All posts by EZ Malaysia

Haematopoietic Stem Cell Transplantation: A Lifesaving Approach for Blood Disorders

Introduction
Haematopoietic stem cell transplantation (HSCT) has emerged as an increasingly safe and effective therapeutic procedure, with origins tracing back to the early 1960s.

Today, HSCT is a crucial curative strategy for patients with haematological malignancies, such as leukaemia, lymphoma, multiple myeloma, myelodysplastic syndrome, myeloproliferative neoplasm, and for some non-malignant blood disorders such as acquired bone marrow failure syndrome.

Summary of Indications for Haematopoietic Stem Cell Transplantation

  • Acute myeloid leukaemia
  • Acute lymphoblastic leukaemia
  • Chronic myeloid leukaemia in blast crisis
  • Primary myelofibrosis with intermediate or high DIPSS score
  • Myelodysplastic syndrome with excess blasts, high-risk multilineage dysplasia
  • Chronic lymphocytic leukaemia with high-risk disease, Richter’s transformation
  • Hodgkin’s lymphoma
  • Non-Hodgkin’s lymphoma
  • Multiple myeloma & primary amyloidosis
  • Very severe aplastic anaemia

Types of HSCT

  • Autologous HSCT (patient’s own stem cells)
  • Allogeneic HSCT (stem cells from a donor)

         –   HLA-matched related donor (sibling)

         –   HLA-matched unrelated donor (local or overseas)

         –   HLA-mismatched related donor

         –   HLA-mismatched unrelated donor

         –   Syngeneic transplant (identical twin, non-identical twin)

         –   Haplo-identical donor (half HLA-matched, parents or children)

         –   Umbilical cord blood

Peripheral Blood Stem Cell (PBSC) Apheresis
Stem cell apheresis is a unique procedure that collects stem cells from peripheral blood using a cell separator called an apheresis machine. The process begins with mobilising haematopoietic stem cells (HSCs) from the bone marrow into the bloodstream, typically through a growth factor called granulocyte colony-stimulating factor (G-CSF). Once enough stem cells circulate in the blood, they are collected through the apheresis machine.

Stem cells are transferred to a collection bag, while the remaining blood components are returned to the body through a catheter. Each session typically lasts 4 to 8 hours, and the procedure may be performed over one to two days, depending on the amount of stem cells required. This non-surgical procedure is generally well-tolerated by both patients and donors.

Basic Principles of Haematopoietic Stem Cell Transplantation
Before the infusion of HSCs, patients receive a combination of drugs with or without total body irradiation (TBI) as a conditioning regimen. Conditioning eradicates residual disease, creates “empty space” within the bone marrow cavity, and suppresses the immune system. Following the conditioning, HSCs are infused into the patient, migrating to the bone marrow to produce new blood cells. HSCs can regenerate blood components and reconstitute the immune system of patients whose bone marrow has been compromised due to disease or high-dose chemotherapy. Successful integration of transplanted cells is monitored, leading to the recovery of haematopoiesis and healthy bone marrow function.

Advantages and Risks of PBSC HSCT
Compared to traditional bone marrow transplantation (BMT), PBSC HSCT offers faster blood cell count recovery and a lower incidence of complications. Studies indicate that patients undergoing PBSC HSCT experience quicker haematopoietic recovery, resulting in shorter hospital stays. Additionally, PBSC use has become more common due to its availability and the relative ease of collection compared to bone marrow.

Despite its benefits, PBSC HSCT carries risks. Patients may encounter complications such as infections and organ dysfunction, particularly in the early post-transplant period. One significant complication of allogeneic HSCT is graft-versus-host disease (GVHD), where the donor’s immune cells (the graft) attack the recipient’s tissues, recognising them as foreign. Infections are another primary cause of morbidity and mortality, as the conditioning regimen and procedure significantly weaken the patient’s immune system, increasing susceptibility to bacterial, fungal, and viral infections. Managing these risks requires vigilance, effective prophylaxis, and timely treatment.

Conclusion
While HSCT can be a life-saving treatment, it also entails substantial risks, particularly with infection and graft-versus-host disease in allogeneic transplants. Careful patient selection, optimised conditioning protocols, effective anti-GVHD strategies, and robust anti-infective measures are critical for improving outcomes. Through these advancements, HSCT continues to offer hope for patients with otherwise incurable blood disorders, providing the potential for long-term remission and enhanced quality of life.

All images courtesy of LohGuanLye Specialists Centre


Consultant Clinical Haematologist & Physician


MD (UPM), MRCP (UK), Fellowship in Clinical Haematology (Malaysia), Fellowship in Bone Marrow & Stem Cell Transplantation (Taiwan)

Dr. Teoh Ching Soon is the Clinical Haematologist & Physician in LohGuanLye Specialists Centre. He has a keen interest in the management of malignant haematological disorders such as leukaemia, lymphoma, multiple myeloma, myelodysplastic syndrome and myeloproliferative neoplasm. His clinical work also focuses on benign haematological diseases, red cell and platelet disorders, coagulation and haemostasis, consultative haematology and haematopoeitic stem cell transplantation.

