Assessing competency
Looks like there'll be yet another bureaucratic exercise when the Ministry of Health comes up with it's competency assessment program which will assess all healthcare providers including doctors. Already short-staffed medical departments have to release doctors to attend dubiously relevant and needlessly long PSD courses otherwise they won't be promoted. Now the MOH wants to get in the act too and have their own objective assessment exercise. Why two systems? I say do away with one (the PSD one comes first to mind) otherwise it'll just be more bureaucracy.
From the
NST Dr Ismail said what the Health Ministry hoped to implement with its involvement in the Continuing Professional Development (CPD) of healthcare providers was to link the assessment to what they did in their daily routine. "Doctors should not complain anymore about being assessed for competency based on something irrelevant." He said doctors were unhappy about the competency assessment as they felt that some portions of it were not relevant.
But with the new directive from Health Minister Datuk Dr Chua Soi Lek, he said, the ministry had come up with its own assessment for allied healthcare providers besides that of the Public Services Department (PSD).
"We cannot just promote people with any form of objective assessment. We will start with doctors first. Later, we will rope in the pharmacists, physicists, researchers and other allied health personnel." He said the competency assessment would also be based on credit points and logbook, meaning doctors would be assessed on how they performed in certain procedures and how they related to patients and others. |
Focus on Arthritis
Two associations for rheumatology. I was just wondering the redundancy and such waste of resources. The battle in the pharmaceutical industry supercedes all else I suppose.
Anyhow, the search for these sites stemmed from the fact that a patient with a rheumatological disorder lamented that he was not able to find a support group that was based in Malaysia. I found the above sites useful. Becoming members of their associations can also be done online. There is also a list of upcoming events on their sites, which sadly appears to be outdated. As usual, starting a site is easy, maintaining one is the actual challenge!
Thalassaemia in the news
The Star today features
an article and interview with Professor Elizabeth George, a local expert on Thalassaemia.
Some staggering figures:
* About 4.5% of Malaysians are thalassaemia carriers.
* Every year, there are about 141-150 beta- thalassaemia births in West Malaysia.
* Sabah has the highest number of thalassaemia major patients in Malaysia.
* 4.5% of Chinese are carriers of alpha- thalassaemia, and most are not aware of it.
* There are over 2,400 transfusion-dependent thalassaemia patients in Malaysia.
* At least 80% of thalassaemia major patients do not live beyond the age of 10 or 20. |
Planning to get married? Have you checked to see if you or your future life-partner are carriers?
If you want more information on Thalassaemia, you can check out
Malaysian Thalassaemia Website links from the MMR's
Public Societies and Associations pageThalassemia.org
Specialists' register
When is a specialist a specialist? It's long overdue but as mentioned in
Specialist doctors to be evaluated:
Doctors who apply to be specialists after passing examinations in the respective fields will have their qualifications vetted by a credentials committee before being accorded recognition.
Health Minister Datuk Dr Chua Soi Lek said this was part of the government’s move to launch the National Specialist Register next year, a move to ensure that specialists were fully competent to practise in their chosen specialty. |
Good move. It's not only about paper qualifications but also adequate training which deems a specialist competent in his or her chosen field.
The onus is on the
Academy of Medicine and the various Colleges within it to set the guidelines and ensure the standards.
Did you know the Academy of Medicine already has an online Register of Specialists? You can search for Specialists from any discipline. This search page has been included in the
MMR's Directory for your convenience.
More on herbs
In
Himalaya Herbal Healthcare picks M’sia as regional hub, the CEO is quoted as saying
| “Herbal products are safe and do not have any side effects on consumers. We have combined our herbal products with contemporary science and we spend a huge amount of money on research and development. |
Absolute rubbish.
There aren't any drugs - herbal or otherwise - that have absolutely no side effects at all.Side effects are potential adverse events which come about from taking a particular drug. They are not inevitable events. The risk of developing these adverse effects is variable. Side effects may not be documented simply because there have been no clinical trials and there is no system in place for surveillance and monitoring for these side effects.
The following day, the Star had this article on
Doc: Herbal drugs may not be safe.
Take home message: herbs are drugs. Like all drugs, there is the potential for side effects and interaction with other drugs. Do be careful.
Links:
The Herbal Minefield
Feedback: doctor shortage
dino writes:
| i want to know about the shortage of doctor in malaysia and effect to the country and how to prevent it in long term or short term for my school project as soon as posible. |
Well dino, you might start by working on your English ;)
To get you started on your research, the MMR has a vast archive of "news report clippings" on this issue. You see the
Google search the MMR form at the top? Just enter "doctor" and "shortage" (without the quote marks) and you'll get many articles on this issue. When you complete your project, do send it in to the
Ministry of Health as they sorely need help in this problem area too, since they've clearly been unable to solve it for many years now.
