Directions in Healthcare 2013

I will touch briefly on 4 emerging topics in healthcare today based on what I read at Arab Health forum in LinkedIn. You can join there to read more and pick up on details.

The emerging topics are:

1. Extending healthcare to the Arab community by way of medical benefits & aids, building hospitals, etc
2. Attending to the needs of the diabetics via innovations in medical R&D, eg increasing insulin production/supply/access, podiatry clinics, orthopedic clinics, etc
3. Improving R&D on cancer diagnostics, eg using a single marker to detect all existing cancers within a person, cancer staging and documentation, etc
4. Improving e-learning to cover healthcare and diagnostics

GM Foods: Frankenfish vs Real Salmon

Genetically engineered (GE) salmon or "Frankenfish", exhibits high levels of insulin-like growth factor-1 (or IGF), a hormone that has been linked to a variety of cancers in humans. GE salmon express 40 percent higher rates of the hormone than non-GE salmon, suggesting a significant risk to consumers.

The American Cancer Society acknowledges the link between IGF-1 and cancer, but has stated that more independent science is needed before any conclusions can be made about the safety of products like recombinant bovine growth hormone (rBGH).

The FDA approved rBGH in 1993 and it became widely used in American dairies for about a decade, despite concerns over IGF-1 and the fact that most other industrialized nations banned it. 

After more science emerged, many American companies, including Kroger, Walmart and Starbucks, took the extraordinary measure of independently banning rBGH from their products.

GE = genetically engineered; the DNA is modified; same as GM
GM = genetically modified; same as GE

MORE INFORMATION

Engineered Fish Moves a Step Closer to Approval (NY Times)
http://www.nytimes.com/2012/12/22/business/gene-altered-fish-moves-closer-to-federal-approval.html

GM salmon: FDA's assessment of environmental risks (LA Times)
http://www.latimes.com/health/boostershots/la-heb-aquabounty-salmon-fda-assesses-risks-20121224,0,2554480.story

Genetically Modified Animals (Women’s Health Magazine)
http://www.womenshealthmag.com/nutrition/genetically-modified-animals

Protect our waters from GE Salmon (Center for Food Safety)
http://ge-fish.org/

Below the Surface: The Dangers of Genetically Engineered Salmon (Food & Water Watch)
http://www.foodandwaterwatch.org/factsheet/below-the-surface/

Genetically Engineered Salmon (Ocean Conservancy)
http://www.oceanconservancy.org/our-work/aquaculture/aquaculture-genetically.html

Pig Products

The pig is used worldwide to make a lot of products which are not halal.

http://vimeo.com/10717795

The pig is used to make paper, printing ink, pumpernickel bread, animal feed (cat food, bird food, dog food, fish pellets, etc), gelatin powder, gelatin capsule, gelatin softgel, pudding, marshmallow, licorice strips, gums, cupcakes, whipped cream, chocolate bar, health bar, insulin, heparin, automotive paint, paintball, bullets, bone china (pinggan mangkuk), bio diesel, foundation for makeup, body lotions, antiwrinkle creams, crayons, toothpaste, antifreeze, floor wax, electrical sockets, battery, brushes, etc. No part of the pig is wasted.

USM-University of Songkla @ Pattani

USM is meant to be a "science" university while USIM is meant to be an "Islamic" university. Both universities offer medical programmes. However, it should not be misconstrued that USM is unIslamic. While USM Health Campus is deemed as Islamic it has great competitors in the peninsula - Universiti Malaya (UM), Universiti Kebangsaan Malaysia (UKM), Universiti Putra Malaysia (UPM). As such USM (via its past MoU) has gone cross-border to bring Islam into its curriculum. It is bringing in Islam from Pattani, an ancient place where sufi sheikhs, ulama' and murids were centred to study Islam and spread it to this region.

