TOYOTA RECALL – IS MALAYSIA AFFECTED TOO? LEARN FROM TOYOTA CASSA CHIEF TELLS NAZA!

‘If only more manufacturers are so responsible our addressing of consumer woes would be vastly reduced!’- Dr Jacob George 

TOYOTA RECALL – IS MALAYSIA AFFECTED TOO? LEARN FROM TOYOTA CASSA CHIEF TELLS NAZA!

I am advised that Toyota Motor Corp will recall 3.8 million vehicles in the United States!

If I remember carefully this in my estimate will be the said company’s largest-ever U.S. recall addressing problems with a removable floor mat that could cause accelerators to get stuck and lead to a crash!

It is a shock that the said recall will involve popular models such as the Toyota Camry, the top-selling passenger car in America, and the Toyota Prius, the best-selling gas-electric hybrid.

But what impressed me in this fiasco was that the manufacturers were being responsible and working with officials with the National Highway Traffic Safety Administration to find a remedy to fix the problem!

They practiced corporate accountability and owners were notified about the recall!

In the meantime they have advised that owners should take out the removable floor mat on the driver’s side and not replace it.

The reason being that a stuck open accelerator pedal may result in very high vehicle speeds and make it difficult to stop a vehicle, which could cause a crash, serious injury or death!

This episode also saw a win-win situation between the government and a private business entity where both issued separate warnings to owners of Toyota and Lexus vehicles about the safety problems tied to the floor mats!

The recall will affect 2007-2010 model year Toyota Camry, 2005-2010 Toyota Avalon, 2004-2009 Toyota Prius, 2005-2010 Tacoma, 2007-2010 Toyota Tundra, 2007-2010 Lexus ES350 and 2006-2010 Lexus IS250 and IS350.

I am advised that Toyota’s previously largest U.S. recall was about 900,000 vehicles in 2005 to fix a steering issue.

The company declined to say how many complaints it had received about the accelerator issue.

In mid-September, Toyota ordered 1,400 Toyota and Lexus dealers nationwide to ensure that each new, used and loaner vehicles had the proper floor mats and that the mats were properly secured. In September 2007, Toyota recalled an accessory all-weather floor mat sold for use in some 2007 and 2008 model year Lexus ES 350 and Toyota Camry vehicles because of similar problems.

If only more manufacturers are so responsible our addressing of consumer woes would be vastly reduced!

‘ driving difference - this is a joke!’
I have a special beef to pick with Malaysia’s NAZA who has been a big disappointment to me after I highlighted to them several complaints recently!

Worst, it is embarrassing that one is unable to get in contact with any of the senior management even after leaving messages with staff!

Even worst, it is a nightmare trying to call them over the telephone!

‘always available and ‘hands on’ when problems arise and I miss him!’
It is sad how things have changed since my dear friend the late Tan Sri passed on!

If manufacturers and car importers do not know the first two ingredients of the business which is the need for positive communication and accountability – it is futile! Says a lot does it not?

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CASSA: ARE THE MORTALITY NUMBERS HIGHER IN PRIVATE FOR PROFIT HOSPITALS THAN IN OTHERS?

‘I am willing to bet that the results will be rather interesting and will show that for-profit hospitals were associated with significantly higher mortality.’ - Dr Jacob George
CASSA: ARE THE MORTALITY NUMBERS HIGHER IN PRIVATE FOR PROFIT HOSPITALS THAN IN OTHERS?
We continue our take on the rising mortality numbers into another zone of healthcare contention!

Did you realize that a study of data from more than 26,000 U.S. hospitals covering outcomes of 38 million patients has shown that people treated in private for-profit hospitals in the U.S. have a greater risk of dying than those cared for in private not for-profit hospitals?

The study was carried out by researchers from McMaster University in Hamilton, the University at Buffalo and University of Toronto.

The researchers undertook the meta-analysis of mortality statistics to help inform the debate underway in Canada over whether to move into the for-profit health-care-delivery arena.

In view of this, the Consumers Association of Subang and Shah Alam Selangor (CASSA)-http://www.cassa.org.my/ will be initiating a similar study here in Malaysia.

What we want to do is base the entire argument and research on economics.

The emphasis will be to determine if for-profit hospitals and we have many today in Malaysia run by Malaysia’s version of business empires with their fancy, manipulative and greed driven management and staff, doctors, specialists and board of directors with obese profiteering salaries and perks can contain costs and run more efficiently by being more sensitive rather than be driven by high powered greed?

‘Datuk Seri Dr Chua Soi Lek - the best health minister Malaysia has ever had who put private hospitals in their place!
We need to also look at how expansion of private for-profit hospitals would affect patients.

And since I am already on a run with this argument on the issue of high suspicious mortality in hospitals in Malaysia it would be good and relevant to zoom the study on the relative impact of private for-profit versus private not-for-profit delivery of hospital care on patient mortality!

My definition of not-for-profit hospitals would be like those owned by religious organizations, communities, regional health authorities or hospital boards.

