Friday, March 20, 2009

Enlarged thyroid gland and Hyperthyroidism

What Is Hyperthyroidism?

Hyperthyroidism is a condition in which there is overproduction of thyroid hormone by the thyroid gland, causing the levels of thyroid hormone in the blood to be too high. People who have it are often said to have an "overactive thyroid".

Miss Manaf''illa hyperthyroidism patient for 20 years

The thyroid gland is a small, butterfly-shaped organ located in the neck below and in front of the Adam's apple.

Thyroid hormone is a chemical substance produced by the thyroid gland and released into the bloodstream. It interacts with almost all body cells, causing them to increase their metabolic activity.
This abnormally high level of thyroid hormone typically speeds up the body's metabolism. Metabolism is the chemical and physical processes that create the substances and generate the energy needed for cell function, growth, and division.

Symptoms of hyperthyroidism may include a rapid heartbeat, tremor of the fingers and hands, weight loss, and the inability to tolerate heat.
About the thyroid gland

The thyroid lies just under the Adam's apple in the neck. There are two lobes to the gland, and they lie just in front and at either side of the windpipe (trachea).
The thyroid is part of the body's endocrine system, which consists of glands that secrete hormones into the bloodstream.
The thyroid gland secretes thyroid hormones, which control the speed at which the body's chemical functions proceed (metabolism). To produce thyroid hormones, the thyroid gland needs iodine, an element contained in food and water.
The para-thyroid gland also produces a hormone, called calcitonin, which is involved in the metabolism of our bones.

Thyroid and par-thyroid glands

What Is Thyroid Hormone?
Hormones are chemical messengers released into the bloodstream by specialized glands called endocrine glands.
The hormone circulates through the body in the bloodstream delivering a message to other parts of the body. The "message" causes effects far from the gland that produced the hormone.
Thyroid hormone is produced in the thyroid gland, which is located in the front of the neck. It is released by the thyroid gland into the bloodstream and circulates throughout the body. Almost every cell in the body, from those in the brain to those in the feet, responds to the hormone.
There are two different forms of thyroid hormone present in the bloodstream. The two forms of thyroid hormone differ in the number of iodine units or molecules attached to the hormone. Iodine is a very important component of thyroid hormone.
. Thyroid hormone with four iodine units is abbreviated as T4.
. Thyroid hormone with three iodine units is abbreviated as T3.
Most thyroid hormone in the blood is T4.
. T3 is the form that is active in the body, not T4.
Certain cells in the body convert T4 to T3.

Nice To Know:
Just about all the iodine we consume in food is used for the production of thyroid hormone. Iodine is added to regular table salt to ensure that individuals get enough iodine in their diets. Salt boxes are usually labeled "iodized salt." People with deficiency in iodine will develop hypothyroidism, a condition in which the circulating levels of thyroid hormone are too low..

What Does Thyroid Hormone Do?
Cells respond to thyroid hormone with an increase in metabolic activity. Metabolic activity, or metabolism, is a term used to describe the processes in the body that produce energy and the chemical substances necessary for cells to grow, divide to form new cells, and perform other vital functions.

If you think of each cell in the body as a car, then thyroid hormone acts as if you were tapping on the accelerator pedal. Its message is "go."
Because thyroid hormone stimulates cells, it causes major body functions to "go" a bit faster.
. Heart rate increases.
. Breathing rate increases.
. Use of proteins, fats, and carbohydrates increases.
. Skeletal muscles work more efficiently.
. Muscle tone in the digestive system, such as those in the walls of the intestines that help to move food through the digestive system increases.
. Mental alertness and thinking skills are sharpened.

How Are Blood Levels Of Thyroid Hormone Controlled?
Normally, the body runs like a car on cruise control-functioning at a steady rate. This steady state is known as homeostasis. The body's control system that regulates the cells to function at a steady, appropriate metabolic rate may be explained as follows:

. Special "detector" cells in the brain monitor the level of thyroid hormone in the blood.
. When the level of thyroid hormone drops, these cells send signals to a nearby organ in the brain known as the pituitary gland.
. These signals stimulate the pituitary gland to release a substance called thyroid-stimulating hormone (TSH) into the bloodstream.
. TSH signals cells in the thyroid gland to release more thyroid hormone into the bloodstream.
. When the blood level of thyroid hormone has increased enough, the detector cells in the brain detect the increase in thyroid hormone level.
. These detector cells send signals to the pituitary gland to stop release of TSH.