USM-U Songkla @ Pattani - ties for Islamic Studies:
Usaha untuk perkasakan pengajian tinggi

2012 Nobel Prize in Physiology or Medicine

Shinya Yamanaka & Sir John B. Gurdon: Stem Cell Research
http://www.cell.com/cellpress/nobelprize2012

Electronic Medicine

Electronic medicine (e-medicine) is a big field and is quite challenging. There are a lot of things which can be learned and done. For beginners, these external links will help to orient you to simple things in the field. You can then go on and create new things and learn new things.

http://www.medipro.com/blog/

http://www.youtube.com/watch?v=mE9Qh_NuclM

http://www.youtube.com/watch?v=DpRsMKNdnn8

Electronic prescribing (e-Rx)
http://www.youtube.com/watch?v=x0Bo6Gy20gI

Nenas Batu

There are many varieties of pineapples. Long long ago, pineapples were sour and not many people liked to eat pineapples. Today, pineapples are sweet. There are big and small pineapples. The Malay people eat pineapple slices with rojak buah, paceri nenas or acar nenas. The Chinese use small pineapples (mutiplets) as offerings in their prayers. There is a small variety of pineapples, as big as 2 fingers, which is called nenas batu. Nenas batu has a medicinal value and is used by the Malay people to dissolve renal stones (batu karang kecing). The pineapple is soaked and the water drank for its curative properties.

More on medicinal uses of nenas batu:
http://adrydaud.blogspot.com/2010/02/nenas-batu.html

Jarum Tujuh Bilah

Jarum tujuh bilah (7 needles) is a plant with edible leaves. Seven leaves are eaten at one sitting for their medicinal value. The plant has very small but sharp spines or prickly needles which sting when accidentally pierced. The sting lasts a long time, and is worse than those from cacti. The Malay people consume the leaves raw to ward off cancer. The leaves are tasteless and a bit slimy but crispy.

Medicinal uses of jarum tujuh bilah:
http://adrydaud.blogspot.com/2010/03/jarum-tujuh-bilah.html

Castor Oil

The castor plants grow wild on unused land by the roadside as well as old parking lots or house sites after demolition. The plants need no care and can even thrive in abandoned places.

What does the castor plant look like? Are they poisonous?

The leaves of the castor plant look similar to the leaves of the opium plant. The castor plant bears castor fruits which are the most toxic substance known in Malaysia. The seeds are used for making castor oil, and are used by the car industry as a lubricant (minyak pelincir).

Castor plant in Jelutong, Penang

Castor plant in the parking lot, a former house site

Close-up of the castor fruits

Castor plant growing by the fence near a parking lot where a house once stood 

Castor plants in Kota Bharu, Kelantan

Castor plants by the roadside, beside the newly constructed expressway

Close-up of the above photo

Castor plants some distance from a wooden Malay house, by the roadside, near the newly constructed expressway

Terung Susu Kambing

Have you ever seen the breasts of goats? We call them kopek kambing or tetek kambing. There is a type of brinjal plant that produces green coloured brinjals that mature to become bright yellow brinjals shaped like the breasts of goats!! LOL. Thus, we call them terung susu kambing, terung kopek kambing, and other similar hilarious names. The dried yellow brinjals are used for interior decor in expensive hotel lobbies such as the Marriott Putrajaya. They are mainly used by the Chinese around Chinese New Year for decor.

Terung susu kambing (bright yellow brinjals). Botanical name: Solanum mammosum. Plant family : Solanaceae. Photo from Medicinal Plant Interest Group in Facebook

More on medicinal uses of terung susu kambing from Dedaun Alam:
http://adrydaud.blogspot.com/2010/08/terung-susu-kambing.html

Crabs Eye

Crabs sure have big eyes, don't they? But the bright red-black beans called crabs eyes are no ordinary "eyes", they are poisonous beans!! They are discussed in Facebook Medicinal Plant Interest Group.

Crabs eyes (Abrus precatorius) of the Fabaceae plant family

In Facebook, a question was asked whether these seeds are dangerous. I wrote the following:

Yes, these seeds are poisonous. Way back in 1981-82, my US professor & myself researched on these seeds for anti-diabetes properties, etc. We did drug discovery using these seeds as a source of some analogue. I can't remember the details anymore. You can try and Google my professor, Prof Alexander McPherson. He was from MIT and working with another of my professor, Prof Frances Ann Jurnak. The couple moved from MIT to U of California Riverside, and later to UC Irvine. I left before they moved to Irvine.

The seeds are poisonous as they contain abrin, a toxic protein. The seeds are first heated and then boiled to denature and remove the toxin. The seeds are then dried. The leaves are not known to be poisonous and are either consumed raw or made into tea which clears the throat and improves the quality of voice for singing.

