Penambahbaikan perkhidmatan kesihatan bukti keprihatinan kerajaan (Utusan Malaysia Online)

Kesihatan adalah keperluan asas manusia dan rakyat mengharapkan pihak kerajaan menyediakan kemudahan perkhidmatan kesihatan yang baik secara percuma ataupun pada kadar kos yang paling minimum.

Dalam hal ini, kita amat tertarik dengan beberapa inisiatif dan langkah yang telah diperkenalkan oleh Perdana Menteri Datuk Seri Najib Tun Razak sejak mengambil alih jawatan Perdana Menteri.

Semuanya bermula dengan pelancaran Klinik 1Malaysia yang telah diwujudkan mulai Januari lalu bertujuan menyediakan perkhidmatan rawatan perubatan ringan kepada penduduk di kawasan bandar sesuai dengan pendekatan kerajaan 'Rakyat Didahulukan, Pencapaian Diutamakan' pada kadar bayaran serendah RM1 sahaja.

Ia disusuli pula dengan pelancaran Inisiatif Klinik Bergerak 1Malaysia pada awal bulan ini, yang menawarkan perkhidmatan penjagaan dan pemeriksaan kesihatan secara percuma ke kampung di kawasan pedalaman.

Melalui Klinik Bergerak 1Malaysia ini, bas- bas yang telah disediakan akan membawa doktor, jururawat dan staf sokongan untuk merawat mereka yang sakit dan memberikan perkhidmatan kesihatan yang berkualiti di tempat yang tidak ada kemudahan klinik dan hospital terutama di kawasan pedalaman.

Terkini Najib mengumumkan kerajaan akan memperkenalkan klinik bot bergerak hibrid untuk memberikan perkhidmatan kesihatan ke kampung yang dihubungkan melalui sungai di Sabah dan Sarawak.

Tambah Najib, langkah ini bertujuan memastikan rakyat dapat menikmati kesihatan lebih baik dan menerima pemeriksaan perubatan, ubat dan nasihat yang sewajarnya.

Komitmen dan pelbagai inisiatif seperti ini jelas membuktikan tahap keprihatinan dan keikhlasan kerajaan dalam menjaga kebajikan rakyat, membela nasib golongan yang kurang mampu serta membuka ruang akses kepada masyarakat luar bandar untuk turut sama menikmati kemudahan kesihatan yang berkualiti sama seperti masyarakat di kawasan bandar.

Hal ini amat signifikan kerana dengan adanya klinik-klinik bergerak seperti ini, ia dijangka mampu mengurangkan beban pesakit di klinik kesihatan di kawasan bandar yang sedia ada dan ini juga dapat memudahkan serta mempertingkatkan akses rakyat untuk mendapatkan rawatan ringan terutama di kawasan luar bandar.

Kita perlu sedar bahawa masih ramai penduduk luar bandar berpendapatan rendah dan sederhana. Golongan ini sering menghadapi masalah kekangan kewangan untuk mendapatkan rawatan perubatan di klinik mahupun hospital swasta. Tambahan pula hospital ataupun klinik kesihatan kerajaan yang sedia ada agak jauh dari lokasi penempatan mereka dan jumlah pesakit pula ramai yang jelas akan melambatkan proses mendapatkan rawatan yang dikehendaki dengan segera.

Keprihatinan pihak kerajaan dalam aspek kesihatan rakyat memang tidak perlu diragui ataupun dinafikan kerana buktinya bagi tahun 2010 Kementerian Kesihatan Malaysia (KKM) telahpun diperuntukkan bajet berjumlah RM14.8 bilion yang merangkumi perbelanjaan mengurus sebanyak RM11.2 bilion dan perbelanjaan pembangunan sebanyak RM3.6 bilion.

