NST: KUALA LUMPUR: The National Heart Institute wants its surgical teams to have access to the operating theatres in Serdang Hospital.
The call was made by IJN chief executive officer Datuk Mohd Radzif Mohd Yunus to the Health Ministry to reduce the number of patients awaiting cardiac surgery.
IJN had recently proposed a “practical, cost-efficient solution” which will capitalise on its expert surgical teams and the under-utilised cardiac facility at Serdang Hospital.
It has a waiting list of some 111 paediatric surgeries, both simple and complex.
Radzif said all urgent cases were immediately operated on.
Those on the waiting list were mainly patients who were still not ready for the operation, needing further tests, suffering complications and other problems.
“We have the expertise but not the capacity to accommodate all the cases.
“The problem of capacity will be resolved when our new wing is ready next year.”
“The long waiting time and waiting list faced by IJN are due to capacity constraints and not lack of expertise. We have the expertise to do even the most complex paediatric case,” said Radzif.
Currently, the IJN paediatric team comrprises five consultant paediatric cardiologists assisted by three paediatric specialists.
Also lending a helping hand are seven consultant surgeons.
IJN currently handles more than 10,000 outpatient paediatric cases yearly of which more than 2,000 are newly referred cases.
Last year, it performed more than 1,000 surgeries and procedures to treat paediatric heart patients.
Radzif said the ministry should consider the proposal as the New Straits Times had reported on July 6 that operating theatres at the RM300 million Serdang Hospital, designed to be the reference centre for cardiology, cardiothoracic, urology and nephrology surgery in the country, have remained empty since they were opened in 2005.
He said IJN’s resources could be used far more efficiently if they were given the opportunity to jointly operate at the newly established heart unit at the Serdang Hospital.
He also said IJN was keen to jointly operate at other government hospitals with fully-equipped heart units, such as those in Penang, Johor Baru, Kuching and Alor Star, which were either under-utilised or not operational due to a lack of manpower.
He added IJN was also offering to provide on-the-job training for medical personnel at government and university hospitals to help alleviate the lack of manpower.
NST: KUALA LUMPUR: Sex education will soon be part of the curriculum of the National Service Training Programme.
Women, Family and Community Development Minister Datuk Dr Ng Yen Yen said emphasis would be given to reproductive healthcare and youth sexuality.
She said the move was also to ensure better health for women, mothers and babies.
She added that life-long quality reproductive health services, especially during pregnancies, could reduce fatalities during deliveries.
“Maternity, obstetrics and family planning services are integral to reproductive healthcare. In this context, the role men play in family healthcare is equally important.
“Socio-economic development, especially in health and industrialisation, has led to a reduced mortality rate,” she said in a statement in conjunction with World Population Day, yesterday.
Dr Ng added although there were adequate reproductive healthcare facilities at government and private clinics and hospitals, there remained some hardcore poor who were deprived of the service.
In conjunction with World Population Day 2008, the ministry is hosting a conference themed Youth and the Changing Demographics on Aug 18 and 19 here.
NST: KUALA LUMPUR: The government is coming out with a law to regulate spas and beauty salons.
Health Minister Datuk Liow Tiong Lai expects the Cosmetology Bill to be tabled in Parliament by the end of the year.
He said better governance was needed in view of the growth of the beauty industry, which had become an attraction for foreign tourists.
Liow was speaking after opening beauty centre Trois International’s seventh outlet at Ampang Waterfront yesterday.
He said the Medical Act was being used to bring to book those establishments that flouted the law.
The proposed legislation would limit the type of centres that were allowed to do invasive procedures, such as those involving Botox, and these procedures would have to be done only by doctors.
“It is difficult to regulate beauty centres using the Medical Act that governs doctors. For now, we merely inspect their products and services.
“If we find that a product causes an allergy or the centre is carrying out procedures that it is not supposed to, then we take action but not through a direct method.
“The bill provides for a faster and easier process to bring them to book.”
He said with strict regulations in place, foreigners would feel assured of a high standard of service and fly-by-night centres would not be able to survive.
On the incidence of adverse reactions by people using cosmetic products, Liow said this was under control.
In the last eight years, the authorities received only 53 reports of this nature.
Also, as a result of the ministry’s post-market surveillance programme, 24 cosmetic products had been taken off the shelves.
This was because they contained banned ingredients such as hydroquinone and isotretinoin.
Products containing these ingredients can only be prescribed by doctors as they may cause serious side effects.
For example, the overuse of hydroquinone can cause irreversible skin reactions while isotretinoin can pose a danger to pregnant women.
