Improve quality of care for post-partum period, docs urged

Star: PETALING JAYA: Doctors need to improve the quality of care for the post-partum period, said Health director-general Tan Sri Dr Ismail Merican.
He said 60% of the deaths occurred during post-natal period and the rate was higher among women over 40 and those who had given birth more than five times, he said.
“Patient factors such as unbooked cases (where mothers did not receive antenatal care and did not register with a health facility for child delivery) and non-compliance to doctors’ advice, admission and therapy were identified as contributory factors to maternal deaths.”
Common remediable clinical factors included failure in communication and lack of technical knowledge and skill that resulted in failure to recognise early warnings, he added.
Dr Ismail said for every maternal death there were many “near misses” and this might provide doctors with more information on areas for improvement than mortality figures.
The implementation of inquiry recommendations and guidelines had shown to improve maternal health policies, procedures and practices and save the lives of mothers and their babies, he said.
He pointed out there was a steep rise in Caesarean section rates over the world with patients not fully understanding the risks involved. Since they might suffer complicated subsequent operative procedures, he urged senior doctors to be more actively involved in the management of high risk cases.
He added that the risks involved must be discussed and informed consent obtained and documented.

Health Ministry to take over new centre

Star: KUCHING: The Federal Government has agreed to take over the newly completed Sarawak International Medical Centre (SIMC) in Samarahan, near here.
Deputy Chief Minister Tan Sri Dr George Chan Hong Nam said the Health Ministry was now evaluating the centre’s buildings and facilities.
“An occupation permit has been obtained, and all the essential facilities are available to start operations.
“I will ensure that the Health Ministry will be able to operate the SIMC as a general hospital for the benefit of the people within the shortest possible time,” he added.

New strain of cholera found

Star: PUTRAJAYA: Those in Terengannu suffering from diarrhoea or vomiting should seek immediate medical attention, said Health Minister Datuk Seri Liow Tiong Lai.
This, he added, was because of the outbreak in the state of a new strain of cholera that has already caused one death.
He said severe dehydration from vomiting or diarrhoea would affect vital organs, especially the kidneys and if help was not sought quickly enough, the patient could die from organ failure.
“The current outbreak in Terengganu is caused by a new strain that is resistant to the antibiotics usually used to treat cholera.
“Although we can still treat it, we want those suffering from such symptoms to go to the nearest medical facility quickly to ensure early diagnosis,” Liow told a press conference after attending the National Food Safety and Dietary Council meeting and launching the Infants and Children’s feeding guidelines here yesterday.
Liow said there have been 174 confirmed cholera cases in the state since the outbreak on Nov 11 and it was suspected to have been due to food, especially ice-cubes, that was not hygienically prepared.
He said all those confirmed suffering from cholera were warded in hospitals and only allowed to return home if there was no trace of the bacteria in their faeces for three consecutive days. Hospitals in the state have so far discharged 33 of the patients.
“We have already dispatched a surveillance team to start conducting checks to identify the source of the problem and expect it to complete the task soon.
“We want to advise the people to observe good hygiene in food preparation, eat cooked food and avoid eating in shops where the cleanliness is questionable,” he said.
Liow also said the outbreak in Terengganu was not caused by the recent floods and did not involve any of those placed in various flood relief centres.

Go for regular dental check-ups, public urged

Star: KUALA LUMPUR: Only six per cent of the 28 million population in Malaysia seek dental treatment and services with half of them being schoolchildren.
Health Ministry’s oral health director Datin Dr Norain Abu Talib said this was because Malaysians prefer to seek treatment when there was a pressing need and not as a preventive measure.
“It is common for Malaysians to visit the dentist when they have toothache. If they don’t have toothache, they don’t think they have any dental problems,” she said.
Dr Norain said this at a press conference after officiating at the 20th Scientific Convention and Trade Exhibition and the 41st Annual General Meeting of the Malaysian Private Dental Practitioners’ Association here yesterday.
“Six per cent is a very low number and more than half of that percentage is actually schoolchildren,” she said.
Although there was a shortage of dentists, she said the ministry was optimistic in resolving the problem.
Currently, the ratio is one dentist to every 7,800 Malaysians.
“We have targeted to achieve a ratio of one dentist to every 4,000 Malaysians by 2020 but with the 11 dentistry schools nationwide, we believe we can achieve the figure two years earlier than expected.”

