- S E G A L A_ M A C A M_ P E N Y A K I T -

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HFMD cases hit record high of 1,466 last week, more centres to close
By Julia Ng/Lian Cheong, Channel NewsAsia | Posted: 28 April 2008 2210 hrs


A teacher at a local childcare centre carries out checks for sores or blisters on a young boy.

SINGAPORE: The Health Ministry says a record 1,466 cases of Hand, Foot and Mouth Disease (HFMD) were reported last week.

The figure for the April 20-26 week was 17.75% higher than the previous week.

However, the daily numbers have been falling. On 22 April, there were 235 cases, but the number gradually went down to 103 as of 3pm on Monday, 28 April.

More affected childcare and pre-school centres have volunteered to close temporarily to curb the spread of HFMD.

Eight more centres will shut for 10 days from 30 April to 9 May, bringing the total number of centres on voluntary closure to 34.

Eleven other centres affected by the HFMD were ordered by the Health Ministry to shut for 10 days.

As more and more centres close their doors, some nanny services are reporting a 30% jump in business.

Agents said the demand for nanny services started going up since last month as more kids came down with HFMD.

Nannies, like Lilian Gan, are paid up to S$600 a month to look after a kid for 12 hours a day, five days a week.

But it is no easy money. With the outbreak raging on, nannies are taking extra care to maintain a high standard of hygiene and conduct regular checks on their charges for HFMD symptoms.

Lilian Gan said: "Last time, I used to clean the floor once a day. Now, I have to clean the floor two times with Dettol, and sterilise the baby bottles and wash our hands more frequently.

"In the morning, when I bathe her, I'll check her mouth and see if there's anything in the mouth, any red spots. And the fingers - got to wash in between, because she likes to put her fingers in her mouth." - CNA/ir

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Number of new HIV cases hit record high of 422 in 2007
By Dominique Loh, Channel NewsAsia | Posted: 29 April 2008 1839 hrs


This rapid HIV test kit uses saliva from a quick swab of your gums, and the results are out in 20 minutes.

SINGAPORE: Latest figures from the Ministry of Health (MOH) showed 422 new cases of HIV infection were detected in Singapore in 2007, the highest in a single year since 1985. MOH added that 93 per cent of the cases were men.

This brings the total number of reported cases as of end-2007 to 3,482. Out of these cases, 1,534 are carriers showing no symptoms, while 804 have AIDS-related illnesses and 1,144 have died.

MOH said sexual transmission remains the main mode of HIV infection resulting in 95 per cent of the new cases. Out of the 422 new cases, 255 were infected during heterosexual sex. Meanwhile, 130 of them caught HIV through homosexual activity, a 38 per cent rise compared to 2006.

One reason for the increase in this group could be due to more screening.

29 per cent of homosexuals had their HIV detected during voluntary screening compared to just 5 per cent of heterosexuals. Action for Aids said this is a result of greater awareness arising from more intensive and targeted campaigns for men who have sex with men.

Meanwhile, infection via intravenous drug use halved from 14 cases in 2006 to seven last year.

One case saw HIV being contracted through blood transfusion overseas and is the first such reported case in the past six years.

57 per cent of all new cases reported in 2007 were Singapore citizens and permanent residents between 30 and 49 years of age. About one-eighth of the cases were between 20 and 29 years of age.

Ten people aged under 20 were diagnosed HIV positive. Of these, one was a baby infected by his mother during pregnancy.

Action for Aids said: "More young persons are having sex and at a younger age. Programmes meant for young people must address all aspects of sexual behaviour, including homosexuality and condom use, otherwise those most at risk will not be helped."

According to the ministry, 53 per cent of the new cases already had late stage HIV infection when they were diagnosed.

Only 13 per cent of new cases were detected through voluntary screening, while most had their HIV status detected while they were undergoing some form of medical care.

In its annual HIV/AIDS update, the health ministry urged those engaging in high-risk sexual behaviour to use condoms properly and go for HIV testing regularly. - CNA/vm

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April 30, 2008         
S'pore at forefront of effort to decode cancer genes
It is part of global team studying 50 types of cancers with samples from 25,000 patients
By Liaw Wy-Cin

AN AMBITIOUS global team aims to create new weapons in the war against cancer, and Singapore is one of its generals.

Armed with a $100 million war chest, the International Cancer Genome Consortium will see the world's top scientists joining forces to decode cancer's genetic blueprint.

Modelled after the Human Genome Project effort that sequenced all human genes, the new project hopes to change the face of cancer treatment, diagnosis and prevention.

'Cancer's complexity poses an enormous challenge,' said Dr Elias Zerhouni, director of the United States National Institutes of Health (NIH) which is part of the decade-long effort.

'NIH is highly encouraged that the worldwide scientific community is joining together to meet this challenge.'

The group will study over 50 types of cancers, taking tumour samples from about 25,000 patients. The information will be released to researchers for free to help them fast-track their work.

Genes are playing an increasing role in the fight against cancer, and new cancer drugs are, more and more, targeting specific genes.

