Health+ Newspaper August 2016 Issue 06 by Health+ Newspaper

Organic galore

NUTRITION Opika Organic Market and Restaurant serves good food, though not the cheapest around

... page 45

www.healthplus.com.my

AUGUST 2016

RM5.00(+GST) issue 06 KDN: PP18743/05/2015 (034197)

The Pulse of the Nation

Seeing light in darkness Local news+

Ending AIDS by 2030 ... page 11 Month-long activities at Red Ribbon Popup Store to promote campaign to wipe out epidemic

Schizophrenia, depression, substance abuse, and personality disorders are key psychological disorders that lead to suicidal attempts XTRA ... pages 02-08

Climbing against cancer

GENERAL + Vemanna Appannah and team conquer Mt Kilimanjaro to support cancer patients

... page 41

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FOREIGNNEWS+

AUGUST | 2016

FIRST Note

Overcoming the gloominess

t is a surreal experience for me to have given the chance to write on this month’s First Note. The amount of hours I have stared at my computer screen is well-worth it for this awesome honour. Before I forget, Health+ would like to graciously wish our readers a very happy Ramadan and a prosperous Aidilfitri! The scorching heat and downpour of rain so far had been a big challenge for us. We here at Health+ are striving to bring interesting and timeless discussion about the well-being of Malaysians. To start off our journey into health issues in Malaysia, we look at the most recent National Health and Morbidity Survey (NHMS) to date. The NHMS 2015 is the first of the three-year cycle to be done. It discusses various aspects of public health which include; public’s health seeking behaviours, risk factors of diabetes, hypertension, levels of cholesterol in the blood, smoking, the level of physical activity among Malaysians, eating status and obesity among the public, and eating patterns and alcohol intake in Malaysia. Prevalence of diabetes among settlers 18 years and above is at 17.5%, with 3.5 million affected by the mostly lifestyle disease. What’s worse, about half of diabetics are seen to not even know that they are diabetic. People living with hypertension in addition, are one in every three person 18 years an above. The amount totals up to 30.3% which is about 6.1 million Malaysians. The same can be said for people with hypertension as the diabetics, as half doesn’t know their blood pressure levels are at an all-time high. 2016 have been a harsh

Organic galore

As we are reaching nearer to the end of the year, we should find the lighter side of things in every dark spots we stumble upon.” reminder to us all. The amount of bad news we received from television and internet are indeed scary. It has made into a gloomy year so far. These bad news surrounding us of late had helped fuelled us to touch base on one of the most dreaded mental condition a lot of us are facing now. Depression. To fall into the dark pits of depression is daunting and can be damaging to some. We have reached out to a few local professionals and caregivers to shed some light on the condition here in Malaysia. What are the signs of someone being depressed? Is it leading to suicide? How can we help them out of depression? These questions are answered in our Xtra section in the centre of the newspaper. Going into a more joyous topic, we also take a look at the benefits of fasting. As many Malaysians partake in the practice for the whole month of Ramadan, it is indeed beneficial for us to know how we can take advantage of it to become healthier. As a chef whose passion lies tremendously with Malay cuisine, we had the chance to speak to chef Marina Mustafa and get her to talk about our diet during the holy month. Additionally, recent development of cancer research in Malaysia had brought genetic

testing to the eyes of the public, and a brave story from a brave individual battling cancer are sure to keep you inspired. These are only a fraction of stories you can find in this issue of Health+. As we are reaching nearer to the end of the year, we should find the lighter side of things in every dark spots we stumble upon. News of terrorist attacks may sway our belief for humanity, but to trust ourselves to keep our bodies and our minds healthy is a step in the right direction. Michael Jackson’s ‘Man in the

NUTRITION Opika Organic Market and Restaurant serves good food, though not the cheapest around

... page 45

www.healthplus.com.my

AUGUST 2016

RM5.00(+GST) ISSUE 06 KDN: PP18743/05/2015 (034197)

THE PULSE OF THE NATION

Seeing light in darkness LOCAL NEWS+

Ending AIDS by 2030 ... page 11 Month-long activities at Red Ribbon Popup Store to promote campaign to wipe out epidemic

Schizophrenia, depression, substance abuse, and personality disorders are key psychological disorders that lead to suicidal attempts XTRA ... pages 02-08

Climbing against cancer

GENERAL + Vemanna Appannah and team conquer Mt Kilimanjaro to support cancer patients

... page 41

Clinically disruptive ... pages 02-08 Depression is recognised globally as a clinical condition with awareness beginning to engulf like wild fire

www.healthplus.com.my

THE PULSE OF THE NATION

AUGUST | 2016

Essence of fasting Huge opportunity for us to attain the spiritual and physical benefits during this holy month. See pages 09-10

A chef’s guide to a healthier Ramadan

Chef Marina Mustafa shares her knowledge and tips on commemorating the fasting month, the healthier way

Packing off habit World No Tobacco Day advances the attempt to tackle the ever-present issue with smoking

... pages 10

... page 11

Mirror’ suitably comes to mind. As long-winded my rantings could go on, I end my note on a wish for a healthier Malaysia. Have a blessed Ramadan and Selamat Hari Raya to my family, friends, and of course, to you. May we overcome this gloomy year with a bang. Norman Hussaini Senior Writer

Published by: Hash Plus Communication Sdn Bhd (1110279-M)

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Lot 2063A, Jalan Kusta Sg. Buloh, Kawasan Industri Taman Jaya, 47000 Sg. Buloh, Selangor, Malaysia. Tel: +603-6145 8163 (100 lines) Fax: +603 6141 2345 http://www.superiorpress.com.my/ Disclaimer: The content of this publication aims to inform and educate the public on health issues, developments and news, both locally and globally. In addition to our editorial team, we also invite distinguished medical practitioners and other experts to contribute articles on their respective fields of expertise. The information contained in this publication is for general information only, and readers should always seek independent, professional advice and consultation where appropriate. Whilst every care has been taken to ensure that the content is correct, the publisher and editors of Health+ will not be held liable for any loss or damage resulting from reliance upon any information in this publication, including products and services advertised. Unauthorised reproduction of this publication is strictly prohibited, in whole or in part, without the written consent by the publisher. Statements and opinions expressed by writers, contributors and advertisers are not necessarily those of the editors or publisher.

AUGUST | 2016

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localNEWS+

AUGUST | 2016

Cardiothoracic surgeons to be trained locally Move to ease shortage of doctors specialising in thoracic and cardiovascular surgery

UALA LUMPUR: The Malaysian Association of Thoracic and Cardiovascular Surgery (MATCVS) is finalising a training programme to train cardiothoracic surgeons, which is expected to ease the shortage of doctors specialising in thoracic and cardiovascular surgery. The first intake will be in July, says MATCVS president Dr Hamdan Leman in his opening address at the recent 17th MATCVS annual scientific meeting. About 400 participants comprising doctors, nurses and paramedical staff from local and international hospitals attended the three-day meeting with the theme “Maintaining Quality, Training for The Future”. They discussed various topics, including recent advances in cardiac surgery, maintaining high quality in patient care and challenges of training

PIONEERS: Dr Hamdan said the first intake will be in July.

future cardiac surgeons. Health Ministry’s director of medical development Datuk Dr Azman Abu Bakar, in his officiating address, said training is vital to ensure that the practice of cardiac surgery is fully equipped to face future challenges. “I am very pleased to announce that the Malaysian Board of Cardiothoracic

FULL HOUSE: Over 400 participants came together to discuss the latest issues in thoracic and cardiovascular surgery. Surgery has been working closely with the Royal College of Surgeons of Edinburgh to coordinate and improve advanced cardiac surgical training in Malaysia.” He also emphasised the quality of care for patients. “Improvement in care, however, can only come with having the correct information on how effective our treatment measures are. We must have the tools in place to measure the effectiveness of our treatment. In this regards, I commend the MATCVS on its successful implementation of the National Cardiovascular and Thoracic Surgical Database (NCTSD).” The database tracks adult patients undergoing cardiac surgery in three places – the ministry’s cardiac units, university hospitals and the National Heart Institute. It will provide healthcare professionals with critical data on how best to treat their patients. D r T i m o t hy G ra h a m ,

representing the Royal College, delivered the Razali Hashim Memorial Lecture titled ‘International Collaboration in Surgical Training and Education’ which highlighted the global nature of medical education and the increasing need for collaboration in order to maintain a high level of quality in teaching and training. The training will aim to be on par with the training programme offered in the UK. This means that practitioners undergoing cardiac surgery training in Malaysia will have the same quality of education and practice as UK colleges and universities. “This opens up new possibilities for the doctors in Malaysia to receive quality training while still remaining in the country. The aim is to relieve the scarcity of doctors specialising in thoracic and cardiovascular surgery in Malaysia,” concluded organising chairman Dr Alwi Mohamed Yunus.

Multilingual cancer support helpline KUALA LUMPUR: A new cancer helpline is available to the public, particularly those living outside cities, to access free cancer information and support. Launched by the National Cancer Society of Malaysia (NCSM), the Cancer Information Service (CIS) toll-free helpline aims to assist the public on any cancerrelated questions or concerns. The multilingual, confidential and dedicated helpline with email service addresses questions on the treatment and prevention of cancer, caring of cancer patients, available cancer facilities, services, financial help and support groups at the callers’ vicinity, and more. Operated by nurses who are qualified and experienced, including in oncology, the CIS also provides detailed information on how to cope with cancer.

“One in four Malaysians are at risk of developing cancer. Globocan also predicts that the number of new cancer cases will rise from 37,000 now to 56,000 by 2025,” said NCSM president and medical director Dr Saunthari Somasundaram. “Many Malaysians may not have access to cancer-related information or other types of support that they need.” NCSM developed the CIS in view of these gaps, especially for Malaysians who may otherwise be unable to access such support, Dr Saunthari explained: “Many callers tell us they simply don’t know where to go for advice, or that they just need someone to speak to. Some are simply confused and frustrated by the different advice that they receive from people around them.”

programmes, and education, care and support services. “However, the helpline and email service does not provide medical advice, or to replace the role of physicians or oncologists,” said Dr Saunthari. “We respect and support the patient’s relationship with their doctors, and encourage callers to seek medical opinion.” The service also contains a dedicated computer programme that captures the major concerns of callers, allowing NCSM to better identify cancer-related needs as well as knowledge gaps among Malaysians, and improve its early detection and prevention

NCSM encourages Malaysians to take advantage of this service and call 1800-08-1000 or email help@ cancer.org.my. Operating hours are from 8.30am to 4.30pm, Monday to Friday.

localNEWS+

2016 | AUGUST

Tackling chronic lymphocytic leukaemia Gazyva is new option to help patients achieve deep responses to treatment with longer lasting remissions

By YOUNG SIN YEE

UA L A L U M P U R : Chronic lymphocytic leukaemia (CLL) is a slow progressing disease, and 40-60% of patients show no symptoms at all. Furthermore, some patients make the mistake of associating some of its symptoms with other everyday ailments. According to Malaysian Society of Haematology president Dr Alan Teh, patients will often feel fit and well, but a routine blood test performed as part of a regular health

check will reveal that they actually have CLL. “Hence, the diagnosis of CLL is often incidental. Patients with CLL are usually the elderly and have other medical conditions that make intensive chemotherapy unsuitable for them,” he said at the launch of Gazyva by Roche Glycart AG. The Malaysian Cancer Registry 2007 reported that CLL accounted for 8.1 % of lymphoid leukaemia cases in Malaysia. CLL is a common form of leukaemia in western countries, but less common in Asia. Besides the elderly, Dr Teh said CLL is more common among males than females. However, the causes of CLL are mainly unknown but some research has focused

SEEMINGLY OK: Dr Teh said patients will often feel fit and well, but a routine blood test performed as part of a regular health check will reveal that they actually have chronic lymphocytic leukaemia.

on some possible contributory factors, which include genetic factors, impaired immune system and viruses. “Some families are more likely to have cases of CLL without having defined genetic alteration,” he explained. It is difficult to diagnose CLL patients during the early stages unless they undergo blood tests. Common symptoms include enlarged but painless lymph nodes, fatigue, fever, pain in the upper left portion of the abdomen which may be caused by an enlarged spleen, frequent infections, weight loss with no apparent reason and night sweats. According to Datuk Dr Chang Kian Meng, national head of haematology at Hospital Ampang, CLL might be diagnosed through few

BETTER REMISSION: Professor Bosch said Gazyva is a new option that helps patients achieve deep responses to treatment that translates to longer lasting remissions.

La Juicera halal-certified

Oats in trouble

KUALA LUMPUR: La Juiceria has finally obtained its halal certification early in April this year after a two-year wait. According to its founder and managing director Anabelle Co-Martinent, La Juiceria is the first cold-pressed juice outlet to be certified halal in Malaysia. Obtaining the halal certification is indeed a big relief for Anabelle as 60 to 70 per cent of La Juiceria’s customers are Muslim. “A halal certificate is not only for Muslim, but this is a sign of confidence for our consumers,” she says. The ceremony was attended by Minister in the Prime Minister’s Department major general Datuk Seri Jamil Khir Baharom (B), chairman of Port Klang Authority Tan Sri Kong Cho Ha, and acting director of JAKIM’s Halal hub Dr Sirajuddin Suhaimee. The company’s co-founder Kong Len Win said that they are on the lookout for partners to help grow the business. “The opportunities are definitely there. We are now searching for the right partner

Ministry of Health Malaysia had taken notice on an issue last month regarding the discovery of residual herbicide glyphosate in a popular food product Quaker Oats that was made viral. Glyphosate is an herbicide under the sub regulation 41(3) of the Food Regulation 1985 which outlines the use of it in cereal food product (including oats) to not exceed 30mg/kg. It is used exclusively to kill weeds in crops which are processed for food products. Fox News and the New York Post reported on the discovery and had sent ripples of worry among the public in the United States. Reports had stated that a consumer in Brooklyn, New York had sued the company producing the product on the basis of them using the herbicide as a drying agent for the plants. Seeing as the product is quite well-known here in Malaysia, the ministry had taken the initiative to investigate. It was found that the product sold in local market are indeed free of glyphosate. The use of glyphosate in plant-based food products has been in heated discussion for years. Most countries including Malaysia keeps regulation on the maximum amount of the substance to be present in food for it

as penetrating the market in other country is very challenging.” Co-Martinent aims to further widen the La Juiceria brand in Southeast Asia and become a Malaysian brand outside of Malaysia. What is cold-pressed juice? Cold pressed is a process where just enough pressure is applied to extract juices from vegetables and fruits, while preserving its vitamins, enzymes, trace minerals, and overall nutrients. At La Juiceria, the process is done under low temperature condition. Cold-pressed juices are said to be healthier as no preservation is added.

• 05 methods such as blood test, cell markers, bone marrow, cytogenetic abnormalities and molecular abnormalities. “The main ways in which CLL is treated are chemotherapy, targeted therapy, radiation therapy and stem cell therapy. Besides, treatment goals are required to be determine between potential benefits to the patients are balanced against the risk of more aggressive therapy.” Gazyva is approved in combination with chlorambucil for people with previously untreated CLL and have co-morbidities. It is a new, type II, glycoengineered monoclonal antibody designed to attach to CD20 a protein found only on B cells. It attacks targeted cells both directly and together with the body’s immune system. Professor Francesc Bosch, investigator of CLL11 study, said Gazyva is a new option that helps patients achieve deep responses to treatment that translates to longer lasting remissions. “The CL11 study compared the combination of Gazyva and chemotherapy to chemotherapy alone, and rituximab with chemotherapy in CLL. “The results from the study showed a significant reduction of 82% in the risk of disease progression when combined with chemotherapy versus chemotherapy alone, and 61% reduction as compared to treatment with rituximab and chemotherapy. Gazyva was also found to reduce the risk of mortality in people with previously untreated CLL by 59% as compared to those who received treatment with chemotherapy alone.”

Typical scenario in crop growing where farmers spray regulated amount of glyphosate to kill off weeds. to be safe. The ministry is always on alert in all things health-threatening that may affect the Malaysian population. They urge the public to contact the respective State Health Department or the Food Quality and Safety Department’s facebook if any complaints regarding food safety are present.

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localNEWS+

MAKNA support researchers to fight cancer The MAKNA Research Award recently marked its 15th year of supporting young cancer researchers in the country by giving grants close to RM90,000 to fund their research.

AUGUST | 2016

Other news in brief

The rules now are strict as cigarettes cannot be sold to youth below 18. Those who break this rule will be prisoned for a day”. On the consequences of selling cigarettes to the under-aged. YB Datuk Seri Dr Hilmi bin Haji Yahaya Deputy Minister of Health

By ali-azmin hassan

he award was initiated by the National Cancer Council Malaysia (MAKNA) in 2001 to encourage and recognise the importance of research and development by local scientists in advancing knowledge that is geared towards helping cancer patients and discovering potential cures for the disease. The recipients for the 2015 award were Dr Nethia Mohana Kumaran (Universiti Sains Malaysia), Dr Chua Eng Wee (Universiti Kebangsaan Malaysia), who were each awarded RM30,000, and Dr Nor Fazila Che Mat (Universiti Sains Malaysia), who was awarded RM29,835. The selection of the recipients was conducted by a panel headed by Professor Datin Paduka Dr Khatijah Mohd Yusof, Academy of Sciences Malaysia (ASM) fellow and dean of Universiti Putra Malaysia’s Faculty of Biotechnology and Biomolecular Science, alongside other experts and medical practitioners in the fields of hematology and oncology among ASM fellows. MAKNA president Datuk Mohd Farid Ariffin said the award is part of the council’s research-related endeavours, which include collaborations with universities and research institutes in Malaysia to advance knowledge in the field in the hope of helping cancer patients throughout the country and finding a potential curative treatment for cancer. “It is heartening to note that in 2015 the

MAKNA general manager, Farahida Mohd Farid MAKNA Cancer Research Award received the highest number of applicants, totalling 51. This is a firm indication that the MAKNA Cancer Research Award is looked upon by the research community as a source of support to continue their work. It is also an indication that work is continuing in this area, which gives us renewed hope. There is no short cut or overnight result in research. It takes a lot of patience, determination, dedication and failure to succeed. As such we are patient and willing to keep encouraging our researchers.” MAKNA has awarded a total of RM1,284,835 towards funding cancer research by young researchers in Malaysia. To date, the programme has funded 45 researchers. “We are grateful to ASM for their partnership and continued support that ensures that the MAKNA Cancer Research Award is able to nurture young scientists in their pursuit of new knowledge and scientific breakthroughs,” said MAKNA general manager Farahida Mohd Farid.

Dr Chua Eng Wee (left), Dr Nethia Mohana Kumaran, and Dr Nor Fazila Che Mat, the winners of The MAKNA Research Award 2015.

New strategies needed to combat dengue menace KUALA LUMPUR: Dengue experts from the Asia-Pacific region and Southeast Asia gathered at the Asia Dengue Conference 2016 from April 23 to 24 to share information on the current status of the killer disease as well as its clinical management, research initiatives and control strategies. The objective was to form close partnerships to strengthen regional capacity to respond to the dengue threat and ensure global health security. The conference, with the theme “Dengue: New Challenges, New Strategies”, was co-organised by the Malaysian Society of Infectious Diseases, Tropical Infectious Disease Research and Education Centre, the World Health Organisation Collaborating Centre for Arbovirus Reference and Research and Aesculap Academy Malaysia, and supported by the Health Ministry. Health Minister Datuk Seri Dr S Subramaniam, in his officiating address, said cases of dengue infection have been increasing in Malaysia every year. “As of April 20, 2016, the cumulative dengue cases reported across the country were 41,749 cases, an increase of 10.8% (4,076 cases) compared with 37,673 cases reported in the same period of 2015. The Health Ministry is taking the issue seriously and is doing all it can to combat this increase.” He said dengue infection remains a public health challenge for the Asia-Pacific region. “It is not an easy disease to prevent and control. There are many reasons, and one of the issues that need to be addressed is environmental cleanliness. In order to control and prevent dengue, it is important to eradicate the breeding sites of mosquitoes, to eliminate the environment where mosquitoes lay their eggs and where larvae thrive until they reach adulthood,” he added. He said the fight against dengue can only be successful if people understand they have the power to change things for the better. More research on the vector, virus and the disease is needed to understand dengue and save more lives in future.

localNEWS+

2016 | AUGUST

• 07

Using barn owls to combat rat menace First-of-its-kind initiative in Asia reaping results with photographs and videos showing birds feeding on rats

By prasad chandra segaran

UBANG JAYA: A second pair of barn owls reintroduced in Bandar Sunway at the end of March to help control the rat menace has starting hunting and feeding on their own along the streets and back lanes of Sunway Metro’s commercial shop area. Professor Dr Abu Hassan Ahmad, Universiti Sains Malaysia (USM) head researcher for the barn owl project, said the owls had started hunting for rats and feeding on their own since they were released in PJS9, Bandar Sunway on March 29.

HANDS OFF: Barn owls are protected under the Wildlife Conservation Act 2010.

Radio transmitters had been attached to both owls for tracking and monitoring. Dr Abu Hassan said the first-of-its-kind initiative in Asia is reaping results with photographs and videos showing the owls feeding on rats. “The owls were introduced into the urban neighbourhood of PJS9 which has suitable trees for their owl box. Our research team has been tracking the owls daily since the release. The pair was recorded making their way in the neighbourhood for about two days before they flew over to Sunway Metro across the road. They even stopped at the Sunway Lagoon BRT station for a night on their way across the road.” The barn owl project, a joint effort between USM, Subang Jaya Municipal Council, Department of

Wildlife and National Parks and SJ Echo, is the first-of-its-kind initiative in Malaysia and Asia to urbanise barn owls to control urban rat populations. University Putra Malaysia has since joined the project led by Assoc Prof Dr Hafidzi Mohd Noor, an expert in vertebrate pest ecology and biological pest control. A total of 12 pairs of barn owls sponsored by the corporate sector will be involved in the project. The remaining owls housed in USM’s aviary in Penang will be despatched to Subang Jaya in batches. Subang Jaya Municipal Council president Datuk Nor Hisham Ahmad Dahlan said given time, the

owls will be able to help the council reduce the rat population in the project area, while reminding the public that barn owls are protected under the Wildlife Conservation Act 2010. “We have received reports from our research team and the police that some members of the public had tried to disturb the birds. We have even received reports that someone tried to shoot them. I would like to remind the public that it is an offence to do so. You can be arrested and fined RM100, 000 or imprisoned for three year or both if found guilty of trying to hunt, hurt or catch the bird.”

appointment. This minimises waiting and cuts down the overall time needed to seek care,” she added. “We would like to thank BookDoc in advance for the donation which will go towards supporting NCSM’s cancer information system. The system will enhance the visibility of NCSM services to the public, namely our cancer & health screening as well as nuclear medicine imaging, which are heavily subsidised by the society. The public can now easily make appointment anytime anywhere with their smartphones or through

the BookDoc website allowing timely access to healthcare.” BookDoc has grown regionally with presence in Malaysia, Singapore, Hong Kong and Thailand. It is backed by a diverse group of investors, from entrepreneurs to seasoned healthcare and insurance professionals, bankers, regulators as well as ICT professionals. It achieved the highest pre-seed and seed evaluation in Asia tech app history. Bookdoc aims to connect and unite customers with the healthcare professionals of their choice.

Cancer info and services at your fingertips by ali-azmin hassan The public now has easier and wider access to cancer-related information and services via a joint initiative between BookDoc and the National Cancer Society Malaysia (NCSM). The collaboration was officiated by NCSM principal patron Tan Sri Rafidah Aziz, BookDoc founder and CEO Datuk Chevy Beh on April 27. Services offered by NCSM’s cancer & health screening clinic and nuclear medicine centre can be searched and booked online instantly though BookDoc’s free apps and website, BookDoc.com anytime and anywhere. “Even though BookDoc is a technology start-up launched barely six months ago, we deeply appreciate the importance of

timely access to care. Early detection of cancer and immediate treatment greatly favours the chances of recovery. As part of our corporate social responsibility Initiative, in conjunction with this collaboration, BookDoc is launching a fundraising campaign for NCSM. From April 27 to June 30, anyone who registers a new account will be prompted to enter a special code. Just key in the word “CANCER”, and we will be donating RM1 to NCSM,” said Chevy. NCSM president Dr Saunthari Somasundaram said the society is glad to have a new partner to support its effort in battling cancer. “With BookDoc, users can now easily search and book slots which are convenient to them, and only need to arrive no more than 15 minutes before the scheduled

HAND IN HAND: Dr Saunthari and Chevy Beh discussing collaboration between NCSM and BookDoc.

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localNEWS+

AUGUST | 2016

Versatile for toddlers and adults Philips AVENT 4-in-1 Healthy Baby Food Maker can steam, blend, defrost and reheat for quick hassle-free baby food preparation

COOK RIGHT: Chef Marina demonstrating how to use the device correctly.

UALA LUMPUR: To ensure that their babies and toddlers get a healthy start in life, parents need to be mindful of the food and nutrition they consume. According to the Health Ministry, it is recommended to start your baby on complementary good food from as early as six months. This can be done by weaning your baby from milk to solids by blending, grinding and crushing food into smooth purees. However, in this day and age, finding the time to prepare your child’s next healthy meal can be quite a challenge. With this in mind, Philips recently launched the Philips AVENT 4-in-1 Healthy Baby Food Maker. Delivering the ultimate convenience, the device is specially designed with innovative steam technology that helps cook healthy, nutritious meals while allowing parents to steam, blend, defrost and reheat all in one large jar. “As parents, we only want the best for our children and that starts with providing them with proper and sufficient nutrients at a young age. However, modern parents face the challenge of setting aside time to personally prepare that much needed well-balanced meal for the little ones and the family. At Philips, it is our aim to deliver innovative time-saving solutions across the health continuum so that Malaysians, from toddlers to adults, can experience life to their FULLNESS OF LIFE: Ali saysy that fullest the product helps parents to achieve potential,” a better quality of life for their s a i d children. Muhammad Ali Jaleel, Philips Malaysia country manager and general manager for personal health. Chef Marina Mustafa demonstrated her cooking skills to showcase the device’s versatility. “For the busy adult, it’s a very handy device to have when preparing meals for babies or even the whole family. Without having to change equipment, you can steam, blend, defrost and reheat all in one convenient jar which saves the hassle of cleaning up after,” she said. The Philips AVENT 4-in-1 Healthy Baby Food Maker comes with its unique flip mechanism that simply turns the jar upside down, after steaming for the next step which is to blend. This easy transition save parents the hassle of having to transfer the ingredients to a separate jar leaving little or no mess to clear up. Its versatility makes cooking for toddlers hassle free. Chef Marina said the device can also be used to prepare simple food for adults like porridge, mashed potatoes and pasta sauces.

localNEWS+

2016 | AUGUST

• 09

Fruit juice drinks vs fruit drinks Nutritionist shares quick tips on how to distinguish them and enjoy the real goodness

UALA LUMPUR: It’s not surprising that many cons umers assume fruit juice drinks and fr uit drinks are the same. To enlighten consumers on their differences and nutritional benefits of fruit juice drinks, Marigold Peel Fresh recently hosted an educational session with American Fitness Professionals and Associates (AFPA) certified nutritionist Alexandra Prabaharan. Marigold Peel Fresh deputy general manager Michael Ong said most consumers tend to assume that fruit juice drinks and fruit drinks are the same. “They would not know the differences between juices that are placed on the shelves and those kept in the chillers. The educational session with Prabaharan plays a pivotal role in helping Malaysians to identify and differentiate correctly between fruit juice drinks and fruit drinks to ensure they pick the right choice with fresh goodness and nutrients to lead a healthy and balanced lifestyle.” Prabaharan shared quick tips to

help consumers distinguish fruit juice drinks from fruit drinks. “While fruit drinks may appear to look the same as fruit juice drinks, the key difference lies in the fruit juice content. “One easy and practical way to recognise juices with higher juice content is to read and look out for the label description.” She said consumers should also be aware that according to the Food Act 1983 (Act 281), fruit drinks shall contain no less than 5% fruit juice only, while fruit juice drinks shall contain no less than 35% fruit juice. “Besides having at least 35% of fruit juice content, fruit juice drinks also go through a pasteurisation process which helps maintain the nutritional values and retain its natural freshness.” Prabaharan shared three simple ways to identify a pasteurised fruit juice drink. “First, simply look out for the label ‘fruit juice drink’ on the packaging. Second, because pasteurised fruit juice drinks are fresh, you can find them only in the refrigerators or else they will turn bad. This leads us to the third identifying point where you may notice that fruit juice drinks have

FRUITY TRIO: The mocktails prepared by Alexandra to promote healthier choices in juices.

a shorter expiry date compared to long-life fruit drinks that can be found in both chilled and nonchilled conditions.” Besides the enlightening talk, Prabaharan also discussed with

KNOW THE DIFFERENCE: Alexandra explaining the differences between the two types of drinks and benefits of fruit juice drinks.

