Wednesday 28 November 2018

Urine FEME

The doctor will advise on which urine test or analysis to be done.

1. Urine dispstick

So many urine samples by 12 noon at OPD Lab (85 samples).

Urine dipstick test strip with 3 test patches.
Photos taken at OPD Lab, HUSM. 27 Nov 2018.


Purpose of doing Urine dipstick test

This is done at the first appointment when the doctor wishes to know if there is renal involvement and if the urine content is affected.

If the urine test is just to test for normal or abnormal urine, Urine dipstick is done. The lab report is that based on the test strip findings - positive, negative or trace, for each element tested.

In urine dipstick test, the urine test strips can contain 3 or more test patches. A basic test strip will contain patches for protein, glucose, ketones.

The usual urine test for finding out if a patient has renal involvement is a urine dipstick with 3 patches, in order to save cost.

This 3-patch test strip Urine dipstick test is usually done at the Outpatient Department (OPD) lab.

For more detailed urine test, the test strips may contain more test patches. Some will contain up to 13 test patches. This adds to cost of each test strip.

In hypertensive patients (patient with hypertension), the renal system is monitored. This is because, doctors will need to detect kidney involvement in hypertension. Hypertension is a disease affecting the blood vessels to all vital organs. In hypertension, these small vessels will be damaged (burst or busted), leading to abnormal urine, which is detected by urine dipstick.

Doctors will request hypertensive patients to do "urine test" (dipstick) before coming to see the doctor at the next appointment (ie To Come Again  or TCA). If there is renal involvement (eg protein in urine or microalbuminuria), the doctor will advise the patient accordingly, ie there is renal involvement, ie the disease or condition has worsened, and now the kidneys are affected.


2. Urine FEME

Fixed-angle rotor
Centrifuge
Urine sample after centrifugation

Examination of urinary sediment
Urine FEME test results
Photos above taken at OPD Lab, HUSM 27 Nov 2018.


Purpose of doing Urine FEME

If the doctor wishes to know whether there is infection of the renal system and needs to know the region of origin in the renal system, then the doctor will request for Urine FEME. Urine FEME will involve Urine dipstick test and Microscopic Examination of the urine. Meaning 2 tests will be done on a single urine specimen.

If the doctor wishes to know whether the urine is clear or cloudy (berkeladak) or dark coloured (warna merah kehitaman), the doctor will order Urine FEME.

In the case of bacterial infection (eg severe cough and cold that does not seem to subside in a week), and the patient complains of severe bouts of coughing, sore throat (gatal tekak), nausea (rasa loya nak muntah), loss of appetite (LOA, tak lalu nak makan), and pain (renal colic) in the kidney region (right or left kidney or both) in the back (not back pain), then the doctor will order Urine FEME to be done at OPD lab.

Urine FEME is a walk-in test performed at the OPD lab. The patient takes the green requisition slip from the doctor's office and then walks over to OPD to have it done. The test takes less than 20 minutes. Urine is collected in a small container (10-20 ml) in the toilet. The lab technologist will process and perform Urine FEME. The urine is pipetted and placed in a 10 ml clear glass test-tube. The tube is then centrifuged. Much of the supernatant (cecair bahagian atas) is removed and the sediment mixed and examined under the microscope (high and lower power fields). The lab technologist will look for "formed elements" inside the urine debris. The urine debris or sediment will contain nothing or some "elements". These "elements" can include cells (rbc, wbc) and epilthelial casts (which indicate their origin within the renal system). The lab technologist then fills in the results slip (same green slip) and returns that to the patient to take back to the doctor. The patient then walks back to the doctor's office to have the Urine FEME test results interpreted and explained properly.

In cases where there is renal involvement (of the kidneys, renal tubes and urinary bladder), there will be wbc, rbc, epithelial casts observed in the urine tested for Urine FEME. Otherwise the urine stays normal without any indication (ie negative Urine FEME).

The Urine FEME test is very important because in bacterial infection, the bacteria can go to the kidneys and infect the kidneys, causing excruciating pain. Sometimes breathing is affected. Sometimes sleep at night is impossible because of the excruciating pain. Upon inspection of the urine, rbc, wbc and epithelial casts can appear in the urine. There may also be bacteria present. All these elements will change urine composition and will be detected in Urine FEME.

