Malaysian Society of Transplantation Calls for More Organ Donation Pledges Among Malaysian University Students

WORDS LIM TECK CHOON

On 14 February 2024, the Malaysian Society of Transplantation, in collaboration with the National Transplant Resource Centre and the Ministry of Higher Education, launched the Varsity P.U.L.S.E (Pledge for the Urgent Life Saving Efforts).

This event was launched at Hospital Al-Sultan Abdullah UITM Puncak Alam by Datuk Dr Nor Fariza Ngah, the Deputy Director-General of Health, to mark the beginning of an annual campaign engaging all universities nationwide, regardless of public or private status.

Datuk Dr Nor Fariza Ngah stated during the launch: “Our organ donation rate is among the lowest globally. With 9,641 patients awaiting organs, each representing a person with a family, dreams, and hopes for a better life, it’s our responsibility to raise awareness and create a significant impact, fulfilling the true purpose of Varsity P.U.L.S.E–to ignite awareness among university students, the future generation of our nation.”

THE NEED FOR ORGAN DONATIONS REMAINS LARGELY UNFULFILLED

The most recent data indicates that there are 9,641 transplant patients waiting for their lifesaving procedures. The highest demand is for kidney transplants, both for adults (9,211) and pediatric cases (397).

Shockingly, only 1.07% of the population is currently registered as organ donors, underscoring the urgent need for action.

Varsity P.U.L.S.E aims to:

  • Increase awareness of organ donation among the younger generation in Malaysia
  • Dispel prevalent misconceptions surrounding organ donation
  • Boost the number of organ donor pledges.
CHALLENGES WITH ORGAN DONATION RATES IN MALAYSIA

Despite efforts to increase awareness, misconceptions about organ donation persist, fueled by cultural and religious beliefs.

Additionally, there’s a lack of trust in the healthcare system, with concerns about fairness and transparency in organ allocation processes.

Socio-economic factors also play a role, as many Malaysians are unaware of the benefits of organ donation or lack access to information.

Dr Mohamad Zaimi Abdul Wahab, the organizing chair of the Varsity PULSE, said: “The low rate of organ donation in Malaysia poses a grave threat to the lives of those awaiting transplants. Through Varsity P.U.L.S.E, we aim to foster a culture of awareness, understanding, and compassion among our youth, inspiring them to make a difference by pledging to donate their organs.”

The campaign comes at a time when pledging as an organ donor has never been easier, thanks to the integration of donor registration into the widely used MySejahtera app, facilitating seamless participation for Malaysians across the country.

UKM & AMM Organized Liver Cancer Awareness Day in Conjunction with World Cancer Day

WORDS LIM TECK CHOON

February 4 was World Cancer Day. In conjunction with World Cancer Day 2024, the Gastroenterology and Hepatology Unit, Department of Medicine and the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) collaborated the Academy of Medicine Malaysia (AMM) organized a Liver Cancer Awareness Day event at Komune Living & Wellness, Bandar Tun Razak, Cheras, Kuala Lumpur.

THE MINISTER OF HEALTH CALLS FOR REMOVAL OF GREATER AWARENESS OF CANCER AMONG MALAYSIANS

The event was officiated by YB Datuk Seri Dr Dzulkefly Ahmad, our Minister of Health, and witnessed by the residents of Bandar Tun Razak.

In his speech, Datuk Seri Dr Dzulkefly congratulated the UKM Faculty of Medicine for organizing a community program that has the community closer to the university.

“Approximately 48,639 new cancer cases and 29,530 cancer deaths were reported in 2020 in Malaysia. And more worryingly, experts have predicted that the incidence of cancer in Malaysia will increase 2 times by 2040,” he shared.

He further stated: “There is no doubt that cancer is on the rise. I strongly believe that, as a community, we should learn what cancer is and most importantly to remove the taboo behind the word ‘cancer’.”



LIVER CANCER IS ONE OF THE TOP 5 MOST COMMON CANCERS IN MALAYSIA

“Currently, liver cancer is one of the 5 most common cancers in Malaysia; others are breast cancer, colorectal cancer, lung cancer and nasopharyngeal cancer,” Datuk Seri Dr Dzulkefly revealed. “Primary liver cancer, which starts from within the liver itself, unfortunately, has one of the worst prognoses because it is often diagnosed at a late stage when symptoms appear.”

Our Minister of Health also added that obesity is often associated with an increased risk of fatty liver disease known as metabolic dysfunction associated fatty liver disease (MAFLD), which is becoming the main cause of liver cancer.

However, liver cancer can be prevented either through hepatitis B immunization or early treatment of liver disease detected in patients with known hepatitis or cirrhosis.

LIVER CANCER DAY OFFERED EDUCATIONAL EVENTS & HEALTH SCREENING FOR ALL ATTENDANTS

The objective of the Liver Cancer Awareness Day event was to increase community awareness of liver cancer in addition to knowing more about liver cancer, its symptoms, risk factors, detection, and prevention.

