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

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June 3, 2008         
Diabetic's wake-up call: A lost limb
First diabetes drive to feature graphic ads on amputated leg
By Eisen Teo


MAKING ADJUSTMENTS: Diabetic Rahmat Mohd Yunos, who is fitted with a prosthetic leg, was once an active sportsman. He now goes to the gym three times a week for weight and cycling exercises. -- PHOTO: HEALTH PROMOTION BOARD

WHEN 56-year-old Rahmat Mohd Yunos was diagnosed with diabetes 21 years ago, he knew the dangers of the disease.

His mother had already lost her right leg to the same condition.

However, a combination of apathy and the rigours of a round-the-clock job as a personal driver made Mr Rahmat neglect his treatment.

'I would skip check-ups and my medication because I was the sole breadwinner in my family then,' he recalled.

The oversights eventually led to a limb being lost. By 2004, an ulcer on his foot became gangrenous and his right leg had to be amputated just below the knee.

In an effort to spare others the same fate, the Health Promotion Board will launch the first Diabetes Be a-Ware Campaign on Saturday. It aims to spread greater awareness about the dangers of diabetes through a media blitz that includes advertisements on television, MRT trains and even toilet cubicles.

The campaign, which runs until November, will also feature graphic newspaper ads showing an amputated leg.

There will also be a roving interactive exhibition at Suntec City Mall's Tropics Atrium and four heartland malls.

Meanwhile, Mr Rahmat now wishes he had kept closer tabs on his condition.

Fitted with a prosthetic leg, the unemployed father of three tries to lead as normal a life as possible.

The once-active sportsman, who loved playing soccer and rugby, now goes to the gym three times a week for weight and cycling exercises.

'Life has to go on,' he said. 'I have to motivate myself to be as normal as possible.'

Mr Rahmat's experience, however, serves as a warning to his three children, aged between 20 and 30, to take good care of their health and go for regular check-ups.

'They don't need to look elsewhere for a good example of the dangers of diabetes,' he said.

'The best example is right in front of them.'

[email protected]

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June 3, 2008         
HFMD cases fall in four weeks
By Lee Hui Chieh
THE number of hand, foot and mouth disease (HFMD) cases continues to fall for the fourth week running. Last week, 665 people caught it - a 9 per cent drop from 729 in the previous week, the Health Ministry said on Tuesday.

In the three preceding weeks, the numbers had dropped by 15 to 25 per cent each week. But a Health Ministry spokesman cautioned against complacency, as last week's patient count still exceeded the epidemic level of 565.

'While the number of HFMD cases has been declining in recent weeks, it is still high,' she said.

At the peak of the epidemic in April, 1,466 cases of this usually mild illness - which causes fever, mouth ulcers and rashes on the palms, soles and buttocks - surfaced in a week.

To stop the disease from spreading, the ministry ordered 28 schools to close, and urged another 81 to consider doing so.

Last week marked the first week in which schools closed for a month-long break, which could have cut down on children passing the bug on to others.

Nine of the newly diagnosed patients last week had to be hospitalised, mainly because they had feeding problems caused by the disease.

This brings the total tally of HFMD patients this year to 14,063, of whom 177 had to be admitted to hospital.

The virus that causes the most severe form of the illness, EV71, was behind 32 per cent of the patients' illnesses. It also caused three children to develop encephalitis, or inflammation of the brain lining, this year.

The only one who is still hospitalised, 3-month-old Muhammad Hafiz Badrulhisham, is in a stable condition, said the Health Ministry.

He was transferred last Wednesday from the intensive care unit to the high dependency ward in KK Women's and Children's Hospital (KKH).

A 10-year-old boy was discharged from KKH last Thursday. The first to fall severely ill from the virus this year, seven-year-old Sharmaine Lee, has fully recovered.

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AVA monitoring Tyson chicken products
By Tan Hui Leng, TODAY | Posted: 05 June 2008 1044 hrs



SINGAPORE: The Singapore Agri-Food and Veterinary Authority (AVA) is keeping an eye on the situation following reports, out of the United States, that Tyson Foods has begun culling 15,000 chickens that had been exposed to a mild strain of avian flu in Arkansas.

An AVA spokesperson said Singapore imported 289 tonnes of Tyson chicken products this year.

揥e are monitoring the situation and are in close contact with our counterparts,

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June 6, 2008         
High cholesterol may increase risk of Parkinson's disease

NEW YORK - HIGH cholesterol levels are associated with an increased risk of Parkinson's disease, according to findings from a Finnish study.

While it's well established that high cholesterol increases heart disease risk, 'the association between serum cholesterol level and neurodegenerative diseases risk has been debated,' write Dr Gang Hu, of the National Public Health Institute, Helsinki, Finland, and colleagues.