Nice To Know:
The medical specialty called endocrinology is devoted to the study and treatment of disorders of endocrine glands, including hyperthyroidism. Primary care physicians refer individuals to an endocrinologist for a consultation and ongoing care for hyperthyroidism or other endocrine conditions.

Facts about hyperthyroidism
Hyperthyroidism is a medical condition characterized by an abnormally high level of thyroid hormone in the bloodstream.
Hyperthyroidism is commonly referred to as "overactive thyroid."
Hyperthyroidism is also known as thyrotoxicosis from the prefix "thyro-" meaning thyroid, the term "toxic" meaning poisonous, and the suffix "-osis" meaning condition.

Thyroid literally means "shaped like a shield." The thyroid gland lies in front of the voice box. The gland and it associated support tissues are shaped like a shield.
Symptoms of hyperthyroidism may include a rapid heartbeat, muscle weakness, tremor, weight loss, and the inability to tolerate heat.

About one or two in every 100 Americans develop hyperthyroidism. Most of them are women or girls.
Each year, about 500,000 Americans are diagnosed with hyperthyroidism.
The most common form of hyperthyroidism is Graves' disease. About 95 percent of affected individuals have this form of the disease.

Barbara Bush; Graves' disease sufferer

Nodular thyroid disease is much less common than Graves' disease as a cause of hyperthyroidism.
The three major treatment options-medication, radioactive iodine, and surgery-work by decreasing the amount of thyroid hormone produced. The goal of treatment is to bring the body into a healthy, balanced condition.

About 30 percent of people with Graves' disease have associated eye disease. Hyperthyroid eye disease may cause significant changes in vision along with eyes that bulge or protrude from the face. Other problems with the eyes vary greatly and may include discomfort, pain, or excessive tearing to blurry vision or even double vision.

What Causes Hyperthyroidism?
These are two major causes of hyperthyroidism.
About 95 percent of persons diagnosed with hyperthyroidism are found to have a condition called Grave's disease
Most of the remaining persons have a condition called nodular thyroid disease
A less frequent cause is inflammation of the thyroid gland, called thyroiditis
Uncommon causes include hormone producing tumors of the pituitary gland or ovary and iodine-induced hyperthyroidism from iodine-containing drugs
What Is Graves' disease?
Graves' disease is a condition resulting from a problem in the body's immune system.

The immune system is a complex network that normally defends the body against "invading" organisms and other foreign substances. When the immune system detects a foreign substance in the body, it responds to this by producing antibodies against the invaders. These antibodies will recognize and attack this foreign substance when they next encounter it.
In Graves' disease the immune system mistakenly directs an immune "attack" against its own healthy cells. Antibodies are manufactured and misdirected against the thyroid gland, mimicking the action of the hormone from the brain (thyroid stimulating hormone) that normally controls the thyroid function. These antibodies act like a switch put into a permanent "on" position. Thyroid cells are continually stimulated to produce and release thyroid hormone, even after blood levels are already high.
Any condition in which the body's immune system attacks its own cells is called an autoimmune disease.
Graves' disease is more frequent in women than in men. The symptoms of Graves' disease may begin at any age but those between the ages of 20 and 40 are more likely to develop this condition.
What Happens With Graves' Disease?
With time, the over stimulated thyroid becomes generally enlarged and may eventually become noticeable to the affected person or others as a swelling in the front of the neck. In addition, in some people Graves' disease may be associated with particular eye and skin changes.

