ANOTHER day, another shooting. It seems as if we are becoming as dangerous as some South American nations where gun violence seems to be the norm.
It’s just not confined to one or two areas but is happening across the nation.
Three shootings in two days. A 25-year-old man, Jasrafveendeerjeet Singh, was shot in front of a restaurant in Ipoh at 10.15pm. Another man, G. Santhana Samy, 30, was wounded in the thigh when he stopped at a traffic light in Butterworth at 8.30pm.
And in Kuala Lumpur, Arab-Malaysian Development Bank founder Hussain Ahmad Najadi died from multiple bullet wounds. He was shot in Lorong Ceylon while walking with his wife to his car in broad daylight.
These incidents followed the murder attempt of MyWatch chairman R. Sri Sanjeevan in Seremban on Saturday who was shot when his car stopped at the traffic lights.
The police response: the setting-up of yet another “high-powered” task force to investigate the crime. Actually, we have lost count of how many high-owered or high-level committees and task forces have been set up to investigate the various shooting crimes.
In fact, we are still waiting for some indication of the progress made by the task force set up in May to hunt down those responsible for the spate of shooting cases then, including the murder of Customs deputy director-general Datuk Shaharuddin Ibrahim.
Federal CID director Comm Datuk Seri Mohd Bakri Zinin had announced that the special CID task force, headed by Federal principal assistant director of Serious Crime (D9) Senior Asst Comm Datuk Huzir Mohamed would identify and arrest the criminals.
At the same time, Penang police have also set up a separate task force to probe a series of shootings, which left at least four people dead over the past five months.
From seemingly ordinary Joes to prominent people being gunned down, the public can’t help but wonder whether we are on a rapid slide to a state of lawlessness. The sense of insecurity and nervousness is definitely growing.
Apart from gun-toting criminals, robbers are crashing restaurants to rob the patrons en masse.
Eateries that used to operate till the wee hours are now closing early; there are way fewer people who want to risk being robbed while having supper.
Even snatch thieves have grown more vicious and brazen. They do not just grab but often slash their victims to incapacitate them, making their getaway easier.
In such a state of affairs, we are almost relieved to read of cases where the “victim” is an ATM. The thieves who hack away and drag out these cash-vending machines seem almost harmless and preferable to those who prey on people.
Undoubtedly, the police have their hands full. Theirs is no easy task with no easy solutions. So far, they are focusing on identifying weapons smugglers to try to root out the source of gun-related crimes.
But more action and arrests are what is desperately needed because the ferocity and the increasing number of assassinations are striking fear in all of us.
Our top cops may continue to try to assure us that our nation is still very safe but unfortunately, that’s just not good enough.
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Thursday, August 1, 2013
Fitch downgrades Malaysia due to high government debts and spending
PETALING JAYA: Fitch Ratings, after cutting Malaysia’s credit rating outlook to “negative”, sending the stock market and the ringgit reeling, has said it is more likely to downgrade the country’s rating within the next two years on doubts over the Government’s ability to rein in its debt and spending.
The Government, in response to Bloomberg News, rebutted such concerns and said it was committed to fiscal responsibility, stressing that it would rationalise subsidies and broaden the tax base.
It said the economy was fundamentally healthy, with strong growth and foreign currency reserves.
Standard & Poor’s had last week, however, reaffirmed its credit rating on Malaysia and said it might raise sovereign credit ratings if stronger growth and the Government’s effort to reduce spending resulted in lower-than-expected deficits. “With lower deficits, a significant reduction in Government debt is possible,” it said.
It might lower its rating for Malaysia if the Government fails to deliver reform measures to reduce its fiscal deficits and increase the country’s growth prospects.
“These reforms may include implementing the Goods and Services Tax or GST, reducing subsidies, boosting private investments and diversifying the economy,” said S&P.
The downgrade in Malaysia’s rating outlook by Fitch on Tuesday took a toll on the capital markets, and sent the ringgit to a three-year low against the US dollar.
