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Archive for March 29, 2012

HSA and Malaysian health ministry ink MOU

SINGAPORE – The Health Sciences Authority (HSA) yesterday signed a Memorandum of Understanding (MOU) with Malaysia’s Ministry of Health.

The MOU seeks to strengthen, promote and develop pharmaceutical regulatory affairs and cooperation in areas including regulatory science and enforcement.

It is a milestone for both parties, as HSA is the first national drug regulatory agency the Malaysian ministry is signing an MOU with.
Read More: AsiaOne

A 5-bed ward to combat elderly delirium


Photo by OOI BOON KEONG

by Amanda Lee

SINGAPORE – A pilot initiative at Tan Tock Seng Hospital (TTSH) has helped to reduce patients’ length of stay at the hospital and the number of days they suffer from a medical condition known as delirium.

The Geriatric Monitoring Unit (GMU), which was started in October 2010, is a specialised five-bed ward set up for the management of elderly hospitalised patients with delirium and difficult-to-control behaviours.

Delirium is a common, serious and potentially reversible condition which affects many elderly admitted to the hospital.

An elderly patient suffering from delirium is at a higher risk of falling, suffering incontinence and developing back ulcers. Hence, these patients require higher level and frequent observation for acute delirium and redirection of behaviour.

The unit aims to treat these patients through “minimal physical and medication restraints, made possible with a programme that enables focused care”, said Dr Chong Mei Sian, Senior Consultant of the Geriatric Medicine Department in TTSH.

A total of nine trained geriatric nurses are deployed in the ward to take care of the patients. Inside, a foldable activity table will be set up during the day for patients to engage in activities such as mahjong sessions.

“Together with a multi-disciplinary team, patients have improved functionality and they recover faster with shorter length of stay,” added Dr Chong.

According to a study conducted between August 2010 and September last year, the average length of stay for patients suffering from delirium reduced from 22 to 17 days.

The number of days patients suffer from the condition have also been shortened to eight days, from 15 days previously.

While no patients staying in the GMU ward need to be physically restrained as yet, the rate of patients needed to be administered with medication has also fallen – from 78.7 per cent of patients previously to 70.2 per cent.

Admissions and discharges are determined by a specialist, based on a set of pre-determined clinical criteria.

Patients who stay in the GMU pay between S$30 and S$150, on top of their hospitalisation fees.

The GMU pilot, which is funded by MOH, has no plans to expand just yet. The hospital intends to compile results from a two-year long study, before deciding further.

Read More: TodayOnline

Cheaper TCM services for elderly residents in Bukit Panjang

By Poon Chian Hui

Some 30,000 elderly residents in Bukit Panjang can look forward to traditional Chinese medicine (TCM) care at cheaper rates.

Come July, a new TCM clinic run by the Singapore Chung Hwa Medical Institution will open its doors, and also offer health talks to residents.

Those on the Community Health Assist Scheme – which allows people to get subsidised primary care in their neighbourhoods – will also receive subsidies at this clinic.

MP for Bukit Panjang Teo Ho Pin said he hopes the branch can ‘provide good quality and low cost TCM services’ to the residents.

Read More: StraitsTimes

Tips on healthy ageing

By GRACE CHEN
Keep busy, sweat it out, and embrace the years. These are some simple tips on healthy ageing.

THE golden rules of healthy ageing are very simple: eat right, exercise, be your age and do not smoke. Most of all, focus on being happy and don’t forget your life goals.

To embrace the years with positivity, says Professor Makoto Suzuki, 87, one should look at them as chouju, meaning “celebrating long life” in Japanese. “The onus is on us to focus on quality, and work on having many momentous occasions.”

Suzuki, chief director of the Okinawa Research Center for Longevity Science, was speaking to a captive audience at the 1st World Congress of Healthy Aging, in Kuala Lumpur last Wednesday. The title of his talk was, Secrets Of The Okinawan Centenarians’ Longevity.

