Clinical trials in Malaysia

Star Health: According to Director-General of Health Tan Sri Dr Ismail Merican, Malaysia would be a good place to host clinical trials.
WITH Asia being an emerging “power house” in pharmaceutical research and development (R&D), Malaysia wants in on the action when it comes to clinical trials, which plays an important role in the research of developing a new treatment.
However, the Health Ministry laments that Malaysia seems to be “ignored” with players preferring instead to go to countries like India, China, Thailand and Singapore.
Asia, after all has 80% of the 6.4 billion world population and Asean itself comprises more than 50 million people. “They seem to bypass Malaysia. The question is why,” said director-general Tan Sri Dr Ismail Merican.
“Maybe they do not know much about what we can offer. Or they know much about what we can offer but are saddled with problems like bureaucracy, delayed timelines or long approval processes.”
He said people were flocking to Asia because they wanted quality research besides cutting down on R&D cost.
And Dr Ismail, in a recent interview, listed many “good reasons” why Malaysia would be a good hub to host clinical trials.
Point number one, he said was the lower cost of doing clinical trials in Malaysia.
“We are good and cheap,” he said.
Clinical trials in Malaysia can be conducted in ministry establishments, private hospitals and medical teaching hospitals.
The recently launched network of clinical research centres (CRC) as a “one-stop-centre” for clinical trials to be carried out by the ministry was another indication of how serious the ministry took the matter.
The network will act as the main contact point where the 14 CRCs will facilitate access to the more than 50 general and district hospitals, and more than 100 health clinics as potential sites for clinical trials.
It is hoped that this could be further expanded to more sites in the future.
Phase I trials in Malaysia have improved from nil four years ago to seven in 2005, while Phase II trials were 11 in 2005 compared to two in 2003.
There were 96 Phase III trials in 2005 compared to more than 70 four years ago.
To reduce cost and shorten timelines, pharmaceutical companies are now outsourcing work to contract research organisations (CROs), who in turn were coming to Asia.
A report by Frost and Sullivan estimates that most of the world’s CROs are small niche players specialising in short-term projects while about 20 are large and global-reaching.
Another plus point is that Malaysia has a diverse genetic pool.
We are, he said, a multiethnic population, which would be tremendous for research, while Malaysia, he said, has a consistent record of achieving recruitment targets.
He went on to say that there was also strong government backing, where funding for research to the ministry under the Ninth Malaysia Plan was RM90mil.
In addition to this, the ministry’s infrastructure of having 14 clinical research centres (one in each state) and the future 9 Bio Sdn Bhd, which was the Institute of Natural Products, Vaccines and Biology, is good.
He was also quick to remind us that Malaysia has a strong regulatory framework where researchers have to have approved good clinical practise (GCP). Dr Ismail said that they underwent training and took examinations afterwards to get the certificate.
“This is so that the data generated from the trial will be of integrity and cannot be questioned by anyone,” he said.
Consequently, he said that the trained researchers would ensure the safety of human subjects where patients had the right to know issues such as their rights, why they were being enrolled, whether there would be any changes, alternative therapy and compensation.
“We have got dedicated staff and trained human capital to carry out the trials. We have trained more than 300,” he said.
One new venture set up by the ministry is the National Medical Research Register (NMRR), which is meant to help the industry and researchers identify good researchers who have a good track record.
He said that with the NMRR, eventually every clinical trial would need to be registered online. This would create a database that will give the pharmaceutical industry access to expert clinical researchers, the number of trials conducted and how many have been completed.
It is currently undergoing pilot testing by the Clinical Research Centre.
The networking of Malaysia’s research institutes with others such as the National Institute of Health in the United States is also a plus point.
“And the majority of our researchers speak comparatively good English,” he reminded.
Dr Ismail emphasised that not every trial was “simply” accepted but instead had to undergo a rigorous review, as it was necessary to ensure that all trials conducted were of high standards and patients were protected.
“Many may not realise the stringent monitoring and regular audits done by international regulators to ensure authentic data. They think we are just doing the trial, that all the person has to do is present to us. It is not that easy,” he said, adding that in any trial there were four “players”: the sponsor, monitor, investigator and ethics committee.
There were also lengthy procedures for obtaining approval, which include the Drug Control Authority and Medical Research Ethics Committee. In addition, there’s the need to comply with the International Committee on Harmonisation and Good Clinical Practice guidelines in areas such as recruiting trial sites and patients.
He said that six weeks was the average time taken for any organisation to obtain approval to carry out clinical trials in this country, provided they had all the necessary documentation.
Another reason for lack of interest in clinical trials, he cited was that patients in the developing world still had a measure of “fear and apprehension” because they did not know what such trials were all about.
“In developed countries, patients willingly participate in clinical trials because they view it as a means for researchers and pharmaceutical companies to develop new and improved therapies for human diseases,” he said.
“Many of them also volunteer to gain access to new experimental medications for their disease when all other treatments have been exhausted.”
So, he said it was important for clinicians who wanted to carry out research to give adequate information to the patients.
Among the issues being explored are the need to introduce new legislation or review existing ones to facilitate approval process, management of finances and protecting Intellectual Property rights, using ICT to increase efficiency in conducting clinical trials and create a database of clinical investigators and research done in Malaysia and need to have more awareness and education programmes.
Dr Ismail added that there was also a need to have specific human resource development strategies to build up a pool of experienced healthcare professionals who are trained and committed as clinical investigators and site coordinators.
“It is time to sit tight, look back and forward. And if we do not do anything about this, we will lose out,” he added.

Set up specialist panels

Star: KUALA LUMPUR: Panels of specialists should be set up within various medical disciplines to cut down on the number of medical negligence cases brought to court.
This will consequently lessen the trauma on doctors, patients and their families.
Retired High Court judge Datuk R.K. Nathan made the suggestion in his keynote address at the “Assessing and Determining Quality of Life for People with Medical Disabilities” seminar on Saturday.
He said medical specialists should form their own guild according to their discipline and each guild would then set up a panel of its own specialists to look into complaints of negligence to ascertain whether there was a need for a particular doctor to settle the case or fight it out in court.
“This way, the moment a notice is given, the doctor or surgeon will be called up by the panel.
“If there is a clear case of negligence, the panel can advise the doctor to settle the case quickly,” said Nathan, who is also an expert in medico-legal cases.
Nathan said the findings made by the panels should be confidential.
He said it was timely that “the medical profession self-regulates itself” especially with the December landmark ruling by the Federal Court, which raised the standards for medical professionals when carrying out their duty.
The Federal Court unanimously ruled on a negligence suit by quadriplegic Foo Fio Na against Assunta Hospital and an orthopaedic surgeon that the Bolam test based on a 1957 negligence suit in England could no longer be used as the yardstick to measure the degree of negligence.
(The Bolam principle restrains the courts from scrutinising and evaluating the professional conduct of a doctor possessing a special skill and competence.

Parkinson’s patients being sent to psychiatrists instead

Star: PETALING JAYA: Some Parkinson’s Disease (PD) patients have been misdiagnosed as suffering from depression and were referred to psychiatrists, said a neurologist.
“We have to teach the public that the moment they have tremors, they have to think about PD.
“Patients suffering from depression may have slower movements but not tremors,” said Dr Chew Nee Kong at the Red Tulip campaign on World Parkinson’s Disease Day recently.
He said some had also been sent to heart specialists because of their difficulty in breathing and to bone specialists because they had body aches.
“As a result of the non-specific nature of the disease, coupled with the lack of specialists and public awareness, diagnosis can be a challenge and delayed,” he said.
Symptoms of PD include the slowing down in speech and body movements, softening of voice and lacking in facial expression resembling ageing process.
Patients tend to think of these as a natural process and do not seek treatment, said Dr Chew.
PD is the result of a lack of dopomine, a biochemical substance that is needed for body movement.
Patients lack energy, have uncontrollable trembling of hands, sometimes of the head and jaw, and body stiffness.
“With newer medication and brain surgery, patients do not have to suffer anymore. PD patients can now lead normal lives for 15 to 20 years,” he said.
In 95% of PD cases, the cause was unknown while the other 5% were due to inherited genes or chemical substance in the environment, he said.

Breathe easier

Sun2Surf: KUALA LUMPUR (April 19, 2007): People with asthma can breathe easier and even cheat "sudden death" from the condition, with Simple Inhaler Maintenance and Reliever Therapy (SMART).
Asthmatics currently have in their possession two asthma control inhalers - one brown and another blue.
The brown inhaler is used in the morning and just before bedtime to prevent inflammatory effects of the disease.
The blue inhaler, which patients carry with them, gives them immediate symptomatic relief from broncho-constriction (narrowed air passage) during an attack but does not treat the underlying inflammation.
"So patients tend to be overly dependent on their blue reliever', which is not proper, as it does not provide good overall control because the inflammation is not kept in check," Prof Dr Richard Loh Li-Cher, consultant respiratory physician at the Penang Medical College, told journalists today.
He said there were also patients who totally ignored the brown inhaler, not using it twice a day as advised by doctors, so long as they are not bothered by a full-blown attack.
An impending full-blown attack actually gives tell-tale warning signs like wheezing and coughing, and turns chronically bothersome over a period of six days.
"It is sad that this six-day window of opportunity is lost and they finally use the blue inhaler to alleviate their condition which may have already turned chronic.
"For some, it may be too late, as their condition could turn morbid and fatal," Loh said.
To avoid such a situation, medical science has introduced SMART - a red three-in-one inhaler which carries a cocktail of medication for daily maintenance, a reliever for use when necessary, and a timed increase in anti-inflammatory therapy to sustain control.
Loh said a real life effectiveness and patient satisfaction study of 22 patients in Malaysia with severe asthma using the SMART approach was undertaken at a local public hospital.
"Lung function and asthma attacks over a three-month period were also appraised via interviews with nurses."
SMART was found to be effective and a safe treatment option for patients with inadequately controlled and moderate to severe asthma.
The results of the study have been peer-evaluated and submitted for publication in the Medical Journal of Malaysia.