Last year, the pharmaceutical division’s enforcement unit seized 401 unauthorised products valued at RM264,000 from 55 beauty salons, spas and aromatherapy centres.
A total of 122 products valued at RM55,000 were seized between January and June this year.
Star: KUALA LUMPUR: Doctors who performed cosmetic surgery on Datin Fatimah Wan Chik who is now in a coma, have been summoned for questioning and stern action will be taken against them if they are found to have violated the Medical Act.
Health Minister Datuk Liow Tiong Lai said ministry officers had called the doctors to explain the complicated surgery of the still-hospitalised Fatimah, wife of former Labuan MP Datuk Suhaili Abdul Rahman.
Fatimah has been on life-support since Jan 18, after she had a tummy tuck, liposuction and surgery for her eye bags at a clinic in Klang on Jan 9.
“We expect to have the outcome of the investigation soon,” he told reporters after opening the Trois International Beauty Care Outlet here yesterday.
He said his ministry would table the Cosmetology Bill in Parliament by the end of this year so that beauty centres could be strictly regulated.
“Beauty care centres should exercise self-regulation and ensure that they use or sell only approved products. They must place the safety of consumers above all else,” he said, adding that his ministry had inspected 19 premises and seized 122 unauthorised products worth around RM56,000 for the first six months.
On another issue, Liow said he would personally look into a complaint by medical graduates that a local university did not hold a competency test as scheduled.
He said three local universities - Universiti Malaya, Universiti Sains Malaysia and Universiti Kebangsaan Malaysia - hold the test for graduates from unrecognised institutions.
The graduates are required to pass the competency test before they can register with the Malaysian Medical Council. The graduates can only take the test three times.
Recently, a Chinese newspaper reported that a group of graduates who had been assigned to sit for the test at Universiti Sains Malaysia, found that the university had cancelled the test and they were now forced to wait for another year.
Star: MIRI: Hospitals and clinics in Sarawak have been told to watch out for a possible outbreak of the hand, foot and mouth disease (HFMD) in the coming months.
There was a minor scare last week in Miri City when a kindergarten shut down for a few days after several children showed HFMD symptoms.
The state Disaster Relief Committee and the health and medical authorities are not taking things for granted.
Chairman Deputy Chief Minister Tan Sri Dr George Chan Hong Nam sounded an early alert yesterday, saying precautions must be taken for a possible outbreak of HFMD.
He is particularly worried about the possible re-emergence of the usually lethal Enterovirus 71 (EV71) strain of HFMD that killed several people a few years ago in this state.
“The cases in Miri were isolated cases and they were not the EV71 type. They were of the ordinary HFMD strains. So far, only two EV71 cases were detected in Kuching this year.
“However, we are not taking anything for granted. There is a possibility that we will see another peak season for an HFMD outbreak next year.
“All relevant authorities have been told to take early precautionary measures to make sure we are fully prepared for any eventuality. Hospitals and clinics have been told to be on the lookout and help the state authorities monitor any unusual increase in infections,” Dr Chan, who is also the state Industrial Development Minister and State Agriculture Modernisation Minister, told a press conference yesterday.
He stressed that the Miri cases did not indicate an imminent outbreak.
Dr Chan said the experience from the 2006 HFMD outbreak (that resulted in more than 20,000 cases and 11 deaths) had enabled the health department and his committee to establish important data on how to deal with future outbreaks.
HFMD outbreaks usually follow a three-year cycle but the effect can be mitigated through cleanliness, proper hygiene and early detection, he added.
Star: MALACCA: Only 57% of the country’s female population above 20 years of age conducted breast self-examination while 52% underwent clinical examination, according to the National Health and Morbidity Survey 2006.
“The figure shows only half the female population has the awareness of performing self-check, which is very low considering the 3,800 new cases of breast cancer reported each year,” said Health Minister Datuk Liow Tiong Lai.
“Breast cancer can be detected early through self-check and clinical examination. If detected and treated early, the five-year survival rate of breast cancer patients is more than 90%,” he said.
He added that cervical cancer was the second most common cancer among women with 1,600 new cases reported each year.
“Our survey found that only 43.7% of women above 20 underwent pap-smear screening although the ministry introduced the screening in health clinics in 1981,” he told reporters after officiating the ‘Early detection – the path to cure’ health awareness seminar by Malacca Wanita MCA here yesterday.
Liow also urged Malaysians to maintain healthy eating habits to avoid weight-related diseases such as obesity and diabetes.
