Taking vital signs to heart

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 Cardiovascular diseases hitting Malaysians at an earlier age 

'The most common risk factors for CVDs are uncontrolled blood sugar levels (diabetics), hypertension and high cholesterol (hypercholestrolaemia' - Dr Wan Azman.

“It has been estimated that CVD-related deaths will reach approximately 31,000 cases annually by 2025 if no concrete measures are put in place to reduce CVD rates,” said Dr Wan Azman, adding that this would form about 55% of all non-communicable diseases related deaths in the country.

With the arrival of Covid-19 in Malaysia in 2020, CVDs still formed a substantial part of deaths, with ischaemic heart diseases and cerebrovascular diseases combining to contribute 20.2% of deaths in 2022, as per the data from the Statistics Department.

“CVDs account for the largest share in costs for hospitalisation (47.77% or RM1.01bil) and medication (46% or RM792mil) compared to other non-communicable diseases, while resulting in annual productivity losses of approximately RM4bil,” said Dr Wan Azman.

He said the most common risk factors for CVDs are uncontrolled blood sugar levels (diabetics), hypertension and high cholesterol (hypercholestrolaemia)

While monitoring blood sugar and blood pressure are relatively straightforward things, monitoring one’s cholesterol level, especially levels of the “bad” cholesterol otherwise known as the low-density lipoproteins (LDLs), has proven to be more challenging, for a variety of reasons.

A person with high cholesterol has no symptoms, he said, adding that a comprehensive blood test was the only way to detect it.

“What makes it more complicating is that while a person’s total cholesterol (combination of high-density lipoproteins and LDL) count may be fine, the percentage of LDL in the total cholesterol count may have breached risky levels,” added Dr Wan Azman.

Health Ministry family medicine specialist consultant Dr Sri Wahyu Taher who was another member of the panel at the event said blood pressure (BP) and blood sugar could be measured easily in public health clinics or general practitioners or at retail pharmacies.

“Checking for cholesterol is not as easy as there is a need to draw a blood sample from the vein to be tested in the laboratory,” she said.

Typically, LDL testing are part of a lipid panel test (that measures total cholesterol, breakdown between HDL and LDL, as well as triglycerides) that are done in comprehensive health screenings.

The challenge includes disseminating information that cholesterol screening is readily available even at government health clinics.

“It is not necessary for a person to go to the hospital to get a cholesterol test done,” added Dr Sri Wahyu. 

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Many misconceptions about cholesterol, survey finds - The Star

PETALING JAYA: As many as 85% of Malaysians claim that their level of knowledge of cholesterol-related issues ranges from “average to good,” according to a recent survey.

The State of Health of the Nation perception survey conducted online nationwide in December 2022, was designed to be representative of the overall population by location, gender, and race.

Conducted by The Green Zebras on behalf of the Malaysian Medical Association (MMA) and Novartis, a pharmaceutical company, the survey polled 500 Malaysians aged between 40 and 64 years.

ALSO READ:Taking vital signs to heart

The not-so-good news is that cholesterol myths are still prevalent, with 75% saying there would be symptoms if a person has high cholesterol, which is untrue.

In a statement, MMA said the survey also found other misconceptions about cholesterol, such as that cholesterol could be managed through a change in lifestyle (92%), while only 40% believe that cholesterol could only be controlled with medication.

Slightly more than half (56%) of the respondents aged from 40 to 60 assumed that cholesterol testing was needed at least every five years or more frequently, and 49% disagreed that someone within a healthy weight range could actually have unhealthy cholesterol levels.

Despite these misconceptions, most Malaysians (89%) are aware that poorly managed high cholesterol levels could lead to severe diseases such as cardiovascular diseases that include stroke and heart problems, with 84% of the respondents wishing for easier ways to manage high cholesterol.

MMA president Dr Muruga Raj Rajathurai said while the response in the survey showed that Malaysians claimed to be well-informed on cholesterol, there were some fallacies in their sentiments.

He said there were no symptoms for high cholesterol and that a blood test was the only way to detect it.

The recommended cholesterol screenings for adults between 45 to 65 years are every one to two years and should be done annually for those above 65, he added.

“Therefore, taking charge of your health and doing regular health screenings is relatively important. Do not wait to visit the doctor when you feel unhealthy or unwell, everything may be too late.

“I strongly advise them not to rely on health-related information from friends, family, and social media only as these are often skewed through the sharing process,” he said in a statement.

Mohamed ElWakil, country president of Novartis Malaysia, said many people were unaware that cholesterol was one of the silent killers, along with high blood pressure and diabetes.

