Breast Cancer in Malaysian Women.

My Dearest Gang,

A few of my friends spoke to me quite some weeks back to request if I could highlight some issues on breast cancer.

I therefore approached someone I know in the specific field and that someone is OG Dr Humairah Samad Cheung (K Mai), Director , IIUM Breast Centre, Kuantan. She has kindly sent the article to me.

Here it is....



Introduction
Many weeks ago Ruby asked whether I would write something on the subject of breast cancer in Malaysian women. The demise three days ago of our First lady, Datin Seri Endon bte Mahmood, after a brave battle with breast cancer, made the request that much more pressing

Breast Cancer Statistics in Malaysia

Breast cancer is common, and no woman is immune to the disease. It is in fact the commonest cancer amongst women worldwide. In Malaysia, the 2002 statistics are that 4337 women were newly diagnosed with it. It is not only the commonest cancer amongst Malaysian women, but the commonest cause of cancer deaths amongst us. Cancer of the cervix trails behind it in second place. There is evidence that it is increasing in incidence.

It is estimated that a woman in Malaysia has a 1 in 19 chance of getting breast cancer in her lifetime. There is a racial difference seen in its incidence, with Chinese women having a 1 in 14 chance, Indian women a 1 in 15 chance, and Malay women a 1 in 24 chance of developing the cancer. This may seem low when compared to American women in whom the chance of developing it is 1 in 7.

The Age Standardised Incidence Rate (ASR) in American white women, British women and Malaysian Chinese women are 91 per 100,000, 69 per 100,000 and 70 per 100,000 respectively. Amongst Malay women this is 42 per 100,000.

IN Malaysia, the cancer is commonest amongst women aged 50-59 years. However there are many cases of younger women who are affected, and the consequences on a young family may be greater.

Why are we hearing much more of breast cancer now? Why is breast cancer so common?

The direct cause is unclear; however many factors have been noted to be associated with increasing risk of developing breast cancer. It is commoner with increasing age, and this may be related to damage to our genetic material. When a woman has a first degree relative (mother, sister, daughter) affected by breast cancer her risks multiplies 9 times. There are hereditary breast cancers in women who have the BRCA1 and BRCA 2 genes.

Life style factors are important too. With changes in women’s lifestyles from the time of our mothers, families have become smaller, and women tend to postpone child-bearing to a later age. There is also a lesser tendency to breast-feed amongst career women. The more a woman breast feeds the greater the protective effect against breast cancer. Other protective factors include having periods later, and menopause earlier in life. Other lifestyle factors include diet, exercise, and the level of stress. These factors are given in Table 1

Table 1: Risk Factors for Breast Cancer

1	Being female	<1%>
2	Age	Its incidence increases with increasing age. In Malaysia it is commonest in the 50-59 years age group
3	Genes	Increased risk in those with a positive family history, especially if the person affected is young. Gene traits linked to breast cancer include BRCA1 and BRCA2 genes
4	Hormones	Increased risk in women with early onset of menstruation and late menopause, in those who are childless or with delayed child-bearing beyond age 30 years. Breast feeding protects against breast cancer
5	Diet	Increased fat intake is associated with higher risk
6	Other life-style factors	Lack of exercise, obesity and stressful lives are associated with increased risk
7	Carcinogens	In food, and in the environment, including exposure to radiation and cigarette smoke are associated with increased risk.
8	Biopsy	Results such as atypical ductal hyperplasia predispose to higher risk

What can protect us from breast cancer?

Protection is never 100%, as there are many things we can’t change; at least not for the time being. These include our genetic constitution and the family into which we are born!

However, there are also some things we can change. These include developing a healthy life style, and becoming more pro-active in maintaining and preserving our health. Regular exercise and an active life style, avoiding over-indulgence in rich food, and maintaining a steady body weight and body mass index and avoiding obesity are some ways by which cancer and other disease may be kept at bay.

Being pro-active in health matters include having regular check-ups, and early consultation over bodily complaints or developments which seem unusual. Many health conscious women, (and in my experience Chinese women are in the fore-front here) go for regular check-ups and screening tests, and then spend time quizzing their doctors over the results of blood and other tests!

In the case of breast cancer, the best and most sensitive way of checking for its early signs in by performing a mammogram. It is recommended that a baseline mammogram be performed when a woman turns 40. From that age on she should have the examination at least once in two years. Mammogram does not prevent a woman from developing breast cancer. It merely detects early signs of cancer, in the form of a small breast lump or the presence of minute calcifications within a small area of the breast, which is referred to as “clustered microcalcifications”. Not all calcifications in the breast is associated with or caused by cancer. And that is why you should insist that your mammogram be read by a radiologist with sufficient experience in reading mammograms!

Other methods are available. These include breast self examinations (BSE), physical examination by your general practitioner of family physician, Breast Ultrasound, and Magnetic Resonance Imaging.

Women are now increasingly being taught, and learning how to perform BSE. Not all clinics offer this service, and medical practitioners should teach and encourage women to do this. BSE should be performed in the first 10 days after the period, when the breasts are not tender or swollen. For many this may be the first method by which a lump is discovered in the breast. It is important not to panic at this stage, because the majority of breast lumps (~80%) are in fact not cancer. However it is wise to seek medical help and ask to be referred for a mammogram, so that the appropriate advice and management can be offered. Other signs that one must look out for is a nipple discharge, especially if it is frankly bloody, or blood-stained. A skin rash or redness in the nipple or areolar area, a change in the “feel” of one breast, (such as hardening or firming) may be early signs too. Sometimes a dimple in the skin or a nipple that is noted to be pulled inwards may be other signs.