And for-profit hospital (Oh God there are far too many!) would be those owned by shareholders or investors and by big business!

To conduct our review, CASSA researchers would systematically identify all relevant studies that compared private for-profit with private not-for-profit hospital mortality.

Tan Sri Dr Ismail Merican Malaysia’s DG for Health Services - the best DG we have had who in my opinion should be made a senator and appointed Malaysia’s new health Minister!

We will seek the Ministry of Health’s support to analyze certain studies containing data from patients hospitalized.

The data will be adjusted for confounders such as teaching status of the hospital, the patients’ severity-of-illness and hospitals’ case mix.

I am willing to bet that the results will be rather interesting and will show that for-profit hospitals were associated with significantly higher mortality.

My analysts tell me that even if the relative increase in risk amounts to 2 percent in our analysis, which may seem small, the absolute number will be frightening!

My contacts in Canada tell me that in their context this percent is equivalent to 2,200 deaths yearly, which equals Canadian death rates for suicide, colon cancer or motor vehicle accidents.

My expert opinion is that the total numbers will be much higher if the US is used as an example!

You do not have to be a rocket scientist to point to pressure to achieve the expected profit for investors and the parent business company as the probable cause of this increase in mortality!

It is also because chief executive officers of these for-profit hospitals are rewarded based on meeting or surpassing the profit margin, as their directors, senior management get big salaries, and for-profit organizations also have to pay taxes.

When reimbursement comes from the same source as not-for-profits, such as from insurance groups, for-profits are faced with trying to achieve the same outcomes while having less to spend on patient care.

I believe these issues raise concerns that the profit motive causes hospitals to limit care in ways that affect patient outcomes!

So let us see if my contentions are indeed justified after our intended survey.

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ARE THERE TOO MANY DEATHS IN OUR HOSPITALS?

‘there is far too many deaths in our hospitals!’ - Dr Jacob George
‘time for periodic accountable and transparent audits on surgeons!’

IS THE TIME RIGHT TO LOOK AT MALAYSIA’S PATIENT CHARTER OF RIGHTS?

The objective and purpose of a national patient charter of rights is to support safe and high quality care by addressing and articulating the key rights of all patients when seeking healthcare in Malaysia!

In my opinion the said charter must focus on nine (9) principle rights which I would call the JACOB’S 9 PRINCIPLES - which is not all exhaustive and should be reviewed from time to time and not be caught in a time wrap!

They are as follows:

1. RESPECT: Respect, dignity and consideration always being the hallmark.
2. SAFETY: We should promote safe and competent care
3. ACCESS: There should be equity of access to public healthcare.
4. COSTS: The costs should be fair and reasonable leaving no room for profiteering!
5. COMMUNICATION: Communication is paramount and should be the trade throughout the period of patient care!
6. INFORMATION: Information on treatment, services, care should be constant and periodically updated!
7. PARTICIPATION: This facilitates informed decisions and choices
8. PRIVACY: There should an assurance that personal data and information is secure!
9. REDRESS: There should be a professional mechanism having care and concerns addressed!

I would be seeking Malaysia’s Director General of Health’s  views of the above when I meet him soon to discuss this and several other concerns.

I am certain being the proactive individual he is - my concerns will be addressed and things should move forward.

I am certain many reading today’s blog would be asking why I am moving in this direction and wondering whether something is upsetting me in Malaysia’s healthcare delivery system?

I am concerned at receiving allegations on the high rate of ‘mortality and blotched surgeries in Malaysia!’

I am concerned whether there are doctors and surgeons out there operating when they are competent to and should not?

I am concerned whether nationally we have a peer review board looking at these and other issues in a transparent, accountable and professional manner?

Most of all, I want doctors and surgeons who ‘mess up’ to be removed - period!

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MY ANSWER TO NST’S FEATURE TODAY (page 10-11) - ‘WOMAN HAVE YOU GOT CHEATING ON YOUR MIND?’

‘Despite the hurt, betrayal and despite the fear to trust again, the bitterness or the ‘mental flashbacks’ if there can be room for forgiveness it should be practiced and allowed to flow! More so, if there are children of the marriage involved! But if one of the partners refuses to change, is arrogant or defiant and wants their own way, refusing to accept fault and change it adds hurt to insult to one’s self esteem! In such circumstances, with no way out,  it is best to move on though it is a very sad result!’ - Dr Jacob George Steps to Saving your Relationship & Marriage