Monday 12 November 2018

Cancer Therapy: GcMAF, Nagalase and Macrophage

Body's defence system
Our body contains cell stores which help us to generate cells which fight cancer. These stores or nodes are present throughout the body.

Macrophage & phagocyte locations
Macrophages and phagocytes are produced by the skin, gut and intestinal Peyer's patches, lungs, blood, bone marrow, connective tissue, lymphoid tissue, spleen, and thymus.

Types of phagocytes

  1. Skin - macrophages, resident Langerhans cells, dendritic cells, mast cells
  2. Gut and intestinal Peyer's patches - macrophages
  3. Lungs - macrophages, monocyes, mast cells, dendritic cells
  4. Blood - neutrophils, monocytes
  5. Bone marrow - macrophages, monocytes, sinusoidal cells, lining cells
  6. Connective tissue - macrophages, monocytes, dendritic cells, histiocytes
  7. Lymphoid tissue - macrophages, monocytes, dendritic cells
  8. Spleen - macrophages, monocytes, sinusoidal cells
  9. Thymus - macrophages, monocytes


Peyer's patches
The nodes in the intestine are most important. These nodes are called Peyer's patches. They are found beneath the basement membrane of the intestinal mucosa. They are a source of macrophages and immunoglobulin A (Ig A) in response to contents of the food a person consumes.

Invaders that invade the human body

  1. Viruses (viral infection)
  2. Cancer


Viral infection
(keywords: viral enzymes (nagalases), macrophages, immunity)
When a batch of virus launch an attack on the body, the viruses produce an array of enzymes that weaken the macrophages, rendering them ineffective in fighting off the viruses. This is described as a weakened immune system because the body fails to defend itself and fails to fight off the invading viruses.

Cancer
Cancer cells also produce nagalases which act on macrophages, rendering them weak and inefficient in protecting the body against invading cancer cells. With a weakened immune system, the cancer is able to grow and metastasise.

GcMAF-nagalase loop

  1. GcMAF (contains Gal-GalNAc)
  2. Nagalase


GcMAF
GcMAF is Gc Protein-derived Macrophage Activating Factor. GcMAF is a glycosylated protein bound to vitamin D. There are three forms (subtypes) of GcMAF. They differ in the number of sugar and sialic acid residues in the side chain. The sugar found  in GcMAF are glycosamines.

Structure of Gc protein
The Gc protein contains a threonine (Thr) residue, to which is attached a disaccharide side chain containing galactose (Gal) and Galactosamine (GalNAc) and sialic acid (SA), or simply, Gal-GalNAC-SA. Gal-GalNAC is a cancer biomarker for colon cancer (carcinogenesis). There are three forms of Gc which can be converted to GcMAF. They are Gc1f, Gc1s and Gc2.

(Gc1f):  -aa-aa-aa-aa-Thr-aa-aa-
                                    |
                        Gal-GalNAc
                                    |
                                  SA

Gc1s: -aa-aa-aa-aa-Thr-aa-aa-
                                 |
           (SA)-Gal-GalNAc
                                |
                              SA

Gc2: -aa-aa-aa-aa-Thr-aa-aa-
                               |
                   Gal-GalNAc


Nagalase
Nagalase if one of the viral enzymes. There are two types of nagalases - ie exo- and endo-nagalases. They act at different sies (loci) on GcMAF.

Pathway
When virus or cancer attacks the body, they produce nagalases, which act on macrophages and inactivate them. GcMAF on the other hand, acts opposite of nagalase, ie, they promote macrophage activation. Activated macrophages can transform into natural killer cells (NK cells) which can actively fight a viral infection or cancer.

Production of GcMAF
GcMAF is produced by a laboratory in Japan. There are two productions of GcMAF, ie first and second generations.

  1. First generation GcMAF (1991-2010)
  2. Second generation GcMAF (2011-present)
First generation GcMAF
This GcMAF was less concentrated, unstable at room temperature and had a short half-life.

Second generation GcMAF
This GcMAF was more concentrated, more stable and can last two weeks without refrigeration and up to a year with refrigeration. This is the preferred form for use.