Injuries During Childbirth: What Every Mom Should Know

by Dr. Tan Hoo Seong
Consultant Obstetrician & Gynaecologist

Perineal Lacerations
Each year, between 130 to 150 million babies are born worldwide. Many new mothers experience a tear in the area between their vagina and anus (called the perineum) during delivery. This can affect their physical, emotional, and mental well-being. It can also impact healthcare systems, as treating these injuries can be costly.

In Malaysia, these types of injuries are often not well-reported or managed, mainly due to a lack of awareness and guidelines among healthcare providers and mothers. This article aims to shed light on the issue and encourage better care for new mothers.

Overview
What is a vaginal tear?
A vaginal tear occurs during childbirth. Also called a perineal laceration, it is a tear in the tissue (skin and muscle) around the vagina and perineum. The perineum is the area between the vaginal opening and the anus.

During vaginal delivery, the skin of the vagina prepares for childbirth by allowing the skin around your vagina to stretch. While the vagina is designed to stretch to allow the baby’s head and body to pass through, it is very common for it to tear. Up to 90% of people who give birth experience some degree of tearing. Treatment for vaginal tears depends on their severity.

What are the four types of perineal lacerations?
There are four levels (or degrees) of vaginal tears, based on how deep the tear is:
Normal Anatomy


First-degree tear
The least severe type of tear, this small injury affects only the first layer of skin around the vagina and perineal area. It usually doesn’t require stitches, or only a few simple ones.
First-degree tear


Second-degree tear
This is the most common type of tear. It extends deeper through the skin into the underlying muscles of the vagina and perineum. This type of tear requires stitches.
Second-degree tear


Third-degree tear
A third-degree tear extends from the vagina to the anus. It affects the skin and muscles of the perineal area and causes damage to the anal sphincter muscles, which control bowel movements. Stitches are required for this type of tear.
Third-degree tear


Fourth-degree tear
This is the most severe and least common type of tear. It extends from the vagina, through the perineal area, the anal sphincter muscles, and into the rectum. Repairing a fourth-degree tear may require a procedure in the operating room rather than in the delivery room.
Fourth-degree tear

Second-degree tears are the most common type. They affect both the first layer of skin and some of the underlying muscles in the perineal area. In contrast, third- and fourth-degree tears are much less common, occurring in only about 5% of deliveries.

Who is more likely to tear during childbirth?
Certain factors can increase the risk of tearing during childbirth, including:

  • First-time delivery
  • Having a large baby (more than 3.5 kg)
  • Use of forceps or vacuum during delivery
  • Prolonged second stage of labor (pushing stage)
  • Baby’s face-up position (malposition) during delivery
  • Use of an epidural

It’s advisable to discuss potential risk factors for vaginal tearing with your healthcare provider.

What are the potential complications of vaginal tears?
While vaginal tears can be uncomfortable and painful, most small tears heal within two weeks. Discomfort may last a month or two for larger tears. Third- and fourth-degree tears are more severe and come with additional complications, such as:

  • Infection
  • Bleeding
  • Painful intercourse
  • Faecal incontinence
  • Persistent pain and soreness

Can you feel yourself tear during birth?
Every birth experience is different, so there is no definitive answer. If you had an epidural or other pain relief during delivery, you likely won’t feel the tear or know how severe it is until your provider informs you. Even without pain medication, you may not feel a vaginal tear.

Management and Treatment
How are vaginal tears treated or repaired?

  • First-degree tear: You may not need stitches, or only a few simple ones.
  • Second-, third-, and fourth-degree tears: Stitches will be required to repair the tear. These stitches dissolve on their own within six weeks. 

All images courtesy of LohGuanLye Specialists Centre

Royalty, Business, and Leadership

His Highness Prince Sulaiman Shah Al-Haj ibni Almarhum His Majesty Sultan Salahuddin Abdul Aziz Shah Al-Haj, D.K. (Johor), D.K.II (Selangor), S.P.M.J (Johor), S.P.M.S (Selangor), S.J.M.K (Kelantan), P.I.S (Johor)


Y.A.M Tengku Laksamana of Selangor


His Highness Prince Sulaiman Shah Al-Haj ibni Almarhum His Majesty Sultan Salahuddin Abdul Aziz Shah Al-Haj is a Malaysian corporate figure and member of the Selangor royal family.

