HEARTTALK Heart Foundation(383498-P) No.11, 1st Floor, Lot 2343, Block 10 KCLD Bormill Estate Commercial Centre, Jalan Tun Ahmad Zaidi Adruce 93150 Tel: 082-258 212 Fax: 082-258 303 Email: [email protected] Website: sarawakheartfoundation.org.my Facebook: SarawakHeartFoundation Volume 9 June 2014 KDN No.: PPK434/04/2013 (032273) HEARTTALK HEARTTALK Volumn 9 - Jun 2014 Volumn 9 - Jun 2014

Message From Editor Chairman Content TYT Tun Pehin Sri Haji Abdul TaibMahmud Pg Happy New Year 2014, Gong Xi Fa Chai and Selamat Hari Gawai!

Deputy Chairman 1 Message from Editor First of all, the Editorial Committee and Board of Trustees would like to extend our heartiest congratulations to: YB Tan Sri Datuk Amar Dr. James Jemut Masing - Mr. Eric Lim Swee Khoon is also a Trustee of the Foundation -our Chairman, His Excellency Tun Pehin Sri Haji on being appointed Governor of Sarawak on 1 March 2014 and also being conferred the Board of Trustees title “TUN” by the Yang Di-Pertuan Agong XIV on 26 May 2014 2 i) 30th Anniversary of YJM Dinner YABhg Puan Sri Dato Hajjah Jamilah Anu -YAB Tan Sri Datuk Amar Haji Adenan Bin Haji Satem on his appointment as the 5th YB Senator Datuk Prof Dr Sim Kui Hian ii) Women’s Heart Day 2014 Chief Minister of Sarawak on 28 February 2014 YB Dr Annuar Rapaee iii) Fund-Raising Dinner jointly organized -our Trustee, Senator Datuk Prof. Dr. Sim Kui Hian on his appointment as Senator YBhg Dato Sri Empiang Jabu by SABATI and Sarawak Heart Foundation on 26 May 2014 and also being conferred the title “DATUK” by the Yang Di-Pertuan YBhg Dato Anne Teng Agong XIV on 7 June 2014, and

YBhg Datuk Dr Stalin Hardin -Professor John Chan Kok Meng for the Hunterian Professor award 2014/2015 by YBhg Datuk Fong Joo Chung 3 Congratulatory message to Chairman, SHF The Royal College of Surgeons of England. YBhg Datuk Prof Dr Chew Peng Hong The first half of the 2014 proved to be a very eventful year for the Sarawak Heart YBhg Dato Haji Abdillah Haji Abdul Rahim 4 Congratulatory message to Chief Minister of Sarawak Foundation. It started off with the fund-raising dinner jointly organized by SABATI Dr Mohd Hirman Ritom and Sarawak Heart Foundation on 8 March 2014 at Pullman Hotel where RM2 Ms Pauline Kon Suk Khim million was raised to fund the acquisition of medical equipment for the minimally invasive heart surgery at SGH Heart Centre and also for the Foundation’s activities. Mr Eric Lim Swee Khoon 5 Congratulatory message to Board of Trustee, SHF During the first half of 2014, various community health screenings were carried Advisor 6 Hunterian Professorship out. The first health screening was held in conjunction with Women’s Heart Day 2014. The event was held on 8 March 2014 at Merdeka Plaza. The Foundation also – Prof Dr.John Chan, YBhg Datuk Patinggi Tan Sri Dr. Wong Soon Kai did the health screening at Saratok and Betong on 17 and 18 May 2014 respectively. Consultant Cardiothoracic Surgeon, SGH The response to these events was overwhelming to say the least. These events would not be made possible without the support from the nurses and doctors from Medical Advisor the Sarawak General Hospital Heart Centre, Divisional and District Health Offices at 7-8 Health Talk by Dr. Chai Chiun Hian, Neurologist, Betong and Saratok. Dr. Yii Kie Sing Sarawak General Hospital, Kuching The Miri Heart Week 2014 was our main event for the first half of this year. The 3-days event was held from 27 to 29 June 2014 at Bintang Megamall, Miri. There Editor 9 i) Health Screening @ Betong were public health screenings, poster exhibitions, coloring contests, health talks, healthy cooking and various activities to liven up the atmosphere such as zumba, Mr. Eric Lim Swee Khoon ii) Health Screening @ Saratok aerobics, body-building and cultural dance troupe.

