Materia Medica Malaysiana

April 30, 2006

Blinded by the lens: Look closely and be warned

Filed under: Uncategorized — malaysianmedicine @ 8:39 am

NST: KUALA LUMPUR: She slept with her contact lenses on. It turned out to be a costly mistake as the eyes were so badly infected that she became blind on one side.
Aishah (not her real name) suffered from severe cornea ulcer — a common injury among those who fail to follow the correct procedures in the wearing of contact lenses — and had to spend almost a month in hospital.
Things only returned to normal after a cornea transplant. After that, Aishah, 20, vowed never to wear contact lenses again.
Cases like this are becoming a worrying trend, especially among women and schoolgirls, according to health authorities. The Health Ministry has recently set up a task force to look into the problem of cornea ulcer.
Representatives from the ministry, government, private and university hospitals are in the task force.
Eye doctors in the country have also been asked to report cases of corneal ulcer.
This would help them gauge the extent of the problem in the country and also compile data on patients.
Aishah was only 15 when she started wearing lenses and was disciplined in her use for almost a year. But the one slip of wearing them overnight caused the blindness in the left eye when it developed an ulcer.
"It was Hari Raya and I was away from home with friends. Being late, I decided to sleep at my friends’ place. I slept with my contact lenses on," Aishah said. The next day, the eyes became red and irritated.
Yet, she continued wearing the lenses the whole of the next day until she reached home.
By night, the left eye was so badly infected that she had to be rushed to the hospital. A doctor told her that she had a severe cornea ulcer and had to be admitted.
"I was warded for almost a month and seeing no sign of improvement, I was transferred to Universiti Kebangsaan Malaysia Hospital (HUKM) where I was admitted for two weeks. It was too late. I was blind in the eye.
"I was inconsolable. I cried for days but I saw a ray of hope when the HUKM ophthalmologist told me that I could have a cornea transplant."
Aishah, who is studying at a public university, said she had a cornea transplant done three years ago.
Melissa (also not her real name), 23, is another person who lost her left eye, just two months into wearing lenses. She, too, developed a corneal ulcer and sought treatment at a private clinic.
"It was only after the fourth day, when my condition worsened that the doctor referred me to HUKM."
Melissa said that the ophthalmologists did their best to save her eye but it was too late.
Melissa uses a blank on the affected eye while waiting for a cornea transplant.
HUKM senior consultant specialist and professor Dr Muhaya Mohamad said contact lenses were safe to wear if the wearer strictly maintains stringent lens hygiene.
"All contact lenses are foreign bodies to the eyes. They can and sometimes cause problems.
"However, these complications are fairly uncommon and easily remedied."
What is worrying the health authorities and the ophthalmologists is the increasing number of women, including schoolgirls, coming in with corneal ulcer and other eye complications from the use of contact lenses.
Dr Muhaya, who is president of the Ophthalmological Society of the Malaysian Medical Association, said: "It’s even worrying now with the sale of cosmetic lenses in the market. There are women buying them off the shelf instead of at an optical outlet".
She said an optometrist would advise buyers on the proper use and handling of the lens to avoid infections.
"The risk is greater in soft lens wearers and those wearing lenses on an extended basis."
She said symptoms of acute eye pain, foreign body sensation, discharge and a red eye should warn the wearer to remove the lens and seek immediate medical help.
"Delay in treatment of this condition can lead to corneal scarring or corneal perforation in extreme cases."
It is also important to make sure that contact lenses are stored and cleaned in proper commercially-prepared, sterile solutions.