“There are no obvious symptoms. However, cholesterol can be managed if it is detected early.

“Following the doctor’s recommended treatment plan and lifestyle changes may help prevent severe heart-related problems.

“In fact, there are now easier and more convenient treatment plans available. Patients should actively seek the best treatment options from their doctors.””

The dangers of too much processed and fast foods

GEORGE TOWN: Unhealthy lifestyles have led to people suffering from cardiovascular diseases (CVD), including heart attack and stroke, at a younger age.

Universiti Sains Malaysia (USM) family medicine specialist Dr Mastura Mohd Sopian said CVD among young people is mainly caused by high levels of low-density lipoprotein (LDL), commonly known as bad cholesterol.

“CVD is the leading cause for morbidity and mortality globally and Malaysians are not spared from it,” she said.

Aside from poor dietary habits, she said a largely sedentary lifestyle and stress have added to the increase in CVD and metabolic diseases.

“Too much fast food and processed food, which are cheaply available, are among the main reasons the younger generation has become more prone to these diseases,” she added.

The medical lecturer said to combat these diseases, prevention was better than cure.

Dr Mastura urged people to stick to healthy diets, and for those who smoke, to kick the habit.

She said one must move more and exercise often – as much as 30 minutes of moderate exercise every day or at least three days a week.

“We should all learn how to manage our stress, seek help and advice when needed and see the doctor yearly for a health screening,” she said, adding that getting six to eight hours of sleep each night was vital.

For those dealing with diabetes or other non-communicable diseases (NCD), Dr Mastura said these healthy habits were necessary to manage their condition.

She said the greatest visible indicator of being at risk of CVD was being overweight or worse, obese.

Public health expert Datuk Dr Zainal Ariffin Omar said too much food consumed by Malaysians now were laden with saturated and even trans fats.

This, he said, were among factors causing Malaysians, especially the younger generation, to be at risk of CVD.

Dr Zainal said it was important to maintain a healthy balance of cholesterol in the body by limiting their intake of saturated and trans fats.

LDL is the type of cholesterol that can cause build-ups and blockages in arteries that can lead to heart diseases and strokes. 

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A Plant-Based Diet and its Benefits

Importance and Challenges of Plant-Based Diets – Food Tank

Alarm over medical misinformation

 

Setting the record straight: Zamora showing one of her TikTok videos on her smartphone during an interview in Manila.— AFP

 Philippine social media users face barrage of bogus medical posts

Vlogger Rosanel Demasudlay holds a heart-shaped “virginity soap” bar in front of the camera and assures her hundreds of YouTube followers it can be safely used to “tighten” their vaginas.

The video is part of a barrage of bogus and harmful medical posts on social media platforms where Filipinos rank among the world’s heaviest users.

Even before Covid-19 confined people to their homes and left them fearful of seeing a doctor, many in the Philippines sought remedies online because they were cheaper and easier to access.

During the pandemic, AFP’s Fact Check team saw an explosion of misinformation about untested cosmetic products and quick-fix treatments for chronic illnesses.

The majority appear as free posts or paid advertisements on Facebook, the most popular social media site among the 76 million Internet users in the Philippines.

They can circulate for weeks or even months without detection as Facebook struggles to keep up with the torrent of misinformation flooding its platform.

Many of the products are promoted in videos that have been doctored to make it look like real medical professionals are endorsing them. 

Others appear in falsified news reports, while some are touted by vloggers such as Demasudlay.

AFP fact checkers have debunked dozens of claims, including a manipulated Philippine news report that appeared to promote a herbal supplement for diabetics as an alternative to insulin.

Demasudlay’s 15-minute video was posted in August 2022 and viewed more than 10,000 times.

She falsely claimed the “Bar Bilat Virginity Soap” had been approved by the Philippine Food and Drug Administration as a treatment for skin conditions and a way to tighten the vagina.

In fact, the FDA has warned consumers against using the “unauthorised” soap due to possible health risks that range from skin irritation to organ failure.

A few months later, Demasudlay admitted in another video that the soap had left her “itchy to the point of bleeding” – but she kept promoting it.

Philippine doctors worried about the explosion of medical misinformation during the pandemic began posting videos providing free information about common health conditions.

But the move backfired as promoters of spurious treatments used clips from those videos and inserted them into their own posts for credibility.

Geraldine Zamora, a rheumatologist in the capital Manila, was among those targeted.

In 2020, she began recording videos and posting them on TikTok, where she has more than 60,000 followers.