The eye changes are called hyperthyroid eye disease and occur in about 30 percent of people with Graves' disease. These changes are visible as protruding eyes. There is no relationship between the appearance of eye changes and the severity of the hyperthyroidism. There is increased risk for infection and visual problems in persons with severe hyperthyroid eye disease.
Eye disease is most likely to progress in people who fit a certain profile.
This includes those:
. Whose hyperthyroidism is not promptly corrected and controlled
. Whose thyroid hormone level is not within normal limits
. Who smoke cigarettes

The autoimmune process that causes hyperthyroid eye disease is poorly understood. Doctors do understand what causes the swelling of tissues behind the eyeball, decreased range of motion of the muscles around the eyeball, and retraction (a pulling back) of the eyelids.
Common symptoms include pain, excessive tearing, increased sensitivity to light, blurred vision, double vision, or protrusion of the eyes from the face.
The most common skin problem associated with Graves' disease is called pretibial myxedema, which is characterized by swollen patches of skin on the front of the lower legs. This skin change is found in about five percent of persons with Graves' disease. These patches itch and become bothersome; usually no other symptoms or problems are associated with them. Doctors evaluating a patient with possible hyperthyroidism check for pretibial myxedema because it is almost never found in persons who do not have Graves' disease.

What Is Nodular Thyroid Disease?
Nodular thyroid disease is unlike Graves' disease in five important ways:
Nodular disease is much less common.
. The cause is not known.
. It tends to develop in persons older than those who develop Graves' disease.
. The disease process is not found throughout the thyroid gland.
. No particular problems outside the thyroid, such as eye or skin disease, are seen with nodular thyroid disease.

When a physical exam is done, the thyroid is usually enlarged and painless. As untreated disease progresses, distinct nodules (lumps) may be felt with the fingertips. Within the thyroid gland, nodules of abnormal thyroid cells are visible among areas of normal cells. This patter of nodular disease is seen as spots of over activity on radioactive iodine uptake scanning.

Is Hyperthyroidism Genetic?
Certain genetic factors may make someone more likely to develop an autoimmune disorder. It is not uncommon for individuals with Graves' disease to develop other autoimmune conditions including:
.. Hashimoto's thyroiditis, a thyroid condition that results in an unusually low thyroid hormone level

.. Pernicious anemia

Nice To Know:
The fact that there is a genetic basis for Graves' disease means that more than one member of a family may develop it. When one person is diagnosed with Graves' disease, other family members should have their thyroid function checked by their doctors

What Are The Symptoms Of Hyperthyroidism?
If you think of the body as a motor car, the most common symptoms of hyperthyroidism imitate a vehicle that is running too fast, for too long.
These symptoms include the following:
. Rapid heartbeat, sometimes with palpitations
. Extreme tiredness
. Inability to tolerate heat
. Excessive sweating
. Weight loss, with a normal or increased appetite
. Nervousness and irritability
. Inability to sleep
. Shakiness and muscle weakness, often with trembling in the hands
. Diarrhea
. Menstrual problems in women, especially lighter periods or absence of periods
Some symptoms, such as excessive sweating and the inability to tolerate a hot environment are directly due to heat generated within the body by increased metabolic activity.
Weight loss reflects use of body stores of fats, proteins, and carbohydrates, as normal food intake cannot keep up with demand.
The presence and severity of symptoms varies from person to person. For reasons not understood, older individuals with hyperthyroidism often have far few symptoms compared to younger people. Although many symptoms of hyperthyroidism cause distress, most are not dangerous.
An exception occurs in some people who have heart disease. In these cases, untreated hyperthyroidism places additional stress on the heart, causing problems such as heart failure, irregular heartbeat (atrial fibrillation), or abnormal heart rhythm (arrythmia).
How Is Hyperthyroidism Diagnosed?
Individuals with hyperthyroidism usually tell their doctors about symptoms such as rapid heart rate, intense fatigue, inability to tolerate a hot environment, and constant nervousness, jitteriness, or irritability. In addition, doctors look for physical signs such as weight loss, rapid heartbeat, slight tremors of the hands, or excessive sweating. The presence of such symptoms and signs strongly suggests the need for diagnostic testing for hyperthyroidism.

Hyperthyroidism is diagnosed from blood tests:
. Abnormally high levels of T3 and T4. This indicates that hyperthyroidism is present.
. An unusually low level of circulating thyroid stimulating hormone (TSH). This is normally due to an abnormality within the thyroid gland.
In some cases of hyperthyroidism, a special diagnostic scan of the thyroid gland using radioactive iodine called radioactive iodine uptake (RAIU) testing may be particularly useful. This test is often done on an outpatient basis in the nuclear medicine department of a hospital.

