We regret the inconvenience experienced by the patient but do allow us to elaborate on this issue.

Patients are supplied medications on a monthly basis for several reasons.

Firstly, it is to enable the pharmacist to monitor these patients in terms of compliance and/or occurrence of adverse reactions.

Secondly it is to ensure the quality of medicines used as not all patients keep their medicines in accordance with proper storage conditions and this will compromise the efficacy of these medications and safety of the patient.

Lastly, periodic supply of medications also helps to avoid wastage as patients do not always inform the pharmacy if they still have stock at home when they get their new prescriptions filled.

In addition to this, all medicines supplied from public health facilities are fully subsidised by the Government.

In order not to tie up Government funding with excessive stocks and also to avoid the issue of wastage, the norm for stock holding in Government hospitals and clinics is two months.

Hence, the policy to supply medicines on a monthly basis is not because the hospitals have insufficient stocks but it is an effort to practise good store management, maintaining the delicate balance between maximum stock (to avoid overstocking) and minimum stock (to avoid under-stocking) which is vital in these prudent times.

Facilities that frequently experience the issue of under-stocking will be looked into and advised to take effective corrective action to rectify the matter.

However, the Pharmaceutical Services Division has introduced several mechanisms to ease the medication collection process for patients on long-term therapy.

Patients can request to collect their repeat medications from facilities which are nearer their homes using the Sistem Pendispensan Ubat-Ubatan Bersepadu (SPUB) services offered at all government hospital and health clinic pharmacies.

Alternatively, patients can also opt to have their repeat medications posted to their homes on a regular basis.

This service is already being offered at major hospitals in all states and will be expanded to include other healthcare facilities based on the coverage offered by the postal service.

With this, we hope to overcome the woes of patients and care-givers who find it inconvenient to come to the Government hospitals and health clinics to collect their medications.

We would like to suggest that the patient concerned discuss with the respective pharmacist on the various medication collection options available through which he/she can collect his/her repeat medications.

DATUK EISAH A. RAHMAN,
Senior Director of Pharmaceutical Services,
Health Ministry.

First published by TheStar Online on 21st July 2011: Why medications given on monthly basis

Forced to make extra trips for medicine

I AM a diabetic patient and I write this letter because of the numerous times I have been asked to return to collect my medicine. This has been going on for about a year.

We diabetic patients are reviewed every three months and are given a three-month supply of medication. But each time we collect our medicine we are only given one month’s supply.

Therefore, we have to come back two more times to collect the medicine. This is very tedious and time wasting especially for those who stay far away from the hospital and have to take a bus or taxi.

Money is being drained out o our pockets unnecessarily during these bad economic times.

It is indeed terrible for those who are old and feeble, especially the pensioners.

Not only is the hospital short of medicine for diabetes but it also has no supply of simple tablets such as calcium.

DM PATIENT,
Port Dickson.

First published by TheStar Online on 16th July 2011: Forced to make extra trips for medicine

A picture paints a 1000 words. LOL!

Join us for fun and more interesting activities on The Volgograd Times (TVT) Facebook Group here:
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Photo credit for preview thumbnail (from Flickr):
http://flickr.com/photos/waldoj/97187153/

No, this is not talking about unfit HO or graduates who couldn’t practise (but partly about it). Amateur Transplants is out with their new album! ‘Unfit to practise’. If you all are aware with their previous hits like Eternal Clerking, London Underground and Final countdowns, remember to listen to their new album!

This time, most of the songs are short and names according to subjects. Like Paediatrics, Urology and Department of Surgery. They are the songs’ name.

Personally I like the song ‘Paediatrics’, have a look at the lyrics -

You need a little patience,
When you trying to examine a child,
It is source of such a frustration,
When you need them to keep still for a while,
They fiddle, they gargle, they giggle, they struggle, they wriggle,
No matter how many times you give them,
They’ll cryyyyyy
God knows whyyyyyyy
You must employ cunning tactics,
when you do paediatrics,
just tryyyyyy,
when you have a little patient.

Enjoy!

The article is about Professor Chua Kaw Bing of Universiti Malaya and his journey of discovering the Nipah virus in Malaysia, which had an outbreak during 1998 in malaysia causing 265 cases of encephalitis and 105 deaths within 8 months.

The first outbreak of this virus happened in a pig farm situated in Ampang, Ipoh. The government had quickly took measures and contain the area, and most experts believe that it was the mosquito-born Japanese encephalitis virus. However, Prof Chua didn’t thought the same way. There are few reasons that why he decided to investigate the matter.

First of all, the manifestation of the disease is the pigs was quite unusual. The disease also showed prevalence in male adults. Both of these points are not JE trait. Despite all the measures taken to contain the area, the disease continue to spread.

Prof Chua was the 5th people to be given the chance to discover the virus. The initial four institution decided to let him do the job. The work wasn’t easy as he need to convince a lot of people that this is probably a new virus and was officially involved in working with Nipah virus in Feb 1999. His work ultimately suggested that the virus belongs to paramyxovirus (for example those causing measles and mumps), instead of arbovirus which is transmitted by anthropods. The discovery of Nipah virus made the government changed the control measures and the outbreak was being controlled. The public thinks that the pigs may have been the reservoir host. Further research by Prof Chua identified that 2 species of fruit bats happened to be the natural reservoirs of the virus.

Editor’s note: It would be really cool if he named the virus with his name!

Picture taken from http://upload.wikimedia.org/wikipedia/en/a/a1/Henipavirus_structure.png

So, lets have a quiz.

1)

This is suitable for Year 3,4,5,6

2)

This is suitable for Year 5,6

Click to enlarge

Questions

1. ECG interpretation

2. Your management

Answers will be out on Sunday.

Year 3, 4 and 5 are most welcomed to try. This quiz is meant to educate, without participation it would be meaningless.

1. R I > R II > R III
2. R I > 15mm
3. R I + S III >25mm
4. R avL > 11mm
5. R avF > 20mm
6. Корнельский критерий R avL + S v3 > 28mm (male) , >20mm(female)
7. R v6 > R v5
8. R v5 or R v6 > R v4
9. R v5 or R v6 > 26mm
10. S v1 or S v2 > 20mm
11. Индекс соколова-лайена = R v5 or R v6 + S v1 > 35mm

Remember , 1 large box on the ECG is 10mm.

Try out some examples here , here and here

The kid is normal during examination. Do not have any kind of distress. Auscultation and percussions yeild normal results. Other examinations on other cutaneous parts of the body are unremarkable except for this lesion on his right hand. Before this, he was treated with topical antibiotic and antihistamines but is of minimal improvements. After one week, a repeat visit to the physician and further questioning revealed that they had been staying in multiple hotels during the vacation 1 week ago. The parents deny knowing any similar lesion on relatives and thsoe in contact with him.

Lesion on the right hand. Try your best to guess what is it.

Questions:

1. What’s the diagnosis?

2. What’s the treatment?

Answer will be announced on coming friday.

Question of the week:

1. What is your diagnosis based on the picture seen?