A public forum on liver cancer was held during the event. This forum became a platform for liver cancer patients to share their experiences. Additionally, a group of panelists from the Ministry of Health Malaysia, University Hospitals, agencies and medical associations discussed the issue of public access to affordable cancer medicine in an effort to bridge the gap between the rich and the needy when it comes to cancer care.

In addition to public forums, the Liver Cancer Awareness Day event also provided attendants with screening services such as mammograms by Majlis Kanser Nasional (MAKNA), metabolic disease screening, hepatitis B and C screening, and fatty liver screening as well as consultation by experts, health fairs, quizzes, and lucky draws.

Meanwhile, the Malaysian Relief Agency (MRA) donated food packs to 90 residents of Bandar Tun Razak, Cheras. The participation of residents in this area was made via a community network between the UKM Faculty of Medicine and the residents of Bandar Tun Razak, Kuala Lumpur.

AUSPICIOUS GUESTS ADDED IMPACT TO THE EVENT

In addition to the gracious presence of the esteemed Minister of Health, the Liver Cancer Awareness Day event was attended by: Professor Dato’ Dr. Hanafiah Harunarashid (Pro Vice Canselor Kuala Lumpur Campus UKM), Professor Dr. Abdul Halim Abdul Gafor (Dean of the Faculty of Medicine UKM), Professor Datin Dr Marina Mat Baki (Deputy Dean of Industry Community and Partnerships Affairs), Professor Dato’ Dr Razman Jarmin (Director of Hospital Canselor Tuanku Muhriz UKM), Professor Dato’ Dr Ismail Sagap (Director of Hospital Pakar Kanak-Kanak UKM), Professor Dr Rosmawati Mohamed from the Academy of Medicine Malaysia, as well as various hospital directors and heads of department.

This program was made possible by the efforts of the Dean of the UKM Faculty of Medicine, Professor Dr Abdul Halim Abdul Gafor, and members of the faculty’s top management.

 

An Oncologist Spotlights the Newest & The Latest in Stereotactic Radiosurgery Technology

WORDS DR AMINUDIN RAHMAN MOHD MYDIN

FEATURED EXPERT
DR AMINUDIN RAHMAN MOHD MYDIN
Consultant Clinical Oncologist
KPJ Damansara Specialist Hospital

It’s an undeniable fact that cancer is one of the leading causes of death both in Malaysia and worldwide.

HOWEVER, CANCER NEED NOT NECESSARILY BE A DEATH SENTENCE THESE DAYS

There are numerous developments in the technology behind cancer screening that allows more precise cancer treatment and hence a greater potential for better treatment outcome.

Many exciting developments have taken place in the field of radiation therapy, also called radiotherapy.

Radiation therapy involves the use of high-powered X-rays and other types of radiation to disrupt the growth of a tumour.

As a result, the tumour will eventually start to shrink.

Depending on the type and severity of cancer, it can be used as a single form of cancer treatment.

It can also be used alongside chemotherapy and other forms of cancer treatments. For example, after a surgery to remove a tumour, the patient may receive radiation therapy to eliminate any leftover cancer cells in their body.

One significant development in radiation therapy is stereotactic radiosurgery, which is available in Malaysia.

WHAT IS STEREOTACTIC RADIOSURGERY (SRS)?

Click on the image for a larger, clearer version.


  • This is a very precise form of radiation therapy.
  • It can be used on both cancerous and non-cancerous or benign tumours.
The advantage of SRS over older radiotherapy systems
  • Delivers high doses of radiation in tiny, precise beams that target the tumour(s) while minimizing damage to surrounding tissues.
  • Its high precision allows for treatment of very small tumours as well as tumours located close to important organs.
  • High doses of radiation allow for more effective treatment of tumours.
  • Less damage to surrounding healthy tissues means fewer potential side effects compared to older systems.

Stereotactic radiosurgery is commonly used to treat the following:

  • Abnormalities in the brain and spine, including cancer.
  • Benign or non-cancerous tumours.
  • Epilepsy.
  • Trigeminal neuralgia, a rare and very painful chronic disease that affects the trigerminal nerve in the brain.
  • Abnormal connections between arteries and veins, or arteriovenous malformations.
THE DIFFERENT TYPES OF STEREOTACTIC RADIOSURGERY
Gamma knife
  • Commonly used to treat tumours and lesions in the brain.
  • No actual knives are involved here—the ‘knife’ here is a highly focused beam of radiation!
  • The beam is typically delivered under the control of a computer-guided treatment.
  • The use of artificial intelligence or AI shows promise in optimizing delivery route of the radiation beam to the targeted areas of treatment.
Stereotactic body radiation therapy (SBRT)
  • Commonly used on cancers that are still confined to a small area of the body and have not yet spread into nearby tissues.
  • This treatment method delivers high doses of radiation to the targeted area over a matter of days. (Conventional radiation therapy may take place over a matter of weeks.)
  • While highly concentrated radiation is applied, don’t worry—the treatment isn’t painful.

