NHG and Tanoto Foundation partner for diabetes reversal in Singapore

The National Healthcare Group (NHG) is working together with Tanoto Foundation (Tanoto) to combat diabetes amongst the populace through a “Diabetes Reversal Programme.” This programme aims to control blood sugar levels in diabetes patients through behavioural changes, without the need for medication or surgery.

Contributions from both the NHG and Tanoto Funds, at S$1 million (approx. U$D0.73 million) and S$2.6 million (approx. U$D1.88 million), respectively, are also expected to boost diabetes research in primary care and in the community.

In Singapore, obese individuals with early diabetes are commonly prescribed glucose-lowering medications, or recommended to undergo bariatric surgery, to regain control over their increasing blood sugar levels.

However, diabetes control and reversal can be achieved and maintained more thoroughly through positive health behaviours instead of medication and surgery, as suggested by the researchers from NHG – they seek to study the barriers and facilitators related to such behaviour.

The researchers will also conduct a clinical trial for an intensive weight management regime in reversing early diabetes in obese patients. The trial will entail a close partnership between diabetic patients, doctors, and dietitians, to create custom, low-calorie meal plans.

Senior Minister of State for Health, Dr. Janil Puthucheary graced the official launch of the much-anticipated Diabetes Reversal Programme at Kallang Polyclinic recently, in addition to a host of senior representatives from NHG and Tanato and primary care physicians.

Associate Professor Chong Phui-Nah, CEO of National Healthcare Group Polyclinics (NHGP) and Primary Care, said health education, patient engagement, and empowerment of diabetes patients are of “paramount importance” to successful modification of self-care behaviours and lifestyle, and to manage diet and level of physical activity.

“Our aim is to better understand the challenges that patients face in their social environment and how we can better support them to take greater ownership of their health outcomes through research. The Diabetes Reversal Programme is one such study that proposes a new model of care to help patients reverse diabetes and manage their condition well,” said Assoc. Prof. Chong.

Professor Benjamin Seet, Deputy Group CEO (Education and Research) of NHG, added, “At NHG, we do things differently by putting the patient first, and focusing on real world research that directly leads to better health outcomes and quality of life. A good example would be the programme we are launching today – this partnership, where a philanthropic organisation like the Tanoto works closely with primary care doctors, dieticians, and patients, right within the community, can only bring about impactful change.”

Meanwhile, Bey Soo Khiang, Executive Advisor at Tanoto, disclosed that the collaborative programme between NHG and Tanoto will be conducted in the local primary care setting, to better study and address how the Singaporean diet, environment, and culture can affect health and disease patterns.


Are migraines eating away at your life?

Migraine attacks are accompanied by a throbbing pain either on one or both sides of the head. Unlike a regular headache, the consequences of a migraine is likely to seep into and impact all areas of our lives. Sunway Medical Centre (SMC) Consultant Neurologist Dr. Raymond Tan, based in Kuala Lumpur, Malaysia, has said that migraines are as incapacitating neurological disorder, and comes with a wide range of symptoms including blurred vision, nausea, and vomiting.

People who suffer from migraines may be sensitive to lights, noises, and scents, and — for some, experience aura or focal neurologic symptoms; episodes as such can last between 4 to 72 hours in duration.

According to the Office on Women’s Health, migraine is three times more common in women than in men, and is the fourth leading cause of disability in women.

Dr. Sharmina Kamal, SMC Consultant Obstetrician and Gynaecologist, revealed that this is largely due to specific changes in the hormone oestrogen: “Oestrogen helps regulate the female reproductive system and controls chemicals in the brain that impact the sensation of pain. Therefore, a drop in oestrogen levels can contribute to the development of chronic headaches or migraines.”

Still, migraines can affect both men and women, from all walks of life.

In childhood, migraines are more prevalent in males but cedes once the influence of oestrogen begins – that is when the prevalence starts to rise in females, contributing to more common, longer-lasting migraines in women between the ages of 20 and 45. Besides hormonal changes, factors such as stress, lack of or too much sleep, skipped meals, weather changes, alcohol, and caffeine can also trigger migraines.

Fortunately, migraines are a modifiable disorder and there is hope for relief through very simple methods.

