Global Burden of Depression


1. The Australian study conducted by Australian Institute of Health and Welfare shows depression as no 1 disease that causes disability in Australia. 4% males and 7% females are affected.

2. 62% of cases do not get any mental health intervention.

3. 75% of those who do receive care are dealt with in primary care.

4. Disability-adjusted life -years (DALY) is a measure of the years of ‘healthy’ life lost due to illness or injury (one DALY is a one-lost year of ‘healthy’ life). Depression contributes to 3.7% of DALY.

5. In the younger persons, those with alcohol, tobacco and cannabis abuse at high risk to develop co-morbidities with depression whereas the older ones are those with vascular diseases and cognitive impairment.

6. Problem with our patients and services are:  i) poor access to risky patients esp the young and the old, ii) lack of funding for atypical antidepressants, iii) poor recognition by the society and family members, iv) non-compliance to standard treatment, v) denial by society at large, vi) traditional belief in emphasis on religious-based treatment, vii) lack of proper in-patient facility to treat depressive patient, viii) lack of continuous care and support, ix) lack of integrated medical care between medical and psychological services x) little recognition of management of comorbid substance abuse

Belacan


1. I have no idea how Ghafar is able to make his own belacan. But Miri’s belacan is special, especially to sambal belacan’s lover. When I was presented with a year stock of belacan what can I say?

2. According to Ghafar, making belacan is not difficult. What he needs to do is to ‘jemur’ those tiny shrimp on top of the roof after mixed well with ‘garam’ and leave for it to dry and ‘tumbuk’ with ‘lesung batu’ till ‘lumat’. You got to Google translate those words!

3. One thing amazing about Miri’s belacan is that it has very much less foul smelling aroma. Am still in a daze how he makes it that way.

4. Don’t be surprised. the famous actor has a side business in making belacan too (Read Here). It has potential to become a serious business for him one day.

5. Budu is analog to belacan. A colleague claims that budu is good for the brain (brain food) and I have no idea of how to counterstrike his statement so he may be right! ha..

Inquiry About Virginity


1. Many a time we encounter people come to be examined on virginity. A 2-year-old child was found to have some question marks on vulva areas; the mum suspected foul play and wanted to find out what went wrong.

2. Are we going to dismiss maternal instinct, even without a trace of evidence and vehement suspicion?

3. The world has become the unsafe place for indefensible folks. People are not just being robbed of their property but their feeling and dignity. That was what Wardina Safiyyah said in MHI early morning today.

4. Yes, as inquisitive clinicians, we will investigate…

……………

Update

1. When parental divorce happens, children used to become the scapegoat. When a mom starts to be suspicious of her ex-husband, everything is being questioned.

2. The truth that prevails, at last, is a big NO. No evidence of abuse.

Training Makes Empathy Perfect


1. Empathy belongs to how you put yourself in another’s shoes.

2. Some people have superficial empathy, some very deep empathy. Whoever they are, the fundamental principle is the empathy must be guided by knowledge and fact.

3. By perceiving other people emotion, a successful interpersonal interaction develops which encompass intellectual and emotional contagion and finally perspective taking.

4. Scientists have mapped different brain regions such as ventral striatal response to happy faces correlated positively with Empathy Quotient (EQ), precuneus and lateral prefrontal cortical response to angry faces correlated positively with EQ.

5. The region in the left dorsal inferior frontal gyrus/premotor cortex was positively correlated to the EQ across all four emotions i.e happy, sad, angry and disgust. This region could, therefore, constitute a biomarker for trait empathy across emotions. (http://www.ncbi.nlm.nih.gov/pubmed/18633800)

6. I believe empathy can be trained. So training makes empathy perfect and so the history taking..

Chicken and Egg


1. Sleep is the most frequent question we ask when enquiring about psychological problems. Sleep a lot or having less sleep will always be indicator for psychological problem. Circadian rhythm is like an internal clock that works 24 hours a day.

2. Now we know if one has difficulty sleeping, his circadian rhythm is altered. But which one comes first? (chicken-and-egg question)

3. Perhaps, agomelatine has the answer. No bias, please!

4. Since agomelatin activates kinases (which involve in intracellular signaling that took part in the survival of newly formed neurons) and therefore influence clock gene expression and hence sleep-wake cycle, then it is safe to say that the circadian rhythm affects sleep not the other way round….

5. Wonder if I just learned a new thing or an old fact that has just been turn-around?

Dare To Make Mistakes


1. I trust mistakes are good to make except during final exam time. Because learning occurs when mistakes are made. At the same time, learning from mistakes will help to prevent making the same mistakes in the future.

2. The first step in learning is to acknowledge and not stay in denial.

3. A mistake that knocks one down is only another opportunity to get back up and proceed more diligently! I didn’t read the bestseller book ‘Dare to Fail’ but I suppose the story is about how someone rebound back after went through some catastrophic failures.

4. So, Dare To Make Mistakes..it’s OK but more important: learn from the mistakes.

Ex-Military Chief’s Conspiracy


If DS Anwar’s story has become the most popular political headline in Malaysia, this is another political headline in Turkey.