Five organ harvesting centres to be set up

Sun2Surf: PENANG (April 20, 2007): The Health Ministry is planning to set up five regional centres nationwide for organ harvesting to complement transplant efforts which are now lacking due to poor coordination.
A coordinating centre in the Klang Valley will serve as a hub to relay information immediately and communicate with the regional centres so that when an organ donor is available for harvesting, the harvesting teams can be despatched immediately.
Ministry parliamentary secretary Datuk Lee Kah Choon said a blueprint on organ harvesting is now being scrutinised by the ministry and will be implemented soon.
Lee said currently organ harvesting was only being carried out in selected hospitals where there were experts and if an organ donor died elsewhere, it was near impossible to immediately despatch a team to carry out the harvesting.
"With a population of 25 to 26 million people, sadly we have only about 100,000 registered organ donors (0.004%).
"There are at least 5,000 people on the waiting list for transplants but only 20 transplants can be carried out yearly due to organ shortage.
"Even when someone who is registered as an organ donor dies, we may not be able to harvest his/her organs due to various reasons, including the reluctance of the family members to allow the harvesting to be carried out.
"We have to double our efforts to dispel the wrong perception about organ donation and hopefully, more lives can be saved when there is an awareness among the people that their noble act can save lives," he said after officiating at the opening of a new dialysis centre set up by the Penang Fo Yi Haemodialysis Society today.
Lee said due to lack of kidney donors, at least 10% of the 13,000 end renal failure patients died yearly.
He appealed to NGOs and private organisations who have set up dialysis centres to treat 36% of kidney patients in the country to help educate the public on organ donation.
"It is just not enough for you to provide these dialysis centres, but you must also help to educate the people on kidney ailments and also on organ donations.
"It is alarming to note that where there were fewer than 50 people needing dialysis treatment in the 1980s but last year there were 13,000 on the list which is growing about 2,700 new patients," he added.

We stick by report, says Chua

Star: JOHOR BARU: The Health Ministry does not want to be drawn into a debate with Maktab Sains Mara Merbok on the measles controversy.
Its minister Datuk Seri Dr Chua Soi Lek, who had said that measles was the diagnosis of the illness that hit 539 students earlier this week, is standing by his statement despite the college countering that only two students were down with it.
Dr Chua said he would stick by the report submitted by the district medical health officer.
“The report states that more than 500 students in the college displayed symptoms such as fever, headache and sore throat. These symptoms can be diagnosed as a viral-lie fever, which could be measles.
“We believe someone who is trained (in this matter). The one trained is the doctor, not the principal (of the college),” Dr Chua added.
A Bernama report quoted college officials as saying that the matter was blown out of proportion by the media.
On another matter, Dr Chua gave an assurance that the safety of patients and the quality of services at the Sultan Ismail Hospital in Pandan, Johor Baru, would not be compromised.
He was responding to a report in The Star on missing portions of the ceiling outside the hospital.
A hospital spokesman had said that the ceiling problem was due to structural defects.
The spokesman said the hospital had asked the ministry for an allocation to repair the ceiling.
Dr Chua said he was not aware if any allocation had been made.

Logo to help you choose healthier food

STar: JOHOR BARU: Consumers will find it easier to eat healthier soon with the launch of the “Healthier Food Choices” logo.
Health Minister Datuk Dr Chua Soi Lek said that the public should be able to spot the logo on food packaging in stores in three to four months.
To be allowed to sport the logo, food products must meet ministry requirements including having a lower sugar, fat and salt content.
Dr Chua said the initiative was meant to combat the trend towards overweight and obese Malaysians.
“Since 1991, the ministry has embarked on a Healthy Lifestyle campaign. There is increasing awareness but it is not being put into action, in terms of exercise, in terms of consumption of food,” he said.
He said the ministry has held discussions with manufacturers such as Nestle and Dutch Lady who have agreed in principle to the move.
“Food manufacturers can play a role to help the ministry. If we can reduce the sugar, fat and salt content, we can produce food that can be branded as a 'Healthier Food Choice',” he said, adding that the manufacturers have until June to submit their application to the ministry.
A technical committee will then analyse the food content to ascertain if they meet the requirements.

JB hospital ‘sick’ again

Star: JOHOR BARU: The Sultan Ismail Hospital is facing structural problems again.
Large portions of the ceiling at the front of the building had to be removed last week due to structural defects.
The RM550mil hospital was closed in September 2004 for 17 months due to a fungus problem. It was only reopened in February last year.
The hospital’s deputy director (management) Md Yasin Ibrahim told The Star that the ceiling problem surfaced last week.
“We have informed Pantai Medivest that is responsible for the maintenance work at the hospital about the problem.
“It is investigating. It is believed that the cause is most probably due to structural defects,” he said.
Md Yasin ruled out strong winds and storms as reasons for the ceiling coming off.
“We noticed some portions of the ceiling are coming off, so we got the maintenance staff to remove them before they could fall on anyone,” he said.
He added that Pantai Medivest did not give an estimate on the cost of repairs, or how long they would take.
He said the hospital would remain open, as the defects did not affect hospital operations.
“We have cordoned off the affected areas with tape to ensure the safety of patients and visitors,” Md Yasin added.

Expert: Go for annual blood sugar tests

Star: KUALA LUMPUR: Those above 35 years of age are advised to check their blood glucose level annually, even if they do not have any symptoms of diabetes.
“Don’t wait until symptoms set in. It will be too late by then,” said Universiti Sains Malaysia senior consultant endocrinologist Datuk Dr Mafauzy Mohamed.
Diabetes could set in as far back as 10 years before symptoms appear, he said, adding that it was the sixth leading cause of death in the world.
He said that around 40% of heart attacks was due to diabetes, which was also the number one cause of kidney failure, blindness in adults and amputation, while 60% to 70% of patients suffered nerve damage.
He was speaking at A Diabetes Outcome Progression Trial media briefing yesterday.
“It is not a mild disease but a dangerous and deadly one,” he said.
The 1986 National Health and Morbidity Survey revealed that 6.3% of adults suffered from diabetes and, last year, the figure had almost doubled, he said.
The best way to combat diabetes is to control it at the pre-diabetic stage, where blood sugar level after fasting is 6% to 7%, or 7.8% to 11.1% two hours after a meal, he said.
“If nothing is done, the risk of getting diabetes will increase by 10% each year. If detected early, we can get the blood sugar to normal level or delay the onset of diabetes,” he said.
The Medical Journal of Malaysia reported that the condition of 80% of diabetic patients seeking treatment at private clinics in 2005 was not well controlled, while the figure was 67% in government clinics for 2006, he said.
Ideally, it is possible for people to achieve the 6.5% or below blood glucose level and not suffer any risks from diabetes throughout their lives, he said.
“The poor control could be due to patients not complying with treatment, proper diet and exercise, or doctors not prescribing more aggressive treatment,” he said.
Professor of medicine and senior consultant endocrinologist Dr Chan Siew-Pheng said patients who become diabetic at ages between 40 and 49 lose 10 years of their lives, and between 50 and 59, six years, and less for those who become diabetic older.
“The good news is that even if you start at a blood sugar level of 11% but it drops to 9%, you reduce the risks of complications,” she said.
With newer medication such as the rosiglitazone maleate, the declining function of insulin-producing beta cells has been delayed by up to 60 months before more drugs are needed to control blood sugar level, she said.

Rights to drugs sought

Star: SUBANG JAYA: Malaysia wants to reserve the right to import any patented drug and also wants the right to produce it locally if it is in the national interest or use it for natural disasters or non-profit purposes.
Health Minister Datuk Seri Dr Chua Soi Lek said Malaysia reserved the right to compulsory licensing under the Patent Act.
“We want to exercise our rights if a certain drug is important to us,” he said after presenting Pharmaniaga's Excellence Vendors Awards 2006.
The right to compulsory licensing is among the topics of discussions in the Free Trade Agreement talks with the United States.
Dr Chua said drug prices would not be affected through the country's exercising of its rights but it would give intellectual property protection to the local industry.
He cited the mostly patented anti-retroviral drugs for HIV/AIDS patients as an example.
He said Malaysia started importing the drugs from India in 2004 and managed to bring down prices from RM1,200 per month for a patient to RM200. The price has since been brought down further to RM150 a month as the drugs were now produced in Malaysia.
Dr Chua also rejected a US request that patents for diagnostic, therapeutic and surgical procedures for humans and animals should be granted.
“A procedure should not be patented. If it is patented by a doctor, then other doctors cannot use the same method,” he said.
He said Malaysia would allow data exclusivity (DE) for pharmaceutical products for five years from the same date as in the country of origin and that the decision to give DE was under the purview of the Drug Regulatory Authority.
The minister said that no DE would be given to pharmaceutical companies that merely changed the strength of dosage of a product or how it was presented.
However, DE would be given for a new indication of a known product.
DE happens when a company creates a new product and has to submit all information to the ministry's Drug Regulatory Authority in order to market it. The data then becomes exclusive rights of that company.

Malaysians rank sixth fastest in love-making

NST: KUALA LUMPUR: Malaysians spend an average of 19.9 minutes when they make love.
Hardly the stuff romance novels are made of, they ranked sixth quickest in the world in terms of time spent in a love-making session.
However, if it’s any consolation, the average time spent is above the global average of 18.3 minutes.
India’s lovers were the world’s quickest, spending only 13.2 minutes per session.
Nigeria once again topped the ranking on a leisurely 23 minutes.
Singapore, Hong Kong, Japan, Thailand and Australia were all well below the world average time.
Malaysians were just a heartbeat ahead of China’s lovers who took 20 minutes.
This was the findings from the "Global Sexual Wellbeing Survey" by condom-maker Durex. It was revealed at the ongoing World Congress on Sexual Health in Sydney, Australia.
More than 26,000 people from 26 countries were screened online by global research firm Harris Interactive from August to September last year.
Durex’s local distributor SSL Healthcare Malaysia general manager Voong King Yee said sex played a fundamental role in the physical and emotional well-being of a person.
The survey found two in five (or 38 per cent) of the 1,026 Malaysians polled were fully satisfied with their sex lives.
Forty per cent of Malaysian women were completely satisfied compared with 37 per cent of their male counterparts.
Want to know how you can spice things up?
"Seven in 10 (74 per cent) of the Malaysians surveyed said the situation could be remedied by injecting some old-fashioned love, tenderness, adventure and romance.
"Two-thirds (64 per cent) like more intimacy and better communication with their partners," said Voong.
Even in the "country of romance", France, they do not get it right all the time. Only 25 per cent said they were satisfied with their sex lives.
Nigerians, on the other hand, know something others don’t. They have the most people (67 per cent) satisfied with their sex lives, followed by Mexicans (63 per cent) and Indians (61 per cent).
The survey found that Malaysians have sex 115 times a year compared with the global average of 103.
The Greeks made an Olympian effort of 164 times, with Brazilians the next most amorous at 145, followed by the Poles and Russians (both 143) and Indians with 130.
The survey also found that Asians were least satisfied with their sex lives.
Australia’s Bond University sex expert Gabrielle Morrissey said it reflected cultural issues relating to sex in Asia. "Work is more important than sex in many Asian countries."