Administration routes of GcMAF
GcMAF can be administered via four routes, ie, skin, muscle, intestine and lungs.

  1. Skin (subcutaneous, SC)
  2. Muscle (intramuscular, IM)
  3. Intestine (oral)
  4. Lungs (inhalation via nebulizer)


Conversion of Gc1f to GcMAF
  1. B cells contain lyso-PC inducible beta-galactosidase. This enzyme removes galactose from the Gal-GalNAc side chain.
  2. T cells contain sialidase. This enzyme removes sialic acid from the GalNAc-SA side chain.

GcMAF: -aa-aa-aa-aa-Thr-aa-aa-
                                      |
                                 GalNAc


Macrophage activation and transformation
GcMAF acts on dormant macrophages to activate them. Activated macrophages transform to NK cells.

Is GcMAF therapy effective?
YES, in the 99 patients who obtained successful treatment.
NO, in one patient in which treatment failed.
Failure rate is 1 in 100 or 1% ineffectiveness, which is negligible.


External links
https://www.immunotherapy-cancer-and-chronic-disease.com/frequently-asked-questions-about-second-generation-gcmaf/

http://gcmaf.timsmithmd.com/book/chapter/53/

https://www.advancedrejuvenationinstitute.com/cancer/3-immunotherapy/cancer-research-gcmaf.html

https://healingoracle.ch/2017/09/06/tutorial-how-to-inject-gcmaf/

https://www.researchgate.net/figure/Plasticity-of-macrophages-in-tumor-microenvironment-and-pathogenesis-of-HCC_fig2_275041931

https://www.immunopaedia.org.za/clinical-cases/infectious-diseases/a-case-of-decreased-joint-function-fever-and-rash/

http://cancerres.aacrjournals.org/content/76/3/513/F1

https://healingoracle.ch/2017/09/06/tutorial-how-to-inject-gcmaf/

https://cancer-cures-plus.com/persecuted-heroes/how-gcmaf-works/new-cancer-fighter-gcmaf-update/

https://thetruthaboutcancer.com/gcmaf/

http://www.brainimmune.com/endogenous-catecholamines-in-immune-cells-discovery-functions-and-clinical-potential-as-pharmacotherapeutic-targets-3/

https://immuno-oncologynews.com/2015/06/09/pd-1-protects-t-cells-burning/

https://www.ncbi.nlm.nih.gov/pubmed/8839767

Sunday 11 November 2018

Mysteries Surrounding Vitamin D

* Emeritus Professor Anthony Norman at the University of California, Riverside campus discovered vitamin D in the 1950s when he was researching hens. Hens which lacked vitamin D had bowed legs. Prof Norman and wife Prof Helen Henry, researched and taught at UCR, Biochemistry and Medicine. Both visited Penang in the 1980s. I met them when I attended UCR in 1980-1982 and when I was working at USM based in Penang.

Photo by Brooke Cagle on Unsplash

* Anorexia nervosa was a fad in the 1960s and 1970s in California. Hippies were often thin and wore Bohemian-styled clothes. They probably suffered from severe acidosis and osteomalacia and vitamin D deficiency.

* In many poor communities, children do not receive adequate nutritious food. Often, young children had big heads and tummies and bowed legs. Children developed rickets due to malnutrition.

* In the modern world where mothers work, babies and toddlers are left at nurseries. Nurseries can leave the children in walkers for long periods. This adds burden to tiny legs, which will eventually bow as the bones are still soft to bear the body's weight.

* Cancer has become quite common today worldwide. Apart from the effects of the atomic bombing of Hiroshima and Nagasaki, and the Bopal carbide disaster, there is breast cancer, colon cancer, bone cancer, brain tumour, pancreatic cancer, prostate cancer and many other cancers which have afflicted many people, young and old.

* Researchers have tried creating vitamin D analogues for use in alternative cancer therapy. However, lack of evidence-based medicine has plagued its acceptance and adoption for widespread use for otherwise prospective cancer sufferers.