More on Mammograms
Many women are fearful of having a mammogram because of preconceived idea that it is painful. However modern equipment are more friendly in their design, and breast compression during mammography is shortened and automatically relieved as soon as the exposure is made.

Mammogram is advised after age 40 years in all women, and thereafter once every 1-2 years. Women with a family history of breast cancer are advised to have a baseline mammogram at 35 years. Mammography is more sensitive in cancer detection in older women because the breasts are fatty and less glandular; this gives a dark background and small cancers are best displayed and detected. In young women the breasts are glandular and the cancer detection rate is lower because small cancers may be hidden within the higher density of the glandular breasts. In this situation, the attending radiologist will perform an ultrasound, which complements the mammography in this clinical situation.

Do note that for the above reasons, mammography can miss cancers. Some studies have shown that this may occur in 5-15% cases, even in skilled hands. Mammography should always be performed at places with skilled and trained mammographers and radiologists for optimal technique and interpretation.The performance of Quality assurance (QA) tests are essential in mammography centres.

In developed countries women above 50 are invited to undergo mammography because it has been shown that early detection by mammography has indeed saved lives. Women are also protected by the Mammography Act and accreditation of mammography centres, and this is yet in the infantile stage in Malaysia.

What happens if the investigations (e.g. mammography) show a lump that is suspicious for cancer?

Further investigations are required in this situation. In a one-stop centre sampling of the lump is arranged as soon as it can be performed, often in the same day so that diagnosis is not delayed. This will take the form of a core biopsy where an elongated 1-2cm of tissue is removed form the lump and sent to the Pathology Laboratory where the Pathologist will read and interpret the cellular components which will confirm cancer or otherwise. This is the best and most accurate method of making the diagnosis.

Sometimes only an aspirate (Fine Needle Aspiration Cytology; FNAC) is taken from the lump, especially if the pathologist reading it is experienced in cytology (interpretation of the cell type from the aspirated material smeared on a slide). The attending radiologist or physician will advise accordingly. These procedures will require your written consent, following your being fully informed of the procedures.

The above procedures are best performed under image guidance using either an X-Ray technique called stereotaxis, or under ultrasound-guidance. This will ensure that the sampling has been accurate, with the needle placed within the lump. There is a possibility that the lump can be missed if it is done blind (guided by feel with the hands only), especially if the lump is small, and less than 2 cms.

A woman with a lump that she can feel with her bare hands should insist on mammography and/or breast ultrasound to be performed. In some women the breasts can be normally lumpy, due to the arrangement of glandular tissue and fat lobules within it. This may cause difficulty for the physician who only performs a physical examination manually.

Can one survive breast cancer?
The simple answer to this is yes! This is provided that the cancer is diagnosed and treated early.

Once diagnosed the cancer is staged form Stage 1 to Stage 4, based of the size of the cancer and whether it has spread to other sites known to commonly be involved by its spread. Stage 1 cancer is when the cancer is less than 2 cm in diameter, and confined to one site in the breast. Women with stage1 breast cancer have an 80% chance of survival 5 years after treatment. However if the cancer is diagnosed in Stage 4 when it has already spread to distant sites such as bone, liver or brain, the expected survival at 5 years is much reduced.

The “survivors’ pool” of women who have had breast cancer and survived it is growing, and in many places these women have organised themselves to become a group that is committed and effective in helping other women newly diagnosed with the cancer. Some are registered as NGOs (Non-Governmental Organisations) and other formal organisations. They work as voluntary groups, and work hand-in-hand with medical practitioners (mainly surgeons, radiologists and oncologists) to create a higher state of breast cancer awareness.

Some Malaysian women (especially Malay women) feel that getting breast cancer somehow confers a stigma on oneself, and will keep the cancer a secret from family and friends. My own personal opinion that the burden of breast cancer can be lessened if one shares it with loved ones, who can lend a shoulder to cry on. It is a natural response to become depressed initially, and to feel that “this cannot be happening to me”, and to feel that life is unfair. However the earlier one gets out of this denial stage and get on with the “complete” treatment, the better, because the best of life may still be beyond the cancer.

Accept the fact that no woman is immune from breast cancer. And see it the way I do; even though that it may mean losing an asset, it is after all a superficial appendage, (unlike say, cancer of the ovary or lung), and surgical removal does not require opening the abdomen or pelvis or rib-cage. In the same way that one can wear a wig when you lose your hair, there are breast prostheses and special underwear that can make you feel like a whole woman again should you have one breast removed. One should always look on the bright side, as a positive mental outlook is half the battle won!

So while we grieve with the family of our beloved Pak Lah, let us remember AllahYarham Datin Seri Endon who went about her life’s work courageously, and gave so much of herself, even while it was widely known that she was undergoing treatment for breast cancer. The simple and brave message that she left behind must surely be for us not to be defeated by breast cancer – that life must go on despite it.

Humairah Samad Cheung
Director, IIUM Breast Centre, Kuantan


Thank you K Mai, for your sheer effort and dedication.

Touched,
Ruby Ahmad.

Banana facts!

