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LETTER: While stress is a common feature of modern life, defining stress, its causes, symptoms and effects is very complex.

It is often characterised as a primitive reaction to modern organisational and social factors, known as stressors.

Under normal circumstances, people should be able to find ways to balance and respond to new situations. As stress is not necessarily negative, one should remember that a moderate level of stress can be motivational and instrumental in adapting to new situations.

To be healthy, one has to be balanced. A healthy individual is one that can positively interact with other people and the environment. Stress is, therefore, both normal and necessary.

Unhealthy levels of stress at work and in the family may lead to a number of disorders and illnesses including chronic fatigue, depression, insomnia, anxiety, migraine, headache, emotional problems, allergies and abuse of tobacco and alcohol and drugs.

Stress can contribute to hypertension, heart and cerebrovascular disease as well as to peptic ulcers, inflammatory bowel disease and musculoskeletal problems. It may also alter immune functions which may in turn facilitate the development of cancer. Taken together, these disorders may be responsible for a large number of diseases, deaths and cases of disability.

All of us are affected at one time or another by stress. Although occupational stress is by no means a new phenomenon, it is becoming increasingly globalised and affects all categories of workers, including both blue and white-collar workers as well as families. It has an impact on society as a whole. Although stress at work is most frequently considered a problem of industrialised countries, workers in developing countries are also undoubtedly affected.

Because stress is so widespread, it has a very high cost for individuals, companies and organisations and for society. For the individual, in addition to the devastating impact of the serious health impairments referred to above, the loss of capacity to cope with working and social situations can lead to lower levels of success at work, including loss of career opportunities and even employment. It can give rise to greater strain in family relationships and with friends. It may even ultimately result in depression, death or suicide.

For the company or organisation, the costs of stress take many forms. These include absenteeism, higher medical costs and staff turnover, with the associated cost of recruiting and training new workers. It has also been shown in recent years that stress takes a heavy toll in terms of reduced productivity and efficiency.

It is now widely acknowledged that stress at work is a very common problem and that it has a very high cost in terms of workers health, absenteeism and lower performance.

Yet, it has been proven time and again that effective solutions exist for the prevention of stress at work. The best of these offer a very good return in terms of reduced absenteeism, better health, improved efficiency and productivity and lower medical and other benefit costs.

Work stress is an increasing health hazard to workers all over the world. In fact, the World Health Organisation reported, “about 50 per cent of the entire working population are unhappy in their jobs, and about 75 per cent of those who consulted psychiatrists are experiencing problems that can be traced to a lack of job satisfaction.

However, research evidence on work stress around the Asian region, is generally still minimal. There should be more research into stress and the prevalence of mental disorders amongst Malaysians.

Research evidence suggests a clear link between excessive levels of stress and sickness. The most significant cause of all illness or disorder that cannot be explained at the molecular level is stress. Stress-related disorders are not obvious, unlike physical disorders, but the impact may be as detrimental, if not more. We should equip our workforce on how best to cope with stress.

We need to develop skills to manage stress. Such skills include how to manage anger and conflict resolution, think positively, time management, addressing problems and finding solutions. Another effective way is by practicing relaxation. The use of relaxation should be promoted to organisations as well as the Corporate Sector.

Stress beyond a minimum level can threaten the wellbeing of any worker. It triggers automatic, persistent attempts at its resolution and forces one to do something about it. Some people suffer in silence, some act out, some decide to end their life.

Therefore, we should practise skills to handle stress so that we are more able to cope with stress when it comes knocking at our door.

by TAN SRI LEE LAM THYE.

Read more @ https://www.nst.com.my/opinion/letters/2020/12/652501/develop-skills-manage-stress

KUALA LUMPUR: Some 8,000 Malaysians have been diagnosed with end-stage kidney disease that require them to undergo stage 5 dialysis treatment, annually.

Nephrologist Dr Lily Mushafar said between 65 and 70 per cent of chronic kidney disease patients in the country are those suffering from diabetes followed by those suffering from hypertension, kidney stones, chronic glomerulonephritis (inflammation of the tiny filters in the kidneys) and SLE (systemic lupus erythematous).

“That is why we encourage people who are 55 years old and above as well as those with a family history of kidney disease and kidney stones to undergo health screening at least once a year.