Closer to a pandemic?
The news that the
H5N1 (Avian flu) virus was found in pigs (last year would you believe it, and only now admitted by the Chinese govt) is disturbing indeed.
Scientists have predicted that if the pigs were harbouring both bird and human flu viruses, the two strains could interact and mutate to create a strain capable of transferring easily to humans.
Once this occurs, a
pandemic could ensue.
On a brighter note, all Avian flu suspects in Kelantan
have been cleared of having the disease.
Now, vote here and tell me what you think:
Waste disposal
In the NST,
Disposing of medical waste safely
Ranjeetha Pakiam
MALACCA, Aug 20:
Used syringes, bandages and human tissue should be disposed of properly but many doctors carelessly throw them into dustbins and waste dumps. |
It is quite surprising that the knowledge that doctors have acquired during all those years before and after graduation have failed to create an awareness of the principles and issues involved in Universal Precautions. Are General Practitioners no longer sensitive to this issue or has the monetary gains superseded all else?
Universal Precautions
1. Barrier protection should be used at all times to prevent skin and mucous membrane contamination with blood, body fluids containing visible blood, or other body fluids (cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids, semen and vaginal secretions).
Barrier protection should be used with ALL tissues.
2. The type of barrier protection used should be appropriate for the type of procedures being performed and the type of exposure anticipated. Examples of barrier protection include disposable lab coats, gloves, and eye and face protection.
3. Gloves are to be worn when there is potential for hand or skin contact with blood, other potentially infectious material, or items and surfaces contaminated with these materials.
4. Wear face protection (face shield) during procedures that are likely to generate droplets of blood or body fluid to prevent exposure to mucous membranes of the mouth, nose and eyes.
5. Wear protective body clothing (disposable laboratory coats (Tyvek)) when there is a potential for splashing of blood or body fluids.
6. Wash hands or other skin surfaces thoroughly and immediately if contaminated with blood, body fluids containing visible blood, or other body fluids to which universal precautions apply.
7. Wash hands immediately after gloves are removed.
8. Avoid accidental injuries that can be caused by needles, scalpel blades, laboratory instruments, etc. when performing procedures, cleaning instruments, handling sharp instruments, and disposing of used needles, pipettes, etc.
9. Used needles, disposable syringes, scalpel blades, pipettes, and other sharp items are to be places in puncture resistant containers marked with a biohazard symbol for disposal.
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It is sad when we personally encounter GPs that do not practice basic hygiene and safety precautions. The practises of reusing syringes and needles should no longer be practiced although unfortunately still evident in certain clinics. Proper disposal of biohazardous materials is also the responsibility of doctors. It should have been an issue that was settled in medical school. However, for the press, politicians and the public alike, to raise this issue is both humiliating and does not augur well for the reputation of the profession.
Yet, it now remains to be seen if indeed these unscrupulous doctors will comply.
Site update: PDM
The
Persatuan Dermatologi Malaysia (Dermatological Society of Malaysia) webpage has been updated in the
Professional societies listing of the MMR.
Thanks to Dr. Cheah for the tip.
Avian Flu Update
It has now been
reported that :
A 16-year-old girl was taken to hospital after health officials checked 297 families living near where the virus was found in two chickens in the village of Pasir Pekan, Health Minister Chua Soi Lek told reporters.
But he played down the risk that she would be the outbreak's first human victim.
"To this day, we don't think it's avian flu because she's having no fever, only a cough, sore throat and runny nose," he said. "There's no symptom of lung infection." |
Let's hope for the best that it's not Avian flu and wish the girl a speedy recovery.
Feedback: gamat
marlisyaa writes:
| i would like to know more about gamat in making beauty product cause i'm doing my reseach on gamat and its benefits in skin problems |
Well, marlisyaa, I strongly believe that any benefits should be documented scientifically using clinical trial methodology - here an unproven treatment is compared with standard treatment or placebo in a significantly large number of patients to demonstrate whether or not the treatment is effective. You can see from the
Gamat website that evidence is given in the form of "
testimonials" which are not good evidence of response since other influences/treatment and natural recovery are not taken into account.
I did a PubMed search again using "skin sea cucumber" as keywords and I could not find any randomised clinical studies in the area of your interest. I did however locate a paper on the
Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues. This was a small study but we need to see more (and larger) studies like this before one can conclude that Gamat is beneficial.