Hi there Gang,

Bananas are so readily available in Malaysia that it is one of the commonest fruits around, somehow only a little attention is given to it. Not abroad, where it is considered one of the most exotic fruits! It is treated like gold. I think after reading this article, bananas will be given it's due respect once again and thanks to OG Mashita Abdullah Mohd Noor (MCE73) for sending this article to us, this most enlightening peep into the exciting world of bananas, that I'm sure, most of us did not know yet!! Be enlightened.

Here goes......

Bananas: Containing three natural sugars-sucrose, fructose and glucose combined with fiber, a banana gives instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world's leading athletes.

But energy isn't the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet!

Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain trytophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood generally and make you feel happier.

PMS: Forget the pills---eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood.

Anemia: High in iron, bananas can stimulate the production of hamoglobin in the blood and so helps in cases of anaemia.

Blood Pressure: This unique tropical fruit ia extremely high in potassium yet low in salt, making it the perfect way to beat blood pressure. So much so. the US Food and Drug Administration has just allowed the banan industry to make official claims for the fruit's ability to reduce the risk of blood pressure and stroke.

Brain Power: 200 students at a Twickenham (Middlesex) school were helped through their exams this year by eating bananas at breakfast, break and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert!

Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives.

Hangovers: One of the quickest ways of curing a hangover is to make banana milkshake, seetwened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system.

Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief.

Morning sickness: Snacking on banans between meals helps to keep blood sugar levels up and avoid morning sickness.

Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of the banana skin. Many people find it amazingly successful at reducing swelling and irritation.

Nerves: Bananas are high in B vitamins that help calm the nervous system.

Overweight and at work: Studies at the institute of Pdychology in Austria found pressure at work leads to gorging on comfort food like chocolate and crisps. Looking at 5,000 hospital patients, researchers found the most obese were likely to be in high-pressure jobs. The report concluded that , to avoid panic-induced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady.

Ulcers: The bananas is used as a dietary food against disorders because of its soft texture and smootheness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over acidity and reduces irritation by coating the stomach.

Smoking: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassium and magnesium found in them, help the body recover from effects of nicotine withdrawal!
.

Stress: Potasium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body’s water balance. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be re-balanced with help of a high-potassium banana snack.

Strokes: According to research in the ‘New England Journal of Medicine’, eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%!

So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrates, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around.

So maybe its time to change that well-known phrase so that we say, ‘A banana a day keeps the doctor away!’

Take good care of yourself,
Ruby Ahmad.

Al-Fatihah for Allahyarhamah Datin Seri Endon.

My Dearest Gang,

Today is indeed a very sad day.

MGC/TKC OGA sends our deepest condolences to our Prime Minister, YAB Dato' Seri Abdullah Ahmad Badawi and family for the loss of his beloved wife Allahyarhamah Datin Seri Endon Mahmood very early this morning.

We have of course not only have lost a most courageous First Lady who has shown us the graceful way to face great challenges, but also a lady who has championed so many worthy causes for the shared benefit of all of us.

May Allah bless her soul and may Allah place her amongst the blessed ones, inshaallah.

Al-Fatihah...

With deep sadness,
Ruby Ahmad.

YOUR AGE BY CHOCOLATE MATHS - IS THERE SUCH A THING!!!

Hi there Gang,

This would be such an interesting break between chores today. Sent by our OG Dato' Sabariah Sabtu. Please rush for your pen and paper. Let's do some maths here. Have fun gang!(You can do this maths for anyone you know!) Here goes...



DON'T CHEAT BY SCROLLING DOWN FIRST!


It takes less than a minute ....

Work this out as you read ...

Be sure you don't read the bottom until you've worked it out!

This is not one of those waste of time things, it's fun.


1. First of all, pick the number of times a week that you would like to
have chocolate (more than once but less than 10)




2. Multiply this number by 2 (just to be bold)




3. Add 5




4. Multiply it by 50 -- I'll wait while you get the calculator .




5. If you have already had your birthday this year add 1755 .... If you
haven't, add 1754.




6. Now subtract the four digit year that you were born.





You should have a three digit number .





The first digit of this was your original number (i.e., how many times
you want to have chocolate each week).




The next two numbers are ....





YOUR AGE! (Oh YES, it is!!!!!)



Amazing wasn't it? Any Mathematicians out there knows how this works?!!

Cheers,
Ruby.

Illustration: www.godiva.be

Annual Dinner 2005

Budaya Disemai Budi Dituai Dinner, 3rd July 2005 at Palace of the Golden Horses in the Malaysian Tatler Magazine October 2005.



We posted for the benefit of our OGs who are residing abroad and those who did not get the opportunity of a glimpse of this spread before.



Cheers,
Ruby Ahmad.

Please click twice on Tatler page for a larger view.

The Joy of Reading 1.

My Dearest Gang,

As they say knowledge is power!

Everyone knows that one of the ways of attaining this knowledge is by reading. If anything, this is the main reasons for the campaigns run by our Government to encourage us to read.

I find it strange that the habit of reading seems to die off once we graduate or begin our working careers (I don’t mean all of us, but still quite a majority!) It would appear reading is associated with academic qualifications...we read because we want to qualify or pass in an exam! Apart from the odd newspapers, our reading habits are almost nil and this is dangerous.

Dangerous for two reasons. (The word 'dangerous' sounds strong here...but it is true!)

