Bedwetting in children

By K.M. LEW

Most children can control voiding by the age of five years. However, incontinence can occur in about 1% of those aged 18 years. 

      THE kidneys produce urine, which passes through the ureters to enter the bladder, a hollow and distensible organ that sits on the pelvic floor. The stored urine exits the body through the urethra, which is a tubular structure. This act (voiding) involves muscles, nerves, the spinal cord and the brain.

      The bladder has two types of muscles. The detrusor muscle stores urine and contracts when emptying the bladder. The bladder sphincter is a circular group of muscles found at the bottom of the bladder. It automatically contracts to retain urine in the bladder and relaxes when the detrusor muscle contracts (when the urine gets into the urethra).

      When the pelvic floor muscles contract, urine is held back in the bladder.

      The newborn’s bladder fills up to a certain set level at which the bladder muscle contracts automatically, leading to voiding. As the newborn grows, his or her nervous system matures. The brain starts receiving messages from the filling bladder through the spinal cord and also sends messages to the bladder.

      Eventually, the child is able to stop the bladder from voiding automatically until the child decides when and where to void.

      When the control mechanisms are immature or fails, it results in bedwetting (incontinence). Most children are able to control voiding by the age of five years. However, incontinence can occur in about 1% of those aged 18 years. Incontinence is twice as common in males as compared to females.

There are certain medical terms used to describe incontinence in children:

      > Primary enuresis is incontinence in someone who has never been dry for at least six months

      > Secondary enuresis is incontinence that begins after at least six months of dryness

      > Nocturnal enuresis is incontinence which occurs during sleep. It is also called night time incontinence

      > Diurnal enuresis is incontinence which occurs when awake. It is also called daytime incontinence

      There are several causes of bedwetting in children and they vary from the simple to the complex.

Causes 

      Nocturnal enuresis is more common than diurnal enuresis after the age of five years. The causes of nocturnal enuresis are not well clarified yet. Most cases result from a variety of causes that include slower physical development, an increased production of urine at night, a lack of ability to recognise bladder filling when asleep, and, occasionally, anxiety.

      Nocturnal enuresis between the ages of five and 10 years due to a smaller bladder capacity usually disappears gradually as the bladder capacity increases.

      The body produces a hormone called antidiuretic hormone (ADH) which reduces the production of urine. As less ADH is produced at night, the need to void is less. Sometimes the body does not produce sufficient ADH at night, leading to the production of more urine. If a child does not sense the increased volume of urine in the bladder and awakens to void, bed wetting will result.

      Anxiety has been suggested as a cause of bedwetting in children between two and four years of age when they have yet to achieve total control of their bladders. Anxiety after the age of four years can also lead to nocturnal enuresis after the child has been dry for six months or more. The anxiety-causing events include angry parents or relatives, birth of a sibling, and unfamiliar social situations.

      Incontinence itself can cause anxiety. Diurnal enuresis can cause anxiety that leads to nocturnal enuresis.

A strong family history of bedwetting is suggestive of genetic causes. Studies have reported that a child has an 80% chance of bedwetting if both parents had been bed wetters.

      There is a small group of children who have physical abnormalities in their urinary tract which lead to incontinence, e.g. a blocked bladder or urethra, and nerve damage associated with spina bifida, which is a birth defect of the spinal cord.

      Diurnal enuresis is less common than nocturnal enuresis and usually disappears earlier than nocturnal enuresis.

      An overactive bladder is one of the causes of diurnal enuresis. When the detrusor muscle of the bladder contracts strongly, the bladder sphincter may be unable to prevent voiding. This occurs frequently when there is a urinary tract infection (UTI), which is more common in girls because of their short urethras.

      Many children who have diurnal enuresis have abnormal habits, the most common being infrequent voiding. They ignore the feeling of a full bladder and do not void for long periods for various reasons, e.g. not wanting to use the toilets at school. As the bladder is overfilled, the urine leaks. Such children are prone to UTIs, which in turn leads to an overactive bladder.

      The causes of nocturnal enuresis may interact with infrequent voiding to lead to diurnal enuresis. These causes include small bladder capacity, anxiety, and physical abnormalities of the urinary tract. Pressure from a distended lower bowel, when a child has constipation, and caffeine-containing foods or drinks, that increase urine output, are other contributory causes.

Management

      There are various management modalities available. They include no treatment, bladder training, medicines, dietary modification, and moisture alarms.

      Most cases of bedwetting in children resolve spontaneously without any treatment as the child grows up. It has been estimated that the incidence of bed wetting reduces by 15% annually after the age of five years.

      The body’s changes with the passage of time include an increase in bladder capacity, resolution of an overactive bladder, the normal production of ADH, the resolution of anxiety provoking events, and the child learning to respond to the signals that it is time to void.

      Bladder training involves exercises that help to strengthen and co-ordinate the bladder’s muscles. The child learns to anticipate the need to void and to control oneself when there is no toilet nearby.

      The methods used for nocturnal enuresis include determining bladder capacity, drinking less before bed time, and having a routine for waking.

