertility Centre to provide counseling to all IVF patients. This will enable them to understand the treatment they are going through and help them to make a fully informed decision.

Consent Forms
Once treatment, a treatment schedule has been decided upon, you will be asked to sign the relevant consent forms. We recommend you to read them carefully before signing them at the start of the treatment programme. Please discuss with the relevant staff if you require further explaination.

Review Consultations
We have follow-up consultations following unsuccessful treatment to review your future management and provide emotional support. This may help you decide if you wish to pursue further treatment

For futher enquiries:

KPJ JOHOR FERTILITY CENTRE
7th Floor,Johor Specialist Hospital
39-B, Jalan Abdul Samad
80100 Johor Bahru, Johor

Tel: +607 225 3190
Fax: +607 225 3198
Email: ivf@kpjhealth.com.my

Hearing loss affects every aspect of your life including your physical, mental and emotional health. If you're struggling to understand what others are saying you are under negative stress. It is a well documented medical fact that negative stress is a root cause (contributor) of many of the health problems we face today.

We have also seen the tremendous joy experienced by those who have regained their lives through better hearing – HEARING AIDS.

Do not wait for another day. Call Audiology Services KPJ JOHOR now (07-2253180) to help you.
Regain your life through better hearing, and find out for yourself just how much better life can be.

Newborn hearing screening

Does your six-month-old make sounds back when you talk? Does your one-year-old look at your face when talking to you? Does your two-year-old take turns in a conversation? If you answered no to one of these examples of communication questions, your child may have a communication disorder.

A child's ability to communicate effectively is vital and central to all social and academic skill development. The first few years of life are particularly critical. Early identification and intervention for children with speech, language and/or hearing disorders will ensure they have the best possible help during critical years of their intellectual, social and communication development.

Newborn hearing screening (NHS) is the first step in the process to improve developmental (social, educational, cognitive, etc.) outcomes in children with hearing loss. NHS leads to early identification, which then leads to improved hearing and facilitates communication development.

All newborn babies of KPJ JOHOR have undergone NHS to identify hearing loss since birth. We strongly recommend all newborn babies to be screened too.

For further information, please feel free to meet our Audiologist at Audiology Services (07-2253180).

The sooner parents learn how to help their child develop speech and language skills though every day experiences the better the child's outcome will be

The KPJ Johor Specialist Hospital Cancer Centre



ELEKTA SYNERGY WITH VMAT TECHNOLOGY

This is a comprehensive cancer centre which provides the full spectrum of cancer treatment such as radiotherapy, chemotherapy, biological targeted therapy, hormonal therapy, palliative care and cancer counseling. The Cancer Centre has recently installed the state-of-the-art Elekta Synergy Radiotherapy System which can deliver advanced 3-D Conformal Radiotherapy (3-D CRT), Intensity Modulated Radiation Therapy (IMRT), and Image Guided Radiation Therapy (IGRT), which will greatly improve the rates of cancer cure and reduce the side effects of treatment. This system will eventually have the Volumetric Modulated Arc Therapy (VMAT) technology which is a very advanced form of IMRT, making this center one of the few centres in the country with this new technology. The Cancer Centre also has a dedicated Oncology Day Care Centre, with well-trained and experienced oncology nurses, and a new PET/CT scanner, scheduled to be installed in 2013, used for both diagnostic imaging and radiotherapy treatment planning.

Meeting the Consultant Oncologist

The Consultant Oncologist, the doctor who specializes in cancer treatment, will discuss all the treatment options available and recommend the best treatment for a particular patient based on the latest international guidelines. He will give a thorough explanation regarding the disease and the most appropriate treatment including the cost. He will also provide a holistic approach of cancer care for the patient and the family.

Patients and family members will be counseled by our experienced oncology nurses during their visits to the Cancer Centre regarding the cancer diagnosis, choices of treatment and possible side effects, and the importance of maintaining a healthy lifestyle including a well-balanced diet, regular exercise and positive thinking.

Medical Therapy

Chemotherapy is cancer treatment with medications that have the ability to destroy cancer cells by different methods. Often, two or three different types of chemotherapy may be combined to get the best outcome. Chemotherapy is usually delivered every two to three weeks for a few months. The oncologist will discuss with you regarding the possible side effects that you may encounter. Patients requiring ambulatory infusion pump for prolonged infusion chemotherapy will receive complimentary usage of our electronic infusion pump.