Few Malaysians satisfied with their sex life

Star: KUALA LUMPUR: Although most Malaysians agree that sex is important, fewer than two in five (38%) of them are satisfied with their sex lives.
According to the latest Durex Sexual Wellbeing Global Survey 2007/08 report, loss of romance and sexual prowess are key factors for the lack of sexual satisfaction.
SSL Healthcare Malaysia general manager Voong King Yee said: “Many Malaysians have lost the sense of adventure, interest and romance, which explains why they are not fully enjoying their sex lives.
“Sex plays a fundamental role in our physical and emotional well-being. Thus, it is important that we protect and nurture our sexual health as well as that of our partner's,” he said, adding that 64% of Malaysians would like more intimacy and better communication with their partners.
The survey was conducted on more than 26,000 respondents across 26 countries, of which 1,026 were Malaysians.
The respondents were asked about every aspect of their sex lives. covering health, general well-being, education, beliefs, attitudes to sex, and social circumstances, in a bid to comprehensively chart what constitutes sexual well-being.
Consultant clinical andrologist, reproductive and sexual health specialist and Durex Sexual Wellbeing Global Survey local expert Dr Mohd Ismail Mohd Tambi said: “There are reasons why people are not satisfied with their sex lives. It could be due to problems in physical and emotional health as well as physiological issues such as vaginal dryness, painful sex, and erectile dysfunction.”
“Such issues can be dealt with and cured. Despite sex being perceived as fun and exciting by most, satisfaction is still only marginally equal between men and women, with 40% of Malaysian women saying they are satisfied, compared to 37% of men,” said Dr Ismail.
He pointed out that people could also improve their sex lives and sexual satisfaction by spending more time with their partners, de-stressing and introducing more romance into their sex lives.
“The ability to talk things out with your partner can lead to an emotional relationship filled with love and respect, which can then lead to ultimate sexual pleasure.

Housewife gave birth to only one baby, says dept

NST: KUALA LUMPUR: There is no second baby. And this is final.
Selangor Health department, after conducting an investigation into the alleged missing baby at the Sungai Buloh Hospital, said the complainant was not expecting twins as she had alleged.
"In fact, the woman was told many times before delivery that she was expecting one baby," said department director Dr Ang Kim Teng.
Dr Ang was commenting on the complaint lodged by housewife S. Aruputhamalar, 37, and her husband, P. Selvanayagam, 46, who claimed one of their twins was missing.
The couple had alleged that they were told by hospital authorities that Aruputhamalar was expecting twins.
They told a press conference on Monday that ultrasound tests confirmed she was expecting twins.
But after she delivered last month through Caesarean section, Aruputhamalar was told that she had given birth to a healthy baby girl.
Dr Ang said the hospital authorities had many times explained the situation to the couple.
"There is no second baby. Doctors had told them many times that only one baby was born. We will be preparing a report on the matter for the Health Ministry," she said.
When asked if there could have been a problem with the ultrasound, Ang declined to comment.
"We will wait until we have submitted the report."
Aruputhamalar and her husband took the matter to the MCA Public Services and Complaints Department. They also lodged a police report on Monday.
Aruputhamalar and her husband, a lorry driver, have three other children between the ages of 4 and 11.
Gombak police chief ACP Mohd Abdullah said foul play had been ruled out.
"There was no second baby," he said.
"They may have misunderstood what the doctors told them. There may have been problems with the ultrasound. Based on the explanation provided by doctors, we are certain that she gave birth to one baby."

IJN Performs First Complex Cardiac Surgery On Premature Infant

KUALA LUMPUR, April 17 (Bernama) -- The National Heart Institute (IJN) accomplished another milestone in cardiac surgery when it successfully performed the complex procedure on a premature infant on April 5.
Datuk Dr Azhari Yakub, who led the team of cardiothoracic surgeons, performed the surgery on Ong Yee Ling, who was born premature at 34 weeks via caesarean section at the Kuala Lumpur Hospital (KLH) on Feb 3. She was referred to IJN on Feb 14.
"Yee Ling was diagnosed to have type A interrupted arch with Ventricular Septal Defect (VSD), and underwent surgery to repair the interrupted arch and closure of VSD on April 5 and is currently in the Intensive Care Unit (ICU) with stable haemodynamics and is being treated for lung infection," he told a news conference here today.
"The success of this surgery means a lot to us and IJN, especially because it's quite a hard task to do surgery on a very small baby and that is the challenge," he said.
Dr Azhari said that during the 66-minute surgery, doctor had to cool down the patient with very low temperature of about 16 degrees and stop the blood circulation to the whole body, including the brain, for about 14 minutes.
"Within that time, the doctors managed to join up the lower and upper parts of the atria," he said, adding that the success showed that IJN had the capacity to deal with similar cases in future.
Meanwhile, Yee Ling's mother, Yap Soh Theng, 25, told reporters that five days after Yee Ling, her first child, was born she was informed that she had a hole in the heart.
Doctors at KLH referred Yee Ling to IJN and she was admitted on March 19 for surgery.
"Initially, I was afraid when I learnt of my baby's condition, especially when she was born premature," she said.
"I'm now relieved and happy with my baby's condition and I thank all the doctors who treated her." said Yap who had to quit her job as a clerk with a private company here to look after Yee Ling.
"The doctors said that Yee Ling can be discharged in a week or two depending on her condition," she added.

Here’s a new manual on how to treat the heart

NST: KUALA LUMPUR: A total of 40,000 patients died of heart diseases in public hospitals last year.
This represents 15.5 per cent of the total deaths in public hospitals.
"By 2010, cardiovascular disease is projected to be the leading cause of death in developing countries. It will be a huge challenge as clinical care is costly and prolonged," said Health Ministry medical division deputy director-general Datuk Dr Noorimi Morad.
She was speaking at the launch of the revised clinical practice guidelines (CPG) on heart attack and heart failure, released by the ministry and the Academy of Medicine on Friday.
The two bodies had worked on the revised guidelines together with the National Heart Association of Malaysia (NHAM).
The CPG was launched at the 11th National Heart Association of Malaysia Annual Scientific Meeting 2007.
Dr Noorimi said the meeting’s theme, "Cardiovascular Prevention: Targeting Today’s Goal", was appropriate as the number of smokers, linked to cardiac complications, was on the rise.
"Many of those diagnosed with cardiac problems are between the ages of 30 and 40. This group represents those at their productive peak. Their contribution to their family and the country is essential.
"Some are actually well informed and aware of the diseases but the problem is they fail to adopt a healthy lifestyle until it is too late."
Dr Noorimi said the ministry planned to set up cardiology centres in Alor Star, Ipoh, Kuantan and Kota Kinabalu by the end of the Ninth Malaysia Plan. Currently, there are 35 centres throughout the country.
The chairman of the committee on CPG for heart failure, Datuk Seri Dr Robaayah Zambahari, said the CPG helped in the management of patients and decision-making as treatments should be tailored to an individual.
"Healthcare personnel should be trained to treat cardiac patients properly while hospitals should develop management strategies to maximise treatment benefits."
She added the committee was also working on another CPG on the management of women’s diseases, considered another neglected area.
The revised CPG on the management of heart attack comes in two versions — a pocket edition for doctors to slip into their gown pockets and a larger one for the ministry.
Dr Jeyamalar Rajadurai, a committee member of the CPG for heart failure, said the prognosis for heart failure was worse than for some cancers.
"In a large community-based study, about 40 per cent of those with heart failure died within a year of initial diagnosis. About half of all deaths were sudden."
Prof Dr Sim Kui Hian, another committee member, said the guideline revision was in tandem with current research and findings.
"The CPG is widely circulated in various clinical institutions and will be used by specialists and practitioners as well as paramedics nationwide."

Number of women smokers has doubled to 480,000

Star: PENANG: The number of women in the country who have taken up smoking has doubled in recent years.
Health Ministry parliamentary secretary Datuk Lee Kah Choon said 8% of the estimated six million smokers were women – which comes up to 480,000.
“This may not seem much, but several years ago women only made up of 4% of the nation’s smokers,” he said.
Lee said the ministry would continue with its efforts to discourage smoking, including controlling and analysing the market and creating awareness through its Tak Nak campaign.
“The price of a pack of 20 sticks of cigarettes is now RM7.40 compared with RM7 before the last Budget. According to a World Bank report several years ago, raising the price of cigarettes by 10% would bring about a reduction of 4% to 8% in sales.
“Other steps we have taken include banning the sale of loose cigarettes and small packs of eight, 10 and 12 sticks,” he said.
Lee said the Government was now formulating a Tobacco Products Act and that once it comes into force additional measures can be taken.
These include having images of damaged lungs on packets, registering cigarette factories and manufacturers, and stepping up checks to ensure that nicotine and tar content did not exceed permissible levels.