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Dr Chua: Only safe treatments will be allowed

Filed under: Uncategorized — malaysianmedicine @ 8:39 am

NST: BANTING: Only traditional treatments like acupuncture, reflexology and herbal medicines will be allowed in government hospitals under the plan to incorporate such treatments.
Health Minister Datuk Dr Chua Soi Lek said the current proposal had identified several areas the practitioners could work on, including pain management, oncology, rehabilitation and post-natal care.
"We will only allow treatments that are proven to be safe and effective. However, there are many issues to be ironed out such as the legal aspect of such treatments."
Speaking to reporters during a visit to the Banting Hospital yesterday, Dr Chua said it was wrong to assume that spitting bomohs and incense-filled corridors would now be a common sight in hospitals.
"What we are trying to do is to integrate Western and traditional treatments, and it will not be like what was described in Parliament."
On Thursday, Member of Parliament for Sri Gading Datuk Mohamed Aziz asked whether all hospitals would be filled with smoke from incense, and have dukun and pawang spitting on patients, and practitioners going into trance and speaking in tongues.
Dr Chua said to regulate the practice, a Traditional Treatment and Complementary Medicine Act was being drafted.
"Accreditation is another issue and we want those who practise to be recognised by the National Accreditation Board and Public Service Department."
He said a committee will be set up comprising officials from the Health and Higher Education Ministries to evaluate practitioners who qualified from countries such as China, India and Indonesia.
He added that the plan was only expected to be implemented in three years.

Poor pay keeping best brains away

Filed under: Uncategorized — malaysianmedicine @ 8:38 am

Star: LONDON: Peanut salaries and an obsession with world-record breaking. These were some of the reasons given by Malaysia's best brains in Britain for them being reluctant to return home.
In a candid, no-holds barred report to the Government, Malaysian students and professionals spoke their minds on the “pull-push” factor surrounding the brain drain issue.
Their grouses ranged from measly salaries and long working hours to the lack of government support and appreciation for talent and expertise.
Some were particularly irked by what seemed to be a national obsession for world-record breaking and called on the Government to rid itself of its “first world infrastructure, third world mentality” image.
Others commended the Government for its efforts to find out why they were not returning but hoped for more measures to involve them in the nation-building process.
In a nutshell, they would like the Government to instil among overseas Malaysians a love for the country and the desire to see it march forward in unity.
That would be the strongest reason for them to return and serve the nation, they said.
The findings were compiled by the 10,000-strong UK Executive Council for Malaysian Students and submitted to Deputy Science, Technology and Innovation Minister Datuk Kong Cho Ha earlier this week.
The deputy minister had requested for the feedback after meeting council chairman Wan Mohd Firdaus Wan Mohd Fuaad in London last month.
The survey, which started last month, covered mostly medical, engineering and accountancy students who formed the bulk of Malaysia’s 12,000-student population in Britain.
Firdaus said they had received very good response from students and professionals.
“We’ve submitted the preliminary report to the ministry as more feedback is still coming in everyday,” he said, adding that they hoped to compile the full report after the students had finished their final examinations.
The council represents 58 Malaysian student societies or about 80% of the Malaysian student population in Britain.

Health Clinic For Pulau Mantanani Islanders

Filed under: Uncategorized — malaysianmedicine @ 8:38 am

KOTA BELUD (Sabah), April 29 (Bernama) — A health clinic will be built at Pulau Mantanani under the Ninth Malaysia Plan for the benefit of more than 1,000 residents on the island.
Medical officer at the Kota Belud Clinic Dr Redzal Abu Hanifah said it was among three clinics proposed to be built in the district under the Ninth Plan.
Currently, the islanders have to go to the nearest clinic in Kuala Abai, more than an hour's ride by speedboat, for treatment.
During bad weather and rough sea conditions, usually in March, the islanders faced difficulties getting medical treatment because they could not leave the island and health personnel could not come to the island.
"We will normally attend to them (Pulau Mantanani residents) first when they come for treatment to clinics on the mainland because we are aware of their transportation problems.
"The boat service to the island is only until 3pm," said Dr Redzal, who was in the entourage accompanying Assistant Agriculture and Food Industry Minister Japlin Akim, on a visit to the island recently.
Japlin, who is also Usukan assemblyman, said public toilets would be built on the island this year following islanders' requests.
On residents' requests for land ownership, he said, the state government would study the matter.