“Kidney disease is a silent killer since it will not display any warning signs (symptoms) until at a later stage.

The head and consultant nephrologist at the nephrology department of the Tuanku Ja’afar Hospital in Seremban, Negri Sembilan was among the panellists during a “chit-chat session” held in conjunction with the launching ceremony of the MyBuahPinggang’s website today.

Moderated by Putrajaya Hospital’s nephrologist Dr Rafidah Abdullah, other panel members included Dr Nor Fadhlina Zakaria, a nephrologist attached with Universiti Putra Malaysia, and Khairul Shazwali Taib, a patient who had undergone a kidney transplant early last year.

At the same session, Dr Nor Fadhlina dismissed myths that medications prescribed by nephrologists compounded the condition of kidney disease patients.

“Apart from diabetes, hypertension and genetic diseases, other contributing factors to kidney problems are the consumption of painkillers and other medications that are not prescribed by medical personnel.

“Health and medical experts will not prescribe any medication that has side effects and detrimental towards the health condition of their patients,” she said.

Meanwhile, Malaysian Society of Nephrology chairman Prof Dr Abd Halim Abdul Ghafor dismissed myths that taking supplements would help reverse the health condition of a kidney disease patient for the better.

Dr Abd Halim said the issue arose from unverified information that is available on social media platforms and some supplements’ advertisements.

“When a person is diagnosed with kidney disease, of course, they or their family members want to help in alleviating the problem.

“Compounding the situation is the several information about studies and testimonies claiming that some types of supplements can help delay the process of a person undergoing dialysis treatment, highlighted in social media platforms.

“We also found out that studies (of taking supplements) that failed are not highlighted (in social media platforms),” said Dr Abd Halim.

He advised kidney disease patients or their family members to refer to doctors before taking any supplements.

Dr Abd Halim was among the three panellists of the second “chit-chat” session moderated by Dr Hirman Ismail, who is a public health expert with the Health Ministry. The other panellists are Dr Bryan Leong Chong Men, a nephrologist at the Kulim Hospital in Kedah, and MedTweetMy chairman Dr Khairul Hafidz Alkhair.

Dr Leong said the MyBuahPinggang’s website is a good effort to counter misleading information on kidney disease and treatments that are available on social media platforms.

“Before this, there is no dedicated website that offers verified information related to kidney disease and its available treatment.

“I hope the website will educate the public and encourage them to undergo necessary screening and get the immediate treatment needed,” he said.

By Adib Povera.

Read more @ https://www.nst.com.my/news/nation/2020/12/652544/many-unaware-they-are-suffering-kidney-disease

LETTER: Smoking has always been associated with lung cancer. Seven out of 10 patients diagnosed with lung cancer are chronic smokers.

According to the American Cancer Society, most of them are diagnosed at the age of 65 and above. Since it mainly occurs in the elderly, younger people may not take the adverse effects of smoking seriously.

What if I tell you that even if you do not catch cancer later in life, smoking may cost you to lose your limbs faster. You may lose them to Buerger’s disease before you reach the age of 45.

The exact mechanism of Buerger’s disease, which is also known as thromboangiitis obliterans (TAO), remains unknown. Researchers, however, believe that it is almost exclusively linked to smoking.

At this point, your fingers or toes will appear pale and become cold. You will start to experience sharp and burning pain. If you do not receive any proper medical intervention immediately, your fingers or toes will become gangrenous and may fall off spontaneously.

If you are in your 20s or 30s and are thinking TAO is not relevant to you, you may want to think again. TAO had also been diagnosed in a 19-year-old Japanese student a few years back.

She started smoking at the age of 16 and was smoking 20 cigarettes per day for three years. This patient had experienced numbness and coldness of her left toe for a week and later was diagnosed with TAO after undergoing imaging scans and lab investigations.

She had undergone angiography, but the treatment did not ease her condition. After completing an anticoagulant regime, she was discharged and advised to stop smoking. However, like 57 per cent of TAO patients, she decided to continue.

Four months later, she returned with a similar complaint. This time, however, she developed an extensive vascular complication, which required her left leg to be amputated.

The question now is, can TAO be cured? Unfortunately, there is no definite cure for the disease.