      The methods used for diurnal enuresis include voiding according to a schedule, avoiding caffeine containing foods or drinks, and relaxing the muscles. There is, however, no guarantee of success with these bladder training methods.

      There are medicines available to treat bed wetting. ADH levels can be increased with desmopressin, and an overactive bladder controlled with anticholinergics.

      The medicine, imipramine, which acts on the brain and bladder, is used for short term treatment of nocturnal enuresis.

      Moisture alarms awaken a person when voiding starts. The device has a water-sensitive pad that is placed in the pajamas and is connected to a battery-driven control. An alarm goes off when moisture is detected on the pad. The child has to wake up when the alarm goes off and go to the washroom to void.

      The use of such alarms may require another person to sleep in the same room as the child to awaken him or her.

      Bedwetting is common in young children. It resolves spontaneously in most instances. The management modalities include no treatment, bladder training, medicines, dietary modification, and moisture alarms. Anyone whose child has bedwetting would benefit from a reassuring discussion with the doctor.

Top 5 Tips for Better Eye Health in a Digital World

By Y.C. LIM

In attempting to sum up the world in 2010, one word comes to mind: connected. Everywhere we go we carry devices that keep us connected to something important to us. Be it a sleek new tablet letting you share photos with the person helping load your groceries, or a smartphone making sure you don’t miss that late night e-mail from a colleague; we are now constantly connected to the world around us, more than ever before.

We’ve become dependent on these digital devices to survive both professionally and personally, and with the holiday season now upon us and digital devices topping most of our gift wish lists, the amount of time we spend with these gadgets will only increase. Yet many of us forget to consider two devices we are naturally equipped with that keep us more connected to the world than anything else: our eyes. Consumers often don’t think about the impact digital devices might have on their vision, and it can be to the detriment of not just their health, but also productivity.

In an effort to help consumers keep their eye health in mind this winter while enjoying these amazing products, we’ve put together five tips for creating a vision-healthy environment for digital device usage.

1. Customize Your Environment

You can adjust your environment when using digital devices to promote healthier eyes. If possible, use a large monitor or screen magnifier to reduce eye strain. Make sure your chair is close to your computer and you are sitting in a chair with adequate lower-back support. Position your chair so that you are comfortable.

Each person has a preference for his or her chair, so take some time to find what’s best for you. Making sure you’re comfortable before you start using a device will decrease the amount of stress you put on your eyes trying to find the best viewing angle.

2. Think About Lighting

For extended reading, change your monitor settings to a reflective lighting scheme. But don’t only think about your computer lighting.

Good room lighting isn’t just flattering. It’s also healthy for your eyes. So, keep bright lighting overhead to a minimum. Too much lighting overexposes and irritates the eyes, while too little causes the eyes to strain in order to see. Keep your desk lamp shining on your desk, not you. Try to keep window light off to the side, rather than in front or behind you. Use blinds and get a glare screen. Position the computer screen to reduce reflections from windows or overhead lights.

3. Adjust Your Reading Angle

Adjust the screen so you look at it slightly downward and are about 24 to 28 inches away. The center should be about 4 to 6 inches below your eyes. Also, make sure your screen is big enough and with just the right brightness and contrast so you’re not straining to see text or images clearly. Adjust the screen settings to where they are comfortable for you.



4. Magnify Text on Screen

For those with permanently reduced vision, magnifying the text and images on your device will help you avoid straining your eyes from squinting. Almost every device can be adjusted to display larger text, and for those with compromised vision, this can make reading much easier.

5. Blink and Take Frequent Breaks

Devices are set up for virtually nonstop work — but you aren’t a machine. You need to take breaks to recharge, and so do your eyes. Use the “20-20-20 rule.” It’s easy to remember: every 20 minutes, take a 20-second break, and look at something 20 feet away. And don’t forget to blink! Blinking washes your eyes in naturally therapeutic tears. If you regularly wear glasses, also make sure you have proper lenses for the computer.

Follow the above tips, and you can enjoy your slick new technology without worrying about consequences to your eye health, productivity and overall peace of mind.

Women of substance

By K.M. LEW

At a time when there’s never been a greater need for change, nothing is more refreshing than a competition which celebrates diversity in beauty.

     Hotelier Karina Abdullah is, at 107kg, not your average beauty queen. First, the 24-year-old does not conform to the oh-so-boring rule stating that all beauty queens should be tall, willowy and hourglass-perfect. Second, she has more secrets than Miss World or Miss Universe would care to admit.

     “Of course I wanted to be thin when I was younger,” says Karina, when I asked if she ever had issues with her weight.

From left: First runner-up Mandy Ong Liam, title holder Karina Abdullah and second runner-up

     “I was 55kg when I was 15. My weight shot up due to the gastritis medication I was taking and, all of a sudden, I lost all confidence in myself.”

     Looking at her now, one would never think that. She is, after all, basking in the afterglow of the recent Jumbo Queen competition organised by Plaza Sungei Wang in Kuala Lumpur, where she was crowned reigning queen for 2010. She walked away with RM5,000 in cash, a trophy and sash.

