Skewed

October 29th, 2008

Its been quite a while since I posted and after seeing AngryDoc’s post, I sorta felt the urge to write something.

I know its becoming a laboured chore to hear me say “I’ve been rather busy lately” but its really true.

Not just busy but feeling rather miffed. 

A certain presentation made me really angry not too long ago and it would be unethical and unreasonable to talk about it here. However, I’ve always been wonder how far one would go to support one’s fellow professional in times like these. Should we stand aside, arms akimbo, thinking its none of our buisness? Or should we point it out in private, only to be violently rebuffed by the obstinately self righteous? Or take the other side and pity the “professional” in question, ignoring the welfare of the ill-informed patient? Simple rhetorical questions indeed.

How can one be so irresponsible escapes me. Looks, demeanour and voice rarely deceive me but to hear and observe even more has made me repulsed beyond words. Its one thing to not know anything, being inept or incapable or imbecilic but yet another to exploit the welfare of another innocent being in your position of
“power”. Its manifestation at this stage is worrying and the consequences that follow (if the said person is allowed to continue in its ways) might be disastrous. 

I’m displeased and sincerely hope things might somehow be set right. Till then, I’m speaking nothing of this here.

The Cherished Right of Reply, Refused.

September 15th, 2008

“If healthcare professionals who have been aggressively attacked are not given the right to respond, and present their case, who will be?”  – Richard Seah, Guest Writer (www.theonlinecitizen.com)

It has been close to a month since the publication of his article, entitled “A Straits Times campaign against alternative therapies?” and it is about time to review how peddlers of pseudoscience scream for the right of reply and when confronted with the cold, hard facts, shirk away slowly into oblivion. 

Mr. Richard Seah, describes himself as an ex journalist with the Buisness Times from 1980 to 1989 and claims to have published a newsletter on natural health called The Good Life from 1989 to 96. He claims to be a free-lance writer and web-builder and has worked closely with several alternative/complementary health practitioners, including a Mr. John Yeo, nuritionist at The Autism Recovery Centre, Biomedical practitioner and a parent of an autistic teenage daughter.

The stage is set when Mr. Seah accuses our national newspaper, The Straits Times of “waging a vociferous campaign against alternative therapies for autism - and singling out biomedical treatment”. In a series of articles, the daily paper detailed in an easy to understand yet scientifically accurate analysis of the “complementary / alternative medicine” (CAM) field, one of which includes the scientific sounding “biomedical treatment”. He goes on to explain that at least two letters have been rejected for publication to the Straits Times Forum page and hence he accuses the newspaper of denying him and his fellow advocates of CAM the right to respond to the allegations.

As such, TheOnlineCitizen, a local website whose aims are to tell “the stories about Singapore and Singaporeans that weren’t being told in the mainstream press”, published Mr. Seah’s highly misinformed and irresponsibly misleading article. Subsequently replies in the form of comments came quick and furious on the website from both sensible people who are versed in the scientific process and those who are blind supporters of unproven, baseless and potentially dangerous therapies.

Mr. Seah and Mr. Yeo were first challenged to produce research to support their claims for their alternative therapies. Mr. Seah responded that anyone interested should visit their website which covers “studies” on chelation, probiotics, vitamin B12, HBOT, neurofeedback and chelation therapies. Some of which are published by Mark Geier, of the Mercury-Vaccine-Autism link fame.

A fellow commenter, hansolo had the patience to peruse through the references but found them lacking, details of which are found on the original post. Leng Hiong of Freshbrainz together with Angrydoc roundly disproved all of the claims, from why anecdotal evidence cannot be used to providing specifically why the few studies quoted were either of flawed experimental design or just randomly quoted to support a flawed treatment modality.

What follows is highly indicative of the typical CAM-monger. Mr. Seah and Mr. Yeo, out of excuses, vanished and relinquished the right of reply they have so desperately sought and out of nowhere, various commenters such as “Energetic Believer” and “Just a mom of 2” started appearing to support Mr. Seah and Mr. Yeo with anecdotal evidence and verbal support.

This whole incident is highly unfortunate for several reasons.

Firstly, it is very sad that people like Mr. Seah and Mr. Yeo are unable to read and assess the evidence available. They not only dismiss the scientific method, like CAMongers around the globe, they also attempt to make a mockery out of the educated audience by postulating deceiving and misleading information vaguely disguised as evidence.

