Health+ Newspaper November 2015 Issue 01 by Health+ Newspaper

EYECARE+

Seeing vision in a new light ... pages 36-37 THONEH celebrates World Sight Day by raising awareness on eye health

www.healthplus.com.my

NOVEMBER, 2015

RM2.00 ISSUE 01 KDN: PP18743/05/2015 (034197)

THE PULSE OF THE NATION

As at Oct 13, 2015 alone, dengue cases in Malaysia rose to a staggering 96, 811 cases, with 253 deaths recorded nationwide. Recognizing that the most effective way to tackle dengue requires a multi-sectorial approach, the Ministry of Health has often welcomed dengue prevention initiatives led by private companies and NGOs. See pages 02-09 (pullout)

The buzz gets louder BEAUTY+

LOCAL NEWS+

Hospital Shah Alam finally opens its doors ... page 07

Go nonchemical

Herbal and organic products are proven best and safes

... page 30-31

02 •

FOREIGNNEWS+

NOVEMBER | 2015

EDITOR’SNOTE

Welcome to the Health+ newspaper

ELLO READERS! I’d like to welcome you all to the first issue of the Health+ newspaper. This newspaper will serve as an extension of our interests on wellness with articles written by specialist doctors, writers, and contributors and from wire services like AFPRelaxnews. All of the articles have been written exclusively for the newspaper. For many, the public have been devoid of health news or a newspaper that provides information on health and wellness. The Health+ newspaper is not only to educate the public on health and wellness but gives detail information on the various kinds of diseases, its causes and the medications – both modern and traditional. I couldn’t find anything that adds value to our way of life. The Health+ is providing something more than just reading. The Health+ entertains many ideas and put them together for the best read in health and wellness. So, that’s what we are doing. The Health+ will automatically format itself to deliver the optimal reading experience for the public. The design and layout gives a reading experience that’s easy on the eyes - an easy to read newspaper that’s focused on original contents. The Health+ can also be read via the e-edition and is distributed FREE. However, it will be sold at newsstands.

EYECARE+

Seeing vision in a new light ... pages 36-37 THONEH celebrates World Sight Day by raising awareness on eye health

www.healthplus.com.my

The Health+ newspaper is not only to educate the public on health and wellness but gives detail information on the various kinds of diseases, its causes and the medications – both modern and traditional.”

The Health+ will be published monthly. We will also be introducing subscription for those who want the newspaper to be sent to their homes. The style, quality and the experience staff of the Health+ newspaper and its quality contents, will certainly be a perfect window to the world for advertisers and business associates. To this end, we ask or readers and the general public to give us feedback for further improvements. The first issue of the Health+, features some great writers covering the issue of dengue, sight, and osteoporosis – some of the common health problems. I hope you enjoy it!

NOVEMBER, 2015

RM2.00 ISSUE 01 KDN: PP18743/05/2015 (034197)

THE PULSE OF THE NATION

The buzz gets louder BEAUTY+

LOCAL NEWS+

Hospital Shah Alam finally opens its doors ... page 07

Go nonchemical

Herbal and organic products are proven best and safes

... page 30-31

Weak and brittle bones

www.healthplus.com.my

Osteoporosis literally leads to abnormally porous bone that is compressible

... page 10

THE PULSE OF THE NATION

NOVEMBER | 2015

Threatening! Aedes mosquitoes swarms to plague Malaysia BY HEALTH+ REPORTERS

HERE is an alarming rise in dengue fever case in Malaysia. Dengue is an infectious disease caused by a virus. Common in warm, wet areas, a person can get it if he or she is bitten by an infected mosquito. Outbreaks happen during the rainy season. Most people with dengue recover within two weeks. Some dengue infections are severe and cause bleeding from your nose, gums or under your skin. Severe dengue can also cause massive bleeding and shock,

which is life-threatening. Symptoms of classic dengue fever usually start within four to seven days with symptoms like fever, nausea and vomiting, pain behind the eye, severe headache, severe joint and muscle pain. Now we have heard of Genetically Modified Mosquitoes and other possible treatments for Dengue and how far away are we from a vaccine or cure for dengue. Datuk Dr Noor Hisham Abdullah director general of Health Malaysia, said at the moment, there is no dengue vaccine available yet worldwide.

A new breakthrough Gene found to pave way for new drugs to help rheumatoid arthritis patients

... page 14

Aedes Aegypti, the urban terrorist.

“Currently, a few dengue vaccine trials are ongoing in many countries including Malaysia. One company has submitted a potential dengue vaccine for registration with the Pharmacy Bureau, Ministry of Health Malaysia and the ministry is at present evaluating on the impact and efficacy of implementing dengue vaccine in this country.” In the absence of a vaccine, many diagnosed with the disease are already accepting traditional treatment such as papaya leaf juice at hospitals and treatment at home. Dr Noor Hisham said the Institute of Medical Research (IMR) had conducted a study on papaya leaves juice in 2013. The study showed that papaya leaves juice significantly accelerates the increase in platelet count among patients with dengue fever and dengue haemorrhagic fever.

CONTINUE PAGE Xtra 08-09

Seeing it right

Children given free check-ups and spectacles in conjunction with World Sight Day 2015

... page 17

ALUOSIES FRANCIS Editor-in-Chief aloy@hashplus.com.my

| AZLYRA KARMELIA | azlyra@hashplus.com.my

Published by: HASH PLUS COMMUNICATION SDN BHD (1110279-M) H-08-02, Block H, Plaza Kelana Jaya, Jalan SS7/13A, 47301 Petaling Jaya, Selangor. Tel: +603 7865 9211 Fax: +603 7865 9215 Printed by: ULTIMATE PRINT SDN BHD (62208-H) Lot 2, Jalan Sepana 15/3, Off Persiaran Selangor, Seksyen 15, 40200 Shah Alam, Selangor. Tel: +603 5101 3888 Fax: +603 5101 3608 Disclaimer: The contents of this publication aims to inform and educate the public on some of the health issues in Malaysia. It is a collection of articles from qualified doctors as well as interviews from experts. The publication is for general information and readers are advised to seek medical consultations from doctors if they have a condition. Health+ will not be held liable for the products and services advertised. Unauthorised reproduction of this publication is strictly prohibited without written consent by the publisher. Opinions expressed by columnists, writers and advertisers are not necessarily those of publishers and editors. While the accuracy of the information is at the utmost care, the publisher assumes no responsibility should any effects arise from them.

2015 | NOVEMBER | 03

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LOCALNEWS+

Dengue Mission Buzz rolls out! A community service initiative against dengue

UALA LUMPUR: In the first half of 2015, dengue cases in Malaysia rose to a staggering 66,721 cases, with 165 deaths recorded nationwide. Recognizing that the most effective way to tackle dengue requires a multisectorial approach, the Ministry of Health has often welcomed dengue prevention initiatives led by private companies and NGOs. Realising that more initiatives need to be done to remind Malaysians on the importance of preventing dengue,pharmaceutical company Sanofi Pasteur in collaboration with SC Johnson Malaysia, and the Malaysian Society for Infectious Diseases and Chemotherapy (MSIDC) has launched Dengue Mission Buzz with the support of the Ministry of Health, Malaysia. The campaign aims to educate and inform the public on effective ways to fight the spread of dengue and kicked off on Aug 7, 2015. “Dengue Mission Buzz is the first community outreach of its kind for Sanofi Pasteur with an objective to create on ground awareness on dengue prevention

initiatives,” said Baptiste De Clarens, managing director for Sanofi Pasteur (Malaysia, Singapore and Brunei). “The need for Dengue Mission Buzz is especially important because there has been an increase of dengue cases in Malaysia. Dengue is preventable and that is precisely what this campaign aims to do, to continue educate and remind the public on the simple preventive steps they can take to keep their surroundings clean and Aedes free,” said Cristina Ronski, senior director general manager of SC Johnson–Malay Cluster. The Dengue Mission Buzz truck was specifically designed for this cause. It will be dropping by media houses, to share information on dengue prevention (with and) through the media. The truck will travel around Klang Valley to educate and empower the community to proactively practice preventive measures to help keep dengue away. In addition, the road shows will comprise of interactive games focused around dengue prevention methods. There will also be prizes

For more information visit http://www. dengue.info/

NOVEMBER | 2015

and memorabilia for every participant to take home as reminders on how to help fight dengue. “Education is key to effectively fight against dengue. That is why we at Sanofi Pasteur feel it is our community responsibility to step in and re-engage Malaysians on the topic of dengue. It is imperative that Malaysians understand and take active steps to best protect themselves from this deadly disease,” said De Clarens. “Dengue does not discriminate. That is why educating and raising community awareness about dengue prevention has been of great importance to SC Johnson Malaysia. As a leader with more than 50 years of expertise in pest control, we are committed to using our knowledge to aid in the fight against dengue,” Ronski adds. What makes an epidemic even more unwelcomed, is the substantial burden it has on the country’s economy. The economic cost of dengue fever in Malaysia is particularly striking. The estimated burden of dengue illness in Malaysia is US$102 (95% CI: 78–311) million per year (RM359.79 million), approximately US$3.72 (RM13.08) per capita. “We tend to forget that surviving dengue the first time doesn’t make us immune to reinfection because there are four dengue sterotype and they are all present in Malaysia. This makes us at increased risk for getting dengue more than once and the symptoms may get worse each time. We’re talking about multiple organ failures and other warning signs apart from bleeding and high fever,” said Associate Professor Dr Ariza Adnan. Each year, 10,000 cases are reported in Malaysia at a cost of

Malaysia is the VP of World Health Assembly 2016 KUALA LUMPUR: Malaysia has been appointed by the World Health Assembly (WHA) Western Pacific member states as Vice President of the upcoming 69th WHA in Geneva, Switzerland. According to Bernama, a statement from the Ministry of Health explained that Malaysia’s appointment which was made unanimously at the 66th WHO Regional Committee Meeting for the Western Pacific Region in Guam, United States on Oct 14, 2015 is a recognition for its active role on the

global health platform. “It is indeed a great honour and we will take this opportunity for Malaysia to pursue a bigger role in the global health arena,” according to the statement. Malaysia will be representing 37 member states from the Western Pacific region for the 69th WHA, which will be held next year. WHA which comprises of 194 member states is the highest decision-making body of the World Health Organisation (WHO). —

LISTEN UP: the World Health Assembly sets health policy and is a part of the World Health Organization

around US$13 million. This is equivalent to 940,000 lost workdays. Each of these hospitalised cases of dengue fever is equal to one fifth of the per capita gross national product in Malaysia. About 70% of the US$718 treatment cost per case is paid for by the government, whilst the rest of the cost is borne by the patient. This cost per patient alone is equal to 53 days of lost economic output. Dengue fever is therefore economically devastating for individuals and the private sector as well as governments. “The cost of dengue is not only measured by the pain and suffering of patients and their loved ones. Treatment and management of dengue also imposes an enormous economic burden upon governments and communities in Malaysia,” said Dr Ariza. More worrying is that Malaysians are in general apathetic when it comes to the topic of dengue. In a research commissioned by Sanofi Pasteur and conducted by global market research company Ipsos on Dengue: Understanding Consumer Knowledge and Attitudes, findings show that while 96% out of 500 adults interviewed know about dengue, only 38% view it as a lifethreatening disease and 11% feel that they are at high risk of catching dengue. Global efforts notwithstanding, the cure for dengue has yet to be found. At the moment, prevention is the best cure. Focused on educating and empowering the public on being proactive in preventing this fatal disease, Dengue Mission Buzz aims to re-engage Malaysians on the topic of dengue, to build high awareness on its prevention and to encourage the nation to take proactive steps in fighting this lifethreatening disease.

2015 | NOVEMBER | 05

2015 | NOVEMBER

LOCALNEWS+ • 05

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LOCALNEWS+

Cash boost for IJN QL Resources to raise the RM100,000 for Foundation via ‘Good Heart Campaign’

UALA LUMPUR: QL Resources Bhd (QL ) and IJN Foundation kicked off the second leg of its “Good Heart Campaign”. This year, QL is targeting to raise RM100,000 for IJN Foundation, double the amount pledged in 2014. The “Good Heart Campaign” began last year (2014) and is part of QL commitment to the foundation with a target of RM150,000 over a three-year period; which translated to a minimum of RM50,000 per year. The IJN Foundation (IJNF) is a non-profit organisation with a philanthropic mission to raise funds and financially assist the surgery cost of poor and needy heart patients seeking treatment. The IJN Foundation, which is a charity organisation affiliated with the Institut Jantung Negara, is also the main supporter of ongoing

research done by IJN’s specialists in cardiovascular diseases. The Good Heart Campaign will see QL contributing 50 sen for each pack of QL Omega or QL Deli Fresh eggs sold in September and October. Two-hundred thousand packs of eggs bearing the Good Heart Campaign donation logo will be made available for sale nationwide over this two-month period. Chia Seong Pow, executive director of QL Resources Bhd, said: “QL believes in long term commitment for the benefit of all, synonymous with our name, which is the initialism of Quan Li. The Good Heart Campaign is one such platform to make a conscious effort towards a worthy cause that resonates with our core values. We support the good work and research that IJN Foundation has been undertaking. This is QL’s way to help raise aware-

NOVEMBER | 2015

ness on cardiovascular disease and the importance of leading a healthy lifestyle with a balanced diet and exercise,” Chia added. He said the company hoped that QL’s commitment as the IJN Foundation’s Gold Partner becomes an inspiration to other organizations and they will follow suit. “Between 2006 to 2014, IJN Foundation has helped more than 1,000 patients and this was made possible with the generous contribution and support from organisations and individuals. We hope that more corporate organisations would come forward and becomes the IJN Foundation’s corporate partner,” said Toh Puan Dr. Hajjah Aishah Ong, chairman of IJN Foundation. “We are grateful to have a committed corporate partner such as QL who believes in our mission and helped us to raise funds. Further to that, we are indeed proud to be associated with QL who with their own initiative has proactively create awareness of how to live a healthy heart,” said Dr. Aishah. A good heart begins with the right nutrients and eggs are an essential part of a healthy balanced diet as they contain high quality protein, unsaturated fat and more than 10 essential minerals and vitamins. QL Omega and QL Deli Fresh eggs have up to 40% cholesterol than normal eggs, are completely free of synthetic colours, and are enhanced with natural feed ingredients and probiotics. QL Omega

eggs are enriched with Omega-3, an essential fatty acid that is associated with reducing the risk of cardiovascular diseases, including heart attack and stroke. Through last year’s Good Heart Campaign, QL donated RM75,000 to IJN Foundation. The said amount was 50% more than the targeted RM50,000 per year for IJN Foundation and has committed to the foundation until 2016 to IJN Foundation. Should QL achieve its RM100,000 target this year, QL would have surpassed its overall pledge of RM150,000 for three years within a two-year period. The funds raised from the Good Heart Campaign will go towards key areas under the IJN Foundation, namely the Foundation’s Patient Assistance Programme, Research and Clinical Trials as well as Education and Training Programmes. QL is the largest eggs producer in the Asean region with almost five million eggs daily, across operations in Malaysia, Indonesia and Vietnam. Being one of the leading egg producers in Malaysia with a daily production of 3.2 million eggs, QL continues to invest in nutrition research, farming technology and product development in order to bring quality food products to consumers. QL Eggs are produced with specially formulated feed, enhanced bio-security, and stringent quality screening processes. The result is QL Eggs that are natural, nutritious and fresh. QL Eggs stand for quality, freshness, cleanliness and nutrition.

the chief executive officer of IJN who is also a senior consultant cardiothoracic surgeon had this to say following the official launch of the Incredible Heart event on Sept 7, 2015: “This year’s theme from the World Heart Federation is Heart-Healthy Environments and

to realise this theme, IJN created a campaign called The Incredible Heart to educate the public on how to take care of your heart.” Many activities were conducted as a part of the month-long event, which included free adult and paediatric heart screening every Monday, Wednesday and Friday of the month. Every Tuesday and Thursday, had dietetics and food services department of IJN doing a healthy cooking demonstrations. They had also conducted a free quit smoking clinic involving a Carbon Monoxide PPM test to create awareness on the negative effects of the smoking habits of Malaysians. Additionally, the IJN had also conducted easy to do exercises, hygiene hand washing, education on the variable tests available at IJN and many more. IJN’s Incredible Heart theme carries the hashtag #ijnwhd2015 and #worldheartday to promote the awareness to everyone in Malaysia and not just the visitors of IJN. More information on the Incredible Heart can be found on www.ijn.com.my/ incredible heart. Find them also in Facebook and Twitter at www.facebook.com/ijn.malaysia and twitter. com/ijndotcomdotmy.

The incredible heart KUALA LUMPUR: The National Heart Institute of Malaysia (IJN) organised a heart awareness programme dubbed “The Incredible Heart” in conjunction with the worldwide World Heart Day celebration on the Sept 29, 2015. The ongoing month-long IJN programme is ongoing has various activities to promote awareness for a healthy heart to the public. This year’s theme announced by the World Heart Federation is to create Heart-Health Environment. Being the largest single set up hospital for cardiovascular and thoracic care in Malaysia, the IJN took it upon themselves to be the curator for the World Heart Day celebration by creating more awareness on heart diseases and prevention in the country. The World Heart Day was first established in the year 2000 as an initiative to inform and educate the public around the world that heart diseases and stroke are the world’s

leading cause of death and the ways in which to prevent them. Cardiovascular Diseases (CVD) is the one to take the number one spot on the list of killer diseases. At least 80% of the premature heart disease and stroke could have been prevented if the risk factors such as tobacco use, excessive alcohol consumption, salt intake, physical inactivity and high blood pressure were to be controlled. However, it was found that many people do not have the luxury to engage in heart-healthy activities due to their working and living environment. IJN hopes The Incredible Heart initiative is able to help the public to learn about making healthy choices in their lives especially on their food consumption as well as their living environment. Ministry of Health announcement earlier this year said; “Malaysia is the most obese nation in Southeast Asia, and the figure is still increasing.” Datuk Dr Mohd Azhari Yakub,

LOCALNEWS+ • 07

2015 | NOVEMBER

Hospital Shah Alam finally opens its doors ELEGANT: An artist impression of the hospital

YB DATUK SERI DR S. SUBRAMANIAM, Minister of Health

The typhoid outbreak is under control. My advice is to be careful of places you choose to eat and stay away from eateries that look unclean.” On the recent spike in typhoid cases in Malaysia.

Ministry of Health to raise legal smoking age to 21 THE Health Ministry is drafting a new tobacco bill to raise the legal smoking age to 21 from 18 and to ban smoking in vehicles with children inside. The New Straits Times (NST) reported earlier this month that the new bill also includes a ban on displaying tobacco products in shops. “The ministry has, in fact, been lobbying for a tobacco Act since 2005, when Malaysia became a party to the World Health Organisation Framework Convention for Tobacco Control on December 15, 2005. A draft of the tobacco act has actually been prepared since 2009. Unfortunately, it was not tabled in Parliament due to some circumstances,” an unnamed official from the ministry told NST. Malaysia has She added that the ministry renewed its recorded death efforts to table the bill last year. of 10,000 She also said a study by the National smokers Poison Centre and Southeast Asia Tobacco annually. Control Alliance showed that some Malaysian children have tried smoking before the age of 13. The NST article cited the Global School-Based Student Health Survey 2012 in Malaysia which showed that 71% of teenagers who smoke had tried a cigarette before the age of 14. Although Kuwait, Honduras and Sri Lanka also set the legal age at 21, it is unclear if the move had reduced the number of teenage smokers. The official from the Health Ministry also said awareness campaigns should be conducted as early as preschool and that parents should warn their children on the severe consequences of nicotine addiction.

SHAH ALAM: Shah Alam settlers has had its fair share of inconvenience regarding their options to receive health treatments over the years. As of late, people from Shah Alam in need of medical attention had to go to Tengku Ampuan Rahimah Hospital located in Klang. Other options is to opt for private clinics and medical centres which medium-level to lowlevel income groups would find inconvenient. Hospital Shah Alam (HSA) started construction back in 2007 and said to be completed in 2011. Discrepancies followed and the construction was delayed indefinitely. A second construction company took over in 2010 and finished construction early 2015. In October, Hospital Shah Alam located in Seksyen 7 near i-City have opened their

doors to outpatients. After a seven-year delay, the cost shot up to RM565m. The people of Shah Alam can breathe a sigh of relief. Health Minister Datuk Seri Dr S. Subramaniam said inpatient services will start in phases in November, and full services of the hospital’s 14 specialties will be available by next year. In January 2016 the hospital will be fully operational, accepting outpatients and inpatients into the 300-bed hospital facility. “The equipment has arrived and we are currently in the midst of testing the equipment and making sure that the computer system works properly before admitting patients.” Dr Subramaniam said to local daily .

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LOCALNEWS+

NOVEMBER | 2015

Towards good health First global wellness community-building campaign storms

ANY equate mental and physical fitness to health. In fact, to be truly healthy – one needs to manage the health of the mind, body, emotions and holistic well-being aspects. In recognition of the importance yet lack of understanding, awareness and practice of wellness in Malaysia, Malaysian Wellness Society (MWS), The Laureate, HerbaLine Facial Spa & The Mines Wellness Hotel in June collectively staged the 1st Global Wellness Day (GWD) CSR campaign entitled “Bringing Wellness Communities Together” in Malaysia. (The International GWD in US is the nest day, on June 13). Close to 250 people comprising public, media, wellness companies and their guests enjoyed a kaleidoscopic range of wellness activities, health screenings, workshops, talks and discussion forums aimed at creating education, embracement and participation of wellness. In addition, various wellness companies came to network and explore future wellness development campaigns and planning towards GWD 2016. All collaborators made a commitment to bring a renaissance of wellness in Malaysia by signing a pledge and introduced wellness educational booklets and privileges to participants. Other sponsors such as Beacon Health, RPA Holistic Wellness Academy, The Naked Lunchbox, Nippo BioFertiliser and HerbaLine In- House Café came in

MEDI-TOONS WORK COMMITMENT

with goodies, interactive activities and vouchers for participants. The Laureate (a subsidiary company of Beacon International Specialist Centre) sponsored a lucky draw in the form of a genetic profiling programme for personalised wellness worth RM4,280. The Naked Lunch Box, a healthy delivery service, showcased a cooking demo for heathy meals to the public. The event also garnered the supper of wellness practitioners in the likes of Datin Rajinder Gill, an author who has been a fervent believer and avid practitioner of wellness for a long time. Choo Mei Sze, a columnist, TV Host and a colon cancer survivor shared her story on how wellness practice had transformed her life. The Mines Wellness Hotel (under Country Heights Holding Berhad founded by Tan Sri Lee Kim Yew), sponsored the venue, facilities and lucky draw prizes. Organiser, HerbaLine Facial Spa which is essentially a facial centre operating in a spa environment has always been committed to creating a relaxing customer experience to bring about the essence of beauty from inside out. Gary Sho, senior marketing manager of HerbaLine Facial Spa said HerbaLine was proud to present and organise the 1st GWD in Malaysia. “The management is highly inspired by the founder of GWD in the U.S. We decided to emulate and bring this concept of “one day dedicated to wellness

ALL FOR HEALTH: Dr Rajbans, an advocate on wellness and healthy living

advocacy” campaign to Malaysia,” enthused Gary. On the level of wellness awareness in the country, Malaysian Wellness Society president, Datuk Dr Rajbans Singh said that many are still clueless about wellness or possesses a vague notion of the meaning and essence of wellness. Consistent with the World Health Organisation’s definition of “health,” the 2013 Global Wellness Tourism Economy report defines wellness as a state of complete physical, mental, and social well-being. It goes beyond mere freedom from disease or infirmity and emphasises the proactive maintenance and improvement of health and well-being. Expressed on a continuum that extends from reactive to proactive approaches to health, wellness falls firmly on the proactive side, incorporating attitudes and activities that prevent disease, improve health, enhance quality of life, and bring a person to increasingly optimum levels of well-being.

“Many corporations and individuals spend millions on healthcare plans and medical treatments but little to none on proper wellness programmes which can pre-empt or delay one from getting ill. Consider the stark facts: Total death in Malaysia (2014) was 146,000 people. Noncommunicable diseases are estimated to account for 73% of total deaths, including cardiovascular diseases, cancers, chronic respiratory diseases, diabetes and other non-communicable diseases. The probability of dying between ages 30 and 70 from the four main NCDs is 20%. While the stats will climb in future years, practicing wellness would be key to cushion the acceleration of an increasingly ill-stricken society, explained Dr Rajbans. Dr Rajbans explained that many a times, the public would like to get started on wellness practice but don’t know who to seek for advice. Vice-versa, companies from the wellness industry do not have a conducive platform to acquaint wellness insights, products and services that could help the public. In view of this, GWD will bridge this gap and serves as a conducive interactive / exchange platform for internal and external interest groups to address and gain everything on wellness. Sam Yee, general manager The Laureate said,”Personalised wellness medicine is the future of healthcare and key to prevention of health issues that may arise in our lifetime. By taking proactive measures to identify potential problems or contributing factors that may lead to chronic health issues, public will be able to prevent diseases, restore health and slow down their body’s ageing process. “If you are serious about understanding and improving your wellness conditions, you may like to explore adopting a wellness management programme for your life-long wellness. Here at The Laureate, we have introduced the latest science-based Genetic Profiling testing solutions to ensure keeping wellness personalised and more effectively,” said Sam Yee.

LOCALNEWS+ • 09

2015 | NOVEMBER

The centre, packed with people waiting for eye checkups. Various health check-ups were present as well.

In eyesight BY NORMAN HUSSAINI PETALING JAYA: To say the eyesight is important to us is the same as saying the ocean is made out of water. Yet with something as important as seeing the world, we sometimes tend to take it for granted. Malaysia has a very high percentage of blindness as compared to our neighbouring countries, with cataract leading the race. A disease like cataract is highly avoidable, if one could detect symptoms at an early stage. Vista Eye Specialist Centre located in The Curve Damansara shopping mall had recently housed a carnival offering general eye tests to patrons. The event went on for three days between 16 and -18th October. Vista Eye Specialist has been organizing this carnival since year 2010. Bernard Chan, the Marketing Manager of Vista Eye Specialist, had found some time to talk to Health+ about the company’s event. “The main reason for this event had always been about helping people. We found it alarming that catarqct is the main cause of blindness in Malaysia, more than most developing countries in Asia,” Bernard said during an interview with Health+. Malaysians are gripped by eye diseases like cataract and Glaucoma which are highly Bernard donning a cute avoidable if detected ‘minions’ t-shirt in early. conjunction with the theme “From the 9 years of of the carnival. experience I have had working in this industry; I noticed that eyesight is something we really take for granted. It is only when severe symptoms starting to show will we go to have our eyes checked, by then it may already be too late,” he said. The Eye Carnival is a way for Vista Eye to encourage the public to have their eyes checked. “It is more of a public service than anything, for the ROI is not substantially higher than other marketing events and given the large amount of effort comparatively. “We are delighted by the positive response from the public. I have one that came all the way from Australia just to join our carnival and have his eyes checked,” Bernard adds. Vista Eye Specialist has six branches located nationwide and the branches ran the Eye Carnival concurrently over a 2 weekend period. The carnival at The Curve had form partnership with other health related groups offering various health screenings like bone density tests, breast cancer tests, skincare tests as well as blood pressure tests. Since the event was an attraction for families, it also offered free family portrait service as a way of saying thank you to their customers.

YB DATUK SERI DR HILMI BIN YAHAYA, Deputy Minister of Health

Communicable diseases have remained the bane of humankind but Malaysia has been successful in overcoming many of them in the past.” During his opening speech of the 10th Allied Health Scientific Conference 2014 in Kuala Lumpur

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LOCALNEWS+

Gintell roadshow tackles stress KUANTAN: Gintell has been promoting good health to Malaysians for a very long time. The recent Gintell roadshow in conjunction with Malaysian Health Day had seen them offering great deals on their premium DéVas HD massage chair as well as the CyberAir EZ treadmill. A special appearance by Datuk Jalaludin Hassan, the longtime ambassador for Gintell during the roadshow made it that much more eventful. The event saw a whole series of promotions lined up for the public where they got a chance to win special pack-

NOVEMBER | 2015

ages for the massage chair and treadmills. Gintell feels that being stressful can lead to serious health issues. Stress is not on itself an illness, yet it can cause serious illness if it is not dealt with. It’s important to recognize the symptoms of stress early. Exercise should be included as an important component of a healthy lifestyle. It is a known fact that exercises such as walking, running, jogging and swimming are beneficial to increase the metabolic rate, burn excess fat, reduce weight, improve blood circulation, enhance mental acuity and most importantly, improve our overall health. One of the most common mental benefits of exercise is stress relief, both physical and mental. Exercise also increases the secretion of norepinephrine, a chemical that can moderate the brain’s response to stress. Regular exercise reduces the amount of stress hormones in the body, resulting in a slower heart rate, relaxed blood vessels and lower blood pressure. Exercise also boosts the neurotransmitter serotonin in the brain. Neurotransmitters are chemicals that send specific messages from one brain cell to another. Though only a small percentage of all serotonin is located in the brain, this neurotransmitter is thought to play a key role in keeping your mood calm. In conjunction with the World Stroke Day, Gintell is encouraging all women and every one of us to make healthier lifestyle and to get a health check to avoid preventable stroke and cardiovascular disease and introducing the Wellness & Relaxation Package to create the awareness importance of the Exercise and relaxation of state of mind helps prevent stoke and improve stroke recovery as well. It is very important to keep healthy and to manage our stress levels especially during the period we are now in Malaysia. Health is the utmost important asset we have and we should be able to get the best care for ourselves to ensure a better lifestyle.

Healthcare sector focused seminars for GLICs launched by Bursa Malaysia and HLIB PETALING JAYA: Bursa Malaysia and Hong Leong Investment Bank (HLIB) have launched the first series of its Bursa-HLIB Stratum Focus, aimed at Government-Linked Investment Companies (GLICs) along with a seminar focusing on the healthcare sector. Aimed to equip GLICs with sufficient knowledge on various sectors of the industry, the Bursa-HLIB Stratum Series is expected to amass interest from institutional investors by identifying potential investment trends. In a statement, HLIB head of dealing Zunaidah Idris said “For the first series of the Bursa-HLIB Stratum Focus seminar, we decided to delve into the Healthcare sector given its above-market return potential. This is attributed to the healthcare sector’s defensive nature, a sustainable above-trend growth as well as the sustainability of the industry growth from the demographic perspective; which include standards of living, the aging population, income growth; and increase in health tourism potential.” Among the speakers who presented during the Healthcare-themed seminar were Ministry of Health Pharmaceutical Services Division deputy director Dr Ramli Zainal, Frost & Sullivan Asia Pacific Healthcare senior vice-president RhenuBhuller, Pharmaniaga Bhd managing director Datuk Farshila Emran and Frost & Sullivan consulting associate Fakhirah Roslan. Topics covered included National Pharmaceutical Policy and Practices, Overview and Trends of the Healthcare Industry, Healthcare for the Aged and a special lunch talk session on Healthy Lifestyle: Live to 100.

FOREIGNNEWS+ • 11

2015 | NOVEMBER

Not sweet at all About half of US adults are diabetic or prediabetic: study

A SHINGTON: Approximately half of the US adult population has diabetes or is prediabetic, although prevalence of the disease appears to be leveling off after decades of increase, researchers said. Nearly 40% of US adults had prediabetes and 12 to 14% had diabetes between 2011 and 2012,

according to new research in the Journal of the American Medical Association (JAMA). Among those with diabetes, 36.4% of cases were undiagnosed. That percentage was higher for Asian-Americans and Latinos at approximately half of all cases. Diabetes - diagnosed or not - was likely to be highest among Latinos (22.6%), African-Americans (21.8% and Asian-Americans

DO IT YOURSELF: Keep track of your blood sugar level with self checkups

(20.6%). Prevalence among white participants was 11.3%. Diabetes affected 9.8% of the population between 1988 and 1994, increased to 10.8% between 2001 and 2002, and grew again to 12.4% between 2011 and 2012. Despite these increases, the researchers said recent growth was slight and could signal a “plateauing of diabetes prevalence” that is “consistent with obesity trends in the United States showing a leveling off around the same period.”

“The current data provide a glimmer of hope,” endocrinologists William Herman and Amy Rothberg, of the University of Michigan, wrote in an accompanying editorial. “The shift in cultural attitudes toward obesity, the American Medical Association’s (AMA’s) recognition of obesity as a disease, and the increasing focus on societal interventions to address food policy and the built environment” were helping tackle circumstances that contribute to obesity, they said. Diabetes is a serious public health problem in the United States, racking up an estimated $245 billion in health care costs and lost productivity in 2012, the researchers said. The researchers based their estimates on surveys conducted from 1988-1994 and 1999-2012 and defined prevalence of diabetes based on a previous diagnosis or markers in patients’ blood that indicated they either had or were likely to develop diabetes. - AFPRelaxnews

Consumers need not worry as the Ministry of Health is always monitoring issues of food safety to ensure the people’s health is not endangered.” His statement in regards to the cinnamon bark issue being hazardous to consumers.

