Howzit 29

2019 MAAM Convention

19 - 20 July 2019. Weil Hotel, Ipoh

Take Out Your Phone Now and
Enter These Dates Into Your Diary

Dr. Koh Kar Chai

Editor’s words

An event to look forward to. A few days for camaraderie, to reminisce on the good old days and to meet new Manipalites from all over Malaysia, and of course, to also collect CPD points for 2019/2020. We are looking at 8 CPD points for this event. Looking forward to a record breaking number this year.

The current committee members have been an active lot under the current leadership of Dr. Roshan, and I must say that the current alumni members have been very supportive of the association and participated in it’s many various activities. Keep it up and we will be among the most active alumni in the medical fraternity of Malaysia.

This edition of HOWZIT is special on account of the efforts made by many of our younger members in contributing articles and we have made an effort to ensure that each and every contribution gets published. We do hope for this continuing trend when the call goes out for articles towards the next issue of HOWZIT. Be it an academic article, something on current lifestyle or just penning down your thoughts (nothing overtly cheeky which may bring on embarrassment nor controversial issues with the potential of fistfights please), every member is welcome to contribute to HOWZIT.

On a sidenote, we do have many Manipalites endeavouring either in their medical practice, other NGOs, in politics etc. Do support them if you know that they are capable in what they are striving for. That is what the alumni is for, support for our fellow Manipalites. The alumni is only as strong as the collective participation of it’s members, so do partake of our activities in whatever small way you can.

A note of thanks goes out to the contributors and members of the Editorial

Editorial Committee:
Dr. Gayathri K. Kumarasuriar, Dr. Keerthana Murali Tharan, Dr. Khairina Adliah Kamal Ariffin, Dr.Tharishini Chandra Segaran, Dr. Venothini Rajamuniandy
Dr. Koh Kar Chai
Editor, HOWZIT

Message from Dr JOHN EMMANUEL

Organizing Chairman MAAM Convention 2019

When I was first asked to organize the 34th Manipal Alumni convention, I was rather terrified. I have had experiences of organizing events, but not one with such magnitude and prestige, truth be told I felt a little out of my league. However, with the Secretary being relentless in asking and buoyed by the blend of experience and youth present within the current committee, I accepted.

We are currently a little more than 3 months away from 2 exciting days that have been specially laid out for delegates of this convention. Passion has always been the forte of all Manipalites, that innate desire to host events with a bang and blow it out of the water. I attended the last two Alumni dinners and truth be told I was excited to meet many old buddies, a great catch up of sorts. However, the dinner proved too short a period to actually truly catch up. The last couple of years have witnessed a flurry of activities within the alumni setup. We have witnessed spikes in membership registrations with the membership drive, collaborations with our brother organizations of the Manipal group, CPDs, charity events including the Manipal Run.

The initial planning of this convention revolved around our objective – deliver two days of excitement coupled with learning while keeping costs at a bare minimum. It was imperative that the venue be ideal to allow delegates to converge from all over Malaysia, and what better place than Ipoh itself. A city right in the heart of Malaysia, with a unique blend of its rich history and culture beautifully embracing the pace of modern development. In many ways, this concept seems to exemplify the Manipal Alumni, where the old and the new come together.

The primary venue of the convention will be Weil Hotel, Ipoh. This modern hotel is situated within the main hub of activity of the city centre and is adjacent to Ipoh Parade. All convention activities will be focused within these two blocks. Its ideal location within the heart of the city offers easy access to all tourist sites. Delegates who are driving down to Ipoh could find destinations easily using navigation apps. Grab would be an ideal alternative to travel around Ipoh.

History and cultures buffs would find Ipoh a seeker’s paradise. Places of interest to visit would include The Time Tunnel Museum, Ho Yan Hor Museum and Ipoh World. In addition, there are numerous sacred and religious sites including the Ipoh State Mosque, Kek Long Tong Limestone Cave Temple, Kallumalai Arulmigu Subramaniyar Temple and Sam Poh Tong Temple. Nature lovers would find the sights at DR Seenivasagam Recreational Park, Taman Rekreasi Gunung Lang and the cave paintings at Gua Tambun simply mesmerising.

Ipoh is known as a food haven and offers an array of mouth-watering culinary delights from its diverse cultures. It would be a travesty to highlight few selected venues in this article as I believe they each exemplify the term “heaven within a meal”. While you are in Ipoh, do not forget to sample their rojak, cendol, dim sum, bean sprout chicken, kuey teow, soya bean and their ever-flaming Nasi Ganja.

The convention proper would be held over two days, beginning on Friday the 19th of July. Reservation of rooms at Weil Hotel could be done via online booking sites or directly with the reservation team at the hotel. Exciting family themed activities have been lined up from the time the delegates check in at the hotel. The afternoon would include bowling and laser tag at the adjacent Ipoh Parade. In addition, a Children’s Games Fantasia have been arranged to allow children of delegates to join in the fun. Delegates would then proceed to a “Free & Easy” informal night cum BBQ session which will be held at The Deck situated at the rooftop of Weil Hotel. The Deck encompasses the infinity pool, a lawn area and a club house – the entire place exclusively open to delegates of the MAAM convention for the night. It would be the ideal avenue to catch up with friends in a laid back fashion while enjoying good food and music while taking in a phenomenal aerial view of Ipoh. It is promising to be a mega replica of the rooftop parties that are unique to Manipalites.

An exciting comprehensive medical and surgical symposium has ben arranged to take place on Saturday, the 20th of July. This unique two-track symposium would feature lectures involving sub-specialities within the medical and surgical field. Experts who are leaders within their field, both from government and private institutions have been engaged to deliver talks on a fairly comprehensive symposium. In addition, there will be a lunch talk entitled “Everything You Need To Know About Medical Professional Indemnity” by JA Insurers. Government regulations dictate all medical practitioners require medical indemnity insurance before being granted their APCs for the year 2021. This lunch talk and subsequent Q&A session has been specifically arranged to offer a platform for delegates to air their views and queries and seek out differences and advantages offered by the various indemnity providers in the market. The MAAM AGM would take place after the symposium and is open to all members of the association. Spouses of delegates are welcome to join the Ipoh Day Tour & Food Galore which will include sight seeing around Ipoh and a food trail.

The highlight of Saturday evening would be the gala night “Casino Royale”. A night filled with glitz, glamour and the works has been laid out to include great food and beverages, top-notch performances, lucky draws and a dance floor. The children will not be left out either, a children’s party is scheduled concurrently to allow them to have their own brand of fun. A perfect opportunity for delegates to don the finest dresses and suits and party the night away.

 This entire two-day convention package would cost delegates an affordable RM 370 (early bird registration before 31st May 2019). Two exciting days to include family themed activities, an informal night, a two-track medical & surgical symposium, a gala night and activities for the family. The convention would be the perfect opportunity to get away from the daily grind and serve as an ideal retreat or reunion for your entire batch. Let’s make this opportunity count. See you there.

President’s Message

Your President,
ROSHAN

As the new President of the Alumni, I have my job cut out for me. Having been active in the alumni since 2009 and being guided by 4 past presidents, I have a lot to live up to.

Just a recap for the benefit all our new readers, the Alumni was established in 1986 by our founder President Dr.V.Surendranathan. Since its inception the Alumni has grown steadily. Every President doing the best during his term and the next building on the previous success.

The Alumni is for all Manipalites, anyone who studied in Manipal or Mangalore either in Kasturba Medical College, College of Dental Science, College of Pharmacy and Manipal Institute of Technology could become members. As the years passed the Alumni and its members steadily grew. In 1997, the Melaka Manipal Medical College was incepted. We have a large number of doctors graduating from MMMC now and they have also been supporting the Alumni. In college we always referred to each other as seniors and juniors but in the Manipal Alumni family everyone is another brother or a sister. Our family is steadily growing. Like all families we may have our ups and downs. The difference in the Alumni family is, in our up moments, we enjoy together and in our down moments we support each other.

I have been blessed with a wonderful committee, a good mix of dedicated and hardworking members. We have been able to achieve a lot in a short time because of this commitment.

We had the 2nd Manipal Run in MIU in October 2018, 2nd Ultrasound Workshop at Armada Hotel in March 2019, MAAM Golf Tour in April 2019, our regular monthly Football at RRI, our regular monthly Sportivo and many more that have been done and are in the pipeline.

What I am most excited about is the 34th MAAM Convention and AGM from 19th July to 21st July. It starts on a Friday afternoon at 3pm and check out is on Sunday at 12pm. The Convention will be at the Weil Hotel in Ipoh this year. Our Organising Chairman Dr John has lined up a wonderful 3 day 2 nights for the members and their family, full of camaraderie, education, fun and games.

The next interesting project that the Alumni has been focusing on is the Medical Indemnity Insurance. As you all know by now the Ministry of Health has made Medical Indemnity compulsory for the 2021 APC renewal.

The Alumni has tied up with JA Assure Sdn Bhd, a Singapore based broker with CHUBB Malaysia as the Underwriters. The committee has spent many hours with many meetings to get the best Medical Indemnity cover for all our members. I hope that all our members will take advantage of this opportunity and indemnify yourselves. If the response is good we will work on getting better rates for all our members for the following years. Please visit our website and use the special link created for a discounted rate. Alternatively you c a n g o t o t h i s l i n k d i r e c t l y https://medicalmalquote.ja.insure/promo/manipal

The Alumni has also been working on the MAAM Membership card. We sent out the first round of cards but had some logistic hiccups. We then decided to get one of our own committee member to help us with the database. I must say, Dr Krishila Basil our Dental rep in the exco, did a painstaking but wonderful job on our database. We are now in the process of getting the cards reprinted and should be posting them out to the members soon. If any of the members missed or deleted the Whatsapp message sent to you, please contact Dr Krishila to update your details at +60 18-370 0217

The Alumni has also been working on a number of membership benefits for the members.

You can log on to our website @ www.manipal.org.my for more information on this. Once we get the membership cards out to the members, we will work on getting more benefits for the members.

I hope all our MAAM brothers and sisters, young and old, can join us in Ipoh on the 19th & 20th of July, 2019 for our 34th Convention and AGM.

just do you

BY - Ruthra Devan Nair

“Be who you are and say what you want
because those who matter don’t mind and those
who mind don’t matter”

by Dr. Seuss.