Avian flu strikes Malaysia
There is no room for complacency and the authorities have acted promptly.
Malaysia joins resurgence of H5N1 avian fluAug 19, 2004 (CIDRAP News) – H5N1 avian influenza has today been confirmed in a privately owned flock of chickens in northern Malaysia near the Thai border. The country joins three others, Vietnam, China, and Indonesia, in which the disease has resurfaced in recent weeks following the widespread outbreaks across Asia earlier in the year.
Secretary-General Abi Musa Asa'ari Mohamed Nor of the Malaysian Health Ministry made the announcement at a press conference, according to a Xinhaunet story. The H5 virus was identified yesterday in two birds near the village of Baru Pasir Pekan, and further testing confirmed it as H5N1, the subtype that can infect humans and has caused 27 deaths in Asia this year.
The Malaysian government yesterday immediately quarantined a 6-mile area around the farm and halted exports of poultry and poultry products. All of the birds in the village, reported as about 300 by Reuters, are to be killed today as a precautionary control measure, and all movement of poultry is banned in the Kelantan state where the village is located. People and birds in the area are being monitored and tested, says the story.
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Let's hope we are kept informed and not kept in the dark on further developments.
According to
ScreenshotsThe official Bernama news agency on Wednesday night carried an "urgent note to editors" saying that "the Prime Minister's Department has directed the media not to use any story relating to the so-called bird flu in the country."
But on Thursday afternoon Bernama carried a brief report saying Prime Minister Abdullah Ahmad Badawi's department had issued a statement denying having made such a directive. |
No cover up please.....
Links:
Dr Vadivale's Avian Flu Page
Hope for psoriasis
Psoriasis is an immune mediated genetic disease manifesting in the skin and joints. Each patient can present in different ways. It can cause great discomfort and depression among patients with this disease. At this point in time, there is no cure for psoriasis, only drugs to control the problematic symptoms. Now there is hope.
Possible New Cure for Psoriasis Found
BONN, GERMANY -- August 16, 2004 -- Cell biologists of the University of Bonn, in cooperation with the University of Leeds (U.K.) and industry may have discovered a new effective therapy for psoriasis -- a specific group of what are known as metalloproteinase inhibitors that can normalise the increased tendency of epidermis cells (keratinocytes) to divide, which is the cause of this unpleasant lepidosis.
The researchers were not able to detect any toxic side-effects, at least not in cell cultures. Their findings are being published in the Journal of Investigative Dermatology (Vol. 123, No. 3).cont.. |
Although still undergoing trials, it does offer a glimmer of hope to millions of psoriatic patients. A hope of cure to a disease that can potentially steal away one's confidence and comfort in life.
Psoriasis Association, Dermatological Society of Malaysia
Putting on a front
Recently, the Emergency and Trauma Centre of the UMMC was officiated by the Higher Education Minister. As usual, a grand show was set up and the manpower beefed up. Equipments were duly placed strategically to portray a center that is well equipped. Little did our dear minister realise the extend of fabrication in such a grandiose display.
The center boasts facilities that includes "18 consultation rooms, a 10-bay resuscitation room, two operating theatres, a 20-bay acute medical care centre, an observation ward with 20 beds, two CT-scan rooms, two decontamination rooms and two isolation rooms". These facts are accurate. However,the problem is that the staff of 130 is insufficient to run a center purportedly at the cutting edge of emergency care. A 10 bay resuscitation unit for example, is run by a doctor and at most 4 nurses at any one time. In a situation that involves 3 or more resuscitation cases, the limitations of this group of staff is clearly evident. The emergency care rendered would at best be patchy and most probably, inadequate. In the acute medical care which has 20 bays, on most occasions only has 2 nurses on duty. The point is, despite having a staff of 130, the actual situation appears far more grave than have been portrayed. A poor management of human resource perhaps.
Working as a doctor in the Emergency is no easy feat. There is little support for the doctor on duty. He/She has to clerk the case, set the IV line, take the necessary blood investigations and make appropriate referrals. The role of nurses it seems is contracting. They are not allowed to set IV lines. They are not allowed to give IV medications. Ultimately a basic medical skill like inserting IV lines is lost. The most a nurse will do is to take the vital signs on admission of a patient. Ask any doctor on duty in this Emergency unit, and his/her frustrations will surface.
There are many limitations to this Emergency Unit and despite the headlines that say "All geared up for an emergency", they remain ill prepared for true emergencies of a larger scale. Ministers should make it a habit to visit unannounced to avoid a display that only serves to put up a false front of competency and efficiency.