Having an intimate knowledge of cancer genes means doctors can better diagnose and treat the disease, the top killer in Singapore.

Worldwide, more than 7.5 million people die of cancer each year, and 12 million new cases were diagnosed last year. With people living longer, these numbers are expected to more than double by 2050.

Said Dr Thomas Hudson of the cancer consortium's secretariat: 'Clearly, there is an urgent need to reduce cancer's terrible toll.'

To help meet the need, he said, the group would produce comprehensive catalogues of the genetic mutations involved in major cancers.

Cancer researchers here are excited by the international nature of the project.

Associate Professor Goh Boon Cher, senior consultant at the National University Hospital's department of haematology-oncology, said: 'It allows comparisons of the cancer genome across different ethnic groups, which would be essential to understanding the diversity of cancer throughout the world.'

The group hopes to collect 500 tumours for each of the 50 cancers from around the world.

So far, the project has attracted funding of about US$80 million (S$109 million) for five years.

It has about 10 member countries now, contributing in different ways, such as funding, expertise and tissue samples. Among its members are Britain's Wellcome Trust, the Chinese Cancer Genome Consortium and the European Commission.

Singapore, one of the members which helped conceptualise the organisation, is represented by the Genome Institute of Singapore (GIS).

GIS is contributing its technology to map out the precise rearrangement of genes in cancerous tumours.

Said its executive director, Professor Edison Liu: 'It is the first time this is being done for cancer and we hope to have a complete genetic map of human cancer.

'The first human genome project, which also took about 10 years, changed how we studied biology. In another 10 years, we hope to use this work to revolutionise cancer treatments.'

wycin@sph.com.sg

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Two new flu strains expected to hit Singapore.

SINGAPORE: Two new strains of the flu bug are expected and together with a prevailing strain, they have been identified by the World Health Organisation as being the most likely to cause the flu this year.

On Tuesday, GlaxoSmith-Kline announced that its updated vaccine for the circulating flu strains this year had arrived in Singapore.

This is just as 15,761 cases of acute upper-respiratory infections were reported at polyclinics last week

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Gradual rise in HIV cases ringing warning bells for others at risk
By Margaret Perry, Channel NewsAsia | Posted: 30 April 2008 2349 hrs

SINGAPORE: The number of reported HIV cases may still be small but the gradual rise means many more are at risk of catching the disease. An expert said the misconception that HIV is a homosexual disease is fuelling the increase.

Some 422 new cases of HIV were reported in 2007, up from 357 in 2006.

While the numbers of diagnosed cases are still low, sociologist Paulin Straughan warns there's a much larger pool of people who are at risk of infection.

Associate Professor Paulin Straughan, Deputy Head, Sociology, National University of Singapore, said: 揟hat's sad and also scary at the same time. Because for every additional person who has caught the disease, it means there's another person at risk and who could cause risk to others."

Professor Straughan said one problem is that people still have the misconception that HIV is a homosexual disease. This is dangerous because heterosexuals tend to let their guard down.

Two-thirds of the new HIV cases last year were infected via heterosexual sex.

Men who have sex with men are at high risk of catching HIV, which is why the Ministry of Health (MOH) has worked with the charity 慉ction for Aids

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Noting dehydration symptoms can save a child's life
By Hasnita A Majid, Channel NewsAsia | Posted: 02 May 2008 2338 hrs



SINGAPORE: If your child cries without tears, has a dry mouth or sunken eyes, be warned

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Doctors warn of new flu strains in Singapore
By Hoe Yeen Nie, Channel NewsAsia | Posted: 02 May 2008 2349 hrs



SINGAPORE : Doctors are warning about the emergence of new flu strains in Singapore.

Out of the three most common strains of the flu bug that hit Singapore this year, two of them are new. According to the World Health Organisation, these are the Brisbane H3N2 strain and Florida Influenza B virus.

Some 630,000 people come down with flu every year, usually in May and June.

While most recover within a week, it is the elderly and young children, as well as chronic disease sufferers, who are the most vulnerable.

Complications include lung infection, and doctors said it is best to get vaccinated. However, with the new flu strains, even those who have had flu shots may still be susceptible to the viruses. - CNA /ls

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Obesity Prevention Taskforce for schools to be set up by April 2009
By Hasnita A Majid, Channel NewsAsia | Posted: 03 May 2008 1802 hrs

SINGAPORE: An Obesity Prevention Taskforce for schools will likely be set up by April 2009 as part of a major anti-obesity campaign to be launched next year.

The taskforce is one of Health Promotion Board's initiatives to help students battle the bulge.

12-year-old Shawn Roshan Pillay from the Loyang Primary School weighed 56 kilogrammes last year.

But after joining his school's Special Workout Programme to fight obesity, the Primary 6 student managed to shed 5 kilos and has even been discharged from the programme.

His classmate, Billy Aw, also lost weight - 2 kilos to be exact. Billy also joined the programme last year. Since then, he has trimmed down to almost his ideal weight.

Both boys now know the importance of keeping the flab off.