The researchers examined this relationship in a cohort of 24,773 Finnish men and 26,153 women between the ages of 25 and 74 years. A total of 321 men and 304 women developed Parkinson's disease during an average follow-up of 18 years, the researchers report in the medical journal Neurology.

Compared to people with the lowest cholesterol, those with the highest had an 86 per cent greater likelihood of developing Parkinson's disease.

This increased risk applied to people 24 to 54 years of age.

'However, no association was found among subjects aged 55 years or older at baseline,' Dr Hu's team explains. -- REUTERS

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MOH to examine if there are any lapses in living donor transplant programme
By Hasnita A Majid, Channel NewsAsia | Posted: 28 June 2008 1943 hrs



SINGAPORE: Health Minister Khaw Boon Wan has said his ministry will review the living donor transplant programme to see if there are any lapses, after a current case of organ trading wraps up in court.

He is confident that this episode will not dent Singapore's reputation as a medical hub.

In the first case of its kind, two men - both Indonesians - have been convicted of organ trading.

One of them had his kidney transplanted into Indonesian woman Juliana Soh. This was done at the Mount Elizabeth Hospital.

The other had planned to sell his kidney to 55-year-old Tang Wee Sung, the executive chairman of retail company C K Tang. But the operation never took place, after the authorities intervened hours after the Mount Elizabeth Hospital ethics committee gave the go-ahead.

The doctor who handled both cases was Dr Lye Wai Choong, the president of the Society of Transplantation (Singapore). He has a clinic at Mount Elizabeth Medical Centre.

Digging for more information will help shed light on the current kidneys-for-sale case, said Minister Khaw at a community event in Sembawang on Saturday.

Until the facts are clearer, Mr Khaw said, there should not be any speculation on whether the Transplant Ethics Committee involved in the case is negligent.

"Let's find out first how they reach their conclusion, how they do their job," he said.

The minister noted that the donors in both cases had lied about being related to the patients and also about not being paid for their organs.

"They were misrepresenting, so a lot depends on the interview (when the donors appeared before the Transplant Ethics Committee)...." Mr Khaw said, adding that sometimes it may not be easy to detect the misrepresentation.

"But, if they (committee) were doing their job too casually, to allow even a clear-cut misrepresentation to pass through, then I'll be very disappointed. We also have to review, from the minutes of the meeting (interview), what actually happened in this case and whether there were lapses. If there were, we hope that the hospital ethics committee will learn from this, so that there will be no repeat of such lapses," added the minister.

Mr Khaw said that the law is "crystal clear" about the buying and selling of organs. But he acknowledged that although laws are in place, there will always be those who will break them.

"How you enforce the law makes a difference....If we do it robustly, it enhances our reputation rather than weakens it," the minister said.

Mr Khaw also acknowledged that organ trading is a global phenomenon but added that except for Iran, most countries have largely banned the illegal trade. - CNA/ir

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Muslim community support HOTA but concerns remain
By Chio Su-Mei, Channel NewsAsia | Posted: 04 July 2008 2208 hrs



SINGAPORE: Come August 1, the Human Organ Transplant Act (HOTA) will automatically apply to all communities in Singapore. This means kidneys, livers, hearts and corneas suitable for transplant can be removed from those aged between 21 and 60 upon death, unless they opt out.

The Muslim community which was previously excluded from the act has given its support although concerns still remain.

To address these concerns, dialogue sessions are being held within the Muslim community to explain the scope and processes of the HOTA.

The first session in a mosque was held at the Darrusalam Mosque at Commonwealth Avenue West.

The Ministry of Health said it has received a substantial number of queries regarding the procedures involved in organ transplant as well as the parameters by which a patient is declared dead.

So the ministry said it'll step up its public education through more dialogue sessions and will send out a second batch of HOTA booklets to each Muslim household.

At hospitals, designated doctors and medical support officers have also been trained to counsel affected family members. - CNA/vm

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KHIDMAT DI POLIKLINIK

PANTAU RISIKO PESAKIT

Sistem data kiraan risiko penyakit bantu pesakit mengetahui sejauh mana tahap serius serangan jantung ke atas mereka

ENCIK Mohamad Yusoff Abdullah, 44 tahun, berasa agak sedih melihat beliau tergolong dalam kalangan mereka yang berisiko tinggi mengalami serangan jantung kerana penyakit kencing manis yang dihidapinya.

Risiko itu diletakkan oleh Dr Hwang Siew Wai, penolong pengarah Poliklinik Pasir Ris, sebagai lebih daripada 20 peratus dalam tempoh 10 tahun.

Tetapi sungguhpun jangkaan itu pahit untuk ditelan, ia adalah peringatan yang amat berguna bagi Encik Mohamad Yusoff, bapa dua orang anak dan bekerja sebagai pemandu teksi untuk terus menjaga kesihatannya.

Malah, beliau berasa lega kerana paras glukos dalam darahnya telah turun kepada 7.7 - lebih rendah daripada 10.5 pada Februari lalu, tetapi belum sampai ke tahap ideal baginya iaitu 6.7.