ANKARA, Turkey: A former military chief was jailed Friday (6/01/12), accused of leading a terror organization and conspiring to bring down the government, his lawyer said, becoming the most senior officer to face trial in a series of investigations into alleged anti-government plots.

Gen. Ilker Basbug was arrested and placed in a prison near Istanbul overnight after seven hours of questioning by prosecutors investigating allegations that the military funded dozens of websites aimed at discrediting the Islamic-rooted government of Prime Minister Recep Tayyip Erdogan in 2009.

Some of the suspects already charged in the case, including senior generals and admirals, have said they acted in a chain of command. Basbug, who retired in August 2010, led the military at the time.

The jailing of a former military chief — unimaginable a few years back — comes as the government, which has won three successive elections, has sharply reduced the political clout of the military. Military leaders have staged three coups and forced an Islamist prime minister to quit in 1997.

Basbug’s lawyer, Ilkay Sezer said his client has denied accusations during questioning. NTV television said the former general told court officials the charges were “tragicomical.”

“If I am being accused of bringing down the government with a couple of press statements and one or two Internet stories, this is very bitter,” the Hurriyet newspaper quoted Basbug as saying, citing court papers.

“If I had such bad intentions, as the commander of a 700,000-strong force, there would have been other ways of doing it.”

Basbug told journalists before being taken to prison: “The 26th Chief of Military Staff of the Turkish Republic is being accused of forming and leading a terror organization. I leave it up to the great Turkish people to decide.”

The alleged conspiracy was first reported by a Turkish newspaper in 2009, which printed a photocopy of an alleged plan to damage the reputation of the government by portraying it as corrupt. Investigations into the reported conspiracy were inconclusive because the original document, allegedly signed by a navy colonel, could not be found. The probe was revived last year after an unidentified military officer allegedly sent the original document to Istanbul’s chief prosecutor.

Hundreds of people, including civilians, retired generals and active-duty officers, are already on trial accused of terrorism charges for alleged involvement in separate plots that prosecutors say were aimed at destabilizing Turkey and bringing the government down. The military says 58 serving generals or admirals are in jail.

Erdogan’s opponents see the trials as a government effort to intimidate them through the courts while the long imprisonments without verdicts and alleged irregularities in the handling of evidence have cast doubts over the legal process.

Kemal Kilicdaroglu, the leader of the pro-secular opposition party, criticized the arrest saying courts prosecuting the anti-government plots were “not distributing justice” but “approving decisions taken by the political authorities.”

Deputy Prime Minister Besir Atalay said he could not comment on a legal process but said he hoped the trial would be “fair and quick.”

Last year, the nation’s top four military commanders, including the chief of staff that succeeded Basbug, resigned in protest against the arrests and prosecutions of military officers.

Protest and Social Justice


1. Politic is like religion. You can never separate politics from human life. Therefore, I understand why people protest and the dire need to build up civil society.

2. I’d rather be a rational person. I can’t take sides and close my eyes on one side or the other. I have been told in academia to avoid bias. I am very irritated with those who keep changing their stance. To me, they are politicians without principle.

3. I’ve nothing against Mike Ficken’s, Reader Digest article on the importance of peaceful protest. Without protest how could we uphold social justice. History has shown it again and again when people are oppress they fight back in a robust momentum like a spring with the domino effect.

4. Many students use political activism to escape ache and pain striving for excellence in the classroom. Few student activists are really good in their study though. In the end, balance is very much needed. Students must show excellence in their study and at the same time knowledgeable on issues faced by the nation.

A Child with Horrifying Imagination


1. She presented with scary feeling, seen ghost, stories full of horrifying imagination. At 7 years, sleeping with mum and dad on the same bed. Mum complained she was quite restless at night, keep changing position until the end of the bed. Due to unnoticed insomnia, she required extra day sleep, making her wake up till 12.00 noon. In the daytime, she was over-active and had abundance eating as if she is discharging unfulfilled wishes.

2. Mum claimed she was easily fatigued and lethargic. Slightly overweight since young, she has had rhinitis, sinusitis when she was five. Nasal Spay was prescribed and she recovered. Until around September when she had developing sleep problem associated closely with abnormal behavior.

3. Obstructive sleep apnoea in young children is rare and most of the time overlook by physician treated children for sinusitis and tonsillitis. Most doctors do not ask about sleep pattern in children. They assume children sleep soundly especially when they are sleeping with their parents.

4. This kid has sleep deprivation characterized by symptoms of fatigue, listlessness and overactive behavior the next morning, the mom noticed she was moving and turning in bed. Sometime children who do not get enough sleep would show moodiness and tantrums behavior.

5. In most cases, removing the tonsil or adenoid would solve the problem. Medical treatment for sinusitis and URTI help in the minority of cases on a temporary basis as illustrated earlier on in this case. CPAP machine can be quite intimidating for children in the beginning. Proper diagnosis needs to be done in sleep lab before starting CPAP.