Peruntukan ini menunjukkan peningkatan sebanyak 7.6 peratus berbanding tahun sebelumnya iaitu RM13.2 bilion. Malah, peruntukan yang diterima oleh KKM ini juga merupakan antara yang tertinggi berbanding kementerian lain. Data ini sudah cukup untuk menjelaskan rasa tanggungjawab kerajaan terhadap aspek kesihatan rakyat negara ini terutamanya bagi membantu golongan yang tidak berkemampuan.

Dalam pada itu, kerajaan juga dilihat amat serius dalam mengekang tindakan beberapa klinik dan hospital swasta yang mengenakan caj rawatan melampau dan tidak munasabah sehingga pesakit mengalami kesukaran untuk menjelaskan bil tersebut.

Ini terbukti apabila pihak KKM melalui mesyuarat bersama Persatuan Hospital Swasta Malaysia, Persatuan Perubatan Malaysia, Majlis Perubatan Malaysia (MMC), ketua pegawai eksekutif dan orang bertanggungjawab bagi hospital swasta, wakil Organisasi Jagaan Yang Diuruskan (MCO), syarikat insurans, kumpulan profesional serta profesional perseorangan baru-baru ini telah memutuskan agar hospital swasta kini perlu memaklumkan secara terperinci dan telus mengenai caj profesional serta caj anggaran dan di luar jangkaan sebelum pesakit diberi rawatan atau dimasukkan ke wad.

Penulis berharap agar pihak kerajaan akan meneruskan lagi inisiatif-inisiatif murni seperti ini agar seluruh rakyat Malaysia mampu akses kepada kemudahan rawatan perubatan yang berkualiti demi melahirkan sebuah masyarakat yang sihat and cergas.

NOOR MOHAMAD SHAKIL HAMEED

Penolong Pendaftar Kanan Pusat Kesihatan Universiti, Universiti Putra Malaysia

Klinik 1Malaysia | Pusat Rawatan Alternatif Rakyat

Oleh JAGATHESWARY NARAYANAN
n.jagatheswary@kosmo.com.my

Klinik 1Malaysia yang diwujudkan di kawasan penempatan golongan berpendapatan rendah dan sederhana misalnya di kawasan Projek Perumahan Rakyat (PPR) telah pun meringankan beban rakyat untuk mengunjungi klinik swasta.

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SULAIMAN Awang, 72, sudah boleh menarik nafas lega. Dia tidak perlu risau lagi tentang tempoh perjalanan kalau hendak pergi ke klinik. Sebabnya sekarang dia hanya perlu berjalan kira-kira lima minit untuk mendapatkan rawatan kesihatannya. 

Klinik 1Malaysia yang diwujudkan di kawasan penempatan golongan berpendapatan rendah dan sederhana seperti di kawasan Projek Perumahan Rakyat (PPR) nyata meringankan beban rakyat biasa, terutama warga emas seperti Sulaiman. 

Klinik yang dibina di 50 buah lokasi di seluruh negara itu dilancarkan secara serentak pada 7 Januari lalu. Sempena perasmian secara besar-besaran, Perdana Menteri, Datuk Seri Najib Tun Razak telah berkunjung ke Klinik 1Malaysia di Kerinchi dan Lembah Subang sebagai simbolik bermulanya operasi klinik secara rasmi.

Ia diperkenalkan bagi memudahkan golongan kurang mampu yang ingin pergi ke hospital-hospital kerajaan, semata-mata mendapatkan rawatan sebagai pesakit luar.

Bagaimanapun, Klinik 1Malaysia hanya menyediakan rawatan untuk penyakit ringan seperti demam, selesema dan batuk. Selain itu, rawatan untuk sakit kepala, cirit-birit, jangkitan mata merah, gastrik, gatal-gatal, luka kecil dan sebagainya turut ditawarkan kepada orang ramai. 

