Showing posts with label Expert Opinions. Show all posts
Showing posts with label Expert Opinions. Show all posts

Monday, April 6, 2009

Bridge holding Antarctic ice shelf shatters


Monday, April 06, 2009

By Alister Doyle, Oslo

AN ice bridge which had apparently held a vast Antarctic ice shelf in place during recorded history has shattered and could herald a wider collapse linked to global warming, a leading scientist said.

"It’s amazing how the ice has ruptured. Two days ago it was intact," David Vaughan, a glaciologist with the British Antarctic Survey, said of a satellite image of the Wilkins Ice Shelf on the Antarctic Peninsula. The satellite picture, from the European Space Agency (ESA), showed that a 40km long strip of ice believed to pin the Wilkins Ice Shelf in place had splintered at its narrowest point, about 500 meters wide.


The Wilkins, now the size of Jamaica or the state of Connecticut, is one of 10 shelves to have shrunk or collapsed in recent years on the Antarctic Peninsula, where temperatures have risen apparently because of global warming.



Separate research shows that when ice shelves are removed, the glaciers and landed ice behind them start to move towards the ocean more rapidly. It is this ice which can raise sea levels, but by how much is a matter of ongoing scientific debate.

Sunday, April 5, 2009

Tea drinking habits and oesophageal cancer in a high risk area in northern Iran: population based case-control study.

BMJ. 2009 Mar 26;338:b929. doi: 10.1136/bmj.b929.


Islami F, Pourshams A, Nasrollahzadeh D, Kamangar F, Fahimi S, Shakeri R, Abedi-Ardekani B, Merat S, Vahedi H, Semnani S, Abnet CC, Brennan P, Møller H, Saidi F, Dawsey SM, Malekzadeh R, Boffetta P.

Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, 14117 Tehran, Iran.

RESULTS:
Nearly all (98%) of the cohort participants drank black tea regularly, with a mean volume consumed of over one litre a day. 39.0% of participants drank their tea at temperatures less than 60 degrees C, 38.9% at 60-64 degrees C, and 22.0% at 65 degrees C or higher. A moderate agreement was found between reported tea drinking temperature and actual temperature measurements (weighted kappa 0.49).

The results of the case-control study showed that compared with drinking lukewarm or warm tea, drinking hot tea (odds ratio 2.07, 95% confidence interval 1.28 to 3.35) or very hot tea (8.16, 3.93 to 16.9) was associated with an increased risk of oesophageal cancer.

Likewise, compared with drinking tea four or more minutes after being poured, drinking tea 2-3 minutes after pouring (2.49, 1.62 to 3.83) or less than two minutes after pouring (5.41, 2.63 to 11.1) was associated with a significantly increased risk.

A strong agreement was found between responses to the questions on temperature at which tea was drunk and interval from tea being poured to being drunk (weighted kappa 0.68).

CONCLUSION: Drinking hot tea, a habit common in Golestan province, was strongly associated with a higher risk of oesophageal cancer.

Friday, March 20, 2009

Please be very very careful

We must never let these horrific acts frighten us into paralysis.

Thomas Jefferson said 200 years ago:

"The price of freedom is eternal vigilance".

Vigilance....Vigilance.....Vigilance......




Thursday, March 12, 2009

Green and Black Tea Consumption and Risk of Stroke. A Meta-Analysis

Stroke. 2009
Published online before print February 19, 2009, doi: 10.1161/STROKEAHA.108.538470

Background and Purpose—Experimental models of stroke provide consistent evidence of smaller stroke volumes in animals ingesting tea components or tea extracts. To assess whether a similar association of black or green tea consumption with reduced risk is evident in human populations, we sought to identify and summarize all human clinical and observational data on tea and stroke.

Methods—We searched PubMed and Web of Science for all studies on stroke and tea consumption in humans with original data, including estimation or measurement of tea consumption and outcomes of fatal or nonfatal stroke. Data from 9 studies involving 4378 strokes among 194 965 individuals were pooled. The main outcome was the occurrence of fatal or nonfatal stroke. We tested for heterogeneity and calculated the summary effect estimate associated with consumption of ≥3 cups of tea (green or black) per day using random-effects and fixed-effects models for the homogeneous studies. Publication bias was also evaluated.