Save the Gamat
In
Healing power of gamat, we have publicity on Prof Hassan Yaacob, a pharmacologist, who appears to be promoting Gamat (a sea cucumber). The article cites Gamat, used in Malay traditional medicine, as being "effective" based on anectdotal case observation and animal studies.
The only way to prove whether or not Gamat is effective is to perform randomised controlled clinical trials in humans. I searched
PubMed for "sea cucumber" and I could not locate any such trials. Incidentally I tried to look for publications listed in PubMed by Prof Hassan Yaacob but I could not find any either.
In the meantime, the article goes on to quote that Prof Yaacob has "set up Healwell Pharmaceuticals Sdn Bhd in Shah Alam. He is executive chairman and director of Healwell and Eastern Biotech Resources Sdn Bhd, a local company dealing in production and consultation of gamat and anti-ageing skincare products. He is also chairman of Dermatech Sdn Bhd, a joint local and Singaporean company exporting cosmetic products to the United States."
It seems to me that commercial interests supercede adequate peer-reviewed scientific proof of efficacy. Academics should stick to academia. It does not go down well with many people if academics have much vested commercial interest. It's like political parties doing business. The public should realise that products associated with academic's names on the label and endorsements does not necessarily mean the product works as claimed or there has been any proper clinical studies in the first place. It only goes to show how much we need proper regulation in this country. If one sells a product with a claimed clinical benefit (wound healing for instance) we should demand there be adequate clinical studies before one is allowed to market the product. But this is Malaysia - anything goes!
In the meantime, the poor Gamat are being threatened with extinction as the Star also reports that
Sea cucumber are being over harvested. Save the Gamat!
Regulating Beauticians
In
Tighter rules for health and beauty salons (
MMM Permalink ), the Health Minister claims the Ministry is "handicapped in the absence of the regulations" and is waiting for legislation - the Private Healthcare Facilities and Services Act 1998 to be exact.
He said the rules would also govern the practices of these salons to protect the public.
The standards would cover professional qualifications, facilities, treatment procedures, advertisements, offences and penalties.
Topping the list to come under the regulations are treatments involving cosmetic breast surgery, weight loss programmes, Botox and lamb cell injections as well as laser technology. |
Breast surgery by Beauticians? It happens more commonly than is reported. Nothing comes out in the press unless civil action is taken as in this case:
In the absence of regulations, there are no official records or statistics on such beauty treatments except for the botched jobs that end up in court.
In 1994, a restaurant owner, Soo Yok Lin, sued beautician Linda Lee Yoke Sim for damages for a botched breast surgery allegedly done by Lee.
Lee was ordered to pay RM87,920.62 to the mother of four, who lost her breasts after a botched breast enlargement treatment. |
Just only yesterday, I attended to a woman who presented with recent onset bleeding and all her blood counts were low (the medical term for this is pancytopenia). One of the possible causes is
Aplastic Anemia and a thorough drug history is required as certain medications and chemicals may cause this disorder. She volunteered that she was given
Sibutramine (a prescription only drug used as a short-term supplement to diet and exercise in the treatment of obesity ) by a Beautician! Shocking that these people not only perform surgery but now also prescribe drugs without a license. To top it off, the patient was not obese in the first place!! Fortunately for the Beautician, blood disorders are not listed as one of the possible side effects of Sibutramine. Still, such people should be hauled up at once lest more people are harmed. The Health Minister may lament the "lack of legislation" but even now we have ample laws at the moment and what is even more important is that no amount of legislation would be of use without
adequate enforcement.
Doctors and nurses to be redeployed
From
The StarA nationwide re-deployment exercise of doctors and nurses involving 117 government hospitals is underway to serve the people better.
Dr Chua: 'Deployment from now on will be based on actual workload'.
Health Minister Datuk Dr Chua Soi Lek said the failure to distribute manpower based on “actual workload” has resulted in either under-utilisation in some hospitals or “overloading” in others.
“Last year, 61 of the 117 hospitals nationwide had a bed occupancy rate of below 50%, the lowest being Hospital Daro in Sarawak with 9.8%.
“This is in contrast to those filled to the brim, like the Queen Elizabeth Hospital in Sabah with 99% bed occupancy rate and over 1,000 outpatients daily,” he said in an interview here yesterday.
Dr Chua attributed this to the rigid deployment method used – one doctor for 28 beds and one doctor for 50 out-patients daily.
He said a minimum of seven doctors have been allocated for each district hospital but some have up to 10.
The mushrooming of hospitals in recent years further aggravated the “so-called” shortage of some 3,000 doctors and 4,000 nurses in the country, he added.
