Experts Call For New Ways To Tackle Dengue In S'pore

Experts Call For New Ways To Tackle Dengue In S'pore

By Jackson Sawatan

SINGAPORE, Oct 1 (Bernama) -- Singapore's previous success in controlling dengue may have contributed to the ongoing outbreak of the disease in the republic, according to a finding by a panel of expert formed to advise the government on ways to tackle the problem.

"The success of the Singapore programme has reduced the Aedes aegypti (the mosquito which transmits the disease) population to such a low level that conventional methods of assessing populations such as the house index are no longer sufficient.

"Moreover, an increase in the Aedes population is not always a pre-requisite for increased dengue transmission," Clinical Professor and Assistant Chief Executive Officer of National Healthcare Group Dr Chee Yam Cheng told a press conference.

Dr Chee chairs the panel comprising seven members from local and international institutions whose job is to advise the government on ways to tackle the outbreak that has left the authorities baffled on why Singapore, a highly health conscious nation, has to deal with the disease that is more associated with filthy surroundings.

Twelve people had died of the disease from about 11,000 cases reported this year -- a record high.

The panel agreed that Singapore's dengue control programme is one of the best in the world, which has resulted "in sustained suppression of the Aedes aegypti mosquitoes for three decades".

But Dr Chee said: "Aedes is highly adaptable and exploits hard-to-find habitats in the urban environment. The increase in the dengue cases in Singapore may include importation of new strains of dengue virus with greater epidemic potential into a densely populated Singapore population".

He also said that Singapore's prior success in dengue control programme "has resulted in a highly susceptible human population".

The panel acknowledged that the problem was not unique to Singapore.

"Dengue is a resurgent problem globally; and being endemic to the region, Singapore can expect dengue to recur on a regular basis. The current dengue outbreak in Singapore coincides with the increase in the number of dengue cases in the region," Dr Chee said, adding that public education on dengue prevention and community participation in control activities remained the key to stop dengue transmission.

The panel recommended a host of short-and-long-term measures to deal with the problem including the need for an "active laboratory-based disease surveillance programme to provide early warning for epidemic transmission".

"Laboratory methods should include the latest technology in both serologic and virologic diagnosis. Quality control for this programme should be provided by a national reference laboratory for infectious diseases," Dr Chee said.

A continuing medical education programme should be implemented to increase the knowledge of physicians on clinical diagnosis, management, prevention and control.

"It is a common perception that most dengue transmission occurs at home. However, recent epidemiologic evidence indicates that significant transmission also occurs at sites away from the home. Current emphasis on active clusters does not provide an adequate understanding of transmission dynamics.

"This limits the effectiveness of vector control measures, because in the present situation, it appears that 60 to 70 per cent of all notifications occur outside of known clusters and in some instances transmission is not reported," Dr Chee said.

Emphasis should now be placed on new and innovative methods of entomologic surveillance to assess the impact of control activities on Aedes populations, he said.

Mosquito control activities, including those by private pest control operators, must continue to be subjected to stringent and improved quality control measures using new techniques, he said.

Long-term measures include: to maintain Aedes populations at a low level that will prevent epidemic dengue transmission, to use vaccines and antiviral drugs when they become available and to use new validated technologies as they become available.

The quarantine of dengue patients is not recommended, he said.

"Infected people can infect mosquitoes with dengue viruses 24 to 48 hours before showing any symptoms. Infected people, who do not show any symptoms may also infect mosquitoes. With Singaporeans being highly mobile and the local dispersal of mosquitoes, the virus may be widespread in the community before it is reported," he said.

-- BERNAMA

It looks like dengue is going the way of Hepatitis A. In the local scene, improvement in sanitation has resulted in a small population of immuned individuals in the community. This paradoxically has resulted in a "more susceptible population" as the number of individuals with antibodies against the Hepatitis A virus is smaller. And when an epidemic occurs, more individuals are infected and affected.
Fortunately, for Hepatitis A there is an effective vaccine available and vaccinating those without antibodies can help to stop an epidemic. Such a vaccine is not available for Dengue.
So for Dengue, mosquito control measures are important and need to be maintain all the time. As mentioned quarantine of dengue patients are not helpful. So for such vigilance, all need to play their part.

MOre Dengue Deaths in Penang

Young Pregnant Mother Third Dengue Victim In Penang

PENANG, Sept 25 (Bernama) -- A young mother in her first pregnancy is the third victim to have succumbed to the dengue fever in the state.

Fairuz Aziz, 25, who is believed to be carrying twins, died yesterday after she was admitted to the Penang Hospital on Thursday for dengue haemorrhagic fever.

Her seven-month-old fetuses also did not survive, a state health department spokesman said.

Fairuz, a housewife from Taman Sahabat in Teluk Kumbar here, was in a critical condition when she was admitted to the hospital. She died at about 6am yesterday.

The dengue outbreak reported in several areas in the state claimed two lives last week -- a 46-year-old woman from Bukit Gelugor and a 21-year-old man from Kampung Binjal in Bayan Lepas.

State Executive Councillor for Health P. Subaiyah said the Health Ministry would be alerted of the rising dengue cases.

He said while the health department was carrying out fogging in dengue-prone areas, the public must do their bit by destroying aedes mosquito breeding grounds.

Bayan Lepas, Teluk Kumbar and Sungai Nibong are among the dengue-prone areas, he added.

-- BERNAMA

No Aedes, No Dengue,
No Dengue, No Dengue Haemorrhagic Fever,
No DHF, No Deaths

HOSPITEL::A combination of Hospital & Hotel

Bernama.com
Malaysian National News Agency

Pusrawi Spearheads "Hospitel" Concept In M'sia
General
September 22, 2005 14:06 PM
By Faizah Izzani zakaria

KUALA LUMPUR, Sept 22 (Bernama) -- If you pass by Jalan Tun Razak here, you will see a new building, "Hotel Putra KL", beside the National Library.

The three-star hotel, developed together with the Pusat Rawatan Islam (Pusrawi) Hospital building, not only will be the new landmark in the city, but would be pioneering a new service concept in the health tourism industry currently being promoted in this country.

The "hospitel" concept, a combination of hospital and hotel, might be new to the Malaysian society but it would be spearheading the change in the country's health services in the future.

Hospitel could provide accommodation for the patients' family members, its outpatients, as well as for local and foreign tourists to stay at the hotel while receiving treatment.

Pusrawi Hospital Corporate Development Manager Mohd Azlan Md Arshad said Hospitel, among others, targetted tourists from Indonesia and West Asia.

He said Pusrawi Hospital, which was now operational at Jalan Ipoh here, was scheduled to expand its services when the new hospital and hotel buildings at Jalan Tun Razak began their operation by year end.

The new hospital is quite special because it offers medical services based on Islamic teachings and at the same time provides hotel facilities, he said.

Mohd Azlan said the hotel rooms would undoubtedly be a great convenience to the family and friends of patients from out of Kuala Lumpur, and it would also be open to other visitors who needed comfortable and affordable accommodation.

He said the hospital would have 250 beds as compared to 90 beds at the present hospital at Jalan Ipoh, while the hotel would provide 102 rooms.

The Hospitel construction project began with the first phase in 2000 and the second phase began in 2003, comprising the construction of a nine-storey hospital building and an 11-storey Hotel Putra KL which were linked to each other.

Owned by the Federal Territory Islamic Religious Council (MAIWP), the RM100 million project was leased to Pusrawi Hospital and Hotel Putra KL, who would be cooperating to promote health tourism, he said, adding that the cost was covered by a subsidiary of Tabung Haji Board, TH Properties Sdn Bhd.

Mohd Azlan said the hospital and hotel's location was very strategic as it was in the heart of the city and situated just in front of the National Heart Institute (IJN).

Indirectly, Hotel Putra KL would also be offering hotel accommodation to IJN visitors, he said.

"Hospitel, which adopts the Islamic concept, would be equipped with the latest facilities such as laboratories and blood bank, operation theatre, X-ray, pharmacy, circumcision services, creches and a 24-hour emergency service.

"The hotel would be offering facilities including seminar and meeting rooms, cafeteria and over 200 parking spaces," he said.

Mohd Azlan said the Islamic concept applied in the Hospitel services, would not be restricted to Muslim patients but to all patients regardless of religious or racial background.

He said Muslim patients would be treated based on Islamic teachings such as the staff would say a prayer prior to a surgery and the hospital and hotel staff would always be dressed according to the Muslim way by covering their "aurat".

Non-Muslim patients would be treated like any normal hospital patients while discounts would be given to the needy but for Muslim patients from the low income group, they are entitled to apply for the wakaf fund aid, he said.

Meanwhile, Hotel Putra KL Senior Marketing Manager Normawati Zainal Abidin said the hotel would be offering a service which would suit the middle and low income groups.

She said the hotel had not decided on the room rates or whether it would be offering special rates for clients who were dealing with Pusrawi Hospital, but added that the room rates would be affordable and reflected the hotel's standard.

--BERNAMA

Another Horror Epidural Tale

Sometime ago there was an incident, reported in the American media, where an epidural was involved, the victim turned out to be the husband of the patient who had the epidural. Now here is another unfortunate incident involving a labouring patient who had an epidural. In this case both the patient and her husbands became victims. Let the husband tell their story in full as found in the letter section of Malaysiakini ::

Local healthcare? Not for me...