Good hand hygiene protects patients Healthcare workers must practise good hand hygiene as bacteria on unclean hands can have dire effects on patients and visitors. This was the message at an event to commemorate the National World Hand Hygiene Day 2016 held at Hospital Shah Alam on May 5. Health Ministry’s medical development division director Datuk Azman Abu Bakar, representing Health Minister Datuk Seri Dr S Subramaniam, said Malaysia was among the first to sign the country’s pledge in 2006 to support the WHO’s World Alliance for Patient Safety

“Global Safety Challenge”, the first of which was “Clean Care Is Safer Care”. “Since then, the Health Ministry has made the prevention and control of healthcare associated infections a key strategy for patient safety improvement. Infection control remains a key issue in Malaysia,” he said when officiating the event with Datuk Dr Christopher Lee, senior consultant infectious disease physician and chairman of the National Infection and Antibiotic Control Committee. “Today, Malaysia is on the path towards attaining a safe healthcare

CLEAN HANDS: Datuk Haji Azman Abu Bakar touring the hand hygiene booths.

system with many programmes to enhance the key aspects of patient safety in the Malaysian healthcare system. “Understanding the modes of transmission of infectious

the attendees nutritional benefits of fruit juice drinks as compared to fruit drinks and led a mocktail demonstration. The demonstration was an engaging activity to highlight that fruit juice drinks such as Marigold Peel Fresh can provide consumers with the essential nutrients and vitamins needed in their diet in a unique way. “Some antioxidant-rich fruits such as berries, mangosteens and purple carrots are usually seasonal or imported, making them not only hard to find in the market, but also expensive in most cases. At times, it would be more convenient to get fruits and vegetables in juice form, or pick up ready-to-drink fruit juice drinks like Marigold Peel Fresh for a quick and easy daily nutritional fix. So make the right choice when you’re at the store and ensure that you’re bringing home a fruit juice drink instead of a fruit drink,” added Prabaharan.

organisms and knowing how and when to apply the basic principles of infection prevention and control is critical to the success of an infection control programme. This responsibility applies to everybody working and visiting a healthcare facility, including administrators, staff, patients and their caretakers. Hand hygiene, a very simple action, is well-accepted as one of the primary modes of reducing healthcare associated infection and enhancing patients’ safety,” said Azman. Lee noted that hand hygiene is one of the solutions to reduce the risk of getting bacterial infection. “Not only do the staff in the hospital carry bacteria but the public also. They should wash their hands before and after touching patients,” he said. There were booths showcasing different types of hand sanitisers for use in hospitals.

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Celebrating World Haemophilia Day Haemophilia Society of Malaysia commemorates event with movie day out for members and families

UALA LUMPUR: More than 1,000 people have been diagnosed with haemophilia in

Malaysia, but another 2,000 remain undiagnosed with no access to treatment. In conjunction with World Haemophilia Day recently,

Haemophilia Society of Malaysia (HSM) held a movie day outing for 130 members and their families with support from Baxalta.

They were treated to a screening of The Jungle Book after an intimate sharing session aimed to create further awareness on the disease. The event featured an introduction to the society, a disease awareness talk along with a meet-and-greet session with the members. Younger members were also awarded with “The Excellence in Studies” award, an initiative by HSM to recognise the academic achievements of school-going members and motivate them to continue striving for their dreams. HSM vice-president Edwin Goh shared how the society has been constantly supporting the haemophilia community in Malaysia. “Our society is made up of 100% volunteer workforce, consisting of doctors, nurses, haemophilia patients and their family members. This makes us so much more committed and passionate about what we do in providing and improving treatment for haemophilia and other inherited blood disorders.” One of the major issues that remains a challenge for the haemophilia community is an enormous discrepancy in the level of care available to patients around the world. While some are diagnosed very young and have medical care throughout their life, most do not. Treatments do exist, but without the correct care, many patients still suffer debilitating pain, permanent joint damage or even death. Goh said HSM’s key role is to ensure that patients get early diagnosis and are given access to treatment. “What we aim to do is to create a support system for Malaysians who live with haemophilia. We want them to know that there are others like them and it is possible to go on living and achieving their goals despite the disease,” he added. “We encourage Malaysians to learn more about us and haemophilia. We welcome any form of help and support. I would like to take this opportunity to thank those who have been supporting us in making World Haemophilia Day an exciting event for everyone.” World Haemophilia Day is celebrated globally on April 17 by the bleeding disorder community and led by the World Federation of Haemophilia (WFH). This year, WFH’s focus is to bring attention to a challenge that too many people in the community face – the lack of access to treatment and care. The theme for this year’s celebration is “Treatment for All is the Vision for All”.

Allergy alert PETALING JAYA: Allergic reactions are pretty common and, while they can be a nuisance and hamper your normal activities, most are pretty mild. Though not everyone is prone to allergies, lots of people do – and many live with some limitations. Observing this year’s World Allergy Day, Caring Pharmacy hosted a forum public on allergies on April 30 to get people to engage with specialists and know more about the condition. Three speakers enlightened about 130 participants on signs, causes, preventative measures, treatments and public perceptions of allergies. Dr Adrian Yong Sze Wai, a consultant dermatologist and dermatological surgeon from University of Malaya Specialist Centre, in his talk on “Itching for a Solution” highlighted ways our skin reacts to allergies

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Ending AIDS by 2030 Month-long activities at Red Ribbon Popup Store to promote campaign to wipe out epidemic

UA L A L U M P U R : Imagine a world without AIDS! It’s doable if everybody puts their heads together and works tirelessly to end this deadly scourge. Renewed optimism and urgency underscored the latest HIV and AIDS public awareness campaign jointly organised by the Malaysian AIDS Council (MAC) and Malaysian AIDS Foundation (MAF) in collaboration with the Health Ministry. “The ‘Ending AIDS Begins Now’ campaign is a timely reminder of the robust progress of the AIDS response over the past decade – characterised by a 40% reduction in new HIV infections and wide expansion of harm reduction and HIV prevention services – which provides a strong foundation for ending one of the most challenging public health crises the world has ever seen,” said Datuk Raj Karim, MAC president and MAF trustee at the launch of the campaign. “Bearing this in mind, it is also an urgent call for fast-tracking our concerted effort as well as collective resilience and resources that must be achieved through meaningful public engagement and multi-sectoral partnerships,” she added. The “Ending AIDS Begins Now” campaign builds upon the aspirations and goals of the

new chapter in the global AIDS response, Ending AIDS by 2030. These goals are outlined in the National Strategic Plan for Ending AIDS 2016-2030, the blueprint that charts the course of the national AIDS response towards a 90% reduction of new HIV infections in the next 15 years. The campaign, launched by Deputy Health Minister Datuk Seri Dr Hilmi Yahya, coincided with the opening of the MAC and MAF Red Ribbon Popup Store in partnership with Pavilion Kuala Lumpur. In his speech, Hilmi explained: “Ending AIDS does not mean to end new cases of HIV, but it aims to reduce new HIV cases by 90% by the year 2030 following the modelling agreed upon on a global scale. The ultimate aim for the national strategic plan is to have 90% of people with HIV to receive proper antiretroviral treatment, with 90% getting the benefit of viral suppression and 90% increase in advocacy and awareness efforts.” Between May 3 and June 6, the Red Ribbon Popup Store serves as an interactive space for HIV and AIDS knowledge sharing and a host of exciting fundraising activities, including special appearances by MAC and MAF Red Ribbon Celebrity Supporters. Visitors to Pavilion Kuala Lumpur will also be greeted by a giant red ribbon installation placed near the entrance of the building as a

and how to identify them. “There are various causes for our skin to be itchy. Though not all are because of allergies, most persistent itchiness due to contact with certain objects or materials can be a sign that we may be allergic to something. The two most widely used tests to determine if you have allergies are by doing a scratch test or a patch test. Both involve minimal-invasive techniques that can accurately determine which allergens you are susceptible to,” he explained. Dr Paul Lim Vey Hong, a consultant ear, nose and throat specialist and surgeon at Tung Shin Hospital, speaking on “Allergic Rhinitis: What to Look Out for and Do”, informed the attendees about the fundamentals of allergic rhinitis. “Allergic rhinitis is a diagnosis associated with a group of symptoms affecting the nose. It occurs when allergens such as dust, animal dander or pollen are inhaled. It can also manifest when we eat food that we are allergic to. Common symptoms to signify an allergic reaction include itchy areas around the face,

RED RIBBON CUTTING: Officiating the Ending AIDS Begins Now initiative with the opening of the Red Ribbon Popup Store.

“Ending AIDS does not mean to end new cases of HIV, but it aims to reduce new HIV cases by 90% by the year 2030 following the modelling agreed upon on a global scale.“ - Hilmi

SIGNING IN: Hilmi getting ready to sign the plaque to officially launch Ending AIDS Begins Now.

problems with smell, runny nose, sneezing and watery eyes.” The third speaker, Foo Fung Jiun, a pharmacist from Caring Pharmacy, shared his experiences living with allergies as well as how to properly manage the condition. “As a pharmacist, I understand and empathise completely with patients coming in to the pharmacy to get medication. I have been living with severe allergies to multiple things since I was a child, and I constantly prevent myself from being exposed to a lot of things all my life. I think that it helps to share my experience with the public to be more aware of the symptoms and signs of allergies as it can help prevent more severe conditions.” The forum was met with considerable amount of interest and the floor was buzzing with questions as the doctors provided informative answers to the attendees. Together with Bayer, Caring Pharmacy hopes to further spread the awareness for allergy to the public for a brighter future.

symbol of awareness and concern for people living with HIV. Standard Chartered Scope International, another campaign partner, will be mobilising its 1,000-strong volunteers throughout the campaign period, besides supporting the setting up of the popup store. The campaign also received support from L’Oreal Professional Malaysia, Sime Darby Foundation, Serai Group Sdn Bhd, Flora Luxe Décor and Grand Hyatt Kuala Lumpur. “Smart partnership remain the crux of our AIDS response, and we are most grateful for all the partnerships that we have forged over the years as well as new ones on the campaign,” Dr Raj noted. Fast-tracking the “Ending AIDS Begins Now” campaign, a RM100,000 donation from a league of concerned corporate figures and entrepreneurs called Kingsmen, led by Red Ribbon Business Icon Datuk Kelvin Tan, was handed to MAF in support of its high-impact HIV treatment, care and support programmes.

INFORMATIVE TRIO: (from left) Dr Adrian, Dr Paul and Foo presented valuable information about allergies, including symptoms and ways to treat and manage them.

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Other news in brief

The result that we get from the quitsmoking campaign is encouraging”. Commenting on the progress of the quit-smoking campaign. YB Datuk Lokman Hakim bin Sulaiman Deputy Director-General of Health (Public Health)

Catalyst for change

Poster_MRI_FINAL_co.pdf 1 18/03/2016 9:46:47

Malaysia celebrates the International Nurses Day 2016 with a bang

very year the world dedicates a special day to celebrate one of the most underappreciated professions in history, nursing. The day is observed on May 12 each year to mark the huge contributions they make to society. The national level celebration of the International Nurses Day was in Putrajaya this year and was met with big reception. The theme set for this year was “Nurses: A Force for Change, Improving Health Systems’ Resilience”. This year’s celebration focused on how nurses as the frontliners of health services can be the catalyst for improvement in the healthcare system. The focus was in line with recent spike in both non-communicable and communicable diseases in Malaysia, such as Ebola, Mers-covi, and dengue, as well as the need to help victims of natural disasters and accidents. Director-general of Health Datuk Dr Noor Hisham Abdullah aptly outlined the importance of the profession: “Nurses are the front soldiers in healthcare. They are a part of the retrieval team to scenes of disasters or accidents. They are the movers of primary care services in public healthcare services. They are the founders of various service groups for diabetes, hypertension, and personalised and domiciliary care. “I give my utmost trust for them to strive forward in primary care services in health clinics in Malaysia. At the same time, I would also like to implore nurses to further improve their knowledge and skills so that managing patients becomes an easier task, especially during times of natural disasters.” The need to further improve nurses’ abilities was reflected with the Ministry of Health plans to upgrade one of their nursing colleges to a university college. Health Minister Datuk Seri Dr S. Subramaniam had stated that the government colleges were only accredited to offer diploma courses, even though they are equipped to teach degree courses. “The facilities and manpower in our colleges are better than some private institutions offering degree programmes. However, because of this handicap, we are not able to. This is why we hope to upgrade our status.” It was reported that the ministry was already in talks with the Malaysian Qualifications Agency (MQA). During the event, three individuals were given awards for their outstanding achievements. Puziyah Khalid, Katipah Awang dan Elizabeth Vijaya Raghavan were each awarded the prestigious Leadership Award in Nursing 2016 (Anugerah Tokoh Jururawat). Puziyah won the award for community services, Katipah for outstanding services, and Elizabeth for her achievement in education. The International Nurses Day 2016 celebration was attended by some 3,000 nurses.

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Immunisation vital The Ministry of Health underlines the importance of immunisation during launch of National Immunisation Week 2016.

UTRAJAYA: The spreading of diseases among the human population has been well-documented over the course of history. The dangers of diseases being able to spread are worrisome, given the deadly plagues in historic times. However, modern medicine has put cataclysmic events such as plagues to rest. The development of vaccines has ensured dramatic rise in the quality of health among people. It is mind boggling then to have a portion of the world’s population to not believe in vaccination and immunisation. This year in late April, the Ministry of Health officially launched the National Immunisation Week celebration and was graciously officiated by Seri Paduka Baginda Raja Permaisuri Agong Tuanku Hajah Haminah. The aim of the event was to remind Malaysians about the importance of immunisation among children, as the number of people who are against it are expected to rise. Minister of Health Datuk Seri Dr S. Subramaniam urged parents to make sure their children are immunised in all 12 types made available in the country. “For the national immunisation programme, the government had implemented 12 types of vaccines to be given for free to Malaysian babies and children in every Ministry of Health facility. Overall, Malaysians are to be proud as 95% of the programme proved to be successful,” he says. The success rate of immunisation in the country is based on the fact that Malaysia has an efficient vaccine delivery system that involves all health clinics and schools. Ill issue The issue stands however, when the ministry noticed a portion of the society voluntarily rejecting immunisation. Some of the factors contributing to this issue are largely misconceptions. The outcome of it is seen through the elevated cases of measles in Malaysia. Since 2014, cases of measles reported had increased, especially among children who were denied immunisation from their parents. 1,400 cases of voluntary rejection on immunisation had been reported since last year and continues to grow as of today. March of this year had seen a whopping 584 cases of measles, with a 461.5% compared with 2015 with only 104. Taking the steps As a preventative measure, Ministry of Health will reinforce the awareness towards immunisation while also attempting to break the misconceptions towards it. “The ministry as well as the Department of Islamic Development Malaysia (JAKIM) are ready to accept any enquiries about immunisation from the public should there be a need,” says Dr Subramaniam. The aim is to reverse the negative perception of immunisation. The event was held in conjunction with the World Health Organisation (WHO) World Immunisation Week 2016 where the slogan reads; Close The Immunisation Gap: Immunisation For All Throughout Life”.

1400

cases of voluntary rejection on immunisation reported in Malaysia in 2015.

584

cases of measles reported March this year, a rise of 461.5% since 2015.

Seri Paduka Baginda Raja Permaisuri Agong Tuanku Hajah Haminah (left) signing the log book to signify the launch of the National Immunisation Week 2016 while accompanied by Datuk Seri Dr Chen Chow Min, Datuk Seri Dr Subramaniam, Datuk Dr Noor Hisham Abdullah, and Datuk Lokman Hakim.

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K Sales and marketing director Hiroshi Hamada (second from right) and general sales manager Minoru Osada contributes to chairman of the mosque Datuk Idris Shaari Mat Aris with Yakult ambassadors Scha and Awal.

Yakult in Ramadan spirit Yakult (M) Sdn Bhd gives away free bottles and donates RM5,000 to Masjid Jamek Kg Baru

uala Lumpur: Yakult celebrated Ramadan with the spirit of giving at the Masjid Jamek Kg Baru to get helpings of the highly sought-after bubur lambuk and free bottles of Yakult cultured milkdrinks. Yakult (M) Sdn Bhd with celebrity family and Yakult brand ambassadors Scha Alyahya and Awal Ashaari with daughter Lara Alana announced 500 bottles of Yakult Ace health drinks will be distributed daily with bubur lambuk at the mosque during Ramadan. The atmosphere at the mosque was definitely buzzing. The sponsorship of 150,000 Yakult health drinks worth more than RM13,000 together with a donation of RM5,000 for the mosque is part of the Yakult (M) Sdn Bhd’s corporate social responsibility (CSR) activities to encourage healthy eating habits among Malaysians.

“As a manufacturer of products closely related to the digestive system, we feel Ramadan is a good time to raise public awareness about the importance of regular intake of probiotics for a healthy digestive system. We also hope more people are able to experience the health benefits of Yakult for themselves,” says Mazlyn Mena, Yakult’s senior manager of public relations and science. “Yakult helps take care of our intestines which is sometimes prone to digestive troubles due to the change in eating habits, especially during this fasting month. Drinking Yakult is very much recommended throughout Ramadan and also during the Hari Raya festive season,” adds Mazlyn. The CSR activity is in line with Yakult’s corporate philosophy of preventive medicine, healthy intestines leading to long life and delivering good health to as many people as possible.

NOBLE CAUSE: Scha distributing to the public at the mosque.

Dengue alliance 10,200 healthcare providers and communities unite to defeat dengue at national level

UALA LUMPUR: In conjunction with Asean Dengue Day, Allied Against Dengue (AAD) announced it has empowered more than 10,200 healthcare providers and communities to reduce the burden of dengue through public education at the national level. As part of effort to engage a greater level of efficiency in the fight against dengue, UCSI University Malaysia, a Malaysian-based multi-campus private university, joined the AAD coalition to foster a sustainable community

participation among its students. At the UCSI campus, members of the AAD coalition conducted a train-the-trainers programme to more than 60 lecturers and students. Through outreach on the campus, more than 700 students were certified as dengue warriors to create awareness and engage with the communities they live in. “We are pleasantly surprised by the overwhelming response to the Allied Against Dengue campaign. Since launching the AAD campaign, we have received a number of enquiries from organisations

ONE FOR ALL: Students of UCSI joining in the movement to eradicate dengue.

expressing their interest to be part of the movement. It is really exciting to have UCSI University Malaysia on board with their ability to reach out to young people in Malaysia” says Stacy Wallace, general manager of GlaxoSmithKline Consumer Healthcare for Malaysia & Brunei. “Our goal is to reduce the impact of dengue in our society. This is our moment to combine our collective expertise and resources to make our efforts more impactful. Our goal is to recruit 20 alliance members by end of 2018,” she adds. The coalition was founded by GlaxoSmithKline Consumer Healthcare Sdn Bhd (GSK), the Ministry of Health, the Malaysian Medical Association (MMA), the Malaysian Pharmaceutical Society

(MPS), and Guardian Health & Beauty Malaysia with the aim to galvanise all forces and efforts to unite, take action and defeat dengue. The AAD alliance continues to deploy robust education and empowerment campaigns nationwide with the aim of engaging 8,000 healthcare providers, recruiting 50,000 dengue warriors in the community and educating one million Malaysians. Public can get further information about dengue prevention and management from all participating clinics and pharmacies which are identifiable by the AAD emblem. A to-go dengue toolkit, which consists of a thermometer, mosquito patch, plush toy and leaflet on dengue, is available in the retail partner shops nationwide.

foreignNEWS+

2016 | AUGUST

India’s sexchange surgery business New line in budget medical tourism draws growing number of foreigners for budget operations

FTER decades of battling depression, former soldier Betty Ann Archer finally flew to New Delhi to complete her gender transition, one of a growing number of foreigners heading to India for budget sex-change operations. Born Dale Archer, the 64-yearold American says she felt trapped in the wrong body right from the start, recalling secretly trying on her mother’s dresses as a boy – much to the horror of her conservative military father. “I attempted to kill myself twice... I didn’t like myself. I didn’t like my body at all. I couldn’t be myself,” says Archer, who is from Arizona. “I became very ill in 2011 and almost died,” she says, wearing a bright blue sari and ornate Indian jewellery that she bought after her gender reassignment surgery in Delhi. “While I was recovering I came to the conclusion that I had to transition or die.” A small but steadily increasing number of transgenders are travelling to socially-conservative India for such procedures, which are cheaper than those in their homelands and with no waiting

FELT TRAPPED: Archer speaks during an interview at Olmec Clinic in New Delhi.

lists, according to industry experts. Some are even choosing India, which has traditionally shunned its own transgender community, over leading sex-change destination Thailand which is regarded as more accepting on this issue. In November, Archer found herself at the Olmec Centre nestled in a northern Delhi neighbourhood, which she picked over clinics in Thailand which she felt were “just a bit too expensive”. “This is affordable. This is an option that some transgender people can look at and not have to kill themselves because they can’t afford it,” says Archer, who paid about US$6,000, a fifth of the price back home, and says India’s conservative views on transgenders had not been an issue when deciding to come. Shopping trips For up to US$22,000, Olmec

Global competition shows technology aids weight loss A friendly international competition to encourage exercise using pedometers and online tools was successful in helping people lose weight and improve their fitness over the course of three months, researchers said recently. The results of the study, based on self-reported data from 68,000 people who participated in the virtual event known as Stepathlon, were presented at the American College of Cardiology’s annual meeting in Chicago.

Stepathlon is run by a start-up company in Mumbai, India. The fee to participate is US$62.50 per person. Often, corporations sponsor employees to join as part of a workplace wellness programme. Grouped into teams of five, people from 64 countries were given inexpensive pedometers “and encouraged to increase their daily step count through an interactive, multiplatform application that engages them with frequent emails, quizzes and social media

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provides the treatment, but also accommodation, airport shuttles and post-operative care that includes shopping trips and visits to the Taj Mahal and other tourist favourites. Olmec founder and plastic surgeon Narendra Kaushik says he operates on up to 200 mostly local patients a year. But Kaushik says he is also seeing increasing numbers of foreigners: Westerners from countries such as the UK, US, and Australia, seeking lower costs and those from developing countries wanting better quality care than they receive at home. The number of foreign nationals having such surgeries has jumped from between five and ten to as many as 20 a year, Kaushik says, predicting the figure would continue to rise. “The number of surgeries are increasing day by day. This community is very well connected all over the world... If they are satisfied with their procedures in India, they spread the word.” The government is actively promoting India’s booming medical tourism industry, including by recently overhauling a special M-visa, now issued faster and valid for one year. The $3 billion industry is expected to more than double in size by 2020, a report published last year from the Confederation of Indian Industry says. More than 250,000 patients -- seeking everything from hip replacements to facelifts -- are travelling to India annually, according to US-based consulting firm Patients Beyond Borders. The number pales in comparison to Thailand which draws up to two million patients a year, but the firm’s CEO Josef Woodman was confident India would become a future leader in the niche area of gender affirmation surgeries. “I think in another three to five years. It takes time,” Woodman tells AFP of the surgeries, performed by less than a dozen Indian surgeons mostly in Delhi

and Mumbai. Woodman said, however, some foreigners might question India as a destination given that its own transgender community is vulnerable to discrimination. Known as “hijras”, India several million transgenders are often outcasts. Shunned from society some end up destitute forced to beg or into prostitution.

communication,” says the study. The teams competed in a virtual international race that featured prizes for certain categories. “The idea is to increase physical activity and wellness, but in a fun and social way that builds on teamwork and camaraderie,” says lead author Anand Ganesan, associate professor at Flinders University in Adelaide, Australia. Researchers found that on average, “participants increased their amount of walking by more than 3,500 steps per day, exercised nearly one additional day per week, lost just over three pounds and reduced their time spent sitting by about 45 minutes per day,” says the study. Even though the data was all self-reported, the consistency

across nations and groups of people over the three years studied (2012-2014) led researchers to believe the findings are reliable. “To our knowledge, our study is the first to provide comparative data on the effectiveness of this kind of intervention in both the developed and developing world,” says Ganesan. Future research will aim to find out whether participants were able to maintain their fitness after the end of the 100-day competition. “Physical inactivity, sedentary lifestyles and obesity are massive global problems,” he adds. “Our study suggests that by using technology in a clever way, perhaps we, as a community, can devise solutions to this problem.” – AFPRelaxnews

‘Wanted the best’ Retired British violinist Rosy Mica Kellett decided to travel to India for male-to-female surgery based on glowing recommendations for her surgeon. It was also £14,000 pounds – less than half the cost in the UK. A bargain of which some can be envious about. “It’s significantly cheaper here than it is back home and in most countries, even including Thailand,” says the married 50-year-old during a recent follow-up appointment with Kaushik. “Some of the feedback I received for this kind of procedure in Thailand didn’t seem to be as super advanced as my surgeon performs,” said Kellett, formerly known as Michael, dressed in a flowing maxi dress. I wanted the very best and I got the very best.” Indian surgeons are also developing their own techniques for transgender operations, including for female-to-male surgeries, which are complex and less widely available, according to industry experts. But Shobha Mishra Ghosh, senior director of Indian industry body FICCI, says policymakers need to work harder if India was to become a top destination. She suggests further streamlining of visa and immigration processes, as well as help desks at airports and more language interpreters. “If we can bring the entire ecosystem in place, a lot of traffic that is going to other countries will get diverted to us,” Ghosh says. “In that sense, I think we have a winner out there.” – AFPRelaxnews

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care of them share their belief and understanding,” says Omar. According to him, the focus on Islamic practices is emphasised more in the maternity clinic than in any other department. Being a Muslim is not something of a requirement however, as the hospital receives non-Muslim patients as well. “The focus of the hospital is not to only treat Muslim patients. It is far from it. It is an effort by MAIWP to meet the needs of Malaysians that demand a certain level of comfort. We believe that having Muslim doctors and nurses gives that kind of comfort to some our patients. This is where we strive on.” Besides the hospital in Jalan Tun Razak, PUSRAWI also operates three clinics. One is located in Jalan Ipoh, the place they started back in 1984. The other two are located in Anjung Felda and Ulu Klang. An issue to tackle As an individual who has been in hospital management for 14 years, Omar sees that it is still a prevalent issue among Malaysians with regards to health. “We as a nation still lack the conscience to take care of our health. Certain community within the society is more worried about their health and is taking the steps to improve, but most still choose to not care until it is too late. This is a mindset that we have to change, and I believe that this is also a part of what PUSRAWI aims to do.”

PUSRAWI caters to all CEO Omar Zakir Bawadi narrates company’s humble beginnings and its prospects for the future

By norman hussaini

rom its humble beginnings as a clinic with an added maternity ward, PUSRAWI hospital has come a long way since its inception 1984. It is now a fully facilitated hospital catering to various patients

with various illnesses and is also operating three GP clinics under its management. Located in Jalan Tun Razak, it stands tall among other officebuildings in the vicinity. It houses more than 40 specialists and offers all specialties. The hospital is led by chief executive officer Omar Zakir Bawadi, a man with great experience in hospital management. Health+ talks to the CEO and finds out the vision he has set for the hospital to build its

RELAXED WAITING: The waiting area offers entertainment during long stays for families and patients. prospects. The unique healthcare centre continues to move forward in development and is committed to improving its services.

HIGH COMFORT: An executive single room in the Ar-Raudhah ward provides ample space for families to visit.

Islam focused healthcare centre PUSRAWI is a company ownedwholly by the Kuala Lumpur Islamic Council (MAIWP) and at its essence, a hospital leaning on Islamic healthcare. The hospital is made unique in that way and this does not mean that it is only a hospital for Muslims. “Being a hospital under the Islamic council, we are more driven to have Muslims as our doctors and nurses. It is proven that many Muslims in the country feel more comfortable when the ones taking

Still going strong The existence of the hospital is an achievement on its own, given its humble beginnings. Funding from zakat has had laid the foundation of the hospital, and it shows how well the public contribution has gone into. The hospital has quite some achievements under its belt over the years. In 2014, it was certified as a baby-friendly hospital under the Baby-Friendly Hospital Initiative. “The certification is quite hard to achieve as a private hospital, and we are proud to be one of the few in Malaysia to be certified,” he says. Also in 2014, PUSRAWI achieved a record-breaking figure in sales with RM100 million, the first in its 32 years of operation. The hospital topped the 2014 record with RM105 million in 2015. Recently, the hospital opened up a new ward which offers high level of comfort at an executive level. Aptly named Ar-Raudhah (paradise), the latest ward provides excellent comfort for both patients and their visiting families. Looking ahead Omar has quite a clear view of PUSRAWI’s future. As a company with ISO9001:2008 certification, they are working to be certified as an organisation to practise 5S. “Moving forward, we are also

2016 | AUGUST

healthbusiness+

The focus of the hospital is not to only treat Muslim patients. It is far from it. It is an effort by MAIWP to meet the needs of Malaysians that demand a certain level of comfort. We believe that having Muslim doctors and nurses gives that kind of comfort to some our patients. This is where we strive on.” - Omar looking to get accredited by the Malaysian Society for Quality in Health (MSQH). An accreditation from MSQH will put us further into the frontiers of healthcare in Malaysia, at par with other more established hospitals on a global level,” he explains. Yet, to get accredited is no small feat, as it is a very taxing effort that involves each and every department and partners of the hospital. Omar says that they are still in need of major improvements still for accreditation to become a reality. PUSRAWI will double its efforts to boost its yearly sales to RM108 million this year. “With possible accreditation, this target is not impossible,” says Omar. It is also looking to improve its services as a gateway to further promote health tourism in Malaysia. The number of expatriates from Arab countries have played a major role in the hospital’s continued prosperity. “We cater well to Arabic expatriates in PUSRAWI. We have a few staff on deck that speaks fluent Arabic. We believe that they feel more welcomed because of the ease in communication.” Furthermore, Omar says there is still room for expansion within the tremendous building itself. “The addition of the executive ward is a step in the right direction for us. We are looking to make full use of the space we still have to improve our facility and services before considering opening up a new hospital altogether. The haemodialysis centre will grow in due time, and we are looking to reach patients far away by launching new clinics in other locations.”