     Clad in a canary yellow maxidress that drapes beautifully across her voluptuous size-14 frame and red high-heel pumps, she is a picture of serenity and self-assurance.

     “I never expected to win,” she says. “I spent a lot of time rehearsing what I was going to say when I got on stage, but I was so nervous that I forgot my speech when the time came. It was embarrassing!”

     But if the praises of Sungei Wang’s senior manager K. K. Lim are anything to go by, Karina is destined for things much bigger than herself.

Diana Lau (also above) won the Most Talented Jumbo Queen title for her dance.

     “She’s a natural beauty. She outshone the other nine finalists because of the way she carried herself,” he gushes later when she is out of earshot.

     Lim, who sat in as a judge for the finals, was also in charge of organising this unusual beauty pageant, which was originally held in Thailand to highlight the plight of Asian elephants (according to Thai stipulations, a Jumbo Queen has to weigh more than 80kg and reflect the grace and beauty of the majestic pachyderm). However, Lim’s motive was a purely tactical one. He wanted to boost weekday attendance at a shopping mall which receives a bulk of its clientele on weekends.

     “I was holidaying in Bangkok when I came across some magazines with Jumbo Queens on their front page, and I thought what a great idea,” he says. “But from the very beginning, I knew that it would take Malaysians some time to warm up to the idea.”

     Just as Lim expected, our nation’s very first Jumbo Queen pageant only had 20 applicants when it was held in 2007.

No big deal

     After a two-year hiatus, the Jumbo Queen pageant is back with more big-name sponsors and monetary backing. This time, however, more than 40 aspirants, including a 50-year-old housewife, signed up to compete (yes, there is no age limit, simply because Lim is afraid that imposing too many restrictions could work against his favour).

     “The competition provides an opportunity for all plus-sized women to be in the limelight,” he says. “The only rule is that you have to be above 18 and confident! Many applicants who didn’t make the cut were actually quite pretty, but were painfully shy.”

     Confidence, it seems, can get you far, as with 33-year-old Suhaily Mohamad Ali, who was one of those who had no qualms singing and dancing in front of hundreds of spectators, despite being the heaviest contestant at 143kg. As such, the mother of six managed to breeze her way through rounds one and two to emerge among the top 10.

     “This is actually my second time competing in Jumbo Queen because I didn’t win the last time!” she says, smiling mischievously. “My best friend Azurah asked me to join in with her this year. I’ve always been interested in modelling, so I thought why not? I want everyone to know that big women can be beautiful too.”

     Suhaily may not have won this year’s pageant either, but she claims that participating in it was one of the best decisions she’s made in her life. Of course, it also helped that she had a tremendous amount of support from close friends and family.

     “Yeah, you should’ve seen her supporters. They all came dressed in pink, waving banners and cheering very loudly!” exclaims a very amused Lim.

     “I’ve never had a problem with the way I look and neither do my kids or husband, who’s much smaller than I am,” says Suhaily, adding that his love and adoration for her did not waver even when she was piling on the kilos after the birth of their second child.

     “If anything, I think he loves me even more. He gets really jealous when he sees me talking to other men!” she says, eyes twinkling.

     The housewife — whose daily chores consist of everything from keeping the house spick and span to caring for the kids (her youngest is five) — claims that her weight has never interfered with her work.

     “I think the only problem for me is finding the right clothes because everything here is so tiny! That, and the fact that I’ve never been brave enough to get into a Kancil!” she says. “Otherwise, I feel healthy. I cook, I clean, I dance.”

     According to Lim, the public has a clichéd, and often mistaken, perception of plus-sized women — “Even I was guilty of thinking that once,” he admits.

     However, the pageant has taught him that not all of them are as “lazy” or as “helpless” as their weight implies.

     “This negative stereotyping is really unfair,” he says. “I found out after organising this event that they’re all great girls, fun and friendly. Some of them are even more energetic than their skinnier peers!”

     He is referring to Diana Lau, 27, whose effortless shimmies, gyrations and leg-splits during the pageant’s talent portion won her the Most Talented Jumbo Queen title.

     Lau, who works as a dance teacher by day and a lounge performer by night, is also present for the interview. Clad in a short denim skirt and hot pink tube, she is easily the most brazen and effervescent of the bunch.

     “I’ve been dancing for eight years and I know several dance styles including bellydancing, hip-hop, freestyle and new jazz,” she says, after apologising for her halting English. “I didn’t even choreograph the routine that I performed that day. It just comes naturally.”

     The Sarawakian, who migrated to the big city five years ago in search of a better lifestyle, says that opportunities are scarce for someone her size. Her talent, however, is enough to wipe the smirk off most faces. Take Lim, for instance, who can’t help but rave over what he witnessed on stage a week ago.

     “I guess it runs in my family,” says the very athletic Lau, who had also represented her home state in national basketball and wushu competitions when she was younger. “My older brother is a break-dancer and my older sister is an aerobics instructor. They’re all really skinny, however. I’m the only one who weighs 90kg.”

Don’t give me attitude!

     For someone with multiple tattoos and a well-rehearsed tough-girl act, Lau is surprisingly gracious and trusting. Within moments of meeting me, she prattles on about her life, including the recent messy divorce she’s had to go through (it ended with the husband winning sole custody of their six-year-old) and the sudden, unexpected break-up from her current fiancé.