He is the second son of the late Sultan of Selangor, Al-Marhum HRH Sultan Salahuddin Abdul Aziz Shah Al-Haj, and the brother of the current and ninth Sultan, HRH Sultan Sharafuddin Idris Shah Al-Haj.

Currently, HH Prince Sulaiman Shah is second-in-line to the throne of Selangor after his nephew, Crown Prince HRH Tengku Amir Shah.

The state of Selangor is the largest economy in Malaysia in terms of gross domestic product (GDP), constituting 25.6% of Malaysia’s GDP. It is the most developed state in Malaysia and has the largest population in Malaysia with high standards of living.

With H.E. Mr. Irfan Davudov, Ambassador of the Republic Of Azerbaijan to Malaysia

HH Prince Sulaiman Shah was educated at Aitchison College, Lahore, Pakistan, then in the United Kingdom at Wellingborough School, Northamptonshire. In 2019, HH Prince Sulaiman Shah received an Honorary Doctorate of Humanities on Social Work at California Public University, USA.

In 1972, his father, the then Sultan of Selangor, HRH Sultan Salahuddin Abdul Aziz Shah Al-Haj, appointed HH Prince Sulaiman Shah Al-Haj as the Y.A.M. Tengku Panglima Besar, a post he held for six years. In 1978, his father raised the rank of HH Prince Sulaiman Shah Al-Haj to Y.A.M. Tengku Panglima Raja, or The Chief of Ceremony for the State of Selangor, and he held the post for 38 years. The father of HH Prince Sulaiman Shah, Al Marhum His Majesty Sultan Salahuddin Abdul Aziz Shah Al-Haj, was appointed the eleventh (11) King of Malaysia from April 26, 1999 until his demise on November 21, 2001.

In 2016, his elder brother, the current HRH Sultan of Selangor, Sultan Sharafuddin Idris Shah Al-Haj, promoted HH Prince Sulaiman Shah Al-Haj to Y.A.M. Tengku Laksamana of Selangor, or The Admiral Palace State of Selangor. He is also a member of the Council of the Royal Court of Selangor (Dewan Diraja Selangor).

HH Prince Sulaiman Shah Al-Haj began his professional career in 1971 with the international advertising company Ogilvy & Mather Kuala Lumpur where he gained wide knowledge in the advertising and branding industry.

With His Majesty Sultan Ibrahim, The King of Malaysia (2nd from left), YAB Dato’ Seri Anwar bin Ibrahim, Prime Minister of Malaysia (left) and YAB Dato’ Seri Haji Amirudin bin Shari, Menteri Besar Selangor (right) at the “266th Meeting of The Conference of Rulers” – Istana Negara, Kuala Lumpur, July 2024. 


Since 1975, HH Prince Sulaiman Shah has become actively involved in business, particularly in building, construction and housing development. His motivation drives him to be more enterprising, and the ultimate goal is to be a major player in the construction industry. HH Prince Sulaiman Shah is a founder of Syarikat Pembinaan Setia Sdn Bhd, which is now known as SP Setia Berhad, a public listed company on the main board. In 1997, he relinquished his position in SP Setia Berhad, the first construction company to bring prefabrication technology to Malaysia.

At the launch of Pesta Buku Antarabangsa Kuala Lumpur, held at the World Trade Centre Kuala Lumpur, May 2024. Seen here with Dr. Hazami Bin Jahari, Director-General of Dewan Bahasa dan Pustaka (left) and Prof. Dato’ Sri Dr. Haji Irmohizam bin Haji Ibrahim, Group Managing Director, WTCKL (right)
With YAB Dato’ Seri Anwar bin Ibrahim, the Prime Minister of Malaysia at Istana Bukit Keyangan, Selangor

HH Prince Sulaiman Shah was formerly a Director of the following publicly listed companies:

   1)   Malaysian Resources Corporation Berhad (MRCB) – Property Development

   2)   Samanda Holding Berhad – Construction

   3)   MCB Holding Berhad – Construction

   4)   SIME UEP – Developer

   5)   Bina Goodyear Berhad – Construction

   6)   Baneng Holding Berhad – Textiles

   7)   KFC Holding (Malaysia) Berhad– Fast Food

   8)   QSR Brands Bhd – Fast Food

   9)   General Aluminium Sdn Bhd – subsidiary of a public listed company

With local and foreign dignitaries at the 106th Anniversary of the Declaration of Independence of the Republic of Azerbaijan – May 2024
“Celebrating in Royal Style!” – HH Prince Sulaiman Shah cuts his surprise birthday cake alongside TYT Tun Dato’ Seri Utama Ahmad Fuzi and Dato’ Chng Huck Theng at the CHT International Awards 2024 in Kuala Lumpur

HH Prince Sulaiman Shah Al-Haj is currently a Director of the following public listed companies:

   1)   DF City Group Berhad – Development of Town Centre in Beranang, Selangor

   2)   WTK Holdings Berhad – Plantation

   3)   LLC Berhad – Construction, Water Specialist, Developer

HH Prince Sulaiman Shah was the Chairman of Malaysia – UAE Business Council, appointed by the Ministry of International Trade and Industry (Malaysia)(MITI)

With H.E. Mr. Irfan Davudov, Ambassador of the Republic Of Azerbaijan to Malaysia (left) and Datuk Dr. Ras Adiba Mohd Radzi at the 106th Anniversary of the Declaration of Independence of the Republic of Azerbaijan

Champion of CEO Development

Richard Wong Chin Mun

Founder, Vistage Malaysia Sdn Bhd


Richard Wong Chin Mun is a distinguished figure in Malaysia’s business community, best known for founding Vistage Malaysia in 1994. After serving as Managing Director and Group CEO of Nylex Malaysia Bhd for 18 years, Richard launched Vistage Malaysia (formerly TEC Asia Centre), establishing it as a leading platform for CEO development. During his tenure at Nylex, he introduced the Adizes collaborative leadership methodology and achieved the ISO 9001 certification, positioning Nylex as the first company in Malaysia to earn this recognition. Under his leadership, Nylex was also ranked among the top five best-managed companies in Malaysia by Asia Money in 1991/1992.

Vistage Malaysia, under Richard’s stewardship, has grown into a thriving community of over 1,400 members with combined annual revenue of over RM90 billion and 60 Chairs as of August 2024.  The organisation offers confidential peer advisory groups and personalised coaching for CEOs and business leaders, helping them steer through critical decisions and attain superior results. Serving as Master Chair and “Chief Listener,” Richard has been instrumental in Vistage Malaysia’s expansion across Southeast Asia. Notably, Vistage recently received the Excellence Award at the CHT International Awards 2024, hosted in Kuala Lumpur by CHTNetwork.

A proud moment: Richard (left) receiving the CHT Excellence Award from Y.A.M. Tengku Laksamana Selangor, His Highness Prince Sulaiman Shah Al-Haj Ibni Almarhum His Majesty Sultan Salahuddin Abdul Aziz Shah Al-Haj, State Of Selangor at the CHT International Awards 2024 presentation ceremony. Looking on is Dato’ Chng Huck Theng, Founder and President of CHT International Awards (right)

In collaboration with MIER, Vistage Malaysia has been publishing the quarterly CEO Confidence Index since 2003, providing valuable insights into the challenges and opportunities within Malaysia’s business community.

Beyond Vistage, Richard holds several influential roles. He is the Independent Non-Executive Director and Audit Committee Chairman for Scientex Berhad and Khind Holdings Berhad. His contributions extend to various non-profit organisations, including Transparency International Malaysia, the Malaysian Rubber Export Promotion Council, Cancer Research Malaysia, and Rise Against Hunger.

Jimmy Foo Ascends to New Heights

Jimmy Foo Kok Keong

Director and Chief Executive Officer, Areõma Wellness Sdn Bhd

Jimmy Foo Kok Keong embodies passion, perseverance, and purpose-driven endeavours. His journey, marked by a relentless pursuit of personal growth and societal impact, spans education, business, and wellness.

Jimmy’s academic prowess shone early on, earning him an honours degree in Science with Education from Universiti Sains Malaysia (USM) in 2006. He continued his scholarly pursuits with a Master’s in Educational Technology and a Ph.D. in Education, all while working as a Research Officer at USM.

In 2011, Jimmy’s entrepreneurial spirit led him to transition from academia to business. He founded an education centre offering tuition and alternative educational services for young students, while also excelling as a certified HRDF corporate trainer and facilitator. By 2015, he expanded into tourism, creating popular attractions such as the Dark Mansion – 3D Glow in the Dark Museum, Made in Penang 3D Interactive Museum, and The Wizherd Magic Museum. As a committee member of the Association of Tourism Attractions Penang (ATAP), his insights are highly valued in advancing Penang’s tourism industry.


Jimmy has been recognised for his dedication and success. He was named one of the “Faces of Penang 2019 – Top 50 Below 50” and featured in “Successful People in Malaysia 2019” by Britishpedia. In 2020, he achieved the prestigious Doterra Diamond Rank and Essential Oils Specialist title within just ten months. During the pandemic, he pivoted to wellness, spearheading initiatives through online platforms. In 2022, he founded Areõma Boutique Spa, promoting aromatherapy as a globally recognised healing therapy. In 2023, he was awarded the “Pingat Jasa Masyarakat (P.J.M)” by the Penang State Governor for his significant contributions to the local economy. Jimmy’s latest accolade came in the form of the ‘Emerging Entrepreneur Award’ at the CHT International Awards 2024, presented by CHTNetwork, held in Kuala Lumpur, in recognition of his visionary leadership and drive for excellence. He was also in Jakarta, Indonesia, to receive two awards for Areõma Boutique Spa, Penang – “No. 1 Favourite Spa & Wellness Award 2024 in the ASEAN Winner Class” and “The Best Spa & Wellness Centre” at the ASEAN Awards 2024, presented by Asia Award Media, Indonesia.

