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Monday, May 8, 2023

Relieve pain, relieve suffering

Tnterventional therapies include blocking nerves so that the pain sensation is not felt by the patient. — 123rf.com
 

Many cancer patients may experience pain, especially during the advanced stages of the disease, but there are various ways to relieve this debilitating symptom.

CERTAIN cancers are more painful than most.

And most types of cancer, especially in the later stages (stage 4), are painful.

Among the most painful types of cancer are bone cancer, head and neck cancer, and brain and spinal cord cancer.

The presence of pain depends mainly on the location of the cancer and the stage of the disease.

Pain in cancer may arise from a tumour compressing or infiltrating nearby body parts; treatments and diagnostic procedures; or changes to skin, nerves and other tissues caused by a hormone imbalance or immune response.

However, the pain from most types of cancer can be controlled.

While most cancer pain can be managed with pharmacological treatment (using drugs such as opioids, anti-neuropathics, anti-depressants, etc), about 10% to 20% of cancer pain would need other methods, such as interventional pain management techniques and other non-pharmacological techniques like psychosocial management, physiotherapy techniques, and traditional and complementary medicine.

Pain management is important in palliative care.

Palliative therapy represents active care for patients whose illness is not responding to the curative treatment.

It aims to provide comfort and prevent the suffering of patients, especially towards the end of their life.

Thus, treatment of the pain presents an important integral part of palliative care.

Proper pain management can achieve a better quality of life for patients and their families.

Meanwhile, poor pain management has been shown to increase complications and reduce a patient’s life expectancy.

Proper assessment required


Patients with cancer pain need to undergo a comprehensive assessment of their pain.

This is the first step to achieving successful cancer pain management.

Similar to other clinical assessments, a complete pain assessment requires a detailed medical history, physical examination and relevant investigations.

The assessment aims to determine the nature and pathophysiology of the pain, severity of the pain, impact of the pain on functions and quality of life, and the response to interventions.

From the assessment, a plan can be formulated to help treat the patient’s pain.

Methods of pain management


Managing cancer pain is highly complex.

It can be divided into pharmacological treatment, anticancer treatments, non-pharmacological methods and interventional techniques.

Pharmacological treatment includes using drugs such as opioids (e.g. morphine), drugs to treat neuropathic pain (anti-epileptics, antidepressants etc), and steroids.

Non-pharmacological methods include exercise therapy, psychosocial therapy, and traditional and complementary medicine (e.g. acupuncture).

Anti-cancer treatment includes radiotherapy and chemotherapy.

Meanwhile, there is a wide range of interventional techniques available for the relief of cancer pain.

These methods should be considered when conventional therapy, as mentioned above, fails to provide adequate pain control.

Examples of interventional techniques are nerve blocks, neurolysis, and insertion of an intrathecal morphine pump.

A nerve block is done by injecting local anaesthetics – sometimes combined with steroids – to block sensation to an area of the body.

For instance, if a patient has bone cancer of the arm, we would inject local anaesthetics around the nerve that supplies the arm in order to stop the pain sensation there.

However, the application of local anaesthetics may not last long due to the drugs’ limited time effect, thus, this is usually done for diagnostic purposes.

Neurolysis is a technique that is used to alleviate pain.

It is done either by using chemical agents (e.g. alcohol or phenol) or thermal techniques (e.g. radiofrequency ablation) on the nervous system.

Neurolysis is only used when the disease has progressed to a point where no other pain treatments are effective.

And an intrathecal pump is a device that delivers small quantities of pain medication such as morphine, directly to the spinal fluid.

When these drugs are used and delivered in smaller doses, it may minimise the side effects often experienced with larger oral doses of the same medications, and patients may also experience better pain relief.

Patients who should be considered for these interventions include those with significant pain from locallyadvanced disease, severe neuropathic pain, and severe pain on movement.

Challenges in pain management


There are barriers to effective pain management in cancer patients, including:

> Restrictive policies governing healthcare practice

> Regulatory scrutiny when prescribing controlled substances > Lack of knowledge among patients, healthcare providers and caregivers about cancer pain management

> The use of religious and cultural strategies to cope with pain. > Inadequate attention to pain in certain patient populations, and

> Patient concerns about addiction and the harmful effects of pain treatment.

Although effective cancer pain management is highly recommended, the patient’s cultural beliefs may ingrain a deep pain tolerance, thus discouraging effective treatment of cancer pain.

Some cultural and religious beliefs may discourage the use of certain pain management methods, such as medications, while others uphold alternative therapies or spiritual practices to cope with pain.

Some examples would be:  

>Belief in karma

In many cultures, pain and suffering are perceived as a result of past actions and may be necessary for spiritual growth.

This belief can result in patients not seeking treatment or not reporting their pain because they feel that it is deserved.

>Belief in spiritual healing

Spiritual practices such as prayer or meditation, are believed to be more effective at managing pain than medications.