Proton therapy

  • Commonly used to treat both cancerous and non-cancerous tumours that are located near important organs such as brain and spinal cord. It is also frequently used to treat cancer in children.
  • This is a pretty complicated treatment, as the oncologist and their colleagues would need to first determine the specific location, size, and dimension of the tumour. This is often done via imaging tests such as computed tomography (CT) scans and magnetic resonance imaging (MRI).
  • Once these details are obtained, the radiation oncologist will direct high-energy proton beams onto the tumour.

Linear accelerator (LINAC)

  • Commonly used to treat cancers of the prostate, lung, breast, oesophagus, stomach, rectum, uterus, bladder, liver, and more.
  • This is a high-definition dynamic radiosurgery (HDRS) treatment that allows for accurate delivery to small areas of the body.
  • It can target areas accurately, thereby minimizing exposure to healthy cells and hence side effects.
  • It is also capable of delivering high-dosage radiation beams. This usually means that the patient’s radiotherapy sessions will take less time, and they will also require fewer sessions compared older radiotherapy systems.

A Neurologist Discusses the Link Between COVID-19, Younger Adults, and Stroke

WORDS DR JOYCE PAULINE JOSEPH

FEATURED EXPERT
DR JOYCE PAULINE JOSEPH
Consultant Neurologist
Aurelius Hospital Nilai

The COVID-19 pandemic has fundamentally altered the physiological landscape of individuals around the globe. The virus has demonstrated its ability to traverse various bodily functions, leaving a trail of physiological changes in its wake. From the intricate dynamics of the immune response to cardiovascular issues, COVID-19 has brought about unprecedented impacts on human health in various ways.

But what are the correlations, if any, between COVID-19 and an increase in stroke incidences especially amongst the young? In light of the increasing number of cases of COVID-19 in Malaysia again, we attempt to investigate the links.

THE LINK TO STROKE

Traditionally, when we speak about strokes, it tends to be an “elderly persons” disease, a health concern prevalent amongst those aged 50 and above.

However, over the past 3 years since the first outbreak of COVID-19 pandemic, a worrying connection has emerged between the virus and incidences of strokes in younger individuals.

COVID-19 is associated with a higher risk of stroke, a majority of them being ischaemic strokes caused by a blockage in an artery that supplies blood to the brain.

A study suggested a connection between the high prevalence of vascular risk factors and concurrent elevation of proinflammatory and procoagulation biomarkers in this.

In the same study, it has been proposed that the virus that causes COVID-19 infects the cells that line the inside of the blood vessels.

These infected cells release several pro-inflammatory factors that attract other immune cells to the affected area.

In turn, this leads to damage to the lining cells, activating platelets and other factors involved in clotting.

This chain of events eventually increases the risk of a blood clot that could potentially travel up to the brain and cause a stroke.

Hypercoagulability and inflammatory response cause vascular complications, increasing the risk of strokes, regardless of age.

Findings from another large-scale study suggested that COVID-19 is a risk factor for deep vein thrombosis, pulmonary embolism, and bleeding.

The risk of developing blood clots in the lungs and legs is significantly elevated for up to 6 months upon contracting COVID-19.

After the initial 30 days of infection, individuals afflicted with COVID-19 displayed heightened susceptibilities and endured a year-long burden of newly emerging cardiovascular conditions.

These conditions range from cerebrovascular issues and dysrhythmias to inflammatory heart disease, ischaemic heart disease, heart failure, thromboembolic disease, and assorted cardiac disorders.

Strikingly, these risks manifested consistently across various demographic factors, such as age, race, and gender, as well as other established cardiovascular risk factors like obesity, hypertension, diabetes, chronic kidney disease, and hyperlipidemia.

Notably, even those without any pre-existing cardiovascular conditions prior to exposure to COVID-19 exhibited these risks, suggesting a propensity for these complications to manifest in individuals traditionally considered at low risk for cardiovascular diseases.

IN SUMMARY

The data and evidence gathered do point to a heightened risk of stroke brought about by COVID-19, regardless of age.

Even though it remains an uncommon occurrence, it remains a risk especially for individuals pre-existing health conditions that are known to boost the risk of stroke.

While the correlation between incidences of stroke, COVID-19 and how it affects younger individuals remains a subject of ongoing research and study, it remains crucial in recognizing the potential risks and taking appropriate and proactive measures.