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Healthy prospects in the state. Besides, Selangor is the most advanced state in the country. Our portfolios are skewed more towards property development. Even our subsidiaries like Worldwide Holding Berhad and Selangor Industrial Corporation (SIC) are skewed towards the property segment. “Property business is cyclical. So, if you have your 90 percent of your business skewed towards property business, then you are going to be affected, especially when there is a market downturn. Therefore, it only makes sense that we should be looking at businesses that bring in recurring incomes and contribute positively to bottom line. We can achieve it by taking advantage of the assets and the strategic landbanks,” he adds. In view of this, PKNS and

PKNS and SELGATE banking on five hospital development projects to boost prospects and healthcare services in Selangor

By ALI-AZMIN HASSAN

elangor State Development Corp’s unit (PKNS) and Selgate Corporation Sdn Bhd are joining forces to develop five new hospitals in Gombak, Rawang, Shah Alam, and Setia Alam in the latter’s quest of boosting i t s business prospects and healthcare services to the public. Tuan Haji Azlan Md Alifiah, the general manager of PKNS; Noor Hisham Hj

Mohd Gouth, chief executive officer of Selgate Corporation Sdn Bhd; and Muaz Omar, chief executive officer of Selgate Healthcare Sdn Bhd share with Health+ their vision and mission of building the hospitals. Tuan Haji Azlan, who has been with PKNS for more than two years, was Kumpulan Darul Ehsan chief financial officer and head of syariah risk management, and Malaysia Nasional Insurance (MNI) and Celcom head of finance. Needless to say, with his profound track record Tuan Haji Azlan will be making sure the development of these hospitals will become a reality. “In PKNS, we have been doing very well in the property sector as we have good assets in strategic locations

Selgate Corporation are into building hospitals. “Selgate has been entrusted to go into healthcare business while PKNS’ modus operandi would be to assign and transfer the strategic landbanks to Selgate, which would be building the hospitals. The first one we’re going to build is in Rawang,” says Tuan Haji Azlan. “The key aspect of the services industry is location. If your location is bad, it will take years to turn around. Location, accessibility, and parking are vital components. “We did a study on Rawang, and we found that there is a need for hospital because the people are underserved there We are targeting somewhere early 2017 for construction while in late 2018 it should be the first area to be in operations, he says.

Selgate has been entrusted to go into healthcare business while PKNS’ modus operandi would be to assign and transfer the strategic landbanks to Selgate, which would be building the hospitals. The first one we’re going to build is in Rawang.” - Tuan Haji Azlan

Rawang welcomes affordable healthcare BY ALI-AZMIN HASSAN SHAH ALAM: Selgate Corporation Sdn Bhd (Selgate) inked a memorandum of understanding (MoU) with SALAM Group of Hospitals through its holding company, Hatimuda Sdn Bhd, to jointly develop a hospital in Rawang. PKNS General Manager cum Selgate Chairman Tuan Haji Azlan Md Alifiah, Selgate chief executive officer Noor Hisham Mohd Ghouth, Hatimuda Sdn Bhd Managing Director Datuk Ir Zainal Bachik and Hatimuda Sdn Bhd

Director Izhar Ibrahim signed on behalf of their respective company on May 6 2016. Noor Hisham says the hospital project with a gross development cost (GDC) of RM140 million will be built in phases. It will have a total capacity of 200 beds once completed by 2020. “The initial phase will see 80 beds to be commissioned by 2018. This hospital will be serving a population of almost 362,000 people in Rawang,” he says. “Selgate believes this is a viable and sustainable project based on

From left: Izhar Ibrahim, Datuk Ir Zainal Bachik, Tuan Haji Azlan Md Alifiah and Noor Hisham Hj Mohd Ghouth with their signed memorandum.

the population growth projection and healthcare needs in Rawang and its surrounding areas,” adds Noor Hisham. This joint-venture partnership between Selgate and SALAM Group of Hospitals is expected to open the doors for future successful ventures what more with SALAM’s impeccable financial

track record coupled with a professional medical personnel team.This join-venture hopes to bring success in business and provide healthcare to the public. “Selgate is spearheading PKNS and state’s venture into medical healthcare business with a vision of providing affordable quality care,” says Noor Hisham.

BUSINESS+

2016 | AUGUST

Besides Rawang, Selgate Corporation also plans to build more possibly five hospitals within seven years. “Our next target is actually Gombak and also Shah Alam. In Gombak, we are in the midst of acquiring land,” says Tuan Haji Azlan. “We are eyeing at least two to three hospitals to be operational in five years. While two hospitals are manageable, three looks tough. It depends on how our management team is going to do it. Two have already been confirmed with regards to land. The rest is in the midst of acquiring and conversion,” he adds. Their main selling point for the hospital is affordability as it it not looking to compete directly with other hospitals. “The design of the building would be attractive and userfriendly. At the same time, it would be able to raise the number of beds easily. Excellent services and affordability will attract the public.” “The market penetration will be difficult if you don’t have the right strategic landbanks. We want to boost our percentage from the non-property segment and also from global waste management that is contributing positively to the group. PKNS also ventured into healthcare as the sector is less

cyclical compared to other industries. In fact, if there is a downturn, there’s tendency for more people to get sick. “We are doing some restructuring at Selgate not as an investment holding company worldwide, but to find a core business. We think there should be a direct feed to Selgate Corporation, like venturing into healthcare,” he adds. Meanwhile, Noor Hisham says they should have about two hospitals operating in five years. “I would say that by the third year, we should be starting to be profitable. With that, we should be able to go to the next stage, which is by the third or the fourth year. We shall be going to the next two hospitals that we’re going to construct and implement. That’s what I hope to see with Selgate. Our target is ambitious. Five hospitals within the next five to seven years. But within five years, two hospitals should be operational.” Selgate Healthcare has two main core business. One is in the property development and the other is in hospital under Selgate Corporation. In the property business, it has PKNS Andaman as subsidiary. “With the kind of expertise we have, our property development section can handle the hospital projects. There is quite a synergy

From Left: Muhammad Azfizam, General Manager of SELGATE Corporation; Noor Hisham Hj Mohd Gouth, CEO of SELGATE Corporation and Muaz Omar, CEO of SELGATE Healthcare.

Super Pharmacy next big thing

pharmacy is a place where we can look for items ranging from toiletries, cosmetic products, medications, and even the occasional snacks and trinkets. With the need for us to purchase these essentials in pharmacies, many are available and operated by local companies and individuals. To be unique among the pharmacy scene is not an easy task. The challenge however, was dutifully accepted and achieved by Super Pharmacy Megastore. How it came to be Health+ talks to group chief executive officer David Mah Chez Yong about how the idea behind the largest pharmacy warehouse in Malaysia came about. “I told my partner that if we want to set up a pharmacy, we have to be different. That was where the warehouse concept came to be basically,” he says. “We looked at the costs per square feet and the requirements taken to operate a pharmacy and found that a warehouse concept actually costs less per square feet to build. This makes for a great

opportunity to become different than others.” Super pharmacy is a brainchild of Symbion International that provides a range of scheduled medicine, dietary and food health supplements, organic food, skincare products and medical devices. What makes it unique Super Pharmacy focuses on not just their products, but also looks to enhance the shopping experience of its customers. They are constantly looking to entertain and inform visitors by organising health talks, cooking contests, and colouring contests for children, to name a few. The ample space within the pharmacy proves no limitation for the company to organise such activities. The store is open from 8am to 11pm daily, and the amount of products available is staggering. Besides the usual toiletries and health products, Super Pharmacy also sells an array of used rehabilitation equipment for the disabled. It also stocks various in-house products that can only be bought in Super Pharmacy. The pharmacy is big on going green and is a big

Super Pharmacy is an effort of Symbion International to become a leader in retail pharmacy led by Datuk Dr Jennifer Low Moi Ing (left) and Mah.

EXCLUSIVE: Super Pharmacy imports products from Japan and South Korea and are only available exclusively here.

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there. If we get a sizeable piece of land, it’s not impossible for us to do mixed development. Once we have two or three within the next 10 years, then you can see the revenue stream be almost be reversed, perhaps 70 percent on the hospitals and 30 percent on the property segment. “Ultimately, if we have good results with our medical healthcare, we should be able to look at listing. For listing, one should have about 25 percent market floatation. So that’s something that we can look at. We need to have as far as PKNS is oncerned a company that is able to add value to the assets we own,” he says.

Together with their partners, Selgate Healthcare is embarking on a few programmes, such as medical clinics, health screenings, blood donation campaigns to name a few. Only time will tell the future prosperity of the company. Muaz Omar, chief executive officer of Selgate Healthcare Sdn Bhd says, “We would like to invite partners, collaborators, and local and international companies to come forward and talk to us about our expansion plan. With a leverage from our mother company, we have strategic landmarks in the state. Interested partners can collaborate with us for a smart partnership.”

supporter of reusing containers and other green technology.

Mah, the process will be in stages as it is capital-intensive. Another innovation by the pharmacy is the development of its online store. “We have worked together with Pos Malaysia and been leveraging on their 930 physical stores to advertise the use of our E-Pharmacy virtual shop mobile app. With eight million customers visiting Pos Malaysia nationwide every day, we are aiming to promote faster services through our online store.”

Vision for the future “Our vision for Super Pharmacy is to not only become a unique type of pharmacy, but to become a lovemark for pharmacy in the country. A lovemark is a concept which intends to replace the idea of brands. We want to become the brand that everyone thinks of when they say pharmacy,” explains Mah. The ambition is marked further with a plan to open 50 outlets in the next five years. According to

A solid groundwork Super Pharmacy is shaping to be the next big thing in healthcare, especially for consumers. The comfortable shopping environment is a breath of fresh air for the ones looking for a more relaxed shopping experience in pharmacies. With various partners already and many more soon to sign, Super Pharmacy has the potential to be a giant in the pharmaceutical business soon.

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senior+

Bow-ing to thyroid Hypothyroidism is common among the older generations. Here’s a breakdown of the condition.

here are many factors contributing to various medical conditions one may have. Obesity, for instance, can lead to diabetes, joint pain, stroke, heart disease, and even cancer. Yet, the common knowledge about obesity is that a person will become obese if he or she leads an unhealthy diet. There is a condition however, that can also lead to obesity. The inability for our thyroid gland to not produce enough important hormones is the culprit that can also lead to joint pains, infertility, and even heart disease. What is hypothyroidism? To understand hypothyroidism, we must first identify what is a thyroid. By definition, a thyroid gland is a large ductless gland located in the neck that secretes hormones regulating growth and development through the rate of metabolism. It is shaped almost like a bow tie, and fittingly also located in the area where a bow tie should be on the neck. The thyroid’s hormones regulate vital body functions, which includes breathing, heart rate, central and peripheral nervous systems, body weight, muscle strength, menstrual cycles, body temperature, and cholesterol levels, among others. Hypothyroidism then is a condition in which the thyroid gland doesn’t produce enough of those important hormones. The condition upsets the normal balance of chemical reactions in the body because of the less produced hormones. Who does it affect? Typically women older than 60 years old are more inclined to have

hypothyroidism although there has been rising report of men being diagnosed as well. According to a report in 2015, symptoms of thinning hair and erectile dysfunction in men are being overlooked as signs for hypothyroidism, leading to the condition being diagnosed at a later stage. The condition may also affect infants and children apart from it being common in elders. In infants, the problem may be congenital as they may be born without a thyroid gland or with one that doesn’t work properly. The causes Hypothyroidism can be caused by a few things. Less often, the condition may also be caused by congenital conditions in new borns, pituitary disorder (failure of the pituitary gland to produce enough thyroid-stimulating hormone), pregnancy, and iodine deficiency. The risk factors that may lead to the condition are listed as few. You are at an increased risk if you: Are a woman older than 60 Have an autoimmune disease (rheumatoid arthritis or lupus) Have a family history of thyroid disease Received radiation to your neck or upper chest Have had thyroid surgery (partial thyroidectomy) Have been pregnant or delivered a baby within the past six months The signs The signs and symptoms of hypothyroidism vary as it usually depends on the severity of the hormone deficiency. In general however, any problems you have tend to develop slowly and often over a number of years.

august | 2016

At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain, or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms. It may include: Fatigue Increased sensitivity to cold Constipation Dry skin Weight gain Puffy face Hoarseness of voice Muscle weakness Elevated blood cholesterol level Muscle aches, tenderness, and stiffness Pain, stiffness or swelling in your joints Heavier than normal or irregular menstrual periods Thinning hair Slowing heart rate Depression Impaired memory It is important to remember that none of these symptoms are absolutely specific for hypothyroidism. However, they can be an indicator. When hypothyroidism isn’t treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid gland to release more hormones may lead to an enlarged thyroid (goiter). In addition, you may become more forgetful, your thought processes may slow, or you may feel depressed. Therefore, it is always wise to consult a specialist if any of the symptoms above remains and becomes severe over time. Treating it Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (levothroid, synthroid, others). This oral tablet medication restores adequate hormone levels, thus reversing the signs and symptoms of hypothyroidism. Treatment with levothyroxine is usually lifelong, but because the dosage you need may change, your doctor is likely to check your TSH (thyroid stimulating hormone) level every year. Determining the right dosage for you may take a bit of time as the process will usually involve trial-and-error. This means that doctors will monitor your THS levels after two to three months of medication use. Excessive dosage will lead to few side effects, such as an increase in appetite, insomnia, heart palpitations or shakiness. This will be the point of which doctors will adjust the dosage. Levothyroxine causes virtually no side effects when used in the appropriate dose and is relatively inexpensive. Information extracted from various sources, including Mayo Clinic, endocrineweb and report from foreign news website.

hen you reach a certain age, you are limit to what your body can handle. Finding someone who’s above 50 and doing extreme sports such as mountain climbing or skateboarding, it’s one in a million. Because when you reach 50, health problems arise. You become less energetic, you’re starting to have bones and joints problems, and with age, the body takes a little longer to repair itself. But, that doesn’t mean elderly people are deprived from exercising. There are ways for the elderly to enjoy the benefits of exercising without worrying of injure. According to the American Academy of Family Physicians, almost all older people can benefit from additional physical activity. Regular exercise prevents chronic disease, improves mood and lowers chance of injury. As a matter of fact, many medical conditions are improved with exercise, including Alzheimer’s and dementia, heart disease, colon cancer, high blood pressure and obesity. Health+ met with a few elderly folks exercising at a local park. Hassan Ali, a 64-year-old retiree with 7 kids, exercises regularly on the weekend morning. Hassan says, “For a man my age, the only thing I do to exercise is just brisk walking here at the park and joins in the ‘pocho-pocho’ (group aerobic exercise), I know it’s not much. But it’s something at least.” “I feel more energetic ever since I start my routine of exercising. I don’t sleep all day in the afternoon anymore (he laughs),” Hassan added. Karina Adnan, a 54-year-old housewife, then tells her exercise routine, “I jog regularly on weekends and on some weekdays. It’s hard for me to find the time to exercise nowadays but I’ll do it when I can. Besides from jogging, I do join in Tai Chi sessions here at the park and also Pilates and Yoga classes too.” According to AgingCare, the ideal senior exercise regimen consists of three components. Aerobic and endurance exercises, strength and resistance training, and stretching and flexibility exercises. Each of these components plays a vital role for anyone of any age to become healthier. But the implementation of it to the elderly comes with limitation and requires a specialize routine. For example, with stretching and flexibility exercises, the elderly can do activities like Yoga or Pilates. Yoga and Pilates helps muscles warm up and cool down gradually and improves and maintains flexibility, prevents injury, and reduces muscles soreness and stiffness. In addition, Yoga and Pilates encourage better posture and reduce allover muscle pain. Regular exercise can improve immune function, cardio-respiratory and cardiovascular function, bone density and reduce the risk

2016 | august

Elderly gets energistic Regular exercise prevents chronic disease, improves mood and lowers chance of injury By ali-azmin hassan of osteoporosis, gastrointestinal function, and chronic conditions and cancer to name a few. Besides the improvement of the physical aspect, it can also boost mental capacity. Research shows a strong link between physical activity and the slower of mental decline. Exercise increases blood flow to all parts of your body, including the brain, and might promote cell growth there. Exercise – particularly if it starts early and is maintained over time – is beneficial in preventing dementia and Alzheimer’s disease. Do note that even a little goes a long way. It’s not going to be easy. And there will be times where you feel like giving up and even said, “I’m too old for this.” But it’s never too late. According to the National Institute of Aging, exercise isn’t just for seniors in the younger age range. The key is to find the type of exercise that you enjoy doing and it’s important to start at a level that you can manage and work your way up slowly. But of course, it’s undeniable that there are some people whose physical abilities are limited by medical conditions or general frailty. These seniors have to go about exercise more carefully than others. There are gyms and trained professionals that can give proper instruction and guidance. A consistent exercise is also associated with decreased mortality and agerelated morbidity in older adults. To the young people out there with parents who doesn’t exercise, it’s high time you encourage them and bring them out to exercise together. Exercising together with your parents is a good way to spend some quality family time while getting fit and healthy.

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men+

august | 2016

Turning exercise into a routine Once that happens, it’s no longer a chore, says Mark Williams, teacher, avid runner and fitness enthusiast

By ali-azmin hassan

inding balance between work and life in our fastpaced world is getting increasingly difficult. We are putting more hours and pressure on ourselves to achieve greater results, but at what cost? Maintaining work-life balance is not only vital for personal health and relationships, but can also improve the efficiency of our work performance. Health+ met up with Mark Williams, a teacher and also an avid runner and fitness enthusiast, to share with us how he balances his work and life. Mark Williams was born in Sydney, Australia, but has lived in many places like South Africa, India and Abu Dhabi due to his father’s work in the oil and gas industry. “We finally settled in Wales when I was 10. I am now 45 years old and am the head of Geography at the Alice Smith School in Kuala Lumpur where I have worked for the past eight years,” says Mark. Have you always had a passion for teaching and running? No, not really. I have led a bit of a

pinball existence, bouncing from one thing to the next. Luckily for me, working with and teaching/ coaching people is something that I am good at, but in no way would I ever say that “it was a calling” like I hear some teachers/coaches saying. I love being fit more than I love running. I would much rather spend my week doing a combination of different fitness activities (i.e. running, cycling, swimming, gym work, CrossFit, etc.), rather than just running which I do at the moment. But I am conscious of the fact that if I want to continue to be successful at the sport of competitive running, the majority of my training has to be exactly in that one discipline! Being a full-time teacher and also committing your time to running, how do you balance between the two? Two ways really. First of all, running/fitness has become a routine for me so that I do it daily – very much like breakfast, showering and sleeping. Once that happens in your life, it no longer becomes a “chore”. Secondly, I am very organised. I plan my day meticulously on my drive to work in the morning so that I can make sure that everything is covered and that I have enough time to do things to the best of my ability.

Have you ever thought of committing to just one thing? Yes, for about 30 seconds, then realised how “dull” everyone that I have ever met who has committed to just one thing is. They may be very good or even brilliant at that one discipline and even very famous or wealthy, but boy are they dull!!!! Has it ever got too much to handle and took a toll on you? If so, how did you handle it? Absolutely! I like a drink or two, so getting up to train after one too many with the lads on a Friday night can take its toll. Also, after a tough day teaching children all day which can be exhausting, trying to get yourself motivated to do a Tuesday evening session of 8*1km, with each 1km being completed in 3 mins 10 secs with a 3 minutes’ interval in between at 45 years of age, can be a little bit daunting at times. How do I handle it? Well, I go back to the previous question on routine. If you can make fitness/ training into a daily routine, then it does not become a question of being able to handle it or not – you just do it! What are you currently working on? Are you are participating or coaching any running event or marathon?

I am currently working up to the World Athletics Masters Games in Perth in Australia in October 2016. I am entered in the 5K track and the 8K XC race. Ideally, I would love to podium in the 45-49 age category in at least one of these events. Do you have any advice for our readers on how they can balance their work and life? Yes, as you get older, life and lifestyle start to become more about habit more than anything else. Therefore, in your younger years, develop habits that you know are going to be beneficial in the long run. For example, every Wednesday, I meet with my friend Jeff for our run at 3.30pm in the Lake Gardens. That is now a habit – a good habit that we will keep up as long as both of us are here in Malaysia. We are all creatures of habit, so create habits that suit your lifestyle and are good for you! Mark, in his parting remark, says: “Be careful with how you display your affection for the love of your new healthy lifestyle, especially with regards to social media. A girl and guy who have just taken up a new gym regime can become incredibly dull to their social media friends by posting updates on their daily sessions or pictures of how defined their abs are. No one is really interested, believe me, and if anything, all it creates is animosity.”

We are all creatures of habit, so create habits that suit your lifestyle and are good for you.” - Mark

5 Running Tips for Beginners What does one talk about, when they talk about running? The beauty of running is, is the solidarity. One can run alone, or one can run with someone else, but the effort, time, and progress you made, is clearly your own. Goes to show that when it comes to running, the only expectation you should meet, is the one you expect of yourself. Here are 5 tips to make you an effective runner for beginners. 1. Get Fitted As the saying goes, the suit makes the man. Same goes for running. You need proper shoes. Pay a visit to your local running store. Either it be from local smaller stores or even big retail stores. Whatever you do, don’t skimp on your

shoes. A good pair of running shoes goes a long way. 2. Get a Plan Having and following a plan for a run is important to get that mind set. Find a beginning running plan to follow. One of the most effective ways to start is with a run/walk method. Begin with a 1-minute run/5-minute walk interval. Repeat the interval for five times for a great 30-minute workout. 3. Get Fuelled Like every physical activities or exercises, your body needs the fuel to keep it running. Fuelling is very important. It’s a good rule of thumb to eat about 200 to 400 calories of carbs and a little

protein at least 2 hours before your run. 4. Get Hydrated Being hydrated is just as important as being fuelled. Be sure to drink about 1 half litres of water two hours prior to running. Bring a water bottle during the run to keep yourself hydrated when things gets too tough. 5. Get Warmed-Up And finally, warming up. Most people don’t realize the importance of warming up before they do any physical activities. Be sure to warm-up your muscles with a dynamic stretch. A five-minute walk is a great way to do this. This will help decrease the chance of your muscles feeling right during the run.

There’s tons of tips on running out there. But the best kind of tips, is the one you learn yourself from your experience. So get out there and dust that running shoes off. They say the first step is the hardest. Well, this first step is meant to be taken literally. Once you get going, it’s hard to stop. Happy running.

2016 | august

men+

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Discarding male nurses’ stigma While people still perceive nursing as female-dominate, there is a rising number of males joining the ranks

By ali-azmin hassan

o some, it’s odd to see a male being a nurse due to the fact that nursing is a femaledominated career. But nowadays, for a male to become a nurse is more common. But are people accepting the fact? Do male nurses receive backlash or face stigma on their career choice? Ten Chi Hong, a 19-year-old diploma student of nursing at International Medical College (IMC), tells Health+ his story and passion of becoming a nurse. “From my personal experience, I don’t have face much stigma when I chose nursing as a professional career. In fact, my friends and family support me. but they were shocked when I told them I chose nursing. They still have the perception that nursing is a femaledominated career. There are more male students joining nursing courses. But I can say that there’s still a bit stigma of men choosing nursing as a professional career. “I think that nursing can give me more opportunity to interact with patients and know them more in depth on an emotional level,” he adds. Ng Kok Toh, the head of Nursing Programmes at IMC, also tells us her opinion on the stigma against male nurse. “People are more open minded and they are more flexible than most parents nowadays that allow their male child to take nursing.” When it comes to the difference of how male and female work as a nurse, Ng says: “Male somehow is not as gentle as a female. That is a fact. Definitely there are pros and cons. The softer part of the female helps in certain aspect of nursing. The inner strength of a female can withhold a lot of pain and challenges”. On the other hand, Joy Chua Guek Ling, director of Nursing from Tropicana Medical Centre, says that gender doesn’t play a role on how nurses perform. “Male or female, they can do their job well. But, personally I like male nurses. Because in my career, I work a lot with female nurses. Male nurses are not sensitive people. You can talk to them directly. But when you talk to a female nurse,

PROUD: Ten Chi Hong (left), and Ng Kok Toh are proud and immune from society’s stigmatisation of male nurses.

you need to be careful with what you say. That’s why I like to work with male nurses.” Marshal Lim, an IMU alumni and now a staff nurse in Singapore, says: “Many nurses started their nursing career as a bonded student under an institution and its guarantee to get a job after graduate. I believe every single male nurse is special and they have their own belief and purpose in life which will help them to overcome any social stigmatisation. “Most nurses work in shift. This also allows men to have the flexibility and ability to contribute more time to their family in this era where both husband and wife are working,” he adds.

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women+

AUGUST | 2016

Juggling work and family Ex-beauty queen, celebrity, entrepreneur, voice for many organisations, and politician, Geethanjali G still finds time for health and family by norman hussaini

now because of her children, and this has helped her to be a better person overall.

ult i ta sking is commonplace and describes the process of working on multiple tasks at one time. We hear a lot of this when talking about computers and smartphones which seem to perform endless tasks for us, making our lives run substantially smoother. When we think of multitaskers, the first group of people who come to mind are mothers. Who else but mothers who seemingly are able to take care of family, work, house chores, cooking, driving the kids around, et cetera, all at the same time. No amount of smartphone apps can ever replace a mother’s multitasking ability. To dig deeper into the life of a successful multitasker, Health+ talked to Datuk Geethanjali G to find how she balances her work and family life while still keeping herself healthy. Besides being well-known, especially among the Indian community, as a beauty queen and actress, she is also into politics with a deep passion for women’s rights. So how does she take care of herself and her two children while juggling a hectic schedule? Her answer was simple: “I believe in taking long breaths and staying conscious. The teachings of Ayurveda have taught me that by taking longer breaths, I will live longer. “I am also learning to stay

conscious and not waste time doing things that are unnecessary. We are now so absorbed in the going-ons on social media that more important things are being put aside. I consciously try to avoid that.” Family time is important Despite her busy calendar, scheduling time for her family is very important to her. “I went through a lifestyle change when I conceived my twins. As part of motherhood, we all have to go through those inevitable systemic changes at one point in life or another,” she says. She says it’s about keeping a conscious mind and be aware of what she is doing all the time so as not to be stuck doing unnecessary activities. She spends time with her family whenever she is free. “I am better off spending quality time with my husband and two kids then to scroll new things on social media. Prioritisation is important.” She feels she is more social

BALANCE IN LIFE: Geethanjali explains how she is able to keep her work and family hand in hand, ensuring a healthy lifestyle.

Maintain a healthy pregnancy to avoid threatened abortion One of the most prevalent pregnancy fears is threatened abortion, also known as threatened miscarriage. Threatened abortion is

defined as vaginal bleeding which typically occurs during the first 12 weeks of pregnancy. While 30-40% of women experience bleeding

Experience is essential Since her childhood days, Geethanjali had always wanted to be a doctor. After excelling in television and beauty pageants, she continued pursuing her ambition to be a doctor. However, she stopped pursuing it when she realised a doctor’s lifestyle wasn’t what she wanted. She then went into biomedicine and became a researcher. That pursuit also took a toll on her wellbeing as the work pressure was overbearing and she felt her health was affected. “After all that, I sat down with my husband and told him that I really wanted to do something else, something that I love doing.” That was when she invested in business. Helping others As a prominent voice, especially among the Malaysian Indian community, she is the president of MyWomen, a non-governmental organisation (NGO) dedicated to empower women in various ways. “The role of MyWomen is to not just help women with mistreatment and harassment, but also empower and encourage them to be part of the social, economic, and political front in the country,” she explains. One of MyWomen’s initiatives is the “Back to Work” programme which rehabilitates women to return to working lives should they

during their pregnancies, it does not mean they will eventually lose their babies. Who are at risk? According to Dr Premitha Damodaran, a consultant obstetrician and gynaecologist at Pantai Hospital Kuala Lumpur, threatened abortion may be caused by many factors, one of which is an imbalance of the mother’s hormones during the early stages of her pregnancy for which hormonal medicine is prescribed.

need to. Health is wealth Geethanjali enjoys what she is doing. That, she says, is how she is able to keep healthy while doing so much at the same time. “We must be able to come into our workplace and be happy about it. That is key to keeping ourselves healthy, physically and mentally.” Of course, living a healthy life always involves practising a healthy diet, and that is part of her lifestyle. “We as Malaysians are blessed with good food, and it can be hard to control ourselves when it comes to eating. But I try my best to keep my diet well balanced and nutritious, though having a few scoops of ice cream every once in a while is nothing to be ashamed of,” she says light-heartedly. Besides trying to keep a balanced diet and healthy physical activities, she also finds her family time to be therapeutic. She says after a busy day, it is reenergising to see her children and spend time with them. She keeps the pressures of working life in check with her family’s help. Her advice is simple: “Always be conscious of the things we do in our daily lives. We should not be too preoccupied with things that do not affect our lives and focus on things that do. Keeping a good relationship with family and friends can also relieve the pressure at the workplace and help to preserve our overall wellbeing.”

She says the mother’s poor health conditions such as high blood pressure, diabetes or other serious diseases may also cause miscarriage. In some instances, the shape of the uterus may not be ideal for the foetus, resulting in miscarriage. Which age groups have higher risk of threatened abortion? Dr Premitha says no age group is spared, but older expectant mothers have higher risk. “A 40-year-old mother has a 40% risk compared with a 20-year-old mother who has

women+

2016 | AUGUST

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Teenage pregnancies at worrying level Almost 50 teenage girls get pregnant daily in Malaysia, but are they ready?

