Brain drain or Brain Circulation

KUALA LUMPUR, 19 APRIL 2012- A number of ENT specialists trained in The National University of Malaysia (UKM) have been snatched to work abroad thereby regarded as being part of the brain drain phenomena for the country. However its Vice Chancellor, Prof Tan Sri Dato' Wira Dr Sharifah Hapsah Syed Hasan Shahabudin looked at it differently.

 She is of the view that these experts who chose to work abroad will one day come back home and will then bring back their expertise to the country. Opening the 4th ASEAN Academy of Neuro-Otology & Audiology Congress (AANOA) here today, she likened it as ‘brain circulation’ rather than ‘brain drain’. Neuro-Otology is a branch of clinical medicine which studies and treats neurological disorders of the ear. It is a subspecialty which stems from Ear, 

Nose and Throat (ENT) specialisation. She said their going abroad will allow them to gain invaluable experience and will one day bring their expertise back home. Though it does cause a shortage to the country in the immediate term the specialists nonetheless are helping people no matter where they are. What is more important is that the people should benefit regardless of boundaries, she said. Prof Sharifah Hapsah also said that new developments in ENT treatment like cochlear implants have revolutionised the treatment of hearing impairment where hearings can now be revived even in cases once considered impossible. Sign language may one day become obsolete, she said.

 Hearing impairment needed to be detected early as it can have a detrimental effect on an individual’s learning ability, she said. UKM began its coclear implant programme in 1995 and to date had given such implants to 295 patients. The honourary founding president of the conference, Prof Dr Suchitra Paransuk in her keynote address said she was treated with skepticism and sometimes ridiculed when she said that hearing disability can be tackled with Neuro-Ontology some 40 years ago. She had then just got back home from studying abroad. Now the Thai government is subsidising cochlear implant surgery while Neuro-Ontology is also recognised globally.

 Prof Suchitra said though cochlear implant surgery is accepted, the treatment depended on facilities available in a country. In some places it is only available to those who can afford it. This has to change because every child deserves the gift of hearing. UKM started its cochlear implant programme in 1995. The cochlear team also trained health personnel from other hospitals both locally and foreign.

 The AANOA conference which began today ends on Saturday 21 April. It also consists of various workshops on the latest technique available for ear surgery. AANOA President, Prof Dato’ Dr Lokman Saim, participants and guests from United Arab Emirates, Thailand, Australia, Singapore, Indonesia, Malaysia and the Philippines attended the conference.

Cure for Osteoporosis

KUALA LUMPUR, 6 April 2012 - Researchers from The National University of Malaysia (UKM) have discovered that ‘tocotrienol’ (a form of Vitamin E) derived from palm oil, can strengthen brittle bones thereby reversing incidences of osteoporosis.

This discovery was made by Prof Dr Ima Nirwana Soelaiman and her team, Assoc Prof Dr Norazlina Mohamed, Assoc Prof Dr Ahmad Nazrun Shuid and Dr Norliza Muhammad of the Faculty of Medicine, UKM after a series of comprehensive studies.

Prof Ima who is Head of the Bone Metabolisme Research Group, said: “our extensive animal studies have shown that Tocotrienol can improve the bone structure of osteoporotic bone and bring it back to its original condition.”

She said that the studies also revealed that besides reversing osteoporosis, Tocotrienol can also prevent the development of osteoporosis. The studies conducted over fifteen years have produced consistent results time after time; which is that tocotrienol can prevent and cure osteoporosis.

Her work has won awards in international scientific expositions, such as at the Invention and New Product Exposition (INPEX2008), Pittsburgh, Pennsylvania, USA, 2008 [Gold Medal, Award of Merit] and 34th International Exhibition of Inventions, New Techniques and Products, Geneva, Switzerland, 2006 [Gold Medal, with Merit]. She has also published almost 80 scholarly articles in indexed journals, of which half are on vitamin E and bones.

Tocotrienol is a family of vitamin E which is derived from palm oil. In recent years, Tocotrienol has gained recognition as a potent antioxidant that protects cell membranes and DNA from free radical damage. Free radicals are by products generated when oxygen is converted into fuel for the human body. As an antioxidant tocotrienol prevents cellular damage. Therefore diseases such as osteoporosis which have strong oxidative component will benefit from tocotrienol.

Understanding osteoporosis

Bone is made of a hard outer shell with a mesh of collagen (tough elastic fibres), minerals (including calcium), blood vessels and bone marrow. This mesh looks a bit like a honeycomb, with spaces between the different parts.