The seeds are known by many names. In Indonesia it is called Saga Manis while in Terengganu it is called Saga Keneri. Keneri was an old unit for weighing gold; one seed equals "satu mas" (1 seed = 1 gold). The term "mas" continues to be used today in the state of Kelantan even though gold was not used after the British colonial system in Malaya introduced their not-so-glamorous coins which were not gold coins but metal alloys.

After more than 90 years of the Kelantan gold coins missing from the Kelantan business scene, Kelantan has recently re-introduced gold coins to the general public. Gold coins and wafer-thin pieces of gold are still preferred items as "mas kahwin" in Malay weddings in Kelantan.

Urang aring

Urang aring is a small herb used in traditional medicine. Its synonym is black henna. It is used to make the hair black and shiny. It has many other health uses too.

DQ Farm:
http://www.facebook.com/DQFarm

Urang aring:
Eclipta alba (L.) Hassk: A Valuable Medicinal herb

Erectile Dysfunction (ED)

http://www.youtube.com/watch?feature=endscreen&NR=1&v=-7CxMl5oiIk

Diabetes Education

http://www.youtube.com/watch?v=rgNf8nsXA0Q

Insulin Resistance

http://www.youtube.com/watch?v=YXFJWoHura8

Care of the elderly

Caring for the elderly is an expensive job today. In any family with an old person, the family spends quite a large sum of money on the needs of the elderly. Supplements alone for the elderly can amount to RM700 for a month. That's sufficient for a normal healthy elderly.

What if a family has an elderly who is a diabetic? Diabetic medications are expensive if the family has to pay for the medicine. If there is a rich family member who is willing to pay for the elderly's medicines, then that's fine. But what if, the breadwinner earns just RM1,000/mo (minimum pay in Malaysia today)? Will that be sufficient to support and provide health care for the elderly?

What else do the elderly need? Special homes? Special care? Special food? Special room? Special kitchen? Special garden? Why special?

Next time you see an elderly, ask these questions and share here.

http://www.guardian.co.uk/commentisfree/2012/dec/30/social-care-elderly-funding

Frozen Shoulder

A 65-year old Malay lady was always fatigued. She could not walk 15 flights of stairs without getting breathless. She was sleepless night after night due to arm pain. She used rubs and also drank ginger tea (teh halia) which helped. However, she still could not sleep at night because the hand was painful in all positions except when it hung down. She could only sleep on her right and back. The pain affected the neck, back and arm.

X-ray did not show fracture. MRI showed frozen shoulder, and herniated and fused 3,4,5,6 vertebrae. That had been for some time and some muscles (for eg majora pectoralis), under the lower arm and on the top of the palm seemed dead and wasted (jadi kempis).

An angiogram was done.

She was diagnosed with 3 medical problems: frozen shoulder, herniated & fused  vertebrae and mild ischaemic heart disease.

She did daily neck traction. She was told her frozen shoulder would take 18 months to heal.

She was prescribed aspirin, blood-thinning, heart medications and anti-cholesterol.

She needed prayers.

More on frozen shoulder:
http://orthoinfo.aaos.org/topic.cfm?topic=a00071
http://www.aafp.org/afp/1999/0401/p1843.html
http://en.wikipedia.org/wiki/Adhesive_capsulitis_of_shoulder

E-Learning in Medicine

More and more sophisticated gadgets are made and many are in the marketplace today. Not all of us like these gadgets. Families use these gadgets for a purpose. Working adults use them for a purpose. Students need them for a purpose. Children also need them for a purpose.

What matters is what gadgets fit whom and for what needs. When do you go out to buy an expensive sophisticated gadget that you think will fit your fancy? Or do you just own them just to be like the Jones?

In medical education or the teaching of medicine at undergraduate level, these gadgets have managed to find a place in the pockets of medical students, regardless of whether lecturers are aware or otherwise. Medical students are among the most responsive users of gadgets for learning. They surely must own the world's fanciest gadgets at such a young age. But do these gadgets help them in their learning or improve their grades? How do we know that these sophisticated expensive gadgets are indeed helping students to learn and learn better?

If students have these gadgets, will university education and mode need to change too? What should we do about didactic teaching? How should we transform lectures? Is there room for the improvement of lectures at all universities that teach medicine today?

This is the move by Stanford University to make better use of lectures and lecture time. What do you say?
http://www.nejm.org/doi/full/10.1056/NEJMp1202451