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Radiation Exposure : putting some perspective

February 14, 2017 – 2:48 am

Radiation leak: Residents of Shah Alam apartment at risk

Recent radiation leak from a stolen radiation canister releasing up to 300mSV/hour of gamma radiation is worrying. How could such a radioactive canister be compromised, from being …

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High dose fish oil supplements in late pregnancy reduce asthma in offspring, finds study

January 2, 2017 – 5:44 am
fish-oil-dog-food

BMJ 2016; 356 (Published 30 December 2016)
Cite this as: BMJ 2016;356:i6861

Susan Mayor

Taking supplements containing high doses of n-3 long chain polyunsaturated fatty acids derived from fish oil in the last three months of pregnancy reduced the risk of persistent wheeze or asthma and infections of the lower respiratory tract in offspring by nearly a third in the first five years of life, a randomised study has found.1

A diet deficient in n-3 long chain polyunsaturated fatty acids during pregnancy has previously been suggested to be associated with an increased risk of asthma and wheeze in children, but results from randomised trials looking at use of supplements in pregnancy have been ambiguous.

Danish researchers randomised 736 pregnant women at 24 weeks of gestation to take 2.4 g of n-3 long chain polyunsaturated fatty acids from fish oils each day or to placebo (olive oil). They then followed up 695 of the offspring for three years, when investigators and parents were blinded to treatment assignments, and a further two years when the investigators remained unaware.

The results, reported in the New England Journal of Medicine, showed that the risk of persistent wheeze or asthma in children born to women who took fish oil supplements in late pregnancy was 31% lower than in those born to women in the placebo group (16.9% v 23.7%; hazard ratio 0.69 (95% confidence interval 0.49 to 0.97); P=0.035).

A pre-specified subgroup analysis indicated that the reduction in wheeze and asthma was greatest in children born to women whose blood concentrations of the two major n-3 long-chain polyunsaturated fatty acids in the fish oil supplements (eicosapentaenoic acid and docosahexaenoic acid) were in the lowest third of the trial population at randomisation (17.5% v 34.1%; hazard ratio 0.46 (0.25 to 0.83); P=0.011).

“These findings show that n-3 long chain polyunsaturated fatty acid supplementation during pregnancy was associated with a significantly diminished burden of wheezing and asthma in children in this Danish birth cohort,” said the researchers, led by Hans Bisgaard, from the University of Copenhagen.

In a commentary, Christopher Ramsden, from the National Institute on Aging in Baltimore, Maryland, described the results as “highly promising” but cautioned that the dose of fatty acids used in the trial was around 15-20 times higher than the average US intake from foods.2 He said, “It is imperative to ensure that this dose had no adverse effects on behaviour, cognition or other long-term outcomes,” but added that further work should determine whether lower doses were effective.

Secondary endpoints in the Danish study showed that taking fish oil supplements in late pregnancy was associated with a reduced risk of lower respiratory tract infections in offspring (31.7% v 39.1%; hazard ratio 0.75 (0.58 to 0.98); P=0.033) but not with a statistically significant reduction in asthma exacerbations, eczema, or allergic sensitisation.

References
Bisgaard H, Stokholm J, Chawes BL, et al. Fish oil-derived fatty acids in pregnancy and wheeze and asthma in offspring. N Engl J Med2016;375:2530-9. doi:10.1056/NEJMoa1503734. pmid:28029926.
Ramsden CE. Breathing easier with fish oil: a new approach to preventing asthma?N Engl J Med2016;375:2596-8. doi:10.1056/NEJMe1611723. pmid:28029914.
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Happy New Year!

January 1, 2017 – 12:38 am
NewYear_2017

 
Wishing all our readers and supporters a Happy New Year! We will have more exciting content this coming year and hope that you will continue to support us here as we write from our hearts.
Medicine …

The future of artificial intelligence in healthcare

December 16, 2016 – 1:00 am
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Using machine learning to predict deterioration of patients, in this case paediatric patients, is something that will likely be the norm in the future landscape of healthcare.This study looks at machine learning as a tool to predict decompensation of paediatric patients in the ward thus needing ICU stay.

Technology has always been touted to ‘mend’ the failures of Man. Medical errors are common and often under-reported and unknown. Patients can sometimes pay the ultimate price for such failures in the healthcare system. The question remains, ” Can technology be depended upon to ensure patient safety?”

Time to change the drug rehabilitation process

December 10, 2016 – 9:00 am
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“Pusat Serenti”, Malaysia’s compulsory drug detention centres has always been deemed a failure. It has been plagued by inefficiencies, corruption and poor staffing.

Drug addicts are often involved in crime and some of them violent, inviting a label of being the pariahs of society. So such detention centres are often seen as justice.

However, many do not believe that criminalising drug addicts and keeping them in a confined space is humane and this practice may even contradict basic human rights.

Drug rehabilitation advocates have longed fought for a change in the way Malaysia runs its drug rehabilitation process. Adding humanity to this process via a voluntary programme has been seen as more effective and certainly humane way of tackling this issue.

More transparency in drug pricing needed

November 24, 2016 – 4:37 am
drugpricing

We have written about this on several occasions. However, there is a need to inject more urgency into this issue. Drug prices are escalating especially the newer generations of medicines.
Often the defence to expensive …

Elusive Dengue Vaccine

October 13, 2016 – 2:53 am
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There has been much debate on why the Government has yet to introduce the dengue vaccine in Malaysia.

Many reasons from the poor efficacy against the DEN2 serotype which is the most prevalent strain in Malaysia, to the fast that cost benefit aspect needs to be taken into account.