References:

  1. Mbonde, A. A., O’Carroll, C. B., Grill, M. F., Zhang, N., Butterfield, R., & Demaerschalk, B. M. (2022). Stroke features, risk factors, and pathophysiology in SARS-CoV-2-infected patients. Mayo Clinic proceedings. Innovations, quality & outcomes, 6(2), 156–165. https://doi.org/10.1016/j.mayocpiqo.2022.01.003
  2. Xie, Y., Xu, E., Bowe, B., & Al-Aly, Z. (2022). Long-term cardiovascular outcomes of COVID-19. Nature medicine, 28(3), 583–590. https://doi.org/10.1038/s41591-022-01689-3

A Dermatologist Addresses 3 Common Misconceptions About Dry Skin

WORDS LIM TECK CHOON

FEATURED EXPERT
DR FELIX YAP BOON BIN
Consultant Dermatologist
Sunway Medical Centre
MISCONCEPTION 1
DRY SKIN IS NOTHING SERIOUS.

Dr Felix Yap Boon Bin points out that this is not always true.

“Lack of water or skin dehydration will cause dry skin to peel, crack, irritate, itch and become sensitive,” he explains. “If we scratch the itch, it may lead to damage of the skin’s epidermis, causing it to become thinner or eventually recede away.”


Our skin consists of three layers: the epidermis, the dermis, and the subcutaneous layer. Click on the image for a larger, clearer version.


“When the epidermis is compromised, germs and dust can penetrate into the second layer of the skin or dermis, causing inflammation, in addition to causing other skin problems, such as eczema and psoriasis,” Dr Felix shares.


A comparison of healthy and dry skin. Click on the image for a larger, clearer version.


What causes dry skin?

Dr Felix says that being under the hot sun for a long period of time can cause dry skin.

Being in an air-conditioned room for long periods of time can also be a factor, as air conditioning can cause the skin to dry.

However, many cases of dry skin are due to genetic factors. “Some individuals are born without a protective skin layer, causing their skin to be easily dehydrated,” Dr Felix says. Therefore, it is possible for someone to develop this condition without spending much time under the sun or air-conditioning.

Additionally, the use of improper skincare products can lead to dry skin. Dr Felix cites the frequent usage of body scrubs or soaps with a higher pH level (pH above 7) as an example.

If you spend much time under the sun or in air-conditioned rooms, Dr Felix recommends, applying moisturizers regularly to ensure that the skin is healthy and has a good level of hydration. “However, if dryness is at a serious level, it is recommended to use medicated moisturizers,” he says.
MISCONCEPTION 2
ANY SKIN MOISTURIZER WILL DO.

Not true. 

“For dry skin types, oil-based moisturizers are more suitable because the oil content will moisturize the skin and reduce itching or peeling,” Dr Felix explains.

He adds: “Individuals with oily skin can choose oil control moisturizers to prevent acne growth.”

For sensitive skin, Dr Felix recommended the use of specialized moisturizers, products without fragrance or chemicals produced by certified medical brands.

Hence, he reminds everyone to identify their own skin type before choosing their skincare products, in order to ensure that these products are suitable for long-term use.

MISCONCEPTION 3
DRINKING A LOT OF WATER AND EATING VEGETABLES REGULARLY CAN HELP THE SKIN STAY HYDRATED

Research has proven that this assumption is inaccurate.

“Lack of water in the body will certainly affect the quality of the skin, but drinking a lot of water at one time does not help the skin to stay hydrated,” Dr Felix elaborates.

“Also, consuming a lot of vegetables does not necessarily help to hydrate the skin. Healthy and hydrated skin requires a balanced diet, which includes a variety of nutrients and not just vegetables,” he adds.

BONUS: DR FELIX’S TIPS TO PROTECT YOUR SKIN

“The water content in our skin will also decrease as we age,” Dr Felix reminds us. “The protective layer will become thinner and its efficiency to trap water will also become lower when we reach between 40 to 50 years old.”

Therefore, he offers some tips to help us take care of our skin in order to avoid skin problems in the future.

  • Sleeping for 7 hours a day and have a consistent bedtime, preferably before 12 midnight.
  • Lead an active lifestyle to improve the immune system. Low immunity can cause skin diseases such as eczema.
  • Use moisturizers before going to bed, especially in rooms with air conditioning.
  • Apply sunscreen before leaving the house.

An Expert Discusses What Happened to the Generational Endgame Bill of Malaysia

WORDS MUHAMMAD ZAID ZAINUDDIN

FEATURED EXPERT
MUHAMMAD ZAID ZAINUDDIN
Lecturer (Anatomy)
Centre of Preclinical Science Studies
Faculty of Dentistry
Universiti Teknologi MARA (UiTM)
IN RECENT NEWS

In November 2023, the Dewan Rakyat passed the Control of Smoking Products and Public Health Bill.

The Bill aims to regulate the sale and purchase of tobacco products, smoking materials, tobacco substitute products, and smoking devices, which includes smoking products such as electronic cigarettes or vape.

