Source: Jamaica Gleaner, YouTube
1 NEW YEARS DAY
8 MAJ Executive Meeting
12 AGPJ Conference
19 CCFP Conference
Annual Nephrology and Hypertension Conference
30 JMHS Seminar – Alzheimer’s
disease: what next?
2 JMDA Ethics Seminar
5 MAJ Executive Meeting
9 CCFP Triennial Conference – Planetary Health 2020
9 JCS Conference on Multiple Myeloma
15 Annual Cardiology Symposium
22-23 DOBGYN Annual Perinatal Conference
23 ACPJ Ethics Symposium
4 World ObesityDay
4 MAJ Executive Meeting
4 HFJ Medical Symposium & Prof. Knox
Hagley Memorial Lecture
8 World Sight
15 CCFP Conference
15 JCS Colon Cancer Medical Symposium
22 OSJ Annual Conference
26-27 HFJ Advanced Cardiac Life Support
29 JEMA 20th Annual Conference
1 MAJ Executive Meeting
5 MAJIF Risk Mgmt & Ethics Seminar
5 JCS Dr. Joseph St. Elmo Hall Memorial
10 GOOD FRIDAY
19 AGPJ Conference
23 CCFP Seminar
23-24 HFJ Paediatric Advanced Life Support
23-25 26th Annual UDOP Conference
“Diabetes: What’s trending?”
25-26 CGCS Conference
26 DAJ Annual Symposium
Seminar – Ageing with wealth: Healthy
6 MAJ Executive Meeting
7 HFJ ECG Dysrhythmia Recognition Course
10 World Lupus
16-17 ASJ 62nd Annual Clinical
17 CCFP Conference
19 World Family
23 LABOUR DAY
24 MAJ Council Meeting
25 MRH Annual OBGYN Symposium
28-29 HFJ Advanced Cardiac Life Support
31 MAJ Annual Church Service
31 World No
4 MAJ Opening Ceremony
5 MAJ Annual Ethics
ScientificSymposium – Jamaica Pegasus Hotel
14 World Blood
2-5 UWI Annual Internal Medicine Review
12 ACOG Conference
12 AGPJ Conference
30 JMHS Seminar – The
ABC’s of a Healthy Long and Productive Life: 20/20 vision
5 MAJ Executive Meeting
27 CCFP Seminar
27 HFJ ECG Dysrhythmia Recognition Course
30 MAJ Council Meeting
11 UWI/ ACPJ Rolf Richards Distinguished Lecture
12-13 ACPJ Annual Symposium and Banquet
20 CCFP Conference
24-25 HFJ Advanced Cardiac Life Support
27 MAJ Annual General Meeting
27 JCS Prostate Cancer
28 MRH Annual Research Day
4 MAJIF Risk Mgmt & Ethics Seminar
7 MAJ Executive Meeting
11 Jamaica Pain Collaborative
11 JCS Breast Cancer Medical Symposium
18 JMHS Seminar – Menopause:
A new beginning (World Menopause Day)
24 JKKF Paediatric Nephrology Workshop
25 Jamaica Kids Foundation
25 KPH Annual Conference
1 CCFP/ JVMA One Health Conference
1 Annual Lupus Symposium
3 World One
5 HFJ ECG Dysrhythmia Recognition Course
8 AAJ Conference
8 AGPJ Conference
15 JACP Annual Conference
15 ETT Annual Symposium
11-14 CANS 45th Annual Scientific
16-17 HFJ Advanced Cardiac Life Support
19-20 MOH Annual National Health Research Conference
22 JCS Lung Cancer Medical Symposium
26 CCFP Seminar
26-27 HFJ Paediatric Advanced Life Support
29 MAJ Council Meeting
2 MAJ Executive Meeting
13 CCFP Seminar
of Consultant Physicians of Jamaica
of General Practitioners of Jamaica
of Surgeons of Jamaica
Association of Otolaryngologists
Association of Neurological Surgeons
Association of Gynaecological Endoscopic Surgeons
CGCS Caribbean Gynecologic Cancer Society
College of Family Physicians
CCS Caribbean Cardiac Society
Institute of Nephrology
Association of Jamaica
DOBGYN Department of
OBGYN & Child’s Health, UWI
ESC Epilepsy Society of the Caribbean
FMS Faculty of Medical Sciences
Foundation of Jamaica
JAA Jamaica Anaesthetists
JACP Jamaica Association of Clinical Pathologists
Association of Otolaryngologists – Head and Neck Surgeons
JAR Jamaica Association of
JMDA Jamaica Medical Doctors’
Midlife Health Society
JOA Jamaica Orthopaedic
Kidney Kids Foundation
Association of Jamaica Insurance Fund
MRH Mandeville Regional Hospital
Society of Jamaica
Society of the West Indies
Association of Jamaica
of the West Indies
WFDD World Family Doctors’ Day
Author: Dr Patricia Yap. Email: firstname.lastname@example.org
Keloids are nodular, firm, tender, movable, non-encapsulated masses of hyperplastic
scar tissue, occurring in the dermis and adjacent subcutaneous tissue, usually
after trauma, surgery, burns, or severe cutaneous disease such as cystic acne. Traditional treatments have largely relied on combinations of surgery,
radiotherapy, chemotherapy and cryotherapy, in part reflecting the historic
view of keloids as benign tumours. These treatments have relatively poor
outcomes, often complicated by keloid regrowth after repeated attempts at
removal. Medical management of keloids remains underutilized, so too has the use
of medical treatments to prevent recurrence.