By young sin yee

ome 18,000 cases of teenage pregnancies were reported nationwide in 2014, with almost 50 teenage girls getting pregnant daily. Teenage pregnancy in Malaysia is defined as any pregnancy occurring among adolescent girls aged 19 years old or younger. Dr Premitha Damodaran, a consultant obstetrician and gynaecologist at Pantai Hospital Kuala Lumpur, says teenagers should not get pregnant because they are not ready for it. “Their bodies are not ready to get pregnant, and the effects will depend on their age. So we are looking at a lot of problems which affect them mentally, physically and psychologically ,” she explains. “Let’s say a teenager is pregnant and she is not married. By the time she goes to see a doctor, it is usually (too) late. She might not have taken a blood test and vitamins, and she may already have a pregnancy problem.” When a teenager gets pregnant too early, the growth of the foetus may be hampered. However, not every pregnancy will encounter

just 15%.” Symptoms She says the usual symptom of threatened abortion is bleeding, but the expectant mother may also experience lower back pain and abdominal cramps. In many

such problem, says Dr Premitha. For instance, the baby may be born undersized and this may cause some mental or physical problems later on. Besides, the young expectant mother may face the risk of getting high blood pressure during her pregnancy. According to Dr Premitha, a teenager’s body is still growing and her bones are not fully developed. As a result, she may face delivery complications, especially if her baby is reasonably big, in which case she may have to undergo surgery to deliver her child. Furthermore, the attending doctor may not be aware of the teenager’s background prior to getting pregnant because certain negative habits such as drinking alcohol or taking drugs could affect pregnancy . Dr Premitha says many pregnant teenagers lack family support, which can make them confused as who to turn to in their predicament. And this has resulted in many cases of pregnant teenagers resorting to illegal abortions or abandoning their newborns, besides the risk of getting infection during the abortion process. Dr Premitha recalls some teenage patients telling her they feel that they can no longer have babies when they get married because they had made the wrong

instances, when a pregnancy is already unhealthy, miscarriage occurs naturally. Working women face all kinds of stress, both at work and at home. Dr Premitha says stress is a kind of negative pressure which is harmful for the formation of a baby.

decision of undergoing abortions in their youth. Nevertheless, there are some unfortunate cases where teenagers get pregnant after being raped. For such cases, Dr Premitha says the decision will depend on how soon these girls see a doctor. “The doctor can prescribe medication to let the period come to reduce the chances of getting pregnant. After that, they continue to (monitor) the situation in the coming month. Besides, the girls should also undergo a sexuallytransmitted disease test to make sure they are safe from diseases which c a n a f fe c t their whole lives. “The important thing is

they should get counselling from the right people on what to do if they get pregnant. Do they want to keep the baby? Give them proper advice based on their emotional support and how any decision will affect their future. They need the right people to guide them in making the right decision,” says Dr Premitha. She says many teenage pregnancies occur because teenagers lack sexual knowledge and are curious to find out, but they cannot get the right people to discuss the matter with. While some schools have started organising sex education talks for their students, many teenagers still do not have a clear understanding of the subject. They need people with the right knowledge and skill to educate and guide them on the right path.

“Hormones inside a woman’s body support the growth of the baby but stress will alter the hormones which lead to miscarriages. It’s not only psychological stress, but physical stress, like over-exercising or an accidental fall, which might also cause a miscarriage.”

maintaining a healthy pregnancy. “The couple should always plan for pregnancy and make sure they are ready to welcome a new member to the family. Next, both of them need to go for their medical checkups, maintain healthy weight and exercise to ensure they are fit for their next journey. The mother should take folic acid three months before pregnancy to cut down the risk of neural tube defects.” Most importantly, the mother must learn to relax. “The more relaxed the mother is, the easier she can accept the changes during the early stages of pregnancy. Relaxation also helps the mother with an easier delivery,” says Dr Premitha.

SOUND ADVICE: Dr Premitha says teenage girls need the right people to guide them in making the right decision.

Treatments Dr Premitha says the best way to manage threatened abortion is to be patient. “There’s no need to interfere unless necessary. We normally give the mother some hormones and allow her to rest. If the periods become painful or heavy she may be going through an inevitable miscarriage.” She stresses the importance of

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JUNIOR+

AUGUST | 2016

Lying in wait Pneumococcus bacteria may remain dormant or turn deadly when least expected

treptococcus pneumoniae or pneumococcus is a highly contagious and potentially deadly bacterium that is responsible for up to one million deaths annually, among children under the age of five years. About 40-90% of children are pneumococcal carriers, with the bacteria commonly found colonising the nasal passages. Pneumococcus is transmitted easily through direct contact with respiratory secretions, including the mucous and saliva of infected individuals.

Pneumococcal meningitis is not easy to treat. That is why we would rather encourage parents to take all preventive measures, including vaccinating their children against the disease.” Dr Musa

Streptococcus pneumoniae can attack various parts of the body, causing pneumococcal diseases of varying severity. These diseases range from less severe yet debilitating illnesses such as otitis media (inflammation of the middle ear) to severe and deadly invasive pneumococcal diseases such as pneumonia (lung infection) with septicaemia (blood stream infection), and meningitis (infection of the protective layer of the brain and spine). Children under five attending nurseries or kindergartens are two to three times more likely to

develop invasive pneumococcal diseases and acute otitis media. Children in this age group are more susceptible partly because their immune systems have yet to mature. Furthermore, they are exposed to more carriers at nurseries or kindergartens. How to protect children The good news is that there are ways to protect your child against pneumococcal disease and these include practising proper hygiene and vaccination. However, some parents still refuse to take preventive measures such as vaccinating their children. Some prefer to leave things to chance and fail to realise that the presence of such bacteria is like a ticking bomb. Pneumococcus may stay idle for months or years, but once it causes severe infection, it can be difficult to treat, causes hospitalisation and may have longterm negative health-implications or even lead to death. Case #1: Literally taking your child’s breath away According to consultant paediatrician and paediatric cardiologist Datuk Dr Zulkifli Ismail, a child suffering from pneumonia often experiences high fever, cough and difficulty in breathing that will lead to prolonged hospitalisation, frequently in the intensive care unit (ICU), and sometimes even surgery and death. He points out that treatment of pneumococcal infection can be tricky because it may not even be recognised or diagnosed, and resistance to antibiotics is increasing. For example, two-year old Lucy* was admitted to hospital after seven days of prolonged coughing and fever. The fever reached as high as 40°C despite her mother dutifully administering

the prescribed antibiotics at home. Upon admission to hospital, Lucy was diagnosed with pneumococcal pneumonia and, much to everyone’s dismay, her x-ray results showed that her right lung had collapsed and filled with fluid, making it extremely difficult for her to breathe. She had to have a tube inserted in her right chest to drain about 250ml of fluid, and was then placed under close observation for two days at the high dependency unit where stronger intravenous antibiotics were administered. Thankfully, after 10 days of treatment at the hospital, Lucy recovered with some transient psychological trauma of hospitalisation and with only a scar on her chest. Later, Dr Zulkifli discovered that she had not been vaccinated against pneumococcal infection. Her mother said that, if given the choice, she would have vaccinated her child if only to spare Lucy the agony of having to fight against pneumonia and not have to watch her daughter fight for her life. Case #2: Fever should not be taken lightly According to consultant paediatrician and neonatologist Datuk Dr Musa Mohd Nordin, high fever arising from pneumococcal infection may well be one of the first signs that the bacteria have spread to the brain. This disease, called meningitis, is often fatal, especially in children under five years. Dr Musa elaborates by citing a case in which a five-month-old baby girl, Adlin*, had pneumococcal meningitis within four days after the onset of high fever. She was brought to the hospital two days after her fever failed to subside despite being given medication from a clinic. Upon admission, she was irritable,

JUNIOR+

2016 | AUGUST

feeding poorly and vomiting. She was immediately placed in the ICU, given ventilation, intravenous antibiotics and closely monitored. Unfortunately, her cerebrospinal fluid test confirmed spread of pneumococcus infection to her brain and spinal cord. Despite the medical team’s best efforts, she died within 10 hours of admission. “It is really heart-breaking to watch parents grieve the loss of a child,” says Dr Musa. “As medical doctors we know that pneumococcal meningitis is not easy to treat. That is why we would rather encourage parents to take all preventive measures, including vaccinating their children against the disease,” he adds. Case #3: Ear infections may affect language development One of the things to look for according to consultant paediatrician and paediatric cardiologist Dr Yong Junina Fadzil will try to establish is whether they have ever suffered from otitis media. Chronic otitis media is the leading cause of hearing loss among children and it can be the result of pneumococcal infection. Infection reduces hearing ability because the pus developed in the middle ear prevents the

eardrum and middle ear bones from moving as freely as they should. In a worst-case scenario, too much pus can put pressure on the eardrum and eventually cause perforation in the eardrum. Hearing loss from otitis media may range from mild to moderate, to severe to profound. If this hearing loss occurs at the time when it is crucial for speech and language development, the child will most likely end up with speech and language disabilities. Often, such speech impairments also lead to learning difficulties and poor academic performance. Such problems were experienced by Zikri*, who was susceptible to repeated ear infections from birth. He had speech delay and was unable to speak properly even by the time he enrolled in his first year of primary school. For his first assessment at school, he did so poorly that the teacher decided to place him in a special-needs class. His mother, not realising that his speech delay may have been caused by his ear infection problems, did not consult with ear, nose and throat specialist until the following year, when Zikri had an episode of severe and painful ear infection. Upon treatment, his hearing improved, as did his grades.

Treatment of pneumococcal infection can be tricky because it may not even be recognised or diagnosed, and resistance to antibiotics is increasing.” - Dr Zulkifli

Chronic otitis media is the leading cause of hearing loss among children and it can be the result of pneumococcal infection.” - Dr Yong Junina

Antibiotics can lead to weight gain in children Children who take antibiotics too often put on more weight than those who do not, reports a new study which also says that the effects could last into adulthood. Antibiotics have come under scrutiny once again, this time in a study published in the International Journal of Obesity. A team of researchers, led by Professor Brian Schwartz of the Johns Hopkins Bloomberg School of Public Health in the US, discovered that when high doses of antibiotics are taken frequently during childhood, those youngsters put on more weight than those who do not take any.

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The scientists analysed the electronic medical records of 163,820 children aged between 3 and 18. The records contained useful indicators including Body Mass Index (BMI), height and antibiotic prescriptions. They also examined the prescriptions to see whether the antibiotics had any temporary or reversible impact on weight gain and if the weight gain was long-lasting. The records, which covered paediatric exams between 2001 and 2012, showed that over 30,000 children, or 1 in 5, had taken antibiotics 7 or more times. At the age of 15, these youngsters weighed an average of 3

pounds (1.36 kilos) more than those who had not taken any antibiotics. They noted that most of the children who were prescribed antibiotics (twice, on average) in the past year gained weight, and that they lost that extra weight once the treatment stopped. But as they analysed the cumulative effect of these medicines on the body, the team discovered that children who took antibiotics regularly were more likely to gain weight and keep that weight on when they reached the age of 18. Dr Brian Schwartz explained, “While the magnitude of the weight increase attributable to antibiotics may be modest by the end of childhood, our finding that the effects are cumulative raises the possibility that these effects continue and are

compounded into adulthood.” The scientists admit they do not have an explanation for the link between cause and effect. However, they assume that the compounds in these drugs destroy the “good bacteria” in the children’s bodies, leading to permanent changes in the bacterial balance in the digestive tract. Such changes modify how food is broken down and absorbed and consequently the way in which calories are assimilated. “Systematic antibiotics should be avoided except when strongly indicated,” Schwartz noted. “From everything we are learning, it is more important than ever for physicians to be the gatekeepers and keep their young patients from getting drugs that not only won’t help them but may hurt them in the long run.” – AFPRelaxNews

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opinion+

june | 2016

JUNIOR

By Dr Ling Shih Gang

Discipline in children:

One of the key challenges of parenting is instilling good discipline in children. There are five important principles that are most applicable in providing the right kind of discipline to our children. We covered the first two principles – love and understanding – in part 1, and the balance three – consistency, respect and repentance – will be discussed here. 3. Consistency  Consistency between dad and mom. Both parents must agree first with regard to the rules in the home as well as the types of punishment to be carried out for each offence. Whenever one parent disagrees with the methods used in disciplining a child, this should not be voiced out in front of the child. This may cause confusion to the child as to which parent to listen to. Some children may even take advantage of the situation to pit one parent against the other. Whatever disagreements between parents should be discussed privately.  Consistency between word and action. We often hear parents tell their children something like, “If you don’t finish your homework, I will call the police to arrest you!” While some of these words are said out of jest to scare the children, in the long run, they may realise that their parents do not follow through with their initial intention to punish. Subsequently, what the parents say will have less and less impact. Therefore, it is important that words are solidly supported by firm action. Parents’ words must also match their actions in every aspect of their lives. It is not possible for example to teach a child not to swear when parents themselves curse and swear.  Consistency between offence and punishment. The punishment meted out must match the degree of offence committed. Sometimes parents allow their stress and emotions to dictate the type of punishment given to a

child. A child may end up getting a lesser punishment for a major offence when the parents are in good mood and a heavy punishment for a minor offence when parents are stressed out. When this happens, children will never know what to expect from their parents. Parents must not allow their own emotional state to influence the way they discipline their child. 4. Respect  Respecting your child. Children are individuals who deserve to be treated with respect. They have their self- esteem too and it is important that we guard their dignity. Disciplinary action should be done in private to avoid embarrassing the child. If disciplinary action is done in front of others, the child may be too preoccupied about what others may think and not pay attention. He may also end up being more defensive. As children mature, they develop a higher level of responsibility and self-discipline. This should be recognised and respected by allowing more privileges and applying less restrictive rules. For example, a child who may not be allowed to cycle outside the house compound initially can be given the privilege to ride his bicycle to school when he has demonstrated the necessary skill and responsibility.

The Young Ones

Back to basics – part 02

 Gaining respect from your child. Parents must recognise that they cannot demand respect from a child. This respect must be gained. Parents gain respect when they show genuine love and are consistent with their actions. A major pitfall for many parents is when they fail to recognise defiant behaviour in their children and rise up to tackle the challenge convincingly. An example of defiant behaviour is when a child angrily kicks the dustbin in disapproval in front of the parent when asked to take out the rubbish. Such behaviour must be curbed immediately and firmly through strict discipline and must be commenced when the child is still very young. When parents fail to tackle defiant behaviour firmly and allow their children to walk away without consequence, the parents will lose authority over their children. If this continues into adolescence, parents’ words will lose their effect and any disciplinary action applied at that time unto the children will be useless and even counter-productive. 5. Repentance When a child commits an offence, learning and change in behaviour can only occur when there is repentance. Therefore, whatever disciplinary action parents take, be it advising, warning, withdrawing privileges or caning must be aimed to be a deterrent and to bring about repentance. For some children, the thought of causing disappointment to their parents when they disobey is enough to cause them pain and a repentant spirit. For some, there may not be any repentance even after receiving several lashes of the “rotan”. Therefore, parents must be wise

In an environment where truth is revealed with love, children will mature into adults with competency and character.”

in discerning which method of discipline is most suitable for their children to produce repentance. While bad behaviour should be dealt with disciplinary action leading to repentance, good behaviour should receive its just reward, leading to motivation to more good behaviour. Rewards can come in many ways including words of praise, a small gift, an outing to the zoo or extra privileges. Back to basics again Ultimately, the key to successful discipline is to integrate love and truth. Love is manifested in acts of kindness, affirmation, forgiveness and quality time, while truth has to do with facing reality, drawing boundaries, teaching and disciplining. When love and truth are separated, children will feel insecure and grow to become either overly- dependent or rebellious. In an environment where truth is revealed with love, children will mature into adults with competency and character. These are what we parents can ever hope for in our children. DR LING SHIH GANG is a consultant paediatrician at Tropicana Medical Centre.

2016 | AUGUST

BEAUTY+

Being fat not a fad Everybody thinks they should lose weight but some may be confused. Do they mean losing fat? The expressions are often used interchangeably but they share the least resemblances. BY SYED ZAID SYED OSMAN

he general view of a person being overweight is biased heavily upon the physical appearance of said person. To some, wearing the smallest cloth size is the idea of being thin. Some go to spend extra cash to look thinner but a vast majority of them have no grasp of the concept of not being overweight. Losing fat vs losing weight The two are separated by a very clear line. Losing fat means to decrease the amount of fat to the desired percentage. According to the world standard, 10% for men and 15% for women are the healthy fat goals. Losing weight is to drop the overall kilogramme of your body. This includes the overall mass of bones, organs, muscles, and fat. These are typically done by athletes who are involved in combative sports to qualify for a weight class and for actors to fit a role they are playing. It is important that a person understands what the body requires. Often a misconception, a thin person does not automatically make a healthier person. Huge scale reading doesn’t mean you’re fat Don’t get depressed when you see a huge figure on the weighing machine. It is possible that a person who shares the same height shares the similar body mass, while looking completely different since 5kg of fat will consume more space than 5kg of muscles. In addition, the total sum of bones and cup size may differ from one another. What is fat? Think of your body something like smartphone for this part. Most of us keep a power bank handy for the occasion so they can recharge the battery. After the power that been stored been drained, the bank is recharged for the next usage. The act of exercise has the same concept. The battery being carbohydrate, the power bank is your fat and socket recharging is food. Once the carbohydrate runs out, fat will be accessed for extra energy for the body to act. Why skipping meals helps you gain weight The easiest way to lose fat known to the public is to decrease the food intake in your body. Hunger is sent as a signal to identify that the body needs to restore

the energy used during the course of the day. The human digestive system, while trying to save whatever energy left, will hold on to the fat and keep track so the body will automatically store additional fat for future deficits. While doing so, the body will try to

• 29 outsource the energy by the alternative source, the human muscle. Even the ones you try so hard on building by tireless gym hours and vigorous exercises. Now that the energy from the muscle is used up, come next mealtime, the muscle is re-built at a slower rate due to the loss of metabolism and the calories are stored up with the remainder from the last process. Instead of cutting off fat completely, taking in moderate amount combined with good exercise routines are the keys to losing fat. Consume fat enough to meet the body requirement and slowly yet surely fat will begin to dismiss from your body, while at the same time keeping your body in a healthy state.

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BEAUTY+

AUGUST | 2016

‘Cosmetic’ beauty Cosmetics used may speed up formation of wrinkles, age spots, and a lot worse

By ALI-AZMIN HASSAN

ronically, the beauty industry has an ugly secret. Most skin care products either regular or “organic” contain harmful chemicals. There’s a lot of scientific research that shows that makeup, face cream, moisturiser or cleanser may disrupt your hormones and fertility, and can expose you to cancer-causing chemicals and deliver dangerous toxins that can age your skin. That shortcut to beauty only shortens your natural beauty. The cosmetics you use may actually speed up the formation of wrinkles, age spots, and a lot worse. But it goes to say that not all makeup products can give you this effect. According to Global Healing Centre in the United States, researchers have found one in very eight ingredients used in cosmetics is an industrial chemical product. Many of these were originally created to keep concrete soft, remove

grease from auto parts, and as surfactants paints and inks. It listed 19 ingredients that one should avoid at all cost. They are BHA/BHT, boric acid, coal tar, formaldehyde preservatives, PEG compounds, mercury, hydraquinone, oxybenzone, triclosan, parabens, fragrance, phthalates, petroleum distillates, siloxanes, sodium lauryl, toluene, retinol, fungicides, and nanoparticles. It’s scary how these things have not been informed to the public. One might think if the chemicals were that bad, they’d have been banned. As a matter of fact, many already have with European authorities banning thousands of these chemicals. Sadly, we can’t say much for Asian countries. But don’t be discouraged from using makeup as not all use harmful chemicals. Even though the cosmetic industry is largely unregulated, it’s not impossible to heal and restore back your skin. Natural products, such as olive oil, coffee berry, and green tea, can treat and prevent premature ageing of your skin. One might say that you’re better off without makeup. Go for that natural look. Well, living in an unfair and unjust world, it’s hard to

RISK OF BEAUTY: Some makeup contain chemicals that are harmful to the skin

meet people’s expectation. Beauty standard has always been a part of life. It’s not a good thing. But it exists. Makeup is now a staple in our modern culture of meeting the outer beauty. Granted, women (or men) uses makeup to feel good about

themselves. And there’s absolutely nothing wrong with that. Being confident is always a good thing. But when it comes to a point that it deteriorates your health, that’s when you need to start asking the right question. What kind of chemicals are in the makeup? Why are the people not well-informed about this by cosmetic company themselves? Always be aware of the things you buy and the ingredients it contains. The cost of beauty is a high price. But the matter of fact is, it shouldn’t be. There’s tons of cosmetic products out there that only uses natural ingredients for their makeup. While it is important and crucial that you curb your dependence on cosmetics, it is equally important that the products you purchase are of good quality. Not just makeup, even the skin cleansers. Point being, be smart when you shop. Especially if the product is used directly on yourself, or others.

supplementation and cream, usually taken from bovine and porcine. Or in other words, from a cow and a pig. But it has been shown to be less effective in increasing one’s collagen level. Fortunately, in recent times there has been an advancement in collagen supplementation with the emergence of collagen peptides or to be more specific, fish collagen peptide. Studies have shown that fish collagen peptides

increase absorption and ingestion, giving positive effects on the skin as would be expected by a rise in collagen in one’s body. Many pharmaceutical companies are looking towards the use of collagen as well in their products. Perhaps skip the superficial beauty from make-ups and cream. Instead adopt by taking collagen supplements that raises collagen levels, thereby rejuvenating one’s youth naturally.

Looking young again BY ALI-AZMIN HASSAN There are many cosmetic products that claims to rejuvenate one’s youth. Whether that claim is true or otherwise is another story. However, one can rejuvenate the old, dry and wrinkly skin with collagen. Collagen is a protein present in body’s organs and tissues. It occurs throughout the body, and to date, 29 types of collagen have been identified. Over 90 percent of the collagen in the body is of type I-IV with the most abundant being Type 1. Collagen is the most abundant protein in our bodies. It is found in our muscles, bones, skin, and

tendons. Basically, it gives our skin strength and elasticity, and helps replace dead cells. How this relates with anti-ageing is as we grow older, the collagen level in our body decreases. And by taking collagen, there’s a chance that it can increase one’s collagen level back, hence rejuvenating oneself. Basically. to regain back youth and beauty through natural means. Through wonders of science, signs of ageing such as wrinkles, fine lines, drop of smoothness and suppleness of the skin can be treated with boosting the levels of our body collagen. Collagen can be taken through

2016 | AUGUST

HEARING+

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Loud and clear Research and developments on hearing aid to equip the hearing impaired with the best BY SYED ZAID SYED OSMAN

ack in 2012, the mother of a four-years-old comic book fan Anthony Smith reached out to Marvel because her son believed that superheroes do not have to wear hearing aids. In response, the comic book publisher announced that one of the recent characters Hawkeye has impaired hearing for years and was also using hearing aids. Hearing is one of the five basic human senses along with touch, sense, taste and sight. When sound travels, it sends out sound energy into the canal through the eardrum. Synchronised with the energy, the eardrum vibrates and triggers the three smallest bones consisting of the anvil, hammer, and the stirrup that activates the cochlea of which the hair cell changes the sound energy into chemical signal to the brain. When overworked, the hair cell becomes temporarily paralysed and this causes less sound being converted. The solution? Input amplification. Joyce Chuah, the general manager of BEST Hearing Aid Centre explains: “Humans usually perceive sound around 20db and if the count exceeds more than 25db, the person is considered hearing impaired. Hearing aid helps to collect and amplify the sound created directly into the ear”. Sound waves are detected by the microphone which is then processed by the microchips. The amplifier then increases the amplitude of the sound to the required volume which then is transmitted into the cochlea. When we hear about this particular impairment, we are almost certain that the case would involve elderly people and their natural loss of hearing. According to Joyce, this is not always the case. “There are instances where infants are born without hearing from unknown factors and there are many customers who work in loud places that are prone to noise-induced hearing loss,” she adds. When a person loses hearing ability, there are limitations to their daily life and may pose danger due to it. Studies have shown a lot of negativity connected to the loss of hearing. While some just avoid the classical communications channel that is talking. In addition, it impairs the ability to learn new tasks. Some may be comfortable with the life, while some would crave more. “Different people may require different hearing aid. This is where the price

plays a role. The research and development team has been working on extra features, such as the quality, the sound balancing, weight, and battery capacity. The standard hearing aid with basic requirement may cost around RM1,000,

while the added features may go up to RM12,000 each,” adds Joyce. Additional features may include wireless connectivity, hands-free and applications compatible with the aid.

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senior+

AUGUST | 2016

eye+

By Dr Wong Hon Seng

s sitting too close to a computer screen or television the cause of bad eyesight? Or is it a symptom? With more than 10 years of experience in ophthalmology, I have seen an interesting rise in awareness and ophthalmological health trends in Malaysia, particularly among the youth. To begin with, Malaysian parents are becoming more proactive in educating themselves on their children’s health and eyesight. This is a good thing as children under the age of 12 stand in the “golden period” in controlling the progress of refractive error and other sight problems. Refractive error is simply the inability for the eye to bend light correctly to provide a clear vision because of its shape. The key forms of refractive errors are myopia (short/near-sightedness), hyperopia (farsightedness), presbyopia (loss of near vision with the progression of age) and astigmatism. With the current lifestyle trends of young Malaysians, the importance of maintaining vigilance over our children’s eyesight has become more important. Genetics, screen time and eyesight In many cases, refractive error is inherited. Therefore, there is very little chance of preventing refractive error. However, there are measures to help minimise the effect of refractive error in your child. Malaysian children are using screened and mobile devices more than ever before. Whether they are using it for entertainment or learning, it is time for us to admit that our children’s world revolves a r o u n d electronic screens. O u r children’s depend e n c e o n electronic devices and computers

can increase their chances of developing myopia. However, the cause for near-sightedness is multi-factorial. Environment, genetics and lifestyle all play a part in many cases of sight problems. If the child has a family history of refractive error, he or she may be more likely to develop sight problems. Given the Malaysian climate, many children have grown accustomed to enjoying indoor activities. With the amount of time an average Malaysian child spends attached to screened devices, reading for school work and maintaining indoor lifestyle, he or she does not have enough time outdoors to develop the ability to see things in the distance. This can prove detrimental to the state of the child’s eyesight in the long run. Many people don’t realise that outdoor activities are beneficial not just for children’s overall health and wellbeing, but also help in the development of their vision. When children prefer an indoor lifestyle, they are unable to balance their visual and spatial awareness. Causes vs symptoms Parents are often up in arms about their children sitting too close to the television. While it is a valid concern for parents to attempt to limit the strain to their children’s sight with screen exposure, the children sometimes just need a better look at what’s on the television. I often advise parents to observe their children’s behaviour to get clues on whether their eyesight is a cause for concern. When children sit too close to the T V or hold their books or devices too near

Look and See

A clear look into childhood vision

their faces, it is more likely to be a symptom of near-sightedness, although some eye diseases such as glaucoma, cornea or retinal diseases may also have such symptom. It is advisable to consult an eye doctor to rule out any possible eye disease. Watching for behavioural cues in children is crucial to ascertain whether a child has vision problems. If they hold their reading materials too close their eyes, sit too near to TV or computer screens or even habitually squint or narrow their eyes, these are behavioural cues for parents to take them to either an ophthalmologist to rule out treatable eye diseases, or an optometrist to check for refractive error. Children may sometimes also complain of headaches, dizziness and discomfort when trying to focus on things at a distance. These are cues that parents should look for and not ignore. Keeping a close eye Upon discovering refractive error in their children, parents should consult an optometrist or optician annually to follow up on the progress of their refractive error. When children are growing up, the structure and curvature of their eyeballs is subject to change. Parents should be prepared for certain threshold of change in the power of their corrective lenses until they reach adulthood (18 years old and above), when the curvature and growth of their eyeballs stabilise. One of the key reasons I stress to parents to treat their children’s refractive error as soon as possible is to reduce their risk of developing amblyopia (lazy eye). Amblyopia is a condition where an eye is unable to see properly despite its normal structure or use of a corrective lens. Typically, a lazy eye begins in early childhood and needs to be promptly treated to avoid the loss of vision the affected eye. One of the most common causes of amblyopia is when there

is a discrepancy in refractive error in the affected eye. When the variant is too large, it is important to consult an ophthalmologist to understand what is behind the discrepancy. If a child is diagnosed with a lazy eye, it can be treated with “suppression therapy” whereby the ophthalmologist prescribes a structured therapy of covering the child’s “stronger” eye to help the child gain better vision in the weaker eye. This treatment usually lasts a few months or longer and requires a lot of commitment and cooperation from the parents to help their child regain use of the lazy eye. The best time to treat amblyopia is when the child is under 12 while the neuro-pathways between the eye and brain are still developing to form life-long effects on the child’s vision. Seeing the distance While refractive error is a multi-factorial condition, parents can do their part by closely monitoring their children’s vision. By making annual visits to the optometrists and maintaining vigilance over any discrepancy in the degree of their children’s corrective lenses, parents will help their children maintain healthy vision. Parents shouldn’t be too alarmed when the power of their children’s corrective lenses gradually increases in their teenage years. As they experience the growth spurt into adulthood, the structure of their eyes will change and impact their vision, but this will stabilise when the children reach adulthood. Parents should ensure their children go for annual sight checks, and also encourage them to engage in more outdoor activities to help regulate their ability to see beyond a book or screen. Dr Wong Hon Seng is a consultant ophthalmologist specialising in retina at Gleneagles Hospital.