"I feel more healthy, more fit and I do not fall sick easily," said Billy.

"Now, I don't get so tired easily....." said Shawn.

Loyang Primary's weight management programme has proved successful.

At the beginning of last year, 80 pupils were found to be overweight. Ten months later, 30 of them attained an acceptable weight.

This year, 82 students were overweight. But within four months, 17 managed to slim down.

The result was not achieved through exercise alone.

Food and drinks sold at the school canteen must fall under HPB guidelines. This means that food must contain less salt while drinks contain less sugar and preferably, they should also carry the 'Healthier Choice' symbol.

Loyang Primary is involved in the Model Tuckshop Programme run by the HPB to encourage schools to provide healthier choice of food and drinks to students.

Parents and teachers have also been roped in to help students cut down their weight.

Vevian Ng, the school's Head of Department (Health Education), said: "During our 'Rise and Shine' programme, our teachers will work out with the pupils and on the 22nd of every month, we have the 'Fruity-Vege Day'. On that day....the teachers will bring their fruits and eat together with the pupils in the classrooms. The pupils also keep a food diary and this is to make the pupils conscious of the food that they are taking.

"Once a week, the pupils will take the diary home and parents will look at the food the children have been eating......to help them be aware of the food that they have to pack for the children."

Loyang Primary is just one of many schools working in partnership with the HPB, which has various health education initiatives to help students battle the bulge.

HPB is rolling out more programmes in future.

Dr Wong Mun Loke, HPB's deputy director for Youth Health Division, said: "To engage the young, for instance, we know that we need to look for new, innovative ways to reach out to them. For example, 'The Healthy Food Trail' that we'll be organising......(it's) like treasure hunt out there to look for healthier choices.....either in the supermarkets or food courts, therefore raising their awareness on how to make healthier food choices out there.....for example, by recognising the (Healthier Food) symbol......."

HPB added that it will continue to work with stakeholders such as parents, caregivers and industries that play a key role in providing healthier food choices to students.

Singapore will also glean lessons from other countries on how they tackle obesity. - CNA/ir

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May 4, 2008         
Their blood types don't match, but he's getting her kidney
Man to receive kidney from wife in region's first incompatible blood-type transplant
By Nur Dianah Suhaimi


Mr Khairul Anwar Ibni, whose blood type is O+, will undergo extensive preparation before his operation to receive a kidney from his wife, Madam Radiyah Mohamad Som, whose blood type is A+. The operation will cost $120,000. -- ST PHOTOS: WANG HUI FEN

A Singaporean renal patient will be the first person in South-east Asia to receive a kidney donation from someone with a different blood type.

Mr Khairul Anwar Ibni, 46, whose blood type is O+, will be getting a kidney from his wife, Madam Radiyah Mohamad Som, 43, whose blood type is A+.

The transplant will be done by Dr Lye Wai Choong, a renal specialist in private practice, at Mount Elizabeth Hospital at the end of this month.

Under normal conditions, the transplant would have been impossible.

In standard kidney transplants, both donor and recipient must belong to a common blood group. If not, the kidney will be rejected automatically by the recipient's body. This also applies when other organs such as the heart or liver are transplanted.

The procedure, known as the ABO incompatible kidney transplant, allows for a kidney to be accepted by the recipient even when blood types do not match.

The ABO transplant was first done in Sweden in the 1970s and, later, more commonly carried out in Japan in the 1980s. It caught on in the United States and Europe only in 2000, although just a handful of hospitals carry out the procedure.

ABO incompatible transplants were unheard of in Singapore because of high risks, extensive preparations and exorbitant costs, Dr Lye told The Sunday Times.

'Normal kidney transplants have a 98 per cent success rate. But in ABO incompatible transplants, the success rate is 85 to 90 per cent. Given a choice, not many patients may want to take the risk,' he said.

But Dr Lye recommended the procedure to Mr Khairul as it is his only chance. Mr Khairul's heart is so weak that if he does not get a kidney soon, he will not live beyond 18 months.

Dr A. Vathsala, director of the adult renal transplantation programme at the National University Hospital (NUH), said transplant nephrologists have been talking to patients about exploring the possibility of an ABO incompatible transplant over the past few years.

But many are reluctant to be the first patient to undergo such a transplant here.

Although the surgery is carried out the same way as normal kidney transplants, extensive preparation is needed beforehand to remove antibodies from the recipient and prepare him for the transplant.

This involves highly sophisticated and expensive machinery and medicines. This is why ABO incompatible transplants are so expensive.

While a standard kidney transplant can cost about $60,000, an ABO incompatible transplant can easily cost two to three times as much. Mr Khairul's transplant is expected to cost $120,000.

Also, few doctors have the expertise to carry out and monitor this process. The Sunday Times understands that there are only four such doctors in Singapore, one of whom is Dr Lye.

There were 555 renal patients in Singapore waiting for a kidney last year. The average wait is nine years.

In 2006, 139 patients were taken off the kidney waiting list, mostly because they were no longer fit to undergo surgery even if a suitable kidney donor came along.