'Data ini buat saya lebih berhati-hati dan terus menjaga pemakanan saya,' katanya.

Bagi Dr Hwang pula, beliau dapat merumuskan risiko Encik Mohamad Yusoff yang merupakan salah seorang pesakitnya di Poliknilik Pasir Ris, berdasarkan data Kiraan Risiko Penyakit Jantung atau 'Cardiovascular Disease (CVD) Risk Calculator' yang disediakan bagi pesakit kroniknya seperti mereka yang menghidap kencing manis, tekanan darah tinggi dan kadar kolesterol tinggi.

Sistem kiraan risiko CVD tersebut mengandungi data tahap kesihatan semua pesakit kronik Dr Hwang seperti kadar kolesterol, glukos, tekanan darah tinggi dan berat badan mereka yang dimuatkan dalam sistem komputer beliau.

Sekali melihatnya, Dr Hwang dapat menjangkakan sama ada pesakitnya berisiko tinggi, sederhana atau rendah untuk mendapat serangan jantung.

Menjelaskan lebih lanjut, Dr Hwang berkata: 'Seorang yang menghidap kencing manis, sekaligus tergolong dalam mereka yang berisiko tinggi iaitu lebih 20 peratus untuk mengalami serangan jantung dalam tempoh 10 tahun.

'Risiko sederhana adalah antara 10 hingga 20 peratus dan risiko rendah di bawah 10 peratus. Tetapi sama ada seseorang berisiko rendah atau sederhana bergantung kepada beberapa faktor seperti umurnya.

'Seorang penghidap tekanan darah tinggi atau kolesterol tinggi mungkin berisiko rendah, tetapi sebaik saja beliau merokok, risikonya meningkat,' jelas Dr Hwang.

Sebelum diadakan sistem data CVD, kerja mengira risiko pesakit dijalankan secara manual dan sangat rumit sekali, kata Dr Hwang.

'Tapi kini dengan adanya sistem data dalam komputer ini, doktor dapat membuat penilaian terhadap pesakitnya dengan cepat.

'Doktor tidak perlu menghabiskan masa memeriksa dahulu tekanan darah tinggi pesakit dan sebagainya, sebaliknya mereka dapat meluangkan lebih banyak masa memberi kaunseling dan mendidik pesakit tentang pemakanan, senaman dan gaya hidup sihat di bilik rawatan,' katanya.

Tugas memasukkan data sejarah kesihatan para pesakit kronik ini pula, termasuk mengambil berat badan, Indeks Jisim Tubuh (BMI) untuk mengira lebihan lemak, dan hasil ujian makmal mereka, dilakukan lebih awal oleh kakitangan di Stesen Pantauan Kesihatan (HMS) di poliklinik itu.

Cara yang lebih cekap ini yang bertujuan melancarkan sistem kerja di poliklinik-poliklinik SingHealth, telah diperkenalkan pada 2006.

Mulai Mei tahun ini pula, mereka yang menghidap semput juga dikategorikan sebagai pesakit kronik dan perlu menjalani ujian kawalan semput dahulu di HMS sebelum berjumpa doktor.

Sistem ini juga menjimatkan waktu doktor dan pesakit di kesemua sembilan poliklinik SingHealth yang menemui 500,000 pesakit setahun. Di Pasir Ris, bilangan pesakit yang mengunjunginya ialah antara 400 hingga 500 sehari.

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Regular exercise good for dementia patients

NEW YORK - REGULAR daily exercise benefits elderly women with dementia and these benefits appear to accrue over time, researchers from the Republic of Korea report.

Dr Kwak Yi Sub, assistant professor of sports medicine at Dong-Eui University in Busan, and colleagues compared daily functioning as well as mental and physical abilities of 30 women with senile dementia before and after half participated in a regular exercise programme.

Their findings, reported in the International Journal of Sports Medicine, suggest 'regular exercise improves the mental and physical health in senile dementia', Dr Kwak said.

The researchers enlisted 15 women who were about 80 years old on average and had doctor-diagnosed dementia, to participate in 30 to 60 minutes of exercise 2 to 3 days each week for a year. A similar group of 15 women did not participate in regular daily exercise and served as the 'control' group.

At study entry and again 6 and 12 months later Dr Kwak's team evaluated the participants' mental abilities through tests that determine orientation to time and place, memory recall, identifying and remembering objects, reading, and writing.

After 6 months, women in the exercise group showed a 20 per cent overall improvement in these abilities. After 12 months, mental ability scores improved by 30 per cent.

By contrast, the researchers noted no changes in the mental ability scores of the non-exercisers.

Women who exercised also improved in their abilities to perform acts of daily living, like getting dressed, feeding, and bathing. They also enhanced their capacity to exercise and their muscle strength.