Secondly, Mr. Seah who proclaims that he deserves a right to reply simply gives it up upon facing opposition to his lofty ideas about treatment modalities for Autism. This is not the kind of engagement befitting of neither someone who has strong beliefs in his methods nor someone who rails at the mainstream media for not publishing his preposterous claims. This is a disappointing reversal of his indignant stand which he took at the start of his article.

Thirdly, whilst the intention of TheOnlineCitizen to give air to views that are rejected by the mainstream media, it has not acted responsibly in helping its readers filter out potentially dangerous content, such as the information published by Mr. Seah. While it is fortunate that there are many responsible people who take time to respond to the article, people who are desperate for treatment who happen to stumble upon the article may be tempted to try out Mr. Seah’s dangerous suggestions without reading the comments below. If a website wishes to join the ranks of a responsible and reliable media outlet, it must be able to filter objectively the positively flawed and misrepresented views, especially in the scientific arena where a competent science editor would be a useful addition to the theme. Otherwise, it is most prudent that if the website does not have the expertise to evaluate such content, it should refrain from publishing such material.

Lastly, the publication of such a letter marks the start of the spread of pseudoscientific beliefs here in Singapore, a place which has been relatively sheltered from the onslaught of pseudoscience.

Oh well, at least there is Clearthought around to help dispel such pseudoscience and promote rational thinking but for how long to what extent we are able to rally enough supporters and people to join Clearthought to counter such pseudoscience remains to be seen.

Holidays

September 7th, 2008

Its the holidays for the next 3 weeks for me and I am sure gonna soak up ever ounce of it for the past 9 weeks have been a whirlwind of excitement and stress.

I’ve a few projects that I am working on now and so might not be that free after all but I shall attempt to revive this blog a bit.

Projects I will be busy with include:
1) Welfare home dental screening and special needs dentistry research.
2) My final year research project.
3) Community service project with HPB and NorthWest CDC.
4) Youth Engagement Project with Tampines.
5) Working on the Faculty’s 80th anniversary yearbook + DVD

Things I wish to start seriously reading include:
1) Oral Pathology (First, I’ve got to go buy the textbook…)
2) Internal Medicine (I have been going to ward rounds and guessing too much. Must. Memorise. Clinical. Examinations. Book.)
3) Periodontology (I’d better brush up on this if I wish to take the competency tests next term)

Things I want to enjoy include:
1) Catching up with friends I have not been able to meet up for a long time.
2) Catching up with friends whom I’ve never really had a chance to sit down and chat casually.
3) Sitting around (preferably alone at the beach) without having to worry about which patient is coming when and whether they remember the appointments or will come late.
4) Waking up late with a silly smile on my face, knowing I really don’t have to do anything that day.
5) Walking around deserted malls during school hours shopping for the things I’ve been dying to buy (New glasses/bags/shoes)
6) Going for some exercise in the morning just because I can.
7) Playing games till the wee hours of the morning till there is no one else online.
8) Reading all the things I’ve been wanting to read but didn’t have the time to.
9) Drinking coffee for taste, not for the caffeine.
10) Blog, to entertain you.

Okie thats all for now, I’ve gotta prepare some worksheets for my students tomorrow so I’d better go do that before taking a nice long sleep again. Catchya arnd and thanks for dropping by,

Wisdom of Stem Cells

August 22nd, 2008

As usual, odd dental stuff gets Edgar all excited.

From The Straits Times:
Stem Cells From Wisdom Teeth
TOKYO - JAPANESE scientists said on Friday they had derived stem cells from wisdom teeth, opening another way to study deadly diseases without the ethical controversy of using embryos.

Researchers at the government-backed National Institute of Advanced Industrial Science and Technology said they created stem cells of the type found in human embryos using the removed wisdom teeth of a 10-year-old girl.

‘This is significant in two ways,’ team leader Hajime Ogushi told AFP. ‘One is that we can avoid the ethical issues of stem cells because wisdom teeth are destined to be thrown away anyway.

‘Also, we used teeth that had been extracted three years ago and had been preserved in a freezer. That means that it’s easy for us to stock this source of stem cells.’

The announcement follows the groundbreaking discovery by US and Japanese scientists last year that they could produce stem cells from skin, a finding that was hailed by the Vatican and US President George W. Bush.