Editorial Board iii) Miri Heart Week I would like to take this opportunity to thank all our corporate sponsors and donors, the staffs and nurses from the various public hospitals and friends of the Ms Jennifer Goh Foundation for their support in all our events and hope that they will continue to 10 Upcoming Events/Friends/Donation support our cause. I also hope that other new corporations will step forward and adopt some of the future events of the Foundation as part of their Corporate Social Responsibility (CSR) Programme.

Eric Lim Swee Khoon Editor

II 1 HEARTTALK HEARTTALK Volumn 9 - Jun 2014 Volumn 9 - Jun 2014 th 3030th AnniversaryAnniversary Heartiest Congratulations to ofof YJMYJM DInnerDInner Our Chairman, His Excellency, Tun Pehin Sri Haji Abdul Taib Mahmud SMN, SBS, DK (Johor), DK (Pahang), DP, PSM, SPDK, SUMW, SSDK, SSAP, DSGM, DPPN, SSSA, SPMT, KT.WE (Thailand), @ Hotel Istana, KL KEPN (Indonesia), SPMB (Brunei), K.O.U (Korea), AO (Australia), PCD 27 February 2014 On being appointed as WOMEN’S HEART DAY 2014 Governor of ON 8 MARCH 2014 Sarawak on 1 March 2014 and also on being conferred Darjah Seri Maharaja Mangku Negara (SMN) which carries the title “TUN” by Seri Paduka Baginda Yang Di-Pertuan Agong XIV Almu’tasimu Billahi Muhibbuddin Tuanku AlHaj Abdul Halim Mu’adzam Shah Ibni Almarhum Sultan Badlishah

on 26 May 2014 From: Deputy Chairman & Board Of Trustees FUND-RAISING DINNER on 8 March 2014 Sarawak Heart Foundation The Sarawak Heart Foundation had collaborated with SABATI for the fund- raising dinner which was held on 8 March 2014 in order to raise RM2 million for the minimal invasive heart surgery programme and SHF activities.

2 3 HEARTTALK HEARTTALK Volumn 9 - Jun 2014 Volumn 9 - Jun 2014 Heartiest Congratulations Heartiest Congratulations to to Our Board of Trustee, Yang Berhormat Senator Datuk Prof. Dr. Sim Kui Hian On his appointment as Senator on 26th May 2014 and also on being conferred Yang Amat Berhormat panglima Jasa Negara (PJN) which carries the title Tan Sri Datuk Amar Haji Adenan Bin Haji Satem “DATUK” DA, PSM, PNBS, JBS, PPB, PPD by On being appointed as Seri Paduka Baginda Yang Di-Pertuan Agong XIV Almu’tasimu Billahi Muhibbuddin Tuanku AlHaj Abdul the 5th Chief Minister Halim Mu’adzam Shah Ibni Almarhum Sultan Badlishah of Sarawak in conjunction with His Majesty’s Official Birthday on 28th February 2014 on 7th June 2014

From: From: Chairman & Board Of Trustees Chairman & Board Of Trustees Sarawak Heart Foundation Sarawak Heart Foundation