There are 11,500 doctors and 28,000 nurses in the government hospitals nationwide.
Dr Chua said construction of new hospitals would also be put on hold for the Government to focus on the consolidation exercise.
The 117 hospitals have 28,633 beds with 5,456 beds available in special medical institutions like Pusat Tibi Negara, Hospital Bahagia, Hospital Permai, Hospital Bukit Padang, Hospital Sentosa and RCBM Sarawak.
“Deployment from now on will be based on the actual workload,” he said, adding that transfers would be confined within the state to reduce the impact on those involved.
Nurses would soon undergo the same exercise, he added. |
Will shuffling doctors from "underutilised" hospitals to the busier ones help things? I have my doubts.
The busy hospitals will only get busier. What will happen is that more people will shun the understaffed hospitals and head for the ones they perceive as being better staffed and better equipped.
What do you think of the current ratio "one doctor for 28 beds and one doctor for 50 out-patients daily". This sounds like an understaffed ratio to me. On top of this, if doctors go on leave, there is no addtional staff allocated and remaining staff have to do double duty. So overall, it looks like there is a gross shortage and I fear that there won't be much impact on the overall picture.
Firetraps
Think hospitals are hazardous places? Yeah there's a chance one may not come out alive ;)
Seriously, there's now this shocking revelation that some hospitals in Malaysia are
Firetraps Sources said such hospitals, including one in Kuala Lumpur that was well-known, had not obtained fire safety certificates from the Fire and Rescue Department because they had failed to meet safety requirements – staffing and physical facilities on fire safety – as required under the Private Hospitals Act 1971.
“The electrical wiring of some of these hospitals are also in question while some did not have fire insurance coverage,” said a source, who noted that the Act to regulate private hospitals stopped short of empowering the ministry to shut down such illegal hospitals.
“Such illegal hospitals are simply exposing patients, in particular, to danger,” said a senior medical specialist.
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Thankfully there's yet to be any serious disaster in local hospitals as far as fires are concerned. But I think we shouldn't wait for one to happen before action is taken against those who flout the law.
I recall once incident years ago in a government hospital up north. A patient was being transported to a waiting ambulance and anxious relatives were helping to move the bed. The thing was the patient was on oxygen being delivered via nasal prongs and this idiot relative was next to him with a lighted cigarette dangling from his lips. Talk about smoking being hazardous to health!
What a waste!!
The MOH admits that up to
20% of foreign doctors recruited to work in Malaysia are booted out (
MMM Permalink)
Penang: Health Ministry Parliamentary Secretary Lee Kah Choon disclosed that between 10 and 20 per cent foreign doctors and medical experts recruited by the Government to work in Malaysia had to be sent back as their service was not up to the standard required.
Language, background and cultural differences were among the reasons why they had failed to perform their duties well, he told reporters when visiting Penang Hospital, here, Friday.
He said at present, most foreign doctors in Malaysia were from Indonesia, Bangladesh and Pakistan, and lately, the Government was eyeing to recruit more doctors from Myanmar as they had been said to have the capability in providing good service.
On the cost borne by Government in recruiting foreign doctors, Lee said the Government spent about RM40 million annually to pay their salaries. |
I don't think the 20% will get booted out immmediately, knowing how slow the bureaucratic process in the MOH is. Let's say they were booted out only after one year - that would mean 20% of RM40 million, i.e. RM8 million was a total waste of public funds. Who is responsible for this pathetic recruiting exercise? You are really wasting public money - tax payers' money in case you have any conscience. How about spending some of this RM40 million to improve the lot of your local doctors, MOH? Why can't the message get into some thick skulls that the priority should be keeping your local talent?
Looking for Dr Alamelumangai
Dr Anbuselvam writes
Could you please try and let me know where DR Alamelumagai is in Malaysia?
She did her MBBS in Kilpauk Mediical College in Madras 1979-1986. We want to contact her to inform about our batche's silver jubiulle celebration. I would be grateful if you could help me in this! I am in Brunei, a neurosurgeon. |
Well there are a couple of Doctor search links you can take from the
MMR's Directory page but neither the MMA's search page nor Prohighway.com's database yields any positive result I am afraid.
I even thought of looking in
Telekom's White pages Residential listing but could not locate anything under that name either.
So if anyone reading this knows the whereabouts of Dr. Alamelumagai, please send me
feedback or post as a comment here.