There are times when a relationship reaches a point where either you, your partner or both of you feel that you can no longer proceed with your relationship.Though this may be so, the two of you still have a connection and really do want to make your relationship work, but do not know exactly how to approach the rescue. If your relationship is going through a rocky period, but you do not want to lose your partner and wish to make things better and continue to build a strong bond together, then consider the following steps to save your relationship: 1. Acknowledge the Reasons for your Rocky Period. Most of the times, couples break up because they are having problems or feel they can no longer get along, but never really acknowledge what the true problem was. It is important that you both know what the root of your conflicts are so that you both see a clear picture of what is going on and where it all came from and why. 2. Be Rational, Reasonable & Calm. When a couple is experiencing conflicts and hard times, there all kinds of emotions flying around, which can cause one or both of you to act irrationally, and say or do things that will only worsen your already frustrating situation. Though it can be very challenging, it is essential that you make a real effort to stay calm and think rationally, as well as speak rationally. Your partner may be acting completely uncooperative, and that is exactly when you need to take charge of the situation and make sure that things do not get out of hand. Be patient and hear everything your partner has to say before you take your turn in speaking. Make sure you do not say things that you will regret later. 3. Use Space to your Relationship?s Advantage. If your rational, reasonable and calm approach does not work and you notice that the two of you are getting nowhere at the current time, then take some time apart. It may be hard for you to do and go through, but it really would be doing your relationship good. Many people get overly emotional when they are having problems with their lovers and want to work out their problem right away and do will not leave their partner alone until they do, but this id definitely the wrong way to go about it. The only thing that will happen is frustrating your partner more, making him or her feel more pressured and therefore pushing your relationship further back instead of forward. Take some time apart so that you both have the space to think on your own and set your emotions and thoughts in order. 4. Agree to Disagree. The next time you and your partner feel ready to attempt another rational discussion, be sure to agree to disagree first. It is important that you both remember that although you may be one as a couple, you are still both very much individuals with your own thoughts and beliefs about certain things. Make an agreement that being different does mean you both are incompatible, but what it does mean is that you are both unique in your own ways and will respect your differences and use those differences as a way to better your relationship instead of trying to change each other. 5. Find a Middle Ground. There are probably some things you would prefer your partner not do and vice versa, but the fact of the matter is, you cannot change your partners personalities or hobbies. What you must do is find a middle ground where you both feel more secure and comfortable with certain situations where you can both trust each other and feel that your relationship is safe from any damage or harm. 6. Work as a Team. Saving a Relationship and maintaining it requires effort from both of you, not just one of you. If your partner shows no interest or effort in making your relationship work, it would be best to leave him or her alone until he or she figures out just how important saving the relationship is. Sometimes the results will be painful for you and they will not want to have a relationship anymore. However, it could very well be that they realize how important sharing their life with you is, and will eventually come to you-ready to give full cooperation in mending your wounded relationship. 7. Patience is Key. Do not panic! Relationships are very fragile when they are going through a rocky period and cannot be repaired in a day. Do not feel afraid or depressed if things do not go at a pace of your expectation. There is no spell or psychic who can predict your future or make things better. The only thing that will give you real and honest results is time, patience and effort. If you truly want this to work out, then it will be worth the wait. Keep in mind that no matter what happens, you did your best and will survive regardless of what the ending results are. 8. Take it Slowly. Once you and your partner have smoothed things out, be sure to take things slowly. Rushing back into things can make your relationship an easy target to the same problems that caused your rockiness in the first place. Have a serious conversation together about what happened and work together on how you can prevent the same conflicts in the future and/or how you can handle it differently in the future if it does come to surface again. If the two of you agreed to stay together, then there is no need to rush. No of you is going anywhere. MAY GOD THE ALMIGHTY GUIDE YOU!  Our campaign against RACISM of all forms!

DO NOT BE SO STUPID - BN WILL BE BACK PROFESSIONAL, YOUNGER AND STRONGER!

‘ In politics - no one is indispensable and I will put my money on the BN doing far better the next time out! - Dr Jacob George 

‘premier Najib about to make drastic changes to reflect the wishes of all Malaysians! No more place for war lords, those overstaying their welcome and old farts of politics!’

DAP’s  Party vice-president M Kulasegaran is predicting that the next general election will the see the Pakatan Rakyat triumphant over the Barisan Nasional as he claims its leadership is too busy fighting for survival than in strengthening the coalition.

He is reported to have stated:

“BN component party leaders are now more interested in their own political survival rather than strengthening the BN political philosophies of safeguarding the voters’ interests.”

He is reported to have stated said the ruling coalition continues to suffer from the aftermath of the March 8 tsunami which saw its two-thirds parliamentary majority slashed and four states falling to the Pakatan while tightening its hold on the fifth.

Describing the BN members current troubles as a second tsunami, Kula saw this as a plus point for the Pakatan in next polls as electorate’s faith and confidence in the coalition will deepen.

Worst he believes that despite all the BN leaders have the cheek to talk about disunity in Pakatan when the whole structure of BN is about to collapse from their internal bickering and power craziness.

My response is basically this!

After seeing what took place in Kedah, Penang, Perak and worst Selangor many are just disillusioned at the manner we replaced one pack of opportunists with another!

Worst the manner issues of governance and inter party decision making process on policy leaves much to be desired!

Just look at the havoc created by PAS party head for Selangor!