On another matter, Liow said the Government would not cut down on the RM400mil allocation to his ministry for its human capital development, despite the increase in cost.
“We never cut down on human capital development because we need more doctors, specialists and nurses in our hospitals.”
NST: KUALA LUMPUR: If there is one thing that tugs at the heartstrings of Dr Patrick Lawrence, it is reports of parents appealing for donations to enable their children to undergo corrective heart surgery in private hospitals.
Due to insufficient facilities and paediatric cardiac surgeons at Institut Jantung Negara and government hospitals, the waiting list for surgery is long. Time is often not on the side of young patients.
As a result, many desperate parents have been forced to source public donations to fund their child’s treatment at private hospitals.
“No child should have to beg for funds to live,” said Dr Lawrence, the medical director of MediAssist4U, an NGO providing medical care to haves and have-nots.
“Our aim is to make healthcare affordable to everyone because the language of pain and suffering does not discriminate. Our services are available to everyone, regardless of their financial status.”
Since 2006, MediAssist4U has helped about 60 Malaysian children undergo corrective heart surgery with the help of the Narayana Hrudayalaya (NH) Institute of Cardiac Sciences in Bangalore, India.
The Bangalore operations cost less than those in Malaysia.
Heart surgery for children costs around RM10,000 at the Narayana Hrudayalaya, while for adults, charges are between RM8,000 and RM10,000.
This has been made possible through telecardiology, pioneered by the Narayana Hrudayalaya chairman and chief cardiologist, Dr Devi Prasad Shetty.
According to Dr Lawrence, the initial diagnosis was done at the MediAssist4U clinic, which is online to the Narayana Hospital.
“For example, we do the ECG and other tests at our clinic here and the information is transmitted to the cardiologists at Narayana Hrudayalaya, who diagnose the patient’s condition and recommend treatment.”
“We have done more than 2,700 ECGs for free over the last five years. And it doesn’t cost us anything because everything is online and we have specialists from private and government hospitals who volunteer their services.”
Once a diagnosis has been made, the patient can choose to have the treatment or corrective surgery done locally or at Narayana Hrudayalaya.
“Because of the long waiting period and high cost of surgery here, many opt to do it at Narayana Hrudayalaya.”
In most cases, the cost of surgery, plus travel and accommodation for the accompanying relative, does not exceed RM15,000.
The low cost and world-class treatment at the hospital have come as a blessing to hundreds of Malaysians, especially children, who suffer from a range of heart ailments, including complicated cases such as ectopic heart (where the heart is not properly located in the body).
Since 2006, 10 Malaysian toddlers and about 40 adults have undergone treatment at Narayana Hrudayalaya. Some of the patients were from low-income backgrounds and their surgeries were done for free.
During a teleconference with the Malaysian media recently, Dr Shetty said the telecardiology service between the Narayana Hrudayalaya and cardiac care centres in Malaysia, Mauritius and Bangladesh, had made cardiac care more affordable.
This facility also enabled easier follow-up treatment of the patient from his home country.
The 285-bed Narayana Hrudayalaya conducts 30 open heart surgeries every day, half of which are done free.
As one of the world’s largest paediatric heart hospitals, Narayana Hrudayalaya conducts 40 per cent of its surgeries on children, some as young as a day old.
It is the first hospital in Asia to carry out an artificial heart transplant on a 54-year-old Indian man in March.
NST: KUALA LUMPUR: Although thousands of children remain on the waiting list for corrective heart surgery, eight operating theatres (OTs) for cardiac surgery at Serdang Hospital remain unused for want of cardiothoracic surgeons and staff.
The OTs at the RM300 million Serdang Hospital, designed to be the reference centre for cardiology, cardiothoracic, urology and nephrology surgery in the country, have remained empty since they were opened in 2005.
Health Minister Datuk Liow Tiong Lai said recently: “We don’t have the experts. We don’t have the manpower.”
He said it was for this reason that the government had offered to send urgent paediatric heart cases to the Nara-yana Hrudayalaya Institute of Cardiac Sciences in Bangalore, India, for corrective surgery.
It had identified 200 children with complicated heart problems to be sent there soon for corrective surgery.
The first batch of about 10 children, who are stable enough to travel by air and for whom the prognosis is good, is likely to be sent in the next couple of weeks.
Liow said there was a need to send these children there for surgery as there are more than 300 infants on the Institut Jantung Negara’s (IJN) waiting list.
This excludes the 3,000 children who need surgery for congenital heart diseases every year.
“We are handling about 1,200 paediatric cases a year, 75 per cent of which are carried out at IJN,” said Liow.