April 29, 2006

Top Dentist In Armed Forces Retires

Filed under: Uncategorized — malaysianmedicine @ 11:02 am

KUALA LUMPUR, April 28 (Bernama) — Malaysian Armed Forces (ATM) Dental Director Mejar Jeneral Datuk Dr Mohamad Termidzi Junaidi, who retired Friday, created history when he became the first Asian chairman of an international military dental service under the United Nations (UN).
He chaired the Section Defence Forces Dental Services (SDFDS), one of the main components of the International Dental Federation (FDI), from 1998 to 2000.
For Dr Mohamad Termidzi, 53, it was the high point of his military service spanning nearly 30 years.
"I chaired the SDFDS during conferences in the United States, South Korea, Spain and Mexico," he told Bernama after handing over the ATM Dental Director's duties to Kolonel Dr Sukri Hussin at the Defence Ministry here.
He said he had served as a SDFDS executive member from 1995 to 1998 and was entrusted to be the FDI Field Dental Parts Working Group Head in 1996 in Seoul, South Korea.
He also successfully organised a SDFDS/FDI conference in Kuala Lumpur in 2001.
Through Dr Mohamad Termidzi, a dental and biomedical research cooperation programme was being planned with the United States Navy Institute of Dental and Biomedical Research.
The third in a family of nine siblings from Kuching, he received his early education at Sekolah Rakyat and Sekolah St Thomas in Kuching before being accepted into the Royal Military College in Sungai Besi in 1967.
"I was the only one selected among 25 candidates from Sarawak at the time," he said.
He received an ATM scholarship to study for the Bachelor of Dental Surgery in Universiti Malaya and graduated in 1972.
He is married to Datin Halimaton Zawiah Busu and they have a son and three daughters.

Tests to find cause of illness

Filed under: Uncategorized — malaysianmedicine @ 11:00 am

NST: MALACCA: Blood and urine samples of rats and cattle are being analysed to determine the source of a viral outbreak at a National Service training camp recently.
The State Health Department has sent the samples, found near the camp in Alor Gajah, to the Veterinary Services Department’s laboratory in Kuala Lumpur.
Deputy director Dr Ghazali Othman said some of the sick trainees were infected with leptospirosis.
"It is caused by the bacteria of the genus Leptospira which is found in the body of animals like rats, cattle and even wildboars but there are many sub-types of the bacteria.
"We are trying to find a match between the Leptospira found in the blood of the sick trainees with those in the rats and cattle to determine the strain of bacteria which infected them," he said in a telephone interview yesterday.
The results of the laboratory analysis would help the department recommend preventive measures to the Taboh Naning NS camp to prevent future outbreaks.
"We expect to finalise a report detailing more conclusive recommendations to the camp operator on how to better safeguard the health of their trainees by next month.
"They will probably have to take some prophylactic (preventive) antibiotics especially for leptospirosis," he said.
It was reported that over 94 NS trainees at the camp had come down with viral fever since April 18, and at the height of the outbreak 52 trainees had to be warded and 79 isolated at the camp.
At Press time, only 10 remained warded at the Malacca Hospital and 14 isolated at the camp.
On Wednesday, Health Minister Datuk Dr Chua Soi Lek revealed that there was a concurrent infection at the camp, with trainees falling sick with Influenza B and leptospirosis.
He had said those who with leptospirosis fell ill after undergoing a water adaptation exercise for 15 to 30 minutes at a nearby pond, which could have been contaminated with rat and or cattle urine.
The two water ponds used were full of Leptospira.

Chua: Government To Strengthen Medical Professionalism

Filed under: Uncategorized — malaysianmedicine @ 10:59 am

SinChew: KUALA LUMPUR (Fri): Malaysia will strengthen local medical professionalism over the next five years by improving the profession of specialists, sub-specialists, nurses and medical officers in order to face the global challenges.
The government has allocated RM1bn for medical training under the 9th Malaysia Plan, said Health Minister Chua Soi Lek.
He said the government had decided to train 400 specialists and sub-specialists.
"We will allocate RM300,000 for short courses and scholarships over the next five years in order to train more specialists and sub-specialists," he added.
Chua told Sin Chew Daily that medical, healthcare and professional services could not stay stagnant in Malaysia, especially on the prevention of infectious disease.

