Do You need jabs, antibiotics?


Antibiotics

OUR population is getting more and more educated and knowledgeable. With the convenience of internet and smart phone, information can be assessed anytime and anywhere.

Facebook and Google have become the source of reference for most people. Many can now be “experts” in many specialised fields, including engineering, law and even medicine.

Nowadays, the medical practitioners enounter some patients who are so-called internet savvy, and refuse antibiotics and vaccines.

This issue arose due to the spread of such information in the internet, claiming antibiotics could lead to “superbug” and are associated with many adverse effects, while vaccines could cause autism or death.

Well, the risks of administration of both drugs are certainly debatable.What we know for a fact is that since Alexander Flemming discovered penicillin and the pox vaccine, many lives were saved.Nevertheless, I am not in the position to comment on the good and bad of both antibiotics and vaccines. But, it is more important for the general public to understand more about the need for antibiotics and vaccines.

Antibiotics or more specifically antibacterial, is a medicine indicated to kill (bactericidal) or inhibit the growth (bacteriostatic) of the bacteria.

There are various types of antibiotics with different mode of actions and indications. Strictly speaking, the mechanism of action for antibiotics is rather complicated.

However, it works mainly to counter attack the rapid reproduction of bacterial colonies, so that our immune system has enough time to defeat the illness.

Thus, the usage of antibiotics is strictly limited to the bacterial infection. In common clinical conditions, like acute exudative tonsillitis, abscess formation and urinary tract infection, antibiotics are strongly prescribed.

It must be understood that antibiotics have no role in curing diseases caused by fungus, virus or other parasites.

Therefore, it should not be overprescribed in cases like common cough and cold, flu and fungal infection of skin.

As for vaccines, they are biological preparations that help to boost immunity. Its primary focus is on disease prevention. It is always better to prevent a disease than to treat it.

Vaccines work by introducing the weakened form of “disease germ” into the body. The body will respond by producing antibodies to fight these invaders. At this stage, technically, the immune system is being sensitised. If the actual disease germ attacks the body, more antibodies will be produced to destroy the real enemy.

Vaccines are responsible for the control of many infectious diseases that were once common in this country and around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, Hepatitis B and Haemophilus influenzae type b (Hib).

Many patients question the need for further vaccination as diseases such as diphtheria, pertussis are very rare these days.

Furthermore, there are people that do not get vaccination, yet able to live healthily until old age. This is the myth behind “herd immunity”.

Herd immunity serves as a preventive barrier as most of the population had been vaccinated, thus, the disease is contained from spreading. If herd immunity is compromised, the widespread of the disease may occur.

A piece of advice to all, a little knowledge is a dangerous thing. Before you start to tell doctors about the negative effects of antibiotics and vaccines, why not, give them a chance to explain to you before you make a decision.

Contributed by DR H.B. CHEE, Muar, Johor The Star/Asia News Network

Related posts:
1.Love your liver! World Hepatitis Day today
2. Life is not meant to be lived alone

Malaysia’s healthcare system is one of the best in the world


Malaysia's health care

Country is third best and practioners ‘equal to or better than most Western countries

PETALING JAYA: The country’s achievement at being rated third best in the world for healthcare services is something to be proud of, said Health Minister Datuk Seri Dr S. Subramaniam.He also gave credit to the boom in the country’s medical tourism sector through strategic investments on good medical facilities and competitive rates compared to other parts of the world.

“Medical tourism has benefited the Government in terms of foreign direct investments and also spin-off effects in the hotel and shopping sectors,” he said yesterday.

The Star Online reported yesterday that a study by the American publication International Living rated Malaysia’s healthcare system as the third best out of 24 countries in its 2014 Global Retirement Index, beating Spain, Italy, Ireland and New Zealand, among other countries.

The index, which was recently released by the Baltimore-based magazine, praised Malaysia’s healthcare, which scored 95 out of a possible 100 points, as the medical expertise of Malaysian healthcare practitioners is “equal to or better than what it is in most Western countries”, according to InternationalLiving.com’s Asia correspondent Keith Hockton.