Though the passing of the bill is a positive step for the country’s public healthcare system and future generations, it has left members of the parliament and public health experts outraged.

WHY THE OUTRAGE?

The passed Control of Smoking Products and Public Health Bill is a watered-down version of the ambitious proposal initiated by our former Minister of Health, Khairy Jamaluddin.

The previous bill, dubbed the “Generational Endgame Bill”, proposed to prohibit persons born on or after 1 January 2007 from purchasing and smoking tobacco products, substitute tobacco products and smoking substances which includes e-cigarettes and vapes.

The bill passed in November 2023 removed this bold clause that would give rise to a smoke-free Malaysian generation in the future.

WHAT WOULD HAPPEN IF THE GENERATIONAL ENDGAME BILL WAS PASSED IN ITS ORIGINAL PROPOSED FORM?

In terms of impact on healthcare, the proposed Generational Endgame policy would ban smoking and vaping for those born in 2007 and onwards for the rest of their lives.

Ideally, this will create a smoke-free generation in the coming decades and save north of RM6 billion ringgit per year in terms of healthcare expenditure in the years to come.

This is stipulated by 2020 data, whereby the country had spent RM6.2 billion to treat three major diseases caused by smoking; lung cancer, heart disease, and chronic obstructive pulmonary disease. This cost was estimated to increase to RM8.8 billion by 2030 and will increase further if smoking had not been curbed.

THEN, WHY WAS THE GENERATIONAL ENDGAME CLAUSE DROPPED?

The Generational Endgame clause was dropped after considering the views from the Attorney-General’s Chambers, who claimed potential constitutional arguments.

The clause is unconstitutional.

In brief, the passing of the bill would create unequal treatment under the law between persons born before 1 January 2007, and individuals born after.

This is contradictory to Article 8 (1) of the Federal Constitution, which states that every person shall be equal under the law and have equal protection of the law.

The proposed bill would be unconstitutional as it would create two sets of laws for two different groups of citizens based on age.

Socio-economic impact on Malaysians.

An assessment of Malaysia’s Generational Endgame Policy by Oxford Economics, published in September 2023, states that the policy would be unlikely to deliver a reduction in healthcare costs. This is because future smokers would switch to illicit products.

This is on the basis that Malaysia has one of the largest illicit tobacco problems globally, with an estimated 57% of all cigarette sales in 2022 occurring through illicit channels.

An argument against the bill claims that a total ban of tobacco products would just expand the illicit tobacco market.

Impact on the economy.

The report also estimates that the legal tobacco industry in Malaysia currently supports a RM983 million contribution to the country’s GDP, RM3.3 billion in tax receipts, and 7,940 jobs.

A total ban of tobacco products would decrease these economic benefits on top of having to sustain an expensive expenditure on policy implementation, public communication, and enforcement programmes in addition to efforts needed to control the expanding of illicit markets.

IS THIS THE END OF THE GENERATIONAL ENDGAME POLICY?

Absolutely not!

The passing of the current bill is a small step forward toward achieving the Generational Endgame policy.

Though not banning the selling of tobacco products in its entirety, the Control of Smoking Products and Public Health Bill protects the younger generation from modern smoking devices, a rampant disease amongst our teenage youths.

The bill prohibits the sale and purchase of tobacco products, smoking materials, or substitute tobacco products as well as the provision of any services for smoking to under 18-year-olds, ultimately curbing the increase of smoking and vaping habit amongst children and teenagers.

IN CONCLUSION

Though our healthcare workers and policy makers are working hard to curb the rise of smoking and vaping, it is of the highest importance to maintain public awareness of the dangers of smoking and vaping. Such public awareness should be promoted and reiterated from generation to generation.


References:

  1. Bernama. (2023, December 7). Experts: Anti-smoking bill first step towards a smoke-free generation. NST Online. https://www.nst.com.my/news/government-public-policy/2023/12/987431/experts-anti-smoking-bill-first-step-towards-smoke-free
  2. Choy, N.Y. (2023, November 23). Health minister pledges to table Generational Endgame bill on tobacco before the end of Parliament sitting. The Edge Malaysia. https://theedgemalaysia.com/node/690959
  3. Harun, H. N. (2023, November 28). GEG dropped due to constitutional arguments – Dr Zaliha. NST Online. https://www.nst.com.my/news/government-public-policy/2023/11/984010/geg-dropped-due-constitutional-arguments-dr-zaliha
  4. Cabello, K. (2023, October 6). An assessment of Malaysia’s ‘Generational Endgame Policy’. Oxford Economics. https://www.oxfordeconomics.com/resource/gegmalaysia/

Autoimmune Encephalitis: When Your Own Immune System Attacks Your Brain

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ELLIE KOK HUEY TEAN
Consultant Neurologist and Internal Medicine Physician
Sunway Medical Centre Velocity

Autoimmune encephalitis, often abbreviated as AE, is a relatively new and hence frequently misdiagnosed group of related conditions in which the body’s own immune system attacks the brain.