Worrying trend as charity turns big business

Star: KUALA LUMPUR: Fund-raising for charity has turned into a booming business, with huge chunks of public donations ending up in the pockets of people who least need help.
These days, professional fund-raisers team up with charitable bodies and non-governmental organisations (NGOs) – all in the name of charity – and split the collections.
There are private firms offering management or marketing services to raise funds on behalf of NGOs who only seem all too happy to “pass the buck” to these “professionals.”
For example, if a particular charity home needed RM10,000 a month to sustain itself, then the order to the firm would be for it to raise at least RM20,000.
This was the deal involving one home for children with special needs and a professional fund-raiser, which had been handed a six-month collection “contract”.
What makes it more lucrative is that, apart from certain guidelines, there seems to be no written laws governing the way funds can be raised.
It could be through the sale of greeting cards, car stickers, badges or cookies, or even via organising huge fund-raising events.
Many of these charitable bodies raise funds in the name of the terminally-ill, those afflicted with chronic diseases and the handicapped.
But such collaborations are bad practices as far as Health Ministry parliamentary secretary Datuk Lee Kah Choon is concerned.
Urging the people to donate wisely, he said private firms which raised charity for a profit should be exposed.
He had also turned down people who approached him for such collaborations.
Women, Family and Community Development Ministry parliamentary secretary Datin Paduka Chew Mei Fun said she was aware that several NGOs registered under her ministry had engaged professional fund-raisers.
She affirmed that there were no laws to regulate such fund-raising but said the NGOs registered under the ministry which wanted to raise funds for charity could seek a letter of verification.
“However, such letters will not be issued to professional fund-raisers,” she added.
Deputy Internal Security Minister Datuk Fu Ah Kiow said those soliciting donations from door to door needed a police permit to do so.
“However, to me, getting a cut from charity does not make sense, besides short-changing the donors.”
Deputy Culture, Arts and Heritage Minister Datuk Wong Kam Hoong summed it up this way: “Charity is no longer a culture of sharing and caring for the needy, once the cause is commercialised.”
Calling for laws to check fund-raising, Wong, an accountant by training, said it should be made mandatory for NGOs and fund-raisers to reveal the breakdown of monies collected.

Health Ministry's Latest Guidelines On Treatment Of Heart Disease

KUALA LUMPUR, April 13 (Bernama) -- The Health Ministry today announced two sets of latest Clinical Practice Guidelines (CPG) for the treatment of heart attack and heart failure to ensure that patients are attended to according to the latest standards.
Deputy Director-General of Health Datuk Dr Noorimi Morad said the CPG for treatment of heart failure and acute ST segment elevation myocardial infarction (STEMI) or heart attack would be distributed to cardiologists and relevant specialists in the field as well as general practitioners and families.
There was a need to continue with current campaigns and seek ways to ensure that the target groups understood the CPG and applied them, she told a media conference after launching the CPG in conjunction with the 11th annual scientific conference by the National Heart Association of Malaysia (NHAM).
"What is necessary in Malaysia is to handle cardiovascular problems with the involvement of the doctor to ensure that the patients are accorded good treatment and the ailment is controlled to prevent complications," she said.
"The awareness among the people in the country about cardiovascular diseases is rising. However, despite the awareness, the practice of a healthy lifestyle is most lacking among those who know the risks of smoking and consumption of certain foods," she said.
Dr Norimi said the Health Education Unit took measures through advertisements and a media campaign to ensure that the health message was conveyed better, with more relevance and in an easily understandable manner.
"Besides, we are also striving to train -- apart from doctors -- a number of personnel of the associated groups such as nurses and medical assistants to get involved in preventive activities including counselling," she said.
She said that cardiovascular diseases, which had the fifth highest number of patients in hospital and the second highest number of deaths among diseases, could cause the cost of medicine to rise if left uncontrolled.
So far, the ministry had borne RM800 million in cost of medicines for all types of disease at the 134 government hospitals, she said.
"If the No. 1 killer such as cardiovascular disease is not controlled, the cost of medicines could exceed RM1 billion," she said.
Cardiovascular-related diseases were the cause of 20 per cent to 25 per cent of the deaths in government hospitals between 2000 and 2005 while heart failure was the cause of about 10 per cent of hospital admissions in the country, with 45 per cent of the patients getting readmitted to hospital at least once in 12 months.

Needle Exchange Program For Addicts To Be Expanded

KUALA LUMPUR, April 12 (Bernama) -- The Syringe Needle Exchange Program for drug addicts which was carried out on a pilot project in Kuala Lumpur, Penang and Johor since February last year would be extended to Kuantan in Pahang, Kota Baharu in Kelantan and Alor Setar in Kedah this year.
Health Ministry Parliamentary Secretary Lee Kah Choon told the Dewan Rakyat today that 3,000 addicts were targeted for the program this year.
"Currently, the selection of a non-governmental body (NGO) as the program implementer is being carried out," he said when replying to Abdul Fatah Harun (PAS-Rantau Panjang).
He said the program aimed to eliminate or reduce the risk of infectious diseases such as the HIV, Hepatitis B and Hepatitis C being spread among addicts.
He said the pilot project carried out in Chow Kit in Kuala Lumpur, Jelutong in Penang and Ngee Heng in Johor last year involved 1,380 addicts using syringe needles and was run by the Malaysian Aids Prevention Foundation.
"Thirty-seven percent of the program participants received clean needles once a month as replacement for the ones which have been used or contaminated," he said.
On the supply of free condoms to those with high risk of being infected with HIV/Aids which was raised by Abdul Fatah in a supplementary question, Lee said it should not be perceived as encouraging adultery because efforts at preventing HIV and Aids from spreading to the loved ones were more important.
Meanwhile, Deputy Minister of Internal Security Datuk Mohd Johari Baharum said 22,811 drug addicts were detected throughout last year, a decline of 30.47 percent from 2005.
Of the 22,811 addicts recorded by the National Drugs Information System (Nadi), 10,381 were new addicts while 12,430 were repeat addicts, he said replying to Datuk Bung Moktar Radin (BN-Kinabatangan).

UM To Start Masters In Nursing Science In July

KUALA LUMPUR, April 9 (Bernama) -- In an effort to upgrade the standard of nursing in the country, the University of Malaya (UM) will begin a masters in nursing science programme with the first batch of 16 students to be enrolled in July.
UM Department of Allied Health Sciences' Nursing Science Unit head Prof Rohani Arshad said four of the students enrolling for the two-year programme were from overseas.
He said although the course was approved by the Higher Education Ministry in June last year, it had poor response from nursing science graduates initially due to poor publicity.
"The clinical course entails course work in the first year followed by practical and research work the following year under the supervision of seven lecturers," she told Bernama.
Rohani said UM which started a bachelor in nursing science course in 1992 would be the first local university to offer the masters in nursing science.
To date, UM has produced 379 nursing science graduates, of which 20 per cent were men.
Besides UM, the nursing science degree is offered at Universiti Kebangsaan Malaysia, Universiti Putra Malaysia, Universiti Sains Malaysia, Universiti Malaysia Sarawak, Universiti Islam Antarabangsa Malaysia and Universiti Teknologi Malaysia.

Integrated Approach Rather Than Tax Hike To Deter Smokers

ALOR GAJAH, April 8 (Bernama) -- An integrated approach is needed to curb smoking habits among the public instead of merely imposing sales tax on cigarettes, said Health Minister Datuk Seri Dr Chua Soi Lek.
He said although numerous studies had shown that when the price of cigarettes was raised significantly, there would be a drop in demand, it would also encourage cigarette smuggling.
"This (raising the price of cigarettes) is not a simple matter, in the past, the price of hard drinks was raised from RM3 to RM12, yet the people still consumed such drinks," he told reporters after visiting the Public Health Campaign organised by the Health Ministry at Machap Umboo, here tonight.
Dr Chua said this when asked to comment on the press report today that two consumer associations had urged the government to impose a higher sales tax so that a pack of 20 cigarettes would cost at least RM10.
The Malaysian Muslim Consumers Association (PPIM) and the Federation of Malaysian Consumer Associations (FOMCA) believed that increasing the sales tax could prevent the multinational cigarette companies from reducing cigarette prices arbitrarily.
Dr Chua said it was estimated that 30 per cent of the cigarettes sold in Sabah were smuggled cigarettes.
The minister reminded smokers that there was no reason for them to smoke because each year, 10,000 people died of diseases related to cigarette smoking.

Businessmen using docs as proxies to open clinics

Star: PUTRAJAYA: The private healthcare business has become so commercialised that even businessmen are setting up clinics to reap profits.
It has come to a stage where they are also hiring unregistered doctors and mere medical assistants to man the clinics, which usually operate round-the-clock.
Concerned doctors and patients have alerted the Health Ministry, which has acted by conducting raids on clinics.
So far, one such clinic operator in Shah Alam is awaiting trial, while five cases – two each in Selangor and Johor and one in Negri Sembilan – are being investigated.
Many other clinics are under watch, including those in Sabah and Sarawak.
Health Ministry Medical Practice Division director Dr Mohd Khairi Yakub, who confirmed that more raids were being planned, said businessmen were using doctors as proxies to register clinics.
This contravened the Private Healthcare Facilities and Services Act 1998, which clearly stipulated that only qualified doctors can set up clinics.
“Some of these businessmen have even opened a chain of clinics,” he said in an interview.
Dr Mohd Khairi said the “proxy” doctors in clinics where non-medical practitioners operated should realise that they were also guilty, as their names were used to register the clinics.
“The unscrupulous businessmen might get off scot-free as the law is silent on their participation in the business,” he added.
Last month, Health Ministry director-general Tan Sri Dr Ismail Merican warned that clinic operators would be held liable if they employed those unqualified to treat patients.
This followed a report that a medical assistant at a government clinic in Johor Baru had been moonlighting as a locum, earning about RM40 an hour in private clinics.
He was arrested after allegedly having molested a housewife.
Dr Ismail then reminded doctors to display their annual practising certificates at clinics so that patients would not doubt their status as qualified medical personnel registered with the Malaysian Medical Council.
However, this advice seems to have gone unheeded, as checks by The Star at clinics in Puchong and Petaling Jaya on Friday night revealed.
At the Puchong clinic, there were rows of patients waiting to be treated, all seemingly unaware of the concerns being expressed on the way some clinics were managed.
When our reporter identified herself and asked the clinic assistant for the doctor's medical practitioner’s certificate, the doctor appeared to say that the “owner of the clinic” was keeping it.
“But I can produce a copy of my certificate which is in my car,” he said.
Asked why he had not displayed the certificate in the clinic as required, the doctor said it was not his duty to do so as he had given copies of his documents to the “owner.”
“I do not display my certificate at this clinic or any of the other clinics (I work in) as I am paid on an hourly basis.
“It is impractical to do so but I carry a copy of the certificate wherever I go just in case enforcement officers turn up,” he explained.
The doctor said there was a lack of enforcement by the ministry, citing as an example a nearby clinic which had been run by a bogus doctor for years.
He said the matter came to light when a doctor who was ill went to the clinic for treatment.
He called on ministry enforcement officers to act without fear or favour to weed out the menace.
At the clinic in Petaling Jaya, the doctor in attendance, who claimed to be a locum, was dressed in jeans and slippers.
He was not very keen to take a blood pressure reading, saying “the young should not be worried.”
His actual “status” remains a mystery.