Special Report: The crushing years

Filed under: Uncategorized — malaysianmedicine @ 9:00 am

NST: Children fall down, and scrape their knees. They get tired and cranky, and often they cry. But depressed? It happens, and stress makes it a possibility that parents should consider, writes ANITA ANANDARAJAH.
Dr Toh believes stress causes depression.

RANI used to smile when her 10-year-old son Rakesh put his palms together, as if praying, whenever he passed the altar room. But then he started doing it whenever he passed a broom, and the rice cooker in the kitchen.
The first doctor they saw ran some tests, then said he was normal. She went to the University of Malaya Medical Centre for a second opinion, and discovered he was suffering from depression.
It’s an uncommon disorder in children but not any less serious whenever it strikes.
Loosely defined, it is a prolonged low mood.
Children get depressed for many reasons, said Dr Toh Chin Lee. It has always been present but few parents or doctors recognise it, said the Kuala Lumpur Hospital child and adolescent psychiatrist.
In 1996, a Health Ministry survey found that 13 per cent of children aged between five and 15 have mental health problems. The survey, the second National Health and Morbidity Survey, also found 8.7 per cent of this age group were predisposed to depression.
Four years later, it made mental health the theme of a campaign to promote healthy lifestyles. Primary school pupils were one of its target groups taught to recognise stress.
Dr Toh believes stress causes depression in children.
"Most handle it successfully. But stress piled upon stress can be difficult to cope with. Some families may not recognise the child's needs."
A marriage break-up can cause undue stress, for instance. So can being bullied, or becoming a victim of verbal abuse.
Children may feel sidelined by a sibling, scared of fierce teachers, or struggle to meet parents’ expectations.
Children need stability, routine and predictability in life, he said.
How can parents tell if their a child is suffering from depression?
It was Rani’s training as a nurse which helped her notice Rakesh’s behaviour, shortly after he began tuition classes.
"He was frightened of his tuition master who would beat other children. I thought the discipline would help my son learn better," she said.
Attending psychiatrist Dr Aili Hanim Hashim saw Rakesh’s family environment as the predisposing factor. "There is little nurturing of the child in the family."
Aside from depression, Rakesh was diagnosed as suffering from obsessive compulsive disorder.
"His tic has been there for many years. The problem was exacerbated with the strict tuition master," Dr Aili explained.
Now 16, Rakesh is responding well to therapy and anti-depressants, and his tic subsided after six years.
At the UMMC’s child and adolescent psychiatric unit where he was treated, the youngest patient diagnosed with clinical depression is 14 years old.
The unit gets 10 new cases a week, excluding referrals from other units in the hospital.
Changes in behaviour should tip off parents and teachers, said child psychiatrist Dr Subash Kumar Pillai, also with UMMC.
This is important because struggling continually with negative thoughts and a poor self image will lead to an inability to cope with problems, he said.
The problem is, too often, bad behaviour is thought of as just being naughty.
"Children can be treated. Bad behaviour is just a symptom."
Parents need to look deeper into what the child may be going through.
"If previously he enjoyed going to school but suddenly refuses to go, it could be a sign that something is bothering him.
"Look out for somatic symptoms like frequent stomach aches, headaches and fever. Older schoolchildren may come up with cleverer complaints as their brains are better developed compared to pre-schoolers."
Can children get over it, like they get past teasing? Dr Subash points to genetics.
"If a parent has depression, and the child gets it at a young age, it may take a longer time to get better," he explained.
"The earlier it is caught the sooner we can offer better treatment and medication."