2016 | AUGUST

DENTAL+

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Bioactive glass could be used to fill teeth

he fillings of the future could be bioactive glass, according to engineers at Oregon State University. The futuristic-sounding bioactive glass is a crushed glass containing compounds such as silicon oxide, calcium oxide and phosphorus oxide. It has already been used for decades in some types of bone healing, however bioactive glass is new in the world of dentistry. Researchers believe that when used in composite tooth fillings it could prevent bacteria from attacking the filling, helping them to last longer. This could be important news for the future of dental fillings, as more than 122 million composite tooth restorations are made in the United States alone every year. To test the idea, the team used recently extracted human molars to make samples that simulated the human mouth. Composite fillings containing 15% bioactive glass were placed in some samples, and non-bioactive composite fillings were placed in others. Microscopic gaps were allowed to form around the fillings, before tooth-decaying bacteria were added. The results showed that in the samples with bioactive glass fillings, there was a significant reduction (61%) in bacterial penetration into the gaps, reducing their ability to attack the fillings. In the other samples however, with no bioactive glass, there was 100% penetration. Commenting on the results, Jamie Kruzic, a professor and expert in advanced structural and biomaterials in the OSU College of Engineering says: “The bacteria in the mouth that help cause cavities don’t seem to like this type of glass and are less likely to colonize on fillings that incorporate it. This could have a significant impact on the future of dentistry.” Bioactive glass has this antimicrobial effect partly thanks to ions such as calcium and phosphate, which have a toxic effect on bacteria. As well as slowing tooth decay, bioactive glass could also provide some minerals that could help replace those being lost said the researchers, making an even longer lasting tooth filling. If the findings by Kruzic and his team can be confirmed by clinical research, Kruzic believes bioactive glass could be easily incorporated into existing formulations for composite tooth fillings to help prevent decay and promote dental health. The research was published in the journal Dental Materials, and supported by the National Institutes of Health. – AFPRelaxnews

GLASS FILLINGS: Bioactive glass, which is more resistant to bacteria, could be used to fill teeth in future.

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fitness+

Crossfitting gaining traction

AUGUST | 2016

HIGH INTENSITY: Crossfit incorporates elements from gymnastics, weightlifting, and cardiovascular conditioning.

Crossfit incorporates elements from gymnastics, weightlifting and cardiovascular conditioning

By ali-azmin hassan

here are many workout routines and fads nowadays, but not too many are credible. Yes, perhaps no matter what way you exercise, if you sweat it out, it’s enough right? But, are you sure it’s effective enough for you? You may want to try crossfitting for full effectiveness in exercise. Crossfit is a fitness programme that consists of constantly varied functional movements performed at high intensity. It incorporates elements from gymnastics, weightlifting and cardiovascular conditioning. This fitness programme was created by Greg Glassman in 2000 in the United States. It is promoted as a physical exercise philosophy and competitive fitness sport. Jonathan Wong, head coach and founder of Pushmore/Crossfit

(Malaysia) Sdn Bhd, shares with Health+ on what makes crossfit one of the most effective workout regiments. Jonathan started doing crossfit as a way to improve sports performance. And now he is competing at the national and regional levels in crossfit, weightlifting, and powerlifting. Pushmore is the first crossfit centre in Malaysia, expanding the knowledge on crossfitting to Malaysians. Jonathan says: “PushMore was founded in 2008 by myself and and my buddy, Soon Kheng Teik. We started doing crossfit on our own about a year before. We witnessed the rapid rise in performance and were having a lot of fun at the same time. We were really excited about the programme and wanted to share it with more people ... so that’s when we decided to found PushMore”. Jonathan says what makes crossfit different from other workouts is that crossfit has an advantage as it challenges participants to improve both in fitness

HAVE FUN : The most important aspect of any workout is to have fun and enjoy the time you’re having at the gym.

and movement of skills in a variety of domains. This combination increases neuro-muscular involvement, allowing for faster improvements in fitness and performance. The other big part of crossfit is the element of community and competition. Having a good support network combined with friendly competition nourishes the motivation for participants to reach their fitness goals. Taking the elements from gymnastics, weightlifting, and cardiovascular conditioning, a few examples of crossfit exercises are pull-ups, push-ups, jumps, deadlifts, running, rowing, skipping, and many more. Jonathan says: “When we first started, crossfit was new, so we spent much of our time educating people about the programme. Fast forward to 2016, crossfit is growing fast in Malaysia, with numerous affiliates in Malaysia and an ever growing community of local crossfitters. “More Malaysians from all age groups are taking up the programme and I foresee crossfit community continuing to grow rapidly over the next few years,”

he adds. Stepping into a CrossFit gym for the first time can be a bit overwhelming and possibly even intimidating. Granted, it can be a lot to take in at first glance. You’ll see someone doing a kipping or a butterfly pull-up and it probably will demotivate you to even try. But fret not. These people won’t bite. They’re actually pretty friendly and supportive once you get to know them. Things to keep in mind is, you’re competing against yourself, not others. Go at your own pace and let the intensity finds you. I bet the couple of times will be hard. As a matter of fact, it won’t exactly get easier either. But most definitely you’ll get better. And the most important aspect of any workout, is to have fun. Enjoy the time you’re having at the gym. Granted that most workouts are not fun. But when it comes to Crossfitting, you’ll learn how fun It is. Gymnastics, Olympic lifts, muscle soreness in places you didn’t even know you had muscles, these are the things that made Crossfitting and working out fun. It’s never too late to start. Time to dust yourself off.

wellness+

2016 | AUGUST

• 35

Time to create health-promoting environments We need to rethink our daily lives to eat healthily, be physically active and avoid excessive weight gain

he number of people living with diabetes has almost quadrupled since 1980 to 422 million adults, with most living in developing countries. Factors driving this dramatic rise include overweight and obesity. Ahead of World Health Day on April 7, the World Health Organisation (WHO) issued a call for action on diabetes. In its first “Global report on diabetes”, WHO highlights the need to step up prevention and treatment of the disease. Health-promoting environments reduce risk factors According to WHO, governments must take the lead to expand health-promoting environments to reduce diabetes risk factors, like physical inactivity and unhealthy diets, and strengthening national capacities to help people with diabetes receive the treatment and care they need to manage their conditions. “If we are to make any headway in halting the rise in diabetes, we need to rethink our daily lives: to eat healthily, be physically active, and avoid excessive weight gain,” says WHO director-general Dr Margaret Chan. “Even in the poorest settings, governments must ensure that people are able to make these healthy choices and that health systems are able to diagnose and treat people with diabetes.” Among the key findings of the report are:  Many of the diabetes deaths (43%) occur prematurely, before the age of 70 years, and are largely preventable through adoption of policies to create supportive environments for healthy lifestyles and better detection and treatment of the disease.  Good management includes use of a small set of generic medicines; interventions to promote healthy lifestyles; patient education to facilitate self-care; and regular screening for early detection and treatment of complications.

The WHO findings clearly tell us that many cases of diabetes can be prevented, and measures exist to detect and manage the condition, improving the odds that people with diabetes live long and healthy lives. As a community and individuals, we need to do more to combat diabetes, but where do we start? Firstly, we need to create environments that support healthy lifestyles that make a positive impact on the wellbeing of the community. Secondly, it’s our joint responsibility and moral obligation to promote environments that ensure healthy choices are available wherever we spend their time. Thirdly, we need to develop health-promoting environments that make healthy foods choices the easy choice for everyone. Let’s place good health at the centre of our everyday lives by helping to create health-promoting environments in places where we Malaysians spend our time such as in childcare centres, schools, workplaces, health services, food outlets, parks and sporting centres. A good start is to provide healthy foods and drinks to the public. Making healthy choices isn’t just about having personal self-discipline. In some neighbourhoods it is easy to get fresh and affordable produce, while in other neighbourhoods people are limited to fast-food outlets and convenience stores with less healthy choices. The most supportive environments make healthy choices the easiest choices. Creating supportive environments is one of the key action areas that the authorities need to focus on. Supportive environments offer people protection from factors that can threaten good health. They foster participation in health and let people expand their capabilities and self-reliance. This is critical for a person-centred approach to health. Supportive environments are sometimes referred to as supportive settings. Settings refer to environments where people live, learn, work and play, such as schools, hospitals, workplaces

ALL AROUND: Healthy environments such as good food, exercise, and clean air are catalysts for a healthier living. and cities. Creating supportive and health promoting environments can have many dimensions and may include:  direct political action to create policies and regulations, such as tobacco control legislation  providing financial incentives or disincentives, for example, sponsoring alcohol-free events  advocacy designed to gain political commitment, social acceptance or policy change, for example, supporting community groups to advocate banning junk food advertising to children  providing education and empowerment, and enabling communities and individuals to take control of their health and environment, for example, teaching people in a disadvantaged community the skills to research local health needs  strengthening links between health and environmental strategies, including creating partnerships, for example, working with sustainable living practices and implementing walking or cycling programmes  ensuring equitable access to supportive environments for health by mediating between conflicting interests in society, for example, promoting sexual health and wellbeing for people with disabilities being inclusive in plans involving community

 being inclusive in plans involving community members and staff, for example, consulting community members to identify the best approaches to health and wellbeing  creating supportive settings for people using health services, for example, making waiting rooms feel welcoming for people with friendly staff, seating, play areas for children, access to water and promotion of the role of the arts in health  promoting health in the workplace, for example, implementing stress management programmes for staff, helping staff quit smoking or providing healthy snack options in vending machines. Communities come in all shapes and sizes. They include people who live in the same area as well as those with a common social identity. Communities differ in their access to and control over the social determinants of health. Strengthening community actions means supporting collective efforts in communities to increase their access to and control over the social determinants of health. This is often done through community development processes, in which community members take a meaningful role in defining their priorities for health, as well as making decisions, planning, and implementing strategies to improve health. People and communities become more and more empowered when they take part in gaining more control over the decisions and actions that affect their health. Knowing how to take social actions that improve health within one’s community is an important part of health literacy. Creating health-promoting environments seems like a tall order for us Malaysians who have long been accustomed to environments where health considerations are often disregarded or given low priority. But then, nothing is impossible and it always starts with a change of mindset. We can all make a difference – after all, it’s for our own good and that of our future generations.

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wellness+

AUGUST | 2016

Ayurvedic therapeutic Get immersed into traditional Ayurvedic treatment to keep one healthy always

By ali-azmin hassan

yurveda can be considered as an alternative and traditional health treatment. It originated from India 5,000 years ago and is considered to be the most ancient traditional health practice of all. Similarly, Ayurvedic treatment is just like traditional Chinese medicine and traditional Malay medicine. Health+ met up with Shiv Kumar Vats, an Ayurvedic physician at Samkkyya Naturo-Ayur in Bangsar, Kuala Lumpur to get a hands-on experience and a better understanding on what Ayurvedic treatment is all about. And to the treatment was therapeutic and relaxing. Firstly, what Ayurveda is all about. Shiv explained, “Ayurveda derived from a Sanskrit word. Ayu means life and Veda knowledge. Basically, Ayurveda is the science of life which helps us to understand what a person should do in a daily routine so one can stay healthy. “5,000 years ago, there were no doctors, no pathological labs, no

MRIs, or X-Rays. So how do these ancient people treat day-to-day problems? Whenever they have cough, cold, flu, or fever, they use to crush the leaves of plants, apply the poultice or drink the juice of it, and they observe the results. It’s not like an experimental science like how modern day science is, but experienced-based science,” he adds. Shiv explains that the good thing about Ayurvedic treatment is it is preventive and keeps people healthy forever. “It has a therapeutic aspect as well as preventive aspect.” “We get people from many walks of life and they have various health issues. The common theory nowadays is I think we are living in a quick-fix system. Ayurveda is not like that. It’s about bringing a change in your living pattern that will keep you healthy. We get people that are diabetic, and have high blood pressure, cholesterol, obese, slip disc, musculoskeletal problems, headaches, migraines, asthma, and skin allergies. We deal with people who come here to seek a natural and medical advice based on the philosophy of Ayurveda.” Hands-On Ayurvedic Treatment

ancestors, but which are becoming less common in today’s society – in order to lead to better developed adults. These evolved needs include six different components – soothing, naturalistic perinatal experiences, responsiveness to a baby’s needs including sensitivity to the signals of the baby before the baby cries, constant physical presence with plenty of affectionate touch, extensive breastfeeding, playful interactions with caregivers and friends, and a community of affectionate, mindful caregivers – which lead to better child development.

can be really relaxing. There were some tough, and, perhaps, even hurtful massaging that went on, but it’s all part of the process. The applied pressure is to loosen the hard and stressful body. And in the long run, it was all worthwhile. It starts off with a head massage, then the shoulders, front and back, and ends with the legs and arms. Every inch and part of the body except the private area was covered with 100 percent herbal oil that is known to be nourishing and detoxifying. The benefit of Ayurvedic massage is it ensures balance between the mind and body. It serves not only to relieve pain, but also to boost circulation, stimulation, and strengthening of the body. The massage was probably about an hour, but the passage of time was lost due to the relaxing nature of it. We were in a trance of deep relaxation and we would go for it again. Ayurveda is an experience you have to try.

To research her theory Narvaez and colleagues questioned over 600 adults on their childhood experiences, asking how much physical affection they received as children, did they play freely outside and inside the home, did they do things as a family inside and outside the home, and did they feel supported by parents. The adults who reported receiving more of these parenting practices in their childhood showed less depression and anxiety, more compassion, and a greater ability to look at things from another’s perspective as adults. However, adults who reported less of these parenting practices

in their childhood showed poorer mental health, more distress in social situations, and were less able to take another’s point of view. “Our research shows that when we don’t provide children with what they evolved to need, they turn into adults with decreased social and moral capacities,” says Narvaez. “With toxic stress in childhood, the good stuff doesn’t get a chance to grow and you become stress-reactive. It’s hard to be compassionate when you are focused on yourself. We can see adults all around us who were traumatised or undercared for at critical times.” Narvaez’s previous research also supports the results of this current study. The children who experienced more of these parenting approaches showed better mental health, greater empathy, more self-control, and a higher level of intelligence. – AFPRelaxnews

KNOWLEDGE OF LIFE: Ayurveda is the science of life which helps us understand what a person should do in a daily routine to stay healthy.

Positive parenting A new study has found that affection, physical touch, and support from parents are vital for child development. Research from the University of Notre Dame of the United States has found that parents’ affection and support in childhood can have lasting effects on development well into adulthood. University of Notre Dame professor of psychology Darcia Narvaez believes our childhood experiences need to be in line with our evolved needs – the characteristics of parenting that have been used since our distant

Health+ experiences one of Ayurvedic treatment which is the massage therapy. And it is truly therapeutic. It is said that Ayurvedic massage is one of ancient India’s best kept secrets. From the experience we got, we felt relaxed and stretched out after the massage. Ayurvedic massage is performed with warm essential oil. Just like how a car needs to change oil, the body is in need of it as well. The smooth oil with a massage

LASTING IMPRESSION: Parents’ affection and support during childhood can have lasting effects on development well into adulthood.

education+

2016 | AUGUST

• 37

Worldclass Irish education Local university brings international training in surgery to medical students to provide more accessible education.

By syed zaid syed osman

rofessor Dr David Adams, the dean of Perdana University Royal College of Surgeons in Ireland, discusses PURCSI programme during an exclusive interview with Health+. Q: Tell us more about the Perdana University Royal College of Surgeons in Ireland (PURCSI) programme in Malaysia. A: The PURCSI was established in 2011 and we now have the first cohort graduating this September. It is a five-year programme that follows the credited Royal College of Surgeons in Ireland based in Dublin. During the programme, students will be equipped with everything they need to efficiently lead the healthcare provision in Malaysia. Q: What are the added advantages students obtain upon graduating? A: The curriculum uses the same syllabus taught in Dublin but is altered according to the urgency. For example, dengue fever might not be common in Dublin. Therefore, the syllabus might not require much details as what the doctors are dealing with here. In addition, the student body is able to access the world-class database to broaden their reach. Graduates receive the bachelor of medicine, bachelor of surgery and bachelor of the art of obstetrics (MB BCh BAO) of the National University of Ireland, Licentiate LRCP & SCI of the Royal College of Physicians of Ireland and Royal College of Surgeons in Ireland.

Q: What are the requirements to join the programme? A: To join the PURCSI, the candidate must obtain an A and 2 B+s for STPM in biology, chemistry, and physics or mathematics. The matriculation & Foundation students require a minimum CGPA 3.5 out of 4.0, focusing on biology and chemistry and physics or mathematics. All students must either have either a minimum MUET score of Band 4, OR IELTS score of 6.5 with no individual section lower than 6 OR TOEFL iBT (minimum subscores of 26 reading, 26 listening, 22 writing and 25 speaking).

Dr Adams tending to a patient model on the bed. of preparing them for the real occasion. Q: Who makes up the teaching force at PURCSI? A: As of now, I would say the expatriates make up 70% of the teaching force. But, I do have plans to produce more local doctors to teach in PURSCI. The expatriates are from Ireland, India, Myanmar and other countries. Q: How would you rate the programme’s success rate? A: We might not have the statistics this batch are first ones to graduate after PURCSI started in Malaysia. I do however, feel positive about them. Having been in the medical field for 30 years, these young graduates are the best team of doctors I have ever gotten the chance to work with. I see bright future in them and I can say they will be great and wonderful doctors one day.

Q: What is the mission and vision of the programme? A: The objective of the PURCSI School of Medicine is to provide the education and experience that will enable its graduates to enter post-graduate training in the medical specialty of their choice. In other words, we aim to produce outstanding medical graduates who are able to deliver high level of healthcare in Malaysia. Q: Does the programme make PURCSI unique compared to other universities and colleges in Malaysia? A: The programme is a five-year Irish medical programme completed wholly in Malaysia. Here, the students acquire the understanding and clinical competence under the supervision of our experts and it is another advantage that majority of the medical leads are from Ireland. In addition, we do fully equipped clinical skills unit lab with medical mannequins to be used as models for our lessons and preserved human anatomy museum in our campus. The models and preserved anatomy help students understand the human body better in addition

Human legs part of the training model at the PURCSI laboratory.

Real life human body mummified in plastic used for practise and lessons.

Graduates receiving the bachelor of medicine, bachelor of surgery and bachelor of the art of obstetrics (MB BCh BAO) of the National University of Ireland.” – Dr Adams

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general+

AUGUST | 2016

Rheumatic diseases affect young and old 80-90% of those who get arthritis are in the 20-50 years old age group

By prasad chandra segaran

heumatic diseases are common among Malaysians, but there’s a prevalent misconception that only older people are at risk, but the truth is, even infants are not spared. There are many types of rheumatic diseases, but a common one among Malaysians is gout, which also affects the younger generations. Gout is a disease in which defective metabolism of uric acid causes arthritis, especially in the smaller bones of the feet, deposition of chalkstones, and episodes of acute pain. The older generation suffers from osteoarthritis, sometimes called degenerative joint disease or “wear and tear” arthritis. Dr Emily Goh, consultant rheumatologist and physician at Gleneagles Kuala Lumpur, tells

Health+ that 80-90% of people who get arthritis are in the 20-50 years old age group. “There is a misconception that only old people are affected by arthritis, but many young working people also get it. This is due to the amount of stress the generation carries now and living in a busy city without sufficient workout. Women are most likely to be affected by rheumatic diseases, while gout is more prevalent in men,” she says. Dr Emily says only a few rheumatic diseases can be cured, while most of them are only controllable. “Some patients have autoimmune system disorder where their immune system wouldn’t recognise a certain disease to reverse it. This is where we as rheumatologists will work with them to live a productive life as much as possible.” Know your condition According to Dr Emily, the challenge of fighting any type of rheumatic disease will depend

EARLY DIAGNOSIS: Dr Emily says undergoing proper treatment at a proper medical is centre is very important. largely on an individual’s mental strength. “There are three stages in every disease, which are mild, moderate and severe. The most challenging part is to fight the severe stage. An individual’s mental strength is very important to fight a chronic disease. A

rheumatologist will normally give more counselling to the patient to adjust and give motivation to strengthen his mental ability.” She advises those affected by any rheumatic disease to do their own proper research to get a better understanding of their condition.

diseases and it was hard for them to find rheumatologists. When she embarked on her

new journey, it was the right time to enter the rheumatology field because new medicines for

Finding her calling as a rheumatologist BY PRASAD CHANDRA SEGARAN The medical profession is unique in that having a medical degree is not a means to an end, but a first step in the medical training process. Many doctors go on to gain postgraduate qualifications in their specialist areas and this is great for their appraisal folders. Among the most popular medical subspecialties are cardiology, nephrology and haematologyoncology. But when it comes to rheumatology, not many consider it as a subspecialty interest. According to Dr Emily Goh, a consultant rheumatologist and

physician at Gleneagles Kuala Lumpur, the country was facing a shortage of rheumatologists when she completed her medical study years ago. The situation has not improved much over the years as doctors are still reluctant to major in rheumatology. “That’s why we still lack specialists to treat rheumatic diseases,” she laments. Dr Emily was inspired by her Oxford professor who attended to all his patients and enjoyed his job. “He was always calm and patient talking with his patients,” she recalls him fondly. She was motivated to be a rheumatologist because people were suffering from rheumatic

Deformation on bones caused by rheumatic diseases.

2016 | AUGUST

“They should collect all the facts about the disease and avoid listening to wrong information about it from other people. This is because people around you may have misconceptions about the disease and guide you with the wrong information, which may worsen the disease. Getting the right opinion from specialists is the best way to fight a chronic disease.” Dr Emily says there is a little difference between rheumatism and arthritis. “Some may think that having some joint pains means they have arthritis, but is normal for some people to have joint pain due to stress and work. For this joint pain which is called rheumatism, applying some gel or cream will relieve the pain.” Arthritis, she explains, is more severe whereby the joints get hot or swollen, and that’s when the affected person needs to seek medical attention. “The pain will be even more severe than rheumatism and the pain will sustain for at least half an hour or more. Arthritis will make one difficult to do daily work. It will hard for the person to even button his shirt, driving or to chop vegetables,” she says. Dr Emily says gout, which is also called the disease of kings, can be prevented by eating a balanced diet. “Exercising regularly can prevent one from getting gout. However, autoimmune diseases are a little bit tougher to prevent because they are due to stress, hormonal changes or viruses.” “I would like to stress that people need to maintain normal body weight so that if any of these diseases affects them, it will be easier for them to fight it,” she explains. “It’s important to consult a doctor as soon as you realise the symptoms because it is said that bones are like teeth, and once they are damaged, it is impossible to reverse to how they were before. We will mostly replace the affected joint with an artificial joint so that the person can live a productive life. However, in that case too, the artificial joint won’t work perfectly like a natural joint.” She says ultrasound needle may be used if the joint is swollen. “The joint will be ultrasounded to make sure the needle goes in to draw out the fluid from the swollen joint space. The earlier the diagnosis is done, the better it is for the patient. If it’s too late then it is hard for the patient to live with rheumatic disease. Undergoing proper treatment at a proper medical is centre is very important.”

rheumatic diseases were introduced into the market. “The demand for rheumatologists was very high in those days and still is in our country,” she says. “To be a rheumatologist, you first need to be a physician followed by doing a master’s degree in medicine, and then a three-year post-graduate course in rheumatology, and finishing with training in many hospitals and an oral examination with the Rheumatology Board. It is not easy to be a rheumatologist as you need a lot of patience and it takes a long time to be one.” Dr Emily enjoys her work as a rheumatologist. “I get to meet people and build good relations with them. I get close to my patients and eventually become their friend or family doctor.”

general+

An individual’s mental strength is very important to fight a chronic disease. A rheumatologist will normally give more counselling to the patient to adjust and give motivation to strengthen his mental ability.” – Dr Emily

• 39

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general+

AUGUST | 2016

SWEET MEMORIES: The 17-team members posing for a shot to remember before continuing their ascent to the summit.

The Kilimanjaro breeze Vemanna Appannah and team conquer Mt Kilimanjaro to support cancer patients

By norman hussaini

ount Kilimanjaro stands strong at 5,895 metres above sea level and is the highest point in Africa. It is located in Tanzania and is prominent with its three volcanic (dormant, thankfully) cones named “Kibo”, “Mawenzi”, and “Shira”. The behemoth has attracted countless climbers to take the challenge to reach the Uhuru peak, the summit of Kilimanjaro, over the years. One of those brave climbers is Vemanna Appannah, a Malaysian who takes climbing as his greatest passion, besides supporting cancer patients. Health+ met up with Vemanna, who is National Cancer Council (MAKNA) deputy general manager, recently to listen to his adventure climbing and conquering Mount Kilimanjaro in March.

Aim of expedition Vemanna is a mountain climber at heart, and the expedition, he says, was just a holiday for him. “This particular expedition was not specifically to raise awareness about cancer or anything. I just love climbing mountains and I thought of using my favourite activity as a way to appeal to the supporters of MAKNA to fight cancer,” he begins to relate his adventure. Vemanna had been involved in many climbs over the years to support cancer patients, notably the Mount Everest base-camp climb in 2011 and the Kamchatka Peninsula expedition in Russia in 2012. His annual feat with MAKNA is the council’s annual fundraising climb; ‘Klimb Kinabalu’ against cancer, with the upcoming one in August. The Kilimanjaro climb, although not a MAKNA fundraiser, collected RM11,000 and boosted its presence among the public nonetheless. Preparing for the climb According to Vemanna, it is important to train and be prepared

Tembe PolePole, Hakuna Matata: Walk Slowly, No Problem for an arduous climb like Kilimanjaro. A good level of health and fitness is important. However, you don’t need to be a fitness freak or an experienced marathon runner. He and his team trained for three months climbing mountains and hills around Malaysia, including the likes of Gunung Datuk and Gunung Nuang, and doing laps at Bukit Gasing. They also regularly went to the gym to improve their stamina. “To be perfectly comfortable, proper climbing attire is important. The mountain range displays a few different climatic zones, from hot and piercing sun to strong and chilly breeze to extreme cold. Therefore, layering of clothes to stay warm and comfortable as you ascend is important. It is a must to have proper breathable hiking pants, thermal layer, mid fleece, waterproof outer jacket, headwear with right gloves and hiking boots. The use of trekking pole becomes helpful for balance and takes pressure off your knees,” he says. And most importantly, you need to have some knowledge of

the type of terrain to expect, he adds. Looking back, he was glad the team was guided by experienced climbers who know Kilimanjaro as if it is in their backyards. “Knowing what to expect and preparing for the unexpected is essential. We were glad to have them help us.” The challenge As any person with no experience climbing mountains would imagine, climbing Mount Kilimanjaro is by no means a walk in the park. Vemanna says it was a tough expedition that took huge amount of preparation. “It was a six-day expedition, with four days taken to climb and another two to descend. The team was made up of 17 friendly mountain climbers with considerable amount of knowledge in mountain climbing. The friendly company proved very helpful as the team was very encouraging and supplied enough humour and fun that helped us overcome the expected challenges faced during the climb.” Besides the 16 team members,

general+

2016 | AUGUST

Vemanna also received help from local travel agency. A 52-person entourage was engaged to carry the camp equipment to summit Kilimanjaro. They included one chief guide, six assistant guides, two cooks, and 43 porters. The big group treaded the route to the summit in the day and camped at night. They carried all the gears, tents, cooking supplies and water. There are seven major routes leading to the summit, namely Marangu, Machame, Rongai, Lemosho, Shira, Northern and Umbwe. The Rongai route was the team’s pick. The Rongai route is the only route that begins from the north-eastern side of the mountain, closer to the Kenyan border. Positioned close to the Equator, Mount Kilimanjaro is the highest mountain in Africa and the highest free-standing snow-capped mountain in the world. He says the climb took them through several climatic zones before they reached the summit. They started trekking through the scrubby rainforest; this section remained lush and green. From rainforest zone, the terrain took to the team to the moorland zone where the vegetation was sparse. Once they reached an altitude of 4,000 meters, the team encountered cool, dry alpine desert while an arctic zone awaited them at the summit. The most challenging day was the summit push that began from Kibo Hut, which was an elevation of 4,720 meters where the team transited the rocky uneven landscape of the alpine desert to the freezing arctic zone. The summit push from Kibo Hut started half hour before midnight. From Kibo Hut, it is a gruelling eight-hour climb up the steep scree to Gilman’s Point located on the crater rim at 5,685 meters. Climbing in the dark was disorientating. The fatigue was telling, as team members found themselves constantly misstepping. “We were guided only with the light from our headlamps. Up in the sky we could clearly see stars shining brightly, but when we looked down we could only see our feet illuminated by the headlamps. We had to be very cautious negotiating this part of the climb, as the path was rocky and it zigzagged all the way up to Gilman’s Point,” says Vemanna.