The top two countries, France and Uruguay, scored 97 and 96 points, respectively.

On the methodology of the index’s ratings, the magazine said both the cost and quality of healthcare were evaluated.

Another report in International Medical Travel Journal News reported that medical tourism receipts in Malaysia from foreign patients totalled RM509.77mil in 2011 involving 578,403 patients.

Dr Subramaniam added that Malaysia remained competitive with players like Singapore and Thailand and the focus was to consolidate the country’s position.

He said the key towards improving the overall healthcare sector would be to focus on the preventive and primary healthcare divisions.

Malaysia Medical Association (MMA) president Datuk Dr N.K.S Tharmaseelan also acknowledged the findings, saying that the country has one of the best healthcare systems in the world.

“The Health Ministry has become a massive seamless service provider in healthcare that has produced magnificent results over the years. Our statistics prove it,” he said, adding that this was despite general practitioners being the lowest paid in the world with their fees being regulated.

He added that impressive figures such as life expectancy for women reaching 80 years and about 72 years for men were reflective of the excellent healthcare provided by the ministry and the private sector.

By G. Surach The Star/Asia News Network

Five tech-powered changes in next five years, IBM predicted


IBM_five tech

Technology stalwart IBM on Tuesday predicted classrooms getting to know students and doctors using DNA to customize care are among five big changes on the horizon.

IBM said that its annual forecast of five ways technology will change lives in the coming five years was “driven by a new era of cognitive systems where machines will learn, reason and engage with us in a more natural and personalized way.”

And while software evolves to “think” in ways similar to the human brain, computing power and troves of data kept handy in the Internet “cloud” will enable machines to power innovations in classrooms, local shops, doctors’ offices, city streets and elsewhere, according to the firm behind the Watson computer that triumphed on US television game show Jeopardy.

“Over time these computers will get smarter and more customized through interactions with data, devices and people, helping us take on what may have been seen as unsolvable problems by using all the information that surrounds us and bringing the right insight or suggestion to our fingertips right when it’s most needed,” IBM contended.

Predictions for the coming five years included “classrooms of the future” equipped with systems that track and analyze each student’s progress to tailor curriculum and help teachers target learning techniques.
IBM_five tech_children
“Basically, the classroom learns you,” IBM vice president of innovation Bernie Meyerson told AFP. “It is surprisingly straight-forward to do.”

In another prediction, IBM sees retail shops large or small blending online and real-world storefronts with ‘Watson-like’ technologies and augmented reality.

Also, doctors will tailor treatments using patient DNA, according to Meyerson.

“Knowing your genetic make-up lets you sort through a huge variety of treatment options and determine the best course to follow,” he said.

“They don’t have to carpet bomb your body to treat cancer,” Meyerson continued. “There is the ability to tailor the attack to improve the efficacy against cancer cells while leaving healthy cells untouched.”

Smart machines tapping into the Internet cloud will also be able to serve as “digital guardians” protecting people from hackers by recognizing unusual online behavior, such as shopping binges at dubious websites, and spying scam email messages or booby-trapped links.

“The digital guardian will know you are not someone who goes to a poker site and tops off your account,” Meyerson said. “Not only does it shut down the behavior, but it tracks it back to who is doing it and passes the information on to authorities.”

The final prediction was that cities will weave social networks, smartphones, sensors, and machine learning to better manage services and build relationships with citizens.

“The city will help you live in it,” Meyerson said. “There is a new generation of leaders coming in who are extremely tech savvy and making good use of it.”

Sources: AFP-Times

Get ‘smart’ pill is just sugar! What science are they teaching in schools?


School smart pills
The ‘smart pills’ sold in school are nothing more than just sugar.

PETALING JAYA: The pill that can supposedly make children “smarter and more obedient” is nothing more than sugar, said the Malaysian Medical Association (MMA).

According to its president Datuk Dr N.K.S. Tharma­seelan, upon analysis, it was found that 95% of the pill marketed as Dimensi 108 consists of sugar and other carbohydrates.