This presentation reviews the experiences of
three patients that benefitted from medical treatment of confirmed keloids, all
managed by Dr. Patricia Yap in her clinical practice in Kingston Jamaica. We introduce the application and results of a
novel topical treatment option which demonstrates objective improvements in
clinical outcomes (reductions in the size, appearance and recurrence of
keloids) with enhanced patient satisfaction.
In 2002, a middle-aged female patient attended Dr. Yap’s practice
for a consultation regarding multiple keloids on her back. At this time, the
typical treatment would have been the painful, uncomfortable intralesional
steroid treatment. Each and every keloid would have had to be injected,
therefore, the volume of Triamcinolone Acetonide (TA) solution would result in
systemic side effects. The patient suggested that there should be a cream
(topical treatment). With this suggestion, Dr. Yap who has a first degree in chemistry,
created a unique delivery system that allowed the introduction of the steroid
into the dermis topically.
commencing treatment, the decision was taken to not to use intralesional
steroids on the entire back as it would have incurred side effects. Consequently,
a half back approach to application was implemented.
the left of the patient’s back, intralesional steroids along with topical
therapy was used, whereas on the right side, only the topical therapy was used.
The keloids on both sides decreased in thickness, even though the left side
progressed much faster. The patient experienced little-to-no systematic side
effects and the outcomes (Figure 1.) were satisfactory for the patient with
significant reduction in reported pain, itchiness, and growth.
Figure 1. Before and after images
of Patient A. Female. Kingston, Jamaica
Following this initial positive response, Dr
Yap has refined and expanded the application of topical treatment for patients
with keloids over the past seventeen years. The following case studies present
3 cases which demonstrate the success of topical treatments alongside or
instead of intralesional injections.
In the three cases below and pictures that
follow, it is evident that using a novel topical treatment option is beneficial
to the patient. This not only gives control back to the patient but also
results in decreasing the burden in the healthcare system.
35 years old, presented with extensive folliculitis keloidalis on the scalp
involving the crown and the back of the head.
The patient was diagnosed with both
folliculitis keloidalis on the crown of the head and folliculitis keoidalis
nuchae at the back of the head (occipital area). For the former, the patient
was applied the topical treatment only
for one month. The folliculitis
keloidalis of the crown resolved completely after this period (see Figure 2a).
For management of the folliculitis keloidalis
nuchae, the patient was prescribed both intralesional and topical
treatments. The intralesional steroid
was given at the end of the first and second months of treatment to the
folliculitis keloidalis nuchae. The third month only topical treatment was
used. The resolution over the 3 month period is shown in Figure 2b.
Figure 2a. Before and after images
of Case 1. Male. Aged 35. Kingston, Jamaica
Figure 2b. Before and after images
of Case 1. Male. Aged 35. Kingston, Jamaica
32 years old, with past history of keloids on chest and shoulder from minor
After having developed keloid scars after her
first cesarean section, the patient requested post-op treatment for her second
cesarean section to prevent keloid recurrence.
At two weeks post-op care, the patient’s keloid already started to
develop, shown on the right. The topical treatment was then applied for two
weeks which resulted in 100% flattening.
Figure 3. Before and after images
of Case 2. Female. Aged 32 years. Kingston, Jamaica
67 years old, referred from a general practitioner with chronic itching and
spontaneous keloid formation on chest for the past nine years.