Sulaiman yang tinggal di PPR Permai sebelum ini terpaksa berjalan jauh ke klinik untuk mendapat rawatan. Dalam keadaan fizikal yang semakin uzur, warga emas itu perlu meminta bantuan daripada sahabat handai atau jiran tetangga untuk membawanya ke klinik swasta mahupun hospital kerajaan yang terletak lebih setengah jam perjalanan dari Kerinchi. 

"Tempoh perjalanan sudah membuatkan saya rasa sangat penat. Sampai klinik, saya perlu jalan lagi untuk dapat rawatan pesakit luar. Saya sudah tua, tidak ada tenaga untuk berjalan, tetapi hendak buat macam mana, kena hadapi juga semua ini.

"Bagusnya kerajaan bina klinik baru ini. Kawan yang beritahu ada klinik untuk golongan sederhana seperti saya. Hati pun rasa senang dan gembira," demikian luah Sulaiman ketika ditemui Kosmo! baru-baru ini. 

KLINIK 1Malaysia di Kerinchi ini merupakan salah satu daripada 50 buah klinik yang dilancarkan secara serentak di seluruh negara pada 7 Januari ini.

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Dia berjalan perlahan-lahan sambil memegang erat tongkat kayunya menuju ke arah klinik yang bertempat di Kuarters Dewan Bandaraya Kuala Lumpur (DBKL) berhampiran (PPR) Permai. 

Pesara tentera yang telah menetap di PPR Permai sejak setahun lalu itu, datang ke klinik kerana masalah sakit sendi yang sudah berlarutan selama dua hari. Kawannya yang menyedari tentang kewujudan klinik itu terus membawa Sulaiman ke sana. Klinik 1 Malaysia Kerinchi dikendalikan oleh seorang Penolong Pegawai Perubatan (MA), dari Jabatan Kesihatan Wilayah Persekutuan Kuala Lumpur, jururawat terlatih dan pembantu rawatan kesihatan. 

Sebelum berjumpa dengan MA, pembantu rawatan kesihatan, Shazilah Hasan membuat pemeriksaan awal ke atas Sulaiman. Klinik kecil itu turut menyediakan pemeriksaan kesihatan seperti tekanan darah tinggi, paras gula dalam badan dan berat badan ideal. Pemeriksaan mendapati tekanan darah Sulaiman agak tinggi, mungkin kerana dia berjalan dalam cuaca panas dan dinasihatkan untuk rehat buat seketika. 

Setelah lebih kurang 15 minit berlalu, MA, Iszwan Cabrini Muhamad memanggil Sulaiman untuk membuat pemeriksaan kesihatan. Selepas selesai pemeriksaan, Shazilah tampil untuk memimpin Sulaiman keluar dari bilik pemeriksaan dan memberi ubat-ubatan yang sesuai kepadanya. 

Selepas ini dia tidak perlu risau untuk mencari klinik di tempat lain jika menghadapi kecemasan. Pada masa yang sama, dia tidak bimbang akan bayaran kerana kosnya jauh lebih murah berbanding klinik swasta. 

Sungguhpun murah, layanan dan rawatan boleh dipercayai sama seperti perkhidmatan yang disediakan di hospital atau klinik lain.

PEMBANTU Rawatan Kesihatan, Shazilah Hasan membuat pemeriksaan awal ke atas Sulaiman Awang.

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Klinik 1Malaysia yang beroperasi setiap hari dari pukul 10 pagi hingga 10 malam hanya mengenakan bayaran RM1 kepada pesakitnya.

Bagi pemegang kad Suruhanjaya Tinggi Bangsa-Bangsa Bersatu bagi Pelarian (UNHCR) akan dikenakan caj sebanyak RM7.50 dan warga asing pula perlu membayar RM15. 

Pengecualian diberi kepada kakitangan kerajaan yang membawa surat dari jabatan, pelajar sekolah, kolej dan universiti yang mempunyai surat pengecualian serta kanak-kanak berusia bawah setahun. 

