That’s the blurb from the Journal Watch commentary (free text) on yet another negative Ginkgo trial for the prevention of dementia: the Ginkgo Enhancement of Memory (GEM) study (DeKosky ST et al. Ginkgo biloba for prevention of dementia: A randomized controlled trial. JAMA 2008 Nov 19; 300:2253)
This randomised placebo controlled trial clearly shows that Ginkgo does not prevent dementia. Ginkgo can cause a bleeding tendency (and in fact one should not take Ginkgo if you are on blood thinners and indeed you should not consume it within a week of surgery) so it was interesting to note that there was a higher number of hemorrhagic strokes in the gingko group though it was not statistically significant.

Related MMR posts on Ginkgo

Edwin Leap reminds doctors why they took up medicine. A good read. And a reminder that we care for all, yes even those patients or relatives we’d love to “Fed-Ex to China”

The practice of medicine is an art, not a trade; a calling, not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with potions and powders, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, of the wise upon the foolish.
Sir William Osler

Bernama reports on the Health Minister’s reassurance on the Sabah QEH debacle

He said the ministry was deeply concerned over the situation in the Queen Elizabeth Hospital (QEH) here after the tower block, forensic block, and boiler room at the hospital were found to be unsafe for occupation.

“This is a matter of urgency and has the utmost attention and commitment from the Ministry of Health.
“We want to ensure the safety of patients, fellow staff, and the continuity of medical services in the state capital. That’s why I came here to give moral support to my staff and patients,” he told reporters after attending a briefing at the hospital today.

Liow said that so far, 129 patients had been evacuated and relocated to nearby hospitals, including the Likas Hospital and the Sabah Medical Centre. He said the last ICU patient shifted out of the tower block around midnight last Friday.

Well Datuk Liow, perhaps you can explain the earlier report on this Unsafe Hospital and I’ll once again quote what Malaysiakini reported

Meanwhile, it is learnt that the QEH management had alerted the Health Ministry as early as 2000 about deteriorating conditions at the hospital. The problem initially started with falling concrete fragments in the wards and toilets. Although safety measures were taken by the management to reduce the problem of concrete fragmentation, the incidents continued with increasing frequency over the years.
The Health Ministry is supposed to monitor and carry out maintenance and repair works on the hospital from time to time through its concession company Syarikat Faber Mediserve and the JKR Sabah. It is not known whether such works were in fact carried out satisfactorily and on schedule. Liow said JKR Sabah conducted an inspection of the hospital in 2006 and last year but “could not ascertain the real status of the safety of the buildings concerned

The MOH was allegedly aware of this 8 years ago. Does it take the deterioration to reach a state where patients have to be evacuated for the MOH to “act urgently”?
If eight years of warnings are not enough, somehow I don’t feel very reassured, Datuk Liow.

via Medgadget.com

Apparently it was handed out to attendees at this year’s American Society For Reproductive Medicine conference.

According to this report in Malaysiakini, Axed UM VC says its because she’s a woman

(photo from Malaysiakini)

Former Universiti Malaya vice-chancellor Rafiah Salim has alleged gender bias by the government towards local academicians amidst the controversy of her not being re-appointed to the post.
The first woman to head a public university in the country, Rafiah’s contract was not renewed recently and she was informed on the decision merely 48 hours before the expiry of her term.

“Just because we are women and we don’t have that thing between the legs so we are not good,” she told Malaysiakini in an one-hour interview today held at her new office at UM.

My analysis is, it’s not that “thing between the legs” but what you really need, Madam, is a BEARD.

After all the NS deaths that have been occurring, there will be Medical screening for all trainees at camps

All national service trainees for the next intake will have to undergo medical screening after they report for training.
The 140,000 trainees due to attend training will be screened by one of the seven medical officers at each camp.
The screening will be done in the first two weeks of the programme.
National Service Training Department director-general Datuk Abdul Hadi Awang Kechil said this would be the standard operating procedure for future intakes to prevent any medical mishaps among trainees.
“Some teenagers will not declare that they have any problem when they report for training. So, we have to examine them,” he said in an interview.
He said if a trainee was deemed unfit for training and required further treatment, the medical officer on duty would defer his training. It, however, would not be cancelled outright.

Screening may or may not pick up significant pre-existing medical conditions. There are also no details on what constitutes “screening” in the camps. Some of the NS deaths may have occurred as a result of lack of prompt medical attention to illnesses contracted while attending NS and this screening will not address this problem. Somehow I don’t feel very comforted by the NS director-general’s press statement. Will the NS camps still be a death trap for some kids?

More MMR posts on the National Service

Malaysian National Service in Wikipedia

You know, sometimes I have patients who surprise me by asking me to take care of myself. It’s a touching thought. After all we are the ones who are taking care of their health and illnesses.
Science Daily features studies recently published in the BMJ which reminds us that Doctors Must Look After Their Health Too. Don’t think doctors are immune to stress and burn out. There are those who turn to substance abuse too, even though they should know better.

In critical care (hat tip to Xiao Zhai for the link), an Age article tells of a Melbourne doctor who took his life as he could not cope with the stresses of post-graduate surgical training. It also deals with how the Australian system affects junior doctors in training.

Now back to Malaysia. No doubt our junior doctors too face stressful times in their training years. Who can they turn to? Does the MOH have a hotline like the Victorian Doctors Health Program?