Although it required substantial physical and mental strength to clear this demanding trail, the team was rewarded with a spectacular sunrise when they reached Gilman’s Point. “The clouds looked as though they were on fire,” recalls Vemanna. He says one of the major challenges during the climb was the slow decrease of oxygen as they climbed higher and higher. Drop in oxygen means lesser air to breathe, which slows the walking speed. Seasoned climbers know pretty well that thin air can sometimes cause them to become dizzy, light-headed or nauseous, and even unconsciousness if they persist further. The essence of getting up the mountain is “Pole-Pole” that means “slowly-slowly” in the local Swahili dialect. Pole-Pole is the mantra that the guides repeated religiously from the first day to carefully pace the climbers so that all of them will safely summit Kilimanjaro. The guides also closely monitored the group for signs of altitude sickness, but according to Vemanna, it is just as important for each climber to “listen” to their own body and be attuned to any symptom. “We experienced cases of disorientation, nausea and, for some, vomiting during the climb. All these are to be expected, but dehydration can lead to serious complications to health. A fairly mild cautionary tale for climbers to keep themselves hydrated at all times,” he advises new climbers. The temperature, especially towards the peak, was another challenge as Vemanna and his team had to endure extreme cold as low as -20°C. “Moreover, the terrain was more unforgiving the closer we got to the summit,” he says. He remembers two incidents clearly; a team member lost his footing due to disorientation and his trekking pole left a small tear near his eye, just narrowly missing his eye ball. Another had difficulty breathing after returning from Gilman’s point – the cold air had caused water retention in his lungs. Both incidents were handled with great efficiency, thanks to the experience and quick thinking of the group. The sudden change of weather also brought down hailstorm while descending that lasted less than 10 minutes. Luckily no one was hurt, he says.

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MALAYSIA BOLEH: Vemanna proudly waving the Malaysian flag at Mount Kilimanjaro’s summit, the Uhuru Peak.

Passing what’s left of the Kilimanjaro glaciers and ice fields. To keep his spirits up and stay relaxed, Vemanna kept reminding himself that he was on a holiday. And generally, it did feel very much like a holiday. Except for the summit push day, the rest of the days consisted of four to six hours of walking. That provided ample time to catch up with other members of the team and for learning about the local culture and dialect from their guides and porters. All these, says Vemanna, helped the group to stay calm and relaxed, especially at higher altitudes that were more demanding both physically and mentally.

GETTING READY: The team rests before continuing their journey.

The experience All the challenges and the exhaustion were forgotten the moment he set foot on Uhuru Peak. “Determination, more than anything, is important if you want to get to the top of the highest free-standing snow-capped mountain in the African continent,” says Vemanna. As Vemanna recounted his experience climbing Kilimanjaro, it was clear that he really enjoyed himself. His hobby is tough but enjoyable as it brings with it an experience like no other. He

gets to meet new people, see the wonders around the world and its glory, and overcome a challenge that many can only dream of. He gets to see places very few get to see, and, at the same time, it gives him the chance to give back to the community in a very fulfilling way. “Summitting Kilimanjaro is not something that you do every day and it still thrills me to know that I made it. At the same time, it is fulfilling and it makes me happy. I believe I will keep climbing. Overcoming the challenges, to keep on going no matter how difficult, then to get there in the end. I am motivated by that sense of accomplishment and satisfaction.” His advice to readers is you can turn your passion to something meaningful, be it scuba diving, yoga retreat at an island resort, visiting iconic landmarks across the globe, bungee jumping, participating in marathons, skiing in the Alps or mountain climbing. There’s really no limit to how you can use your hobbies to raise money for your favourite charity. His position in MAKNA comes only as a bonus and he feels thankful that he can help support cancer patients in Malaysia doing what he loves.

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nutrition+

AUGUST | 2016

Organic galore Opika Organic Market and Restaurant serves good food, though not the cheapest around

By norman hussaini

he lifestyle of people nowadays is unfathomable for earlier generations who lived without smartphones, Internet and organic foods. It seems that time had been a cruel yet unrelentingly lovable mother that had spoiled us to the brim. The only thing that had yet to be modified and made easier, at least for now, is eating. Sure buying food now is as easy as a tap on our smartphone touchscreens, but we still have to put it in our mouths, chew and swallow to get that deliciousness into our tummies. However, the things we eat have changed over the years. When I was little, the term “organic’’ food didn’t exist. Yet now with the burgeoning healthy movement in our country, I found myself curious about it. Frankly, I have never been a believer of the whole “organic is better” thing, but I thought it would be interesting to get a sense of it in a restaurant where organic food is the nail holding it all together. Opika Organic Market and Restaurant is a trendy place located in the enormous shopping centre One Utama. Started by entrepreneur and organic product advocate Selina Gan, the place not only serves organic foods but also sells organic produce. Getting to the matter at hand, I was there essentially to taste the food and feed my curiosity – and stomach, of course. The first thing I saw which stirred my interest was how the menu shows the

percentage of organic ingredients in each dish. Well, it makes sense as very few complete dishes are truly 100% organic, unless you’re eating organic vegetables like Bugs Bunny eats carrots. I was graciously presented with three of the restaurant’s most popular dishes to try. Chargrilled Free Range Chicken Breast Salad The first was the appetiser, typically a salad with grilled chicken breast marinated with Cajun spice. It was very normal, presentation and flavour wise. The free range chicken breast was tasty but a bit dry, and the vegetables were oddly cut into juliennes (very fine strips) which felt like I was eating a whole lot of garnishing instead of salad. It was seasoned well enough for me to make it through though, but it wasn’t the most pleasant salad I have ever had. Braised Free Range Australian Lamb Shank with Sweet Basil Potato Mash If you think that the name of the dish is a mouthful, then you are correct on two accounts. Probably this lamb shank, the highlight of my visit, is a strong candidate of how organic food can be introduced to non-believers such as myself. According to the menu, it is set at 92% organic. Lamb dishes have always found their way to my heart and, trying not to be biased because of this, the dish is a nice addition to my long list of good food. The tomato-based gravy in which the lamb was braised in complemented it well, bringing the flavour in full colour. As a

COLOUR IT: The Nasi Ulam was delicious, but more colour can improve its appeal.

CHOICE DISH: Lamb shank was my favourite, but it lacked texture and bite. perfectly-braised lamb shank would, the meat fell off the bone spectacularly. I was also quite pleased with the mashed potato. The addition of fresh basil leaves was a good idea as it brought quite a unique taste to the boring old mashed potato. The only gripe I had with it though was its lack of texture. As the lamb was braised and served with mash, there was no bite to the whole dish. It could have been better had the cook added some toasted nuts or leafy greens to the mix.

NORMAL: Chicken salad was not the best one I’ve tasted.

Nasi Ulam with Chicken Percik My feelings were torn when I experienced this dish which comprised a few components – Malaysian-style herb rice, chicken thigh with percik sauce, a dollop of sambal belacan, some fish crackers, salted fish, a wedge of salted egg and salad (garnishing). Each component added

something different to the overall dish, and it worked quite well with one another. I liked the chicken and the rice was quite flavourful, but I felt the dish was a bit boring. There was no colour to it, and the salad felt obligatory and didn’t add much to the dish. It’s not to say the dish was not good; it was quite delicious and reflected how well the chef handled his craft in flavouring the dish. However, the appeal wasn’t quite there. I felt it should have been more exciting in terms of colour and presentation. It was interesting to see the concept of restaurant/market that Opika strives on and how much organic products there are. I think the place would be heavenly for people having high regards for all things organic. It was even more interesting to know that Opika takes the cleanliness of their food very seriously. All the equipment used is free of aluminium, the vegetables are either raw or slow cooked, the meats and eggs are free range, and the oil used in cooking is of high grade. Putting things in perspective, Opika was a visit I felt happy about. The atmosphere is modern yet inviting. Although the prices are not the cheapest you can find, the food is good and it can be a great place to hang out with friends or family.

opinion+

2016 | AUGUST

• 43 alternative

By Adi Satria

he Internet is a s u p e r h i g h w ay o f information. From trying to find a life partner, lost pets, used cars to everything and anything, you can be sure that Wikipedia or Lebai Google can assist you. And of course one of the hottest topics today are alternative cures and remedies from light ailments to more serious stuff like diabetes, heart problems and cancer. Come to think of it, my grandparents lived a long and fulfilling life in the kampung. Tok Ahmad Tonganang was married seven times and had 14 children, including my father who was the youngest then. Or so he thought until my grandfather married again at 70 and had a daughter. The grand old man lived on till 90. That brings me to the question: What was the diet that maintained his health and made him productive? God definitely had a lot to do with his health as he allowed him to marry more than one and up to four at any one time. I read a recent research saying a healthy sex life or regular ejaculation can actually prevent prostate cancer. Playboy king Hugh Heffner will attribute his long life to pretty women surrounding him all the time. Indonesi a’s tradi t ional medicine and herbal industry, particularly jamu, is testimony to the efficacy of traditional herbs to maintain a healthy lifestyle. Even

with the stress of modernity and urban living, we cannot deny the benefits of a daily dose of jamu. There is a growing trend in Malaysia to tap the multi-million ringgit traditional health and herbal industry. I am particularly interested in the basic ingredients used in our regular cooking such as ginger, lemon, honey, garlic and apple cider. Benefits Ginger has many health benefits, including lowering blood sugar, stimulating circulation, relieving digestive issues, and reducing pain and inflammation. Lemon is said to heal indigestion, heartburn, cough, cold sores and psoriasis, besides reducing high blood pressure and contributing to weight loss. Honey’s health benefits are legendary. Besides boosting energy, it reduces muscle fatigue, regulates blood sugar, contributes to weight loss and is also good for the skin. All these antioxidant properties, which are also abundant in garlic, detoxify, improve cholesterol levels, lower blood pressure and combat sickness. Apple cider vinegar, on the other hand, is used to treat diabetes and high cholesterol levels, blood pressure, heart diseases as well as assisting in weight loss. These everyday kitchen ingredients can be blended together to concoct a highly potent health drink which when consumed on

different strokes

Homegrown remedies – effective or just bull?

a daily basis can help to maintain your health. I have been consuming some of these raw ingredients including turmeric, sky fruit and mahkota dewa, and I can attest they do make a difference to my daily energy levels. Of course I do not consume them all in one go but rotate them to provide variety. So far I have avoided seeing the doctor for a long time, especially in this heatwave. There are many brands in the market produced by individuals and families as lucrative home businesses, including one by my brother and his in-laws called RICAJ. This blend, which is quite tasty, is a traditional concoction scientifically reformulated based on research conducted by a scientist who intends to make this a major brand in the market. Thanks to social media, everyone can now market a homegrown herbal product via the Internet. These manufacturers basically use the same ingredients blended in the product, which is testimony to their efficacy. In a recent seminar on the local herbal and health industry, the government has identified some of the challenges facing this homegrown industry. Production of raw materials is mainly by smallholders with prices that are uncompetitive and supply that is uncertain. It is also mainly sun-dried and thus cannot meet regulatory requirements. There is a

lack of evidence-based information in product development Processing is also on a small scale contributing to the problem of price uncertainty. Competition from established foreign brands can impede its penetration into the market. There is a need to develop and establish brand presence which can be costly. In terms of distribution in the international market, the insignificance of Malaysian herbs and products is a major challenge. So manufacturers depend on a stream of regular customers who order via friends and family but the Internet has become its major platform for brand awareness, referrals and distribution. I guess for me and many others, we have faith in herbs and age-old ingredients to maintain our health and strength. We avoid antibiotics which we have discovered have been greatly abused as even the simple and common cold can be effectively treated with these ageold common herbs and ingredients found in our kitchen. Adi Satria has been in the marketing communications industry for 30 years. Since retiring from corporate life, he has embarked on an active physical and mental journey of discovering the elixir of long life via alternative and time-tested therapies from various cultures.

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alternative+

AUGUST| 2016

Prenatal yoga to ease pregnancy HAPPY YOGA FAMILY: (from right) Master Kumar, Asu, Priya holding baby Sanuraa and Vasughi.

Master Kumar of Arogya Yoga uses complex form of prenatal yoga to assist expectant mum by syed zaid syed osman

ating back 5,000 years or more, the spiritual and ascetic practices and traditions of Hinduism have been used by millions as a form of exercise. Till today, practitioners believe that meditation and workout provide great benefits not only to our physical being but also the psychological part of our brain as they include excellent features such as breathing, posture and calming meditation. Master Kumar of Arogya Yoga can certainly attest to these great benefits as he used the complex form of prenatal yoga to assist a couple – Sanmugapriya Jayasimhan or Priya and her husband Asurayaan Sharleh or Asu. When they found out about the pregnancy, they were elated. Like many pregnant mothers, Priya experienced a series of pregnancy complications. She realised her legs were swollen, suffered cramps and detected nauseating smell in the air. She claimed to always detect the smell of ammonia. According to Priya, she went to see Master Kumar in her second month of pregnancy and started the prenatal yoga programme in the fifth month. The postures and practices came easy to Priya. “The postures and positions were not hard to do at all. They were all customised to fit the requirement of a pregnant mother. There wasn’t a step I couldn’t do,” she says. “I would definitely start practising yoga soon after I recover from my delivery.” “I had always been plump but when I was pregnant, I was in a very good shape. I remember my friends asking me about my due date. I still remember their faces of disbelief when I said it was a week away and I was still active. After delivering, I lost all my pregnancy weight within one and a half months,” Priya says with a satisfied look on her face. Master Kumar focused on both Priya and her baby. He says the postures were created to focus on the physical aspect to ease the mother’s childbearing process while also concentrating on the psychological parts to keep tab of the baby’s health and wellbeing. Prenatal yoga, he says, is known to also improve the mother’s sleep, reduce stress and anxiety, besides reducing back pain, swollen feet, nausea and other pregnancy complication. The reduction, as described by the couple, was almost immediate. Master Kumar says he recommends food according to the mother’s appetite,

alternative+

2016 | AUGUST

• 45

Seeds of healing Going natural in preventing illness and living a healthier lifestyle is the way By norman hussaini

edicine is something of a necessity in our daily lives. Most medicine are created from various chemicals for a specific purpose. It seems however, that they are moving farther and farther away from our natural surroundings. It is widely agreed that natural ingredients and substances do provide beneficial properties for our health, but the practice of which natural treatment is made staple still faces huge scepticism from public. Health+ talks to consultant pharmacist and naturopath Prof Dr Ananthan Krishnan of AK Pharmacy and Naturopathy Centre to find out just how important it is to prevent illnesses and live a healthier life through nature. The essence of naturopathy Dr Ananthan had worked as the deputy chief pharmacist with Hospital Kuala Lumpur, a member of multiple associations related to alternative treatments, and a holder of 12 degrees of different disciplines. The experience he gathered over the many years has brought upon him a paradigm change to alternative treatment. He had realised after years of service in the Ministry of Health, hospitals and clinics that drugs have been causing a lot of irreversible and detrimental damages to patients with its side effects. Dr Ananthan explains: “Drugs

body and acceptance level. In Priya’s case, he recommended beet roots and vegetable which are healthy for the growth of the mother and her child. Besides posture practices and diet recommendations, he also used hypnotherapy to “reprogramme” the baby in the womb, and acupressure to further the relaxation. Priya’s pregnancy complications eased during the programme. “Three days before giving birth,

contain various chemicals and poisons. They have specific purposes to adjust specific functions of our bodies. They can be used to slow down the heart rate or block certain processes for instance. But they do not have the three important aspects in healing; repair, restore, healing”. According to him, any remedy we take must have the power to repair whatever has gone wrong with our well-being. It must be able to restore what has been lost, and it must have the ability to heal. “Drugs cannot do these three things, it can only manipulate,” he states. The essence of naturopathy is the ability to identify natural ingredients which contains enough biochemical and nutrients required by our bodies and use them to prevent illnesses without resorting to chemicals and poisons. The discovery It was when he left the hospital that he wanted to find the secret of healing hidden among nature. He realised, after much contemplation and meditation, that the most powerful substance in nature is seeds. “A small, single seed can extend to become a tree. This reflects

Asu drove me to Batu Pahat for a day trip. I didn’t face difficulties sitting through the long trip after I did the prenatal yoga,” she confesses. Master Kumar cautions t h a t p re n a -

The formulas developed by Dr Anathan use natural, edible seeds to ensure healthy wellbeing.

THE TEAM: AK Pharmacy and Naturopathy Centre in Puchong houses professionals and provides consultations and treatment as well as education in the near future.

how powerful it is,” Dr Ananthan recollects. He was on the path to finding out the combination of edible seeds that can provide the required nutrients for the body to function properly and to achieve perfect balance, so to speak. It is safe to say that he did find out. The key, he says, is to look at the body as a whole system and not divided by multiple systems. The formula he has developed is to balance out the body by supplying it with enough nutrients and biochemicals. He explains: “The aim is to keep the physiological metabolic efficiency in line. When the body is taken care of properly and is not harmed, you won’t go into weakness. And if you don’t go into weakness, you won’t go into illness”.

upon an efficient system whereby prescribing a particular drug for a particular patient is easy. There is no such system established for natural treatment. Because of this, doctors, specialists, and the general public tend to generalise natural medicines. This creates a certain stigma towards it. An added worry is the large amount of untrained individuals who are now developing products using natural ingredients which had resulted in unwanted results. Dr Ananthan warns of the dangers of going to people who are not qualified.

The scepticism Dr Ananthan had established quite a strong foundation in natural, alternative treatment. He had created 13 formulas based on edible seeds available in AK Pharmacy. All of his formulas have been proven by research to improve the well-being of patients. And as a pharmacist, he had experienced first-hand the dangers posed by drugs to health. His findings and practices however, still faces a lot of scepticism. To him, the scepticism comes mainly from the lack of a proper system to implement alternative treatment. The subsequent question then is what is a proper system? He says that with drugs for example, the foundation of knowledge towards it has been well-established. Backed up by years of study, drugs are widely accepted to be solution. This knowledge had brought

Establishing greater foundation With the lack of belief from the public and doctors, Dr Ananthan aims to solidify the research he had done and to provide education for professionals on natural medicine. AK Pharmacy and Naturopathy Centre in Puchong is looking to expand its facility to provide certificate, diploma, and degree courses for natural medicine by year-end. This is to tackle the problem of unqualified individuals producing unqualified natural products. For doctors, the team at AK Pharmacy plans to organise a series of short courses to inform them of the benefits of natural medicine. With this, Dr Ananthan hopes to further establish natural medicine among Malaysians to help us maintain better health and wellbeing. Many have benefitted from his natural medicines, and many more are welcome to be better informed. He calls for a paradigm shift among the public on natural medicine.

tal yoga has certain limitations. Pregnant mothers are not supposed to do yoga unless supervised by an expert. Prenatal yoga is designed to help expectant mothers improve their physical being to help them stretch and increase their flexibility. Rigorous practices can bring negative results which can endanger the lives of both mother and child. “Prenatal yoga focuses more on the hip and the pelvic bone to give the mother

enough support while carrying a baby in her belly. The prenatal yoga is designed to promote the joint activity to assist in the energy flow,” he says. Sanuraa Asurajaan was born on December 16 last year. The healthy prenatal yoga child was glad to see us and, according to Priya, is learning fast and even spoke her first word two weeks after birth, which dropped the jaws of the parents and others.

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healthtech+

AUGUST | 2016

Extending a helping 3D hand Ricoh Malaysia partners with E-Nable to provide prosthetic limbs to children with amniotic band syndrome

rosthetic limbs, which have been in use for many years, help amputees live more independent and easier lives. However, creating prosthetic limbs is complicated and time-consuming. But thanks to technology, the process of developing prosthetic limbs has been greatly simplified. This is made possible with 3D printing, a technology that is on the rise and

continues to improve over the years. E-Nable, a US-based non-governmental organisation (NGO), is using 3D printing to help children with amniotic band syndrome. Last year, Ricoh Malaysia Sdn Bhd together with Ew Chee Guan, an industrial electronic design and maintenance technician from Batu Pahat, Johor, teamed up with the NGO to bring 3D printed prosthetics to Malaysia. Ricoh Malaysia contributed

TECH WONDER: The design of the prosthetic hand is standardised by E-Nable to help child amputees.

? BRIGHTER FUTURE: Kong (third from right) and her family together with Ew and Peter (right) celebrate the achievement.

RM10,000 for Ew to build 3D-printed prosthetic limbs, and the initiative has so far benefited seven recipients. Ew has received applications for the 3D-printed prosthetic limbs from as far as Ipoh, Kuala Lumpur, Johor and Singapore. Ricoh Malaysia managing director Peter Wee says the partnership with Ew started after he won the individual category in the company’s Imagine 3D Contest last year. “Noting his plight and good work, it was only natural for us to be part of this movement which has seen fruition. With the advent of 3D technology reaching our shores, such innovations are now more accessible to Malaysians and affordable than the initial impression. We saw an opportunity to speak to the public about such technology through the CSR (corporate social responsibility) window,” he says. “The wonders and capabilities of a 3D printer are endless. Designed for the use of niche markets back then, 3D printers are now for the innovator in everyone and at the same time for a good cause. On average, it takes an hour to 3D print a single finger, 15 hours for a palm and up to 200 hours for a lower arm. Some special cases require more materials to create an elaborate limb which we call the myoelectric hand powered by hardware and software components such as microprocessors and motor parts.” Ew recently assembled a prosthetic hand for sevenyear-old Kong Kai Li. His mother Chang Siew Yeng says her husband found out about E-Nable after a long

search. “We are truly grateful to E-Nable and Ricoh Malaysia for the initiation in such CSR activities. We hope this will create greater awareness among the public and ultimately prompt them to come forward to look for a solution,” she says. The growing awareness about 3D-printed prosthetic hands has helped many individuals to progress from their initial condition. “Amidst growing demand (resulting in) prosthetic hands becoming increasingly more costly, the collaboration with Ricoh Malaysia has allowed more people, young and old from all walks of life, to approach E-Nable,” says Ew in a recent statement. “Through this courteous cooperation with Ricoh Malaysia, I have been able to produce more 3D limbs within a short timeframe. It is the contentment of giving back that made me pursue this hobby during my spare time. I am sincerely glad to work on board as a credible partner with Ricoh Malaysia towards this worthy cause.” Ew initially built a 3D printer to print industrial parts. However, his talent and fondness to fix and build things, and solve problems as a child has developed into a hobby which now benefits those in need. In 2014, he learned about E-Nable, a global network of volunteers based in the US who use 3D printing to create 3D-printed upper limb assistive devices to anyone in the world in need of a “helping hand”. And as they say, the rest is history with a bright future ahead for many in need.

what’snew+

2016 | AUGUST

Good riddance to fungal infections Three Legs, a flagship brand under the Wen Ken Group, recently launched Tinea-Kare anti-fungal spray and cream. It contains clotrimazole, an active ingredient that treats a wide variety of fungi. Clotimazole fights fungal infections by blocking the production of ergosterol, which weakens the fungal cell wall, allowing it to be easily destroyed. Tinea-Kare anti-fungal spray and

Garmin launches two new trackers OFFICIAL REVEAL: The Official reveal and launch of the brand new Tinea-Kare anti-fungal spray and cream.

cream can help relieve symptoms associated with white spots, jock itch and ringworms. It is also suitable for treating athlete’s foot and yeast infections. According to Wen Ken Group business director Chris Lim, the company has in recent years been focusing on creating more innovative products. “We developed this product because we believe that with the active lifestyle

of most people today, it is suitable to be conveniently used in a tropical climate like Malaysia. Tine-Kare not only helps in fighting fungal infections. Our product philosophy has always been one that goes beyond quality and affordability. As a pharmaceutical company, we ensure our products comply with both safety and efficacy,” he says.

Shine J-Care 7, New Medication for Arthritis Does your joints hurt? Or perhaps performing simple tasks such as walking or climbing stairs might be a bit hard. Then sadly, you might have a case of Arthritis. Arthritis can be caused by several factors, such as extreme physical movement or sports, hereditary, and even from being overweight. Y.S.P. Inudstries (M) Sdn Bhd features one of their most comprehensive product in the market, Shine J-care 7, that can help with arthritis. Shine J-care 7 is a natural product that contains undenatured Type II collagen derived from chicken sternum cartilage with natural blend of ginger powder. The formulation was made to be effective for those who have suffered from joint paint such as osteoarthritis,

Health and beauty; The organic Way. Neal’s Yard Remedies is one of the few cosmetic companies pushing against synthetic chemical approach to skin and

• 47

rheumatoid arthritis and gout. Shine J-care 7 adopts the US patented extraction method to ensure Type II Collagen remains biologically active in its most native state. Hence, making it a unique product for joint supplements in the market, due to the fact that most joint supplement products utilizes high heat or chemicals to process it. Furthermore, Shine J-care 7 is the joint health food product that is backed by years of commitments from scientists, researchers, and technicians. Each case of Shine J-care 7 contains 30 sachets in powder form. It is recommended to consume one sachet each day before a meal in the morning. Shine J-care 7 is available in all leading

health care. In some way or form, all their products use organic ingredients such as beeswax, shea butter, hemp, seed oils, rosemary, palmarosa, and many more. Neal’s Yard Remedies has just released their new Wild Rose Moisturizer SPF30 for Face, in line with their best voted product, Wild Rose Beauty Balm. Wild Rose Moisturizer SPF30 for Face allows one to stay protected, nourished and nurtured in the sun with organic, high level broad spectrum UVA/UVB protection. The all natural moisturizer contains 100 percent natural non-nano mineral filters, blended with antioxidant radiance-boosting organic wild rosehip oil, shea butter, and baobab oil. Other than that, Neal’s Yard

Garmin launches two new trackers with auto activity detection and heart rate monitor. The Vivofit 3 features new auto activity detection and the Vivoactive HR has built-in heart rate technology. In the third iteration of Vivofit, the popular activity tracker takes on Move IQ, a feature that can automatically detect different activities such as running, biking and swimming and continuously monitor users throughout the day. The tracker is water resistant to 50m, and can be personalised with interchangeable pink, white and blue accessory bands designed by Jonathan Adler. The Vivoactive HR is designed to monitor users’ heart rates, particularly useful for measuring progress during high intensity workouts such as running and aerobics. The newest editions of Garmin’s activity trackers were officially unveiled at Mobile World Congress in Barcelona recently. – AFPRelaxnews

Taking charge of your skin condition

pharmacies and Chinese Medical Hall.

Remedies also feature their most fan favourite product, the Wild Rose Beauty Balm. This product is famous for its wide range of use, from head to toe. It can act as a cleanser, moisturizing treatment, hair treatment, hair balm, lip balm, makeup primer, eyebrow tamer, an after-sun skin-quencher, flight repair, heel balm, mild burns, bites and grazes, bug bites, cuticle and nail treat, sports barrier, and even works for eczema as well. Basically a cosmetic swiss-army knife. Their range of products makes use of high quality organic plant-based ingredients, and where available, they also source ingredients through ethical sourcing programmes. Neal’s Yard Remedies products are approved by animal welfare bodies including PETA and BUAV.

Leading post-acne scar care brand, Hiruscar Post Acne, recently unveiled its new education campaign My Skin, My Confidence to generate greater awareness on the incidences of acne scarring in Malaysia. The campaign also aims to help Malaysians to better understand how acne scarring can affect their quality of life so that they can take better control over their skin condition. As many Malaysians are suffering from acne scars, this product may be able to help them. Hiruscar Post Acne adopts a unique approach to engage with consumers and encourage them to take charge of their skin condition. This anti-bacterial clear gel contains MPS (mucopolysaccharide polysulphate) as its active ingredient that promotes the natural body wound healing process and stimulates regeneration of new cells which improves the appearance of acne scars. It also contains ingredients that inhibit bacterial growth which prevents acne from recurring and maintain the healthiness of acne-prone skin. Hiruscar Post Acne is clinically tested, alcohol-free and hypoallergenic. Formulated by Medinova AG, Switzerland, the gel is also non-greasy, fast absorbing and pleasantly scented. Hiruscar Post Acne 10g retails at RM41.10 for 10g and available at all leading pharmacies nationwide.