My two cents worth is just this not that I am the mouthpiece of the BN or Malaysian Premier Najib Tun Abdul Hj. Razak he is professional and articulate himself!

People in glass houses should not throw stones!

The opposition pact should clean up their own backyard which is now very messy before pointing fingers at the BN!

I know all too well from our intelligence operatives working on the ground in all states that in the administrative level of the states governed by the opposition - nothing has changed in fact the manner certain elected reps are behaving shows that they are far no better than the ones that were replaced!

In politics - no one is indispensable and I will put my money on the BN doing far better the next time out!

With the data and intelligence gathered and perhaps my humble advice to the premier he will certainly surprise the Malaysian electorate and masses by first retiring all overstayed and impotent political war lords and the old farts of politics!’

Premier Najib will in my contention be moving away from past practices by inducing new blood from all races and religious persuasions from outside – especially those with the qualifications and track record even among the NGOs!

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RISING CRIME RATE NEED TO BE ADDRESSED!

‘ We should tackle the rising crime rate NOW!’ - Dr Jacob George

BANGLADESHI ORGY IN THE BUSH AND NOW CHARGERS!

So 3 local women caught having an orgy with 19 Bangladeshi men on the first day of Hari Raya will be charged!

Strange that none of them realized they were being monitored by a group of policemen, who had surrounded the house in Felda Krau, Raub, before they were raided at 2.30am.

Media reports now quote the Raub OCPD Supt Wan Mohd Samsudin Wan Osman stating that all 22 were arrested, including the three women aged between 17 and 43.

He said investigations revealed that the women had spent the past two nights in the house to satisfy the lust of the Bangladeshis, aged between 20 and 30.

So I guess all the three women are detained for investigations under Section 372B of the Penal Code for soliciting for the purpose of prostitution?

And a 56-year-old man, suspected to be the pimp, was also detained later under Section 372A of the Penal Code for trading in prostitution?

Brilliant police work!

Now I hope the same positive response will target similar activities in all Malaysian hotels, noted vice dens and other areas well known to our ‘boys in blue!’

Certainly we do not want to give the impression that we only want to target foreign workers and some two bit ‘small time pimp and his harem of 3 girls?’

And worst, creating a media spin as if nothing is happening in a nation where the crime statistics has been skyrocketing with all kind and nature of allegations in popular media reports and websites!

And allow the well organized and connected ‘sharks of the trade’ operating in posh sites to get away?

Need I say more?

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WAGE COUNCIL SHOULD DO MORE TO PROTECT WORKERS INTEREST IN MALAYSIA!

‘ We should not allow the age old redundant argument of costs of operation and competitiveness of the country as a whole in the market to offset the rights of Malaysian employees!’ - Dr Jacob George 

‘industrial harmony vital!’ 

I am pleased of the move by the Human Resources Ministry to reactivate the Wages Council to review salaries on a sectoral basis!

The Human Resources Minister has stated publicly that the Wages Council would review salaries in the security, hospitality, electrical, electronic and textile industry sectors.

That is welcomed but I share the sentiments of my Labor organizations friends that it does not address the issue.

A major issue is increasing wages!

I am surprised that council had failed to look at the manufacturing sector and plantation sectors which had millions!

Of course I am aware that at the Plantation Sector we have the vulgar collective agreement between the plantation union and plantation operators but is it not time to review that in the spirit of industrial harmony and fine tuning?

  Our campaign against RACISM of all forms!

UNCLE KU LI RIGHT ON TARGET AGAIN!

‘ well supported statement!”

WELL SAID BUT WILL IT EVER HAPPEN IN 1MALAYSIA?

‘In our now dangerously divided society, it is important not just that elections be won, but that they be won with honour and by honourable individuals’ - Tengku Razaleigh Hamzah.

 Our campaign against RACISM of all forms!

I HAVE A LIGHTER SIDE TOO! TRUST ME!

‘lets us have a laugh today prior to the holiday weekend!’ - Dr Jacob George

HUSBANDS FOR SALE !

A store that sells husbands has just opened in New York City , where a woman may go to choose a husband. Among the instructions at the entrance is a description of how the store operates.

You may visit the store ONLY ONCE!

There are six floors and the attributes of the men increase as the shopper ascends the flights. There is, however, a catch …. You may choose any man from a particular floor, or you may choose to go up a floor, but you cannot go back down except to exit the building!

So, a woman goes to the Husband Store to find a husband.

On the first floor the sign on the door reads:

Floor 1 - These men have jobs and love the Lord.

The second floor sign reads:

Floor 2 - These men have jobs, love the Lord, and love kids.

The third floor sign reads:

Floor 3 - These men have jobs, love the Lord, love kids, and are extremely good looking.

‘Wow,’ she thinks, but feels compelled to keep going. She goes to the fourth floor and sign reads:

Floor 4 - These men have jobs, love the Lord, love kids, are drop- dead good looking and help with the housework.

