Health Information Today

Go Green Campaign

2019-12-04T18:47:00.002-08:00

Introduction

Nowadays, it is undeniable that the use of plastic bags is a norm in our society. Even a small purchase of sweets from sundry shop will come with a plastic bag. However, the continuous use of plastic bags will eventually lead to environmental pollution as it is made of chemical composition called polyethylene that may take thousands of years to break down. In the long term, the inability of plastic bag to decompose will cause negative impact to the environment including marine creatures, climate change and eventually our health.

Hence the question, are we willing to live in an environment polluted with rubbish and indecomposable plastic bags that will remain for decades? Or consume food that is contaminated with chemicals used to make plastic bags, which in turn might cause cancer? Of course the answer will surely be a big NO!

Diabetes and Oral Health

2019-12-04T18:42:00.000-08:00

Introduction

Too much glucose (also called sugar) in your blood from diabetes can cause infection and other problems in your mouth. Your mouth includes your teeth, your gums, your jaw, tissues such as your tongue, the roof and floor of your mouth, and the inside of your cheeks.

Glucose is present in your saliva-he liquid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful germs, called plaque, grow. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease.

Gum disease can happen more often, be more severe, and take longer to heal if you have diabetes. In turn, having gum disease can make your blood glucose hard to control. Some studies show that treating your gum disease makes it easier to control your blood glucose

Categories of diabetes: Type I, which results from an absolute insulin deficiency; Type II, which is the result of insulin resistance and an insulin secretory defect (Ship, 2003).

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Banjir

2019-12-04T18:38:00.001-08:00

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Situasi Terkini Penyakit Tangan, Kaki dan Mulut (HFMD) di Malaysia

2019-12-04T18:35:00.000-08:00

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Rokok Elektronik & Vape

2019-12-04T18:26:00.000-08:00

Rokok Elektronik & Vape

Definisi Rokok Elektronik & Vape

Kementerian Kesihatan mendefinisikan peranti elektronik yang mengandungi nikotin adalah dirujuk sebagai ‘rokok elektronik’ (eCig), sementara yang tidak mengandungi nikotin, adalah dirujuk sebagai Vape.

Komponen utama Rokok Elektronik dan Vape adalah

Bateri
Atomiser
Katrij

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Health Advisory For Workplaces During Haze

2019-11-20T20:43:00.002-08:00

HEALTH ADVISORY FOR WORKPLACES DURING HAZE
MINISTRY OF HEALTH, MALAYSIA

Introduction

Haze is a situation where there is pollution to the air by suspended particulate matter. The various determinants of air pollution are, Sulphur Dioxide, Nitrogen Dioxide, Ozone, Carbon Monoxide and PM10. The fine particulate matter or PM10 (particulate of size 10 micron and below) is the main concern as it may lead to adverse health conditions.

Haze is caused when sunlight encounters tiny pollution particles in the air. Some light is absorbed by particles while other light is scattered away before it reaches an observer. The more the pollutants, the more the absorption and scattering of light, which reduces the clarity and color of what we see. Air quality is determined by the Air Pollutant Index which is measured by the Department of Environment, Ministry of Natural Resources and Environment.

The Occupational Safety and Health Act 1994, stipulates that it is the responsibility of the employer to ensure the safety, health and welfare of the employee. The employer is thus responsible to ensure that preventive measures are taken for employees who are performing their tasks during the haze.

Health Advice For Service Sector Workers (Service Sector) During Haze

2019-11-20T20:40:00.000-08:00

Pengenalan

Jerebu boleh menyebabkan masalah kesihatan di kalangan orangramai. Sebagai langkah pencegahan semasa jerebu, orang ramai dinasihatkan supaya meminimakan aktiviti luaran. Walau bagaimananpun, pekerja di sektor perkhidmatan terutamanya anggota seperti hospital, klinik kesihatan, Polis, Bomba, Jabatan Perkhidmatan Awam, dan lain-lain adalah terdedah kepada persekitaran yang kurang sihat semasa jerebu. Sektor pekerja tersebut juga terpaksa meneruskan kerja walaupun situasi persekitaran semakin merosot.Panduan merupakan nasihat kesihatan bagi pekerjaan di sektor perkhidmatan.

Tindakan untuk diambil oleh organisasi

1. Mengenal pasti keperluan anggota yang minima untuk melaksanakan tugas semasa keadaan persekitaran tidak sihat.

2. Mengenalpasti anggota berisiko tinggi iaitu dengan masalah kesihatan seperti penyakit paru-paru dan penyakit jantung yang tidak boleh melakukan tugas luaran dan memberi mereka tugas dalaman untuk sementara waktu.

3. Menyediakan jadual untuk giliran tugas supaya anggota tidak terdedah untuk tempoh masa yang lama.

4. Menyediakan alat pelindung diri ( topeng muka) yang mencukupi untuk di gunakan oleh anggota semasa menjalankan tugas. Latihan dan fit testing perlu dilakukan di mana perlu.

5. Memberi nasihat kesihatan kepada anggota mengenai langkah-langkah pencegahan untuk diambil semasa melaksanakan tugas semasa jerebu

Tindakan untuk diambil oleh pekerja

1. Memastikan kebersihan diri. Mencuci tangan setelah masuk dari luar bangunan.

2. Memberitahu status kesihatan kepada majikan jika mempunyai masalah kesihatan seperti penyakit paru-paru dan penyakit jantung.

3. Mengambil rawatan seperti dinasihati doktor jika mempunyai masalah kesihatan seperti penyakit paru-paru dan penyakit jantung.

4. Menggunakan alat pelindung diri semasa menjalankan tugas di luar.

5. Menjaga kesihatan dengan meminum air yang banyak, memakan makan berkhasiat terutamanya buah-buahan.

6. Mengelakkan daripada merokok, meminum kopi atau alkohol.

7. Melakukan senaman dalaman.

KKM

5th NATIONAL HEPATITIS CONFERENCE 2020: TOWARDS ELIMINATING VIRAL HEPATITIS

2019-11-20T20:31:00.000-08:00

About #NHCMY2020
Malaysia’s National Hepatitis Conference serves as an important professional knowledge and thought exchange platform that unites the nation’s diverse multi-stakeholder groups and spans geographical boundaries via its compelling case studies and international collaborations. ‘Towards Eliminating Viral Hepatitis’ will remain the core theme of this year’s National Hepatitis Conference as we work together to find our #missingmillions.

This year’s key highlights include –
• 35 subject matter experts (national and international)
• Over 14 thought-provoking sessions led by experts.
• 8 countries represented in interactive sessions over two days.
• Local, regional and international updates on the progress of viral hepatitis.

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis [WHO]. Globally, over 300 million people are living with viral hepatitis with approximately 1.3 million deaths per year. In 2016, World Health Assembly adopted the Global Health Sector Strategy on viral hepatitis to eliminate hepatitis by 2030. Different World Health Organization member countries are working on hepatitis control strategies to achieve hepatitis elimination [NCBI].