Ref: BMJ Editorial Doctors’ health 2008;337:a2161

Senator T. Murugiah has taken to task hospitals that take “too long” to conduct post-mortems. The Star reported

Murugiah, who oversees the Public Complaints Bureau, said he received a complaint on Friday and decided to check it out personally.
He said the police had sent the body of a murder victim, believed to have been killed on Wednesday, to Hospital Universiti Kebangsaan Malaysia at 4pm on Thursday.
“The family complained to me at 9.30am on Friday that the body has not been released because the post-mortem has not been conducted.
“I called the hospital and sent a letter to them (asking them) to explain. They promised to conduct a post-mortem that morning and the body was released at 12.30pm.

Keeping the body overnight and performing a post-mortem the next day is not an uncommon practice. Pathologists are not going to come into the night to perform a non-urgent post-mortem just to pander to relatives. Please be reasonable lah Senator Murugiah. The country is already so short of pathologists you want to stress them out some more. Instead of “taking to task” these hospitals, I think we should take to task the Public Complaints Bureau chief who doesn’t know how to handle the flak from unreasonable relatives.

What an unusual idea!

Related MMR posts:
Great business card for a doctor!
New Business Card?

Pharmalot squeals on Astrazeneca’s TiggerGate

An AstraZeneca regional sales manager allegedly directed the sales reps in her region to use some of Winnie the Pooh’s well-known friends - specifically, Tigger and Eeyore - to promote the Seroquel antipsychotic.

I think you could sell even more drugs if you think about ways to Medicate The Seven Dwarves

I spotted this item in Malaysiakini which says the ex-Health Minister Chua faces hurdles to the cabinet

I suppose Engrish even finds its way into Malaysiakini reports from time to time, a sign of our declining standard of English I believe. I think it should read “rules will be bent…” not bended. One can say “on bended knees” or “bended back” but this adjective otherwise is seldom used nowadays.
Anyway the gist of it is “morally bended” politicians should not hope to become Cabinet Ministers again. Not unless you know how to cover your tracks!
Speaking of Bent, you might or might not be aware that slang usage of this term has other meanings as well.

More posts on the Health Minister

Malalysiakini published A Letter from the Sarawak rainforest

The Letter is addressed to the the chairperson of Suhakam with a copy to the Ministry of Health. It was dated 9 September 2008. It goes as follows:

‘Dear Sir,

Re:A Penan patient untreated

We are writing this letter to complain about one Penan woman, J from Long B, 36 years of age, who had died due to bleeding from her private part after giving birth without getting proper attention from the Dresser (Medical Assistant) C.

Ms J had delivered her baby in November 2006. She was healthy after giving birth to her baby and there was no sign of sicknesses. Suddenly in the middle of December 2007, Ms J had found that her private part started bleeding like period, but the bleeding would not stop. She went to Long L clinic on the same month and her private part was washed and checked by a nurse named JA. After medical treatment, more blood came out from her private part in two weeks’ time. Two weeks after the treatment by the nurse, she felt very weak and almost fainted on the morning on 2 January 2008.

WKK (Village Health Committee member) Mr H went to Long L Clinic at 8.30am and met Dresser C. He told Dresser C to inform the doctor to send helicopter to save Ms J’s life because her private part kept bleeding and it was getting so bad that she could not move anymore. She couldn’t take the 40 minute boat trip from Long B to Long L because she was too weak.

Dresser C said “It is not easy to get a helicopter; it will cost us a lot of money. If the sickness is not serious, people will scold me. Just take her to Long L by today. I will go down to Marudi by today at 10.15 am by MAS”.

Mr H said “Ms J cannot reach Long L, and I was hoping you Dresser C to look after Ms J and give her some medicine while she is waiting for the helicopter”.

Dresser C said “Ms J’s husband didn’t take his wife to go down to Marudi while she was pregnant, as instructed by me, and so if she dies, perhaps that was his responsibility”.

Mr H, “Ms J did not have enough energy to go down in 2006. This sickness was not her choice either”.

Dresser C said the clinic phone was not working properly. Mr H was asking Dresser C to give him permission to use the phone at Long L’s School. He went to the said school. After that Mr H came back to meet Dresser C again just to inform him that the phone at the said school was working properly and the principal has approved its use, in accordance with Dresser CJ’s instruction.

Dresser CJ said, “I have no time and am too busy trying to go down to Marudi. If the bleeding has been going on for two weeks, usually there is no escaping death.”

Mr H said, “Ms J is still alive; she’s not dead yet. You have to try your best to treat her. She is a human being just like us”.

Dresser Charles said, “Perhaps, I might get the helicopter to Long L when I reach Marudi later, while you wait for it in Long B by tomorrow morning”.

Mr H heard from the nurse telling Dresser C that she couldn’t treat the said patient properly even if they take the said patient at Long L’s clinic. Then, Dresser C left for Marudi.

Mr H went back to Long L at 12.30pm. Ms J couldn’t sit and talk anymore, but was still able to eat.

Finally, she died at 5.30 pm on 2 January 2008. There was no helicopter coming to Long L or Long B.

We hope there will be nobody who will not take care of the Penan people. We are not lying, if we say we do not have money to go to Marudi hospital for our medical care. We accept medical care and development with an open heart.

According to Mr H’s son, Dresser C even said to him “your father is not a good guy because he led people to mind the blockade to fight with the timber company. That makes it hard to have development in Long B.

Penan people are human too and their lives are as important as others. We disagreed with the timber’s company but agreed with the development that would provide us with the facilities such as medicine, education, clinic and MAS airport. Our land is our life.

H, Committee of Health Village, Long B

J J, Eldest son of J

Related post:
A Penan baby dies - does anyone care?