September in a Nutshell

nutshell

Here is our round-up of five newsworthy stories that were published in September 2017. Please click on the arrows on each side to navigate. Enjoy!

Lack of Specialists in Malaysia

Having just over 7,000 specialists in the country (as reported by The Star in June) is not enough to meet Malaysia’s current medical needs.


Universiti Kebangsaan Malaysia Medical Centre (PPUKM) Faculty of Medicine dean, Prof Dr Zaleha Abdullah Mahdy, believes that the long period between graduating and specialising discourages medical students who dream of pursuing Masters Programme. This is because it would take an extra four years of studying- not including training on the job. The arduous journey can take a toll on medical officers by interfering with their marriage and family plans.


Therefore, the Medical Deans Council will collaborate with the Malaysian Examinations Council early next year in conducting the entrance examination for the clinical Masters programmes. This is initiated as part of the effort to fast track the housemanship programme, coupled to the good tidings that most universities now provide private candidacy for specialist training. As a consequence, outstanding housemen could undergo a shorter housemanship instead of the usual 24-months.

Dressed for the Job

Increasing numbers of students are getting frustrated over the confusing dress codes at medical schools and hospitals, which had resulted in them being faced with unpleasant situations whilst on placements.


In April this year, this controversial topic prompted a motion by the University of Plymouth’s medical school at the BMA’s annual medical student committee conference.


According to Charlie Bell, co-chair of the BMA Medical Students Committee, there is no uniformity in terms of the guidelines set by each school and hospital trust. Because of this, it is almost impossible for students to work out what they should wear.


A systematic review which included 11 533 patients found that formal attire and white coats were preferred in 18 of the 30 studies analysed. Furthermore, a study at Edinburgh Medical School showed that students wearing white coats were rated highest in trust and confidence, cleanliness, and professionalism.


Given the absence of national guidance and the varying views on what is and is not appropriate attire, medical students and doctors need to be mindful of the population they are treating. They also need to understand that appearance is also a part of communication.

Base Editing: A Novel Genetic Technique

Research done recently at Sun Yat-sen University demonstrated a promising technique in genetic medicine. Using base editing as an approach to manipulate the four main DNA bases- adenine, cytosine, guanine and thymine- the team managed to correct base errors. This demonstrated the viability of curing human embryos from diseases, particularly inherited conditions such as beta-thalassaemia.


This research proves the significance of the genetic revolution in providing potential alternatives of curing blood disorders. As with all genetic manipulation methods, this one will definitely require in-depth ethical and societal discourse before gaining acceptance. However, repairing DNA codes might just be the next big thing in treating incurable hereditary diseases that have long plagued us.

Long Live Coffee?

The International Agency for Research on Cancer and Imperial College London carried out a study on healthy people over the age of 35 from ten EU countries. The study was published in the Annals of Internal Medicine.


The researchers asked the participants at the start of the study how much they tended to drink, then looked at deaths over an average of 16 years. They found a link between increased coffee consumption and a reduced risk of death, especially for heart and gut diseases.


If the extended lifespan was solely down to drinking coffee, an extra cup of coffee per day would on average increase male lifespan by about three months and female lifespan by about a month.


People who drink more coffee may be richer and therefore have healthier lifestyles. The study did not address the difference in earnings between coffee drinkers and non-coffee drinkers.


Higher coffee consumption was linked to a higher rate of ovarian cancer.


The effects of drinking coffee on people who are unwell were not accounted for, as those with a history of diabetes, heart attacks or strokes were excluded from the study.


Previous studies on coffee have shown conflicting results. Anecdotal reports of caffeine improving alertness temporarily are well noted, but the effects can vary from person to person.


Coffee during pregnancy may increase the risks of low birth weight and miscarriage. NHS experts recommend a daily limit of 200mg of caffeine- a limit that can be reached after just two cups of instant coffee, or two cups of tea and a can of cola.


Studies on coffee drinking will likely never be able to control for other factors that affect health and longevity. It may be better to focus on proven methods instead, such as exercise.

New Dual-action Cholesterol Drug

MSD Malaysia recently announced the approval of a once-daily combination tablet for patients with high cholesterol levels.


This combination therapy of ezetimibe and atorvastatin utilises two mechanisms of action to bring down cholesterol levels: firstly, by inhibiting cholesterol absorption in the digestive tract through ezetimibe and; and secondly, by restricting cholesterol production in the liver through atorvastatin). It presents an alternative to statin monotherapy in treating patients with poorly managed cholesterol levels.


According to the National Health and Morbidity Survey in 2015, the overall prevalence of hypercholesterolaemia among young adults aged 18 years and above in Malaysia is 47.7% (diagnosed and undiagnosed).


The drug has undergone seven clinical trials involving more than 2400 patients to ensure its safety. It was well tolerated aside from diarrhoea and myalgia being reported as common side effects.

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