Emergency care system to be revamped

NST: The country’s emergency care system, particularly the ambulance services, will be revamped soon to make it more efficient.
Health Department director-general Tan Sri Dr Ismail Merican said the existing fleet of ambulances would be expanded and a more stringent procedure introduced in selecting drivers.
"We will train them on pre-hospital care to enable them to attend to patients on-site before sending them to hospitals.
"We are also looking at many other things which can be done to improve our emergency care system," he said after opening a conference on infectious diseases yesterday.
Other measures include the setting up of motorcycle squads and call response centres nationwide.
The three-day conference, which ends tomorrow, was jointly organised by the local branch of the Malaysian Medical Association and the state Health Department.
Dr Ismail’s comments come in the wake of allegations by a factory engineer against the Kepala Batas Hospital’s ambulance service.
Ghafur Mohd Ibrahim, 37, filed a RM1 million suit against the hospital accusing it of gross negligence in the death of his wife, whom he claimed had died due to a delay in getting treatment because the hospital’s ambulances had run out of petrol.
Dr Ismail, who refused to be dragged into the controversy, described the incident as an isolated case.
After a visit to Penang Hospital later, Dr Ismail said the retirement age of doctors working at public hospitals would be raised to 58 soon.
He said the move is aimed at retaining the services of experienced doctors.

Cigarette war has Chua fuming

Star: MALACCA: There is a price war among cigarette companies, and the Health Ministry is smoking with fury.
“The price war must stop. The companies have slashed their prices to unreasonable levels to attract smokers,” said minister Datuk Seri Dr Chua Soi Lek.
He gave them two weeks to stop the “war” or said the ministry would intervene by setting a minimum price.
The price war has indirectly made cigarettes cheaper despite the annual duty increase, as manufacturers are willing to cut prices and offer attractive packaging to lure the young to boost sales.
“Smokers can buy a packet of 20 cigarettes for about RM3,” Dr Chua said when visiting the Machap Baru health clinic here yesterday.
He lamented that the price war had hampered the Government’s effort to discourage smoking.
Tobacco manufacturers and importers needed to register with the ministry so that the Government could easily monitor them, he said, adding that the ministry met tobacco company representatives here yesterday, including those from Philip Morris, British American Tobacco and JT International Bhd.
Dr Chua said the companies had asked that the graphic warning be reduced to less than 50% on cigarette packs, while the Government had suggested the image be set at 60% of the package.
He added that a final decision on the matter had yet to be made.

Meanwhile, the ministry will start a pilot project by mid-year to promote healthy eating habits among primary schoolchildren.
Four schools each from Kuala Lumpur, Penang, Malacca and Putrajaya would be involved in the Healthy School Campaign project, reports LOH FOON FONG.
The Health and Education ministries had agreed that the school canteen was the best place to inculcate good eating habits.
Speaking to reporters in Kuala Lumpur on Thursday, Dr Chua said: “We will come up with dietary guidelines and recommend food that schools can prepare.”
He said food operators have agreed to use a logo depicting Healthy Choice for food with reduced fat, sugar and salt content and his ministry would carry out checks on set standards.
Regarding his recent suggestion on fast food advertisement, Dr Chua said the ministry would go ahead and ban such advertisements. The proposal would be ready in a week for the Cabinet.
“We decided to ban fast food advertisements, not the food. Sellers of nasi lemak or bak kut teh do not advertise.
“We don’t want our children to be influenced by bad eating habits,” he said.

Health officers to go undercover to nab medicine peddlers

Star: PENANG: Roadside “doctors” and traditional medicine outlet operators who sell prohibited medicines and slimming pills may soon run into the wrong customers.
Health officers will be going undercover to nab them.
Health Ministry director-general Tan Sri Dr Mohd Ismail Merican said yesterday the ministry would step up its enforcement because it continued to receive complaints that medicines containing prohibited chemicals were still available on the streets.
“The sale of such medicines still exists because there is a market for medicines like slimming pills.
“The public must realise that there is no short cut to treating their ailments or even to lose weight,” he told reporters after opening the Conference on Infectious Diseases at the Bayview Beach Resort yesterday.
Dr Mohd Ismail said the ministry would also step up campaigns to create awareness among the public on the need to be wary of such prohibited medicines and control advertisements on traditional medicines.
“The Medicine Advertisement Board will strictly vet these advertisements,” he said.
Dr Mohd Ismail also said that the ministry was training more experts under the government’s Avian and Pandemic Influenza Preparedness Plans to ensure efficient and coordinated response in case of a pandemic.
“We now have only 20 experts in the health sector and other related government sectors like the police and Fire and Rescue Department trained to respond quickly to the threat of an infectious disease,” he added.
In his speech, Dr Mohd Ismail said dramatic changes in society, technology and the environment had resulted in many infectious diseases, once thought to be controlled, to re-emerge.
He urged general practitioners and those in the health industry to have their “tentacles” ready to identify any patterns of disease in the country.
The three-day conference was organised by the Malaysian Medical Association.

Gullible Public Fuelling Sale Of So-called Medicinal Products

PENANG, April 6 (Bernama) -- The Health Ministry is unable to control so-called medicinal products sold on the street, promising beauty and health to their users, as long as members of the public are gullible enough to fall for such deception.
Health director-general Tan Sri Dr Mohd Ismail Merican said unscrupulous parties would continue to market these products if people chose to ignore the ministry's advice.
"It's not easy to control such merchandise although we have time and again explained that these products are dangerous and may be lethal," he told reporters after opening a conference on contagious diseases organised by the Malaysian Medical Association's Penang branch here Friday.
He said the ministry had never endorsed the sale of such items as they had not been backed by any clinical evidence.
"For this reason, people who consume these medicines may come down with various illnesses that can kill them," he said.
Mohd Ismail said those wishing for an attractive face and a slim body would need to take care of their diet and exercise regularly as only a healthy lifestyle could ensure their well-being.
He said that people who were obese should seek treatment in hospitals as medical prescriptions were issued under strict supervision there.
Noting that the ministry would intensify public awareness campaign so that people were wary of dubious medicinal products, he said that all advertisements pertaining to medicine should carry the ministry's advertisement board permit.
Without such a permit, the media can't carry the advertisements concerned.

Many becoming doctors for wrong reasons

Brunei Times: WITH his quick mind and love of puzzles, the medical genius works through an unconventional medical testing and symptom elimination process, aided by his shrewd, instinctive understanding of human nature, to diagnose a patient's condition.
His success rate is high, amazingly so, although his bedside manner is practically non-existent. Meet Dr Gregory House, of the medical drama House, currently one of the most popular TV doctors around.
He is also one of the popular medical myths misleading students about the profession.
"The lack of communication skills is the biggest complaint against local doctors," says Malaysian Medical Council member Prof Dr Zabidi Azhar. "You need to like people and have a caring character, as well as be able to communicate well."
Another myth, he adds, is that to excel in medicine, one would need straight As. "It is true that you need to have some brains to be a good doctor but the fact is, a flat four CGPA (cumulative grade point average) does not make a good doctor."
However, given the growing number of students with a 4.0 CGPA, the admission process into medical school has become an annual circus. It does not help that some students even treat studying medicine as their god-given choice.
Malaysian Medical Association branch chairman Dr Kuljit Singh is another who is of the opinion that exam results may not help medical students.
"Many of those who score a 4.0 CGPA are result-oriented. But are they good when dealing with patients?
"Except for the few who are all-rounded students, many do not have interpersonal skills. To be a doctor, you are required to deal with emotions and feelings; patients are not machines."
For a final-year student who only wants to be known as David, the lesson has been slow but well-learned: "I came into the programme with the idea that all I have to do to succeed is to slog but now I've come to realise that it is only half of it.
"The most important thing is to develop good people skills. You need to communicate well. And you need to want to help people."
Students have to know what they are really interested in and why they want to do medicine, says Universiti Kebangsaan Malaysia medical faculty dean Prof Datuk Dr Lokman Saim.
"For example, is it because they want to help cure people or because they like learning about diseases? If they are interested in diseases, maybe they are better suited to medical labs, not to hospitals."
For a fifth-year medical student who only wants to be known as Amira, medicine was not her first choice.
Although she has not had trouble coping with her studies, she admits that she has had to motivate herself to learn things:
"I was more interested in pharmacy but my parents advised me to take up medicine. When I first started my medical course, it was difficult because I was not that interested.
"I advise those thinking about it to really examine if they have a passion for medicine before enrolling."
Medical academics concur that interest or passion is a matter not to be taken lightly.
According to cardiologist Dr Ong Hean Teik, who wrote The Life of a Doctor, a guide for prospective students and their parents, those doing medicine for other people usually don't make good doctors and are depriving the ones who are truly interested of a place in medical school.
Universiti Putra Malaysia medical health sciences faculty dean Prof Dr Azhar Md Zain agrees: "The best doctors are those who are really keen on the vocation, not those who are in it for reasons they are imagining or not clear of.
"It is a tough job being a medical student and then a doctor. It also does not pay as well as other vocations if you compare head to head.
"So, only true believers in the profession, and those with love for the sick people with the right attitude and minds will succeed. Those who lack this will not do well. They will get through but cause heartache to themselves, their families and their patients."
Dr Leticia W, who graduated recently, advises prospective medical students to take up something else if they cannot tell themselves honestly why they want to do medicine.
"It's a calling. If you are pursuing it under another person's influence, or because of other superficial reasons, you are better off pursuing something else," she says, adding that one does not need lofty aspirations to be a doctor.
"You don't have to be driven by dreams of saving mankind or finding a cure for cancer.
"Years of medical school have taught me that you need to be grounded to be a good doctor it is hard work and sometimes unrewarding. Other times, it takes small things to make it worthwhile, like getting a relieved look, a smile or simple 'thank you' from patients after you have allayed their fears by simply talking to them or just listening to their worries."
The Star/Asia News Network