Results—Regardless of their country of origin, individuals consuming ≥3 cups of tea per day had a 21% lower risk of stroke than those consuming <1 cup per day (absolute risk reduction, 0.79; CI, 0.73 to 0.85). The proportion of heterogeneity not explained by chance alone was 23.8%.

Conclusions—Although a randomized clinical trial would be necessary to confirm the effect, this meta-analysis suggests that daily consumption of either green or black tea equaling 3 cups per day could prevent the onset of ischemic stroke.

Fish intake of Swedish male adolescents is a predictor of cognitive performance

REGULAR ARTICLE
Acta Pædiatrica
Volume 98 Issue 3, Pages 555 - 560



ABSTRACT

Aim: Fish intake is reported to positively influence cognitive performance in infants and the elderly. In a longitudinal cohort study, we evaluated how fish consumption related to later cognitive performance in healthy young male adolescents.

Methods: In 2000, all 15-year-olds (n = 18 158; 9260 males) in the western region of Sweden were requested to complete an extensive questionnaire with items on diseases, fish consumption and socioeconomic status. Questionnaire data from the male responders (n = 4792, response rate 52%) were linked with records on subsequent intelligence test performance at age 18 from the Swedish Military Conscription Register (n = 3972). Multivariate linear models were used to estimate associations between fish intake and cognitive performance, adjusting for potential confounders.

Results: There was a positive association between the number of times having fish meals per week at age 15 and cognitive performance measured 3 years later. Fish consumption of more than once per week compared to less than once per week was associated with higher stanine scores in combined intelligence (0.58 units; 95% confidence interval 0.39, 0.76), in verbal performance (0.45; 0.27, 0.63) and in visuospatial performance (0.50; 0.31, 0.69). The association between fish consumption and the 3 intelligence scores was the same in lowly and highly educated groups. This indicates that education did not influence the association between the frequency of fish meals consumed and cognitive performance.

Conclusion: Frequent fish intake at age 15 was associated with significantly higher cognitive performance 3 years later.

Monday, March 9, 2009

Delay no more

I have been reading closely the current issue of english in the teaching of science and maths.

But instead I have learned new cantonese/hokkien words.

1. Delay no more- this was started in Hong Kong, where curses in Cantonese are often very colourful. If you pronounce the English words in a quick Cantonese accent, you will find that it refers to someone’s old mother.

2. Curry Lembu- Hokkien equivalent of 'Delay no more'

A trip to Audley End







Audley End House and Gardens

King Henry VIII gave Walden Abbey to Sir Thomas Audley, who transformed it into his mansion, Audley End.
Audley End remains one of England’s grandest country homes with over 30 lavishly decorated rooms to enjoy and explore.
The sumptuous interior is largely due to the third Baron Braybrooke who inherited Audley End in 1825, filling it with treasures including paintings by Masters such as Holbein and Canaletto.
Imagine yourself back in Victorian times when visiting this place.

Only 14 miles from Cambridge, UK


All pictures taken with Canon 350D 24-70mm L f/2.8 USM
ISO 800 used for indoor shots.

Tuesday, March 3, 2009

Updates in medicine

Achives of Surgery
2008;143(12):1222-1226
Requirement of perioperative stress doses of corticosteroids: a systemic review
• Patients receiving therapeutic doses of corticosteroids undergoing surgical procedure do not routinely require stress doses of corticosteroids as long as they continue their usual daily dose of corticosteroids.
• Adrenal function testing is not required in these patients because the test is overly sensitive and can’t predict which pt will develop an adrenal crisis.
• However, patients receiving physiological doses owing to hypothalamic-pituitary-adrenal axis d/o require supplemental doses of corticosteroids in the perioperative period.