Malaysia has a long way to go as far as locating and verifying doctors. The GMC UK has
online methods to locate and verify doctors. The databased produced by the
Malaysian Medical Council (Dr. Anbu you could try calling them up) is available only in paper form. It is sorted by State so it would be a nightmare to try to locate anyone if one does not know where the doctor is practicing. She may or may not be a practicing doctor and in the latter case, she would not be on the MMC register.
I have posted the query in
Dobbs as well, so hopefully another doctor out there might know something.
Left in the lurch
200 medical students left in the lurch so reports the Star,
OVER 200 students pursuing medical degrees overseas are now left in the lurch, as the universities they had enrolled in are not recognised by the Malaysian Government, Tamil Nesan reported.
Quoting MIC vice-president Datuk S. Veerasingam, the paper said students who returned to Malaysia with these unrecognised certificates face numerous problems when applying to practise medicine in the country.
Indian students were among those studying medicine abroad due to the shortage of places in local public universities, he said, advising those concerned to check with the Education Ministry on the suitability of their courses. |
But it's
not the Education Ministry Mr MIC Vi ce-President
I have said this again and again in this website, the proper body to contact to determine whether or not a particular Medical degree is recognised in Malaysia is the
Malaysian Medical Council - not the PSD and not the Education Ministry.
Vaccines for life
The Star has a good article on
Vaccines for LifeWorth a read if you are a parent and want to know more about vaccination for your kids.
Heavy metals found in "hair supplement"
Here's a warning from Health Canada via
Consumer Health Digest:
Health Canada has ordered a recall and is warning consumers not to use Sesa Hair Supplement capsules, a product alleged to treat hair loss. The product is manufactured by Inc. of Scarborough, Ontario, but may also be sold by herbalists and acupuncturists without the company's name on the label. Health Canada investigated after learning that a patient taking the product required hospitalization due to lead poisoning. The assessment found that the capsules contained more than 7,000 times the allowable limit of lead in a health product and also contained mercury and arsenic. Health Canada strongly advises anyone who has used Sesa Hair Supplement capsules to consult their physician. [Health Canada warns Canadians not to use "Sesa Hair Supplement." News release, July 23, 2004] http://www.hc-sc.gc.ca/english/protection/warnings/2004/2004_42.htm
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Reminds me of a patient I had not long ago who was taking some Chinese herbal supplements (these came in capsule form) and she presented with severe abdominal pain, anaemia and a blood film showing basophilic stippling - classical signs and symptoms of lead poisoning. Sure enough her blood lead levels were sky high.
There is no data on the incidence of heavy metal poisoning in this country unfortunately.
Guess what you should not be testing
In
Guess what you should not be eating , the NST highlighted Makna and a proposed study into possible carcinogenic effects of some foodstuff consumed locally.
..a year-long study has found that 70 per cent of Malaysians struck by the deadly disease consistently down yummy items like Ikan bilis, ikan masin, belacan and udang kering bought off the shelves of supermarkets.
The study, conducted by Universiti Kebangsaan Malaysia's Faculty of Allied Health Science, found that cancer patients, especially those living in coastal states, liked such salty and highly-preserved foods.
"There might be something in the food which causes cancer," said National Cancer Council (Makna) president Datuk Mohd Farid Ariffin.
"We have asked the faculty to do further studies on this. We believe that such foods may be loaded with salt and preservatives." The study, sponsored by Makna, is headed by the Faculty's Department of Nutrition and Dietetics head, Associate Professor Dr Fatimah Arshad.
An official announcement on the study will be made once the research is completed. |
Such studies are welcome but are not easy to do and will require careful analysis as there may be other confounding contributory factors (both genetic predispostion and environmental) and more importantly, cancer is not one disease and different cancers have different multi-step causes.
I was interested to read a final point in the article
| The Makna, Pathlab and Parkson cancer screening campaign offers general health screening, cancer marker screening and breast cancer screening. The campaign will run from Aug 5 to Dec 31 at various Parkson outlets. |
Cancer marker screening? I sure hope they will not be employing blood tumor markers. The NST already highlighted
Indiscriminate testing raises doctors’ concern (
MMM permalink)
Doctors said tumour marker tests can either cause unnecessary concern or give a false sense of security. "These tests are a waste of money," said Dr S.K. Dharmalingam, president of the National Cancer Society.
"The authorities should regulate this indiscriminate testing," said Dr Leslie Lai, who last year helped the Academy of Medicine of Malaysia, an association of specialists, produce guidelines on the use of these tests. |
Professor Emeritus
Microbiologist Datuk Dr Lam Sai Kit, 66, has been appointed Professor Emeritus of Universiti Malaya.