To Russia with hope

NST: KUALA LUMPUR: Are Malaysians flying in droves to Moscow for surgery to enlarge their penises?
A posting on a Malaysian medical blog has created ripples within the medical fraternity by announcing that such surgery has increased the length of a man’s penis from two inches to seven inches.
According to "palmdoc" who made the posting on Malaysia Medical Resources, a medical blog, "news of the pioneering surgery on a man born with genitals so small that he was unable to have sex had reached Malaysian shores".
But there is more in the posting to interest Malaysians: Apparently, the operation involved amputating the penis, growing it on the forearm and then returning the enhanced organ to its original place.
"In an 11-hour operation, plastic surgeons in Moscow removed the 28-year-old’s undersized penis and stitched it on to his left forearm, where they grafted on additional flesh and tissue taken from his inner arm," he quoted an article in the Telegraph of London as saying.
Palmdoc had said that travel agents were reportedly making brisk sales in tickets to Moscow after Malaysians came to know about the surgery.
But the posting did not explain the sudden interest among Malaysians despite the fact that the operation took place in 2005.
In a later posting, he said that while it could not be confirmed that thousands of Malaysians were travelling to Russia for the surgery, it was true that the 2005 operation had taken place.
While the fact that Malaysians are making their presence felt in Moscow may be open to debate, the operation itself is a fact.
According to the Telegraph, Professor Mikhail Sokolshchik, of the Russian National Medical Surgical Centre, hoped that the patient would eventually be able to have sexual relations and father children.
Nick Holdsworth, its correspondent in Moscow, had written that the patient had paid more than £1,000 (RM6,800) towards the cost of the operation after being warned that the operation was at his own risk.
"The bulk of the cost, however, was borne by the clinic, which hopes to market the procedure to similarly afflicted men around the world."

In an immediate reaction, Malaysian urologists advised against the operation as the risks far outweighed the gains.
University Malaya Medical Centre Faculty of Medicine Department of Surgery head Prof Dr Azad Hassan A. Razack said only very few Malaysians would need such surgery which was for people born with an abnormally small penis.
He said only one man had the surgery so far with details of the case yet to be published.
"Wait for more cases and longer term results to get full evidence to prove it works," he said.
Dr Azad, a consultant urologist, said some men felt that the penis was small due to something called the "Locker Room Syndrome" where men tended to compare sizes of the penis when undressing to go swimming.
"Men feel their penises are small when they look from the top but in actual fact they are bigger if seen from the side or front.
"That is why they always feel that the other person’s is bigger and this makes them feel anxious and inferior.
"Most of the time it is not a problem. As long as they can have a normal sexual life, it is not problem," he added.
Dr Azad advised men who felt their penis was small to seek the advice of their urologist "before undertaking expensive and risky procedures".
Asked on the risk factors, he said, the surgery could cause damage to a normal penis.
"The nerves can be affected especially transferring organs and most of the time they look at the blood vessels. The nerve sensation can decrease. If anything goes wrong, for example the blood vessels, it can result in complications."
He said interruption to the blood flow to the penis due to blood vessel narrowing or other reasons could damage the penis which could result in a person not being able to have sex.
"Worried about your penis size? See a urologist. Most of the time its psychological rather than a physical problem," said Dr Azad who is also the honorary secretary of the Malaysian Urological Association.
He said the issue would be raised in the association’s forthcoming meeting.
Dr Azad said such surgery could be performed on a patient who had a damaged penis due to self-mutilation, accidents or cancer.

UMMC Associate Prof Dr Stephen Jambunathan, a consultant psychiatrist, said people undertook such surgeries for various reasons including emphasis on sexual activity and lack of awareness of medical conditions that caused erectile dysfunction.
"They go and do an enlargement for the wrong reasons. People should do so for pure practical needs such as organ abnormality."
He advised Malaysians who wanted to go for such major operations to go for a psychological assessment so that they could be assessed as to whether they were doing it for the right reasons.
The test will also ascertain if they are prepared for the surgery and its consequences.
Dr Jambunathan said people must be made aware of the long-term physical and psychological effects of such operations.

Chua: Have a heart

Star: KUALA LUMPUR: The Health Ministry is appealing to private hospitals to give affordable heart surgery – at a minimal rate – to the poor.
If they will not do it, the ministry will look at the provisions in the Private Healthcare Facilities And Services (PHFS) Act and Regulations to see if it has the power to direct the hospitals to carry out this “social responsibility.”
Minister Datuk Seri Dr Chua Soi Lek said the demand for heart surgery in Malaysia is high but the waiting time at government hospitals was two to six months.
“The Government has not been able to meet all the needs and understands the hardship,” he told reporters after opening a gathering of the Asia Pacific Obesity Conclave and the Malaysian Association for the Study of Obesity here yesterday.
Dr Chua, who recently visited the Narayana Hrudayalaya Institute of Cardiac Sciences in Bangalore, said each private hospital in Malaysia could do two or three surgeries in a year.
He added that the ministry had discussed with the institute's world-renowned director, Dr Devi Shetty, to accept patients from Malaysia at a minimal rate.
The hospital has treated 14 Malaysians.
“We either need to arrange for the poor to be treated in Bangalore at a minimum rate or at a private hospital that has the facilities to offer the service,” he said.
Commenting on Dr Chua's remarks, Association of Private Hospitals Malaysia (APHM) vice-president Datuk Teddric Mohr said some hospitals were already providing services for the poor.
He said the APHM had been collecting data since February from member hospitals on how much medical service they had given to the poor and how much more they could give.
He hoped the data collection would be completed in a couple of months.
Asked if two or three heart surgeries a year was a reasonable number, he said they need to first compile the data before giving an opinion on this.
He added that while the ministry may be under pressure to meet the needs of the nation and wishes to apply the PHCFS Act, it has to also look into the affordability and capacity of each hospital.
Federation of Private Medical Practitioners’ Association of Malaysia president Dr Steven Chow said the federation supports the minister's call.
However, he added, acts of charity for deserving cases should be made on a voluntary basis rather than by invoking the PHCFS Act.

Students can postpone their return

NST: PUTRAJAYA: Government-sponsored students are now allowed to postpone their return upon completing their studies.
Public Service Department director-general Tan Sri Ismail Adam said stiff competition in getting jobs here prompted the decision.
He said the decision to allow students to stay and seek employment after completing their studies abroad would help them acquire specialisation in their career and broaden their knowledge and perspective.
In a circular dated March 30, Ismail said the decision affected government-sponsored students awarded scholarships who had to serve the government after completing their studies, and students given study loans who did not have to join the civil service.
"However, this does not include courses where students’ services are urgently needed, and those who are necessary to ensure the delivery service is not affected."
Medical, dentistry and pharmacy students either on scholarship or loan must return to do housemanship after completing their courses.
These students, however, could apply to postpone their return for two reasons: To pursue their studies or to wait for their spouses (also on government scholarships or loans) to complete their studies.
They also have to get the approval from the Health Ministry.
Ismail said students intending to postpone their return should apply to their respective "sponsors" before completing their studies.
"There is no such thing as blanket approval as approval would be based on case-by-case basis.
"However, they must be prepared to return any time when asked to do so.
"The government has the right to cancel any postponement and students must return," the circular said.
Once approval was given, Ismail said, the government was no longer obliged to pay for their return ticket to Malaysia or visa to stay longer in a country.
"However, students’ responsibilities as stipulated in the agreement remain."

Fake Medicines Worth RM7.8 Million Seized Last Year

KUALA LUMPUR, April 4 (Bernama) -- The Health Ministry seized fake medicines and beauty products worth RM7.8 million in 12,362 raids nationwide last year.
Its Deputy Minister Datuk Dr Abdul Latiff Ahmad said the fake products seized included traditional remedies and medicines categorised as poison.
"Some of the fake medicines seized were sold over the counter," he said in reply to an additional question from Datuk Tengku Putera Tengku Awang (BN-Hulu Terengganu) in the Dewan Rakyat here today.
To the original question from Tengku Putera, he said the government estimated that between five and eight percent of medicines in the market were fakes.
Dr Latiff said to overcome this problem, starting next month the government would implement a new meditag hologram with added safety features to identify genuine medicines.
"All pharmacies will have the equipment to ascertain whether the meditag hologram is genuine."
He said the public could also verify the registration numbers of the medicines by checking with the Pharmacy Enforcement Branch of the ministry in the states or visit its website www.bpfk.gov.my

Made-in-Malaysia medicine ‘cheapest’

NST: Are Malaysian-made generic drugs among the most expensive in the world or the cheapest?
Malaysian Organisation of Pharmaceutical Industries vice-president Jimmy Piong said they were fairly priced and affordable to all Malaysians.
"Considering their quality and reliability, Malaysian-made medicines are among the cheapest in the world."
This contradicts Universiti Sains Malaysia lecturer Dr Zaheer Ud Din Babar’s statement that doctors were marking up generic drug prices by an average of 316 per cent.
Dr Zaheer’s findings were in a 2005 survey published by the Public Library of Science (PLoS) Medicine recently.
The study was conducted by University College Sedaya International and USM in collaboration with the World Health Organisation and Health Action International.
Dr Zaheer had said that doctors were marking up prices by up to 76 per cent for patented drugs, with pharmacies upping prices by up to 140 per cent for generic drugs and 38 per cent for patented ones.
Piong said medicine prices increased with margins added in the supply chain from production to the end-user.
He said products from Malaysian manufacturers at the top of the supply chain were not overpriced. "The value added, or margins, increase towards the end of the supply chain."
He said generic medicines were always cheaper than patented medi- cines, the prices being determined by competition among the numerous generic manufacturers worldwide.
Patented medicine prices are monopolies and are determined solely by the brand or patent holder, whose interest is best served by higher prices.
Piong said healthcare professionals have an important role to play in the rational use of drugs and was crucial in ensuring, among other things, the affordability of medicines.
"If the public and healthcare professionals practice and promote the rational use of medicines, using cheaper generic versions or alternatives instead of more expensive branded or patented medicines, the cost of medication can be dramatically reduced."
He said price control or capping of medicine prices warranted careful study, considering that medicines were essential and strategic commodities.
Health Ministry pharmaceutical services division director Datuk Che Mohd Zin Che Awang said the ministry would look for new ways to cut the prices of medicines.
"We cannot say for sure whether we will control the price of essential drugs, but we are trying to get the World Health Organisation to help us figure out ways to do it," he said.