NHCMY

Penyakit Anjing Gila (RABIES) "Malay Vision"

2017-10-24T01:48:00.001-07:00

KES PENYAKIT ANJING GILA (RABIES) DI SARAWAK

Kementerian Kesihatan Malaysia (KKM) ingin memaklumkan bahawa kes kelima rabies iaitu seorang lelaki berumur 52 tahun dari Kampung Remun, Sarawak yang telah dilaporkan oleh KKM pada 19 Julai 2017 setelah disahkan positif rabies pada 18 Julai 2017, telah meninggal dunia pada 23 Julai 2017, jam 10:43 malam. Penyebab kematian adalah rabies with underlying pulmonary tuberculosis.

Sehingga 24 Julai 2017, terdapat lima (5) kes dalam kalangan manusia yang telah disahkan positif rabies di mana kesemuanya telah meninggal dunia. Kesemuanya adalah dilaporkan di Serian, Sarawak. Tiada kes baru dilaporkan buat masa ini.

Sebanyak 20 kawasan di dalam tiga (3) bahagian iaitu Bahagian Serian, Bahagian Sri Aman dan Bahagian Kuching telah diisytiharkan kawasan jangkitan rabies dalam kalangan haiwan oleh Kerajaan Negeri Sarawak. Sehubungan itu, aktiviti kawalan dan pencegahan termasuk pengesanan kes gigitan anjing mengikut prosedur sedia telah dilaksanakan oleh Jabatan Kesihatan Negeri Sarawak dan Pejabat Kesihatan Bahagian yang terlibat. Sehingga 23 Julai 2017, sebanyak 770 kes gigitan haiwan (anjing dan kucing) di dalam tiga (3) bahagian yang terlibat telah dikesan dan diberikan rawatan lanjut.

KKM menasihati orang awam yang tinggal di Bahagian Serian, Bahagian Sri Aman dan Bahagian Kuching, Sarawak agar mengambil langkah-langkah pencegahan seperti berikut bagi mengelakkan dari dijangkiti penyakit rabies:

Cuci bahagian tubuh yang digigit dengan sabun dan air mengalir bagi menghilang kesan air liur;
Dapatkan rawatan segera ke klinik kesihatan atau hospital terdekat jika telah mengalami gigitan haiwan seperti anjing atau kucing peliharaan yang agresif atau anjing liar;
Pastikan anjing atau kucing peliharaan telah mendapatkan suntikan anti-rabies di klinik haiwan terdekat dan elakkan kontak bersama haiwan atau anjing liar;
Jika anjing atau kucing peliharaan didapati tidak sihat atau agresif dapatkan rawatan di klinik haiwan dan laporkan ke Pejabat Jabatan Perkhidmatan Veterinar setempat;
Laporkan kepada Pihak Berkuasa Tempatan jika terdapat anjing liar yang berkeliaran di kawasan tempat tinggal; dan
Sentiasa mengekalkan tahap kebersihan diri yang tinggi seperti amalan kerap membasuh tangan dengan menggunakan air dan sabun selepas kontak dengan anjing peliharaan.
KKM dan Jabatan Kesihatan Negeri akan terus mempertingkatkan kerjasama dengan Kerajaan Negeri, Jabatan Perkhidmatan Veterinar serta agensi-agensi lain di negeri berkaitan bagi memastikan langkah-langkah pencegahan dan kawalan jangkitan virus rabies dapat dilaksanakan secara menyeluruh.

Sekian, terima kasih.

DATUK DR. NOOR HISHAM ABDULLAH
KETUA PENGARAH KESIHATAN MALAYSIA
24 Julai 2017

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Apakah Penyakit Rabies?

Penyakit rabies adalah sejenis penyakit yang disebabkan oleh jangkitan Lyssavirus dari haiwan seperti anjing yang dijangkiti rabies.

Rabies berjangkit melalui luka gigitan, luka terbuka pada kulit dari air liur, cairan atau tisu tubuh dari haiwan tersebut kepada manusia.

Masa inkubasi rabies adalah 3 minggu hingga 2 bulan dari gigitan haiwan rabid hingga timbul gejala.

Individu yang dijangkiti rabies akan mengalami tanda klinikal seperti demam, sakit badan dan kepala, hidrofobia, lumpuh dan koma. Rabies adalah satu penyakit yang menyebabkan kematian 100% jika tanda-tanda penyakit telah timbul.

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Traditional Medicine or Complementary Medicine. What is it?

2016-01-10T23:04:00.000-08:00

Traditional Medicine or Complementary Medicine. What is it?

What is traditional medicine?

“Traditional medicine as define as diverse health practices, approaches, knowledge and beliefs incorporating plant, animal, and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness.”

WHO Traditional Medicine Strategy 2002-2005

What is complementary medicine?

“Complementary medicine also sometimes referred to as non-conventional or parallel medicine, are used to refer to a broadest of health care practices that are not part of a country’s own tradition, or not integrated into its dominant health care system.”

WHO Traditional Medicine Strategy 2002-2005

What is traditional and complementary medicine?

“Traditional and complementary medicine means a form of health-related practices designed to prevent, treat and / or manage illnesses and / or preserve the mental and physical well-being of individuals and includes such practices as traditional Malay medicine, traditional Chinese medicine, traditional Indian medicine, homeopathy and complementary therapies and excludes medical or dental practices utilized by registered medical or dental practitioners.

T&CM Division, Ministry of Health, Malaysia 2007

LINK

Combating Obesity: Societal and Environmental issues and challenges

2016-01-10T22:51:00.000-08:00

MASO 2015 Scientific Conference on Obesity

“Combating Obesity: Societal and Environmental issues and challenges”

Date: 28-29 October, 2015

Venue: Seri Pacific Hotel, Kuala Lumpur

This two-day conference will provide up-to-date information incorporating both research and practice elements on the interaction between societal and environmental factors in combating obesity.

CME / CPD points will be given by MMA and BKBP.

This conference will fully utilize ONLINE REGISTRATION.

To register online please goto: http://www.maso.org.my/cgi-bin/RegisterMASO.cgi

http://www.maso.org.my/cgi-bin/RegisterMASO.cgi

Information on payment is available in the Second Announcement (page 3).

Download: Second Announcement | Tentative Scientific Programme

LINK

Weight-loss surgery outcomes affected by vitamin D status, study suggests

2015-12-28T01:59:00.000-08:00

Outcomes for patients who undergo weight-loss surgery may be influenced by vitamin D levels, according to a new study by researchers from Johns Hopkins Medicine.Exposure to sunlight is a key factor in vitaminD levels; ultraviolet radiation from the sun triggers vitamin D synthesis in the body. As such, people with low sun exposure often have lower vitamin D levels, which has been linked to numerous health problems.Vitamin D plays a number of important roles in the body; it helps maintain bone health, aids immune system function and supports lung and heart health, among numerous other functions.

Now, in a new study published in the journalObesity Science & Practice, researchers suggest low vitamin D levels may worsen outcomes for patients undergoing weight-loss surgery, or bariatric surgery.

Study leader Leigh Peterson, of the Centers for Bariatric Surgery at Johns Hopkins, and colleagues found individuals in the US who underwent weight-loss surgery in winter - when vitamin D levels are at their lowest - were more likely to experience complications than those who had the surgery in summer.

In addition, the team found bariatric surgery patients from the northern US - where there is typically less sunshine - had poorer outcomes than bariatric surgery patients from sunnier southern areas.