     “He just packed up and disappeared when he found out that I had joined the pageant,” she reveals. “He’s been pressuring me to lose weight for some time and keeps comparing me to other girls. I didn’t hear a word from him after that.”

     Asked if she was heartbroken, Lau, who seems unruffled by her experience, says in Chinese: “I suppose what is yours, is yours, and what isn’t, will never be. I’m just glad that I got to see his true colours before we got married.”

     Like Karina, Lau has struggled with her body since she was a teenager (“I used to weigh 130kg,” she declares).

     She has tried everything — dieting, medication, health supplements and even regular appointments with a nutritionist — to shed those pounds. Unfortunately, her tenacious quest backfired.

     “I was on this yellow pill about two years ago,” she says. “Not only was it cheap, about RM1 for one, it was also very effective. I was 12kg lighter after one month. This would’ve been a good thing if I hadn’t blacked out one day. I did not wake up till two days later — in the emergency ward of a hospital.”

     Karina, who could relate to what Lau had gone through, quips, “Yes, I know the pill! It gives you heart palpitations, doesn’t it? I was on that too!”

     Lau and Karina may have sworn off diet pills since the passing of the “yellow pill” fad, but the former is still coming to terms with her own body.

     “I need to lose more weight because my profession requires me to be slim and slender. They call me “Diana-saur” at the club now. Also, the salespeople always give me hell when I’m out shopping for clothes for my job. They get very rude and condescending when they see me picking out the sexy stuff,” says Lau.

     Despite their monumental confidence, Karina and Suhaily are not exempted from societal prejudice either. The public, it seems, can be “cruel”, “unforgiving” and “judgemental” when you’re a plus-sized woman trapped in an over-starved, over-plasticised society.

     “Even my children’s friends tease them about having a fat mother. However, my kids would always reply, ‘My mother is beautiful. Is yours?’,” says Suhaily, smiling.

     However, both women do not let such pettiness get to them.

     “Yes, it’s not unusual for the public to discriminate against us because of our size. They just stare at you and start to make snide remarks. But whenever that happens, I just put on a whole lot of sass, like my role models Aretha Franklin and Queen Latifah. My boyfriend loves it!” says Karina.

     She claims that the competition has helped her “see the light” by reinforcing her belief that plus-sized women can do anything they put their minds to, including landing themselves a spot in the entertainment industry.

     “For years, I’ve wanted to join Akademi Fantasia but I hadn’t dared to,” says Karina. “Now I’m ready to fulfil my dreams!”

     Lau, meanwhile, claims she only told her parents about the competition after it ended because she didn’t want them to worry needlessly — “They’re very traditional people and wouldn’t approve,” she says. Their reaction, she tells me, was expected: shocked one moment, happy the next.

     “It was something I had to do for myself. I wanted to prove that I could achieve something. Not to the world, but for myself,” says Lau.

     While the Jumbo Queen pageant still remains of little national or international interest (the only other Jumbo Queen pageant outside of Thailand is held annually in Italy), Lim says he hopes to change this. And as far-fetched as this may sound, he believes that, with enough support, the pageant can be taken as seriously as Miss Universe or Miss World in the future.

     And why not? The pageant could send a message of self-acceptance to all the little girls struggling with demons of their own.

     “You shouldn’t change yourself because of other people’s mistakes, especially if your family and close friends already love you,” says Lau firmly.

     “Happiness is a choice. The days will pass even when you’re sad. Being happy makes life a whole lot easier and you’ve got only one life.”

Immune Boosters

By K.M. LEW

Folate (or Folic Acid)
 
One of the B vitamins, folate is crucial to the growth and reproduction of all cells in adults and for maintaining DNA for normal cell production (including the immune system's white blood cells, which help fight disease), says Karen Collins, nutrition adviser and registered dietitian at the American Institute for Cancer Research. Concerns about the potential effect of folate deficiency prompted the U.S. government to have foods such as cereal fortified with the nutrient, which makes taking in the recommended dietary allowance (RDA) of 400 micrograms fairly easy for adults. Eating healthy plant-based foods will also get you there: dark-green vegetables such as broccoli and spinach provide 100 to 200 micrograms per cup, while lentils contribute about 350 micrograms per cup.
 
Sources
 
Dried beans, leafy greens (kale, romaine, spinach), fortified cereals, and whole grains

Vitamin B6
 
B6 helps to produce antibodies that are needed to fight diseases, including heart disease. The RDA is 1.3 milligrams for adults 50 or younger and slightly higher for those who are older. Bananas and potatoes are particularly rich in vitamin B6: A medium banana provides .68 milligrams and a medium baked potato (with the skin) has .7 milligrams.

Sources
 
Dried beans, fish, some produce (bananas, potatoes, avocados, cauliflower), poultry, lean red meat, and whole-grain breads

Vitamin C
 
Vitamin C increases the production of infection-fighting white blood cells and antibodies, as well as interferons, a group of antiviral proteins. Massive amounts of vitamin C aren't needed to reap its benefits. The RDA is only 75 milligrams for women and 90 milligrams for men, although many researchers suggest aiming for 200 milligrams a day.