Cook, food handler, woman sources of cholera outbreaks

NST: A cook, a food handler and a woman living on the bank of Sungai Tawaran were identified as the sources of the outbreaks of cholera in three districts in northern Sabah.
The cook, who had prepared food for a wedding party, was identified as the source of the outbreak in Kudat, which began on March 12.
The food handler at an eatery near a timber camp was determined as the source of the one in Pitas five days later, while an elderly woman living upriver from here, in Kampung Pampang Poring, was said to have caused the outbreak in the district on March 26.
The outbreak has since been contained as health officials launched control measures a day after the first case was detected.
Only one death has been recorded, that of a six-year-old Indonesian boy who lived in Kampung Pinggan-Pinggan, Pitas, on March 18.
Public Health Department principal assistant director Dr Jenurin Jilip said yesterday that the boy died due to dehydration, six days after showing symptoms of cholera: Vomiting and diarrhoea.
He said control measures taken by the department were to treat those who developed the symptoms, investigate the source of the outbreak and dispatching teams to villages where the suspected cholera patients came from. "The teams will disinfect areas that were dirty, advise the villagers to practise good hygiene, collect samples for tests and close down premises when necessary.
"Carriers will also be brought to the hospital for observation."
Jenurin said in the past four days, there had been no new cases in Pitas, while in Kudat and here, officials had begun identifying "healthy" carriers of the disease.
Healthy carriers are those who carry the cholera strain but do not suffer from it.
"What this means is that at this stage, where we are able to identify healthy carriers, we have the situation under control. This is because by identifying the carriers, we can prevent the spread of cholera."
In Kudat, 16 villages were affected, 10 in Pitas alone, said Jenurin.
He said the entire state had been put on alert to identify possible cases.
No cases have been reported elsewhere.
Teams of health officials were brought in from Tuaran, Kota Kinabalu and Kota Belud to help officials from the three districts over the past three weeks.
Jenurin, however, was unable to provide the exact number of cases, carriers and suspected patients pending results of tests and compilation of data from the various districts. "To determine cholera cases, we need up to five days after collecting stool samples from the patients."

No reason for debt collectors

Star: THE Health Ministry does not agree with the move by the Universiti Kebangsaan Malaysia Hospital (HUKM) to collect unpaid bills through a debt collection company, Sin Chew Daily said.
Health Minister Datuk Seri Dr Chua Soi Lek told the paper the ministry could not condone the move, especially when it also affected some underprivileged patients.
He advised the hospital to first check on the background of its patients or get details of the patients from the Welfare Department, to find if they could afford the medical fees.
He was commenting on a recent press report that said the hospital had appointed a debt collection company to collect unpaid medical bills from seven women whose husbands had received treatment at the hospital.
“HUKM has no reason to do this. It is not necessary to collect unpaid bills through debt collectors,” Dr Chua said in an interview with the daily.
He said any patient who could not afford medical treatment could apply for financial aid from the ministry, urging the seven widows to contact his ministry if they needed help.

Suspended – sale of drug to treat IBS

Star: PETALING JAYA: The import and sale of a drug used to treat women with abdominal pain and constipation associated with irritable bowel syndrome (IBS) has been suspended with immediate effect.
The medication Zelmac (tegaserod maleate), which is marketed in the United States under the brand name Zelnorm, has been found by the Food and Drug Administration (FDA) to cause a higher incidence of cardiovascular events, according to a press statement by the Health Ministry’s Drug Control Authority (DCA) yesterday.
Zelnorm was taken off the US market recently. The suspension would be in effect until further information was obtained, said the ministry’s director-general Tan Sri Dr Ismail Merican.
The statement also said that Novartis Corporation (M) Sdn Bhd, which has suspended the import and sale of Zelmac had advised patients being treated with the medication to seek alternative treatment for their condition.

Only 6% of Malaysian adults making use of public dental services

Star: PETALING JAYA: While masses of schoolchildren are getting teeth checked by Health Ministry officers, only less than six percent of Malaysian adults are making use of public oral healthcare services.
And a survey by the ministry carried out in 2000 revealed that only 25.2% of adults had a dental check in the past year while only 15.3% had their check in the past one to two years.
"An annual oral health examination is important if promotion of wellness is our concern," said Health Minister Datuk Seri Dr Chua Soi Lek in his speech on Tuesday to launch the Colgate-Palmolive and Malaysian Dental Association (MDA) "Oral Health Month".
His speech was read out by the ministry's oral health director Datin Dr Norain Abu Talib.
He said that in 2005, the ministry's school dental services provided oral examinatons to 95.2% (2.9 million) of primary school children and 62.7% (1.3 million) of secondary school children.
Only an estimated 5.8% of adults used public oral healthcare services two years ago.
Dr Chua added that more needed to be done to ensure continuity of care from childhood to adult.
"We need to step up efforts for improvement in periodontal health and early detection of oral cancer in the adult and elderly population," he said.
He added that the ministry was also providing oral health training for teachers in teacher training institutions, pre-school teachers and childcare providers undergoing basic childcare provider course.
MDA president Dr Wong Foot Meow said in his speech that oral health is a necessary part of overall health although it is often neglected.
He added it had been closely linked with diseases such as diabetes and heart disease.
He added that nine out of 10 Malaysians had cavities, where tooth decay was heavily influenced by one's lifestyle.
Dr Wong told a press conference later that a reason why individuals were reluctant to visit the dentist was because they associated treatment with pain even while knowing that it was good for them.
During the month, free dental check-ups are being carried out in about 430 participating dental clinics, dental stations at road show events at shopping malls.

Ten Per Cent Of Medical Students Forgo Ambition To Be Doctors

PUTRAJAYA, April 2 (Bernama) -- Ten per cent of the 1,500 medical students who graduate annually decide against pursuing medical practice as a career, Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said Monday.
This was because they had not expected the profession to demand such high commitment and come with the pressure of heavy work, he said.
He said this could be due to the age factor as they graduated when they were rather young.
"The decision was made after the students had gone for practical training at hospitals or clinics where they were exposed to the real working conditions although not yet commissioned as doctors," he told reporters.
Although the percentage involved was small, it would be better if the decision was made before they took up the course or during the course so that others could take their place, Dr Latiff said at the signing of an agreement between Universiti Malaya (UM), Universiti Kebangsaan Malaysia (UKM), Allianze College Of Medical Science (ACMC) and the Health Ministry on the use of health facilities at the ministry's hospitals and clinics.
Dr Abdul Latiff said the ministry welcomed the measure implemented last year by the Public Service Department (PSD) to expose future medical students to the working environment of doctors for three days.
"We only want medical students who really desire to become doctors and not those who pursue the course due to pressure from others," he added.

Ministry mulls price control

NST: GEORGE TOWN: The Health Ministry will conduct a study on possible price control mechanisms for pharmaceutical products in the country. However, such mechanisms may not necessarily be the best solution to cheaper medicines.
Health Ministry parliamentary secretary Datuk Lee Kah Choon said yesterday the ministry would have to work out the best way to ensure Malaysians did not have to pay high prices for medicines.
"We want to see whether we can implement price control mechanisms without jeopardising the network we already have."
Lee was commenting on calls by pharmaceutical industry players for the ministry to control the prices of drugs in the country.
In the NST’s Letters To The Editor pages, they had urged the ministry to put a stop to price wars for drugs.
Lee said the ministry was monitoring the situation.
"We have an international indicator which we use to compare the prices of our drugs.
"We are constantly checking for differences."
News reports had quoted Universiti Sains Malaysia lecturer Dr Zaheer-Ud-Din Babar as saying that Malaysians may be paying the highest prices in the world for medicines, a finding the ministry dismisses as "misleading".
The 2005 study was conducted by Sedaya International University College and USM in collaboration with the World Health Organisation and Health Action International.
Zaheer had said doctors were marking up prices by up to 76 per cent for patented drugs and 316 per cent for generic drugs.
Pharmacies, the study found, marked up prices by up to 140 per cent for generic drugs and 38 per cent for patented ones.
The study was published by the Public Library of Science (PLoS) Medicine, a peer-reviewed journal.
Meanwhile, Lee expressed confidence that Zaheer’s findings would not affect Malaysia’s medical tourism.
"Our procedures and treatments are some of the best in the world and we do not compromise on our quality."

Measures to attract and retain local doctors

Star: A BETTER working environment, better financial perks and career advancement are among measures to attract and retain local doctors, reported Sin Chew Daily.
The daily, quoting Health Ministry parliamentary secretary Datuk Lee Kah Choon, as saying that the Government had put these measures in place to prevent a shortage of healthcare professionals in the country.
Lee added that the Government was looking into ways to offer better remuneration to local medical graduates.
He, however, added that the remuneration would still be slightly lower than that offered by the private sector.
He said the Government would not simply recognise medical degrees of other countries in its efforts to address the shortage problem.

Cholera outbreak in northern Sabah contained

Star: KOTA KINABALU: A cholera outbreak in three northern Sabah districts has been contained with dozens of patients suspected to be infected or carriers of the disease already being discharged from hospitals.
“The situation has settled down. There has been no new cases,” state Deputy Director of Health Dr Mohd Yusof Ibrahim said when contacted yesterday.
The outbreak that began about a month ago saw some 50 people being hospitalised in Pitas, where one person was pronounced dead on arrival at the district hospital.
Another 17 people were admitted to the Kudat hospital while 15 people were hospitalised in Kota Marudu after showing symptoms of being infected or being carriers of the disease.
Many of the patients in Kudat were from nearby villages such as Kampung Tanjung Kapor, Kampung Marabahai, squatter settlements and islands, including Kampung Mariangin.
Following the outbreak, Health Department staff in the three districts began alerting the public about the need to practice clean hygiene and consume only boiled water.
The cholera outbreak was one the most severe since last May, when the disease struck six Sabah districts. The northern Kota Belud district was the worst hit with more than 100 villagers hospitalised.