Our lack of interest in reading or rather our selective reading habit is passed on to our children, the future generation of this country. Secondly, it also leads to an isolationist mentality ie we tend to disregard what is happening in the world out there as well as being left out in the rat race towards progress. How many of us, for example, keep in touch with the progress made in our field of work?

We also tend to, strangely enough, adopt a know-it-all attitude with our lack of knowledge! Instead of being hungry to find out about a particular subject matter being read or espoused by someone, we downgrade the person and subject by saying...it’s out of date, it’s irrelevant and numerous other defensive reasons! Why, some of us go even as far as saying we cannot even read certain books. It’s as if, merely glancing through these books makes us untouchables!

Sad.

One of the joys of being in London, for me is reading. Believe me, here they read. Londoners read standing in the Underground tube, buses and trains to work! They read newspapers, novels...'serious' books...the works. And the bookshops...aaahhh they are to die for!

Think of the bookshops, and there are hundreds(!) in London and I remember two things, the easy accessibility of books and coffee! Bookshops even provide baskets for us to pick any amount of books and any subject matter for us to bring into the ever present coffee area run by the likes of Starbucks, Caffe Nero and Costa.

So there we are. Books, coffee and comfortable seating...h-e-a-v-e-n!

If we are to be serious in wanting to progress and to seek knowledge (and this is actually even mandatory in our religion), then start by making sure reading is a joy. When you are in a book shop, inform the book management to throw away those uninviting cellophane wraps. Install coffee/tea area with seating to browse through all the books. Tell them in no uncertain terms that they will profit from it as well in the long run.

Then we will progress!

Cheers,
Ruby Ahmad.

Please scroll down for 'The Joy of Reading 2'.

Photo 1 Borders.
Photo 2 Starbucks at Borders.
Photo 3 Waterstones.
Photo 4 Interior of Waterstones.

The Joy of Reading 2.

My Dearest Gang,

This is the second part of The Joy of Reading. I am so grateful our OG Fern has taken the initiative to share with us some potential reading list.

Here you go...enjoy.

Cheers,
Ruby Ahmad.

Books for Your Moods
By Fern Raja Harris

The only reason I have 4 (or 6) books on the go simultaneously (the untidy pile by my side of the bed being a favourite topic of disagreements) is that I love to read according to my moods. I figured I can’t be the only creature with this eccentric silly habit, so I thought I’d share some of my mood-driven reads (in the hope that that would justify my peculiar habit).

Raj by Gita Mehta
When for? Just the book to reach out for when you need complete cultural immersion. Or simply when you need to psyche yourself up for that once in a lifetime trip to Rajasthan/Jaipur.
What’s it about? Set at the turn of the 19th century in India during the time of the British Raj and great upheavals in the Indian political scene, this novel is a great insight into the fictional life of a fictional Indian princess, Jaya. Princess Jaya is an unconquerable spirit – a woman caught between her strict traditional Indian court upbringing and the modern Anglophilic tendencies of her husband, a modern Maharajah who panders to the whims of the British at the cost of his subjects’ loyalty and his kingdom’s coffers. A riveting read, Mehta is an old-fashioned storyteller and that’s not a bad thing.

Pride and Prejudice by Jane Austen
When for? When you feel a little bit in need of a pick me up and the assurance that there is such a thing as romance. An ideal antidote to Lolita.
What’s it about? In true Austen tradition, this one is filled to the brim with interesting characters and laden with much wit and humour. The story revolves around the Bennett family, whose five girls absolutely must make good marriages if their mother was to have her dearest wish. The arrival of an evidently eligible bachelor, Mr. Darcy, raises a flutter amongst the ladies in the village. Facing the obstacles of class and expectations, Lizzie Bennett and her sisters strive to achieve their own romantic ambitions while toeing the line in trying to ‘marry well’.

High Fidelity by Nick Hornby
When for? A perfect read before you embark on that all-important weekend of sorting your dust covered music collection or tidying up your playlist.
What’s it about? Rob owns an indie record shop, and with his two employees Dick and Barry have this obsession for making and declaring their lists: “All-time top five episode of Cheers”, “Best side one, track ones of all time”. Splitting up with long-time girlfriend Laura, Rob attempts to track down his “Top five most memorable split-ups” in search of answers to all his relationship conundrums. This book is a brilliant look into the inner workings of the (seemingly juvenile) male mind. Essential reading – this most certainly makes my “All-time Top Five Lad-Culture Reads”.


Eats, Shoots and Leaves by Lynne Truss
When for? Indulge your inner pedant. Don’t deny it – you’re the one who has a permanent scowl thrown in the direction of a misplaced comma or a misused semi-colon.
What’s it about? A self-proclaimed “zero tolerance approach to grammar” Truss navigates through a minefield of correct grammar and punctuation, giving examples of bad usage and misuse and demonstrating how to actually apply the numerous rules and exceptions. An essential guide for those who aspire to better use of grammar and punctuation, and for the advanced grammarian this is still worth reading for the giggles.


Fern can be contacted at rf_rajaharris@yahoo.com for book chats and general yak. Currently reading Waiting by Ha Jin, Kafka on the Shore by Murakami, Don Quixote by Miguel de Cervantes and A Short History of Nearly Everything.

