Nala Talk

For young professionals, consuming coffee in the morning and fast food for lunch, and perhaps other unhealthy snacks to prevent drowsiness is a normal daily diet. Not infrequently, lunch was missed because of the limited time squeezed by various meetings. Not to mention that the office environment and exposure to other people cause young professionals to get sick more often, and sometimes hinder recovery.

Back with Emilia Achmadi, Clinical Dietitian, Disease Prevention Management, and Sports Nutritionist, in this episode of NalaTalk, we will discuss the importance of vitamins and minerals for young professionals!

As we herald the New Year 2022, dr. Esther sat down with dr. Catherine Tjahjadi from Triha Clinic in Jakarta. As a practitioner of Functional Medicine, dr. Catherine emphasized the importance of approaching health, not only through pharmacological intervention methods but also through nutrition and lifestyle modification. She explained how each of our needs vary depending on our lifestyle and genetics, thus it is important for us to really understand ourselves. She also shared a brief explanation of the different technologies and services available for us to do so.

In this Christmas episode, we spoke to Ms. Emilia Achmadi, a nutritionist from Oklahoma State University, about optimizing our diet based on our genetics. She shared a lot about how different people have varying nutritional needs. Not only that, she also emphasized the importance of assessment, including the nutrigenetics test, to provide a more accurate personalized plan and help people understand themselves better. Ms. Emilia expressed her optimism on the future of a genetics-guided nutrition plan.

We dove deeper into the topic of nutrition this week where we invited our Nala NutriReady™ Product Manager, Astrid Karunia, back as our guest speaker. In this episode, we explored the differences between pharmacogenomics and nutrigenomics, from how drug molecules interact differently from micronutrients, e.g. vitamin and mineral to how applications of nutrigenetics in our daily life. Tune in to find out more about this relatively new field and how you can utilize it for better health!

With clinical genetics still being a nascent field today, a lot of effort needs to be made by many healthcare practitioners to update their knowledge of the field. In this episode, Fadhli and Esther revisited some fundamental concepts in genetics, particularly its relation to drug action in the body. Basic terms such as pharmacogenetics, pharmacokinetics and pharmacodynamics were explained in this episode and we also touched briefly about nutrigenetics and its recent development.

Diving deeper into relevant illnesses during the festivities, Fadhli and Esther sat down to discuss gout or hyperuricemia. The condition once dubbed as the "rich man's disease" turned out to have quite a bit of genetic implication, both on the pathophysiology and even on the pharmacogenomics of it. We focused on the important mainstay drug for gout, Allopurinol, and the presence of certain genetic variation that increases the likelihood of Stevens-Johnson Syndrome. The episode also spoke about how this condition is markedly higher in certain populations, including Asians.

With incoming big feasts and hampers as we ushered in the holiday season, Esther and Fadhli are back to having conservations around cholesterol and its impact on our health when it's in excess.

Statins are widely prescribed by doctors to control cholesterol levels within acceptable limits and reduce the risk of cardiovascular disease. While effective, statins can also cause side effects in some people and we learned how genetic variation in one of the transporter proteins can increase one's risk even further.

Aside from genetic factors, we also discussed other aspects that are usually considered in deciding which statin therapy would be most suitable.

Continuing on our discussion about mental health, this week we interviewed Kathleen, Nalagenetics' Clinical Research Associate, about her research effort about the pharmacogenetics effect of Schizophrenia medicine. We talked about this ongoing research in collaboration with Rumah Sakit Cipto Mangunkusumo and other public hospitals in Jakarta. Kathleen also shared her discovery about how Asian patients respond to medicine differently from the Western counterpart and how genetic testing could glean useful insights to improve decision making.

Taking care of mental health is so important! With increasing awareness revolving around mental well-being, we decided to discuss the different aspects of psychiatry, and of course its link with genetics. In this episode, Fadhli and Esther sat down and explored in particular the major depressive disorder, elaborating from diagnosis, management, all the way to prevalence and awareness. We also chat briefly about the unique perception of mental health in Asian society and how we can try to break the stigma.

Back with another episode where we talk about common use cases in the community. This week, Esther and Fadhli discussed managing stomach pain caused by gastroesophageal reflux disease known as GERD. Some people take medications to relieve the symptoms of GERD and proton pump inhibitor (PPI) is usually the first line of pharmacological treatment. PPI is effective in relieving GERD however in some people with genetic variations, the treatment can be ineffective. Tune in as we dove deeper into how our body metabolizes PPI and how pharmacogenomics tests can help us get the best from our medications.