Most of us have a quote that we follow or try to live up to and this is mine. Not all of us can say we have never wanted to be another person. At least I have for a couple of times. But here’s the thing, I am no robot to not have feelings or admirations. So, I assume it is fine for me to feel such at times. However, when I finally stop being in awe of someone else’s life, I realize mine is nothing less.

As an example, I have admired models for so long. Yes, you got it right. Models. They are portrayed to have the perfect everything; be it shoes, glamorous clothes and hair. They seemed like real life Barbie dolls and it is no shame for me to say that I wanted to be one as it was common among teenage girls. But, I felt more of the contrary when I compared their likings to mine. Well, comparing the food and clothes part was just enough for me to not want to be like them. Models can’t just dive into a big bowl of ice cream sundae, or even a slice of rich, buttery and moist chocolate cake as often as I could for the fat content these food render. Imagine saying no to a chocolate cake? Could you? I most definitely can’t. Also, as much as they have the pleasure of wearing high end clothes, models spend most of their time walking on 6’ inch heels which I bet would leave their feet soar by the end of the day. I could escape the pain simply by slipping into a pair of cozy sneakers to walk all day. To be honest it is also because of the fact that if I can trip on a flat shoe then I bet I will end up with lots more bruises from wearing heels. I told myself that I wasn’t capable of living such a lifestyle and the admiration ended.

Only then I gathered, no one has a perfect life; even if it seemed seamless. There is always something we lose. We are all humans who can’t evade imperfections. Some of us try to change ourselves just to fit in within a community or merely a group of friends. But, what we should actually do is to be ourselves for we are who we are. Those who really care would acknowledge our presence and accept us as we are. If they don’t, they might just be the ones we don’t have to give a second thought about. The most important thing is to know that the person we are and the life we have is enough. Little do we know, many others are wishing to have what we have just as we are wishing that of the others. This habit is quite tricky to master but, nothing is impossible. So the next time you admire someone and wish to have what they have, remind yourself to just be you and that should be plenty.

Judging
HOW WHAT YOU THINK IS NOT WHAT IT IS

By: Suraj Ashwath Rajiv

Judging. It is defined as the act of looking down upon someone; to regard with contempt or disdain; to regard as an inferior by Urban Dictionary.

Most of us are familiar with the term ‘don’t judge a book by its cover’, but sadly the people of today brush this aside, thinking it is irrelevant. Ironically, the same people who would not want to be judged , are more than happy to do the same to others.

‘To err is human, to forgive is divine.’ A meaningful saying by Alexander Pope echoes through the valley of time. No human being is born perfect, and the imperfections are what makes us, us. When we see an unsmiling person, we cannot just assume that the person is grumpy or serious all the time. There could be something troubling his or her thoughts. Sometimes, we see people that laugh too much. It is fallacious to surmise that these people are weird for laughing at trivial things. It may be a way for them to mask the overwhelming distress or sadness within by fabricating a smile.

We, as human beings, must understand people’s emotions and forgive them. Sometimes, challenges and difficulties are thrust upon them; and the seemingly odd things that they do, could be their way of giving themselves a shred of happiness. Naturally, human beings are inclined to be judgmental, but there should be limitations as well. We need to be sympathetic with others’ plight. Not everybody have the strength to express what they truly feel, as the world is a cruel place. They may assume that no one would care about how they feel, so they bottle up their emotions inside.

I hope that the community will be more open-minded and are conscious of their surroundings. We do not live in an idealistic world where everything are sunshine and rainbows, but rather in a realistic world full of rain and thunderstorms. Being judgmental is an issue not to be taken lightly, as feelings of those being judged will be hurt . This in turn will negatively affect them in various ways. Let us all strive to live in a world where emotions and assumptions do not get the better of us.

Housemanship Kit 2019

By Premkumar a/l ravichandran B35

In February 2017, it was revealed that of the 10,000 housemen in Malaysia, 2000 doctors had difficulties in completing their training and had to extend their housemanship period. The year before, 1.2% of housemen were terminated or had to quit. Some even went missing for up to 400 days without notice. The then Health Minister, Datuk Seri Dr. S. Subramaniam, confirmed that 20% to 30% of 5000 housemen opt to extend their housemanship every year with stress being the main reason contributing to this statistic. Is the arduous work demand intentionally set to fail these junior doctors? Or are our doctors just simply not resilient enough?

To address this issue, for the first time ever, Student Council of Melaka Manipal Medical College (MMMC) 17/18, in collaboration with Manipal Alumni Association Malaysia (MAAM) and Asian Medical Student Association (AMSA) MMMC, had organised Housemanship Kit 2018. The objectives of having this event were to provide a platform for MMMC alumni to share their experience with current MMMC medical students and to identify the issues faced by doctors when going through their housemanship.

This event was held on 2nd June 2018, Saturday, at the Sports Complex at Melaka Campus. The event started off with a dialogue session with Dr Mitesh Chandrakant, Senior Principal Assistant Director of Health Of Melaka Health Department, regarding the current housemanship system in Malaysia and the situation faced by housemen in the hospital.

Following the dialogue was a talk by Professor Dr. Aizura Syafinaz Binti Ahmad Adlan, Associate Professor and Organising Committee Member of the Pre-Housemanship Programme (PreHop), University Malaya. She spoke about PreHoP, which is a programme similar to the current shadow housemanship period that MMMC has implanted for a few batches now.

The next few sessions were sessions with MAAM. It started with an introduction to MAAM and success  stories of MMMC Alumni by Dr. Sivasuthan Letchumanan, the Secretary of MAAM, followed by forum session moderated by Ms. Tharishini from Batch 33 with the speakers from MAAM.

The forum session entitled ‘How Can We Do Better’, featured five MBBS graduates of MMMC. They were Dr. Vikneswaran Vaithylingam (Batch 9), Dr. Azliana Liza Binti Borhan ( Batch 12), Dr. Venothini Raajamujandy (Batch 19) , Dr. Shakilone Tharmaseelan ( Batch 27) and Dr. Nandhineey (Batch 29). Various issues were touched upon by the panellists, ranging from the difficulties faced by these doctors when they started working up to their working life.

After the lunch break, students were separated into smaller groups for the ‘Table Talk with MAAM” session where they can ask more questions and interact closely with panellists. Overall, the event went well. Feedbacks from students were very encouraging, with most of them requesting for this to be an annual event as it benefited those who attended. In a nutshell, students who are about to embark on their journey of the working life should never give up easily. It takes passion, initiative and maintaining a good attitude to remain on the path. There are no such things as a magic lamp and a genie to grant our wishes, but rather our own skills and goodwill that will make us the good doctors that we aspire to be.

FEMTO-LASER ASSISTED CATARACT SURGERY
A Yes or No?

By Chu Hui Xin

Cataract surgery has been one of the oldest and commonest surgeries performed worldwide, to remove clouded crystalline lens formed due to ageing and various other factors.1 It has evolved from couching, to ECCE (extracapsular cataract extraction), then to ICCE (intracapsular cataract extraction), and then again back to ECCE as ICCE is associated with high risk of sight-threatening complications. The major advancement in cataract surgery over the past century was the invention of phacoemulsification in 1967 by Sir Charles Kelman. This, coupling with the introduction of foldable intraocular lens, the entire cataract surgery industry was revolutionized: Minimally invasive surgery (manual small incision cataract surgery, MSICS) was introduced, where the corneal incision can be as small as 3mm, obviating the need of suturing for cataract surgery.

The next cornerstone in cataract surgery was the introduction of femto-laser into cataract surgery in 2008. Since then, femto-laser assisted cataract surgery (FLACS) has been gaining popularity all over the globe. By incorporating an anterior segment OCT (optical coherence tomography) together with the laser machine, FLACS creates accurate, reproducible corneal incision, capsulorrhexis, and fragmentation of the brunescent cataract.2 It has also been suggested that FLACS can be used to prevent “after cataract” as it can be used for primary posterior capsulotomy3, which means, the patient can enjoy clear vision in one go, without the hassle of going through the pain of clouded vision and another uncomfortable dilation process for YAG posterior capsulotomy in later years. FLACS also reduces the amount of ultrasound energy and time of phacoemulsification, which reduces the risks of cystoid macular edema, corneal dystrophy and damages to the other structures of the eyes.3 Thus, patients can potentially enjoy clear vision immediately after the operation. For patients with high demands for their visions, femto-laser can be used to make precise markings and capsulotomy for toric lenses and multifocal lenses. This, coupling with the limbal-relaxing incisions, can potentially offer clear visions without glasses for presbyopic patients and patients with high astigmatism.

That said, in experienced hands, the visual and refractive outcomes of MSICS are equally good compared to FLACS, especially in uncomplicated cases. In fact, conventional manual cataract surgery remains as the gold standard of cataract surgery. One of the main drawbacks of FLACS is its costs. Not all private eye specialist centres in Malaysia have introduced FLACS in their practice, mostly because of the cost of the laser machine and the strict temperature and humidity requirements for the maintenance of the machine. However, for insured patients, most insurance companies in Malaysia do cover the cost for laser cataract surgery. Besides that, FLACS also has a certain selection criteria. It is contraindicated in eyes with conditions which can potentially interfere with the full penetration of the laser energy, i.e. corneal scars/abnormalities, deep- seated eyes, prominent nose, prominent eyebrows, pronounced kyphosis, obese patients, eyes with glaucoma.

In short words, although most studies debate that the visual and refractive outcomes of FLACS and conventional MSICS are not statistically significant, FLACS is a better option for patients with dense cataract, multifocal lens, toric lenses, astigmatism, paediatric patients, and challenging cases3,4, as it reduces surgery time, (hence reduces the risks of thermal injury to the surrounding structures) and eases the surgery process for the surgeon.

EXERGAMING FOR E-SPORT
Moving Forward with Serious Games

Dr. Maziah Mat Rosly,
Medical Lecturer (MBBS, PhD)
Department of Physiology,
Faculty of Medicine,
University of Malaya.