Herbs constituted only 7.5mg, or 1.5%, of the 500mg pill, he said.

“Although some of the herbs have been used in traditional Chinese medicine, the amount in this pill is minuscule to be of any use.

“In conclusion, Dimensi 108 is just a sugar pill with a tinge of herbs,” he said in response to The Star’s Thursday cover story which reported that schools in several states have been pushing the pills to pupils.

Dr Tharmaseelan called for the sale of the pills to be stopped immediately until the manufacturer can substantiate its claims through proper studies.

The Dimensi 108 pills were alleged to be able to “alter” children’s behaviour to make them more obedient and resistant to illnesses, and its listed ingredients include red dates, water lily seeds, rock sugar and spirulina.

Tiga G Dimensi Satu Kosong Lapan Sdn Bhd’s managing director Omar Mohd Yusos had claimed that the pills supplied by his firm were safe, and that the product had been distributed to schools since 2010.

Consultant psychiatrist Dr Ting Joe Hang said the notion of popping pills to make children more obedient was preposterous, and there was no drug in the world that could do that.

– Contributed by  By YUEN MEIKENG  meikeng@thestar.com.my/Asia News Network

What science are they teaching in schools?

I REFER to “Schools push ‘magic’ pills” and “Get smart pills are safe to be consumed, says firm” (The Star, Aug 29 – Malaysian schools push ‘magic’ pills!)

I’m sure in the coming days the reports will elicit many and varied responses from all the concerned stakeholders.

I am disturbed in particular by the “explanation” by the firm on how the pills are supposed to work.

In loading some scientific terms in its “explanation”, I opine that it is making not sense but rather nonsense out of its defence.

Let’s abstract from the reports: “When consumed, the hydrogen and nitrogen in the tablets will go into the bloodstream and form a molecule chain that acts like a ‘bullet’ to destroy negative molecules and generate positive energy … This energy also works as a defense against bacteria or viruses that cause illnesses.”

What “defense molecule chain” is formed from “hydrogen and nitrogen” that can fight off “bacteria and viruses”?

And, what “negative molecules” and “positive energy”? What are these? I don’t remember coming across these in my studies of the sciences?

What is more alarming is we have school teachers and administrators who are buying into such arguments.

What sciences are we really teaching in schools nowadays?

It looks like not only the language of instruction and the pedagogy that need re-examining but also the contents of our science curriculum and syllabi. I cry for our innocent charges!

Indeed, our soon to be revealed Education Blueprint 2013-2025 and its implementation has a taunting and heavy task ahead, especially in the field of science education.

–  LIONG KAM CHONG Seremban

Related news:
 Stop distributing ‘magic pills’
From A CONCERNED MOTHER of Kuala Lumpur.

Related post:
Malaysian schools push ‘magic’ smart pills!

Malaysian schools push ‘magic’ smart pills!


School magic pills
So called food supplement supposedly makes pupuls cleverer

PETALING JAYA: Schools in several states have been “pushing” pills that supposedly make pupils cleverer.

The promoters also claim that the “get smart” pills, named Dimensi 108, which are marketed as food supplements, can alter children’s behaviour to make them more obedient and hard-working as well as resistant to illnesses.

Concerned parents from a school in Kuala Lumpur contacted The Star when the tablets were distributed to Year Six pupils earlier this week, saying their children were being forced to buy the pills.

One parent said she had asked her daughter to return the pills to the class teacher and refused to pay for them.

“When my daughter and a few of her friends returned the pills, the teacher told them not to blame her if they are tak pandai (not clever) in their UPSR (which starts on Sept 9).

“Can you believe that? The teacher is supposed to encourage the kids to work hard for their exams and not rely on some pills with so-called magical properties,’’ the outraged parent told The Star.

Another complainant, whose brother is studying at the school, has lodged a written complaint with the Health Ministry.

“A ministry official told me that they will look into the matter, and I have also sent pictures of the packaging of the pills with the ministry’s logo on it.