“(We’re not moving fast) enough, because it’s a full house at IJN. Some of the children cannot wait long because they are urgent cases. So, there is pressure on us to perform surgery quickly.”
Among the measures being taken by the ministry to ease the backlog is to offer Hospital Serdang’s unused facilities to the private sector.
So far, only IJN has taken up the offer.
“IJN does not have enough OTs. It has a long waiting list for surgeries. It is negotiating with Hospital Serdang for use of its cardiac care facilities.”
Another measure is to send these children to India, where costs are a fraction of what they are here.
Liow said the Narayana Hospital, for instance, was only charging RM10,000 for the surgery, compared with the RM17,000 charged by IJN.
Additional costs for airfare, visas, accommodation and other logistical matters for the child and an accompanying parent would only come to RM4,900, bringing the total to RM14,900 a case.
The government has allocated RM2 million for this programme. The hospital was chosen because of its quality care and the close working relationship it has with the ministry.
As for the shortage of specialists, Liow said the ministry’s long-term plan was to increase the number of cardiothoracic surgeons and paediatric cardiac surgeons by training more specialists here.
He said he hoped other private hospitals would emulate the Penang Adventist Hospital, which had offered to perform 50 paediatric cardiac surgeries free to reduce the waiting period.
Star: PETALING JAYA: Apart from methadone, heroin addicts now have an alternative treatment that is more user-friendly, minus the addiction.
According to University of Western Australia’s Professor Gary Hulse, who specialises in Addiction Medicine, over 4,000 heroin addicts have been successfully treated with the Sustained Release Naltrexone Implant (Naltrexone) worldwide.
He explained that once an addict has a Naltrexone implant, which lasts for about six months, there would be no craving for heroin during that period.
“This is because the drug works by blocking the opiate receptors in the brain. So an addict won’t get a high, even if he chooses to still take heroin,” he told the press here yesterday.
A chief executive officer of a hospital Datuk Dr S. Guna said that the Health Ministry’s Medical Research and Ethics Committee had given the green light for the hospital to run Naltrexone Implant clinical trials here.
“It should commence in October/November this year or even earlier.
“However, there are financial constraints as it will cost up to RM3mil to run clinical trials for 200 people,” he said.
Should it reach the commercial market, Dr Guna said it could cost about RM12,000 per implant, but added it was “not much more than the methadone treatment for a period of six months”.
Prof Hulse explained that the implant consists of 10 small tablets, which would break up once inside the patient’s body.
In a 20-minute process, the implant is inserted into the patient’s abdominal region through a 2cm incision using a syringe.
The United Kingdom’s Naltrexone Treatment Centre’s website (www.naltrexonecentre.co.uk/about_naltrexone_info.htm) said the the incision can be closed with four sutures.
“Naltrexone is not a new drug, but it’s effective and safe. It’s not a drug you can get addicted to,” he said, adding that clinical trials in Australia had delivered very encouraging results.
Star: KUALA LUMPUR: The Health Ministry will launch a campaign where office cafeterias prepare food with recommended calorie content to ensure Malaysians do not exceed their daily dietary needs.
Minister Datuk Liow Tiong Lai said that the Health Cafeteria campaign would begin at such outlets in Kuala Lumpur.
“It will not be a choose-what-you-like method.
“We will give you the menu where food is prepared with specific calorie count and balanced diet content,” he told reporters after launching the “Greens for Life” campaign by Wellness Concept Sdn Bhd.
“We would like to encourage eateries to serve healthy food. A lot of people go for tasty food.
“All this goreng (fried) food has high content of fats that is unhealthy for the body,” he said.
He said that the necessary information would be provided to cafeteria operators to calculate the calorie content when preparing food.
He urged parents to “guide” their children to eat more vegetables because it was an important food category.
“Parents do not know how to guide their children to eat greens. You have to start them from young,” he said.
The ministry’s Adult Nutrition Survey five years ago indicated that only about 40% of Malaysian adults ate green leafy vegetables on a daily basis.
Liow said that there had been had a slight increase in the number of adult Malaysians who exercised 20 minutes three times weekly, from 11.6% in 1996 to 14.4% in 2003.
In his speech, Liow said that the ministry had multi-pronged strategies that focused not only on individual “nutritional case management” at its facilities but also on health and nutrition promotion activities.
This included publishing and disseminating the Malaysian Dietary Guidelines, conducting public awareness campaigns on healthy eating, and promoting the availability of healthy food choices through specialised training for food caterers and handlers.