Renal specialists said this first ABO incompatible transplant would be a significant breakthrough for Singapore's medical scene.

Said kidney transplant surgeon James Tan: 'In the past, many patients stood no chance of getting a kidney. Every kidney is so precious that it's given only to the person with an exact match. But now with ABO incompatible transplants, we can have a bigger donor pool.'

Renal specialist Pary Sivaraman agrees. 'About 20 to 30 per cent of kidney donors are usually rejected because their blood types don't match. This transplant pushes the limits.'

Restructured hospitals are also gearing up and preparing themselves to perform future ABO incompatible transplants.

The Singapore General Hospital renal transplant programme has set up a special team to perform such transplants.

Said Dr Vathsala from NUH: 'Our restructured hospitals have the facilities and expertise to carry out such high-risk transplants. However, it is not a standard therapy and is still experimental. The risks and benefits must be properly weighed.'

ndianah@sph.com.sg

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Number of dengue cases expected to be higher this year
By Hasnita A Majid, Channel NewsAsia | Posted: 04 May 2008 1707 hrs

SINGAPORE: The number of dengue cases is expected to be higher this year.

South West CDC Mayor Amy Khor on Sunday said, in the first four months of the year, there is already a 35 per cent increase in the number of dengue cases compared to the same period last year.

Dr Khor added that the number of breeding sites has also increased, 40 per cent higher than last year.

As of 19 April, there were 3212 breeding sites, and about 55 per cent of them were outdoor - mainly discarded receptacles such as plastic pails.

It is, therefore, important to engage every individual to help fight dengue.

In the latest effort, some 200 foreign students and 500 residents were roped in to spread the importance of good public health habits.

The "My Hostel Shines @ South West" programme will see three key measures implemented - a pilot dengue prevention ambassador training for 20 foreign students; block washing by 100 foreign students and 20 residents; and a joint community vigilance programme where foreign students join grassroots leaders in house visits to comb potential mosquito breeding sites.

"There is no shortcut to preventing dengue and minimising the number of cases. The most effective and best way is still source reduction, which is to eradicate any potential dengue breeding sites," said Dr Khor.

"There continue to be a segment of the population who are not vigilant, who are not diligent enough, who continue to litter. In fact, discarded receptacle is one of the top most dengue breeding sites... Therefore we need to continue with our public education and awareness campaign," she added. - CNA/ac

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May 5, 2008         
Drug firms told to stop running 'educational' adverts
HSA says the campaigns are really thinly veiled ads, which are banned here; some also use scare tactics
By Salma Khalik, Health Correspondent



DRUG companies have been told to stop running 'educational' advertisements because they are anything but educational.

The Health Sciences Authority (HSA), Singapore's medicines regulator, is concerned about the increasingly 'creative' slant drug companies are taking. It told The Straits Times that these educational campaigns were thinly veiled advertisements, which are banned here.

It plans to re-look the issue with the industry. It wants stricter rules to ensure that drug companies do not cross the line, using campaigns to push their products.

Like most countries, Singapore does not allow direct-to-consumer advertisements for prescription drugs. It prefers to let doctors tell patients about medicines.

When the HSA agreed four years ago to allow drug companies to run educational campaigns, the understanding was that they would provide objective and unbiased information about a disease.

This would encompass alternative treatments, including the benefits of diet and exercise.

Instead, some advertisements rely on scare tactics and give little information. Some promote new and innovative products that lack long-term safety data, said HSA deputy director Madam C. Suwarin.

She said some drug companies were also becoming 'too creative', such as paying for coverage in newspapers, magazines and on the radio.

A few years ago, the HSA chided Merck, Sharpe & Dohme (MSD) for its bus stop ads. MSD promptly removed them.

MSD marketing director David Peacock said his company had no intention of breaching the rules and all the campaigns that the company has run since then had complied with the regulations.

He felt that there was a role for educational campaigns, especially when many are unaware that they have a disease.

Dr Kevin Tan, vice-president of the Diabetic Society of Singapore, agreed that a review might be timely. But he also felt that campaigns by drug companies had helped patients and he 'would not like to see this end'.

Educational efforts by the Government were not enough and 'coverage would just not be as intense without the help and drive of pharmaceutical companies', he said.

Dr Beh Suan Tiong, president of the Obstetrics & Gynaecology Society of Singapore, also supported industry education. He said: 'They are important components in any disease management and prevention, be it by public or private organisations. Both have their roles.'

Madam Suwarin said the HSA also thought it good for the industry to help patients. She said: 'We know we need to work with others. We want to be a smart regulator, carrying a small stick, like a conductor building a symphony. Not a big stick to hit them with.'

But it must also make sure that drug companies do not push patients into demanding medicines that they do not need.

She said that the focus on depression in the United States has sent the number of prescriptions for anti-depressants soaring. Such medication is meant only for severe depression, but doctors dole it out freely.