I am a doctor in one of the hospitals. I have always wondered why patients are complaining about us doctors. I have been doing my best, and still they complain and complain. That is until my wife became a patient when she was about to deliver.

My wife recently gave birth via cesarean section after an unnecessary complication caused by an inexperienced and unsupervised doctor. This is our first baby and I was very concerned about my wife's well being as she was post-dated one week.

A miracle happened when her water broke and she was having very good contractions. As she was unable to tolerate the pain, we were offered an epidural to reduce the labour pain.

When the anesthetist came, he was very impolite. He never spoke or greeted me. I let him proceed with the epidural as I was confident that our doctors are well-trained. After waiting for 10 minutes, my wife’s room door remained closed. My suspicion grew as the anesthetist walked past me twice without even talking to me. I then went to check on my wife.

To my horror, my wife was on oxygen and barely conscious. Her systolic blood pressure was 44 when the epidural was given (this, my wife later told me after she had the operation). The anesthetist apparently was just standing there looking at his mobile - he did not call a red alert, he did not inform me my wife was in critical condition and my baby’s safety was compromised.

They later called an obstetrician and my wife went off for an emergency caesarean. My wife and baby survived the ordeal. After calming my nerves, l went to find out why would my wife with a healthy, low-risk pregnancy suddenly went into a complication.

The hospital immediately went into a defensive mode. The anaesthetist who did the procedure had only three months experience. This period is so brief that I would not be surprised if my wife was among his first few patients.

The hospital’s resident anesthetist who was supposed to be on standby was not available that day and later called me up without any apology or remorse to say that the doctor that day was good enough and that I was too stressed out. She said I should have let them take care of things.

Excuse me, had I not checked on my wife, that doctor would have waited until my wife went into coma. What wouldn’t I be stressed out? I placed my wife in the hands of the system which I am part of and look what happened.

I can really understand now why people complain about doctors and how they are treated by the latter. I received a phone call early in the morning the next day from the hospital’s administrator who told me there are people who would ‘get very angry’ if l lodged a formal complaint.

He said a little drop in blood pressure was to be expected and my wife was mistakenly thought to have a low blood pressure. I later spoke to another anesthetist who came all the way to check my wife and he noticed that the epidural was too high, too deep and there was an inadequate one-sided nerve block.

I immediately went mad. Is this how a loyal, seven-year in-service doctor gets treated? Is this the system l believed in? Is this what our director-general of health thinks we should be?

I am very frustrated and really thinking of quitting soon. The system does not care for its own, what more the public. Should I keep quiet because some people who want a promotion have threatened me about complaining?

I am now in depression and do not think l can ever use government health-care again especially for pregnancies. I really sympathise with those who have had the same problem. I do know now why patients complain.

I cannot do anything as I am being asked to keep quiet or people would get ‘upset’. I have nobody to turn to.

---Malaysiakini

As reported by the husband, it appears in this case the epidural, done by an inexperienced doctor, was not properly carried out. And a complication had resulted. Fortunately, at the end of the day, the patient and her baby came to little harm. But the treatment of the husband and the patient after the event was certainly uncalled for. The way the hospital authorities went into 'defensive mode' and the seemingly unacceptable explanations and subtle threats were certainly unwarranted. The patient and her doctor husband obviously had every cause to be very annoyed, frustrated, upset, depressed with the system. But all is not lost, if he wants to, he should take up the case with our new DG of Health and he may yet get satisfaction. According to media reports the DG is super-efficient and will not tolerate fools. He can definitely be expected not to expect his own MOH doctor to be so shabbily treated by the system.

As Of 2008 Heart Patients Need Not Wait Long

KUALA LUMPUR, Aug 29 (Bernama) -- Heart patients who currently have to wait anything from six months to a year to receive treatment or undergo an operation at the National Heart Institute (IJN) need not wait long by 2008.

Health Minister Datuk Dr Chua Soi Lek said that under the expansion plans for a new block of the IJN building, estimated to cost RM209 million, heart patients will only have to wait three to six months.

"Ten years ago, IJN only received 50,000 outpatients a year and 8,000 warded patients. Now, IJN has 122,000 outpatients a year and 12,000 patients in the wards," he said at the agreement signing ceremony for the appointment of the project contractor, here Monday.

IJN was represented by Chief Executive Officer (CEO) Mohd Radzif Mohd Yunus and Medical Director Datuk Seri Dr Robaayah Zambahari, whereas the construction companies, UEM Construction Sdn Bhd and Intria Bina Sdn Berhad Joint Venture, were represented by Datuk Mohd Nor Idrus and Abdul Hamid Abdul Rahim, respectively.

Speaking to reporters later, Dr Chua said that the government had subsidised RM144 million last year to cover the medical expenses of civil servants and the needy, compared to only RM35 million in 1992.

"When the expansion project is completed, IJN will have an additional 158 beds, 12 in the Intensive Care Unit (ICU). After this IJN should receive more outstation patients, with health tourism being a source of income," he said.

He also complimented the IJN for its decision to obtain funding by creating what is called Islamic Bonds (Sukuk Musyarakah), rated by the Malaysian Rating Corporation Berhad (MARC) as "AAA", for RM100 million to mature in seven years or less.

Dr Chua also denied claims that in the last three years a large number of IJN staff had resigned because only three consultants and eight clinical specialists had resigned during that period.

-- BERNAMA

It maybe true that by 2008, the long wait maybe over but will things at IJN prove to be beyond the reach of many financially. Already many patients are finding it difficult to pay for their treatment there. This is what happens when corporatisation comes into the picture.

Malaysian Haze Fighters in Indonesia Sick

12 Malaysian Firemen Fall Sick In Riau, One Admitted To Hospital

By Mohd Nasir Yusoff

PEKANBARU (Riau, Indonesia), Aug 18 (Bernama) -- Twelve Malaysian firemen who are members of a team sent here to help douse forest fires in the Rokan Hilir district, have fallen ill with one of them in serious condition and admitted to the hospital in Kota Dumai.

Riau Environment Management Agency head Khairul Zainal told reporters here today that three other firemen were treated at a clinic in Simpang Bangko and the remaining eight at the clinic in the Malaysian camp.

"They fell sick two days ago but I don't know the nature of the illness, whether it is a common cold or fever," he said.

The 128-member Malaysian team, comprising men of the Fire and Rescue Department and the Special Malaysian Disaster Assistance and Rescue Team (Smart), arrived here on Aug 15 to assist Indonesia to put out the forest and peat soil fires which have blanketed the region, including Malaysia, with a thick haze.

They are assisting about 300 Indonesian firefighters made up of firemen and volunteers.

Riau land and forest fire management centre head Wan Abu Bakar said at least 20,000 hectares of peatland in seven out of the 11 districts in Riau province were burning.

Abu Bakar, who is also the vice governor of Riau, said it was difficult to put out the fires because they were fanned by strong winds and the fires had penetrated deep into the peat soil.

"The fires on the surface have been doused but the soil underneath is still burning," he said.

He said many new fires had started in different districts, such as in Kota Dumai where there were still no firefighters.

Meanwhile, a 54-member Singapore civil defence corps team arrived at the Sultan Sharif Kasim II airport this afternoon to join the firefighting effort.

Khairul Zainal said the Singaporeans would be sent to Rokan Hilir where many fires were still burning.

-- BERNAMA

Poser Hospital Kulat

Poser Over When Sultan Ismail Hospital aka Hospital KulatWill Reopen

JOHOR BAHRU, Aug 18 (Bernama) -- No one knows when the Sultan Ismail Hospital will reopen after it was closed almost a year ago following a fungus attack.

Deputy Health Minister Datuk Dr Abdul Latif Ahmad visited the hospital, Thursday, and the press were invited but he had nothing to say to the reporters and photographers who had waited for more than three hours.

Dr Latif, who emerged from a room where he had apparently listened to a briefing, just gestured at the waiting newsmen and left.

None of the hospital management staff attended to the journalists, who were left wondering why they were invited when it was supposed to have been a closed-door function.

Last September, the hospital was forced to close just two months after it had opened because of a fungus attack that was deemed hazardous to health.

Subsequently, the Works Ministry directed the contractor to undertake the necessary repairs.

In June this year, Health Minister Datuk Dr Chua Soi Lek was reported to have said that the repairs were expected to be completed this month.

-- BERNAMA

To Snore or Not to Snore

To snore or not to snore, that is the RM3000 to RM4000 question. For many of our spouses who complain of snoring spouses, the cure is at hand. A 15 minute operation is all that is required. But like most things these days with rising fuel prices and toll hikes, the cure does not come cheap even though the procedure is short. HUKM is proud to announce that Malaysia is the second country in Southeast Asia to start this innovative "pillar procedure" for the treatment of snoring. HUKM in Cheras is also the first hospital in BolehLand to adopt the technique.
So all you snorers out there, are you or your sleeping partner(s) ready to cough up that amount for peace and quiet and better sleep? Before deciding you might want to view this and this[requires WMP].

Read the BERNAMA report for more details ::

HUKM's Breakthrough In Snoring Treatment

KUALA LUMPUR, Aug 18 (Bernama) -- Though there is no data on snoring, it can cause discomfort to one's sleeping partner and sometimes it can be more embarrassing if celebrities and VIPs snored in public.

However, the phenomenon common in all age groups, both male and female, can now be overcome by a new technique called "pillar procedure".

The technique has been introduced in Malaysia by a leading provider of medical devices to treat sleep disordered breathing, Restore Asia Pte Ltd, through its company in Singapore.

