For the upcoming fasting month, we are pleased to share some important advice from the good people at Alpro Pharmacy.
WILL THE USE OF INHALERS INVALIDATE YOUR FASTING?
There are 2 types of inhalers: ‘preventer’ inhalers and ‘reliever’ inhalers. If you are unsure which of your inhalers is which, check with your doctor.
While fasting, you should continue to use your preventer inhalers, typically twice a day—before sahur and before you go to bed. It’s best to check with your doctor how often and when you should use your preventer inhaler.
Use your reliever inhalers when you have an asthma attack.
WILL FASTING PUT YOU AT RISK OF DEHYDRATION OR LOW BLOOD GLUCOSE (HYPOGLYCAEMIA)?
If you have diabetes, check your blood glucose 2 hours after sahur and when you experience symptoms such as dizziness, cold sweat, blurred vision, and shivering. Checking your blood glucose won’t invalidate your fasting.
If your blood glucose level is below 3.9 mmol/L, you will need to break your fast for the sake of your health.
People with diabetes shouldn’t delay breaking their fast. Keep some dates with you if you have diabetes and you’re fasting. That way, when you’re still stuck in traffic or at work during iftar, you can break your fast with 1 or 2 dates.
Eat foods rich in dietary fibre for optimal blood glucose control during the fasting month. Dietary fibre helps keep you feel full longer and stabilize your blood glucose levels.
HOW TO FAST WHEN YOU HAVE GASTRIC PROBLEMS
If you have gastric problems, break your fast by eating moderate amounts of foods.
Avoid eating fried foods and gassy drinks in too much amounts or too quickly.
Also, it’s best to avoid drinks that are high in caffeine, such as coffee.
Most people with diabetes or those that have someone close to them that have this disease will know that the disease can harm many organs in the body—such as the eyes, nerves, kidneys, heart, and more.
DO YOU KNOW THAT DIABETES CAN AFFECT THE TEETH AND GUMS AS WELL?
People with diabetes are more likely to have:
Periodontal or gum disease
Persistent bad breath
Tooth decay or cavities
Oral fungal infections
Oral ulcers
Loss of teeth
Diabetes can cause increased levels of glucose in the blood as well as saliva
Progression of gum disease, from gingivitis to the more serious periodontitis. Click on the image to view a larger, clearer version.
The increase of glucose in the saliva encourages the growth of bacteria in the mouth and together with food particles can build soft sticky whitish layer called plaque.
Plaque is the yucky smelly stuff that you can scrape off from your teeth if you haven’t been cleaning them properly. It is the main cause of bad breath.
If left unchecked, the persistent plaque buildup can cause tooth decay and harden to form tartar.
Persistent plaque or tartar buildup causes irritation to the gums
The gums can become red and swollen, and bleeding may occur.
This is the first warning sign that it’s time to visit the dentist.
Comparison of normal tooth and a tooth with periodontitis. Click on the image for a larger, clearer version.
Otherwise, the infection will go deeper under the gums, causing infection of the bone structure supporting the teeth. This is periodontitis, the second stage of gum disease.
The gums will start to recede, trying to pull away from the tartar formed. Over time the teeth will become unstable, and one may experience pain as a result.
At the final stage of gum disease, the teeth will become so infected and painful that it may need to be removed
In poorly controlled diabetic cases, the gum disease may progress much faster. The severity of the condition may be worse, which is why it is important to visit the dentist early to resolve the issues.
Diabetes and certain drugs can reduce the production of saliva in our mouth
Our saliva contains minerals to protect our teeth from tooth decay, mucin to keep the teeth moist and slippery, antibacterial substances to eliminate potentially harmful bacteria, and it also has the ability to neutralize the acids produced by bacteria in our mouth.
Without the presence of saliva, there is a higher risk of tooth decay and gum disease.
Dry mouth can increase the risk of developing fungal infections called thrush, which are painful white patches in the mouth.
In denture wearers, the dryness can decrease the suction effect of the denture and increase abrasion against the gums, leading to ulcers and mouth sores.
Smoking will worsen the condition further.
In severe uncontrolled diabetic cases, some people can develop burning mouth syndrome—a continuous burning sensation in the mouth that will alter taste and sensation.
HOW THE DENTIST CAN HELP YOU
Gingivitis or periodontitis
The dentist will need to carry out deep cleaning of the teeth and gums, in order to decrease the bacterial load and to allow the gums to heal.
However, the dentist can only do so much—you have to also keep good oral hygiene and use of mouthwash daily.
Fungal infections
Your dentist may prescribe some medications to kill the fungus responsible for the infection.
If you use dentures, they will be checked to ensure that they are still fitting properly. You must keep them clean in a disinfection solution at night.
Dry mouth
For most non-severe cases, the simplest solution is to keep your body well hydrated at all times. Drinking water regularly also moistens the mouth.
Only in severe cases are saliva substitutes prescribed.
Burning mouth syndrome is usually more complicated and will require specialist attention.
HELPFUL TIPS
A well controlled blood glucose level as well as a healthy diet and lifestyle are key to reducing and preventing oral health problems. Keeping your mouth healthy will also prevent diabetes-related health problems such as heart disease and kidney disease.