The Star reports:
In a citation read out by the UM Medical Microbiology Head of Department, Assoc Prof Dr Hamimah Hassan, Dr Lam, who had served for 37 years with the university, was described as a man who possessed admirable vision, dedication and commitment.
“Like a beacon on a hill, he provided the path for those he trained and guided them to achieve excellence,” Dr Hamimah said.
“The motto commitment to the path to excellence has served well for those who worked with him,” said Dr Hamimah.
Dr Lam's involvement in emerging infectious diseases led to the discovery of the new virus like the Nipah Virus through the research team that he headed.
The finding automatically placed Universiti Malaya as the main university for viral research particularly after the research's team's efforts in controlling and identifying the cause of several outbreaks like the Enterovirus 71 encephalitis in 1997, the Nipah virus encephalitis in 1998 and the Chickugunya polyarthritis in 1999. |
Congratulations Prof. Lam. You well deserve it!Footnote:
The Nipah virus was discovered in 1999 by Dr. Chua Kaw Bing who at that time was a staff member of Professor Lam's Department. For links and more on the Nipah virus, visit Dr. Vadivale's
Nipah virus page.
More Watch sites
You might be interested to know that
Quackwatch has launched additional "sister" sites making it 15 in all.
Some of the newer ones which I find interesting are:
**Casewatch: A guide to health fraud- and quackery-related legal
matters.
http://www.casewatch.org**Chelation Watch: A skeptical view of chelation therapy.
http://www.chelationwatch.org**Device Watch: A guide to questionable medical devices.
http://www.devicewatch.org**Infomercial Watch: A critical guide to health-related infomercials.
http://www.infomercialwatch.orgWe need to have "Malaysianised" fraud and quackery-watch sites. We'll try to highlight some of these in the MMR as they appear in our media and what not. If you spot any, do let us know.
Site update: MSA
Lawrence wrote in to inform of the
Malaysian Society of Anaesthetists' website which I have included in the updated MMR's listing of
Professional Societies and AssociationsThanks for the tip, Lawrence.
Now anyone else with more links, please send me
feedback.
Site update: MSN
Added the
Malaysian Society of Nephrology webpage to the MMR's listing of
Professional Societies and Associations Is your Medical society or association listed in the MMR?
If not, please send me
feedback for inclusion in the listing.
Feedback: colonoscopy
W writes:
I recently underwent a colonoscopy by a gastroenterologist.I reviewed the CD at home and noticed
that during the colonoscopy, the CD recorder recording the procedure was paused and then stopped (possibly due to recorder malfunction) when the scope was partly retracted, thus possibly leaving some loose ends. I am really disheartened after all the purging I had been through. This was my second colonoscopy; the first one (done about 2 years ago) was not very clear as I had a lot of bubbles and greenish-yellow liquid in my colon although the gastroenterologist insisted that it was clear.
Perhaps such procedures are based purely on good luck! |
Thanks for the feedback. Yes, the most unpleasant aspect of colonoscopy is actually the bowel prep and not the scope procedure itself. The key thing is what the endoscopist sees and records in his report. He's concentrating on the scope itself and the video recording is not in his control - as you said, it could be a glitch with the recorder. The object is not to get a good video recording but for the endoscopist to get a view of what he intended to see in the first place.
Patient Information on Colonoscopy
Breast MRI
Breast cancer remains the commonest malignancy among women in Malaysia. Due to the aggressiveness of breast cancers, early diagnosis and treatment is paramount for the best treatment outcome and survival. Unfortunately, many women in Malaysia still present at a late stage of breast cancer due to reasons that are trivial at best. It is very heartbreaking to see patients presenting with fungating, ulcerative, unsightful and foul smelling breast tumours. Many of these patients are mothers of young children, whom are still oblivious to the fact that they are about to lose their mothers to this disease.
The pictures below depict the progression of breast cancer in a patient who refused treatment.
The best strategy in breast cancer management is early detection and removal.
Breast cancers spread early through the blood stream and lymphatics of the breast tissue. It is therefore important to develop a technique that can identify breast cancer at the earliest possible time. Our current strategy is breast self examinations and mammogram. Both of these techniques are not flawless and have low sensitivities to breast cancer. Breast MRI(magnetic resonance imaging) has been in existence since the early nineties but not widely practised due to the high cost involved. Nevertheless, there is increasing evidence of its usefulness especially in patients with high risk, ie those with a family history of breast cancer or with gene mutations for breast cancer (BRCA 1 & II)
Breast MRI enables small tumours to be clearly visualised. Something that BSE and mammograms remain incapable of or at most unreliable.