Monday, March 2, 2009

Invest In Our People!

by M. Bakri Musa

Millions of Chinese had a rude awakening when they returned last month from celebrating their Lunar New Year in their villages. They discovered that the jobs they had in the cities before they left only a few weeks earlier had now disappeared. Tragic though that may be to them individually, the aggregate loss pales in comparison to that suffered by their government through its massive investments in the stocks of American companies and other paper assets like bonds and Treasury Notes.

If only the Chinese government had invested in its people, imagine the good that would do to them, and to China. If their government had spent the funds to build better schools, Chinese schoolchildren would not have dangerous physical facilities that collapse with the slightest tremor. Had those funds been used to build affordable apartments, the Chinese people would have been better housed. That would at least help alleviate their miserable existence.

The Chinese people suffered twice. First, they worked incredibly hard under intolerable conditions and insufferably meager wages so the West could enjoy inexpensive consumer goods. Then the foreign currencies earned by their government from the exports created through their hard work vanished with the downward spiral of Western economies.

When Western consumers could no longer afford to spend, the Chinese were forced to work under even harsher conditions so the products they make could be sold cheaper still. This is just a modern twist to the old “coolie” concept. In the early part of the last century, millions of indentured Chinese were brought to America to work on the gold mines and railways. Today the coolies remain in China; America brings in only the products of their hard labor.

China is not alone in engaging in this folly of investing abroad instead of in their people, so is the rest of Asia. Singapore lost a hundred billion dollars on its American investments. On a per capita basis, Singapore’s loss is massive and readily dwarfs that suffered by China.

Granted, Singaporeans live in a different universe from those folks in China, at least with respect to the creature comforts of life, though not in personal freedom. That notwithstanding, imagine how much better off Singaporeans would be if only their government had invested in them instead of being enamored by the fancy financial papers hustled by those Ivy League-educated white boys on Wall Street.

A Singaporean friend who owns a subsidiary in Silicon Valley lamented that the secretary to the head of his American company enjoys a lifestyle far better than his: larger home, a decent car, more social amenities, and better opportunities for her children. Meanwhile back in Singapore my friend has to make do with one of the pigeon holes of a home in those monotonous urban high-rises, and his children have to spend what little spare time they have in “cram schools.”

On another level, had Singapore invested those billions in nearby giant Indonesia instead of faraway America, imagine how much good it would do to the poor Indonesians. More pragmatically, a developed Indonesia would be a more high-value market for Singapore’s products and services. Besides, imagine the gratitude and goodwill created through such investments. You cannot put a monetary value to that. Indonesia desperately needs those investments; America could easily do without Singapore’s dollars.

Malaysia Fortuitously Spared

Fortunately in this current global crisis Malaysia is spared this tragic fate of losing its investments abroad. This is not the result of any brilliant foresight on the part of the nation’s leaders, rather the consequences of our own harrowing experience with the Asian economic crisis of 1997. For one, Malaysia has not yet fully recovered from that trauma and thus does not have the extra cash to be investing in any new and exotic financial instruments concocted in the West, those acronym-filled papers that are the “assets” of what former Finance Minister Tun Dain Zainudin derisively termed the “cowboy economics.”

For another, the capital controls implemented by Mahathir, though now largely dismantled, have left a deep impression on Malaysian economic managers, immunizing them against future meddling in such poorly understood foreign “investments.”

That has not always been the case. Prior to 1997, agencies of the Malaysian government were active players on the London Stock Market, as well as the London Metal Exchange and the Foreign Exchange Market.

It was at the London Stock Market that Malaysia executed its famous (or infamous, at least to the Brits) “Dawn Raid” on September 1981 that effectively nationalized the huge British plantation company, Guthrie. That was hailed as a brilliant move that also satisfied our national pride. It proved that we natives were fast learners and could be just as agile as those pros in the City, a much-needed confidence booster for those who require it periodically.

Malaysia’s brash attempt to corner the world’s tin market at the London Metal Exchange also involved mega sums. This time however, there was no rush to accept responsibility for this squandering of citizens’ precious funds. There were other colossal losses, including Bank Negara’s forex debacle, as well as the now defunct Bank Bumiputra’s many expensive foreign misadventures.