A hybrid of virtual reality (VR)-based sports and an exercise game is termed exergaming, referring to active bodily movements required for in-game control typically featured in sports-like video gaming. The use of virtual or augmented reality in gaming carry potential to bridge the gap between barriers to exercise and the level of participation and adherence. Current advancements in technology point to elements within VR exercise training that can help in promoting enjoyment, motivation, engagement, distracting pain and providing transferable skill acquisition. However, the prospect of e-sports games have failed to capture the fundamental aspects of what VR-based e-sports should truly be. In 2018, the 2019 SEA Games expected in Philippines have introduced five medal categories for e-sports events, Dota 2, Starcraft 2, Tekken 7, Mobile Legends: Bang Bang, and Arena of Valor. Sadly, the introduction of this category of e-sports have missed the mark. It has neither introduced a VR-counterpart of conventional sport acyiviyies such as Squash or Tennis nor has it required the current selecyion of e-sports yitles to produce any major active bodily movements that matches a true sport athlete. Thus, the notion goes, should these e-sports players be considered as athletes by their own right?

The introducyion of VR-based exergaming is only slowly gaining attention at various levels of organisations and communities. There is a growing body of work addressing health benefits of VR exercise training; where the users/players will also perform some level of physical exertion to play e-sports exergaming. This new form of exercise intervention can now be used to address different persistent and emerging health issues related to a sedentary lifestyle. Significant progress can be made in helping to improve the quality of life and health among different groups of sedentary populations, including those with physical disabilities, as well as marginalised women. This is where e-sports exergaming has shown potential, where it can make momentous strides towards lifting vulnerable populations out of social deprivation related to sports participation.

How so? Future directions of VR-based sports now point toward providing platforms for exercisers to train and enhance their skills indoors, with lesser incidence of injury when factors such as weather, space or ability become an issue. This need is what creates potential for continued usability and significant outcomes in VR training. Predominant wheelchair users in particular, can participate in wheelchair-adapted exergaming that has demonstrated better enjoyment than the conventional sports counterpart. Several architectural exergaming designs can also be adapted to fit specific requirements for individuals with special needs. For instance, systems can be designed to convert low-frequency sounds into vibrations that can be felt throughout the body, allowing even those with visual limitations, to interact with the VR e-sports environment.  

In November 2018, the youngest government minister of Malaysia, Syed Saddiq, passionately defended the use of VR technology in sports by promoting the introduction of e-sports as a beneficial pursuit for society’s progress and can unite Malaysians. Quoted as saying, “Usually things that lead to the greatest of benetits will come with strong resistance in the beginning”, the three-time Asia Bri_ish Parliamentary Debate champion assured the crowd at a press conference, that scep_icism and critics were part and parcel of any progress. Syed Saddiq was also known as the “Minister of Gamers”, as he has lobbied for the government to inject RM10 million into the development of e-sports in Malaysia and asked corporations to respond in kind. The future of e-sports exergaming must target the three major goals in clinical and health science; good health and well-being, industry innova_ion and infrastructure, as well as reduced inequality. These goals align with the sustainable development goals promoted and spearheaded by the United Nation’s Vision 2030. VR-based exergaming allow for fair knowledge distribution, enhanced via a digital network environment among individuals who face large disparities in sports participation. Exergaming can also promote comprehensive opportunities such as athletic employment, exercise training and improved physical activity levels for all Malaysian individuals.

33rd MAAM AGM & GALA DINNER

4th AUgust 2018, Holiday Villa, Subang

Manipal Alumni Association Malaysia 33rd AGM & Dinner was held on 4th August 2018 at Holiday Villa Subang. The Annual General Meeting was preceeded by a CPD from 2.30pm to 4.00pm. We had Dato Dr. Ganesanathan Shanmuganathan & Dr. Vijayavel Vadiveloo doing the talks on gastroenterology and obstetrics & gynaecology. We had 40 people attending the CPD.

The AGM commenced at 4.30pm with the welcome speech by President Dr. Arun Kumar followed by the annual secretary report by Dr. Sivasuthan and the annual financial report by Dr. Kewaljit Singh. This was followed by the election of new office bearers of MAAM for the term 2018-2020.

The gala dinner kicked off informally as early as 6.00pm and the official proceedings started at 7.30pm with the opening video and the speech by the incoming president Dr. Roshan.This was followed by a sumptuos buffet dinner and band,dance & dj entertainment through out the night.While the parents were enjoying,the kids were treated to a childrens’ party of games and movie.There was also a special moment to honor our alumni Dr.Amar Pritpal Singh who was elected as a state assemblyman in the recent 14th General Elections.Around 300 people attended the gala dinner.We also thank CVSKL and Active Scientific Sdn Bhd very much for being our partners during the event.

Below is the newly elected exco :

 

  • President :
  • Sivaroshan Puvaneswaran
  • Vice President :
  • Kewaljit Singh
  • Secretary :
  • Sivasuthan Letchumanan
  • Assistant Secretary :
  • Koh Kar Chai
  • Treasurer :
  • Venothini Rajamuniandy
  • Exco members :
  • Arun Kumar
  • Ramon Varughese
  • John Emmanuel
  • Nagappan Ganason
  • Krishila Basil

MAAM Sportivo POOL

Dr.Rubenandran Ramachandran / Dr.Vickneswaran Werasingam
MAAM Pool Captains

MAAM Sportivo Pool / Billiards was started in January 2016 as a bi-monnthly event. This get together over a game of pool basically serves as a catch up session among the Manipalites. The homeground of our pool team is Interlude Tapas & Bar, Taman Tun Dr. Ismail, Kuala Lumpur.

2nd MAAM Abdominal Ultrasound Workshop

Dr. Sivasuthan Letchumanan
MAAM Secretary

Manipal Alumni Association Malaysia had successfully organised its 2nd ultrasound workshop on 10th March 2019 at Hotel Armada, Petaling Jaya. The first workshop was held in 2018 at Manipal Hospital, Klang.

The response was overwhelming as 48 participants attended the workshop, way beyond the target of 35 participants. Participants from as far as Sabah, Perlis, Kedah & Johor were present. The workshop was divided into 2 main sessions which was a lecture session in the morning and a hands-on session in the afternoon. Topics covered were from the hepatobiliary and urinary system and CPD points were awarded to the participants.

The organising chairman of the workshop was Dr. Apsara Panicker and the esteemed speakers were Dr. Sivakumar Karupayah, Dr. Laxmanshri Jaya, Dr. Alan Basil Peter, Dr. Chitra Supuramaniam and Dr. Farah Naz. Dr. Nagappan Ganason was the person in charge on behalf of the alumni ExCo. Overall, participants expressed satisfaction with the lectures and hands-on session.

This workshop would not have been possible without the provision of ultrasound machines for the hands-on session by Active Scientific Sdn Bhd for the 2nd year in a row. Due to the success of the previous two workshops, this collaboration is set to continue for the 3rd time soon and we look forward to cater to more participants in the future.

MAAM Sportivo Football

MAAM Sportivo started as a bi-monthly futsal event in January 2016 . From year 2017 onwards, we decided to have football instead of futsal. It is really great that we are into our 4th year now. This football team managed to bring together many Manipalites of various batches. To date, we have around 25 active players in the team. The matches are normally held around Klang Valley namely RRI Field Sg.Buloh our so-called “homeground”.

Our team has been gelling and progressing very well . We aim to steer to greater heights by competing in matches outside the Klang Valley and also by participating in local social leagues. The support from fellow Manipalites are of utmost importance as we try to achieve our goals. A big thank you to the Melaka Manipal Medical College (MMMC) and Manipal International University (MIU) students who are integral parts of our team. And we express our gratitude to the MAAM Executive Council (ExCo) who have been very supportive of this team from the very start.

Following are the results so far :

 

  • February 2017: vs Hangover FC : Drew 3-3
  • April 2017: vs Pasung FC : Lost 1-3
  • June 2017: vs Prime FC B : Won 3-1
  • August 2017: vs Pan Global FC : Lost 0-1
  • December 2017: vs Mines Veterans : Won 3-1
  • January 2018: vs UUM Old Boys : Won 5-3
  • March 2018: vs Majlis Daerah KKB: Won 2-0
  • June 2018: vs Port Klang Rangers : Won 3-2
  • August 2018: vs Arjuna FC : Lost 1-2
  • November 2018: vs Kilat 50s : Drew 1-1
  • January 2019: vs Spirit Terminal 3 Subang : Won 3-0
  • March 2019: vs Damansara Veterans : Won 5-1

Manipal Playoffs 2018

Dr. Sivasuthan Letchumanan
MAAM Secretary

The MAAM Sports carnival which was held in 2016 & 2017 was rebranded as Manipal Playoffs for its 3rd edition on 1st & 2nd December 2018. This is also the first time it is a stand alone event after being held together with the gala dinner during the previous years. The event was held at UNITEN Kajang, Sports Garage Futsal PJ & Ubowl Dpulze Cyberjaya over a period of 2 days. There were six teams that took part ; MAAM, Melaka Manipal Medical College, Manipal International University, cUcMS, Jengkings and the Bar council. Dr.Ramon Varughese was the organising chairman for this playoffs.

Around 200 people from 4 teams took part in the event and it gives us great pleasure to say that it was indeed a great success. This event has been ongoing for the 3rd year in a row and the competition is getting tougher each year. Therefore, the alumni is planning to make this event more challenging yet fun for the 2019 edition with the introduction of prize money for winners.

Following are the results of the event :

  • Mens basketball :
  • Bar council (champions) MAAM (runners-up)
  • Womens basketball :
  • Bar council (champions) MAAM (runners-up)
  • Badminton :
  • Bar council (champions) MMMc (runners-up)
  • Table tennis :
  • Bar council (champions) MMMc (runners-up)
  • Sepak takraw :
  • MAAM (champions) MMMc (runners-up)
  • Bowling :
  • MMMc (champions) MAAM (runners-up)
  • Mens futsal :
  • MIU (champions) MMMc (runners-up)
  • Womens futsal :
  • Bar council (champions) MMMc (runners-up)

MMMC TIGERS

Pranava Singham
President, MMMC Tigers

It was not more than a year ago, a vision beyond what we thought could ever happen. It was just mere words of a fantasy, but later on, those words eventually became a reality. It was like young boys dreaming big together about their ambitions, only for us to say now, dreaming big is not for any age category. It was just as simple as playing football together during our free evenings, forfeiting the hours of sleep deprivation, in exchange for the beautiful game, and because of this, we eventually formed a network that will connect us all for our lifetime.