“It was a good thing for us because we were able to extend our medical knowledge to people who otherwise wouldn’t be able to consult with doctors,” Zamora said.

But then the footage was used to promote an unregistered brand of supplement for arthritis, which the FDA had warned consumers about.

The manipulated posts were viewed tens of thousands of times before being taken down by Facebook.

Zamora said that some of her patients considered purchasing the product in the belief she was endorsing it.

The World Health Organisation said “inappropriate promotion and advertisements” for unregistered medical products had long been a global problem and the pandemic may have made it worse.

The consequences of using unapproved treatments can be dire.

Vicente Ocampo, president of the Philippine Academy of Ophthalmology, said patients as young as 12 had become blind after using eye drops bought online instead of consulting a doctor.

“It saddens us that people will readily believe advertisements that claim to heal all eye problems as speedily as possible and pay exorbitant prices for these eye drops,” Ocampo said. — AFP 

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https://filipinohealthy.com/cardio1/

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What you can do with an MBBS

 

Smiling female doctor with lab coat in her office holding a clipboard with medical records, she is looking at camera

MEDICINE is still a career of choice for young Malaysians leaving high school, but does pursuing an MBBS necessarily mean you would need to become a practicing doctor?

.

The 3D anatomy and virtual dissection table help build stronger anatomy knowledge aside from cadaveric dissection.

Students actually have multiple pathways - they can choose to remain in practice, advance into research, go into corporate organisations by becoming a hospital manager or administrator, become an occupational health specialist or choose to serve the community by being in public health.

Qualifying with an MBBS is merely the first step as it is no longer a fixed road to being a practicing clinician.

The practitioner

With the growing population, the doctor practitioner is still much needed in all sectors of society. While the hours may seem long and un-family friendly, it comes back to the individual. As the saying goes, “do what you love, and you would never feel as if you’ve worked a day!”

 

.Professor demonstrating a procedure to students during Obstetrics and Gynaecology class.

In a future where technology dictates, those skills that are distinctly human will be among the most valuable and it is these skills that are enriched through postgraduate study. Considering how vital this is, Manipal University College Malaysia organises workshops for the United States Medical Licensing Examination (USMLE), Professional and Linguistic Assessments Board (PLAB) and various Royal College Fellowship/Membership exam prep courses at its campus in Melaka, so students can prepare for them before graduation with minimal travel involved from their on-going routine.

The researcher

For the doctor who is constantly intrigued by how things start and how things can be resolved or diseases cured, becoming a researcher would be a good choice. As the world shrinks with ease of travel, so looms larger the threat of infectious diseases. Research work is also more structured today, whereby evidence collected is based on a cross-section of causes. With the advent of the systematic review, the physician research is now part of a larger multidisciplinary team.

The community advisor

If it has always been your dream to treat communities, the role of a doctor as a community advisor by way of being in public health would then be the right path. Strong love of medicine coupled with mathematics and statistics are the core ingredients to excel in this pathway. By being able to read into trends and form analytical solutions, a public health physician would be better able to formulate strategic preventive measures.

The right place to do your MBBS

MUCM’s resort style campus provides students with an environment that is conducive for learning.MUCM’s resort style campus provides students with an environment that is conducive for learning.

With over three dozen medical schools in Malaysia to choose from, Manipal University College Malaysia (MUCM), formerly known as Melaka-Manipal Medical College is miles ahead as a top medical school. 

Students strolling along swimming pool after class.

The name Manipal has resonated with the Malaysian healthcare system for the past 68 years with thousands of medical doctors graduating from Manipal in India and over the last 25 years from Manipal University College Malaysia (formerly known Melaka-Manipal Medical College) in Melaka. The contribution from the graduates to the healthcare services is time tested within the country with many others creating a mark in the US, UK and Australia.

Students are guided to find their true paths before graduation, being continuously exposed to the real lives of doctors, researchers and public health individuals through the college’s annual postgraduate fair and monthly seminars and exhibitions.

Fulfil your dream with Manipal

The pursuit of medicine is a marathon, not a sprint. As such, parents and students are invited to visit Manipal University College Malaysia and experience for themselves life as a future Manipalite.

*For more details on the programme, call 1700 811 662 or visit www.manipal.edu.my

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Scientists Finally Discover How the Obesity Gene Works

Scientists have finally figured out how the key gene tied to obesity makes people fat, a major discovery that could open the door to an entirely new approach to the problem beyond diet and exercise.

The work solves a big mystery: Since 2007, researchers have known that a gene called FTO was related to obesity, but they didn’t know how, and could not tie it to appetite or other known factors.