YB DATUK DR NOOR HISHAM ABDULLAH Director General of Health

Setting aggressive targets for hypertension saves lives: report WASHINGTON: Treatment for high blood pressure that goes above and beyond what was previously recommended can significantly reduce risk of cardiovascular disease and even death, preliminary results from a US study. The research, which applies to adults age 50 and older, showed that risk of heart attack, heart failure and stroke was reduced by nearly a third, and death by almost a quarter, when patients were asked to bring down their systolic blood pressure below what is currently recommended. Recommendations for systolic blood pressure - the greater of the two numbers that measure blood pressure - currently indicate that patients should aim for less than

140 mm Hg. The researchers, however, adjusted participants’ blood pressure medication to achieve a target systolic pressure of 120 mm Hg. “This study provides potentially lifesaving information that will be useful to health care providers as they consider the best treatment options for some of their patients, particularly those over the age of 50,” said Gary Gibbons, director of the National Heart, Lung, and Blood Institute (NHLBI), the main sponsor of the clinical trial. Initial results were so convincing that the NHLBI halted the study well before its 2017 end date, so it could publish the research. “We are delighted to have

LET’S CHECK: A patient is being checked for hypertension

achieved this important milestone in the study in advance of the expected closure date,” Gibbons said. High blood pressure - which affects an estimated one-in-three Americans - is the leading risk factor for heart disease, stroke, kidney failure and a slew of other problems, the study said. “Our results provide important evidence that treating blood pressure to a lower goal in older or high-risk patients can be beneficial and yield better health results

overall,” said Lawrence Fine, head of NHLBI’s clinical applications and prevention branch. The trial began in late 2009 with more than 9,300 participants 50 years and older, recruited at hundreds of medical centres across the United States and Puerto Rico. The study is the largest clinical trial to date to examine the effects of hypertension treatment targeting systolic blood pressure at a level below current recommendations. - AFPRelaxnews

12 •

FOREIGNNEWS+

NOVEMBER | 2015

Different strokes Brain and muscles interact differently for endurance sports and strength training

NDUR A NC E spor ts prime your brain to communicate differently with your body compared to sports based on strength, according to a new study that could provide new insight on performance and rehabilitation. The study focused on how athletes communicate with their quadriceps muscles, located in the thighs, as researchers measured muscle responses of long distance runners, weight lifters and sedentary individuals who comprised the control group. “The communication between the brains and (the long distance runners’) muscles was slightly different than (in) the resistance trainers and sedentary individuals,” says co-author Trent Herda of the University of Kansas in the US. “This information also suggested that resistance trainers and those

who are sedentary were more likely to fatigue sooner, among other things.” For starters, endurance athletes are able to fire up their quadriceps muscles faster than weight lifters or sedentary individuals, according to results. The research team recruited 15 healthy participants: five long distance runners, five who practiced weight lifting and five who led sedentary lifestyles. The runners had been in practice for at least three years and logged 61 miles per week, on average, and the weight lifters had been training four to eight hours per week throughout a minimum of four years prior to the study. The weight lifters were all able to squat twice their body mass, however, none of them practiced aerobic exercise such as cycling, swimming or running.

TWO TRACK ACTION: Communication between the brains and muscles depends on the person’s athletic practices

Dermatologists share advice on how to kick the nail-biting habit WASHINGTON: Typically it begins in childhood, continues through adulthood, and the consequences are not limited to exposed fingertips, say dermatologists from the American Academy of Dermatology who want to help you let them grow. “Chronic nail biting can cause serious problems,” says boardcertified dermatologist Margaret E. Parsons, MD, FAAD of the University of California, Davis. “In addition to making the skin around your nails feel sore, repeated nail biting can damage the tissue that makes nails grow, resulting in abnormal-looking nails. It can also leave you vulnerable to infection as you pass harmful bacteria and viruses from your mouth to your fingers and from your nails to your

face and mouth.” It may seem ironic, but letting your nails grow starts with keeping them trimmed short to reduce the temptation to gnaw as you embark on stopping, says Dr Parsons. Yet almost all nail biters have short nails and are simply waiting for a sliver to appear, so it’s important to apply a bitter tasting coating to discourage the habit. These are available without a prescription in most countries, and Dr Parsons also recommends getting regular manicures to keep the nails looking too good to chew. Alternatively, she says, wearing gloves or putting tape or stickers over your nails works for those who prefer not to get manicures. Find a stress ball and keep it

STOP BITING: Risks of nail biting habits include nails growing adnormally and infections

Sedentary participants had not taken part in a structured exercise programme for at least three years before the investigation began, according to the researchers. In the study, two kinds of electrode sensors that provide an inside look at muscle activity were attached to participants’ thighs. They were asked to extend a leg from a sitting position and, using the data provided by the electrodes, the research team measured the contractions and overall force exerted. After extending, participants were asked to exert extra force in attempts to achieve between 40 and 70% of the total force in that

muscle. A difference in rates of muscle fibers that fired indicated that brain-to-muscle communication differed depending upon participants’ choice of sport - or lack thereof. Sedentary participants and weight lifters had the most similar communication patterns, while the endurance athletes were faster to contract their quads. This could mean that human beings adapt more naturally to cardio exercise than to weight lifting, say the researchers, whose experiments spawned two papers that were published in the Journal of Sports Sciences and Muscles and Nerve. - AFPRelaxnews

with you for moments when you just gotta nibble, and try squeezing it instead, she says, and ask yourself what provokes the need to bite. Some people are provoked by hangnails or unkempt hands whereas others do it out of boredom, stress or anxiety, so find out what gives you that urge to nosh on your nails, says Dr Parsons. That way, you’ll know when to reach for your stress ball. “For some people, nail biting may be a sign of a more serious psychological or emotional prob-

lem,” she says. “If you’ve repeatedly tried to quit and the problem persists, consult a doctor. If you bite your nails and develop a skin or nail infection, consult a boardcertified dermatologist.” If you find yourself taking one step forward and two steps back, that’s just fine, according to Dr Parsons, who recommends quitting gradually. Try to stop biting one set of your nails - such as both of your thumbnails - and add other fingers little by little until you’ve stopped, she says. - AFPRelaxnews

FOREIGNNEWS+ • 13

2015 | NOVEMBER

Checking emotions Regulating emotions could be key in fighting insomnia

WEDEN: Having trouble controlling your emotions could increase the likelihood of insomnia, which could become persistent if things spiral out of control, according to a new study. “These findings are important because, though the effect size is small, they suggest that teaching people strategies for regulating their emotions might help prevent new cases of insomnia to occur and decrease the risk of persistent insomnia,” says study co-author Markus Jansson-Fröjmark of Öre-

bro University in Sweden. Working with 2,333 adults from Sweden, the researchers asked them to complete several questionnaires on emotions and insomnia. Participants were asked if they had difficulties with impulse control and whether or not they were emotionally aware and whether they had problems falling asleep or waking up too early and if they did, what sort of consequences did they suffer during the day as a result. Analyzing the results, the researchers found no link between a lack of ability to regulate emotions

and experiencing insomnia. Yet when follow-up questionnaires arrived six months after the first analysis, the picture began to appear differently. Of the original participant group, 1,887 of them returned follow-up questionnaires after six months and 1,795 sent in followup questionnaires 18 months later. Those who had lost their ability to regulate their emotions were more likely to have developed insomnia - most likely the persistent kind. Analysis of the new data led the researchers to conclude that reduced ability to regulate emotions was associated with an increased risk of developing temporary or persistent insomnia.

The study was published in the British Journal of Health Psychology. A recent experiment at Northumbria University helped 73% of participants end their insomnia after a one-hour cognitive behavioural therapy session. Treatment was given to participants whose insomnia was still in the acute phase, meaning it had been occurring for less than three months. The research team, whose study was published in the journal Sleep, recommends treating insomnia in its acute phase, noting that it saves patients considerable time and quality of life, bypassing the major depression that often comes as a result of chronic insomnia. - AFPRelaxnews

14 •

HEALTHBUSINESS+

NOVEMBER | 2015

3D printing - A SIRIM perspective BY VICTOR DEVADAS

3 DEMC’s women and children hospital to be completed by 2018 SHAH ALAM: Darul Ehsan Medical Centre (DEMC) is building a RM220 million Women and Children’s Specialist Hospital (WCH) in Shah Alam, targeted for completion by January 2018. This is the first specialist hospital in the country where it is dedicated solely for women and children. It will offer a wide range of specialist services such as obstetrics and gynecology, Urogynae, maternal fetal medicine, infertility treatment, pediatric neurology, pediatric dentistry, pediatric surgery and child development. The 19-storey DEMC WCH facility will include 150 wards, three operating theatres, eight labour rooms, four intensive care unit (ICU) wards, and four neonatal ICU wards.

This boutique hospital also features a health spa for mothers and children, a crèche, mini home-theatre for children, rooms for caretaker and a range of cafes and restaurants for visitors. In a statement, DEMC WCH said it hopes the hospital will help to boost Selangor medical tourism portfolio. It hopes to attract those seeking healthcare treatment from Indonesia, Australia and Middle East. According to the Health Ministry, foreign patients increased to 770,000 in 2013 which amounted to RM690 million as compared to 393,000 foreign patients in 2010 amounting to RM379 million. Malaysia was ranked the third best out of 24 countries in the world in the provision of health facilities.

D Printing started in Malaysia in 1996, when SIRIM, a statutory body then, became the technology recipient under the Off Set programme initiated by the government. This off-set programme was the result of the FA-18 purchased, by the government. SIRIM through technology transfer set up a Rapid Prototyping facility, the very first in Malaysia in 1996. The technology transfer was facilitated by McDonald Douglass, the manufacturer of FA-18, and SIRIM acquired the Stereolithography Machine (SLA 250) in 1996. This was the very first Additive Manufacturing machine, or 3D printer or otherwise also know as Rapid Prototyping machine, in Malaysia. Prototyping has been the technology’s greatest application, thus the term Rapid Prototyping and it continues to remain a key application. But before we go further, the definition of Additive Manufacturing, Rapid Prototyping and 3D printing should be established. The ASTM International Committee F42 on Additive Manufacturing Technologies defines Additive Manufacturing (AM) as the process of joining materials to make objects from 3D digital model data, usually

layer upon layer, as opposed to subtractive manufacturing methods. The definition also covers additive fabrication, additive processes, additive techniques, additive layer manufacturing, and Rapid prototyping. In this fast-growing, everchanging industry, terminology evolves rapidly. The term 3D printing is defined by the ASTM F42 committee as the fabrication of objects, layer upon layer, through the deposition of a material using a print head, nozzle, or other printer technology. However, the term is often used synonymously with additive manufacturing

NEW ADVANCES: Advances in 3D printing paved the way to more detailed prototyping of prosthetic limbs.

HEALTHBUSINESS+ • 15

2015 | NOVEMBER

A mobile application tool to predict dengue outbreak AN epidemiologist from Kota Kinabalu, Sabah has developed a mobile application tool to predict dengue outbreak which is believed to be 80 per cent accurate. According to a local daily, the 31-year old Dr Dhesi Raja was offered a two-month scholarship at Singularity University at the national Aeronautics and Space Administration (Nasa) Research Park in Silicon Valley, US to help further develop his innovation.The tool, known as Artificial Intelligence Medical Epidemiology (AIME), is able to notify where and when the disease is expected to erupt, by studying how the disease and data behave. AIME’s platforms can geo-locate exactly up to 400-metre radius on the possible outbreak areas for up to three months in advance. It will also distribute educational information and outbreak warnings to public via short messages services and online. Dr Raja hopes to find business partners to assist its research further, primarily targeting countries affected by dengue. He said in future, he also hopes to improve on the platform to detect outbreak of other desease like malaria, flu and tuberculosis.

3D printers have been able to produce intricate products with precision.

The medical industry is the biggest user of 3D printing.

Additive manufacturing is the official industry standard term according to ASTM and ISO, but 3D printing has become the de facto standard term, and has become more popular than AM. APPLICATION

AM is used to build physical models, prototypes, patterns, tooling components, and production parts in plastic, metal, ceramic, glass, and composite materials. AM systems use thin, horizontal cross sections from computer-aided design (CAD) models, 3D-scanning systems, medical scanners, and video games to produce parts in about every shape imaginable. Design and manufacturing organisations use AM parts for products in the consumer, industrial, medical, and military markets, to name just a few. Digital cameras, mobile phones, engine parts, interior trim for automobiles, parts and assemblies for airplanes, power tools, and medical implants are just the beginning of a very long list of products that have benefited from AM technology. SIRIM Berhad has been proudly servicing the local industry both local and multi nationals since 1996. It has over the years upgraded its facility. It has now on its premis-

es, state of the art 3D printers or AM machines, such as Fused Deposition Modleing FDM 400MC Fortes, SLA 7000, Stratsys Connex 350 printer and the Selective laser Sintering Nylon powders machine (Formiga P110) The medical industry is biggest user of 3D printing. 3D printing’s greatest utility is in manufacturing, says Wohlers. According to his consultancy’s research, 28% of all money spent on 3D printing last year was used to manufacture industrial parts. That figure is up from less than 4%10 years ago. A breakdown of that figure reveals that the medical industry is the biggest user of 3D printing followed by the dental products and services industry. According to Wohlers, the jewelry industry, which is as big as the automotive industry (which has been using 3D printers since the 1980s) in market size, emerged as a surprise destination for 3D printers. Because the jewelry industry is an unregulated industry (unlike the medical industry), Wohlers says use of 3D printers has grown exponentially in the industry. SIRIM Berhad has also seen growth in its applications in two main ares in tandem with the growth world growth i.e medical and dental areas. SIRIM has to date assisted surgeons in more than 100 cranio facial reconstructive surgeries. In the field of dentistry, it has assisted dental surgeons in reconstruction mandibles, enabling patients to have a good bite after cancer has damaged the mandibles.

Shortage of geriatricians

MALAYSIA faces shortage of geriatricians as the nation expects to attain Ageing Nation Status by year 2035. Senior citizens make up about seven per cent of the country’s population of 28 million. Currently, there are only 16 such doctors in Malaysia – nine in Selangor and Wilayah Persekutuan, three in Perak, and one each in Penang, Malacca, Sabah and Sarawak. Women, Family and Community Development Minister Datuk Seri Rohani Abdul Karim has suggested for Health Ministry and universities to offer scholarships to young doctors who would like to specialize in geriatrics. It is also important to educate schoolchildren on elderly care by introducing more activities for both young and old to participate in. This will help to bridge the gap between the two generations within the community.

16 •

HEALTHBUSINESS+

NOVEMBER | 2015

Many reasons, one solutions Attune Technologies make waves with cloud technology

EALTHCARE is an interesting sector and it has been successfully embedding emerging technologies so as to make the tenious processes easier. Attune Technologies is also making constant endeavours in the same arena. With its headquarters in Singapore, this company by and large operates from India with more than 250 employees. Currently, the company’s platform maintains an overall record of 9mil patients. Making the segregation simpler, two cloud based platforms are provided. Atom (Public Cloud) - Launched in 2014, this platform focuses on the small and medium sized hospitals. K ernel (Private C loud) Launched in 2009, the application was designed using a multi-tenant architecture. To explain how this cloud technology helps: Multi-Center/Multi-Geography Healthcare Chain – Cloud enables the maintenance and updating of a common Database on a real time basis for such customers. Thus a patient registered and treated at a center say in Kuala Lumpur today can walk in the same day at any cen-

ARVIND KUMAR: Founding member & CEO, Attune Technologies, India.

ter of the hospital or laboratory say in Petaling Jaya without having to carry any physical records with him. All records are available in the application at all locations which can be accessed using the unique patient

ID assigned to each new patient at the time of first walk-in. Remote access – Helps professionals to access patient reports and records remotely using their secure and unique application access portal. The platform inevitably needs to secure its humongous data. The data center provides an intrusion monitoring service and support for queries or operations on the server. Also, the data access is highly restricted or just cannot be accessed without the customer’s permission by anybody. Other regular security features include Role based Access Control which means that a person can view only those pages which are assigned to his/her role by the hospital administrator. The company plans to enhance its platform with a major focus on Analytics, IoT and Mobility. Interestingly, one of their key interests in IoT space is to bring technologies that will allow machines/ equipment inside a laboratory or a hospital to talk to each other and make life easier for the staff. Arvind, founding member & CEO, Attune Technologies, India, said: “As an overview, we have close to 150 customers currently. We currently have a presence in 13 countries in Southeast Asia, Middle East and Africa. Our revenue model is both SAAS based and also License based. We do not charge based on the number of users as such. We suggest our customers to go for our monthly rental (SAAS) model as it takes away infrastructure investment and lump sum payment burden of the customer. This model has been very successful for us in the market,,” said Arvind. The company’s growth pros-

pects are expected to surge in the next few years. He said: “With the introduction of health insurance scheme, the government has given a real boost to the insurance sector and expect private health insurance players to also dive into this opportunity pretty soon.” Arvind said with more and more players coming in and insurance becoming the key driver of healthcare, hospitals and laboratories will surely feel the need of a good and efficient software. “Also the rise of healthcare chains in the country is also a good sign for us as our software can ease out most of their problems. In fact most of our large customers are large chains which have benefitted immensely from our platform. We have two product lines, Atom and Kernel. Atom is regarded as small hospitals , clinics and small labs while Kernel is for big enterprises – hospitals and labs. Thus the future looks really bright and exciting,” said Arvind. Details: www.attunelive.com or email: contact@attunelive.com FOCUS ON BUSINESS BENEFITS AND USAGE

The biggest challenge in any technology implementation is not the technology itself, but its relevant usage. The company’s relentless focus on business relevance and usability provides visible return on investment in shortest possible timeframe. TRULY INTEGRATED

Attune products not only integrates all your departments from pharmacy, diagnostic lab, imaging units, physiotherapy, wards, inpatients and outpatients, but also integrates branches and collection centers in different geographic locations. The

2015 | NOVEMBER

Water vending machine WATER Vending Machine operators must have a license from Ministry of Health beginning January 1st next year. The cost for applying for a license for one unit of water vending machine was RM150 for a period of two years. According to Health Ministry, a total of 2,450 license applications have been received and of these 59 applications were approved and granted license while the remaining are still being processed. Water vending machine is regularly checked by enforcement officers. Since last year to date, a total of 630 vending machines have been checked and 22 were confiscated for various reasons like not maintaining hygiene, containing bacteria and for claiming that the water sold can improve health like curing diabetes.

HEALTHBUSINESS+ • 17

Creamatocrit Plus A PORTABLE machine designed to measure the calories and energy content of human breastmilk has been widely used at the neonatal intensive care unit (NICU) to ensure premature babies are receiving the calories they needed. Creamatocrit Plus uses a simple micro method to estimate the percentage of cream or “creamatocrit” to guide the separation of foremilk

and hindmilk. This helps to accelerate weight gain in premature infant. It takes approximately three minutes for the machine to measure the caloric and lipid content of breastmilk. Besides NICU, Creamatocrit Plus is also designed for use in clinical or research setting and epidemiological studies where portability and space constraint as well as noise level are a crucial consideration.

Creamatocrit Plus.

integration can be extended even to your partner organization. TRUE SAAS AND CUSTOMIZABLE

SAAS provides various benefits for customers but normally comes as a standard product, without customization. However, Attune understands that whether it is SAAS or not, its customers want customization. True to this spirit, Attune’s technology solution is an SAAS software that is highly customizable for each customer, making them unique. PAY AS YOU GO AND USE

Customers get to use the software on a monthly rental model and for the modules that they want. Pay for what you use and actively reduce the risk of exposure to huge upfront expense for software implementation. EXCELLENT SERVICE AND SUPPORT

Service makes the biggest difference between efficient adoption of technology product and its failure. Being a truly web-based product with complete configuration and management capabilities, it can be completely managed from a single point making it extremely simple to manage and support.

Media partner:

www.healthplus.com.my

KDN: PP18743/05/2015 (034197)

THE PULSE OF THE NATION

18 •

SENIOR+ OPINION+

NOVEMBER | 2015

By Dr. Mohd Ismail Tambi

MACHO MAN

Men’s health and wellness

Habit of taking quick fixes and rely on unorthodox methods, treatment and supplement that usually cause more problems than remedy. They have poor wellness consciousness.

ENDER based health care needs and requirements have reached a level where health care provisions are challenged, especially for health care and support for men. This challenge is already getting the attention of most health care providers and it is expected that men’s health care services be incorporated in the community health services with a division of its own to bring health care provision and wellness awareness to men. Men’s health is defined as the holistic management of health conditions and risks that are most common or specific to men in order to promote optimal physical, emotional and social health. While male sexual health is important, men’s health goes beyond sexual and reproductive health.Wellness is an approach to healthcare that emphasizes preventing illness and prolonging life, as opposed to emphasizing treating diseases. Health and wellness have always been a concern for women. Men too are concern about health and wellness, but only for their family. Men’s health seeking behaviour is rather peculiar in that it is not really helpful to them. They are self reliance to spurious health products. They seek treatment on the sly, because they are open to local traditional therapies and cures. They have this misplaced macho attitude that seeking medical treatment is not ‘manly’. They are not health conscious when come to certain habits and practices: Smoking 12% vs 7% in women, more likely to drink alcohol daily compared to women, more likely to use illicit drugs, more likely to be involved in unsafe sex and exposure to STI/ HIV-AIDS, willingness to go for high risk and life threatening jobs compared to women. Men’s health dilemma can be seen in the following scenarios. The life-expectancy of men is shorter than women across both developed and developing countries by an average of 3.9 years. The death rates for adult men across all regions in the world are

higher than women. Most causes of death in men such as cardiovascular disease, injuries, road traffic accidents, cancers, violence, war, infectious diseases (including HIV/ AIDS) and chronic obstructive pulmonary diseases are not malespecific and they are preventable or amenable to early intervention. A further analysis on six of these, accidents and their adverse effects, suicide, cancers, cardiovascular diseases, injuries, and chronic liver diseases among middle age adults in the major continents of the world has noted that men stand a higher risk of premature death than women. Men tend to go for health issues consultation lesser when compared to women ( 60% women compared to 40% men) In Malaysia, the difference in the average life expectancy between men and women is similar to the global pattern. The life expectancy in Malaysia was about 72 years for men and 76 years for women in 2013(WHO). The common causes of death in Malaysian men are similar to the trends mentioned above, with cardiovascular disease and transport accidents being the top two. Men in Malaysia also suffer high prevalence of many chronic disorders and health risk factors. In the 2006 National Health Morbidity survey, the high prevalent health morbidities include hypertension (33.2%), hypercholesterolemia (18.6%), diabetes (12%), and smoking (46.4%). The

prevalence of male-specific disorders was also high. Among other male-specific conditions, two-thirds of men aged 40 and above have moderate to severe erectile dysfunction, 19-29% have moderate to severe lower urinary tract symptoms. Having noted the potential for early intervention in these male-predominant causes of death, early identification of the related health risks becomes important. These health risks include smoking, poor dietary intake, diabetes, hypercholesterolemia and high risk behaviors such as addiction, violence and reckless driving. Male attitude of associating health problems as a weakness rather the reasons to seek medical assistance. Associating macho and ‘dare to do’ as a glory rather than bad attitude or risk taking behavior that may land them in trouble like getting into accidents, fights, trauma and sexual infections. Men are more likely to be both the perpetrators of violence and its victims. Habit of taking quick fixes and rely on unorthodox methods, treatment and supplement that usually cause more problems than remedy. They have poor wellness consciousness. The Men’s health initiatives that can be incorporated may include preventives measures, active treatment and active rehabilitation. Men need to be reminded from time to time to mind their health as they mind their profession and career. This can start from home, wife and children remind them to stop smoking and cease alcohol consumption, family outings and togetherness to alleviate stress and treasure lives and coaxing husbands and fathers to go for annual health and medical checkup. The Community can provide men caring services like men friendly health services and health clubs and to conduct more health seminars with free health screening. The initiative of the November Movement is a good example of that.

Note: Dr. Mohd Ismail Tambi Consultant Clinical Andrologist Wellmen Clinic Damai Service Hospital (HQ) Sdn Bhd

SENIOR+ • 19

2015 | NOVEMBER

Men aged 65 and above with access to nature sleep better ACCORDING to the results of a new study from researchers at the University of Illinois in the United States, men and people over 65 who live in an environment where nature is more present, sleep better. Diana Grigsby-Toussaint, professor of kinesiology and community health and member of the division of nutritional science at the University of Illinois in Chicago explained that “Studies show that inadequate sleep is associated with declines in mental and physical health, reduced cognitive function, and increased obesity. This new study shows that exposure to a natural environment may help people get the sleep they need.” Professor Grigsby-Toussaint worked with two researchers from the university and with several scientists from the New York University School of Medicine to reach these conclusions. The team used data from the Behavioural Risk Factor Surveillance System, a monitoring tool put into place by the CDC - the Centre for Disease Control and Prevention. A total of 255,171 representative American adults were questioned to find out if there was a link between declared days of insufficient sleep and access to green spaces. The research team also used a USDA index to measure the hours of sunlight in various geographical areas, an important parameter in regulating a person’s circadian rhythm, and temperature. In response to questioning on quality of sleep in the last month, researchers found that the most common answer was that participants had slept poorly for less than a week. MEN ARE MORE SENSITIVE THAN WOMEN

“Interestingly, though, across the entire sample, individuals reporting 21 to 29 days of insufficient sleep consistently had lower odds of access to green space and natural amenities compared to those reporting less than one week,” noted professor Grigsby-Toussaint. For men, the relationship bet-ween sleep and exposure

Relief by Devil’s Claw RESEARCH has shown that devil’s claw; a plant that is found in South and South Western Africa, is effective to help reduce swelling in joint and ease joint stiffness which are usually due to arthritis and gout. Its analgesic effects also help in pain relief commonly in the lower back, thereby improve mobility. In addition to alleviating pain and swelling, the Devil’s Claw is also observed to help reduce uric acid levels. High uric acid in the body can cause gout, another form of painful joint disease. In fact, it is possible that devil’s claw can help some people with degenerative joint diseases to reduce or eliminate their use of prescription pain medication altogether. The Devil’s claw is a fruit shaped like claws that curves upward. The plant has been found to have healing properties and was introduced to Europe in the early 1900s. This information is brought to you by Solaray. For more information, please contact us at 03-78800103

to a green environment was much stronger than for women. However, both males and females 65 and over found nature to be a “potent sleep aid,” she pointed out. Grigsby-Toussaint also underlined that there is an association

Being close to nature is important for elderly men as it helps with their sleeping.

of individuals living in proximity to green spaces and increased levels of physical activity, believed to help foster healthy sleeping. The study’s findings could eventually be used to help treat people who have sleeping

difficulties. For example, inciting patients to spend more time in nature and creating nursing homes with more space, sunlight and gardens that encourage outdoor activities. - AFPRelaxNews

20 •

MEN+

NOVEMBER | 2015

Sexual activity not a factor in heart attack risk HEART attack patients often worry about whether sexual activity can trigger another heart event, but a research letter published recently reveals they have little to worry about. Researchers studied 536 heart disease patients between the ages of 30 and 70, evaluating their sexual activity in the 12 months leading up to a heart attack, which allowed them to estimate the relationship between frequency of sexual activity and future fatal heart attacks, strokes or cardiovascular death. They concluded that sexual activity - which they likened to moderate physical activity such as a brisk walk or climbing two staircases - was not a risk factor for subsequent adverse cardiovascular events.

Men can still have sex even when they have been a victim of a heart attack.

The research letter was published in the Journal of the American College of Cardiology. – AFPRelaxNews

Study links erectile dysfunction drugs with skin cancer A CLASS of erectile dysfunction drugs that includes Viagra has been linked to a slight increase in the risk of the skin cancer melanoma, according to a study. While the research in the Journal of the American Medical Association stops short of proving that the drugs cause melanoma, researchers said their findings warrant a closer look at medications known as PDE5 (phosphodiesterase type 5) inhibitors. They include sildenafil, vardenafil and tadalafil, which go by brand names such as Viagra, Levitra, Cialis and others. Using Swedish medical records spanning 2006 to 2012, researchers found about 4,000 cases of melanoma. Of those patients, 11% had filled at least one prescription for a PDE5 inhibitor to treat erectile dysfunction. When comparing these men to a control group of cancer-free men selected randomly from the same registry and matched by age, researchers found the risk of melanoma was 21% higher in men who took the erectile dysfunction drugs. However, the most pronounced risk was seen in men who had filled a single prescription - 32% higher. The risk of melanoma in men who filled multiple prescriptions was 14% higher, which was not statistically significant, according to the study led by Dr Stacy Loeb of New York University. Researchers were also puzzled by the finding that men taking ED drugs were more likely to be diagnosed with low-grade melanoma, not advanced or high risk cancers. Study authors stressed that

It is proven that weight gain for first time fathers are a normal occurrence.

Study: Firsttime fathers put on weight

recent study found that first time fathers gain weight, whether they are living with their children or not. Northwestern University in Illinois, USA followed the weight of more than 10,000 men, from an adolescent age to young adulthood. They have found that a typical six-foot-tall man who is living with his child gained 2 kg (4.4 pounds) after becoming a father for the first time, resulting in a 2.6% rise in body mass index (BMI). A man of the same typical physique who are not living together with their child gained about 1.5 kg (3.3 pounds)

A popular sex enhancer used worldwide, known best with the name Viagra.

the risk of melanoma they found among erectile dysfunction drug takers was modest, and would translate to about seven additional cases of cancer per 100,000 men taking PDE5 inhibitors. According to Chris Chapple, secretary general of the European Association of Urology, the findings are an “interesting observation” but more research is needed. “This paper reports a previously unreported potential association,” said Chapple, who was not involved in the study. “It’s an interesting observation, but it should not be a trigger for any change in current clinical practice relating to the use of drugs for the treatment of erectile dysfunction such as Viagra and related compounds.” - AFPRelaxNews

with a rise of 2% in BMI. Participants were measured for four times during the length of the study. From early adolescence, later adolescence, in their mid20’s and in their early 30’s. They were put in categories each time as a non-father, a resident father or non-resident father. During the weight gain of fathers – be it resident or non-resident, non-fathers actually lost about 0.6 kg (1.4 pounds). The study had suggested that the lifestyle change involving the prioritization of a baby with a possible change in eating habits because of the abundance of snack foods could be the reason behind the ‘Fatherhood Effect’. – AFPRelaxNews

Expectant dads can suffer pregnancy blues too: study WHILE female baby blues is well documented, new research shows that firsttime expectant fathers can also experience depression during pregnancy. Published in The American Journal of Men’s Health, the findings from McGill University in Montreal, Canada, show that while men may not experience the same physical changes in their bodies, the spectre of parenthood can also alter their mental health and lead to depression. “The mental health of men remains a neglected area of research and one that

is not adequately addressed during the transition to parenthood,” said senior author Deborah Da Costa in a statement. “Highlighting these findings in Canada increases awareness in expectant parents, new parents, and importantly in health care providers who are in contact with expectant couples during prenatal appointments.” For the study, researchers followed 622 men in Quebec over 18 months. Expectant fathers filled out online questionnaires which measured factors such

MEN+ • 21

2015 | NOVEMBER

5 steps to control your blood pressure

CHECK YOUR BP REGULARLY

Taking steps to control your BP will not amount to much if you don’t check them regularly. Go to your local clinic to check or have your own home BP monitor. TAKE MEDICATION ACCORDINGLY

A standard chart to define the optimal blood pressure for us.

MEN are more likely to have high blood pressure as compared to women. High blood pressure or hypertension could open up a plethora of health complications with stroke and heart attack being the more serious ones. Given the right step, hypertension can be avoided. Here are 5 simple steps you can take to control your blood pressure (BP), as recommended by numerous experts from the National Heart institute (Institut Jantung Negara), the World Heart Federation, and the American Heart Association. KNOW YOUR NUMBERS

To control your BP levels, you will first need to know the numbers. An ideal

BP reading will usually be in between 90/60 to 120/80. Go lower than 90/60 than you probably have low blood pressure. However if your BP is above 140/90, then you probably have hypertension. WORK WITH YOUR HEALTHCARE PROVIDER

When you have identified the level of BP you want to achieve, consult with a healthcare provider to work out a plan for yourself. Consultation with doctor, nutritionist or qualified dieticians is recommended to plan for your health. MAKE SOME LIFESTYLE CHANGES

If you have an abnormal level of BP, then there must be something that

SLEEPING WELL: Depressive symptoms in men during the wives, pregnancy can be avoided with adequate sleep time

as mood, physical activity, sleep quality, marital adjustment, and financial stress. Researchers recorded a 13 percent increase in depressive symptoms during their partner’s pregnancy.

But the study also stressed that one of the best ways to avoid pregnancy-related stress for men, is to try to get enough sleep, as poor sleep quality was linked to increased risk of depression. – AFPRelaxNews

A good diet ensures that our blood pressure stays at an optimal level.

you are doing wrong. Here are some lifestyle changes you should probably change; Lose weight – Exercise more. Find a physically active activity you can partake and stick to it. Try aiming for a more ideal Body mass index (BMI) Healthy Eating – Try increasing the amount of fruits, vegetables, and low-fat dairy while avoiding simple sugars, saturated fats and trans fat. Limit alcohol consumption – If you are drinking alcohol, limit to 1-2 drinks a day and no more.

During your consultation with your healthcare provider, it is possible that you may already need medication to control your BP. If you do, take them exactly as what the doctor had instructed. Reducing or increasing the dosage of the medication can present you with other health complications. So please listen to your doctor!

Good blood flow is a result of a healthy diet as it prevents clogging of the arteries.

22 •

MEN+ OPINION+

NOVEMBER | 2015

HEART TALK

By Datuk Dr Rosli Mohd Ali

A person with CHD symptoms should see their doctors immediately so that they may investigate thoroughly to find out exactly what the causes are and how severe the situation is.”