Being away from home, was not a difficult matter, as we were all together because of football. The true beauty of this team, is how we have integrated all the players, from different courses, from different batches, of different ages, all together to become a team, a brotherhood, a family. We are always in support for one another, ensuring all players succeed well in their vocation. We live strong by our motto, that we all sing in pride ‘’One Team One Family’’.

There is only one rule in this club, and that is ‘’Prioritise your studies first’’. Only during one’s free time, and availability, is one encouraged to join during friendly matches and tournaments. The true beauty is that, the club is privileged to have student athletes as its members, as all our players have championed themselves very well in both their first passions, medicine or dentistry and football.

We are blessed to have a team, that not only motivates each other, but also to motivate young aspiring teens from schools, to dare to dream, and to dream is to do. Our services for the team, is services to the community as well, which is to educate and inspire, and at the same time, to be a good example.

Throughout our journey thus far, and since our branding in 2018, it has been a real success for all of us and the club. We play weekly friendly matches with teams from social leagues, universities, colleges, and even schools. We have made friends, and gained a lot of experience together as a team. We have started our own brand, by printing jerseys, training kits, tracksuits, and other accessories, in which every player, can be proud of themselves as they are part of a team. Not many of our players have had the privilege of representing their schools during their adolescents, nor played for clubs and other teams. Some have never played football before studying medicine in India. With this club, all players have had the opportunity to experience football at both a social and competitive level, locally and interstate. It will always be a sweet memory and a story in which they can carry with them throughout their life, to have been part of a team, and a brotherhood.

After we graduate, this team will not graduate with us, but it will continue to connect students in the college, year after year. This club was what united us, made us make new friends, build stronger together as a team, create memories and experience and grow as a brotherhood year by year. We will always be connected via club, we will always be a lifetime brotherhood, we will always call ourselves, MMMC Tigers!

Manipal Run 2 0 1 8

Dr. Sivasuthan Letchumanan
MAAM Secretary

The Manipal Run 2018 was held for the second successive year on 7th October 2018. The theme of the run was “Every step we take for autism counts!” and the run was to raise funds for the National Autism Society of Malaysia (NASOM). The run was held at Manipal International University (MIU) Nilai. This was also the 2nd year in a row that MAAM is collaborating with NASOM for the run.

The run had two categories mainly which was the 3km fun run and the 10km competitive run. Around 600 runners took part in the run which was officiated by Prof Dato Dr. S. Shamala who is the Deputy President of Malaysian Hockey Federation and the Vice President of Olympic council Malaysia. Together with her were other VIPs from Manipal International University and Melaka Manipal Medical college.

The event started as early as 7.00am in the morning with the flag off for the 10km run followed by the 3km run. All finishers of the run were presented with a medal and certificate. Winners of the 10km run were presented with trophies and prize money. There was also a lucky draw at the end of the event and various booths were set up offering services to the participants most notably MILO who brought their truck to sponsor the drinks.

The main sponsors of the event were Manipal International University, Melaka Manipal Medical college, Green Target Group, Bangle Publika and Manipal Hospital Klang. Other sponsors were Interlude TTDI, USG Boral, Stream Environment and Milo. At the end of the event RM5000 was raised and presented to Ms. Feilina Feisol the chairman of NASOM. The fund was a sponsorship for NASOM kids to take part in the ASEAN Autism Games in Jakarta.

Overall the event was a succcess even though the numbers dropped slightly compared to the first run but the objectives were met and MAAM was very pleased with the support given by its members and the public for its CSR project. Also a special mention to the student volunteers of Manipal International University headed by Mr. Thanesh Delcosta and student volunteers of Melaka Manipal Medical college headed by Mr. Prem Kumar. The student volunteers were basically the main pillars in making the event a success. Dr. Nyanakalaiwani was the organising chairman of this Manipal Run 2018.

Respect Thyself

Gayathri K. Kumarasuriar
Batch 88, K.M.C Manipal

Men of Perverse Opinion Do Not Know The Excellence Of What Is In Their Hands, Till Someone Dash It From Them- Sophocles.The art of respecting each other has gone through an evolutionary process just like any other skill involving the human. This evolution can be seen in parenting, among peers, between races, religions and so on. Evolution per se may not necessarily be a good thing. There is a general lack of tolerance that is attached to this specific evolution. I may be wrong and stand to be corrected.

R…E…S…P…E…C…T Take a moment and reflect within. What does this word mean to you? How much do you respect others ? How worthy are you of the respect you expect others to show you? Let’s focus on self-respect. People who respect themselves, respect others. Yes? No? Not Sure?

When you carry yourself with dignity and your communication skills reflect the same, you automatically evoke the respect of others. People who are loud, put others down, abuse their position when in power or feel a sense of entitlement are people who lack self-respect, not to mention self-esteem. They get worked up when people try to avoid them. Some become more obnoxious while others retreat and play the role of the ‘victim’. Either way, they allow their emotions to control them. This group of people also lack the insight, never seeing their contribution to the situation. All of us have been in the company of such people- family, friends, bosses, colleagues, our seniors, our juniors, our peers. It is challenging is it not? We cannot just conjure ‘respect’ with the wave of our wands. It has to come from within.

Many expect or demand respect. Some buy respect by throwing money and lavishing gifts upon others. How long will this type of respect sustain? As long as the rewards keep coming their way? But really, can one truly buy respect? Is it really respect that’s felt towards that person? Or are people just happy because the reward centre in their brain is being triggered ? Will they continue to ‘respect’ this group of people even after the well is depleted? Having said that, there are some who live in a delusional world expecting money to drop from heaven. So how can we develop the skill of respecting ourselves? First we need to understand that respect is mirrored. The way you treat yourself sets the standards on how others treat you. These few simple rules may be helpful;

  1. Practice humility : The first obstacle to respecting oneself is narcissism. Gas lighting others, being obnoxious and being so full of oneself is a definite no. Donald Trump is a perfect example. So first be humble.
  2. Stop gossiping : People who respect themselves do not practice or associate themselves with scandal mongers and back biters. No doubt many will sit and listen to the tails spun by these individuals as a form of entertainment. That’s where it ends. People like these gain temporary attention but permanent disrespect.
  3. Voice out : Speak up for yourself and others if you feel they are not being treated fairly. Not letting others put you or the people in your circle down, sends a message to the others,” I respect myself and my friends and I will not let you treat us this way.’ Of course do this assertively and with diplomacy. But do bear in mind, that some whom you support may jump camps! Therefore, it is best not to have any expectations.
  4. Be honest : Learn to express your opinions diplomatically without putting others down. That said, reality is such that many will not be happy with you for being honest. You may lose the support of some but gain the respect of many. Anyway, ask yourself which is more important to you and decide for yourself.
  5. Respect for general rules : There are certain rules and etiquette set in society. Something as simple as replying a RSVP. A habit sorely lacking amongst Malaysians. We either don’t reply then turn up or do the opposite. Understand the fact that you are indeed showing disrespect both for yourself and to your host.
  6. Know when to walk away : Never allow another person to humiliate you or put you down. Love yourself constructively. When I say, walk away, I mean with quiet dignity minus the fuss. Do not waste anymore of your time and energy on people who cannot see your worth. Use that time and channel that energy into positivity and healing. In other words, do not react but respond. We need to be aware of the difference. Human beings are generally reactive by nature. We react to any untoward situations by unleashing the fight or flight mechanism. We either stand there and yell our guts out, broadcast all over the various social medias or retreat into our shell for a long time, silently crying out- ‘Boo Hoo! Why Me?’
  7. Stop publishing your ‘issues’ on Social Media : You are inviting people, not all who are friends into the privacy of your own psyche. Ask yourself honestly, out of the 400 likes and comments that you get, how many can you confidently affirm responded genuinely to your plight? Can you be positive that they will not go on to talk about your issues with others who you may not even know? Or does this not even matter? We would not be human if our emotions were not provoked in an uncalled for situation. People who respect themselves, process these emotions, in a constructive manner. A helpful way would be to work on them with trusted individuals or a trained professional. However, there are people who do share their experiences on the social media. This is done under a different banner. The intention here is to help others in similar circumstances and to empower or motivate them towards making a constructive change for themselves.

In a nutshell, remember that in order to gain respect, you must be worthy of that respect. That said, you are definitely worth it! So start showing yourself the respect you deserve.

Staying Calm Under Pressure

Nisha Fareena Khan

“Pressure can burst a pipe, or pressure can make a diamond”

When an athlete, singer, musician, public speaker, actor, professional player or in general any competitor who misses or go wrong during the most important moment of their life – they experience a phenomenon known as choking. Choking happens when competitors under intense pressure try to perform their best and are suddenly hit by performance anxiety. This circumstance can be experienced by one of the world’s best players, musicians, public speakers and in general by anyone who is under intense pressure to show the best for which they have trained for months or even years.

Most people intuitively blame it on their nerves, but why does being nervous undermine expert performances? There are two theories which primarily say that choking under pressure boils down to focus. The first theory is the distraction theory – it determines that performance suffers when the mind is pre-occupied with worries, doubts or fears instead of focusing on the main task relevant and irrelevant thoughts compete for the same attention. Therefore, something has to give way as the brain can only process one set of information at any given time. Under a study of human cognitive level, tests were conducted on university students where they were given a set of math problems and were divided into two groups. The first group had to perform at a competitive level whereas the second group were to solve those problems without any pressure of competition, results were shown that the students under no pressure performed better that the group under pressure.

Second theory is the explicit monitoring theory where pressure causes people to over analyse the task at hand. Here the logic goes like once a skill becomes automatic, thinking about its precise mechanics interferes with your ability to do it. Tasks we do unconsciously seems to be most vulnerable to this kind of choking. Diving deep into a task’s mechanics makes it worse to derive accurate charts. Simply by focusing more on your ability and skills makes it a lot easier to perform the particular job accurately. So choking affects everyone and anyone under pressure although the level can vary as some of us will experience it lesser or more depending on our self-confidence, self-consciousness and sensitivity.

So how do we avoid choking when it really counts? After a bunch of studies and research, experts found that in order to avoid or at least minimize the phenomenon of choking one should practise not just under normal circumstance but to also practise under stressful conditions. Secondly a pre-performance routine as simple as taking a deep breath, repeating a keyword or doing a rhythmic sequence of movements and finally having an external focus on an ultimate goal works better than having an internal focus where someone is already tuned into the mechanics of what they are doing instead on focusing on the mechanics at that particular moment. In short, practise under pressure with focus on the glorious end goal is perfect. In conclusion, the pressure of today will make you shine tomorrow just like if there was no pressure there won’t be any diamonds.