Photo 1 Raj www.amazon.com/exec/obidos/tg/detail/-/0449905667?v=glance
Photo 2 Jane Austen www.amazon.com/exec/obidos/tg/detail/-/0553213105?v=glance
Photo 3 High Fidelity www.amazon.co.uk/exec/obidos/ASIN/0575400188
Photo 4 Eats Shoots and Leaves. www.amazon.com/exec/obidos/tg/detail/-/1592400876?v=glance

Fatehpur Sikri.

My Dearest Gang,

...And so, on to Fatehpur Sikri...

Fatehpur Sikri is only a short drive from Agra as it is only approximately 30 miles from Agra. Mind you, with the Ambassador going at the sedate pace of 30mph...

On the subject of the Ambassador, we spotted the driver putting in lubricant oil as well as the normal petrol in the tank! On being asked, the driver said it helps to cool the engine! Comments anyone? In the defense of the Ambassador though, I have to say that throughout our journey to Fatehpur Sikri and onwards to Jaipur, we never encountered any problems. It is truly a car made for India...well the Indian countryside anyway!

Why do I say this? For one thing, you have to see the road to believe it. Firstly there were no road markings! Ha ha ha...so it was a case of drive as best as you can really. We wondered as to how travel would be safe at night in the absence of these markings! Every now and then we would come across lorries that had broken axles that were, I suppose, waiting for their repair trucks. India is such a vast country and the countryside just seems to go on and on.

I also understood then that it does not really matter that one did not have a powerful car under such circumstances as the nature of the road meant we had to drive reasonably slow, at least by Malaysian standards anyway. India’s infrastructure may be at that time comparatively less developed in terms of standards but in terms of connectivity, it was good.

Finally, Fatehpur Sikri.

Fatehpur Sikri, as history would have it was built on the orders of the Mughal Emperor, Akbar and briefly served as his capital. Legend had is that he was without an heir and he made a pilgrimage to a saint who lived in a village near to this complex to seek his blessings. Whan later a son was born to him, Jahangir, Akbar built the capital and it is now a World Heritage site.

The construction took 15 years and is primarily of red sandstone. It is arguable that Fatehpur Sikri is the greatest accomplishment of Mughal architecture and is surpassed only in reputation by the Taj Mahal. Yet, after work was completed,, they realized that there was an inadequate supply of water and they had to abandon the complex!

The complex itself is made of several buildings all serving various functions needed of a capital such as a treasury, mosque, meeting area, courts and of course private palaces.

The main palace had on its outer wall screens, which was richly carved in ornate Islamic pattern. This, besides being decorative, also served as a shading device form what I would imagine would be hot summers. As I was there during summer, I can tell you that it’s really hot! Anyway, these screens had thousands and thousands of ribbons tied to it by visitors. Apparently, there is a belief that whoever made a wish would need to tie a ribbon or thread to the screen and it would, within reasons of course (!), come true. It must have connection to the fact that Akbar had his wish fulfilled upon visiting the saint in Fatehpur Sikri.

Akbar, himself, was a man of the world, if you like. Besides the pool in the complex, there are four palaces, each for his four wives who, story has it were of different religions. There is even a giant chess ‘board’ where it is said the Emperor played using human beings as the pieces! We can almost transport ourselves back through time and imagine the scene...music wafting through the air, women laughing, men on the chess board (some said slave girls...!) and Akbar himself in the middle of this complex which in turn was in the middle of well...nowhere really. You could see for miles all around from the city as it was on a hill and all around was the plains, miles and miles of it.

As Fatehpur Sikri is basically an abandoned city and therefore was not developed thereafter, we could not stay (yes, no air conditioned hotels around here!) and after a few hours exploring the city, we made our way to Jaipur, the capital of Rajasthan. This was to take a few hours as the city is far, relatively speaking that is.

Nonetheless, we left Fathepur Sikri in awe as to what was the might and wealth of the Mughal empire in its heydays.

Cheers,
Ruby.

Photo 1 Fatehpur Sikri. www.ignca.nic.in/agra058.
Photo 2 and 3 Fatehpur Sikri. www.GreatBuildings.com/buildng/Fatehpur-Sikri
Photo 4 The famed-Indianised car that has been around for 5 decades, the Ambassador. www.carsonhire-india.com/royal-ambassador-car-rental-in-delhi-india

The Health Benefits of Fasting.

Fasting during Ramadhan, as we know it is obligatory for every adult Muslim. In the Quran, it is stated (2:183) 'O ye who believe!Fasting is prescribed to you as it was prescribed to those before you, so that ye may (learn) self-restraint-' (The meaning of the Quran by Yusuf Ali).

There is a footnote (189) from the above translation. The Muslim fast is not meant for self-torture. Although it is stricter than other fasts, it also provides alleviations for special circumstances. If it were merely a temporary abstention from food and drink, it would be salutory to many people, who habitually eat and drink to excess. The instincts for food, drink and sex are strong in the animal nature, and temporary restraint from all these enables the attention to be directed to higher things. This is necessary through prayer, contemplations and acts of charity, not the showy kind, but by seeking out those really in need. Certain standards are prescribed, but much higher standards are recommended.

The act of fasting, inculcates sound conscience in man. Why? It is because the fasting person keeps his fast in secret as well as in public. Sincere fasting, is voluntary. There is no authority to check man's behavior or compel him to observe fasting. One fasts to please God and satisfies one's own conscience by being faithful in secret and in public. There is no better way to cultivate a sound conscience in man.