“I hope they will get to the bottom of this as quickly as possible because we need to know whether the product is legitimate or not,” said the complainant.

The school’s headmistress said parents had “misunderstood” the nature of the pills and it was not compulsory for pupils to buy them.

“We would not promote anything that is bad for the pupils … these are just like herbal supplements to help pupils concentrate and build energy for the upcoming examination.

“They have ingredients such as spirulina and red dates, which are known for their health-giving properties. I myself give them to my child near the examination period.

“The product also has the endorsement of the Malaysian Federation of the Council of Headmasters, meaning that it has been approved by the Health and Education ministries,” she said.

The headmistress claimed that the pills were supplied to the school by the council.

“One parent shared her concerns with me personally, and when I explained the situation, she was very supportive,” she added.

Some parents remained sceptical.

“Only RM5 for a behaviour altering drug? This is way too affordable for the best thing since the discovery of DNA,” quipped a parent on Facebook.

“Spend a few hundred bucks, behavioural issues solved … Where can I mass order? Or how to sign up to be an agent?” added another.

 Related news:  
Get smart pills are safe to be consumed says firm
Health Ministry to probe pillpopping schools

‘Super’ slimming pill harmful to health


Super sliming pill
Coming forward: (Seated, from left) Chong, Wong and lawyer P.Y. Leong. Looking on are two other people who had also used the product

KUALA LUMPUR: A 32-year-old housewife was overjoyed when she lost 6kg in less than two months after consuming slimming pills she bought online.

She then spent almost RM15,000 purchasing the pills for her friends and family before realising that it contained a harmful substance banned in Malaysia, called “Sibutr­amine”.

“When I first began consuming the pills, I had palpitations, headaches and difficulty sleeping.

“The distributor of the product told me I was experiencing this because there was caffeine in the pills,” said Irene Wong, who started taking the pills after it was recommended by her friend.

Wong had asked her friends, including a woman living in Hong Kong, to buy the product as it was offered at a cheaper price when purchased in bulk.

The woman in Hong Kong had sold the pills to her friends there and one of them was admitted to hospital after suffering from severe palpitations. It was then discovered that the product has been banned in Hong Kong.

When Wong discovered this, she immediately sought the help of the MCA Public Services and Complaints Department, which wrote in to the Health Ministry.

The ministry, in a letter made available to The Star, confirmed that the product was not registered with the National Pharmaceutical Control Bureau (NPCB) and prohibited from being sold in Malaysia as it contained Sibutramine.

The ministry said the substance, which is an appetite suppressant, increased the risk of heart attack and stroke.

Wong said she had contacted the distributor of the product via Face­book many times to inform them about the dangers and to ask them to stop selling it.

However, she said, the product was still being sold openly, for RM160 per bottle, and many seemed to be purchasing it.

Department head Datuk Seri Michael Chong, in a press conference with Wong yesterday, cautioned the public from buying the product, and urged those who had already bought it to stop consuming the pills.

He added that a police report would be lodged over the matter soon.

P. ARUNA The Star contributed to this post

Love your liver! World Hepatitis Day today


A look at one of the most insidious infectious in the world 

Many people are unaware that being diagnosed with hepatitis B and C is a lifelong sentence.

Love your liver
Dr Syed ... Patients diagnosed with hepatitis B and C need to come for their annual check-ups to catch signs of liver damage in the early stages. – LOW LAY PHON/The Star
Dr Syed … Patients diagnosed with hepatitis B and C need to come for their annual check-ups to catch signs of liver damage in the early stages. – LOW LAY PHON/The Star

MANY ancient civilisations rightfully believed that the liver is one of the most crucial organs in our body.

Although their understanding was not based in scientific fact – for example, the Babylonians, Estrucans, Romans and Greeks believed that the liver was the seat of all emotions and the organ closest to divinity, while in traditional Chinese medicine, it purportedly helps to regulate the flow of qi and blood in the body, and governs anger – the liver is indeed vital to our existence.

Like the heart, we cannot function without our liver.