4 5 HEARTTALK HEARTTALK Volumn 8 - Dec 2013 Volumn 9 - Jun 2014 STROKE AND PREVENTION OF STROKE Hunterian Professorship by Dr. Chai Chiun Hian, Neurolgist, SGH 1. What is Stroke? Professor John Chan Kok Meng, Stroke, or Brain Attack, is caused by insufficient blood supply to part of the brain, leading to brain damage. Consultant Cardiothoracic Surgeon, Stroke is common and it is the second leading cause of death worldwide (1). Stroke is also the leading cause of adult disability. In , stroke is the third largest cause of death after heart disease and cancer (2). It is estimated that 6 new stroke cases occur every hour in SGH Heart Centre Malaysia (3). 2. Are there different types of Stroke? 3. What is a mini-stroke or There are 2 main types of stroke: Ischaemic stroke : most common type of stroke and accounts for about ~80% of stroke. It is Transient Ischaemic attack? caused by blockage of blood vessels supplying the brain. The Royal College of Surgeons of England Transient Ischaemic attack (TIA) is when symptoms of stroke last less than 24 hours Haemorrhagic stroke : less common type of stroke, accounting for the remaining ~20% of recently awarded the Hunterian Professorship and the person recovers fully. It is caused stroke. It is caused by rupture or burst of weakened blood vessel, leading to bleeding inside the by temporary interruption of blood supply to 2014/2015 to Professor John Chan Kok Meng, brain. Haemorrhagic stroke causes higher death rate compared to ischaemic stroke. Consultant Cardiothoracic Surgeon at the area of the brain. Sarawak General Hospital Heart Centre in In both Ischaemic and Haemorrhagic Stroke, symptoms of stroke persist for more than 24 hours. Kuching, Sarawak. Professor Chan will deliver the Hunterian Lecture to the Society of Cardiothoracic 4. What are the symptoms and signs of stroke? Stroke occurs suddenly, sometimes only noticed when a person wakes up from sleep. As different areas in the brain control different Surgery of Great Britain and Ireland in March functions, symptoms of stroke depend upon which area of the brain is affected. Some of the common symptoms are: 2015 during which he will be formally presented with the College Medal. • Numbness, weakness, or both over one-side of the body (arm & leg) • Severe headache or vomiting • Difficulty talking, slurred speech, or difficulty in understanding speech • Confusion • Difficulty swallowing • Blurring of vision in one or both eyes The Hunterian Professorship is a highly regarded and prestigious award • Dizziness, nausea, vomiting or loss of balance within the field of surgery and is awarded annually in stiff competition. It was founded by the Hunterian Trust at the end of the 19th century, and is named after John Hunter, who lived from 1728-1793, and is considered to be the What is F.A.S.T? founder of scientific surgery. Past recipients of the Hunterian Professorship A simple checklist if you suspect someone has a include such famous surgeons as Abernethy, Brodie, Treves, Spencer Wells, stroke. The acronym of stroke symptoms stands for: Bland Sutton, Hutchinson, Trotter and Moynihan. The title of Professor is accorded for the duration of the year of the award.

The award is in recognition of Professor Chan’s contribution to surgical research, in particular, his work on the pathophysiology and surgical treatment F A S T of functional ischaemic mitral regurgitation, carried out at the National Heart Face drooping: and Lung Institute at Imperial College London, UK. Professor Chan was also Arm Speech difficulty: Time to call ambulance: ask the person to smile. recently formally awarded a PhD by Imperial College London for this work. weakness: ask ask the person to repeat a if someone shows any of the above Does one side of the face simple sentence or talk to This ground breaking research provided additional insights into this very the person to raise symptoms, call an ambulance (call 999 droop? them. Is the speech slurred or send them to the nearest hospital challenging medical condition, led to the development of a new technique to both arms. Does one arm drift downward? or strange? immediately. Check the time so you image the mitral valve using cardiovascular magnetic resonance, and also know when the stroke occurred. demonstrated the benefits of repairing the mitral valve at the time of coronary artery bypass graft surgery in patients with mitral valve regurgitation. It Stroke is a medical emergency! has been recently referenced in the latest guidelines of the American Heart Once stroke is suspected, call an ambulance or send the person to the nearest hospital, as soon as possible. Association (AHA) and the American College of Cardiology (ACC) on Valvular The earlier the treatment is initiated the better is the outcome for the patient. Heart Disease. Professor Chan first presented his findings at the AHA Scientific Sessions in 2012 and has been invited back again to provide an update on this subject at the upcoming AHA Scientific Sessions in November 2014. He was 5. What are risk factors for stroke? also invited to organize an international course on this subject at the European Risk factors are categorized as non-modifiable and modifiable risk factors: Non-modifiable risk factors: risk factors that cannot be changed. Association of Cardiothoracic Surgery at Windsor, UK, in February 2014, and a • Age: Risk of stroke doubles every decade after 55 year-old (4). But strokes can affect young people too. repeat course is planned in February 2015. • Gender: Men have higher risk than women to develop stroke. • Ethnicity and family history of stroke.