The FTSE Bursa Malaysia KL Composite Index closed 1.25% or 22.46 points lower at 1,772.62, and the ringgit fell to RM3.2425 against the greenback, its lowest since June 30, 2010.
The bond market, where foreign shareholding recently was at an all-time high, also saw yields climb dramatically. The yield for the 10-year tenure for Malaysian Government Securities rose seven basis points yesterday to 4.13%. The yield for the 10-year Government bond has climbed 77 basis points since April 30.
In a conference call yesterday afternoon, Fitch Ratings warned that a downgrade in Malaysia’s credit rating was “more likely than not” over the next 18 to 24 months. It highlighted Malaysia’s public finances as its key issue for the rating weakness.
Its head of Asia-Pacific sovereigns Andrew Colquhoun said over the phone that there was a concern over the Government’s commitment to fiscal consolidation after the May general election (GE).
“It is difficult to see the Government pressing forward with any fiscal reform steps or budget reforms,” he said, adding that the rating would reverse if any action was taken.
CIMB Research, in a note by its head of research Terence Wong and economics research head Lee Heng Guie, said Fitch’s revised outlook on the country was “bad news” for the stock market.
“While we believe there will be a knee-jerk selldown, the average lifespan for a rating outlook is about 18 to 24 months before a downgrade is enforced, giving Malaysia time to prevent that,” the report said.
They said the Fitch downgrade was a warning to Malaysia to improve its macroeconomic management, and was of the opinion that the Government had time to get its house in order.
“We believe the authorities will take the warning seriously and move to address any weaknesses,” they noted.
Both Wong and Lee, however, felt that any weakness in the stock market was an opportunity for investors to accumulate shares.
“The depreciation of the ringgit benefits exporters, such as plantation, rubber glove and semiconductor players, as well as those with foreign currency revenues,” they said.
Meanwhile, Areca Capital chief executive officer Danny Wong told StarBiz that foreign investors might use the downgrade as a reason to exit from Bursa Malaysia.
“There is a concern that the downgrading may affect foreigners to exit Malaysia in a big way. Hence, it created a ‘knee-jerk’ reaction to the market.
“However, I think the impact would be minimal on the equity market but the concern is on the bond market because of the 33% foreign ownership,” he said, adding that the outlook by Fitch was earlier than expected since the 2014 budget is set to be announced in two months’ time.
RAM Holdings Bhd chief economist Dr Yeah Kim Leng said the cut in the outlook by Fitch had rattled the market, but feels the country’s fundamentals such as gross domestic product (GDP) growth, high foreign reserves and current account surplus would soothe worries over any rating concerns.
“I believe the Government will pursue its target to reduce the budget deficit by 4% this year, or at least show a sign of reduction.
“However, Malaysia’s current account balance will narrow further by end-2013 due to a weakening in exports, although a deficit account is unlikely to happen,” he opined.
High debt levels have been a growing concern in recent years in Malaysia, as the Government debt-to-GDP ratio is among the highest in South-East Asia. At 53.5% as at the end of last year, it is higher than the 25% in Indonesia, 51% in the Philippines and 43% in Thailand, noted a report by Bloomberg.
The ratio for Malaysia is almost to the debt ceiling limit of 55%.
Fitch, it its notes accompanying its decision to downgrade Malaysia’s credit outlook, said the country’s budget deficit had widened to 4.7% of GDP in 2012 from 3.8% in 2011, led by a 19% rise in spending on public wages ahead of the May GE.
It believes that it will be difficult for the Government to achieve its 3% deficit target for 2015 without additional consolidation measures.
By INTAN FARHANA ZAINUL intanzainul@thestar.com.my
Wednesday, July 31, 2013
Tuesday, July 30, 2013
Protect your investment in smartphones; How to handle a phone virus
Keep your Galaxy S4 well protected with this Otterbox.