Now experiments reveal that a faulty version of the gene causes energy from food to be stored as fat rather than burned. Genetic tinkering in mice and on human cells in the lab suggests this can be reversed, giving hope that a drug or other treatment might be developed to do the same in people.

The work was led by scientists at MIT and Harvard University and published online Wednesday by the New England Journal of Medicine.

The discovery challenges the notion that “when people get obese it was basically their own choice because they choose to eat too much or not exercise,” said study leader Melina Claussnitzer, a genetics specialist at Harvard-affiliated Beth Israel Deaconess Medical Center. “For the first time, genetics has revealed a mechanism in obesity that was not really suspected before” and gives a third explanation or factor that’s involved.

Independent experts praised the discovery.

“It’s a big deal,” said Dr. Clifford Rosen, a scientist at Maine Medical Center Research Institute and an associate editor at the medical journal.

“A lot of people think the obesity epidemic is all about eating too much,” but our fat cells play a role in how food gets used, he said. With this discovery, “you now have a pathway for drugs that can make those fat cells work differently.”

Several obesity drugs are already on the market, but they are generally used for short-term weight loss and are aimed at the brain and appetite; they don’t directly target metabolism.

Researchers can’t guess how long it might take before a drug based on the new findings becomes available. But it’s unlikely it would be a magic pill that would enable people to eat anything they want without packing on the pounds. And targeting this fat pathway could affect other things, so a treatment would need rigorous testing to prove safe and effective.

The gene glitch doesn’t explain all obesity. It was found in 44 percent of Europeans but only 5 percent of blacks, so other genes clearly are at work, and food and exercise still matter.

Having the glitch doesn’t destine you to become obese but may predispose you to it. People with two faulty copies of the gene (one from Mom and one from Dad) weighed an average of 7 pounds more than those without them. But some were obviously a lot heavier than that, and even 7 pounds can be the difference between a healthy and an unhealthy weight, said Manolis Kellis, a professor at MIT.

Related: More U.S. Adults Are Now Obese than Overweight

He and Claussnitzer are seeking a patent related to the work. It was done on people in Europe, Sweden and Norway, and funded by the German Research Center for Environmental Health and others, including the U.S. National Institutes of Health.

Researchers can’t guess how long it might take before a drug based on the new findings becomes available. But it’s unlikely it would be a magic pill that would enable people to eat anything they want without packing on the pounds. And targeting this fat pathway could affect other things, so a treatment would need rigorous testing to prove safe and effective.

The gene glitch doesn’t explain all obesity. It was found in 44 percent of Europeans but only 5 percent of blacks, so other genes clearly are at work, and food and exercise still matter.

Having the glitch doesn’t destine you to become obese but may predispose you to it. People with two faulty copies of the gene (one from Mom and one from Dad) weighed an average of 7 pounds more than those without them. But some were obviously a lot heavier than that, and even 7 pounds can be the difference between a healthy and an unhealthy weight, said Manolis Kellis, a professor at MIT.

Related: ‘Healthy Obesity’ Turns Unhealthy Over Time

He and Claussnitzer are seeking a patent related to the work. It was done on people in Europe, Sweden and Norway, and funded by the German Research Center for Environmental Health and others, including the U.S. National Institutes of Health.

“It’s a potential target” for drug development, said Dr. Sam Klein, an obesity researcher at Washington University in St. Louis. He called the work “an amazing study” and “a scientific tour de force.”

Dr. Rudolph Leibel, an obesity expert at Columbia University in New York, used the same term — “tour de force.” Still, some earlier research suggests the FTO gene may influence other aspects of obesity such as behavior and appetite.

“It’s possible there are several mechanisms being affected,” and that fat-burning is not the whole story, he said.

Read This Next: There Are 6 Types Of Obesity — And Each Should Be Treated Differently

- Associated Press

Are antibiotics an end to modern medicine?

A warning by the head of WHO that antibiotic resistance is so serious that it may lead to an end to modern medicine should alert health authorities to contain this most serious health crisis.

A schematic representation of how antibiotic resistance is enhanced by natural selection (Photo credit: Wikipedia)

LAST week, the head of the World Health Organisation (WHO) sounded a large alarm bell on how antibiotics may in future not work anymore, due to resistance of bacteria to the medicines.

Antibiotic resistance has been a growing problem for some time now. From time to time, there will be news reports of the outbreak of diseases, old and new, that cannot be treated because the bacteria have grown more powerful than the antibiotics used against them.

And experts have been warning about how the wrong use of antibiotics has given the bacteria the opportunity to develop resistance, enabling them to become immune to the medicines.