While these practices can provide some relief, they may not be sufficient for more severe or chronic pain.

Some also believe that certain medications or medical procedures are “impure” or interfere with spiritual purity.

> Fear of addiction

Some cultures and religions view pain medications as addictive, and therefore, discourage its use.

This can result in patients not receiving adequate pain relief because they are afraid of becoming addicted to such medications.

Relieving the suffering


Expertise in pain management techniques is continuously growing.

Hence, healthcare professionals should be aware of their roles and appropriately refer their patients to specialists who are trained in pain management where available. 

To a cancer patient, the pain he or she feels can stand in the way of positive treatment outcomes.

When the pain is managed and becomes bearable – if not gone altogether – the patient’s focus can shift from one of suffering to one of hopefulness. 

The Star Malaysia, By Dr RUSHIN MARIA DASS 

Dr Rushin Maria Dass is a consultant anaesthetist. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

 

Managing the pain that is caused by cancer

 

https://www.thestar.com.my/lifestyle/health/2023/05/10/managing-the-pain-that-is-caused-by-cancer?utm_source=smt&utm_medium=email&utm_campaign=HFNL_May_11&utm_content=main_article&__sta=vhg.uosvpxjsmahjmkpob%7CHVUY&__stm_medium=email&__stm_source=smartech


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Sunday, May 7, 2023

Nocturia: Symptoms, Diagnosis & Treatment





If you wake up more than one time each night to go to the bathroom, you may have nocturia. Sleep disruption from having to urinate during the night can impact your quality of life.

About 1 in 3 adults over the age of 30 experience nocturia. The rate of people affected increases with age. It can be caused by a lifestyle habit or an underlying health problem. Nocturia can be caused by:

  • Polyuria: when your body makes too much urine in a 24-hour period 
  •  Nocturnal polyuria: when your body makes too much urine during the night 
  •  Bladder storage problems: when your bladder doesn't store or release urine well 
  • Mixed nocturia: when more than one of these problems are happening


It helps to talk with your health care provider to learn why you make multiple trips to the bathroom at night. You may learn that your nocturia is fairly easy to treat, or you may find it's from something more serious. 

https://www.urologyhealth.org/urology-a-z/n/nocturia

How Does the Urinary Tract Normally Work?



The "urinary tract" includes the organs in your body that make, store and remove urine. Urine is liquid waste from your body. Urine forms when the kidneys clean your blood. Normally, the kidneys make about 1½ to 2 quarts of urine each day in an adult; less in children. Urine travels from the kidneys to the bladder through the ureters (the tubes that join them). The bladder holds urine until you are ready to empty it.

The brain and the bladder work together to control urinary function. The muscles in the lower part of the pelvis hold the bladder in place. The muscular neck (end) of the bladder stays closed to store urine. The urethra is a tube that carries urine from the bladder, out of the body. It is kept closed with sphincter muscles.

Parts of the bladder control system


Once you are ready to urinate, the brain sends a signal to the bladder. Then the bladder muscles contract. This pushes urine out of the bladder and through the urethra. The sphincter muscles then open and urine is released out of the body.

If you have to get up two or more times each night to go to the bathroom, it’s not normal. This is a clear sign of nocturia. We should be able to sleep for 6 to 8 hours during the night without needing to use the bathroom.

Waking to go to the bathroom obviously affects your quality of sleep, and your quality of life. Most people don’t function well without solid sleep. It makes us grumpy and less productive during the day. Over time, poor sleep can become a severe problem for many of us.

It’s important to remember that nocturia is a sign of something going on in our bodies. It is not a disease in and of itself.

Nocturia can be from a simple habit like drinking too much fluid (especially caffeine or alcohol) before bed. Or it could be from certain medication, illnesses or reduced bladder capacity. The following lifestyle habits are known to cause nocturia in either men or women:

  • Drinking too much fluid before bedtime (especially caffeine or alcohol)
  • Behavioral patterns (you've trained your body to wake up during the night to use the bathroom, even if you don't necessarily have to go)
  • The timing or dose of medicines, such as: diuretic medicine (water pills), cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D
  • Sleep disorders, like insomnia or sleep apnea


Underlying health conditions can cause nocturia. For example:

  • Diabetes 
  • High blood pressure 
  • Heart disease,
  • vascular disease or congestive heart failure Bladder obstruction ((stones)), inflammation or other problems that affect bladder capacity (like bladder surgery or fibrosis from radiation)
  • Overactive bladder  symptoms
  • Prostate obstruction
  • Vaginal prolapse
  • Menopause Childbirth Pelvic prolapse
  • Enlarged prostate (prostatic hyperplasia (BPH)
  • Restless leg syndrome
  • Edema in the lower limbs, or leg swelling
  • Interstitial cystitis 
  • Reduced bladder capacity
  • Nocturnal polyuria (when your body produces too much urine at night for your bladder to hold)


Often, several of these issues may be going on at once.