“The best thing to do at the start of a migraine is to stop your activity and get some rest, preferably in a quiet and dim lit room or area. Taking a simple analgesic like paracetamol at the start of the migraine often helps to limit the severity. Application of topical menthol may also lessen the intensity of acute migraines, although this is best avoided in women who are pregnant or breastfeeding,” suggested Dr. Raymond.

Combining therapy or medication with behavioural measures and a lifestyle that promotes overall good health is also a proven way to handle migraine attacks. For example, maintaining a healthy lifestyle includes consuming nutritious foods, as well as ensuring adequate hydration, frequent exercise, and proper sleep.

You can also speak to your physician about daily vitamins or supplements, such as vitamin B or magnesium.

Migraines are a real source of pain, but most of the time, they are not signs that one has a serious medical problem. However, it is worth speaking to your doctor when you have symptoms that are more severe than normal, including:

  • Uncontrollable vomiting
  • Loss of consciousness
  • Seizures or convulsions
  • Blurred vision or other vision changes
  • Loss of balance or coordination

“Occasionally, the migraine attacks persist for more than 72 hours and become debilitating and resistant to conventional treatment. And in cases associated with persistent vomiting, this could lead to potential dehydration and its associated problems, which could require hospitalisation with intravenous fluids and medications,” Dr Raymond said.

Young women, in particular, who experience migraines with aura, especially those who smoke or use oral contraceptives, have an increased incidence of strokes and seizures. It is advisable for women at risk to avoid smoking and choose other forms of contraception, if possible.

As a close, you should know and avoid your triggers, treat symptoms early, and find medications or therapies that work best to relieve your migraine pain. When it comes to treating migraines, timing is everything – waiting too long to address your migraine symptoms or take preventive steps can increase how often and severely a migraine strikes.


Prevention and early detection of scoliosis in children and adolescents

Scoliosis: the hereditary spinal condition in which the spine curves to one side, taking after the shape of an “S” or “C,” is often misbelieved to be the result of bad posture, and, in children, caused by carrying heavy bags – neither are true.

Although most cases of scoliosis have no known cause (idiopathic scoliosis), early detection is recommended to prevent it from causing serious detriment to a person’s health, according to Dr. Wong Chung Chek, Consultant Orthopaedic and Spine Surgeon at ALTY Hospital (ALTY) in Kuala Lumpur.

Scoliosis is said to affect about 2-3% of the population in Malaysia. It is most often detected during adolescence, but can also affect adults and the elderly, albeit at a lower rate.

As scoliosis can worsen very quickly during childhood growth spurts and adolescence, parents should make it a point to examine their children on a regular basis. Scoliosis progresses very rapidly during these growth spurts and only slows down or stops once the child reaches bone maturity.

Signs of scoliosis become more noticeable as a child grows in age or as the curve progresses, but that doesn’t mean that scoliosis is impossible to notice early.

Parents can look out for any imbalances in the height or position of shoulders, shoulder blades, or hips — for example, one shoulder appears to be consistently drooping below the other. Parents should also watch for protruding shoulder blades, unevenness in gait, or misalignment of the head with the rest of the body, as these are all common symptoms of scoliosis.

In addition to home surveyance by parents, it is recommended to have posture screening for children in schools, together with regular health screenings. This will help to identify any symptoms earlier, especially since most children are developing rapidly at this time, which is typically when scoliosis begins to occur; and raise awareness about the condition, at the same time.

Recently, ALTY organised a Community Scoliosis Screening campaign – with pharmaceutical business, Viatris – around Klang Valley which resulted in over 250 walk-ins. From the screening sessions, it was discovered that a majority of parents and guardians were unsure of what signs to look for in their children, especially concerning scoliosis.

Most were also unaware that posture screening is available at most health clinics that can highlight growth or development related issues in children.

Dr. Wong said that one away to ensure early detection of scoliosis in children is to make early screening accessible in schools. School authorities and government collaborations can be considered in the future to ensure that posture screening is included as part of regular health assessments for Malaysian children.

However, if you are still unsure, it is best to consult an orthopaedic specialist as soon as possible. An orthopaedist who specialises in paediatric conditions will be able to examine spinal curvatures in children or recommend preventive measures as necessary.

While scoliosis is not a preventable condition, measures can be taken for early detection that can slow down the worsening of the condition, thus avoiding surgery. Even in situations where surgery is still needed, early detection would translate to shorter segments and safer surgeries.