Sebanyak 50 buah klinik yang dibuka terletak di seluruh negara. Lima buah di Pulau Pinang, Johor, Wilayah Persekutuan dan Selangor. Empat buah klinik di Perak, Sabah dan Sarawak. Tiga klinik sama pula beroperasi di Terengganu, Pahang, Melaka, Negeri Sembilan dan Kelantan. Selain dua buah di Kedah dan sebuah klinik di Perlis. Kerajaan telah membelanjakan kos sebanyak RM10 juta untuk membina semua klinik tersebut. 

Sementara itu, Thanaletchumy Sundaraj, 41, yang datang ke klinik itu mengakui pembukaan Klinik 1Malaysia berhampiran tempat tinggalnya memang memudahkan hidupnya. Dia yang menghidap penyakit lelah sering juga mengalami selesema dan batuk. Kalau keadaannya serius, hendak pergi ke klinik swasta bukan sahaja jauh, cajnya juga mahal. 

"Sejak dahulu lagi, saya sering terfikir akan kebaikan adanya kemudahan klinik seperti ini. Tidak disangka hasrat yang lama terpendam akhirnya menjadi kenyataan dengan pembukaan Klinik 1Malaysia di seluruh Malaysia. 

"Kami yang tinggal berhampiran bandar pun tetap berasa perit kerana sukar mendapatkan rawatan untuk masalah kesihatan biasa. Bagi mereka yang tinggal di luar bandar, nasib mereka mungkin lebih membimbangkan," jelas ibu kepada empat orang anak itu yang tinggal di PPR Permai sejak lapan tahun lalu.

PEMERIKSAAN dan rawatan di Klinik 1Malaysia jauh lebih murah berbanding klinik kesihatan dan swasta yang sedia ada.

---

Seorang lagi pengunjung yang dikenali sebagai Azlin Sari, 30, memberitahu dia datang dari Melaka untuk menziarah saudaranya di Kerinchi. Dia cukup tertarik dengan reka bentuk dan suasana klinik berkenaan. Walaupun ruang klinik terhad, tetapi ia masih dapat memenuhi keperluan orang ramai. 

"Penubuhan klinik seperti ini secara tidak langsung mampu meningkatkan kualiti kesihatan masyarakat setempat dan menyedarkan mereka tentang kepentingan penjagaan kesihatan. Ini kerana penyakit boleh menjangkiti kepada sesiapa tanpa mengira umur, pangkat, bangsa dan agama.

"Penyakit kecil-kecil seperti demam, batuk, selesema dan cirit-birit boleh mengundang kepada pelbagai penyakit kronik yang membahayakan nyawa seseorang," ujarnya yang bersetuju bahawa inisiatif kerajaan dalam menitikberatkan kebajikan golongan berpendapatan rendah dan sederhana adalah satu langkah positif dalam melaksanakan tanggungjawab sosial kepada rakyat jelata. 

Iszwan Cabrini Muhamad memberitahu, klinik itu dilengkapi dengan kemudahan asas rawatan. Misalnya, set memeriksa tekanan darah, troli kecemasan, sofa pemeriksaan, nebuliser dan ECG (mesin kardiogram elektro). Turut disediakan, risalah-risalah kesihatan untuk bacaan orang ramai.

Katanya, angka kunjungan orang ramai ke klinik di Kerinchi itu sudah pun mencecah kira-kira 100 orang setiap hari. Kadangkala, bilangan yang ramai membuatkan mereka terpaksa menunggu lama untuk mendapatkan rawatan. 

Ada juga pesakit yang mencadangkan supaya klinik itu menawarkan rawatan untuk penyakit kronik dan mewujudkan kemudahan ambulans jika berlaku kes-kes kecemasan. 

Selain merawat penyakit-penyakit tidak serius, dia juga perlu mematuhi Standard Operating Procedure (SOP) untuk merawat para pesakit. Pada masa yang sama, harus mendidik para pesakit mengenai kepentingan kesihatan untuk kesejahteraan hidup mereka. Dengan ini, orang ramai lebih peka terhadap kesihatan dan mengutamakan gaya hidup yang sihat.