Biological targeted therapy is cancer treatment with medications that stimulate the body's immune system to target and destroy cancer cells. It can be given as an injection i.e. monoclonal antibodies (mAb) such as Herceptin, Avastin and Erbitux, or as tablets taken orally i.e. tyrosine kinase inhibitors (TKI) such as Iressa, Tarceva and Sutent. Targeted therapy can be used alone or in combination with chemotherapy and radiotherapy.

Hormonal therapy is cancer treatment with medications that block the effects of hormones in the body that stimulates cancer cells. This form of treatment is commonly used in breast and prostate cancers. It can be given as oral tablets taken daily e.g. Tamoxifen, Arimidex and Casodex, or injections given at regular intervals e.g. Zoladex.

Bone-building medications may also be given to patients who have cancer which has spread to the bones. These medications can strengthen bones, reduce the pain and other serious complications caused by bone metastases such as fractures. Cancer treatment such as with chemotherapy and hormonal therapy can result in significant bone loss (cancer treatment-induced bone loss) and increased risk of fragility fracture, which can be prevented with bone-building medications. These medications can be administered every few weeks through an injection e.g. Zometa and Xgeva.

Chemo Port is a small disc made of plastic or metal inserted under the skin of your upper chest by the Consultant Surgeon as an outpatient procedure. It allows the doctor and nurses to to draw blood and deliver chemotherapy and other medications directly into a vein without having to insert a needle into your arm each time. The chemo port produces a small bump under your skin. A soft thin tube called a catheter connects the port to a large vein.

Radiotherapy

Radiotherapy involves delivering focused radiation (high energy X-rays) to destroy cancer cells. Radiotherapy can be the main treatment modality to cure the cancer e.g. in Nasopharyngeal Cancer (NPC), Cervix Cancer and Prostate Cancer, or it can be used before and after surgery e.g. Breast Cancer and Rectal Cancer. Often chemotherapy is used together with radiotherapy to enhance the effect of radiotherapy on the cancer cells. Radiotherapy is also very effective to palliate and relieve symptoms caused by advanced cancer such as pain, bleeding, etc.

Radiotherapy treatments are delivered in a series of painless daily sessions. Each treatment takes only a few minutes, but each session takes about 30 minutes to get checked in, change clothes, get into position and receive the radiotherapy. Treatments are usually scheduled daily, Monday through Friday, for several weeks. Before radiotherapy begins, your treatment plan will be designed. You will undergo a procedure called a CT simulation, where a CT scan is done in the position you will be treated, often with a supportive device to keep you comfortably in the same position for treatment. You may also receive tiny marks on your skin, like a permanent tattoo, to help the radiation therapist precisely position you for daily treatment. With the CT scan, three dimensional plans can be created to fit the shape of the treatment area.

3-Dimensional Conformal Radiotherapy (3-D CRT) combines multiple radiation treatment fields to deliver precise doses of radiation to the treatment area, while limiting radiation to healthy, normal tissues around it.

Intensity Modulated Radiation Therapy (IMRT) is a new and advanced form of 3-D CRT that further modifies the radiation by varying the intensity of each radiation beam. This allows a precise adjustment of radiation doses to the treatment area, allowing higher radiation doses to the cancer with improved cure rates, and lower radiation doses to normal tissues with less side effects of treatment. This will greatly help improve the quality of life of patients during and after radiotherapy.

Image Guided Radiation Therapy (IGRT) uses a variety of two dimensional and three dimensional imaging techniques throughout the course of radiation therapy to accurately identify, pinpoint and monitor your tumour for changes. IGRT, along with IMRT, increases the cancer cure rates.

The Oncology Team

Staffed with experienced, caring and dedicated Oncologist, Oncology Nurses, Medical Physicist, Radiation Therapist and Clinic Assistants, and equipped with advanced technology for cancer treatment, the Cancer Centre is able to provide the best and holistic cancer care to patients in Malaysia and the Asia Pacific region.

Contact information:

Dr Aminudin Rahman Bin Mohd Mydin
Consultant Clinical & Radiation Oncologist
Radiotheraoy & Oncology Centre
Basement 2, Outpatient Block
KPJ Johor Specialist Hospital
39-B, Jalan Abdul Samad
80100, Johor Bahru, Johor, Malaysia
Tel: +607-2253000 Ext 500; D/L: +607-2253055 (Clinic)
Fax: +607-225 3120
Email: aminudinrahman@googlemail.com