Medicine shortage expected to be resolved in 2 weeks

The shortage of medicines in the country is expected to be resolved within two weeks, says deputy health minister Dr Noor Azmi Ghazali.

He said the health ministry was working hard to resolve the issue quickly.

He said medicine supply was probably slow due to raw materials arriving late and possibly due to the sudden high demand.

“It is also likely due to the war in Ukraine.

“So, there is not only a shortage of meat and eggs but also medicines,” he said when met by reporters after opening the National Institute of Health scientific seminar here today.

Before this, the ministry had said it would release government medicine stockpiles to private clinics and hospitals following shortages in the market.

Health minister Khairy Jamaluddin said the move followed the loaning of medicines, as announced on June 13, from the ministry’s health clinics and hospitals to private clinics as part of a temporary solution. – FMT


Thailand’s Lab International/Bio Asia Pacific under one roof in September

This year, Thai shows, Lab International, Bio Asia Pacific, and FutureCHEM International, will be held under one roof from 14-16 September at BITEC, Bangkok. Organiser VNU Asia Pacific, together with Thailand Centre of Excellence for Life Sciences (TCELS), the organising partner for Bio Asia Pacific, says it is also confident of staging a physical event this year.

VNU says that more than 100 companies will be participating at the shows.

Anucha Parnpichate, Senior Project Manager, VNU Exhibitions Asia Pacific Co., Ltd. said, “This year, we have received very positive feedback from exhibitors. We had organised the exhibition in the hybrid format in 2020 and the full virtual format in 2021, at this moment we are confident that all of the exhibitors are ready to return to the normal format. Many exhibitors will bring the new technology and new innovative products & research. We are confident that this year’s event will become more interesting and stimulate the economy, especially in the scientific laboratory instrument, biotechnology, life sciences, and pharmaceutical industry.”

“For the physical event, it is the platform to connect the people, producers, buyers, traders, and industry workers to interact with each other in a way that everyone is familiar with. The participants can learn from the LAB professionals who present the new tools and innovative laboratory instruments of their companies. Participants can also see, test, and experience real-time demonstration together at the exhibition,” said Dr. Sopon Purawatt, Product Manager of Becthai.

Bio Asia Pacific is a new leading conference and exhibition platform for Biotechnology, Life Sciences and Smart Health. It will focus on therapeutics and healthcare services; while Lab International will showcase all laboratory equipment and instrument covering areas of Analytical & Testing, Calibration & Metrology, Clinical & Diagnostic, Environmental & Safety, and R&D, as well as a variety of conferences & seminars to be conducted.

For more information, please visit www.thailandlab.com and/or www.bioasiapacific.com


SMCV experts share about chronic headaches and migraines and when to get them checked out

Headaches or the more debilitating migraines can disrupt daily activities – while they may stem from various causes that are treatable, medical experts at Sunway Medical Centre Velocity (SMCV) in Kuala Lumpur, Malaysia, say that worsening headaches or migraines may point to an underlying condition.

Tension headaches, the most prevalent type of headache in Malaysia (26.5%), and migraines (9.0%) have the potential to turn into chronic headaches, according to Dr. Kok Chin Yong, Consultant Neurologist and Internal Medicine Physician from SMCV.

“Chronic headaches are defined as headaches that last 15 days or more in a month, for more than three months,” Dr. Kok said. “Chronic headaches should not be taken lightly – while it may not always be a marker of something serious, one should seek medical attention if the headache is accompanied by other symptoms such as numbness, weakness, difficulty speaking and walking, visual disturbance, fever and loss of weight.”

Dr Kok went on to explain how most patients experience episodic headaches that come and go, with some needing little to no painkillers to manage the pain. Half of patients with chronic headaches may also suffer from what is called a medication overuse headache (MOH), which is often underdiagnosed but can be treated by managing the usage of painkillers to reduce its severity.

“Migraines can affect one’s life and work. It can worsen with physical activity, affecting focus and concentration that in return reduces one’s efficiency at their workplace. Episodic migraines can be prevented from turning into chronic migraines by taking good preventative medications and making lifestyle changes,” added Dr. Kok.

These lifestyle changes include regular exercise, managing stress levels, and getting proper hours of sleep.