Medical advancements help detect coronary heart disease

A L AY S I A h a d fallen to Coronary Hear t Disease (CHD) for decades as the number one cause of death. A little known fact; victims of CHD in Southeast Asian countries are a decade younger than victims from western countries and Australia. The average age for a male to develop CHD in Malaysia is 59 years old, and 69 for females. Although men are more prone to have CHD rather than women. Interestingly, CHD is actually the leading cause of death for Malaysian women, not cancer. CHD is developed by the narrowing of blood vessels by cholesterol plaque, which in turn prevents blood from flowing properly and getting oxygenated which then leads to a heart attack. A heart attack occurs when blood vessels are suddenly closed and this could damage the heart and result in death. There are multiple risk factors contributing to the development of CHD. One of them is the noncommunicable diseases such as diabetes, hypertension or obesity. These diseases are closely related to individuals’ lifestyle choices and are generally avoidable. Individuals leading an unhealthy lifestyle such as having smoking habits, bad eating habits and lack of recreational activity increases the odds of developing CHD. The genetic predispositions are however, a factor that is unfortunately unavoidable. This points to the inevitable predisposition of an individual to develop CHD if their parents or their parents’ siblings also had CHD. A person with CHD symptoms should see their doctors immediately so that they may investigate

thoroughly to find out exactly what the causes are and how severe the situation is. Most people fail to act quickly when symptoms are present which increases their risks. With the advancement of modern medical technology, there has been several ways to investigate, diagnose and treat CHD. Medical technology has advanced greatly over the years and investigation and diagnosis became much quicker and more accurate. Here are some of the technologies used for imaging available in Malaysia: Electrocardiogram (ECG) and stress test These tests help to diagnose the presence of CHD by observing the heart through electrical activity. Nuclear scan This is where a radioactive agent is injected into the blood stream. Paired with a stress test, this helps ascertain proper blood flow through the blood vessels into the heart. Stress echocardiogram Stress echocardiogram is a test that uses ultrasound imaging to show how well your heart muscle is working to pump blood to the body. Paired with an exercise stress test, it can detect a decrease level of blood flow to the heart. Cardiac MRI Magnetic resonance imaging of the heart gives an accurate picture of what the heart is doing while under stress. The patient is given medication to stimulate stress and injected with a dye that will “light up” the heart. The MRI can indicate if the blood vessels are narrowed, any damage to the heart muscles and measure the heart function. Multi-slice CT A dye is inserted through the vein, and a CT scan is taken of the heart. The scan collects several ‘slices’ of images at the same time. Images of the blood vessels will be constructed to show if there are blockages. Intravascular ultrasound (IVUS) A small catheter (less than 1mm

in diameter) is passed through the blood vessel and an ultrasound is emitted from it, producing an image of the blood vessels in the heart. Doctors can see the build-up of cholesterol, plaque and calcium within the vessels. Optical Coherence Tomography (OCT) This is similar to IVUS, except that optical coherence tomography uses light instead of sound to capture an almost instant image of the heart and blood vessels. The images are much clearer than IVUS. Fractional Flow Reserve (FFR) Fractional flow reserve is a test where a fine wire is inserted into the blood vessel to measure pressure and calculate flow down the blood vessel. This allows doctors to determine whether or not the narrowing in the vessel is severe. These technologies have eased the decision making process when it comes to which treatment a patient should receive, as they are far more accurate than the traditional angiogram. He went on to say that while there are several treatments available for heart disease, prevention is still the best countermeasure. The best and easiest way to prevent heart disease is by leading a healthy and active lifestyle. It does not have to be a chore and you don’t have to give up having fun. You just have to incorporate healthy eating habits and exercise into your lifestyle. Once it’s a part of you, it won’t be a hindrance to living your life to the fullest.

Note: Datuk Dr Rosli Mohd Ali is the head of the department of cardiology National Herat Institute or IJN (Institut Jantung Negara).

2015 | NOVEMBER

Andropause, a threat to your sexual life HAS your strong, easy-going and good-tempered partner not been his usual self lately? Does he often get irritated for no apparent reason, suffering from mood swings, complaining of fatigue, and seeming weak and getting depressed? Has he appeared to have lost interest in sex? He may be experiencing symptoms of andropause. WHAT IS ANDROPAUSE?

Andropause, also known as Low T, is defined as a gradual decline of testosterone levels in men. Testosterone is the male sex hormone that is responsible for typical male characteristics such as facial, pubic and body hair as well as muscle development. This hormone also helps maintain sex drive, sperm production and bone health. As a man gets older, his testosterone levels will slowly start to decline. In Malaysia, two studies have found that an average 20% of men above the age of 40 experience testosterone deficiency, i.e. total testosterone levels lower than 11 nmol/L or 350 ng/ dL. Otherwise, for healthy men, testosterone levels decrease as they age, typically about 1% to 1.5% per year after the age of 40. It may not sound like much, but over time, the decline can have unpleasant consequences in some men. Results from scientific researches show that: One in every five men lacks sexual desire One in every nine men does not experience pleasure during sexual intercourse One in every four men has low testosterone levels and low libido A man’s sexual activity declines as they age If your man has low libido, low arousal, less energy and seems depressed or bored with your relationship, it could be due to low testosterone levels. Signs and symptoms of andropause: Low libido (sex drive) Decreased erectile quality Decreased lean body mass Lack of muscle bulk and strength Increased abdominal fat Diminished physical or work performance Bone loss and osteoporosis Hair loss or decreased body hair Changes in mood (irritability, depression, anger, mood swings) Enlarged breasts Low or zero sperm count Low testosterone levels cause both physical and mental symptoms. Many men start to experience a decline in their physical performance upon reaching middle age. This will affect their ego and confidence and they might begin to feel less macho and less capable as it dawns on them that they are not as young as they used to be. This can further lead to frustration, depression and irritability which can interfere with their daily lives. Testosterone deficiency is linked to metabolic syndrome and conditions such as hypertension, hyperlipidaemia, diabetes and obesity. If you have any of these medical conditions, you may be at risk of low testosterone levels. NATURAL HEALTH REMEDIES TO RESTORE TESTOSTERONE LEVELS

Testofen® is a unique fenugreek (Trigonella foenum-graecum) extract, standardised to 50% Fenuside™ and patented and owned by Gencor Pacific Group Inc., U.S.A. Testofen® has the ability to enhance libido and improve muscle mass, properties not seen in any other

MEN+ • 23 currently available non-standardised fenugreek extracts. Research has shown that Testofen® demonstrated both androgenic (increase of male functions) and anabolic (increase in muscle tone and strength) properties, that is, it displays “testosterone-like” activity. In 2009, a double-blind, randomised, placebo-controlled clinical study was conducted on 60 healthy men aged 25 to 52 in Australia. Using a standardised formulation (containing Testofen® as a major ingredient) for 6 weeks, results of this study showed that 85.2% of the Testofen® group experienced an overall positive effect on the physiological aspects of libido. The active group also experienced a statistically significant increase in sexual function and performance. In addition to that, the study participants reported an increase in muscle

strength, energy levels, and wellbeing. According to traditional Chinese medicine, there are several types of ginseng commonly used for their health benefits, with each type having unique healing properties. For example, Asian or Korean ginseng (Panax ginseng) possesses “heating” properties which help improve blood circulation to the extremities. The active compounds in Panax ginseng are believed to be the steroid-like ginsenosides which are termed “adaptogens”. Panax ginseng is often used to improve cognitive performance (e.g. thinking, concentration, memory and work efficiency) and appears to be effective in the treatment of erectile dysfunction. For more information, please call Cambert (M) Sdn. Bhd. at 1300-881712 or email ask-prime@cambert. com.my.

24 •

WOMEN+

NOVEMBER | 2015

Stumbling block Being diagnosed with fibroid is not peculiar among women especially during pregnancy BY NUR HIDAYAH HUSLAN

OST pregnant women desire healthy pregnancies. Having anything that possibly complicates your pregnancy and especially tiny little one seems to be terrifying and scary. Being diagnosed with fibroid is not peculiar among women especially women in pregnancy. Fibroid tumor, also known as leiomyoma or myoma, is a mass of compacted muscle and fibrous tissue that grows on the wall or sometimes on the outside of the uterus. It can be as small as a pea or as large as a grapefruit. Stating the research, fibroid tumors occur in 50 to 80 % women worldwide. Besides, fibroid is commonly said to be linked with fertility and pregnancy. According to Dr. Natasha Ain Mohd Nor, 39, a Consultant of Obstetrician and Gynaecology of Kuala Lumpur Fertility Centre, in her blog http://drnatashafertility.com explained that, “Fibroid in pregnancy is not going to harm your pregnancy. However, for women who are conceiving it are advisable by majority of medical experts to remove the fibroid before getting pregnant. According

Diagram of different types of fibroid in the uterus.

until they have an ultrasound or the fibroid is discovered during a pelvic exam. If you know prior to pregnancy that you have fibroids, ask your doctor whether their size or position could cause problems, and which symptoms to watch for. It is true that it probably will not harm your baby but to be cautious is important especially in the early weeks of pregnancy. However, your risk of miscarriage and premature delivery does increase slightly if you have fibroids. They occasionally cause the baby to be in an abnormal position for delivery. They can also stall labor, or, if they are located in or near the cervical opening, they may block the baby’s passage and might increase the likelihood of cesarean delivery.

Dr. Natasha Ain Mohd Nor, a Consultant Obstetrician and Gynaecology of Kuala Lumpur Fertility Centre

to the global research conducted on women who are greatly risky of getting fibroid, the chances are rather high among African-American women. And the risk is getting higher if they are overweight or obese with high blood pressure problem and it might be inherited from the family members. Other than that, other potential factors are early menstruation as well as insufficient vitamins and nutrition that can be found in dark leafy vegetables and red meat.”

TREATMENT FOR FIBROIDS DURING PREGNANCY

Fibroid will not harm your pregnancy.

Symptoms of uterine fibroids among women.

SYMPTOMS AND EFFECTS TO PREGNANCY

Most women who have one or more of these noncancerous growths experience no pregnancy complications because of them. For the 10 to 30 % of pregnant women with fibroids who end up having complications, the most common is abdominal pain, which occasionally may be accompanied by light or sometimes heavy vaginal bleeding. They may also experience constant abdominal pain, pelvic pressure, frequent urination, and constipation. However, despite all complications of having fibroid during pregnancy, it is fortunate that the baby is rarely affected unless the bleeding is substantial. Fibroids usually develop prior to pregnancy, though many women do not know they have one

Most fibroids do not need to be treated unless the symptoms are causing you problems. Even then, in many cases, your doctor may talk to you first about ways to ease your symptoms. Painful fibroids are usually treated with bed rest, ice packs, and when necessary, medication. Your doctor will recommend the safest treatment for you and those symptoms usually subside within a few days. Fibroids sometimes grow larger during pregnancy, due in part to pregnancy hormones and when uterus expands. Your doctor may recommend ultrasound examinations to see whether your fibroid is growing or likely to cause complications. However, conducting surgery for fibroids before getting pregnant is not necessary, unless you are having troublesome symptoms, such as painful periods and heavy bleeding.

2015 | NOVEMBER

Pregnancy hazard: Birth defects THE vast majority of babies born in Malaysia are healthy, normal and perfect. Unfortunately, there are babies who born with defects recent years. Behavioural, environmental, psychological and nutritional all together contribute to a healthy or unhealthy pregnancy. Poor nutrition and exposure to harmful substances increase your risk of pregnancy problems. These same prenatal factors increase your newborn’s risk of future diseases, learning disabilities and behavior disorders. SMOKING

Everybody knows not to smoke while pregnant, but not many people know why. Mothers who smoke cigarettes or marijuana during pregnancy are likely to bear children with ADHD, low test scores, difficulty processing information, or behavior problems.

DRINKING

Alcohol is one of the most dangerous teratogens, or substances that cause severe birth defects. Alcohol exposure during pregnancy leads to a whole lot of development problems for the fetus, including severe brain damage, ADD, developmental delays, language and speaking delays, fetal alcohol syndrome, and lower reading test scores. EATING JUNK FOOD

Junk food is loaded with artificial additives and flavourings. It also contains a lot of high fructose corn syrup. Many studies have shown that the artificial chemicals found in junk food affects a child’s brain development, even in the womb. Avoid feeding your unborn baby loads

WOMEN+ • 25 of artificial chemicals and flavourings by eating fresh fruits and vegetables and preparing your meals from scratch as often as possible. CONSUMING CAFFEINE

Have you ever wondered why pregnant women are not allowed to drink coffee or tea? Caffeine exposure increases a fetus’s chance of lowered IQ, learning problems, and hyperactivity after being born. DRUGS IN MEDICINE

Once you have confirmed positively pregnant, you probably started worrying about everything that went into your body food, medicine and otherwise. That is probably a very

healthy attitude. Talk with your doctor about your prescriptions and avoid high dosage of drugs in your medicine. HOUSEHOLD TOXIC SUBSTANCES

Harmful substances can get into your body through your skin or when you breathe, eat or drink. Environmental experts advise that you avoid common household solvents, such as turpentine, hazardous cleaning supplies and indoor and outdoor pesticides. Protect you and your baby by choosing more natural cleaning supplies. Ventilate the house regularly by opening the windows for a few minutes each day.

26 •

WOMEN+

NOVEMBER | 2015

Baby! Let’s move! Prenatal exercise, a good benefit during pregnancy

BY NUR HIDAYAH HUSLAN

REGNANCY might seem to be the best time for you to sit back and relax. Feeling “knackered” and exhausted all the time than usual, backache, and swollen ankle are the perfect reasons to stay at ease and slow down lots of physical activities. However, for momsto-be, a new study finds that exercise throughout your pregnancy can improve your mood and boost your energy levels. Therefore, no more feeling extremely fatigue and goodbye mood swings. Findings show significant improvements in the moods of the women, as well as reduced levels of fatigue among pregnant mothers. Prenatal exercise for 30 minutes about four times a week will not only benefit you during your preg-

nancy but it also triggers better postnatal performance of yourself. Prior research has found that prenatal exercise can help manage pregnancy related musculoskeletal issues, improves sleep, prevents excessive weight gain, strengthens the muscles and boosts up stamina as well as shortens labour. Moderate to intensity exercise three times a week during your second and third trimesters, halves the risk of your newborn being overweight and also makes you weigh lighter than mothers who do not exercise regularly. Still, prior studies have found that between 60 and 75% of pregnant women are inactive. Additionally, exercise during pregnancy might also reduce the risk of gestational diabetes and pregnancy-related high blood pressure, as well as lessen the symptoms of postpartum depression. In addition, it might reduce the risk that your baby is born significantly larger than average or scientifically called as fetal macrosomia. Fur-

Regular prenatal exercise eases your delivery.

Walking is the best prenatal exercise for beginners.

“Congratulations, you’re pregnant!” “CONGRATULATIONS, you are pregnant!” Are those the most magical four words you anticipate to hear after you got married? Pregnancy is an exciting time. Revealing pregnancy varies from one mother-to-be to another. Pregnancy is a big news to parents who are expecting and an absolute joy to married couples who have been trying to conceive. As a pregnant mother, I had my own experience in announcing my ‘bun in the oven’ news to my husband, family and friends. I found out I was expecting after almost a week of starting my new job. This ‘baking bun’ somehow triggers in me that sort of unexplainable feeling; extremely excited and slightly worried. Adapting to the nature of my

new career with a baby growing inside my womb is somehow rather testing to my patience and emotion. Feeling needy of a strong support system, it gave me no second thought to utter the brow-raising sentence “I am expecting” when I was just a month pregnant. Many suggested that breaking baby news is most ideal when you hit your 13 to 14 weeks or when you are in your second trimester. Despite it all, it is still very thrilling to witness people shouts and jaw-dropping facial expressions and not forgetting their hugs and warm wishes when you announce your pregnancy. It feels so good! When you decide the best time to spill the beans, there are many fun ways you can do to break the baby news to partners, family,

thermore, regular moderate prenatal exercise will prep yourself to delivery later on. It makes perfect sense that the better shape you are in, the stronger you will become at labour and delivery time. Giving birth requires lots of stamina, determination, and focus, thus exercise will help you to face that tough situation at the same time making

friends and also bosses. PLAYING SCRABBLE

To announce the big news to your partner who is also your baby’s daddy is the most exciting moment for you both. Playing Scrabble is one fun and creative way to break the news to your spouse. ‘BAKING YOUR BABY’

Pregnancy is a big news to tell.

Do not take its literal meaning. Baking a bun in the oven could be a fun trick to symbolize that you have ‘bun in the oven’ and your partner will become a father. You can try putting an ultrasound picture of your peanut in the oven and ask him to take it out for you. He will definitely be crying out of joy looking at the picture. It could be the funniest and most memorable moment for both of you!

it much easier and faster than you could ever imagine. For hot mommas, gaining pregnancy weight might be stressful. However, gaining weight needs no worry if you practice regular exercise during your pregnancy. Your prior body image and weight will soon be gained again. When you have maintained your strength and muscle tone all through your pregnancy, your body will have easier time bouncing back after giving birth. Still, before you begin an exercise programme, be sure to talk to your doctor or midwife about any risks with your pregnancy. It is advisable to most pregnant women to do at least 30 minutes of moderate exercise on most days. In fact, light exercise such as walking is a great exercise for beginners who intend to start doing prenatal exercises. Other good choices includes swimming, low impact aerobics, and cycling on a stationary bike.

FAMILY DINNER

Big family dinner that may be held once in a month could be the best time to break the big news. You can first tell your mother and she will be cooperative enough to take action in the middle of eating time. Your mother could first say “I am becoming a grandmother!” If you have a married sister, it could be more dramatic when everybody started looking at your sister and suddenly she shakes her head. That is the moment when everybody start turning at you and said, “You’re pregnant!” BABY FOOD

Another fun trick you can easily try is by telling your husband that you are going to cook dinner for him. Show him your grocery list you have prepared for him to buy for you. On it written al the ‘baby veggies’ like baby back ribs, baby carrots, baby peas and other foods with ‘baby’ in it. Then the last one you can write is your baby’s daddy. He will surely get the message crystal clear and his overwhelming expression is indeed priceless. – Nur Hidayah Huslan

OPINION+ WOMEN+ • 27

2015 | NOVEMBER

DELIVERY TIME

By Dr Mohd Suhaimi Hassan

One is nice, two is fun, three is crowded

AV I N G t w i ns or multiple pregnancy seems to be the desire of most couples who undergone fertility

breech and the presence of medical conditions such as gestational diabetes and pregnancy induced hypertension. Screening for chromosomal anomalies such as Down’s syning for obstetricians. It will be dif-

treatment. “Oh, I wish I had twins, I hope I have twins, why not have two at a time? Pleading to their doctors. What could be better than completing your family in one go, with twins or even more babies? However the reality is that for many twins and triplets, life can be

Reproductive specialists are always being pressured by couples to put in more than two embryos during their IVF treatment. Putting in more embryos would result in higher pregnancy rate but the rate of higher order multiples such as twins and triplets also increases. At present, about 1 in 4 IVF pregnancies lead to a multiple

time, small size of the baby (low birth weight) and possibly birth defects which include cerebral palsy. Cerebral palsy is more likely found in premature babies. At least half of twins are born before 37 weeks and with low birth weights, making them at high risk of serious health problems and death. Many are born before 35 weeks, when they often need neonatal care. Twins also have higher risk of anemia or low hemoglobin during pregnancy. Hemoglobin carries oxygen, and if the oxygen is low, it

ICSI, you are around 20 times more likely to have a multiple pregnancy than you would be if you have conceived naturally. Women should understand that the human womb was created for just one baby. Having two is fun but three is a crowd for a small womb. Yes, we do understand that having twins or multiples are fun, but it is not without risks. Compared to having one baby, twins and other multiples are more likely to have serious and even life threatening health problems. mother and baby. It can cause early or late miscarriage more than singleton. Medical condition risks such as gestational diabetes and pregnancy induced hypertension tend to be higher in women with multiple pregnancies. Women with gestational diabetes will have the risk of sudden intra uterine death which can be devastating to women who have been waiting long to get pregnant. ly than single-birth babies to die many reasons for this which includes being born prematurely i.e. born before the actual expected

Note: Dr. Mohd Suhaimi Hassan is a Consultant Obstetrician, Gynecologist & Fertility Specialist at the Columbia Asia Hospital in Setapak.

have a higher risk of bleeding following delivery. Bleeding can also take place before delivery. Emotional risk tends to be higher in those with twins. It can be costly emotional roller coaster to go through IVF treatment but having premature babies can add to the psychological burden. Hence their post natal recovery can be slow leading to postnatal depression or post natal blues. During birth, mothers of twins are more likely to require intervention, more likely to experience serious problems and more likely to die than mothers of singletons. Caesarean is common among twin births. Most women would request for Caesarean as generally they would not like to go through the risk of normal labor .Other reasons as to why Caesarean increases is because of higher risk of placenta praevia (low lying placenta), mal-

other one has Down’s syndrome. In identical twins who shared the same placenta, there is a 10% risk of twin to twin transfusion syndrome which can cause serious health problems and death. In this syndrome one of the babies received enough oxygen from the umbilical cord and the other one is receiving less oxygen is because of problem does not occur in non identical twins. Women with twins or mulshould also consider the potential problem of bringing up twins in could lead to long term impact to the couple leading to separation of family in the future which is often twins not just as babies but as they get older as well. Dividing care and attention between two children can If women have twins or multiples, it is not the end of the world for you. You will need to have more checks with their obstetrician throughout the pregnancy. For those with triplets or more you have the option of fetal reduction. of the fetuses resulting in singleton or twins pregnancy. However this procedure is not without risks. It may cause miscarriage of all the fetuses. Having multiples can be fun but understanding the risks is very important before you embark on IVF treatment. It is my hope that this article will guide you on deciding the number of embryos to be put into your womb during your treatment.

28 •

JUNIOR+

NOVEMBER | 2015

Hazards of haze to children

IGHT-YEAR-OLD Ahmad (not his real name) was a picture of joy, he was going home. No more rashes. No more itch. No more hospital stay. What a relief after a traumatic two weeks which first saw rashes break up, then spread, clump together like hives, and make him itch all over. Over a period of 11 days, he had been taken to see three doctors but his condition did not improve. Only after his parents decided that he had to see a pediatric specialist that he was diagnosed with Urticaria Rash or commonly called Hives, a condition triggered and worsened by the haze. After the second day of admission, his condition improved and was discharged the following day. Just when he thought everything was fine, the rashes appeared when he reached home. The air quality as a result of the haze brought the hives back and Ahmad was back in the hospital again. In the same hospital was sixmonth old Mei Choo (not her real name), who just three weeks ago developed a cough and the condition worsened even after seeing several doctors. The cough was so bad that she could not take her regular feed of milk. In the hospital, it was detected that she had lung infection and her condition, aggravated by the haze, had developed to Bronchitis and Pneumonia. Prolonged haze and the accompanying poor air quality have been commonly known to cause respi-

ratory problems but it can be hazardous to those with sensitive skin too. It can rain blows on particularly children who are more susceptible to worsening conditions than adults. The small particles that cause haze are composed of microscopic solids or liquid droplets that are so small that they can get deep into the lungs and cause serious health problems. When inhaled, they can enter the bloodstream and get absorbed by underlying tissue, potentially interacting with other compounds and substances in the body. Due to their greater respiratory rate, children breathe a proportionately greater volume of air than adults. As a result, children inhale more pollutants per kg of body weight. Children’s physiological vulnerability to air pollution arises from their narrower airways and the fact that their lungs are still developing. Irritation caused by air pollutants that would produce only a slight response in an adult can result in potentially significant obstruction in the airways of a young child. Malaysia uses API (Air Pollutant Index) to calculate air quality in the region. A reading of 0-50 is considered ‘good’, 51- 100 ‘moderate’, 101-200 ‘unhealthy’, 201-300 ‘very unhealthy’. A reading above 300 is ‘hazardous’. API readings take five things into account: ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2) and sulphur dioxide (SO2), and particulate matter with a diameter of less than 10 micron

By DR JOYCE LOO

(PM10). PM10 is the dominant pollutant in haze, and this is what is mostly measured to determine the API reading. The naked eye can in general only see particles larger than 40 microns. HOW DOES THE HAZE AFFECT THE YOUNG?

Exposure to the haze can harm the nose, lungs, and eyes of young children and result in the following signs and symptoms: Dry cough Itchy eyes/ nose Rashes Wheezing Dry/ sore throat Reduced effort tolerance Worsening of underlying medical condition such as asthma, and skin allergies Considering that children are more susceptible and prone to re-

spiratory and skin discomfort, it is advisable to take the following precautionary measures to protect them from the haze: Stay indoors and reduce outdoor activities as much as possible Take a shower once they are back from exposure to outdoor Keep home clean by mopping the floors to reduce indoor particles Change children’s beddings more frequently to prevent inhaling particles during sleep Use an air purifier if available preferably one with HEPA filter Drink plenty of water Keep windows and doors closed and keep the air conditioner filters clean Seek medical attention immediately if symptoms are not improving Adult who smokes should not do it indoors

Encourage your kids to eat healthy BY ZURINNA RAJA ADAM I HAVE three kids at home aged seven years old, three years old and five months old. While I do give them leeway sometimes to have some chocolate spread and icecream as treat, I make sure they are well-aware of the difference between

healthy and non-healthy food. Here are 6 tips I pick up from the internet which I find very helpful to encourage healthy eating among children. 1 – BE A ROLE MODEL

Monkey see, monkey do. Make sure you put those broccolis in your

FOOD FOR THOUGHT: Snacking healthily

mouth before preaching its benefits to the little one. Studies have also found that children’s food tastes are significantly related to what their mothers like and dislike. So brace yourself with those greens!

2 – GET YOUR KIDS INVOLVE IN MEAL PLANNING

Gone are the days when our mothers would shoo us away from the kitchen while they were cooking.

CONTINUED PAGE 28

2015 | NOVEMBER

JUNIOR+ • 29 Clear skies in months PERSISTENT rain have cleared the air of haze in parts of Indonesia, Malaysia and Singapore for the first time in months. Cleanest air was enjoyed by citizens starting from Thursday the 29th of October. The director-general of the Malaysian Meteorological Department, Che Gayah Ismail told AFP news that “we should have blue skies and no more haze. Any haze after the fires and resulting regionwide pollution occur to varying degrees each year during the dry season as vast Indonesian plantation lands are illegally cleared by burning. Experts had warned that this year’s outbreak was on track to become the worst yet due to bone-dry

Kids who are on medication should remain compliant to pre-existing medication for their underlying medical condition. Older kids should wear a N95 masks when outdoor and exposed to haze. Children generally do not like to put on masks for a longer period as they find it suffocating. The N95 masks with a small window by the side will be more suitable as they do help to ease the discomfort and feel of suffocation. The N95 mask is, however, not suitable for younger kids with smaller face because it does not fit perfectly and will not be adequate to offer appropriate protection. While it is advisable for children to wear a mask outdoor during a haze, NEVER put on a mask on babies and young toddlers as they can restrict the child’s breathing. In addition to these precautionary measures, parents should always monitor their children’s condition closely particularly those who start to develop respiratory and skin conditions so that they do not worsen as the case of Ahmad and Mei Choo. In cases where the allergy or rash do not subside or improve after three days, please consult a doctor. And in cases of respiratory problem or where lung infection has developed, also consult a specialist if conditions do not improve especially if the child is not active or the appetite is not better within 48 hours after consumption of medications. Parents are also advised not to treat symptoms with over the counter medication and antibiotics from pharmacies because the dosage for medications varies according to age group. Note: Dr Joyce Loo is a Consultant Paediatrician of Manipal Hospital Klang. This article is courtesy of Manipal Hospital Klang. The information provided is for educational and communication purposes only.

conditions caused by the El Niño phenomenon, which alters weather patterns across the Pacific basin. Indonesian authorities say 19 people have died either fighting the fires or due to the smoke, and that half a million Indonesians are suffering from respiratory illness.

30 •

JUNIOR+ OPINION+

NOVEMBER | 2015

By Dr. Ling Shih Gang

experience as possible about the

OU have just returned from a hectic day at work. As you go over to fetch little Justin from the baby sitter, you notice that your little one is not quite himself. His body is warm and the baby sitter informs you that he has just vomited twice. Your anxiety mounts as you bring him to the paediatrician. After coming home from the doctor’s visit, you and your spouse stay up all night worrying and tending to your sick little one. our modern homes these days. While it is fully understandable for parents to feel anxious whenever their child falls ill, such circumstances can still be viewed in a positive light. Having some of these positive attitudes will certainly help parents remain calm and reap moments: ILLNESS BUILDS MEMORIES

What incidents do we, as adults, remember of our parents’ love during but they almost always include times when parents cared for us during our illness. Such memories are important in the long run. Even after the children had long grown up, these memories will form the basis of their relationship with their loved ries of how they were being cared for during their childhood illnesses will prompt them to care for others the

same way. In addition, such memories often serve to remind the children of our unconditional love for them build enough of such memories in our children, no matter how far they may stray away from us in later years (especially during adolesway back to us again because of the memories we have built in them. So, when your children fall ill, fuss over them, pamper them. Take leave from work if you must. Start building memories in your children that will last a lifetime. ILLNESS IS A TEACHABLE MOMENT

Children are very temperamental to learn new things. Most of the time, when we try to teach children something important, they are either not paying attention, or even if they do pay attention, they would just smile and run off to do their own activities, as if nothing registered in their young minds. However, there are time pockets where they are more receptive to learning. able moments. And these moments occur ever so frequently when the child is sick. You can identify a teachable moment by how focused and responsive your child is to what you have to say. So use this time to talk (not nag) to them about important

THE YOUNG ONES

Being positive during your child’s illness

Note: Dr. Ling Shih Gang, MBBS (Malaya), MRCP (UK), M. MED (Malaya) Consultant Paediatrician at Tropicana Medical Cantre.

ILLNESS BUILDS FAMILY BONDS

When a child falls sick, the whole family would usually rally around with one common goal – to ensure

attitudes and values. At times, you can use a particular illness to illustrate a point. A few months ago, I saw a nine-year-old girl with an infected wound followprobably set in due to her excessive plained that the child had very bad temper. So I used the opportunity to get across a very important lesson. “You know, Julie (not her real name),” I started. “Getting angry is very much like the mosquito bite you had. But if you do not control your anger, it will hurt you a lot more, as much as this wound is hurting you now.” ILLNESSI IS A LEARNING EXPERIENCE

When your child comes down with an illness, it is helpful for you to gather as much information and

Encourage your kids to eat healthy FROM PAGE 26

Today, we see Instagram picture of kids as young as 3 years old baking fast. Get your kids involve in grocery may set them way ahead in managing their own expenses in future. Make healthy snacks available within reach for your kids and have absolutely NO JUNK FOOD in the

sometimes. I think it is perfectly all right for kids to have “cheat day treat” once a while. What’s important is making them aware of the choices they make. When such practice is impose, kids are sometimes

form of unity is a strong stimulus to building solid family bonds. I recently had an opportunity to make a home visit to treat a nine-year old child who was wheel-chair bound. In the home I noticed how the whole family, the father, mother, siblings, grandmother and maid showed so much concern and care for the sick child. Through the child’s illness, I believe the family ties have been further strengthened. I told the siblings, “Your sister cannot care for herself now. So it is your responsibility to care for her and help her get well again.” However, each family member must be careful not to start blaming the child, blaming themselves or blaming each other during the child’s illness. How often do we hear parents say, “Oh I’m a bad mother,” or “It’s all your fault. You shouldn’t have allowed him to have the iced drink” Such remarks would not help the situation at all and may make the situation worse by getting everyone tensed up. Certainly no parent would want their children to fall ill. However, getting sick is part and parcel of cial that parents look towards the illnesses aren’t such a bad thing after all.

ferent dish the next time. Studies show that children need multiple exposures (up to 10 times) to try and begin to take a liking in certain food.

house. Encourage simple snacks like fruit cocktail, parfait, yogurt, nuts, raisins and dried fruits to children. My mother told us she gets wary

experience you go through, the less likely you will become over-anxious the next time the illness comes. I have a longtime friend who used to call me up regularly to ask for advice whenever her children fell ill. After a couple of years, she had become so well versed with various illnesses that she was able to handle most of her children’s illnesses on her own, just occasionally calling me up to double check. She has reached a stage where she can take charge of her children’s health.

Inspire kids to eat green

able to set the limit themselves, even with a chocolate fountain spread in front of them the entire evening. ..and don’t give up. And don’t force feed either. If your kids do not like

Plan your meal ahead on a weekly or monthly basis and you may even note the nutritional value your family has for the day. I make my meal chart on a three week basis on repeat. It saves times to plan the meal for the day and it is always comforting to know my children are getting nutritious food at home. All the best!

2015 | NOVEMBER | 31

32 •

BEAUTY+

NOVEMBER | 2015

Go nonchemical Herbal and organic products are proven best and safe BY NUR HIDAYAH HUSLAN

E are all concerned about our health and well being, which means that it is important that we are proactive in choosing products that are good for us. Choosing organic skin care products and organic make-up does not have to be a tedious process. Herbal

or natural products are considered best for the skin and hair care. These products have gained the popularity mainly because of their lack of side effects. Herbal products are very effective for enhancing the health of skin and hair and they are becoming very popular worldwide. Herbs play crucial role in the beauty treatments and also in promoting overall health. Herbal products are just like herbal medicines which are made from herbal ingredients or herbal extracts to enhance the physical beauty of human body. This kind of product has been

JUST NATURAL: Be a natural beauty, you do not need harsh chemicals.

a part of beauty regime from the ancient times. Unlike synthetic or chemical based products, herbal cosmetics and herbal products are not harmful for the body as they do not have any side effects. Another important advantage of herbal cosmetics is that with proper knowledge and guidance,

people can make their own herbal beauty products very easily. The successor of a well-known local herbal product, Jamu Mak Dara, Halimah Shuib, 71, said she makes her own herbal products that benefit majority of local women in Malaysia. The ingredients used in certain products are very

BEAUTY+ • 33

2015 | NOVEMBER

SHAMPOO

HAIR SPRAY

AVERAGE NUMBER OF CHEMICALS: 11 MOST WORRYING: Octinoxate, Isophthalates. POSSIBLE SIDE-EFFECTS: Allergies, Hormone Dysruption, Irritation to eyes, nose and throat, Changes in cell struture.

Afi q

r No

AVERAGE NUMBER OF CHEMICALS: 15 MOST WORRYING: Sodium Lauryl Sulphate, Propylene Glycol, Methylisothiazoline. POSSIBLE SIDE-EFFECTS: Neurological damage in fetus, irritation, possible eye damage.

EYE SHADOW

DEODERANT

AVERAGE NUMBER OF CHEMICALS: 26 MOST WORRYING: Polythylene Terephthalate. POSSIBLE SIDE-EFFECTS: Linked to cancer, Infertility, Hormonal Dysruptions and Damage body organs.

AVERAGE NUMBER OF CHEMICALS: 32 MOST WORRYING: Aluminium Zirconium, Isopropyl Myrislate. POSSIBLE SIDE-EFFECTS: Organ Irritation, Hormone Dysruption.

Endangered health. LIPSTICK

BLUSH

AVERAGE NUMBER OF CHEMICALS: 33 MOST WORRYING: Polymenthyl Methacrylate. POSSIBLE SIDE-EFFECTS: Linked to cancer, Allergies.

AVERAGE NUMBER OF CHEMICALS: 16 MOST WORRYING: Ethylparabens, Methylparaben, Propylbaraben. POSSIBLE SIDE-EFFECTS: Rash, Irritation, Hormone Dysruption.

FOUNDATION

NAIL VARNISH

AVERAGE NUMBER OF CHEMICALS: 24 MOST WORRYING: Polymethyl Methacrylate. POSSIBLE SIDE-EFFECTS: Allergies, Discrupts immune system, Link to cancer.