‘Oh, mercy me!’ she exclaims, ‘I can hardly stand it!’ Still, she goes to the fifth floor and sign reads:

Floor 5 - These men have jobs, love the Lord, love kids, are drop- dead gorgeous, help with the housework, and have a strong romantic streak.

She is so tempted to stay, but she goes to the sixth floor and the sign reads:

Floor 6 - You are visitor 4,363,012 to this floor. There are no men on this floor. This floor exists solely as proof that women are impossible to please. Thank you for shopping at the Husband Store.  Watch your step as you exit the building, and have a nice day!

Please send this to all men for a good laugh and to all the women who can handle the truth!

 Our campaign against RACISM of all forms!

VINTAGE MAHATHIR SAYS IT AGAIN!

‘my hero says it again!’
MY TAKE FOR THE WEEK!

Brilliant statement this from vintage ‘Papa Mahathir!’

‘the Malaysian Indian community - a new ‘tak nak campaign?’

‘Previously there was no Hindraf. Now there are scores (of pressure groups from the Indian community.) It’s him that the people don’t want but he still wants to be president,” he added.

He said leaders who resorted to money, pressure, abuse of power and threats could remain as party presidents but would not win elections.

 Our campaign against RACISM of all forms!

JG’s SITE UNDER ATTACK FOR ARTICLE ON GENERIC DRUGS?

I say it again - CASSA has been receiving complaints from Malaysian patients from time to time about the ineffectiveness of the generic drugs which are now being prescribed by all public hospitals!

Does the FDA have constraints monitoring the generic trade in Malaysia?

If so can they enlighten me just what is the mechanism of quality control / surveillance in Malaysia?

And ….. don’t attack my site for asking pertinment questions! - Dr Jacob George CASSA CHIEF.

According to my webmasters – yes - as many of you indicated my site was under attack for reasons I have no clue whatsoever, except in the midst of the present debate on healthcare and more so, my recent blast against multi-profiteering generic producing pharma – I am not the least surprised!

Yes – a police report will be made and my team of intelligentsia is also tracking the source of that attack!

Of course, ‘Jacob George must be stopped’ as he is now asking for accountability, governance, proper audits and surveillance of generic drugs that are being mass produced and marketed without proper FDA monitoring and these companies ‘laughing all the way to the banks’ with their brand of owner parasites - the many we have in this country leading lavish bourgeois lifestyles – thanks to the bastardized marriage between politics and business and mass profiteering!

If instead of wasting effort on childish pranks like ‘site attacks’ these ‘fellas’ should instead ask me out for a ‘masalla tea session’ - which may be more useful and provide us all a mental orgasm!

Got my drift?

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KEEPING THEM HONEST - FDA AND GENERIC TRADE IN MALAYSIA SLAMMED BY CONSUMER ADVOCATE!

‘

CASSA has been receiving complaints from Malaysian patients from time to time about the ineffectiveness of the generic drugs which are now being prescribed by all public hospitals!

Does the FDA have constraints monitoring the generic trade in Malaysia?

If so can they enlighten me just what is the mechanism of quality control / surveillance in Malaysia? - Dr Jacob George CASSA CHIEF.

FDA AND GENERIC TRADE IN MALAYSIA SLAMMED BY CONSUMER ADVOCATE!

I will predict that in the forthcoming budget 2010 there will be huge cuts in the allocations given out to most ministries!

I will predict billions may be cut!

And I am certain among the Ministries that will be affected - the Ministry of health will be one!

Will this then cause a chain reaction to use then available funds to buys generics rather than the ‘real thing’ making those having this monopoly ‘vulgarly rich’ at the expense of the Malaysian consumer seeking a cure at all public hospitals?

And why do I say this?

Well If you took a prescription pill recently, odds are it was generic: Nowadays, generics constitute almost 70 percent of all the prescriptions dispensed nationwide racking up $58 billion in sales in 2007.

Worldwide anxious to cut costs, health insurers and certain governments’ including Malaysia are stampeding to switch patients to drugs that are cheaper to make, test and ultimately buy because their manufacturers can piggyback on the research and marketing already done by brand-name-drug companies!

But we all agree that generic drugs cost 30% to 80% less than their brand-name counterparts and most people feel safe taking them because the FDA requires that both types of medications provide the same active ingredients and level of effectiveness.

But is this a fact?

I am advised that a 2006 survey found that about 25% of 300 doctors throughout the US do not believe that generics are chemically identical to brand-name drugs!

Worst nearly one in five believe those generics are less safe and more than one in four believe that generics cause more side effects.

So what is the truth about generic drugs?

I am advised that since 1976, thanks to the book The People’s Pharmacy being published as a consumer guide to drug and health information, thousands of patients have contacted them about their experiences with medications.

I am advised that in the last few years, they have received hundreds of letters and E-mails and sadly most of them complaints about generic drugs, including pain relievers, antidepressants and blood pressure medicines.

Sadly the number of such complaints has increased dramatically in that time.

I am advised by reliable sources that some patients who switched from a brand-name to a generic drug did report a decline in effectiveness!

