Multiple sclerosis affects more women than men in Singapore: What treatments help fight this autoimmune disease?

Secondary progressive MS (SPMS): This is the second stage of MS diagnosis and often a progression of RRMS where the disease becomes more severe, without improvement in the symptoms or any remissions. SPMS symptoms show more nerve damage, which indicates steady progression of the disease.

Without treatment, 50 per cent of people with RRMS get SPMS within 10 years while almost 90 per cent of RRMS cases develop into SPSS in 25 years.

Primary progressive MS (PPMS): The rarest of MS cases, where symptoms accumulate, and neurologic functions and ability worsen. This type of MS accounts for 10 to 15 per cent of all MS diagnoses and affects both men and women equally.

PPMS tends to be diagnosed in people in their 40s and 50s. Those with PPMS tend to have more problems with walking, along with other symptoms that become more severe.

MULTIPLE SCLERORIS AFFECTS MORE WOMEN THAN MEN

Dr Quek said that in Singapore, multiple sclerosis affects more women: ”Four in five MS patients are women.”  

It’s not fully understood why more women than men develop MS, she said. Researchers have proposed explanations that involve an “interaction between genes, hormones and differences in the immune system” but more research is needed.  

According to this Johns Hopkins report, a woman’s nervous and immune system is different to that of a man’s, and coupled with hormonal fluctuations, may be why MS is more common in women. 

A University of Pennsylvania study stated that women suffering from MS find their mobility impacted, and their MS symptoms can flare up during their menstrual cycle and at menopause.

The Multiple Sclerosis Society in the United Kingdom also said that some contraceptives may increase the risk for blood clots due to mobility issues from nerve damage, leading medical experts to say there is a risk of clotting using certain birth control.

MULTIPLE SCLEROSIS IN PREGNANCY AND MENOPAUSE

There is a common misconception that MS affects fertility in women and the hormonal changes during pregnancy can worsen the disease, said Dr Quek.

However, she said that while MS often affects women who are diagnosed in their child-bearing years, patients with multiple sclerosis are just as likely to become pregnant and have a healthy pregnancy and baby as their peers without MS.

“Studies have even shown a decrease in the frequency of MS relapses during pregnancy,” she said.

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Network notes antiretroviral shortage

The Thailand Network of People Living with HIV (HIV network) is calling on the National Health Security Office (NHSO) to provide more antiretroviral drugs to patients amid a shortage at the Government Pharmaceutical Organization (GPO).

Apiwat Kwangkaew, chair of the HIV network, and other representatives filed a letter with the NHSO, demanding that the government agency solve the problem.

Mr Apiwat said the shortage of the drugs has been going on for a long time, with many patients having been prescribed month-long courses instead of for three to six months.

He said that the shortage has affected the lives of people who require such medication. Some of them were not prescribed the adequate amounts of pills required to resist HIV.

The shortage of HIV medication will eventually lead to overburdening at hospitals, he noted.

The GPO is responsible for providing medication to people living with HIV in Thailand via three programmes — the social security, universal healthcare and government official schemes.

Mr Apiwat said the GPO should clarify why it fails to provide enough HIV medication to hospitals across the country.

“Even if people have enough money, they still cannot buy the medication. The GPO still has not paid for the medication bills that hospitals had reimbursed to their patients,” Mr Apiwat said, adding the GPO can provide half of the medication needed by hospitals.

Mr Apiwat said he had spoken to GPO officials and found that the organisation had struggled with the drug’s production for over a year, and the situation worsened this year.

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PM failed to curb pollutants

Prayut: Faces other local lawsuit
Prayut: Faces other local lawsuit

Chiang Mai: The Administrative Court on Monday ruled that Prime Minister Prayut Chan-o-cha and the National Environmental Board (NEB) had neglected their duties in tackling toxic air pollutants in the province, in a case brought forth by a local resident.

Wasuchart Pichai had petitioned that he was affected by the haze problem and claimed that Gen Prayut and the NEB had failed to address ultra-fine dust or PM2.5 pollutants.