Fasting during Ramadan is one of the five pillars of Islam (the other four are: the declaration of faith, prayers (five times a day), zakat and making the pilgrimage to Mecca.

Ramadan is the ninth month of the Islamic lunar calendar. Depending on the phases of the moon, it begins eleven or twelve days earlier each successive solar year.

Everything that God asked of his subjects are always for our own good. God is all-merciful. Fasting from time immemorial is good for both body and soul. Here I would like to share some findings by some renown health experts, as to the health benefits of fasting.

I have extracted opinions from three world renown experts on fasting, Evart Loomis MD, Patricia Bragg Ph D and Lonny J Brown Ph D.

Here goes gang....

Evart Loomis M.D. -"Fasting is the world's most ancient and natural healing mechanism. Fasting triggers a truly wondrous cleansing process that reaches right down to each and every cell and tissue in the body. Within 24 hours of curtailing food intake, enzymes stop entering the stomach and travel instead into the intestines and into the bloodstream, where they circulate and gobble up all sorts of waste matter, including dead and damaged cells, unwelcome microbes, metabolic wastes, and pollutants. All organs and glands get a much-needed and well-deserved rest, during which their tissues are purified and rejuvenated and their functions balanced and regulated. The entire alimentary canal is swept clean. By rebuilding immunity, health is naturally restored and disease disappears. If health and immunity are thereafter conscientiously maintained, the individual is no longer vulnerable to disease and dieting become unnecessary. Surely one of the most overlooked and yet most valuable modes of healing that will be rediscovered in the future of the new medicine is the fast. This is because of the increasing interest in looking to oneself for healing powers. For the fast is an inward process and cannot be entered upon only from an outer approach with any expectation of a lasting benefit. The person must invariably be involved with the overall results. This therapeutic encounter is in direct contrast to the usual non-involvement in the physician-directed, disease-oriented medical practice of today."

Patricia Bragg Ph.D.- "Proven throughout history for physical, mental and spiritual rejuvenation, fasting promotes cleansing and healing; helps normalize weight, blood pressure, cholesterol; rebuilds the immune system; and helps reverse the aging process. If we are to get these poisons out of our bodies we must fast. By fasting we give our bodies a physiological rest. This rest builds Vital Force. The more Vital Force we have, the more toxins are going to be eliminated from the body to help keep it clean, pure and healthy."



Adventures in Therapeutic Fasting
by Lonny J. Brown, Ph.D.

Although nowadays the common response to illness is usually to "take something," it may be advisable to try the opposite. Therapeutic fasting is an excellent self-healing practice. It induces metabolic changes that are inherently cleansing and repairing. The organs empty and rest, conserving energy, promoting the elimination of waste and accumulated toxins, and making cell regeneration much more efficient. Fasting is mankind's most ancient healing strategy. Many traditional cultures, including Oriental, east Indian, and Native American, have long regarded it a dependable curative and revitalizing personal health measure. Hippocrates prescribed fasting, as did Galen and Paracelsus, and it was practiced by Plato, Socrates, Pythagoras, and Mahatma Gandhi. In modern Europe, reputable clinics that support therapeutic fasting are quite common. In Sweden it's practically a national sport.

Proponents of fasting offer thousands of testimonials from recovered asthmatics, arthritics, insomniacs, and ex-sufferers of migraines, skin and digestive disorders, and dozens of other ailments. They maintain that - with the exception of serious conditions like tuberculosis, ulcers, diabetes, hypoglycemia, blood, liver, kidney and heart diseases- systematic voluntary abstention from eating is almost always a healthy first response to illness. Dr. Bernard Jensen, author of "Tissue Cleansing Through Bowel Management" has supervised over 50,000 fasts at his center in Escondido, CA."

Stay Healthy always with regular Fasting,
Ruby Ahmad.

Photo 1 dates turning yellow.
Photo 2 dates turning red.
Photo 3 date palm
Photos from www.chinaranch.com/dates.html

Need for orthopaedic surgeons for earthquake relief work

My Dearest Gang,

There is no telling as to when a catastrophe would strike, be it on personal, national or any level. We don't even know what form of catastrophe will surface. When it does strike we are always least prepared for it (no matter how prepared we think we are!!). Believe me.

We had the tsunami...hundreds of thousands perished and those survived are in dire straits still at this very moment with inadequate amenities, inadequate medical supplies, lack of food and water and the list of needs is so long. Basically they are still struggling to survive!! They are still fighting for their lives. Activities on fund raising to alleviate sufferings of tsunami victims are far from over yet, so much still needed...then suddenly we had hurricane Katrina. How much needed aid did not arrive in time for many victims there. Distressing indeed! In between we had more bomb attacks in Iraq. Another round of Bali bombings just recently. And now...an eartquake in Pakistan, a massive one.

What were we to do? It is numbing indeed...with these spate of endless disaters and catastrophes! It is easier to freeze and hide in our comfort zone, than do anything.

Please don't do that! Come out and help...

To me, do the most that we can in our little corners. Give what we can, for when disater visits us, we want all the help we can get!! Remember this. Do empathise!

Today, in our little blog corner, I post a call for help from my friend, Dr Hyzan (an orthopaedic surgeon), who has tirelessly given so much to alleviate sufferings from around, any which way he could.