You and your health care provider will want to learn the cause of your nocturia. You'll be asked about your symptoms and health history. Your health care provider may also ask you to keep a bladder diary in order to help with a diagnosis. This diary is used to keep track of things like the kind and amount of liquids you drink, trips to bathroom, etc. to track trends over a period of time which can lead to useful treatments.

Some questions your doctor may ask:


  • When did your symptoms first start?
  • How many times do you need to go to the bathroom each night?
  • Is there a large or small amount of urine when you go?
  • Has the amount of urine you make changed (increased or decreased)?
  • How much caffeine or alcohol do you drink each day? When?
  • Do you feel like you're getting enough sleep?
  • Has your diet changed recently?
  • Do you wake up wet? (Are you leaking?)


If your health care provider needs more information, you may have a:

  • Urine cultureandurinalysis check for infection, unwanted blood, and other elements in your urine.
  • Blood test: checks the kidney and thyroid, cholesterol levels and the presence of anemia, diabetes or other problems.
  • Bladder scan shows how much urine is still in the bladder after you go to the bathroom.
  • Cystoscopy: checks for a tumor or other causes of your symptoms by having the doctor insert a narrow tube with a tiny lens inside the bladder.
  • Urodynamic testing: checks to see how well your lower urinary tract stores and releases urine.


Lifestyle changes


  • Restrict fluid intake at night.
  • Drink plenty of fluids during the day (especially water), but limit fluids 2-4 hours before you go to sleep. Be sure to limit alcohol and caffeine (soda, tea and coffee).
  • Manage your use of diuretics.
  • If you have to take a diuretic, then do so at least 6 hours before you go to sleep. This will help reduce the number of times you urinate during the night. Elevate your legs or use compression socks.
  • Some people experience fluid build-up in their legs. When you elevate your legs, it helps to redistribute fluids back into the bloodstream, reducing the need to urinate. Elastic compression stockings help by putting pressure on your legs to prevent fluid build-up.
  • Enjoy afternoon naps.
  • When you sleep poorly, a nap can be help you feel better during the day. Naps can also allow liquids to be absorbed into the bloodstream. However, be careful not to nap too long or too often. You don't want to disrupt nighttime sleep patterns with naps.


Management


If you experience bed-wetting, there are several products to help keep you and your bed dry. For example, waterproof mattress covers, absorbent briefs and skincare products. Visit our  incontinence website article to learn more about managing leaks with products and devices.

Medicine 

If lifestyle changes alone don't help with your nocturia, some medicines may. Some people try one type, then another, until they find what works best for them. Not everyone benefits from prescription drug options, but it helps to know about them.

  • Medicines to help the kidneys produce less urine. For example, Desmopressin (DDAVP®).
  • Anticholinergic medicines to treat bladder muscle problems. They relax the bladder if it spasms. These are used to correct overactive bladder. For example, Darifenacin (Enablex®), Oxybutynin (Ditropan®), Tolterodine (Detrol®), Trospium Chloride (Sanctura®), or Solifenacin (VESIcare®).
  • Diuretic medicines to regulate urine production and high blood pressure. For example, Bumetanide (Bumex®), Furosemide (Lasix®).


If an underlying illness leads to nocturia, then treating that illness will surely help. It's important to treat diabetes, high blood pressure, congestive heart failure, obstructive sleep apnea, and/or enlarged prostate (BPH). Changing the timing and dose of prescribed medicine may also help.

With long-term lifestyle changes and caring for other health problems, your symptoms should improve. You should be able to sleep well again.

Pay attention to the things that help you sleep through the night. Keep up with these changes to prevent nocturia in the future. Keep in touch with your health care provider to let him/her know if you don't improve over time.

  • Do I need to see a specialist?
  • If I need a specialist, can you give me a referral?
  • Will I need to have tests to find the cause of my nocturia?
  • What other problem could be causing my symptoms, and why?
  • What treatments do you think are right for me and why?
  • What are the pros and cons of each type of treatment?
  • After I start treatment, are there problems I should I watch for?
  • How soon after treatment will I feel better?
  • When should I call you?
  • Will I need treatment for the rest of my life? 

 https://youtu.be/zoLlKwhTXxQ

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Forwarded messages from friends:

Nocturia (Night time urination). Drinking water at night and how it helps.

Noctoria and heart problems are related. It is worth spending two minutes to read the information below.

An American doctor tells us that Nocturia, heart problem and cerebral infarction are related.

The most common symptom of middle-aged and elderly people is nocturia (waking up at night to urinate). Because of nocturnal urine, the elderly are afraid of drinking water before bedtime. They don't know that not drinking water before going to bed, getting up in the middle of the night to pee without drinking water is an important cause of early morning cerebral infarction in middle-aged and elderly people. In fact, nocturia is not a problem of bladder dysfunction. Nocturia is caused by the aging failure of the heart function in the elderly, and the inability of the right heart atrium to suck blood from the lower body.