Together, these findings indicate that regular exercise appears to help senile dementia patients maintain their independence, Dr Kwak and colleagues note. -- REUTERS

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July 12, 2008         
Fruit juice tied to modest rise in diabetes risk


While the findings must be replicated, Dr Bazzano said, there are plausible mechanisms by which fruit juice could increase risk. -- PHOTO: MOHD KHALID BABA

NEW YORK - WOMEN wanting to ward off type 2 diabetes should load their plates with green leafy vegetables and whole fruits, but perhaps stay away from fruit juice, new research suggests.

Eating an additional three servings of whole fruit daily, or one more serving of spinach, kale or similar leafy green vegetable was tied to a lower risk of developing diabetes over an 18-year period among 71,346 women enrolled in the Nurses' Health Study.

'It was a modest decrease,' said Dr Lydia A. Bazzano of Tulane University School of Public Health and Tropical Medicine, New Orleans. 'This is not going to...prevent it if you have many, many risk factors and you're overweight...it's a tool in the prevention strategy.'

Dr Bazzano and colleagues analysed data on the diets of Nurses' Health Study participants - 4,529 of whom developed type 2 diabetes while they were being followed. They divided women into five groups based on fruit and vegetable intake, and also grouped them based on fruit juice consumption.

They found that an increase of three servings a day of whole fruit was associated with an 18 per cent lower risk of type 2 diabetes, while a single additional serving of leafy green vegetables cut the risk by 9 per cent. However, an additional daily serving of fruit juice increased the likelihood of developing diabetes by 18 per cent.

While the findings must be replicated, Dr Bazzano said, there are plausible mechanisms by which fruit juice could increase risk. 'It's a big sugar load and it comes in a liquid form which is absorbed rapidly,' she noted.

The findings, the study team concludes, suggest that 'caution should be observed in replacing some beverages with fruit juices in an effort to provide healthier options. The same caution applies to the recommendation that 100 per cent fruit juice be considered a serving of fruit as it is in the present national dietary guidelines'. -- REUTERS

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July 12, 2008         
Virus helps flush cancer cells out of hiding

CHICAGO - A GENETICALLY engineered version of the cold virus helped flush dangerous prostate cancer cells out of hiding in mice, making them easier to see on imaging equipment, United States researchers said on Friday.

If the same approach works in humans, it could offer a way to catch prostate cancer as it begins to spread, they said.

Ultimately, the hope is to use the approach to kill cancer cells as part of a highly targeted, image-guided therapy.

'If we can catch the cancer before it invades other organs, we have a better chance to change the outcomes for these patients,' Dr Lily Wu of the University of California, Los Angeles, whose study appears in the journal Nature Medicine, said in a statement.

The finding offers an example of a much-anticipated new use of imaging technology known as molecular imaging, in which advanced diagnostic equipment can be used to target and treat cancers on the cellular level.

Conventional scans known as computed tomography or CT scans have a hard time spotting the earliest stages of prostate cancer as it spreads, or metastasises, to hard-to-reach lymph nodes in the pelvis.

To help get a better look, Dr Wu's team tinkered with the common cold virus so that it would only target prostate cancer cells.

Once inside the cancer cell, genes in the virus trick the cancer into making a protein that can be seen using positron emission tomography, or PET scans. The protein serves as a sort of a flare signal identifying the location of the cancer.

'The virus happens to be lymphotropic, which means it favours the lymph nodes. We were able to exploit its natural capability for this particular function,' Dr Wu said in a telephone interview.

Using genetic engineering, Dr Wu said her team deleted all of the parts of the cold virus that make people sick. Next, they spliced in genes that make proteins that can be seen on PET scans, and they added in other genes that target prostate cancer cells.

'It's a prostate cancer-specific control switch,' she said.

The result was a virus that specially looked for prostate cancer cells in the lymph nodes, which is typically the first stop cancer makes before it spreads to other organs.

When Dr Wu and her team injected the engineered virus into tumours in mice with prostate cancer, PET scans picked up signals only from lymph nodes with cancer cells in them, suggesting the virus was able to target and tag prostate cancer cells.

Dr Wu and her colleagues are now working to develop a toxic agent they can add in that would find and kill the cancer cells at the same time, watching it all on a PET scanner.

She said the team plans to start testing the technique in dogs with prostate cancer. Her team is working to perfect the technique so that it can be tested in humans within the next two years, she said.

Prostate cancer occurs usually in older men. With an estimated 254,000 deaths annually, prostate cancer is the sixth leading cause of cancer death in men worldwide. -- REUTERS

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July 12, 2008         
Botox shots may help ward off migraines

NEW YORK - INJECTIONS of botulinum toxin - better known as Botox - may help prevent migraines in people who suffer frequent migraine attacks that are poorly controlled with oral prevention therapies, research hints.

In a study lasting six months, Drs Roger Cady and Curtis Schreiber of the Headache Care Center in Springfield, Missouri evaluated the efficacy and safety of a single series of Botox injections, versus placebo shots, for preventing migraine.