AVERAGE NUMBER OF CHEMICALS: 31 MOST WORRYING: Phthalates. POSSIBLE SIDE-EFFECTS: Linked to cancer, Hormone Dysruptions, Fertility issues and Problems in developing babies.

Natures beautify you. FAKE TAN

important to ensure the quality and effectiveness of them towards customers. She said, “Herbal and natural ingredients used in the products might take a longer time to prove its effectiveness, nevertheless the result gained will be better. Another factor is that herbal and natural ingredients will not cause you any harm and adverse effects even for now and the future. They are totally safe.” When we are young, our body is programmed to maintain clear, smooth, soft skin, and we have to really ignore our skin or take it for granted to derail this programme. As we age, however, our skin begins to work less efficiently, thinning out, losing elasticity, and sagging. Exposure to stress such as environmental, physical, and mental only aggravates this natural aging process. However, the ageing signs can begin at a much younger age if our skin does not receive proper care. Proper care does not have to mean using lots of expensive or complicated products. Organic skin care, a logical and relatively simple approach that holistically nurtures our skin’s natural ability to maintain good health. Halimah added, “Herbal and organic products are not only proven best and safe but they also treat our skin and health from the inside out and from the outside in.” As mentioned above that herbal cosmetics or natural cosmetics do not have any side effects. The natural elements in them are highly beneficial for the body and we do not need to worry about the harmful chemical substances. These cosmetics are also very easily available in the market and come in wide range of products. You can either buy them or can make your own cosmetics and daily products like body lotion and shampoo with very little effort. Some The healing of the very common herbal or natural powers of ingredients for enhancing beauty are olive oil. aloe vera, lemongrass, calendula, basil, lavender, thyme, sandalwood, turmeric, fuller’s earth, saffron, honey and neem.

It’s good to go organic and natural.

PERFUME

AVERAGE NUMBER OF CHEMICALS: 22 MOST WORRYING: Ethylparaben, Methylparaben, Propylparaben. POSSIBLE SIDE-EFFECTS: Hormone Dysruptions, Rashes, Irritation

BODY LOTION

AVERAGE NUMBER OF CHEMICALS: 32 MOST WORRYING: Methylparaben, Propylparaben, Polythylene Glycol, also found in cleaners. POSSIBLE SIDE-EFFECTS: Rash, Irritant, Hormone Dysruption.

AVERAGE NUMBER OF CHEMICALS: 250 MOST WORRYING: Benzaldehyde, Toluene. POSSIBLE SIDE-EFFECTS: Sperm damage, Organ Irritant, Link to cancer, Hormone Dysruption.

“The National Cosmetology Association, gives out more than 1 million cosmetics and personal-care products each year to about 30,000 breast cancer patients.” -Dr. Epstein MD. LINKED TO CANCER COULD AFFECT YOUR FETUS

Toxic beauty: How chemicals ‘beautify’ you.

Decipher product labels worth a try to healthy future PETALING JAYA: If you want to protect your body from the harmful ingredients that are used in most commercial brands, you should check out organic skin care products and organic make up. Of course, you will need to get in the habit of reading product labels, just as you probably do already when it comes to the foods that we buy. Getting reasonably familiarise with the “bad” ingredients that are so commonly used in skin care products, will let you learn to distinguish between synthetic and natural products. Becoming a more conscience consumer will allow you to make smart choices while shopping for your skin care and body products. ALPHABETS ARE NOT INDICATORS

It may get a little frustrating

Skin rashes; the effect of chemical products.

when you are initially trying to interpret labels because there are so many ingredients listed. One thing you can use that will help you to understand product labels is to break each label into thirds. Focus on these three ingredients first, because they usually make up the majority of the product. The ingredients should be listed in descending order according to

the amount used to make up the formula. The bigger percentage of one particular ingredient than the others is practically proven that it makes up the majority of the product. IMMEDIATELY ABSORBED AND ADVERSELY AFFECT

Most of these compounds are absorbed easily by the skin, yet the body has no way of ridding itself of them. According to research, chemical substances in our daily used products will be directly absorbed into our bloodstream causing toxic effects. The toxins remain in your intestine and eventually get spread through the body and can damage organs throughout your body. Some of the harmful ingredients that are used frequently in manufacturing the most common non-organic skin care and make up items include: Mercury, Dioxane, Nitrosamines, DEA, Cyclomethicone, Ammonium Laureth Sulfate, Alcohol, Isopropyl (SD-40), Polyethylene Glycol and Polyethylene eth. It is necessary to know about these essential ingredients for all organic skin care products and organic make up that there are both synthetic and natural versions of each. Synthetic emollients, humectants, emulsifiers, surfactants, and preservatives are all harmful for our bodies. In fact, the wealth of information that is available to us on the Internet, researching almost any product is a task that is relatively simple, and well worth the effort. Some of the ingredients that you will find present in many type of skin care products, including organic skin care products and organic make up: Emollients, Humectants, Emulsifiers, Surfactants and Preservatives. Organic shampoo and conditioner can help to revive your hair and scalp from years of harsh treatment caused by the use of traditional store bought products. Of course, these traditional products are the easiest ones to buy, and they are cheaper, but when it comes to what is good for you and your health, consider spending more that actually save your future funds on treating diseases. – Nur Hidayah Huslan

34 •

BEAUTY+ OPINION+

NOVEMBER | 2015

LOOKING GOOD

By Dr Alice Prethima Michael

How popular are cosmetic treatments in Malaysia

LASTIC surgery might be a touchy subject as it deals with changing the general outlook of a person. In fact, it can be quite a taboo for some people and communities while in other more modern societies; plastic surgery seems like a norm. Plastic surgery is not always about changing your outlook to look younger or prettier. However, reconstructive plastic surgery is sometimes necessary especially when someone needs corrective surgery due to accidents or mishaps. According to the Malaysian Medical Council, the billion dollar industry is growing by 15% annually. In fact, plastic surgery is a

Many centers claim that they are aesthetic clinics when in fact there are no practicing licensed professional on the staff roster. Consequently, it has affected the industry with factors like unskilled work as well as potentially harmful practices.” growing industry where more and more Malaysians are finding ways to stop the aging effects as well as to change their image in one way or another. Malaysians are becoming more conscious of the importance of their physical appearance. The advantages of non-invasive and minimally invasive procedures which can make a difference with little or no downtime, has prompted many to take their first step toward looking better. Despite all those scare stories about botched boob jobs and liposuction gone wrong, cosmetic surgery is still a booming industry in Malaysia. With the advent of Malaysia’s status as a hub for medical tourism in the region, aesthetic clinics in Malaysia are receiving an increasing number of patients from outside the country. There is confusion often amongst consumers as to

the nature of different types of aesthetic centers. Many centers claim that they are aesthetic clinics when in fact there are no practicing licensed professional on the staff roster. Consequently, it has affected the industry with factors like unskilled work as well as potentially harmful practices. Often in different centers, there are alternative technologies which are offered to the consumer. Sometimes these alternative technologies are unproven and unlicensed. These technologies can also cause harm to consumers, especially if the proper research is not done beforehand. CURRENT ISSUE RELATED COSMETIC TREATMENTS IN MALAYSIA

There are no direct laws to prevent an unqualified person to perform cosmetic surgery or non-surgical procedures or to make them face criminal charges even if the patient dies or is disfigured as a result of a botched job. Other than that, The Consumers Association of Penang (CAP) wants the federal government to legislate tough laws to allow criminal charges with severe punishments, including jail sentences, on unqualified cosmetic surgeons; especially those who caused death or disfigurement on clients. The potential for huge profits, however, has spurred the growth of back-street practitioners with little experience or expertise in handling the surgeon’s scalpel or even other non-surgical cosmetic equipment. This has lured not only “quack doctors” but also general practitioners who are untrained in the field to want to make a quick buck. Presently the Health Ministry has powers only to act under the Private Healthcare Facilities and Services Act (PHFSA) 1998 and also the Medical Act 1971 if doctors untrained in cosmetic surgery

are found to be involved. These antiquated laws are deemed to be insufficient to protect consumers from being duped by these unqualified so-called “cosmetic surgeons”. Given the situation, more and more people, especially young women, are falling prey to unscrupulous beauty centres which feed on their insecurities and desires. In 2007, the Health Ministry drew up a guideline on the dos and don’ts of cosmetic surgery. Under the guidelines, non-medical specialists, including private general practitioners, are not allowed to carry out procedures such as breast implants, liposuction, eyelid surgery, laser and light-based therapies and hair transplant.

Note: Dr. Alice Prethima Michael, the Cosmetic & Aesthetic Expert & Founder of Ageless Medispa Dr Alice Clinic +6013 339 9887 facebook page: Dr Alice Total Wellness Center. Cosmetic Physician/ Cosmetic Surgeon/ Board Accredited Laser Surgeon, (MBBS Medicine & Surgery) Madras India, (MFM) Australia, (LFOM&MFOM) Royal College of Physician Ireland, (Dip in Reproductive Medicine) UPM Malaysia, (Dip in Dermatology) Cardiff, (Dip in Cosmetic Medicine & Surgery) ACCS Australia, Member of American Society of Medical Laser & Surgery USA, Member of American Board of Laser Surgery USA, Member of American Academy of Anti-Aging USA

2015 | NOVEMBER | 35

36 •

EYECARE+

NOVEMBER | 2015

Seeing vision in a new light THONEH celebrates World Sight Day by raising awareness on eye health

ETALING JAYA: Every second Thursday of October, organisations from all around the world observes World Sight Day – placing global attention to blindness and vision impairment. In conjunction with this awareness raising event, the Tun Hussein Onn National Eye Hospital (THONEH) launched the World Sight Day 2015 at its new building here. In their bid to raise public awareness on blindness and vision impairment, THONEH partnered with the Department of National Unity and Integration (JPNIN), the Japanese Chamber of Trade and Industry, Malaysia (JACTIM), Lions Club, and Rotary Club to celebrate this year’s World Sight Day, themed “Eye Care For All”. The auspicious moment was officiated by Gandesan Letchuman-

an, director general of JPNIN, who thanked THONEH for including the Rukun Tetangga community in its eye-screening programme. He also congratulated the premier eye hospital for taking the lead to raise awareness on preventable blindness and vision impairment as well as initiating private-public-government collaborations to bring better eye care for all. In his speech, Gandesan highlighted the need to prioritise the wellbeing of the community, especially with regards to improvements in healthcare. He thanked THONEH for providing affordable eye screening services to the community, with its high-end facilities, modern equipment, and skilled and experienced workforce. “This collaboration is not just about achieving a comfortable standard of living or quality of life,

Fatty fish.

Clementines, oranges and mandarins.

GETTING TOGETHER: The launching of 2015 World Sight Day by THONEH

but it is about building a caring and inclusive nation,” said Gandesan. “The wellbeing of the rakyat plays a key role in realising this aspiration, and vision is a vital health issue.” A SHOW OF SUPPORT

At the launch ceremony, Hajime Tokuda, chairman of JACTIM International Culture Exchange Committee, presented a mock-up of the Fundus Camera, which they partly sponsored to Dato’ S Kulasegaran, the vice chairman of THONEH. The Fundus Camera is a specialised microscope, designed to allow an ophthalmic photographer to photograph a wide area of the retina, which is used to diagnose and treat eye diseases. The Petaling Jaya Lions Charity

Foundation, represented by president Ronnie Wong Chim Yiam, presented a mock cheque of RM50,000 to THONEH, highlighting their support for THONEH’s mission to raise public awareness and provide assistance to the visually impaired. The funds will go towards screening programmes and other activities to raise awareness on the need to protect eyesight. The World Sight Day 2015 celebrations at THONEH saw eye examinations being conducted, with more than one hundred people being screened for eye diseases or problems, ensuring visitors can look forward to a bright future. COLLABORATIVE EFFORTS

Since the Lions Sightfirst Pro-

Blueberries.

6 TOP foods for healthy eyes

Spinach.

WORLD Sight Day took place this year on Oct 8, the perfect occasion to review your eye health. Read on for a selection of the most beneficial foods to counter eye disorders and help maintain excellent eyesight.

FATTY FISH Rich in omega-3, fatty fish like tuna, herring or sardine (steamed or grilled) nourish the cell membranes of nerve cells, including the retina and also prevent the onset of eye diseases linked to aging.

CLEMENTINES, ORANGES AND MANDARINS As with all citrus fruits, these three foods can be found almost year-round and are rich in vitamin C. They contain antioxidants that protect the cornea and crystalline lens of the eye and help prevent cataracts, a disease caused by age that causes clouded vision, especially at night.

BLUEBERRIES Renowned for improving night vision and tested for this by Royal Air Force pilots during World War II, blueberries contain vitamin C and anthocyanins, components that boost visual acuity and that can help alleviate eye fatigue.

CARROTS As with a number of other orange and yellow fruit, the carrot is full of beta-carotene, an antioxidant precursor of vitamin A and rich in pigments that protect the retina, especially against cataracts. It’s also important to note any vitamin deficiencies that could provoke decreased visual acuity. Carrots should be consumed cooked several times per week.

EYECARE+ • 37

2015 | NOVEMBER

gramme in conjunction with World Sight Day 2000, the Lions Club of Petaling Jaya (LCPJ) and THONEH have collaborated to carry out projects in rural areas, providing assistance to the needy through eye awareness campaigns, screenings and even cataract operations. In 2003, it created a fund raising and public awareness project called the “Blind Leading the Blind Charity Walk”, which has gained national attention and international recognition. This unique event sees a parade of pairs – one of them blindfolded, the other guiding them – in order to understand the loss of sight and associated fears such as disorientation and loss of independence. The funds raised are donated to THONEH for cataract operations provided to those who are unable to afford such treatments. LIFESTYLES LEADING TO VISION IMPAIRMENT

As the world population continues to grow, people are living longer, but this has also led to an increase in a population with vision impairment. According to the World Health Organization (WHO), there are over 45

Broccoli.

SPINACH Rich in pigments, beta-carotene and vitamins, spinach is a super food for eye health as it protects against loss of visual acuity and UV rays. It should be a staple of your kitchen ingredients and consumed several times per week either alone or with sides, in a salad or cooked to your liking.

45mil

blind people, with 80% of which are aged over 50.

30%

prevalence of diabetes, which affects approximately of Malaysians.

Carrots.

BROCCOLI This green vegetable, as well as its entire family of cruciferous vegetables, are rich in pigments and antioxidants and contain a high level of vitamin C that protects the retina and the crystalline lens from UV rays as well as free radicals, harmful to vision. These vegetables are to be consumed without moderation in gratin dishes, steamed or in tarts all year long. – AFPRelaxNews

million blind people, with 80% of which are aged over 50. The majority of these are either unaware of blindness prevention, or are unable to afford treatment to prevent vision loss. “If diagnosed and treated early, blindness is usually preventable,” shares Dr Pall Singh, who is the THONEH Medical Advisory Chairman. “Another worrying trend is the prevalence of diabetes, which affects approximately 30% of Malaysians. A complication of diabetes mellitus is damage to the blood vessels in the retina, leading to Diabetic Retinopathy.”

Age-related conditions leading to blindness, such as cataracts, refractive errors and glaucoma can be treated or cured, with timely intervention being important in reducing loss in vision. Hence, education and awareness is critical, and the World Sight Day is recognised to reduce the incidence of blindness worldwide. THONEH, established by the Malaysian Association for the Blind in 1986, supports the aims of World Sight Day through various programmes to raise awareness and treat blindness using state-of-the-art eye care at affordable prices.

38 •

EYECARE+ OPINION+

NOVEMBER | 2015

LOOK ANDSEE

By Dr Yen Siew Siang

Lasik above 50? Other considerations: Dry eyes – they are more common in those above 50, due to changes in their body, and also as

ECHNOLOGICAL advances in laser eye surgery have brought continuous improvement in safety and efficacy.

usage - drugs for hypertension, hormone replacement theraphy, anti-histamines, antidepressants, and sleeping pills. Dry eyes are a common side effect of Lasik, especially during the

surgery) has become a mainstream procedure for the correction of refractive errors - over 31 million surgeries performed worldwide in the last two decades. It is a well established fact that most people experience a decline in the quality of their vision when they hit their 40s. And with a very large population of baby boomers now in their 40s and above, the demand for corrective eye surgery has been on the rise. In fact, we see more and more patients over 50 coming in and asking about Lasik.

cant amount of corneal nerves will nerves help to reduce dry eye. But with a newer technology called SMILE (Small Incision Lenticule Extraction) the corneal nerves are preserved and the chance of develSome medications taken by older patients may also cause ocu-

UPPER AGE LIMIT FOR LASIK?

Let’s take a look at a study done by Dr Dimitri Azar and colleagues at University of Illinois, Chicago to dictability of Lasik in patients 40-69 years old. The study involved 710 consecutive laser eye surgeries done by Dr Azar between January 1999 and September 2005. three groups based on age: group one 40 to 49 years old (359 eyes); group two 50 to 59 years old (293 eyes); and group three 60 to 63 follow up check ups, they found

69 years old presbyopic population. Coming back to the question above: Is there an upper age limit? I would say not necessarily. It depends on the state of the eyes rather than the age of the patient. However, this age group has its challenges as they have presbyopia and may have other co-existing seeking refractive surgery must undergo a thorough eye examination, and be considered on a case

by case basis. CONSIDERATIONS AND PRECAUTIONS TAKEN BEFORE PERFORMING LASIK IN THIS GROUP OF PATIENTS

1. The natural lens inside the eye has to be clear and the patient must understand that Lasik will not prevent a cataract from developing in the future. 2. Stable vision and eye power changes in vision or prescription may indicate early onset of cataract. Patients who undergo Lasik when they are already developvision a few years down the line nothing to do with the laser eye surgery not being permanent the culprit is the cataract. 3. Signs of age-related eye diseases, history of diabetes, glaucoma and family history of corneal disorders.

Lasik is contraindicated if a patient is on Amiodarone (a drug to help keep the heart beating normally in patient with heart disorders). Amiodarone may cause coloured haloes around lights, photosensitivity, blurred vision, dry eyes, and lens opacities. So prior to doing any laser eye surgery, your doctor should ask you your medical history and whether you are on any prescription drugs. So in conclusion, being eligible for LASIK has more to do with the condition of your eye rather than your age. Most can expect good outcome when they have realistic expectations. If you do seek laser eye surgery to correct vision problems, make sure you talk to your risks of surgery at your age. Make sure you are fully informed of the advantages and disadvantages as well as understand the aftercare tips to follow postoperatively.

Note: Dr Yen Siew Siang, MD (USM), MS (OPHTHAL) (UKM) is a senior ophthalmologist and laser refractive surgeon with years of clinical experience from Optimax Eye Specialist.

EYECARE+ • 39

2015 | NOVEMBER

Bringing back radiance and sparkle to your eyes THE eyes are an important, but often overlooked, part of overall health. While a bright-looking pair will help make a person look well rested, having clear vision is something essential, as well. New from Kino Biotech is Kinohirevolutionary products work together to not only provide a complete and effective protection for tired eyes, but also minimise wrinkles, lighten dark the eye area. Kinohimitsu Lutein as an oral supplement enhances blood eyes. One sachet before breakfast each day is enough to reduce the appearance of dark eye circles, moisten eyes and protect against UV light. A key ingredient is the FloraGlo It protects the retina, strengthens

Eye health is no longer a geriatric health problem TODAY’S technology-driven society has exposed the younger generations who evolve around computer and video culture, both at work and at home, to “Chronic Eyes Fatigue Syndrome”. Age-related eye diseases which are now afflicting more younger adults may be correlated to the effects of a technology-driven society and a lack of nutrition for eyes protection. Numerous scientific and clinical studies have emphasized the importance of proper nutrition in the maintenance of eye health. The followings are some of the key nutrients which are well studied for the maintenance of a good and healthier vision: Bilberry: Antioxidant for Eye Health Bilberry’s active constituent is the Anthocyanosides, which provides a variety of protective effects for the eyes. These bioflavonoids strengthen the structural integrity of the tiny capillaries that deliver nutrients to the eyes, and

contains extracts of Macqui berry, algae and purple rice, plus lycopene and beta-carotene. Kinohimitsu EyePro, a non-inplied to the eye area, is rich in Acmella Oleracea extract, Kombuchka, Collageneer, PhytoCellTec and Cytobiol. and keep eyes looking fresh. within 10 seconds of use. It defour weeks, as well. Just dab a small amount onto the eye area every mornChew, 45, says Kinohimitsu Lutein has improved his vision. Only after two weeks of taking the product, he

help prevent free radical damage to the delicate structures within the eye. Natural Source of Lutein and Zeaxanthin: Marigold, Wolfberry and Dunalliela Salina Lutein and Zeaxanthin are found exclusively in the macula lutea of the eye and protect the eyes against oxidative damage. Low retinal lutein and zeaxanthin concentrations are shown to be a risk factor for eye problems. Eyebright Eyebright is used for relieving eye problems such as eye strain, or tired eyes. Prevention is always better than cure! Biogrow® OPTIbrite offers you a nutritional solution for healthier eyes. It comes with 5 in 1 comprehensive formulation which consists of Marigold that provide you with the natural source of Lutein and Zeaxanthin, Bilberry, Wolfberry, Eyebright and Dunaliella. Biogrow® OPTIbrite is encapsulated in a vegetable capsule that is suitable for vegetarians. It is beneficial for computer users, individuals who read a lot, drive long hours, exposed to UV rays, watch TV for long hours, and those with fatigue, strained, and watery eyes. Details; call 03-7628 8888 / 03-7956 2220 (Direct) or check out www.biogrow.com.my

feels that his eyes are no longer dry – even after an extremely long day at work. “On nights when I have to work late, I can wake up the next day feeling fresh. My

Grace, 24, and Jamila, 31, both notice promising results from using Kinohimitsu When taken with together with Kinohimitsu EyeBright Lutein, their eyes feel refreshed. One sachet of Kinohimitsu Lutein is equivalent to 15mg pure lutein and 100%

natural and safe, with no sugar, preservatypes of hormones, steroids and chemicals too. Kinohimitsu Total Eyebright is suitable for all age groups. Even children as young as six –who are constantly facing electronics devices such as a smartphone, tablet or Especially recommended for people who are constantly exposed to sunlight or the use of electronic devices, as well as contact due to long hours of reading or driving.

Lazy child or a lazy eye? BY ASHLEY JAMES AS a parent, you would sometimes hear complaints from your child’s teacher at school that he or she seems disinterested and aloof during classes. You would also sometimes see that your child behave the same at home. Before confronting your child and asking him why he is so lazy, you might consider that he maybe, probably, has a lazy eye. Amblyopia, often termed as having lazy eyes, is a condition whereby there is a reduction of vision in one or both eyes in the absence of any ocular pathology. It usually happens when one of your child’s eyes begin to lose more focus in relation to the other eye. As a result, the brain will ignore the image from the poorer eye, not allowing the poorer eye to see. Over time, the vision development of the eye becomes impaired and this impairment is permanent once the child reaches a certain age. Not being able to see well can explain your child’s behaviour of disinthen will fall to the parents to detect possible Amblyopia in their children. toms of developing Amblyopia. Most commonly, a child with an uncorrected power in one eye and is in need of spectacles can develop a lazy eye if the short-sightedness isn’t dealt with. Another way to see if your child has the possibility of developing a lazy eye is through his or her behaviour. Lazithings like recreational activities or even watching television can be a red Lastly, certain children could develop lazy eyes if they are a victim of congenital cataract. Although fairly unto develop Amblyopia.

tion is to stop the possibility of your child from developing lazy eyes. Send your child to an eye check-ups and see whether he or she are in need of spectacles.

A congenital cataract should be remove at once as it will definitely affect the quality of life of your child. For children who had already developed lazy eyes, common treatment include wearing an eye patch over the good eye to help develop the poor eye. Other than that, doctors also make use of special eye drop that basically does the same thing as wearing an eye patch as it blurs the good eye to make way for the poor one to develop. An important note on the treatment of the child is below the age of three. Children who receives treatment around the age of To conclude, early detection is key to avoid children from having lazy eyes, as with numerous other diseases. So if your child seems to be lazy and disinterested in most things, always mind the possibility that he or she might be developing lazy eyes. Ashley James is an Optometrist at Optimax

40 •

FITNESS+

NOVEMBER | 2015

Four mindful exercises for reducing stress in doctors

ANY studies have consistently shown that doctors experience tremendous amount of stress. Doctors generally have better physical health compared to the general population - but not for mental health. This article will introduce to you simple and practical mindfulness-based exercises for stress reduction. What is mindfulness? It is a popular self-help concept that springs from ancient contemplative traditions, in particular Buddhism. However, it was introduced in a secular way by Dr. Jon KabatZinn as Mindfulness-based Stress Reduction (MBSR) programme in the University of Massachusetts Medical Centre in 1970s for coping with chronic pain. Recent metaanalyses indicate that mindfulnessbased interventions are effective for reducing stress, anxiety, and depression among healthy and clinical population. It has also specifically proven to benefit primary care physicians in reducing burnout; improving mood, empathy, job satisfaction, well-being, and quality of life (Fortney, Luchterhand, Zakletskaia, Zgierska, & Rakel, 2013; Goodman & Schorling, 2012; Krasner et al., 2009). Mindfulness involves training the mind to pay wise attention to the present moment with attitude of kindness and beginner’s mind.

The opposite of it is mindless preoccupation with worries about the future and regrets over the past. Below are four mindfulness-based exercises that you could apply easily in busy clinic or hospital settings. 1. MINDFUL-S.T.O.P. This is an exercise for taking short breaks throughout the day and ‘seasoning’ it with positive energy of mindfulness. Taking regular mindful breaks (e.g. 3 times per day) recharges ourselves and enables us to cope more effectively with challenges. Remember Kit Kat chocolate slogan? It is “Have a break, have a Kit Kat.” Similarly, “Have a break, take a Mindful-S.T.O.P.” 2. MINDFUL BREATHING. This involves paying attention to breathing for calming the mind and developing positive mental attitude. As breathing is accessible to us at all times, it is a wonderful natural resource for cultivating mindfulness. 1. Gently invite our attention to rest on the breathing: movement of tummy, c h e s t , shoulder; tiny air sensations around the nostrils or throat, sound of breathing, etc. It is not

By DR. PHANG CHENG KAR

necessary to change the breathing - just observe with curiosity and kindness. 2. Notice how the experience changes during in-breath and outbreath. See if we could follow the whole cycle of breath, observing any changes moment-to-moment. You may gently place your hand on your tummy (which moves with breathing) to help you focus. 3. If the attention drifts away, it is OK. Gently bring it back to the breathing. At times, labelling the breathing, “breathing IN, I know I’m breathing in; breathing OUT, I know I’m breathing out” could be helpful in anchoring attention. 4. Anchoring the breath with positive attitude could also be helpful, “Breathing IN, I see myself as a flower (imagine), breathing out, I’m fresh and energized,” “Breathing IN, I see myself as a tree (imagine), breathing OUT, I’m strong and stable.”

3. RADIATING ‘LOVING-KINDNESS.’ This involves cultivating kindness and related feelings (e.g. friendliness, gentleness, compassion) towards ourselves and others. As kindness is a positive feeling, it buffers stress, promotes wellbeing, and improves interpersonal relationships. This practice has been shown in studies to reduce burnout and empathy fatigue (Klimecki, Leiberg, Ricard, & Singer, 2014; Seppala, Hutcherson, Nguyen, Doty, & Gross, 2014). 1. Recall to mind all the people whom you have met throughout the day, e.g. patients, family members, nurses, other doctors, birds tweeting outside the clinic. 2. Mentally send positive wishes to them, “Pinky (patient), I wish you a speedy recovery,” “Pinky, may your family be free from worries,” “Liza (nurse), I hope you could have a good rest over the weekend.”

3. Do not forget to send good wishes to yourself, “I wish myself well, healthy, and happy. Well done for trying your best to help all your patients.” Savour the kind, friendly, gentle and loving feelings – it is therapeutic. 4. ‘GOOGLE-WWW-YAHOO.’ This involves training the mind to pay attention to the positive aspects of life (e.g. strength, blessings, good deeds, accomplishments) – the opposite of finding faults. Instead of allowing our mind to generate thoughts randomly, we could purposefully cultivate positive thoughts. Research in positive psychology has shown that this helps in rewiring the neurons in the brain to stay positive, healthy and happy. After a busy day of clinical

work, try to ‘Google’ (mentally search or recall) all the good things that have happened throughout the day (e.g. good health, able to help many patients, having helpful nurse, written an article for sharing, read a journal paper, had lunch with a friend) – the WWW’s (What Went Well). Then, rejoice or celebrate (‘Yahoo’) on the blessings. Happiness is found ‘here-and-now’ whenever we pay mindful attention to the wonderful moments of life. To be mindful is easy; remembering to do it is difficult. For improving compliance in mindfulness training, we may install a phone apps (i.e. ‘Mindfulness Bell’) that could be programmed to chime periodically (e.g. 3 times per day) to remind us on mindfulness practice. As a start, I recommend the following daily ‘mindful vitamins’ prescriptions: 1. Mindful Breathing – OM (5 minutes) 2. Mindful-S.T.O.P. – TDS (1-2 minutes each time) 3. Radiating Loving-Kindness – OD (while driving back home from clinic/hospital) 4. Google-WWW-Yahoo – ON (before sleep) Have a mindful day. Note: Dr. Phang Cheng Kar is a consultant psychiatrist who offers mindfulness-based therapy at Sunway Medical Centre. He is the developer of MINDFULGym (www. mindful-gym.blogspot. com).

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2015 | NOVEMBER

Baby-wearing revival gets a fitness twist in Hong Kong HIGH up in one of Hong Kong’s ubiquitous skyscrapers a group of women are being put through their paces, straining against the weight of a novel training accessory -- their children. Dubbed ‘Mumba’ these exercise classes are a new twist on the babywearing trend gripping mothers in the city. Once the preserve of traditional communities, the art of wrapping a baby across a caregiver’s body so it can be carried during daily activities is being taken up by modern parents. In Hong Kong, where narrow hilly streets and unforgiving urban landscape often render strollers and prams useless -- many frustrated

This photograph taken on Oct 6, 2015 shows mothers with their babies attending an exercise class dubbed ‘Mumba’, a new twist on the baby-wearing trend gripping mothers in the city of Hong Kong.

parents are now going back to basics out of necessity. Proving the old adage, invention has followed. ‘Mumba’ fitness, baby-wearing bellydance, ballet, yoga and pilates classes, and even suspension training (TRX) classes have sprung up in recent months -- all allowing parents to exercise while their baby is strapped to them in a carrier. “There is huge demand from mums who wanted to get back in shape and to get strong again after the challenges of labour, but who also didn’t want to leave their young babies behind while they spent time exercising,” explains Ifat Hindes, co-founder of Mumba Fitness. “We have combined different types of exercise including yoga, dance, TRX, and pilates, and the bonus is that you are using your baby for weight training,” she says. “There’s no need for expensive gadgets -- it’s just you and your baby, with other parents, being guided by a professional. You know everyone is in the same boat. Hong Kong can be a difficult and unwelcoming city for new mothers.” – AFPRELAXNEWS

adidas adds activity tracking to Fit Smart adidas has

announced that its Fit Smart fitness band will now offer activity tracking in addition to coaching and heart-rate monitoring. The new feature is available via a free update to the Trail & Run app that allows users to set daily goals for steps, distance and calories burned. Weekly goals allow for a more varied, less regimented approach while training plans have been built with help from Adidas coaches and offer more structure and real-time guidance. – AFPRELAXNEWS

42 •

WELLNESS+

NOVEMBER | 2015

Give your body energy boost

RE you feeling constantly run down and fatigued most of the time? This may be the warning sign that your body is alerting you that something is amiss. You may be wondering what actually saps your energy. Most of the time, fatigue is interrelated with emotional and physical stress. The worries and strains of life’s demands stemming from work, family and relationship can be exhausting, leaving you restless and worn out. Lifestyle factors on the other hand, such as inconsistent sleep, lack of exercise, poor nutrition, irregular mealtime, and overconsumption of alcohol can also cause tiredness. Fatigue can be a symptom of a weak immune system or underlying medical conditions. Needless to

say, constant exhaustion can take a toll on you if left untreated. It can pose profound consequences on your health, job performance and overall quality of life. HOW TO COMBAT FATIGUE?

It is time to adopt a healthy lifestyle and fuel your body with essential nutrients it needs. This way, you can keep your immune system working up to the par. You can get started by obtaining enough sleep and rest, managing stress, having a regular exercise regime, consuming nutritional-balanced diet, staying hydrated and staying away from known stressors before your body becomes worn down. You can also increase your nutritional intake by taking herbal supplements. ENHANCE YOUR ENERGY AND VITALITY WITH LINGZHI

Ganoderma lucidum, also known as

lingzhi or reishi, has a long tradition of use in Asian countries, particularly China and Japan. It is a medicinal fungus with a variety of bioactivities that has been praised for its capability as one of the best fold remedies to promote health and longevity. The main health benefit of lingzhi is its positive role towards the immune system. It acts bi-directionally to normalize the immune systems by bringing it down when it is overstimulated, and ramp it up when it is weakened. A strong body with a robust immune system is vital for optimal health maintenance, not only to keep you off from weariness, but also to fend off catastrophic illnesses such as cancer. Besides its immune-enhancing benefits, lingzhi may also help to boost energy, improve the body’s recovery and healing ability, reduce fatigue, and nourish the heart, liv-

Natural soaps are made with some kind of fat or oil and of course sodium hydroxide or ‘lye’. Most of us have heard our whole lives that oil and water don’t mix. And they don’t - Unless you change their chemical composition. Sodium hydroxide does exactly that. It changes the oil and water so that they can blend and

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Healthy Treats with GlucosCare Herbal Tea

Natural wellbeing THE many benefits of handmade Natural Soap just begin with Aromatherapy. The demand for natural based soap is growing as people are more informed of synthetic additives in commercially made soap and its effect on skin.A natural-based soap will not be using ingredient like chemical colorants, hardeners, latherers or preservatives.

er, lungs and kidney. Recent studies discovered that lingzhi spores are more potent than the fruiting bodies. The spores are cracked using advanced technology to facilitate the release of the active ingredients. The essence of lingzhi obtained from cracked spores is more readily absorbed by the body, hence, offering greater curative efficacy. Along with Lingzhi, shiitake, cordyceps and yunzhi are among the other medicinal mushrooms which have gained much attention due to their various therapeutic properties. A proprietary blend of medicinal mushrooms can be an excellent adjunct to boost your immunity, health and overall quality of life.

become soap. Experience the relaxing benefits of Nature and the high quality ingredients of cold process soaps, massage oils and handmade blends. Inspired by the beauty found in nature, all of our products are made with oils, butters & botanicals derived from the earth, and are scented with pure essential oils.