Again, I could only imagine the immense good had our government invested those precious funds in our people instead. Although average Malaysians have it considerably much better than the average Chinese, nonetheless our quality of life could always be improved.

Contrary to the soothing but misplaced assurances from our leaders, Malaysia cannot insulate itself from the current global economic storm. There is no “comfort zone.” Yes, Malaysia was fortunate enough not to have been entangled in those highly deceptive newfangled financial instruments with such fanciful acronyms. However, when our biggest trading partner and consumer of many of our commodities is in economic difficulties, rest assured that Malaysia will also inevitably be roped in.

Invest In What You Know

Like other countries, the Malaysian government has also introduced its own economic stimulus in an attempt to deal with the crisis. Our economists too have read Maynard Keynes and understood the rationale for counter cyclical public spending in a downturn.

Understanding the concept is one thing, translating it into reality in our local context is entirely another matter. The challenge is to make sure that our economic stimulus does indeed work, meaning it does spur the economy, and that our investments are indeed investments, meaning they would produce returns in excess of the capital expended.

At the height of the dotcom boom, the legendary American investor Warren Buffet was asked why he was not investing in that sector. He answered, “I invest only in things I know!”

I live in California and know that the real estate dynamics in San Francisco is radically different from that of San Bernardino, so I invest only in my community. I can at least follow the trend. Yet we have bankers in Singapore and Beijing pretending to be knowledgeable about real estate in the entire United States. That is the only explanation for their readily investing billions in securitized American mortgages!

Follow Warren Buffet’s maxim: Invest only in what you know. What do Malaysian leaders know? For one, more than any Western banker or Nobel prize-winning economist, our leaders know our people, their daily needs and living conditions. So invest in them, our people. For another, the economic “multiplier” of such spending is considerable; there is no such local multiplier when we invest in foreign stocks and other paper assets.

Our leaders are aware of the deplorable conditions of our schools especially in rural areas. They also know that these children risk their lives daily in crossing rickety bridges to get to schools. When they return home, their houses are flimsily built and in an unhealthy environment. They also have poor access to healthcare. So why not invest in building new schools, bridges, clinics, and affordable public housing?

Similarly we all know that those rural children could not get good teachers. So why not invest in teacher training and provide greater incentives for teachers to serve in rural areas?

The beauty of such investments is that they generate values way over and above the capital and other efforts we put in. The benefits are also enduring, and indeed “recession-proof.” Should there be an economic downturn, the superb education those children had received would still be with them; likewise their good health. Indeed a populace that is healthy and better educated, and thus productive, is the best weapon against a downturn.

In the last budget, and also in the proposed additional stimulus, considerable sums were devoted to investing in the local stock market and in furthering the government’s already considerable involvement in the private sector. Come another recession or a market misjudgment, such “investments” could easily evaporate. We have already squandered hundreds of billions on Bank Bumiputra, State Development Corporations, and the myriad GLCs. All we have to show for such investments are some old, tattered letterheads. We have not even learned any useful lessons from those debacles.

Let the investment bankers, brokers and other middle men and paper shufflers invest in exotic financial assets; governments should invest in their people, and in infrastructures that would enhance their lives. Those are the only investments that are properly the purview of governments, not company stocks, foreign bonds, or fancy derivatives.

Investing in our people is also the only effective way to prepare them for the increasingly competitive world. More significantly for leaders, that would also ensure that come election time when citizens would make decisions about their future, our leaders would not be rudely awakened to find themselves without jobs.

Thursday, February 26, 2009

The Girl Who Silenced The World For 6 Minutes



Forwarded by DrLohCL

Climate disaster is occuring faster than expected



Polar bears can't catch seals in open water. They are only able to do so on the sea ice.
On the ice, the bears catch their prey when they surface to breathe.
Seals swim to the surface to breathe every five to fifteen minute but because they visit as many as fifteen breathing holes, a polar bear's wait for its prey can be long.

Polar bears locate breathing holes with their powerful sense of smell. When a bear finds an aglu, it waits patiently for the seal to surface — which can take hours or days.

Polar bears depend on the presence of ice for access to seals. In summer, when the floes retreat north, polar bears will travel hundreds of miles to maintain contact with their prey.