"Sun exposure is critical in the synthesis of vitamin D, so the notion that people living in less sunny northern states may suffer from vitamin D deficiency is not surprising," notes Peterson. "What is remarkable is how closely sun exposure, vitamin D and surgical outcomes were linked."

71% of postoperative complications occurred in northern states

To reach their findings, the team analyzed the outcomes of 932,091 patients of an average age of 43 who underwent bariatric surgery in the US between 2001-10.

Adverse outcomes from bariatric surgery were rare, with less than 1% of patients developing infections. Prolonged hospital stays - defined as spending more than 3 days in the hospital - were a more common outcome, according to the researchers, affecting almost 40% of patients.They compared outcomes of those who had the surgery in winter (January-March), summer (July-September) or fall/spring (October-December and April-June).

The researchers found that patients who lived in areas north of South Carolina were much more likely to have experienced infection or a prolonged hospital stay after weight-loss surgery.

Around 150,000 more patients from northern states had an extended hospital stay than those in southern states. Accounting for the 300,000 surgeries in the study that led to prolonged hospital stays, the team notes that 71% of all postoperative complications occurred in northern states.

Additionally, the researchers found that most adverse postoperative complications - such as wound infections, non-healing wounds and delayed wound healing - occurred in colder seasons with less sunshine. For example, around 16% of delayed wound healing cases occurred in summer, compared with 0.07% in winter.

According to the researchers, these findings suggest vitamin D may affect the outcomes of patients who undergo bariatric surgery, though they caution further research is warranted before the use of vitamin D supplements can be recommended to reduce postoperative complications for these patients

Still, Peterson says the research may have important clinical implications:

"The growing rates of obesity and increased popularity of bariatric surgeries mean that primary care clinicians and bariatric surgeons should consider screening their patients and correcting any confirmed vitamin D deficiency."

One limitation of the study is that the researchers did not have a direct measure of patients' vitamin D status through serum 25(OH)D concentration, with levels only being defined by vitamin D season, which could have affected the results.

On the back of this, the researchers say it is possible that other seasonal differences could have contributed to patient outcomes, noting that exposure to specific infectious agents is greater in winter. "Future studies should be conducted measuring 25(OH)D to confirm our findings," they add.

Medical News Today recently reported on a study that linked low vitamin D levels to irritable bowel syndrome (IBS).

Written by Honor Whiteman

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Hepatitis C may raise risk for Parkinson's

2015-12-27T23:48:00.000-08:00

While some people with hepatitis C may experience short-term illness that occurs within 6 months of exposure to HCV, around 70-85% of infected individuals experience chronic illness, which can lead to severe liver problems such as liver cancer or cirrhosis.Hepatitis C is a contagious liver disease caused by the hepatitis C virus (HCV), which is most commonly transmitted through contact with blood from an infected person, primarily through the sharing of needles.

According to the Centers for Disease Control and Prevention (CDC), around 2.7 million people in the US have chronic hepatitis C infection, though the majority of these individuals are unaware they are infected because they have few symptoms.

Study coauthor Dr. Chia-Hung Kao, of China Medical University Hospital in Taiwan, and colleagues note that previous research has suggested HCV is neurotropic - meaning it can infect nerve cells, or neurons - and can replicate in the central nervous system.

Furthermore, the researchers point to a recent study that claimed HCV can trigger death of neurons that secrete the neurotransmitter dopamine, which is believed to be a key contributor to Parkinson's disease.

30% greater Parkinson's risk for hepatitis C patients

For their study, Dr. Kao and colleagues set out to investigate whether hepatitis C may be a risk factor for Parkinson's by analyzing 2000-10 data drawn from the Taiwan National Health Insurance Research Database (NHIRD).

Of the participants who had hepatitis, 270 developed Parkinson's during the 12-year follow-up - of whom 120 had hepatitis C - compared with 1,060 participants who were free of hepatitis.The data involved 49,967 people with either hepatitis B, hepatitis C or both, alongside 199,868 people without hepatitis. All participants were followed-up for an average of 12 years in order to monitor any development of Parkinson's.

After controlling for potentially confounding factors, including participants' age, sex and diagnosis of diabetes or cirrhosis, the researchers found participants with hepatitis C were at 30% greater risk of developing Parkinson's than those who did not have hepatitis.

The team found that participants with hepatitis B and those with both hepatitis B and C had a similar Parkinson's risk as those without the viruses after possible influential factors were accounted for.

It is estimated that as many as 1 million people in the US are living with Parkinson's, and around 60,000 Americans are diagnosed with the neurodegenerative disorder each year.

The exact causes of Parkinson's are unclear, though past studies have suggested it may be triggered by a combination of environmental and genetic factors. Pinpointing the possible causes of Parkinson's is key to finding a much-needed cure, and this latest research may have uncovered another risk factor for the disease.

Commenting on the findings, Dr. Kao says:

"Many factors clearly play a role in the development of Parkinson's disease, including environmental factors. This nationwide study, using the National Health Insurance Research Database of Taiwan, suggests that hepatitis caused specifically by the hepatitis C virus may increase the risk of developing the disease. More research is needed to investigate this link."

There are some study limitations. The researchers note that hepatitis and Parkinson's were identified through International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes rather than through clinical assessment, neuroimaging or lab data, which may have led to less accurate results.

In addition, the researchers point out that the Longitudinal Health Insurance Database - part of the NHIRD - does not hold information on duration of viral hepatitis and risk factors for HCV infection, such as the sharing of needles and tattooing.

"These factors for HCV infection might have confounding effects on Parkinson's disease development, but could not be controlled for analysis in the current study," they explain.

Earlier this month, Medical News Today reported on a study that suggests a pesticide called heptachlor epoxide - found in milk in the 1980s - may contribute to Parkinson's development.

Written by Honor Whiteman
LINK

Move of the Week: Cross-Leg Diagonal Crunches

2015-12-27T23:43:00.002-08:00

To achieve a cinched waist, it’s important to target all of your core muscles. This move in particular is fantastic for working out your obliques (those ab muscles on the side of your body.) Learn how to do Cross-Leg Diagonal Crunches with the help of Health‘s contributing fitness editor, Kristin McGee.

http://bcove.me/q97pgj8y

Here’s how to do it: Lie down on your back. Bend your knees, place your feet flat, and shift your hips over to the right. Then extend both legs straight in that direction. Take your left leg, cross it over your right leg. With your hands behind your head, crunch straight up to the ceiling. Go for 50 reps on that side and lower down.

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E-CIGARETTE & VAPE - PRESS

2015-12-02T23:42:00.000-08:00

PRESS STATEMENT
MINISTRY OF HEALTH MALAYSIA
MINISTRY OF HEALTH WILL ACT ON ELECTRONIC CIGARETTE CONTAINING
NICOTINE USING THE POISON ACT 1952

Recently, there were a number of references on Vaping made in the social
media as well as the newspapers. The Ministry of Health (MOH) would like to clarify
its stand in this matter.

For the sake of clarity in discussion, electronic vaping device that contains
nicotine will be referred to as electronic cigarette (eCig) while those that does not
contain nicotine will be known as vape or vaping.

The sales and use of electronic cigarettes (containing nicotine) are subjected
by law to the rules and regulations under the Poison Act 1952 and Food Act 1983
(Control of Tobacco Product Regulations 2004). Thus, the distribution, sales and
usage of these products will be subjected to the above legislations.

