God's Timing

"Immediately the leprosy left him and he was cured. Jesus sent him away at once with a strong warning: 'See that you don't tell this to anyone'" (Mark 1:42-45).

Have you ever had a problem keeping a secret? Especially if that secret involves good news. I have certain friends who can't keep a secret like this. They are sure to blurt it out to the wrong person at the wrong time.

There is a timing that is ideal for releasing information or moving forward with a project. Jesus understood the importance of timing. When He performed His first healing miracle He instructed the man he healed with leprosy to not tell anyone. Now that would be difficult - not to share being healed from leprosy with your friends who have known you and your condition. He could not keep the secret.

As a result, Jesus could no longer enter a town openly but stayed outside in lonely places. Yet the people still came to him from everywhere. Jesus desired to do more things in that city, but because the man could not keep quiet, He could not do so.

Timing is Critical

Written by Bill Strom

“A man with leprosy came to him and begged him on his knees, “If you are willing, you can make me clean.” Filled with compassion, Jesus reached out his hand and touched the man. “I am willing,” he said. “Be clean!” Immediately the leprosy left him and he was cured. Jesus sent him away at once with a strong warning: “See that you don’t tell this to anyone. But go, show yourself to the priest and offer the sacrifices that Moses commanded for your cleansing, as a testimony to them.” Mark 1:40-44

This account of Jesus healing the leper early in his earthy ministry is peculiar. It runs against the grain that anyone new in town with an agenda to make a difference would tell people he helped to stay mum about it. Can you image politicians running for office cautioning people in their riding “Now be careful! Don’t tell others what I’ve done for you to make your life better!” It just doesn’t make sense.

The Key to Faith

How can you believe if you accept praise from one another, yet make no effort to obtain the praise that comes from the only God? —John 5:44

This verse is a warning and an encouragement to you and me. The warning: if you and I do not make an attempt to receive the praise that comes from God rather than the praise of people, we too will find it impossible to exercise genuine faith. The encouragement: we are not required to have obtained the honor and praise of God, but only to make an effort to obtain it. God's commands are not burdensome (1 John 5:3).

He is not demanding that we perfectly repudiate the praise of people and absolutely receive His praise; He is only asking us to make an effort to obtain His praise. Nothing can be more reasonable than that.

Is it Time for a Heart Health Screen?

Source: Contributed by the National Heart Centre Singapore (NHCS), this article was first published in Asiaone as part of a series on heart health. 

In Singapore, cardiovascular disease - a class of diseases affecting the heart and blood vessels - is the leading cause of death and morbidity. Coronary heart disease - a subset of cardiovascular disease - is the number two killer. It is the failure of the coronary arteries or vessels supplying oxygen to the heart and surrounding tissue. Coronary heart disease (also known as coronary artery disease) is expected to afflict more people at a younger age as we become more sedentary and develop unhealthy eating habits. Coronary heart disease is known to develop over a long time and can go undetected in the early stages as there may be no symptoms. For some patients, the onset of a major heart attack with its attendant complications is the first and only symptom of coronary artery disease. This can be avoided if more patients, especially those with known risk factors, keep track of their heart health. What is heart health assessment? Heart health assessment plays an important part in the early diagnosis and treatment of heart disease. This is especially important for people who do not seem ill. "This is because cardiovascular risk factors could be detected, allowing for earlier therapy," explains Dr Paul Chiam, Consultant Cardiologist at the National Heart Centre Singapore. "Early heart problems (if any) could also be picked up. Treatment - including lifestyle modification - can help to prevent or delay complications". A basic assessment is relatively pain-free, except for routine blood taking. The assessment usually begins with a medical history review and a detailed physical examination. It also includes tests such as the ECG (electrocardiogram), chest x-ray, and fasting lipid and glucose profiles to evaluate basic cardiac status and risk profile. The results will help to determine if the risk factors for heart disease - such as high blood pressure, diabetes or elevated cholesterol levels - are present. Besides cardiovascular risk factors, early heart conditions such as underlying heart artery blockages can be picked up. Early intervention can prevent the condition from becoming worse. Who can do the screening? A family physician or GP can provide most of the basic screening. He or she may refer patients to a cardiologist for further tests, such as an exercise stress test, based on clinical findings from the basic screening. Who should have heart health screening? The recommended age to start assessing heart health for most people is around 40-45 years. For people with strong family history of heart disease, they should perhaps start earlier, at around 35 years old. As for the frequency of the check-ups, Dr Chiam says, "Depending on the patient's clinical history and the risk profile, the doctor may recommend that a checkup be done every one to five years." What are the tests for heart disease? Blood testsThis analyses cholesterol levels, kidney and liver function and diabetes mellitus. It can also confirm if you are having a heart attack if you are experiencing chest pain Electrocardiogram (ECG) Identifies abnormal heart rhythm and evaluates if symptoms of chest discomfort are due to heart disease. The patient will be asked to lie on a bed and electrodes will be placed on his chest, arms and legs. These electrodes help to detect the electrical activity of the heart. Patient can breathe normally during the procedure, but should avoid moving or talking to prevent distortion of test results. This test takes about 5 to 10 minutes. Chest x-ray Diagnoses abnormalities in cardiovascular and pulmonary systems - heart, lungs and blood vessels. Exercise stress testThis assesses the response of the heart to increased workload and demand for blood supply during exercise or exertion. Electrodes are placed on the patient's chest for ECG monitoring before the test. The patient's ECG and blood pressure are taken at rest. The patient is then asked to walk on the treadmill machine. The speed and gradient of the slope will increase every 3 minutes to stress the heart gradually. During the test, the patient's blood pressure, heart rate, ECG and general condition are monitored closely. The patients should inform the doctor to stop the test at any time if they are feeling tired, unwell or unable to continue. The procedure takes up to 1 hour, inclusive of preparation time. Calcium score on CT scan By assessing the amount of calcification in the coronary arteries, this test detects coronary artery disease at an early stage when there are no symptoms and helps to determine its severity. The technologist begins by positioning the patient on the computed tomography (CT) examination table, usually flat on the back. Straps and pillows may be used to help the patient maintain the correct position and to hold still during the scan. Electrodes for ECG will be attached to the chest to monitor heart beats. This makes it possible to record CT scans when the heart is not actively contracting. Patients are asked to hold their breath for a period of 10 to 15 seconds while images are recorded. You may also feel a little warm upon injection of the contrast, which should subside after a short while. When the examination is completed, you will be asked to wait until the technologist verifies that the images are of high enough quality for accurate interpretation. Sign up for our free e-newsletter to stay up-to-date with the latest health tips ! http://www.healthxchange.com.sg/healthyliving/SpecialFocus/Pages/Is-It-Time-For-A-Heart-Health-Screen.aspx

