Archive for the ‘Health’ Category

Hypertension: The silent killer

Wednesday, March 13th, 2019
A comprehensive population study is under way to get a better understanding of the root cause of hypertension.

A FEW weeks ago, I received a shocking call from my sister. A nephew had collapsed and died. He was only 37. It was unexpected. The diagnosis was hypertension. But it made no sense, my nephew led an active lifestyle

Hypertension does not choose its victims. Increasingly, many under 40 had died because of it. It is known as the silent killer.

There have been many studies, but the results have not been conclusive, only inferences to the cause.

Now, a comprehensive population study is under way to get a better understanding of the root cause. It is a collaboration between Malaysia, the United Kingdom and the Philippines. It will span a few years, collecting population data on lifestyle parameters.

In Malaysia, the vice-chancellor of UCSI University leads the project, bringing collaborative partners from Universiti Putra Malaysia and Universiti Teknologi Mara. Funded by the Malaysia-UK joint research fund, named the Ungku Omar/Newton fund, the study hopes to get more conclusive findings on how to tame hypertension.

There is no doubt the findings will be beneficial. The endgame is to improve understanding of the cause of the rise in non-communicable diseases like hypertension. We should give priority to such high-impact research.

Of late, there have been far too many low impact researches. I have been following the research trend in the country. Yes, we have witnessed an impressive rise in the number of research publications, mostly driven by the obsession with ranking. But the data shows a majority of them have low citation index, confirming their low impact. It is unfortunate that such ranking-motivated researches are rampant.

There was a High-Impact Research Programme at Universiti Malaya. This, unfortunately, met an early demise.

The problem is with research planning. We do not plan for the long term. We lack the long staying power. No wonder we are not among top achievers in research. It is time we rethink our strategy on research planning.

The tri-country study on hypertension, branded RESPOND, has run for more than a year. I had the opportunity to join the research group in their data collection. In Malaysia, they picked four states for the study — Penang, Selangor, Kelantan and Johor.

In each state, they interviewed two sets of population — people from rural and urban areas. Some initial results were shocking — many people are either unaware they have hypertension or give serious attention to therapeutic prescriptions. They also do not strictly follow the medication regime advised by doctors.

Scientists are looking at other behavioural data to link to such practices. Comparisons will be made between rural and urban data, as well as between the three participating countries.

It is evident through past studies that clinical drug trials alone will not provide answers to many of our medical problems. Different people respond differently to drugs. This has been explained as the influence of each individual’s genetic make-up on the efficacy of drugs.


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Vaccinations – a vital line of defense.

Friday, March 8th, 2019

ON June 18, 2016, seven-year-old K. Durgasini passed away. Her cause of death? Bacterial diphtheria.

Then on June 22, a two-year-old boy from Kuala Muda was admitted to Sultan Abdul Halim Hospital along with six siblings for suspected diphtheria.

Of the seven siblings, four children were not immunised against diphtheria – including the deceased two-year-old.

Back then, I had a glimmer of hope that these would be the last cases of preventable diphtheria I’d see.

However, this was not to be as a two-year-old child from Johor Baru who was not immunised passed away on Feb 21 this year, and the child’s death was due to diptheria.

Since then, the Health Ministry has said that misinformation about vaccination had led to a huge jump in the number of vaccine-preventable diseases, with cases of measles jumping over 10-fold from 2013 to  last year.

It also said that a lack of immunisation was detected last year in all six measles deaths recorded and in 19 of the 22 deaths from whooping cough (pertussis).

So yes, after reading all this, you’re going to hear me say the same thing I said in June 2016 – that parents need to immunise their children to prevent utterly avoidable tragedies like this.

And once again, I’m going to urge you to do more than just take my word for it and listen to experts like paediatrician and neonatologist Datuk Dr Musa Nordin, especially if you’ve yet to keep your kids up to date on their vaccinations because of doubts about vaccines.

On the issue of vaccines causing autism – especially the measles, mumps and rubella vaccine – Dr Musa said in a TV Al-Hijrah talk show that no study has been able to replicate what was claimed by Andrew Wakefield linking the vaccine to autism

“Autism is a disorder that is strongly linked to genetics. In the case of identical twins, if one has autism the chance that the other twin is also autistic is as high as 90% because they share the same genetic material. There is no relation whatsoever with the mercury or aluminium used in vaccines,” added Dr Musa.

At this point I’ll just put in my own thoughts and ask parents who refuse to vaccinate their kids because of these fears if they think that autism is so bad that they’ll rather their kids be dead than autistic?