It is one of the most hardworking organs in our body, performing over 500 different functions, including processing and storing nutrients, manufacturing proteins and hormones, neutralising toxins, breaking down drugs and removing waste from our body.

It is the second largest organ in the body after the skin, and the only one that has significant regenerative capabilities, being able to grow back to full size from as little as a quarter of its cells.

However, even this ability cannot overcome the insidious presence of the two hepatitis viruses that cause chronic infection in the liver.

These viruses work silently – often residing in the infected person’s body quietly, slowly damaging the liver without causing any outward signs of illness, until it is too late.

Passed on through bodily fluids, they can be contracted through sex, the sharing or reuse of unsterilised sharp objects like needles, razors, and even earrings, from mother to child in the womb, and basically, any activity that can result in the transference of blood, semen, vaginal fluid and saliva directly from the infected person to someone else.

The virus usually gains access into the body via the bloodstream through minor wounds, like nicks or cuts, that one may not even notice.

But because these viruses rarely cause any specific symptoms during the acute stage, people are unaware that they have been infected, and may go on to infect other people unknowingly.

This is why, according to consultant hepatologist Dr Syed Mohd Redha Syed Nasir, the most important form of transmission is perinatal or early childhood transmission.

He explains: “If someone in the family has hepatitis B, it is likely that someone else will have it too; that’s why we have to screen everyone in the house.”

This is especially in the case of children whose immune systems have not completely matured yet.

As a rule, hepatitis is usually only picked up upon screening, or when patients have already developed complications from the disease.

A chronic problem

Despite being considered a major global health threat – it is one of only four diseases that the World Health Organisation (WHO) considers crucial enough to mark with an international World Day, the awareness of hepatitis is still disturbingly low among the general population.

This infectious disease, which causes inflammation of the liver, is caused by five viruses: hepatitis A, B, C, D and E.

Of these, hepatitis B and C are the most worrisome as they can become chronic infections, which may result in liver cirrhosis (also known in layman’s terms as scarring or hardening) and liver cancer. (See Acute infections for more information on the three other viruses.)

These two viruses are also the main focus of the World Hepatitis Day campaign.

According to the World Hepatitis Alliance website, “The long-term objective of the campaign is to prevent new infections and to deliver real improvements in health outcomes for people living with hepatitis B and C.”

In Malaysia, hepatitis B is an important enough health concern that the vaccine is part of the compulsory national immunisation programme for all babies.

Despite that, Dr Syed says that around 5% of the population still has hepatitis B.

There is no vaccine for hepatitis C; neither is there any local data on the spread of hepatitis C or the three other hepatitis viruses in the country, according to him.

“In our setting, from my experience, we often encounter patients, who are diagnosed to have hepatitis B in particular, many years ago.

“Little do they realise that hepatitis B is a chronic infection that has the potential to cause long-term damage to the liver,” he says.

The doctor, who was previously with the national referral centre for liver diseases at Hospital Selayang and is now in private practice, adds that this often results in the patient being unaware of the importance of long-term follow-up, and creates the tendency for them to skip their annual check-ups.

“For these patients, you can’t be sure whether their infection will become active again, or develop into liver cancer.

“A few years down the road, they will come and you discover they have liver cirrhosis, and it is already a lost battle.”

He says that most patients tend to come in when they already have decompensated liver cirrhosis, which presents with abdominal swelling, with or without accompanying leg swelling, and either vomiting or passing motion with blood.

Some may also come in with a yellowish complexion (jaundice), episodes of losing awareness of their surroundings (hepatic encephalopathy), and other bacterial infections, as the liver is part of the immune system.

Too late to treat

While treatment is available for both hepatitis B and C, Dr Syed cautions that patients need to be carefully evaluated before the decision to start treatment is made.

This evaluation is to determine the degree of viral activity, as well as the level of liver damage. Both these factors need to be carefully balanced in order for treatment to be fully effective.

“When we give treatment, we must make sure it is indicated, because it is for life. For example, if a patient is 25 years old, he has to take it for the next 40 to 50 years (until he dies),” he says.