This patient developed multiple keloids on her
chest from scratching. The increased irritation caused loss of sleep and
general discomfort. After one month of receiving the novel topical treatment,
the patient was no longer uncomfortable and the keloids were flattened.
Figure 4. Before and after images
of Case 3. Female. Aged 67. Kingston, Jamaica
These three cases are illustrative of the very
positive treatment outcomes for keloids being achieved with medical treatment
(topical applications) in Dr. Yap’s clinical practice for the past seventeen
years. Unfortunately, when the patients are satisfied with the outcome, whether
due to the decrease in pain, itchiness and size they often do not return to the
clinic for the final picture. Further, more robust clinical studies are now
planned to systematically study and document patient outcomes and improvements
in patient experience.
However, from these documented case studies
and clinical experience, it is evident that self-applied therapeutics can minimize
healthcare burden by promoting self-treatment rather than intensive in-office
treatment. The ability to self-manage with topical preparations also encourages
early treatment to prevent future recurrence of keloids. They may therefore
form the basis for effective first-line therapy for the medical treatment of
Please open the pdf file below
Statement from the Medical Association of Jamaica (Oct 2017) on the HPV Vaccine
Dr. Clive Lai
Cervical cancer is the 7th commonest cancer in the world and the 4th commonest in Jamaica. Every year 528,000 (392 in Jamaica) new cases are diagnosed and there are approximately 270,000 deaths (185 in Jamaica). By 2050, without any intervention, cases diagnosed with cervical cancer will increase to one million per year with approximately 90% of the deaths being in developing countries. In Jamaica, cervical cancer is the second commonest cancer among our female population after breast cancer, and accounts for 63% of cancers of the female reproductive tract. The incidence is about 25/100,000 and accounts for 15% of all female cancer deaths.
The central cause of cervical cancer is the Human Papilloma Virus (HPV), which is found in 90% of all cases. The HPV is the most common Sexually Transmitted Disease (6 M new cases each year) and most men and women who have been or are sexually active have been exposed to HPV. More than 75% of sexually active women tested, have been exposed to HPV by age 18-22 and 15% show evidence of current infection
The human papillomavirus (HPV) infects the cells and transforms normal cells on the cervix to cancer. It is a slow process which can take a few years (10-15) to develop. Only women with persistent HPV (sub-types 16 & 18) are at risk for cervical cancer.
Research, studies and trials have been done over the years, resulting in the formulation of a safe vaccine, which has yielded good results in other countries. The vaccine is not new to Jamaica, as it is currently being used in some institutions and in private practice.
The Medical Association of Jamaica therefore supports the Ministry of Health in its drive to protect the country’s women from cervical cancer by making the bivalent HPV vaccine (for 16 & 18) available to the public sector. Jamaica has been a leader in the elimination of vaccine preventable diseases such as polio, measles and congenital rubella syndrome. With regards to cervical cancer, a vaccine preventable disease, the bivalent HPV vaccine, if administered to girls ages 9 to 14 years, will drastically reduce the risk of cervical cancer. However, this does not mean that as they get older that they should stop doing their regular screening tests like pap smears. The HPV vaccine is safe and the MAJ is encouraging parents to get their daughters vaccinated, as it will have a significant public health impact by decreasing the incidence of cervical cancer.
The MAJ fully endorses the implementation of this program and will continue to work with the Ministry of Health in ensuring its success. However, every effort must be made to continue to educate and inform the public so that they can make an informed decision about the vaccine.
The Medical Association of Jamaica views with concern the statements made by the Minister of Heath Dr. The Hon. Christopher Tufton and the President of the Nurses Association of Jamaica Mrs. Carmen Johnson on the Special Feature entitled “Prescriptive Rights” aired on the TVJ Prime Time News on Wednesday 4th July 2018.
The Minister stated that changes to the Nursing and Midwifery Act to allow prescriptive rights for Nurse Practitioners have been accepted. Accepted by whom? It was the Medical Council of Jamaica along with the Medical Association of Jamaica under the Medical Act, who approved the implementation of the Nurse Practitioner Program in the late 1970’s. This was done because there was an acute shortage of doctors at the time due to migration and there was a move towards Primary Health Care with the staffing of 345 Health centers. It was also agreed that this would be a temporary measure until more doctors were available and the policy was made very clear to the Nurses Association of Jamaica at the time, that prescriptive rights could never be given to nurses because they had not fulfilled the formal medical training to have competences necessary to practice as doctors. However, we would like to commend the nurse practitioners who filled the gap and thank them for working in collaboration and under supervision by a medical doctor. The Minister also alluded that the change will happen before we even know it, but the Medical Association of Jamaica will be vigilant and active to ensure that this does not happen.