----------------------------------------------
Precursors of vitamin D
  1. cholesterol
  2. 7-dehydrocholesterol (7-DHC)
  3. pre-D3
-----------------------------------------
Forms of vitamin D
  1. Vitamin D3 (cholecalciferol, made by skin via UV light) ... found in fish
  2. Vitamin D2 (ergocalciferol, derived from plant sterol ergosterol) ... used for food fortification ... a vitamin D analogue
  3. 25-hydroxyvitamin D (25OHD)
  4. 1,25-dihydroxyvitamin D (1,25(OH)2D) ... active form, a hormone
----------------------------------------
Enzymes in vitamin D metabolism
  1. CYP2R1 (25-hydroxylase)
  2. CYP27B1 (1-hydroxylase)
  3. CYP24A1 (catabolism)
  4. 3-epimerase
  5. CYP11A1

CYP2R1 is the most important 25-hydroxylase.

CYP27B1 is the key 1-hydroxylase.

Both 25OHD and 1,25(OH)2D are catabolised by CYP24A1.

----------------------------------------
Sources of vitamin D
  1. Vitamin D3 is made in the skin from 7-dehydrocholesterol with exposure to UV light
  2. Vitamin D2 (ergocalciferol) is derived from ergosterol, a plant sterol
----------------------------------------
Production of vitamin D

The production of vitamin D3 (D3) in the skin is not an enzymatic process but requires UV light from sunshine. Both UVB intensity and skin pigmentation level contribute to the rate of D3 formation.

* Exposure of the skin to sunshine in the morning for 15 minutes daily is sufficient for vitamin D production. Babies can also be exposed to the soft sun-rays in the morning for this purpose.

D3 (cholecalciferol) is produced from 7-dehydrocholesterol (7-DHC) through a two-step process in which the B ring is broken by UV light (spectrum 280–320 UVB) radiation from sunshine, forming pre-D3 that isomerizes to D3 in a heat-sensitive but non enzymatic (non catalysed) process.

* Melanin in the skin blocks UVB from reaching 7-DHC, thus limiting D3 production. However, Blacks have large amount of melanin in their skin and yet have good strong bones. Kareem Abdul-Jabbar is a tall, dark and handsome successful famous professional basketball player who played for the National Basketball Association (NBA), USA.

* Sun-screens are worn  for sun bathing or when spending time outdoors as they block sunshine and prevent sunburn, which is painful. Even with sun-screen, basking is limited as sun bathing gives headaches and migraine from excessive UV irradiation.

* Clothing also blocks sunshine from reaching the skin, but not completely. Women who wear thick clothing as a jacket, such as the abaya or jubah, are thought to lack vitamin D or suffer from vitamin D deficiency. This is untrue. These women only wear such long protective jacket when they go out in public, ie for a short time only. They do not wear such clothing at home. This misconception should be corrected among Western researchers and professors.

The intensity of UVB from sunlight varies according to season and latitude. The further one lives from the equator, the less time of the year one can rely on solar exposure to produce D3.

* The Incas of Bolivia live in the highlands of the Andes where the air is thin. They rely on chewed coca leaves or coca drink before climbing to such heights and avoiding dizziness and vomiting. They are exposed to strong levels of UV radiation. La Paz is heavily polluted with brown industrial smog as a result of thinning of the ozone layer and high ozone chemical activity.

Inca women in Copacabana, Lake Titicaca shore, Bolivia 30 Sept 2018.
Courtesy of Noraini Ismail and her travel buddies.
Copacabana is on the shore of Lake Titicaca at 3,841 m (12,602 ft) above sea-level.
Highest navigable lake with surface elevation of 3,812 m (12,507 ft) above sea-level.
Reed boats of the Incas at Lake Titicaca, Bolivia 30 Sept 2018.
Courtesy of Noraini Ismail.
***

Highest capital city at 3,640 m (11,942 ft) above sea-level.
Entering La Paz by coach, Bolivia 30 Sept 2018.
Courtesy of Noraini Ismail.
Highest capital city, La Paz skyline, Bolivia 30 Sept 2018.
Courtesy of Noraini Ismail.

* People who live in the equator have full exposure to sunshine for at least eight hours a day. They have good dentition, dark skin and strong bones. The sea Bajau of Semporna, Sabah (in Borneo) spend a lot of time at sea. They are a great example of sufficient vitamin D intake and exposure to sunshine.