Let me explain - for example, blood pressure that is not controlled or a case where there is a worsening of depression.

Others using generics complain of developing rashes or other types of allergic reactions!

According to some sources this could be because of one of the inactive “filler” ingredients in generic drugs.

There are also claims that there are problems with the timed-release mechanism of some generics.

For example there were allegations of there being more than 100 complaints about a generic version of the long-acting anti-depressant Wellbutrin XL.

I am advised that at least one manufacturer’s timed-release generic formulation appears to be different from the brand name and may be releasing too much of the drug too quickly (known as “dose dumping”).

As a result patients consuming such generics suffer side effects such as headaches and anxiety which the same patients do not experience when they take the brand-name version.

I cannot but wonder what the FDA is doing about such claims and complaints and whether they are also monitoring laboratories across the globe namely in China and India including independent laboratories to analyze this formulation.

It is my contention that the FDA is simply not doing enough!

I am certain in mitigation the FDA will tell me that drug companies must apply to the FDA to sell generic versions of drugs.

And that to attain the FDA approval a generic drug must contain the same active ingredients as brand-name medications and meet the same criteria for such factors as quality, strength and purity.

If this is the gospel truth than why are the fuss and feedback and nightmarish complains?

I maintain that the possible problems with generic drugs are as follows:

Periodic checks for impurities. True the FDA monitors generic drugs, testing for such things as proper dosing and active ingredients. But the agency only checks about 300 “dosage forms,” such as tablets and capsules, among brand-name and generic products a year out of a total of more than three billion prescriptions.

Infrequent inspections. For example in the US the FDA is supposed to inspect each US drug manufacturing plant every two years but the truth is they do not and the excuse is that they lack the resources to meet that requirement.

Overseas manufacturing. An enormous percentage of drug ingredients and raw materials for drugs (primarily generic and over-the-counter) come from India, China and other countries where quality assurance is not as rigorous as in the US and where drug counterfeiting has been a problem and so how does the FDA track this issue or attempt to contain it?

I am certain that the overseas manufacturing plants like those in Malaysia are not inspected or if done certainly less frequently than those in the US!

So common sense will concur that without testing there is no way to tell whether drugs and drug ingredients derived from these plants have impurities or come in “subtherapeutic” doses (for example, a drug labeled as 10 mg may be only 6 mg)!

So my call would be how does a consumer stay safe?

Most of the evidence for problems with generic drugs is based on anecdotal reports.

However, research published in Neurology in 2004 reported that people with epilepsy who switched from the brand-name form of the antiseizure drug phenytoin (Dilantin) to the generic form of the drug began to have higher-than-expected rates of seizures.

Investigators found that in many patients, blood levels of the active ingredient had dropped by 30%.

So should patients give up on generic drugs?

What with the cost savings which may be considerable?

And since there is no conclusive evidence so far that the majority of generic drugs will cause problems for most patients?

A difficult call indeed!

In this kind of situation what does a consumer do?

Stick with one manufacturer. This is particularly important if you’re taking a drug with a narrow therapeutic index (NTI), such as the anticoagulant warfarin, the antipsychotic lithium or the anticonvulsant carbamazepine.

NTI drugs, which typically require periodic blood tests to measure blood levels of the medications, have a very thin margin between an effective dose and a toxic dose. If you are taking a generic form, ask your doctor for the name of the manufacturer and request that the pharmacy stick with that company, if possible to avoid variations between products.

Track your numbers. Many conditions, such as hypertension or high cholesterol, do not cause obvious symptoms. The best way to tell whether a drug is working is to monitor your numbers by taking daily blood pressure readings, tracking blood-sugar levels and keeping track of cholesterol levels with frequent blood tests at your doctor’s office.

Important: Ask your doctor to give you copies of your test results. Check them periodically to make sure that you are maintaining adequate control particularly if you had recently switched from a brand name to a generic or the reverse.

Trust your instincts. Some medications affect the body in subtle ways. A patient taking a thyroid drug, for example, might feel slightly run-down if it is not working exactly the way it should, even if test results appear to be normal.

Pay attention. If you’ have just switched to a generic and notice a difference either in effectiveness or side effects, immediately inform your doctor.

Do a “challenge, re-challenge” test. If you suspect that a generic drug is not working the way it should, write down changes in how long the drug works and side effects.

Then, ask your doctor to switch you to the brand-name equivalent and see if there’ is an improvement.

In most cases it will be apparent in about two weeks. Under the close supervision of your doctor, repeat the test, going back and forth until you have a clear idea which drug is more effective for you.

I hope the FDA would do more than it is at the moment!

The FDA in my contention should respond to complains by analyzing generic drugs to determine if they contain the stated amount of active ingredient.

And if there was misrepresentation punitive action and sanctions must be the order of the day in the public interest!

An advice to consumers addressing complains.

Before you report a drug to the FDA/MOH ask your doctor/pharmacist to provide the name of the manufacturer, the lot number and exactly when the drug was dispensed to you it will be helpful!