“Non-drug strategies are crucial as they can worsen and trigger migraines. One needs at least seven hours of good quality sleep – do not consume alcohol in order to sleep or take caffeine later than 3pm as it affects your sleep quality. High screen time can also trigger migraines especially in young adults, and these patients are sensitive to lights and flickering sound, which can also worsen the migraines.

“The key to prevent migraines is regularity. Patients with migraines need to have a regular eating and sleeping time, as a lack of it can trigger migraine attacks. If someone has high frequency of migraine attacks, one must be aware that there are good and effective preventative medications to reduce the burden. Some come in the form of pills and some in the form of injections [which are] very easily administered and can reduce the frequency and severity of migraine attacks.”

As for constant headaches and migraines as indicators of more serious health issues, SMCV Consultant Neurosurgeon Dr. Gerard Arvind Martin revealed that some headaches can be signs of tumours or other such anomalies, which are fatal if left untreated.

“We have seen this to be especially true for those whose headaches are caused by tumours or vascular conditions such as aneurysms. A tumour may announce itself by affecting that specific area it is pressing against or developing in, therefore causing symptoms related to that part of the brain. A growing tumour may grow, either quickly or slowly over time, and push aside the brain, causing the brain to react to tumour tissue and brain swelling occurs, and headache ensues,” said Dr. Martin.

Aside from these headaches, patients should also look out for effects in other neurological functions such as impairment of decision-making, thinking, and memory. The presence of a seizure, either before, during, or after the onset of headaches can also be an accompanying feature to brain tumours.

“While it is alarming to think that [headaches] are always caused by something sinister occurring within ones’ head, the truth is that headaches can also be caused by other parts of the head such as the eyes, ears, neck, the sinuses, or even teeth. Therefore, it is a good practise to rule out anything occurring in these areas as well during an initial consultation.

“Those who act upon their symptoms in a timely manner and get themselves treated are able to mitigate their conditions and, depending on the diagnosis, able to continue to lead fuller lives,” Dr. Martin concluded.


Malaysia needs more medical assistants

The Health Ministry has expressed concern over the low number of medical assistants in the country, with the medical assistants to population ratio now at 1:1,466.

Health Minister Khairy Jamaluddin said if this continued, the manpower would not be able to cope with growing demand in the healthcare sector.

“We fear the situation may become more critical in the future. Although we have 22,257 medical assistants up to December last year, at a ratio of 1:1,466, our target is 1:1000,” he said in his speech at the National Conference of Medical Assistance at a hotel here on Monday night.

The speech was read by Deputy Health Minister I Datuk Dr Noor Azmi Ghazali.

Khairy said further discussions with the Public Service Department and Public Services Commission would be held to create additional posts to beef up and improve healthcare services.

“I was told that 4,328 graduates from the Health Ministry’s training institutions are still contract workers. We will ensure these graduates get permanent positions in stages.”

He said the government would review employment rules in healthcare services in line with new developments in the sector.

“This will ensure occupational projections are on the right path. This is crucial as a guide for effective planning.”

In February, the government agreed to create 8,686 permanent positions for medical, dental and pharmaceutical officers from 2022 to 2025. Appointments to these positions began this month, with 3,586 medical officers, 300 dental officers and 300 pharmaceutical officers getting permanent positions.

The government also decided that at least 1,500 permanent healthcare positions would be created every year from next year to 2025. – NST


Debunking five period myths for Menstrual Awareness Month

Menstruation is a natural bodily process but is yet looked down upon today – there are numerous ludicrous misconceptions surrounding menstruation in our society. In conjunction with Aurelius Healthcare Malaysia’s Menstrual Awareness Month, Dr. Azizah binti Rusly, Consultant Obstetrician & Gynaecologist at Aurelius Hospital Nilai helps us to debunk some common myths surrounding menstruation.

Menstruation is the discharge mainly of blood and uterine lining that vagina-owners have every month, essentially a self-cleansing process. Products and facilities for menstrual hygiene has come a long way, however, according to a report by the World Bank Group, at least 500 million women and girls worldwide face period poverty i.e., lacking proper access to sanitary products and facilities for menstrual hygiene management. With the lack of access comes the limited awareness and understanding of the best way to manage menstrual hygiene.

Myth: “My mum said I need to wash my pad because blood is dirty, and it will attract devils!”