This specialist in cardiology and gerontology had moved to Okinawa from Tokyo to accept a tenure with the University of Ryukyus 35 years ago. He also had a role model in his own mother, who passed away last year, at the age of 100 years and 10 months.


Forget the wrinkles: Keep active, eat moderately and embrace the years, says Professor Makoto Suzuki, happily posing for a photo with his wife, Yoko.

From the lessons gathered from a community that boasts the highest and healthiest longevity rates in the world, Suzuki says a diet laden with vegetables, but less meat, plays a big part in healthy ageing. The goal is to maintain the same body weight one had at the age of 30.

Statistics from 2006 show that women in Okinawa have an average life expectancy of 87 years, about 10 years higher than that of the men. (In Malaysia, life expectancy averages 73.17 years.)

“The Okinawans have a custom of saying ‘harahachibu’ before each meal. This is a reminder not to overeat. Preferably, one should stop when the stomach is about 70% full,” Suzuki says, when met after his talk at the KL Convention Centre.

He also points out that the Okinawan diet is rich in anti-ageing ingredients such as polyphenol, phytoestrogen, isoflavones and good amyloids. These are commonly found in bitter gourd, soybean products like tofu (Okinawa is especially famous for its silky beancurd), brown rice, cereals and fatty fish.

Okinawans also favour the use of mugwort (artemisiabulgaris), touted for its medicinal qualities. Its leaves are dried, ground and used to flavour grilled meats and vegetable stir frys.

Exercise also comes into the equation and Suzuki advises the young to start as early as possible as the effective benefits of that lessens after the age of 40.


The dapper Tan Sri Dr Ahmad Mustaffa Babjee feels it’s important to follow the ways of nature.

As an archer and mountain climber himself, he emphasises that the elderly must find a way to sweat it out. Since his move to the flat plains of Okinawa, he has exchanged his climbing gear for a hoe because his wife, Yoko, has a farm where they spend most of their weekends.

For them, as with the majority of Okinawans, it is simply a matter of maintaining ikigai, the Japanese equivalent of raison d’être.

“Don’t worry about the wrinkles or being slow. Just be busy,” says Suzuki, who still lectures and conducts research at Ryukyus.

Inevitably, talk of active, healthy living leads to the question of bedroom frolics – which turns the hearty professor a shade of pink. Although he is not telling, from his exchanges with Yoko, 80, a homoepath, one gathers they are “quite active”.

“Funnily, I asked an Okinawan centenarian the same question but he refused to answer me. However, his wife said it is because of her that he is still healthy,” Suzuki says, laughing.

Death is also inevitable, but for the elderly in that island, what’s far more important than the end of one’s days is the role of the community in ensuring that they have a place in society.

“Elderly people need to have a sense of belonging, to know their role in a family is still valued. One of the reasons why the centenarians of Okinawa are able to lead a happy life is because they are revered by the younger people,” he says.

Suzuki elaborates on a daily ritual called ugan, during which the Okinawans pay respect to their ancestors at the family altar, and air their grievances to the dead. This has a therapeutic effect for the living, as it helps to alleviate stress.

On that loaded issue, fellow speaker Professor Suresh Rattan says mild stress is necessary for healthy living because it helps one stay alert and active. Exercise is one example of beneficial stress, as are brain teasers and games (like Sudoku), all of which help to keep the body flexible and the mind nimble.

Suresh, 57, a biogerontologist at the University of Aarhus’ Department of Molecular Biology in Denmark, spoke about Healthy Ageing – From Molecules To Hormesis.

On the home front, a specialist in healthy ageing at Pantai Medical Centre, KL, says often, senior citizens are not encouraged to keep pushing themselves, both physically and mentally.

“The Malaysian mindset is that old people should not exert themselves. As a result, their physical and mental faculties are left to decline,” says Dr Rajbans Singh, 52.

To have wellness and health in old age, it is crucial for an individual to take a proactive stand, like taking up tai chi, for example.