Sudden Cardiac Death: Are You at Risk?

Source: Article first appeared in "Know Your Man Inside Out" by SingHealth / Her World

Did you know?

Heart attacks are not confined to the old. Even young men can get a heart attack leading to sudden death.  80 per cent of all sudden cardiac death are related to coronary heart disease which, in most cases, can be prevented.

What causes young men to die suddenly?The most common cause is sudden cardiac death (SCD), of which 80 per cent is related to coronary artery disease (CAD) (see box below), with or without a heart attack.

Unfortunately, over half of sudden cardiac death victims have no prior symptoms. Some patients have chest pain, breathlessness or sweating. When these occur in a patient at risk of heart problems, treatment should always be sought immediately.

An SCD attack is not the same as a heart attack. SCD is caused by an abnormal heart rhythm due to an abnormal ‘electrical circuitry’ of the heart. A heart attack is caused by blockage of the arteries supplying blood to the heart. The subsequent damage to the heart muscle may or may not lead to an SCD attack. It is estimated that 1,000 Singaporeans die from SCD every year, about half of whom are below 60 years old.

Learn to recognise these symptoms

• Central or left-sided chest pain often associated with sweating, nausea or breathlessness. The pain is described as something weighing heavily on the chest and is usually brought about by physical or emotional stress. It usually goes away within minutes when the stressful activity is stopped.

• Shortness of breath. Because the heart muscles are damaged by the shortage of blood supply or from a heart attack, it can’t pump blood efficiently to meet the body’s needs.

• Discomfort on exertion, jaw tightness on exertion or after meals. These symptoms immediately subside on resting.

In anyone at high risk for heart disease (eg diabetics, high cholesterol, hypertension, strong family history of heart disease), any chest symptom, even atypical, should be investigated. Diagnosis is made with an electrocardiogram and blood tests.

Treatment may involve hospitalisation and ways to restore blood flow in the coronary artery (by angioplasty or thrombolysis).

If you are around...

1. Call the ambulance immediately. Early treatment increases survival rate.

2. Perform chest compression CPR. This will also improve the chances of survival.

Cardiac Artery Disease (CAD) CAD is a common type of heart disease where fatty deposits accumulate in the coronary artery and impede the blood flow. Reduced blood flow to the heart can cause chest pain (angina). A sudden, complete blockage can lead to a heart attack. Many people who have this form of heart disease are not aware they have it. CAD develops slowly and silently over decades. It can go virtually unnoticed until it produces a heart attack. You can prevent or slow down CAD by taking steps to improve your heart health. Drugs and surgical techniques can open up narrowed coronary arteries, but the best long-term solution is to make the right lifestyle choices.