Dr. Azizah: Period blood is similar to other blood from our body and is not dirty. It is made up of blood, uterus membrane, mucus lining, and bacteria. While it can sometimes appear to be clotted or darker, such occurrences are completely normal.

Disposable pads should be appropriately wrapped and thrown after a single use. However, if you are using reusable pads or menstrual cups, soak them with cold water and wash using normal detergent, baking soda, or vinegar. It is also important to keep them dry! Doing so can avoid infections.

Myth: “I used to hide my sanitary products as it is inappropriate and disrespectful to be shown in public.”

Dr. Azizah: Sanitary products are everyday lifestyle items just like tissue and toothpaste, which support and help women feel more comfortable during menstruation. Every woman should have the freedom to purchase sanitary products without feeling embarrassed about a monthly natural occurrence.

Myth: “A tampon will break my hymen.”

Dr. Azizah: Tampons may cause some stretch or tear of the hymen, but this could also happen when you engage in vigorous activities. Some women may experience discomfort when inserting a tampon the first few times – however, it will eventually get better!

Myth: “I was told that sticking a washed pad to my face gives me clear skin.”

Dr. Azizah: It is unhygienic as menstrual waste or products should be disposed of properly.

The methods for getting clear skin will vary depending on a person’s skin type. A healthy and balanced diet can help you be the best version of yourself [and your skin], so eat plenty of fruits and vegetables, drink an adequate amount of water, and exercise at least three times a week.

Myth: “I should avoid cold foods/beverages as it will give me heavier flow and period cramps.” 

Dr. Azizah: There are no studies to prove or disprove the effects of cold drinks or food on menstrual cramps. Menstruation is connected to the reproductive system, whereas eating or drinking is linked to the digestive system. These systems function separately and do not affect one another. However, some women are sensitive to cold food or drinks, which might increase or induce cramps. At the end of the day, you should know what your body is used to and act accordingly.


Covid-19: Evusheld antibody treatment soon

The Ministry of Health (MOH) will start administering treatment with the monoclonal antibody drugs Tixagevimab and Cilgavimab (EVUSHELD) in the near future to ensure that high-risk groups continue to be protected from COVID-19 infection.

Health Minister Khairy Jamaluddin said that currently the EVUSHELD antibody drugs would only be administered in government hospitals, and they could be used as pre-exposure prophylaxis (PrEP) for those who were not yet infected with COVID19 but were at high risk of becoming infected.

“Studies show that the EVUSHELD antibody drugs can protect recipients against COVID-19 infection for a period of six months after injection,” he said in a statement, today.

Khairy explained that the method of administering the antibody drugs was through two consecutive intramuscular injections of Tixagevimab and Cilgavimab.

He said for immunocompromised patients who had received the COVID-19 vaccine, EVUSHELD should be given at least two weeks after vaccination.

Commenting further, Khairy said the assessment of the patient’s eligibility to receive the antibody medication would be done by the treating physician.

Among the selection criteria were those aged 12 and above; weighing more than 40kg and are among the moderate to severe Immunocompromised group (taking into account the immune response of this group to COVID-19 vaccination which is unlikely to reach a satisfactory level of immunity).

In addition, another criterion was individuals who were unable to take the vaccine completely due to medical reasons or had a history of severe reactions to the COVID-19 vaccine.

Meanwhile, Khairy said that treatment using the antiviral drug Paxlovid to treat COVID-19 patients would be extended to selected private health facilities in the near future, to ensure better access to patients.

He added that the distribution of Paxlovid medicine to patients in private health facilities is free of charge, but patients are still subject to consultation service charges and other related charges determined by the private health facility.

The use of antiviral drug Paxlovid, which has been implemented at MOH health facilities since April 15, is the first oral antiviral drug in Malaysia to treat COVID-19 patients with mild to moderate symptoms (categories two and three).

In the meantime, he said the priority of Paxlovid treatment was to the high-risk group of COVID-19 patients.

“As of June 5, 2022, a total of 1,364 patients were given Paxlovid treatment and have fully recovered, and no serious side effects have been reported. This treatment has proven to be safe and effective, and can reduce the severe effects of infection and mortality of COVID-19 patients,” he said.

Khairy said that the MOH believed and was confident that Malaysia was now on the best track to go through the transition to endemic phase effectively and safely, due to the ever-improving medications and treatment methods. – Bernama