During the day, we are all in a standing position, The blood will flow down. If the heart is not good, the blood volume of the heart is insufficient, the pressure on the lower body will increase, so middle-aged and elderly people will have lower body edema during the day. When they lie down at night, the pressure on the lower body will be relieved and a lot of water accumulate in the tissues. The water returns to the blood. If there is too much water, the kidneys will work hard to separate out the water and drain it to the bladder, causing nocturia.

Therefore, it usually takes about three or four hours after lying down to sleep to get up and go to the toilet for the first time. After that, the water in the blood continues to increase. So after another 3 hours, they will have to go to the toilet again.

Why is this an important cause of cerebral infarction and myocardial infarction? Because after two or three urinations, the water in the blood is greatly reduced. The body also continue to lose water through breathing. The blood then begins to become thick and sticky, and the heart rate slows down due to the low metabolism of the body during sleep. With thick blood and slow blood flow, the stenosis of the blood vessel is easily blocked... This is why the middle-aged and elderly people almost always have myocardial infarction or cerebral infarction at 5 or 6 in the morning. This situation will lead to death while asleep.

The first thing to tell everyone is that nocturia is not a malfunction of the bladder, but a problem of aging heart. The second thing to tell everyone is that you must drink some warm water before going to bed, and you must drink some warm water after you wake up in the middle of the night to pee. Don't be afraid of nocturia, because not drinking water may take your life.

The third thing is that you must exercise more in normal times to strengthen the function of the heart.

The human body is not a machine. A machine will wear out when used frequently, but the human body will be the opposite. It will become stronger when used frequently.

Do not eat unhealthy food, especially high starch and fried foods.

If you like this article, kindly forward it to your friends.

 

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Saturday, May 6, 2023

Self-confidence after middle age is not in the "brain" but in the "feet'

 

Tell everyone: Self-confidence after middle age is not in the "brain" but in the "feet".

"Legs Feet"

Issues that the elderly must pay attention to: 

1. As we get older, our feet and legs must always remain strong.

2. When we get old, we shouldn't worry about our hair turning gray or our skin sagging or wrinkled.

3. Among the signs of "longevity," strong leg muscles are listed as the most important and fundamental muscles, as outlined in the American Journal of Prevention.

4. If you do not move your legs for two weeks, your leg strength will decrease for 10 years.

5. A study by the University of Copenhagen in Denmark found that, regardless of age, within two weeks of "inactivity", the strength of leg muscles will be weakened by one-third, which is equivalent to aging for 20 to 30 years.

6. As our leg muscles weaken, it will take a long time to recover even as we rehab and exercise.

7. Therefore, regular exercise (such as walking) is very important.

8. The weight (load) of the entire body remains on the legs.

9. The foot is a kind of "pillar" that bears the weight of the human body. Interestingly, 50% of a person's body weight is in the bones, and 50% of the bones are in the two legs.

10. The largest and strongest joints and bones in the human body are also in the legs.

11. The "iron triangle" formed by strong bones, strong muscles and flexible joints carries the most important load on the human body.

12. 70% of human activities and energy burning in life are completed by two feet.

13. Did you know? When a man is young, his thighs are strong enough to lift a small car!

14. "Legs and feet" are the center of body movement.

15. The two legs have 50% of the nerves of the human body, 50% of the blood vessels and 50% of the blood flowing through them.

16. This is the large circulatory network that connects the body.

17. When the feet and legs are healthy, the regular blood flow goes on smoothly, so people with muscular legs will definitely have a "strong heart".

18. The "aging" of the human body starts from the feet first, and then develops upwards.

19. As we grow older, the accuracy and speed of the transmission of instructions between the brain and the legs decrease, which is completely different from that of young people.

20. With the passage of time, the calcium of bones will be lost sooner or later, making the elderly more prone to fractures.

21. After the bone fracture of the elderly, it is easy to cause a series of complications, especially fatal diseases, such as cerebral thrombosis.

22. Did you know that 15% of the elderly will die within a year once their thigh is broken!

23. It's never too late to exercise your legs, even after 60 or older.

24. Although our feet and legs will bi gradually age over time, exercising our feet and legs is a lifelong task. . 🤷🏻‍♂. 🧠👂👁️..🥂 

 

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Friday, May 5, 2023

‘Empire of hackers’ uncovered


BEIJING: An investigation report was released on the Central Intelligence Agency (CIA) of the United States, one of the major intelligence agencies of the US federal government, revealing an “empire of hackers” under US manipulation.

Over a long period, the CIA has been secretly orchestrating “peaceful evolution” and “colour revolutions” around the world, continuously conducting espionage activities, said the report by China’s National Computer Virus Emergency Response Centre and internet security company 360.

The rapid development of the internet this century has presented new opportunities for the CIA to conduct its infiltration, subversion and trouble-making activities, the report said.