In it, he asked the court to order Gen Prayut to take action, including ordering cloud-seeding operations to improve the air quality. He also called for the entire province to be declared a disaster zone so the authorities could disburse funds to mitigate the pollution’s impact.

At the hearing, the court heard from agencies concerned and expert witnesses, including the dean of Chiang Mai University’s Faculty of Medicine, the director of the National Health Security Office Zone 1 and the director of Maharat Nakhon Chiang Mai Hospital.

The court said that based on the testimonies of witnesses, fine dust pollution had worsened every year and negatively affected the health of people both in the short and long term. It found that the defendants had neglected their duties in resolving the problem under the law.

The court then ordered the defendants to exercise their power under the law on the prevention and mitigation of disasters, the law on the enhancement and conservation of national environmental quality and others to better regulate and manage air pollution in the province.

In April, about 1,700 residents in the province also filed a lawsuit with the Administrative Court against Gen Prayut and related state agencies over their alleged failure to resolve the haze issue in the North.

The residents claimed that people living in urban areas were at risk of being exposed to unsafe levels of ultra-fine dust particles, which could shorten lifespans by up to five years due to prolonged exposure.

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Pita future in doubt

EC move could end MFP leader’s PM bid

Move Forward Party leader Pita Limjaroenrat takes selfie with supporters in front of CentralWorld shopping centre in Pathumwan district, Bangkok on Sunday evening. (Photo: Wichan Charoenkiatpakul)
Move Forward Party leader Pita Limjaroenrat takes selfie with supporters in front of CentralWorld shopping centre in Pathumwan district, Bangkok on Sunday evening. (Photo: Wichan Charoenkiatpakul)

If the Election Commission (EC) forwards a case involving Move Forward Party (MFP) leader Pita Limjaroenrat’s previous iTV shareholdings to the Constitutional Court, this could sway senators in the crucial vote for a new PM on Thursday, according to a former election commissioner and an academic.

Former election commissioner Somchai Srisutthiyakorn said if the court accepts the case for consideration, the court can order Mr Pita to be suspended from duty as an MP, which will affect voting on Thursday.

Mr Pita would not be allowed into parliament as an MP, though he still could enter the premises as a prime ministerial candidate, Mr Somchai said.

This would also be cited by senators as a reason to abstain from voting as they would fear the vote could be problematic due to Mr Pita’s alleged ineligibility, he said.

Mr Pita, who is the MFP’s sole prime ministerial candidate, stands accused of being ineligible to contest the election because he held 42,000 shares in iTV, which is believed by some critics to be an operational media company when he registered his candidacy in the 2019 election. Mr Pita has denied the allegation, saying he only served as executor of the family’s inherited shares.

The constitution bars individuals with media shareholdings from running for office.

Mr Somchai said the EC should summon Mr Pita to defend himself against the accusation before it decides to forward the case to the court.

An EC inquiry panel looking into Mr Pita’s alleged ineligibility wrapped up its investigation and forwarded findings to the EC’s main committee yesterday.

EC chairman Ittiporn Boonpracong on Monday said that the poll agency has yet to forward the case to the Constitutional Court as the inquiry panel only briefed the EC’s main committee on its findings on Monday.

Jade Donavanik, a legal scholar and ex-adviser to a charter drafting panel, echoed the view, saying if the EC finds grounds for the accusation against Mr Pita, the next step is for the poll agency to forward the case to the court.

If the court accepts the case, it will ask the House speaker to suspend Mr Pita as an MP pending a trial, Mr Jade said.

However, Mr Pita can still be nominated for prime minister in the vote on Thursday, Mr Jade said.

Even if Mr Pita wins the vote, he still cannot carry out the duties of a prime minister pending the trial, Mr Jade added.

In that case, senators may decide to abstain from voting until the court rules on his eligibility, Mr Jade said, adding that another way out of the problem is for political parties to nominate another alternative candidate.

“It is not easy. I don’t think a new prime minister can be elected in the July 13 vote,” Mr Jade said.