Now, returning to Dr Musa, he also shared his observations about the anti-vaccine information online.

“In the hierarchy of information, right at the top are randomised control studies and at the bottom are testimonials, or anecdotal evidence. Much of the anti-vaccine information online is anecdotal and we cannot use this because the evidence is insufficient,” said Dr Musa

Additionally, he urged people to be careful when going online to look for information on vaccines

” If you google ‘vaccines’, 60% of what you’ll find are anti-vaccine websites and many of them go on excessively about adverse effects following immunisation. That is why the World Health Organisation and Unicef have come out with a website with information,” said Dr Musa.

He added that the website is called the Vaccine Safety Net Project at and said that it addresses any information about adverse effects.

Dr Musa then spoke of another critical reason why people should be vaccinated, and that is to prevent the spread of diseases that would otherwise be contained if people were vaccinated.

“In 2015, an unvaccinated child went to Disneyland and caught the measles. It then spread to 20 states, north to Canada and south to Mexico. In Malaysia, we had 195 cases in 2013. In 2018, we had over 1,900 cases,” he said.

This is also something touched on by the University of Oxford in the United Kingdom, which also put forward an argument in favour of vaccination through their Vaccine Knowledge Project.

“For example, if someone with measles is surrounded by people who are vaccinated against measles, the disease cannot easily be passed on to anyone, and it will quickly disappear again. This is called ‘herd immunity’ or ‘community immunity’, and it gives protection to vulnerable people such as newborn babies, elderly people and those who are too sick to be vaccinated,” said the Project.

So yes, I am completely for vaccinations and I am totally in support of any proposal to make immunisation mandatory.

As it stands, there have been too many preventable deaths already and Malaysians need to step up, heed the evidence-based science and do something before it’s too late.

By Tan Yi Liang
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The importance of knowledge

Wednesday, March 6th, 2019
(File pix) A culture of lifelong education for all must be inculcated. Courtesy Photo

IF you’ve kept your ears to the ground in recent years, you’d have noticed a rather disturbing trend amongst society. There has been an insurgency against various normal life practices for no other reason than because of lack of knowledge and common sense.

These include the anti-vaccination movement, racism-driven groups, flat earth societies, global warming deniers and a disturbing wave of support for fascist ideologies. These examples stem from a dismissal of a mountain of historical facts humans have already accumulated in establishing scientific and ethical truths. Truths such as the fact that vaccines do not cause autism, and the direct correlation between the rate polar ice is melting and global warming caused by humans. Anti-intellectualism is on the rise, and you would do well to equip yourself against it.

Educational institutions from kindergartens to universities are the bastions of defence against anti-intellectualism. One thing that has not changed from ancient Greece till today is the need to confer with experts then to gain more knowledge. This includes direct methods of acquiring knowledge such as studying under them, applying the Socratic method and reading materials provided by experts. Let us be reminded of Socrates’ horse-breeder analogy in which he states that only very specialised people such as horse breeders are able to positively influence the development of a horse whereas those without the knowledge would be doing more harm to the horses.

One of the lessons to take from this analogy is that you should only entrust an expert in a subject matter to impart knowledge. In a more modern vein, when applied to anti-vaccination movements, we must ask ourselves the source of the information and the research done to reach the conclusion. An afternoon of online searches does not equate six years of studies culminating in a doctorate degree. If you must use a search engine online to find an answer, ensure that you get it from experts.

Students these days are far better equipped to obtain knowledge on various subjects from many experts than ever before. The Internet is one such tool that can be utilised but it is unfortunately a double-edged sword. When using a search engine, the problem that arises is that both sides of an argument will turn up. In fact, if a person words their search in such a way that it merely seeks out one side of the argument, that is the only answer they will see.

For example, you could make the search inquiry “How do vaccines cause autism?” and you would likely get a hit on the infamous 1998 Lancet paper that implied a link between the Measles, Mumps and Rubella vaccine and a “new syndrome” of autism and bowel disease written by Andrew Jeremy Wakefield, a discredited former British doctor who was struck off the UK medical register for unethical behaviour, misconduct and dishonesty in academia. One might accept his findings based on his former credentials as a doctor. It is a good idea to also read counter-arguments by other experts. In this case, a coalition of experts discredited him and more research found that vaccinations are in fact good.