The drugs can have severe side effects, including suicidal thoughts in youth.The HSA does not want to see it happen here.

salma@sph.com.sg

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Ekstra! : 7 Mei 2008        

MASALAH PENGLIHATAN

KOMPUTER BAIKI MYOPIA

MEMBAIKI penglihatan hanya dengan menggunakan komputer - itulah yang dicapai oleh sekumpulan murid yang menyertai kajian klinikal mengenai program membaiki myopia dengan menggunakan satu program komputer.

Mereka tidak perlu menjalani sebarang prosedur perubatan seperti pembedahan atau ubat-ubatan, sebaliknya melakukan latihan menggunakan komputer selama kira-kira 30 minit setiap dua hari selama 10 minggu.

Kajian tersebut yang dijalankan dari 2006 hingga akhir 2007 itu melibatkan 31 murid darjah dua dan tiga dari Sekolah Rendah Evergreen dan dijalankan oleh Institut Kajian Mata Singapura (Seri) dengan sokongan Lembaga Penggalak Kesihatan (HPB) dan Kementerian Pendidikan.

Hasilnya?

Penglihatan mereka bertambah baik sebanyak 70 peratus dan tahap peningkatan myopia mereka (maksudnya, tahap ia menjadi lebih buruk) berkurangan sebanyak 50 peratus.

Purata tahap peningkatan myopia di kalangan murid-murid darjah dua dan tiga di sini ialah 94 darjah setiap tahun, tetapi bagi murid-murid yang menyertai kajian itu, tahap tersebut merosot kepada purata 50 darjah setahun atau hampir 50 peratus.

Program yang disertai murid-murid ini ialah program NeuroVision yang dipasang di komputer-komputer sekolah mereka dalam makmal komputer.

Murid-murid itu perlu menggunakan tetikus yang diketik untuk menjalani latihan pada skrin komputer di sebuah makmal yang gelap.

Latihan yang dijalankan merupakan rangsangan pada bahagian otak yang bertanggungjawab bagi fungsi penglihatan.

Dengan melakukan latihan itu, seseorang dapat mempertajam imej yang dilihat dan membuat perbezaan-perbezaan yang lebih tepat antara objek dengan latar belakangnya.

Untuk merangsang murid-murid itu agar tidak jemu menjalani latihan tersebut, permainan komputer turut diselitkan.

Pengarah Seri, Profesor Donald Tan, yang juga Timbalan Pengarah Pusat Mata Nasional Singapura (SNEC) dan Ketua Jabatan Optalmologi, Sekolah Perubatan Yong Loo Lin, Universiti Nasional Singapura (NUS), mengulas:

'Kami sangat gembira dengan hasil positif kajian klinikal yang pertama ini. Implikasinya sangat luas kerana penglihatan kanak-kanak boleh dibaiki hanya dengan menggunakan program komputer yang mudah digunakan.

'Kami kini bercadang untuk meluaskan kajian ini untuk melibatkan lebih ramai kanak-kanak dan murid sekolah rendah dengan tujuan menjalankan kajian klinikal rambang terkawal yang lebih besar.'

Myopia ialah masalah rabun jauh yang menyebabkan objek jauh kelihatan kabur kerana imej objek tertumpu kepada bahagian depan retina (lapisan sensitif di bahagian dalam bola mata), dan bukan di atasnya.

Di Singapura, myopia ialah masalah mata yang paling lazim dihadapi oleh kanak-kanak. Tahap peningkatan myopia di kalangan murid-murid sekolah rendah di sini adalah yang tertinggi di dunia.

Myopia menjejas satu daripada setiap empat orang kanak-kanak berusia tujuh tahun, dua daripada setiap tiga kanak-kanak berusia 12 tahun, dan empat daripada setiap lima orang berusia 18 tahun di sini. Apabila mereka dewasa, tahap myopia mereka dijangka boleh mencapai 600 darjah atau lebih.

Ketua Pegawai Eksekutif (CEO) NeuroVision, Encik Nir Ellenbogen, menarik perhatian bahawa teknologi programnya adalah berdasarkan pletform perubatan yang inovatif.

'Kami melabur dalam kajian klinikal dan saintifik ini selama lebih 20 tahun. Tujuannya ialah menghuraikan masalah penglihatan tanpa pembedahan atau ubat-ubatan, lantas tiada risiko buruk atau komplikasi akan dialami,' katanya.

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May 9, 2008         
HIV man to face cheating charges
By Elena Chong


If convicted, Chan Mun Chiong faces a fine of up to $10,000 and/or jail of up to two years. -- ST PHOTO: LIM CHIN PING

THE HIV-positive chef who allegedly had oral sex with a teenager without telling him of the risk of catching the disease will also face cheating charges against him.

Chan Mun Chiong, 43, on Wednesday pleaded guilty to two offences - one under the Infectious Diseases Act and the other of committing an act of gross indecency.

His case was then transferred to a sentencing court, where his plea was to have been taken again.

But on Thursday, when he was due to plead guilty, the prosecution applied for the case to be adjourned, pending cheating charges.