Artikel Penuh: http://www.kosmo.com.my/kosmo/content.asp?y=2010&dt=0114&pub=Kosmo&sec=Urban&pg=ur_01.htm#ixzz2L8e8nJj5
Hakcipta terpelihara

200,000 Doses Of H1N1 Vaccine For High-Risk Groups From February

KUALA LUMPUR, Jan 12 (Bernama) -- Some 200,000 doses of Influenza A(H1N1) vaccine will be allocated for high-risk groups such as pregnant women, children, the elderly and people with chronic diseases beginning next month.

Health Minister Datuk Seri Liow Tiong Lai said they could get vaccinated with the vaccine for free at the government hospitals and clinics.

Speaking to reporters after visiting Tung Shin Hospital here today, Liow said the balance of 300,000 doses of H1N1 vaccine from the 400,000 ordered from Britain would be received at the end of this month.

"We will conduct (100,000) vaccinations on the frontline workers first, and then the high-risk groups like pregnant women, the obese, and those with high blood pressure and so on.

"They are our priority before the vaccine is distributed for other groups in preventing and curbing H1N1 infections," he said.

On the H1N1 situation in the country, Liow said it was under control, with the ministry abiding by the World Health Organisation's directive for continuous close monitoring of all cases of flu.

"We are worried if the H1N1 virus will mutate. But our monitoring have so far not shown that the virus has mutates into other forms."

He said the district health officers had also been instructed to obtain all flu samples for further tests.

On another matter, Liow said the ministry would work at enabling private doctors to serve as locums at government hospitals and clinics as soon as possible.

"They told me that they had applied to serve as locums but they never got invited. After our dialogue session with the Malaysian Medical Association last Friday, we will work together at improving health services in the country."

Asked whether the private doctors would want a higher payment as locums at the government hospitals, Liow said the current payment was reasonable at RM80 per hour.

Earlier, he handed over two mock cheques for RM2 million each to Tung Shin Hospital and the Chinese Maternity Hospital for the purchase of equipment and medicines.

Liow called for the setting up of more non-profit-based hospitals to enable the low-income group to seek treatment at such hospitals.

-- BERNAMA

Tualang Honey Has Potential To Be Used In Cancer Therapy - USM Study (BERNAMA)

KOTA BAHARU, Jan 11 (Bernama) -- Tualang honey, mostly found in lowland rain forests of Peninsular Malaysia, has the potential to become a supplement for cancer therapy, especially breast cancer, said Universiti Sains Malaysia (USM) Prof Madya Dr Nik Soriani Yaacob.

Dr Nik Soriani, USM Kubang Kerian Pathology Department's Head of Department, said initial research found honey from the Tualang trees had a very high potential to be used for proliferation of cancer cells and destroy 'bad' cells to prevent them from spreading.

"However, the research is still in the early stages and need a more in-depth study to determine honey can kill active cancer cells," said Dr Nik Soriani who presented a paper on the activities of Tualang Honey as an Anti-cancer supplement, at the 2nd International Conference on the Medicinal Use of Honey.

About 300 delegates attended the two-day seminar organised by the Federal Agricultural Marketing Authority (FAMA), to discuss the qualities and nutritional values of honey in the medicinal field and explore various ways of popularizing the product.

Dr Nik Soriani said the next step would be to study whether Tualang honey can kill active cancer cells or would be able to reduce the dosage of drugs and radiation used to kill cancer cells.

"The study is to identify whether honey can reduce or prevent cancer because earlier studies have shown honey had components like anti-oxidant, anti-inflammatory and anti-cancer," said Dr Nik Soriani.

She added that studies had also shown that Tualang honey had anti-cancer qualities and significant cytotoxic effect on cancer cells cultured in the lab.