Bajau boy, Semporna, Sabah.
Photo by Logan Lambert on Unsplash

* Apart from the skin, vitamin D can also be obtained from the diet such as milk, liver and eggs.

* Most natural and processed foods, with the exception of freshwater fatty fish (eg ikan patin), contain little vitamin D unless fortified. The Incas consume freshwater trout from Lake Titicaca as a source of EFAs and vitamin D. They have thus good strong bodies.

* The vitamin D in fish is D3, whereas that used for fortification of processed ingredients (eg milled white all-purpose flour) and foodstuff (eg milk, bread, cornflakes, biscuits) is often D2 (ergocalciferol). Many native communities consume fish as a protein and vitamin D source. Fast food outlets offer fish fillet.

Amazon 14 Sept 2018
Brazil 14 Sept 2018
Rio de Janeiro, Brazil 17 Sept 2018
Trout at Copacabana from Lake Titicaca, Bolivia 30 Sept 2018
All photos of fish above are courtesy of Noraini Ismail.

* Phytosterols compete with cholesterol for absorption in the small intestines. When we eat vegetables, phytosterols are preferentially absorbed, and less cholesterol is absorbed. It is therefore advisable to eat vegetables when eating steak and meat dishes.

D2 is produced by UVB irradiation of the ergosterol in plants and fungi (e.g., mushrooms).

* Algae grow to confluence in freshwater. They are a good source of essential fatty acids (EFAs). Seaweeds grow in seawater and are used for making jellies, which can withstand hot temperatures of the equatorial countries.

* Mushrooms, papaya, mangoes and beansprouts are good for encouraging fertility in otherwise barren women.

* Structure-wise, vitamin D resembles cholesterol but with many hydroxyl groups. D2 differs from D3 in having a double bond (C=C) between C22 and C23 and a methyl group (CH3) at C24 in the side chain.

* Since D2 is structurally and chemically different from the active form of vitamin D, D2 can be considered a natural analogue of bioactive vitamin D.

These differences from D3 in the side chain lower its affinity for vitamin D binding protein (DBP), resulting in faster clearance from the circulation, and limit its conversion to 25-hydroxyvitamin D (25OHD) by at least some of the 25-hydroxylases, and alter its catabolism by the 24-hydroxylase (CYP24A1).

Unless given daily, D2 supplementation does not result in as high a blood level of 25OHD as comparable amounts of D3.

On the other hand, 1,25(OH)2D2 and 1,25(OH)2D3 have comparable affinities for the vitamin D receptor (VDR).

----------------------------------------
Metabolism of vitamin D

Once it is made under the skin, vitamin D is metabolised first to 25-hydroxyvitamin D (25OHD) in the liver, then to the hormonal form 1,25-dihydroxyvitamin D (1,25(OH)2D) in the kidneys.

Vitamin D is transported in blood by a vitamin D binding protein (DBP).

----------------------------------------
Vitamin D receptor

The vitamin D receptor (VDR) is found in nearly every tissue except in rbcs (anucleated)

VDR is located in the nucleus and is found in almost all nucleated cells.

1,25(OH)2D is the ligand for the vitamin D receptor (VDR).

1,25(OH)2D is a transcription factor. It binds to sites in the DNA called vitamin D response elements (VDREs).

There are thousands of VDR binding sites throughout the genome, and they regulate hundreds of genes in a cell-specific fashion.

VDR-regulated transcription is dependent on co-modulators, the profile of which is also cell specific.

---------------------------------------
External links

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3968073/

https://www.ncbi.nlm.nih.gov/pubmed/21197695

https://www.nature.com/articles/s12276-018-0038-9.pdf

https://medschool.ucr.edu/faculty_research/faculty_profiles/norman_anthony

https://www.researchgate.net/figure/Vitamin-D-synthesis

https://www.nature.com/articles/nrc2196/figures/1

https://www.nature.com/articles/srep37593/figures/1

https://www.semanticscholar.org/paper/Vitamin-D

https://www.researchgate.net/figure/Vitamin-D-metabolism_fig1

http://www.biochemj.org/content/441/1/61.figures-only

https://www.researchgate.net/figure/Overlay-of-the-systemic-phosphate-homeostasis-with-the-major-players-in-the-phosphate_fig2