Rather young, and weight is their worry

NST: Too fat? Too thin?
Common questions we all ask ourselves.
But now, even children as young as seven are worrying about their figures.
Two studies of children aged four to 12 have found that up to a third of them were worried about their weight.
In her talk on the Eating Habits and Nutritional Status of Malaysian Adolescents, Dr Norimah A. Karim said mothers play the most important role in the development of the child’s self-image, followed by friends and the children’s favourite celebrities.
Teachers play the least important role.
Dr Norimah, a council member of the Nutrition Society of Malaysia, said that in a study of 220 Malay primary schools in 2004, 32 per cent of the pupils were worried about their weight.
A 2005 study of 157 Chinese schools found that 26 per cent of the primary school pupils were concerned.
The nine-year-olds were the most anxious — 40 per cent in the Chinese schools and 32 per cent in Malay schools.
Among 10-year-olds, this had dropped to 21 per cent among the Chinese and 29 per cent among the Malays.
Rokiah Don, senior assistant director of the Family Health Development Division, Ministry of Health, said in her paper on Promoting Healthy Eating Habits in Schools that a 2003 study found that one in five Malaysian adolescents was overweight or obese, and teenage obesity is a bigger problem in urban rather than rural areas.
Dr Norimah blamed snacking on junk food and skipping breakfast, while Dr Nik Shanita Safii added a sedentary lifestyle to the list.
In her talk on the Benefits of Good Nutrition, Dr Nik Shanita, the treasurer of the Malaysian Association for the Study of Obesity, said too many children spend too much time watching television and playing computer games.
She added that good eating habits started in the teenage years would be carried into adulthood.
Dr Norimah said that rice meals are the favourite among adolescents, but two per cent confessed to eating fast food every day, and nearly half eat it at least once a month.
Rokiah said the Health Ministry has faced an uphill battle introducing healthier food into school canteens.
Despite listing what may and may not be sold and trying to exclude junk food, most operators are still selling it.
Responding to a question about the hawkers who sell junk food outside the schools, she said that her department had called the local authorities, who pass them from one department to the other.
No one wants to accept the responsibility.
The seminar on Adolescents and Nutrition for secondary school teachers was held in conjunction with Nutrition Month Malaysia, which begins today.
Sponsors were the Nutrition Society of Malaysia, Malaysian Dieticians Association and Malaysian Association for the Study of Obesity.

Ministry studying circumcision plan

Star: PETALING JAYA: The Health Ministry will study the implications of a World Health Organisation’s (WHO) recommendation for male circumcision to reduce the risk of HIV infection, said Health Ministry director-general Tan Sri Dr Ismail Merican.
“We will study it first before recommending it to non-Muslims,” he told The Star when asked if male circumcision would be recommended as part of the HIV/ AIDS Harm Reduction Programme.
“It is a matter of choice. We’ll counsel men and it is their choice. We cannot force this,” he said.
He said the correlation between male circumcision and reduced risk of HIV and sexually transmitted diseases was an accepted fact here.
Experts from WHO and UNAIDS, the UN agency that coordinates the global fight against AIDS, recommended on Thursday that male circumcision now be recognised as an additional important intervention to reduce the risk of heterosexually-acquired HIV infection in men, after strong evidence showed that it reduced their risk by 60%.
The recommendation was based on a conference in which experts discussed three trials – in Kisumu, Kenya; Rakai District, Uganda; and Orange Farm, South Africa – that produced strong evidence of the risk reduction resulting from male circumcision.
The evidence supports the findings of numerous observational studies that had suggested geographical correlation between lower HIV prevalence and high rates of male circumcision in some countries in Africa.
Currently, an estimated 665 million men, or 30% of men worldwide, are circumcised, said WHO.
“Being able to recommend an additional HIV prevention method is a significant step towards getting ahead of this epidemic,” said UNAIDS associate director Catherine Hankins.
“However, we must be clear that male circumcision does not provide complete protection against HIV. Men and women who consider male circumcision as an HIV preventive method must continue to use other forms of protection such as male and female condoms, delaying sexual debut and reducing the number of sexual partners,” she said.

Mentally ill need more perks

Star: KUALA LUMPUR: More benefits such as insurance coverage and income tax relief should be granted to the mentally ill, said National Institute of Occupational Safety and Health (NIOSH) chairman Tan Sri Lee Lam Thye.
“People who are mentally ill are denied insurance coverage due to their condition,” he said in a statement yesterday.
Lee also called for better health services at government hospitals to mentally ill.
“Psychiatric drugs used by them should be affordable,” he said.
He urged corporations to create an employee assistance programme to help those with mental health problems.
“Some do not see that investing in staff well-being can bring beneficial returns in productivity and work performance,” he added.
Lee also wanted those who recovered from mental illnesses not to be discriminated against.

Nutritionists concerned over unhealthy canteen food

Star: KUALA LUMPUR: Prohibited food and drinks are still being sold in school canteens and this is worrying nutritionists and dieticians.
Health Ministry Family Health Development Division principal assistant director Rokiah Don said it was important that canteen operators abide by guidelines set out in the Education Ministry’s school canteen guidebook.
According to the guidelines, canteens are not allowed to sell, among others, drinks with added colouring, titbits, sweets, and preserved fruits.
“It is important to ensure that healthy and nutritious food is prepared for the children,” she said in her talk at the Adolescents and Nutrition seminar held in conjunction with Nutrition Month Malaysia 2007.
Health Ministry dietician Noor Safiza Mohamad Nor said hawkers were normally seen peddling their products outside schools.
She said she had come across situations where a large number of students rushed out of the school compound to purchase ice-blended drinks after their co-curriculum activities.
“This is worrying. Teachers can play a role by organising interesting projects or assignments that promote healthy eating habits,” she added.

UM, UKM medical grads allowed to practise in Singapore

Star: PETALING JAYA: Singapore’s gain will be Malaysia’s loss, this time over the recruitment of doctors.
This follows the decision of the Singapore Government to allow medical graduates from Universiti Malaya and Universiti Kebangsaan Malaysia to practise in the city-state.
UM and UKM are the first institutions within Asean to receive such approval in the republic, which was announced by Singapore's Ministry of Health on Friday.
The Malaysian Medical Association (MMA), which said Singapore's move would worsen the shortage of medical specialists here, nevertheless welcomed the announcement that was also hailed by the Singapore Medical Association.
MMA president Datuk Dr Teoh Siang Chin said the decision was to do with “quality, not quantity.”
“It is a good thing for both patients and the profession. Doctors should be free to move where they want,” he said.
On the medical “brain drain” impact on Malaysia, Dr Teoh said this was bound to occur in any case.
“This is a lesson for our Health Ministry ... to appreciate the fact that Malaysian doctors, especially government doctors, are valued around the world,” he said.
Singapore Medical Association president Dr Wong Chiang Yin was reported to have described the decision as a step in the right direction, and hoped it would lead to more medical interaction on both sides.
“It is about going forward, and we welcome each other.
“There is a lot of talent, especially from those two universities (UM and UKM),” he added.
UKM greeted Singapore's decision with pride. Its medical faculty dean, Prof Datuk Dr Lokman Saim, said:
“It is a good move as it shows that the standard of our medical graduates is being recognised. Singapore's standard of care is higher and it will be a good opportunity for our local graduates to show their capabilities. This augurs well for our local education system.”
He did not think that there would be a doctor exodus as Singapore was not heavily populated.
“Our public universities produce about 1,000 doctors every year and we will have enough doctors in our country,” he said, but acknowledged that Singapore held the edge in terms of remuneration.
A senior staff of a private medical institution here revealed that private hospital groups from Singapore had been coming over in a bid to woo those with potential to be good doctors.
“Before, they were high and mighty and did not recognise medical transfer degree programmes.
“But now they're facing a shortage and need to get the manpower so their health system can function,'' he added.
Medical graduates from 18 institutions, from Canada, China, India, Pakistan, South Korea, Sri Lanka and the United States, can also practise in Singapore.
The Singapore ministry said re-cognising the additional universities would help Singapore hospitals in the republic recruit good doctors to meet rising demand.
As at the end of 2006, there were 250 positions for doctors waiting to be filled in public hospitals there.
Singapore currently has 7,611 registered doctors, including 2,286 who were trained in foreign institutions.
The Singapore Medical Council currently has 86 Malaysian doctors on its register.

Recognition soon for Polish medical degrees

The Star PUTRAJAYA: Malaysian students wishing to pursue medical studies will soon have another option.
The Malaysian Medical Council (MMC), the main body responsible for evaluating and according recognition to foreign institutes, is expected to add Poland to its list of destinations for medical studies.
It is believed that the MMC has so far conducted two visits to three institutes in the country, the first in June last year and the last one as recently as a month ago.
The three institutes are the Medical University in Lodz, the Faculty of Medicine of University of Krakow and the Medical Academy of Warsaw.
However, it is said that only one of the three – most probably, the Medical Academy of Warsaw – would be accorded recognition this year while two others would have to wait.
Health Ministry director-general Tan Sri Dr Ismail Merican, who is also MMC president, confirmed that the council would be according recognition to Poland’s medical degrees.
“We have visited the institutes in Poland and an approval is pending. Hopefully, it will be this year,” he said, but declined to name the institutes.
Recently, the Public Service Department had announced that it would be sending its scholars to Poland and the Czech Republic for this year’s medical study intake.
So far, Poland is not included in the list of countries under the Second Schedule of the Medical Act 1971, which currently has 333 recognised institutes in, among others, Egypt, Australia, Ireland, Russia and Indonesia.
Deputy Head of the Polish mission in Malaysia Slawomir Krakowski confirmed that the MMC had conducted visits to the three institutes mentioned.
“Our embassy has yet to receive the announcement of the Government’s final decision. But we do know there is already a first batch of students from Malaysia ready to pursue medical courses in Poland,” he said.
The three Czech Republic medical institutes recognised are the First Faculty of Medicine at Charles University in Prague, the Faculty of Medicine at Charles University in Hradec Kralove and the Faculty of Medicine, Palacky University, Olomouc.
Dr Ismail also confirmed that there were currently no universities in Romania recognised by the Government despite advertisements in newspapers.