Diabetes threat bigger than H1N1

Star: PETALING JAYA: The country is heading towards becoming a “sick nation” as far as diabetes is concerned, a health expert has cautioned.
“The (diabetes) situation is getting worse. It could get worse than H1N1 or AIDS if the people don’t do something about their health,” Malaysian Dia­betes Association president Prof Dr Ikram Shah Ismail said.
He said a National Health and Morbidity Survey in 2006 showed a prevalence rate of 14.9% for those aged above 30, with a third of Malay­sians with diabetes not being aware of it.
The survey also estimated that about 70% of diabetics in the country had poor control over the disease.
About 95% to 98% of those affected have Type 2 diabetes, which is non-insulin dependent.
Dr Ikram said neglecting medication or continuing to indulge in sweet food like ice cream contributed to poor control of diabetes.
“And there are those who do not see the doctor regularly, so they don’t know what their control is like. The problem with diabetes is that those with a HbA1c reading of more than 10 do not show symptoms. They feel normal even if their blood glucose is high,” he added.
The ideal target for good control of diabetes is having a HbA1c (a blood test that provides the average of blood sugar control over a three-month period) reading of 6.5% or lower.
He said Malaysians were also getting diabetes at an earlier age.
“They are not healthy because they are not eating healthy food or exercising. Previously, although they had the genes, they did not get diabetes until they were much older,” he added.
Consultant endocrinologist Prof Datuk Dr Khalid Abdul Kadir, who is a professor of medicine at Monash University Malaysia, said the country’s increased prevalence rate was similar to that in Singapore, Thailand and Indonesia.
He added the effects of the Govern­ment’s intervention programmes to promote a healthy lifestyle had not been evident.
Dr Khalid and a team of researchers are studying whether stress in­c­reases the risk of humans developing diabetes.
Tests conducted on rats by the team determined stress as a risk factor.
In Putrajaya, Dharminder Singh reported that Health Minister Datuk Seri Liow Tiong Lai said the National Strategic Plan would be launched early next year to combat the rising number of cases of non-communicable diseases such as diabetes, hypertension and cardiovascular problems.
The plan was formulated after the National Health and Morbidity Sur­vey reported the percentage of obese Malaysians aged 18 and above had risen from 4.4% in 1996 to 14% just 10 years later while cases of diabetes among those aged 30 and above rose from 8.3% to over 14% during the same period.
He added that obesity was a worrying trend because it increased health risks.
Liow spoke to reporters after launching the “1Malaysia Brings Diabetes To Light Campaign” yesterday.

200,000 A(H1N1) vaccine doses for high-risk group

Star: KUALA LUMPUR: A total of 200,000 influenza A(H1N1) vaccine doses will be available for the high-risk groups, including pregnant women and those with chronic diseases by January.
Health Minister Datuk Seri Liow Tiong Lai said the country had ordered a total of 400,000 influenza A (H1N1) vaccines, half of which would first be administered to frontliners like healthcare workers and civil servants.
“We are now identifying those in the high-risk groups and we should be able to provide them with the injection by January next year,” he told reporters here on Saturday after attending the Sara Lee-Tesco Anti-Aedes Campaign here.
He said research was being carried out now to incorporate the A(H1N1) vaccine into the seasonal flu vaccine.
“This kind of vaccine will give protection to all sorts of flu, including the H1N1 virus,” he said.
However, Liow said he was unsure when such vaccine would be available in the market as the research was still ongoing.
“Hopefully, we will get it by next year,” he said.

On dengue fever, Liow said there were 34,975 such cases with 75 deaths as of last Saturday.
“There is a drop of 10% in the number of such cases compared to 38,995 cases with 84 deaths during the same period last year,” he said.
He said Selangor recorded the highest number of dengue cases with 47% of 16,591 cases happened in the state.
“Currently, there are nine dengue hotspots in Selangor, of which two are in the Hulu Langat district,” he said.
He said some of these areas had been having the epidemic for more than two months and most of the breeding grounds were found at empty houses or students’ accommodation.
Liow said as part of the ministry’s effort to eliminate Aedes mosquitoes, it had launched the Anti-Aedes campaign to urge the public to spend at least 10 minutes a week to check their house and eradicate Aedes breeding.

Too few cadavers for organ harvesting, says Ismail

Star: KUALA LUMPUR: The cadaveric donation rate in Malaysia is 0.97 to every one million of the population, said Health director-general Tan Sri Dr Ismail Merican.
“At this rate, in addition to the increase of patients with chronic diseases, the waiting period for donated organs has become too long.
“Furthermore, Malaysia is far behind in its organ donation rate at 0.97 as compared to developed countries such as Spain which has a rate of 34.3 donors per one million citizens and Singapore with 5.9,” he added.
“What’s more saddening is, there are patients who could not be saved as they had succumbed to their diseases while on the waiting list,” he said after opening the new National Transplant Resource Centre office in Wisma Sejarah at Jalan Tun Razak yesterday.
Dr Ismail said the ministry was taking steps to improve on the matter.
The centre will have 15 full-time ministry officers to help manage the service.
Previously, the centre operated at the main lobby of the Kuala Lumpur Hospital with only one officer in charge.
The centre was launched in 1997 to spread correct information and increase awareness on organ donation and transplantation in Malaysia.

Brace for new wave of H1N1

Star: PUTRAJAYA: The country should brace itself for a possible second wave of Influenza A(H1N1), after reports of the disease resurfacing in the Northern Hemisphere and an alert announced by the United States.
Health Minister Datuk Seri Liow Tiong Lai said the surveillance teams set up when the first A(H1N1) cases appeared in Malaysia were still in place and were continuing to detect and monitor all cases of the flu.
He said thermal scanners at all entry points into the country were still operating, adding that he was confident the second wave would be quickly detected and control measures put in place if it were to hit the country.
Liow was speaking at a press conference after launching his ministry’s Innovation Day celebrations here yesterday.
However, the minister said the spread of the A(H1N1) virus has slowed tremendously over the last few months, from 400 to 500 cases a day to just between 20 and 30 cases a day now.
On the 1Malaysia Community Clinics announced by Prime Minister Datuk Seri Najib Tun Razak during his 2010 budget speech, Liow said the ministry had already identified several locations for the 50 clinics to be opened nationwide in January next year.
He said the clinics would be run by medical assistants and offer outpatient services like dressings for wounds as well treatment for simple colds, coughs and headaches.
“There will be visiting doctors making rounds at the clinics and if the patients need more serious attention when the doctors are not around, they will be referred to the nearest private clinic,” he said.