The development of resistance to the antiviral medication given for the disease is also another reason why doctors need to make the decision to treat judiciously.

Aside from oral antiviral drugs, patients may also be treated with interferon injections, which are typically given for the period of one year.

Dr Syed explains: “Interferon modulates your immune system, as well as clears the virus, so there is an added effect. After one year, your immune system will be able to clear the virus on its own.”

According to studies, the percentage of patients on interferon in which the virus can no longer be detected increases from 3-5% in the first year to 12% five years after completing their treatment.

However, he adds that this treatment is often not an option for most Malaysian patients, as the damage to the liver is already too advanced by the time they go see the doctor.

Unfortunately, the reality of the situation in Malaysia is that most patients with chronic hepatitis only see the doctor when their condition is so advanced that they are already well on the way to requiring a liver transplant.

– By TAN SHIOW CHIN The Star

Related Notes:

Hepatitis A
Transmitted through the oral-faecal route, usually through water or food that has been contaminated with the faeces of an infected person. Prevalent in places with poor hygiene and sanitation. There are an estimated 1.4 million cases of hepatitis A every year worldwide. Symptoms include fever, malaise, loss of appetite, diarrhoea, nausea, abdomi -nal discomfort, dark-coloured urine and jaundice. There is no treatment, but the immune system is usually able to get rid of the infection by itself. There are a number of vaccines available.Hepatitis D

Transmitted through bodily fluids, usually through sex, contact with the blood of an infected person, sharing of sharp objects like needles, razors or syringes, and from mother to child in the womb. Requires the presence of the hepatitis B virus to replicate, and as such, is usually found together with hepatitis B as a co-infection or a superinfection. Not usually tested for in a clinical setting. Treatment and vaccination for hepatitis B is equally effective for hepatitis D.

Hepatitis E
Transmitted through the oral-faecal route, usually through contaminated drinking water and eating products from an infected animal. Every year, there are 20 million infections, over three million acute cases, and 57,000 deaths. Over 60% of infections occur in East and South Asia. Symptoms include jaundice, anorexia, an enlarged, tender liver (hepatomega -ly), abdominal pain and tenderness, nausea, vomiting and fever. There is no treatment, but the immune system is usually able to get rid of the infection by itself. However, complica -tions may arise in pregnant women. The first vaccine was registered in 2011 in China, but is not currently available globally.

Sources: WHO, the US Centres for Disease Control and Prevention, and consultant hepatologist Dr Syed Mohd Redha Syed Nasir.

 
There are vaccines available for hepatitis A, B and E, but the vaccine for hepatitis E is only available in China. – AFP

Facts an figures -by the Numbers:

  • There are over 400 million cases of  HEPATITIS every year, compared to 34 million cases of  HIV/AIDS cases (IN 2011) and almost 29 million cases of CANCER  (in 2008).
  • HEPATITIS B & C infections cause an estismated  57% of liver cirrhosis cases and 78% primary liver cancer. Liver cancer is the SIXTH most common cancer worldwide.
  • Around 240 million people have chronic Hepatitis B, with 600,000 dying every year due to complications from the infection.
  • The percentage of  those who develop chronic Hepatitis B infections are: 80-90% of infants infected before he age of one, 30-50% of children infected before six and <5% of otherwise healthy adults.
  • The Hepatitis B vaccine is administered at ZERO (at birth), one and six months of age in Malaysia. It is 95% effective at preventing infection.
  • About 150 million people have chronic Hepatitis C, with over 350,000 dying every year due to complications from the infection.
  • Around 80% of peopole do not exhibit any symptoms follwoing initial Hepatitis C infection.
  • Around 75-85% of Hepatitis C patients develop chronic infection, of which 60-70% develop chronic liver disease. 2-20% will develop cirrhosis, with 1-5% dying from cirrhosis or liver cancer. Hepatitis C causes 25% of liver cancer cases.
  • July 28 was chosen for World Hepatitis Day in honur of the birthday of Nobel Laureate Prof Baruch Samuel Blumberg, who discovered the Hepatitis B virus.

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