High-end smartphones have become must-have items that are drooled over and lusted after whenever a new model is released. With so much marketing going on, many can’t resist the latest and trendiest smartphones.
However, in pursuit of designs which are sleeker and more lightweight to entice the crowd, manufacturers have compromised on the durability of smartphones.
Take for example Samsung’s latest flagship, the Galaxy S4. It’s a great lightweight smartphone with an amazing 5in screen squeezed into a sleek body.
This makes the bezel (the area between the edge of the phone and the screen) extremely small, making me worry that the slightest drop is going to ruin the screen. As smartphones today consist predominantly of the display, even the slightest damage to the screen will cost a significant amount to replace or repair.
As such, it is best to invest in a good casing for peace of mind. For me, a good casing is one that provides full protection around all edges of the phone, rather than one that looks fancy but leaves the corners of the phone exposed.
Enter the Commuter
Otterbox is a company well known for producing hard travel cases for all kinds of sensitive electronic equipment.
They have been producing a few different lines of full protective cases for most smartphone brands in the market. The Commuter series is one of their popular product lines, and here we have the Galaxy S4 version of the case for review.
More than just good looks
The casing itself is a two piece set up (three if you count the screen protector that’s included). It has a polycarbonate outer layer and a silicone inner layer which fits the S4 perfectly.
Unlike the more rugged Defender series, the Commuter is simple enough to assemble that you don’t have to read through a user manual or watch a video tutorial.
The review unit we received was an ocean blue colour. It’s a vibrant, striking colour but I’d have to say that it isn’t everyone’s cup of tea. I for one, didn’t fancy this colour.
The Commuter has flaps to cover both the audio port as well as the charging port. This is to protect the ports from dust and any other unwanted debris from entering and damaging the innards of the phone.
Build and feel
I appreciated the fact that the flap left enough room for my thick MHL adapter to be plugged in, something which was not possible with the Defender casing for another phone that I have tested.
However, at times it did feel bothersome to have to keep opening and closing the flaps, as I frequently needed access to the micro USB port to charge my phone.
I personally don’t fancy my devices being too thin, so the added bulk around the device actually made it feel better in my hand. I sometimes freak out when my pocket feels too light, only to find that my device is still in there, just that it isn’t heavy enough to be noticeable. The additional pounds that the S4 puts on with the Commuter makes its presence better felt in my pocket.
If there’s one other thing I don’t like about the review unit that I received, it is the material used for the casing. Having used other Otterbox products before, I was left a little disappointed with the texture of this Commuter casing, as it felt too cheap for its class. It gave me an impression that it wasn’t worth the price tag attached to it.
I didn’t have the heart to do any major drop tests with the device. I tried dropping the S4 from the most likely heights that a phone will be dropped from, such as when getting up from a seat as well as from a table top. As expected, the device was well protected by the casing.
Conclusion
The Otterbox Commuter is a protective case that provides full protection around the edges for your precious Galaxy S4. While it may not be the best looking casing in the market, it gives you peace of mind if you are a careless person by nature or someone who leads an active lifestyle.
However, we weren’t too fond of the way that the polycarbonate outer layer was designed as it felt a little too cheap.
While the flaps for the ports were appreciated, it did seem a little obtrusive at times.
Pros: Gives the S4 a more secure feel; protects all edges; screen protector.
Cons: Polycarbonate outer layer feels cheap; flaps for the port can be obtrusive.
Commuter:
(Otterbox)
Samsung Galaxy S4 protective case
Specifications: Silicone inner layer, polycarbonate outer layer
Other Features: Screen protector included
Dimensions (|W x D x H): 143.25 x 78.92 x 14.58mm
Weight: 45.35g
Rating: ***
Review unit courtesy of KWS
Distribution SdnBhd, www.kwsdis.com or eamil info@kwsdis.com
- By Donovan Quek The Star
How to handle a phone virus
Stay safe: Your phone is like your PC - only install apps that you trust
If you get a virus on your mobile phone, the best action to take is a factory reset. Most phones have this option, which returns your phone’s operating system (OS) to the state it was in when it left the factory.