Between summer and winter the amount of ice-covered water can change rapidly. Polar bears learn to follow the ice to stay with their food source.

Those polar bears that are stranded on land in summer must stay there until the ice forms again in fall. On land, the bears face lean times, for they seldom catch seals without a platform of ice.

The picture above is a polar bear being killed as it went rampaging into a nearby town looking for food.

With the thinning ice caps, more polar bears are dying day by day...


The SUN, 26th February 2009

ALLIGATORS bask off England. Brazil is a desert. Saigon, New Orleans, Venice and Mumbai have disappeared — along with 90 per cent of the human race.

This is what scientists believe could happen 41 years from now if the world warms by just 4°C.

Here we graphically illustrate how Earth could become a whole new world.

Rivers would disappear, as would entire species such as lions and tigers. Most marine life would be extinct.

These are among the dire predictions made by experts in the latest New Scientist magazine, on sale this week.

They have begun to consider what the world could look like if we are unable to do our bit to stem climate change — and say only one in ten humans would survive to see it.

Many scientists believe this could happen by 2100, but others fear it is just two generations away, and could arrive as soon as 2050.

Peter Cox of the University of Exeter, who studies climate systems, says: “Climatologists tend to fall into two camps. There are the cautious ones who say we need to cut emissions and won’t even think about high global temperatures — and there are the ones who tell us to run for the hills because we’re all doomed. I prefer a middle ground. We have to accept that changes are inevitable and start to adapt now.”

If the planet warms by an average of 4°C — as it might this century — it will change beyond all recognition.

All of the world’s major deserts are predicted to expand, with Africa’s Sahara reaching right into central Europe, while we would see Europe’s rivers drying up, from the Danube to the Rhine.

Two massive belts of desert-dry land would girdle the earth’s central zones.


The only places with guaranteed water will be in the high latitudes.

Former NASA scientist James Lovelock, one of the UK’s most highly regarded environmentalists, says: “Everything in that region will be growing like mad. It’s where all the life will be.

“The rest of the world will be largely desert with a few oases.

“Humans are in a pretty difficult position and I don’t think they are clever enough to handle what’s ahead.

“I think they’ll survive as a species but the cull during this century is going to be huge.

“The number remaining at the end of the century will probably be a billion or less. And you can forget lions and tigers — if it moves we’ll have eaten it. People will be desperate.”
Relocate

The world’s population would relocate to the coolest regions — including Britain, Scandinavia, Russia, Canada, Greenland, New Zealand and North Australia. However, with less land the world will be crowded and food scarce.

Human survivors’ diet will be mostly vegetarian — as the seas become acidic with higher amounts of dissolved carbon dioxide killing off most marine life.

This is not the first time the world has faced a catastrophe on this scale.

Similar temperature rises occurred 55million years ago, when vast quantities of methane bubbled explosively from the deep ocean, filling the atmosphere with carbon and wiping out sea life.

The planet’s temperature rocketed almost 6°C, sea levels rose 330ft higher than today’s and desert stretched from southern Africa into Europe.

Sadly we have no survival lessons to learn from it — mankind didn’t develop on the planet until quarter of a million years ago.

Nobel prize-winning scientist Paul Crutzen says: “I would like to be optimistic that we will survive but I’ve got no good reason to be.

“In order to be safe we would have to reduce our carbon emissions by 70 per cent by 2015. At the moment we are putting them up by three per cent... ”

Coming soon: Ecology disaster


Arctic ice cap keeps melting under the effects of global warming.
August 2008 saw second largest summer shrinkage since satellite observations began 30 years ago.
Artic sea ice shrank to the smallest area on record recently, US scientist have cofirmed.
The Artic sea ice which spread across he north pole could disappear during the summer in 1-2 decade (as early as 2013), US scientist warned.


It is silly to say global warming is not taking place on a massive scale.
The world already is experiencing major changes.
Global warming no longer can be stopped.
What has to be done now is to deal with a planet with ultra high speed winds, sudden deserts and large scale extreme weather events.