Sources
 
Dark-green vegetables (kale, broccoli), kiwi, and yellow and orange produce (citrus, bell peppers)

Phytochemicals (aka Phytonutrients)
 
This large group of nutrients boosts the number of infection-fighting cells in the body. The term comprises carotenoids and bioflavonoids.

Sources
 
Deeply hued produce of all colors (blueberries, carrots, sweet potatoes) and dark, leafy greens

Zinc
 
This mineral is needed for developing and activating the immune system's T cells, which are white blood cells that fight off infection. Zinc helps white blood cells release more antibodies. The RDA is 8 milligrams for women, 11 milligrams for men. Taking too much zinc may actually produce negative results, such as iron deficiency and decreased immunity function. The National Academy of Sciences has set 40 milligrams as the maximum recommended daily intake for adults. Because the mineral is plentiful in many foods, experts generally don't suggest using supplements.
 
Sources
 
Dried beans, lean red meat, nuts, poultry, seafood (especially shrimp and oysters), pumpkin and sesame seeds, whole grains, and yogurt

Healthy Juice Recipe

Spinach-Cucumber-Celery Juice

By K.M. LEW

Because celery isn't overpowering, it allows the spinach and cucumber juices to stand out. Spinach is a good source of calcium, iron, and potassium.Per serving: 80 calories, 0 g fat, 0 mg cholesterol, 16 g carbs, 140 mg sodium, 7 g protein

Ingredients

Makes 12 ounces; serves 1

• 2 cups packed spinach (4 ounces)
• 1 cucumber
• 1 celery stalk

Directions

1. Cut large produce into chunks, and remove big seeds or pits. Don't worry about those in fruits like apples and pears -- a juicer will filter them out. To combine several fruits and vegetables, alternate between soft pieces and hard ones. Finish with the latter to push through anything that's stuck.

Multiplying stem cells

By K.M. LEW

A researcher discovers a technique that might make it easier and cheaper to replace worn-out cartilage.

     HAVE your knees started to creak? If your joints are beginning to make crackling noises when you bend them, this may be a sign that the cartilage there is starting to wear out.

     As cartilage acts as a cushion to soften the impact of movements on our joints, this is not a good sign. Imagine your bones grinding together every time you move – definitely a painful proposal!

     Unfortunately, as we grow older, our cartilage wears out through repeated usage. And that is the inspiration behind Universiti Malaya (UM) research scientist Chong Pan Pan’s current work.

Important discovery: Dr Chong Pan Pan found a way to separate mesenchymal stem cells from blood, and growing them in the laboratory.

     “As we know, most people have knee problems when they are older, that is osteoarthritis. So I wanted to find something to help solve their problems,” she says.

     The PhD student, who is attached to the Tissue Engineering Group in the Medical Faculty’s Department of Orthopaedic Surgery, has come up with a method to increase the number of mesenchymal stem cells available from a patient’s blood.

New method

     Mesenchymal stem cells are a type of pluripotent stem cell that have the ability to differentiate into various types of cells that make up our blood and connective tissues (refer to Hierarchy of stem cells). This includes chondrocytes, which are the cells that form cartilage.

     In adults, stem cells are usually taken from the bone marrow. However, there is also a small amount of these cells floating around in our blood. The problem is the number of stem cells available from blood is too small to be of practical use.

     What Chong has discovered is a method of separating the mesenchymal stem cells from the rest of the blood, and growing them in the laboratory.

     According to her, this means that from a mere 2ml of blood, she can obtain around one million mesenchymal stem cells, of which 90% can be differentiated into chondrocytes.

     Although the number of cells needed for cartilage repair depends on the size of the defect, Chong estimates that a small defect would probably require around 10-20 million mesenchymal stem cells.

     “My advantage is that I can shorten the differentiation time,” she says. “It usually takes about three to four weeks, but I’ve managed to shorten it to two weeks.”

     Currently, the cell-based treatment procedure for damaged knee cartilage, known as an autologous chondrocyte implantation, requires two operations.

    The first one is to allow healthy cartilage to be harvested from the patient’s knee using an athroscope. These cells are then cultured and grown in the laboratory until they reach the amount needed to cover the damaged area. This usually takes around four to six weeks.

     The second operation is to place these healthy cells onto the damaged area, where they are suppose to grow into new cartilage.

     But Chong says: “Autologous transplantation works only if you still have cartilage left (to transplant). If not, you have to do a total knee replacement.”

     While using mesenchymal stem cells from bone marrow also requires two surgical procedures – the first to harvest the stem cells from the bone marrow, and the second to place them on the damaged area – the advantage is that the harvesting procedure costs less and the knee only needs to undergo one procedure.

     According to Chong, 2ml of bone marrow can produce around three million mesenchymal stem cells.

     Although this is more than what even her new method of growing stem cells from blood can produce, the advantage in her method lies in the fact that the drawing of blood from patients is a simple and cheap procedure.