The Universiti Kebangsaan Malaysia Hospital (HUKM) in Cheras is the first to adopt the technique.

Disclosing the technique Thursday, HUKM's Head of Ear, Nose and Throat Department, Prof Dr Abdullah Sani Mohamed, said snoring was divided into habitual snoring (without sleep apnoea) and snoring with sleep apnoea.

He said snoring was a sign of obstruction of the upper airway during sleep and sleep apnoea occurred when the obstruction was completed.

Sleep apnoea might be graded as mild, moderate and severe, he said.

Dr Abdullah Sani said HUKM offered and had performed the full range of surgery from aggressive uvulo palato pharyngo plasty and laser uvuloplasty to the newer radio frequency ablation techniques.

He said the ideal cure for snoring caused by floppiness of the soft palate was to stiffen it without doing any cutting of the tissue.

These could be done with the pillar procedure, he said.

The procedure was designed to reduce airway obstruction where three inserts made from multiple polyester materials woven together about 18mm in length and 2mm in diameter, embedded in the soft palate using a specially designed preload delivery tool, he said, adding the palate was neither cut nor removed.

"It can be done in less than 15 minutes in the clinic with minimal pain. The patient can go home with normal diet and daily activities almost immediately," he said.

The pillar procedure, first introduced in the United States in April 2003, is now available in Australia, China, Hong Kong, Ireland, Israel, South Korea, Portugal, Singapore, South Africa and Turkey.

Malaysia is the second country in Southeast Asia to start this innovative treatment.

Dr Abdullah Sani, who performed the technique on five patients this year, said the complication risk was very low.

He said the therapy costs between RM3,000 and RM4,000 at HUKM.

He performed the technique on his fifth patient today, Syaiful Izam Jabar, 26, a secondary school teacher in Melaka.

After the implant procedure, Syaiful Izam, who has been snoring since Standard Four, said he did not feel any pain and was glad for the RM2,200 treatment he underwent.

-- BERNAMA

An Effective Avian Flu Vaccine

American government scientists say they have successfully tested in people a vaccine that they believe can protect against the strain of avian influenza that is spreading in birds through Asia and Russia.
Present worry is that the avian flu virus could mutate and combine with a human influenza virus to create a new virus, such a virus could spread rapidly through the world with humnan-to-human transmission.
Tens of millions of birds have died from infection with the virus and culling to prevent the spread of the virus. About 100 people have been infected, and about 50 have died from this strain of the avian influenza virus, called A(H5N1). So far there has been no sustained human-to-human transmission, but that is what health officials fear, because it could cause a pandemic. And that fear has driven the intense research to develop a vaccine.
Tests so far had shown that the new vaccine produced a strong immune response among the small group of healthy adults under age 65 who volunteered to receive it, although the doses needed were higher than in the standard influenza vaccine offered each year. The vaccine, developed with genetic engineering techniques, is intended to protect against infection, not to treat those who are sick. Further tests are required for groups over 65 years of age and children.
Additional tests are needed in part to determine the optimal dose of vaccine; the number of shots people will need for protection; and whether adding another ingredient called an adjuvant to the vaccine could raise the potency of lower doses, stretching the number of people that could be protected.
Though the vaccine needs further testing before it can be approved for general use, it could be released for use if a pandemic should occur.
See a graphic presentation of how the vaccine was developed here

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Health: New thalassaemia treatment gives hope

Health: New thalassaemia treatment gives hope
Aug 7:
The treatment can seem almost as bad as the disease but a new therapy in trials offers relief, writes MEERA MURUGESAN.

PAIN and inconvenience are often associated with treatment for thalassaemia, a genetic disorder that affects the body’s production of haemoglobin – the oxygen-carrying protein in red blood cells. This inherited disorder can cause severe anaemia and can be fatal without ongoing treatment.

With no cure, the only options for thalassaemia patients are regular blood transfusions and nightly injections through a slow infusion pump. These infusions, lasting up to 12 hours a day, five to seven days a week, limit social activities and interfere with patients’ intimate relationships.

Desferal infusions therapy, as it’s known, is also difficult for children who dislike needles and fear pain, says Professor Dr Chan Lee Lee, paediatric haematologist/oncologist at the University Malaya Medical Centre. Even older teens and young adults find these infusions extremely burdensome, he adds, and often will not comply with therapy even though they see first-hand the risks of not doing so.

But this painful procedure could soon be a thing of the past as Malaysian thalassaemia patients and their caregivers are looking forward to a clinical trial which offers an oral treatment for this condition.

Dr Chan is among three Malaysian investigators who will spearhead the trials to determine the safety and tolerability of the world’s first and only once-a-day iron chelator, ICL 670 (deferasirox).

The others include Dr Hishamshah Ibrahim, senior consultant in the paediatric department of the Kuala Lumpur Hospital and Professor Rahman Jamal, director of molecular biology at Universiti Kebangsaan Malaysia.

An easy-to-administer oral iron chelator in tablet form, ICL 670 is taken once daily after dissolving the tablet in a glass of water.

The drug was developed by pharmaceutical giant Novartis to extend the benefits of iron chelation to a greater number of patients receiving blood transfusions, and to address the needs of thousands of adult and paediatric patients who have been using Desferal (deferoxamine).

The three-centre, one-year study will cover 100 Malaysian patients. Besides Malaysia, trials are also being carried out in 12 countries across five continents ranging from the USA, Germany, Greece and Italy, to China, Hong Kong, Thailand and Taiwan.

The preliminary results of studies on paediatric patients treated with the oral chelator presented at the latest annual meeting of the American Society of Haematology, have been very promising, especially in terms of safety and tolerability, says Dr Chan.

“Oral therapy offers welcome relief and the Malaysian thalassaemic community and their professional caregivers are looking forward to the trial,” says Dr Chan.

ICL 670 would also redefine the clinical management of patients frustrated by years of inconvenience, bruising and scarring as a result of daily insertion of the deferoxamine infusion needle, says Dr Hishamshah.

“Their quality of life will drastically improve and this should impact positively on the overall treatment regime,” he says.

The Government, has also announced its intention to invest approximately RM40 million annually in the Thalassaemia Control and Prevention Programme, he adds, a move will which directly benefit the few thousand thalassaemia patients nationwide and the estimated 600,000 to one million Malaysians who are carriers of the thalassaemia gene.

---Malay Mail

Other related links::

• ICL 670- The New Oral Chelator being developed by Novartis
  
• IMPACT Children Foundation
  
• Study of Deferasirox for Treatment of Transfusional Iron Overload
  
• Thalassaemia drug trial in Malaysia
  
• Advances in Management of Thalassemia
  
• Thalassaemia Association Malaysia (TAM)
  
• Sarawak Thalassaemia Online::Links

An HMO Manager at the Pearly Gates

Two doctors and an HMO manager died and lined up at the pearly gates for admission to heaven. St. Peter asked them to identify themselves.
One doctor stepped forward and said, "I was a pediatric spine surgeon and helped kids overcome their deformities." St. Peter said, "You can enter."
The second doctor said, "I was a psychiatrist. I helped people rehabilitate themselves." St. Peter also invited him in.
The third applicant stepped forward and said, "I was an HMO manager. I helped people get cost-effective health care." St. Peter said, "You can come in, too."
But as the HMO manager walked by, St. Peter added, "You can stay three days............"

Now what more did St. Peter said to the HMO manager, find out, here.

Condoms In M'sia Safe For Use - Chua

KUALA LUMPUR, July 25 (Bernama) -- Condoms sold in Malaysia are safe but the Health Ministry will enforce stringent checks on their quality soon to ensure that defective condoms are not sold to consumers.

Health Minister Datuk Dr Chua Soi Lek said Monday the ministry, through its Engineering Department, would use the Medical Devices Act 2006, which is in its final stage of enactment, to monitor condom quality.

"Malaysian condoms are of good quality and we have not received any complaints so far," he told Bernama after opening the 26th Asian Medical Students' Conference here.

Dr Chua was asked to comment on whether the government would monitor the quality of condoms following a recent report that in Hong Kong more than one in 10 condoms sold was likely to leak or burst.

Last week, a Hong Kong Consumer Council survey revealed that 28 popular brands of condoms failed laboratory pressure tests and they included popular brands like Infinity, Strawberry Flavour, Wedding and Wonder Life Fruit Flavour.

Some 15 million condoms are sold annually with a market value of nearly RM17 million, said an industry source.

Condoms, mostly latex made, are either produced locally or imported and there are about 10 leading manufacturers in the country.

Dr Mohamed Ismail Mohd Tambi, an advisor with the Condom Evaluation Technical Committee under the Standards and Industrial Research Institute of Malaysia (Sirim), said quality was vital as more people use condoms to prevent sexual diseases.

"Quality is important because more people are using condoms to prevent sexually transmitted diseases like HIV rather than to prevent pregnancy, especially in the developing world.

"It is sad if end-users use condom and yet get infection. More clinical tests need to be done to ensure that there is less slippage and breakage," he added.

-- BERNAMA

Healthcare Development Industry Unit

Ministry To Help Generate Income From Health Industry

KUALA LUMPUR, July 25 (Bernama) -- The Health Ministry will establish a Healthcare Development Industry Unit to develop and promote the lucrative healthcare industry which is likely to hit RM8 billion in the next five years.