Until there is enough evidence that the benefits of electronic cigarettes
outweigh the harmful effects, MOH is very much inclined towards prohibiting them as
stipulated by the World Health Organisation Framework Convention on Tobacco
Control (WHO FCTC) and the International Union Against Tuberculosis and Lung
Disease.

On Vaping per se (without nicotine) the MOH strongly advise all users to stop
vaping and non-users not to start on this bad habit. We are strongly against the
introduction of foreign substances into the lungs, with unknown long term health
effects, solely for the purpose of pleasure. There are growing body of evidence from
animal and cultured human lung tissue studies that the use of non-nicotine vape
causes harm to the body1,2,3

. This Ministry will not support such unhealthy behaviour.
Smokers must strive to curb their nicotine addiction by getting help from
smoking cessation services available in our health facilities and other professional
organisations.

Kementerian Kesihatan Malaysia
Aras 2, Blok E3, Parcel E,
Pusat Pentadbiran Kerajaan
Persekutuan
62590 Putrajaya
Tel : 03-8892 4527
Faks : 03-88924526
Email : noraryana@moh.gov.my

The consequences of Vaping may not be seen until years to come and it will be
too late then to help the unfortunate victims of who succumbed to it.
We are thus calling for the public to emphatically reject Vaping and eCig, thus
protecting ourselves, our children and future Malaysian generations from the dangers
of an unknown lifestlye.

DATUK DR LOKMAN HAKIM BIN SULAIMAN
TIMBALAN KETUA PENGARAH KESIHATAN (KESIHATAN AWAM)
KEMENTERIAN KESIHATAN MALAYSIA
PUTRAJAYA
4 November 2015

LINK

PRESS STATEMENT BY MOH : E-CIGARETTE & VAPE 04-11-2015

Ice Cubes issues Viral Causes Typhoid Be in Kuala Lumpur

2015-11-05T19:40:00.000-08:00

Ministry sources viral on social media about allegations that typhoid fever in the Federal Territory of Kuala Lumpur due to the ice cubes produced by factories operating illegally.

The Ministry of Health would like to stress that under Rule 394A, the Food Regulations 1985, the Food Act 1983 all ice factory must be licensed by the Ministry of Health and any unlicensed ice plant will be subject to enforcement action. In this case, the owner of an ice factory operating without a valid license from the Ministry of Health shall be liable to a fine not exceeding RM5,000.00 or to imprisonment not exceeding two (2) years.

Up to now, there are two (2) ice plant licensed by the Ministry of Health which supplies ice to food premises in the Federal Territory of Kuala Lumpur and Putrajaya. The Ministry of Health is carrying out monitoring of the ice plant includes carrying out sampling for analysis. To date, no ice sample was found to contain pathogenic bacteria.

The Ministry of Health is to improve the monitoring and enforcement on an ice factory in the Federal Territory of Kuala Lumpur.

The Ministry of Health expects the public to report any suspected ice factory operating without a license to the District Health Office or your nearest Department of State Health Division website or through the Food Safety and Quality (BKKM) http://fsq.moh.gov .my or facebook BKKM http://www.facebook.com/bkkmhq .

COMMISSIONER DR. NOOR HISHAM BIN ABDULLAH
THE DIRECTOR GENERAL OF HEALTH MALAYSIA
22 October 2015

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Reduced Fat Creamy Skippy® issues Peanut Butter Spread Called Back For Reliable Contaminated With Metal Fragments

2015-11-05T19:38:00.000-08:00

The Ministry of Health took note of a report from the website of the US Food and Drug Administation (FDA) in www.fda.gov.my about me recall voluntarily and is limited by the company Hormel Foods Sales LLC, United States (US) against a batch of peanut butter product SKIPPY® Reduced Fat Creamy Peanut Butter Spread is distributed in Georgia, Virginia, Alabama, North Carolina, South Carolina, Delaware and Arkansas, the US feared contaminated with fine metal fragments. Batch involved are packing 16.3 ounce jars, "Best If Used By" the DEC1416LR1 with the UPC code 37600-10500.

DKSH company which imports and distributes its products in Malaysia SKIPPY® Peanut Butter also confirmed that the products were recalled in the United States only distributed to seven (7) states in the United States as noted above and the products were not distributed to other countries, including Malaysia ,

However, as a precautionary measure, the Ministry of Health does not allow the import of a batch of the product concerned.

COMMISSIONER DR. NOOR HISHAM BIN ABDULLAH
THE DIRECTOR GENERAL OF HEALTH November 4, 2015

LINK

Nicotine Replacement Therapy (NRT)

2015-10-28T09:40:00.000-07:00

Introduction

Smoking is the leading cause of preventable morbidity and mortality in the world. Tobacco use causes more than 5 million deaths per year worldwide, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030. In Malaysia, smoking remains one of the top 10 reasons for hospitalization and causes of death. The Global Tobacco Survey 2011 reported 4.75 million smokers aged 15 and above in Malaysia. Tobacco cessation can significantly reduce the risk of smoking-related disease. One of the common smoking cessation treatments available is Nicotine Replacement Therapy (NRT). According to Cochrane Study 2008, NRT increases the rate of quitting by 50% to 70%.

How does NRT works?

NRT works by providing low doses of nicotine; without the other harmful chemicals present in tobacco smoke, to the brain in order to replace the nicotine from cigarette smoke. This approach aims to reduce the craving for nicotine and ease or prevent the withdrawal symptoms associated with stopping smoking.

What are the types of NRT available?

Nicotine replacement product comes in several forms and strengths to accommodate the different needs and level of nicotine addiction of the smokers. Below are the 5 different types of nicotine products available in the market:

Nicotine gum
Nicotine inhaler
Nicotine lozenge
Nicotine nasal spray*
Nicotine patch

*Not available in Malaysia

These nicotine products are designed with different nicotine delivery mechanism in term of pace and site of absorption. The nicotine gum, inhaler, lozenge and nasal spray deliver nicotine to the brain more quickly compared to patch, but less rapidly than smoking cigarettes. Nicotine is absorbed through the buccal mucosa membrane from the gum, lozenge and inhaler, where as through the nasal mucosa membrane for the nasal spray. In contrast, nicotine patches deliver nicotine dose slowly and passively which is why it is usually used with combination of other NRT products. These varied properties provide the healthcare provider and smokers the choices to choose the products that suit the smokers’ daily routine, smoking habits and degree of nicotine dependence. All these nicotine products work effectively provided they are taken correctly.

What are the regimens for NRT products?