     It also means that patients would only need to undergo one operation to place the new stem cells onto the damaged area.

A long way to go

     But Chong cautions that her technique is just moving into the animal testing stage.

     “To get to the patient, there are three stages: the fundamental research work, immuno-animal studies, and the clinical trials.

     “My colleagues in the Tissue Engineering Group have just started the immuno-animal testing,” she explains.

     She says that this stage will take one to two years as the researchers will have to take time to see if the blood-derived stem cells can repair cartilage damage after transplantation, as well as to observe if there are any side effects from the procedure.

     “Clinical trials (in human patients) will also take another one to two years. So, the fastest we can introduce this to patients would be within three to five years,” she says.

     She adds that if the trials go well and receives the appropriate approval, this treatment method will be offered at the UM Medical Centre.

     While Chong hopes that her technique will help to phase out the need for total knee replacements in the future, she adds that only hospitals with laboratory facilities will be able to provide this method of treatment.

     “Cell-based therapy like this needs lab facilities, and you need to involve scientists to prepare the cells for culture and growth,” she says.

     In the meantime, she is in the process of patenting her technique, as well as continuing her research work and PhD studies.

     Currently, she is researching methods to revert mesenchymal stem cells back to pluripotent stem cells, so that a source of these cells – which can differentiate into almost any of the specialised cells in our body – will be readily available in our own bodies for future therapeutic use.

Eat right with the new Malaysian food pyramid

By K.M. LEW

   

     We Malaysians love food so much that we even greet each other by asking, “Have you eaten?”

However, let’s also remember that eating is not just about satisfying our taste buds, but also meeting our nutritional needs.

     We need energy (carbohydrates, protein and fats), micronutrients (vitamins and minerals) as well as healthy phytochemicals (naturally occurring food substances in plant-based foods). Fortunately, we can meet such diverse requirements by eating a variety of foods every day.

     Our bodies need different nutrients in varying amounts (e.g. more energy-giving carbohydrates, moderate levels of protein and small quantities of vitamins and minerals). The way to achieve the required nutritional balance is by ensuring that our daily diets comprise mostly foods from the base of the Malaysian food pyramid and least of those at the top.

Proper diet following the food pyramid (below) is important for good health.

     Another factor to note is moderation. We should not eat too much or too little, but just enough. The Pyramid recommends the number of servings that we should eat daily from each food group to meet our nutritional needs which are, in turn, determined by our gender, stage of growth, physical activity level and state of health.

     Besides observing variety, balance and moderation, we can further optimise our nutrition by better acquainting ourselves with the main food groups that contribute to our daily energy and nutrient needs, based on the Malaysian Dietary Guidelines (MDG) 2010.

Energise your life

Eat adequate amounts of rice, other cereal products (preferably wholegrain) and tubers.

·Eat rice, other cereal foods (e.g. noodles, bread, oats) or tubers (e.g. potato, sweet potato) at every main meal.

·Choose cereal products (e.g. bread, biscuits, breakfast cereals) that are high in fibre and low in fat, sugar and salt.

     Choose wholegrains — these retain all parts of the natural grain, including the bran and germ. They contain more vitamins, minerals, healthy plant compounds and fibre, compared with refined grains.

     Wholegrains can help improve gut health, reduce common gastrointestinal problems (e.g. constipation) and lower the risk of chronic diseases (e.g. obesity, heart disease and cancers).

     Here is a wholesome wholegrain tip: Choose unpolished rice, wholemeal biscuits and bread, whole wheat noodles and wholegrain breakfast cereals. Read food labels for wholegrain content.

Protect your health

Eat plenty of fruits and vegetables every day.

·Eat at least three servings of vegetables and two servings of fruit each day.

·Eat a different type of fruit and vegetable with every meal.

·Have dark green leafy vegetables with edible stems (e.g. sawi or kailan) every day, or a few times a week.

·Eat tomatoes, bittergourd, ladies fingers, carrots and non-leafy vegetables (e.g. cauliflower, broccoli) several times a week.

·Fruits can be taken fresh, canned, naturally dried and unsweetened, or in the form of 100% fruit juice without added sugar or preservatives.

     Go multicoloured — the phytochemicals in fruits and vegetables give off the green, red, orange, yellow, purple and other marvellous hues that make them look so appetising.

     Most phytochemicals act as antioxidants that combine with other nutrients to help protect body cells.

     Some of the more well-known phytochemicals include:

·Carotenoids (e.g. beta-carotene in mangoes and carrots, and lycopene in tomatoes)·       

·Polyphenols (e.g. resveratrol in grapes, quercetins in apples, and anthocyanins in red dragon fruit).

·Glucosinolates/indoles (found in cauliflower, broccoli, cabbage and kailan).

Build up your body

Consume moderate amounts of fish, meat, poultry, egg, legumes and nuts.

·Choose lean cuts of meat and poultry.

·Consume eggs in moderate amounts, up to an average of one a day (whole or in dishes).

·Eat legumes daily. Add peas, beans and lentils or dhal to soups and dishes, or serve legume products (e.g. tempeh and tauhu).