EULAR recommendations- vasculitis

Visit myvasc.blogspot.com

Monday, February 23, 2009

Hospital Kuala Lumpur- a world class health facility



How I envy those working in this world class hospital.

I was told that only the best could work there.....

Truly a people's hospital.

I will want to be admitted there if I fall ill.

RM5/= for anyone who can spot Dr Ghazali

Wednesday, February 18, 2009

Immunisation in renal transplant patients

Update from the NCP Nephrology.

Visit renaltransplanthkl.blogspot.com

Tuesday, February 17, 2009

Top Gear UK and Proton- shared by CL Loh


This is one of the few hot programmes currently running in BBC.

Top Gear is an International Emmy Award-winning BBC television series about motor vehicles, primarily cars.
The show is presented by Jeremy Clarkson, Richard Hammond, James May and The Stig, an anonymous test driver.
The programme is estimated to have 350 million viewers worldwide.

The show has received acclaim for its visual style and presentation, as well as considerable criticism for its content and comments made by presenters.

This is what they say about Proton cars.

Go into their official website for a detail review of each Proton model.

Those currently driving Proton cars should probably avoid reading further.

Thursday, February 12, 2009

Its snowing again




Severe weather warnings have been issued across the north of Scotland, where thick snow is falling and more is forecast.

Blizzard conditions are also affecting major roads in the county of Angus and Market Weighton in East Yorkshire.

How I wish I have my Canon 5DII to capture these moments..

Sunday, February 8, 2009

Jamaican Blue Mountain Coffee



Jamaican Blue Mountain Coffee or Jamaica Blue Mountain Coffee is a classification of coffee grown in the Blue Mountains of Jamaica.

Over the last several decades, this coffee has developed a reputation that has made it one of the most expensive and sought-after coffees in the world.

In addition to its use for brewed coffee, the beans are the flavor base of Tia Maria coffee liqueur.

This coffee has a few distinct features.

The first is a notable lack of bitterness, and the second is a mild, very complex, almost creamy flavor.

Coffee tasters often detect a profusion of floral notes in Jamaican Blue Mountain, along with an almost chocolaty flavor.

Fans are willing to pay high prices for this incredible coffee, which is delicious when drunk black or with cream.

This coffee is well worth trying, if you have an opportunity to do so.

Whittard UK, sells it for 24 pounds (per 250g of ground coffee) but is not available at the moment as stocks are scarce. As you can see, the price is 10 times of ordinary coffee that we usually buy from the stores.

Wednesday, February 4, 2009

Engage Engineers, Not Doctors, To Control Dengue

by M. Bakri Musa

Florida in the summer has the same hot and humid climate as Malaysia. Its topography too is like Malaysia, with plenty of swamps and other stagnant bodies of water. Unlike Malaysians however, Floridians are not regularly threatened with outbreaks of dengue.

The secret is not that Florida has more and better doctors than Malaysia (although that is true) rather that Florida engages its civil engineers and not medical doctors to control vector-driven diseases like dengue. That is much more effective as well as cheaper, both in financial costs and human suffering.

While it is commendable that Dr. Ismail Merican, the Ministry of Health’s Director-General, is spearheading public awareness of dengue during this latest outbreak – the most severe – he is not the best person to do that. Neither his professional background nor his regular duties prepares him for this awesome responsibility. His ministry is not the most appropriate agency to undertake this monumental task.

Like Florida, we should engage civil engineers in local councils and the Ministry of Works, instead of medical doctors in local hospitals and the Ministry of Health. If those engineers could get away from their air-conditioned offices, they would notice those stagnant drains, silted ponds, and ditches with overgrown weeds. If those officers could brave the stench and examine closer, they would see mosquito larva luxuriating in the stagnant waters.

The solution is not to pour toxic chemicals into the water or fog them into the air. Yes, that would be effective, but those same chemicals could eventually leach into our water tables and poison us, that is, if we have not already inhaled them. Get rid of the stagnant water and you would kill off the larva. No larva, no adult mosquitoes, and no vectors to spread the dengue virus.