If any of you readers are able to disseminate this plea to get more orthopaedic help please do so. The contact is Dr Hyzan Mohd Yusof at Fax 603 74910708 or email me at rubyahmad@gmail.com

Here's the plea...

Dear Friends,

I received call from Malaysia Red Crescent Society (MRCS),Yayasan Salam, and Global Peace Mission Malaysia (GPM)today.

All request for orthopaedic surgeon for the the relief work in Pakistan or Kasmir. The duration will be between one to two weeks. MRCS 2nd team will be going in two weeks time after their first team comes back. For the MRCS team, they will ask the volunteer to register as a Red Cresent member so that they can cover the volunteer with insurance etc.

The Yayasan Salam and GPM is sending in a few days time or one week time.

Kindly circulate this information to our members and the website.

Thanks,

Hyzan


Dr Hyzan Mohd Yusof
Consultant Orthopaedic Surgeon
Sunway Medical Centre
First Floor, No. 5 Jalan Lagoon Selatan
Bandar Sunway,46150 Petaling Jaya
Selangor,Malaysia

Fax 603 74910708

Hopeful,
Ruby Ahmad.

Photo
news.bbc.co.uk/2/hi/south_asia/4324534.stm

Picture Yourself Fabulous and Happy!!

Hi there Gang,

Having a bad-image day?

Try visualisation exercise from Tracy McWilliam's book 'Dress to Express (New World Library, 2004). Find a photo of yourself that shows you at a moment when you looked fabulous and felt happy. Study the picture, noting the facial expression and body language. Then think back, remembering why you were so comfortable with yourself at the time. Summon this memory whenever you need it and you'll instantly give your confidence a lift.

I read this in a fitness magazine sometime back. I thought this is a nice piece to share with my gang.

Have a good-happy-image all the time then...
Ruby Ahmad.

Photo, the Leo (or rather the cub...ha ha ha!) in me on a lion in Perth, Western Australia.

Never Outshine the Master-Law 1.

Morning Gang,

Always make those above you feel comfortably superior. In your desire to please and impress them, do not go too far in displaying your talents or you might accomplish the opposite--inspire fear and insecurity. Make your masters appear more brilliant than they are and you will attain the heights of power.

Food for thought, gang?

Law 1, from the 48 Laws of Power by Robert Greene.

Happy thinking,
Ruby Ahmad.

Photo...Taken at a recent Art exhibition. From left Sharifah Sazita Syed Hamzah Shahabudin, yours truly and Terrie Fong. Click twice on photo for larger view.

Lactose Intolerance.

My Dearest Gang,

A lot of us (especially Asians) have gone through life not knowing that we are lactose Intolerant. Time and again we get stomach upset and we blame it on indigestion, not suspecting that it could be cow's milk (as one possible common reason). Unfortunately with propaganda that milk is nutritious for all adults (remember all the glamorous 'Got Milk?' ads fronted by celebrities with the white 'milk' moustache in Vogue, Tatler and Harper's and Queen and of course various fitness magazines)? Actually milk is great for caucasians but not suitable for majority of Asians unfortunately.

The ads are so effective, that one desires to drink only cow's milk all day long, minute to minute...nevermind the bloated tummy! It is oh-so-ultra-hip indeed to drink cow's milk with images of Brad Pitt, Andie MacDowell, Freddie Prinze Jr, Claudia Schiffer, Shaquille O Neal, Naomi Campbell, and more, all with that famed white 'milk' moustaches! Ha ha ha!

Well, not so long ago, after a few of my blogs on health, I received a special request from a visitor to our blog, requesting if I could post something on lactose intolerance! Well, I thought this would benefit most of us, so why not? I contacted a nutritionist that I know and she has kindly sent me this article. Here you go...Enjoy and be enlightened by this article!
Lactose Intolerance.

Lactose intolerance is the body’s inability to digest significant amounts of lactose, which is the predominant sugar of milk from mammals including mother’s milk. Lactose intolerance is a result of a shortage of the enzyme lactase, which is normally produced by the cells in the small intestine. Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. When there is not enough lactase being produced by our body to digest the amount of lactose consumed, it brings up distressing symptoms like nausea, stomach cramps, bloating, gas and diarrhea. In severe cases, it may lead to complications such as weight loss, malnutrition and slow growth. Many parents confuse milk allergies with lactose intolerance. True milk allergies are allergic reactions to the proteins in the milk products. Lactose intolerance does not mean you are allergic to milk, but you experience uncomfortable symptoms after taking milk products. The symptoms often begin about 30 minutes to 2 hours after taking foods containing lactose. The severity of symptoms varies depending on the amount of lactose each individual can tolerate.

What causes lactose intolerance?
There are 3 major causes of lactose intolerance:
- Normally, your body produces large amount of lactase at birth and in early childhood when milk is the primary source of nutrition. However, like all mammals, your body begins to produce less lactase after about the age of 2 years. The gradual decline causes symptoms of lactose intolerance. However, many people may not experience symptoms until they are much older.
- In rare cases, it is possible for babies to be born with lactose intolerance (known as congenital lactose intolerance) which is a genetic disorder and they are intolerant to the lactose in milk including mother’s milk from birth.
- Injury or illness in the small intestine may also cause lactose intolerance, which usually last only a few weeks and can be completely reversible. However, if it is caused by a long tem illness, it may be permanent.