They report in the journal Headache that Botox had 'beneficial, albeit limited, effects on measures of migraine frequency and was not effective in lowering headache pain severity'.

However, Botox-treated patients did have fewer headache 'episodes' and fewer headache days than placebo-treated patients.

Moreover, Botox had a 'measurable' positive impact on quality-of-life.

For example, improvement in the Headache Impact Test - a six-item survey of pain, role functioning, social functioning, fatigue, cognition, and emotional distress - was significantly greater for Botox-treated patients than for placebo-treated patients.

Drs Cady and Schreiber think Botox 'may be a useful treatment option' for headache patients who are not doing well on other migraine preventive agents. -- REUTERS

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July 12, 2008         
Mum's smoking tied to oral birth defect


Past studies have linked mothers' smoking to cleft lip and, less consistently, to cleft palate. -- ST PHOTO: ALPHONSO CHAN

NEW YORK - PREGNANT women who smoke or regularly breathe second-hand smoke may be raising the odds that their baby will be born with a cleft lip, a new study shows.

Cleft lip and cleft palate are among the most common types of birth defect. They arise when the tissues that form the roof of the mouth and the upper lip do not fuse properly, sometime between the fifth and ninth week of pregnancy.

In the current study, Norwegian researchers found that women who smoked more than 10 cigarettes per day during their first trimester were nearly twice as likely to have a baby with a cleft lip as nonsmokers were.

Similarly, non-smoking women who were near a smoker for at least two hours each day had a 60 per cent higher risk than women who were not exposed to passive smoking.

Researchers led by Dr Rolv T. Lie, of the University of Bergen in Norway, report the results in the journal Epidemiology.

Past studies have linked mothers' smoking to cleft lip and, less consistently, to cleft palate.

The new findings add that to that evidence, and also suggest that smoking affects the odds of cleft lip regardless of certain genes.

Dr Lie's team assessed 1,336 infants - 573 of whom had an oral cleft - for several variations in 'detoxification' genes believed to help the body rid itself of tobacco smoke toxins.

In most cases, their parents were assessed as well.

In theory, certain variations in these genes may make people more or less vulnerable to the toxic effects of tobacco smoke. However, Dr Lie's team found no evidence that these genes affected the cleft lip risk connected with maternal smoking and passive smoking.

'First trimester smoking was clearly associated with risk of cleft lip,' the researchers conclude. 'This effect was not modified by variants of genes related to detoxification of compounds of cigarette smoke.' -- REUTERS

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July 17, 2008         
Voluntary HIV testing doubles to over 1,700
More women and singles go for tests.
By Judith Tan

MORE people, especially women and singles, are going for voluntary anonymous HIV screening at the two GP clinics here.

The number of such patients has doubled from 678 last year to 1,723 this year, according to a second survey carried out by Rockeby using OraQuick between last July and June this year.

The two anonymous screening centres are Enteh Clinic at Geylang and Cambridge Clinic at Kreta Ayer.

A significantly higher number of women are going for the HIV screening - from 9 per cent to 12 per cent, as well as first-timers - from 65 per cent to 74 per cent.

Last year, 422 people in Singapore tested positive for HIV, the highest since 1985, bringing the number of HIV carriers here to 3,482.

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July 17, 2008         
Two genes may prevent HIV infection: study

CHICAGO - SCIENTISTS have isolated two genes which may prevent people from contracting HIV or at least slow the rate at which they develop Aids, a new study has found.

The genes were isolated by comparing the genetic profiles of people in their first year of HIV infection with those who managed to resist infection despite repeated exposure to the virus.

The 'good' versions of the two genes were present in 12.2 per cent of those who resisted infection compared with only 2.7 of patients in primary HIV infection.

Researchers are not yet sure how this protection works.

One of the gene codes for a receptor on the surface of the immune system's natural killer cells which destroy infected cells in the body.

The other codes for a protein which binds the first gene and dampens the natural killer cell activity.

The most likely explanation is that HIV prevents the protein that dampens the killer cell activity from being expressed, allowing the killer cells to destroy cells infected with HIV.

Since this can happen very soon after the initial infection, people carrying those genes may be able to more efficiently destroy infected cells and lower their chances of developing Aids.

'More research is needed to determine the exact mechanism behind the protection we have observed, but these findings have revealed a promising avenue,' said co-author Dr Nicole Bernard of the Research Institute of the McGill University Health Centre.

'In the future, our findings could be used to somehow 'boost' the innate immune system and thus fight the virus as soon as it enters the body.' The study was published on Wednesday in the journal AIDS. -- AFP

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July 17, 2008         
Vical says its DNA vaccine for bird flu works

WASHINGTON - A DNA-BASED vaccine against avian influenza can safely stimulate the immune system to levels expected to protect against flu, San Diego-based Vical Inc reported on Thursday.