With some phones, a factory reset will allow you to keep your personal data like pictures and music when resetting the OS. If not, you can also sync your phone with your PC after resetting to return your applications and data to your phone.
In the future, protect yourself against viruses by treating it like a PC — never install something you do not trust or recognise, and do not open suspicious text messages or e-mail messages.
It is also helpful to install antivirus software on to your phone, which can help prevent malware and alert you if you have been infected.
Recent data shows that Android malware has grown 580% between September 2011 and September 2012. Apple iOS malware is rarer, but it still important to protect yourself and use safe practices when connected online with your mobile device. — McClatchy-Tribune Information Services
Related posts:
28 Jun 2013
05 Jun 2013
Monday, July 29, 2013
Don't burn money, use it wisely
It is time to learn from our past and put our skills and resources into positive value creation.
NEXT month will be 68 years since the Hiroshima and Nagasaki atomic bombings in Japan.
To some, it is just another month at work. Some may celebrate their birthday, some become parents and for some, it may coincide with festive celebrations. Certainly few of us are old enough to remember the impact of the devastating events.
Being an avid reader, this date reminds me that the real tragedy of war is that it uses man’s best skills to do man’s worst work.
The creativity and perseverance that led to the discovery of the power of atoms, which could light up the world and potentially solve our energy issue, was used to create hell on earth.
The discovery of neutron by James Chadwick in February 1932, Niels Bohr’s discovery of fission and ultimately, Leo Szilard’s method of producing a nuclear chain reaction or a nuclear explosion, of which he even filed a patent, would lead to the creation of what was euphemistically called Little Boy.
Hardly little at all, for the bomb had the power of more than 20,000 tonnes of TNT, which destroyed most of Hiroshima, killing an estimated 130,000 people on Aug 6, 1945. Three days later, a second bomb, nicknamed Fat Man, was dropped on Nagasaki, killing between 60,000 and 70,000 people.
Looking at the incident as a case of creative discoveries being used for war efforts, one can’t help but reflect on how much of these resources could be used if such a detonation did not take place.
Going beyond the obvious tragedy of the loss of human life, there is the immense economic cost of cleaning up contaminated areas, reconstruction of buildings, productivity lost due to the physical injuries and sickness of the casualties, loss of national income, psychological damage, etc. How does one quantify that?
To me, it’s very clear that we need to divert our military resources to build more educational and medical institutions, research facilities, provide housing or even venture capital funds for start-ups that could create a world that is different, not destructive.
The 34th US President, Dwight D. Eisenhower, said in a speech to the American Society of Newspaper Editors that “every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those whose hunger and are not fed, those who are cold and are not clothed”.
And he was a military man, the former supreme commander of the Allied Forces during World War II.
We may not be sure of how much Eisenhower’s grasp of value is, but it makes sense.
He said that the cost of a modern heavy bomber could finance a modern brick school in more than 30 cities.
It could even contribute to two electric power plants, with each serving a town of 60,000 in population. It could even construct two fully equipped hospitals.
As headlines blaring financial uncertainties continue today, it is a good time to wonder where all the money is going, and where are all the innovators and entrepreneurs to lift the standard of living and to fulfil the needs of society?
According to the Stockholm International Peace Research Institute, nearly RM6 trillion is spent annually on military, defence and armaments.
In economics, the idea of opportunity cost always arises in business. An entrepreneur will always need to consider the cost of giving up something in order to achieve a business objective.
So what is humanity giving up by laying down arms?
- Open Season by LIM WING HOOI The Star
Business writer Lim Wing Hooi believes that the human race needs to invest wisely in its own future.