I am advised in Malaysia generics are commonly used and I cannot but wonder who is really doing the serious transparent and accountable check and balances in the public interest?

Or are certain groups in Malaysia enjoying ‘a vulgar monopoly’ thanks to their political connections and sine biotic relationships laughing all the way to the bank at the Malaysian consumers’ expense?

 Our campaign against RACISM of all forms!

DOES MY COUNTRY LOVE ME?

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KEEPING THEM HONEST - TIME TO BAN INDIRECT ALCOHOL ADVERTISING!

‘Self regulation will never work! What is needed is an outright ban!’ - Dr Jacob George

TIME TO BAN INDIRECT ALCOHOL ADVERTISING!

Several years ago, I remember campaigning that there should be a ban on all alcohol advertising, including in sports and music sponsorship in Malaysia!

But as usual, the hard core drunkard’s lobbyists were out sharpening their knives targeting me!

Certain media which made millions out of these booze adverts send their emissary to talk to me to take a more ‘moderate approach!’

But I kept on with the campaign, the big boys with their war chest on the other end kept the pressure on me!

So after several years to read that my counterparts and friends at the British Medical Association are treading the same path with an intended crackdown on booze marketing and to cut-price deals to stop the rising rates of consumption cannot but be welcomed!

I was not the least surprised to be advised that the lobbyists/industry spends £800m a year on promoting drinks - just a quarter of which goes on direct advertising.

This was the entire stranger, despite knowledge that alcohol was one of the leading causes of early death and disability.

Apart from this, the other dangers are smoking and high blood pressure which is responsible for a greater burden of disease!

That reminds me how we failed so miserably despite spending millions on the ‘tak nak’ anti- smoking campaign!

When you look at the damage you are really troubled.

Do you know that the cost to the NHS for treating injury and illness linked to drink has been estimated to be anything up to £3bn a year in the UK.

It comes as alcohol consumption has been rising rapidly in recent years with over a third of adults now drinking above the recommended amounts.

But the report I read stated there was particular concern about the impact of marketing on young people the same argument we used on cigarettes indirect advertising through sports, branded goods and merchandize, leisure holidays, fast cars and bourgeois lifestyles!

The report points out that while the money spent on alcohol advertising -nearly £200m a year - remained significant, there had been a growth in more subtle types of marketing.

Expecting to see the industry regulate itself is poppycock and would not work!

So what do I want to see happen:

1. Saying No - to indirect adverts of alcohol over TV, in magazines, on billboards, as part of music festival or football sponsorship deals, on internet pop-ups and on social networking sites!

2. To ban any such adverts or promotional activities which gave an impression that alcohol consumption was an essential part of every day life!

3. While calling for an outright ban on such marketing and advertising I believe there should be a reduction in licensing hours and tougher rules in place on price.

So basically I am urging our beloved Premier and Minister of Finance, Najib Tun Razak to increase the taxes on alcohol when the budget is soon announced!

Lookout - Tomorrow, Dr Jacob George urges the Malaysia government to say no to generic drugs and its multi million industry!  

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MALAYSIA - AM I ASKING TOO MUCH?

There is a difference from being an honest professional doing his/her duty without ‘fear or favor’ and another being a political lapdog!

Let us first seen in motion the rule of law, the separation of powers, the independence of the judiciary and other organs of the government and that respect be given to the our intelligence to know right from wrong, blatant abuse, corruption and vulgarity of political office now perpetuating in our corridors of power!

If our founding fathers were alive today they would be in ’shock and mental comatose’ to see the degeneration of our beloved nation all for ‘fascist, racist and political expediency!’

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AS FOR THE COW HEAD CONTROVERSY – HOME MINISTER MADE A MAJOR BLUNDER!

Home Minister Hishammudin Hussein has no business making public statements justifying the actions of the demonstrators, as this may be seen as an attempt to influence the decision-making at the AG’s chambers - Dr Jacob George.

AS FOR THE COW HEAD CONTROVERSY – HOME MINISTER MADE A MAJOR BLUNDER!

There is no necessity to go into a major article outlining the argument for true holistic justice to be seen operating on every shore on God’s earth!

More so, in 1Malaysia!

But it is plain foolishness if certain individuals of authority cloud their judgment and make calls for political expediency and to score ‘political points and thus saddle the nation with more suspicions, doubts and jokes on the impartiality of those expected to maintain ‘law and order’ or provide justice in our badly polarized and divided nation!

So as far as the ‘Cow head controversy is concerned’, Selangor CPO has confirmed that the police investigations into the ‘cow head’ incident has been completed and forwarded to the AG’s chambers and they are awaiting further instructions.

In these circumstances, you do not have to be a rocket scientist or a professor from Harvard Law School to tell our Home Minister, Hishammudin Hussein (above left) that he has no business making public statements justifying the actions of the demonstrators, as this may be seen as an attempt to influence the decision-making at the AG’s chambers.