It said that in a study of 100 volunteers, 67 per cent of the patients receiving the higher dose had immune responses that could protect against infection with the H5N1 avian flu virus, with no serious adverse reactions after two injections.

The Phase I clinical trial, meant to demonstrate the vaccine is safe, was continuing, Vical said in a statement.

'The preliminary results from this Phase 1 trial indicate for the first time that ... DNA vaccination against H5N1 influenza is well-tolerated and can induce impressive antibody responses,' Dr Robert Belshe of Saint Louis University School of Medicine, who monitored safety, said in a statement.

'Successful development of a safe and effective DNA vaccine will help address the potential public health threat of pandemic influenza.'

The company says a DNA-based vaccine could be made in six to eight weeks, compared with four to six months for influenza vaccines made the current way, using bits of the actual virus grown in chicken eggs.

DNA vaccines use bits of genetic material called plasmids.

They are meant to generate an immune response against a specific bit of the virus and are designed to last longer than standard vaccines under conditions of heat and cold.

The H5N1 avian flu virus has become entrenched among birds in much of Asia and parts of Europe, Africa and the Middle East. It rarely infects people but it has killed 243 people out of 385 infected in 15 countries, according to the World Health Organisation.

Experts fear the constantly mutating virus could change into a form easily transmitted from person to person, perhaps sweeping the world and killing millions.

At least 16 companies are working on vaccines against H5N1.

No one knows if they will work against whatever strain might eventually cause a pandemic, but makers agree it is better to be prepared.

'The ability to manufacture DNA vaccines in weeks rather than the months required for conventional vaccines may provide a significant advantage when dealing with an emerging infectious disease such as pandemic influenza,' Mr Vijay Samant, Vical's president and chief executive, said in a statement.

The company will present the interim Phase I results at the IBC Life Sciences Next Generation Vaccines conference being held near Washington. -- REUTERS

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July 17, 2008         
Low-carb diet best for weight, cholesterol

ATLANTA - THE Atkins diet may have proved itself after all: A low-carb diet and a Mediterranean-style regimen helped people lose more weight than a traditional low-fat diet in one of the longest and largest studies to compare the duelling weight-loss techniques.

A bigger surprise: The low-carb diet improved cholesterol more than the other two. Some critics had predicted the opposite.

However, all three approaches - the low-carb diet, a low-fat diet and a so-called Mediterranean diet - achieved weight loss and improved cholesterol.

The study is remarkable not only because it lasted two years, much longer than most, but also because of the huge proportion of people who stuck with the diets - 85 per cent.

Researchers approached the Atkins Foundation with the idea for the study. But the foundation played no role in the study's design or reporting of the results, said the lead author, Ms Iris Shai of Ben-Gurion University of the Negev.

Other experts said the study - being published on Thursday in the New England Journal of Medicine - was highly credible.

The research was done in a controlled environment - an isolated nuclear research facility in Israel. The 322 participants got their main meal of the day, lunch, at a central cafeteria.

'The workers can't easily just go out to lunch at a nearby Subway or McDonald's,' said Dr Meir Stampfer, the study's senior author and a professor of epidemiology and nutrition at the Harvard School of Public Health.

In the cafeteria, the appropriate foods for each diet were identified with coloured dots, using red for low-fat, green for Mediterranean and blue for low-carb.

As for breakfast and dinner, the dieters were counselled on how to stick to their eating plans and were asked to fill out questionnaires on what they ate, Dr Stampfer said.

The low-fat diet - no more than 30 per cent of calories from fat - restricted calories and cholesterol and focused on low-fat grains, vegetables and fruits as options. The Mediterranean diet had similar calorie, fat and cholesterol restrictions, emphasizing poultry, fish, olive oil and nuts.

The low-carb diet set limits for carbohydrates, but none for calories or fat. It urged dieters to choose vegetarian sources of fat and protein.

Most of the participants were men; all men and women in the study got roughly equal amounts of exercise, the study's authors said.

Average weight loss for those in the low-carb group was 10.3 pounds (4.67 kilograms) after two years. Those in the Mediterranean diet lost 10 pounds (4.54 kilograms), and those on the low-fat regimen dropped 6.5 pounds (2.95 kilograms).

More surprising were the measures of cholesterol. Critics have long acknowledged that an Atkins-style diet could help people lose weight but feared that over the long term, it may drive up cholesterol because it allows more fat.

But the low-carb approach seemed to trigger the most improvement in several cholesterol measures, including the ratio of total cholesterol to HDL, the 'good' cholesterol. For example, someone with total cholesterol of 200 and an HDL of 50 would have a ratio of 4 to 1. The optimum ratio is 3.5 to 1, according to the American Heart Association.

Doctors see that ratio as a sign of a patient's risk for hardening of the arteries. 'You want that low,' Dr Stampfer said.