There is of course a major role for the Ministry of Health. The most obvious is to educate the public and health professionals in recognizing and treating the disease early. The other is in collaborative research with international agencies for prevention (as in vaccine development) as well as treatment. Its Public Health Division could develop sophisticated surveillance strategies using the Internet, GPS, cell phones, and traps laced with chemicals to attract pregnant mosquitoes so as to get real-time information so we could initiate effective and immediate interventions, as the Brazilians are doing.

Learning Favors The Prepared Mind

Many Malaysian doctors, engineers and civil servants visit Florida. What they remember of their experiences there are Mickey Mouse and the Magic Castle. Few would notice the well-trimmed parks, underground drains, and smooth flowing streams. And of course, the absence of pesky mosquitoes!

Those visitors would not realize that the beautiful marinas with their posh waterfront restaurants they patronized were once mosquito-infested swamps. Through the marvels of modern civil engineering, those once sources of pestilence are now major tourist attractions.

Malaysia spends considerable sums sending its officers abroad so they could learn how to improve things back at home. However, to modify Pasteur’s famous quote, learning favors only the prepared mind. You have to know ahead what you want to learn; you have to know your deficiencies so you could actively seek out to remedy them. Meaning, there would have to be considerable preparations beforehand and at home if you were to maximize the learning potential of your overseas trip. If it is only a vague notion of “wanting to learn something new,” then you would only be a tourist.

I once had some senior civil servants visit me at my modest suburban California home. They were impressed with the neighborhood, and yet when I queried them what exactly they found attractive, they could not answer.

Only when I pointed them out would they realize that there were no overhead power and phone lines (all underground), no open storm drains (all covered), and no front yard fences or tall walls to blight the open, park-like ambience of the neighborhood.

When they saw the clean sidewalks and well-trimmed side-street lawns, they attributed that to American city councils being efficient providers of municipal services. That may be true. However, I reminded them that homeowners are responsible for keeping the sidewalks and lawns well cared, for if they do not they would not only be fined but also have to reimburse the city for doing that job for them.

When living in Johor Baru in the 1970s I paid my gardener extra to cut the weeds and unclog the drains outside my compound. He initially reminded me that those were the responsibilities of the Town Council. However when I gently chided him in not wanting to increase his income, he readily complied. He could not comprehend why I would do something that should have been done by the “authorities.” He could not appreciate the benefits I would enjoy. At the very least I would not have to endure the stench of clogged drains or risk my children being bitten by snakes.

I could readily excuse my poorly-educated gardener for his narrow perspective. However my neighbors there included a banker and a corporate executive; they too shared my gardener’s view!

I once suggested to my father’s neighbors in Seremban that if they were to contribute a few thousand ringgit each, their neighborhood could have sidewalks and covered storm drains. That would reduce the mosquito population, as well as the stench and unsightliness of plugged drains.

They balked at the added expense, rationalizing that they have already paid their cukai pintu (assessments). It is the responsibility of the Town Council, they argued like my gardener earlier, in between slapping themselves trying to kill the pestering mosquitoes. Yet the costs of these “common space” improvements would be a fraction of what they spent for their gilded gates and high brick fence walls. Had they gone beyond their narrow concerns, they would have gotten not only a functionally wider streets but also safe sidewalks, quite apart from making their neighborhood healthier.

They would also recoup many times more their investments through the increased in property values.

Septic tanks are also major breeding grounds. They should be banned in urban areas anyway; houses and buildings there should be connected to a central sewer system instead. Nevertheless, an engineer from East Malaysia successfully invented a system (light Styrofoam balls placed in the venting pipes of these tanks) that would allow gases to escape but not mosquitoes. This device should be mandated in all septic tanks.

Then there are civil engineering innovations as having V-bottom storm drains with a U-shaped channel in the center so as to maintain fast flow during low volumes. The usual flat-bottom channels would have puddles of stagnant pools during the dry season.

Personal Actions

Mosquitoes have a range of about half a mile. Even if you were to keep your drains flowing and your yards trimmed, but if your neighbors were slothful, you still would have to endure the nuisance of mosquitoes. Hence a neighborhood approach is needed.