What is needed, of course, is a multi-prong strategy to prevent the abuse and wrongful use of antibiotics. Drug companies should not over-market their products. Doctors should not over-prescribe. And antibiotics should not be used on animals that are not sick but to fatten them and thus enable higher profits.

Now, the Director-General of the WHO has given a big warning that the growing threat of resistance may mean an end to modern medicine, and the entry of the post-antibiotic era.

Speaking at a meeting of infectious disease experts in Copenhagen last week, Dr Margaret Chan said there was a global crisis in antibiotics caused by rapidly evolving resistance among microbes responsible for common infections that threaten to turn them into untreatable diseases.

Every antibiotic ever developed was at risk of becoming useless.

“A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill. For patients infected with some drug resistant pathogens, mortality has increased by around 50%,” she said.

“Some sophisticated interventions, like hip replacement, organ transplants, cancer chemotherapy and care of pre-term infants, would become far more difficult or even too dangerous to undertake.”

Dr Chan called for action to restrict the use of antibiotics in food production. “Worldwide, the fact that greater quantities of antibiotics are used in healthy animals than in unhealthy humans, is a cause for great concern,” she said.

She called for measures — doctors prescribing antibiotics appropriately, patients following their treatments — and restrictions on the use of antibiotics in animals.

These actions have, in fact, been suggested for many years, including by the health group REACT, based in Sweden, by health networks such as Health Action International, and locally, by the Consumers’ Association of Penang.

The WHO itself has the scope to do much more in alerting health authorities and in building the capacity, especially of developing countries, to act.

There are forms of TB that have become untreatable because of multi-drug resistance. The TB pathogen has become immune to many antibiotics. This has resulted in a resurgence of the deadly disease. The story is the same for many other pathogens causing other diseases.

As Global Trends reported in June 2011, a worrying development is the discovery of a gene, known as NDM-1, that has the ability to alter bacteria and make them highly resistant to all known drugs, including the most potent antibiotics.

In 2010, there were reports of many such cases in India and Pakistan and in European countries. At the time, only two types of bacteria were found to be hosting the NDM-1 gene – E coli and Klebsiella pneumonia.

But it was then feared that the gene would transfer to other bacteria as well, since it was found to easily jump from one type of bacteria to another. If this happened, antibiotic resistance would spread rapidly, making it difficult to treat many diseases.

These concerns have been proven to be justified. In May 2011, the Times of India published an article based on interviews with British scientists from Cardiff University who had first reported on NDM-1’s existence.

The scientists found that the NDM-1 gene has been jumping among various species of bacteria at “superfast speed” and that it “has a special quality to jump between species without much of a problem”.

While the gene was found only in E coli when it was initially detected in 2006, now the scientists have found NDM-1 in more than 20 different species of bacteria. NDM-1 can move at an unprecedented speed, making more and more species of bacteria drug-resistant.

Since there are very few new antibiotics in the pipeline, when the resistance grows among the whole range of bacteria to the existing drugs, human beings will be more and more at the mercy of the increasingly deadly bacteria.

In May 2011, there was an outbreak of a deadly disease caused by a new strain of the E coli bacteria that killed more than 20 people and affected another 2,000 in Germany.

They were affected by a new strain of the already rare 0104 type of E coli. There are other common types of E coli which normally cause only a mild ailment. The WHO said the variant had “never been seen in an outbreak situation before”.

Although the “normal” E coli usually produces mild sickness in the stomach, the new strain of E coli 0104 causes bloody diarrhoea and severe stomach cramps, while in some of the more serious cases so far, it also causes haemolytic-uraemic syndrome (HUS), which damages blood cells and the kidneys.

A major problem is that the bacterium is resistant to antibiotics. Eradication of these kinds of bacteria is impractical partly because they are able to evolve so rapidly, according to medical experts.

Now that the WHO chief has sounded the alarm bell, health authorities should redouble their efforts to contain the crisis. An “end to modern medicine” and a “post-antibiotic era” are predictions too horrible to imagine.

By  GLOBAL TRENDS By MARTIN KHOR

Related articles

• Antibiotic resistance is a fight we will never win (bio230fall2010.wordpress.com)
• New Delhi NDM-1 superbug: Indian scientists nail British hoax (quicktake.wordpress.com)
• Compound May Help In Fight Against Antibiotic-Resistant Superbugs (medicalnewstoday.com)
• Team discovers how bacteria resist a 'Trojan horse' antibiotic (eurekalert.org)
• Antibiotic Resistance (and other falling skies) Part One (huntgathermedicine.com)