The report disclosed important details of the weapons the CIA used for cyberattacks and details of specific cybersecurity cases taking place in China and other countries, and revealed the agency’s harmful activities including cyberattacks and espionage.

The report said it was meant to provide references and suggestions for victims of cyberattacks around the world.

The CIA has been involved in overthrowing or attempting to overthrow more than 50 legal governments of other countries, though it only admitted involvement in seven, causing turmoil in relevant countries, the report said.

It said the involvement of some Western countries with the help of the internet can be detected in multiple “colour revolution” cases.

After the “Arab Spring” in West Asia and North Africa, certain large multinational internet enterprises of the United States vigorously engaged in sending an abundance of personnel, material and financial resources to the conflicting sides, drawing over and supporting the opposition parties, and publicly challenging the legal governments of foreign countries that were not in the US interests. Such enterprises were also involved in assisting in the disinformation campaign and fanning the flames of protests among the public, the report said.

The report further cited several measures of such operations, including “The Onion Router (TOR)” technology that enables anonymous communication, developed by a US company with a reportedly US military background. It was provided free of charge to anti-government personnel in countries such as Iran, Tunisia and Egypt to help them evade surveillance.

Also, Google and Twitter developed a special service called “Speak2Tweet” to enable users to communicate when they are disconnected. The technology was used by anti-government forces in Tunisia and Egypt, said the report.

The cyberspace hegemony under US manipulation is shadowing the entire world, with the CIA launching automated, systematic and intelligent attacks worldwide, the report said.

After analysing relevant cases, the technical team found that the reach of such attack weapons has covered almost all internet and Internet of Things assets, making a foreign country susceptible to US control or espionage, the report said, adding that the US is a genuine “empire of hackers.” — Xinhua 

Source link

 

'Empire of hacking' exposed: China Daily editorial

 

Although the Central Intelligence Agency had acquired exceptional experience in overthrowing governments by triggering "peaceful evolution" or instigating "color revolutions" in other countries before the emergence of the internet, it is the advancement of information and communication technology, in which the US enjoys huge advantages, that has greatly boosted the intelligence agency's capability to accomplish its goals in the new century.

The disintegration of the Soviet Union — the United States established the CIA in 1947 to counter Soviet intelligence wings — transformed the former socialist republics in Eastern and Central Europe, and created a golden opportunity for the CIA to trigger "color revolutions" in the region as well as in the Middle East and Central Asia.

The end of the Cold War gave the CIA the reason to help establish the US' global hegemony by exploiting its advantages in cyberspace to infiltrate, spy on and subvert other countries' governments.

A report "Empire of Hacking: the US Central Intelligence Agency — Part I" jointly published by China's National Computer Virus Emergency Response Center and the 360 Total Security, a Chinese cybersecurity company, on Thursday deserves credit for not only its systematic and professional approach to the ugly role of the CIA, but also its advice to the agency's "victims all around the world" in order to help them better respond to the US' cyberattacks and manipulations.

The report can also be seen as part of China's efforts to help build a community with a shared future in cyberspace, because it regards maintaining silence in the face of the CIA's dirty tricks as being complicit in the US' overall destructive strategy.

The report says that, working with US internet companies, the CIA provides encrypted network communication services, and reconnects service and on-site command communication tools directly for its proxies in targeted countries and regions. For instance, a software called RIOT, developed and promoted jointly by US companies and the CIA, helps the intelligence agency to remote control its pawns triggering demonstrations and riots in other countries, by ensuring they have reliable internet connection and channels of communication that are free from the local government's supervision.

"We lied, we cheated, we stole … we had entire training courses," said Mike Pompeo, former US secretary of state, on the nature of the CIA, an agency he led as director for years. This fact resonates with anyone who reads the NCVERC report.

The US is a country which pledges to help improve cyberspace governance and build a "clean internet" but actually spends all its expertise and high-tech advantages to further sharpen its cyber-espionage and cyber-attack weapons, while claiming to be the largest victim of cyberattacks. 

 

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Surveillance empire: how US threatens global internet security through decades of cyber surveillance, attacks

China's National Computer Virus Emergency Response Center and cybersecurity company 360 jointly released an investigation report on Thursday, revealing the long-standing use of cyber attacks by the US Central Intelligence Agency (CIA) against other countries. While this is an "eye-opener" for many people, the CIA's obsession and ability to create unrest disturb them significantly.

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The new Cold War heats up

Thursday, May 4, 2023

The new Cold War heats up


 Insightful views: Kishore giving his assessment on the US-China rivalry during his lecture in Kuala Lumpur. -

The new Cold War heats up

International relations expert Kishore Mahbubani has interesting views on US-China rivalry and the role Asean could play.

IT’S not every day that one gets to hear directly from Prof Kishore Mahbubani, one of the best thinkers on international relations.