"Cancer cells treated with Tualang honey went through a apoptosis process where cancer cells die, a process that normally does not happen, and Tualang honey can also expedite the effect of tamoxifen that is used to kill cancer cells," she said.

Meanwhile, USM Clinical Research Dean Prof Dr Nor Hayati Othman said FAMA had contributed 1.3 metric tones of honey for the research, especially for research on cancer.

Through research since 2006, Tualang honey has been identified as among the purest form of honey and probably better than some of the imported honey.

"Honey that is not in its purest form can cause side effects in the long run and must be avoided," said Dr Nor Hayati.

Tualang honey is extracted from honeycombs found atop Malaysia's tallest tree - Tualang tree - which grows to an astonishing height of more than 250m (about 30 storeys) and found in East Asian rainforests and is mostly found in Peninsular Malaysia, southern Thailand, northeastern Sumatra, Borneo and Palawan.

The towering tree is best known as home of the Apis dorsatas or Asian rock bees, the world's largest honeybees and the most ferocious, who build their disc-shaped honeycombs on horizontal branches of the tree and each tree can have more than 100 honeycombs.

Some honeycombs are two metres long and can contain as many as 30,000 bees.

They are said to prefer the Tualang tree because the branches start at least 30 metres above the ground and moreover, the trunk is slippery, making it hard for honey-loving sun bears to climb.

-- BERNAMA

1Malaysia Clinics No Threat To Private Clinics - Najib

January 07, 2010 14:37 PM

KUALA LUMPUR, Jan 7 (Bernama) -- Prime Minister Datuk Seri Najib Tun Razak said private doctors needed not worry that their earnings would be affected with the existence of 1Malaysia clinics.

He said this was because the 50 1Malaysia clinics set up nationwide would concentrate on giving patients normal medical examinations like checking blood pressure level for hypertension, and sugar level.

"Actually, they (private doctors) will not be affected because the cases from here (1Malaysia clinics) will be referred to them for further examination or treatment, or the patients will then go to the government hospitals.

"So, I do not regard this as a win-lose situation but actually a win-win situation...it's easy for the people while the private clinics will receive patients as usual," he told reporters after launching the Kerinchi 1Malaysia Clinic in Lembah Pantai here Thursday.

The prime minister was replying to a question on the concern voiced by the Malaysian Medical Association (MAA) over the existence of 1Malaysia clinics as they felt it could affect their income.

He said Health Minister Datuk Seri Liow Tiong Lai would hold a dialogue session with MMA members to assure them on the matter.

However, he stressed that 1Malaysia clinics were established solely for the benefit of the people.

"It is all for the interest of the rakyat who are our number one concern... this is what the government stands for," he said, adding that there were already 44 1Malaysia clinics in operation nationwide.

Najib said establishing the 44 clinics within two months was a record for the Health Ministry under the 2010 Budget, as the target of setting up 50 such clinics was almost met within such a short time.

On the proposal to increase the number of 1Malaysia clinics, he said the government would evaluate the need based on the public response and the effects of the new approach in expanding public health care.

"If the response and effects are good, the clinics will possibly be increased...but let us evaluate first as 50 (clinics) is a big number. And we also need to determine the effectiveness of these clinics and this new approach. From there, we can decide," he said.

Najib said most of the 1Malaysia clinics were located in town areas as outside urban areas were 2,000 rural clinics which had existed since the country's independence.

He said the government had allocated RM10 million for the 50 1Malaysia clinics this year, but the amount was not for the buildings but for the internal fittings and medicines only.

Earlier, Najib who is also Finance Minister, said the setting up of the clinics was truly in line with the 1Malaysia concept mooted by him, as they were open to all races, especially from the low-income group.

He said the effort was introduced and implemented by the government to ensure that quality health services in this country could be justly, equitably and wholly accessed by the people. "That's the government's aspiration," he added.

"And access to the service (from 1Malaysia clinics) definitely involves a minimum cost, that is, RM1...the cheapest in the world or can be regarded as almost free.