Surgical and medical interventions are meant to restore a TAO sufferer’s blood flow and help reduce the symptoms. The only way to keep it from getting worse is to quit smoking.

Research has shown that amputation has successfully been avoided in 94 per cent of TAO patients who quit smoking. What are you waiting for? Stop smoking now and save your limbs!

by DR SYED ALHAFIZ SYED HASHIM.

Read more @ https://www.nst.com.my/opinion/letters/2020/12/650598/quit-smoking-save-your-limbs

LETTERS: Kiara Hill Walk is a challenging exercise park located in Bukit Kiara, an affluent suburb of Kuala Lumpur, containing some attractive exercise and relaxation spots, a golf course and an equestrian centre.

Formerly a rubber estate, this area is one of the larger yet fast diminishing green spaces in the city — a rarity these days in Kuala Lumpur. There are some roads, trails popular with mountain bikers, as well as walking and hiking trails.

Starting at Taman Rimba Kiara, near the Aether Cafe, running up Changkat Abang Haji Openg and doing a loop at the top is around 5.2km distance-wise. The elevation gain

is 480 feet, with the steepest part being the first 1.4km. The labelled trail is nearly 2km each way, with the first 0.5km being steep before it levels out.

Generally, the place is safe and the facilities are well-maintained by a dedicated team of workers from the National Landscape Department, KL City Hall. It is open from 6.45am to 7pm daily.

The ideal time to walk here is 6.45am, as you get to see the morning sunrise.

Some of the regulars, like my friend Pathma Naban, have walked here for the last 15 years. It is his favourite area not only to sweat it out, but to find peace, tranquillity and solace.

Complementing the quiet ambience is the flora and fauna. A variety of trees in various heights, sizes and shapes as well as flowering plants, ferns and creepers are found here.

Supplementing the beauty are streams, a waterfall and birds chirping merrily along the pathway.

Macaques and occasionally dusky leaf monkeys inhabit this place. Birds, butterflies, squirrels, and less commonly, tortoises, centipedes, snakes and scorpions are also found here, though they won’t harm you unless provoked.

A cool freshness pervades the environment with the absence of vehicles emitting greenhouse gases. This pollution-free atmosphere is immediately felt as you commence the walk from the guard house.

How I wish many parts of KL can be akin to Bukit Kiara in harnessing that harmony with nature.

Several scientific studies carried out have found that people who spent time in natural surroundings with plenty of trees and natural flora and fauna experienced positive improvements in their immune functions.

A person simply needs to visit a natural area and enjoy a walk to calm and rejuvenate their body and mind.

The concept of shinrin-yoku, first developed and practised in Japan during the 1980s, has yielded excellent results.

Researchers at the University of Essex conducted a survey where they found that 94 per cent of individuals believed that spending time in nature and connecting with it helped them to have a positive mood.

At a place like Bukit Kiara, you are also bound to meet up with old friends, renew relationships and make new friends to share many things in common.

For retirees, this is an ideal park to spend your daily routine. The health benefit is just an added bonus.

by Benedict Lopez.

Read more @ https://www.nst.com.my/opinion/letters/2020/12/649458/place-healing-mind-and-body

LETTERS: Recently, due to the temporary closure of education institutions around the world, Emergency Remote Teaching and Learning (ERTL) has emerged to protect the safety and wellbeing of students.

However, most university students are facing difficulties concentrating on their studies and maintaining their mental health. Long-term isolation because of online learning can strongly affect one’s mental health.

“The impact of the pandemic on people’s mental health is already extremely concerning. Social isolation, fear of contagion and loss of family members is compounded by the distress caused by loss of income and often employment,” said Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation.

During the Movement Control Order, numerous reasons caused undergraduates to experience stress, anxiety, fatigue and even boredom.

According to the study, 20.4 per cent of students experienced minimal anxiety, 6.6 per cent experienced moderate anxiety and 2.8 per cent experienced extreme anxiety. Students staying on campus experienced the highest anxiety levels compared with those who stayed with family and friends.

Some of these students are often alone and did not have much activity to participate in, so they did not know how to overcome their anxiety. The most significant element in supporting students’ mental health is getting support from their loved ones.