NRT Products	Regimen*
Nicotine gum	2mg gum: recommended for patients who smoke less than 25 cigarettes per day; 4mg gum: recommended for patients who smoke 25 or more cigarettes per day. Chew 1 piece of gum every 1 to 2 hours for the first 6 weeks, followed by 1 piece of gum every 2 to 4 hours for 3 weeks and 1 piece of gum every 4 to 8 hours for the next 3 weeks.
Nicotine inhaler	Each cartridge delivers a total of 4mg nicotine over 80 inhalations. 6 to 12 cartridges per day for the first 8 weeks followed by 3 to 6 cartridges per day for 2 weeks and reduce gradually to zero for the next 2 weeks.
Nicotine lozenge	2mg lozenge: recommended for patients who smoke their first cigarette more than 30 minutes after waking; 4mg lozenge: recommended for patients who smoke their first cigarette within 30 minutes of waking. Suck 1 lozenge every 1 to 2 hours for the first 6 weeks, followed by 1 lozenge every 2 to 4 hours for 3 weeks and 1 lozenge every 4 to 8 hours for the next 3 weeks.
Nicotine patch	Two range of patch are available in the market: 15mg/16hours, 10mg/16hours, 5mg/16hours 21mg/24hours, 14mg/24hours, 7mg/24hours 1 piece of patch 15mg/16hours or 21mg/24hours per day for the first 4 weeks, followed by 1 piece of patch 10mg/16hours or 14mg/24hours per day for 2 weeks and 1 piece of patch 5mg/16hours or 7mg/24hours per day for the next 2 weeks.
Nicotine nasal spray	A dose of nicotine nasal spray consists of one 0.5mg dose delivered to each nostril (1mg total). 1 to 2 doses per hour and increase the dose as needed with a minimal of 8 doses per day and maximum of 40 doses per day in the first 8 weeks. This is followed by gradual reduction of the number of dose to zero for the next 4 to 6 weeks.

* The above are brief guidelines, subject to patients’ condition.

How to use the NRT products?

NICOTINE GUM	Chew 5 to 10 times until it has a peppery taste and provide tingling sensation. Then park the gum between the cheek and gum until the peppery taste or tingling sensation disappears. Chew and park again at another side of the cheek. Repeat this until all the taste from the gum is gone (about 30 minutes).
NICOTINE INHALER	Align marks on the mouthpiece, pull off top. Insert cartridge into the mouthpiece. Twist to close securely. Align marks again and push the top and bottom together firmly. Twist to lock the mouth piece. Inhale deeply or puff continuously for about 20 minutes.
NICOTINE LOZENGE	Place it between gum and cheek and suck slowly until it is fully dissolved (about 3 minutes). It should not be bitten, chewed or swallowed whole.
NICOTINE PATCH	Apply the patch on the skin that is dry, clean and hairless. It can be applied anywhere between the hand to neck (often the upper arm or shoulder), and hip. Remove backing from patch and immediately press onto skin. Seal it tightly. Leave it for 16 hours or 24 hours then remove it. Apply a new one at a different site before going back to the same site (at least 5 days apart).
NICOTINE NASAL SPRAY	Remove the cap of the nasal spray by pressing in the circles on the side of the bottle. Pump into tissue until the fine spray is seen (6 to 8 times). Throw the tissue away. Tilt your head back slightly. Insert the tip of the bottle as far as you comfortably can into one nostril, pointing the tip toward the back of your nose. Breathe through your mouth. Pump the spray firmly and quickly one time. Do not sniff, swallow, or inhale while spraying. If your nose runs, gently sniff to keep the nasal spray in your nose. Wait 2 or 3 minutes before blowing your nose.

What are the side effects of NRT products?

Some of the common side effects associated with the use of nicotine products are:

NRT Products	Side Effects
Nicotine gum	Mouth soreness, hiccups, dyspepsia and jaw ache
Nicotine inhaler	Local irritation in the mouth and throat
Nicotine lozenge	Nausea, hiccups, heartburn, headache and coughing
Nicotine patch	Skin reaction, insomnia and vivid dreams
Nicotine nasal spray	Nasal irritation, nasal congestion and transient changes in sense of smell and taste

What are the special precautions?

Cardiovascular Diseases – NRT is not an independent risk factor for acute myocardial events. NRT should be used with caution among particular cardiovascular patient groups which include those in the immediate (within 2 weeks) ppost myocardial infarction period, those with serious arrhythmias, and those with unstable angina pectoris.

Pregnancy - Pregnant smokers should be encouraged to quit without medication. NRT has yet to be shown being effective for treating tobacco dependence in pregnant smokers and has not been evaluated in breastfeeding patients.

Last Reviewed	:	06 January 2014
Writer	:	Sharon Ong Chin Wen
Accreditor	:	Mohd Dziehan bin Mustapa

LINK

Tuberculosis mortality nearly halved since 1990

2015-10-28T09:35:00.000-07:00

28 OCTOBER 2015 ¦ GENEVA - The fight against tuberculosis is paying off, with this year’s death rate nearly half of what it was in 1990. Nevertheless, 1.5 million people died from TB in 2014. Most of these deaths could have been prevented, according to WHO’s Global tuberculosis report 2015, which was released today in Washington.

To reduce TB’s overall burden, detection and treatment gaps need to be closed, funding shortfalls filled and new diagnostics, drugs and vaccines developed, according to the report.

Most of the improvement has come since 2000, the year the Millennium Development Goals (MDGs) were established. In all, effective diagnosis and treatment saved 43 million lives between 2000 and 2015, according to the report, the 20th in a series of annual evaluations produced by WHO.

“The report shows that TB control has had a tremendous impact in terms of lives saved and patients cured,” said WHO Director-General Margaret Chan. “These advances are heartening, but if the world is to end this epidemic, it needs to scale up services and, critically, invest in research.”

Those advances include the achievement of the MDG that called for halting and reversing TB incidence by 2015. The goal was reached globally and in 16 of the 22 high-burden countries that collectively account for 80% of cases.

Worldwide, TB incidence has fallen 1.5% per year since 2000, for a total reduction of 18%.

“Despite the gains, the progress made against TB is far from sufficient,” according to Dr Mario Raviglione, Director of WHO’s Global TB Programme. “We are still facing a burden of 4 400 people dying every day, which is unacceptable in an era when you can diagnose and cure nearly every person with TB.”

In 2014, TB killed 890 000 men, 480 000 women and 140 000 children. The disease ranks alongside HIV as a leading killer worldwide. Of the 1.5 million people killed by TB in 2014, 400 000 were HIV-positive. HIV’s total death toll in 2014 was estimated at 1.2 million, which included the 400 000 TB deaths among HIV-positive people.

This year’s report describes higher global totals for new TB cases (9.6. million) than in previous years. However, these figures reflect increased and improved national data and in-depth studies rather than any increase in the spread of the disease. More than half of the world’s TB cases (54%) occurred in China, India, Indonesia, Nigeria and Pakistan. Among new cases, an estimated 3.3% have multidrug-resistant TB (MDR-TB), a level that has remained unchanged in recent years.

Action needed to close diagnostic and treatment gaps

The report highlights the need to close detection and treatment gaps, fill funding shortfalls, and develop new diagnostics, drugs and vaccines.

The detection gap is significant. Of the 9.6 million people who fell ill with TB in 2014, 6 million (62.5%) were reported to national authorities. That means that, worldwide, more than a third (37.5%) of the cases went undiagnosed or were not reported to national authorities. The quality of care for people in the latter category is unknown.

Detection and treatment gaps are especially serious among people with MDR-TB, which remains a public health crisis. Of the 480 000 cases estimated to have occurred in 2014, only about a quarter – 123 000 – were detected and reported to national authorities. The 3 countries with the largest numbers of cases are China, India and the Russian Federation.