Healthy bones are very dense and thus the spaces inside the bones are small. However in bones affected by osteoporosis, the spaces are larger and this make the bones weaker, less elastic and more likely to break.

As a living tissue, bones constantly repair themselves in a process called bone turnover. There are cells which break down old bones (osteoclasts) and cells which build new bones (osteoblasts). Bones become brittle when the osteoclast activity predominate over osteoblast activity. This results in less bone, since bone is broken down at a faster rate than it can be replaced.

These fractures most commonly occur in the spine, wrist and hips but can affect other bones such as the arm or pelvis. A fracture is a huge problem to an osteoporotic patient, since osteoporotic bone is slow to heal and a fracture may not heal completely.
These patients will have to depend on others to do simple tasks such as going to the bathroom.

Osteoporosis Risk Group

Osteoporosis is caused primarily by hormonal imbalance and women are four times more likely to get osteoporosis then men. When women reach menopause, their estrogen production will go down drastically, causing increased bone loss leading to osteoporosis. Women with a low pre-menopausal bone mass are more prone to develop osteoporosis. Tocotrienol can prevent this from occurring.

Men are, however, not totally immune to osteoporosis. Men can become osteoporotic if they lose their testosterone and this is also considered to be osteoporotic due to hormonal deficiency. This problem usually arises when men get very old or if there are problems with their testicles such as testicular tumor that require their testicles to be removed. Removal of the testicles will then cause testosterone to be depleted in the body leading to osteoporosis.
People who are on steroid treatment for asthma, arthritis and cancer can developed osteoporosis as a side effect. From her studies tocotrienol was also shown to reverse steroid induced osteoporosis.

Nicotine found in cigarrette smoke is another risk factor for osteoporosis. Chronic smokers have been shown to have lower bone mineral density compared to non-smoker. Studies by Prof Ima and her team have found that tocotrienol can reverse the osteoporosis and bring the bone back to normal once the nicotine intake was stopped.

Additional studies by Prof Ima and her team found that tocotrienol also enhanced the structure and strength of normal, non-osteoporotic bone. This indicates that tocotrienol can increase peak bone mass. High peak bone mass will reduce the risk of osteoporosis in later life. Her latest studies have shown that it can accelerate the process of fracture healing in osteoporotic bone.
Prof Ima Nirwana Soelaiman can be contacted at imasoel@medic.ukm.my, imasoel@yahoo.com

How notorious is Vitamin E

Well it depends on what type of vitamin E you are talking about.Some can increase your risk to have osteoporosis. But others have the opposite effect. Yes it can help brittle bones get back to normal condition.

There is a lot of confusion about Vitamin E in general. This is more so after the publication of a scientific article in a reputable journal, ‘Nature Medicine’ titled “Vitamin E decreases bone mass by stimulating osteoclast fusion”.

The paper published was referring to the presence of the compound alpha tocopherol found in vitamin E but not the compound tocotrienol which is also found in vitamin E which has been the subject of extensive studies by Prof Dr Ima Nirwana Soelaiman and her team of researchers at the Faculty of Medicine of the National University of Malaysia, UKM. (see accompnying story).

The article did in fact showed that alpha tocotrienol did not have the same effect as alpha tocopherol, which was claimed to be linked to osteoporosis, said Prof Ima, Head of the Bone Metabolisme Research Group of UKM.

Some researchers have shown that tocotrienol found in palm oil is a better antioxidant than tocopherol found in soya oil.

There are even some reports that say tocopherols and tocotrienols may have opposing effects in certain situations. In her studies, Prof Ima has found that tocotrienol was better than alpha tocopherol in preventing and reversing osteoporosis.

While Prof Ima does not dispute the findings of the study itself, she said that the title, which used the general term “Vitamin E” will create the wrong impression.

“You have to be more specific since there are eight isoforms of Vitamin E, four can be classified as tocopherol and another four as tocotrienol,” said Prof Ima.

Therefore, it should be made clear in the title, that it is the alpha-tocopherol isoform of Vitamin E that was being referred to because not every isoform of vitamin E have the same effect. Unfortunately, due to the misleading title, the mass media have started to portray all vitamin E in a bad light .

She has since written to the journal’s editor pointing out the misleading heading and asking for a correction but to no avail.

Prof Ima and her team are continuing their research on tocotrienol and osteoporosis and plan to develop tocotrienol as an anti-osteoporotic agent with a pharmaceutical company.

They are in the final stages of animal testing and will then conduct clinical testing on humans. Once the medicine is produced and reaches the bedside, osteoporosis maybe a thing of the past.