Chan's summons charge accuses him of having had oral sex with the 16-year-old without telling him of the risk of being infected and without getting him to agree to accept that risk.

If convicted, he faces a fine of up to $10,000 and/or jail of up to two years.

The police charge is for having given and received oral sex from the teen in a toilet cubicle in Northpoint Shopping Centre in Yishun last Sept 15, an offence which carries a jail term of up to two years.

A pre-trial conference will be held in three weeks.

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Anti-dengue efforts receive boost with Asia-Pac dengue strategic plan
Posted: 09 May 2008 2203 hrs

SINGAPORE : Efforts to reverse the rising trend of dengue in Asia-Pacific received a boost with the finalisation of the Asia-Pacific dengue strategic plan on Friday.

Among the key activities recommended to combat dengue are surveillance, outbreak response and research.

Under surveillance, many countries recognised that in order to prevent or minimise outbreaks, there is an urgent need to strengthen their overall disease surveillance regime by building up laboratory capability.

There is also a need to establish a formal national coordinating structure to better facilitate inter-sectoral collaborations across agencies and stakeholders within each country.

The countries involved also recognised that effective dengue control is not possible if control efforts are limited to one or a few countries.

The regional strategic plan thus provides a good framework to facilitate collaborations among countries and sustain partnerships. - CNA/ms

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Hip fractures on the rise
By Sheralyn Tay, TODAY | Posted: 09 May 2008 1152 hrs

SINGAPORE: Imagine bones so fragile that a slight fall can cause them to crack or shatter. For sufferers of the brittle bone disease osteoporosis, the result can be painful, and for the elderly who make up a large proportion of those afflicted, life-threatening.

According to Dr Lau Tang Ching, a consultant rheumatologist at Tan Tock Seng Hospital (TTSH), studies show a quarter of the elderly with an osteoporosis hip fracture die within a year of the injury from complications like pneumonia and bed sores. Among the survivors, about one in 10 are bed-ridden, and another quarter wheelchair-bound, he added.

The incidence of osteoporosis fractures here, also called fragility fractures, is going up in tandem with the greying population. Currently, one in 12 Singaporeans is aged 65 and over, but this will rise to one in five by 2030.

Hip fractures have risen four-fold since 1960 and affect about one in every 250 persons aged over 50 now, while an estimated 20,000 female Singaporeans aged 50 to 80 have the condition.

This adds urgency for better osteoporosis management here, especially among those who have already had one fall, as they were more likely to suffer a subsequent, and more fatal, injury, said Dr Lau.

A recently-concluded Osteoporosis Disease Management Programme by the National Healthcare Group (NHG) ran from 2003 to last year and included some 1,000 patients from TTSH, the National University Hospital and Alexandra Hospital. The findings of the programme may shed some light on improving patient outcomes.

Prior to the programme, only about 16 per cent of patients with fragility hip fractures were on osteoporosis treatment post-injury, and this proportion dropped to 3.8 per cent after two years.

But, through counselling by specially-trained case managers, the take-up rate of osteoporosis treatment climbed to 44 per cent, while the adherence rate after two years was 71.2 per cent.

Ms Fadzleen Johari, an osteoporosis case manager at TTSH, counsels six to 10 patients a day, and has seen a marked difference in patients. The rapport she builds with these patients through face-to-face sessions and call reminders has made them more aware and empowered, she said.

More significantly, the rate of overall fractures has dropped by 42 per cent. This means significant savings as the average hospitalisation bill for a fragility fracture is about S$12,000, and subsequent cost of care in the first year can be double that.

Dr Lau, who presented the findings of the study at Thursday's NHG Disease Management Conference, said that the scheme would be fine-tuned and expanded. - TODAY/fa

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Singapura : 10 Mei 2008        
         
PROGRAM GALAK WARGA PERIKSA KESIHATAN

HPB hantar surat pada golongan usia 40 tahun ke atas

Oleh
Soraya Salim

WARGA Singapura berusia 40 tahun ke atas akan menerima surat daripada Lembaga Penggalak Kesihatan (HPB) menggalak mereka menjalani pemeriksaan kesihatan di klinik doktor swasta (GP), mulai bulan depan.

Program pemeriksaan itu merangkumi penyakit kronik, termasuk kencing manis, darah tinggi, penyakit lipid (lipid disorder) dan barah rahim.

Ini sebahagian daripada usaha Kementerian Kesihatan (MOH) bagi memastikan warga Singapura diperiksa secara sistematik bagi mengesan penyakit kronik.

Mengumumkan demikian semalam, Menteri Kesihatan, Encik Khaw Boon Wan, berkata inisiatif baru itu bertujuan membantu GP menguruskan penyakit kronik pesakit mereka.

'Tujuan ini semua adalah untuk memastikan penyakit kronik itu dapat ditangani dengan baik,' katanya.

Encik Khaw, yang berucap di Persidangan Perubahan Penjagaan Kesihatan Antarabangsa pertama, menambah bahawa warga golongan 30 peratus paling miskin akan diberi subsidi oleh HPB untuk membantu mereka membayar kos pemeriksaan itu.