Sadly, a psychiatrist or psychologist is often the last person consulted. Parents are desperate to avoid the stigma of the psychiatric unit — the "gila" ward.
That has led many of them to alternatives offered by non-government organisations such as the Agape Counselling Centre.
Housed in shoplot off Old Klang Road in Kuala Lumpur, the centre has incentives that draw children naturally: toys. In its two playrooms, there are hundreds of dolls, action figures and puppets which children use to express their emotions.
The centre keeps a low profile, and visits are by appointment only. Yet its phone rings off the hook, and 235 clients walked through its doors last year.
Roughly one in seven were found to be suffering from depression.
"Cost is also a factor for our clients. They find consultation fees at private hospitals too expensive," said Lisa Sum, the director of the play therapy department.
The play method adopted at Agape was successful in drawing little Tien out.
His mother was deeply worried, for the once happy-go-lucky boy was bossing her about, acting like the man of the house when he was just 10 years old.
After three sessions, he revealed he was missing his father.
"Tien was drawing a picture of a car on the white board when he blurted out that he had dreamt that he was in the car with his father," said his counsellor.
After some gentle probing, he blurted that his father died of cancer. Father and son had been very close.
By the seventh session, Tien reverted to his old self. His counsellor said: "It was as if he had let go."

*Names have been changed to protect the privacy of those interviewed.

Alternative medicine to aid healing

Filed under: Uncategorized — malaysianmedicine @ 9:00 am

Star: BANTING: Introducing traditional or complementary medicine in hospitals is not about allowing hocus pocus or peculiar rituals. Alternative medicine will instead be used to promote wholesome healing.
Health Minister Datuk Dr Chua Soi Lek said alternative medicine could be used to help promote better healing, such as the proven effectiveness of acupuncture, reflexology and post-natal massage.
The Government, he said, would however only introduce alternative healing into hospitals after careful studying.
“Of course, we will not simply allow bomoh or sinseh into hospitals,” Dr Chua said, in response to some negative remarks over the intention to introduce alternative healing in hospitals.
Sri Gading MP Datuk Aziz Mohamed had asked in parliament recently whether bomoh would be “spitting blessed water” on their patients or have the hospitals filled with incense smoke.
Dr Chua said very important issues needed to be addressed first before complementary medicine was introduced.
“For instance, who will be responsible for the healing administered by the alternative medicine practitioners? Which relevant department or agency is tasked with accrediting their professionalism?
“We also need to strictly ensure the herbal products to be used are absolutely safe,” said Dr Chua after visiting the Banting hospital here.
He was accompanied by hospital director Dr Anisah Mohd Tahir and Teluk Datuk state assemblyman Datuk Ei Kim Hock.
Dr Chua said it would take about three years before alternative healing was introduced as a pilot project in selected hospitals.
Five areas of health had been identified as suitable for the introduction of alternative healing.
They are: rehabilitation (such as the physical therapy given to patients suffering from stroke), oncology, pain management, mental health and wellness management.

MMA lauds promotion of specialist doctors

Filed under: Uncategorized — malaysianmedicine @ 8:59 am

Star: KUALA LUMPUR: Specialist doctors have reason to cheer, thanks to the Health Ministry's decision to allow 1,000 of them in government hospitals to be promoted from the U41 grade to the U48 special grade.
According to Dr Vasan Sinnadurai, chief of the Malaysian Medical Association's (MMA) Section Concerning Medical and Health Staff, the move would help keep the doctors in service.
“We're very happy,” he said. “This will definitely encourage more specialists and doctors to stay in government service and serve the people.
“We have to commend the Health Minister for two really good moves recently – allowing us to do locum and giving the promotion,” he said.
Health Minister Dr Chua Soi Lek announced on Thursday that the Public Services Department had agreed to the promotion two days after MMA president Datuk Dr Teoh Siang Chin told the ministry about the plight of specialists stuck in houseman or medical officer posts.
Dr Vasan said many doctors had been leaning towards the private sector recently because they were not getting the U48 grade, as the previous promotion system did not allow immediate promotion from U41 to U48.
“The U41 grade is on par with that of a house officer, so many doctors' self-esteem was starting to be affected.
“Many of them were feeling unhappy staying at that level.
“But now with the minister's intervention, doctors can not only get a promotion but also bypass the U44 grade and go straight to a U48, which is a very big jump for them,” he added.
The promotion comes with a significant pay increase of up to RM2,000, along with added incentives such as extra allowances.

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