Now let us step into greyer territory. Science is arguably easier to digest as it relies on facts that require replicable results through testing. One can test the hypothesis and if it is replicable, and the logic is sound, we accept the data until further testing is required due to a discovery of new knowledge pertaining to the subject. However, this is where we start having a bit of a problem with ethics.

Let’s take one of the most famous “thought experiments in ethics”, namely the trolley problem which states the following: “You see a runaway trolley moving toward five tied-up (or otherwise incapacitated) people lying on the tracks. You are standing next to a lever that controls a switch. If you pull the lever, the trolley will be redirected onto a side track, and the five people on the main track will be saved.

However, there is a single person lying on the side track. You have two options, do nothing and allow the trolley to kill the five people on the main track, or pull the lever, diverting the trolley onto the side track where it will kill one person. The question asks, which is the more ethical option?”

The paper titled Of Mice, Men, and Trolleys: Hypothetical Judgment Versus Real-Life Behavior in Trolley-Style Moral Dilemmas written by Dries H. Bostyn, Sybren Sevenhant and Arne Roets explored the trolley problem in real life albeit with mice instead of humans. Yet the results of that test cannot be replicated using self-reported surveys on the choice people would make in the trolley problem.

Perhaps we need a larger sample size to determine the results better but there is a larger problem at hand even if we bypass laws and ethical safeguards that prevent people from testing the trolley problem in real life. Just because more people decide it is ethical does not make it so.

Again, this is where being knowledgeable is important. Your views on a matter may change over time, and multiple times depending on the information you have acquired along the way.

I am not asking you to take my word that vaccinations are not detrimental to humans, that global warming is happening now and that any one race is superior over others. I am merely saying that education is important, and pursuing knowledge is a never ending process. The wealth of human knowledge pales in comparison to what we do not yet know of the universe; our only option is lifelong studies. But there is one thing I can say with certainty. Knowing more of this world is better than knowing too little, that it may do harm to ourselves and others.


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Unicef: Mandatory laws not best way to ensure children are vaccinated.

Friday, March 1st, 2019

PETALING JAYA: Mandatory laws are not the best way to ensure that parents vaccinate their children, says Unicef Malaysia representative Marianne Clark-Hattingh.

“The government of Malaysia is right in giving importance to vaccination of all children. However, mandatory laws are not the best way to do this.

“Unicef’s experience shows that there is little evidence to show that mandatory laws improve vaccination coverage,” she said in a statement issued Friday (March 1).

Clark-Hattingh’s remarks came a day after the Health Ministry formed a task force to study proposals and calls to make vaccination compulsory.

According to Clark-Hattingh, there are better and more effective approaches to foster and sustain demands for immunisation.

She said it was crucial to understand why parents were reluctant to vaccinate and subsequently guide the parents with the right information and targeted campaigns.

“There is also a need to constantly engage healthcare providers for improved communication with clients,” she added.

Clark-Hattingh expressed concern over the re-emergence of measles and diphtheria, and the escalating number of parents who are reluctant to vaccinate their children.

“No child should be blamed for not being vaccinated. Preventing an unvaccinated child from going to school is a violation of their right to access education.”

She said that the government must consider the consequences of not allowing unvaccinated children to school on their overall well-being.

“Vaccinating every child is critical. Not vaccinating your child puts others at risk,” she added.

Clark-Hattingh said a child’s best interest is protected when parents and caregivers vaccinate them based on informed decisions or are prompted by non-coercive measures and interventions.

She also said that health workers at both public and private facilities should continue their efforts to ensure that every child is vaccinated.

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Safeguarding halal reputation

Saturday, February 23rd, 2019

THE Reputation Institute (RI) reported in November 2018 that nearly 84 per cent of a company’s value is now based on reputational factors. RI estimates that a one-point increase in a company’s reputation yields a 2.6 per cent increase in its market capitalisation. Apparently, reputation has never been more important.

A series of high profile halal crises in recent years with top brands have shaken public confidence in the ability of brand owners to assure the integrity of halal certified products. Muslims today are less prepared to tolerate risks, whether real or perceived, and demand a near zero-risk halal environment. Furthermore, Muslims are intrinsically motivated to actively boycott brands that are in violation of the teachings of Islam. As a result, there is a high chance that a halal issue may snowball into a global halal crisis.

Due to a large, young and fast growing Muslim demographic in combination with a substantial and fast expanding global Islamic economy, Muslim countriesin the Middle East and Asia are one of the leading consumer markets today. However, it is critical for industries operating in or exporting to Muslim countries to recognise the importance of halal compliance and the danger that halal reputational risks pose for a company.