Modifiable risk factors: risk factors that can be reduced or controlled. • Hypertension: most prevalent risk factor, up to 75.1% (5) • Diabetes mellitus [45.7% (5)] • Heart disease (includes irregular heart rhythm – Atrial fibrillation, certain types of heart valves disease and severe heart failure) • Previous history of stroke or transient ischaemic attack [22.0% (6)] • Dyslipidaemia [21.8% (5)] • Active smoker [19.0% (5)] • Others: obesity, physical inactivity, heavy alcohol consumption.

6 7 HEARTTALK HEARTTALK Volumn 8 - Dec 2013 Volumn 8 - Dec 2013 6. What are risk factors for stroke? Health Screening 17/5/2014 Treatment involves doctors and staff from multiple medical disciplines and depends on the type of stroke a person had. @ Saratok

In Ischaemic Stroke: • Blood-thinning medications maybe initiated to prevent further clot formation. • Thrombolytic or “clot-buster” drug to dissolve blood clot blocking blood vessel in the brain. However, it is only available in certain hospitals and only appropriate for selected group of patients who come to hospital within 4.5 hours from the onset of stroke. • Medications to control other risk factors, such as hypertension, diabetes mellitus, dyslipidaemia, atrial fibrillation • Surgery (carotid endarterectomy) maybe beneficial if there is severe narrowing of blood vessel in the neck

In Haemorrhagic Stroke: • Medication to control risk factors, such as hypertension, diabetes mellitus, dyslipidaemia, atrial fibrillation • Surgery. If cause of bleeding in the brain can be found such as abnormal ballooning of blood vessel (aneurysm), or sometimes to relieve pressure in the brain.Rehabilitaton plays an important role in post-stroke care. 7. So, how do we prevent stroke? Stroke prevention could be achieved by controlling the risk factors via life-style modification and drug treatments.

Life-style modifications: • Dietary advice: Reduced daily fat intake to 30% or less, and replacing saturated fat with monounsaturated and polyunsaturated fat. Eat at least 5 portions of fruit and vegetables per day, and at least 2 portions of fish per week. Reduced salt intake to reduce blood pressure. • Physical activity: Exercise 5 days a week, each time 30 minutes or more, but to adjust to each individual maximum safe capacity. Whenever possible to incorporate exercise into daily routine, such as brisk walking, cycling and using staircase. • Weight management: To achieve ideal body weight based on Asian Body Mass Index (BMI) BMI Singapore Western Health Obesity ≥ 27.5 > 30 Overweight 23 – 27.4 25.1 – 30 Screening Normal 18.5 – 22.9 18.5 – 24.9 Underweight < 18.5 < 18.5 @ Betong

Asian Body Mass Index (BMI) (source: Singapore Ministry of Health and Health Promotion Board) http://www.hpb.gov.sg/HOPPortal/ health-article/HPB-039406 18 May 2014 • Smoking cessation: Stop smoking. Seek help at quit smoking clinics. • Modest alcohol consumption: Men: limit alcohol intake to < 21 units per week. Women: < 14 units of alcohol per week

Drug treatments to modify risk factors: • Hypertension: Prevalence of hypertension among Malaysian is high, at 43.5% in people aged 30 years and above (6). Majority of hypertensive patient in Malaysia remained undiagnosed. Target blood pressure for people younger than 80 year-old is < 140/90 mmHg, and for 80 year-old or more is < 150/90 mmHg (6). • Diabetes mellitus: Medications for optimal blood sugar control in addition to diabetic diet • Heart disease: Anticoagulation therapy (to prevent formation of blood clot in the heart) in people with abnormal heart rhythm (Atrial fibrillation), heart valve disease and severe heart failure. • Hypercholesterolemia: High-risk patients required medication (statin) to control cholesterol level.

Conclusions: • Stroke can affect anyone and it is one of the leading causes of disability and death. • Stroke is a medical emergency! • Increased awareness of stroke symptoms and signs (F.A.S.T. checklist) with timely action to seek medical treatment will improve outcome. • Stroke is preventable via control of modifiable risk factors.