Minister Datuk Dr Chua Soi Lek said Monday the cabinet had approved the ministry's proposal to set up the unit which would be in place within the next three months.

"The unit will be focused to help agencies in the health sector to promote, sell and benchmark Malaysian healthcare products to compete in the international market," he told reporters after opening the 26th Asian Medical Students' Conference here.

"The time has come for the ministry to play an active role to generate income from the health sector which can benefit the economy rather than just giving medical services to the public," he said.

He said the healthcare industry, ranging from pharmaceutical products, health tourism, medical equipment to herbal medicine, was worth billions of ringgit and yet remained unexploited.

"The health industry has a big potential but our problem is that we are not focused, we always take the easy way out," he added.

For instance, Dr Chua said, last year Malaysia exported medical equipment, including products like condoms, gloves and syringes, worth RM4.6 billion and drugs worth RM468 million.

"The export of Chinese drugs and traditional herbs like Tongkat Ali and Kacip Fatimah, which is growing without any assistance, is worth RM4 billion a year.

"Health tourism is another revenue generator but remains unexplored compared to Singapore and Thailand," he added.

He said health tourism was a healthy business and more foreigners were arriving in Malaysia for medical treatment.

In 1998, 39,140 foreign patients sought treatment in local private hospitals but the figure rose to 174,189 last year. In 1985 there were only 133 hospitals but the number has increased to 218 now.

"Income (from foreign patients) was RM105 million in the private sector but this is on the low side. This is under-reporting, private hospitals are not revealing actual figures for fear of competition" he added.

He also said that the Medical Devices Act 2006 was being enacted in line with the government’s move to further expand and protect the growing sector,

Some 500 medical students from 14 countries are attending the week-long conference themed "Technology in Medicine" in Kuala Lumpur.

-- BERNAMA

It is good news to the health providers if the gomen can help to encourage the country to develop industries to cater for the health sector. Earlier there was talk of producing our own vaccines. This would help to cut cost and encourage more to get vaccinated. Recently it was pointed out that we have a high number of our population without antibodies to Hepatitis A; the patent rights for this vaccine should be running out soon, maybe we can produce it then. Already we have products like condoms, gloves and syringes which we are exporting. In time we may want to make surgical instruments and other stuff. There are also locally produced hospital equipments like ward beds, delivery beds, trolleys and wheelchairs. Surely we are capable of more items.

Pineapple stem may combat cancer

Two molecules isolated from an extract of crushed pineapple stems have shown promise in fighting cancer growth.

One molecule called CCS blocks a protein called Ras, which is defective in approximately 30% of all cancers.

The other, called CCZ, stimulates the body's own immune system to target and kill cancer cells.

It is hoped the research, carried out by Queensland Institute of Medical Research, could lead to new anti-cancer drugs.

The origin of many anti-cancer drugs can be found in nature :: Dr Julie Sharp

The extract studied by the scientists, bromelain, is a rich source of enzymes and is widely used as a meat tenderiser, to clarify beer and tan leather hides.

The Queensland team discovered that the extract also had pharmacological properties and could activate specific immune cells while, simultaneously, blocking the immune function of other cells.

Lead researcher Dr Tracey Mynott said: "We suspected that different components of the crude mixture might be responsible for bromelain's biological effects.

"In searching for these components, we discovered the CCS and CCZ proteins and found that they could block growth of a broad range of tumour cells, including breast, lung, colon, ovarian and melanoma."

New action

Both CCS and CCZ are protease enzymes, more usually associated with breaking down proteins, as in the digestive process.

Dr Mynott said it was the first time this class of enzymes had been shown to have a specific effect on the immune system.

"The way CCS and CCZ work is different to any other drug in clinical use today.

"Therefore, CCS and CCZ will represent a totally new way of treating disease and potentially a whole new class of anti-cancer agent."

Dr Julie Sharp, at Cancer Research UK, said: "The origin of many anti-cancer drugs can be found in nature.

"However, it's early days for this research and the real test will be to see if the effects seen in the lab can be reproduced successfully in patients."

Story from BBC NEWS:

Malaysians at risk of contracting viral hepatitis A

Malaysians at risk of contracting viral hepatitis
By Annie Freeda Cruez


It is ironic. Malaysians risk getting viral hepatitis, particularly Hepatitis A, because of improved sanitation. This is because the clean environment has affected the ability of the body to form antibodies.

By improving sanitation, providing safe water supply and encouraging personal hygiene, the Government has managed to control food and water borne diseases

Hepatitis A is an infectious, food and water borne disease which is especially common in children aged between five and 14.

Following the improved sanitation, the reported national incidence rate has been decreasing steadily from 2.24 per 100,000 population in 2000 to 0.42 per 100,000 population last year.

The possibility of the risk came to light at the three-day Sixth Liver Update 2005 conference, which ended today. It was revealed that about 50 per cent of Malaysians under 30 years of age do not have antibodies for Hepatitis A and are therefore susceptible to the disease.

Malaysians who do not have immunity against the disease are advised to vaccinate themselves against Hepatitis A, which will confer protection for up to 10 years.

Health experts warned that Hepatitis A in adults may lead to severe liver disease. To date, there is still no specific treatment Hepatitis A except for rest, and avoiding alcohol consumption and heavy exertion.

---NST

Ironic isn't it. Improve sanitation leading to one having a higher risk of contacting an infection. Just like the case of keeping a toddler away from the infections to be found in the nursery! But what it really means is that the incidence of Hepatitis A infection has fallen thus leaving the community immunity to the disease being lowered. Obviously the answer is for those susceptible to get active immunisation and be protected. But at the present moment, vaccination is not cheap. For an effective vaccination programme the cost has to be brought down.

MINIster Clears the Air

Chua Assures Government Hospitals Clean, Safe

BUKIT MERTAJAM, July 14 (Bernama) -- Health Minister Datuk Dr Chua Soi Lek Thursday assured that government hospitals have cleanliness and safety levels that conform to international standards.
He said the public need not worry about visiting or being admitted to government hospitals as measures had been taken to reduce the risk of infection among the staff, visitors and patients.
Critical sections in hospitals such as intensive care units, operating theatres, coronary care units, paediatric wards and delivery wards were constantly cleaned and sterilised, he told reporters after a visit to the hospital here.
He said the airconditioning system also conformed to the standards set by the American Society of Heating, Refrigeration and Air Conditioning Engineers (ASHRE) or the United Kingdom's Health Department."In the operating theatres, the airconditioners have filtering systems to increase the air cleanliness levels," he said.
Dr Chua said the operating theatre staff all adhered to strict safety procedures while on the job by wearing surgical gloves, face masks and special clothing, and they scrubbed their hands well before surgery.
He was commenting on a report in an English daily two days ago that claimed only a few of the government hospitals had equipment to clean the air breathed in by doctors and patients.It alleged the lack of sterilising equipment in many hospitals endangered the health of staff working in them and exposed patients to risk of infection.
According to the report, at least 25 doctors, nurses and staff in 11 government hospitals were infected with tuberculosis last year.Dr Chua said every district and state hospital had its own special team to monitor the condition of patients and staff.
"The total number of staff reportedly infected with infectious disease is minimal compared to the total number of 80,000 staff in all government hospitals," he said.
Last year, he said, government hospitals treated about 40 million outpatients and 1.7 million inpatients.
Dr Chua described the newspaper report as incorrect and confusing which could cause alarm in health professionals and the public.
-- BERNAMA

The NST has caused much concern among Malaysians recently with its scary articles on the safety of the hospital environment, see this and this. The staff of gomen hospital may not go home wondering whether they are carrying dangerous bugs of all sorts but family members and friends may wonder whether they should be keeping a healthy distance. The article concerning the pregnant doctor who contacted TB was definitely alarming to many.
It is good that the MOH has come out to clear the air regarding his hospitals' airs. And for all intent and purposes what he say is true. But it would be good pratice if our children can be kept away from being taken along when their adults go visiting sick friends or relatives warded in hospitals. The rule that children should not be brought during such visits need to be strictly observed by the hospital authorities.
The MOH would need also to have more isolation facilities in its hospitals and with the rise in tuberculosis cases maybe the TB wards may need to be reopened.

Plan To Create 'Super Doctor' Posts

PUTRAJAYA, July 12 (Bernama) -- The government plans to create "super doctor" promotional posts to retain experienced doctors in government hospitals, Health Minister Datuk Dr Chua Soi Lek said Tuesday.
He said experienced doctors promoted to become directors engaged in administrative matters had been a reason for many resignations.
Dr Chua told a press conference that the plan was in accordance with a suggestion by Prime Minister Datuk Seri Abdullah Ahmad Badawi to fill vacancies and to get the specialists to remain longer in government hospitals where they were much needed.
He also announced that the government had agreed to increase to 298 the number of promotional posts for doctors and medical specialists up to the year 2010 compared to the current 111 posts.
Apart from increasing the number of promotional posts, the government agreed that medical practitioners and specialists be allowed to serve until 65 years of age to help reduce the number of resignations, he said.
Dr Chua said his ministry had also suggested to the Public Service Department that medical specialists who came back from overseas be given higher ranking positions based on their qualifications and experience.
"The format of the Bahasa Malaysia qualifying exam for medical officers will also be more practical and focus more on the oral aspects," he said.
Dr Chua also said that nurses, paramedics and a number of personnel in the support services who have university degrees will also be promoted to a better grade.-- BERNAMA

It looks like after having "Super Teachers", we will be having "Super Docs" next. The plans announced by Dr Chua should come as a big welcome by the doctors in public service. Will these plans keep them in gomen service is uncertain at the present but they are moves in the right direction. The starting pay for the most junior, the house officers, may go up by RM1000 will provide these doctors a better start in working life in view of the increasig coat of living.
More incentives for the doctors and other paramedical staff can be glimpsed in this STAR article :: Carrots for Doctors.
These changes have been long overdue but are better late than never. There have been many calls in the past for a separate salary commission for doctors and gomen healh staff. This may be the gomen's answer to these requests.