GLUCOSCARE Herbal Tea is a pharmaceutical grade 100 per cent natural herbal tea, with no artificial color and preservatives. Scientifically formulated with Gymnema herbs and Camellia Sinensis (green tea), GlucosCare herbal tea gives you a combination advantages in traditional Chinese medicine and Indian Ayurvedic. It can be taken daily and is recommended to be taken after food. Packed in small sachets, you just need to dip a tea bag into hot water (300ml) and leave

WELLNESS+ • 43

2015 | NOVEMBER

Healthy drink, happy life GRAINS are a staple food for many people around the world. All grains start life as whole grains and are the entire seed of a plant. Whole grains in natural form are nutritious and offer various health benefits, for example brown rice is made up of three major parts – the bran, the germ and the endosperm. Bran is the outer layer of the grain, which provides 29% nutrients includes fiber, vitamins and minerals. Germ is the smallest part of the grain provides 66% nutrients, including dietary fiber, protein, vitamins B1, B2, B6, E and minerals such as iron, calcium and zinc. Endosperm is the main part of the grain that contains 5% nutrient which is mainly starch. Most people choose to eat white rice as staple food during breakfast, lunch or dinner. In fact, refined grains have been milled to remove 95% of the nutritious parts and remain 100% starch and so-called white rice. People tend to eat white rice as it is soft and easily cooked as compared to brown rice which is rather rough and hard to chew. However, studies show that eating whole grains instead of refined grains provides overall health and lowers the risk of many chronic diseases, such as cardiovascular problems and Type 2 diabetes, as well as helps to maintain better and ideal weight. The benefits are most pronounced for those consuming at least three servings daily - some studies show they reduce risks from as little as one serving daily. WHY CHOOSE GOODMORNING VPLUS 18 GRAINS

There is a saying, “Tasty drinks are unhealthy; healthy drinks do not taste good”. Commonly whole grains give us a perception of not tasting good. However, GoodMorning Vplus 18 Grains is a healthy and nutritious whole grains drink with a heart-warming and delicious taste. Vplus 18 Grains is the ideal

it for five minutes before it is ready to drink. GlucosCare herbal tea is registered under the approval of the Ministry of Health Malaysia. For more information or enquiry, please contact customer service hotline of GlucosCare Malaysia 03-7727 2713 during working hours.

combination of nutritional formula made up of selective 18 mixed whole grains (coarse rice, corn grits, soya bean, red rice, red bean, barley, mung bean, garbanzo bean, brown bean, almond, green bean, lotus seeds, black soya bean, white wheat, organic millet, black sesame,

organic glutinous rice, organic flaxseed). It contains high standard of vegetable proteins, carbohydrates, amino acids, fats, vitamins and minerals needed for proper daily bodily functions. Vplus 18 Grains is also added with five special ingredients that include red beetroot, which is rich in antioxidants and iron and gives the drink its pink colour. Soya lecithin helps to promote brain development. Meanwhile, seaweed calcium helps to strengthen teeth and bones. Other than that, fruc-

tooligosaccharide is a prebiotic for increasing the friendly bacteria in the body and water-soluble fibre helps to improve blood circulation and bowel movement. Besides, Vplus 18 Grains drink suitable for all ages, including kids, adults, elderly or those with health problems. Every cup of Vplus 18 Grains brings you and your loved ones a step closer to better health. For Health Consultation, contact customer careline at 1300 22 1818 / 011- 1100 1818 or log on to www.goodmorning.com.my

42 • 44

WELLNESS+ OPINION+

NOVEMBER | 2015

WISHING WELL

By Datuk Dr Rajbans Singh

Health vs Wealth

CCORDING to World Health Organisation (WHO), the definition of “Health” is a complete state of physical, mental and social well-being and not merely the absence of disease or infirmity. Wellness, on the other hand, is the active process of becoming aware of and making choices towards a healthy and fulfilling life. It is a dynamic process of change and growth in life. In order to achieve health, we need to practice wellness consistently by incorporating healthy behaviours such as having a balanced diet, sufficient sleep and physical activity in our daily lives. Therefore, health is the ultimate goal whereas wellness is the process of doing it. Most people did their annual medical check-up as the only way to practice wellness. However, they may not realise that medical check up is just a diagnostic tool, not a

Most people did their annual medical check-up as the only way to practice wellness. However, they may not realise that medical check up is just a diagnostic tool, not a preventive measure. By the time we have diagnosed with a certain disease, there is nothing much we can do but to accept the fact and receive the treatment. preventive measure. By the time we have diagnosed with a certain disease, there is nothing much we can do but to accept the fact and receive the treatment. Let me ask you a question. When do you usually call a plumber to your house? I believe the answer would be when your pipe is leaking, bursting or has some blockage. On the other hand, when do you usually send your car for service? Is it on the day when your car broke down in the middle of the road or you do

it regularly? As you see, people seek plumber when there is a damage and that requires fixing. The plumber’s job is just like the surgeon performing surgery on a patient with burst artery. Both do their best to treat the damage that has already occured. However, a mechanic works in the opposite way. His job is to maintain cars at optimum condition, for the purpose of making sure that they are in perfect condition at all times. It applies the same with our health. Wouldn’t it be great if we maintained our health the same way we maintained our cars? If we send ourselves in for checks and tuning even there are no breakdown, we can benefit from a body, mind and soul that has no boundaries and limitations to what we would like to do and accomplish every single day. Maintaining an optimal level of wellness is absolutely important to live a higher quality life. Wellness matters because everything we do and every emotion we feel relates to our well-being. In turn, our wellbeing directly affect our actions and emotions. It is an ongoing cycle. There are a total of eight elements in true wellness: Physical, Emotional, Social, Intellectual, Spiritual, Financial, Occupational and Environmental well being. Each dimension of wellness is inter-related with one another and is equally vital in the pursuit of optimum health. Now, let’s look at the definition of each element; physical wellness is the element of wellness that involves our physical state of being and all that affects it. Emotional wellness refers to a person’s awareness to their thoughts, feelings and behaviours: both positive and negative ones. Social wellness refers to relationship we have and how we interact with others. Intellectual wellness focuses on learning, and being engaged in stimulating the mind to expand knowledge. Spiritual wellness explores the meaning of life for ourselves, while being tolerant towards the belief of others. Financial wellness involves the process of learning how to successfully manage financial expenses. Occupational wellness inspires us to prepare for work in which we

will gain personal satisfaction and find enrichment in life. Last but not least, environmental wellness inspires us to live a lifestyle that is respectful of our surroundings. After all, to proactively maintain overall wellness, we should adapt a lifestyle with right nutrition, physical activity, managing our stress, reducing toxins and doing our regular health screening. However, do not get too obsessed by trying to change too much at one time. It is often easier to break bigger goals down into smaller and more achievable tasks. These smaller goals are able to assist you to be on track and keep up your motivation. With the advanced of health care services and technologies, we are moving towards a personalised health care management where medications, supplements, nutrition and lifestyle can be tailored to our inherited genes. For example, nutrigenomics is a field in which we are able to select the right foods and exercise according to our gene. The new DNA profiling can help us to pinpoint the types of food that may have better or poorer chemistry with our genes. Genes cannot be changed, but we can choose to be informed and empowered in order to make effective and targeted lifestyle changes. Nowadays, we are overwhelmed with excessive health information but chances are much of the information and advice that we received might be biased, inaccurate and in some cases, downright dangerous. As a smart health care consumer, we should be equipped with intellectual wellness to ask questions and evaluate all the information reveived before making any healthrelated decisions.

Note: Datuk Dr. Rajbans is the president of Malaysian Wellness Society and also a Certified Nutrigenomics Practitioner. He is International Medical Advisor to Fitgenes Australia and Medical Doctor at The Laureate Wellness Centre.

GENERAL+ • 45

2015 | NOVEMBER

Depression in cancer patients

NE of the most difficult part of being a clinician is having to tell a patient that they have cancer. Although many types of cancers are now curable especially with early diagnosis and treatment, most people still consider cancer to be a one-way ticket to nowhere. Strangely enough, treating cancer as a disease is actually the least difficult part. The most difficult part is handling the patient’s emotional and mental wellbeing after their diagnosis, because it can affect the prognosis and treatment outcome. One example is patients who delay treatment for too long after getting their diagnosis. This can cause the condition to get worse, and it may be too late or take more effort for treatment to work eventually. According to psychiatrists, studies show that about 70-75%

of cancer patients will experience clinical depression. The main reason for depression is deep-seated anxiety, of not understanding what is happening to their bodies and what to expect. Classic signs of clinical depression include losing interest in favourite activities, withdrawal from social activities and simply not wanting to get out of bed in the morning. This is sometimes frustrating for friends and family who cannot understand why the patient is delaying or refusing treatment. What most people do not understand is that treatment is not something that immediately comes to mind when someone is diagnosed with cancer. Usually their minds will first go blank, until the reality sets in. Their most immediate concerns would be mundane things like who will cook for the family and take care of elderly parents, whether they have enough financ-

BY DR RAGU SHANMUGANATHAN Consultant Obstetrician & Gynaecologist; Gynae Oncologist of Assunta Hospital Malaysia

es for treatment, what happens now. Although they may appear calm and collected, they are usually going through great internal turmoil. Having the support of family and friends to ensure that the other aspects of life such as family, finances, work and other responsibilities are well taken care of is crucial. This will allow the patient to focus on his treatment plan without having to worry about daily affairs. It is important to recognize the symptoms of depression in patients and offer support in the form of counselling or medical advice. Depression puts the body under constant stress and may affect healing. Patients with strong support from family and friends tend to cope better. One thing to remember about cancer is that the treatment is a long-drawn process. Even after treatment, the cancer may return after a few years. Hence patients’

emotional needs will sometimes be on a roller-coaster, as they always harbour the fear of their cancer recurring. Continuous support for the patient is necessary in order to keep him/her confident, positive and motivated to continue with treatment. In societies where interpersonal relations are poor, suicide among cancer patients stands at 10%, considering the better prognoses for cancer in recent years. Parasuicidal may be subtle and insidious signs, such as not taking treatment and medications, basically an indication that they have given up fighting their cancer. GETTING THE DIAGNOSIS

When told that they have cancer, most people will go through 5 main stages before accepting their diagnosis. Without emotional support, they will delay treatment until Stage 5. With the support of family, friends and the healthcare team, they may proceed with treatment, at the same time battle their internal demons as below: STAGE 1 - Shock and denial: They will pretend as if nothing has happened and that the diagnosis was just a nightmare. This is sometimes frustrating for family members or doctors who want to initiate treatment as soon as possible for the best results. STAGE 2 - Anger: They start to feel sorry for themselves, asking “Why me?” and go on a guilt trip, blaming themselves, others, even God for their condition. At this point, it is advisable to give the patient space to lash out, whether internally or externally. This stage is necessary for them to internalise the situation and fully embrace the reality of their illness. STAGE 3 – Bargaining: Once their emotions have stabilized, they will try to negotiate with their Maker. Some will pray hard for a miracle, others try to negotiate for more time, promising to do more charity, help someone in need and so on and so forth. STAGE 4 – Depression: Most patients will at some point feel despair or depressed. Symptoms include social withdrawal, loss of interest in favourite past times, lack of grooming and self-care, loss of appetite, and refusing medications and treatment. Emotional support is most critical at this point to ensure the patient does not give up hope.

YB DATUK DR NOOR HISHAM ABDULLAH Director General of Health

“A person will experience fever for one to three weeks after consuming contaminated food and drinks.” He said as a warning to address the recent typhoid breakout.

STAGE 5 – Acceptance: This is the stage in which they come to terms with their disease and move forward to do something about it. Such as proceed for treatment, write a will, get finances and property in order, as well as saying all the thank yous’ and ‘goodbyes’.

46 •

GENERAL+

NOVEMBER | 2015

CANCER SCREENING:

Screening is tests done on healthy individuals to find the cancer at an early stage. The screening guidelines recommended by the professionals are for the early detection of cancer for people without any symptoms. Some people are at higher risks for certain cancers and may need to have the tests more frequently. Talk to a health care professional to find out how these guidelines relate to you. DIAGNOSIS AND TREATMENT MANAGEMENT:

Understanding cancer CANCER also known as a malignant tumors or malignant neoplasm, is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. The most common types of cancer in males are lung cancer, prostate cancer, nasopharyngeal cancer, colorectal cancer, and stomach cancer, and in females, the most common types are breast cancer, colorectal cancer, cervical cancer and lung cancer. Cancer cases are expected to surge 57% worldwide in the next 20 years, an imminent “human disaster” that will require a renewed focus on prevention to combat, according to the World Health Organization. WHO also reports new cancer cases will rise from an estimated more than 14 million annually in 2012 to 22 million within two decades. Over the same period, cancer deaths are predicted to rise from 8.2 million a year to 13 million. In children, acute lymphoblastic leukemia and brain tumors are most common except in Africa where non-Hodgkin lymphoma occurs more often. In 2012, about 165,000 children under 15 years of age were diagnosed with cancer. The risk of cancer increases significantly with age and many cancers occur more commonly in developed countries. Rates are increasing as more people live to an old age and as lifestyle changes occur in the developing world. CANCER INCIDENCE IN MALAYSIA

A total of 21,773 cancer cases were diagnosed among Malaysians in Peninsular Malaysia in the year 2006 and registered in the Na-

tional Cancer Registry. It comprises of 9,974 males and 11,799 females. The Age standardized Incidence Rate (ASR) for all cancers in the year 2006 regardless of sex was 131.3 per 100,000 and the five most common Cancer among population of Peninsular Malaysia in 2006 were breast, colorectal, lung, cervix and nasopharynx. CAUSES:

Tobacco use is the cause of about 22% of cancer deaths worldwide. Another 10% is due to obesity, a poor diet, lack of physical activity, and consumption of alcohol. Other factors include certain infections, exposure to ionizing radiation, and environmental pollutants. In the developing world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C, and (HPV) human papilloma virus. Approximately 5–10% of Cancers are due to genetic defects inherited from a person’s parents.

      

from any part of the body e.g. vaginal bleeding between menstruations or after menopause. An unexplained lump that does not go away e.g. lump in the breast or in the neck region. Hoarseness of voice or nagging cough lasting more than two weeks. A sore/ ulcer that does not heal. Changes to a skin spot, wart or mole. Indigestion or difficulty in swallowing. Unusual nose bleed, deafness or ringing sound in the ears. Unintentional weight loss, fever, being excessively tired.

Cancer cases are expected to surge 57% worldwide in the next 20 years, an imminent “human disaster” that will require a renewed focus on prevention to combat.

Cancer diagnosis begins with a thorough physical exam and a complete medical history. Laboratory studies of blood, urine, and stool can detect abnormalities that may indicate cancer. When a tumor is suspected, imaging tests such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and fiber-optic endoscopy or colonoscopy examinations help doctors to determine the cancer’s location and size. To confirm the diagnosis of most cancers, a biopsy needs to be performed in which a tissue sample is removed from the suspected tumor and studied under a microscope to check for the type of cancer cells. If the diagnosis is positive other tests are performed to provide specific information about the cancer. This essential follow-up phase of diagnosis is called staging. Treatment includes surgery, chemotherapy, radiation therapy, hormonal therapy, immunotherapy, targeted therapy and palliative care. Depends on the type, location, and grade of the cancer as well as the patient’s health and wishes, treatment will be decided by the specialists. The treatment intent may be curative or non-curative ie., palliative. CONTINUED PAGE 51

SIGNS AND SYMPTOMS:

The earlier cancer is diagnosed and treated, the better the chance of its being cured. Some types of cancer such as those of the skin, breast, mouth, testicles, prostate, and rectum may be detected by routine self-exam or other screening measures before the symptoms become serious. Most cases of cancer are detected and diagnosed after a tumor can be felt or when other symptoms develop. In a few cases, cancer is diagnosed incidentally as a result of evaluating or treating other medical conditions. There are 9 warning signs of cancer to look out for:  Any change in bowel or bladder habit.  Unusual bleeding or discharge

Everyone has the risk of developing cancer when certain cells undergo mutation without the body having to stop it in time.

GENERAL+ • 47

2015 | NOVEMBER

Everyone deserves a goodnite sleep SLEEP has never been this comfortable. Uncompromising utmost comfort in sleep, Spinahealth Series – Crown Carlisle Mattress is ideally made to secure your soundless night blissfully. Your day will always be a fresh start from now on with Goodnite mattresses. The Pocketed Spring System follows body contour and reduces motion disturbance. While giving you a longer-lasting mattress, it makes an excellent product for superior comfort. With quality finishing, the mattress excels on the details and transforms every of them into glistening focal point. Goodnite aspires to become the Malaysia’s No.1 mattress brand with its quality comfort and superior sleeping assurance its provide since 1989. It is a trusted brand and enjoys a good reputation for creating quality, innovative and affordable mattresses as well as other bedding products for over 25 years in the bedding industry. Under the sterling leadership of its Managing Director, Dato’ Edmond Chew, Goodnite places great emphasis on uncompromising quality standards and commitment towards total

customer satisfaction. Every aspect of its mattresses, whether it is the conception design, assemblage of materials or incorporated technology, is seamlessly integrated for a single purpose - to create the perfect bedtime companion one can rely on for life. Over the years, Goodnite has expanded into a leading bedding manufacturer in the domestic and international scene. With a solid presence in Malaysia, Goodnite has over 1200 authorised dealers and distributors in nationwide and 200 employees under its payroll. With the belief of promising a good life by conjuring blissful and restful nights for all its customers, Goodnight takes challenge to give everyone a well-rested sleep for a healthy start of the day. Goodnite continues to place top priority in providing the best mattresses to deserving customers due to its promising quality. The company appears firmly focused in its journey of providing a good night’s sleep all over the world.

A proper way to poo using squatty potty THE idea of squatting when pooping in the toilet is not a new one. In fact, humans have done it since the beginning of time. But when the modern toilet was invented, most of us would pick a modern toilet over a squatting one for the comfort and ease it offers. But while sitting to do our business may be considered civilised, studies show the sitting position actually obstructs the flow of waste whereas the squat position aids bowel elimination. The concept is simple! Our body is designed to squat in order to pass motion as it helps to fully relax the puborectalis muscle (a tight muscle that controls our bowel movements). Squatting allows for proper alignment and makes pooping naturally easier. How do we squat when using a modern toilet? Enter Squatty Potty, a toilet footstool that helps put the body in a simulated squat position with knees raised above the hips. Squatty Potty helps you poop without any hassle and provides relief for constipation. Find out more at www.squattypotty. my

48 •

OPINION+ GENERAL+

NOVEMBER | 2015

Hearing loss and hearing aids

EARING loss is one of the five most prevalent health problems of older people. But, it is the least treated health problem. Approximately six out of every 10 individuals over the age of 60 has a treatable hearing impairment. Less than 30% of these people seek any type of hearing assistance and when they do many are told that hearing loss is a natural consequence of the aging process. Others simply tell no one of their difficulties and are astounded by the suggestion that people may already know about their hearing loss. Why do we ignore, misinterpret or attempt to minimize our hearing problems? Much of our hesitance has to do with society’s feelings about the hearing impaired. More than any other impairment, we fear the process of hearing loss. How many times do we refer to the effects of hearing loss as “selective hearing?” This implies the will to break off communication or to ignore people with some intention of hostility. As the saying goes, “There is none so deaf as those who will not hear.” And yet the effects of hearing impairment are real and involuntary. Some who do seek hearing assistance are simply told that hearing loss is a natural process which goes hand-in-hand with aging. As we fear aging, we tend to fear hearing loss. The well meaning emphasis on the natural process of aging ignores the impact of hearing loss. Hearing loss affects our daily interactions with others, making social conversations and interactions less fun and less fulfilling. The individual with a hearing loss may find himself in the process of social withdrawal commonly associated with aging. This process is a self-removal from those who care and the social activities which emotionally sustain us all. The fact is, we have the same needs for social and emotional involvement no matter what our physical age. We cannot afford to ignore the restricting impact of hearing loss on our lives. Hearing loss is a treatable disorder and requires appropriate care. We don’t always even recognize the symptoms of hearing loss. The first effect is almost always denial of the problem. Comments fixing the blame for poor communication on others are commonplace. The

phrase “people these days don’t speak clearly enough”. Anger over the problem may surface as the sufferer blames others for this problem, which separates them or leads to a feeling of isolation. Finally this isolation may cause depression over a problem for which there may not appear to be a solution. Of course this is simply not true. Hearing Loss is in most cases a treatable condition. It is very possible to improve hearing, if not medically, then through the use of amplification. Hearing aids help, and in most cases extend the vitality and improve the quality of lifestyle experienced by those with hearing loss. All Hearing Loss should be evaluated as it is simply not possible, contrary to the belief of many, to assess one’s own hearing without a proper examination. An evaluation is a simple, painless procedure. The effects of the loss may vary greatly from individual to individual. This may be due in part to the fact that the same hearing loss may be caused by different factors. Also the impact of the hearing loss varies depending on the lifestyle and communication needs of each person. The importance of professional testing to determine the individual effect of hearing loss and the prognosis for amplification cannot be overemphasized. All hearing aids should be fitted professionally. Professional evaluation depends on a knowledgeable professional with appropriate experience and training. Find out what training a professional has before you commit to an evaluation. Differences in testing and evaluation can mean the difference in a useful fitting or an annoying or impractical device. As hearing aids become more complex (and as a consequence more expensive) it is important that they are fitted by people that understand what they are doing and they are not merely selling a product. Hearing Aids should also themselves be evaluated periodically. Varying success stories from individual users indicate that it is the professional application of amplification which can actu-

By KIERAN MCCARRY

ally increase the benefit of a hearing aid, more than the hearing aid product itself. Find out what the realistic expectations for improvement may be in your situation. A professional evaluation can determine if the product needs to be readjusted to meet your changing communication needs. Modern technology incorporated into hearing aids means that considerably more satisfaction is obtained with well fitted instruments. However it is also important to recognize that a hearing aid is not a “new ear” it is simply there to help the individuals residual hearing. Hearing aids enhance sound to fill in the gap between natural sound and your diminished ability to hear. While there are many styles and circuit differences, all hearing aids consist of a microphone that changes sound waves into electrical impulses; an amplifier that increases the strength of the electrical impulse; a receiver (loudspeaker) that translates the now-strengthened electrical impulses back into sound waves; and a battery to provide the energy to operate the hearing aid. STYLES OF HEARING AIDS

Behind-the-ear (BTE) hearing aid: Well suited for mild to profound hearing loss. All the hearing aid components are contained in a small, slim case worn behind the ear. Amplified sound is conducted through an acrylic earmould worn in the ear. This style is a flexible and reliable choice. Receiver In The Ear (RITE) – A radical advance in hearing aid design, these ultra-small ear canal devices use sophisticated sound processing technology to set a new standard in aesthetics and comfort. These can be used for mild to severe losses. CUSTOM BUILT AIDS

These aids are precision built to match not only the shape of the individuals ear but also can be configured to match the hearing loss very precisely. In some case they are made using 3D printing technology and computer assisted design programs. In-the-ear (ITE) hearing aid: Suitable for mild to severe hearing loss. All components are contained in a nylon polymer shell that fits within the bowl of the outer ear and extends into the ear canal. Sound is conducted into the ear through the receiver in the ear canal. In-the-canal (ITC) hearing aid: Best suited for mild to moderate

hearing loss. All components are contained in a nylon polymer shell that fits in the opening to the ear canal and within it. Less conspicuous than the ITE type of hearing aid. Completely-in-the-canal (CIC) hearing aid: Generally best suited for mild to moderate hearing loss. All components are contained in a nylon polymer shell that fits completely within the canal and is slightly recessed. These are commonly referred to as “invisible” hearing aids although the degree of visibility is determined by the shape of the individual ear. DIGITAL SOUND PROCESSORS

These are programmable chips using the latest technology in computer programmable hearing aids. Sound is split into multi-channels and within each channel the characteristics of this sound can be digitally specified to match the listener’s unique hearing profile. Feedback problems can be reduced and the hearing aid can automatically adapt to changing sound environments. Some models offer multi-programming options for increased applications in varying noise environments. Directional microphones markedly increase speech recognition in noise background. User satisfaction studies indicate greatest levels of user satisfaction in background noise with directional microphones. WIRELESS COMMUNICATION

Many hearing aids these days are capable of communicating via Bluetooth with other devices, sound from telephones, laptops. tablets and even television can be streamed directly into the aids making the use of these devices easy and simple. Some hearing aids can be controlled remotely from smartphones making them easy to use as visual displays enable people to easily see what their hearing aids are doing.

Note: Kieran McCarry is a UK trained Hearing Aid Audiologist, who has spent more than 20 years in the hearing aid business. He has worked in Malaysia for 12 years and is now the Owner and Managing Director of Clarisound. He can be reached at kieran@ clarisound.com

GENERAL+ â&#x20AC;˘ 49

2015 | NOVEMBER

Veer away cancer side eďŹ&#x20AC;ects PERHAPS one of the most important system that works in our body to preserve health is the immune system. The immune system is a defensive mechanism that fights off any intruding organisms or substance which may harm our physical bodies. A person with a weaken immune system are much more susceptible to diseases and even virtually harmless ones like the common flu or food poisoning might turn deadly. According to scientists, one of the most effective immune modulator is now available. The Lentin Plus 1000 is useful as a functional food as it has anti-cancer effect, anti-inflammatory action, can be combined with chemotherapeutic agent, improve quality of life of cancer patients (reduce adverse side-effect from chemo). Immunologists recommend Lentin Plus 1000 for patients with cancer, before, during and after the chemotherapy and radiotherapy for patients with viruses such as HIV, hepatitis, etc.

Lentin Plus 1000 is a non-toxic glyconutritional nutrition supplement that has been sold in Japan and US for more than 10 years. It is a natural food supplement contains Arabinoxylan compound produced by a patented process which hydrolyzes rice bran together with enzymatic extracts of Shiitake mushrooms. It is a pre-digested fibre, and it could pass undigested through the wall of small intestine and directly into the blood stream. It has been scientifically shown to increase NK cell activity by as much as 300% in just a few weeks, while T and B cells activities increased by 200% and 250% respectively. One of the main causes of cancer is the weakness of the immune system which is considered the first line of defence against the cancerous cells that develop every day in the normal human body. It fights and destroys these cells by the Natural Killer cells. After several trials with patients with different kinds of cancers who undergo chemotherapy and radiotherapy and having their immune system very weak, consuming Lentin Plus one packet dissolved in a 1/2 cup of water two times per day has increased the immune system Natural Killer cells activity during 1 week and having these cells

activity increased during 1 month. Lentin Plus 1000 also has proven to be very effective as a supplement taken by patients who are undergo immunotherapy for hepatitis B, as the result in a study done in 2011 by Dr Tran Thi Minh Phuong. The study followed the development of several patients that showed tremendous recovery with

very little side-effects during treatment. As a natural food supplement that can help reduce side effects of medical treatments for cancer, hepatitis and carcinoma, it is only sensible for Lentin Plus 1000 to also create no side effects. Doctors

and immunologists found that the supplement is safe for prolonged consumption. For more information on Lentin Plus 1000, call 03-78036899 or email at info@lentinplus.net. For the website, go to www.lentinplus. com.my.

50 â&#x20AC;˘

GENERAL+ OPINION+

NOVEMBER | 2015

TEETHTALK

By Dr. Jasprit Kaur

Lingual Orthodontics

IRST impressions matter. Like it or not, it takes mere seconds for someone youâ&#x20AC;&#x2122;ve only just met to form an opinion about

your appearance and demeanour. impression and also helps break the More and more adults are beginning to realise the intangible

cially in their professional lives. As awareness grows, adults are now seeking orthodontic treatment when once braces were shunned and thought of as being only for adolescents. As the demand for adult orthodontics has grown, so too has the demand for more disoptions than ever. the teeth, are the only truly invis-

Lingual braces typically cost more than traditional braces due to the complexity in manufacturing them as well as the additional time the orthodontist has to spend fitting and adjusting the braces.

suitable for those who want to straighten their teeth but do not want to be seen wearing braces. Even teenagers can have lingual braces if they do not want traditional braces (provided their teeth have erupted enough so that the Lingual braces work just as well as (sometimes better than) traditional braces and are suitable for braces work in the same way as traditional braces with slow, gentle pressure being exerted onto the teeth to align them and move them accordingly so as to achieve the desired treatment results. Treatment times are generally the same as those with traditional braces, with most cases ranging from six to 24 months. Appointments are usually four to six weeks apart. Some complex cases may take longer. Another plus point teeth is that the damage which can sometimes occur due to poor tooth-brushing during orthodontic treatment tends to be less severe and less visible as compared to onto the front surfaces of teeth. associated with them. Initially, ulcers occur on the tongue due the rubbing of the tongue against the with time as the patient adapts to the lingual braces. Orthodontic wax or silicone can be applied onto the braces to reduce the rubbing of the tongue against the braces during that initial adaptation period. Also, speech can be altered for a few weeks as the lingual braces encroach into the tongue space and also because the tongue will be contacting the braces instead of the teeth whilst talking. As with traditional braces, there will be some pressure on the teeth as they are moving and this will necessitate a soft diet whilst the patient adapts to the pressure. After a week or two, the discomfort disappears, the ulcers reduce and speech is very often back to normal. Lingual braces typically cost more than traditional braces due to the complexity in manufacturing them as well as the additional time the orthodontist has to spend

more time on preparation of the lingual braces as these are very often custom-made for the patient as opposed to traditional braces which are pre-fabricated. When having braces (regardless of type), oral hygiene is of utmost importance so as to minimise the decay and gum disease. Poor oral hygiene during orthodontic treatment can give rise to the formation of unsightly marks on the teeth which are a form of tooth decay. Your orthodontist will advise you on how to take care of the health of your teeth and gums when having braces (whether traditional or lingual) and these instructions should be adhered to diligently so as to get the best possible results from your orthodontic treatment and also have healthy teeth and gums at the completion of your orthodontic treatment. As with all orthodontic treatment, at the completion of your treatment, retainers will need to be worn to ensure that the teeth are held in their new, straight positions. Retainers are worn inthroughout life and the only way to keep them straight is to wear your retainers to bed every night or a few times a week (your orthodontist will advise you on your retainer wear regime when your retainers Most times, improving your smile will result in an overall improvement in the way you feel about yourself. It is never too late as long you have healthy teeth and thodontist for a consultation is a good place to start to explore your to know before taking the plunge.

Note: Dr. Jasprit Kaur Grewal, BDS (Malaya), Dip. Dent.Clin.Sci. (London), MFDSRCS (Edinburgh), MSc.Orth. (London), Specialist Orthodontist and Founder of Pristine Orthodontics.

GENERAL+ • 51

2015 | NOVEMBER

The water specialist for every need COWAY, the home-wellness appliances manufacturer with the largest market share in South Korea since 1989, has recently launched its latest water purifier models in Malaysia- Villaem CHP-08AR that comes with temperature-controllable feature and the cleanest RO filtration system. Coway positions itself as the lifestyle brand that cares for your health and the environment, providing 100% ecofriendly home appliances for your well-being. To date, there are 5.6 million Coway customers in Korea. There are about 250,000 customers in Malaysia, and the number is rapidly growing. Coway’s Health Planners are always available to suggest the most suitable water for your family’s needs. RO- THE CLEANEST WATER YOU CAN GET

Reserve Osmosis (RO) filtration system is scientifically known as the cleanest filtration method with pore size of 0.0001 micron, which is highly effective in removing organic and inorganic impurities including heavy metals to provide the purest drinking water for whole family consumption. Apart from Villaem, over 250 researchers at Coway’s R&D centre including WQA certified specialists pioneered the invention of Coway latest water purifier, Neo CHP-260N, with exclusive filtration system – Nanotrap™. COWAY NANOTRAP™

Coway’s innovative Nanotrap™ contains Nanofibre with pat-

The earlier cancer is diagnosed and treated, the better the chance of its being cured FROM PAGE 46 VACCINATION:

Vaccines have been developed to prevent infection by some type of carcinogenic viruses. Human papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical cancer. The hepatitis B vaccine prevents infection with hepatitis B virus and thus decreases the risk of liver cancer. The administration of human papillomavirus and hepatitis B vaccinations are recommended when resources allow by a medical practitioner. PREVENTING CANCER:

 A healthy lifestyle can help to prevent almost all type of cancers. Making slight changes to daily habits will reduce the risk of developing cancer.  Do not smoke. If you smoke, quitting will significantly reduce your risk for many cancers.  Be active every day or try to exercise three times a week, at least 30 minutes each time. Try some of relaxation techniques such as yoga or meditation which are proven as complementary healing therapies.  Keep to a healthy weight.  Dietary recommendations for cancer prevention typically include an emphasis on vegetables, fruits, whole grains, fish etc.,  An avoidance of processed and red meat (beef, pork, lamb), refined carbohydrates.  Eat food low in fat, sugar and salt.  Keep your alcohol intake low.  Drink at least 8 glasses of plain water every day.  Be sun aware. Note: This article was brought to you by Nilai Medical Centre, Bandar Baru Nilai, Negeri Sembilan.

ented electrospun coating, has large surface area with high filtering capacity. This technology eliminates turbidity and faster water flow rate to enable abundant fresh drinking water in short time. HYBRID ALKALINE WATER PURIFIER: INCEPTION

Named the hybrid water purifier, Inception is the first water purifier which combines two types of filtration system: Nano Membrane Filtration System to filter clean drinking water with minerals by re-

moving multivalent ions; and Alkaline Ionised System that produces alkaline water from pH 8.5 to pH 9.5, into one water purifier that allows clean drinking water and at the same time enjoy alkaline water. Coway’s Inception is also the first to provide alkaline water in both cold and room temperature. Whether it is a water filtration device or air purifier, the filter is the heart of the equipment. Regular maintenance and replacement of the filter help to prolong the life and performance of the product. To help the consumers develop an insight on the importance of product maintenance, Coway had also introduced the Coway Lady, Cody. Cody consists of a team of attentive and dedicated women who are always ever-ready in assisting our customers with technical mat-

ters related to filter replacements and product maintenance. In short, Cody provides periodic product maintenance service to customers. The Cody team is also responsible in after-sales services, providing the company with consumer insights to help improve the service or product quality provided to our customers. The convenient and friendly Cody service was so outstanding that Cody has become an official occupation in Korea, recognized by the Ministry of Labour. In 2006, the concept of Cody was brought into Malaysia together with the brand Coway. Currently, there are about 13,000 Codys in Korea and around 1,000 Codys in Malaysia. For detailed information regarding Coway, please visit www. coway.com.my or contact the hotline 1800-888-111.