Are You in the High-Risk Group?Age: Age increases a person’s susceptibility to heart disease. Gender: Men are three to five times more likely to have coronary heart disease than women. However, the risk for women increases after menopause. Five to 10 years after menopause, women have the same risk for coronary heart disease as men. Ethnicity: Compared with Chinese, South Asians (Indians, Sri Lankans, Pakistanis, etc) are three times more likely to suffer from coronary heart disease. Malays have double the risk compared with Chinese. Obesity: People who have excess body fat – especially located around the waist – are more prone to heart disease and stroke even if they have no other risk factors. Excess weight increases the strain on the heart. It also raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL, ("good" cholesterol levels). It is also associated with the development of diabetes mellitus. Family history: You can be at higher risk of heart disease if your immediate family members (parents, children, brothers and sisters) have a history of premature heart disease. Certain risk factors tend to run in some families. If there is a history of heart disease in your family, you should try very hard to control your other risk factors. "In general, adults should know their family history of heart disease or sudden death. They should know their cholesterol level and know if they have diabetes mellitus and abnormal blood sugar levels. If you have any high-risk factor, get your doctor’s advice on how to improve those risk factors, change your lifestyle and dietary habits, and embark on a safe exercise programme."  Dr Teo Wee Siong, Senior Consultant Cardiologist, National Heart Centre http://www.healthxchange.com.sg/healthyliving/SpecialFocus/Pages/Sudden-Cardiac-Death-Are-You-at-Risk.aspx?

Sudden Cardiac Death: Not So Random As It Looks

Source: Article by National Heart Centre Singapore (NHCS), Heart Health

It is estimated that 1000 Singaporeans die from sudden cardiac death (SCD) every year, about half of whom are below 60 years old.

Is sudden cardiac death the same as a heart attack?

"A sudden cardiac death, or SCD, is not a heart attack," said Dr Aaron Wong, Senior Consultant at the National Heart Centre Singapore (NHCS). "A SCD can be due to many causes but is usually caused by an abnormal heart rhythmdue to abnormal 'electrical circuit' of the heart. A heart attack is caused by blockages in the heart arteries supplying blood to the heart, causing a portion of the heart muscle to be damaged. Heart attack may lead to abnormal heart rhythm, and therefore SCD, but not always."

Unlike a heart attack, which has symptoms such as chest pains and breathlessness, SCD usually has no warning signs. The only way to treat a SCD is to set the rapid heartbeat back to its normal pace by delivering an electrical shock to the heart using a device called a defibrillator.

Patients at high risk of SCD may be advised by their doctors to have an Implantable Cardiac Defibrillator (ICD)implanted. The ICD is a pocket-sized device which detects abnormal heart beats or rhythm and sends an electric current to the heart. This electric current shocks the heart and helps to reset the heart rhythm like a mini-defibrillator.

The most common cause

The most common cause of SCD is a sudden onset of abnormal heart rhythm. This is usually due to a fast but chaotic heart rhythm called ventricular fibrillation (VF) or tachycardia (VT). An extremely slow heart rate may cause SCD as well but usually presents with prior symptoms of giddiness or fainting episodes.


In a patient with VF (a form of cardiac arrest), the heart beats 400 to 500 beats per minute and the normal rhythmic contractions of the lower chambers of the heart stop. When this happens, blood and oxygen are not pumped to the rest of the body and within seconds, the brain becomes starved of oxygen and the person loses consciousness. Without immediate treatment, the brain will cease to function and the person can die within minutes.

Who is likely to suffer from sudden cardiac death?

SCD does not randomly occur in people. Almost 75 per cent of all SCD patients show signs of a previous heart attack and 80 per cent of them have signs of coronary artery disease (CAD).


It has also been found that people who have high blood pressure, high cholesterol, diabetes mellitus, or a family history of CAD are at risk of developing CAD which in turn could lead to SCD.


According to Dr Ching Chi Keong, Consultant, Department of Cardiology at NHCS, a typical SCD patient is likely to be male, more than 35 years old and has a family history of early heart attack. There is also a higher incidence amongst South Asians.


For those who are younger than 35 years old, risk factors include:

• a family history of sudden deaths or unexplained drownings
• recurrent chest pain and/or fainting episodes during physical exertion and
• known heart disease, especially hypertrophic cardiomyopathy.

Risk factors of SCD 

Coronary artery disease (CAD)

• SCD can occur during a heart attack where the damaged heart muscle induces an abnormal heart rhythm or there is a sudden loss of heart pumping function due to massive damage to the heart muscle. The latter is usually not sudden but presents initially with symptoms of difficulty in breathing.
• Dr Wong advises, "Patients who have CAD (e.g. previous angina, heart attack, angioplasty or bypass surgery) should control their risk factors for CAD and stop smoking. Some medications have also been proven to reduce the progression of CAD, the risk of heart attack and heart failure but may have to be taken on a long term basis. Patients should not stop or reduce their medications dosage without consulting their doctors."