Medscape recently highlighted an article in the New England Journal of Medicine, indicating that
MRIs are more sensitive than mammograms in detecting cancers in high risk women. Other than detecting small tumours, it could visualise effectively dense breasts, an area mammograms remain inferior. In view of this, many now advocate the use of breast MRI as a screening tool in women with a high risk of developing breast cancer. However, it is not without limitations, as highlighted below:
Benefits
1.Sensitive to small abnormalities
2.Effective in dense breasts
3.Can image breast implants/ruptures
4.Can evaluate inverted nipples
5.Can locate primary tumor in women whose cancer spread to armpit lymph nodes
6.Can detect residual cancer after lumpectomy
7.Can determine what type of surgery is indicated: lumpectomy or mastectomy
8.Can detect cancer recurrence after lumpectomy
9.May be useful to screen women at high breast cancer risk
Limitations
1.Non-specific; often cannot distinguish cancerous and non-cancerous tumors
2.May lead to unnecessary, difficult to perform biopsies
3.Cannot image calcifications, tiny calcium deposits that can indicate early breast cancers
4.Expensive and not widely available
5.Some patients who are claustrophobic may not tolerate MRI
6.Requires use of contrast agent
7.More time-consuming than mammography
8.MRI centers cannot always produce results cited in research studies
At this time, breast self examinations and mammograms remain the most reasonable and practical tool for early detection of breast cancers. Perhaps consideration can be given to MRI if there is an element of doubt. The bottomline for breast cancer survival, EARLIEST DETECTION POSSIBLE.
Colonic quackery
The Star features
yet another article which I term pseudo-therapy in their Lifestyle section.
It's about "detoxification" and one of the "treatments" employed is colonic irrigation or colonic "hydrotherapy".
Folks, let me say this once and for all. This is simply
quackery without an iota of evidence of any health benefit.
In
Gastrointestinal Quackery, Dr. Barrett says:
Colonic irrigation, which also can be expensive, has considerable potential for harm. The process can be very uncomfortable, since the presence of the tube can induce severe cramps and pain. If the equipment is not adequately sterilized between treatments, disease germs from one person's large intestine can be transmitted to others. Several outbreaks of serious infections have been reported, including one in which contaminated equipment caused amebiasis in 36 people, 6 of whom died following bowel perforation [7-9]. Cases of heart failure (from excessive fluid absorption into the bloodstream) and electrolyte imbalance have also been reported [10]. Yet no license or training is required to operate a colonic-irrigation device. In 1985, a California judge ruled that colonic irrigation is an invasive medical procedure that may not be performed by chiropractors and the California Health Department's Infectious Disease Branch stated: "The practice of colonic irrigation by chiropractors, physical therapists, or physicians should cease. Colonic irrigation can do no good, only harm." The National Council Against Health Fraud agrees [11]
The FDA classifies colonic irrigation systems as Class III devices that cannot be legally marketed except for medically indicated colon cleansing (such as before a radiologic endocopic examination). No system has been approved for "routine" colon cleansing to promote the general well being of a patient. Since 1997, the agency has issued at least seven warning letters related to colon therapy. |
Eating more fruits and vegetables is excellent advice. Colonic hydrotherapy? I really beg to differ!
Links:
Gastrointestinal QuackeryColonic Promoters Facing Legal ActionsColonic Irrigation (article from the National Council Against Health Fraud)
Com badges!
Remember the com badges the Star Trek crew wore? They just tapped on the badges on their suits and they could communicate with each other.
Well these com badges are now reality and have been put in place in St. Agnes HealthCare, a teaching hospital in Baltimore.
MobileHealthData has the news:
When patients push their call buttons, nurses are notified through the 2-ounce badges they wear around their necks or on clips. Nurses simply push a button on the badge and the system tells them what type of call is coming through. The nurse then can use voice commands to call the patient back, communicating wirelessly through the badge to the call system at the patient's bedside.
"The staff enjoys having direct contact with patients while saving time and steps," Diver says. Previously, nurses had been relying on either seeing the call light themselves or having a secretary or other staff member notify them that a call light was on, she explains. |
Over in this region, patient call bells are still the old fashion type. How well do nurses respond to patients when they use their call bells? There's this
joke that in
St. Elsewhere the patients get charged $$$ every time they press the call bell button. Over here in Bolehland Hospital, there's no such thing as patients being charged for every push of the call button. Then again, the nurses don't respond either ;)
Site update: Doctors webpages
I have added the
Palmo Anest weblog to the MMR's listing of
Doctors' own web pages and also to the Blogroll on the right. Its a blog by a Malaysian anaesthetist. Welcome on board AhLoon ;)