Research involving embryonic stem cells - which can develop into various organs or nerves - is seen as having the potential to save lives by helping find cures for diseases such as cancer and diabetes.

But studies on embryos are strongly opposed by religious conservatives, who argue that such research destroys human life, albeit at its earliest stage of development.

In the new research, cells were extracted from the wisdom teeth and developed for about 35 days.

The researchers then tested them and found that they were stem cells, which can develop into various other kinds of human cells, Mr Ogushi said.

As with last year’s skin cell discovery, the Japanese researchers said it would take time to put the use of wisdom teeth into practical use.

Mr Ogushi estimated it would take at least five years to put the method into clinical use such as trial treatments of congenital bone disease. — AFP

Another reason not to extract asymptomatic wisdom teeth. Until you need them or can store them for future use.

6 Word Life Story

August 14th, 2008

Check out http://www.smithmag.net

Secrets
Never told
Never will be.

-Edgar

Of Work, of late

August 10th, 2008

My lack of blog posts mirrors the fact that I have been very busy of late, with tons of school related work to accomplish with horrible deadlines and inhumane schedules. Not to mention my work outside of school.

As my life swings back to normal, I will get back to blogging.

The new year 1s will start school tomorrow. Haha.
The year 2s will be back to school tomorrow. Haha.
I’m having my Oral and Maxillofacial surgery posting next week. Haha.

Two or more hours worth of internal medicine ward rounds next week, being treated like stupid, second rate students.

Lots of unfinished lab work to be completed next week, inclusive of all my orthodontic retainers that I have not made, denture teeth setup for my patient, provisional bridges for my technique work and pedodontic technique work.

I will attempt to bring myself to send my laptop for servicing. The Hinge has dislodged itself for the third time.

Shoutouts:
Happy Belated birthday Darryl, sorry for the lack of surprise.
Happy Birthday Zhongwei.

Good riddance, Luke.

Congrats to those who got engaged recently! (yes, all THREE of you)

Welcome to the line, Jeffrey and Stella.

Cya around Frank and Chi.
Good luck on your trip CJ!

Edgar is now thinking of Laurent Bernard chocolates… Sarah, this is all your fault!

Removal of Impacted Wisdom Teeth

July 13th, 2008

Okie for those who cannot stand shameless advertisements, just ignore this post.

As part of my clinical requirements, I am supposed to assist in a minimum of two Local Anasthesia Operations before starting on my own LA Ops.

Therefore I will need to find people who wish to have their wisdom teeth removed by a specialist and assist the specialist during the operation.

If you want or know people who want to have their wisdom teeth removed by a specialist at a discounted price of around 200 to 300 dollars (their wisdom teeth should be partially erupted or impacted), kindly leave me a comment or email me at edkieu@gmail.com. I have limited slots and all these operations will take place in the week of 11 August to 18 August 2008 subject to availability of slots in the oral surgery clinics. I will NOT be performing the operation as I am only assisting but perhaps may be tasked to give you one of my nice almost painless LA jabs before we start.

Flood my email now.

For more info, go wiki wisdom teeth.

Amalgams…

July 12th, 2008

With reference to an article on MyPaper on Friday:

Dear Mr. Nanayakara,
 
I object to your insinuations in your article dated July 11 2008, especially your paragraph, quoted below:

“Mercury, which by itself is a highly poisonous metal, makes up almost half of an amalgam filling, which also contains silver and a small amount of copper and tin. When introduced to the body via such amalgams, mercury can have neurotoxic effects on growing children and foetuses.”
 
This is a very damning and highly scientifically inaccurate statement to make.
 
Two very good studies published in the Journal of the American Medical Association have shown no neuropsychological, renal or neurobehavioural effects of dental amalgam in children. Moreover, elemental mercury itself has a different toxicity profile in the form of vapour, liquid or as part of a restoration.