In fact, it had taken the organiser, the Malaysian Institute of Management, over two years to invite the Singaporean diplomat, academician and best-selling author to Kuala Lumpur.

Those of us who turned up for his lecture on Tuesday evening wanted to hear his assessment of the United States-China rivalry, which is certain to get worse in the coming years.

Kishore is a Distinguished Fellow at the Asian Research Institute, National University of Singapore, and has had two notable careers – 33 years in diplomacy and 15 years in academia.

He was the founding dean of the Lee Kuan Yew School of Public Policy and spent over 10 years as Singapore’s ambassador to the United Nations.

He has authored several books, including best-sellers such as Can Asians Think? and Has The West Lost It?.His insightful views on the US-China geopolitical rivalry have grabbed the attention of many.

Gloomy as it may be, it is certain and unavoidable – in Kishore’s own words – that the rivalry will worsen as the Chinese push to challenge the United States for dominance.

For us living in the Asean region, especially Malaysians, it is more troubling as the power play is taking place in our backyard, the South China Sea, while Taiwan is merely about four hours away by flight.

Kishore predicts the contest, if not already a feud, will accelerate in the next 10 years and he doesn’t see it quietening down.

The scenario is unprecedented as for the first time in human history, these two superpowers are colliding.

Driven by what he describes as structural forces, he sees China as the “No. 2 that is about to take over as No. 1 and the US will push down China” at all costs as the latter does not see itself losing its pole position.

“They should learn from the Malaysian monarchy (where the reigning King) steps down every five years,’’ he joked.

He said in his highly provocative titled book Has China Won? that it hasn’t helped that the many US policymakers who will drive this geopolitical contest are “possessed by a psychology that sees all competition among great powers as a zero-sum game”.

“Hence, if China steps up its naval deployments in the South China Sea, the US Navy will see it as a loss and step up its presence in the region,” he said.

There is much insecurity on the part of the United States as “it is far from certain that America will win the contest as China has as good a chance as America of emerging as the dominant influence in the world”.

“In fact, many thoughtful leaders and observers in strategically sensitive countries around the world have begun making preparations for a world where China may become number one,” said Kishore.

He said it was an error of perception for America to view the CCP as a Chinese Communist Party embedded in communist roots, when in the eyes of Asian observers, the CCP actually functions as the “Chinese Civilisation Party” with its soul rooted in Chinese civilisation.

But Kishore has some advice for China – never underestimate the United States.

It’s a giant that has woken up and it has won the narrative, with the support of a powerful international media, that it is a contest between a democracy and an authoritarian government.

“It has been a strategic mistake for American thinkers to take success for granted, it would be an equally colossal strategic mistake for China to assume the same,” he said.

Painting the Chinese as demonic has been an easy selling point to the American public, most of whom have never travelled out of their country, added Kishore, saying in his book that it will be easier “for Americans to persist in the belief that they would eventually triumph against China, no matter the odds”.

Both the Republicans and Democrats have adopted the same tone and strategy of containing China.

So, it doesn’t matter who the next US President is although it got worse under President Donald Trump. It has simply become a bipartisan policy.

The rest of the world, especially Asean, will be affected by this great power play. No one will be spared as pressure will be applied to countries to take sides.

Even a simple acquisition of technology, such as using Huawei’s applications, has turned complicated.

Kishore shared an anecdote of how a British top official had told him that it would use Huawei as security clearance, and with a stiff upper lip, said there was no reason for it to submit to US pressure.

But just months later, the United Kingdom “crumbled” to US pressure and abandoned Huawei.

He feared that Taiwan would be a more sensitive issue than the South China Sea as it benefits the United States and China to keep the international waterways safe for freedom of navigation.

But Taiwan is a more potential flash point. It is the red line that no one should cross, and most Asians know it and “they shut up”, he said, advising Asian countries to continue with this approach.

The Chinese see Taiwan as a renegade province that belongs to China and do not tolerate any moves to push for independence. Most countries adopt a One China policy and have no diplomatic relations with Taiwan.

Kishore said for a long time, the United States stayed away from the Taiwan issue, but now it has been broached and “it is not rational, it’s dangerous and emotional”.

But he said Asean could play an influential role to speak up for moderate measures to initiate dialogues between the United States and China and to help reduce tensions that could contribute to possibilities of a war.

He acknowledged that Asean may be “weak and chaotic”, but paradoxically, no one sees the grouping as a threat and its meetings were all attended by the powerful nations.

“Everyone loves Asean. It has convening abilities,” he said, adding that both China and the United States had invested huge amounts there compared to other regions of the world.

China has been the largest market for Asean exports for the past 12 years and Malaysia’s number one trading partner for the past 15 consecutive years, while Asean countries collectively are the United States’ fourth largest trading partner.

Together, they represent a market with a gross domestic product (GDP) of more than US$3 trillion (RM13.38 trillion). US goods and services traded with Asean totalled an estimated US$362.2bil (RM1.62 trillion) in 2020.