Treatment initiation for those diagnosed with MDR-TB substantially increased and almost all cases detected in 2014 started treatment. Forty-three countries reported cure rates for MDR-TB patients of more than 75%. Nevertheless, globally, data shows an average cure rate of only 50% for treated MDR-TB patients.

Treatment is improving, with 77% of patients known to be co-infected with HIV and TB getting antiretroviral medicines in 2014.

The number of people living with HIV who were given TB preventive therapy was nearly 1 million in 2014, an increase of about 60% compared with 2013. More than half (59%) of these people were in South Africa.

Financing shortfalls stand in way of accelerated progress

“A primary reason for detection and treatment gaps is a major shortfall in funding,” said Dr Winnie Mpanju-Shumbusho, WHO Assistant Director-General for HIV, TB, Malaria and Neglected Tropical Diseases. This shortfall amounted this year to US$ 1.4 billion of the US$ 8 billion needed to fully implement interventions. In addition, an annual funding gap of at least US$ 1.3 billion must be filled for research that would include the development of new diagnostics, drugs and vaccines.

From 2016, the global goal will shift from controlling TB to ending the global TB epidemic. The End TB Strategy, adopted by all WHO Member States, serves as a blueprint for countries to reduce TB incidence by 80% and TB deaths by 90% and to eliminate catastrophic costs for TB-affected households by 2030.

“Ending the TB epidemic is now part of the Sustainable Development Goal agenda” said Dr Eric Goosby, UN Special Envoy on Tuberculosis. “If we want to achieve it, we’ll need far more investment – at a level befitting such a global threat. We’ll also need progress on universal health coverage and poverty alleviation. We want the most vulnerable communities worldwide to gain first, not last, in our efforts.”

For media inquiries, please contact:

Christian Lindmeier
WHO Department of Communications
Telephone: +41 79 500 65 52
Mobile: +41 7 94 45 31 64
Email: lindmeierch@who.int

Prostate cancer: should PSA screening be routine?

2015-09-06T09:32:00.000-07:00

Prostate cancer is the most common cancer in American men behind skin cancer. There are expected to be 220,800 new cases diagnosed in the US this year. Although this number is high, death rates from prostate cancer are relatively low. Almost 100% of men diagnosed with the disease will survive 5 years or more - a rate many medical professionals attribute to prostate-specific antigen testing.

Many medical professionals believe the improvement in death rates from prostate cancer since the 1990s is down to the introduction of PSA testing.

The US Food And Drug Administration (FDA) first approved prostate-specific antigen (PSA) testing to screen asymptomatic men for prostate cancer in the early 1990s. In the decade prior to this approval, 5-year survival rates from the cancer stood at around 70-75%. By 1998, it had increased to 98.2%.

Although some health care experts have hailed PSA testing as the best available method to screen men for prostate cancer, there has been long-standing debate surrounding its use in routine testing.

PSA testing can lead to many false-positive results, meaning men can be alerted to cancers that are not actually present. Furthermore, critics argue that the test can lead to overdiagnosis, causing many men to undergo treatment they do not need.

September is National Prostate Cancer Awareness Month. In line with this campaign, we look at the evidence for and against PSA testing for prostate cancer and ask: should it be used for routine prostate cancer screening?

Questioning the accuracy of PSA testing

PSA is a substance made by cells in the prostate gland. During a PSA test, a clinician will take blood from the patient and send the sample off to a laboratory, where levels of PSA are measured by nanograms per milliliter (ng/mL).

High levels of PSA - usually 4.0 ng/mL or higher - can indicate the presence of prostate cancer, and a man with such levels is likely to need a biopsy to determine whether he has the cancer.

However, high PSA levels can also be a sign of less harmful conditions, such as prostatitis - inflammation or infection of the prostate gland - or enlarged prostate, a condition that can cause urination and bladder problems. Furthermore, the PSA test is unable to determine the difference between aggressive and benign prostate cancers. This is where concerns about the test's accuracy come into play.

Past research has estimated that between 17-50% of men diagnosed with prostate cancer through PSA testing have tumors that would not have resulted in symptoms throughout their lifetime.

This means many men may receive treatment for prostate cancer - such as surgery, radiation or hormone therapy - that they do not need, which can lead to serious side effects, including urinary incontinence and erectile dysfunction.

Recommendations against PSA testing met with criticism

Such factors have fueled recommendations against routine prostate cancer screening. In 2012, the US Preventive Services Task Force (USPSTF) led the way by issuing a recommendation against PSA-based screening for prostate cancer for men of all ages who do not have symptoms.

USPSTF co-chair Dr. Micheal Lefevre said of the recommendation:

"Prostate cancer is a serious health problem that affects thousands of men and their families. But before getting a PSA test, all men deserve to know what the science tells us about PSA screening: there is a very small potential benefit and significant potential harms.

We encourage clinicians to consider this evidence and not screen their patients with a PSA test unless the individual being screened understands what is known about PSA screening and makes the personal decision that even a small possibility of benefit outweighs the known risk of harms."

The move was met with much criticism. In a response published in the Annals of Internal Medicine, a group of prostate cancer experts stated that, given the fact that prostate cancer does not often present symptoms in its early stages, "eliminating reimbursement for PSA testing would take us back to an era when prostate cancer was often discovered at advanced and incurable stages."

This statement was echoed in another study by researchers from the University of Rochester Medical Center in New York, NY, which estimated that without routine PSA testing, an additional 17,000 men every year will likely be diagnosed with prostate cancer in its advanced stages.

Despite such criticism, other organizations - including the Centers for Disease Control and Prevention

http://www.medicalnewstoday.com/articles/281993.php

Ebola transmission in Liberia over. Nation enters 90-day intensive surveillance period

2015-09-06T09:28:00.001-07:00

Today, 3 September 2015, WHO declares Liberia free of Ebola virus transmission in the human population. Forty-two days have passed since the second negative test on 22 July 2015 of the last laboratory-confirmed case. Liberia now enters a 90-day period of heightened surveillance.

Liberia’s ability to effectively respond to the outbreak of Ebola virus disease is due to intensified vigilance and rapid response by the government and multiple partners. Transmission had been declared over previously on 9 May 2015, but the disease re-emerged on 29 June and 6 additional cases were identified.

On 29 June 2015, midway through the first 90-day period, a routine post-mortem swab taken from a 17-year old male, who died on 28 June, tested positive for Ebola virus disease. Upon confirmation of this positive case, a specialized team was immediately dispatched and undertook a detailed investigation.

Under the leadership of the Liberia Government authorities, an effective response was rapidly initiated to contain the new outbreak. Members of the community were engaged and effectively contributed to contact tracing and social mobilization. International partners supported the government in areas such as technical assistance, provision of personnel, food, supplies and equipment. Ultimately, an additional 5 cases arose out of this re-emergence of the disease in Liberia. Out of 6 cases, there were 2 deaths. There were no infections or deaths among health-care workers.

WHO commends the Government of Liberia and its people on the successful response to this recent re-emergence. It is in full accord with government calls for sustained vigilance. It will continue to support the country during the 90 days of heightened surveillance that begins 3 September 2015, and in its early recovery efforts.