Understanding Stem Cells A stem cell is defined as a cell which has self renewal (i.e. self replication) and differentiation (i.e. becoming other cells) properties. It is through these processes that the human body can continuously “recharge” and “repair” itself. When injury occurs, the organ emits a special signal to attract stem cells into action, known as the “homing effect” and is one of the unique characteristcs of stem cells. There are two broad classifications of stem cells: Embryonic Stem Cells and Adult Stem Cells. Hematopoietic Stem Cells (HSCs) and Mesenchymal Stem Cells (MSCs) are classified as adult stem cells.

HSCs

MSCs

Comparison between Hematopoietic Stem Cells/ Progenitor Cells with Mesenchymal Stem Cells Comparison Source

HSCs/ PCs

MSCs

Cord blood, Mobilized peripheral blood, Direct bone marrow.

Tooth pulp, Cord tissue, Fat, Bone marrow.

Potential Usage

Hematopoietic indications such as leukemia, thalassemia, anemia.

Tissue repair; GVHD; Heart functions; Stroke; Arthritis; Bone healing; etc.

Characteristics

Promotes angiogenesis (forming of new blood vessels); Differentiates into blood components (red blood cells, platelets, white blood cells, etc).

Generally more flexible than HSCs; Differentiates into a wide range of cells and tissues (heart, bone, cartilage, cornea, ligament, skin, liver, etc).

Cord Blood Stem Cells (processing: ≤RM2,800, annual storage: ≤RM280); Peripheral Blood Stem Cells (processing: ≤RM15,000, annual storage: ≤RM650).

ToothMSCs (processing: ≤RM5,500, annual storage: ≤RM590).

No.

Yes.

Approximately 5%.

Approximately <0.5%.

Cost Cell Culture Before Storage Percentage in Total Cells Harvested from Source

Mesenchymal Stem Cells

Why Store Mesenchymal Stem Cells Now?

Harvesting & Storing Mesenchymal Stem Cells

It is best to harvest MSCs when a person is in good health because:MSCs harvested is greater in quantity; MSCs harvested is better in quality; Healthy persons produce healthy cells that are able to produce better results when cultured; For certain diseases, it has been shown that earliest possible stem cell treatment (perhaps within 2 weeks) can reduce damages, hence culturing before hand allows optimum results as the culture process may take more than a month.

ToothMSCs

As you will never know when MSCs might be needed to enhance surgical procedures or even save lives, it would be prudent to be prepared. Enroll yourself or your child now; given it’s under the following conditions: Your child’s tooth starts to loose You intend to undergo wisdom tooth removal You intend to undergo orthodontic surgery

Although there are a few variants of MSCs, it is generally characterized by its physical attributes and its ability to differentiate into a wide range of cells and tissues such as heart, nerve, cornea, fat and cartilage due to it being more primitive in nature than HSCs. MSCs are proven to reduce GVHD (rejection to transplants) and has anti-inflammatory effect during transplantation1. It also promotes angiogenesis (forming of new blood vessels) and provide the paracrine effect (cell signalling to enhance the survival of neighboring cells). Many researches are being conducted around the world on the use of MSCs on many different diseases such as heart diseases, joint diseases, GVHD, etc. Fat has been identified as one of the best sources to harvest MSCs. Upon harvesting your fat tissue, they will be transported to our ultra-clean, state-of-the-art laboratory to isolate and grow stem cells to a desired number. Throughout the whole process, stringent quality control ensures uncompromised quality. Upon successful culture, the MSCs are then stored in a cryogenic preservation at -190 degrees celcius, ready for when you might need them. MSCs harvested from tooth pulp (Tooth Pulp derived MSCs) are special cells that live in the pulp tissue inside our teeth. A rich source of MSCs can be found in this tooth pulp tissue, protected and unexposed to the external environment due to the hard and sturdy layer of dentin and enamel, hence instead of discarding the tooth, MSCs are extracted from this source in our cGMP certified cell processing laboratory.

1 R. Ramasamy et al. The Immunosupressive Effects of Human Bone Marrow-derived Mesenchymal Stem Cells Target T Cell Proliferation but Not Its Effector Function, Cell. Immunol. (2008) doi: 10.1016/j.cellimm.2008.04.009.

Early storage of MSCs can be very beneficial for a number of reasons. As MSCs are found to have the ability to differentiate into cells of organs that are critical to the human body, its indications to medical treatment are priceless. Hence, it is better to harvest and store MSCs earliest possible to benefit from research and possible treatment as cell production declines in quantity and quality as one ages.

Contact CryoCord at 1800 88 3300 to learn more about

ToothMSCs!

Mesenchymal

52 •

NUTRITION+

NOVEMBER | 2015

Autumn delight Five fall foods to bolster your health

F the fall season gives you tender thoughts of pumpkinflavored lattes, you’re in luck because there’s a full harvest of health-giving natural foods to discover. We’re giving you the scoop on how to enjoy the best of what autumn has to offer. APPLES

It may seem obvious, but this fall favourite is rich in disease-fighting antioxidants and fiber, an important dietary element that’s hard to find in prepared food. Fiber can help lower cholesterol and is thought to protect against colon cancer. Apples have a high concentration of pectin, a soluble fiber that eases digestion by soaking up excess water. Biting into a fresh, fall apple stimulates the production of saliva, which flushes out bacteria, keeping your teeth naturally clean and healthy. FENNEL

All parts of this crunchy and delicately sweet fall vegetable are edible including the bulb, stalk, leaves and seeds. A traditional key ingredient in many Italian dishes, fennel is high in a B vitamin called folate and potassium, both of which are associated with good cardiovascular health. It’s also high in antioxidants and the bulbs are a good source of vitamin C, which can contribute to keeping

your immune system in check. HERBS

A no-brainer as far as the fall harvest goes, rosemary, parsley, thyme and sage not only paint the landscape as they grow, they add distinctive flavour to foods that you might otherwise pass up because they’re not tasty enough. Put a new spin on a classic by scrambling eggs with rosemary or thyme, and get your protein intake for the day. Sage goes well with lentils -- a great source of protein -- and carrots, which provide an excellent source of vitamin A as well as minerals such as calcium, manganese and phosphorus. KALE

You’ve probably heard all about the benefits of this super food, so don’t miss it in its prime season. In addition to vegetable protein, fiber, folate and the minerals phosphorous, potassium, calcium and zinc, kale is a source of alpha-linolenic acid, an omega-3 fatty acid. Omega-3s are well known for an array of benefits to the joints and skin in addition to boosting your mood. PEARS

Not to say their benefits are merely skin deep, but the skin is the most important part of the pear, so enjoy them fresh instead

An introduction to QL eggs THE journey of QL eggs start from the chicks that are housed in temperature controlled environment. We use the latest technology to provide the best living condition to the chicks so that they grow healthy and productive when the reach maturity age at 17 weeks of age. Our strict biosecurity and hygiene standards allow the chickens to grow in a disease free environment. When chickens are healthy they can fully utilise the feed for optimum performance. This brings down cost of production. To help the chickens fight common diseases we vaccinate

them with the best vaccines available in the market. Factors such as comfortable environment, high hygiene standard, strict biosecurity practices, complete vaccination and high quality feed make QL chickens perform better that the industry standard. Our best practices also eliminate the need to use antibiotic unnecessarily. We have a team of professionals working with us. They are experts in veterinary medicine, poultry nutrition and animal sciences and husbandry who are highly dedicated in making sure the

GOOD FOOD: Healthly eating bolsters happy living

of canned this fall. Pear skin is thought to be highly concentrated with phenolic phytonutrients that have anti-inflammatory benefits. Recent research suggests pears can decrease your risk for type 2 diabetes

because the flavonoids they contain keep your insulin levels in check. Pears are also a great source of fiber and copper, which is associated with increased cardiac and thyroid health.

chickens are always healthy. Our relentless efforts to maintain high farming standards has enables us to obtained accreditation from Department of Veterinary Services (DVS) under the accreditation scheme SALT (Skim Akreditasi Ladang Ternakan). DVS offices conduct routine surveillance and audit on the farm to make sure we always maintain the required standard. Everybody understands a simple principle: the chickens are what they eat. We are a leader in feed ingredient business securing high quality feed material from all over the world for our chickens. Combined with the use of state of the art feed formulation software we are able to produce the best feed for the chickens to grow and give high egg production. In an effort to differentiate QL eggs with other eggs in the market we have enriched our eggs with functional nutrients that are important for human. This is done by

changing the feed formulation. We enriched our feed with Omega 3 oil so that the eggs are high in Omega-3 and DHA levels. Our specially formulated feed also allows the chickens to produced eggs with up to 40% less cholesterol. To improve the health of the chickens and reduce the reliance to antibiotic, we feed the chickens with probiotics. The freshest these enriched eggs are packed into our QL Omega and QL Deli Fresh range, where two separate QL processes are applied to ensure no defects in the end products. These eggs are packed in specially designed egg packs or trays that follow the curvatures of the egg. This prevents egg breakage during handling and delivery. We use our own fleet of single-use delivery trucks to make sure our top quality eggs reach the customers prompt and unscathed. In QL, we regard eggs as any CONTINUED PAGE 54

NUTRITION+ • 53

2015 | NOVEMBER

Fun and healthy food BY NORMAN HUSSAINI MALAYSIANS nowadays are a more open-minded bunch. The rise of healthy eating in Malaysia is a promising trend to be looked forward upon, what with the growing concern of obesity, hypertension, and heart diseases in this country. A few good lads from Malaysia has taken initiative to help us eat healthier and improve our state of well-being. One of them is Dennis Lee, a part of a duo who started the Chai Bar in Oasis Square, Ara Damansara. Chai Bar is a salad bar that has been operating since October 2014, with the two owners – Dennis Lee and Edward Wong – at the helm. A recent unique concept in Malaysia as the bar offers a wide array of ingredients to choose from and customers can choose the ingredients one-by-one to make their own perfect salad. The ‘make your own salad’ concept is a nice touch as it provides customizability to customers. Chai Bar also offers ready-made salads. Salads such as the ‘Caesar’, ‘Sombrero’, ‘Steakhouse’ and ‘California Girls’ are some of the ones decorating the menu with each displaying different combinations and flavours. The variations become even wider with the addition of 15 salad dressings to choose from. They also specializes in meat where its salad can be accompanied by quite a portion of beef or chicken besides fresh vegetables. In an interview, Dennis said they wanted people to enjoy food without having to compromise on their health. “We want to give Malaysians the option of being healthy, while still have a good time eating,” he said. The idea for Chai Bar came about a few years back. The two owners have experience working in Singapore where healthy eating outlet are plenty. “Back then, it was hard to find any kind of healthy eating place [in Malaysia]. That is when we thought that it would be a very good idea to open up a salad bar here,” said Dennis. What makes Chai Bar unique is its fusion salad offering. It incorporates local and familiar flavours into their ready-made salads like ‘Porntip’ and ‘Chicken Rice’. Dennis explained that they wanted Malaysians to experience something new while still feel the familiarity of local cuisine. “We incorporate Asian flavours into our salads as a way to appeal better to our customers,” he said. The Chicken Rice salad for instance, uses ingredients like poached chicken, fried shallots, beansprouts, spring onions, red rice and sesame soy dressing to have that Chicken Rice feel, with much less carbs. The customizability of Chai Bar’s ‘make your own salad’ concept also makes eating salad a fun activity. “We try to make eating healthy fun, not boring.” Dennis adds. When asked why it is important to offer healthy food to the Malaysian mass, he replied: “I found out recently from The Star that we are now one of the fattest countries in Asia. Our obesity level is very high and I was legitimately surprised.” “We want to make an impact and try to change the way we eat by providing a better option for people,” he said. The culmination of healthy salad bars begs a curious question; how are Malaysians reacting to having a healthier option besides their usual ‘NasiCampur’ and ‘Char KueyTeow’? Dennis said that transitioning is no easy feat. “In my

opinion, I wouldn’t say that it is easy for people to just start eating healthier. We are so used to eating very heavy tasting food which uses a lot of salt, oil, and sugar. Being an Asian country, a lot of our food also relies heavily on carbohydrates. A diet of more carbs than protein and fibre is an unhealthy one indeed,”. “It will be hard to change the way we eat. Eating a salad for lunch may feel less fulfilling then rice. But if you have the resolve to change, 3 weeks of eating healthy salad can be just as fulfilling,” he said. The focus the owner is trying to give with the creation of the salad

AT WORK: The crew preparing salads for customers

bar is to make healthy food fun and delicious, not boring and bland. As we are now living in the digital age, Chai Bar also provides nutritional information for each of their ready-made salads on their website. The nutritional info can also be found on the MyFitness App for those who are counting their

calories. As a closing statement from Dennis, he advised: “Start eating healthy guys! Don’t procrastinate and start now! It is easier for you to start quickly and improve your health as soon as you can. Procrastinating only makes things worse for you in the long run.”

54 •

NUTRITION+

NOVEMBER | 2015

Modifying bad habits

RADUATING with a Nutrition/Dietetics degree from the United States, Datin Farah DiBa Khan, Manager of the Lifestyle Modification Centre at Prince Court Medical Centre (PCMC), has been a practicing dietitian for the past 28 years. She is an avid advocate of good nutrition for all and provides dietary advice to patients with kidney, liver or heart disease, cancer patients, diabetics and also patients recovering from surgery at the hospital. Another key role is to advise and, in some cases, monitor patients who have had bariatric (weight loss) surgery. “We get them every month, usually from Australia,” she explained. One Malaysian patient, she proudly recalls, lost 36kgs and now enjoys marathons and cycling. “He’s aiming for the Iron Man competition!” Datin Farah frequently counsels individuals who are weight challenged. After they are weighed and their goals discussed, she will draw up a program for them to lose weight healthily. She draws up menus and tells them what to eat, how to eat and in what portions. “I give them a range of measuring tools for food,” she explains, holding out the kind of measuring spoons and cups that you would use for cooking and baking. “I give them tips on the amount of exercise they need to do given a certain amount of calories consumed. They are given a food log and must write down everything they have eaten and the exercise they do.” If they have a weighing scale at

Homemade Soy Bean Curd with Crabmeat and Vegetable Farah DiBa Khan, manager of the Lifestyle Modification Centre.

home, they can track their weight as well, though not every day, she says, as a variety of things (water retention, for example) can cause weight to go up and that can be discouraging. She sees her weight challenged patients every fortnight to check their progress. When it comes to quotes about nutrition and healthy lifestyle, Datin Farah seems to be the goto person for the media and has appeared on a range of television and radio programs, magazines and newspapers. She frequently does presentations for large corporations, embassies and schools that are eager to see their staff or students leaner and fitter. Datin Farah advocates heathy eating by providing easy healthy recipes. This month’s recipe features bean curds and soy.

Simple principle: The chickens are what they eat FROM PAGE 52

other high quality processed food products. Furthermore, eggs are an essential part of a healthy balanced diet as they contain high quality protein, unsaturated fat and more than 10 essential minerals and vitamins. QL Omega and QL Deli Fresh eggs have up to 40 per cent less cholesterol than normal eggs, are completely free of synthetic colours, and are enhanced with natural feed ingredients and probiotics.

QL Omega eggs are enriched with Omega-3, an essential fatty acid that is associated with reducing the risk of cardiovascular diseases, including heart attack and stroke. We will continue to improve our farming to meet the ever increasing demand from consumers for nutritional food with high safety standard. We are able to do this with our designer eggs

Serves 4 Prep Time : 15 minutes Cook Time : 15 minutes Ingredients 1: Soy Bean Curd 250 ml fresh soya milk 2 fresh eggs 2 egg whites 3 g fine salt Ingredients 2: Crabmeat and Vegetable Sauce 200 ml homemade fish stock 30 g oyster sauce 40 g fresh crabmeat 3 g diced young ginger 30 g diced celery 30 g diced carrot

5 g chopped spring onion 40 g cornstarch 3 g salt 2 g sesame oil

a square shape and arrange on plate Method: To make the sauce, add fish stock, diced young ginger and oyster sauce in a pot. Slowly bring it to boil. Add in crabmeat, diced celery, diced carrots, salt and pepper to taste Simmer slowly then thicken the sauce with cornstarch and some sesame oil Pour the sauce over soy bean curd and garnish with spring onion, fresh coriander leaves and red chili.

Ingredients 3: Garnish Sliced spring onions Fresh coriander leaves Sliced red chili Preparation: To make the soy bean curd, mix all ingredients together then whisk slowly to avoid bubble Strain and pour in mould then steam for 15 minutes until firm Allow to cool then cut into

NUTRITION FACTS Serving Size Amount Per Serving Calories Protein Carbohydrate Fat Sodium

Homemade Soy Bean Curd with Crabmeat and Vegetable 125g 170.3

Kcal

15.8 13 5.7 373.8

g g g mg

Calories from Fat % Daily Value* 4.21% 3.47% 3.42%

51.3

Kcal

* Percent Daily Values are based on 1500 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

and good farming practices. We are also addressing other external factors such as increase feed material cost and unpredicted feed stock by sourcing, research and development of new feed ingredients using agriculture by products. We are very proud of our farming business because we believe we are providing a very nutritional food for the people. At the time we are helping the country in term of food security because we make sure the country is self-sufficient in chicken eggs. And QL is taking the leading role in these two aspects. We operate our company

with four values: integrity, innovative, winwin and teamwork. In our efforts to contribute more to the society, we have partnered with IJN Foundation and launched the ‘Good Heart Campaign’ which will run during September and October this year. We will donate 50 sen from every pack of QL Omega or QL Deli Fresh eggs sold during the campaign period. QL is an abridged version of the Chinese phrase Quan Li, which means “Benefits For All” and this campaign is a good representation of our company’s core value where we produce nourishing food for consumers, support IJN Foun-

dation though funding and help raise public awareness on heart health at the same time. Besides that, we also believe in creating a complete experience for our consumers, from the farm to their dining tables, which is brings to the launch of a new initiative in 2015, QL Kitchen (www.qlkitchen.com). It is a cooking blog featuring showcasing our products with mouthwatering recipes, handy kitchen tips and innovative ideas. Through this platform, consumers may learn more on how to enjoy these nutritious eggs in healthy yet mouth-watering ways!

OPINION+ • 55

2015 | NOVEMBER

HEALING ZONE

By Dr Vijaendreh Subramaniam

Incorporate integrative strategies

ANCER is not a modern disease, but in modern times it has assumed epidemic proportions. In the 45 years since the global war on cancer was launched, we are yet faced with a cancer incidence that is exploding, despite achieving remarkable successes in treating early stage cancers. Currently, the allopathic standard of treatment for all cancer comprises almost entirely of three modalities - surgery, chemotherapy and radiation - all focused on the destruction of tumors. Meanwhile, our efforts to elucidate the causes of cancer have been directed almost exclusively on a genetic basis for cancer, and on the erroneous understand-

I was a product of such training, and for 25 years of my medical practice, I believed entirely in this approach as the only way to overcome disease. As a cancer surgeon in particular I was convinced of surgical excellence, with complete excision of the cancer being the gold standard of treatment. ing that for most cancers, all it takes is one rogue cell to form a cancerous mass. There are many deficiencies in this model of looking at cancer primarily that the human genome has not changed considerably in the past 30,000 years, so why have cancer rates increased so tremendously in the last century? The likelihood of getting cancer in this day and age, especially in the last 50 years is many times what it used to be, and even the advancements in screening and diagnostic procedures cannot begin to explain it. Is it then not natural that we should broaden the scope of research to consider other origins, and therefore other approaches to treating cancer? This is not a new line of thought, in fact an immense wealth of research on the develop-

ment of cancer has been published by brilliant scientists, including Linus Pauling, considered to be one of the greatest scientists of the 20th century, Nobel laureate Otto Warburg, seven-time Nobel prize nominee Dr Johanna Budwig, alternative Nobel prize nominee and inventor Dr Royal Rife, Dr Emanuel Revici, Dr. James W. Forsythe and many others. By ascribing to just the genetic basis for cancer, we are severely limiting our ability to understand and treat the root causes of cancerous transformation in the body. The advent of allopathic medicine goes back a little over a hundred years, and in that period of time it has been firmly established as mainstream disease treatment. The study of medicine places great emphasis on making diagnoses which are disease based, and on subsequently finding the right treatment which very often ends up being a drug, or an intervention that is designed to disrupt the disease process. An example of this would be…. Medical students and healthcare professionals spend a huge amount of time studying drugs and the effects of their interactions, and generally believe that the right combination of drugs will be able to overcome a diseased state. The success of modern allopathic medicine is undeniable, and in many areas we have achieved truly incredible progress, example; in making childbirth safe, advances that makes survival of severely premature babies possible, making the miracle of childbirth possible for childless couples. I was a product of such training, and for 25 years of my medical practice, I believed entirely in this approach as the only way to overcome disease. As a cancer surgeon in particular I was convinced of surgical excellence, with complete excision of the cancer being the gold standard of treatment. Years of experience has revealed that amidst its advantages, allopathic medicine has also considerable shortcomings. For example, in advanced gynaecological cancers, we see a good initial response with

regard to tumor shrinkage, only to see the cancer recur in up to 80% of cases, within a short span. Clearly this should be viewed as a treatment failure, as the subsequent survival rate is so poor. With insight into both alternative and conventional views, I have had the privilege of comparing and evaluating the outcomes of cancer treatment in end stage patients using purely allopathic methods, and also with the help of complementary healing medicine. I have thus far been amazed and humbled by the results that I have seen when we incorporate integrative strategies. The issues in this series of articles are not intended simply to present statistical data, and throw a winning pitch in favour of nonconventional therapies, but to encourage critical thought and debate and to “think outside the box”. Recognising that up to 95% of cancer is due to non-genetic factors, both patients and healthcare officers need to explore different approaches to healing cancers. Doctors must embrace all forms of knowledge and empower patients to question and understand the options presented to them in conventional medicine. There is a dire need to incorporate healing into the paradigm of cancer treatment, and to address the root causes of cancer while keeping an eye on the big picture of causes of cellular dysfunction. In the next article we will examine a very basic question - what is Cancer?

Note: Dr Vijaendreh Subramaniam is a Consultant Gynaeoncologist at MMC Melaka. He retired after 25 years with the Ministry of Health and focusses on Gynaecological Cancer. He is highly passionate about integrative treatment and bringing a healing paradigm into conventional cancer care.

56 | NOVEMBER | 2015

Weak and brittle bones

www.healthplus.com.my

Osteoporosis literally leads to abnormally porous bone that is compressible

... page 10

THE PULSE OF THE NATION

NOVEMBER | 2015

Threatening! Aedes mosquitoes swarms to plague Malaysia BY HEALTH+ REPORTERS

A new breakthrough Gene found to pave way for new drugs to help rheumatoid arthritis patients

... page 14

Aedes Aegypti, the urban terrorist.

CONTINUE PAGE Xtra 08-09

Seeing it right

Children given free check-ups and spectacles in conjunction with World Sight Day 2015

... page 17

02 •

November | 2015

Lack of enforcement activities to shore up cleanliness In a Q & A with Health+ Datuk Dr Noor Hisham Abdullah answers some pertinent questions about dengue What is dengue? Dengue is a mosquito-borne viral infection causing a severe flu-like illness and, sometimes causing a potentially lethal complication called severe dengue. The dengue virus (DEN) comprises of four distinct serotypes (DEN-1, DEN-2, DEN-3 and DEN-4), which belong to the genus Flavivirus, family Flaviviridae. What is dengue haemorrhagic fever? Severe dengue (also known as dengue hemorrhagic fever) is characterised by fever, abdominal pain, persistent vomiting, bleeding and breathing difficulty and is potentially lethal complication. Early clinical diagnosis and careful clinical management by trained physicians and nurses increase survival of patients. How are dengue and dengue hemorrhagic fever spread? Dengue is transmitted by the bite of a mosquito infected with one of the four dengue virus serotypes. It is a febrile illness that affects infants, young children and adults with symptoms appearing three to 14 days after the infective bite. What are the symptoms of the disease? Dengue should be suspected when a high fever (40°C/104°F) is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands or rash. Symptoms usually last for two to seven days, after an incubation period of between four and 10 days after the bite from an infected mosquito. What is the treatment for dengue? Is there an effective treatment for dengue haemorrhagic fever? There is no specific treatment for dengue fever. Severe dengue is a potentially lethal complication but early clinical diagnosis and careful clinical management by experienced physicians and nurses often save lives. Where can outbreaks of dengue occur?

A dengue outbreak is defined as the incidence of two or more dengue cases in a single locality. Dengue outbreak can occur anywhere provided there is Aedes mosquito carrying dengue virus. What can be done to reduce the risk of acquiring dengue and how can we prevent epidemics of dengue haemorrhagic fever? Ensuring our environment is clean and free from Aedes breeding site is the key element to prevent dengue disease to occur. Weekly search and destroy activities by the individual or the community are the best solutions to prevent the Aedes from breeding especially in an outbreak area. The public must involve in the COMBI projects and environmental cleanliness activities such as Program Ayuh Gempur Aedes, gotong royong etc. A clean environment will reduce the potential breeding sites for mosquitoes thus reducing the number of dengue cases. The public should wear long sleeve clothes and use insect repellent to protect themselves from mosquito bite especially between 6 and 8am and 6 and 8pm. They can also use aerosols or other insecticide vaporizers to kill the Aedes mosquitoes. If they had symptoms and signs of dengue fever, seek immediate treatment at nearby clinics or hospitals. What do you think of the health reforms in the country? The health reforms should improve the management of public health services in terms of the quality of service deliver, scarce resources and overcome the health issues. What do you think of the public’s attitude towards healthcare and cleanliness? Public’s attitude need to be changed especially towards healthcare and cleanliness. Clean environment can prevent the occurrence of dengue fever and other diseases such as food poisoning and leptospirosis. Do you think there is lack of enforcement in maintaining cleanliness? Yes, there is still lack of enforcement activities in maintaining en-

Datuk Dr Noor Hisham: There is no specific treatment for dengue

vironmental cleanliness. However, the enforcement activities can be improved especially to tackle the issues of illegal rubbish dumping sites and breeding at vacant lands. Local councils should increase the enforcement activities to overcome these problems. What are the best possible ways to educate the public in healthcare? Health education is essential for the control of diseases such as dengue, ensuring that community members understand the mechanisms of infection and the key behaviours or activities that need to be addressed to prevent transmission, reduce severe disease and avoid fatalities. Therefore, the best possible way to educate the public is through the involvement of the community itself in the Communication for Behavioural Impact (COMBI) project for dengue prevention. Health education in schools is another best possible way in gaining their commitment in dengue prevention activities. There has been an alarming rise in dengue fever. What are the main reasons for this? Increase in the people travelling has increased the spread of dengue virus to dengue free areas when a mosquito bites infected travellers, which subsequently spreads the virus to

other healthy individuals. Community behaviour of littering has contributed to the increase of potential breeding places for the Aedes mosquito. When there is rain, discarded containers will be filled with water and this can provide a place for the mosquito to breed. Illegal rubbish dumping has also contributed a place for the mosquito to breed. Changes in serotype, so called the “serotype shift”, is a well-known reason for the occurrence of a dengue surge. Usually seen four to five months after the shift, it has been observed that cases increase due to the lack of immunity towards the new serotype emerging in the community. Climate change especially alternate rainy and hot seasons will facilitate Aedes breeding to increase further. During the rainy season, any containers or locations that collect water will provide a place for the Aedes to breed. Therefore, this will enhance the spread of the dengue virus in the community. Apart from the factors above, Ministry of Health has strengthened the dengue diagnosis by implementing the usage of COMBO rapid test kit to all the suspected dengue cases in 2014. Indirectly, this saw more dengue cases being detected from the public and private clinics and hospitals.

• 03

2015 | november

Alternative treatment

Or the benefit of the public, there are some known traditional approach to treating dengue fever. This involves the use of natural ingredients such as plants and other food items to help the patient fight off dengue.

Dr Ashok Philip, president of the Malaysian Medical Association had also lend a hand in illuminating the matter. He stated that “the platelet count is not the only indicator of severity we look at, nor is it the most important, it is only one of the way to monitor the severity of the fever. It is far more important to monitor the patient’s blood pressure, pulse, symptoms, appetite and urine output.” To simplify things, one of the indicator for dengue fever is the drop in the platelet level, however patients should not be fixated on getting his or her platelet level up as a way of “curing” dengue. The most effective way so far in treating dengue is to first get tested as soon as a fever is present, getting well hydrated and to let the body take its natural course in fighting the virus. “As for the papaya leaf juice, many forms of it have now appeared, and none of them seem to be standardised at all, so there is no way of knowing what one is consuming when taking them,” said Dr Ashok Philip.

PaPaya leaf extract

One of the most common traditional methods is the use of Carica papaya tree leaf extract. It is by popular belief that consuming the juice of papaya tree leaves can help increase the platelet count, which dengue fever tends to do to an infected person. The Ministry of Health stated that “the Institute of Medical research (IMr) had conducted a study on papaya leaf juice in 2013. The study showed that papaya leaf juice significantly accelerates the rate of increase in platelet count among patients with dengue fever and dengue haemorrhagic fever.” The IMr research in 2013 was conducted to investigate the platelet increasing property of Carica papaya tree leaves juice in patients with dengue fever. The abstract from the research reads: “An open labelled randomised controlled trial was carried out on 228 patients with dengue fever (DF) and dengue haemorrhagic fever (DHF). Half of the patients received the Carica papaya leaf juice (CPLJ) for three consecutive days while the others remained as the control group with standard - without consuming papaya leaf juice - medical care. Their full blood count was monitored eight hours for 48 hours in total. There was a significant increase in mean platelet count observed in the intervention group but not in the control group 40 hours since the first dose of the juice. Comparison of mean platelet count between intervention and control group showed that mean platelet count in intervention group was significantly higher than control group after 40 and 48 hours of admission. It was concluded that CPLJ does significantly increase the platelet count in patients with DF and DHF.” The studies however were quite small and showed a slightly higher platelet count in patients who took the extract compared to those who did not. Muhammad Saifullah Hashim, a cook from Malacca had recently been a victim of dengue and a good example of a consumer. “I had taken papaya leaf extract when I was hos-

crab SouP

HealiNg leaf: The Carica papaya leaf said to help dengue patients

Cure from tHe sea: sea crab soup is also said to help increase blood platelets

pitalised for dengue as advised by one of the nurses. According to the doctor, my platelet level was way lower than normal and could worsen my blood’s ability to clot. So I gave the papaya leaf extract a try with the help of my mother. After two days of consuming it was apparent that my platelet count did went up.” Saifullah however, admitted that he continued to follow the doctor’s advice to also drink a lot of water during the fever.

chicken soup or bean soup can be as equally effective, as crabs doesn’t have any specific antiviral effect.”

Another well-known food that is said to help with dengue fever is sea crab soup. There has never once been a study done on crab soup so far, and will likely not to be one soon either. The notion of having something as luxurious as crab to cure a disease sure seems nice, however a bit misguided. Crabs naturally are rich in protein and some essential nutrients. Normally, a person should increase their calorie and protein intake during the controlled period of the fever. So this might show that certain food - crab soup for instance - are helpful, provided that a person is not allergic to crabs. It should be known however that crabs also contain high level of cholesterol and sodium. The nutritional values of crabs does not point to the ability to perhaps increase the platelet level as papaya leaf extract might. The cholesterol and sodium content may also become a problem. But if an increased level of protein is the focus, then there are a lot more protein-rich foods besides crabs. Foods like poultry, eggs, milk and legumes are better - and cheaper - source of protein compared to crabs. Dr Ashok commented: “Chicken soup or bean soup can be as equally effective, as crabs doesn’t have any specific antiviral effect.” This shows that crab soup may help in gaining back some calories and protein during the fever, but it is definitely not a food to treat dengue fever with exclusively.– Norman Hussaini

04 •

NOVEMBER | 2015

Prevention, better than cure

Vaccine, a long way oﬀ?

ETALING JAYA: In a recent interview with Dr Chithradavi Vadivellu, the director of the Department of Environmental Health of Petaling Jaya City Council (MBPJ) on prevention of dengue revealed that it was not at all a laughing matter. According to her, Selangor is going all out its effort to reduce the number of dengue cases. Statistics have shown that Selangor has 50% of Malaysia’s dengue cases. The total number of cases in Malaysia as of Aug 16, 2015 stands at 75,595 and counting, with 212 deaths. Selangor alone counts for about 42,193 cases with 96 deaths. Dr Chithradavi, however, explained that they had seen a decline in the number of cases over the past few months, following their programmes in destroying breeding sights and fumigating. “We are now in maximum prevention mode.” she stated. “The vector unit of MBPJ is well equipped and managed, we have a total of 74 dedicated workers working day and night to try and save lives.” said Dr Chithradavi. The search and destroy team are the ones handling the fumigation equipment, be it hand-held or mounted on 4WD trucks. Their work is cut out for them as they will usually start their day around five in the morning, going to multiple affected areas - also known as “hotspots” - to try and eliminate the threat of Aedes mosquitoes. The search and destroy team are mainly responsible for killing the adult mosquitoes terrorising people with the disease, while another set of teams will scour areas reported to be possible breeding grounds for them. The larvae sightings, as they call it, include spraying a special chemical mix of abate to kill off larvae in stagnant waters. Dr Chithradavi had commended her team by saying “the workers have been very dedicated and have sacrificed a lot of their time and strength to do their job.” Even though the statistics had seen a decline in dengue cases because of fumigation and larvae sightings, the most effective way to reduce dengue cases in Malaysia is to actually prevent them from breeding altogether. Prevention has always been much better than cure, and the war against dengue is still going on because of the inability to control and prevent the Aedes mosquitoes. In a directive from the Ministry of Health, everyone should take at least 10 minutes of their time weekly to check their houses and the surrounding areas for possible breeding grounds. This can greatly improve the effort for prevention and can help the community to be free from infectious diseases. Preventative programmes are still a continuous effort made by the council.