Sunday, July 28, 2013
Love your liver! World Hepatitis Day today
A look at one of the most insidious infectious in the world
Many people are unaware that being diagnosed with hepatitis B and C is a lifelong sentence.
MANY ancient civilisations rightfully believed that the liver is one of the most crucial organs in our body.
Although their understanding was not based in scientific fact – for example, the Babylonians, Estrucans, Romans and Greeks believed that the liver was the seat of all emotions and the organ closest to divinity, while in traditional Chinese medicine, it purportedly helps to regulate the flow of qi and blood in the body, and governs anger – the liver is indeed vital to our existence.
Like the heart, we cannot function without our liver.
It is one of the most hardworking organs in our body, performing over 500 different functions, including processing and storing nutrients, manufacturing proteins and hormones, neutralising toxins, breaking down drugs and removing waste from our body.
It is the second largest organ in the body after the skin, and the only one that has significant regenerative capabilities, being able to grow back to full size from as little as a quarter of its cells.
However, even this ability cannot overcome the insidious presence of the two hepatitis viruses that cause chronic infection in the liver.
These viruses work silently – often residing in the infected person’s body quietly, slowly damaging the liver without causing any outward signs of illness, until it is too late.
Passed on through bodily fluids, they can be contracted through sex, the sharing or reuse of unsterilised sharp objects like needles, razors, and even earrings, from mother to child in the womb, and basically, any activity that can result in the transference of blood, semen, vaginal fluid and saliva directly from the infected person to someone else.
The virus usually gains access into the body via the bloodstream through minor wounds, like nicks or cuts, that one may not even notice.
But because these viruses rarely cause any specific symptoms during the acute stage, people are unaware that they have been infected, and may go on to infect other people unknowingly.
This is why, according to consultant hepatologist Dr Syed Mohd Redha Syed Nasir, the most important form of transmission is perinatal or early childhood transmission.
He explains: “If someone in the family has hepatitis B, it is likely that someone else will have it too; that’s why we have to screen everyone in the house.”
This is especially in the case of children whose immune systems have not completely matured yet.
As a rule, hepatitis is usually only picked up upon screening, or when patients have already developed complications from the disease.
A chronic problem
Despite being considered a major global health threat – it is one of only four diseases that the World Health Organisation (WHO) considers crucial enough to mark with an international World Day, the awareness of hepatitis is still disturbingly low among the general population.
This infectious disease, which causes inflammation of the liver, is caused by five viruses: hepatitis A, B, C, D and E.
Of these, hepatitis B and C are the most worrisome as they can become chronic infections, which may result in liver cirrhosis (also known in layman’s terms as scarring or hardening) and liver cancer. (See Acute infections for more information on the three other viruses.)
These two viruses are also the main focus of the World Hepatitis Day campaign.
According to the World Hepatitis Alliance website, “The long-term objective of the campaign is to prevent new infections and to deliver real improvements in health outcomes for people living with hepatitis B and C.”
In Malaysia, hepatitis B is an important enough health concern that the vaccine is part of the compulsory national immunisation programme for all babies.
Despite that, Dr Syed says that around 5% of the population still has hepatitis B.
There is no vaccine for hepatitis C; neither is there any local data on the spread of hepatitis C or the three other hepatitis viruses in the country, according to him.
“In our setting, from my experience, we often encounter patients, who are diagnosed to have hepatitis B in particular, many years ago.
“Little do they realise that hepatitis B is a chronic infection that has the potential to cause long-term damage to the liver,” he says.
The doctor, who was previously with the national referral centre for liver diseases at Hospital Selayang and is now in private practice, adds that this often results in the patient being unaware of the importance of long-term follow-up, and creates the tendency for them to skip their annual check-ups.
“For these patients, you can’t be sure whether their infection will become active again, or develop into liver cancer.
“A few years down the road, they will come and you discover they have liver cirrhosis, and it is already a lost battle.”