Satu lagi inisiatif baru yang diumumkan semalam ialah subsidi bagi warga tua miskin mendapatkan rawatan penyakit kronik di GP.

Ini setelah MOH memutuskan untuk meluaskan Skim Kerjasama Penjagaan Kesihatan Asas (PCPS) bagi merangkumi tiga penyakit kronik utama - kencing manis, darah tinggi dan penyakit lipid.

Di bawah PCPS sekarang, pesakit kurang berkemampuan boleh menikmati subsidi bagi rawatan penyakit teruk seperti batuk dan selesema di klinik privet tertentu.

Dengan perubahan itu, pesakit kronik pemegang kad PCPS tidak perlu ke poliklinik untuk menikmati rawatan lebih murah bagi penyakit kronik.

GP yang menyertai skim itu akan menawarkan subsidi bagi konsultasi, ubat dan ujian makmal, dengan MOH menokok perbezaannya.

Skim yang diperkenal pada 2000 itu sekarang disertai 19,000 pesakit.

Di bawah skim itu, warga tua berusia 65 tahun ke atas dengan pendapatan per kapita keluarga kurang $700 layak menikmati rawatan bersubsidi sama ada di klinik atau klinik gigi privet.

Bagi rawatan penyakit seperti demam, cirit-birit, sakit perut, jangkitan telinga atau mata, mereka dikenakan bayaran seperti di poliklinik pemerintah, iaitu $4 bagi rawatan dan 70 sen bagi bekalan ubat seminggu.

'Ini akan membolehkan pesakit sedemikian berjumpa doktor biasa mereka bagi penyakit teruk dan kronik. Kami akan memanfaatkan platform IT yang sekarang menyokong Medisave bagi penyakit kronik untuk membantu para GP yang turut serta melapor dan memantau keadaan kesihatan pesakit mereka,' kata Encik Khaw.

fatz2

Singapura : 10 Mei 2008        
  
KES HFMD TERUS MENINGKAT

1,083 kes dilapor dari 4 Mei hingga 3 petang semalam

Oleh
Nazri Hadi Saparin

JUMLAH kes penyakit tangan, kaki dan mulut (HFMD) terus meningkat sedang dua pusat penjagaan kanak-kanak dan tadika dibuka semula semalam.

Menurut laporan mingguan Kementerian Kesihatan (MOH) yang diterbitkan di laman webnya, sebanyak 1,083 kes HFMD dilaporkan sepanjang 4 Mei hingga 3 petang semalam.

Namun, ia lebih rendah daripada 1,465 kes minggu lalu dan 1,466 kes minggu sebelumnya.

Sehingga 3 petang semalam, sebanyak 87 kes HFMD dilaporkan.

Tahun ini, lebih 10,000 kes, kebanyakannya menjejas kanak-kanak, dilaporkan.

Penyakit yang biasanya ringan itu menular lebih giat kali ini.

Ramai pakar berpendapat ia akibat bilangan kes yang tinggi disebabkan virus EV71 yang lebih berbahaya.

Antara pusat yang menerima arahan supaya ditutup ialah pusat tadika Masjid Al-Iman di Bukit Panjang. Ia menerima arahan MOH untuk menutup pusat tadikanya selama 10 hari dari 4 hingga 13 Mei ini.

Senarai pusat-pusat yang diperintah supaya ditutup turut terdapat di laman web MOH di www.moh.gov.sg.

Ketika dihubungi, Pengerusi Masjid Al-Iman, Haji Paiman Supangat, berkata pihak masjid telah menutup pusat tadikanya secara sukarela selama empat hari selepas 11 kanak-kanak dijangkiti HFMD.

Namun, sejurus selepas dibuka semula, dua lagi kanak-kanak jatuh sakit dengan HFMD.

Justeru, tadika itu yang mempunyai lebih 170 kanak-kanak tabika dan tadika ditutup hingga Selasa ini.

Perintah ditutup dikenakan apabila sekurang- kurangnya 13 kanak-kanak jatuh sakit dan jika penularan virus itu tidak berhenti selepas 15 hari.

Kes HFMD di sini yang mencapai paras rekod juga membimbangkan ibu bapa, terutama yang mempunyai anak- anak di tadika.

Salah seorang daripada mereka, Cik Nur Raihana Subhan, 31 tahun, berkata beliau memeriksa mulut, tangan dan kaki anaknya yang berusia empat tahun setiap hari selepas pulang dari tadika.

'Bimbang juga, tetapi kami tahu jika dikesan awal, penyakit ini lebih mudah dikawal. Sebab itu setiap hari saya periksa,' katanya.

PERIHAL HFMD

Apa itu HFMD?

# Penyakit tangan, kaki dan mulut atau HFMD berpunca daripada virus Coxsackie dan Enterovirus 71 (EV-71).

# Mereka yang dijangkiti mengalami ulser-ulser kecil di kerongkong tekak dan tonsil manakala tompok-tompok akan kelihatan di bahagian tangan dan kaki.