https://www.pinterest.com/pin/565905509402816520/?lp=true

https://www.researchgate.net/figure/Photochemical-synthesis-of-vitamin-D-and-main-target-tissues-Classical-pathway-of_fig2

https://www.semanticscholar.org/paper/Vitamin-D Metabolism-Molecular-Mechanism

https://www.researchgate.net/figure/Direct-and-indirect-effects-of-vitamin-D-on-muscle-Data-on-direct-effects-come_fig4

https://www.mdpi.com/1422-0067/18/10/2184

http://acuarios-self-help-health-wellness.blogspot.com/2012/11/vitamin-d.html

http://www.revistanefrologia.com/en-publicacion-nefrologia-articulo-vitamin-d-vitamin-d-receptor-importance-its-activation-in-patients

Saturday 10 November 2018

Civilisation, Traditional Medicine and Biopiracy

Traditional medicine exists in every community that has access to clean freshwater, foliage, flora and fauna. The virgin forest is one of the many assets a community can have.  Sometimes it is not the forest of trees and woods, but a dry desert savanna or a beach vegetation, or wild shrubs and flowers which grow wild by the sandy or dusty roadside. Sometimes they are just plants grown around the house for daily or occasional use. In many communities of Asia, their food is their medicine, which is different from Western medicine.

INDIAN SUBCONTINENT
The Indus Civilisation has provided humans with a myriad of good traditional Ayurvedic herbs that work for many common ailments.

In the hot tropics and the equator, people resort to iced-cold water and ices to quench thirst. Cheap unboiled tap water is used for making ice, and then shaved to obtain ice shavings, which are needed to make attractive, colourful, flavoured ice balls. People who consume such ice-balls (or ABC) can contract hepatitis A after a  month of consuming such food. The patient looks terribly unwell. Hepatitis A is a nasty disease which incapacitates the patient. The patient becomes lethargic and fatigued day by day, and appears at the ER on wheelchair. The patient has no energy to even walk or stand. The skin and sclerae are light yellow (mata kuning). Hepatitis A can be rapidly cured with Jetepar, a fast-healing Indian herbal capsule manufactured in India and useful for modern hospital prescription by specialists in Medicine. Jetepar helps to regenerate liver cells (hepatocytes). Use of Jetepar clears hepatitis within two weeks to a month. Use of Jetepar and Malay traditional medicine clears hepatitis A within two weeks, faster than what modern medicine today possibly can.

As we go about our daily lives, we tend to be careless at times, and often fall. Sometimes a slight sudden movement (jerk) can give us a fracture. Children tend to get fractures when they fall down from trees. Adults tend to get fractures as they carry or shift heavy objects about in the house. Some adults get injury while at work, carrying or moving heavy packages. The Indians use ingu for fractures and bone pain. Ingu is a dark (black) herbal paste which can be purchased from well-stocked Indian stores in most Malaysian cities. It is sold in small plastic wrapped balls and smells. Ingu is applied on the skin at the fracture site and then wrapped overnight. It can be replaced if the pain continues. With use of ingu, pain usually subsides after 3 days. Fracture will take about a month to heal and longer to have functional strength.

Indian black tea is served with dusted cinnamon and a dash of honey. This tea is consumed to overcome diabetes. It  may work in some people. It may not work in people who are sensitive to cinnamon and suffer allergy and migraine as a consequence of consuming this type of tea.

INDIA & SOUTH-EAST ASIA
Indian cuisine has curries. Indians do not consume beef, but consume mutton, chicken and fish curries instead. Indian curries have many spices, including seeds, nuts and beans. Indian curries contain coriander seeds (biji ketumbar), star anise (bunga lawang), cinnamon (kayu manis), cloves (cengkih), mustard seed (biji sawi), fenugreek (halba), ginger (halia), galangal (lengkuas), tamarind (asam jawa) and asam keping. Indian curries also have ladies finger (bendi or bendeh), long beans (kacang panjang), moringa (keloh), brinjals/eggplants (terung) and curry leaves (daun kari). When the Malays make curries, they add more spices (jintan), turmeric (kunyit), lemon grass (serai), daun limau purut and extra spicy ground chili (cili boh or cili giling).