Those factors notwithstanding, there are still many things that individuals can do to minimize the threat of dengue. Installing screens on doors and windows is one; another would be using insecticide-impregnated or even plain mosquito nets, though that is more effective against malaria rather than dengue, which is spread by daytime mosquitoes.

Covering your body as much as possible is also protective. You do not need to be in a burka if that is not your sartorial style; light-colored long-sleeved shirt or blouse, with a sarong, long skirt or pants would achieve the same result.

Even an umbrella is useful. Not only does it protect you against the blistering sun, the constant movement of the umbrella causes micro turbulence underneath it, enough to discourage mosquitoes.

Our officials need not venture far to learn these things. If they have paid attention to their colonial predecessors, our officials would know the importance of cleaning up drains during the dry season so that they would not be clogged with the inevitable rains. I learned that during my childhood days watching those coolies employed by the Public Works Department scraping the drains. And this was long before I even heard of Florida and Disneyworld.

Tuesday, February 3, 2009

Be responsible or the next victim may be a loved one- The Star, Malaysia 3rd February 2009

The reason I wrote this article is because dengue fever has reached a really worrying level in Malaysia.


If we don't help tackle the problem, more death will be coming our way.

I came down with Dengue fever a few years ago and the experience was horrifying esp watching the platlets dropping day by day.
And not forgetting the three times a day blood taking. (Luckily it was done by my wife!)

The title and content of the article was more blunt. It was something more sarcastic. The Star modified the title a little and omitted some harsh sentences which made the article more pleasing to read. I think they don't want to stir up any panic.
(I had one sentence which mentioned that I have seen several family members dying from dengue over a span of a few days. One dropping dead after another)

My greatest regret is my failure to call on the bloggers to play a part in the war against dengue at the end of the article.

I just forgot.

I wrote the article at 10pm on the Sunday night (during heavy snowing). I was so preoccupied with taking the pictures for you that I forgot to write about the role of the bloggers.

Perhaps you all could write another article.

And Dr CL Loh was right. Luckily I mentioned myself as a physician rather than a nephrologist. If not, sure 'kena one' and the MSN president would have to clarify why a nephrologist is able to make remarks on dengue.

And perhaps he would then denounce me and say that this Dr is not from Malaysia.




Be responsible or the next victim may be a loved one

IN 2008, 49,335 cases of dengue fever were reported with 112 deaths. In the first 28 days of this year alone, 14 people have died and 5,062 cases have been recorded.

Looking at the current trend, dengue has worked its way to the top of the health priority list.

Vectors of the dengue virus (female Aedes aegypti mosquito) breed in and around the house and in principle can be controlled through individual and community action.

It may be assumed that the vector feeds during the day, rests indoors and lays its eggs in mostly man-made artificial clean stagnant water in a wide variety of sites.

The most effective and sensibile way to control the population of Aedes aegypti is larval source reduction, which is eliminating or cleaning water-holding containers (even a plastic spoon discarded into the environment is sufficient for the breeding of the mosquito) that serve as the larval habitats for the mosquito in the domestic environment.

Unfortunately, community participation is not forthcoming as pointed out by the Health Ministry. The never-ending embarrassing action of our citizens in not cooperating with the authorities has crossed the limits and I am for one fed-up.

They do not seem to understand that it is their ignorance and carelessness that have contributed to this threat in the first place.

As a practising physician for 10 years I have seen lives lost due to this disease.

Many deaths could have been prevented if all Malaysians shed their irresponsible couldn’t-care-less attitude and participate in individual and community action to prevent vector breeding.

I appeal to all Malaysians to treat the war against dengue seriously. I admit that there are no easy solutions to the dengue problem.

However, with community based strategies coupled with a system of proactive surveillance and commitment by the Government on integrated and sustainable long-term vector control measures can dengue infection in this country be reduced in the long term.

Until Malaysians understand the importance of their role in tackling this dreaded infection, more lives would be lost. And the next victim could well be your loved ones.

DR Y.W. CHOW,

United Kingdom.