"Besides that, patients don't have to wait long as the 1Malaysia clinics will provide fast service. In this situation, the Health Ministry also benefits as the government hospitals will be less crowded with patients needing just basic treatment."

Najib said the 1Malaysia clinics would operate daily, seven days a week, from 10am to 10pm, and manned by paramedics comprising medical assistants and trained nurses.

-- BERNAMA

U.S. Swine Flu Response Hurt By Spending Cut

A public health nurse prepares a dose of H1N1 vaccine at the Balboa Park Community Center in Encino, California in this October 23, 2009 file photo. REUTERS/Mark Boster/Pool/Files

By JoAnne Allen

WASHINGTON, Dec 16 (Reuters) -- The U.S. response to the H1N1 pandemic has been as good as can be expected given the recession but cuts in public health spending exposed vulnerabilities, according to a report released on Tuesday.

Layoffs and spending cuts in the public health sector weakened U.S. efforts to battle the pandemic, which has killed an estimated 10,000 Americans, the nonprofit Trust For America's Health found.

"Trying to respond to the pandemic in the middle of the worst economic climate since the Great Depression has meant that we were asking public officials to do more with less and budgets and staff were stretched well beyond their limits," the group's deputy director Rich Hamburg told reporters.

More than half of states -- 27 -- cut public health funds from 2008 to 2009, while federal funds to prepare for pandemics have been cut by more than 25 percent since fiscal year 2005, the report found.

The Trust, which has repeatedly criticized U.S. preparedness for pandemics, recommended increased spending for public health and more funds to modernize flu vaccine production and for vaccine research and development.

Separately, the Government Accountability Office said the White House Homeland Security Council's pamdemic plan was out of date.

"It is incomplete and they need to update it and fill in some of the gaps," the GAO's Bernice Steinhardt, who wrote the report, said in a telephone interview.

"They need to take advantage of the fact that we actually are going through a pandemic and there obviously are lessons to be learned from the real-life experience."

The National Association of County and City Health Officials says that in the first half of 2009, local health departments cut about 8,000 jobs and cut hours for another 12,000 workers.

It said health reform legislation, currently being debated in Congress, presents an opportunity both to save jobs and protect the public's health.

VULNERABLE COUNTRY

"Coping with the widespread economic distress by cutting programs and readiness has really left the country vulnerable," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness.

Redlener said the public health system "got a lot of it right, but the system as a whole is struggling" in its response to the H1N1 outbreak.

Public communication about how the pandemic keeps changing needs improvement, Redlener said. And he said problems with the pace of H1N1 vaccine production fed anxiety because it did not meet the public's high expectations.

"The fact of the matter is that we didn't actually meet those expectations and that was very disconcerting. But once it was made available, the vaccine that is, it was rapidly and effectively distributed," he said.

The U.S. Centers for Disease Control and Prevention says swine flu has infected one in six people in the United States since arriving in April and killed nearly 10,000, including 1,100 children and 7,500 younger adults.

In a typical year, seasonal influenza kills 36,000 Americans and puts 200,000 into the hospital.

The CDC said on Tuesday that 94.6 million doses of the H1N1 vaccine had been made available for distribution so far, up from 73 million doses a week earlier.

© REUTERS 2009

--- BERNAMA

New Treatment Option In Coronary Artery Therapy (BERNAMA)

By Zulkiple Ibrahim

This is the second feature from a series of three on coronary artery disease

KUALA LUMPUR, Dec 14 (Bernama) -- In the treatment of coronary artery disease (CAD), the idea is to deliver growth inhibition drugs to the dilated stenosis site without implanting a stent.

According to Lam Chee Hong the managing director for B. Braun Medical Supplies Sdn Bhd, this approach resulted in the development of a new treatment option for vascular occlusion, the drug eluting balloon catheter - SeQuent�Please.