He says that most patients tend to come in when they already have decompensated liver cirrhosis, which presents with abdominal swelling, with or without accompanying leg swelling, and either vomiting or passing motion with blood.
Some may also come in with a yellowish complexion (jaundice), episodes of losing awareness of their surroundings (hepatic encephalopathy), and other bacterial infections, as the liver is part of the immune system.
Too late to treat
While treatment is available for both hepatitis B and C, Dr Syed cautions that patients need to be carefully evaluated before the decision to start treatment is made.
This evaluation is to determine the degree of viral activity, as well as the level of liver damage. Both these factors need to be carefully balanced in order for treatment to be fully effective.
“When we give treatment, we must make sure it is indicated, because it is for life. For example, if a patient is 25 years old, he has to take it for the next 40 to 50 years (until he dies),” he says.
The development of resistance to the antiviral medication given for the disease is also another reason why doctors need to make the decision to treat judiciously.
Aside from oral antiviral drugs, patients may also be treated with interferon injections, which are typically given for the period of one year.
Dr Syed explains: “Interferon modulates your immune system, as well as clears the virus, so there is an added effect. After one year, your immune system will be able to clear the virus on its own.”
According to studies, the percentage of patients on interferon in which the virus can no longer be detected increases from 3-5% in the first year to 12% five years after completing their treatment.
However, he adds that this treatment is often not an option for most Malaysian patients, as the damage to the liver is already too advanced by the time they go see the doctor.
Unfortunately, the reality of the situation in Malaysia is that most patients with chronic hepatitis only see the doctor when their condition is so advanced that they are already well on the way to requiring a liver transplant.
- By TAN SHIOW CHIN The Star
Related Notes:
Hepatitis A
Transmitted through the oral-faecal route, usually through water or food that has been contaminated with the faeces of an infected person. Prevalent in places with poor hygiene and sanitation. There are an estimated 1.4 million cases of hepatitis A every year worldwide. Symptoms include fever, malaise, loss of appetite, diarrhoea, nausea, abdomi -nal discomfort, dark-coloured urine and jaundice. There is no treatment, but the immune system is usually able to get rid of the infection by itself. There are a number of vaccines available.
Hepatitis D
There are vaccines available for hepatitis A, B and E, but the vaccine for hepatitis E is only available in China. – AFP
Facts an figures -by the Numbers:
Many people are unaware that being diagnosed with hepatitis B and C is a lifelong sentence.
MANY ancient civilisations rightfully believed that the liver is one of the most crucial organs in our body.
Although their understanding was not based in scientific fact – for example, the Babylonians, Estrucans, Romans and Greeks believed that the liver was the seat of all emotions and the organ closest to divinity, while in traditional Chinese medicine, it purportedly helps to regulate the flow of qi and blood in the body, and governs anger – the liver is indeed vital to our existence.
Like the heart, we cannot function without our liver.
It is one of the most hardworking organs in our body, performing over 500 different functions, including processing and storing nutrients, manufacturing proteins and hormones, neutralising toxins, breaking down drugs and removing waste from our body.
It is the second largest organ in the body after the skin, and the only one that has significant regenerative capabilities, being able to grow back to full size from as little as a quarter of its cells.
However, even this ability cannot overcome the insidious presence of the two hepatitis viruses that cause chronic infection in the liver.
These viruses work silently – often residing in the infected person’s body quietly, slowly damaging the liver without causing any outward signs of illness, until it is too late.
Passed on through bodily fluids, they can be contracted through sex, the sharing or reuse of unsterilised sharp objects like needles, razors, and even earrings, from mother to child in the womb, and basically, any activity that can result in the transference of blood, semen, vaginal fluid and saliva directly from the infected person to someone else.
The virus usually gains access into the body via the bloodstream through minor wounds, like nicks or cuts, that one may not even notice.
But because these viruses rarely cause any specific symptoms during the acute stage, people are unaware that they have been infected, and may go on to infect other people unknowingly.