MMA Opposes Move To Replace Doctors As Hospital Directors

KUALA LUMPUR, July 12 (Bernama) -- The Malaysian Medical Association (MMA) opposes the government's plan to replace doctors as government hospital directors with paramedics or administrative officers.

Its president, Datuk Dr Teoh Siang Chin, said today that only a doctor trained in medicine could perform clinical governance.

He feared that the changes would result in a decline in the quality of medical care in government hospitals.

"Currently, hospital directors are those doctors who have been chosen to use their clinical acumen and experience to practise clinical governance of their hospitals so as to ensure a high standard of patient care," he said in a statement here.

He said hospital directors must be professionals trained in medicine to understand the specific needs of other professionals like specialists, doctors, pharmacists and dieticians to command their respect and to ensure the quality of all facets of the care provided.

Since the doctors had been doing an excellent job for decades, they should not be replaced by officers who were less qualified, he said.

"Basically, it is must easier to teach a doctor management skills than to teach a layperson the complexities of medicine," he said

Dr Teoh said the present system was working very well and what the government needed to do was to "look at constructive long-term measures to attract and retain doctors in the service."

Prime Minister Datuk Seri Abdullah Ahmad Badawi recently announced the government's plan to train experienced medical officers and nurses to take over the administration of hospitals so as to release doctors from administrative work to enable them to concentrate fully on their hospital or clinical work.

He was reported as saying that this was one of the approaches identified by the government to overcome the shortage of doctors in the country.

-- BERNAMA

Medical Director of Hospital aka Pengarah Hospital aka Pegawai Perubatan yang menjaga Hospital have traditional been medical doctors appointed to administer with the help of senior medical assistants and nurses. With their medical background they have been the ones running the various hospitals and health facilities for the MOH. Some have been sent for hospital administration courses and eventually became better at administering these health facilities. Over the years they have managed to keep these facilities running with the help of the clinical specialists in the health facilities and the senior paramedical staffs. Now the Minister is thinking of replacing them with administrators without medical backgrounds. First impression is that these administartors may function less efficiently. As pointed out by the MMA president, it may be better to send medical doctors who are keen to function as hospital directors for hospital administration courses in order for them to function better than to have them replaced by pure adminstrators.

Man faints, dies after seeing epidural

Man faints, dies after seeing epidural
Wife sues California hospital for wrongful death

LOS ANGELES - A California woman is suing a hospital for wrongful death because her husband fainted and suffered a fatal injury after helping delivery room staff give her a pain-killing injection.
Jeanette Passalaqua, 32, filed the suit against Kaiser Foundation Hospitals and Southern California Permanente Medical Group Inc. in San Bernardino County state court last week.
In June 2004, Passalaquas husband, Steven Passalaqua, was asked by Kaiser staff to hold and steady his wife while an employee inserted an epidural needle into her back, court papers said.
The sight of the needle caused Steven Passalaqua, 33, to faint and he fell backward, striking his head on an aluminum cap molding at the base of the wall.
Jeanette Passalaqua delivered the couples second child, a boy, later that day. Steven Passalaqua, however, suffered a brain hemorrhage as a result of his fall and died two days later, the lawsuit said.
The suit seeks unspecified damages related to Steven Passalaquas death and to Jeanette Passalaquas emotional distress at being widowed with two young children.
Because Passalaqua was solicited by Kaiser to assist in the epidural, the lawsuit said, the hospital owed him a duty to exercise reasonable care to prevent foreseeable injuries resulting from his participation.
A spokesman for Oakland, California-based Kaiser Permanente called the death a tragic accident.
Some of the allegations in the lawsuit are simply that --allegations. The legal process is under way and we should respect that, said Kaiser spokesman Jim Anderson.

---From MSN

Australian Scientists Win A$28 Mln Vaccine Grant::Courtesy of Gates

MELBOURNE, July 7 (Bernama) -- Australian scientists are part of an international team awarded a A$28 million grant (about RM78 million) to develop a malaria vaccine, courtesy of multi-billionaire Bill Gates.

The team, including scientists from the Walter and Eliza Hall Institute of Medical Research (WEHI) in Melbourne, the Seattle Biomedical Research Institute in the US and the University of Heidelberg in Germany, was among 40 applicants awarded grants by the Microsoft chief's Bill and Melinda Gates Foundation.

About 650 applicants sought the lucrative grants.

A group headed in Australia by WEHI infection and immunity division chief Professor Alan Cowman was awarded A$17.6 million to use genetically manipulated malaria parasites to develop a vaccine for the disease.

Professor Cowman said research would be a major step forward in developing a vaccine for the disease, which kills three million people, mostly children, every year in places such as Africa, Papua New Guinea, Indonesia and East Timor.

Another consortium, involving WEHI researcher Dr Louis Schofield, was awarded A$10.8 million (about RM30.2 million) to study how people in developing countries develop immunities to parasitic infections, and how such immunity can be developed against malaria.

-- BERNAMA

Harm Reduction Programme::January Start

Needle exchange programme expected to begin in January
BY AUDREY EDWARDS

PETALING JAYA: The needle exchange and condom distribution programme to check the spread of HIV among drug users is expected to start in January.

Health Minister Datuk Dr Chua Soi Lek said his ministry has decided that the harm reduction programme, involving the two methods and drug substitution therapy, will go ahead.

“The earliest we can begin is in January. There are many people to train. And I have been told that in terms of amending the law, it can be done administratively,” he said yesterday.

A pilot programme involving 1,200 volunteers will begin at the end of October for the drug substitution therapy, which uses methadone.

Harm reduction focuses on preventing or reducing actual harm associated with risk behaviour.

The concept, which has been around for a long time, realises that some drug users will not stop using drugs despite the risk of HIV/AIDS and other blood-borne diseases.

It also includes providing information to injecting drug users (IDUs) of the risk, outreach programmes, peer education, voluntary counselling and HIV testing.

Recently, the Government said it was seriously considering the needle exchange and condom distribution programme for IDUs in an effort to halt the spread of HIV among Malaysians.

Prime Minister Datuk Seri Abdullah Ahmad Badawi had said that it was necessary as the situation had reached an “emergency level.”

Statistics released by the ministry show that 64,439 Malaysians were infected from 1986 until December last year.

The number of new cases in 2004 was 6,427.

Of the total number of people living with AIDS reported so far, 75% are IDUs.

It has been estimated that if left unchecked, 300,000 Malaysians would be infected with HIV in 10 years’ time.

A study conducted in 1998 among 6,326 inmates at 26 Pusat Serenti (government-run drug rehabilitation centres) found that 65% of them were IDUs and 77.6% were sexually active. But only 18.7% used condoms during sex.

Dr Chua also said that no extra infrastructure was necessary as the ministry would use existing drop-in centres to carry out the programme.

“It is only making sure that we have enough trained staff from both the ministry and NGOs (non-governmental organisations). We have already started talking to some of them,” he added.

A meeting with the ulama will be held on Aug 11 to explain the harm reduction programme. “We will meet leaders from other religions on a separate day,” Dr Chua said.

Meanwhile, Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said the programme must be fully understood to ensure its success.

He said NGOs, the medical fraternity and ministry staff had a role to play in the “social marketing” of the programme.

“We want ministry officers to be really skilled in the programme and there will be human resource training.

“If they do not understand the programme, how can it be implemented successfully?

“If one doctor or staff nurse makes a wrong remark because he or she does not have adequate information, it will affect our goals,” he told reporters after opening the Islamic Medical Association of Malaysia's Seventh National Scientific meeting.

Dr Latiff said that while the programme would follow guidelines set by the World Health Organisation and based on the experiences of other countries, it would be drawn up to suit Malaysian culture.

--STAR

It looks like the gomen is serious about the harm reduction programme. The gomen has finally accepted that many drug addicts will not stop using drugs despite the many efforts taken to get them off their habit. The pilot project involving some 1,200 addicts will be launched in October. It is also obvious that the gomen is keen to ensure that the programme works well and is going to train those involved in the implementation of the programme intensively before the actual programme starts next year. As usual there will be the need to make sure the programme fits in with Malaysian culture, whatever that means. Hopefully, the ulamas and other religious leaders will not get in the way of effective working of the programme.
In the presently on-going Seventh International Congress on AIDS in Asia and the Pacific in Kobe, Japan; Asia has been mentioned as having the second-largest number of people living with HIV/AIDS in the world after sub-Saharan Africa. Papua New Guinea is at risk of an African-level HIV/AIDS epidemic, but other Asia-Pacific nations like Malaysia, Vietnam and Myanmar are also worrisome as the number of infections there continue to rise warned the head of the U.N. AIDS agency.
AIDS is a "silent tsunami" that threatens all of Asia, but the deadly disease can still be conquered if governments take urgent action now, world health officials said. One in four new infections occurs in Asia and 1,500 die in the region each day. Failure to fight AIDS will have a critical economic impact on the region. The United Nations estimates losses could total $29 billion from AIDS alone by 2010 if nothing is done now. J.V.R. Prasada Rao, Director of the Regional Support Team for UNAIDS, said ::

"The virus doesn't kill hundreds of thousands at a thunderous stroke like the tsunami, and it doesn't provide vivid television pictures." "It is more like a silent tsunami."