Kishore said while the US-China contest may be a gloomy topic, there is also a positive aspect as both sides will woo support and attention, adding that it was good to be courted but reaffirmed that Asean members must stay out of the feud.

“It is said that when elephants fight, the grass gets trampled, but let’s not forget that when elephants make love, it tramples too,’’ he said in jest.

Talk is better than war and for a start, the rhetoric can be lowered down. A deeper rationality is needed and surely, there is a need to accept that the world has changed.

A painful and unnecessary clash needs to be avoided. The journey for both sides to work together has to start soon.


Wong Chun Wai began his career as a journalist in Penang, and has served The Star for over 35 years in various capacities and roles. He is now group editorial and corporate affairs adviser to the group, after having served as group managing director/chief executive officer. On The Beat made its debut on Feb 23 1997 and Chun Wai has penned the column weekly without a break, except for the occasional press holiday when the paper was not published. In May 2011, a compilation of selected articles of On The Beat was published as a book and launched in conjunction with his 50th birthday. Chun Wai also comments on current issues in The Star.

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Wednesday, May 3, 2023

Fighting chance to beat scammers

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KUALA LUMPUR: The idea of adopting a 48-hour “cooling period” when money above a threshold is transferred to new bank accounts might give scam victims enough time to pull their money back from the brink before it reaches the greasy hands of scammers.

Cybersecurity law expert and lawyer Derek John Fernandez said that is one of the ways authorities and financial institutions can stop a financial scam.

He said that as victims usually realise they are scammed after 24 hours, there is another 24-hour window for banks to stop the transaction.

ALSO READ : Cutting off the SMS channel scam route

Fernandez said this is among the immediate measures he has proposed in a 75-page paper to the government on what the authorities can do to protect consumers from financial scams.

The good-funds model, which has a cooling-off period for first-time transactions between individual accounts, is practised in some countries such as Australia to ensure that there is no fraudulent activity before funds are transferred for the first time.

“Such a period will enable a person to inform the bank of a scam transaction to a mule account and stop the payment,” said Fernandez.

“At the moment, in Malaysia, a cooling-off period is only observed for the first-time enrolment of online banking services or secure devices. During this time, no online banking activity is allowed to be conducted,” he added.

Fernandez pointed out that the average consumer is ill-equipped to combat cybersecurity threats and cybercrime by themselves.

He said the country had embraced digitalisation without proper consideration of cybersecurity.

ALSO READ : Large amounts cleared out in minutes

“The true cost of digitalisation has been totally understated because the cost of cybersecurity had not been factored in properly. We have emboldened criminals and given them great opportunities to commit crimes in the safety of being outside our country.

“Now cybercrime is the third biggest criminal activity in the world and is growing,” said Fernandez.

“Those who profit the most from digitalisation should be made to bear the true cost of cybersecurity and the losses that occur due to weaknesses in the technology they used to create those profits.

“The government itself is unable to pay totally for the cost of cybersecurity and those companies who have profited the most from digitalisation must bear a proportionate and fair cost of cybersecurity. They must be made to protect their customers with sufficient resources,” said Fernandez.

A concerted effort by law enforcement agencies, financial institutions and telco service providers to coordinate a rapid response for online financial scams is also the key to enabling vulnerable victims of scammers to at least get some of their money back, said National Anti-Financial Crime Centre (NFCC) director-general Datuk Seri Mustafar Ali.

He said that while educating the public on scam awareness is an important step in mitigating the risk of scams, there are several other robust measures that can be put in place to help prevent scams from occurring.

Mustafar listed the factors as improved legislation, enhanced consumer protection, increased enforcement, stronger cybersecurity and better collaboration between government agencies, businesses and consumers that can help identify new types of scams and develop more effective strategies for preventing them.

“Governments can put in place laws and regulations that make it easier to prosecute scammers and discourage fraudulent activities,” he said.

Mustafar, who also heads the National Scam Response Centre (NSRC), which was set up late last year, added that a proposal is in the pipeline to amend the laws and regulatory mechanisms relating to scam victim restitution, mule accounts and the power of the investigating officer.

“Law enforcement agencies can work more closely with financial institutions and businesses to track down and prosecute scammers,” said Mustafar.

He sees NSRC as the command centre – focusing on online financial scams – to coordinate efforts among law enforcement agencies (NFCC, police, Bank Negara and the Malaysian Communication and Multimedia Commission) together with financial institutions and telco service providers to coordinate rapid response for online financial scams.

“However, there is still much work to be done to combat scams and fraud, shift public attitudes towards greater awareness and caution, improve the efficiency and transparency of the financial system, and take effective enforcement actions against criminals,” said Mustafar. 

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Tuesday, May 2, 2023

Many turn to using dubious titles

 

 

 Council lodges police reports over people with fake Datuk, Datuk Seri and Tan Sri titles

PETALING JAYA: Eight individuals, including personalities from the corporate and entertainment industries, had police reports lodged against them for allegedly using unrecognised and dubious titles.