The ratio declined by 20 per cent in people on the low-carb diet, compared to 16 per cent in those on the Mediterranean and 12 per cent in low-fat dieters.

The study is not the first to offer a favourable comparison of an Atkins-like diet. Research published in the Journal of the American Medical Association last year found overweight women on the Atkins plan had slightly better blood pressure and cholesterol readings than those on the low-carb Zone diet, the low-fat Ornish diet and a low-fat diet that followed US government guidelines.

The heart association has long recommended low-fat diets to reduce heart risks, but some of its leaders have noted the Mediterranean diet has also proven safe and effective.

The heart association recommends a low-fat diet even more restrictive than the one in the study, said Dr Robert Eckel, the association's past president who is a professor of medicine at the University of Colorado-Denver.

It does not recommend the Atkins diet. However, a low-carb approach is consistent with heart association guidelines so long as there are limitations on the kinds of saturated fats often consumed by people on the Atkins diet, Dr Eckel said.

The new study's results favoured the Atkins-like approach less when subgroups such as diabetics and women were examined.

Among the 36 diabetics, only those on the Mediterranean diet lowered blood sugar levels. Among the 45 women, those on the Mediterranean diet lost the most weight.

'I think these data suggest that men may be much more responsive to a diet in which there are clear limits on what foods can be consumed,' such as an Atkins-like diet, said Dr William Dietz, of the Centres for Disease Control and Prevention.

'It suggests that because women have had more experience dieting or losing weight, they're more capable of implementing a more complicated diet,' said Dr Dietz. -- AP

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July 18, 2008         
More private clinics to offer anonymous HIV tests
By Judith Tan

CALLS for more anonymous HIV testing are finally being heeded by the Ministry of Health.

MOH wants more private GP clinics to dispense anonymous saliva-based Aids tests and has sent invitations last month to 70 doctors to take it up.

Currently, Anteh Dispensary in Geylang and Cambridge Clinic in Kreta Ayer are the only two clinics permitted to do anonymous testing using OraQuick, the saliva-based test kit for the last two years.

Because testing is anonymous, the clinics do not submit a report when someone tests positive.

This has led to a 2 1/2 times increase in the number going there for such test - from 678 between July 2006 to June last year to 1,723 between July 2007 to June this year.

When contacted, MOH said that it is extending anonymous HIV testing service to other GP clinics as part of its efforts to further encourage those at risk to learn of their status.

'Details will be made available at a later stage when finalised,' said a spokesman.

Last year, 422 people are diagnosed with HIV, up from 357 in 2006. And up to June this year, another 236 tested positive.

And out of the 1,723 people who went to the two clinics for anonymous testing, 16 were found to be HIV-positive.

The clinics, together with Rockeby, conducted a survey and found that the number of women and singles voluntarily testing themselves for the Aids virus at anonymous screening centres has gone up.

The proportion of women rose to 12 per cent between July last year and June - compared to only 9 per cent a year earlier.

And the number of singles getting screened also went up - from 61 per cent to 69 per cent.

People being tested for the first time also rose - from 65 epr cent to 74 per cent.

Doctors who spoke to The Straits Times said Oraquick is more popular than blood tests because it is easy to use, no needles are needed, and results are ready in 20 minutes.

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July 18, 2008         
Breast-feeding triggers pulses of feel-good hormone


A study suggests that breast feeding not only taps the normal brain cells involved in secreting oxytocin, it also recruits dendrites - whose normal job is to create communication channels between brain cells - into secreting the hormone. -- ST FILE PHOTO

CHICAGO - WHEN a baby breast-feeds, it triggers a flood of the hormone oxytocin that releases milk from the mammary gland and a feeling of love and trust in the mother that ensures the baby's needs are met.

This reflex has long puzzled researchers because it requires large surges of oxytocin to pull off all of this.

Using a special computer model, researchers from China, France, Italy, and the United Kingdom said on Thursday they now understand how it works.

Their study, reported in the journal PLoS Computational Biology, suggests that breast feeding not only taps the normal brain cells involved in secreting oxytocin.

It also recruits dendrites - whose normal job is to create communication channels between brain cells - into secreting the hormone.

This increases communication between the neurons and creates a hub of oxytocin production that results in bursts of the hormone released at regular intervals.

'We knew that these pulses arise because, during suckling, oxytocin neurons fire together in dramatic synchronised bursts. But exactly how these bursts arise has been a major problem that has until now eluded explanation,' Professor Feng Jianfeng of the University of Warwick in Coventry in the United Kingdom said in a statement.

He said the findings could help explain other similar activities in the brain.

The study can be found at http://www.ploscompbiol.org/doi/pcbi.1000123. -- REUTERS

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Khaw says key problem to legalising organ trade is exploitation of donors
By Valarie Tan, Channel NewsAsia | Posted: 20 July 2008 2230 hrs


Health Minister Khaw Boon Wan speaking to reporters

SINGAPORE: Health Minister Khaw Boon Wan has said Singapore may consider legalising the sale of organs if there are safeguards against the exploitation of the poor.