Corporate halal reputation is pivotal in protecting your licence to operate in Muslim markets. Muslim countries are introducing new halal regulations and existing halal certification bodies (HCBs) are continuously upgrading their halal standards. HCBs allow very little time for industries to comply with their new halal requirements. It is therefore paramount to be proactive on emerging halal requirements. As a result, halal is not static but continuously in development.

Evidence supports that halal is going through an evolution from a product approach towards a halal supply chain one (where similar to food safety halal is addressed throughout a supply chain) and halal value chain (addressing also aspects such as Islamic branding, finance and insurance).

Corporate halal reputation is key to sustainable competitive advantage in Muslim markets. It is important to choose the right halal certificate, or combination of halal certificates, based on the company’s export goals.

Alignment of the company’s halal supply chain with the market requirements of the Muslim markets that it is serving is becoming necessary. Alignment is about earning respect from the Muslim consumer with the ultimate goal of increasing value to the consumer in terms of Islamic resources, Muslim obligations and Muslim lifestyle.

Companies need to be aware of halal issues. A halal issue is a gap between the stakeholders’ expected and perceived halal practices of a brand owner. A halal issue can be related to contamination, non-compliance or perception.

Halal supply chains today are complex global halal networks that cause halal issues. The halal industry is expanding fast in width (new categories of halal certifiable products are being introduced such as cosmetics, pharmaceuticals, paint, toilet paper, etc.) as well as depth (more brands within a product category are halal certified), leading to an evident scaling up of halal issues.

Desiring economies of scale and scope, multinationals have been acquiring other brands. They have created global integrated systems and a coupling of brands. Muslim markets today are supplied by global supply networks of multinationals, originating from different production locations with a different halal context. The halal context of a country is linked to a different Islamic school of thought, religious rulings (fatwas), and local customs, which comes with different halal standards.

In a single production location multiple brands are produced. It is also very easy to find out online which organisation owns which brands. Although these global supply networks might be efficient, there are also risks from a halal reputation point of view. As seen over the past with big food companies, when a brand is faced with a halal crisis it easily spreads to other brands of the company and other geographical markets.

Second, there is a danger of correlation, where halal issues from outside (supply network) could infect the company’s brand. One of the reasons is the practice of co-branding by multinationals. For example, fast food chains like to co-brand with a big beverage brand. When there is a halal issue with the beverage company it could have major consequences for the fast-food chain, and vice versa

Also, consumer product manufacturers co-brand with special ingredients (e.g.: stevia, vitamin), halal certificate from HCB (with a good or bad track record), or social

cause (e.g.: fairtrade, water fund). Halal issues with a co-brand could damage the company’s brand as well. Correlation can happen when a halal issue affects a competitor but infects the entire industry. This could be related to a perceived non-compliance or an industry practice.

By Dr Marco Tiema.

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Have mobile clinics for diabetes education

Monday, January 14th, 2019
(Stock image for illustration purposes) Only a blood test will establish whether people are diabetic or pre-diabetic.

A RECENT study indicates that there are three million diabetics in Malaysia and 16 per cent of the national budget for healthcare goes to treat diabetes and related complications, like kidney failures, limb amputations and blindness due to nerve damage.

Diabetes has no outward symptoms and will silently damage the nerves, which leads to organ failure.

Only a blood test will establish whether people are diabetic or pre-diabetic.

When people are found to be diabetic, medication and counselling on diet and a healthy lifestyle prevent serious complications.

When people are found to be pre-diabetic, counselling on diet and a healthy lifestyle can prevent the onset of the disease.

Singapore has taken measures like having mobile clinics to screen people for diabetes and lessons on diabetes prevention for schoolchildren.

Similarly, we hope that the Health Ministry will have mobile clinics to screen and educate people on diabetes.

Those in rural areas and the poor have poor knowledge of diabetes and its complications.


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Minister urges for public practice of good hygiene habits

Friday, January 11th, 2019

The letter that has been made viral.

KOTA KINABALU: Health and People’s wellbeing minister, Datuk Stephen Wong has urged the public not to consume outside food that is unhygenic.

He also urges them to drink water that has been boiled and use clean water for their food preparations.

Additionally, people should also wash their hands before eating and practice good hygeine habits, he said.

His advice came in the wake of a cholera information letter issued by the Health office here that has been made viral over the social media.

Stephen said there was only one isolated case detected and urged the public not to make a huge issue out of it.