It may also be necessary to abstain from fast food and fizzy drinks, Dr Rajbans adds, because the high fat, sugar and sodium contents of these foods can lead to or aggravate conditions like hypertension and diabetes.

For Tan Sri Dr Ahmad Mustaffa Babjee, a fellow of Academy of Science Malaysia, acceptance of one’s age is crucial so that growing old can be seen as a positive, natural process. Do not, for example, tell others that you are 47 when you are in fact 74! Instead, learn to enjoy being your age.

“It is important to be what you are and follow the ways of nature,” says Dr Ahmad, 75, who still cuts a dashing figure with his long snowy locks and thick moustache.

As for death itself, he reckons that it will be similar to being under anaesthesia, hence there is no need to fear.

“I am more afraid of being lonely,” adds Dr Ahmad, who continues to drive his 4WD into the jungle for a spot of bird watching, wildlife photography and white water rafting.

Dr Tan Maw Pin, associate professor of geriatric medicine from Universiti Malaya, says the Malaysian government can do more for the elderly in terms providing much-needed facilities.

“One mistake the planners made was to omit the elderly from the nation’s development plan, believing that as ours is a caring nation, they will automatically be taken care of. This is very well for those who are wealthy and can afford to pay for elderly care. What about those who cannot?” Dr Tan asks.

Datuk Seri Dr T. Devaraj, chairman of Malaysian Hospice Council, notes that the family safety net that once existed has been weakened by urbanisation.

Today, it is not uncommon for young people to leave their parents behind as they migrate to bigger cities to seek employment, says Dr Devaraj, 87. Also, the elderly cannot assume that they can spend their twilight years in their children’s homes.

But leaving everything entirely to welfare is not the answer either, he adds.

Since the early days of Hospice, he had insisted that volunteers make home visits and not have the patients placed in a facility. This is so that their families, too, can play their part in the care-giving process.

“The idea is to have a sharing of responsibilities. If the state completely takes over, then family support will decrease,” adds Dr Devaraj. That, in turn, will make the elderly feel even more alienated.

The World Congress on Healthy Ageing was organised by the Malaysian Healthy Ageing Society.

Read More: The Star

Multinational team makes breakthrough in diabetes research

Taipei, March 28 (CNA) A team of researchers from Taiwan and other countries has identified five new genetic locations and confirmed three associated with type 2 diabetes in East Asians, providing new perspectives on the cause of the disease, researchers said Wednesday.

The Asia Genetic Epidemiology Network, a consortium of researchers from Taiwan, South Korea, Japan, Singapore, China and the United States, made the discovery after studying the genetic data of over 50,000 people of East Asian ancestry.

Of the eight genetic locations, four were also found to be associated with type 2 diabetes in Caucasians, but with “very few links,” said Wu Jer-yuarn of the Academia Sinica’s Institute of Biomedical Sciences.

He said the consortium was formed with the aim of finding gene expressions that are unique to Asians in the disease, as studies on type 2 diabetes in the past have focused predominantly on gene studies of Caucasians.

Two of the genes identified — GLIS3 and KCNK16 — are important in the balance and regulation of blood sugar and insulin levels, according to the Taiwanese researchers on the team.

Wu said they contributed to the study by offering an analysis of the genetic data of 2,000 Taiwanese people.

Researchers said the findings, published in the U.S-based scientific journal Nature Genetics in January, could give scientists new leads on drug development that prevent or treat the disease.

In 2011, 366 million people were suffering from diabetes, a number that is expected to rise to 552 million by 2030, said Chuang Lee-ming, an internal medicine professor at the National Taiwan University Hospital and a member of the team.

So far some 40 genes have been identified linked to type 2 diabetes, said Wu.

The five new genes identified by the Asian team are KCNK16, MAEA, GCC1-PAX4, PSMD6 and ZFAND3.