AUGUST | 2016

â&#x20AC;¢ 48

Clinically disruptive ... pages 02-08 Depression is recognised globally as a clinical condition with awareness beginning to engulf like wild fire

www.healthplus.com.my

The Pulse of the Nation

AUGUST | 2016

Essence of fasting Huge opportunity for us to attain the spiritual and physical benefits during this holy month. See pages 09-10

A chefâ&#x20AC;&#x2122;s guide to a healthier Ramadan

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Packing off habit World No Tobacco Day advances the attempt to tackle the ever-present issue with smoking

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AUGUST | 2016

Clinically disruptive Depression is recognised globally as a clinical condition with awareness beginning to engulf like wild fire

By Syed Zaid Syed Osman

enise has been going through some major changes recently. She seems to enjoy the sense of solitude and she doesn’t seem to have nor cared for any of her friends anymore. She is hardly in the canteen during recess and she spaces out a lot in class. Nothing like the old Denise. She was an outgoing person. Everyone liked her as she was helpful, engaging, always curious, and, most of all, she was always happy. Worried about her transformation, the teachers tried helping her but to no avail. Her friends thought that she was not praying hard enough, while her parents

Mentally prepared for the mentally challenged MMHA on mission to help those burdened by mental illnesses and remove societal stigma By Norman Hussaini Public perception of people with mental illness is unfortunately rather negative. We either imagine them as deranged guys walking aimlessly in public without shirts on, or the wacky and hyperactive crowd in mental hospitals with straightjackets. Due to such negative perception and image, no wonder people struggling with mental disorders often carry with them a very bad reputation. And this has somehow

caused them to be perceived in bad light and many people shun them, resulting in them not getting the help they direly deserve. Struggling with conditions affecting the mind, such as schizophrenia, autism and depression, is a serious problem for a growing number of Malaysians. Health+ spoke to Malaysian Mental Health Association (MMHA) secretarygeneral Datin Dr Ang Kim Teng on the association’s role in helping these people who are often misunderstood by their own families and

friends, as well as society at large. Providing the care MMHA was registered in 1968 as an official non-governmental organisation (NGO) for mental health. It was formed by a group of mental health professionals and community leaders from University of Malaya Medical Centre. According to Dr Ang, the association’s core service since its inception is rehabilitating the mentally ill. “We offer various therapies as part of our rehabilitation programme. Here we call it psycho-social rehabilitation, as it promotes interactions between them and their caregivers so that they can learn to be

took it as a sign of rebel from their upcoming divorces. Even with the collective amount of advices, “Denise doesn’t seem to want to snap out of it”. Most unfortunate for Denise, her guesses are about as good as everybody else’s. The Mind Psychological Services and Training’s very own director and clinical psychologist, Joel Low describes it as “disruption towards someone’s social and occupational life. A clinical problem which affects a person’s ability to have social interactions and the capability for doing work or studies”. Often mistaken, depression is not a matter of mood. It is recognised internationally as a clinical condition and awareness has begun spreading like wild fire. That said, curing depression may require therapy or prescribed medications and in some

comfortable in social situations,” she says. “The therapy starts with us teaching the patients about their illnesses, how they can recognise and manage their symptoms, how to communicate their feelings as well as to express themselves better.” The therapy includes activities such as games and music. “It is to create a safe space for them to open up and share their problems with us,” she adds. MMHA also provides care for the mentally ill by providing a small yet comfor table half-way home called D’Light at its centre to accom-

• 03

2016 | AUGUST

the symptoms may develop into a self-harming or even worse. Although the female population seems to have a higher depression tendency, it could be triggered by anything scary, and can happen to anyone without regards to the race, location or age. Treatments are available for depressed patients. Says Joel: “The frontline treatment of depression by the Malaysian Society of Clinical Psychology, the Ministry of Health and World’s Health Organisation is medication and psychotherapy which is what they do at The Mind”. Other methods would be to consult a psychiatrist to prescribe anti-depressant. “The majority would opt for the psychiatric approach because we are more familiar with doctors.” “The drugs take their effect at a faster rate due to the chemical reaction in a person’s brain reacting to the anti-depressant. It is reliable, but the effect wears off and the patients become

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cases, both. According to Joel, there is no one solid reason for depression. It comes differently to different individuals. Some may come from the outside factors, such as failing an exam, sense of disapproval, feeling betrayed and stressed, while some come from the biological reasons, such as menopause, going through puberty, and even inheritance from previous generations. Some may come in stages, while some feel like they have been hit by a train and at that very moment, things go south. A depressed person may find themselves in the state of prolonged sadness, loss of focus, low self-esteem, weight fluctuations, pessimism, insomnia or parasomnia, loss of interest, unex plained fear, indecisiveness and lack of motivation, just to name a few of the symptoms of the disorder. If left unattended,

dependent to the drugs whereas the psychological approach consumes time, but the effect is long lasting,” says Joel. “I would recommend both to have a counselling session with a psychologist in a calmed state. Once coping shows improvement, we can taper off the medicines before finishing the therapy

One of the frontline treatments of depression is psychotherapy which is what they do at The Mind”. - Joel

modate patients facing difficulties getting to their daily therapies. The house, currently open to only women, can accommodate 10 persons at a time. Advocacy through education Dr Ang says the association also promotes advocacy through education. “We inform the public and caregivers on what mental illness is and how they can manage their loved ones suffering the condition.” She explains that its key public education programmes are talks and seminars for caregivers, which are important as support from family and friends is crucial to mental patients.

“We organise a two-day intensive course four times a year on understanding mental illness. We also organise a three-day seminar for people living with mental patients as a way to teach them the proper way to manage and take care of them. “It is important for these caregivers to know the proper way to handle and manage family members suffering from mental illness. They are the ones who live with them and see them every day.” Apart from in-house talks and seminars, MMHA also reaches out to companies by educating and spreading awareness about mental illness so that they have a clearer

It is important for these caregivers to know the proper way to handle and manage family members suffering from mental illness. They are the ones who live with them and see them every day.” – Dr Ang

view of their employees’ wellbeing. Preparing for the challenge At its foundation, MMHA is dedicated to mental illness, by either supporting and rehabilitating people with mental illness or educating the public about it. The association’s centre is small and quite hidden, which may deter the less initiated ones from finding it and seeking help for mental illness. Dr Ang laments that it is hard for the association to get volunteers to manage the centre and

COMFORTABLE: The MMHA halfway home offers adequate space for patients who can’t afford to go back and forth from their homes daily during therapy.

session,” he adds. Anyone can get depressed. Which means that our closest family members or friends can be in a state of depression and it is possible we have been missing every single clue they have been transmitting to us. Some may not know they are depressed, just like Denise. Take time to understand the people around you. More often than not, depressed friends would likely to disclose their feelings with you. Joel calls us to take it seriously and that depression is nothing to be ashamed about, especially when it comes to seeking help. Everything will be okay in the end, if it’s not okay; then it’s not the end- John Lennon.

help patients undergoing therapy. Yet to say the work that the MMA is doing is admirable is a gross understatement. The association, represented by its officer bearers and volunteers, is shouldering a huge weight, which is mental illness, a condition that can greatly impact the lives of people suffering from it, as well as their loved ones and caregivers. Let’s play our respective roles by gaining a better understanding of mental illness and how we can collectively destroy the stigma attached to it.

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AUGUST | 2016

Sharing their burden Let’s not add to struggles of those with compromised mental health, but lend helping hand to ease their load By Norman Hussaini

aying someone has problems with his state of mental health may imply the person is going mad. While it doesn’t mean there’s no such thing as people going mad, it’s wrong and too simplistic to generalise that those suffering from mental conditions are in that “mad” category, as there are different types of mental illnesses. Unfortunately, this negative stereotype or stigma is what people with compromised mental health constantly struggle with. Public perception of them is mostly negative, which is generally misguided. Apart from having to struggle to cope with their mental wellbeing, they also have to put up with such negative stereotyping and stigmatisation, and often times discrimination as well. Due to this negative perception, people with depression often have to put up with others – often with good intentions though ¬– telling them to “just cheer up” and “stop being sad”. Worse still, some people who are mentally challenged are even shunned and put in special homes, while those with schizophrenia and bipolar are hardly understood and therefore largely ignored by society at large. One can only imagine what all these people have to constantly go through just because of their mental conditions. To lighten their burden, we need to develop a better

understanding of their mental conditions and daily struggles, as well as to discard the negative stereotype or stigma attached to such people in need. Let’s take depression, for example. The common misconception is that it’s only sadness and one should just get over it. It is important to recognise that depression is, in fact, a clinical condition which can greatly affect a person’s life. Clinical depression According to Associate Professor Dr Ng Chong Guan, a consultant psychiatrist at University of Malaya Specialist Centre, someone who is devastated from the passing of a loved one, for instance, but is still able to take care of one’s self and be productive is not clinically depressed. “Clinical depression is

HELPING HAND: Dr Ng explains the need for people with mental problems to come forward and seek help.

a persistent low tide of emotion which impairs the functions of a person. He can’t work, socialise or even take care of himself. These are the symptoms a psychiatrist will look for to identify depression,” he explains to Health+. So what actually triggers depression? Dr Ng says no conclusive, single source of depression has been identified so far, but psychiatrists do have some theories. “Looking at it from a biological standpoint, it is said there are some neurochemical changes in the brain which researchers are looking into, such as the levels of serotonin, dopamine and epinephrine which affect the state of mental health and may lead to depression,” he explains explicitly. Dr Ng points out from a psychological point of view, depression is caused by how a person copes with tragedies, stresses or lack of social skills. “These play important roles to identify depression and are the factors which can be the stepping stones to a possible treatment.” Social stresses are a prime indicator of depression. Apart from work, family and financial stresses, social networking unbound by the use of the Internet nowadays may also lead to the condition. Some theories propound that depression can be inherited, which means children of depressed people are more likely to be depressed when they grow up. The bitterness of living with depression often takes a heavy toll on someone’s wellbeing, and the counter-productive comments of some insensitive people only add salt to the injury. And very often it also affects the person’s willingness to seek help. There are still many depressed people out there who are not being properly diagnosed and treated, and some may even be

Clinical depression is a persistent low tide of emotion which impairs the functions of a person. He can’t work, socialise or even take care of himself. These are the symptoms a psychiatrist will look for to identify depression.” – Dr Ng escalating to a point of committing suicide. Let’s not wait until it’s too late! As a caring society, we should share the burden of those with compromised mental health. Let’s support them and give them strength to be released from the grips of their conditions. Why should they suffer alone? And why should we just shrug their struggles off like dust on our shoulders? We should all be supportive if any family member or friend is going through such a mental struggle. When someone hits a brick wall in life, we should be there to help the person get back on his feet and continue on. A helping hand can mean a lot.

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2016 | AUGUST

Quotes toinspire “I hated every minute of training, but I said, ‘Don’t quit. Suffer now and live the rest of your life as a champion.” – Muhammad Ali boxing heavyweight

Suicidal symptoms Duration differentiates between being in normal state of sadness and clinically depressed

By ALI-AZMIN HASSAN

ne may ask what’s the correlation between mental illnesses and suicide. Does one have a higher tendency to commit suicide if they have a prevailing mental illness, such as clinical depression, anxiety disorder, bipolar disorder, and many more. Health+ met with Dr Joseph Jacob, an adult psychiatrist of Valley Psych Human Development Centre in Bangsar, to talk about the matter and how it affects people with such conditions that can lead to suicide. Dr Jacob says they either have the symptoms because they are predisposed to a higher level of stress that are affecting the mind, thinking and judgement, especially so in depression when everything is nega-

tive. And they have this thought that because everything is so negative, there’s no point in living. It’s because of this illness and not because of their normal thinking. “People who suffer from depression have 50 percent chance of suicide attempts. When we look at suicide in general, about 75 to 85 percent of them are depressed. Schizophrenia, depression, substance abuse, and personality disorders are the main psychological disorders that lead to suicide. A person with schizophrenia have 50 percent chance of attempting suicide. Anxiety disorder, social phobia, and OCD also have high risk of suicide. But the main thing is depression,” says Dr Jacob. Dr Jacob says: “People who hide in suicidal thoughts would indicate way much earlier. Most suicide attempts that were successful have been spoken to close friends or families. They do actually tell people and try to get help. When people show how unhappy they are, how much they have changed in life, how much they have

isolated themselves, how much they are not functioning at work ... these are the things people should be aware of and observe”. “We all feel sad sometimes, we all feel happy at other times, but usually there’s a clear cut reason for it. The difference between normal state of sadness and being clinically depressed is the duration. If the duration is extremely long compared to the cause, we call it pathological. If there’s no reason for it, if the person becomes depressed and unhappy for no reason, that is also what we call pathological. Other than that is how sad the person becomes. If you lose your favourite pen and you become sad as if somebody dies, that is also pathological,” he explains. How can we help people, our friends, and our families that have such conditions? “The way we can reach out to them is talking to them, by showing them you care and you’re concerned. Tell them that ‘I think you’re sad. I think you look very sad’”. “And that itself will allow them to talk to you about it. So you must encourage them to talk. If they wish to talk, they will talk. Help is available in many ways like by calling up organisations, counsellors, psychiatrists, or even going to the nearest doctor,” adds Dr Jacob.

We all feel sad sometimes, we all feel happy at other times, but usually there’s a clear cut reason for it. The difference between normal state of sadness and being clinically depressed is the duration.” -Dr Joseph Jacob

“Even the darkest night will end and the sun will rise.” – Victor Hugo poet, novelist “Maybe you have to know the darkness before you can appreciate the light.” – Madeleine L’Engle writer “Once you choose hope, anything is possible.” – Christopher Reeve actor cham pion “I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless and they don’t want anyone else to feel like that.” – Robin Williams actor, comedian “I like living. I have sometimes been wildly, despairingly, acutely miserable, racked with sorrow, but through it all I still know that just to be alive is a grand thing.” – Agatha Christie novelist, playwright

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AUGUST | 2016

Suicide is never the answer Happiness can be found even in the darkest times, when one only remembers to turn on the light

“

By ALI-AZMIN HASSAN

Why did they do it?” people often ask. And that’s the important question, isn’t it? Why? Suicide stories often made headlines because of this prevailing question. But no matter what was dug up, either there’s absolutely no answer, or it’s a sad one. Health+ delves into three reported cases of suicide in Malaysia to further understand the “whys” behind the enigmatic question. In 2010, a 22-year-old teen jumped off the 14th floor of the apartment where he lived. He committed suicide due to emotional distress brought about by the

recent breakup with his girlfriend of four months. His untimely death made headlines due to his countdown of his death. Before he committed suicide, he said his final goodbyes to his sister and asked her to take care of their parents. So, again, why? His father was quoted as saying after his death: “Why didn’t he think about his family as much as he did for a girl he only knew for four months?” The why in this case was likely love, or probably the lack of it. In 2012, a teenager collapsed and died after receiving his SPM examination results. It was claimed that the boy was believed to have consumed pesticide shortly after taking his result slip. The boy told his uncle that he had failed several subjects. In this case, it was perhaps sheer disappointment of not meeting one’s expectations, or

Celebrities also succumbed to suicide Humans are not emotionless. When we hear someone has died, even if we don’t even know the person at all, personally, we empathise and sympathise. Hence, celebrity deaths can be heartrending to some because they could be their heroes. Many celebrities have the charisma and ability to inspire millions of people across generations. Regardless of whether they are actors, singers or songwriters, their positive messages as public figures can really help people pull through in times of need. However, when their heroes who inspire them die, simply because they can no longer inspire themselves to live on, those who have hero-worshipped them are left in a state of confusion. World-renowned personalities who had left us by taking their lives included Robin Williams, Kurt

Cobain, Marilyn Monroe, Vincent Van Gogh and Ernest Hemingway. Despite being public figures whom many looked up to, they’re just like the rest of us – they had their insecurities and self-doubts, as well as lack of confidence, among other personal flaws. The truth of the matter is that heroes whom we admire and aspire to be are just like you and I. Now, whether the deaths involved celebrities or just ordinary people, they are all tragedies in their own rights. But the fact that they were public figures and widely known, their deaths were more impactful to some. Robin Williams was a fine example of this dilemma. The suicide of the beloved actor shocked the world. He won an Oscar for his role in Good Will Hunting, not to mention two Emmys, six Golden

WELL LOVED: Robin Williams’ suicide shocked the world.

maybe those of others. In another reported case, a 27-year-old woman took her own life when she couldn’t bear the loss of her fiancé who was murdered by three parang-wielding men on the eve of Deepavali at her home in Johor. Again, it pointed to loss of a loved one. Most suicide cases seem to raise more questions than answers. We probably don’t know or will never understand the struggles, especially what went through their minds, of these suicide victims in the days, weeks, months or probably years before they ended it all. But there’s always at least one key factor to their actions. Obviously,

the act of killing oneself often stems from depression, and the causes of this sad state of mind vary. They likely went through issues or obstacles they couldn’t overcome, either from heartbreak from love, encountering a terrible failure, or the loss of loved ones. Hopelessness can lead to terrible things. The feeling of hopelessness is like being in a dark void. It’s comfortable being there because facing the truth and moving on is scary. But, perhaps, happiness can be found even in the darkest times, when one only remembers to turn on the light. After all, suicide is never the answer!

Globes, and five Grammys during his distinguished and diverse career spanning almost four decades. And he ended his life by hanging himself at his home, after a long battle with depression. Jim Norton, an American comedian, radio personality, author, and actor, explained the link between comedians and depression. “Over the years, comedy has gone from happy-go-lucky pie-in-the-face jesters to the stuff of the deeply personal and honest with the coming of Lenny Bruce, Richard Pryor and George Carlin. The public began to see, through brilliant material and public battles with

personal demons, that the people who made them laugh the hardest seemed to be enjoying life the least. Maybe all those jokes were hiding something much darker. The cracks in the exterior began to show,” he reportedly said. Yes, Robin Williams made the world laugh, both as a person and through the many characters he played, bringing us inspiration, humour, vision and so many other cherished things. But as they say, the funniest people are sometimes the saddest. And the sad part is, no one will ever know exactly what Robin Williams was thinking and feeling when he made the decision to end his life the way he did. There’s a great lesson we can all learn from Robin Williams’ unfortunate death. Call it a cautionary tale if you will. Depression is not something that should be taken lightly. Robin Williams was someone we thought was least likely to commit suicide. That simply goes to show that even the happiestlooking person can be taken in by darkness. If you know anyone showing the slightest indication of being depressed, always be there for that individual. You never know when that person needs it most.

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2016 | AUGUST

Even men go through depression Causes and symptoms fundamentally similar to women’s, but expectations may differ BY YOUNG SIN YEE

e often hear people saying they are depressed, so much so that many of us hardly pay serious attention to them or their seemingly “depressed condition” anymore. Like stress, depression is a much abused word, and it’s likely that those say they’re depressed are in reality simply feeling temporarily sad or low-spirited. So, what exactly is depression? According to the definition by the University of Michigan Depression Centre, depression is a real illness that impacts the brain. Anyone suffering from depression will tell you, it’s not imaginary or “all in your head.” Depression is more than just feeling “down”. It is a serious illness caused by changes in brain chemistry. Research tells us that other factors contribute to the onset of depression, including genetics, changes in hormone levels, certain medical conditions, stress, grief or difficult life circumstances. Any of these factors alone or in combination can precipitate changes in brain chemistry that lead to the many symptoms of depression. Is it normal for someone to get depressed and when is it a cause for concern? Health+ spoke to Selina Ding, an educational and clinical psychologist with Ding Child and Adult Psychology Centre, to find out more about this sensitive subject. “When we say depression it means the person is in low mood most of the day, nearly every day. They are marked diminished in interest and activities. They often cry. Some may have insomnia or hypersomnia (condition whereby a person has trouble staying awake during the day) problems. They may also have significant weight loss due to poor appetite or increase in appetite than usual. They feel fatigue and have difficulty to concentrate. They usually have low self-esteem. They also feel worthless or guilty and blame themselves, and even may have suicidal ideation or commit suicide,” says Selina. Symptoms Are there any fundamental differences in the causes of depression between male and female? Selina says although there is a higher prevalence depression in women than men, there are no clear differences between genders in symptoms, course, treatment response, or functioning. So, what are the symptoms of a man with a depressive condition? Selina says the symptoms shown by depressed people will generally depend on their personalities, adverse childhood experience, stressful life events, and genetic predisposition. Generally for men, due to cultural and

society expectation, they usually try to play tough and project strong character. Sometimes men do not want to talk about it (their depression) because they find it hard to express their feelings to others due to ego or the trust issue. They also have the cognitive errors that they think there is no point telling others about their problems. Helping the depressed How can a psychologist help a depression patient? Selina says it depends on the factors that are causing a patient to feel depressed. “The factors may be changes in their lives, for example when they had lost their jobs or are facing marital problems that make them feel sad. Some of them are prone to have negative affectivity or affected by the adverse events or upbringing they grew up in.” According to Selina, patients shall see psychiatrists and take medication in order to treat their mental illnesses. Depressed patients can also see a psychologist. The psychologist will also look into the cognitive errors and ask the patients to monitor their emotions and maladaptive behaviour as well. When negative thinking is reduced, positive thinking will increase, so their negative emotions and maladaptive behaviours will be reduced.” Selina says depressed men need the support of others, such as their wives, family members, friends or even colleagues. “A depressed patient needs to generate more positive thoughts to neutralise the negative thoughts so that they can fight depression. After that, they need to build back or enhance their self-esteem. For a depressed patient, it takes a longer time to build up his self-confidence. They have to learn to accept themselves and be always mindful of what they are doing.” They need to exercise, learn to stay positive, be active and lead a healthy lifestyle. A psychologist facilitates therapy with the patient step by step aiming to diminish depression,” says Selina. Last but not least, relaxation plays an important role. Apart from relaxation, it is so important to b re at h c o r r e c t l y. She says many people forget how to breathe properly.

Pushy parents drive children to depression Depression in children is an increasingly recognised problem in our fast-paced and demanding society. Factors leading to child depression may come from environment stress, peer or social pressure, parents’ overly high expectations, learning environments that are increasingly more competitive, as well as fear of being punished or fear of losing out. Selina Ding, an educational and clinical psychologist from Ding Child Psychology Centre, likens a child to a blank sheet of paper, and how he or she will turn out to be will depend on what adults put on the child. “The materials include guidance, bonding, upbringing values and environment, as well as expectations. The amount we put on children will decide what they become in their lives. Every child is born with a certain personality traits which we cannot change, but what we can do is just modify it,” she explains. According to her, children often find it hard to bond with their tiger parents who always use the scold-and-punish method to educate them. “They will also send their children to tuition and different enrichment classes because they set high expectation on their children’s performance.” Parents’ overly high expectations Due to overly the high expectations of such tiger parents, their children often feel they are not good enough compared with their peers. “Attachment between children and their primary care givers is important for children during their growing-up stages. Such attachment will affect the development of their self-esteem, confidence and character. However, their training is more on academic achievements and talents. Hence, they are unable to solve their problems despite doing well in their studies,” says Selina. Depression tends to develop naturally in many communities because children’s self-worth is being appraised by their level of achievements. Such stereotyped discrimination indirectly induces stress on children because no child wants to be categorised as the worst. “In fact, rejection can also occur,” says Selina. Additionally, it is possible depression is hereditary. However, Selina points out that it does not mean that if certain family members have depression, the child will get it genetically. She explains that like attention deficit hyperactivity disorder (ADHD) or autism, depression is linked to the brain and nervous system. Environmental and social factors She says some children develop mental health problems due to environmental and social factors. Environmental hazards during pregnancy, during birth, or after birth can possibly predispose mental health problems. “Sometimes, it is not the mother’s fault but the foetus simply does not develop well during pregnancy, or many traumatic stress to the babies during delivery and after birth.” Social factors, Selina explains, can also affect their thoughts, beliefs, emotions and behaviours. Environmental factors such as bad school experiences, broken home or abuses can make children upset in the long term. The duration to recover from depression varies from one person to another. Selina says the recovery process will depend on the causes and severity, which can differ in every case, and also the patients’ willingness to change their cognitive errors during treatment. She uses the transdiagnostic approach to try to educate her young patients. The benefits of transdiagnostic approach include honing in on common psychological processes that underlie clinical symptoms rather than focusing on discrete diagnostic entities.

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AUGUST | 2016

Indian community at higher risk Indians had the highest suicide attempt rate at 3.67 per 100,000 population

By PRASAD CHANDRA SEGARAN

uicide is often viewed as one of the easiest ways to escape from problems. Perhaps, it is all about facing the fear and being pushed to a corner where you can’t escape. In Malaysia, the suicide rate is at a worrying level. A survey on suicide attempts from 1969 to 2011 published in the AsiaPacific Psychiatry journal in June last year showed that the suicide

rate among youths was 1.03 per 100,000 population in 2009 with 66% of them male. The Indian community had the highest suicide attempt rate at 3.67 per 100,000, followed by the Chinese at 2.44 per 100,000 and Malays at 0.32 per 100,000. Indians were the highest suicide completers (40.4% and 5.6 per 100,000). The most common method of suicide was hanging (56.6%) followed by self-poisoning (15.1%) by consuming poisons, pesticides and weed killers such as paraquat. Health+ spoke to K A Gunah, marriage/parenting educator and trainer of Yayasan Strategik Sosial

to understand the high incidence of suicide among the local Indian community. Yayasan Strategik Sosial was set up by the Malaysian Indian Congress (MIC) to develop a holistic, systematic and an integrated approach in addressing the social problem faced by the Malaysian Indian community. Gunah says many suicide cases were linked to mental depression. “It is common for schoolgoing children to face mental depression due to educational pressure and family issues,” he says. “Mental disorder can be also passed down genetically. If the earlier generation suffered from mental depression, then most likely the current generation could carry the condition as well. Their children are genetically vulnerable to suicide,” says Gunah. He says children growing up in broken homes are traumatised when they witness domestic violence, parents misbehaving due to alcoholism, or when they are neglected by their parents. These are some contributing factors

that cause children to grow up vulnerable to life’s challenges. “The tendency of suicide is high when a person is mentally unhealthy,” he adds. According to Gunah, economic reasons are not among the key factors that drive people to suicide. “Perhaps if a person is being pushed to a dead end with complicated financial issues like loan shark and bankruptcy problems, he may tend to be mentally depressed and this could lead to suicide. This situation occurs when the person can’t help himself or is being neglected by the people around him. Generally speaking, poverty is unlikely to drive someone to suicide, unless the person is facing mental illness or can’t cope with life’s pressures.” Gunah advises people with financial problems to consult a professional counsellor or psychologist for counselling, and a psychiatrist if the problem can lead to clinical depression. He says if they keep to themselves and don’t share their problems with others, their depression may become worse, and this may even lead to suicidal tendency. “However, such cases are rare,” he says. Parental role Gunah says parents play a key role in their children’s lives. “I had surveyed thousands of students and all of them had different perceptions of their parents. The common factor in the community is that parents give high priority to their careers and building luxury lives,” he adds. He continues by saying many parents have high expectations of their children, without considering whether they have the capabilities to succeed. “Parents should understand their children and walk the correct path together with them. Building good mental health is very important as the children will learn how to overcome crises and challenges in their lives. Parents must prepare their children for life’s challenges.” Gunah states that the general public should pay more attention to strengthening their mental health as well as educating the younger generation to overcome stressful situations in life. In a nutshell, people often say suicide is what a coward would do when he is not brave enough to live, but then attempting suicide takes a lot of guts too. So why not fight life’s challenges with the guts you have. That’s certainly a braver option.

It is common for schoolgoing children to face mental depression due to educational pressure and family issues.” - Gunah

• 09

2016 | AUGUST

Ramadan is here!

challenge it poses for some. Fasting in its essence If you were to look up the word fasting in the dictionary or type in the word on google the result would explain that it is a willing abstinence or reduction from some or all food, drinks, or both, for a period of time. There has been numerous scepticism surrounding the practise of fasting, as some might say it is the same as starving oneself. Numerous studies however, have proven that fasting can be advantageous for our health.

Studies show fasting can be of advantage to us

By norman hussaini

a l ay s i a is wonderful. The diversity of culture and way of living surrounding the nation is one that is quite unique. This multicultural backdrop we live in invites the sharing of our culture among different ethnicity in the country.

It is by this harmonious sharing of culture that we are able to talk about the benefits of fasting here in Health+. Ramadan is upon us – and for Muslims all over the world, it is a month of self-reflection, continence and preservation. Fasting is not a practice exclusively for Muslims, as there are varying types of fasting which entails different ways of practising it. To commemorate our Muslim brothers and sisters in Malaysia however, I would like to take this opportunity to talk about the benefit of fasting and the surprising

How beneficial is it? As the spotlight is being shined upon Ramadan, let’s talk about how not eating and drinking during daytime can be a good way to shed PATIENCE: The famous murtabak, a staple in every Ramadan bazaar across Malaysia.

those extra kilogrammes off the scale. In a normal setting, our bodies’ main source of energy comes from glucose. Glucose mainly comes from sugar and carbohydrates, which Malaysians are so accustomed to have on a daily basis. But, with fasting, it is possible for our bodies to gradually switch from glucose to fat as its main source of energy. And when our bodies are using fat as energy, presto! Weight loss in the works. Things however, are not that simple. For our bodies to make that switch, it is essential for us to keep a well-balanced diet. Too much carbohydrates and sugar before and after the fasting period will result in nothing but despair. This, I feel, is the cause for misery for many Malaysians during Ramadan. I am talking of course, about the Ramadan bazaars. The challenge we face Ramadan bazaars are synonymous with fasting during the holy month. This is when we can see rows and rows of delicious foods being sold to accompany the breaking of fast at dusk. It is a challenge for us to try and have a well-balanced diet during these times. A proper way to fast is to still maintain a healthy diet. A great amount of self-control and discipline is needed to help ourselves shave of those pounds during Ramadan. The entirety of this article does not however, say that Ramadan is all about losing weight. Islam tells that fasting provides a gateway to better self-control and selfreflection. It is a time to abstain not only from food and drinks, but from negative thoughts and bad behaviour as well. The spirituality aspect of Ramadan is emphasised more in general, but it is a great opportunity for us to get the physical benefits while at it.

Have dates BY NORMAN HUSSAINI Dates are probably the oldest cultivated fruits in the world, dating back from Babylonian times. It is rich with a multitude of nutrients and vitamins, making it one of the best whole foods to have. A staple treat during Ramadan is widely known to have immense health benefits. The benefits have been welldocumented over many years. They are cholesterol-free, very low in fat, rich in vitamin A, C and various B vitamins while also packed with protein, dietary fibre, iron, potassium, calcium, manganese, copper,

and magnesium. It is proven to help with intestinal problems, such as constipation and diarrhoea. It is a wonder how a mouthful of these nutrients are packed into a such a small, dry fruit. It should also be known that dates packs a lot of fructose. Fructose content counts for a whopping 80% of the fruit. So can it still be considered healthy when it packs that much sugar? Well, like every single thing we eat, too much is never healthy. Essentially, dates are considered healthy and beneficial because of its nutrient content. Magnesium found in dates is

SWEET TREATS: The nutritional value of dates outweighs its sugar content significantly.

found to be anti-inflammatory, which effectively reduces the risk of cardiovascular disease, arthritis, and Alzheimer’s disease, among others. The fibre can also promote better digestive health. And vitamin B6 also found in them has been recorded to boost brain performance. For Muslims fasting this Ramadan, it is found that having a few dates before eating your meal during Iftar helps you to

not overeat. All of the benefits we get from dates outweighs the sugar content by a wide margin. In diet, like in many things, balance is everything. If you are consuming sugar, why not also consume those mouthful of nutrients while you’re at it? So do not get tethered by the sugary content of dates as it is far better to eat them then to drink a can of your favourite carbonated drink.