According to Dr Ellie Kok Huey Tean, autoimmune encephalitis can affect people of all ages, even those with no family history of this condition.

COMMON POSSIBLE SYMPTOMS OF AUTOIMMUNE ENCEPHALITIS 
  • Frequent headaches.
  • Personality and behavioural changes.
  • Decline in cognitive function (thinking, learning, memory, decision-making, etc).
  • Seizures.
  • Abnormal, slow, and/or involuntary movement (movement disorders).
  • Hallucination and/or delusion.

If left untreated, someone with this condition may experience permanent brain injury and even death.

However, Dr Ellie shares that, because the symptoms of autoimmune encephalitis overlap with those of psychiatric disorders, this condition is often misdiagnosed.

WHAT ARE THE COMMON CAUSES AUTOIMMUNE ENCEPHALITIS?

Dr Ellie explains that there are many different possible causes, such as exposure to viruses such as herpes simplex virus and the presence of certain cancers.

ARE CERTAIN GROUPS OF PEOPLE MORE AT RISK?

“Research indicates that AE predominantly impacts individuals from their early teenage years to age 50, with women being more susceptible than men,” she added.

Furthermore, while this condition can develop in people of all ages, certain age or gender groups may exhibit higher prevalence of certain traits linked to autoimmune encephalitis.

For example, N-methyl-D-aspartate receptor (NMDAR) encephalitis tend to be more commonly observed in adolescents and young adults. It is also more prevalent among young women with tumours in their reproductive organs.

Another example is araneoplastic encephalitis, which affects elderly persons with occult cancer. Occult cancer is a term for cancer cases in which cancer cells are detected in the person’s body, but the doctors can’t locate the tumour from which these cancer cells originate from.

WHAT CAN WE DO ABOUT AUTOIMMUNE ENCEPHALITIS?

Dr Ellie advises that family members or caretakers of the elderly should be vigilant for symptoms, especially given that the elderly are more vulnerable to infections, one of the primary causes of autoimmune encephalitis.

“It is also crucial to monitor for symptoms such as memory decline, behavioural changes, seizures, and gait problems, such as loss of balance while walking,” she elaborates.

IS THERE A CURE FOR AUTOIMMUNE ENCEPHALITIS?

Dr Ellie reveals that most people with this condition can be cured after receiving proper diagnosis and the appropriate immunotherapy treatment.

Immunotherapy typically involves the use of immunoglobulin injected into the patient’s bloodstream as well as plasma exchange and the use of immunosuppression agents. The purpose of this treatment is to eliminate the antibodies that direct the immune cells to attack the patient’s brain.

“However, a small number of patients may experience a relapse within 5 years after treatment,” says Dr Ellie, adding that this is the reason why it is important for people that have completed treatment to go for medical follow-ups. These follow-ups will allow the doctor to detect and take steps to prevent the chances of recurrence.

New Year, Healthier You? An Expert Shares a Health Screening Strategy to Help You Get Started

WORDS LIM TECK CHOON

FEATURED EXPERT
DR MURALITHARAN GANESALINGAM
Head of Department
Obstetrics and Gynaecology
School of Medicine
International Medical University (IMU)
FIRST, LET’S REFLECT: DO YOU NEED HEALTH SCREENING? 

Health screening benefits us, even when we believe and feel that we are healthy.

Dr Muralitharan Ganesalingam tells us: “The goal of screening tests is to detect changes in the body before they become unmanageable. In this way, you have the chance to modify your lifestyle and steer away from a particular illness.”

GO FOR HEALTH SCREENING FROM EARLY ADULTHOOD (SUCH AS WHEN YOU START WORKING) AND DO IT TWICE A YEAR AFTER YOU TURN 45

As Dr Murali puts it:

  • Generally, women between 19-24 years of age are considered to be at the peak of health.
  • From the age of 25, fat begins to accumulate, especially in the hips, thighs and abdomen, while muscle mass deteriorates.
  • From the age of 35, bone mass depletes at a rate of 0.5% to 1% each year.

There will be variations to this trend, as people are difference and hence their bodies age differently too. However, these changes with ageing prompt the recommendation given by Dr Murali, as health screening can help in detecting early the health issues that can arise alongside these changes.

Furthermore, health screening can be helpful in detecting the development of certain diseases that may not show obvious symptoms at the early stage.