·Take nuts and seeds at least once a week as snacks or replacement for meat and poultry in cooked dishes.

     Eat fish — they supply protein, B vitamins and iodine. Small fish with edible bones also provide calcium. Generally lower in cholesterol, some fish are also high in omega-3 fatty acids.

     Fish consumption is associated with lower risk of heart disease. Consume a serving of fish daily. Enjoy a variety of fish, including the freshwater variety.

Strengthen bones and teeth

Consume adequate amounts of milk and milk products:

·People of all ages should take milk and milk products every day.

·Choose low-fat milk if you need to reduce excessive body weight.

·Use liquid or powdered milk instead of sweetened condensed milk and sweetened condensed filled milk.

     Are you lactose intolerant? If taking milk causes you to purge, feel bloated or gassier than usual, you might be lactose intolerant. Enjoy the benefits of milk from lactose-free, pre-digested milk products, like yoghurt and cheese.

First outlet of Uniqlo to open in Kuala Lumpur

By K.M. LEW

Uniqlo, known for its high quality casual wear, will make its debut in the heart of Kuala Lumpur.

INDIVIDUAL style is an important part of everyday dressing. A scarf here, a bangle there – every piece plays a role in putting an outfit together and creating a look that is uniquely you.

With this in mind, Japanese brand Uniqlo (which is a combination of the words “unique” and “clothing”) is all set to diversify Malaysia’s world of fashion with the opening of its 945th store right in the heart of Kuala Lumpur.

The brand, known for its wide variety of clothing styles and impeccable quality, will open its doors to the public on Nov 4 at the newly renovated Fahrenheit 88 Shopping Centre (formerly KL Plaza) along Jalan Bukit Bintang.

Uniqlo’s fleece collection is made up of a wide selection of colours, patterns, designs and textures.

The leading Japanese clothing retail brand which opened as a unisex casual wear store in Hiroshima in 1984 under the name “Unique Clothing Warehouse”, has since expanded to China, Hong Kong, South Korea, Britain, France, the United States, Singapore, Taiwan and Russia.

A primary subsidiary of Fast Retailing Co Ltd, Uniqlo was pioneered, and still run by chairman and CEO Tadashi Yanai.

The emphasis on affordability as the concept of Uniqlo is based on the premise that everyone, anywhere, can wear the brand. It doesn’t matter whether you’re 16 or 60, you’re bound to find something you like in the store.

Among the items to look out for will be a wide array of basic casual wear, along with signature items such as high-tech winter wear, Heattech, fleeces, Japanese denim and the +J collection, a collaboration with German designer Jil Sander.

“Clothes play a part in showing personality; the wearer uses them to express themselves,” explained Yanai during a Uniqlo press event in Tokyo recently. “Uniqlo is a fashion brand that will enable everyone to enjoy casual clothes and we encourage our customers to match them with other brands as well.

“Our apparel is geared towards everyone – whether it’s people in their 20s who wear sports wear or career women in their 30s. This is often associated with mass production, low prices and low quality but ‘everyone’ in our definition includes the poor, the rich, those who couldn’t care less about clothing and also, fashionable people,” said Yanai.

Uniqlo is well-known for their wide variety of leggings in different styles and colours.

 

He added that while seasons change, and trends come and go, Uniqlo clothes are designed to be current.

“There are trends that will be gone within a matter of weeks – that’s not something we want to go after. Our clothes are wearable this year and the next as well.” The brand definitely has the diversity element in the bag – no two stores, not even in Tokyo (there are 103) are the same. Shopping in them is a joy; thanks to the simple layout and clear signages displaying the sizes and colours, negating the need for too many retail assistants.

Well-known for its basics, Uniqlo also offers a great variety of casual, office and winter wear, as well as shoes and accessories.

Some of the items you can look forward to at the new KL store include:

Basics – Tank tops, Ts, leggings, shorts and skirts fall under this category. Be sure to check out the various leggings in every colour you can think of, as well as some pretty neat tops and bottoms for the casual dresser.

Uniqlo also has a pretty varied shoe collection.

UTs (Uniqlo T-shirts) – These cute T-shirts are designed with pop culture in mind, by renowned artists, designers, photographers and musicians (including Terry Richardson, Nobuyoshi Araki, Bjorn Copeland of Black Dice). They feature popular characters and themes from anime series like Evangelion, Disney characters like Mickey Mouse as well as musicians and personalities in pop culture. The limited edition Ts come in many colour and size varieties. In the Harajuku store in Tokyo, they are packaged in cute clear plastic canisters resembling tennis ball cans.

UJ collection – Straight, skinny, knit leggings. These are all items under the Uniqlo Jeans label, and they come in your regular blue, dark grey, grey, black, brown, dark green, beige and red. Nearly all of the denim used in making the items are sourced from long-time Uniqlo partner Kaihara, a premium denim producer founded in 1893 and one of the world’s most renowned denim suppliers.

The collection also includes jackets, skirts and more. Look out for “leggings pants”, which look exactly like jeans but fit as comfortably as leggings (otherwise known as jeggings).

Stylishly casual: Uniqlo T-shirts come with attention-grabbing designs.