A proud moment: Jimmy (left) receiving the CHT Emerging Entrepreneur Award from Y.A.M. Tengku Laksamana Selangor, His Highness Prince Sulaiman Shah Al-Haj Ibni Almarhum His Majesty Sultan Salahuddin Abdul Aziz Shah Al-Haj, State Of Selangor at the CHT International Awards 2024 presentation ceremony. Looking on is Dato’ Chng Huck Theng, Founder and President of CHT International Awards (right)

Jimmy’s latest accolade came in the form of the ‘Emerging Entrepreneur at the CHT International Awards 2024, presented by CHTNetwork, held in Kuala Lumpur, in recognition of his visionary leadership and drive for excellence.

Looking towards 2030, Jimmy envisions making a significant impact in the wellness industry by expanding Areõma Boutique Spa and wellness enterprises both nationally and globally, creating more healing spaces, and nurturing leaders to support global well-being.

As Jimmy and his team prepare for the opening of the new Areõma Boutique Spa at the Wyndham Grand Ion Majestic Hotel in Genting Highlands, they are set to make history. At 1,865 metres above sea level, it will be the highest altitude spa in Malaysia, and likely in Southeast Asia, opening in November 2024.

His life motto, “Never Limit Your Challenges, Challenge Your Limits,” indeed encapsulates Jimmy’s resilient spirit and drive for excellence perfectly.

For further information, please visit linktr.ee/AreomaBoutiqueSpa or scan the QR code

Banking on Fine Dining in Penang

Thitid Tassanakajohn

Michelin Chef


Born and raised in a Thai-Chinese household, Thitid Tassanakajohn (Chef Ton) was initially destined to thrive in a stable banking career after graduating from one of Thailand’s best universities – Chulalongkorn University with a bachelor’s degree in economics.

Interestingly, instead of becoming a high-flyer banking professional, he is now internationally-acclaimed as the rising young chef who owns and runs one of Thailand’s most successful culinary empires, consisting of more than 10 restaurants globally – including “Le Du” and “Nusara” which was ranked No.1 and No. 3 in the 2023’s edition of “Asia’s 50 Best Restaurants”.

Chef Ton defied familial expectations when he traded his investment banking career to pursue culinary in New York, training at the Culinary Institute of America and graduating top of his class. He then went on to work in several Michelin-starred establishments to hone his culinary skills, including Eleven Madison Park, The Modern and Jean Georges.

After returning to Thailand in 2013, Chef Ton challenged public perception towards Thai food and Thai ingredients, breaking the stereotype and conventional understanding as “cheap street food”. He elevated the Thai culinary landscape by sharing and highlighting Thailand’s rich medley of cultures and flavours through fine dining.

By combining the inspiration from his grandparent’s cooking and his years of culinary experience, he started “Le Du” (Thai word for “season”) – a fine-dine restaurant offering a four or six-course tasting menu with an emphasis on culinary creations made from locally sourced seasonal produce. These ingredients are weaved with modern culinary techniques to creatively accentuate the Thai flavours, leaving guests an unforgettable dining impression.

Meanwhile, to add-on to his current portfolio of restaurants in Hong Kong, Taiwan and the Philippines, Chef Ton will soon debut his fourth international restaurant in Penang, a destination affectionately known as Malaysia’s food paradise. This venture – “Sood by Chef Ton’’ will be housed in Farquhar Mansion that is nestled in the heart of George Town.

According to Chef Ton, this restaurant is designed to be unique with a “fun dining” concept and will be reflected across its dishes, ambience and service. It will serve Thai cuisine with a twist, particularly localized to suit the likings and palette of the locals.

“To start in Malaysia, I want to start in Penang. It is very close to my heart, and I have been travelling back and forth to Penang for the past 9 years. I enjoy the food, the people, and I also have many friends here,” he said.

Under the stewardship of Chef Ton, this restaurant will also see close collaboration with local culinary talents, adding more flavours into Penang’s illustrious gastronomy scene. Nonetheless, “Sood by Chef Ton” targets to welcome patrons in October 2024 with more than 30 dishes, harbouring hope to write another success story and make it a hallmark of culinary excellence.

Snoring and Obstructive Sleep Apnea

Why do people snore? Snoring is caused by the vibration of respiratory structures due to obstructed air movement during breathing while sleeping. Many people snore occasionally, especially when suffering from a cold or allergies, or after consuming alcohol. This type of snoring is usually not a major health concern.