PRIORITISE THESE HEALTH SCREENING TESTS
  • Blood pressure to check for hypertension. “This disease, known as the ‘silent killer’, progresses without noticeable symptoms and affects 3 in 10 Malaysians (approximately 6.4 million people), and increases the risk of stroke and heart attack,” explains Dr Murali.
  • Blood count to detect conditions like anaemia. On average, anaemia affects 3 in 10 women aged 15 to 49 years and can cause complications during pregnancy such as miscarriage and premature birth.
  • Blood glucose test to check for diabetes.
  • Body mass index (BMI) to monitor weight gain and help prevent obesity. Dr Murali points out that our national statistics show that 1 in 2 adults are overweight or obese, and 1 in 2 have abdominal obesity, of which women accounted for 54.7% and 64.8% respectively.
  • Lipids test to check for elevated levels of cholesterol, which can lead to heart disease. Around 4 in 10 Malaysians, approximately 8 million people, have raised cholesterol levels, with women being more likely to have higher levels than men. In spite of this, 1 in 4 people are unaware they have high cholesterol.
  • Kidney function and liver profile, as chronic kidney disease affects 1 in 7 Malaysians, and diabetes is a significant risk factor for this disease.

Dr Murali also recommends going for annual eye checks, hearing tests, and dental check-ups as we age.

Just for women
  • Pap smears to check for cervical cancer. “Because we have an efficient screening programme through the use of Pap smears, we have been able to reduce the incidence of cervical cancer substantially,” says Dr Murali. “It is the most significant advancement in the control of cancer, hence annual screening for cervical cancer is something I emphatically encourage.”
  • Breast examinations (see below) to check for breast cancer. Dr Murali points out that it is essential for all women to be disciplined about performing their own breast examinations as well as to go for an annual check by a doctor, who will advise if a mammogram is needed.
  • Bone mineral density scans to detect osteoporosis. Dr Murali explains that one’s bone mineral density decreases with age and the risk of fractures increases, hence postmenopausal women 50 years and older should be screened. “Women aged 65 years and older should be screened at least once a year, according to Malaysian guidelines,” he adds.

An overview of how to perform breast self-examination at home. Click on the image for a larger, clearer version. If you are unsure or you have concerns, you can consult your doctor for more information.


FINAL ADVICE

“It is important for you to speak to your regular doctor about any health concerns and discuss what health screenings may be beneficial for you, based on your age, lifestyle and family history,” Dr Murali emphasizes.

A Tips-Filled Bumper Article to Help You Sleep Better Featuring Four Experts

WORDS LIM TECK CHOON

FEATURED EXPERT
CELESTE LAU
Chief Dietitian
Sunway Medical Centre
ADD MAGNESIUM-RICH FOODS IN YOUR DIET

“Magnesium plays a crucial role in various bodily functions, such as muscle and nerve operation, protein synthesis, glycolysis, and blood pressure regulation,” says Celeste Lau.

She explains further that this mineral aids in the conversion of protein into chemicals that induce sleepiness, promote muscle relaxation, and maintain gamma-aminobutyric acid (GABA), a neurotransmitter responsible for promoting restfulness.

You should consume between 100 and 350 mg of magnesium daily for optimal sleep support.

Celeste recommends adding sources of magnesium such as walnuts, almonds, flaxseeds, salmon, and mackerel into your meals. It is recommended to consume between 100-350mg of magnesium daily for optimal sleep support.

“Additionally, refrain from consuming a heavy meal in the evening. It is recommended to have dinner 2 to 3 hours prior to your bedtime,” she adds.

FEATURED EXPERT
MICHELLE CHONG HUI YEE
Clinical Psychologist
Sunway Medical Centre
PRACTICE RESTFULNESS

Michelle Chong explains that restfulness is a deliberate act of nurturing yourself—physically, mentally, and emotionally.

It is characterized by a feeling of peacefulness and contentment, often accompanied by a sense of relief from stress, worries, tension, or fatigue.

Mentally, restfulness means quieting the mind, letting go of worries, and embracing a sense of mental stillness.