The Indian, Indonesians and Malays then add coconut milk and macademia nuts to thicken curries. Salt and MSG are added to taste. Curries are a good source of minerals. Moringa is a rich and cheap source of iron in many countries where the tree grows wild. Drumsticks (beans) of the moringa tree are consumed by mothers who are about to deliver and expedites labour. Moringa seeds are sold commercially at speciality food stores. Brinjals give good clear vision. Lemon grass helps in arthritic conditions. Coconut water is used to cool down the body and expand blood volume in fever and dehydration. Plain water is drank immediately after a fall to overcome shock.

MALAY CIVILISATION
The Malay Archipelago is vast and mainly covers hundreds of scattered islands and a peninsula in SEA in addition to a belt around the equator. It includes Indonesia, Malaysia, Brunei. Borneo, Philippines, Sulu, parts of China, Taiwan, Japan, Polynesia, Melanesia, Guam, Hawaii, Ceylon, South India, Madagascar, South Africa and parts of the Amazon forest also contain Malays.

The Malays use coconut water for healing heat conditions and fever. Coconut water is like blood plasma and is a plasma expander. Guava shoots are used for dengue to increase platelet count. Quinine is consumed fresh to overcome malaria and its fatal outcome. Quinine is close to machang/macang, a fragrant fruit from a perennial very tall tree. Macang is grown and sold in the fresh market, but quinine is rarely sold. Inai leaves are pounded to a paste and applied on severe skin afflictions without bandage. Betel leaves (daun sireh) are chewed and spat onto children to remove evil spirits and to break away a mother from her clinging child. Turmeric is either eaten raw or cooked. Raw turmeric is pounded to make sambal belacan and eaten with hot rice to increase milk in breastfeeding and improve appetite. Fresh fish is covered with a mixture of pounded or ground turmeric, chilli and salt, then deeply fried and eaten with hot rice. Turmeric contains curcumin, and curcumin kills cancer. Betel leaves, pandan (Pandanus leaves), daun cermai and fragrant flowers, are used for mothers to bathe in the post-partum period; they reduce body itch. Soaked crushed watercress (air kangkung) makes a good light latex emulsion for treating itch and warding off chickenpox. It stops chickenpox infection from spreading.

The Malays are noted for their salads (ulam). They eat a variety of salads not found in many other communities. The Malay ulam includes boiled or fresh four-angled beans (kacang botol), watercress (kangkong), ladies finger, big & small brinjals (terung & terung pipit), big & small cucumber (timun & timun susu), cashew shoots (daun ketereh/gajus), long beans, drumstick (kacang keloh), marrows (labu air), young corn (ketiak jagung), jering, petai, etc. These fresh vegetables are dipped in anchovy sauce (budu) or peanut sauce (kuah rojak). Blanching or boiling kills E. coli and flatulence is minimal. Ulam helps to overcome problems of constipation. However, vegetables are regarded as cold food and are avoided by mothers in the post-partum period. As such these mothers suffer from constipation.

Tropical fruits which are grown around the house are eaten fresh by the Malays. They include big & small bananas, big & small papayas, hard & soft guava, durian, mango (mangga), rambutan, pulasan, mangosteen (manggis), langsat, dokong, laichi, grapes, pomegranate (delima), soursop (durian belanda, Graviola), ciku, custard apple (nona), etc. Some fruits are used for making fruit preserves such as acar buah (chutney) and jeruk buah. Pak Ali is a famous fruit preserve brand in Malaysia. It includes nutmeg, prunes, cherries, buah bidara, buah cermai, etc. Preserved fruit is eaten as snacks or made into acar buah.

CHINESE CIVILISATION
Herbs used in Chinese traditional medicine include garlic, ginger, ginseng, lotus seeds, barley, red dates, white fungus, and spices. Mothers are fed garlic and ginger-rich chicken soup in the post-partum period to expedite recovery. Babies get a lime oil rub for colic. There is a plain cabbage soup to avoid constipation. The hot or cold beans drink, leng chi kang, helps to overcome thirst and is nutritious. Barley water is alkaline and is used to cool down the body, for hypertension, diabetes and renal problems. Chinese children eat a lot of oranges for vitamin C.