RAIU testing shows whether:
The entire thyroid gland is overactive, in which case, a large amount of radioactive iodine is "taken up" by the thyroid.
Only portions of the thyroid are overactive. Significant amounts of radioactive iodine are "taken up" by portions of the thyroid, not the entire gland.

Nice To Know:
Typically, Graves' disease produces increased iodine uptake throughout the thyroid gland. Nodular thyroid disease produces a scan that shows patches of increased iodine uptake surrounded by areas with normal uptake.

How Is Graves' Disease Diagnosed?
Most people with hyperthyroidism, or about 95 percent, are eventually diagnosed with Graves' disease.
The diagnosis is confirmed through laboratory testing.
In people with Graves' disease, blood tests usually demonstrate:
. Increased levels of T3
. Increased levels of T4
. Low levels of TSH
. Presence of thyroid stimulating antibodies
A radioactive scan, such as RAIU testing, is usually not necessary to confirm the diagnosis of Graves' disease. If a scan is performed, it typically shows increased uptake of radioactive iodine throughout an enlarged thyroid gland. Areas of iodine uptake represent those areas in the gland producing thyroid hormone.

How Is Nodular Thyroid Disease Diagnosed?
When a physical exam is performed, the thyroid is usually larger than normal; however, there is usually no pain associated with an enlarged thyroid. As untreated disease progresses, individual lumps or nodules may be felt with the fingertips.
RAIU testing may be used to diagnose nodular thyroid disease. In individuals with this form of hyperthyroidism, this test shows clusters or nodules of abnormal thyroid cells among areas of normal cells. After this test, doctors see "spots" of overactivity on radioactive iodine uptake scanning film.
Is Hyperthyroidism Serious?
How serious hyperthyroidism is depends on the severity of the condition causing it. In people whose thyroid hormone levels are only slightly elevated, the symptoms will be fewer and less severe than for those with very high levels of circulating thyroid hormone.

HAIR Falling

The seriousness of hyperthyroidism also depends on how well the body can compensate for the changes brought on by excess thyroid hormones. For example, a heart that is already stressed by heart disease may deteriorate and develop heart failure as the heart rate rises in response to the increased level of thyroid hormone. In addition, serious eye complications are fortunately rare, but need to be properly cared for.
How Is Hyperthyroidism Treated?
There is no known cure for Graves' disease. Three forms of therapy are available for the treatment of hyperthyroidism.
These therapies work by decreasing the amount of thyroid hormone made by the thyroid gland; therefore, an excess amount of hormone does not get into the bloodstream.

The treatments available are:
. Anti-thyroid drugs
. Radioactive iodine, also known as radioiodine or 131I

How-To Information:
When working with a doctor to decide the correct treatment for an individual, consider the following:
. Is there anything in the personal or family medical history that makes one form of treatment better for that individual?
. Will affected individuals be able to take their medications on time, every day, and stick closely to the dosing plan for an anti-thyroid drug over a long period of time?
. Would a permanent treatment choice, such as radioiodine, be better?
. What About Surgery As A Treatment For Hyperthyroidism?
Surgical treatment for hyperthyroidism involves removal of almost all of the thyroid gland. The remaining part of the gland is not able to produce excessive amounts of thyroid hormone. This surgical procedure is known as a near total thyroidectomy. Surgical treatment is less common than in the past.

There are important points to know about surgery for hyperthyroidism:
It brings rapid, permanent control of hyperthyroidism. Preparation before surgery with anti-thyroid drugs is advised; this may require several months.
Almost all patients develop hypothyroidism following surgery.
As with other surgical procedures, there are the usual risks of:
General anesthesia
. Bleeding
. Nerve damage
. Wound infection
. Other type of infection
. Other complications
Need To Know:
If any of the following factors are present, surgery is more likely to be recommended:
. A very large thyroid.
. A nodular thyroid of any size that does not demonstrate much iodine uptake on RAIU scanning. This finding eliminates radioiodine as a choice for therapy.
. A thyroid nodule that may be cancerous.
. Moderate to severe hyperthyroidism in a child or a pregnant woman.

Need To Know:
It is extremely important that people with hyperthyroid eye disease make sure that their thyroid levels remain normal after treatment for hyperthyroidism. Smokers must make every effort to quit. A smoking-essation program involving nicotine replacement therapy or a support group is usually helpful.