If this social isolation is not addressed properly, it could lead to worse cases of stress, mental health issues and would eventually affect students’ personal wellbeing.

Students were also worried about whether they could continue their education due to the reduced income of their family. Malaysia’s economic situation can cause anxiety for students as they are worried about there being another economic crisis that might compromise their future.

It is vital for higher education institutions to help these students, especially with coping with anxiety during this stressful period. Students should also avoid reading or listening to unsubstantiated Covid-19 stories, especially those from unreliable sources.

To reduce stress, students should create a stress-free environment by connecting with family members and friends virtually as it is crucial to stay in touch with loved ones.

Islam values the importance of good mental health and emotional wellbeing. Spirituality and the psychological aspects of Islam are key to achieving the Sustainable Development Goals. The Quran can help those suffering from anxiety and emotional distress.

Muslim scholar Ibn Taimiyyah once said: “I have not seen anything that nourishes the mind and soul, preserves the body and secures happiness more than continuous reading and contemplation of the book of Allah.” University students are the successors of the country, hence, improving their mental health and wellbeing should be the utmost priority right now.

by SUFIA ATHIRAH.

Read more @ https://www.nst.com.my/opinion/letters/2020/12/649169/students-need-mental-health-support

Johor health and environment committee chairman R. Vidyananthan (pic) said that the number had jumped from 32 patients in June and 46 in July, to 678 in August.

“The spike in numbers was due to the launch of an online self-screening for mental health by the state health department on Aug 9. It was part of an initiative to address mental health issues.

“The online QR-DASS (Depression, Anxiety and Stress Score) allows those aged 16 and above to take part in the screening voluntarily and get immediate test results on their mental health status.

“If the result of the screening shows something that is abnormal, they will be encouraged to go to the health clinic for further checks.

“They will also be given a link to make an appointment at the clinic,” he told the state assembly seating here on Tuesday (Dec 1).

Vidyananthan was responding to a question from Sheikh Umar Bagharib Ali (PH-Paloh) on whether the state government has taken any proactive measures to tackle mental health challenges faced by the people due to financial problems, loss of jobs, and other impacts of the Covid-19 pandemic.

He added that some 287,204 individuals went through the online screening in August and 7,311 in September.

KUALA LUMPUR: The number of smokers who wished to quit smoking increased more than two-fold throughout the Covid-19 pandemic period this year compared to last year.

This was reflected in the number of people who registered for mQuit – a free programme to encourage more smokers to kick the bad habit.

Health Minister Datuk Seri Dr Adham Baba told the Dewan Rakyat today that 3,442 smokers registered for the programme online at jomquit.moh.gov.my. from Jan to Oct this year.

This, he said, was a significant increase compared to the 1,678 people who registered for the programme last year.

Dr Adham was responding to an oral question by Datuk Seri Dr Mujahid bin Yusof Rawa (Pakatan Harapan – Parit Buntar) who asked the ministry to state the progress of smoking cessation programmes and the effectiveness of these programmes.

Prior to the implementation of mQuit, which is a Public Private Partnership (PPP) between professional entities, non-govermental organisations and the private sector, Dr Adham said the government had spent RM2 million in 2018 and RM2.8 million in 2019 respectively to fund pharmacology costs to encourage people to quit smoking.

The initiatives which used Nicotine Replacement Therapy and Partial Agonist for Nicotinic Acetylcholine Receptor or Varenicline saw a reduction of participants due to the increase in the prices of the medications involved.

Dr Adham said this compelled the government to switch to implementing the mQuit programme.

The ministry, he said, is also hoping that the Finance Ministry would consider its request for all smoking cessation programmes to be funded using revenue collected from excise duty on cigarettes and tobacco.

He said greater allocation would help the ministry fund programmes which subsequently could help reduce the number of smokers in the country.

“At the moment, there are a total of 4.8 million smokers or 21 per cent of the country’s population.

“Nevertheless, the number of people who wished to quit smoking is also significant at 2.3 million.

“At the moment, only 22,000 people who enrolled into mQuit have successfully been treated,” he said.

By Nuradzimmah Daim, Adib Povera.

Read more @ https://www.nst.com.my/news/government-public-policy/2020/11/645490/increase-number-smokers-wanting-quit