Media inquiries:

Mr Gregory Härtl
Coordinator, News and Social Media
Telephone: +41 79 203 67 15
E-mail: hartlg@who.int

Margaret Harris
Communications Officer, WHO
Mobile: +41 796 036 224
E-mail: harrism@who.int

http://www.who.int/mediacentre/news/statements/2015/ebola-transmission-over-liberia/en/

Considerations for mass gathering events and Middle East respiratory syndrome coronavirus (MERS - CoV) Interim guidance

2015-09-06T09:26:00.001-07:00

Publication details

Editors: WHO
Publication date: 5 August 2015
Languages: English

Downloads

Considerations for mass gathering events and Middle East respiratory syndrome coronavirus (MERS - CoV)
pdf 302.05kB

Overview

This document presents organizers and hosts of international mass gatherings with proposed steps to improve public health preparedness to prevent, contain, and mitigate the impact of Middle East respiratory syndrome coronavirus (MERS-CoV). This document is based on current evidence generated among scientific disciplines, operational research, and academic networks related to mass gatherings.

WHO statement on the tenth meeting of the IHR Emergency Committee regarding MERS

2015-09-06T09:24:00.001-07:00

WHO statement
3 September 2015

The tenth meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (2005) (IHR 2005) regarding the Middle East respiratory syndrome 1 was held by teleconference on 2 September 2015, from 1300 to 1620 Central European Summer Time (UTC +2). During the meeting the WHO Secretariat provided an update to the Committee on epidemiological and scientific developments, including recent cases and transmission patterns in the Kingdom of Saudi Arabia (KSA), Jordan and the United Arab Emirates. The Secretariat also provided current risk assessments with regard to these events, and information on control and prevention measures.

IHR Emergency Committee concerning MERS-CoV

The following States Parties provided information on the status of events and assessments of the MERS-CoV situation in their countries: Jordan, KSA, Republic of Korea, Philippines, Thailand and the United Arab Emirates.

The Secretariat reported on a recent WHO mission to KSA that was conducted on 23 August 2015 because of a hospital-based outbreak of MERS cases. One of the preliminary conclusions was that virus transmission in the emergency room of the most heavily affected hospital resulted in a significant nosocomial outbreak. Despite an established triage system, virus transmission was able to occur because of overcrowded conditions, movement of patients who were infected but did not yet have a diagnosis, and some breakdowns in the application of infection prevention and control (IPC) measures. These key factors facilitated the outbreak.

Members of the EC agreed that the situation still does not constitute a Public Health Emergency of International Concern (PHEIC). At the same time, they emphasized that they have a heightened sense of concern about the overall MERS situation. Although it has been three years since the emergence of MERS in humans was recognized, the global community remains within the grip of this emerging infectious disease. There is continued virus transmission from camels to humans in some countries and continued instances of human-to-human transmission in health care settings. Nosocomial outbreaks have most often been associated with exposure to persons with unrecognized MERS infection. The major factors contributing to the ongoing situation are insufficient awareness about the urgent dangers posed by this virus, insufficient engagement by all relevant sectors, and insufficient implementation of scalable infection control measures, especially in health care settings such as emergency departments. The Committee recognizes that tremendous efforts have been made and some progress has been achieved in these areas. However, the Committee also notes that the progress is not yet sufficient to control this threat and until this is achieved, individual countries and the global community will remain at significant risk for further outbreaks.

Moreover, the current outbreak is occurring close to the start of the Hajj and many pilgrims will return to countries with weak surveillance and health systems. The recent outbreak in the Republic of Korea demonstrated that when the MERS virus appears in a new setting, there is great potential for widespread transmission and severe disruption to the health system and to society.

The Committee further noted that its advice has not been completely followed. Asymptomatic cases that have tested positive for the virus are not always being reported as required. Timely sharing of detailed information of public health importance, including from research studies conducted in the affected countries, and virological surveillance, remains limited and has fallen short of expectations. Inadequate progress has been made, for example, in understanding how the virus is transmitted from animals to people, and between people, in a variety of settings. The Committee was disappointed at the lack of information from the animal sector.

The Committee felt it important to alert all relevant authorities, especially national public health, animal and agricultural agencies, to the continued and significant public health risks posed by MERS. These sectors must collaborate, among themselves and internationally, and follow the advice that has been issued by WHO.

The Committee advised as follows:

Its previous advice remains applicable.
National authorities should ensure that all health care facilities have the capacity, knowledge and training to implement and maintain good practices, especially infection prevention and control measures and early identification of cases.
Appropriate authorities should collaboratively address deeper systemic issues that are impeding control of MERS, both in animals and humans.
National authorities should ensure the rapid and timely sharing of information of public health importance, including epidemiological investigations, viral genetic sequence information and findings from research studies.
International collaboration to develop human and animal vaccines and therapeutics should be accelerated.
In view of the evidence that camels are the main source of community-acquired infections, public health, animal health and agricultural sectors must improve their collaboration to address the public health risk of MERS.
National leadership is essential to ensure a flexible, efficient and well-coordinated whole-of-government response to the challenges posed by MERS.

Based on the Committee’s advice and information currently available, the Director-General accepted the Committee’s assessment. She thanked the Committee for its work.

There is no public health justification for implementing any measures to prevent the spread of MERS through the restriction of travel or trade. Screening at points of entry is considered unnecessary at this time. However, raising awareness about MERS and its symptoms among those travelling to and from affected areas, particularly in light of the Hajj, is strongly advised.

WHO will continue to provide updates to the Committee Members and Advisors. The Emergency Committee will be reconvened should circumstances require.

1 From now on, WHO documents will use “the Middle East respiratory syndrome”, or MERS, to refer to the disease caused by the MERS coronavirus. MERS-CoV will continue to be used for the virus itself.

World Hepatitis Summit harnesses global momentum to eliminate viral hepatitis

2015-09-06T09:22:00.001-07:00

http://www.who.int/en/

2 SEPTEMBER 2015 ¦ GLASGOW - Participants at the first-ever World Hepatitis Summit will urge countries to develop national programmes that can ultimately eliminate viral hepatitis as a problem of public health concern.

“We know how to prevent viral hepatitis, we have a safe and effective vaccine for hepatitis B, and we now have medicines that can cure people with hepatitis C and control hepatitis B infection,” said Dr Gottfried Hirnschall, Director of the WHO’s Global Hepatitis Programme. “Yet access to diagnosis and treatment is still lacking or inaccessible in many parts of the world. This summit is a wake-up call to build momentum to prevent, diagnose, treat - and eventually eliminate viral hepatitis as a public health problem.”

Around 400 million people are currently living with viral hepatitis, and the disease claims an estimated 1.45 million lives each year, making it one of the world’s leading causes of death. Hepatitis B and C together cause approximately 80% of all liver cancer deaths, yet most people living with chronic viral hepatitis are unaware of their infection.

The summit, co-sponsored by WHO and the World Hepatitis Alliance, and hosted in Glasgow by the Scottish Government this week, is the first high-level global meeting to focus specifically on hepatitis, attracting delegates from more than 60 countries. The aim is to help countries enhance action to prevent viral hepatitis infection and ensure that people who are infected are diagnosed and offered treatment.

Policymakers, patient groups, physicians and other key stakeholders attending the summit aim to issue a declaration underlining their belief that the elimination of viral hepatitis is possible and urging governments to work with WHO to define and agree on global targets for prevention, diagnosis and treatment.