Mr Khaw, speaking at a community event on Sunday, said more talks would also help Singaporeans reach a consensus on the issue.

He added that more than one work group will be needed to study the issue.

The debate over legalising organ trade came into the limelight recently after two Indonesians were jailed for selling their kidneys in Singapore.

One of the alleged buyers is well-known Singaporean retailer Tang Wee Sung.

Under Singapore's Human Organ Transplant Act (HOTA), kidneys, hearts, livers and corneas can be harvested from those who die in accidents or are certified brain dead.

But Mr Khaw said there is a shortage of living donors in Singapore who are willing to donate their organs to relatives with kidney failure.

He said: "In countries like Norway, when patients have kidney failure, the doctors will straightaway ask, which family member is going to donate (their kidney). And you see the whole family putting up their hands - grandmothers, grandfathers, grandchildren - everyone offers (their kidney). In the case of Singapore, I asked our doctors, (and they said) first, not many put up their hands. And, (among) the few families that do put up their hands, very few family members put up their hands."

Mr Khaw believed this shortage has led to some people buying organs illegally from neighbouring countries, creating a black market where the poor could be exploited.

That is a problem that must be addressed if Singapore allows organ sale.

Mr Khaw said: "The key problem is exploitation. So if you can find a way to eliminate exploitation or minimise exploitation to a low level, isn't that a better outcome, than pretending that the problem doesn't exist but the exploitation continues?"

Mr Khaw also touched on the recent issue of Venerable Shi Ming Yi, who has been charged in court with forgery and misuse of donations.

Ming Yi was the chief executive officer of Ren Ci, one of Singapore's largest charities.

Mr Khaw said his ministry has proposed two names to Ren Ci to replace Ming Yi as CEO.

The Health Ministry has also offered to take over the management of the charity in the interim. But, Ren Ci has yet to respond to the offer.

- CNA/ir

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HOTA to be amended to increase donors
By Hoe Yeen Nie, Channel NewsAsia | Posted: 22 July 2008 0050 hrs



SINGAPORE : Singapore is amending its Human Organ Transplant Act (HOTA) to raise the number of cadaveric and living donor kidney transplants in the country.

Health Minister Boon Wan told Parliament on Monday that the changes will include removing the age limit on cadaveric donors, and could also allow financial compensation by third-parties to altruistic donors.

Currently only one-third of new kidney patients are suitable for transplants. Even then, only half of them will get their wish.

However, the Health Ministry feels the rate can still be further raised to 70 per cent in the medium term.

While Mr Khaw is not ruling out legalising the sale of organs, he said the bulk of kidney transplants must come from cadaveric and living donors. One way is to amend transplant laws to allow cadaveric donors over the age of 60.

Mr Khaw said: "Many countries, including Spain, do not set such an age limit. The suitability of the organ depends on its condition, rather than the age of the donor. The condition of the kidney can be determined by the transplant doctor and that should be the criterion for determining if an organ is suitable."

Responding to concerns raised, Mr Khaw said the life expectancy of recipients of these organs is unlikely to be affected.

Mr Khaw also wants to change the rules to allow a donor - whose tissue is incompatible with the intended recipient - to be matched with another person in a similar situation.

The process is fairly common in the United States and Europe, and Mr Khaw said his ministry will set up a live donor registry to facilitate this.

The ministry is also exploring how third-party organisations, such as charities and religious groups, can be allowed to compensate donors and their families after the transplants are completed - without having their actions being misconstrued as organ trading.

Mr Khaw explained: "Occasionally, I receive requests from some charities and religious bodies which wish to provide some compensation, in kind and in cash, for the organ donors and their families, to acknowledge their altruistic act. But they worry that this may be construed as organ-trading and they may be breaching the HOTA rules.

"My view is that we should encourage third parties, especially those from the charity and religious sector, to help promote altruistic organ donations, and that we should consider how they can be allowed to provide some financial compensation to the donors and their families after the transplants have taken place.

"My ministry will study whether such an idea is feasible, and if so, whether HOTA needs to be amended to facilitate its implementation."

Mr Khaw added that his ministry will study the Iranian model carefully, seeing that it is the only model of legalised organ trading available. He acknowledged that even then, a black market continues to exist.

However, he said that further study will help better address the issue of exploitation.

Citing an article by Professor Gary Becker, Professor of Economics and Sociology and Senior Fellow at the Hoover Institution, he noted that the issue should also be analysed from a practical perspective.

Mr Khaw said: "On the part of my ministry, even as we take action against those involved in illicit organ trading and unscrupulously exploiting the desperate and the vulnerable, we will take a sympathetic approach to the plight of the exploited donors and the basic instinct of kidney failure patients to try to live." - CNA/ms