THE POWER OF ZONING OUT

Archit Vireshkumar Sharma

As you start reading this article and progress through it, you might lose focus as you drift off into your own thoughts. You may have ended up reading the entire article only to ask yourself, “What did I just read?” Drifting off into your own thoughts and magical land while doing any particular task is called zoning out or mind wandering. (As a matter of fact, I zoned out multiple times while writing this article!)

Zoning out is very common and people experience it on a regular basis, multiple times a day. People zone out while talking, reading, writing, watching something and while doing many more activities. This makes zoning out a crucial state of mind which is beneficial to an individual as it may promote productivity. Yes, zoning out can in fact help you become more productive!

A human brain functions similarly to a piece of machinery. If a piece of machinery is constantly functioning for an extended period of time, the machine may eventually break down or develop issues which will reduce its efficiency. The same applies to a human brain. A human brain is extremely complex and capable of executing unbelievably complex tasks; however, a human brain can only take so much. If an individual is constantly busy, focusing on tasks at hand, the brain can experience fatigue which will reduce its efficiency. As a result, the individual may take 3 hours to complete a 30 minute task. One way to tackle such an issue is to let your mind wander.

A research published in the journal – “Psychological Science” says, that during mind wandering (zoning out) we engage in what researchers call “creative incubation” where a person mentally drifts to another topic. As a result, if a person is finding it challenging to find a solution to a problem, he/she would be able to tackle the problem better if he/she allows the mind to wander off and come back to the problem later. When we mentally drift to another topic, our brains work on the tough problems and sort out challenges in the background.

In addition to problem solving, letting your mind wander and zoning out plays a crucial role in creativity. When your mind wanders off, you tend to start thinking about some unconventional topics and you tend to ask a lot more questions than you generally would. You may ask extremely basic questions such as “Why does water feel wet” or some rather peculiar question such as “If I shine my laser in the sky, what are the odds that the beam of light will hit a random planet.” Not only does this make you think of some very creative solutions, it may also help you look at a problem from a different perspective which will aid in problem solving.

If you feel like you tend to zone out and your mind starts wandering, do not fight it, allow your mind to wander. You may end up thinking of the next revolutionary invention that will change the course of humanity; however, you must not zone out all the time. Zoning out will not be beneficial if you do so during classes and miss out on a lecture or let your mind wander in the middle of a test. Zoning out is very beneficial, but there is a time and place to do so. When you can afford to zone out and let your mind wander, just sit back, relax and let your mind do its own thing.

While reading this article, did you zone out? If you did, there is nothing to be worried about. For all I know, you may have just come up with a revolutionary idea.

BOOK REVIEW

Dr S P Rachagan MBBS, FRCOG, FACS

Dr Rachagan graduated from the Kasturba Medical College, University of Mysore in 1974. He was an Associate Professor at the Department of ObGyn, Faculty of Medicine, University Malaya before going into private practice at Subang Jaya Medical Centre. He served as President of OGSM in 1999/2000.

In March 2007, Dr Rachagan had a stroke – an intracerebral haemorrhage over the left temporal area and part of the left parietal area – resulting not only in muscular weakness on his right side, but also aphasia, hemianopia, paraesthesia and dysphagia.

Stroke: Doctor Turns Patient details his determined and arduous journey back to ObGyn practice which included a one-year proctorship even more demanding than that recommended in the RCOG guidelines.

Dr Rachagan retired from private practice in 2016 but continues to assist at Klinik Derma Sivasanta of the Temple of Fine Arts.

BOOK REVIEW
The essence of the book Stroke: Doctor Turns Patient is captured in its opening quote by Jalaluddin Mevlena Rumi: “But listen to me. For one moment quit being sad. Hear blessings dropping their blossoms around you.”

The focus of this personal autobiography is not so much the debilitating illness, but the healing journey that Dr S P Rachagan underwent in his quest to regain control over his life. It is a narrative that is full of gratitude for the blessings that have been bestowed upon him to face the trials brought forth by the stroke.

Like many others, the stroke affects Dr Rachagan’s physical movement. However, the more serious conditions shared by him in the book revolve around his language skills (aphasia) and vision (hemianopia). The book is narrated in a manner that allows the reader to emphatise with him in terms of the challenges he faced in carrying out his daily activities. It also contains technical descriptions of these conditions written clearly to be easily understood by a layman.

The roles of his family, friends and the dedicated medical and health care professionals who have treated him are very much emphasised. However, through the accounts of his struggles, it is clear that without the single-mindedness and tenacity demonstrated in his efforts, the goal of normalcy would not have been achieved.

If one is to glean a single lesson from this book, it is that recovery would simply not be possible without will power and hard work on the part of the individual concerned.

One of the most unique features of this autobiography is the final chapter which is entitled ‘My Wish for You’. The chapter is straightforward in its intent, from the first wish which simply hopes that the reader would never suffer a stroke, to the wish for fortitude and strong support network, ending with the need for a government-backed National Healthcare System.

The book was written ten years after Dr Rachagan’s successful return to his vocation as an obstetrician and gynaecologist. This time lapse helps in giving a sense of objectivity that underlies these accounts of his ordeals. The effects of the stroke, some he has managed to overcome, some he has to simply accept and cope with, are revealed forthrightly. At the end of these revelations, Dr Rachagan aptly ended the book with Tagore’s quote, “When I stand before Thee at the day’s end Thou shalt see my scars and know that I had my wounds and also my healing.”

SMMAMS
SOCIETY OF MALAYSIAN MEDICAL ASSOCIATION MEDICAL STUDENTS

Dikshya Pakarisamy
MMMC graduate batch 2019
Assistant Secretary of SMMAMS 2018/19

From the “still studying” phases, now to “waiting for housemanship” era, as a medical student or graduate, you would be always looking forward to keep up with your non-medical buddies. Let me put some realization into your cup my fellow peers, medical life has its own pace and path to bring you from one level to another, hence, what all you need is great amount of patience. Meanwhile, we can add along other activities in our normal routine to just keep us moving further.

Well, apart from all the long chapters from humungous books, you can add some spice to your plain life with different deeds. So did I, for the reason that attainment of knowledge doesn’t just arise from books. I involved myself in clubs and associations too. Subsequently, I grasped the prospect to be a part of Society of Malaysian Medical Association Medical Students (SMMAMS).

SMMAMS falls under the umbrella of Malaysian Medical Association (MMA) as a student body. Realizing the significance of embracing the fledgling generation into medical world has become the foremost purpose for this society to be born. This is solely because to cultivate brilliant and vast thoughts as well as guiding the young champs to help refine our health care system to be amongst the finest in the world. To do justice for the aim, it serves as a platform to unite medical students from all over the country and encompass them in various germane events. This approach allows these students to keep au fait with the medical world. We are aware of the extremely competitive medical ground. We need doctors who are highly proficient and to be equipped with right information plus knowledge to face the circumstances at the present time. And here, they are helping to create doctors-to-be for our future.

Our committee members consist of students from most of the medical institutes around Malaysia. Each of us are elected by a voting process and given the respective positions to run the board for a year. This event normally occurs annually during the general meeting where the representatives from every medical institute participates. Aside from the election, this is the time when we usually confer regarding new activities for the year as well as propose budget for it. As mentioned SMMAMS organizes multiple beneficial events and also inspire medical students who represent their colleges to bring along their peers and to be a part of it. For such happenings, SMMAMS provides the support and encouragement in many ways to proceed with the ideas and see them through. Similarly, we had organized the Intervarsity Debate Competition, Gathering of the Great Minds, Medical Research Day, National Medical Students General Assembly. We can proudly say that every major event like these are hosted by our very own representatives from their respective colleges. At the end of the day the ultimate goal of these occasions will be bringing together the younger generations, nurture their ideas for better development and serve as a platform to acquire knowledge through different experiences.

Being a representative of SMMAMS, the responsibilities doesn’t just end there, we will also be involved in MMA state branches. We are part of the team too, as in attending the committee meeting, being a helping hand and participate in some of the events which they’ll be conducting, like, medical camps. Recently, we even had an opportunity to contribute something for a social event. It was an initiative of Universiti Teknologi Malaysia (UTM) entitled ‘Karnival Kampungku Sihat’ and since MMA Melaka branch was a part of it, the student representative of SMMAMS went along. A number of medical doctors and medical students volunteered for this program which has occasioned to a huge success. There were a lot of things going on that day, for instance, health screening camps, nutritional advices, circumcision and home visits. It was a pleasure to be a part of it since I was able to collect a lot of experiences and was grateful for the acquaintance which I have received.

In brief, that’s how SMMAMS works basically, and we are still working on our flaws for the betterment of our system.

Well, these were the part and puzzle of my medical college journey apart from drowning into the “Davidson’s” and “Bailey’s” in the name of examinations. I have to agree that getting involved in these kind of activities also helps you to learn a lot through pleasurable way and gives you tons of memories to be cherished, so, why not give it a shot.

Lastly, let me end with a word of encouragement, each and every one of us has their own way in adapting, accepting and pursuing the “unique” medical life, I would say. All we need is, again patience, hard work as well as perseverance and with all of these we believe that we will definitely reach the right destination!

RUFUS is the young optimistic
Malaysian musician we deserve

by Rogin Losa

You can be from anywhere in the world, at any age, with any background, and still make something out of yourself

SCOUT Friday Picks is our dedicated column on music, with a focus on fresh takes on familiar faces and profiles on new, young voices. For recommendations on who you want us to feature next, send us an email titled “SCOUT FRIDAY PICKS” to [email protected]

“You don’t have to be of high social status to succeed in whatever you want to do. You don’t need to be a social media influencer trying to be a musician to succeed,” the 16-year-old Malaysian musician RUFUS says. “You can be from anywhere in the world, at any age, with any background, and still make something out of yourself.”

Rufus Sivaroshan is fuelled by ambition. For instance, his goals are to inspire artists to pursue their craft regardless of their social status and diverse background. That’s a bit fantastical for a cynic myself. But maybe, that’s why an optimistic wunderkid like RUFUS exists—to make change happen with their own craft and blind determination.