Hyperthyroid Eye Disease
Graves' disease may be associated with particular eye changes.

The eye changes are called hyperthyroid eye disease and occur in about 30 percent of people with Graves' disease. These changes are visible as protruding eyes. There is no relationship between the appearance of eye changes and the severity of the hyperthyroidism. There is increased risk for infection and visual problems in persons with severe hyperthyroid eye disease.
Eye disease is most likely to progress in people who fit a certain profile.
This includes those:
. Whose hyperthyroidism is not promptly corrected and controlled
. Whose thyroid hormone level is not within normal limits
. Who smoke cigarettes
The autoimmune process that causes hyperthyroid eye disease is poorly understood. Doctors do understand that there is swelling of tissues behind the eyeball, decreased range of motion of the muscles around the eyeball, and retraction (a pulling back) of the eyelids.
Common symptoms include pain, excessive tearing, increased sensitivity to light, blurred vision, double vision, or protrusion of the eyes from the face.
Most people with hyperthyroid eye disease do not need any treatment beyond special eye drops. When more extensive care is required, treatments may be needed to decrease the pressure on the eyeball. This increase in pressure is the result of tissue swelling in the eye sockets. Additional treatment may be required to increase the range of motion (ROM) of the eyes or to improve the cosmetic appearance of bulging eyes.
These may include:
. Treatment with certain drugs such as steroids or immunosuppressive drugs to decrease the swelling behind the eyes.
. External radiation therapy to decrease swelling behind the eyes.
.l Surgery to remove a small portion of bone from the eye socket.
. Treatment with certain medications such as steroids or immunosuppressive drugs to help improve eye muscle function and increase range of eye muscle movements.
. Plastic surgery to improve the appearance of eyes or eyelids

How-To Information:
When discussing treatment options, it is important to discuss several issues with your ophthalmologist including:
. Your chief concern about your eyes
. How will this concern be treated
. The chief medical concern from the eye doctor's perspective
. How will treatment address his or her concerns
. The presence of additional, significant medical conditions
. How the proposed treatment plan affects these pre-existing conditions
. The timing of treatment steps and the particular order of these possible treatments. For instance, it may be advisable to correct abnormally high or low levels of thyroid hormone before beginning additional treatment.

Looking After Yourself
People with hyperthyroidism may experience many uncomfortable and sometimes distressing symptoms.
These may include:
. Weight loss
. Heart palpitations
. Anxiety
. Irritability

Before and during treatment for hyperthyroidism, make sure your doctor knows which symptoms or problem are most bothersome to you.
How-To Information:
If anxiety or heart palpitations are troublesome, treatment with anti-adrenergic drugs, also known as beta-blockers, may calm these symptoms. If you already have heart disease, drug treatment with beta blockers may not be advisable.
Be sure that your endocrinologist and other treating physicians are aware of your other medical conditions, if any.
During treatment for hyperthyroidism, there may be some restrictions imposed on your day-to-day activities, including those related to your:
. Work
. Leisure time
. Recreational time
. Travel plans

This is particularly true for people who choose radioiodine therapy or surgery.

Need To Know:
If antithyroid drugs or radioactive iodine is used, thyroid hormone levels are monitored to ensure that they are maintained within normal limits. The treating doctor will schedule laboratory testing and regular visits to complete these tests.
When treatment is complete, most people feel much better than before their treatment. They are able to do more and to enjoy the activities of their daily lives. Most find that, after appropriate treatment, there are essentially no treatment-related limitations on their activities of daily living.
The chance of developing hypothyroidism, or low levels of thyroid hormone, depends on the cause of the hyperthyroidism and its treatment. It is likely, in many cases, that hypothyroidism may persist and become a permanent condition. Fortunately, hypothyroidism is usually treated successfully with thyroid hormone supplementation. This is taken in the form of a daily pill.

Oprah Winfrey diagnosed with hypothyroidism.

Need To Know:
The possibility of lifetime hypothyroidism as a result of treatment for hyperthyroidism is real. Therefore, it is important to make a commitment to regular, lifetime follow-up care. This follow-up ensures that thyroid hormone levels remain normal. After thyroid hormone levels are normal and stable, it is possible that hormone levels may need to be checked only once a year.