Poor heart function or heart failure

• Poor heart function is usually caused by repeated injury to the heart muscle (heart attacks) that leads to scarring and subsequent loss of muscle contraction function.
• Poor heart function can also be due to disease of the heart muscle (known as cardiomyopathy) due to an inherited heart muscle disease or virus infection.
• SCD is one of the most common mode of death in patients with heart failure. Patients with heart failure should be on long-term medications that have been shown to improve symptoms and prolong life expectancy. Patients with severely impaired heart function may benefit from implanting an ICD to reduce the chance of dying from SCD.

Strong family history
Some heart diseases, including CAD, cardiomyopathy and some heart electrical disorders are hereditary.

• The most common inherited risk factor is high cholesterol.
• Extremely high cholesterol can lead to CAD and heart attack at an early age. A person whose parents or sibling had CAD at a young age or high cholesterol should have his/her cholesterol checked regularly. Aggressive control of cholesterol levels can reduce the chance of developing CAD and therefore SCD.
• Hypertrophic cardiomyopathy (HCM)
• An abnormal thickening and arrangement of the heart muscle cells can cause VF or VT leading to SCD, especially during exertion. Certain types of HCM are prone to SCD and a person with HCM who has close family members who passed away due to SCD should have an ICD implanted.
• Arrhythmogenic right ventricular dysplasia (ARVD)
• A structurally abnormal right ventricle is also an inherited disorder. An ICD is often required in these patients.
• Dilated cardiomyopathy
• Features a dilated heart with poor heart function. The condition can also be caused by a virus infection or in some cases, is related to pregnancy.

Electrical disorders of the heart

• Some electrical disorders of the heart can lead to SCD and occasionally can be picked up during routine ECG. Many of these disorders are also inherited, and a strong family history of SCD is important.
• One of these disorders (known as the Wolff-Parkinson-White Syndrome) is caused by an extra nerve connecting the heart chambers, which can cause an 'electrical short-circuit' in the heart, resulting in a rapid heartbeat. This condition is now easily treatable with catheter ablation, a procedure where a thin tube (catheter) is advanced into the heart via a vein (usually from the leg/groin), to deliver a burst of radiofrequency energy to burn off this abnormal nerve or pathway.
• Another type of electrical disorders that can cause SCD is due to abnormalities in the heart muscle cell membrane (e.g. Brugada's and Long QT Syndromes).
• They frequently present in young, apparently healthy individuals with no known heart problems, although some abnormalities can often be seen in the ECG on careful examination. In many, the first presentation is usually SCD. Frequent fainting episodes or even a diagnosis of epilepsy may accompany such conditions. For these patients, the ICD is the only alternative to prevent SCD.

Awareness of your risk factors is important. "If you are more than 35 years old, do adopt a healthy lifestyle. Screen yourself for risk factors of CAD (e.g. diabetes, high cholesterol) and stop smoking, especially if you have a family history of CAD. For those who are less than 35 years old, learn to recognise the above symptoms and go for a medical check up for assessment", says Dr Ching.

What to do if you witness a sudden cardiac death

In the event a person collapses from SCD, the key to survival is early defibrillation. It has been found that each minute of delay before defibrillation reduces survival by about 10 per cent. To help a person who has collapsed from SCD, the following steps have proven to be vital.

1. Call the ambulance.
2. Perform cardiopulmonary resuscitation (CPR).
3. Use the automated external defibrillator (AED), if available.

http://www.healthxchange.com.sg/healthyliving/SpecialFocus/Pages/Sudden-Cardiac-Death-Not-So-Random.aspx?

Beware the Ides of March?

by Alexandra Gekas 

“Beware the Ides of March,” the soothsayer warned Julius Caesar during a public appearance before he is slain by a band of Senators, including Brutus and Cassius as he makes his way into the Roman Senate house. 


But while Caesar’s assassination is the most infamous event on the 15th of March, it is not why the day was originally recognized.

“Ides” is the word used in Latin to delineate the half-mark of each month, and was used for the 15th of March, May, July and October and the 13th day the rest of the months in a calendar year. 


In March, the Ides bore extra significance as it was when Mars, the god of war was celebrated with a parade in ancient Rome.

So whether you chose to celebrate Mars, or take this day as a warning of possible politicking around you, just be sure to take note of its literary, cultural and historical significance.

Read more: Ides of March 2012 - Beware the Ides of March - Woman's Day 

gotquestions  http://www.womansday.com/life/daily-buzz/ides-of-march-2012