The U.N. estimates 8.2 million people are infected with the human immunodeficiency virus (HIV) in Asia, about 5.1 million of them in India. The Chinese government says there are 840,000 patients in China. Worldwide, about 39 million people have HIV/AIDS, including 25 million in sub-Saharan Africa. By 2010, 12 million people are likely to be infected with HIV in Asia if no steps are taken to control the epidemic.

British government goes after smokers' sex lives

British government goes after smokers' sex lives

The British government launched a series of tough anti-cigarette adverts on Friday with the message that smoking is bad for your sex life because it makes men impotent and women ugly.

The campaign is designed to target young Britons' fears about their sexual attractiveness -- an area the government says is more effective than highlighting general health concerns.

One ad uses a burning cigarette end between two "fingerlegs" as a metaphor for a penis with the strapline "Does smoking make you hard? Not if it means you can't get it up."

Another targets women saying cigarettes lead to premature skin aging and warns that smoking causes "cat's bum mouth."

"We know 70 percent of smokers want to stop smoking, however, with younger people, fears about attractiveness and fertility can be a stronger motivation to quit than fears about health," said Public Health Minister Caroline Flint. The government says smoking increases the risk of erectile dysfunction by around 50 percent for men in their 30s and 40s and that up to 120,000 British men in this age group were impotent as a result of smoking.

A recent survey by NHS Smoking Helpline also found two-thirds of young men and women, and over half of smokers, said smoking reduced sexual attractiveness.

---Reuters

Say Tak Nak and other stuff. The British are saying that smoking is not sexy, smoking affects your sexual attractiveness and your sex lives. Smoking also affects fertility.
Apart from sex, smoking has a profound effect on the heart. Researchers have found that even one cigarette has the potential to cause a heart attack. In a study of heart attack patients, the researchers found that those who smoked a cigarette within six hours of developing symptoms had bigger blood clots in their arteries than those who had not smoked for a longer period of time.
Researchers have tried to figure out the cost of smoking. What they found is as follows :: One cigarette costs 11 minutes of life, a pack of 20 costs three hours 40 minute and a carton of 200 cigarettes costs 1.5 days!
For more on smoking and sex, check out this ASH factsheet.

30% Of Deaths In Sabah Hospitals Due To Heart Problems

30% Of Deaths In Sabah Hospitals Due To Heart Problems

KOTA KINABALU, July 3 (Bernama) -- A total of 776 people died of heart problems in Sabah government hospitals in 2003, making up 29.76 percent of all deaths recorded in the hospitals, Chief Minister Datuk Seri Musa Aman said.

He said heart problems constituted the primary cause of death in the state.

Quoting further statistics to show the growing risk to the public's health in the state, he said about 59.8 percent of the population or six out of 10 people neglected physical exercise.

Nationwide, 16.6 percent of adults or about two million people were overweight, he said at the launch of the state-level fitness campaign at Padang Merdeka here Sunday.

The campaign is organised by the National Fitness Council.

Musa said that in the present age when many tasks were done with technological assistance, exercise and sports were gaining importance as essential activities to maintain a balanced and healthy lifestyle.

"Keeping ourselves fit will benefit us, our family, the community and nation," he said.

He said exercise and sports were preferable to negative habits such as loafing, gossiping in coffeeshops on unproductive matters and slandering people.

Speaking to reporters later, Musa, who is the Sabah Umno chief, said the party's divisions would set up community sports clubs coordinated by the respective district officers.

He said the clubs' role would be to build public awareness on the importance of keeping fit and healthy.

-- BERNAMA

Sabahans have cause to worry with such a high perentage of cardiac problems. Time to check in at the heart center to learn some healthy tips of cardiac care. This is a good resource to check on tips and articles on caring for your heart. Don't wait till the heart is going going gone before doing so. A replacement heart, natural or artificial is difficult to come by. Take good care of the one God has given you.

Medical Practitioners Allowed To Provide Basic Information On Services

KUALA LUMPUR, June 28 (Bernama) -- Medical practitioners and health institutions are now allowed to provide basic information on their services and facilities.

Health Minister Datuk Dr Chua Soi Lek announced Tuesday that they could now provide basic information according to disciplines, names, places of practice and credentials but without mentioning experiences or using superlatives.

The information, together with photographs of the practitioners or institutions, could be conveyed through websites, yellow pages and the newspapers, he told reporters after opening the Association of Private Hospitals Malaysia (APHM) Healthcare Conference at Seri Kembangan, near here.

"However, we still require such information to be submitted for vetting and approval by the Malaysian Medical Advertisement Board," he said.

The decision, which takes immediate effect, was made after consultations with the board, the Malaysian Medical Council, medical associations and medical academics, to promote health tourism in the country, he added.

Currently, medical practitioners and health institutions are forbidden to make any statements that would draw attention to themselves or their practices.

Dr Chua said that with the guidelines loosened up, the medical practitioners and health institutions still had to seek approval from the Malaysian Medical Advertisement Board before being allowed to provide basic information on their services.

Anyone found providing the information without prior approval from the board could risk their practices being suspended for several years, he said.

Dr Chua also explained that patients were allowed to access their medical reports, which are summarised reports their medical records if they wanted to seek treatment at a private hospital after being treated at the government hospital, or vice versa.

However, copies of the medical records could only be released for medico-legal cases.

Patients could forward their complaints to the ministry if they were unable to get their medical reports from the hospitals or clinics, he said.

Dr Chua also said that he expected the review by a consultant from the World Health Organisation (WHO) on the patient safety strategies prepared by the Patient Safety Council Malaysia to be finalised by next month.

-- BERNAMA

The best advertisement a doctor can have are some good words from a well treated and satisfied patient. Nothing beats word-of-mouth.

Missing Baby Found

The STAR reports that the baby abducted from the nursery of Sungei Petani hospital recently has been found. Polis is said to have rescued the four-day-old missing baby of Noryati Abu Bakar at a house at about 4 am this morning. The baby is said to be safe and has been warded for observations.
A nurse working in Sungai Petani hospital who is said to have taken the baby has been arrested. The nurse is said to have lost her own baby recently. Syabas to the polis for solving the case within a relatively short period of time.

New Software Speeds Up Results For Breast Cancer Tests

New Software Speeds Up Results For Breast Cancer Tests



PENANG, June 22 (Bernama) -- It used to take between one and two weeks but a new computer software produced by experts of Universiti Sains Malaysia now enables the result of a breast cancer test to be known in only seconds.

Called "Neuralmammo Diagnostic for Breast Cancer Based On Neural Work", the software promises to reduce not only the waiting time for test results but also the number of medical specialists required to conduct tests.

All it takes is some information on the patient and a sample of cells to obtain this information.

The software was invented by a group of researchers from the Centre for the Study of Electrical and Electronic Engineering and the Centre for Medical Science Study of Universiti Sains Malaysia (USM).

It won the gold medal at the Invention Industrial Design Technology 22005 (ITECH) exhibition in Kuala Lumpur last May.

Head of the research team Dr Nor Ashidi Mat Isa said the invention could reduce the number of pathologists required to conduct breast cancer tests.

"With this software, medical assistants can carry out the test," he told a media conference Wednesday.

Dr Nor Ashidi said the research started two years ago and cost RM20,000 and the new software could provide information on the disease from its early to critical stage accurately.

So far the new method had been used to test 330 patients at the Kubang Kerian Hospital in Kelantan, he said.

"99.3 per cent of the results were found to be accurate and we plan to extend its use to the Penang Hospital," he added.

-- BERNAMA

Avoiding soya 'may aid fertility'

Avoiding soya 'may aid fertility'
By Michelle Roberts
BBC News health reporter in Copenhagen

Women should avoid eating too much soya if they are trying for a baby, a UK fertility expert believes.

A study in humans has shown a compound in soya called genistein sabotages the sperm as it swims towards the egg.

Professor Lynn Fraser, from King's College London, said even tiny doses in the female tract could burn sperm out.

She told a European fertility conference that avoiding soya around women's most fertile days of the month might aid conception.

Long swim

Genistein is present in all soya-containing products such as soya milk and many vegetarian foods, as well as some pre-packed meals and pizzas.

It is also present in vegetables such as peas and beans, but the researchers say it is not yet clear if levels if the compound in these foods are significant.

Professor Fraser tested what happened to human sperm exposed to the compound in a dish in the lab.

The compound kick-started a reaction in a large proportion of the sperm that gives them the ability to fertilise an egg.

In real life, this does not usually happen until the sperm have been inside the female for some hours and are close to completing their long swim towards the egg.

Therefore, if women have genistein in and around the womb this could hamper conception by making sperm peak too soon, believes Professor Fraser.

This could mean they would not be able to fertilise the egg, she told the annual meeting of the European Society for Human Reproduction and Embryology.

Low concentrations

In mice she found it took higher doses of genistein to cause the reaction, but in humans very small doses were enough.

"We were really surprised. Human sperm proved to be even more responsive than mouse sperm to genistein, responding to very low concentrations - well within the amounts that have been measured in people's blood."