Hyperthyroidism And Pregnancy
About 1 in 500 women have hyperthyroidism during pregnancy. In some, it is a preexisting condition; in others, the condition will develop during the course of the pregnancy. It can be difficult to diagnose because the pregnancy often "masks" it; that is, some of the symptoms may be attributed to the pregnancy itself rather than to hyperthyroidism.
Hyperthyroidism may affect a woman's ability to become pregnant.
The most common cause of hyperthyroidism in pregnancy is Graves' disease.
Symptoms generally will be worse in the first half of the pregnancy, will lessen during the second half, and most likely will recur after the baby is born.
You should continue with your normal anti-thyroid medication during your pregnancy as prescribed by your doctor.
Most pregnant women and their babies will not experience significant problems if the hyperthyroidism is mild to moderate. If properly treated the pregnancy can be expected to progress normally.
Women with severe or uncontrolled hyperthyroidism have an increase risk of infection, iron deficiency (anemia), and high blood pressure accompanied by too much protein in the urine (a potentially dangerous condition called pre-eclampsia).
If a woman has severe hyperthyroidism, her baby has a chance of having hyperthyroidism as well. There is a risk to the outcome of the pregnancy, having a small baby or a premature birth.

Fortunately, most women who have hyperthyroidism in pregnancy can be successfully treated with medication.
The anti-thyroid drug
. Propylthiouracil or methimazole is commonly prescribed and can be safely used during pregnancy. It may take up to a month on medication for the symptoms to resolve.
. Radioactive iodine cannot be used during pregnancy. Rarely, if the symptoms and thyroid hormone levels cannot be controlled, surgery needs to be considered to remove the thyroid gland.
Hyperthyroidism does not affect labor and delivery. However, thyroid storm can develop which can be life threatening. The symptoms are an exaggeration of the normal hyperthyroid symptoms with a very fast heart rate, tremors, nervousness, altered consciousness, nausea, vomiting, diarrhea, and an extremely high fever. This will require intensive care treatment to try normalizing the very high thyroid hormone levels and keeping the patient cool.
Following delivery, anti-thyroid treatment must continue. Although both the anti-thyroid drugs Propylthiouracil and methimazole do pass into the breast milk, both can be used safely in breast-feeding women. You should discuss this with your physician.
Your baby will be thoroughly checked to be sure he or she is well with no evidence of thyroid problems. Most babies born to hyperthyroid mothers whose hyperthyroidism has been well controlled during pregnancy are normal healthy babies.

Putting It All Together
Here is a summary of the important facts and information related to hyperthyroidism:

. Hyperthyroidism is a condition in which there is overproduction of thyroid hormone by the thyroid gland.
. Symptoms of hyperthyroidism may include a rapid heartbeat, tremor of the fingers and hands, weight loss, and the inability to tolerate heat.
. The most common form of hyperthyroidism is Graves disease, a condition resulting from a problem with the body immune system.
. Some families have a tendency toward developing Graves disease.
. About 95 percent of individuals with hyperthyroidism have this form of the disease.
. About 30 percent of people with Graves disease have associated eye disease, which may cause significant changes in vision along with eyes that bulge or protrude from the face.
. The three major treatment options for hyperthyroidism-medication, radioactive iodine, and surgery-work by decreasing the amount of thyroid hormone produced.
. The effect of antithyroid drugs stops when treatment is discontinued, allowing the individual to switch to another treatment plan if necessary.
. Therapy with radioactive iodine permanently destroys thyroid tissue, meaning that too much thyroid will no longer be produced. The main disadvantage to this type of treatment is that hypothyroidism (low levels of thyroid hormone) may result. However, hypothyroidism is treatable.
. Surgery to remove almost all of the thyroid gland is called thyroidectomy and brings rapid permanent control of hyperthyroidism.
. Most people feel much better after treatment for hyperthyroidism is complete, but thyroid hormone levels still need to be checked periodically throughout a person lifetime.
. Most pregnant women and their babies will not experience significant problems if the disease is mild to moderate.

Wednesday, March 18, 2009

AWAS .. Pirates are on the Road to Kuala Pilah.