Dr Chithradavi: Vector unit of mBpJ is well eqquipped and managed

Statistics have shown that Selangor has 50% of malaysia’s dengue cases. The total number of cases in malaysia as of aug 16, 2015 stands at 75,595 and counting, with 212 deaths. Selangor alone counts for about 42,193 cases with 96 deaths.

An event recently advocated by them was the “Jom Sapu dan Bersih”, a statewide event where they hired 20 contractors over and above the volunteers to clean up the streets in Selangor by targeting all the known hotspots. The event went on from Aug 15 to Sept 16, 2015, also in correlation with Merdeka Day. The classic “gotong-royong” activity can really make an impact towards the eradication of dengue in Malaysia. Dr Chithradavi mentioned that the mosquitoes are smart creatures. “If given 20 containers filled with water, the mosquitoes will definitely choose to propagate their eggs on all 20 containers. It gives them a higher survival rate”. This means that a thorough cleaning is needed to ensure proper prevention effort. The majority of dengue cases leading to death were unsurprisingly due to people’s disregard for their own health. A report seen by MBPJ stated that a recent case of dengue leading to death was because of the persons’ failure to go for a second visit to the doctor after knowing that he might be a suspect for dengue. The struggle for total eradication of dengue in Malaysia is still going on, with new cases being recorded every day. Looking for a cure can only be viewed as a last resort, as prevention should be the first thing on the list to fight off dengue. What we need as a society is the ability to work together and not be dependent on others. To coin the words said by Dr Chithradavi, “teamwork is most important in our war against dengue.” – Norman Hussaini

CCORDING to Datuk Dr Noor Hisham, a few dengue vaccine trials are currently ongoing in many countries including Malaysia. One company has submitted a potential dengue vaccine for registration with the Pharmacy Bureau of the Ministry of Health Malaysia, and they are at present evaluating the impact and efficacy of implementing a dengue vaccine in the country. The challenge in developing a vaccine for the dengue virus lies in the different strains the virus exists in. Prof Datuk Dr Lam Sai Kit, a well-known research consultant from University Malaya explained: “A person who is protected from only one strain of the virus may be prone to severe complications when exposed to another strain of the virus.” This means that if a vaccine is to be developed, it should be able to protect a person from all four virus strains. Sanofi, the pharmaceutical giant based in France is currently leading the development of a vaccine for dengue. Their clinical trial ended with more than three quarters of the participants protected from the fever. They would likely be the one to win the race in developing a vaccine, as they have now completed their third and final clinical trial. The fate of the Sanofi developed vaccine however remained uncertain to Malaysia as the experimental drug is still being verified by the Ministry of Health, with no certain approval in sight. The ministry stated that the Sanofi vaccine is 75% effective for the DEN-3 and DEN-4 of the virus strain, however showed only 50% effectiveness for DEN-1 and a mere 35% for DEN-2. The inconsistency in effectiveness is the reason why the Ministry still feels the need to re-evaluate their decision. In a more recent news for a vaccine, a partnership

• 05

2015 | NOVEMBER

a vaccine for dengue fever is still in the works, with currently no definite confirmation on the use to prevent them

between Pharmaniaga and a biopharmaceutical company Bavarian Nordic have started researching a vaccine right here in Malaysia. With the involvement of the Malaysian Armed Forces (MAF) Health Services, the Malaysianbased research will take about seven to eight years to complete. The research is to involve a twophase process which includes pre-clinical trials and clinical trials, leading up to a possible vaccine distributed nationwide. The research had already begun back in the middle of 2014 with the intent to eradicate the dengue virus in Malaysia. Gen Tan Sri Zulkifeli Mohd Zin, the chief of the MAF stated in an interview that “we are focusing more on the local strain of the dengue virus in Malaysia and I believe this vaccine will be effective to the local people.” Besides Pharmaniaga, Bavarian Nordic and the MAF, the research had also seen support from the Ministry of Health and Univeriti Teknologi MARA (UiTM).

reaDy to go: mBpJ’s vector unit packs a punch with their high quality equipment

Unsung heroes MBPJ’s vector unit has an arduous task eradication Aedes mosquitoes

BY NORMaN HUSSaINI

ETALING JAYA: In a recent visit to the site where the vector unit of MBPJ’s environmental health department would meet before their daily rounds of larvae sighting and eradication of Aedes mosquitoes in Petaling Jaya, it was clear that the men donning the dark blue overalls are a dedicated bunch. Located along Jalan Tandan, the team met to iron out the work for the day. The people behind the gas mask and hulking fogging machines are usually seen in the afternoon fumigating the neighbourhood especially in the areas when dengue cases

were reported. The vector unit had an exhausting job. The crew has two main exercises they have to do every day, one early in the morning and another in the afternoon going towards dusk. Health+ got to visit them during their afternoon round of search and destroy mission around Petaling Jaya. Their aim, the infectious Aedes mosquitoes roaming across the state and spreading the dengue virus left and right. Each vector unit comprise of four or five members. The afternoon session started around 3pm, when the unit receive reports of a spike in dengue cases around the residential areas of town. Each location known to have reports of people getting infected will have a team assigned to it and have them go to fumigate the area.

After the briefing session by their superiors, the unit went the workshop around 4pm where all the equipment were stored. It seemed that the vector unit was well equipped with the latest fumigation machines. Two types of fumigation machines are typically used, the hand-held machines - which despite the word hand-held, was quite big and heavy – and the truck-mounted machines. The hand-held machines are used usually for indoor fumigation as well as to reach certain narrow areas of the streets while the trucks will usually go around the infectious locations on road. The most important aspect of the fumigation process is the chemical mixture of the insecticides. There is an established formula for the insecticides that the unit must follow which includes how much of it should be mixed in with either water or diesel. An interesting fact to know is that the unit uses both water-based and oil-based insecticides with various uses. The water-based is used primarily for indoor fumigation and the oil-based is used for outdoors. This means that indoor fumigations would not leave undesirable oily surfaces in the house when fumigaCoNtiNue page Xtra 06

06 •

November | 2015

‘termiNators’: from left - mohd saiful Khir, muhammad amran abdullah, Noor azmi sanusi, muhammad azri amir, subramaniam a/l approw

gettiNg reaDy: subramaniam loading the equipment in preparation for the fumigation mission

Vector unit well equipped from page Xtra 05

tion is performed. After a brief examination, the unit loaded all the equipment needed in their vans and cars and would disperse to their assigned locations, which is around 4.30pm. The fumigation may last up to 8pm depending on the traffic and the community’s cooperation. The team over the years has met with a lot of challenges during their daily routine. Noor Azmi, the health assistant of the MBPJ’s vector unit who acts as the overseer for all the workers said that the job can at times, be very challenging. A rise in dengue cases in a certain location means that the area must be fumigated as fast as possible to avoid further spread of the disease, however the community may not well be too cooperative at times. They have been harassed in the past, with people throwing garbage and verbally assaulting them for doing their job. “After working in the field for six years, I have seen a lot of cases where some people even turned aggressive towards us.” Noor Azmi said, referring to a case in 2011 where a worker fumigating a house was nearly attacked by the home owner with a machete. It was clear that this particular job is demanding in terms of labour and being a professional towards the occasional angry mob. “It takes a highly trained personnel to take on this job, but the person must also be able to accept that the job doesn’t pay a lot.” Noor

Azmi stated. Being a highly trained personnel is the main requirement to be a part of the vector unit. Most of the workers in the unit are veterans in their field, with some working for almost 10 years. The workers must undergo training and receive a certificate granting them the title of professional fumigator. Certified workers would also be under a strict procedural watch by the health assistant, as each of them must be under constant observation to curb any unprofessional act. Noor Azmi continued: “Everything we do must be met by a certain practice standard so that we can achieve good results and to avoid any mishaps.”

listeN up: Noor azmi sanusi, giving instruction to muhammad azri amir before commencing the fumigation

all togetHer: Dr. Chithradavi with some of her staff

A steady watch over the workers is possible due to MBPJ’s recent decision to keep the vector unit in-house and not hire contractors as workers. “It was made much easier to monitor workers working directly for us as oppose to outsourcing the job to outside contractors, especially in the matter of mixing the insecticide formula.” explained Dr Chithradavi Vadivellu, director of the Department of Environmental Health of MBPJ. A curious notion of the risk of the chemicals used during the fumigation towards people was explained thoroughly by the health assistant Noor Azmi. He said: “The chemicals does have a long-term effect on people, usually affecting the lungs and skin. Yet a person may seriously be affected only after an extended exposure to the chemical at a very long period of time.” This means that the public would not be in any danger of the chemicals as most will not be exposed to it for an extended length of time. The workers on the other hand has a higher risk of danger, which is why they are equipped with safety overalls and gas masks during fumigation. The clothes will then be washed and the workers are required to take bath after the job to lower the risk of poisoning. Dr Chithradavi weighs in by saying “I take the liberty of transferring the workers to a desk job or to another department when I see fit. A yearly health check-up is done to ensure no workers are at risk of over-exposure to the chemicals they are handling on a daily basis.”

• 07

2015 | november

WHat you need to know HiStory

The name “dengue” is derived from Swahili/Spanish roots. It was named apparently from the posture adopted by its victims. Earliest recorded cases of the disease was first mentioned during the Jin dynasty (265-420 AD). Benjamin rush was the person to first confirm a case of dengue fever in 1789 and gave the name “breakbone fever”. The study of viral etiology and mosquito transmission was established in the 20th century. current Situation

About 2.5 billion people live in areas of the globe where dengue has been reported and about 100 countries have since reported the illness. Annually about 50 million (although numbers are reported to be as much as 350 million) are reported worldwide to be afflicted with the virus with about 500,000 of them suffering from severe disease and about 25,000 dying as a result. Virology

On recovery afflicted individuals have lasting immunity to the particular serotype. As there is no cross protecting antibodies against the other serotypes, a person can get potentially dengue fever up to four times during his/her lifetime. Vector

Aedes mosquitoes will lay eggs three times over the course of their lives, and spawns about 100 eggs each time. Eggs can lie dormant in dry conditions up to nine months and can hatch if conditions become favourable again. clinical PerSPectiVe

The phases in which a person go through when contracted with the disease can be classified to three. The febrile phase (fever), the afebrile phase (no fever), and the recovery phase. Features of dengue includes; Fever A continuous high grade fever of about 38-40 C° which usually lasts about five to seven days followed by a period of no fever on the fifth day which may herald recovery. In primary dengue infection, the period of fever may be shorter, at only around three days. Body aches This symptom is why the dengue fever has been called breakbone fever. This includes retro-orbital

pain (pain in and around the eyeballs), Myalgia (muscle pain and aches), lethargy, and having poor appetite. An uncomplicated dengue usually lasts about 5-7 days, although feelings of lethargy, dizziness and weakness may last another week after fever.

BY DR aNBa

treatment

Treatment is usually symptomatic and supportive. Most patients will be managed by being advised to increase oral fluid intake to about 2.0 -2.5 litres a day for and average adult weighing 70 kg. A patient will also expect to be prescribed with Paracetamol for fevers and body ache and myalgia and Anti emetics like Domperidone for nausea and vomiting. Upon recovery (and after fever), you may develop an itchy rash on your arms, legs and trunk. This is temporary and you might be given antihistamines like loratadine and topical calamine lotion by the doctor. Warning SignS of dengue

During the period of fever, you have; Inappropriate fast pulse rate for your fevers but your blood pressure is normal or have narrow pulse pressure Persistent nausea and or nausea Unable to take orally well Persistent abdominal pain especially right hypochondrial pain (region of the liver) Severe headaches unresponsive to simple analgesics Severe diarrhoea Difficulty in breathing

Your doctor tells you that your Haematocrit or Packed Cell Volume (the % of red blood cells in your Full Blood Count) is high while your platelets are simultaneously decreasing. The above situation is usually seen around the fifth to the seventh day of illness and if not addressed promptly, it may lead to severe dengue. dengue HaemorrHagic feVer (dHf)

A type of dengue with rising packed cell volume and rapid fall of platelet count. Plasma fluid accumulation in third space namely in the pleural space and peritoneal cavity. These features are secondary to exaggerated release of blood antibodies called cytokines which cause immune injury and causes the volume of blood to shrink which in turn causes leakage of plasma (fluid blood) into third

2.5 billion people live in areas

of the globe where dengue has been reported and about

space like peritoneal cavity and pleural cavity. If left uncorrected, it leads to shrinking of intravascular blood volume, low blood pressure, multiorgan failure and eventually death.

100 countries have since

Clinical presentation includes Difficulty in breathing right hypochondrial pain Liver enlargement Abdominal distension

An uncomplicated dengue usually lasts about

Clinical bleeding from nose gums gastrointestinal tract and urinary tract lung and in the brain

reported the illness.

5-7 days, although feelings of lethargy, dizziness and weakness may last another week after fever.

A continuous high grade fever of about

38-40 C° which usually lasts

about five to seven days followed by a period of no fever on the fifth day which may herald recovery.

dengue SHock Syndrome

Dengue Shock Syndrome (DSS) is an elevated stated of DHF, caused by the presence of low blood pressure. It occurs as a result of delay in diagnosis, delay in seeking treatment, failure to recognize severity and instituting appropriate treatment and failure to refer to experts. Dengue is more risky in Young children Elderly People with diabetes mellitus or congestive heart failure People with chronic liver or kidney disease People with pre-existing blood disorder. mytH Surrounding dengue feVer

There is an undue reliance in measuring the platelet count to make a diagnosis as well as prognosis as

many cases of dengue fever does not present the patient with low platelet count an at earlier stage. There is also a misconception about the falling platelet count exclusively leads to clinical bleeding. The right way of managing dengue is by monitoring the percentage of red blood cells in the body (Packed red cell volume) and administer fluids regularly to keep it within appropriate range. Practical steps for personal protection against dengue fever Regularly empty and clean water storage containers Use proper mosquito repellent Correct disposal of tyres and other solid waste Report any symptoms of dengue fever Protect infected people from mosquito bites and use bed nets if they are bedridden. Wear trousers and clothing with long sleeves during the day

Dr Anbazhagan Kuppusamy, MBBS (Madras University), MRCP (UK), Fellowship in Infectious Disease (Australia), FRCP (Glasgow), FRCP (Edinburgh), MACP (USA), Academy of Medicine (Malaysia) is a consultant physician and a specialist in infectious disease.

08 •

NOVEMBER | 2015

MMA oﬀers tips to combat dengue

“The common ﬂu usually display fever that takes no more than three days. So if a person has fever for longer spell, it is safe to say that he is suspected to having dengue.”

ETALING JAYA:The Malaysian Medical Association (MMA) was founded in 1959, with the focus on promoting and maintaining the honour and integrity of the medical profession here in Malaysia. MMA is an association fully made up of doctors and practitioners in Malaysia. They serve as a voice of the profession as a whole and to participate in the conduct of medical education and development of qualified doctors. Any doctor who is practising in Malaysia is entitled to become a member of the MMA, as well as any medical students whether studying here or abroad as student members. With the joint efforts of a number of highly qualified doctors, they are certainly the big fish in the pond of medical authority in Malaysia. When asked on their take on the issue of dengue in Malaysia, Dr Ashok Philip, the president of MMA the association’s primary role in infectious and non-infectious diseases is to engage with policy makers, especially in the Ministry of Health in order to ensure that the best possible measures are adopted for the control of these diseases. This of course also apply to dengue, an infectious disease currently running rampant in Malaysia. “The MMA feels that the current dengue situation is due to several factors.” Said Dr. Ashok. The first is because of the shift in serotype of the dengue virus. This means that the four different serotype of the virus may replace each other in a rather unpredictable fashion. He said: “When someone has recovered from infection with one serotype, then gets infected with another serotype, the chances of developing dengue shock or severe bleeding increases.” This explains the escalating cases of dengue in Malaysia over the past few years and with Aedes mosquitoes breeding in our cities and urban areas, it comes as no surprise that the chances of people getting bit multiple times is at an all-time high. The second factor focus on environment. Dr Ashok said: “are were many building sites at present, and some of them

Dr ashok: mma feels that the current denque situation is due to several factors

are abandoned. They become a perfect spot for the mosquitoes to breed, thus more transmission will take place.” Going back to the MMA’s take on the dengue, they are more directed at educating doctors in early diagnosis and management of the disease. They are the ones to device the guidelines on how to approach the disease during the earlier to the later stage in patients. They also actively interact with the Ministry of Health and local authorities on the matter of dengue control. “Public education lies more within the gambit of the Ministry of Health and the local authorities, though we are always glad to assist when requested.” Dr Ashok stated. The MMA has proven that they benefit the public in a lot of ways. They strive to promote and maintain high professional and ethical standards of practice. The MMA became a resource for people who wish to find out more about the profession or about current health issues. Relevant authorities participating in any of the health issues in Malaysia may also come to the MMA, which provides alternative viewpoint concerning said issue. It is a good way to make sure that the responsible authority has all the information needed to make good public health decisions.

Many accepting traditional from page Xtra 01

“However, papaya leaves juice is only a supplement that gives supportive effect and it is therefore not a treatment. Patients still need to seek proper treatment in hospitals to prevent dengue complications such as multi-organ failure, shock syndrome and bleeding. At the moment, there are no other studies with regard to traditional treatment for dengue,” he said. Asked if the local councils are responsible for the eradication of breeding ground for Aedes mosquito and if MoH is satisfied with the level of enforcement by the local councils, Dr Noor Hisham said: “In order to overcome dengue in the country, Ministry of Health

has established a dengue task force committee that involves seven ministries and local councils. A weekly meeting is conducted and the issues and problems regarding dengue prevention and control activities are discussed to seek for best solutions. The local councils play an important role and they are very supportive in tackling the dengue problems especially in handling the issues of illegal dumping grounds. For example, Kajang Municipal Council has increased the rubbish collection frequency from two times per week to four times per week and without any amount limit of rubbish collection.” He also added that Petaling Jaya City Council (MBPJ) had increased

• 09

2015 | november

General practitioners’ role in the war against dengue

HAH ALAM: Dengue fever is perhaps one of the more susceptible disease a person may catch in Malaysia, as seen by the growing number of cases this year. At an early stage, dengue fever exhibits symptoms not unlike the common flu. A person coming down with a fever will typically go to the nearest clinic to see his or her doctor first. Therefore, the general practitioners automatically plays a big part in the early diagnosis of dengue in Malaysia. Health+ reached out to a doctors at Metro Clinic Kota Kemuning, Shah Alam to have their take on the responsibility they have to diagnose dengue in their patients. Dr Yoshimi Bharath, a resident doctor in Metro Clinic said that they were fortunate to have amenities most clinics don’t have, and it had helped them to identify dengue fever in patients early. “One of the reason I came to work in Metro Clinic Kota Kemuning was because they provide equipment that most clinics doesn’t have and I feel that it helps a lot.” Having the equipment to test patients for dengue are usually reserved for hospitals and medical centres, which most clinics in Malaysia lack. Because of the extra amenities Metro Clinic provides, the role of the doctors there be-

comes bigger and much more substantial. The initial step taken by a general practitioner when looking for dengue in patients is to see the state they are in when they come in the clinic. Dr Yoshimi stated: “We look at the brief history of their symptoms, such as the period of time they are presented with the fever and their level of hydration by the frequency of urination.” The dengue virus exhibits similar symptoms as a common flu, so it is pertinent to know how long the patient has been coming down with a fever. Dr Yoshimi continued: “The common flu usually display fever that takes no more than three days. So if a person has fever for longer spell, it is safe to say that he is suspected to having dengue.” The clinic uses a Full Blood Count (FBC) test as a way to identify various infections and afflictions including dengue. Dr Yoshimi explained that they would administer the test daily to patients suspected of dengue. He said: “We will ask suspected patients to come in every day for seven days and do an FBC test given that they can afford it. A drop in blood count on the fourth day with continued fever means that it is highly probable they have developed dengue.” When a patient

The ms4se, a programmable blood testing device capable of measuring various parameters and are widely used in over 70 countries

treatment their enforcement activities by placing enforcement officers in each of the 24 zones. “So far, seven individuals have been caught and compounded for illegal rubbish dumping. However, the level of enforcement by the local councils with regard to issues of illegal rubbish dumping still needs to be intensified,” said Dr Noor Hisham. Over the years, MoH has been successful in controlling several diseases for example Malaria. On some of the that will be implemented by MoH to eradicate dengue in the future, Dr Noor Hisham said for malaria, there are drugs to kill the parasite that causes the disease and thus reduce the source of

infection to others. “Moreover, we can effectively promote and implement the usage of mosquito net in endemic areas as the peak biting time of the mosquito is during bedtime. We can also manage the breeding of the malaria mosquito vector as it breeds in a specific ecology, which could be manipulated or managed appropriately. However, there is no drug to kill the dengue virus in a patient and carrier. “In contrast, the Aedes mosquito not only bites when we are awake and active, it also breeds in any place that can collect water. Hence this makes the prevention and control of dengue fever far more difficult compared to malaria.

Killer iNseCt: The aedes mosquito

As there is no cure or vaccine available for dengue, MoH will emphasise on environmental cleanliness initiatives in collaboration with other ministries and agencies including community participations,” he said. When asked what role can

is confirmed to have dengue, the next step is to manage the fever well, hence the continued testing. “One thing I’ve noticed nowadays is that many people are focusing more on their platelet count, as they feel that it is the only indication of the severity of the fever.” However another important parameter to consider during the fever management is the level of hydration.” Dr Yoshimi explained. As part of the FBC test, a test called the Haematocrit test measures the volume of whole blood that is made up of red blood cells. This indicates whether the patient is sufficiently hydrated. When asked, as a general practitioner what was her advice to the public to fight dengue, she replied: “Be vigilant. The Aedes mosquitoes does not typically travel far and it is mostly because of us that the disease spreads as far and wide as it does now. So try and destroy nesting grounds around the house and kill any mosquitoes you find. For people who feel that thy have fever, especially ones that lasted for three days, be sure to consult a doctor immediately.” In conclusion, the general practitioners have big shoes to fill in, in our ongoing war against dengue. They are the front men and women in early diagnosis of dengue. Dr Yoshimi said that doctors working in clinics do not have the luxury of overloading hospitals and medical centres. If we can detect dengue at an early stage, we will treat them here in the clinic. It is only when the situation becomes severe we then refer them to hospitals.”

NGOs and corporate organisations play as part of their Corporate Social responsibility (CSr) programme to control the spread of dengue? Dr Noor Hisham said, NGOs and corporate organisations can play an important role in promoting community participation in dengue prevention activities. “This will most often involve health education, source reduction, and environmental cleanliness activities. Examples of CSr programmes are the Dengue Free Malaysia Movement started by Country Heights Group of Companies and Dengue Patrol Programme in schools by Sanofi Pasture. Their objectives are to spread the dengue message to all Malaysians and emphasise what each and every one of us can do to fight dengue. They have volunteers and students to help in running the programmes.

10 •

NOVEMBER | 2015

Weak and brittle bones Osteoporosis literally leads to abnormally porous bone that is compressible

Dr. Lee: More women getting osteoporosis than men

By NUR HIDAYAH HUSLAN

etaling Jaya: Our bones help to support our bodies, keep us straight, protect on internal organs such as lungs and heart as well as to enable us to move. However, bone is a living tissue which grows, break downs and gradually rebuilt through a process called “remodeling”. as we grow old, the bone remodeling might not be keeping pace with our age. Therefore, for individuals with low peak bones mass, developing Osteoporosis will be much easier and quicker for them. Osteoporosis is coined from two words “osteo” which means bones and “porosis” means porous. it is a condition where there is a decrease level in the density of bone and subject to fractures. it is the situation where bones drop its strength and resulting in fragile bones. in fact, Osteoporosis literally leads to abnormally porous bone that is com-

pressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures or brakes in the bones. On the other hand, Osteopenia is slightly diﬀerent but related with Osteoporosis in many ways. it is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis. to add, it might be less severe but it is still worth to be prevented. osteoPorosis in MalaYsia

according to Datuk Dr. lee JoonKiong, a practicing Consultant Orthopaedic Surgeon who is also the president of Osteoporosis awareness Society of Kuala lumpur and Selangor (OaSKlS), there are rather high percentage of women getting Osteoporosis compared to men. according to the recent survey, hip fractures surgical remarks relatively a worrying situation where the percentages divide into 25% of the patients who will fortunately become such in normal condition, 50% will be bound to wheel-chair, stick or anything to support their standings and movements and lastly another

hip fractures surgical survey:

25%

of the patients who will fortunately become such in normal condition

50%

will be bound to wheel-chair, stick or anything to support their standings and movements

25% will probably die

75% who might survive the operation, however they still have to bear the side effects of Osteoporosis for the entire life

25% will probably die. With only 75% who might survive the operation, however they still have to bear the side eﬀects of Osteoporosis for the entire life. in childhood and adolescence, the body constantly breaks down old bone and rebuilds new bone in the process called “remodeling”. During this time, the body builds more bone than it removes, thus it grows and strengthens the bones. it is not a rare fact that women need enough calcium but it is indeed crucial that kids and teenagers are essentially in of need ample bone-boosting calcium. in fact, youngsters must have a balance and healthy lifestyle since their early ages to build strong bones. Diet and exercise are very much needed. normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are aﬀected by osteoporosis can break with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking or collapsing. The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone. are You at risk?

Osteoporosis can happen due to several factors encompass lifestyle, diet and genetic. Many risk factors can

lead to bone loss and osteoporosis. Dr. lee added that there are things that you might not possibly change while others you possibly can. These are among the factors that you cannot change but perhaps to be taken aware of; gender- women get osteoporosis more often than men, age- the older you are, the greater your risk of osteoporosis, Body size - small, thin and low BMi women are at greater risk, ethnicity - white and asian women are at highest risk. Meanwhile Black and Hispanic women have a lower risk. - Family history - Osteoporosis tends to run in families. if a family member has osteoporosis or breaks a bone, there is a greater chance that you will too, Sex hormones - low estrogen levels due to missing menstrual periods or to menopause can cause osteoporosis in women. low testosterone levels can bring on osteoporosis in men, Other diseases - Diabetes, anorexia nervosa, arthritis and other serious disease. less in calcium and vitamin D intake - a diet low in calcium and vitamin D makes you more prone to bone loss. Medication use - Some medicines increase the risk of osteoporosis. activity level - lack of exercise or long-term bed rest can cause weak bones. Smoking - Cigarettes are bad for bones, and the heart, and lungs, too and Drinking alcohol - too much alcohol can cause bone loss and broken bones.

• 11

2015 | november

Say ‘no’ to high heels to veer away osteoporosis.

Women’s love… Studies show higher incidence of osteoporosis in women who wear high-heeled shoes

etaling Jaya: you may notice that manifold literatures on preventing osteoporosis will include a line or two about avoiding high heels. But how far it is real as a fact that the two has connection or is it merely vague guesswork among researchers and fear-mongers? lots of studies do reveal that there is a higher incidence of osteoporosis in women who wear highheeled shoes for years together because of the marked degeneration in the bones. nevertheless, researchers are unable to identify what exactly increases the risk but they unanimously agree that there is one. in high-heeled shoes, your feet are not flat on the ground but at a steep angle where the heels of your feet are at a level higher than your toes. The weight of your entire body locates at the back part of your feet and deliberately pushing severely right into the bones of your toes. Moreover, high heels actually change your posture. you may walk like a model on the stage doing fashion show and in fact, this is the main reason that many women want to wear heels- to be looking way classy and gorgeous. They make you arch your back and push your bust forward which is deemed sexy. But the matter of fact is, all this actually changes the natural alignment of your bones which

The X-ray of foot wearing high heel

leads to your knees and lower back having to move into unnatural positions to accommodate your balance in heels. Cushion the adverse risks

Research has shown that there is a connection between prolonged high heel use and decrease in synovial fluid in the joints. The fundamental cause is as yet undetermined but the statistics are undeniable. you can prevent osteoporosis by reducing the instances of risk factors in your life. There are plenty of ways to do this through diet and exercise but by far the simplest lifestyle that you possibly can change is to not treat your heels like daily-wear footwear. Wear your heels occasionally in the true sense of the word, i.e. wear them only on special occasions. if you must wear them every day to boost your confidence, well, that requires much deeper work in your personal growth and sense of self-worth, but in the

Too high: high heels can cause leg strain and lead to osteoporosis

interim go ahead and wear your heels while taking the following precautions. high heels lovers?

How you could possibly stop your sexy habit wearing high heels to office or meeting girlfriends over the weekend? it is sort of impossible to trade high heels with flat shoes plus if you are petite. nonetheless, try to veer away risks of getting osteoporosis in the later age might be worth trying. Here are some helpful tips for the high heels lovers! Wear shorter heels; below two inches. avoid stiletto heels as these are deemed the worst by podiatrists and orthopedic surgeons. Opt for heels with a wider base such as wedges instead as they have been

shown to reduce pressure on the knees. Stretch your legs after you have gotten them out of your heels. Do not forget to stretch out your toes and calves too. This will help cramped muscles to elongate, improve blood circulation in the feet and help to get your bones back to their normal shape and alignment. Massaging feet at the end of the day can also be helpful. Make use of an insole for some extra padding for your feet and bones. Rotate your heels. Wear a 3-inch heel one day and a 2-inch one the next. This will prevent your legs from locking into a particular unnatural alignment from wearing the same heels every day. – Nur Hidayah Huslan

12 •

NOVEMBER | 2015

Milk benefits to arrest osteoporosis

etaling Jaya: Most of us were taught at a young age that drinking milk builds strong bones, and it is true that getting adequate calcium from foods is beneficial for skeletal health. The body gets the calcium it needs in particularly two ways. One is by eating foods or supplements that contain calcium such as dairy products, which have the highest concentration per serving of highly absorbable calcium, and dark leafy greens or dried beans, which have varying amounts of absorbable calcium. Furthermore, the other way the body gets calcium is by pulling it from bones. it happens when blood levels of calcium drop too low, usually when it has been awhile since having eaten a meal containing calcium. ideally, the calcium that is absorbed from the bones will be replaced at a later point. But, this does not always happen. However the concern is, calcium that is replaced will not be the same and sufficient simply by eating more calcium.

sloWing doWn osteoPorosis aMong adulthood

Preventing osteoporosis depends on two things; making the strongest bones possible during the first 30 years of life and limiting the amount of bone loss in adulthood. Several complementary strategies can help in slowing down the bone loss during adulthood and old age. according to Datuk Dr. lee, a practicing Consultant Orthopaedic Surgeon and president of Osteoporosis awareness Society of Kuala lumpur and Selangor (OaSKlS), there are several helpful things you should start putting into actions to veer away the risks of getting Osteoporosis.

sorption into the blood and to the kidneys that can minimize calcium loss in the urine. However, make sure that you are exposed to 8am to 10am sunlight in the morning or otherwise you will just burn yourself out under bad UV rays. dose uP vitaMin k

to opt out. With greater muscle strength, one can often avoid falls and situations that cause fractures. Making physical activity a habit can help maintain balance and avoid falls.

engage in regular eXerCise

Physical activities will put some strain on bones. it causes the bones to retain and possibly even gain density throughout life. Such “weightbearing” exercises include walking, dancing, jogging, weightlifting, stair-climbing, racquet sports, and hiking are activities you might want

ensuring adeQuate CalCiuM

Despite the debates surrounding milk and calcium, one thing is crystal clear that adequate calcium both for bone development and for nonbone functions is key to reducing the risk of Osteoporosis. However, the healthiest amount of dietary calcium has not yet been established. But drinking two glasses of milk is not that excessive and might be really helpful to strengthen your bones.