 +J campaign – Hatched through a collaboration with German designer Jil Sander. The designs are sophisticated, a sort of luxury basics selection for those in the working world. Pencil skirts, blazers, shirts for women and men as well as classy dresses make up this lovely and affordable collection.

Winter wear – We may not have fall or winter in Malaysia, but shoppers yearning for affordable winter wear should not miss out on this collection. It includes the super light wool and premium down ultra light innovations which are essentially winter clothing made through groundbreaking technology. These clothes weigh less than regular winter wear, while still remaining warm.

The collection includes the merino cashmere line, a new material created by blending cashmere with rare high-grade extra-fine merino wool. Also look out for the fleece collection, which offers a wide selection of colours, patterns and designs in a variety of textures.

Another interesting line-up is known as the Heattech collection, using technology that uses moisture generated by the body converted into heat energy to keep you warm. Air pockets between the fibres insulate and prevent heat from escaping, while antibacterial processing reduces unpleasant odours.

Be among the first 500 in line at the store’s opening on Nov 4 at 11am and stand a chance to win an all-expenses-paid trip to Tokyo. The first 1,000 customers will receive a free Uniqlo original tote bag. For details, log on to uniqlo.com/my/

The Biggest Baddest Burger Challenge: Matterhorn

Lai Voon Loong takes on the 9-inch-diamete, 6inch-high Matterhorn pork burger at Euro Deli Shop in Damansara Kim. Watch how the chef stacks 2.75kg of meat, cheese, vegetables and bread into a carnivore?s dream or nightmare.

Ferringhi Garden awarded as 2010 Malaysia's Best Restaurants

By K.M. LEW

     Ferringhi Garden has been awarded 2010 Malaysia's Best Restaurants! It is of Malaysia's Best Restaurant for its exceptional cuisine and service.

     The owner of Ferringhi Garden, Richard Long has put in plenty of effort in beautifying the entire place according to its theme over the years. Skirting the restaurant is a well-groomed ground with trees, beautiful flowering plants, earthenware jars and water features which gives it a relaxing yet intimate ambiance.     

     The compound around the restaurant is well-landscaped, with trees, flowering plants, earthenware jars and water features that exude a relaxing yet intimate ambience.

The surrounding of the restaurant is quite large and it offer many choices of dining areas: enjoying in the comfort of three different air-conditioned dining floors or dining in the patio, and the airy garden surrounded by the beauty of the outdoors plants with the soothing sounds of  water coming from the mini waterfall.

      There are a few choices of dining areas including three air-conditioned dining floors, a patio and an airy garden with gorgeous views and the soothing sounds of water coming from a mini waterfall.

     A six-course dinner with a subtle blend of Asian flavors. The meal kicked off with some wine chosen from their extensive wine collection. They selected two Chilean wines, a white and a red, to complement the meal.

     The Chardonnay from GatoNegro served in classic wine glasses from Zwiesel was a very fruity young wine that was easy on the palate.

      Two large baked scallops came with a mild Thai dipping sauce that had green apples in it. The sauce provided a zesty taste to the scallops.

      Next was delicate foie gras, pan-seared and served on toasted bread with blueberries and a touch of reduced red wine sauce. The foie gras was luscious, creamy, smooth and melted in mouth. It contrasted nicely with sweet fruity flavour of blueberries and the orange sauce cut through the rich, fattiness of the foie gras.

      The bowl of Norwegian clam soup, garnished with basil, was sour, salty and gently spicy. Delicately perfumed with tarragon, sage and dill, it was an ideal course to complement the rich, heavy meal. The soup had a subtle light flavour with a silky smooth texture.

      The grilled smoked Alaskan black cod, smoked in the kitchen in Ferringhi Garden itself, was simply terrific. Lightly flavoured and gently caramelised, the fish had a beautiful colour and was served with shredded carrot, pieces of radish, celery and black mushroom.
The highlight of the evening was the \'snow frosted\' Japanese wagyu. Although this cost more than wagyu from the United States or Australia, it was worth every ringgit.

     The Japanese cattle are fed with a special diet that includes beer and sake. They come in different grades and the price depends on the cut and the BMS (Beef Marbling Standard) grading.

      Executive chef Woei Liang had added nothing more than just a little truffle oil and some herbs. Special care was taken when searing the meat over charcoal as the fat melted quickly and burnt easily.

      The GateNegro Cabernet Sauvignon, with plenty of flavours derived from fruit and spices, was chosen to complement the rich wagyu beef.

      The meal concluded with a freshly baked chocolate souffle served with vanilla ice-cream. The light souffle with the strong chocolate flavour was just heavenly.

      The restaurant is open daily from 2.00 pm till 12.00 am. To get there, take the first right turn after Parkroyal Hotel, into a narrow lane. Drive until you reach a T-junction. Take a left turn and look out for the car park on the left. The main entrance of the restaurant is directly opposite Yahong Art Gallery.

 

Basic information: 

Ferringhi Garden

Address : 34-C Batu Ferringhi
11100 Penang

Tel : 04 8811193

Business Hours : 2.00 pm till 12.00 am