The name RUFUS might be lost to people outside of Malaysia. But as soon as his debut track drops, his name will go beyond his own music scene. He’s been slowly building up his music career for two years now. Starting out as an Ed Sheeran super fan who makes covers on Instagram, he garnered a solid following from different parts of the world, from his home turf to countries he has never even been to like Canada and America.

Today marks his official debut with his single “Fine.” But even before this drop, he’s been working non-stop to get the right support from the right people. This. hard work bore fruit when he became the first Malaysian artist to sign with AWAL for distribution. His current label mates are artists like Lauv, Rex Orange County, and VERITE. Not bad, right?

RUFUS might be fuelled by ambition like any other young hopefuls in the music scene. But what makes him stand out is his determination to break the industry’s toxic standards on fame, while learning the ropes at the same time. For this week’s SCOUT Friday Picks, we talked to this rising electro-R&B musician about the struggle of molding his own sound, the small yet vast Malaysian music scene, and why it took him two years to officially debut.

How would you describe your sound to first-time listeners?
I write acoustic songs, but I sing them over a pop track and I make it sound good. Easy.

If you made a mixtape of musicians who have influenced you, who will be in it?
It’ll be a very very weird mixtape. I’ll put some classic Ed Sheeran songs there ’cause I’m a massive fan of him. I pretty much started off doing acoustic songs or writing acoustic songs. I would throw in lots of Jeremy Zucker, Chelsea Cutler, and then I would even throw in some hip-hop. I would put in Logic and Childish Gambino.

You’ve entered the music scene at a very young age. What pushed you to pursue music in the first place?
 
I was technically born into music, I would say. My mom was very into Indian classical music and my dad used to play the piano when he was younger. My mom pushed me to go into Indian singing classes and I hated it at first. But three to four years ago, I started to pick up singing again. I’ll be in my bedroom and I would constantly practice.

I pretty much taught myself all the techniques when it came to being a vocalist, picked up a guitar two years ago after an Ed Sheeran concert, and I just started writing. All of this came hand in hand. Just over a year ago, I decided that I should probably take this seriously. And here I am.

How did your Indian classical music training influence your craft?
 
I started doing Indian singing classes when I was five. It was definitely the stepping stone for my singing style as of now. And I really like cultural arts for how creative it is, you know? Back in the day, we didn’t have computers, we didn’t have synths, and all this crazy stuff to make music. It was literally banging on tablas and pushing your voice to the limits. That’s what Indian art is.

And to an extent, I’ve taken that to my music production. I love using different instruments whenever possible. And in that sense, cultural arts has poured in my style of music.

How long have you been doing your solo project leading up to this debut?
Around December 2017, I started an Instagram account where I posted lots and lots of covers. And it got traction within a couple of months. It was very overwhelming, especially when a few Canadian people followed me on Instagram. I quickly became their internet friend. That’s when I got exposed to the American music industry.

It’s crazy how my sound reached America and Canada. I eventually learned about cover artworks, marketing, distribution, touring, and merchandising. All of these fundamentals in the music business. And then from there, I got to meet producers and different artists that they know. I got to talk to them ’til one thing led to another and my name started to get around.

I’ve never been to America or Canada once. I planned on going very soon. But as of now, I’ve done literally off my laptop, through email, and through FaceTime.

Did the attention you received from America and Canada’s music scene excite you or overwhelm you?
Definitely both. I started to gain a lot more traction, it’s honestly insane. When you look at it, half of the people who are following me on Instagram and social media are based in Malaysia, but there is like 30 percent from the U.S. and 20 percent from Canada. There are these different people from around the world, telling me that they love what I do. It is pretty scary, not gonna lie.

But I use all of these as my motivation to produce music and go out for everything that I do with this venture. Realistically speaking, this is my first single ever. This is the beginning of a whole plethora of activities to come.

Of all the tracks you created, why is “Fine” the perfect track to debut with?
I was never meant to release “Fine” in the first place. When I started writing it, I was on the train back home at my lowest point ever. My mental health was terrible, I just got out of a relationship, I was getting judged a lot at school, and all of this was very recent as well.

I wrote the song out of nowhere with that initial hook. And then a week later, I called my friend Daniel Ezra (co-writer/producer), and I played him that hook. He loved it. And then he said, “This should be your debut song. I don’t know why you’re considering releasing all the other ones you’ve planned out. This should be it. There’s so much meaning to it.”

“Fine” is a song that people can relate to like with their personal problems, mental health struggles, and anything within that realm is something that my age especially go through. It’s not a love song. It’s a song that tells people that regardless of whatever you’re going through, you’re going to be okay. And to have that as your first song is an incredible feeling.

Going back to your home turf, how’s the Malaysian music scene?
When you come to Malaysia and you talk to people about music, a lot of people don’t know much. Everyone thinks there are only a handful of artists that perform. But when you start going to open mics or any other music venues, you’ll be surprised how big the Malaysian music scene is.

There are so many indie bands with different genres; rock, alternative, and others apart from pop. I’ve taken inspiration from a lot of Malaysian artists who have gone international. For me, it’s Yuna. She’s the first Malaysian artist to start this whole international venture and she succeeded. And AlexTBH, who SCOUT has covered and I am a massive fan of, has done crazy things and he’s done them on his own.

If you speak to your average joe here in Malaysia, they don’t know jack shit about the music scene – and that’s sad. It’s getting better, for sure, but if you were to look into it, it’s crazy how vast and big the music scene is here. I’ve fallen in love with the close-knit, collaborative environment. I can talk to anyone about everything, and I can be myself amongst all my peers here in Kuala Lumpur. I hope everyone in scene gets the recognition they deserve.

What kind of change do you want to contribute as a musician?
I see my friends and they’ll say, “The Malaysian music scene is so messed up. What are the chances of Malaysians like me succeeding internationally?” My goal is to break that barrier while being the youngest musician out there. Location and age don’t indicate success, whether it’s in music or in any field.

Why is 2019 the perfect time for the world to know about RUFUS?
I’ve wanted to release songs in 2017. I wanted to release songs last year as well, but I didn’t. I felt like I wasn’t ready. Not only that, but my production style was not ready and I didn’t have my own sound. I’ve taken the past year to learn everything I possibly could to work with all of the right people until I reach a point where I’m like, “Okay, I’m ready. Let’s put out songs.” And I have reached that point.

This year makes much more sense because now I’m ready for it all.

THE UNNECESSARY VILIFICATION OF CONFORMITY

by Abishek Sekhar

Conformity. Defined formally as compliance to standards, rules or laws, and behaviour that adheres to socially accepted conventions, by Merriam-Webster. Defined as not being able to be your own person by many members of society.

To the majority, people who conform to fit in are simply doing so because they cannot decide what type of person they want to be. They argue that conformity destroys freedom of will and thought, as well as birthing a sense of servitude within the conformer. To some people, anybody who conforms as to not come off as unorthodox in a social setting, is deemed two-faced and untrustworthy. Yet to deem conformity as something not worth practicing even in the slightest, is often restrictive in its own way.

I had recently attended a talk where it appeared as if it was going to be the regular, run of the mill, humdrum talk about sharpening social skills and being your own person to secure a job. Most motivational speakers emphasize on how you can have idols that you look up to but emulating them would result in you being merely an imitation, a shadow of what they are or once were, not being able to create a name for yourself. However, this individual in particular, though he did allude towards the notion of independence and self-worth, which he made clear it was important to have, did not harp on the topic of conformity as one that should be shied away from at all costs. He went on, rather, to speak about how if conformity is evil, it is a necessary evil.

According to him, if we are to survive in the corporate world, a resume and the eagerness to earn are not enough. Unlike many others, he said that if your future company requires you to meet clients for a minimum of 3 hours a day, your tendency to ostracise yourself from social interaction should not inhibit you from getting the job done. Rather, working against your programmed behaviours, to get your work done successfully, should be a key factor in becoming an indispensable worker. Employers search for people who are willing to give their best regardless of the situation. Oftentimes, people who are so against the concept of conformity find themselves in one of two situations; either they find themselves in a very tight spot due to them backing themselves into a corner because of their inability to adapt, or they would be forced to conform and might be so against it they tend to despise the job or do it lackadaisically. On the other hand, people with the ability to conform and come to terms with what they are working with are more likely to do well in any field of their choice, due to their ability to adapt.

It is not just the corporate world in where conformity brings about a benefit. As a student, it hurts harder when someone calls you out for being two-faced or a follower. In truth, it does do you good to be your own person. However, this is not to say that there aren’t situations where if you conform you would be deemed as lesser of a person. For example, if you were at a party and you decide to just enjoy the vibe or overall atmosphere with music that you usually do not gel with, it doesn’t mean that you are fake. It just means that in this particular situation, you realize that you don’t mind shedding certain preferences of yours to have a good time.

Another example, would be when you are in team of highly hardworking and competitive individuals, you would be more driven to conform and keep up to the norms of the people you deem as talented and on the right path, so to speak. In this way, conforming makes you a more motivated and driven person.

All in all, what can we take away from this? We should learn to appreciate the art of conformity, knowing that not only is it not easy to do, but sometimes doing so could be a vital tool in increasing proficiency and likeability. Now, this does not mean you should become someone who merely conforms everywhere you are and in every interaction. This merely means that by adapting, you can personalize your skills and make yourself a truly appreciated commodity, no matter the setting.

To some people, anybody who conforms as to not come off as unorthodox in a social setting, is deemed two-faced and untrustworthy. Yet to deem conformity as something not worth practicing even in the slightest, is often restrictive in its own way.

THE TINY GRAZERS OF THE OCEAN

Vithiya Subramaniam B33

February 2019 turned out to be an amazing beginning for the whole year as my close friends (Tharishini, Subbramaniam, Kabilen & Shobena) and I travelled from all corne rs of the Peninsula to one of the most beautiful islands in our country, the Perhentian Island. Time stops ticking when you lay your foot onto this ground and you find yourselves blessed with the magnitude of nature’s possession throughout this island. The sparkling, salt-seasoned water caresses your feet gently, while your eyes are getting adjusted to the majestic view of the vast ocean, with its water ranging from turquoise to midnight shades of blue. Thousands of seashells of various shapes, sizes and colours wash up to the powder-like sand with every stroke of wave and borders the mile-long beach like a picture frame. Perhaps, our nature’s very own portrait? That said, not everything on an intricate portrait can be seen by the naked eye and much worse, a human’s eye.