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BIG PHARMA’S ACTION BETRAYS CLAIMS OF ADHERENCE TO CODE ON CORPORATE INTEGRITY AND ETHICS!

World’s largest drug company illegally promoting pharmaceuticals, miss-branding, creating sham requests, provides kickbacks for health care providers – so much for ethics, corporate governance and accountability! - Dr Jacob George

Having written about this issue several months ago in my blog I was not the least surprised when alerted this morning by my counterparts abroad that Pharmaceutical giant Pfizer has agreed to pay a record $2.3 billion settlement to resolve criminal and civil liability for illegally promoting certain pharmaceuticals!

We have to thank internal whistle blowers for this!

In some countries which practices selective prosecution, have sham democracies where no  separation of power exist, where business are politics and politicians have a strange mix whistle blowers instead of being rewarded as was in this case are targeted for prosecution, harassment and threats!

According to reports by the Justice Department Pfizer will pay the record fine to avoid prosecution for illegally promoting certain drugs.

The charge was that Pfizer promoted four drugs for use on certain ailments or at dosages that were not approved by the Food and Drug Administration.

One of those drugs (if you remember) was the anti-inflammatory medication Bextra, which Pfizer pulled off the market in 2005 after it was linked to increasing the risk of heart attacks and strokes.

It also added that Pfizer promoted the sale of Bextra for several uses and dosages that the FDA specifically declined to approve due to safety concerns!

To make matters worse - a Pfizer subsidiary, Pharmacia & Upjohn Company, agreed to plead guilty to a felony violation of the Food, Drug and Cosmetic Act for “misbranding Bextra with the intent to defraud or mislead.”

Pfizer also illegally promoted the anti-psychotic drug Geodon, the antibiotic Zyvox and the anti-epilepsy drug Lyrica.

Some may feel this was bad for business and research and development but one should always bear in mind that such behavior of recommending drugs for uses not approved by the Food and Drug Administration creates a situation where public health may be at risk when medical providers are not provided with accurate and full disclosure concerning a drug’s risks and benefits!”

What of course shocked me was the extent of the involvement of the staff in all these when even the sales people created sham requests from physicians asking for information about unapproved uses of certain drugs.

The information was then mailed to doctors.

This once again raises the need of real practiced comprehensive corporate integrity where ‘big pharma’ should say and practice no such despicable behavior of giving kickbacks to healthcare providers, falsifying data, misrepresentation are other undesirable behaviors that evolves around corporate and financial greed rather than a vision to provide health solutions!

Pfizer did issue a statement saying, in part: “We regret certain actions taken in the past, but are proud of the action we’ve taken to strengthen our internal controls.”

That confused me – but I am always thankful to the risks honest dedicated whistle blowers the world over take!

They are the real heroes!

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DID A NEW STRAIN OF MAD COW DISEASE HIT MALAYSIA LAST FRIDAY?

‘I am really worried that post GE12 - a new strain of the notorious ‘mad cow disease’ may have infected the brains of several in the country?’

DID A NEW STRAIN OF MAD COW DISEASE HIT MALAYSIA LAST FRIDAY?

Meanwhile last week’s seditious, provocative and insensitive demonstration outside the Selangor state secretariat which showed insensitiveness to Malaysian Hindus received further rebuttal from the Hindu American Foundation (HAF)!

The HAF has demanded the Malaysian government conduct a quick and robust inquiry to identify and punish leaders of the mob involved in last week’s provocative and insensitive demonstration outside the Selangor state secretariat.

HAF, based in Kensington USA, also wants the inquiry to take stern action on the inaction of the police to stop such an offensive act of religious insensitivity.

If this was not enough - formal complaints are going to be made with the United Nation’s Human Rights Council, European Parliament, United Kingdom Foreign Affairs’ select committee and the Global Human Rights Defense based in The Hague!

All these if Malaysia’s AG’s chambers failed to charge these perpetrators.

Brilliant – more free unadulterated publicity for Malaysia and a much needed boost for our ‘Visit Malaysia – truly Asia campaign’ and no need for private PR contractors to uplift our international image and ranking!

 Our campaign against RACISM of all forms!

KEEPING THEM HONEST - TIME TO PULL BACK SUBSIDIES!

‘..said it on ASTRO AWANI this morning, say it again here…- Dr Jacob George  

Pump prices up! So what?

Time to pull back subsidies and watch out for the parallel importers, distributors and the big boys who are going to raise prices of goods and services causing severe financial strain on Malaysian consumers!

2. Time to introduce the ration card as it is in India and channel subsidies to those really needing them – the poor and marginalized and not the politically connected in the land – the pariahs and cigar smoking fat cats who are an embarrassment to the nation and all things moral!

3. Time to really invest in a comprehensive transport system – go check out squeaky clean Singapore!

4. Learn a thing or two from them of how to select a contractor,  plan and built a quality system free of corruption/kickbacks and fiasco/scandals saving public funds and in public interests!

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