GLIS3 is one of the three type 2 diabetes-related genes that had earlier been found by European and American researchers. The other two are PEPD and FITM2-R3HDML-HNF4A.

(By Christie Chen)

Read More: Focus Taiwan

NKF goes on road tour to promote organ donation

WITH the support from Volkswagen Beetles Club Malaysia, the National Kidney Foundation of Malaysia (NKF) sent its LifeCheck Mobile Health Screening bus, Direct Debit Donor Programme truck and secretariat cars to selected locations in Johor Baru, Malacca, Seremban and the Klang Valley to promote organ donation, which is the theme for this year’s World Kidney Day celebrations.

In Johor Baru, 342 people attended the free health screening at Hospital Sultanah Aminah (HSA). The programme was launched by Johor health director Dr Mohd Khairi Yakub, along with HSA consultant nephrologist Dr Hooi Lai Seong and NKF chief executive officer Chua Hong Wee.


Off you go: NKF board of directors chairman Datuk Dr Zaki Morad Mohd Zaher and Chua joined the secretariat staff in flagging off the Volkswagen Beetles convoy.

 

Supported by about 10 VW Beetles and their owners, the convoy went to Plaza Angsana in the afternoon to reach out to local shoppers.

In Malacca, Pantai Hospital Ayer Keroh senior operations manager Tan Yew Aik welcomed NKF and the convoy team to the hospital as he encouraged the public to attend health screening routine. The hospital staff and nephrologists cheered the convoy which flagged off from the hospital to Dataran Pahlawan in a shower of bright confetti and WKD mini flags.

In Seremban, 16 VW Beetles joined the NKF convoy and managed to make heads turn in Seremban town. Health screening counters, health and organ donation exhibitions, games session and children’s colouring contests were organised by Hospital Tuanku Jaafar Seremban, NKF and National Transplant Resource Centre at Seremban Parkson Parade.

The NKF convoy then reached the Klang Valley, where VW Beetles Club members joined the final flag-off to Tropicana City Mall and 1Utama shopping complex.

Shoppers at both malls were given freebies and goodie bags upon signing up as an organ pledger or upon completion of quiz and puzzles related to the campaign’s theme.

The convoy aims to get members of the public to come forward and pledge as an organ donor, and to raise their awareness on the positive outcomes of kidney transplantation to patients with end-stage kidney failure.


All ears: A couple listening to a National Transplant Resource Centre personnel talk about organ donation.

 

This year’s World Kidney Day theme is, “Donate Kidneys for Life Receive”.

Chua said, “This is one of the ways we reach out to the community to come forward and support our cause. Currently, there are over 15,000 patients in the national waiting list for kidney transplant and we hope our campaign can give hope to these patients suffering from end-stage kidney failure so that their lives can be saved and enriched.”

Read More: The Star

沈志陽:脂肪越多幾率越高‧是否患乳癌FGFR2決定

沈志陽:探討遺傳基因對人類患上疾病的工作,是目前全球醫學界的主要研究趨勢;而FGFR2基因也被證實在決定女性是否患上乳癌上,有著重要的影響。(圖:星洲日報)

(雪蘭莪‧八打靈再也27日訊)台灣中央研究院(Sinica)生物醫學科學研究所副所 長沈志陽指出,科學研究發現人體中的纖維芽細胞生長因子(Fibroblast Growth FactorReceptor2,簡稱FGFR2),在決定女性是否患上乳癌,有著重要的影響。

沈志陽出席由馬大與台灣中央研究院舉辦的基因、遺傳學及DNA研討會時指出,FGFR2是由基 因生產在細胞表面的蛋白質,扮演感受體(Receptor)的角色,其主要的工作是幫助細胞接受外來的“信息”,包括該細胞繼續成長或不成長的指示;所以 感受體屬於良性或惡性,決定乳癌的增長。

“全世界的研究,包括我們的研究都說FGFR2是最重要的,因為它決定乳癌的增長。”