This is why, according to consultant hepatologist Dr Syed Mohd Redha Syed Nasir, the most important form of transmission is perinatal or early childhood transmission.
He explains: “If someone in the family has hepatitis B, it is likely that someone else will have it too; that’s why we have to screen everyone in the house.”
This is especially in the case of children whose immune systems have not completely matured yet.
As a rule, hepatitis is usually only picked up upon screening, or when patients have already developed complications from the disease.
A chronic problem
Despite being considered a major global health threat – it is one of only four diseases that the World Health Organisation (WHO) considers crucial enough to mark with an international World Day, the awareness of hepatitis is still disturbingly low among the general population.
This infectious disease, which causes inflammation of the liver, is caused by five viruses: hepatitis A, B, C, D and E.
Of these, hepatitis B and C are the most worrisome as they can become chronic infections, which may result in liver cirrhosis (also known in layman’s terms as scarring or hardening) and liver cancer. (See Acute infections for more information on the three other viruses.)
These two viruses are also the main focus of the World Hepatitis Day campaign.
According to the World Hepatitis Alliance website, “The long-term objective of the campaign is to prevent new infections and to deliver real improvements in health outcomes for people living with hepatitis B and C.”
In Malaysia, hepatitis B is an important enough health concern that the vaccine is part of the compulsory national immunisation programme for all babies.
Despite that, Dr Syed says that around 5% of the population still has hepatitis B.
There is no vaccine for hepatitis C; neither is there any local data on the spread of hepatitis C or the three other hepatitis viruses in the country, according to him.
“In our setting, from my experience, we often encounter patients, who are diagnosed to have hepatitis B in particular, many years ago.
“Little do they realise that hepatitis B is a chronic infection that has the potential to cause long-term damage to the liver,” he says.
The doctor, who was previously with the national referral centre for liver diseases at Hospital Selayang and is now in private practice, adds that this often results in the patient being unaware of the importance of long-term follow-up, and creates the tendency for them to skip their annual check-ups.
“For these patients, you can’t be sure whether their infection will become active again, or develop into liver cancer.
“A few years down the road, they will come and you discover they have liver cirrhosis, and it is already a lost battle.”
He says that most patients tend to come in when they already have decompensated liver cirrhosis, which presents with abdominal swelling, with or without accompanying leg swelling, and either vomiting or passing motion with blood.
Some may also come in with a yellowish complexion (jaundice), episodes of losing awareness of their surroundings (hepatic encephalopathy), and other bacterial infections, as the liver is part of the immune system.
Too late to treat
While treatment is available for both hepatitis B and C, Dr Syed cautions that patients need to be carefully evaluated before the decision to start treatment is made.
This evaluation is to determine the degree of viral activity, as well as the level of liver damage. Both these factors need to be carefully balanced in order for treatment to be fully effective.
“When we give treatment, we must make sure it is indicated, because it is for life. For example, if a patient is 25 years old, he has to take it for the next 40 to 50 years (until he dies),” he says.
The development of resistance to the antiviral medication given for the disease is also another reason why doctors need to make the decision to treat judiciously.
Aside from oral antiviral drugs, patients may also be treated with interferon injections, which are typically given for the period of one year.
Dr Syed explains: “Interferon modulates your immune system, as well as clears the virus, so there is an added effect. After one year, your immune system will be able to clear the virus on its own.”
According to studies, the percentage of patients on interferon in which the virus can no longer be detected increases from 3-5% in the first year to 12% five years after completing their treatment.
However, he adds that this treatment is often not an option for most Malaysian patients, as the damage to the liver is already too advanced by the time they go see the doctor.
Unfortunately, the reality of the situation in Malaysia is that most patients with chronic hepatitis only see the doctor when their condition is so advanced that they are already well on the way to requiring a liver transplant.