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References: Miri Heart Week: 27-29 June 2014

1. The Global Burden of Stroke. http://www.world-heart-federation.org/cardiovascular-health/stroke/ This year SHF was invited by YBhg Dato Prof. Lau Siu Wai (Dr), Group Executive Chairman, Miri Housing Group of Companies to do health 2. Stroke in Malaysia. http://www.nasam.org/english/prevention-what_is_a_stroke.php screening and physical activities at Bintang Megamall, Miri. There were a total of 1216 people doing health screening. The 3-days 3. Keat –Wei L & Siew-Hua G. Burden of stroke in Malaysia. program had included children’s coloring contest, health talk, healthy International Journal of Stoke 2012;7:165-67. cooking demonstration and various fun dances. About 4,000 people 4. National Institutes of Health, National Institute of Neurological visited and took part in the Miri Heart Week. Disorders and Stroke. Stroke: Hope Through Research. www.ninds.nih.gov, May 1999. On behalf of the Chairman and Board of Trustees, we would like to 5. Nazifah SN, Azmi IK, Hamidon BB, Looi I, Zariah AA, Hanip MR. National Stroke Registry (NSR): Terengganu and Seberang Jaya thank YBhg Dato Prof. Lau Siu Wai (Dr), Group Executive Chairman, Experience. Med J Malaysia 2012;67:302-304. Miri Housing Group of Companies for his generous sponsorship and support, Mr. Alex Chung and Mr.Allen Wong, Bintang Megamall, Dr.Jack 6. Clinical Practice Guidelines on Management of Hypertension. Dr. Chai Chiun Hian MD, MRCP (UK) Wong, Director of Miri Hospital, Ms Jackie Tan, De Jackie Inspiration, 4th Edition. Malaysian Society of Hypertension, Ministry of Health Fellowship in Neurology (Melb) Malaysia, Academy of Medicine of Malaysia 2013. Ms Mandy Wong, Zumba Fitness Erikings, Ms Teresa Lee, Unity Neurologist, Sarawak General Hospital Cultural Dance Troupe, all various performers and volunteers who had contributed and partipated toward the Miri Heart Week a great success.

8 9 • 23/7/14 Hari Raya visit to SGH Heart Centre Up- • 2/8/14 Health Talk & Free Health Screening @ Auditorium Tan Sri William Tan, SMK St. Joseph, Kuching • 16/8/14 Free Health Screening and Physical Activities Coming @ Eastern Mall, 17th Mile, Siburan • 28/9/14 World Heart Day @ Kuching Park Lake, MBKS, Kuching EVENTS • 21-23/11/14 sibu Heart Week @ wisma sanyan, Sibu # “Friend of the Sarawak Heart Foundation foundation” Form (383498-P) How can you Help? If you are someone who is caring and would like to help Sarawak Heart Foundation, you can register as a “Friend of the Foundation” (as a volunteer to help in the various projects Passport undertaken by the Foundation from time to time and especially with fund-raising) Size Please fill in the below and send to us. Thank You. ********************************************************* Full Name : ...... IC/ No. : ...... Address : ...... Tel. No. : ...... Fax No. : ...... E-Mail : ...... H/P No.: ...... Date : ...... Please specify how you can help? (eg. driver, food runner, general worker, exercise instructor, dancer, mc, photographer etc.)

Sarawak Heart Foundation No.11, 1st Floor, Lot 2343 Bormill Estate Commercial Centre , Jalan Tun Ahmad Zaidi Adruce, 93150 Kuching Sarawak Tel: 082-258212 Fax: 082-258303 Email address: [email protected]

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All donations payable to: Sarawak Heart Foundation No. 11, 1st Floor, Lot 2343, Block 10 KCLD Bormill Estate Commercial Centre Jalan Tun Ahmad Zaidi Adruce, 93150 Kuching, Sarawak. All donations are tax exempt. Tel: 082-258212 ; Fax: 082-258303 Ref. JHDN 01/35/42.51/179-6.4381 Website: sarawakheartfoundation.org.my