However, snoring can be more than just a nuisance; it can indicate underlying health issues such as obstructive sleep apnea (OSA), a serious condition where breathing repeatedly stops and starts during sleep. If snoring is loud, chronic, accompanied by choking or gasping, or causes daytime sleepiness, it’s important to seek medical advice to rule out OSA.

The word “apnea” comes from Greek and means “not breathing.” Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that involves cessation or decrease in airflow in the presence of breathing effort. OSA occurs when the muscles relax during sleep, causing soft tissue in the throat to collapse and block the upper airway. Think of this as trying to drink via a narrow, poor-quality paper straw; the sucking negative pressure you put on the straw collapses it, making it hard to pull liquid through to drink. Similarly, when air cannot pass through your windpipe, you are not breathing enough to maintain oxygen levels in your blood. This can lead to a reduction in blood oxygen saturation. As the body detects the lack of oxygen, episodes of brief arousal from sleep will occur to restore normal breathing, resulting in poor quality of sleep and excessive daytime sleepiness.

Many OSA patients remain undiagnosed as the symptoms begin insidiously and are often present for years before the patients are referred for evaluation. The symptoms include a spouse’s report of disruptive snoring, witnessed apnea, gasping and choking sensations that arouse the patient from sleep, excessive daytime sleepiness, nonrestorative sleep, poor memory, and concentration. In adults, obesity is the most common risk factor for OSA. Other risk factors include large neck size, middle-aged and older men, post-menopausal women, enlarged tonsils/adenoids, Down Syndrome, and head and neck bony or soft tissue structural abnormalities.

OSA can be dangerous if left untreated. It is associated with an increased risk of cardiovascular mortality and stroke. It can cause daytime drowsiness, which can be dangerous if you are driving or doing something that needs your full attention. Falling asleep while using power tools, operating machinery, or driving can lead to deadly consequences for you or others. The effects of OSA can also contribute to or worsen high blood pressure or Type 2 diabetes.

Obstructive sleep apnea is diagnosed with overnight polysomnography (PSG). A PSG detects the frequency of apnea and hypopnea during sleep. Evaluation of the upper airway is needed for all patients with OSA. The treatment of OSA partly depends on the severity of the pathology. Positive airway pressure (PAP) therapy is the standard treatment option. While surgery has a certain role in treating OSA, there is a wide range of possible surgical procedures for OSA. The procedure of choice depends on the level of obstruction during sleep apnea. When there is an anatomical deformity that can be corrected to alleviate mechanical obstruction, surgery can be very effective. Oral appliances (OA) are another treatment option but are only useful in certain conditions. Other than these treatment options, lifestyle modifications such as weight loss, avoidance of alcohol prior to bedtime, and sleeping in a lateral position are also very important, especially in obese patients.

It’s important for individuals who suspect they have OSA to seek medical evaluation and treatment. Proper management of OSA can significantly reduce the risks and improve quality of life.

Consultant Ear, Nose, Throat, Head & Neck Surgeon

MBBS (UM), M. Med. (ORL-H&N) (UM), AM (Mal.)


Dr. Sow Yih Liang is a Consultant Ear, Nose and Throat (Otorhinolaryngology) Head and Neck Surgeon in Loh Guan Lye Specialists Centre. He enjoys sharing his medical knowledge with his fellow medical practitioners through organising or contributing as a speaker at workshops, symposiums or conference. Apart from engaging himself in numerous research and publication works, Dr. Sow is also actively involved in delivering oral and poster presentations. He was an adjunct lecturer for University Malaysia Sarawak (UNIMAS) from year 2016 to 2018. He also helped to train open system postgraduate students in Otorhinolaryngology, postgraduate students in Family Medicine Programme and medical student for elective attachment.

Daulat Tuanku

by Bernard Loke

Sultan Ibrahim Ibni Almarhum Sultan Iskandar

Malaysia’s 17th Yang di-Pertuan Agong


Malaysia’s unique rotating monarchy system saw the ruler of Johor, Sultan Ibrahim Ibni Almarhum Sultan Iskandar, ascend to the throne, beginning his five-year reign as the nation’s 17th Yang di-Pertuan Agong (King of Malaysia).

His Majesty Sultan Ibrahim is the second ruler from the southernmost state of Peninsular Malaysia, Johor, to be named King after his late father, Sultan Mahmud Iskandar, who assumed the role about four decades ago, from 1984 to 1989.

Under this system of kingship in Malaysia, the only such system in the world that has been in place since the nation gained independence from Britain in 1957, the sovereigns from the nation’s nine royal families, following an established rotational order, take turns to be elected as King for a term of five years. The 65-year-old Sultan Ibrahim succeeded Pahang’s Al-Sultan Abdullah Sultan Ahmad Shah.