他說,由於每個人體內的基因都不一樣,這些由基因製造出來的蛋白質也會出現不一樣,也就說明了為何一些女性容易患上乳癌,一些則不會。

他指出,這項發現是該研究院和國際研究院的研究結果,在透過比較乳癌病患和健康女性的基因所得;一共動用了2萬名乳癌病患和2萬名健康女性做比對,結果發現FGFR2這個基因,在病患和健康女性有很不一樣的地方。

雌激素促使乳
房細胞增生

他表示,既然發現了FGFR2的重要性,下一個步驟則是解釋台灣的乳癌情況,因為在100名台灣婦女當中,有約15%婦女的FGFR2基因屬於惡性的。

“因此,我們就想探討,到底這些FGFR2基因屬於惡性的女性,患上乳癌的風險有多高。”

女性患上乳癌是因為女性的卵巢排放月經,產生一種叫雌激素(Estrogen)的東西,源自於飲食當中的脂肪。

雌激素會促使乳房細胞的增生,如果增生得太快,就會成為癌症。在台灣,乳癌是女性的第一號殺手,這種趨勢也包括日本、韓國、台灣和馬來西亞。

“現在的人吃的脂肪比以前多很多,所以容易患上乳癌。脂肪越多,雌激素就越多,這造成患上乳癌的危險性就越高;雌激素是由膽固醇(Cholesterol)轉換而成的。”

“雌激素幾乎是脂肪,它是脂肪藉由一些基因的改變後,變成雌激素;西方的食物很多脂肪,東方的食物比較少脂肪,所以以前的乳癌非常的低。”

沈志陽說,目前有一種狀況,就是雖然女性吸取越來越多的脂肪,但不是每一個都會患上乳癌,是因為大家的基因不同,所以他們目前的研究重點在於遺傳基因如何決定不同的人是否患上乳癌。

他說,要探討這個狀況有許多的方法,最主要的則是透過比較乳癌病患與健康女性的遺傳基因差別。

基因對疾病影響
成研究趨勢

他指出,該研究院也參與國際間的研究,因為在進行“比較人類”的研究,一般上都需要有大量的病 人,才會有資料和確保正確性及一致性,所以該研究院與其他的研究院合作,一起尋找與乳癌有關的基因;此外,目前的研究不再是尋找哪一個基因比較重要,而是 透過GenomeWide Scanning的方式,在人體每個基因組(Genome)的位置去尋找乳癌病患和健康女性的差別。

他透露,透過這種研究方式,他們也發現人與人之間基因的少許差異,也會造成有些人較容易患上乳癌,有些則不會。

目前,全球的醫學界都將探討和研究遺傳基因決定人類疾病發生,作為主要研究方向。

“因為外界的危險因素如吸煙、喝酒、不愛運動和飲食習慣的因素,在過去都有人研究過了;可是現在要探討的是外界的因素要加上怎樣的基因因素才會導致疾病的發生。

“研究基因對疾病的影響,是目前全球醫學界在研究方面的一個趨勢。

人體電場能否導致癌細胞移動
鄭郅言:待驗證

台灣中央研究院應用科學研究中心副研究員鄭郅言說,他目前正研究人體自身的電場是否會導致癌症細胞移動,因為癌症的惡化是體內的癌症細胞從一個部位,移動到另一個部位。

他說,人體自身的電場能夠讓傷口癒合的說法,早在100多年前就存在了;而人體自身的電場是否會讓體內的癌症細胞移動的驗證工作,則是在10年前才開始。

“這是一個透過培植皿(Petri Dish)進行的驗證工作,有關癌症細胞是在1997年從病患身上取下來的。”

他說,由於人體自身的電場是否會導致體內的癌症細胞移動的假定(Hypothesis)還未被證實,所以他要驗證這種假定,如果假定屬實,就有人會做進一步的工作,來解決有關問題。

星洲日報/獨家報道:吳靖修)

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