The issue of Melamine tainted milk from China had been up for some time but I was surprised by the fact that not many medical students know it and there are even more that simply do not care or mind to find out. Here is a small article on the basic knowledge of Melamine and hopefully this would help you to more or less grasp the severity of this problem.

Melamine is an organic base which contains some 66% of nitrogen by mass. Melamine is use in producing durable thermosetting plastic and polymeric cleaning products. Some of the end products are glues, erase boards, counter tops, fabrics and flame retardants. It is also used in making high-resistance concrete and fertilizers.

Melamine derivatives of arsenical drugs are used in the treatment of African trypanosomiasis!

Due to it’s high content of nitrogen, some manufacturers added melamine into milk and infant formula to fool the government in the protein content tests. With that, the protein content of the food will appear higher than the normal value.

When melamine is consumed, it can combine with cyanuric acid (which is permitted to be present in some non-protein nitrogen additives used in drinking water) can form insoluble melamine cyanurate, which could crystallize in the renal microtubules. It would damage the renal cells and in the end cause kidney failure. Other than that, it could also lead to reproductive damage, kidney and bladder stones.

In 22 September, nearly 53,000 people had become ill and almost 12,000 people hare hospitalized, affecting mostly babies and kids who consume these milk and infant formula products.

The second highest leading cause of death from cancer amongst Malaysian Women, and worldwide, is CERVICAL CANCER, first being Breast Cancer. Cervical cancer, as the name implies, is the cancer of the cervix, which is the lower part of the uterus that connects to the vagina.

Cervical cancer is caused by certain high-risk type of Human Papillomavirus Virus (HPV). When a female becomes infected with this virus, it may causes abnormal cells to develop in the lining of the cervix, which can lead to precancerous cells, and if not discover early and treated, will lead to cancer.

Over the years, women with cervical cancer, had suffered from minor operations, hysterectomy (removal of the whole uterus), radiotherapy, chemotherapy and even death from cancer spread.

? How is HPV transmitted?
According to the Centers for Disease Control and Prevention, the only way you can totally protect yourself against HPV is to avoid any sexual activity that involves genital contact. In summary, abstinence is the ONLY way to prevent cervical cancer. And I am not talking about multiple partners. A single partner, let’s say your future spouse, can also cause cervical cancer to you. So, unless you are very sure that you can avoid sexual activity life long, I suggest you read on.

? How to prevent cervical cancer?
Thank God, now, researches had developed a vaccine against HPV (Human Papillomavirus Virus), the causative agents of cervical cancer = GARDASIL. HPV types 16 and 18 causes 70% of cervical cancer cases, and HPV types 6 and 11 causes 90% of genital warts cases. GARDASIL is so far the only vaccine that help guard against diseases caused by HPV type 6, 11, 16 and 18.
Note: Anyone who is allergic to the ingredients of GARDASIL should not receive the vaccine. Also, GARDASIL is not for women who are currently pregnant.

? Why am I telling you this now?
A research done on the effectiveness of GARDASIL was done on a population sample on those non-sexually active between 16-26 years old and the result was significant. In fact, the earlier you are vaccinated, the better it is. Therefore, since most of my friends and blog readers are among this age group, I would like to introduce this vaccine to you. It is recommended for girls between 9-26 years old.

? Do one still have to go for PAP smear after vaccinated?
YES. GARDASIL does not protect you 100% from cervical cancer. PAP smear is still the number one screening tool for cervical cancer. It is a cheap and simple procedure. Therefore, once you are sexually active, you still have to go for PAP smear anually (for 3 years, and if all previous smears were normal, screen every 3 yearly).

? Where can I get this and how much?
You can get yourself vaccinated at any local clinic. The price is about RM350 per dose, with a total of 3 dose altogether. Be aware that some vaccine only covers for 2 HPV. Make sure you asked your doctor for more information. Or else, just insist on GARDASIL which provides vaccination against the 4 HPV mentioned above.

? How effective is this vaccine?
As for all vaccine, vaccination with GARDASIL may not result in protection in all vaccine recipients. The efficacy of GARDASIL was assessed in 4 placebo-controlled, double-blind, randomized Phase II and III clinical studies. These studies evaluated 20451 women 16 to 26 years old of age at enrollment. The efficacy of GARDASIL against HPV 16- and 18-related CIN 2/3 or AIS was 100% in all four studies (Protocol 005, Protocol 007, FUTURE I and FUTURE II and combined protocols). The efficacy of GARDASIL against HPV 6,11,16 and 18 CIN was 100%, 100%, 90.7% and 95.2% respectively in studies : Protocol 007, FUTURE I and FUTURE II and combined protocols . While the efficacy of GARDASIL against HPV 6,11,16,18 genital lesions (eg warts, VIN, VaIN) was 100%,100%, 98.6% and 99.1% respectively.

? Possible side effects?
Commonly: Fever, redness, pain and swelling at injection site.
Sometimes: Pruritus (itchiness) and hemorrhage (bleeding) at injection site
Very Rarely: Bronchospasm, syncope

? Is it worth the money?
I shall leave it for you to decide. (It sucks right? When women have to suffer from a cancer spread by man. Sigh.. ) Thinking down the line, between a thousand and cervical cancer, if you have some extra savings to spare, why not?

I wanted to include some pictures of cervical cancer and cervical warts, but I was a bit worried that it might upset some readers, certainly not for the faint heart, and I do not know how to include spoilers in a blog… maybe, some other time, perhaps… or you could try googling for pictures, the internet makes it so convenient…

Most of us medical students know that smoking is bad for health, causes COPD, Buerger’s disease, and a lot more. We are known to the fact that smoking does shorten our life expectancy, but, for how long??

A Finnish study in Archives of Internal Medicine shows that some 1600 men born between 1919 and 1934 with the overall same socioeconomic status, have 372 death after 26 years.

Participants who didn’t smoke lived an average 10 years life longer than those heavy smokers. The quality of life is measured by certain categories of physical functions, social functioning, emotional well-being and general health perception.

So, medical students who smoke, you know what to do!!!