His Majesty Sultan Ibrahim took the oath of office in a traditional ceremony and signed the instrument of the proclamation of office at the royal palace in Kuala Lumpur on January 31, 2024. Present at the ceremony were Prime Minister Dato’ Seri Anwar Ibrahim, members of the other royal families, as well as cabinet members.

Prior to his reign as Malaysia’s King, His Majesty Sultan Ibrahim was already widely known for his outspoken personality and assertive demeanour on a number of social and economic issues, including matters relating to racial harmony, healthcare, education for women and children, and environmental protection. He has also expressed concerns about government corruption and racial discrimination, which are hindering the nation’s progress.

His Majesty has championed notable initiatives to protect natural resources, including efforts to preserve forests and promote sustainability, while also actively spearheading philanthropic efforts to help the communities, especially during the COVID-19 pandemic and during natural disasters such as floods.

Meanwhile, this stern yet people-friendly King of Malaysia is endowed with stellar leadership qualities, evident through his involvement in military training at the Army Combat Training Centre (PULADA) in Kota Tinggi, as well as at Fort Benning, Georgia, USA, where he also completed airborne and ranger training for infantry officers.

His Majesty Sultan Ibrahim with Chinese Ambassador to Malaysia, H.E. Ouyang Yujing, after taking delivery of the Hongqi L5
His Majesty Sultan Ibrahim is the first person in the world to privately own the Chinese-made retro-styled ultra-luxurious Hongqi L5 vehicle

With His Majesty Sultan Ibrahim marking a new reign in Malaysian history, fellow Malaysians are hopeful that the next five years under the leadership of this Malay-British monarch will see better political stability and greater economic development.

In His Majesty’s inaugural address delivered at the Opening Ceremony of the Third Session of the 15th Parliament, His Majesty Sultan Ibrahim reminded parliamentarians that the welfare of the Rakyat (people) interests prevails above the rest, and that the elected representatives should dedicate their focus to safeguarding their constituencies and constituents.

His Majesty stressed that Malaysia’s future is dependent not just on the Prime Minister but also on the joint responsibility of all 222 elected officials. He urged all parties to unite, stressing that he would not consider any request that threatened the country’s political stability.

The Johor royalty is also known to have an impressive business empire under his belt, spanning from real estate to power plants. As an avid fan of sports, His Majesty Sultan Ibrahim enjoys tennis, sailing, shooting, parachuting, and excels in polo, all while also having a penchant for superbikes, vintage three-wheelers and luxury cars, including a Mercedes-Benz 300SL Gullwing, a Bugatti Veyron, and a life-size replica of the “foot-powered car” (albeit fitted with an engine) from his favourite cartoon “The Flintstones.” His Majesty Sultan Ibrahim is also the world’s first private owner of the Chinese-built ultra-luxurious sedan Hongqi L5, popularly known as the Rolls Royce of China.

Yabba-Dabba-Doo! His Majesty and his life-sized replica of Fred Flintstone’s car


His Majesty Sultan Ibrahim is married to Her Majesty Raja Zarith Sofiah, who hails from the royal family in Perak. Apart from being an accomplished author, Her Majesty serves as the Chancellor of Universiti Teknologi Malaysia and received formal education from the University of Oxford. They are blessed with five princes and one princess.

Images by Sultan Ibrahim Sultan Iskandar via Facebook

Yeoh’s Tourism Quest

Dato’ Yeoh Soon Hin

Deputy Chairman of Tourism Malaysia


Dato’ Yeoh Soon Hin sits down with EZ Magazine to discuss his ambitions in his newly minted capacity as the Deputy Chairman of Tourism Malaysia, the country’s primary tourism promotion agency under the purview of the Ministry of Tourism, Arts and Culture.


A lawyer-turned-politician, Dato’ Yeoh Soon Hin, strides into Putrajaya to steer the future of Malaysia’s tourism and to popularise Malaysia in the fiercely competitive global tourism landscape.

Prior to this appointment, Yeoh served as the Penang State Minister for Tourism and Creative Economy from 2018 to 2023, where he led and accomplished a myriad of key initiatives, amongst which is coining Penang’s inaugural Tourism Master Plan. Under his dynamic stewardship, Penang has secured investments from renowned airline companies and international hospitality chains and has even marked diplomatic relationships with South American counterparts and dignitaries.

Throughout his illustrious career, Yeoh has also scooped a string of awards, including the “Golden Horse Award” presented by the Malaysian Association of Theme Park & Family Attractions (MATFA) and the “Most Innovation Tourism Leader of the Year 2022” awarded by the Asian Tourism & Hospitality Awards 2022. Yeoh was also named the “JCI Ten Outstanding Young Malaysian Award 2014 (Political, Legal and/or Governmental Affairs)” and the “2004 Top Ten Outstanding Youth of Penang.”