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murtabak, malay kuih, ayam percik and various colourful beverages – to name a few, it is a challenge to keep a healthy diet during the fasting period. Health+ decided to get in touch with chef Marina Mustafa for advice on how to be healthier for Ramadan.

A chef’s guide to a healthier Ramadan Chef Marina Mustafa shares her knowledge and tips on commemorating the fasting month, the healthier way. by norman hussaini

ime and time again, we have gone through Ramadan with either enjoyment, enlightenment or a new resolution. Yet for the celebration of the holy month, one thing is enjoyed by all Malaysians regardless of religion.

I am talking of course about our Ramadan bazaars. It has become a tradition to trot along the rows upon rows of mouthwatering street food and see which to take home for breaking fast. It is heart-warming even to see nonMuslims joining in the festivities. The abundance of food however, can be disadvantageous. With huge offerings of our favourite

GRILLED: Hawkers cooking our favourite treats, a typical scene in Ramadan bazaars.

Do we have a problem with our diet? We know that Malaysia was crowned the horrible title of Asia’s fattest country quite recently. So it would seem that we generally have a problem with keeping healthy diets. But it was not like that from the start. “Our parents and forefathers ate well within their means and their food was natural, unprocessed and well-balanced. It is only when we were introduced to fast food and processed food that we became unhealthy as a nation,” says Marina. She also points out that our lifestyle of eating out more than cooking at home contributes to the problem. “If we could revert back and start consuming true Malaysian home cooked meals like our forefathers did, we would not be having health problems as we do now.” Ready for Ramadan With the aforementioned blessing of food in Ramadan bazaars, Marina encourages us all to be wise and conscious when choosing what to buy and most importantly to buy only what will be eaten. The latter

advice is also an issue during the fasting month. We have all been guilty of buying more than we can eat when strolling along the bazaar once or twice before. “Try to choose healthier, more balanced and fresh dishes when you are buying from bazaars,” she relates. A starting point There is another view of fasting some people look to besides a compulsory practice for Muslims. It is also a good way for us to lose some weight. According to Marina, maintaining a healthy weight should be a lifetime habit and not only for Ramadan. However, she says that Ramadan can be starting point where we practise self-control and restraint. Benefitting the physical aspect of the fasting month is always a bonus, and to maintain our consumption of food is important for a healthier living. The perfect Ramadan practice Marina recommends us to spend more time cooking at home instead of eating out this Ramadan so that we have more control over what we eat. Try to use as many fresh ingredients as you can and avoid processed food. Most importantly however, she advises all to carry through what we practise during Ramadan throughout the year and lead a healthier lifestyle during and after the celebrated month.

Try to choose healthier, more balanced and fresh dishes when you are buying from bazaars.” - Marina

COLOURFUL DELIGHT: Mouth-watering drinks are a staple, but can be unhealthy.

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Packing off habit World No Tobacco Day advances the attempt to tackle the ever-present issue with smoking.

By norman hussaini

here were times when looking at gruesome pictures of abnormalities caused by medical conditions a hard thing to do. The ones who are exposed to such images were mainly doctors and nurses. And to be honest, who would want to see them anyway? Yet those times of the public stripped of the access to view such images are long gone. I am not however, talking about the Internet. I am talking about those neatly packaged, paper cylinders filled with tobacco that people love to smoke. As with various products, one of the most important factors to consider when promoting it is how well the packaging is. Companies producing foods, toys and accessories – to name a few – had their packaging team key to their success for years. Cigarettes are no different. An effort to discourage

smoking was to add those terrible pictures we see on cigarette packaging. Yet this year’s World No Tobacco Day observed on May 31 is to get cigarette packaging be even less interesting for consumers. Themed ‘Get Ready for Plain Packaging’, WHO aims to get more of its partners to pass the law to enforce plain packaging as mandatory for cigarette producers. According to WHO, plain packaging is an important demand reduction measure that reduces the attractiveness of tobacco products, restricts use of tobacco packaging as a form of tobacco advertising and promotion, limits misleading packaging and labelling, and increases the effectiveness of health warnings. Plain packaging of tobacco products refers to measures that restrict or prohibit the use of logos, colours, brand images or promotional information on packaging other than brand names and product names displayed in a standard colour and font style. Guidelines to Articles 11 and 13 of the WHO Framework Convention on Tobacco Control (WHO FCTC) recommend that

JUST SAY NO: The want to stop smoking or to reject an offer to smokehas to come from us. Efforts made by various organisations are only to help quitting easier.

An example of WHO’s proposition to impose plain packaging in lieu of World No Tobacco Day 2016. are only to help quitting easier.

No more smo-king BY NORMAN HUSSAINI Have you ever seen a sign that tells you not to do something, yet people are doing the very thing they aren’t supposed to right next to it? I would bet my bottom ringgit that as Malaysians, we have seen people park their cars at a “No Parking” sign or garbage bags arranged neatly at a ‘No Littering’ sign at least once or twice before. The same thing is happening for smokers in the country. The ability to ignore a clear and obvious “No Smoking” sign while puffing away is a head-scratcher. To be clear, I am not generalising Malaysians who smoke, but the few cigarette puffing bad apples who smoke in no smoking areas puts other in a bad light.

One of the reasons some smokers ignore no smoking signs is because no enforcements are being done to regulate the law. The Ministry of Health took the initiative on May 12 to tackle the issue with an operation dubbed OPS PUNTUNG. The operation was done across Malaysia and were focused on premises, such as hospitals and health clinics, restaurants and shops with air-conditioning, bus stops and train stations, as well as government buildings and shopping centres. The operation also penalised premises failing to display proper no smoking signs and smokers who are not of legal age. The initiative was also one of the efforts done locally to commemorate this year’s World

Dr Wan Mansor speaking at a press conference for OPS PUNTUNG.

parties consider adoption of plain packaging. Plain packaging builds upon other measures as part of a comprehensive multi-sectoral approach to tobacco control. Policymakers, civil society and the public can take action to ensure that their governments consider adoption of plain packaging. This ruling has been pushed by WHO for a few years, with Australia currently implementing it while France, Ireland and the United Kingdom are looking to do it by this year. It has met with strong objections from tobacco companies for obvious reasons.

further support people who are looking to quit the smoking habit was done earlier this year with M Quit Services. The M Quit Services is an accreditation programme where clinics and pharmacies jn Malaysia can partake, allowing them to offer smoking cessation services which are in line with ministry’s guideline. Another initiative taking aim at smoking by the ministry is the Blue Ribbon campaign. This is a campaign which is similar to M Quit, the difference being that the campaign offers accreditation to various organisations promoting a no-smoking culture in the workplace.

The Malaysian effort Taking a different approach from plain packaging of cigarettes, the Ministry of Health had taken the initiative to further enforce the no-smoking laws already in place in the country. May 12 and 13 were taken to launch the first OPS PUNTUNG operation focused on penalising the public smoking in smoke-free zones around Kuala Lumpur and Putrajaya. The theme set for the national level commemoration of World No Tobacco Day is ‘Don’t Be Deceived, Smoking Endangers Health’. In lieu of the theme, the ministry led by the Deputy Minister Datuk Seri Dr Hilmi Yahaya officiated at a private hospital in Penang on May 14. Recent ministry move to

It comes from us I personally have tried smoking during my school years (peer pressure, what can I say), and was lucky to find that cigarette smoke appalling. A lot has been done over the years to strengthen the awareness among the Malaysian public about the dangers of smoking, and a lot can still be done. To change someone’s daily habit is not a walk in the park. No one can be forced into quitting. Be it plain packaging, making smoking cessation clinics more accessible, accrediting those who support smoke-free lifestyle and penalising those who smoke in prohibited places – if a person doesn’t want to quit, he will never quit. The want to lead a healthier life, to quit that bad habit. It comes from us, and from us only. A type of medication is always valued by how much the benefits outweigh its risks. That is why some widely prescribed medication now still comes with negative side effects. But for a cigarette, there are no benefits outweighing the risks. So why even smoke when knowing that fact?

No Tobacco Day. Representing the ministry as well as the Kuala Lumpur and Putrajaya Federal Territory Health Department was deputy-director Dr Wan Mansor Hamzah. He says the aim of the operation was to continue discouraging smokers in the country, while promoting a culture free of tobacco. “The ministry hopes to raise the awareness of the dangers of smoking as well as to decrease smoking activities among Malaysians. A primary step that can be taken towards this aim is to forbid smoking in places where it is clearly prohibited,” he adds. Data gathered from the Health Department of the two-day operation found that an amount of RM245,350 fines were issued to wrongdoers nationwide, with 989 notices given out. The most prevalent smoking offences found in Kuala Lumpur and Putrajaya were in shopping centres and government premises with both

accounting to RM 22,750 in total fines issued. This operation will be intensified in the coming months and will be a continuous one, says Wan Mansor. OPS PUNTUNG will also focus on cities outside of KL and Putrajaya, enforcing the law to a wider area around the country. Bringing it to full circle, the operation is only one of the many efforts to promote a healthier lifestyle by staying away from tobacco. The dangers of smoking are already well-documented, and the knowledge is well-known to smokers and non-smokers alike. One can only hope that this unhealthy lifestyle can be changed to a healthier one soon. Smoking doesn’t just harm the smokers, but it also puts innocent bystanders at risk with second hand smoke. This is why a stronger, more impactful awareness should be implemented among Malaysians, and people around the world for that matter. Only time will tell.

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Call for genetic counselling Malaysian study shows one in nine ovarian cancer patients inherit an altered BRCA gene.

prevalence in altered genes that heightens the risk of ovarian and breast cancer is a reality as findings and studies in developed countries have found. The matter is being brought to attention among Malaysians following a new study done locally. A Malaysian study, which was published in the top women’s cancer scientific journal Gynaecological Oncology, revealed one in nine ovarian cancer patients inherited the BRCA1 and BRCA2 mutation. The findings of the first comprehensive Asian study suggest for the first time that Asian women with epithelial ovarian cancer should be provided with genetic counselling and considered for testing of germline alterations in BRCA1 and BRCA2. It was previously thought that the frequency for mutations was much lower in ovarian cancer compared to breast cancer patients, and that only individuals with a relative affected by breast or ovarian cancer was at risk of being a carrier.

The study showed that one in nine ovarian cancer patients is a carrier, with four in 10 carriers without a family history of breast or ovarian cancer. This means that the current practice of offering genetic counselling and genetic testing only to women with a family history would be insufficient. Prior studies in Caucasian population have shown that the one in eight Caucasian women with epithelial ovarian cancer has germline alterations in BRCA1 and BRCA2, but it was thought that this higher prevalence was because of common mutations found only in the Caucasian population. The Malaysian study is the first to show that the proportion of ovarian cancer patients with genetic alteration in BRCA genes is similar in Asian and Caucasian women. Each year, nearly 500 Malaysian women are diagnosed with invasive epithelial ovarian cancer. Yet, few have access to genetic counselling and genetic testing because it was thought that the mutations are rare and the test was too expensive.

“To me, finding out whether there is a genetic risk to ovarian cancer enables women to be empowered to make choices that could save their lives, particularly for ovarian cancer where there is currently no good screening method,” said the study’s author and adjunct professor at University of Malaya Dr Teo Soo Hwang. Dr Teo is also head of the Breast and Ovarian Cancer Research Programme at Cancer Research Malaysia (CRM). “These data are so striking but what these results mean to the individual patient is unique to the patient and her circumstances. It is never just a matter of offering a genetic test, but this must go handin-hand with genetic counselling,” adds consultant Gynae Oncologist at University of Malaya Professor Dr Woo Yin Ling.

Dr Teo says that although BRCA1 and BRCA2 genes were discovered more than 20 years ago, few women in Malaysia have access to genetic testing in part because of the cost. In this study, we have also reported a new method that we have developed with University of Melbourne where the test can now be offered for less than RM1,500 compared with the current market price of more than RM5,000 per patient. The study is a collaborative effort by Cancer Research Malaysia, University of Malaya and University of Melbourne with funding from the Ministry of Higher Education, Sime Darby Foundation, Petronas, and a few others.

types of cancer however, that are more hereditary than others. Two of them are ovarian and breast cancer. “These are due to certain genetic factors. If you are carrying a certain genetic change in some of these genes, it actually increases your risk in getting ovarian or breast cancer. “The genes being referred to are the BRCA1 and BRCA2. The two genes are very important genes in our normal cell physiology as it acts as tumour-suppressants which

repairs the structure of our cell structure. So, if there are changes or mutations in these genes, it gives a very high risk of increase of the two cancers,” she explains. The disease knows no discrimination of the sex as the mutations could also exist in male thereby heightening the risks of breast, prostate and pancreatic cancer. The recent local study of BRCA genes mutation leading to ovarian and breast cancer is the first to bring the relevance of the matter to Malaysians specifically. This has brought fresh interest into the field, and CRM is advocating Malaysians to get genetic consultation as a preventative measure for cancer. In conjunction with World Ovarian Cancer Day, CRM has a research programme set up whereby patients diagnosed with ovarian cancer will be given the opportunity to go for genetic testing to know their status. “On our part, the programme is a way for CRM to identify how

Dr Teo (left) and Dr Woo are two of the researchers responsible for the Malaysian research of BRCA genes.

CRM calls for genetic testing By Norman Hussaini If you have heard of the famous actress Angelina Jolie, then you would would also have heard about her brave decision back in 2013. As a refresher, she had found that she was inclined to getting breast cancer through genetic testing. What makes the story more interesting was she decided to perform a double mastectomy, basically got rid of her breasts to prevent from getting cancer. Her decision was an inspiration to countless since. The event however, raised many questions among the public, mainly about the so-called genetic

testing and how it could identify if someone would be more inclined to get certain types of cancer than other people. Genetic testing is not something new, but the understanding of it is still rather lacking among the population. Giving her thought on the matter, genetic counsellor and head of Familial Cancer Research Group at Cancer Research Malaysia (CRM) Yoon Sook Yee explains the essence of genetic testing and its availability in Malaysia. She started off by explaining that cancer among the majority is regarded as sporadic and random occurrences. There are certain

TEST AGAINST CANCER: Yoon explains that genetic counselling can be an effective preventative measure to cancer, if not to detect it at an early stage.

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I truly believe that we should all be more aware of our well-being and should go for health screenings regularly. With genetic consultations now, it is even more easier to take preventative measures...” - Jackie office when he told her that she had stage-two ovarian cancer, and that she should ask her husband to come the next day to take the next step. Her luck turned even more sour the next day – her husband’s hand in hers – when she found out that she had to undergo operation to remove her womb to minimise the spread of the cancer. Her incredible strength to keep moving forward had put her in the operation theatre waiting for surgery. It was during the surgery, when most of the surgery was done and she was on the operation table waiting to be led out that she prayed. She prayed with all her might for strength to keep fighting, prayed that she will be able to continue taking care of her husband, mother, and children. Her prayers were answered spectacularly, given her current presence as she talks to Health+. After the successful surgery, she went on to undergo chemotherapy. It was harder for her family seeing her going through the treatment than her herself. Her children asked her if she was really going to go through the treatment. Besides being in pain, she would lose her hair in the process, said her children. Not shaken by even an inch, she went to the barber and quickly shaved her head and continued on with chemotherapy. She drove herself to chemo most of the time, bringing along lunch that she herself cooked. When she got back, she was up doing chores and cooking for her family. Her unrelenting strength made her journey to beat cancer

Escaping cancer A story about how a woman was able to beat cancer with sheer willpower, bravery and love for her family

By norman hussaini

ackie is a person leading a simple life. She cooks for her family, she drives her kids to school and she and her husband takes care of her mother at home. The

many carriers of the mutated BRCA genes currently are in Malaysia and to understand the psychosocial issues that may go along with it,” says Yoon. Genetic consultation is now available for Malaysians, and the cost to undergo testing has been dropping in recent years. “There are a few companies in the country offering genetic testing where they would send samples to labs overseas. “As CRM now is collecting data, genetic consultation for the public can be done in University of Malaya Medical Centre as well,” she adds. With the ongoing research, CRM aims to accelerate the overall understanding of how the changes in genes can heighten the risk of cancer while advocating the initiative to go for genetic consultation among Malaysians. It also entails better assessment of the cancer among doctors for treating the patients.

life she led was a normal one, and she was comfortable with it. Her comfort however, was turned over on its hind legs when she was diagnosed with second stage ovarian cancer. The feeling she had when the doctor told her was of absolute disbelief. She felt ill, ill to the fact that she did not do anything sinful to deserve her fate. As you might have guessed, Jackie is not her real name, as it is essential to keep her identity sheltered for protection. But, to say that the decision to remain anonymous is a sign of weakness would be incorrect. Her story of overcoming cancer while still being able to go about her daily activities is nothing short of incredible. Jackie’s story starts with an abnormality she noticed with herself one day, when she found that she had been missing her period for three months. She was 47 then, and she felt that maybe she had gone through menopause. But after the third month however, she started to have her period once more. Her initial thought was that maybe her hormones are working again, and she was quite happy. Not until one night as she watched television did she have the notion that something was wrong with her. She saw on television that sporadic menstrual patterns can be an indicator of something going terribly wrong with the body. Her suspicion turned to reality when she consulted a doctor at University of Malaya Medical Centre (UMMC). She was alone in the doctor’s

STRONG TO THE BONE: Telling her story of resilience and willpower as she tackles cancer.

seemed almost easy to some. But it was far from being easy for her, especially during her earlier sessions of chemotherapy. Chemotherapy proved to be the medical field’s cruel soldier, fighting to get you better while still inflicting you with awful pain. At times, she would not be able to come out of her room for days as she would feel irritated and nauseas. She is now in remission and had survived ovarian cancer. Her continued tenacity to live on had attracted the doctors from UMMC to get her to go for genetic consultation, of which she had agreed upon. Life was cruel to her once again when a genetic test confirmed that she was carrying an altered BRCA2 gene, giving her a high risk of developing breast cancer. But she kept her resilience and is now advocating genetic testing for women and men in Malaysia. She is now a healthy looking person, living a happy and healthy life with her family. She is not one to shy away from telling her story, if it means that it can spread the awareness for cancer and the importance of getting tested regularly. “I am blessed to have a very supportive family by my side. I always told people that I was not sick, because I didn’t felt sick. I was a bit unwell, and I took the necessary actions to get better. I truly believe that we should all be more aware of our well-being and should go for health screenings regularly. With genetic consultations now, it is even more easier to take preventative measures. Learn to love yourself and be happy with life,” says Jackie.

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AUGUST | 2016

Walking with haemophilia Edwin and Norhana share their journeys as haemophiliac and carrier

By Prasad Chandra Segaran

aemophilia is a rare disease, yet it is quite prevalent in Malaysia which has about 3,000 registered patients. This bleeding disorder is categorised into two types – haemophilia type A and haemophilia type B. According to Haemophilia Society of Malaysia vice-president Edwin Goh Toke Yen, who is himself a haemophilia type A patient, says he faced many challenges during his childhood. He was diagnosed a haemophiliac when he was only a year old after falling down and started bleeding badly. “According to my mother, after I was diagnosed a haemophiliac, she was traumatised. I am the only child so the news had a huge impact on my parents,” he adds. Edwin is the first haemophiliac in his family. His three aunts are carriers but somehow he got the disease due to genetic factor. His type of haemophilia is more severe than type B. He recalls receiving special treatment from his parents and school teachers knowing that he is a haemophiliac. “My school mates weren’t happy about it as they were caned for doing anything wrong, but I didn’t get any punishment for my mistakes,” he says with a grin on his face. However, one day a replacement teacher caned Edwin over a mistake and he had bruises the next day. His concerned parents went to his school to inform the teacher about his haemophiliac condition. “This was quite hard for me because I was not treated as a normal child in school,” says Edwin. He wasn’t allowed to play or participate in any game and had to sit on the bench during any sports event in school. After he was diagnosed a haemophiliac, Edwin had to under a treatment called trio. The treatment took at least one to two hours because it took a while to prepare the equipment. After each treatment, he used to experience some slight effects like rashes. As technology grew in the early

90s, doctors can actually extract from a donor’s blood a clotting factor missing or defective in a haemophiliac patient and then replace that factor in the patient’s body. As Edwin lacks factor eight in his blood, the doctor will replace the deficient factor in him with a similar factor from a donor’s blood. “These days, factor concentrate is much easier compared with trio because we can actually do it ourselves at home, and it takes only about half an hour,” he says. Edwin faces many challenges in his working life as very few companies provide opportunities for haemophiliacs. It was tough getting a job as he, as an honest person, felt obligated to inform potential employers of his medical condition. But thanks to Citibank, Edwin is now employed and moving ahead to success. Edwin is grateful to the government for its ample support to haemophiliacs. Most government hospitals, he says, provide haemophiliac patients like him with proper treatment at only RM3 ringgit per session, which is comparatively much cheaper than in private hospitals which charge high rates. The Haemophilia Society of Malaysia (HSM) is a not-for-profit organisation working to provide and improve treatment for people with haemophilia and other inherited bleeding disorders. The society, a member of the World Federation of Haemophilia, conducts workshops for haemophilia patients and the public. “In the middle of this year, we will have a workshop in conjunction with World Haemophilia Day,” says Edwin. “This workshop is mainly to educate the people about the disease and create public awareness.” Other than workshops, the society also organises public forums, treasure hunts, walkathons and premium movie screenings. According to the society’s honorary secretary Norhana Hussain, who is herself a haemophilia carrier, says public support is encouraging as many people have participated in its forums and other activities. Norhana was diagnosed a carrier in 1979 when she was just 15, after stepping on a needle. “The bleeding didn’t stop and so I went to clinic. My parents were

“These days, factor concentrate is much easier compared with trio because we can actually do it ourselves at home, and it takes only about half an hour.” - Edwin

MOVING ON: Edwin is haemophiliac while Norhana is a carrier.

It hasn’t been easy after discovering that I am a haemophilia patient, but I don’t have any fear.” - Norhana very worried seeing the amount of blood caused by a small injury. It hasn’t been easy after discovering that I am a haemophilia patient,

but I don’t have any fear,” she says. A blight of being a carrier, Her three children are also haemophiliac.

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Haemophilia disorder Haemophiliacs tend to lack clotting factor that helps to stop bleeding by Prasad Chandra Segaran

e have seen many instances in life both sweet and sour. However, if the situation is sour, we tend to face it and eventually find a solution. Now, how will one face a minor accident where you have a small cut on your skin or fall down on the floor? The first thing we would do is apply some antiseptic lotion on the wound and bandage it or some may even leave it to heal on its own. Unfortunately, the haemophilia patients can’t react

the same way most people do. Haemophilia is an inherited blood disorder that doesn’t allow blood to clot properly. The haemophiliacs will lack a protein called clotting factor that helps a person to stop bleeding after an injury. They will bleed for a longer period than a normal person with their chances of suffering internal bleeding high. Haemophilia can be categorised into two types, namely haemophilia type A and haemophilia type B. It was reported that 70% of the haemophiliacs A are severe cases. Haemophilia is a rare disorder where it is common in one over

CHANGE IN BLOOD: Blood replacement can help patints to stop the bleeding temporarily.

When someone donates blood, we extract the factor from the blood and replace it into the haemophilia patient. We don’t treat haemophilia disease with any types of steroid or drug.” - Dr Faraizah 100,000 births, while haemophilia type B one in every 50,000 birth. In most cases, haemophilia occurs from previous generation of one’s direct blood relation. This condition is caused due to the clotting factor genes that lie on the X chromosome. Even though haemophilia is a

rare disease, the Malaysian government is giving enough support and awareness to haemophiliacs. Anyone can walk in to hospital and get diagnosed if one suspects so. “The patients can go to any of the government hospitals to get free treatment,” says Datuk Dr Faraizah binti Datuk Abdul Karim, head of haemophilia unit and deputy director of National Blood Centre. How severe can it get if a patient avoids haemophilia treatment? “The patient can still survive if it’s a mild haemophilia, but in cases where if it’s severe, the bleeding will start internally in the head and it can lead to death or joint deformity,” says Dr Faraizah. She says haemophilia patients can live a normal life. It is not transparent that the others can literally see the haemophiliacs. It is not like those days when people have to worry much if they have any diseases. “We are moving towards a developed nation and things have improved to provide the public with proper treatment,” says Dr Faraizah. The haemophiliacs should know about the disease and do research on their own and shouldn’t be burdening the doctors. “They should survey about the disease and have proper precautions in order to avoid critical situation as this disease risks the patient’s life,” she adds. The females have more chances of being a carrier for this disorder. They won’t actually bleed like the typical haemophiliac, but eventually the disease will be passed down to the child. In cases like this the patient has to let know the obstetrician that she is a haemophilia carrier as there are high chances of the baby of being a haemophiliac. After delivering, the infant will be tested and diagnosed early in order to avoid bleeding risks. “We can actually test if the foetus is a haemophiliac or not, but in most cases we don’t tell the parents because we don’t want a situation like abortion to take place. But, in situations where the foetus is bleeding internally, then we don’t have choice but abort the baby,” says Dr Faraizah. The treatment is done by replacing the missing factor in the blood. “When someone donates blood, we extract the factor from the blood and replace it into the haemophilia patient. We don’t treat haemophilia disease with any types of steroid or drug,” says Dr Faraizah. Haemophilia patients are just like others, it’s just that they have some disorder in them. They must be supported to live a productive life and people around them should motivate them to battle the situation. We should know that this disease is not infectious and we wouldn’t want to neglect them from our circle.

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AUGUST | 2016

Tackling thalassemia TAM plans to hold a soccer tournament to get youngsters screen their health

By Prasad Chandra Segaran

halassemia is a bleeding disorder that is caused by the abnormal form of haemoglobin. It is an inherited disease and so there is high chance of passing down the disease to the next generation. There are two main types in thalassemia which are alphathalassemia and beta-thalassemia. In alpha-thalassemia, there is abnormality in one of the alpha globin genes, whereas the beta-thalassemia happens when the beta globin is affected. The situation occurs when a deletion of certain key gene fragmentation. As all diseases, thalassemia has its own symptoms, but that depends on the type of thalassemia. There will be no much symptoms in thalassemia minor, but if it causes it will be minor anemia. The other type of thalassemia, which is beta-thalassemia, causes two major symptoms which are thalassemia major and thalassemia intermedia. T he thal ass emi a-ma jor normally appears before a child celebrates second birthday. The symptoms can be life-threatening like causing fuzziness, failure to thrive, enlarged organs, poor appetite, and etc. Thalassemiaintermedia is less severe than beta-thalassemia because thalassemia-intermedia doesn’t need blood transfusion. However, one affected by thalassemia can live a productive life as there are treatments. There are many types of treatment depending on the type of thalassemia the person has. Blood transfusion can be done in cases where patients have the most severe thalassemia. This is done to replenish the red blood cell levels and haemoglobin. The patients have to do transfusion every four months, but in more severe cases, the treatment will be every two to four weeks. Other than blood transfusion, iron chelation is also an option which means removing excess iron from the bloodstream. Patients may be prescribed with

subcutaneous which is injected under the skin or deferoxamine that can be taken orally. In some cases, surgery will also take place. This happens to the patients with bone abnormalities. Thalassemia is supported by many non-governmental organisation in Malaysia and The Thalassemia Association of Malaysia (TAM) has been doing a great job assisting the Malaysian thalassemia patients by creating awareness on the disease. The problem TAM is facing is to educate the nation on marriages involving both couples who are thalassemia patients or carriers. This will worsen the situation as their child will have a definite chance of getting thalassemia. Datuk Abdollah bin Yunos, the president of TAM, says that he is more into creating awareness among the public as prevention is more effective than cure. “The awareness is usually made to the doctors, patients, and the parents where I don’t think so is reaching the grassroots,” says Abdollah. The awareness must be created to the public and it must be more generalised so that everybody will understand the disease and will be aware of it. Thalassemia is a worldwide disease and we might think it is not so prevalent in Malaysia, but you might be surprised with the number of local thalassemia patients. The thalassemia disease has been growing lately in Malaysia. Perhaps, this is due to the high number of foreign workers brought into Malaysia for work. A full health screening should be done before they are brought into the country. They may have it and it can cause the disease to spread in the country. “As per the survey done by the TAM, most of the foreign workers who are working in the north are thalassemia carriers,” says Abdollah. According to Abdollah, the public are not so concerned of getting themselves on health. “One way to attract the public to do health screening is by organising any sports event, as TAM is mainly focusing on youngsters to be more aware of thalassemia” he adds. TAM is planning to hold a football event for the youngsters as they can have free health screening

One way to attract the public to do health screening is by organising any sports event, as TAM is mainly focusing on youngsters to be more aware of thalassemia.” - Abdollah

EARLY IS KEY: Thalassemia usually detected at an early stage of life.

during the event. The government is throwing huge support to the thalassemia association in order to help the public and for higher secondary school students to be aware of

thalassemia. The target is to educate the students on thalassemia so that they know about the disease and make a proper step avoiding these diseases. “I would say that thalassemia is a gift to you because I can see patients with thalassemia are very close to their parents. People around you pay more attention and your parents create a better relationship compared with their other children. “Appreciate the advantages you get from the disease rather than complaining and regretting the disease you have. By fighting the disease one can live a productive life,” says Abdollah.