What can I do?
After the age of 3, milk is not necessary in the diet. Avoidance of milk and dairy products is the simplest way to prevent lactose intolerance for most adults. Most people with lactose intolerance are still able to eat a small amount of dairy depending upon the lactase the body produces. Introduction of live culture may also help in lactose metabolism and enhance digestion of milk products.

Why you should avoid milk if you are older than 3!
- Insufficient lactase produced by body to breakdown milk may be a burden to your digestive system and thus you experience uncomfortable symptoms. Chronic constipation can be a manifestation of intolerance to milk. Severe lactose intolerance may lead to complications such as weight loss and malnutrition and failure to gain weight among children.
- Undigested milk sugar may also cause bad breath. Long term unattented lactose intolerance leaving indigestible compounds in the intestines, eventually weakens the protective intestinal lining and allows the toxic waste products to enter the blood stream cause intoxication.

Alternatives:
Nutrients deficiency such as protein and calcium is a major concern when people choose to eliminate milk from the diet, therefore a milk substitute or alternatives is a necessity. Below are healthy alternatives for milk products and food source to prevent calcium and protein deficiency in children and adults diet.

Item	Description
Non dairy milk alternatives	Soy milk, rice milk, oat milk, almond milk
Calcium	Sesame seeds, almond, broccoli, kale, yogurt, sea vegetables,blackstrapp molassess, Natur Green Soja with Calcium
Protein	Millet, quinoa, buckwheat, all beans especially soy bean, lima beans and black eye bean, cashew nut

Note: Calcium absorption is enhanced by its helper such as magnesium, vitamin D and copper which is commonly found in calcium rich wholesome food. Calcium absorption is affected by the calcium to phosphorus ratio (Ca/P OF 2:1 to 1: 1), higher phosphorus level inhibit calcium absoprtion. Milk or carbonated beverages or processed food often high in posphorus, thus it affected calcium absorption.

Article sent to me, with thanks and appreciation, by my Nutritionist contact, Teoh Siew Ngoh.

Photo 1 My pet cow, Pinky Hearts.(London).
Photo 2 'Got Milk?' ad with Andie MacDowell (lovely girl).
Photo 3 'Got Milk?' ad with Freddie Prinze Jr (lovely as well).
Photo 4 With my other pet bull, Bentley. (too proud of its name that I had to stamp on it's head, poor soul! Ha ha ha!)(London).
Click twice on photos for larger view.

National Cancer Society Malaysia.

Hi Gang,

Last week, I attended a fund raising function held by the National Cancer Society Malaysia (NCSM) at Ki Gallery, located at Kenny Hills. It was an exhibition featuring works by artists from Malaysia, India and Sri Lanka. Part of the proceeds from purchases of the art pieces will go towards NCSM's 'Mobile Cancer Screening Project'.

I went there with Linda Mustaffa (Mashitah Jamaluddin's daughter, a TKC OG). When we arrived there, we were greeted by Zurai (Dato Zuraidah Atan, our own TKC OG), the Honorary Adviser to NCSM. I had the pleasure to get to know the voluteers of NCSM, who has sacrificed time and energy all for the love of humandkind. NCSM's motto is clearly printed on their leaflets...'Strength Through Education and Support'. How very true indeed.

Education is key to everything. Education creates awareness amongst us as to the understanding of the predicaments at hand. Education gives us the sense of preparedness and ability to handle difficult situations.

NCSM also believe in Support. Sometimes in reality, no matter how educated and how prepared one thinks one is, but once one is hit with the predicament, there is no telling as to one's reaction (more so for those who are not in the least prepared or aware). The reactions can be so varied from being calm to suicidal. This is where the support comes in.

To this end, NCSM, has set up several centres around, expanding their services to several aspects of cancer management, from detection to treatment and counselling. These centres are run by dedicated specialist staff. I'd say they are dedicated, I met some of them at the function. They are not only dedicated, they are passionate about their cause, and it was infectious indeed!

Tan Sri Muhyiddin Yassin, the Minister of Agriculture, was gracious to officiate the function in his support of the cause. He emphasised the need for us to empower ourselves with better knowledge of Cancer Management. This is exactly true. With understanding and knowledge, we can be of better service to society.

I write to impress upon all of us, to give a helping hand, and one of the ways is to become a member of the NCSM. The benefits of being a member, you will be informed of activities designed to help you better understand the disease of cancer as well as health management.

Gang, all of us suffer from the attitude of...'It will not happen to me'. Let me tell you, the sooner we shake this attitude off, the better. Trust me. If it never happened to us, great...but, it might happen to a loved one, a family member, or a dear friend. Wouldn't it be great that we could at least be of service? Think about it real hard....

So do sign up. Call, 03-2698 4300 or mail contact@cancer.org.my.



Invest your commitment today for a better and healthier tomorrow.

Cheers,
Ruby.
Photo 1 Tan Sri Muhyiddin Yassin.
Photo 2 Dr Saunthari (NCSM volunteer), Mrs Marshall (Ki gallery owner), Tan Sri Muhyiddin Yassin, Dato Zuraidah Atan .
Photo 3 Some of the happy Guests.
Photo 4 Specialists and volunteers, from left, Anne Jansen, Saunthari Somasundaram, Clare Ratnasingham, Elizabeth Choong Yue Ling.
Photo 5 Yours Truly.