He said the drug eluting balloon (DEB) SeQuent�Please is a new therapeutic option for treating narrowing of the coronary arteries which has produced excellent results.

SEQUENT�PLEASE

Lam said this is the first and as yet only drug eluting balloon (DEB) with successful proof of efficacy in the treatment of narrowing of the coronary arteries.

SeQuent�Please is used in the same way as a coronary balloon catheter for balloon expansion of narrowed blood vessels (stenosis). Unlike conventional balloon catheters, SeQuent�Please also releases a drug from the balloon surface that is absorbed by the surrounding wall of the blood vessel.

B. Braun's Medical Industries Sdn Bhd manager for regional strategy planning (Asia Pacific), Pallraj Armugum, said the drug is paclitaxel, which has been studied extensively in clinical trials and is also used for drug eluting stents (DES).

To enhance transfer of the drug to the vessel wall, the paclitaxel in SeQuent�Please is embedded in an x-ray contrast medium matrix (iopromide). This technology delivers a sufficient dose of drug from the balloon surface to the vascular wall after a brief contact period of just a few seconds.

Paclitaxel inhibits the growth and spread of smooth muscle cells over a prolonged period and so prevents the expanded artery from closing in again due to cell growth.

The matrix is bioabsorbable and dissolves completely after use. No foreign bodies remain at the intervention site, thereby minimising the risk of thrombosis.

ADVANTAGES

According to Lam, SeQuent�Please is a new treatment option in coronary artery therapy with significant benefits.

Unlike stent implantation, no foreign bodies remain in the artery with the new system, he said.

The drug eluting balloon also reaches narrowed areas that would not be accessible for stent treatment, such as, for instance, very small blood vessels, bifurcations and very long areas of stenosis.

Lam said SeQuent�Please is associated with a significantly lower incidence of restenosis of expanded arterial segments. In addition, the required length of treatment with platelet inhibiting drugs (platelet aggregation inhibitors) is much shorter after the new procedure than after DES implantation.

With the latter, patients generally required treatment for as long as 12 months after the procedure. With SeQuent�Please, a treatment period of no longer than three months is sufficient. This is associated with significantly lower treatment costs.

SeQuent�Please thus has the potential to bring about a paradigm shift in the treatment of vascular restenosis, said Lam.

STUDY DATA

Lam said when coronary artery disease (CAD) is treated with an uncoated stent, the artery narrows again over time in as many as 30 per cent of cases, and this occurs at the stent implantation site.

In-stent restenosis, as it is called, can be expanded either with a balloon catheter or by the implantation of a second stent into the existing one. However, there is a high likelihood of recurrence of restenosis in both cases.

To establish whether a paclitaxel eluting balloon catheter reduces restenosis, in-stent restenosis in 52 patients was treated either with a novel drug eluting balloon (DEB) or with a conventional uncoated balloon.

Result: re-narrowing occurred within six months in only 5.0 per cent of DEB patients versus 43 per cent of patients treated with the conventional uncoated balloon.

He said another study showed that the drug eluting balloon is significantly superior to drug eluting coronary stents. Again, subjects in this clinical trial had in-stent restenosis.

In this study, however, one half of patients were treated with a paclitaxel eluting stent, while the other half underwent expansion with SeQuent�Please. At six months after the intervention, only 6.7 per cent of the SeQuent� Please patients versus 20.4 per cent of paclitaxel eluting stent recipients required re-intervention.

The positive study findings are already reflected in the guidelines of the German Society of Cardiology (DGK).Good results were also obtained for the use of SeQuent� Please to treat stenosis of small arteries, with restenosis rates of only 5.5 percent in patients treated with SeQuent� Please alone.

Considerably higher percentages have been observed in similar studies of drug eluting coronary stents in this therapeutic indication.

Further applications for SeQuent� Please are currently being investigated by B. Braun Melsungen AG in an extensive study programme.

-- BERNAMA