Vitamin K can be found mainly in green, leafy vegetables, likely plays one or more important roles in calcium regulation and bone formation. low levels of circulating vitamin K have been linked with low bone density, and in fact, supplementation with vitamin K shows improvements in biochemical measures of bone health. ModiFiCation oF liFestYle

Smoking and alcohol consumption are very threatening to your bones health. getting rid of unhealthy lifestyle may put you on track of taking care of your skeletons besides living your life at a level best as you age into your golden years.– Nur Hidayah Huslan

eXPosure to natural sunlight

Vitamin D plays a critical role in maintaining bone health. When blood levels of calcium begin to drop, the body responds in several ways. it promotes the conversion of vitamin D into an active form, which then travels to the intestines which can encourage greater calcium ab-

Osteoporosis: Why women at a greater risk? PETALING JAYA: It may seem to be unfair but it is true. If you are a woman, you are prone to get osteoporosis at a greater risk than men do. Study shows that osteoporosis affects approximately 200 million women worldwide. So why the gender gap? Women start lower bone density quicker than men. Thus, they lose bone mass more rapidly than men. As women age, they start to lose one-third of their hip bones between the age of

20 and 80. Osteoporosis may start to root in childhood and adolescence, which is the period when your body does the most bone building. In fact, women reach their peak at building bones at the age of 18, while men at 20. After that, both women and men will gradually build small amount of bone mass but men will add more compared with women. However, at the age of 30, bones will be fully stocked and body will continue to replace old

Women are at a greater risk for osteoporosis

bone cells without producing bone mass any longer at this point of time. Datuk Dr. Lee Joon-kiong, a practicing Consultant Orthopedic Surgeon and also the president of

Osteoporosis Awareness Society of Kuala Lumpur and Selangor (OASKLS) said that, “Bone formation for women and men is gradually increasing and reaching its peak between the age of 20

• 13

2015 | NOVEMBER

No bones to pick DEXA test could be done to measure the changes in the bone mineral density can save your life By NUR HIDAYAH HUSLAN

etaling Jaya: everyone hopes to age gracefully. Sadly, the future might be completely different for people afflicted by Osteoporosis. it is normal that it afflicts elderly, however by realising that bone density and quality decades earlier might put you always in a warning mode. nevertheless, for the Osteoporosis patients, seeking Osteoporosis treatment is basically to reduce bone loss and stimulate bone growth. to ensure your medications are prescribed effectively for you, a Dual energy X-ray absorptiometry (DeXa) test could be done to measure the changes in the bone mineral density. Datuk Dr. lee Joon-kiong (pix), a practicing Consultant Orthopaedic Surgeon at JK lee Orthopaedic & traumatology, assunta Hospital, Beacon international Specialist Centre and advanced neuroscience & Orthopaedic

and 25 and stop at the age of 30. After that age, bone mass will be gradually dropping until women reach their menopause. In fact, menopause will cause bone mass to acutely drop but differ from men, who do not have menopause and therefore, bones density will gradually drop as they are ageing.” WoMen lose estrogen QuiCker than Men Other than that, osteoporosis also will attack women with low production of estrogen. Adding osteoporosis to long-list of health issue among women, besides migraines and mood swings. Estrogen is a hormone that

Centre in Malaysia, said, “a bone density test determines if you have Osteoporosis; a disease that causes bones to become more fragile and more likely to break. in the past, osteoporosis could be detected only after you broke a bone. However, by that time your bones could be quite weak. a bone density test enhances the accuracy of calculating your risk of breaking bones. DeXa scan is recommended to confirm the results.” Other than that, Dr. lee who is also the President of Osteoporosis awareness Society of Kuala lumpur and Selangor (OaSKlS), explained that ultrasound; a screening test that is sometimes oﬀered at events such as health fairs is essentially used to detect problems with your bones early on. Ultrasound is quick, painless, and does not use potentially harmful radiation like X-rays. One disadvantage of ultrasound is that it can not measure the density of the bones most likely to fracture from osteoporosis which are the hip and spine. if results from an ultrasound test find low bone density, DeXa still has to be used to confirm and monitor the disease. Before being screened for osteoporosis, you may want to think about what you will do if the tests show that you have a high chance of getting osteoporosis. The higher your bone mineral content, the denser your bones are. and the denser your bones, the stronger they generally

that helps regulate a woman’s reproductive cycle. At the same time, it plays a role in keeping bones strong and healthy for both men and women. Furthermore, women at the age of 50 will slowly encounter menopause symptoms. As they wonder about getting menopause, they actually face a decreasing level of bone mass resulting to experience bone loss and osteoporosis at the same time. In addition, women are prone to suffer osteoporosis if they have problems relating to menstrual cycle or period. If they experience irregular or infrequent periods, or begin having periods at the later age than normal teenagers, they have a tendency

TESTiNg TiME: A bone density test enhances the accuracy of calculating your risk of breaking bones.

Back pain among women is the obvious symptom of osteoporosis.

are and the less likely they are to break. Bone density tests diﬀer from bone scans. Bone scans require an injectio n beforehand and are usually used to detect fractures, cancer, infections and other abnormalities in the bone. Doctors use bone density testing to: identify decreases in bone density before you break a bone; determine your risk of broken bones or fractures; confirm a diagnosis of osteoporosis, and monitor osteoporosis treatment. nevertheless, a bone density test is suggested for all women 65 years old and above, and younger women who are at increased risk for broken bones caused by osteoporosis and also men with risk factors for osteoporosis, such as being older than 70. Besides that, people who lose height at least 1.6 inches or 4 cm in height that may possibly have compression fractures in spines.

for getting osteoporosis higher than others. Furthermore, having had their ovaries removed also will escalate the risk. In addition, women who are going through menopause at an early age also will have a higher risk of osteoporosis. Research shows that women lose their bone density much quicker in the years immediately after menopause than they do at any other time in their lives. Being female puts you at risk of developing

Dr Lee: osteoporosis causes bones to become fragile

Moreover, people who suﬀer fractured bones which bones become so fragile to the extent sneezing and cough will cause fractures. People who have received transplants in addition are subjected to this test as well as women who experience remarkable drop in hormone levels.

osteoporosis and broken bones. However, you should not be worried about getting it if you know the essentials that most women should be knowing at the early stage. Based on the research done for so many years, approximately one from two women over the age of 50 will break a bone because of osteoporosis. In addition, women tend to have smaller and thinner bones than men. To add to the chances of getting osteoporosis is women will have menopause, hence the osteoporosis may not be peculiar disease among women as the estrogen will decrease sharply after menopause. – Nur Hidayah

Huslan

14 •

NOVEMBER | 2015

A new breakthrough Gene found to pave way for new drugs to help rheumatoid arthritis patients

By ZURINNA RAJA ADAM

Uala lUMPUR: Scientist in Britain and ireland have reportedly identified a gene that is linked to rheumatoid arthritis (Ra), a breakthrough that could pave the way for new drugs and help patients to receive a more personalised treatment. Ra is an autoimmune disease (where your immune system attacks healthy cells in your body by mistake) that causes inflammation, pain, stiffness and damage to the joints of the feet, hips, knees and hands. There is no cure for this disease and patients are prescribed with medication to manage the pain and to help prevent deformed joints. Using a simple method of blood test, early detection could be wellestablish to gauge if patients have the gene for the disease. This may help to fast track treatment by sourcing for the most appropriate and aggressive medication. President of arthritis Foundation Malaysia associate Professor Dr Sargunan Sockalingam noted that gene therapy is rather complicated as there is a possibility that the vehicle that carries the replacement gene or the “fixer” protein might be a virus designed specifically for this purpose. However, he said there are synthetic compounds that can be used, delivered either orally, intravenously or subcutaneously. in any case, the treatment may not be very different from what we have now. “For many years researches have suspected that the disease could be inherited as they have observed more than one member of a family developing the disease (such as mother and daughter, and siblings). Doctors will ask for family history of Ra in patients who present with joint stiffness and joint swellings,” Dr Sargunan said in an email interview. He pointed that the link be-

professor Dr Sargunan: one in every two patients does not get proper treatment

tween genetic and Ra have been widely researched and established, but the disease itself has a number of causes that could be environmental and viral triggers. “More research is going on and i am confident that we are closer to finding a good personalized therapeutic model in the next 10 years. But the reality is we are still quite far away from this approach. We

will have to wait for clinical trials and their results before we are assured of this new mode of treatment,” said Dr Sargunan. a report by national inflammatory arthritis Registry revealed that one in every two arthritis patients does not get proper treatment until at least a year after symptoms present themselves. if a patient receives proper treatment within the first six weeks after experiencing symptoms, there is a higher likelihood that the disease can be successfully managed and even put to remission. The government provides free medication for a number of Ra drugs, such as Prednisolone, Hydroxychloroquine, Methotrexate and leflunamide. according to Dr Sargunan, there are three main challenges for arthritis patients in Malaysia. These include: access to regular and more frequent care to treat the disease optimally, especially during flares; adjustments to work schedules and modifying living and working environments to suit those with advanced disease and disability. Currently people with arthritis are expected to contribute to the economy despite their

What is arthritis? left untreated. WHat CaUSeS artHritiS? the causes of arthritis depend on the form of arthritis. Causes include injury, metabolic abnormalities, hereditary factors, the direct and indirect effect of infections (bacterial and viral), and a misdirected immune system with autoimmunity (such as rA and systemic lupus lupus erythematosus). ArtHrItIS is a term covering over 100 rheumatic disease and conditions which is caused by the body’s own immune system attacking joints in the body causing inflammation, stiffness and pain. the disease can lead to damage joints and eventually physical disability if

WHat are tHe different typeS of artHritiS? there are more than 100 types of arthritis but the most common ones are osteoarthritis, rheumatoid arthritis and psoriatic arthritis. osteoarthritis (oA: is the most common cause of limb joint and spine

disease; and finally the cost of treatment has to be borne by Ra patients. This is especially true of those without support from their employers, and people without access to health insurance. “Our public healthcare system is one of the best in the world. However, it is highly understaffed and overwhelmed. More needs to be done to address these issues,” he said. in conjunction with World arthritis Day this month (October), continuous efforts are underway to raise awareness on the disease to general Practitioners and Family Doctors. While Ra cannot be cured, the message that it can be controlled if detected and treated early must be the emphasis. “Many private clinics have access to laboratories which provide facilities for blood tests, hence the doctor can make diagnosis much earlier,” said Dr Sargunan. Sharing experiences and organising group activities among patients support group is really a way to go to help to bring out a sense of comfort to patients. Family support is vital to patients to help them get back to normal life the sooner, the better.

arthritis which usually happens with age when your joints are considered overused. this disease can also be the result of joint injuries or obesity. What are the symptoms? the common sites of oA are hands, knees and hips. Hands oA – effects the base of the thumb and the joints at the end of the finger. At times, these joint become red, swollen and tender especially when the condition first appear. over the years, firm knobby swellings will start to form on the side of the joints called Heberden nodes. knee oA – pain gets exasperated by use. the knee feels stiff and pain and can vary. Hip oA – pain is felt in the front of the groin and sometimes around the thigh, buttocks or down to the knees. there will be discomfort on walking. rheumatoid Arthritis (rA) – is a disease which makes the joints in our body inflamed. the joint is surrounded by membrane called synovium which produces fluid known as the synovial fluid that act as an lbricant to help the

• 15

2015 | NOVEMBER

A brush with stroke Positive attitude is essential en route to recovery

Ual a lUMPUR: Ungku Mokhsin Ungku Mohamed, 60, had aphasia in 2010. aphasia is a type of stroke that disrupts the speech and language part of the brain. For most people, this part is located on the left side (hemisphere) of the brain. in relating to his experience, Ungku Mokhsin said he led a healthy lifestyle consuming organic food and exercise regularly especially after he was diagnosed with Cardio Myopathy (weak heart condition) in 2004. “that morning when i had stroke, i woke up at around 4.15am and felt strange; like my body somehow doesn’t feel right. i got up of bed and walked to the toilet but i felt blank, unsure of why i was standing in front of the toilet. i tried to switch on the light, but somehow i couldn’t. it’s like my brain was telling my finger to press on the switch but my finger stop midway. i didn’t understand what was happening to me.” “i started pacing up and down the room from the bed to the toilet and this woke my wife up. She asked me if i was going to the toilet and then i remembered that was what i wanted to do. after i went back to bed, my wife asked if i was ok. But i couldn’t respond. i couldn’t talk at all. My wife took my blood pressure and my pulse reading was high. She immediately woke up our daughters and brought me to the hospital.”

Throughout the entire journey to the hospital, Ungku Mokhsin said he was well aware of what was going on. as his daughter and wife were discussing which hospital to go and the fastest route to take, he was alert the whole time but he just couldn’t respond. in fact, he remembered everything that happened that night till today to share his tale. “When i reached the hospital, the doctor asked for my name. That was when i felt like crying because i could not remember my name and i could not utter it. no word seems to be able to come up from my mouth.” Miraculously, at 6pm on the same day he remembered his name and about three days later, he was able to speak, albeit very slowly. Ungku Mokhsin stayed in the hospital for the next 10 days and went through several tests to determine the severity of his stroke. He had a speech therapist but he said what helped him most was his session for six months at national association of Stroke Malaysia (nasam). “i highly recommend nasam for stroke patients. i made many friends there and best of all was the affordable therapy session offered at the centre,” he added. Five years on, Ungku Mokhsin is now fit as a fiddle. He is a founder and chairman of an oil and gas company but is now taking a step back from work and is active with volun-

outer layer move smoothly. In rA, the synovium becomes inflamed due to increased synovial fluid production. the pain in joint is caused by the nerve endings that get irritated by the chemicals produced. the disease effects about five in 1000 people in Malaysia.

type of arthritis is usually limited to just a few joints of the fingers and toes but sometimes it affects the spine giving a painful stiff back, neck or end joint at fingers and toes. Finger and toenails would develop discoloration, thickening and pits. this type of arthritis can start as early as childhood. the skin disease (psoriasis) usually shows up first.

WHat are tHe SymptomS? tender, warm and swollen joints; morning stiffness that may last for hours; fatigue and weight loss. early rA tends to affect the smaller joints first, particularly the joints attached to your fingers to your hands and your toes to your feet. the symptom will spread to the wrists, knees, ankles, elbows, hips and shoulders as the disease develop. Psoriatic Arthritis – inflammation of the skin or psoriasis and joint (arthritis). this

WHat are tHe SymptomS? Pain and stiffness in and around your joints; swollen fingers or toes (dactylitis), caused by inflammation both in joints and tendons; buttock pain, a stiff back or a stiff neck, which is caused by inflammation in your spine; pain and swelling in your heels, caused by inflammation where the Achilles tendon attaches to the bone; and pitting, discoloration and thickening of your nails (source: www.afm.org.my).

Ungku Mokhsin Ungku Mohamed

“i highly recommend nasam for stroke patients. i mad many friends there and best of all was the aﬀordable therapy session oﬀered at the centre.”

references: www. afm.org.my; www. mayoclinic.org; www.webmd.com

Having a positive attitude is an abso-

lute must for stroke survivor. learning from other survivors’ experience and getting the right support system are keys to success in life after stroke. “i would say i am about 90% recovered. it does get frustrating sometime because my brain is faster before my speech could catch up especially when i g et excited like bumping into an old friend,” he said. Ungku Mokhsin said his family played a very important role in helping him to remain positive. “i appreciate the fact that they treat me normal and they humor me. That is very important. My wife, norhuda Kumasi has been my pillar of strength. Despite all the treatment i have been to, reading the Quran is the best therapy of all and my wife assisted me daily to help me read them. When i couldn’t talk, i still pray while my wife helped to read the Surah (verses) for me,” he said. – Zurinna Raja Adam

eXerCiSe People with arthritis often receive conflicting advice regarding exercise. However, according to president of Arthritis Foundation Malaysia (AFM) Associate Professor Dr Sargunan Sockalingam the key to overcoming pain in arthritis is exercise. “Different grades of exercise can cater to different stages or phases of the disease. the idea is to stay fit and active at all times,” he said. While rest is needed to settle an inflamed joint, too much rest will weaken muscle and increase stiffness. During period of remission, exercise can be increased to help strengthen the muscle as well as preventing the joint from becoming unstable during periods of active disease. Patients are encouraged to perform exercise between three

and four times a week. Some of the best fitness exercises recommended are walking, exercising in water, swimming and cycling. Another key component of therapy is sleep. Getting good sleep is very important for all arthritis patients. there are reports that the immune system “fixes” itself during the deeper stages of sleep. Going to bed early is always a good thing.AFM secretary S. Shantamalar said arthritis patient must find the right balance between exercise and rest. “Arthritis patient must learn to accept the disease, seek proper treatment and live with it. the faster you accept, the better you are (in coping with the disease),” she said in an interview. “there is no cure for arthritis. Arthritis patient can only control deterioration by being positive, take the medication, control diet and exercise,” she added.

teerism at ngOs. “There is no such thing as a minor stroke or a major stroke. a stroke is a stroke. The brain is like a library that store many information. When i had aphasia, it’s like the library in my brain had an earthquake and now the “librarian” working in my brain is slowly putting the book back where it belong,” he said. The funny thing is, post-aphasia had Ungku Mokhsin now speaking with an accent and sometime he could converse in French and even Hindi. laughing away during the interview, he said “i don’t know how that happens but it happened. There was this one time i was going inside a lift and there was an indian man and i started greeting him in Hindi. Funnily enough, he understood me,” he said. Staying poSitiVe

16 •

november | 2015

There’s life after recovery Therapy sessions after treatment can help patients recover

etaling jaya:Caregivers of stroke patients must encourage and make time to send their love ones to attend therapy session. This will not only encourage them to recover but will also help the caregivers, free themselves from having a stroke patient depending on them (caregivers). national Stroke association Malaysia (naSaM) janet yeo, 70, pointed out that nasam was set up to help stroke patients receive therapy sessions at a very minimal cost. in fact, for those who cannot afford to pay the minimum fee, the sessions are provided free. “i urge caregivers to stroke survivors to make the time and help the stroke patient dress up every morning and come over to our centre (nasam) continuously for at least a year. Here, they have friends to chat and physiotherapist to help them exercise. all these will help them to recover as they get the support needed and eventually they will be more independent in managing their life after stroke,” she said. “This will also help the caregivers to free themselves from having a stroke patient being dependent on them,” janet added. every year, about 50,000 people in Malaysia suffer from stroke which is the third largest cause of death in the country, after heart diseases and cancer. in the aftermath of a stroke, patient may experience temporary or permanent disability. Depending on how quickly a stroke attack is diagnose and treated, patient may also encounter problems such as control of bladder and bowel movement, paralysis or weakness at one or both side of the body, trouble in expressing emotions and in some cases patient may also fall under depression. janet also known as “iron lady” suffered a stroke when she was 44 while at her peak of her career managing two advertising companies. The first thing janet noticed when she woke up that fateful morning was that her right hand wasn’t following instruction. But she thought nothing of it and drove off to work. When she was climbing the stairs to her office, her body was already lopsided. “i had no idea what a stroke was. So i still went ahead with an interview i had that morning with a local daily. My head was pound-

What is stroke? Stroke happens when blood supply to the brain is disrupted due to blockage or when blood vessels within the brain rupture. When this occurs, brain cells get damaged or will die. there are three main kinds of stroke: Ischemic strokes are caused by a narrowing or blocking of arteries to the brain. Hemorrhagic strokes are caused by blood vessels in and around the brain bursting or leaking. transient ischemic attack (tIA) is known as the “mini-stroke.” It is different from the major types of stroke because blood flow to the brain is blocked for only a short time. However, it is important to note that a tIA could be a warning sign of a future stroke.

Serving the people: Janet Yeo was also a stroke patient

ing and when the phone rang beside me, i couldn’t get it. My right hand couldn’t move by then and my manager drove me to the hospital straightaway.” janet said her husband yeo Chee yan is instrumental in making sure she led an independent life post-stroke. “My husband knows that i rise to a challenge. i also have two young kids (aged one and two) so i have a lot to look forward to. i know i will work hard towards my recovery. My husband refused to get me a maid and made me do everything myself which served as a motivation to know that i could. it is also a good exercise for me to use my affected arm and leg,” she said. janet first attended a stroke rehabilitation centre in Singapore and seven months post-stroke and to las gatos, California, travelling on her own, to attend a stroke rehabilitation centre there. She had another stroke patient as roommate and together they walked from their apartment to the bus stop to board the bus to the hospital daily for therapy. “i had to literally learn to crawl before i could walk. By the second month that i was there, i could walk without a stick anymore,” she said adding that she also improved her speech by reading to her two children every night. janet founded nasam in 1996

SignS and Symptom of Stroke Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination. Sudden severe headache with no known cause. If you think someone may be having a stroke, act F.A.S.t and do the following simple test: F—Face: Ask the person to smile. Does one side of the face droop? A—Arms: Ask the person to raise both arms. Does one arm drift downward? S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange? T—Time: If you observe any of these signs, call 9-1-1 immediately.

Note the time when any symptoms first appear. Some treatments for stroke only work if given in the first 3 hours after symptoms appear. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. recommended measures to prevent stroke : eating a healthy diet Maintaining a healthy weight Getting enough exercise Stop smoking Limiting alcohol use (source: http://www.medicalnewstoday.com/ articles/7624.php#what_causes_stroke)

since she noticed there was a lack of information on the disease as well as the non-existence of a support group for stroke survivors. nasam was the first non-profit organization in Southeast asia that provided rehabilitation and support to stroke survivors and family. its main mission is also to inform the public on the risk of stroke and that there is life after stroke through proper rehabilitation and support. today, nasam runs eight centers nationwide where over 400 stroke survivors attend daily therapy sessions. janet hopes to open more centres in the outskirt areas in future. “When you know of anyone who has a stroke, first listen to the doctor and get the treatment rec-

ommended at the hospital. Once discharged, come to nasam and we will help you with the support you need,” she said. janet’s courage and determination as well as her amazing recovery journey caught the attention across the causeway where she has been asked to assist the establishment of a Stroke Support Station (S3) at Singapore’s enable Village located at Redhill Road. Besides rehabilitation activities, the centre which spans on a 30,000 sq meter site will also provide information services to the disabled, a career centre which offers job placement and job support services. There will also be a mentoring space where the disabled with work experience can mentor disabled students. When asked what she missed the most about her life before stroke, laughing away janet said; “i miss wearing cheongsam and my high heels stilettos.” “But don’t let anything deter you to recover from stroke. Believe in yourself and make recovery as your career. live your life as you progress and don’t stop doing what you want to do. Don’t wait until you recover. just do it,” she said. On Oct 25, nasam is organizing a Colour Walk which will start at MBPj Carpark jalan yong Shook lim, Petaling jaya to raise awareness in stroke in conjunction with World Stroke Day. Details: www. walkforhealth.com.my. – Zurinna Raja Adam

• 17

2015 | NOVEMBER

Seeing it right Children given free check-ups and spectacles in conjunction with World Sight Day 2015

By NUR HIDAYAH HUSLAN

UBang Jaya: your vision is precious. There’s nothing you can do without a sound vision. We use them to navigate the world around us, express our emotions and connect with other people. We can take our eyes for granted but we rely on them so much in everyday life. Sound vision will ensure balance human growth and well-being despite having merely healthy body. There are many things we can do to keep them healthy and make sure we are seeing our best as we age into golden years. Dr. Kenneth Fong Choong Sian, a Consultant Ophthalmologist and Vitreoretinal Surgeon and also the Secretary of Malaysian Society of Ophthalmology (MSO), said, there are three major eye problems reported in recent years. “These common eye diseases reported such glaucoma, diabetic retinopathy, and age-related macular degeneration. These three eye problems usually occur among children, young adults as well as ageing generation.” ChilDren to Be given free CheCK-ups anD speCtaCles

He further added on the behalf of MSO, grabbing the responsibility to educate and create awareness has no second thought. in conjunction with, the World Sight Day 2015 (September), MSO organized a campaign to reach out and promote social awareness among children

of refugees and foreign workers to screen their eyes and provide them with spectacles for free. Prior to the splendid achievement of developing an idea of mobile clinic in 2014, the association this year aims bigger for a more effective campaign to help children. Moreover, their aims are to create awareness and organize programmes to help vision-impaired patients especially children to develop healthy daily routine of taking care of their eyes cannot be belittled. MSO with the donation from Bank Simpanan nasional (BSn) recently has bought a Diabetic Retinopathy scanner machine to take pictures of the back of patients’ eyes to diagnose symptoms of diabetic retinopathy. This eye examination will be given free to the public. MSO furthermore recommends that diabetes patients have retinal examination every year. it is painless, takes less than 10 minutes to complete and administered by the physicians. Dr. Fong stated that, early detection of DR still can be cured, with laser treatment. Thus, it is crucial to detect DR symptoms at the very beginning stage.

people who suffer from diabetic retinopathy or DR. He added that, diabetic retinopathy will perilously result to blindness among diabetic patients if left untreated. it is due to the situation where changes happen in the blood vessels of the retina. it will damage the retina, the section of patient’s eye responsible for capturing visual information. in fact, it is worrying that approximately 2% of children in Malaysia suffer diabetic retinopathy. it is not a normal situation where it happens too early among children. He said, “Most of them are very young and they will face the possibility of having loss of sight which result to unable to work and earn incomes. it is literally will jeopardise their financial and living expenses.” Symptoms of Diabetic Retinopathy include blurred vision; sudden loss of sight in one eye; seeing rings around lights and dark spots or flashing lights.

BLURRY: (pix top) The Yeye disorders gives a blurred image

DiaBetiC retinopathy

People who suffer prolonged diabetes may develop eye disorders such as Diabetic Retinopathy or DR. DR is an eye problem that usually happen to diabetic patients. The longer the patient suffers diabetes, the higher the risk of the developing DR. it refers to damage of blood vessels in the retina. DR can cause severe condition for eyes which is called as Diabetic Macular edema or DMe. it is an advanced type of DR where fluid leakage from dam-

treatMent for DiaBetiC retinopathy

Dr Kenneth Fong

aged blood vessels into the macula. Macula is a part of the retina that provides sharp central vision. When this happens, it may cause the macula to swell. Swollen macula is called as Macular edema that results in blurry and washed-out vision which can possibly lead to blindness if left untreated. according to Dr. Fong, approximately 20% of Malaysians suffer diabetes and it is rather worrying situation that 10% of them will encounter bigger risk of going blind. Therefore, it is close to 80,000

in most mild cases of Diabetic Retinopathy, intense treatment is usually unnecessarily to be conducted. Strict control over blood sugar and blood pressure are sufficient to greatly reduce or get rid of the chances for developing DR. However, in more severe cases of DR, intense treatments are recommended to impede the damage caused by DR as well as to prevent loss of the vision. laser surgery could be one of the treatment options. it could be really helpful in treating DR. it will seal the leaking retina vessels on the damaged retina. in fact, it is believed to greatly reduce the risks of developing greater visual impairment.

18 •

november | 2015

Escalating cases of Myopia among children

etaling Jaya: The inability to see objects or visuals at a distance clearly could possibly be one of the symptom of suffering Myopia among children. Myopia, or near-sightedness occurs when the eyeball is too long, relative to the focusing power of the cornea and lens of the eye. it means that the eye does not bend or refract light properly to a single focus to see images clearly. For people who suffer Myopia, close objects look clear but distant objects appear blurred. Myopia is a common condition that affects mostly children. Myopia is inherited and is often discovered in children when they are between eight and 12 years old. Thus, children may encounter higher risk of getting Myopia if their parents are near-sightedness. Patients with myopia have a higher risk of developing a detached retina. ask your ophthalmologist to discuss the warning signs of retinal detachment with you if you are in this risk category. if the retina does detach and it is discovered early enough, a surgical procedure could possibly help to repair it. it is important to have regular eye examinations by an ophthalmologist to watch for changes in the retina that might lead to retinal detachment. if the myopia is mild, it is called low myopia. Severe myopia is known as high myopia. High myopia will usually stabilize between 20 and 30 years old. With high myopia, you can usually correct vision easily with glasses, contact lenses or sometimes with refractive surgery. as a consequence, people with high myopia may also have a higher than average risk of developing glaucoma and cataracts.

Myopia treatMent

eyeglasses or contact lenses are the most common methods of correcting myopia symptoms. Depending on the degree of your myopia, you may need to wear your glasses or contact lenses all the time or only when you need very clear distance vision, like seeing a chalkboard, driving or watching a movie. They work by refocusing light rays on the

retina, compensating for the shape of your eye. eyeglasses can also help protect your eyes from harmful ultraviolet (UV) light rays. a special lens coating that screens out UV light is available. in many cases, people may choose to correct myopia with laSiK or another similar form of refractive surgery. These surgical procedures are used to correct or improve your vision by reshaping the cornea, or front surface of your eye, effectively adjusting your eye’s focusing ability. However, according to Dr. Fong, children should be getting enough sunlight exposure to reduce the risks of suffering Myopia. Outdoor activities are the most basic necessity should be practiced by children at school or even at home. it is very essential to allocate some quality time to do outdoor activities regularly.

ophthalmic examination. The tests will be very simple and painless to detect any changes in your eye pressure, drainage angle, optic disc and visual field. eye Drops

This is a special eye drop for glaucoma. it is very common for the doctors to prescribe eye drop to treat glaucoma. it will either reduce the formation of fluid in the front of the eye or increase its outflow. Side effects of glaucoma drops may include allergy, redness of the eyes, brief stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect the heart and lungs.

an insight into glauCoMa

For elder people, glaucoma is a leading cause of blindness in people over 40 years. it is not an infection or contagious. it usually develops when the production of aqueous humour increases or the aqueous humour does not drain adequately. it causes the rise of pressure in the eye that will later damage the nerve fibres and blood vessels due to the compression. This phenomenon will interrupt the transmission process of visual messages to the brain and will result impaired vision and blindness.

laser treatMent

laser surgery for glaucoma slightly increases the outflow of the fluid from the eye in open-angle glaucoma or eliminates fluid blockage in angleclosure glaucoma. it is more like to open the clogged drainage and channel fluid to flow more freely. MiCrosurgery

Diagnosing glauCoMa

you are at an increased risks of having glaucoma if you age over 40, having a family history of glaucoma, having poor vision, suffering from diabetes, consuming certain medications or having experienced trauma on your vision. Chronic glaucoma usually does not show any obvious symptoms. Thus, it is vital for you to have a regular check-up through

Children should be getting enough sunlight exposure to reduce the risks of suffering Myopia.

This operation is called as trabeculectomy. in t his operation, a new channel is created to drain the fluid, thereby reducing intraocular pressure that causes glaucoma. Sometimes this form of glaucoma surgery fails and must be redone. nevertheless, for some patients, a glaucoma implant is the best option. However, this microsurgery could somehow cause other complications for instance some temporary or permanent loss of vision, as well as bleeding or infection.– Nur Hidayah Huslan

• 19

2015 | november

If you want your eyes to stay strong and healthy, then taking care of them on a daily basis is what you really need to put into practice.

See bright as you age Petaling Jaya: Spectacles seem to be fashionable accessory for elder people these days. it is significantly needed in almost everything that they are up to; reading, watching television, looking at signboards, typing on the mobile phone or even looking at themselves on the mirror, they need to put their spectacles on. it is still fortunate that elder generation aged 50 and above are still be able to see clearly with spectacles. However, there is a disease that can cause vision loss among them, which is called age-related Macula Degeneration or aMD. aMD is a common eye condition and a leading cause of losing vision among people age 50 and above. it causes damage to the macula, a small spot near the center of the retina and the part of the eye needed for sharp, central vision, which lets us see objects that are straight ahead. nevertheless, for some people, aMD advances so slowly that vision loss does not occur for a long time. yet, for some others, the disease progresses faster and may lead to a loss of vision in one or both eyes. as aMD progresses, a blurred area near the center of vision is a common symptom. Over time, the blurred area may grow larger or you may develop blank spots in your central vision. thus, objects may not appear to be as bright as they used to be. aMD by itself does not lead to complete blindness, with no ability to see. However, the loss of central vision in aMD can interfere with simple everyday activities, such as the ability to see faces, drive, read, write, or do close work, such as cooking or fixing things around the house. the MaCula aMD happens when there is a deterioration or breakdown of the eye’s macula. the macula is a small area in the retina, the lightsensitive tissue lining the back of the eye. it is the most sensitive part of the retina, which is located at the back of the eye. the macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly. the macula is made up of millions of light-sensing cells that provide sharp, central vision. the retina turns light into electrical signals and then sends these electrical signals through the optic nerve to the brain, where they are translated into the images we see. When the macula is damaged, the center of your field of view may appear blurry, distorted, or dark. age is not solely faCtor Dr. Kenneth Fong Choong Sian, the Consultant Ophthalmologist and Vitreoretinal Surgeon of Sunway Medical Centre and also the Secretary of Malaysian Society of Ophthalmology (MSO) stated that, “aMD usually will occur among elderly people age 50 and above. For this group of people, supplement may help to cushion the effects of the disease.” However, good and healthy diet may help reduce the percentage of having aMD but age is still the major risk factor for aMD. the disease is most likely to occur after age 60, but it can occur earlier. Other risk factors for aMD include lifestyle such as smoking, unhealthy diet, insufficient vitamins and nutrients and other related factors for instance race, family historic and genetics. aMD is more common among Caucasians than among african-americans or Hispanics or latinos. Other than that, people with a family history of aMD are at higher risk. at last count, researchers had identified nearly 20 genes that can affect the risk of developing aMD. Change your lifestyle Researchers have found links between aMD and some lifestyle choices, such as smoking. you might be able to reduce your risk of aMD or slow its progression by making healthy choices. Dr. Fong said, “Healthy lifestyle is important especially for elderly people to avoid smoking, exercise regularly, maintain normal blood pressure and cholesterol levels as well as eat healthy diet rich in green, leafy vegetables and proteins.” – Nur Hidayah

Huslan

How to get tip-top peepers

etaling Jaya: everyone knows that to maintain a healthy body you have to eat right and exercise, visit doctors regularly, and take prescribed medications correctly when needed. Well, to maintain healthy eyes relatively the same things apply. if you want your eyes to stay strong and healthy, then taking care of them on a daily basis is what you really need to put into practice. CoMprehensive DilateD eye exaM

you might think your vision is fine and your eyes are healthy, but visiting and seeking advises from your eye care professionals for a comprehensive dilated eye exam and eye care tips are well needed. Many common eye diseases such as glaucoma, diabetic retinopathy and age-related macular degeneration often have no warning signs. a dilated eye exam is the only way to detect these diseases in their early stages. eat right for gooD sight

Carrots are good for your eyes. anyhow, consuming a daily diet rich in fruits and vegetables, particularly dark leafy greens such as spinach, kale, or collard greens is important for keeping your eyes healthy. Research has also shown there are eye health benefits from eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut.

Maintain a healthy weight

Being overweight or obese increases your risk of developing diabetes which can lead to vision loss, such as diabetic eye disease or glaucoma. try to put a healthy weight and practice balance lifestyle. Know your faMily’s eye health history.

it is vital to know if anyone has been diagnosed with a disease or condition since many diseases are hereditary. talk to your family members about their eye health history. This will help to determine if you are

at higher risk for developing an eye disease or condition perhaps not now but it may happen in the future. wear proteCtive eyewear.

Wear protective eyewear such as safety glasses and goggles, safety shields, and eye guards specially designed to provide the correct protection for a certain activity. Most protective eyewear lenses are made of polycarbonate, which is 10 times stronger than other plastics. to add, wear sunglasses to protect you from UVa and UVB that may be harmful especially when you do outdoor activities. Quit sMoKing or never start

Smoking is as bad for your eyes as it is for the rest of your body. Research has linked smoking to increase risk of getting blind by developing age-related macular degeneration, cataract, and optic nerve damage. give your eyes a rest

if you spend a lot of time at the computer or focusing on any one thing, you sometimes forget to blink and your eyes can get fatigued. try the 20-20-20 rule: every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain. Clean your hanDs anD your ContaCt lenses properly

to avoid the risk of infection, always wash your hands thoroughly before putting in or taking out your contact lenses. Make sure to disinfect contact lenses as instructed and replace them as appropriate.– Nur Hidayah Huslan

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NOVEMBER | 2015