We knew that the best way to enjoy this God-given wealth would be to dive into the ocean and explore its serenity, and that is exactly what we did. We decided to go kayaking first, as none of us have kayaked in the sea before. With no time to waste, we hopped into our swim wears and started rowing. Apart from the agony of draining all our energies, we also managed to over-turn our kayak in the middle of the South China Sea! Oh, how can one ever forget such fond memories? After laughing our lungs out, we decided to go snorkeling and this is where I learnt about a creature I never knew existed before. What I first thought to be a baby jellyfish ended up giving me a fresh insight about the world of jellyfishes. There they were, floating away harmlessly in the middle of the ocean, crystal clear yet so fragile when touched. This encounter perplexed us as there were not a few but millions of these 20-cent sized transparent blobs suddenly surrounding us.

We were initially amused but that soon changed into disgust as millions of these blobs started crossing our paths while we were snorkeling. Imagine the horror we experienced as we had to gently graze through the surface of the ocean, while trying to prevent these small creatures from entering into our orifices. Even worse, in the midst of this commotion, something stung me over the lateral aspect of my right chest. The immediate burning sensation was horrible. “How could something so tiny and fragile have the potency to sting with such vigour?”,I thought to myself.

What are known as “sea squirt” amongst the commoners are referred to as “Urochordates/ Tunicatas” to the scientists. Most adult tunicates are sessile, immobile and permanently attached to rocks or other hard surfaces on the ocean floor, while the sea salps swim in the pelagic zone (water column of the open ocean which can be further divided into regions by depth) of the sea as adults. According to NIWA plankton expert, Dr Moira Decima, these barrel-shaped organisms are more closely related to us, humans, than they are to jellyfish counterparts. They have a primitive ‘spine’ ;a notochord made out of cartilage. In vertebrates, the primitive notochord has now evolved to become bony spines. Salps also have an intriguing way of reproducing that flips between sexual and asexual stages. The large solitary stage is what is known scientifically as an oozooid. It is an asexual stage, which is either male or female. It produces a long chain of clones that “will be the organisms that reproduce sexually,” says Moira. Once the chain is released, the immature buds separate off. The salps in these chains develop into sexually reproducing blastozooids. First, the whole chain is female and all the individuals produce eggs that become fertilized by any male blastozooids nearby. The eggs develop internally and the salps give birth to live young that swim off to grow and develop into asexual oozoid adults. Finally the whole chain of salps become male and release sperm which fertilises the eggs of any nearby female blastozooids. Intriguing yet complicated, isn’t it?

This chain of sea salps look like a necklace made from linked glass beads. Making chains is part of their life cycle and if these chains break, they cannot link them back together. These chains synchronize their strokes when threatened by predators or strong currents in the vast ocean. As these linear chains are particularly skilled at this migration, they are able to travel thousands of feet each night, at speeds around 10 body-lengths per second. You might think that fast synchronized swimming strokes would be the way to make that happen. In contrary, each salp in the chain pumps to the rhythm of its own built. Although they have a complex life cycle, salps can grow to maturity within 48 hours. They are thought to be the fastest growing multicellular animal on Earth, increasing their body length by up to 10% per hour. This quick turnaround time enables salps to take advantage of algal blooms, increasing their population size rapidly when there is a sudden abundance of food.

Salps play a unique ecological and biogeochemical role as extensive grazers of some of the smallest marine phytoplankton. The phytoplankton captures the sun’s energy and atmospheric carbon dioxide at the ocean’s surface and is eaten by zooplankton, which makes this energy available to larger animals such as fish and whales who feed on them. Both phytoplankton and zooplankton play a key role in exporting this carbon dioxide from the surface to the deepest depths.Salps are near the bottom of the marine food web. They graze on tiny phytoplankton and produce lots of waste that can quickly sink to the deep ocean, effectively removing carbon from the sea surface. Because of this, salps are very important for carbon cycling through the different depth zones of the ocean. As they move up and down through the ocean eating and excreting, they spread nutrients downwards to other ocean communities. Though tiny in size, their contribution to their milieu is undeniably mammoth in nature.

For the five of us, discovering them was a traveler’s wonder. However, none of the others know what these tiny creatures really are but maybe they will, after reading this. Finally, let me share with you a quote by James Cameron that resonates with this experience, “Every time you dive, you hope you’ll see something new – some new species. Sometimes the ocean gives you a gift, sometimes it doesn’t.” I am thankful to the ocean for the gifts I now have ; my best friends and the crazy memories the ocean gave us.

WHY IT PAYS TO BUY MEDICAL MALPRACTICE INSURANCE

by JA ASSURE and CHUBB Insurance

Insurance as a concept is simple and straightforward. When the unforeseen happens, insurance cover gives us the protection not to be swept under the financial burden that often accompanies personal disaster. For the peace of mind of having that protection, we pay a premium amount every year or month.

The same goes for professional insurance that extends this type of protection to the working individual – to protect him or her from being financially ruined due to an incident or accident that happens whilst working. For Medical Malpractice though, the protection has much more layers than the average professional insurance.

Layer One – Cost of Recovery
When medical malpractice occurs, there is a need for restorative work – either through surgery or medication. This cost must be borne by the hospital or doctor responsible and may extend to considerable amounts depending on the circumstances. Naturally, Medical Malpractice Insurance covers this unexpected cost.

But this is not the only aspect of the restorative process for a case of medical negligence (alleged or otherwise). Unlike other industries, the medical profession is centred around people and there may be a need to offer compensation for the trauma or loss caused as a result of the incident. Medical Malpractice Insurance covers this unintended cost as well.

Layer Two – Cost of Investigation
Unfortunately, Medical Malpractice is always complicated due to the nature of involving the lives and wellbeing of other people. Hence, there is an arduous process that follows an incident or accident, involving legal and technical experts reviewing and investigating the case.

In the first instance, there will be an internal inquiry by the medical regulatory body (i.e. MMC), and the doctor will need to be adequately supported by subject matter experts and a lawyer. Medical Malpractice Insurance covers this unavoidable cost.

Then, depending on the complexity of the case and the circumstances surrounding the incident, there might be further legal processes to follow through, such as mediation, arbitration or litigation. Medical Malpractice Insurance covers this unduly stressful cost as well.

Layer Three – Cost of Judgement Call
Medical Malpractice does not just occur in an operating theatre as we often see being played out in TV shows and movies. Sometimes, it occurs in boring day-to-day work activities such as misplacing a document during an office move. Medical Malpractice Insurance covers such untimely cost, too.

In a more operational capacity, a doctor might require a locum to act on his behalf and the unfortunate incident or accident occurs in that context. While he or she may not have been physically responsible, there might be some legal culpability in the grand scheme of things. Medical Malpractice Insurance covers this unnecessary cost.

Likewise, a doctor might be called into action during an emergency situation and something may go wrong. And even though the doctor would have acted in good faith, the outcome might still result in a Medical Malpractice incident. In which case, Medical Malpractice Insurance covers this unsavoury cost as well. 

To a lesser degree, doctors are often in a position to give their qualified opinion in professional settings as well as occasionally in the public sphere. In this modern age, this might expose such doctors to unexpectedly defaming another party. Fortunately, some Medical Malpractice Insurance cover this unusual cost.

Layer Four – Cost of Options
Considering the sensitive and complicated nature of medical malpractice incidents, there is a need for the affected doctor to feel comfortable and reassured that the best professionals are acting on his behalf. This might mean wanting to engage a specific lawyer who is known for his or her expertise in Medical Malpractice, Good Medical Malpractice Insurance covers this undeniable cost.

Finally, Medical Malpractice incidents may not always happen immediately. Considering the nature of health and human lifestyle, medical oversight may only come to light years later. Medical Malpractice Insurance generally recognizes this reality and claims can be retroactively made from the time of first entering practice. Thus, Medical Malpractice Insurance offers cover for such undue cost as well.

Finding the Right MMI Partner
The ten benefits of Medical Malpractice Insurance (MMI) listed here are just the tip of the iceberg. But these considerations are enough to illustrate why it is important to find an insurance provider who is having your best interests at heart. Unlike traditional life insurance or personal accident insurance, medical professionals require a lot more specialized care in how insurance cover is designed for their needs.

JA Assure has been in the business of simplifying the insurance purchase process for a number of decades. It is on the back of this success that we adopted the MMI sector into our portfolio. Currently, we work closely with Chubb Insurance as the underwriter to ensure that comprehensive insurance cover can be made available on our online platform. The easy-to-use web portal allows you to choose the protection amounts that are needed and effects the coverage in real time.

However, recognizing the complex nature of MMI, we have our consultants on standby should medical professionals need advice or guidance in securing the insurance cover that protects them on all layers.

COLORS

by V i k n e s h S e k h a r ( B 3 3 )

I woke up to the warm breath of the blonde temptress in my bed right next to me. ‘Still here?’ I thought to myself, as I saw her spread out in a mess across my yellow comforter. Turning my head to the nightstand, I grabbed my phone.

7.31 AM

School made me an early riser, but how I yearn for late start. I sat up on the edge of the bed, peeking at the yellow sunrise piercing through the slight gap of my drawn curtains. I knew it was going to be a hot day. The sky was a light shade of blue and not a cloud around worth describing. I didn’t want to awake the girl in the bed. But I approached the curtains and took a better look at the view. I saw my reflection, the yellow and blue hue was no match for my blood shot eyes.

My color was yellow

Walking towards my bathroom, flaunting my navy blue boxer briefs to an audience who was still dead to the world, I grabbed a teal colored towel and stepped into my cool tiled personal domain. The mirror, which I like to avoid was a time travel machine. I’m pretty sure I was clean shaven the night before, skin smooth, fresh, with an immaculate hairstyle. But here I was with red eyes, a 5 o’clock shadow, crackling and wrinkling skin and hairspray flaking down my forehead. I turned the tap in the shower three quarters cold.

My color was blue

I probably spent 10 minutes in the shower, not looking forward to the morning or the day ahead. I spilled myself on my charcoal sofa like a glass of milk. My hair was still wet and stiff from the hairspray. I shut my eyes. Tactical secondary sleep. Heavy drinkers will know.