“The alert circular is only for our internal circulation to all members of the Health department in preparation for any eventualities,” he explained to the Borneo Post.

Nevertheless, he urged the public to not be lackadaisical in matters related to hygeine and their health.

by Jenne Lajiun.

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Smoking ban can develop a mindful culture

Wednesday, January 9th, 2019
A smoking ban has been imposed on eateries and public places. FILE PIC

SMOKING on board a plane used to be normal decades ago. When people became more aware of health risks, airlines began to enforce a smoking ban.

In the United States, smoking was banned on domestic flights with a duration of two hours or fewer in 1988, with all domestic and international flights being smoke-free by 2000.

Malaysia, as of Jan 1, imposed a nationwide ban on smoking in eateries. Sabah and Sarawak have yet to impose the smoking ban, pending a decision by the state cabinet.

Sabah ministers are worried about the effects the ban would have on the tourism industry. Some are against the blanket ban, suggesting a place be designated for smokers.

Some quarters have said we should not become a “nanny state”, a conservative British term, which implies the government is trying to give too much advice or make too many laws about how people should live their lives, especially about smoking or drinking alcohol.

It means removing the personal responsibility of individuals for “the greater good”.

In fact, it is good because it develops a culture that is mindful of others.

Of course, it will take time to assess the impact of change. Even in countries that have implemented a similar move, it did not take long for all to fall in line. Few people broke the rules.


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Sabah smoking ban starts on Feb 1

Wednesday, January 9th, 2019
Datuk Stephen Wong said “The decision shows that the state government is committed to ensure a smoke-free environment for the people of Sabah and visitors from outside. (NSTP/KHAIRULL AZRY BIDIN)

KOTA KINABALU: A smoking ban at all eateries in Sabah will take effect on Feb 1.

State Health and People’s Wellbeing Minister Datuk Stephen Wong said: “The decision shows that the state government is committed to ensure a smoke-free environment for the people of Sabah and visitors from outside.

“The state cabinet meeting today agreed to implement the Control of Tobacco Product (Amendment) Regulations 2018 which involves all eateries starting from Feb 1 to give ample time for agencies and premise owners to prepare for it,” he told a press conference, here.

Wong said there would be a six-month grace period to educate the public on the smoking ban.

From July 1, a fine of up to RM10,000 or maximum imprisonment of two years will be imposed.

On the delay in discussing the issue, Wong said although the Health Ministry had announced the ban in October last year, the state government did not receive any notification on the policy prior to its implementation in the peninsula on Jan 1.

Sabah Health Department director Datuk Dr Christina Rundi said 747 officers from the department would look into the implementation of the ban, including in rural areas.

“We hope during the six-month educational period, people will be aware that it is compoundable if they smoke.

By Olivia Miwi.

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Diabetes, hypertension, stones among main causes of kidney failure – doctor

Tuesday, January 8th, 2019

Dr Kenneth giving his health talk on ‘A Powerful Treatment For Kidney Failure’.

KOTA KINABALU: There are about 7,000 to 8,000 recorded cases of kidney failure each year in Malaysia.

Dr Kenneth Wu, a Sabah-based nephrologist, said diabetes, hypertension, stones and wrong medication were among the main causes of kidney failure.

“Patients with kidney failure are left with two options – either to opt for dialysis or a transplant,” said Kenneth in his health talk entitled ‘A Powerful Treatment For Kidney Failure’ at the E-West Banquet Hall yesterday.

He revealed that the total number of dialysis patients had also been increasing rapidly.

“There were 7,800 dialysis patients back in 2000. Then in 2010, the figure increased to 23,000. Now, there are more than 40,000 dialysis patients,” he explained.

Kidney failure is a growing concern among Malaysians due to their sedentary lifestyle.

It is understood that patients suffering from kidney failure require treatment up to three times per week.

Furthermore, private centres usually charge between RM200 to RM300 per session for dialysis treatment alone and these charges vary, depending on extra services such as blood taking, doctor’s consultation and Epogen.

Based on this calculation, such treatment could reach up to between RM3,000 and RM4, 000 per month.

The health talk was a part of the Hemodialysis Kinabalu Sabah Association’s (PHKS) awareness programmes for the public on the kidney disease and dialysis treatment.

Since October 18, 2005 until December 2018, the association had provided dialysis services to a total of 61 patients.

PHKS is currently treating 32 patients who were referred from the Queen Elizabeth Hospital, Perkeso and as well as walk-in applications.

by Neil Brian Joseph.

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