MFP secretary-general Chaithawat Tulathon said on Monday he sent an urgent letter to the EC to protest any decision to forward the case to the court.

He said the poll agency was trying to rush the case, and the EC’s inquiry panel had failed to summon Mr Pita to explain himself before the panel first, as stipulated by its regulations.

Mr Pita said on Monday that the EC had not summoned him yet, but he is ready, adding that talks between the MFP and senators would yield a favourable outcome.

According to sources, the Senate committee on political development and public participation believes if Mr Pita fails to win his PM bid in the first round of voting on Thursday, he cannot be nominated for any further voting rounds.

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Commentary: Should Singapore worry about a loneliness epidemic among seniors?

We also quantified, for the first time, the impact of loneliness on life expectancy among older adults, using data from Singapore. We found that people aged 60, who perceived themselves to be lonely, live three to five years less, on average, compared to peers who perceived themselves as not lonely.

Similarly, at ages 70 and 80, lonely older persons could, on average, expect to live three to four and two to three years less, respectively, compared to non-lonely peers.

LONELY IN A CROWD

It is important to note that loneliness is distinct from social isolation. Loneliness refers to the state of distress or discomfort that arises from a gap between one’s desire for social connection and actual experience of it.  Whereas social isolation is marked by a low number of family and friends, and the quality of those interactions.

We often think that socially isolated people, for instance those living alone or with spouses only, must be lonelier than those living in multigenerational households with family members all around them. In fact, a significant percentage of older Singaporeans who are living in multigenerational households report being sometimes or mostly lonely.

Similarly, an individual could be in a marriage and feel lonely due to the lack of connection with one’s spouse. As the saying goes, one can be lonely in a crowd.

This is exemplified by the experience of Madam Lau*, a participant in one of our research studies. 72-year-old Mdm Lau lives with her husband and son in a large condominium. She describes Mr Lau as a “macho man” who has never helped with chores or taken care of their children because his job was to earn money. He does his own activities and does not initiate conversations.

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DDC warns of grim year for dengue

As many as 150,000 infections predicted

A Wang Thonglang district official sprays fogging chemicals in a residential area in Soi Lat Phrao 69 on Lat Phrao Road to prevent the spread of mosquitoes that cause dengue fever. (File photo)
A Wang Thonglang district official sprays fogging chemicals in a residential area in Soi Lat Phrao 69 on Lat Phrao Road to prevent the spread of mosquitoes that cause dengue fever. (File photo)

Thailand is currently facing what many experts predict will become a severe dengue fever outbreak, with up to 150,000 infections a possibility by the end of the year, according to the Department of Disease Control (DDC).

Opas Karnkawinpong, permanent secretary for public health, said on Monday the number of dengue cases has already surged this year, with over 30,000 cases and 33 deaths recorded so far.

Dr Opas was speaking at “Dengue: Effective Action for Treatment and Prevention”, a seminar held at Rajavithi Hospital on Monday.

“The ministry is highly concerned about the increasing number of dengue infections. They may reach up to 150,000 cases this year if preventive measures fail,” he said.

In the past, infections were mostly found among children, but now the disease has been widely detected among adults and senior citizens, he said.

This phenomenon might be the result of zero immunity as these adults and elderly people who have never been infected with the disease before.

Dr Opas said health authorities found that people living in urban areas have a higher risk of catching dengue than those living in remote areas due to people’s mobility.

“People are now travelling more from one place to another place after the end of the Covid-19 pandemic. That’s why they are more vulnerable to catching the disease.

“We want to raise awareness, and people should urgently visit a doctor if they feel that they are having symptoms related to dengue. With screening and early detection, we can save lives,” he said.

He went on to say that the vaccine against dengue fever is very new and needs further study before widespread adoption can be considered.

“Our academic team is studying the case, and we don’t want to quickly jump to a conclusion. Any decision must be based on academic support, not social pressure,” he said.