Neuropsychological and Renal Effects of Dental Amalgam in Children, A Randomized Clinical Trial JAMA.
2006;295:1775-1783. David C. Bellinger, PhD, MSc; Felicia Trachtenberg, PhD; Lars Barregard, MD, PhD;
Mary Tavares, DMD, MPH; Elsa Cernichiari, MS; David Daniel, PhD; Sonja McKinlay, PhD Neurobehavioral Effects of Dental Amalgam in Children, A Randomized Clinical Trial JAMA.
2006;295:1784-1792. Timothy A. DeRouen, PhD; Michael D. Martin, DMD, PhD; Brian G. Leroux, PhD;
Brenda D. Townes, PhD; James S. Woods, PhD, MPH; Jorge Leitão, MD, MS;
Alexandre Castro-Caldas, MD, PhD; Henrique Luis, MS; Mario Bernardo, DMD, PhD; Gail Rosenbaum, MS;
Isabel P. Martins, MD, PhD

Your article is unduly alarmist, badly researched, irresponsible and potentially misleading to dental patients.
 
There are many indications to use other types of restorative materials such as composites, glass ionomers or ceramics but there are still very good reasons to use dental amalgams.
 
It is indeed disappointing and sad that a newspaper such as yours with a broad public reach would have such poorly researched information thinly veiled as news.
 
I look forward to either an explaination, retraction or clarification of your article, preferably quoting good research to substantiate your claims.
 
Kind regards,
Edgar Kieu

Fantastic Claims

July 1st, 2008
Beware fantastic claims on supplements on the Net
YOUR recent report about two persons who were recently hospitalised for palpitations, hallucinations and anxiety from consuming a food supplement called Relacore they bought over the Internet is a reminder to consumers they should not naively believe everything they read on the Internet. It is commonplace for one to receive in one’s e-mail everyday a flood of information on health foods, dietary supplements and medicines, all claiming to fix a host of ills. You can shed weight, look younger, boost your immune system, relieve chronic pain conditions and turbo-charge your sexual performance. You only need to make a purchase via the Internet. It’s all safe, and why should you think you need to ask your doctor?

The current view is that the slimming pills consumed by the two persons may have been counterfeit versions of the genuine Relacore article. While counterfeit products are generally ineffective and produce little clinical effect, they sometimes cause actual harm.

There are no short cuts to managing one’s weight. It’s not easy, but it can be done. An overweight person needs advice on a correct and safe diet. He needs to increase his physical activity level. If this fails, the use of an approved drug under medical supervision may be appropriate. Be wary of fantastic claims.

Dr Lee Chung Horn
President
Singapore Association for the Study of Obesity

From Straits Times Forum page, Online Edition.

This article caught my eye as it has been a really long time since someone posted on the forums regarding absurd medical claims.
Here in Singapore, we have no shortage of quacks dispensing snake oil and despite much attention being drawn towards fantastic (I’d prefer to label them as fraudulent) claims, we still see many people falling prey to the common and usually harmless supplements.
Despite the lack of evidence supporting the consumption of antioxidants (as blogged before here), people are still lapping up all the advertisments and still buying all their supplements even when the meta-analysis pointed to an increase in mortality rate, however small.
Many of my blog readers might already be familiar with my opinion that there should be greater regulation in the area of health foods and alternative medicine. (I personally don’t like the term alternative/complementary medicine as I don’t think they are alternatives or complementary in any way) Perhaps the authorities should indeed consider having a tighter reign on such claims and start actively prosecuting people making these unjustified claims. A two pronged approach with public education and efficient prosecution coupled with close monitoring would do the industry alot of good.
However, one thought ran through my mind when I read the article: Don’t our immigration authorities screen incoming parcels containing medication? If not, who is to stop people just buying drugs (LSD, Heroin, Marijuana… you get the drift) online?

Courtesy

June 24th, 2008

I think its common courtesy to cancel appointments at least a few days in advance.

Especially dental appointments.

When a dental student arranges to see a patient, it takes more than just making sure a chair is there. You have to ensure the correct instructor/doctor is on duty, the nurses are prepared and ready with the equipment, the receptionist is aware of the patient’s arrival, the patient is booked into the computer system and your lab partner doesnt have any other patient waiting for him too.

So when a patient cancels last minute, he/she inconveniences many, many people. Poor dental students like myself have very few clinic slots to accomplish a fixed number of fillings/dentures/crowns/bridges and other types of treatment and cancelling means that he/she is firstly depriving another patient of the chance to be treated at the ridiculously low prices under undergraduate treatment and he/she is also depriving me of a learning opportunity. My partner who specially reserved his time just to suit your whim now has to find someone else to occupy his time with or just sit around and waste his time.

This is not the first time XXXXXXX. I am highly displeased and upset with you.