# HFMD lazimnya adalah penyakit ringan dan pesakitnya sering sembuh dalam lima hingga tujuh hari.

# HFMD dijangkiti daripada seorang individu ke individu yang lain menerusi lelehan hidung, air liur, najis dan cecair dari ulser atau tompok mereka yang sakit.

# Kedua-dua orang dewasa dan kanak-kanak boleh dijangkiti HFMD, tetapi kanak-kanak berusia lima tahun ke bawah yang paling rentan.

Tanda-tanda penyakit

# demam
# sakit tekak
# ulser di kerongkong tekak, mulut dan lidah
# pening
# tompok seakan-akan melecet (3 hingga 7 milimeter) di tangan, kaki dan bahagian lampin; sering muncul di tapak tangan dan kaki
# hilang selera makan

Rawatan

# Tiada rawatan khusus bagi jangkitan HFMD. Rawatan diberi untuk meredakan demam dan sengal-sengal badan.

# Kumur-kumur dengan air garam (1/2 sudu teh garam bagi segelas air suam) boleh mengurangkan ketidakselesaan.

Nasihat untuk ibu bapa

# Ibu bapa dinasihatkan supaya membawa anak mereka berjumpa doktor serta-merta apabila ada tanda-tanda HFMD.

Pencegahan

# Jauhkan anak-anak dari tempat-tempat awam yang sesak jika mereka menunjukkan tanda-tanda penyakit.

# Setiap anggota keluarga harus mengamalkan kebersihan diri yang baik, termasuk membasuh tangan secara kerap untuk mengurangkan kemungkinan jangkitan.

fatz2

May 10, 2008         
Prostate cancer deaths fall after screening programme

NEW YORK - PROSTATE cancer deaths fell substantially in the decade after one Austrian state began free PSA screening tests for all men ages 45 to 75, according to a new study.

Researchers found that after the state of Tyrol began a programme of free PSA screening and prostate cancer treatment in 1993, the expected death rate from prostate cancer dropped by 54 per cent. That compared with a decline of 29 per cent in the rest of Austria, where free screening was not available.

The findings, reported in the journal BJU International, suggest that routine PSA testing can save men's lives - something that has long been an open question.

PSA tests measure the amount of a protein called prostate-specific antigen in a man's blood. Because prostate tumours cause PSA levels to rise, routine PSA testing can catch the cancer early.

But PSA screening is controversiol because it is not clear that the benefits outweigh the risks. Prostate cancer is often very slow-growing, and PSA screening may lead to treatment of tumours that would never have become life-threatening; treatment can carry side effects, like incontinence and erectile dysfunction.

In addition, PSA concentrations can increase for a reason other than prostate cancer and confirmation of prostate cancer requires a biopsy of the prostate gland, which itself can have side effects, such as infection or bleeding.

However, in the current study, early detection through widespread PSA screening is likely the driving force behind the greater drop in death rates seen in Tyrol, according to the researchers.

Between 1993 and 2005, nearly 87 per cent of men ages 45 to 75 in Tyrol had at least one PSA screening test, the study found. That was up from 11 per cent before the free programme began.

And while prostate cancer death rates declined throughout Austria during the same period, they fell faster in Tyrol. The researchers acknowledge, however, that routine PSA screening remains controversiol, and questions such as which men stand to benefit most from screening are still unresolved.

In general, experts recommend that men speak with their doctors about the potential benefits and risks of PSA screening for them personally. The American Cancer Society recommends that doctors offer most men PSA testing and a digital rectal exam yearly, starting at age 50. - REUTERS

fatz2

May 10, 2008         
Bladder trouble tied to depression, anxiety

NEW YORK - WOMEN who suffer from 'dysfunctional voiding' - like having to urinate often and having difficulty voiding - experience a greater degree of depression and anxiety compared to women without these symptoms, research suggests.

'Dysfunctional voiding...is more commonly seen in recent years,' said Dr Alex T L Lin, of Taipei Veterans General Hospital, Taiwan. 'Although we suspect that depression and anxiety are reactions to the dysfunctional voiding, we could not preclude the possibility that psychological abnormalities might predispose one to the occurrence of lower urinary tract dysfunction,' he commented.

Dr Lin noted that the stressful environment of modern society might be a contributing factor for the increased incidence of dysfunctional voiding.

'From our observations, avoiding stressful situations and stress-reduction are important to prevent dysfunctional voiding,' he advised.

Dr Lin and colleagues assessed anxiety and depression symptoms among 32 women with dysfunctional voiding and 31 asymptomatic control women with no lower urinary tract symptoms. The average age of the women studied was 48 years.

A significantly greater degree of depression and anxiety was observed among patients with dysfunctional voiding compared to controls.

'For patients with dysfunctional voiding, psychological intervention to reduce anxiety and depression should be an indispensable part of the treatment plan,' Dr Lin said.

The researchers' next step is to assess the treatment benefit of psychological interventions on dysfunctional voiding. - REUTERS

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