- By TAN SHIOW CHIN The Star
Related Notes:
Hepatitis A
Transmitted through the oral-faecal route, usually through water or food that has been contaminated with the faeces of an infected person. Prevalent in places with poor hygiene and sanitation. There are an estimated 1.4 million cases of hepatitis A every year worldwide. Symptoms include fever, malaise, loss of appetite, diarrhoea, nausea, abdomi -nal discomfort, dark-coloured urine and jaundice. There is no treatment, but the immune system is usually able to get rid of the infection by itself. There are a number of vaccines available.
Hepatitis D
Transmitted through bodily fluids, usually through sex, contact with the blood of an infected person, sharing of sharp objects like needles, razors or syringes, and from mother to child in the womb. Requires the presence of the hepatitis B virus to replicate, and as such, is usually found together with hepatitis B as a co-infection or a superinfection. Not usually tested for in a clinical setting. Treatment and vaccination for hepatitis B is equally effective for hepatitis D.
Hepatitis E
Transmitted through the oral-faecal route, usually through contaminated drinking water and eating products from an infected animal. Every year, there are 20 million infections, over three million acute cases, and 57,000 deaths. Over 60% of infections occur in East and South Asia. Symptoms include jaundice, anorexia, an enlarged, tender liver (hepatomega -ly), abdominal pain and tenderness, nausea, vomiting and fever. There is no treatment, but the immune system is usually able to get rid of the infection by itself. However, complica -tions may arise in pregnant women. The first vaccine was registered in 2011 in China, but is not currently available globally.
Sources: WHO, the US Centres for Disease Control and Prevention, and consultant hepatologist Dr Syed Mohd Redha Syed Nasir.
Hepatitis E
Transmitted through the oral-faecal route, usually through contaminated drinking water and eating products from an infected animal. Every year, there are 20 million infections, over three million acute cases, and 57,000 deaths. Over 60% of infections occur in East and South Asia. Symptoms include jaundice, anorexia, an enlarged, tender liver (hepatomega -ly), abdominal pain and tenderness, nausea, vomiting and fever. There is no treatment, but the immune system is usually able to get rid of the infection by itself. However, complica -tions may arise in pregnant women. The first vaccine was registered in 2011 in China, but is not currently available globally.
Sources: WHO, the US Centres for Disease Control and Prevention, and consultant hepatologist Dr Syed Mohd Redha Syed Nasir.
There are vaccines available for hepatitis A, B and E, but the vaccine for hepatitis E is only available in China. – AFP
Facts an figures -by the Numbers:
- There are over 400 million cases of HEPATITIS every year, compared to 34 million cases of HIV/AIDS cases (IN 2011) and almost 29 million cases of CANCER (in 2008).
- HEPATITIS B & C infections cause an estismated 57% of liver cirrhosis cases and 78% primary liver cancer. Liver cancer is the SIXTH most common cancer worldwide.
- Around 240 million people have chronic Hepatitis B, with 600,000 dying every year due to complications from the infection.
- The percentage of those who develop chronic Hepatitis B infections are: 80-90% of infants infected before he age of one, 30-50% of children infected before six and <5% of otherwise healthy adults.
- The Hepatitis B vaccine is administered at ZERO (at birth), one and six months of age in Malaysia. It is 95% effective at preventing infection.
- About 150 million people have chronic Hepatitis C, with over 350,000 dying every year due to complications from the infection.
- Around 80% of peopole do not exhibit any symptoms follwoing initial Hepatitis C infection.
- Around 75-85% of Hepatitis C patients develop chronic infection, of which 60-70% develop chronic liver disease. 2-20% will develop cirrhosis, with 1-5% dying from cirrhosis or liver cancer. Hepatitis C causes 25% of liver cancer cases.
- July 28 was chosen for World Hepatitis Day in honur of the birthday of Nobel Laureate Prof Baruch Samuel Blumberg, who discovered the Hepatitis B virus.
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