We took this opportunity to discuss a few cases of period pain which impact the majority of women in their lifetime. Non-steroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for period pain and are effective. However, a proportion of women do not get much relief from them and in this episode, Esther and Fadhli explored why this might be the case. We dove into the genetic variations that exist in the metabolism of NSAIDs and how they can be analyzed through a pharmacogenomic test.

In this episode, we spoke to Pak Johanes who benefited from taking genetic tests. Inspired by the idea of precision medicine he shared what made him interested in taking the tests and the variety of genetic tests that are available. He gained new insights about his health and how it can be implemented in his life. Pak Johanes talked about his excitement about the growing precision medicine scene in Indonesia.

We sat down with the founder of Arcadia Clinic Jakarta, dr Alita, to chat about her experience with clinical genetics testing as well as her journey as a young doctor in Papua that started her interest in the field of personalized medicine.

dr Alita shared her philosophy in patient care, how she empowers her patients to be more confident in managing their own health, and how pharmacogenomics is used as a tool for this. She also explained the pros and cons of utilizing these tests in daily practice.

Baitha Palanggatan Maggadani, M.Farm., Apt. is an experienced pharmaceutical and bioanalysis lecturer in Universitas Indonesia, that is currently conducting research together with Dr. Samuel Haryono, MRCCC, and Nalagenetics on pharmacogenomics.

In this episode, we dove deeply into the perspective of clinical pharmacogenomics implementation from the lens of a pharmacist and academician in Indonesia. Ms. Baitha expressed her hopes for genetics testing in Indonesia as well as elaborated the main challenges for its implementation.

We are honored to be joined by Dr. dr. Samuel J. Haryono, Sp.B (K)Onk, a highly renowned surgical oncologist at Dharmais Cancer Hospital and Siloam MRCCC Hospital. He demonstrated his interest and excitement in implementing pharmacogenomic tests in breast cancer research and kindly shared new insights from his research in tamoxifen.

Dr. Samuel also elaborated his vision and hope that the research can be translated into wider clinical practice in optimizing breast cancer treatment.

This sixth installment of NalaTalks introduces Nalagenetics' highly experienced clinical research associate and medical doctor, dr Amelia Margareta where she talks about the exciting new and ongoing pharmacogenomics research projects in Indonesia. She discussed the research partnerships, especially in the field of psychiatry and oncology, that she is working on. Dr Amel also explained the process of how the research partnerships are initiated and what are the common roadblocks faced during these processes.

We invited our product data scientist, Yash, to our fifth episode of this series. He spearheaded the Covid Likelihood Meter initiative (www.covidmeter.id) for healthcare workers in inaccessible areas, in collaboration with Center for Indonesia's Strategic Development Initiatives (CISDI). Believing in machine learning and artificial intelligence's value in healthcare, he elaborated further on their potential in other disciplines of healthcare.

The fourth episode brought Pingasari Tandrawijaya, Nalagenetics' mobile app product manager, to explain the importance of patient engagement in advancing clinical genetics in Indonesia. Ping introduced the Nala Personal Health Manager app with the idea of increasing the accessibility of clinical genetics and personalized healthcare for everyone in Indonesia. She also emphasized the importance of data privacy and security in this growing field, especially in a world where data breaches have been increasing at an alarming rate.

In this third episode, dr Esther Widjaja sat down with the product manager of Nalagenetics, Astrid Karunia to discuss the rigors of developing a trustworthy clinical database.  Astrid K shared the thought process behind building a knowledge base as well as how does one goes about collecting genetic information from scientific publications and clinical guidelines. She also explained the rationale behind how she chose which gene to include in the report and how to determine the level of evidence that is sufficient for clinical use.

For the second installment of this series, Fadhli Adesta discussed with Dr Astrid Irwanto, geneticist-turned-entrepreneur and Co-Founder of Nalagenetics to discuss the highs and lows of bringing genetics from bench to bedside.  Dr Astrid shared her personal story on how Nalagenetics developed from a research project in Papua to being the clinical genetics provider of choice for pharmacogenetics for some leading hospitals in Indonesia and Singapore. She also shares some insights on current development in genetics research as well as some advice for aspiring entrepreneurs in deep tech and medical tech.