WHO is launching a new manual for the development and assessment of national viral hepatitis plans at the summit. Policymakers and other key stakeholders at the 3-day meeting (2-4 September) are also discussing the draft WHO Global Health Sector Strategy on Viral Hepatitis, which sets targets for 2030. The targets include a 90% reduction in new cases of chronic hepatitis B and C, a 65% reduction in hepatitis B and C deaths, and treatment of 80% of eligible people with chronic hepatitis B and C infections.

The World Summit, which is intended to become an annual event, aims to focus attention on a public health approach to viral hepatitis and to be a central forum for countries to share their experience and best practices to drive rapid advances in national responses.

“This summit is about empowering countries to take the practical steps needed at a national level. It has brought here to Scotland patients’ groups and civil society from across the world to support countries in doing this. We can eliminate viral hepatitis as a major global killer but we must all work together to make that vision a reality,” said Charles Gore, President of the World Hepatitis Alliance.

Putting in place a well-funded and comprehensive response is a challenge for many governments who have a high burden of hepatitis-related diseases. In sub-Saharan Africa and East Asia between 5-10% of the population is chronically infected with hepatitis B. High rates of chronic infections are also found in the Amazon and the southern parts of eastern and central Europe. Hepatitis C is found worldwide. Infection rates are high in Africa and Central and East Asia, and approximately two-thirds of people who inject drugs are infected with hepatitis C.

An increasing number of countries are taking action to address viral hepatitis. They include Egypt, which has substantially increased the number of people receiving treatment for hepatitis C in recent years; Georgia, which has set a goal for the national elimination of hepatitis C; and Mongolia, which has endorsed a comprehensive strategy for the control of viral hepatitis.

Media contacts

Alison Clements-Hunt
Communications Officer, WHO
Mobile: +41 793 863 943
E-mail: clementshuntal@who.int

Christian Lindmeier
Communications Officer, WHO
Mobile: +41 79 500 6552
E-mail: lindmeierch@who.int

Nicotine Replacement Therapy (NRT)

2015-05-17T07:28:00.000-07:00

Introduction

How does NRT works?

What are the types of NRT available?

Nicotine gum
Nicotine inhaler
Nicotine lozenge
Nicotine nasal spray*
Nicotine patch

*Not available in Malaysia

What are the regimens for NRT products?

NRT Products	Regimen*
Nicotine gum	2mg gum: recommended for patients who smoke less than 25 cigarettes per day; 4mg gum: recommended for patients who smoke 25 or more cigarettes per day. Chew 1 piece of gum every 1 to 2 hours for the first 6 weeks, followed by 1 piece of gum every 2 to 4 hours for 3 weeks and 1 piece of gum every 4 to 8 hours for the next 3 weeks.
Nicotine inhaler	Each cartridge delivers a total of 4mg nicotine over 80 inhalations. 6 to 12 cartridges per day for the first 8 weeks followed by 3 to 6 cartridges per day for 2 weeks and reduce gradually to zero for the next 2 weeks.
Nicotine lozenge	2mg lozenge: recommended for patients who smoke their first cigarette more than 30 minutes after waking; 4mg lozenge: recommended for patients who smoke their first cigarette within 30 minutes of waking. Suck 1 lozenge every 1 to 2 hours for the first 6 weeks, followed by 1 lozenge every 2 to 4 hours for 3 weeks and 1 lozenge every 4 to 8 hours for the next 3 weeks.
Nicotine patch	Two range of patch are available in the market: 15mg/16hours, 10mg/16hours, 5mg/16hours 21mg/24hours, 14mg/24hours, 7mg/24hours 1 piece of patch 15mg/16hours or 21mg/24hours per day for the first 4 weeks, followed by 1 piece of patch 10mg/16hours or 14mg/24hours per day for 2 weeks and 1 piece of patch 5mg/16hours or 7mg/24hours per day for the next 2 weeks.
Nicotine nasal spray	A dose of nicotine nasal spray consists of one 0.5mg dose delivered to each nostril (1mg total). 1 to 2 doses per hour and increase the dose as needed with a minimal of 8 doses per day and maximum of 40 doses per day in the first 8 weeks. This is followed by gradual reduction of the number of dose to zero for the next 4 to 6 weeks.

* The above are brief guidelines, subject to patients’ condition.

How to use the NRT products?

NICOTINE GUM	Chew 5 to 10 times until it has a peppery taste and provide tingling sensation. Then park the gum between the cheek and gum until the peppery taste or tingling sensation disappears. Chew and park again at another side of the cheek. Repeat this until all the taste from the gum is gone (about 30 minutes).
NICOTINE INHALER	Align marks on the mouthpiece, pull off top. Insert cartridge into the mouthpiece. Twist to close securely. Align marks again and push the top and bottom together firmly. Twist to lock the mouth piece. Inhale deeply or puff continuously for about 20 minutes.
NICOTINE LOZENGE	Place it between gum and cheek and suck slowly until it is fully dissolved (about 3 minutes). It should not be bitten, chewed or swallowed whole.
NICOTINE PATCH	Apply the patch on the skin that is dry, clean and hairless. It can be applied anywhere between the hand to neck (often the upper arm or shoulder), and hip. Remove backing from patch and immediately press onto skin. Seal it tightly. Leave it for 16 hours or 24 hours then remove it. Apply a new one at a different site before going back to the same site (at least 5 days apart).
NICOTINE NASAL SPRAY	Remove the cap of the nasal spray by pressing in the circles on the side of the bottle. Pump into tissue until the fine spray is seen (6 to 8 times). Throw the tissue away. Tilt your head back slightly. Insert the tip of the bottle as far as you comfortably can into one nostril, pointing the tip toward the back of your nose. Breathe through your mouth. Pump the spray firmly and quickly one time. Do not sniff, swallow, or inhale while spraying. If your nose runs, gently sniff to keep the nasal spray in your nose. Wait 2 or 3 minutes before blowing your nose.

What are the side effects of NRT products?

Some of the common side effects associated with the use of nicotine products are:

NRT Products	Side Effects
Nicotine gum	Mouth soreness, hiccups, dyspepsia and jaw ache
Nicotine inhaler	Local irritation in the mouth and throat
Nicotine lozenge	Nausea, hiccups, heartburn, headache and coughing
Nicotine patch	Skin reaction, insomnia and vivid dreams
Nicotine nasal spray	Nasal irritation, nasal congestion and transient changes in sense of smell and taste

What are the special precautions?

Last Reviewed	:	06 January 2014
Writer	:	Sharon Ong Chin Wen
Accreditor	:	Mohd Dziehan bin Mustapa

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For media inquiries, please contact:

Prostate cancer: should PSA screening be routine?

Questioning the accuracy of PSA testing

Recommendations against PSA testing met with criticism

Ebola transmission in Liberia over. Nation enters 90-day intensive surveillance period

Media inquiries:

Considerations for mass gathering events and Middle East respiratory syndrome coronavirus (MERS - CoV) Interim guidance

Publication details

Downloads

Overview

Related links

WHO statement on the tenth meeting of the IHR Emergency Committee regarding MERS

World Hepatitis Summit harnesses global momentum to eliminate viral hepatitis

Media contacts

Nicotine Replacement Therapy (NRT)