My color was black

30 minutes later I woke up. Feeling slightly more refreshed I wrote on a white piece of paper ‘Success is the best revenge to pay you back and that payment is overdue’. I wanted this to be my own words so badly, but honestly it was an Eminem lyric. Something told me to reach into the drawer next to the porcelain sink. A 9mm gun and single bullet sat unused. A lot of my life had come down to simply doing the right thing, something I failed at so many times before, but every day was a new opportunity to be a new you.

My color was white

ON ARTS

B y D r . K e e r t h a n a M u r a l i T h a r a n ( B a t c h 3 2 )

Greetings my fellow doctors. I am Keerthana Murali Tharan, a proud graduate of MMMC Batch 32 currently serving in University Malaya Medical Centre. As we all know well and are experiencing first hand, the medical profession demands an abundance of attention, energy, sacrifices and a mighty strong heart. It is nonetheless, extremely rewarding. Daily burdens can be exhausting and requires constant use of coping skills. May it be derived from family, friends, a hobby or comfort food. I for one, find arts very diverting, visual arts in particular.

Aside from being in the medical fraternity, I am also a part of the artistic professionals in Malaysia. I specialize in acrylic painting. I have participated in a few exhibitions till date and have attended many exhibitions in support of my fellow colleagues. I have successfully sold a few of my art pieces as well. Some of the exhibitions I have participated in include “Spring is Coming” at the Hulo Gallery and Hotel and also [email protected]

I have been intrigued by visual arts since a very young age. Throughout my life, I learnt various visual art forms including colour pencils, oil pastels, crayons, water colours, pencil sketching, acrylic painting, batik design, mural painting and photography.

I am a very simple person. Everything around me inspires me. Architecture, history, nature, people, etc. I believe that if one is gifted with the ability to see the beauty of this world, inspiration is just a paintbrush-stroke away. On top that, I am roused by the emotions I get from them. So, the essence of my paintings are to reproduce  those emotions. I have travelled near and far collecting such inspirations through sightseeing workshops, classes, competitions and exhibitions.

Coming back to my coping skills. As a doctor, I am always on my feet serving or shall I say, slaving away to ensure the best care for my patients. As an artist, I am at sanctuary. It is just the paint, paintbrush, canvas and I. It is a complete diversion from a hectic schedule providing me my utmost relaxation.

I work on new pieces all the time and showcase them on various platforms on social media mainly Instagram and Facebook. I am a member of the Persatuan Seni Rupa Malaysia (peRUPA). This amazing group always keep me abreast with various artistic events happening near and about Kuala Lumpur and Selangor. I make an effort to attend and participate as much as I can around my work schedule. I learn to balance them all and ensure that I do not compromise either or both.

I aspire to become a surgeon in the near future as this specialty involve artistic hands and good visual perceptions to a huge extent. The difference is that, instead on a canvas, we create art on a human body. The artist in me is indeed looking forward to that. I am grateful to all my teachers for their guidance and I thank God everyday for my 5 senses and hands to enjoy both, the world of medicine and art as “DrArt”.

ASYMPTOMATIC DENGUE: A FLOCCINAUCINIHILIPILIFICATED SUBJECT

By Tan Wing (MBBS B33)

PROLOGUE
To most health professionals, “dengue” evokes a mental picture of a febrile, shivering, groaning patient, with or without the ability to walk. Should the presence of the disease be confirmed, the patients can look forward to a fluid-replacement regimen if necessary, in addition to multiple episodes of “bee stings” on their cubital fossae over the course of a week or so. Meanwhile, medical students are no strangers to exam questions on the pathophysiology, symptomatology, and therapeutics (or lack thereof) of dengue. After all, the textbooks and clinical practice guidelines have delineated the same very clearly.

THE PROBLEM
Apparently, asymptomatic dengue is currently an unchartered sea. Evidences of the subject matter have only begun to surface in the past few years, and to date, researches on asymptomatic dengue are yet to gain ground. News flash: as per the World Health Organization, asymptomatic individuals account for around three-quarters of the estimated 390 million dengue cases worldwide![1] Ergo, it’s prominent that information on the disease is, at present, disproportionately skewed towards symptomatic dengue by far.

Most unfortunately, asymptomatic dengue poses major public health and clinical puzzles which are highly difficult to crack.

The Public Health Conundrum: To Screen or Not to Screen?
The reason we should be concerned over asymptomatic dengue is that individuals with the condition are likely to contribute to the propagation of the disease. In other words, if the viruses in such individuals are found to be as infective as those in symptomatic patients, imagine how easy it would be for the viruses to be chauffered around in cars called Aedes!

As per the literature, asymptomatic/ pre-symptomatic persons are 0.8 – 10.1 times more likely to infect mosquitoes vis-a-vis their symptomatic counterparts.[2,3] Notwithstanding the wide range of infectiousness and the fact that one of the two studies on this matter have employed computer modeling, it’s paramount to establish whether asymptomatics/ pre-symptomatic people are comparable to the symptomatic ones in terms of their role in disease transmission. Should the truism of this hypothesis prevail, then vector and disease control programs will need to take into account the former group of individuals. Accordingly, additional resources will have to be set aside for this exercise.

Clinical Cluelessness: Where’s the Key to Asymptomatic Dengue?
From the clinical aspect, the search for a reliable method to diagnose or detect asymptomatic dengue is akin to hunting for a hidden treasure without a map. It’s much easier to pick up dengue in symptomatic patients because, the presence of its characteristic symptoms aside, the day of onset of fever is a good indicator-cum-predictor of the progress of the disease. In addition, the abilities of a variety of tests (e.g. rapid NS1/IgM/IgG kits, ELISA, PCR, and PRNT*) to serodiagnose dengue are well-established, and a healthy dose of effort is being expended to improve their sensitivities and specificities. On the contrary, asymptomatic dengue doesn’t come with such benefits; there’s no passive way to determine whether or not an individual has asymptomatic dengue. In other words, these cases have to be actively searched for. Regrettably, there are currently no solid leads to suggest the group(s) of people who are at higher risk of the condition, except for individuals who reside within a radius of 50 – 100 meters of symptomatic dengue patients.[4,5]

So what?
Do all these mean that all of us are just one mosquito bite away from a major, secondary manifestation of dengue?

Theoretically, it certainly seems so.

Nevertheless, it’s not the end of the world yet. For starters, a mosquito can only transmit the disease if it has bitten a dengue-infected person within a certain period (usually from days -2 to 6 of the onset of fever[2]). Also, the probability of catching a dengue-infected mosquito in the field is around 2% (based on data from an ongoing study at a densely-populated area in Petaling district).

What’s next?
Well-validated and comprehensive evidences on asymptomatic dengue are unlikely to surface in the next few years. As such, while this condition remains a Pandora’s box, our best shot in the dark could be the utilization of symptomatic indviduals as proxies to identify the asymptomatic ones. Specifically, symptomatic individuals should be encouraged to advise the people who have had contact with them for a significant portion of time over the last two weeks[5] or so to undergo dengue-screening. Besides, clinicians need to educate patients regarding the fact that at present, the elimination of mosquito-breeding sites is the best method to keep the disease at bay. For that matter, apart from discarding stagnant water, all vessels which have contained the same need to be scrubbed so that the Aedes’ eggs get destroyed as well.[6]

In conclusion, researches concerning the dissemination, management, and prevention of dengue should take into account the asymptomatic population, apart from aiming to generate practical, universal (or at least, nationwide), and cost-effective solutions to control the disease for good. In the meantime, it is incumbent of health professionals to engage with the community and mobilize the most effective weapons against the disease.

Epilogue
The author is currently based in the University of Malaya. He is currently involved in researches whose objectives are to determine (1) the efficacy of gravid ovipositioning sticky (GOS) traps and NS1 rapid test kits as vector control instruments; (2) the utility of finger-prick blood to serodiagnose dengue; as well as (3) the occurrence and infectivity of symptomatic and asymptomatic dengue.

 *NS1 = non-structural protein 1; IgM = immunoglobulin M; IgG = immunoglobulin G; ELISA = enzyme-linked immuno-sorbent assay; PCR = polymerase chain reaction; PRNT = plaque reduction neutralization test

CARDIO-GOLI

prepared by: Shalini Rajamany

In conjunction with World Heart Day, AMSA Melaka Manipal Medical College launched their event ‘Cardio-goli’ on 9 October at the MMMC Dato Pathmanathan hall. The event was held to create awareness on health issues pertaining to the cardiovascular system through interactive activities that included various competitions, games and a health bar. The theme for the event, Cardio-goli was ‘A Healthy Heart’. Apart from that, it also provided an opportunity for bonding amongst students of different batches and faculty through various fun-filled activities.

The event kicked off at 5.00 pm with the health bar offering a variety of juices; mango, orange, dragon fruit, banana and carrot catering to the taste buds of the students. There was good demand for fruit juice as many orders were taken beforehand, and during the event. Fruit juices are healthy drinks that are a valuable source of nutrients and recommended for heart health. The fruit juices were prepared on the spot to ensure freshness of the drinks.

This was followed by various competitions and games. The crossword puzzle was stimulating and informative as it was related to the heart whereas the rangoli and colouring competitions required creativity and patience. The rangoli competition which required the participants to create colourful rangoli designs was also based on the theme. Participants showed off their creativity with some impressive designs. The game booths drew the biggest crowd as the games were entertaining and fun similar to that at a fun-fair. Here, they were able to test their dexterity by attempting games like popping the balloon, ring toss, smash the bottle and basket toss.

To mark the event, AMSA also set up a booth for the sale of T-shirts and mugs as mementos for the students. The T-shirts and mugs were attractively designed by the students themselves .

Students and lecturers turned up for the event to show their support to the organisers as well as to relax after lectures. The event ended with a prize- giving session for the rangoli and colouring competitions. The prizes were given away by Dr Sudipta and Dr Soe Moe who were also the judges for these two competitions.

This event, Cardio-goli was enlightening as those who participated were made more aware of health issues related to the cardiovascular system. The organizing committee too benefitted as they had the opportunity to coordinate an event in their campus for the students and faculty to highlight the significance of World Heart Day. Moreover, the committee members were able to put into practice organizational skills acquired during their studies at MMMC. As doctors, they know it is not enough just to treat patients, it is equally important to create awareness on health issues as awareness can reduce health problems. Events such as this should be organized on a regular basis by hospitals and clinics to keep the public informed on current health issues. Hence, a society which is well-informed will place greater emphasis on leading a healthy lifestyle.