Meanwhile, Dr Chantana Pudungtod, director of the Vector Borne Disease Division of the DDC, said that the current number of infections is 2.7 times higher than for the same period of last year.

She said that the North is the main hot spot for infections, followed by the Central Plains and surges in the South and Northeast. The youngest patient was a one-month baby, and the oldest 76. The death rate is 0.11%.

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Jumbo doing well despite 5 tumours

Sak Surin is being nursed back to health at the Thai Elephant Conservation Centre in Lampang.
Sak Surin is being nursed back to health at the Thai Elephant Conservation Centre in Lampang.

The ailing male Thai elephant, Sak Surin, is reportedly recovering well even though a veterinary team found five tumours on his thighs, said the Thai Elephant Conservation Centre in Lampang province.

The 30-year-old elephant is currently under the care of the centre’s elephant hospital, having been flown home from Sri Lanka on July 2 after being kept there for 22 years.

The centre said the hospital ran health checkups and behavioural examinations on Sak Surin last week and found that he is recovering well.

The centre said Sak Surin’s daily intake is 120-200kg of food, mostly fresh grass and fruit, and his sleeping schedule lasts 1-3 hours twice a night, which is a decent sleeping cycle.

Sak Surin has reportedly grown familiar with the sound of his new mahouts and sometimes lets them ride him. But of concern, the physical examinations found five tumours with a 10cm radius on Sak Surin’s thighs and a mass with a 1cm radius on his right cornea. The elephant also has damaged toenails and cannot stretch or bend his front left leg.

Samples of blood, manure and tissue from his mouth and the trunk tip were collected for the Department of Livestock’s Veterinary Research and Development Centre on July 2.

Sak Surin’s blood or manure had no parasites (trypanosoma evans) lab results showed, and he does not carry tuberculosis genes, herpes viruses, antibodies to leptospira, non-structural protein from foot and mouth disease or B. abortus antibodies.

Sak Surin must be quarantined for at least 30 days and pass all regulated disease inspections on the 15th and 30th day of quarantine.

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PM checks progress on Pink Line

The Pink Line monorail is being readied for its soft opening later this year.  (Photo: Government House)
The Pink Line monorail is being readied for its soft opening later this year.  (Photo: Government House)

Prime Minister Prayut Chan-o-cha on Monday inspected progress on the Pink Line, an elevated monorail system under construction, prior to starting a trial run at the end of the year.

Gen Prayut, accompanied by Interior Minister Anupong Paojinda, boarded a train on a test run between Min Buri and Lat Pla Khao stations on Monday. During the ride, the premier received a briefing about construction progress from Pakapong Sirikantaramas, governor of the Mass Rapid Transit Authority of Thailand (MRTA).

The Pink Line is one of several electric train lines and sections initiated by the Prayut government. The others are; the Purple Line covering 23km; the 18.7km Green Line from Mor Chit to Kukot; the 14km Blue Line (Hua Lamphong-Bang Kae section); the 13km Blue Line (Bang Sue-Tha Phra section); the 1.8km Gold Line from Krung Thon Buri to Klong San; the 26.3km Red Line (Bang Sue-Rangit section); the 15.2km Red Line (Bang Sue-Taling Chan section); and the 30.4km Yellow Line from Lat Phrao to Samrong. Altogether they cover a total of 142km.

The Pink Line links Lat Phrao in northern Bangkok with Samrong in the city’s east. It runs along the middle of Ram Intra Road, then heads to Chaeng Watthana before terminating at the Khae Rai junction.

The Pink Line will use the same monorail train model as the Yellow Line that is now in operation, with four to seven passenger carriages capable of carrying up to 28,000 passengers per hour.

There are 30 stations and two extended stations, along the 34km Pink Line, from Khae Rai Station to Muang Thong Thani. They include interchange stations for transfers to and from the Purple Line, the BTS’s Green Line, and the future Orange Line.

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City Hall tackles homeless hub

The Bangkok Metropolitan Administration (BMA) is to limit drop-in facilities for homeless people living on Ratchadamnoen Avenue to tidy up the area.