Barley, basil and pandan drink

Chinese fruit preserves and seeds are widely marketed in Malaysia. It includes dried orange skin, dried plums, dried prunes, pumpkin & melon seeds (kuaci), and crystallised fruits.

In the old days in China, excess oranges were cooked in sugar and made into crystallised oranges. These were consumed in winter when there were no fresh oranges to consume. Crystallised oranges were also used as gifts when the Chinese travelled the world. In California where the Chinese arrived and set up trading posts, crystallised oranges were gifts for exchange with Californian sweet jelly-apple-walnuts clusters dusted with powdered glucose.

Chinese coffee shops offer sweet black coffee to go with char koay. This is good for overcoming hypoglycaemia when rising from overnight sleep. Light unsweetened Chinese green tea is consumed at coffee-break and in the afternoon. This is good for avoiding a multitude of afflictions such as hypertension, hyperlipidaemia and diabetes.

THAI CIVILISATION
Thai snacks include sugar-coated tamarind, skewed honey squids, puffed rice crackers, cashew nuts, coated groundnuts, honey fried anchovies, popcorn, etc. These are cheap nutritious food. Some help to overcome protein needs of poor communities, which is prevalent in South-east Asia (SEA).

The Thais have a special spice mix that is used in terminal cases to overcome near death. This is a fragrant spice mix and is not sold in the open market. This is a protected spice mix and is only available upon request through special people. Not everyone can get hold of this spice. Even if it is made available, it is only available less a teaspoonful and once only.

The Thais have a rich thick sweet green tea recipe. This tea has recently crossed borders and come into the Malaysian market, especially at universities, fresh markets and Ramadan food fair. This tea can be dark green or light green. Its green colour does not resemble that of green algae or natural chlorophyll. It could be artificial edible food colouring or other. It has a metallic odour. Whether this type of green tea is good for health or otherwise is a wonder.

The Thais have invented a soy-based health drink that combines black seed. Black seed is mostly used in Arabic medicine. Black seed is the Mother of Medicine in Arabic medicine. Black seed is especially useful for dissolving tumors (any organic solid mass). Its proper usage is unknown. There is scarce knowledge of its proper use in medicine in order to obtain maximum benefits.

PHILIPPINES CIVILISATION
The Filipinos eat manuk - eggs containing unborn chicks (with feathers, beak, eyes, wings and legs. It is eaten with chilli sauce. It is a good source of protein.

OTHER
There are isolated communities who rely on human flesh and brain for protein. These communities are dying out. Cannibalism and head hunters are a dying tradition. The wild boar and pythons are main sources of protein for isolated communities, especially in hilly regions far from the sea or rivers. Protein malnutrition is rare in these communities. However, transmission of viruses from consuming infected human or animal brains is a possibility.

BIOPIRACY
Patients are always hoping for a miracle drug, only to find out that they are consuming an illegally patented drug in a first world nation but the original source was actually smuggled out from a civilised community of a third world country. It may be too late when this happens.

When entrepreneurs and researchers in biotechnology and pharmaceutical products take a plant, flower, fruit, seed, bark, root, sap or gum out of a country, and do R&D to obtain a patent for a new drug or cure, this is a bad thing for the original country where the plant was first sourced. When this happens, the original country loses its ownership of the original plant source and the newly developed drug. Money may mean everything for big pharma.

Biopiracy did not just  suddenly come into the world. It has been around since rubber seeds were smuggled out from Brazil to Kew Gardens in England and then brought to Malaya for R&D and commercial cultivation. Bitangor is a useful tree for cure of hepatitis. It was smuggled out from Malaysia and now patented for a new drug in the USA. The Chinese eat red yeast rice as part of their normal routine to keep optimal health. Red yeast rice has been exploited to produce statin drugs by pharma in USA. Statins are expensive drugs used in the treatment of hypercholesterolaemia.

External links
Mongabay
https://news.mongabay.com/2015/06/amazon-tribe-creates-500-page-traditional-medicine-encyclopedia/