Despite anticipating challenges and difficulties in the path ahead, this tourism stalwart is positive that his wealth of experience in public service and administration will add value and propel Malaysia’s tourism performance.

“My vision is to gradually reform and strengthen Malaysia’s tourism supply chain over the next two years, from flight arrivals, airport amenities, connectivity, accommodation options, and transportation choices to tourism products. A full-suite and holistic ecosystem will boost foreign tourist arrivals and enhance travellers’ experiences, all of which will contribute to returning visits and a sustainable tourism economy,” Yeoh said.

Meanwhile, in anticipation of Visit Malaysia Year 2026, Yeoh sees it as a campaign to which he can greatly contribute, especially with the insights and learning he has obtained through his brainchild—the Penang Tourism Master Plan and the #ExperiencePenang campaign.

“For Malaysia to catapult our tourist arrivals in conjunction with Visit Malaysia Year 2026, we must first ensure that our offerings are catered to all markets and regions. This means making our destination and products hospitable, accessible, and friendly for all to enjoy,” Yeoh shared.

He explained that enhancing Malaysia’s branding as a Muslim-friendly destination is one of the many avenues to attract foreign tourists, especially the Middle Eastern market, which comprises high-net-worth travellers, eventually resulting in higher per capita spending and greater economic impact.

On a different note, Yeoh also continues to anchor his hope in the Asian market, citing that his warm connection with Chinese counterparts and government officials will be helpful in building Malaysia’s connectivity with the world’s second-largest economy.

Yeoh believes that Malaysia’s multicultural and diverse communities, juxtaposed against the range of urban cityscapes, are strong magnets to attract Chinese travellers, especially with a fair share of the Chinese-speaking population in major cities in Malaysia.

Part of Yeoh’s proposal is mass advertising and promotion to increase visibility and familiarity among Chinese travellers, such as trade shows, ambassadorship and endorsement, bus wraps, billboards, and social media advertisements.

With his new appointment in place, this former three-term State Assemblyman of Penang’s largest state constituency with over 45,000 voters, Paya Terubong, is determined to learn the ropes and framework of federal policymaking, aspiring to work closely with the Federal Ministries in setting new benchmarks for Malaysia’s tourism industry.

Yeoh essentially hopes to bring his success stories from his home ground, Penang, to the doors of Putrajaya, to value-add and assist Malaysia’s tourism leaders in creating new opportunities and writing new chapters in our tourism history.

Nonetheless, Yeoh also wishes to extend his deepest gratitude to the incumbent Minister of Tourism, Arts and Culture, Dato’ Sri Tiong King Sing, for his trust and appointment in naming Yeoh as the Deputy Chairman of Tourism Malaysia.

Visual Storytelling

Ramakrishna Karunagaran

Chief Executive Officer, Filmflix

Ramakrishna Karunagaran is a multifaceted professional in the film industry, known for his versatility as a film director, editor, and colourist. His diverse body of work spans television projects, international music videos, and movies, showcasing his robust set of skills that include directing, cinematography, editing, and colour grading.

As one of the directors of Filmflix, a local homegrown video production company, Ramakrishna is focused on delivering top-quality videos that tell captivating stories.

At Filmflix, Ramakrishna’s directorial acumen shines through as he seamlessly transitions between different roles in the filmmaking process. Whether behind the camera as a director of photography or in the post-production suite as an editor and colourist, he consistently delivers visually compelling narratives that enhance brand identity and connect with audiences on an emotional level.

Aside from commercial projects, Ramakrishna has also made notable contributions to state cultural events such as the George Town Festival in Penang. His involvement in this annual event displays his ability to manage large-scale projects and his keen eye for cultural, artistic and historical elements that represent Penang’s diverse community.

Internationally, Ramakrishna has crafted music videos that have resonated with audiences globally, proving his skill in creating visually appealing and culturally relevant compositions. His film work exemplifies his versatility and dedication to perfection, leaving a lasting impression with his visual sensibilities and technical ability.


Overall, Ramakrishna Karunagaran is a visionary of visual narrative and cultural representation. His extensive experience and adaptability allow him to continue influencing various aspects of media and culture, enriching projects, and paving the way for innovative practices in filmmaking and the visual arts. Through his work at Filmflix and beyond, Ramakrishna continues to inspire and captivate audiences worldwide.


Mr. Ramakrishna Karunagaran and Dato’ Chng Huck Theng (Founder and Editor-in-Chief of iNPenang) after signing the Memorandum of Understanding to jointly produce a travel docu-series on Penang, witnessed by YAB Chow Kon Yeow, Chief Minister of Penang (centre).