According to Bangkok governor Chadchart Sittipunt, a Ministry of Social Development and Human Security report showed that the situation for homeless people had improved, with the number expected to decrease from 1,600 to 1,400 this year.

However, Mr Chadchart said that the situation on Ratchadamnoen Avenue is still concerning, especially after photos of homeless people living in front of the abandoned buildings on Ratchadamnoen Klang Avenue near Satriwithaya School went viral recently.

Mr Chadchart said that the spot drew the homeless as it is known that some people visit at night to offer food and cash.

“One of the main solutions is to limit the drop-in locations to one under the Phra Pinklao Bridge and the another in Sake Alley on Assadang Road,” he said, saying that this aims to not only tidy up Ratchadamnoen Road but also streamline registration procedures for the homeless in the future.

City Hall has also been attempting to make work available, and according to Mr Chadchart, 169 job positions have so far been offered to the homeless.

The BMA also plans to change the location of the Baan Imjai shelter to Chaloem Wan Chat Bridge after the rental contract on a former building in Soi Mansri is over, said Mr Chadchart, adding that a refurbishment will be finished this year.

Meanwhile, according to Weeraphan Suphanchaimat, chairman of the Thai Health Organisation’s (ThaiHealth) Directing Committee on Health Promotion for the Homeless, 500–600 of the 1,217 homeless people in Bangkok live in Phra Nakhon district and Ratchadamnoen Avenue.

This information led ThaiHealth and related sectors to establish a drop-in spot located under Phra Pinklao Bridge, which provides everything from job positions and healthcare support to basic hygiene facilities, such as a laundromat and shower room, for homeless and vulnerable people, said Dr Weeraphan.

According to Thapanee Sirisombun, director of the Bangkok Homeless Protection Centre, the age range of newly homeless people who registered with the drop-in spot ranged from 40 to 60 years old.

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Extortion after German disappears

Mack: Went missing last week
Mack: Went missing last week

CHON BURI: Police suspect extortion was the motive in the disappearance of a wealthy German businessman in Pattaya last week.

They have identified a woman believed to have pointed him out to his abductors, and the recipient of money paid by the missing property broker, 62-year-old Hans Peter Ralter Mack, Pol Gen Surachate Hakparn, deputy police chief, said yesterday.

He said police would find Mr Mack, whether he was alive or dead.

Investigators were compiling their case to apply for court warrants, and he expected an arrest in the near future.

“The case concerns assets. The offenders seemed to know that Mr Mack had assets. Detectives must find out if they knew Mr Mack personally,” the deputy national police chief said.

Police would also look into the business activities of other people in the case, he said.

Regarding the investigation, two suspects, one Thai national, who is said to have identified the victim, and the other, a foreigner identified as Olaf, were called in for questioning at Nong Prue police station on Sunday night, said Pol Gen Surachate.

The two suspects, accompanied by their lawyers, declined to give statements.

Pol Gen Surachate said that the police believed Mr Mack’s property might be the main motive, as some transfers were seen into Mr Olaf’s bank account while Mr Mack was still missing.

Sources said investigators had detected suspicious financial transactions totalling about 2 million baht, which might be linked to the man’s disappearance.

He also said that the disappearance seemed well planned, adding that a forensic investigation regarding a chemical cleanser used to wipe the interior surfaces of Mr Mack’s Mercedes-Benz is needed.

Earlier in the morning, Mr Mack’s family, accompanied by representatives of the Win-Win Foundation, met with Pol Gen Surachate and representatives of the German embassy in Thailand to discuss the case.

Meanwhile, in Chon Buri, Pol Col Tawee Kudthalaeng, Nong Prue police chief, said that the police had also invited Mr Mack’s family members for more questioning on Sunday night.

Mr Mack, 62, has not been seen since July 4 after leaving home to meet a foreign property broker he had recently met.

The family filed a missing person complaint with police on July 5 and later offered a reward of 3 million baht for information on Mr Mack’s whereabouts.

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