The Council of Dato and Datuk Malaysia (MDDM) secretary-general Datuk Samson Maman said nine reports were lodged, eight against the individuals for misusing Datuk, Datuk Seri and Tan Sri titles, and one collective report in general.

“These individuals even include the titles in their designations when appearing on televised talk shows.

“Based on our information and checks, their honorifics are actually fake,” he told reporters at the Puchong Jaya police station yesterday.

Samson said there were also business and prominent NGO personalities using unrecognised and dubious titles.

He said some individuals also included their “titles” in the records of the Companies Commission of Malaysia and the Registrar of Societies (ROS) to enhance their corporate status.

“What is the purpose of doing this when your name as per the identity card should suffice?” he said, adding that MDDM was also looking to enhance and review the Offences Relating to Awards Act (Act 787).

“We will tentatively hand over our proposals (to the respective authorities) later this week.”

He also said the Instagram profile @checkmytitle that highlighted those using fake honorifics included prominent Malaysian personalities.

Samson said the public should always double-check the official government portal at www.istiadat.gov.my to verify the authenticity of someone’s title.

“MDDM is not an enforcement body, but we want to create awareness that it is an offence for anyone to claim to be a Datuk, Datuk Seri or Tan Sri,” he said. 

He warned people against buying the titles from certain parties.

“Only the Yang di-Pertuan Agong, Sultans and governors are authorised to bestow such titles on deserving individuals.

“Malaysians need to uphold our nation’s honorifics as bestowed by royalty and state governors,” Samson said.

MDDM exco member Datuk Seri Michael Chong, who was also present, said the issue of people using unrecognised honorifics had been ongoing for a long time.

“The situation has now become serious with these fake Datuks arrested for scamming and cheating others,” said Chong, who is also the MCA Public Services and Complaints Department head.

He added that the cost of buying dubious titles ranged between RM60,000 and RM120,000.

“Based on the complaints received, we learnt that a Datuk title costs about RM60,000 and about RM100,000 for a Datuk Seri title.

“The complainants who came to us were even told they could pay in instalments,” he said.

Chong also said that they were made aware of a case in which the entire family had fake “Datukships”, with the youngest being in his twenties.

According to MDDM auditor Datuk Ashfar Ali, the dubious “Datuks” used the titles for business transactions such as multilevel marketing, selling housing schemes and others.

“Some want the title to uplift their social status or to be recognised by others,” he said.

Also present were MDDM exco members Datuk Abdul Razak Dawood, Datuk Josephine Anne and council member Datuk Tiong Yap Choon. 

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Monday, May 1, 2023

While taking a shower or bath, fainting, slumping from washing the head in the bathroom

 

 

Someone can faint or slump in the bathroom if you start taking your bath by washing the head first. If the head is washed first, the cold water will make blood to rush to the head and rupture the blood vessels to the head. To avoid this, we were advised to start our bath by washing our feet and gradually moving upwards. I want to know if this is true


The Home: Why Do People Faint Or Slump In The Bathroom?

How To Avoid Fainting Or Slumping In The Bathroom   

We’ve heard of people slumping or suffering a stroke in the bathroom and statistics reveal that more men suffer from this accident than women. What is the cause and why?

What Is The Cause?

When I took part in a healthy lifestyle course, a National Sports Council Professor, who also participated in the course, advised that:

  • The head should not be washed first in the process of taking a bath (even washing of the hair)
  • Other parts of the body should be cleaned first. This is because when the head is wet and cold, blood will flow to the head to warm it up.
  • If the blood vessels have narrowed, it is likely to cause the blood vessels to rupture.
  • Since it usually happens in the bathroom, be sure to raise awareness to avoid this happening again.

Why Do More men Suffer The Accident Than Women?

Men do because most men keep their hair low and during bathing, they pour water of their head. On the other hand, women don’t often wash their heads because of hairstyling.

Correct Way To Take Your Bath:

  • Start the wetness from the sole of the foot.
  • Progress to the small legs, the thigh, abdomen and then shoulder.
  • At this point, pause for 5-10 seconds.
  • A feeling like steam/wind overflowing from the body may be observed, and then take a shower as usual.

WISDOM:

When a glass is filled with hot water, and then suddenly emptied and filled with cold water; what happens? The glass will burst! Then, with regards to the human body, what happens? Naturally, the body temperature is very hot, whereas the water is very cold, a cold shower on the body or the head directly would suddenly trap the wind, or deaden it, because the blood vessels got broken.

This is why people often suddenly fall over in the bathroom; due to a wrong bathing method. And that often causes a stroke or causes a migraine.

ADVICE:

This bathing method is suitable for all ages, especially those with diabetes, high blood pressure, cholesterol and migraine/headache. 

Please, don't only just get enlightened by this; kindly share with your families and friends as well.

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