She said it was not yet known how much soya might be a safe amount to avoid this effect.

"It's not a question of completely stopping eating products containing soya.

"But it might be best for a woman to avoid them for a few days around the time she is ovulating."

'Early days'

Professor Fraser's previous work in mice showed that compounds similar to genistein - one found in hop-based products like beer - affect sperm in the same way.

These compounds are all weak oestrogens, but Professor Fraser does not believe that their action on sperm is the same as the female sex hormone.

Instead, genistein seems to trigger the production of a signalling molecule in sperm called cyclic AMP.

Dr Allan Pacey, Senior Lecturer in Andrology at Sheffield University and Secretary of the British Fertility Society said: "It's early days, but clearly if what happens in the laboratory also occurs in the woman's fallopian tube as the sperm make their way to the egg, then there would be the potential for fertilisation to fail."

A spokeswoman from the Vegetarian Society said: "For anyone struggling to become pregnant, avoiding soya products for a few days a month is worth a try if there is even a slim chance that it will help increase fertility.

"Obviously many vegetarians and vegans use soya in their diet, however as there are lots of vegetarian and vegan alternatives to dairy, milk and meat on the market, it shouldn't pose a problem."

Story from BBC NEWS:

Malaysia's Infant Mortality Rate Drops Dramatically

KUALA LUMPUR, June 21 (Bernama) -- Malaysia has done well in reducing the infant related mortality rates over the past several decades, Health Minister Datuk Dr Chua Soi Lek said.

He said Malaysia's infant mortality rate had dropped from the ratio of 40.8 per 1000 livebirths in 1970 to 13.0 in 1990 and 6.2 by 2002.

"Our under five (years old) mortality rate has also fallen by a similar magnitude over the corresponding period, from 57 to 17 per 1000 livebirths between 1970 and 1990, and to nine in 2000," he said in his speech at the High Level Forum on the Health Millennium Development Goals (MDG) at Mita Conference Hall in Tokyo, Tuesday. His speech was faxed to Bernama here.

The two-day forum started Tuesday and was hosted by Japan in cooperation with the Asian Development Bank and the World Health Organisation. The participants are Health, Finance and Development ministers from Asia Pacific region.

Dr Chua said although Malaysia was facing shortage of doctors and nurses, maternal and child health (MCH) was not compromised.

In fact, a lot of headway was made by training allied health profesionals, such as community nurses, medical assistants and dental nurses and providing basic health care to those in the rural areas.

"We have also provided training to the traditional birth attendants. As a result, the proportion of births attended to by skilled health personnel had increased from 20 per cent in 1970 to 96.1 per cent in 1990 and 99.2 per cent by 2000," he added.

Dr Chua said Malaysia also achieved 99 per cent in "safe deliveries" for the babies due to the specific MCH programme where all the antenatal mothers were tagged according to their levels of risk and those at greater risk were given greater attention.

"We audit every maternal death. Infant growth is monitored by growth charts. There is also nutritional surveillance of children and rehabilitation for those who are mal-nourished," he said.

He also said that to further bring down the infant mortality rate, training was also provided to the staff on neonatal resuscitation.

-- BERNAMA

The MOH certainly has some great low figures to present. Imagine our Infant Mortality Rate must be less than 6 per 1000 livebirths now! The WHO figures for Malaysia are 18 per 1000 livebirths (1990), 11 (1995), 8 (2000) and 7 (2003)!

The Derecognition Controversy

Looks like the withdrawal of recognition of the CSMU medical degree is turning controversial and drawing flak especially from MIC. The MIC president appears to be exasperated. There are said to be some 470 Indian Malaysian medical student in CSMU! Samy is alleged to have accused the MMC of wanting to pevent Indian students from studying medicine.
Not providing CSMU with a grace period to rectify any shortcomings in its medical course is certainly controversial. Lets hope good sense will prevail as so many of our students are involved.
The Opposition leader is going to move an urgent motion in Parliament tomorrow calling for the suspension of MMC's withdrawal of recognition of Ukraine’s CSMU medical degree. His motion reads as follows ::

“That under SO 18 the House gives leave to the Ketua Pembangkang and MP for Ipoh Timor YB Lim Kit Siang to move a motion of urgent definite public importance, viz the Malaysian Medical Council’s derecognition of Ukraine’s Crimea State Medical University (CSMU) medical degree.

“CSMU has become the single biggest university, whether in Malaysia or in the world, with the highest concentration of Malaysian students pursuing medical studies, with some 1,100 Malaysian students i.e. about 300 Malays, 240 Chinese, 470 Indians and 25 others, with students sponsored by government and other agencies, such as Angkatan Tentera Malaysia, MARA, Yayasan Selangor, Yayasan Terengganu, MIED, KOJADI and various banks.

“MMC cannot be faulted in refusing to compromise with patient safety or wanting to ensure that Malaysian students in medical courses, whether locally or abroad, are trained to become quality doctors when they graduate and not be shortchanged, but the MMC must act with fairness, transparency and flexibility, or it has only itself to blame if it is accused of ulterior motives like the serious allegation by the MIC President Datuk Seri Samy Vellu that the MMC just wanted to stop Indians from becoming doctors.

“Unless the CSMU medical standards are irredeemably low, in which case it should never have been given recognition in 2001 in the first place, it is only fair and right that CSMU should be given a grace period to comply with whatever shortcomings found by the MMC, and not for derecognition to be announced so arbitrarily, summarily and absolutely.

“MMC should immediately suspend its decision on derecognition of the CSMU medical degrees, make public the shortcomings of the CSMU medical programme and give the CSMU a grace period to comply with them before a final decision on derecognition is made.”

Yours sincerely,

(Lim Kit Siang)

Ketua Pembangkang
MP for Ipoh Timor

NewBorn Missing from Hospital

Father Pleads For Return Of His Newborn Baby Boy



SUNGAI PETANI, June 20 (Bernama) -- "Please return my baby. I really want my son back. Please don't do anything to him, his health condition is not okay yet," appealed the father of a six-hour baby boy who was missing from the ward at the Sungai Petani Hospital, Sunday.

Mohamad Nordin Idris, 34, said the incident had made him and his family very upset, especially after he was elated to be blessed with a son on Father's Day, Sunday.

"My wife delivered the baby at 8.32am. The nurse informed me that my son has to be transferred to Ward A4 due to breathing problems," he said when met at his house in Taman Sri Tanjung in Sungai Layar here Monday.

Nordin, who has two other sons -- Mohamad Norsyazwan, 10, and Mohamad Norsyamer, 5, -- said the 3.6kg infant was hooked to a respiratory system when he sent the registration document to Ward A4 where seven other babies were treated.

After that, he returned to the ward to meet his wife, Noryati Abu Bakar, 31, before returning home to take napkins and came back to see his son at 11am.

"When I sent the napkins, I saw my son was no longer in the respiratory system and was being fed milk. Then I called for azan but did not touch him," he said.

He said the last time he saw his son was at 1.30pm before going home and received a call from the hospital at 2.45pm asking to come to the hospital immediately.

Mohamad Nordin, who works in a biscuit warehouse here, said he was told by the hospital management that his baby was missing at about 2.20pm from the ward and was asked to be patient.

"How can I be patient, my wife and I are very disappointed over the incident due to the hospital's negligence. This is not the case of losing a cat but missing a baby.

"From what I know, only the baby's parents will be allowed to enter the ward and the ward's door will be locked when the visiting hours ends.

"But, from the three times that I entered the ward, the nurse on duty never asked who am I and the door was not locked. This is the carelessness which really affected me and my wife," he said, adding that the incident should not happen to anybody else. He said he lodged a police report at the Kuala Muda police station even though the hospital Director Dr Harif Fadzillah Che Hashim had made a similar report.

"The hospital's director said I need not have to lodge any report since the hospital has made a report but I don't care, I still lodged a report. I was also asked by the hospital management not to publicise the incident," he said.

He said he would discuss with his family on the next course of action, including suing the hospital.

"What's more important to me now is to calm down my wife, he said.

Noryati, looking dejected and depressed, hoped her son would be found as soon as possible.

She urged the authorities to step up efforts to find her son.

"I appeal to the person who has taken my son to take good care of him and return him to us," she said in between sobs.

Noryati, who was discharged from the hospital at 11am Monday, said she had not even seen her son's face but only knew that her baby was a boy when he was shown to her after she delivered the third child.

Meanwhile, attempts to meet hospital director Dr Harif Fadzillah for comments drew a blank.

-- BERNAMA

Kelantan A Problematic State To Health Ministry - Dr Chua

GUA MUSANG, June 19 (Bernama) -- Kelantan gives the Health Ministry the most problems as a result of the state government's failure in providing satisfactory health services to its people.

Health Minister, Datuk Dr Chua Soi Lek said his ministry had to provide special allocations of almost RM100,000 yearly to implement specific programmes like clean water availability and food supplementation, including provision of vitamins for undernourished children in the state.

"The unsatisfactory state of health of the people in Kelantan, with its many infectious diseases because of poor water quality and unhygienic food, is a big challenge to the ministry.

"All this is known to the state government, but they have still failed to provide clean water supply or raise the socio-economic standard of the people, especially the rural poor," he told reporters after visiting the construction site of a new health clinic for Gua Musang here Sunday.

He said the ministry had to shoulder the risk of potential disease outbreak although it was mainly due to the weakness of the state government.