Today I feel urge to write on social issue instead of writing about medical one!! Aiming to help other peoples not to go through things I already suffered from it. My point from writing this article is to protect the principle issues, and never be about the material ones

There is saying said:

اذا أكرمت الكريم ملكته ،، وإذا أكرمت اللئيم تمرد

If you are generous to the genuine people, you can enjoy them …
If you are generous to sinister people they get revolt against you.


الساكت عن الحق شيطان أخرس

The One who is making quiet on the truth is a dumb devil.

"The measurement of a man have nothing to do if he is short or tall, big or small, only the measurement is about what he says, facts or false, lies or true, fulfill his prom
ises or deny what he says. No matter if he have a faith or with no faith, only his word will judge his legitimately or falsification".
I came to Malaysia as a Retired Medical Doctor after practicing medicine for almost 38 years in different location around the world. This time, I like to enjoy seeing Malaysia in depth; at the same time, my commitment is to help peoples and community around as medical advisory free of charges. My new mission is to educate peoples, how to protect themselves from different kind of aliments, diseases and infection, and stay in good health.
Beside I am medical carrier oriented doctor; I am also practicing applied herbal alternative medicine for 18 years with great successes starting in Canada. My desire is to introduce those medicinal herbs to peoples, and let them understand their potentials and health benefits.
While I am staying in Malaysia, I have to know very good Malaysian peoples; they are outstanding peoples full of manners and characters, they are genuine people no question about that, and the bottom line they are just good like the best apple fruits.
At the same time, I have to meet Some bad peoples, this nature of life!!
While the good peoples like good bright apple fruits in a box. The bad peoples on the other hand look like; and smell like; Rotten egg plant, staying in the same box with apple fruits, and I am trying hard to avoid get my hand dirty on approaching them, but whatever you try to be careful, my hand already get dirty; on knowing and dealing with such peoples before and today.
Last April 2008, we are looking to find some new plant to add to my collection here in Malaysia, working them in unused land at my house back yard. Therefore, my brother In-law suggests driving us to the road of Kuala Pilah. While we standing at one of those stalls on the road buying plant seedling, we meet a couple refer to them (Mr. & Miss Rubber).
They engaged with us by talking in English. I get to understand they are looking for help and advice, since they have a big area of farming land, and they need to know if it possible to utilize this land for good? Since they meet with some other peoples before us, and those peoples apparently simply turn there backs on any advice or action to them for a reason, and we get to know Why later!!
However, for me UNFOURTIONTLY I felt like I would like to help those people to find there way for good.
While we standing there on the corner of their land, I just suggest that I can help them to cultivate medicinal herbs for new concept. We invited them to our house; they came with their eldest daughter, which is already graduate form agriculture institute and having a diploma; and do nothing more than watching TV and staying at home no work, no nothing. (they all admitted this with no any denial).
I am very practical person, I always live up to any given word to any one. We start to talk business unconditionally, I never ask for advice fee, or asking any benefits from them. We start to draw a scheme of starting nursery area around there house to be easily handled by any family member around. For the big farming land area, it would be a future expansion to after developing the start nursery, Then we can talk business more seriously.

I offered to help them in doing plantation on my house back yard nursery, all medicinal herbs on my own expenses; and I start plant them by hundreds, and offering them different Varity of seeds of exotic herbs; none exist in Malaysia before. My plants and small growing trees inside my own herbal nursery where Hijacked continuously, and intentionally, on a frequent times through (Nine months), since we get to know (Mr. & Miss Rubber).
Some of my stoolen Herbs taken by Hundreds each; to Hijackeers place

I thought they would respect our VERBAL agreement of doing business together on foundation of 50/50 calculation. To be partners on the side of my effort; and working with them on developing there land; by thoughts, MONEY, and ideas; and by offering those new herbs; which they already taken it to there land; and planted there.
On the other hand, literally, they hijacked my herbs from my place to there place in Kuala Pilah.I count my plants; and I do have inventory of them, they are OVER 2000 seedling and cutting in plastic poly-bags or just loose. I do prepared them with my own hands; with lots of tiredness, and extra sweat, and money spending - plus 200 small trees (Ten month old) already hijacked from my herbal nursery, moving them by there truck Ta-Ta, with NO payment or return back, or apology from Hijackers.