  • Learn to embrace mindfulness and relaxation techniques.
  • Grounding yourself in the present moment. This heightened awareness allows you to detach from worries about the past and anxieties regarding the future as well as to foster a sense of presence that can alleviate stress and enhance your awareness of immediate experiences.
  • Practice deep breathing exercises and progressive muscle relaxation (PMR) methods to heighten your body awareness and release muscle tension, focusing on achieving a state of ‘physical rest’.
  • Prioritize relaxation techniques that calm the mind before bedtime. “Activities such as mindfulness meditation and journaling can effectively declutter the mind and reduce stress hormones, creating a more seamless transition into sleep,” Michelle says.
FEATURED EXPERT
DR NURUL YAQEEN
Consultant Respiratory, Sleep & Internal Medicine Physician
Sunway Medical Centre Velocity
START SLEEPTIME RITUALS 
  • Do not use your bed as an office to answer calls, respond to emails and avoid watching television in bed,” advises Dr Nurul Yaqeen.
  • Instead, reserve your bed for sleep. Remove electronic devices (televisions, computers, smartphones, etc), from the bedroom.
  • Try to start a sleep ritual as rituals help signal the body and mind that it is time to sleep. Some suggestions from Dr Nurul Yaqeen are drinking a glass of warm milk, taking a bath, or listening to calming music to unwind before bed.
  • “There is also the 10-3-2-1 method to help you rest better at night,” she says, “which is no caffeine 10 hours before bed, no food or alcohol 3 hours before bed, no work 2 hours before bed, and no screen time 1 hour before bed.” 
FEATURED EXPERT
Effendy Nadzri
Interior Designer
ENDO
Website
GET THE AMBIENCE RIGHT
  • Keep your room cool at night,” says Effendy Nadzri. “The ideal temperature in the bedroom should be between 20º and 23º Celsius.”
  • If you have an air conditioner at home, he recommends switching it on at night to signal to your body that it is time for sleep.
  • Set the perfect ambience with dimmable or mood lighting to enhance your bedroom space and create the desired mood for a restful evening before you retire to sleep.
  • “You may want to have aromatherapy or essential oils that can help you relax at night,” Effendy adds.

 

Tuberculosis Cases Are Rising in Malaysia. An Expert Shares What You Should Know & Do About This

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ROSMADI ISMAIL
Consultant Interventional Pulmonologist and Internal Medicine Specialist
Sunway Medical Centre

Quite recently, our Minister of Health Dr Zaliha Mustafa revealed at the United Nations General Assembly High-Level Meeting that there was a concerning increase of 17% in tuberculosis cases in 2022 compared to 2021, along with a 12% increase in tuberculosis-related deaths during that time period.

In light of this development, Dr Rosmadi Ismail shares his thoughts with us about tuberculosis, its detection, treatment, and prevention.


Tuberculosis is an infectious disease that is caused by the bacteria Mycobacterium tuberculosis (MTB) infecting the lungs as well as certain other parts of the body.


An overview of the symptoms and preventive measures of tuberculosis. Click on the image for a larger, clearer view.


IS DETECTION OF TUBERCULOSIS GETTING BETTER?

Dr Rosmadi reveals that there are several innovative techniques currently undergoing clinical trials in a few countries.

These techniques, which include biosensing technologies and nano-diagnostics, promise quicker and more accurate results.

He shares: “Ongoing research focuses on innovative methods like computer-aided detection (CAD) through artificial intelligence, aerosol capture technologies, and antigen-based skin tests. They are poised to revolutionise TB diagnosis, enhancing efficiency and effectiveness in the future.”

In Malaysia, there are diverse methods employed to ensure accurate and timely detection of tuberculosis, such as:

  • Sputum smear microscopy, typically the first test for tuberculosis.
  • Culture and sensitivity testing to diagnose tuberculosis.
  • Nucleic acid amplification tests (NAATs) to facilitate the identification of tuberculosis cases.
  • Chest radiography and clinical tests like the Tuberculin Skin Test (TST) to confirming the infection.

TREATMENT OF TUBERCULOSIS

Treatment of tuberculosis in Malaysia follows the World Health Organization guidelines, which is the global standard.

Dr Rosmadi tells us, “The standard treatment for drug-susceptible tuberculosis in Malaysia involves a combination of four drugs administered for a duration of 6 to 8 months.”

Treatment utilizes the Directly Observed Treatment (DOT) strategy, which sees the patients receiving close supervision from healthcare workers to ensure that they complete their medication intake.

Currently, there are no new medications or treatments that show superior results over current ones when it comes to treating tuberculosis. Dr Rosmadi notes that treatment for drug-resistant TB involves a distinct medication regimen and extended treatment duration.

“This tailored approach has proven effective even in cases of drug-resistant TB, reinforcing our commitment to comprehensive patient care,” he says.

DR ROSMADI’S TUBERCULOSIS TIPS 
  • Stay clear of crowded places. It’s best to avoid crowds, especially if they’re poorly ventilated.
  • If you’re experiencing a persistent cough, fever, or unexpected weight loss, seek medical help promptly. This will help you get better and stop the disease from spreading.
  • Get checked if you’re at risk. If you have a weak immune system or have been around people with tuberculosis, consider getting tested. It’s a simple step that can catch the disease early if exposed.
  • If you’re diagnosed with tuberculosis, completing your treatment is essential. P
  • Preventive measures such as wearing a mask, covering your mouth and nose when you cough or sneeze, and disposing of tissues properly can help protect yourself and those around you.
  • If your job puts you in contact with many people, wear the proper protective gear as an added layer of safety.
  • Think about getting vaccinated. The current vaccine, Bacillus Calmette Guérin (BCG), offers partial protection to infants and young children against severe forms of tuberculosis. It doesn’t protect adolescents and adults that are the primary carriers of the tuberculosis bacteria, but it could help in the long run.