Besides this, he said the PAS government, under the leadership of Datuk Nik Abdul Aziz Nik Mat, had also failed in terms of enforcement, resulting in infectious diseases like cholera, typhoid, malaria and dysentery continuing to be a problem in Kelantan unlike other states which hardly faced such cases.

He said about 30 per cent of Kelantanese children below the age of five were malnourished compared to the 20 per cent average at the national level.

"We hope the state government supports our efforts to help the poor as other states don't have such programmes. It is also proof Kelantan has never been mistreated by the federal government," he said.

On other developments, Chua said the federal government had approved an allocation of RM70 million for expansion of the Gua Musang Hospital.

"It is for the building of three wards, including a maternity ward, operating theatre, laboratory, blood bank, nurses hostel, a pharmacy, X-Ray facilities and upgrading of existing equipment," he said.

-- BERNAMA

Another gomen MINIster hitting out at the only state with a opposition party in the gomen. Health is basically looked after by the Fedral gomen and whatever proramme carried out in the state is directed and initiated at the federal level. Even if a programme has to be carried out owing to local needs, the officers involved are federal officers. But there are stituations and activities where the state may help out to improve the health of its people. Water presently remains a state concern and so those cleanliness of the surroundings and sanitation.
Why is the MINIster complaining about the special allocations of almost RM100,000 yearly to implement specific programmes like clean water availability and food supplementation, including provision of vitamins for undernourished children in the state. This annual amount is a pittance considering the money spent on other things. And to say that this proves that the federal gomen has never been mistreated Kelantan is obvious an understatement. It is obvious whether there has been any mistreatment.
What is welcomed is the news that the Gua Musang Hospital will be due for upgrading. This will definitely be for the good of the population living in that area. This upgrading has been promised for many years and has been brought out for airing at each of the election campaigns.

MMC Withdraws Recognition Of Ukrainan Medical Undergraduate Programmes

PUTRAJAYA, June 16 (Bernama) -- The Malaysian Medical Council (MMC) has withdrawn recognition of the medical undergraduate programme offered by Ukraine's Crimea State Medical University (CSMU) to any students registered and admitted into academic year one after Dec 31, 2005.

MMC president Datuk Dr Mohd Ismail Merican said MMC also decided at its June 14 meeting not to recognise similar programmes offered by 10 other universities in Ukraine.

The MMC was concerned about the quality of medical training or education in Ukraine in producing safe and competent doctors to meet Malaysia's needs, he told a media conference Thursday.

The decision would not affect the current 1,119 medical undergraduates enrolled in various academic years in CSMU as the de-recognition would only apply to those admitted and registered after Dec 31, 2005, said Dr Mohd Ismail who is Director-General of Health.

Those pursuing the pre-medical foundation course would be eligible only if they were admitted and registered into the first academic year before Dec 31 this year.

"In other words, any CSMU undergraduates admitted and registered for academic year one and onwards before Dec 31, 2005 are eligible to register with the MMC upon their graduation.

"Those who register after Dec 31 must sit and pass the Medical Qualifying Examination stipulated under the Medical Act 1971 to be eligible for registration (with the MMC)," he said.

The CSMU was the first institution to be granted recognition by the MMC effective Aug 7, 2001. As of last month, 1,366 students are studying in CSMU -- 1,119 in various academic years and 247 others taking the pre-medical course.

Dr Mohd Ismail said that following numerous complaints, the authorities visited CSMU in October 2003 to verify them as well as the other 10 Ukrainian universities for the purpose of granting recognition.

They found some of the Malaysian students admitted into the medical undergraduate course were school drop-outs with very poor secondary school results.

The students were allowed to pursue the programme after passing the pre-medical foundation courses conducted by the Ukrainian universities.

"Their secondary school qualifications were never taken into consideration. Even arts stream secondary school drop-outs were allowed to pursue such courses," Dr Mohd Ismail said.

He said a study conducted on CSMU graduates working in the Health Ministry, and the feedback gleaned from their supervisors, revealed that the graduates' usage of English medical jargons was limited as they were more fluent and familiar with technical jargons in Ukrainian or Russian.

"Their jargons, being alien to our medical fraternity, may jeopardise the safety of our patients and well-being," he said.

The ability of the Ukrainian universities to provide teaching in English was doubtful as the number of English-speaking lecturers and facilities were insufficient to meet the demand from the sudden increase in the number of Malaysian students.

Dr Mohd Ismail said during the authorities' first visit in 2001, there were only 53 Malaysian students in CSMU, and the number jumped to 900 in 2003.

"The drastic increase in the number of student intake may inevitably compromise the quality of medical education," he said, attributing the spike to purely business considerations.

-- BERNAMA

It looks like our short association with the medical schools of the Ukraine has come to an end. The MMC recognised Ukrainian medical degrees efective Aug 7, 2001. This opened up a means for many who could not get into the medical schools locally to go to the Ukraine. Presently there are said to be more than 1000 Malaysians pursuing medical studies there. The first recognised batch of Malaysian Ukrainian trained doctors have already graduated, this batch is said to consists of about 35. The MMC has announced that students who enrolled for their medical studies after 31st Dec 2005 will not be recognised. And those who are presently in pre-medical classes better ensure that they are in the first year before 31st Dec.
There have been complaints earlier on that these medical schools were not very particular regarding who they admit, now our Health DG has revealed that even arts students and others with a science background in schools. The DG is absolutely right in ensuring that such students should not receive iimmediate recognition upon their graduation.
The CSMU is asking why it has not been told why recognition of its medical degrees has been witdrawn and why it has not been given a grace period to rectify any shortcomings. Lets await answers from the DG.

Malaysia HIV measures under fire

Malaysia HIV measures under fire
By Jonathan Kent
BBC News, Kuala Lumpur


Malaysia's Health Minister Chua Soi Lek has asked religious leaders to drop their opposition to moves to contain the spread of HIV.

Mr Chua was reacting to a World Health Organization warning that the country was on the verge of an HIV epidemic.

Senior Muslim clerics have criticised plans to distribute free condoms, saying it would encourage promiscuity.

The WHO sounded the alarm after studying health ministry data on HIV infection in Malaysia.

The WHO said the virus was in danger of spreading out of control, especially among intravenous drug users.

More than three quarters of the 65,000 cases of HIV infection reported in Malaysia since 1996 have been attributed to the sharing of needles.

But the proportion of cases thought to be due to sexual transmission has also more than doubled in the same period.

Mr Chua has advocated a pragmatic approach, giving out free needles and condoms to reduce the spread of HIV.

It is a brave stand in a country whose many religious groups are united primarily by their conservatism.

Mr Chua will try to win his opponents round when he meets ulamas - Muslim religious teachers - next week.

The senior Muslim cleric in the state of Perak has already decried the plan to hand out free condoms, saying it would lead to more illicit sex.

Political leaders in two other states have said drug addicts, or those who are HIV positive, should only be given condoms if they are married.

Story from BBC NEWS:

An HIV epidemic is knocking on Malaysia’s door

An HIV epidemic is knocking on Malaysia’s door.

This startling conclusion was reached by the World Health Organisation (WHO) after its officials studied statistics and spoke to Ministry of Health personnel.

It disclosed that some 15,000 children have been orphaned by AIDS in Malaysia. Dr Hans Tieru, the WHO representative, said that the development of the HIV situation here was being monitored closely by the world organisation.

"It was only after studies were carried out that a finding was made that Malaysia was at the initial stage of an HIV epidemic," he said. This was reported in the UNAIDS/WHO Report on the Global HIV/AIDS Epidemic 2004.

Nearly 65,000 people have been diagnosed with HIV since 1996. Of this number, 9,444 have developed full- blown AIDS and 7,195 have died.

But the authorities and non-governmental organisations believe the official figures are only a conservative estimate.

Drug use lies behind the bulk of the HIV/AIDS cases in Malaysia. There are 130,000 intravenous drug users, many of whom share needles, raising the risk of infection.

Health Minister Datuk Dr Chua Soi Lek said he was troubled by the WHO finding. "This is a challenge for all Malaysians. We have to find a way to stop the spread of HIV," he said.

The situation called for radical approaches, including free distribution of condoms and clean needles to stop the spread of infection among drug users, he said.

But Dr Chua also sounded a note of caution. Though most HIV-positive Malaysians were drug addicts, a growing number of people were being infected through sexual contact.

---NST


The controversial plan to issue condoms and needles to halt the spread of HIV among drug users looks set to take off.


All Health Minister Datuk Dr Chua Soi Lek has to do is convince influential religious leaders next week that the alternative to the scheme is unthinkable.

"Together with the minister in charge of religious affairs, I will meet the ulamas. We will tell them that what we are doing is to prevent the spread of the disease to a worrying stage," he said.

Dr Chua said under the plan slated to start in October, 130,000 intravenous drug users would be given clean needles. More than 70 per cent of this group who are sexually active will be given condoms.

This harm reduction regime will save 90,000 Malaysians from being infected with HIV/AIDS.

"This will save the Government RM500 million a year in terms of treatment with drugs alone," he said.

Many religious groups have shot down the idea, saying that giving condoms will only encourage sexual promiscuity.

Dr Chua said that condoms would only be given to a targeted group of people — drug users, and will be under close supervision by trained professionals.

The latest figures show that 64,439 people were infected with HIV. If nothing is done to curb the spread of the disease, the number of HIV cases will escalate to 300,000 by 2015.

---NST