What a shame when this can happen from Moslem or non-Moslem peoples.

قال تعالى : يا أيها الذين آمنوا أوفوا بالعهود- سورة المائدة /1
"And fulfilled the Covenant; the Covenant was responsible"
Those peoples can deceive you easily, by showing you there rituals as if they are doing every things just right. They use to complain from surrounding neighbors that they make fun of them, and look inferior to them. At that time of early involvement with those Hijackers, we have another impression, which they are good enough to us; but the dirty stuff is already hiding there, not surface yet.

The rest of the story already long extended to 9 months ago. Where this Mr. & Miss Rubber asks for sharing them in doing a project together; as a joint venture; and take them from zero information about medicinal herbs values, and there potential in the market value. We start with them and took them on high-level stand, to leap forward towards the market, and expand ourselves with them by sharing together incoming profits. this is our agreement on doing so.

But they never fulfill their promises in any given time.

After hard work and lot of effort to teach them the value of the project, now they have there own herbal nursery, and there own Blog site; on their own name. Using my blog site, and use most of my herbs to trade them in open market, freely, solely for themselves; also using my reputation as a medical consultant to give people more confidence about what they are promoting in their blog site, with no consideration for us as a joint partners; and suppliers of the herbs and knowledges, as we agree VERBALY before.
Even though; and by time they were asking for Money capital from our side to do a side project – Planting three ( 3 ) Acers of Corn on there land – and as they says: "They guarantee within 3 month - they will retune back the capital plus our share of the profit from planting this corn." We pay the money 8,000 RM; and wait 3 months, then four months; then 5 months up to 8 months and our money not yet to come back!!

Guess what happened! They hijacked my money for eight months, no planting corn or nothing like that, but doing and improving on our Hijacked herbal plants for themselves. Listed those herbs in there blog, clam they are the owner of those plants, selling them to the public after they learn how it works; and I already suffered hard time during teaching them HOW to do it and how it works!

علمته الرماية فلما اشتد ساعده رماني
"I taught him how to shoot; when his shooting intensified, he shoots me."

Not only they betrayed me, but also they go up higher level aiming to betrayed the governmental agriculture department and get a loan from the bank on reputation of my stolen plant. they succeeded to hijack the government department money too; to pay back my Hijacked money after 8 wasting months.

Not only that, I use to be generous unconditionally even with there kids, I offer to loan there eldest daughter -21 tears old- She Just finished her Diploma in KPM Beranang, and she is in charge for running this swindle operation. I looked to the girl as mature adult; and responsible person and willing to start her carrier life with honesty and credibility.

In addition, in the presence of her parents, I give her 500 Saudi Riyal money, to assist her to buy the necessity materials, and help her to lunch the herbal project operation.
The girl took my money and kept the them in her folder as a souvenir!! She never spends a penny from my 500 Saudi Riyal money in any items, and she liked to foul me too, marching on the same road her parents did to me and grip on my money like bloody sucker leech.

After they already stand on a solid ground, betrayed other peoples on the road the same way they did to me, and after calling them 10 times and sending e-mails to retune my own money back; I admit they succeeded to tortuous me for eight months utile they paid my money back in installment.Yes, I get the eight thousands RM back, but there girl refuse to return the other 500 Saudi Riyals money back "She also likes to bite the hand that helped her" in there hard time.

How Many Chances Do You Give a Cheater?

In conclusion: comparing some human behaviors with animal behaviors you can find in many occasion, the animal behaviors can win as better-quality behavior.

Warning: My aim of writing this short story is to advise other good peoples; they might like to go to that destination; or may be are already there waiting for there turne "on the road to Kuala Pilah" To be watchful; and try to avoid things like that might happen to them too.

The bottom line is that: Those folks declare their identity, and label themselves as rude, anemic -in the since of the mutual respect- opportunistic, penny-pinching, stingy, greedy, very selfish, very calculative, dishonest, break there promises always. No wonder when they says, they are not loved by there close neighbors, relatives, or friends, mainly because their bad attitude; and intentionally misleading honest peoples in non-honorable way.

That is enough for time being; I would continue later.

Full story available on request