Fast forward forty years later and our medical school is now graduating over 300 doctors annually, some of whom cannot get a job with Government after internship. In addition, technology has vastly improved over the years with smartphones, computers and internet services. This would make it easier for the nurse practitioners to contact the doctors and discuss a case with them. Prescriptions can now be countersigned online.
In this modern era, all doctors and nurses are required to continue ongoing training through continuing medical education or by attending conferences and workshops. The President of the Nurses Association of Jamaica stated that the Nurse Practitioners do not require further training to be given prescriptive rights, which is contrary to modern day medical practice. We are very concerned about this statement as it places the patient’s safety at risk. The time has come to reduce the number of Nurse Practitioners being trained and to focus more on training more Critical Care nurses.
Dr. Clive Lai
Protocols and Guidelines
1. MOH-Ebola Clinical Management Protocol
2. MOH-Ebola Epidemiological Surveillance Plan
3. MOH-Ebola Specimen Collection and Transportation for Laboratory Diagnosis Guidelines
4. MOH-Ebola Infection Prevention and Control Guidelines.
5. MOH-Ebola Guidelines For Transportation of Suspected and Confirmed Cases
The Medical Association of Jamaica has taken serious note of our Minister of Justice’s announcement of the
decriminalization of ganja in Jamaica as reported in the media June 12th 2014.
Any future use of medical ganja in Jamaica must be supported by scientific evidence that has been rigorously tested locally and internationally and not emotions.
Undoubtedly, additional investment in medical research is necessary. Jamaica could benefit from the potential profits to be earned both here and overseas from a well conceived and efficient industry. The development of prescription medications such as Canasol and Asmasol by Dr. Albert Lockhart and Professor Manley West demonstrates that this can successfully be accomplished in Jamaica under the existing laws and regulations.
As Physicians we have been confronted first hand with and seen the devastating effects of the misuse of Ganja. The adverse effects of marijuana, include, but are not limited to: addiction, psychiatric disorders, and disruption of neurological development (especially in adolescents). Negative impact on all aspects of memory is also closely associated with ganja use. The ability of cannabis to negatively impact reaction time and perception plays a major role in “drugged driving” often resulting in road traffic or workplace accidents
after cannabis use. We have already seen a significant number of road fatalities in Jamaica. Cannabis withdrawal symptoms can also result in violence. Jamaica already suffers from a high violent crime rate. Many of those who smoke it are at higher risk of developing lung problems including cancer than non-smokers.
Non-communicable diseases (hypertension, diabetes, cancer, psychosis etc.) already cost our health sector billions of dollars, approximately 30% of which is attributable to Neuro-psychiatric disorders such as depression and addiction. (WHO) The medical evidence against the social/recreational use of ganja; smoked or otherwise, is well established. Vulnerable groups like our teenagers and young person’s especially, are the most likely to pay with their health for the changes that are proposed.
Alcohol and tobacco use although legal, also cause terrible effects on the health of the user, which we are already struggling to manage. The popularity of decisions made in other jurisdictions on this topic must be carefully studied but not necessarily followed. Our public health sector is already overburdened and underfunded. The prevention of a public health problem should be the clear focus of the Government. While we are not qualified to comment on the legal arguments around this issue, the MAJ is eminently qualified to declare that the decriminalization of ganja for personal use will cause more mental and physical health problems for Jamaicans, especially our youth.
Medical ganja development and its potential use must be pursued in a responsible, regulated and well thought out manner. It is our hope that Cabinet will reconsider its position in line with health practice and science. The issue of human rights is secondary to the right to protect life.
Dr. Shane Alexis
The Medical Association of Jamaica (MAJ) strongly condemns acts of violence against any citizen. Today we are all deeply saddened that a bright young colleague of ours is battling for her life in hospital.
The doctor was viciously attacked by gunmen outside her home on Friday night (May 2nd 2014). As a member of a Profession that is dedicated to preserving and saving lives this attack has devastated many of our members.
We encourage anyone who may have information on the perpetrator(s) to share what they know with the Police so that justice may be served.
Jamaica must not continue to go down this violent path.
The MAJ wishes to thank ALL members of staff at the Cornwall Regional Hospital for their selfless hard work in attending to our friend and colleague.
Our prayers and support are with her and her family during this difficult time.
Dr Shane Alexis