Good oral hygiene will keep your gums and teeth healthy. Brushing twice a day every day, and use a floss or water floss daily.
Visit your dentist regularly for a routine checkup. Please make sure you tell your dentist if you have diabetes. Keep your dentist updated about any changes to your health and blood sugar levels.
For denture wearers, make sure your dentures fit properly, and clean them by soaking them in denture disinfectant at night.
Quit smoking. Smoking will worsen gum condition and overall health.
IMMUNOTHERAPY IS A NEWER APPROACH TO TREAT CANCER, BUT WHAT EXACTLY IS IT?
According to Dr Hafizah Zaharah, immunotherapy is a pretty unique way to treat cancer, in that it uses the body’s own immune system to attack cancer cells.
“The immune system is like the police force of our bodies,” she says. “It is designed to protect the body against infections, illnesses, and diseases.”
The cells that make up our immune system. Click on the image for a larger, clearer version.
When it comes to faulty or mutated cells in our body, the immune system identifies and eliminates these cells before these cells become a significant threat to our healty.
However, the cells of our immune system may not be strong enough to kill cancer cells, according to Dr Hafizah. Sometimes, the cancer cells are able to fool our immune system by resembling normal cells or hiding themselves.
THIS IS WHERE IMMUNOTHERAPY COMES INTO THE PICTURE
“Immunotherapy can boost or change how the immune system works, so it can recognize and kill cancer cells,” explains Dr Hafizah.
For example, cancer cells originate from normal cells, so the immune system may still mistake them for normal cells.
“These cancer cells can push a ‘brake’ button on the immune cells, so the immune system would not attack them,” Dr Hafizah adds.
Now, a type of immunotherapy called checkpoint inhibitors can take the ‘brakes’ off the immune system, allowing it to now recognize and attack the cancer cells!
There are other types of immunotherapy, of course, and these treatments can be used for various cancers.
CANCERS THAT CAN RESPOND TO IMMUNOTHERAPY
Non-small cell lung cancer
Triple negative breast cancer
Head and neck cancer
Cervical cancer
Gastric cancer
Oesophageal cancer
Bladder cancer
Melanoma
Liver cancer
Renal cell carcinoma
Endometrial cancer
Colon cancer
WHAT IS IMMUNOTHERAPY LIKE?
According to Dr Hafizah, various immunotherapy agents are given as an infusion into a vein (a drip) typically once every few weeks.
These immunotherapy agents can be given to the patient all by itself, or in combination with targeted therapy or chemotherapy.
“For advanced stage cancer, immunotherapy treatment generally is given for 2 years, alongside close monitoring,” Dr Hafizah further says.
IS IT EFFECTIVE, THOUGH?
Although immunotherapy seems like the answer every person with cancer is looking for, Dr Hafizah warns that not all types of cancers will respond well to the treatment.
This is why, before embarking on immunotherapy, one will first undergo a specific biomarker test, such as the PD-L1 test, which will be carried out on a cancer specimen to ensure that the person will respond to the treatment.
ARE THERE ANY SIDE EFFECTS TO BE CONCERNED ABOUT?
“Generally, the treatment is well tolerated,” Dr Hafizah assures us.
However, just like with most types of treatments, side effects are possible. These include:
Feeling tired, skin rash, or muscle or joint pain
Rare side effects include allergic reactions such as dizziness, fast heart rate, face swelling, or breathing problems
Autoimmune reactions, which can lead to serious problems in the lungs, intestines, liver, hormone-making glands, kidneys, skin, etc
The World Health Organization reveals that about 10,000,000—that’s ten million—new cases of dementia are diagnosed every year.
In Malaysia, the Alzheimer’s Disease Foundation shares that 204,000 to 264,000 adults were diagnosed with dementia in 2020, and they expect the numbers to rise to between 637,500 and 825,000 by 2050.
DEMENTIA IS ACTUALLY A GENERAL TERM THAT COVERS CONDITIONS IN WHICH ONE EXPERIENCES SIGNIFICANT DECLINE IN COGNITIVE FUNCTION
Consultant geriatrician Dr Teh Hoon Lang explains that the decline should be significant enough to affect one’s thinking, memory, and social skills until it impedes their ability to carry out their usual day-to-day routines.
DEMENTIA IS A TERM THAT INCLUDE A NUMBER OF CONDITIONS INCLUDING
Alzheimer’s disease, the most common one
Frontotemporal dementia, a rare form that usually develops in people younger than 60
Lewy body dementia
Vascular dementia, caused by blood vessel damage that interrupts blood and oxygen flow to the brain
Mixed dementia, a combination of two or more types of dementia
THERE ARE MANY FACTORS THAT CAN INCREASE ONE’S RISK OF DEMENTIA
“These factors can be divided into modifiable and non-modifiable risk factors,” Dr Teh says.
Non-modifiable risk factors—things that we can’t change—include:
Advancing age
Being female
Certain types of dementia can be passed down from parent to child; however Dr Teh assures us that having a gene for one of these types of dementia is not a surefire guarantee that the person will develop that type of dementia
Meanwhile, modifiable risk factors include:
Diabetes mellitus
High blood pressure or hypertension
Obesity
Excessive alcohol consumption
Smoking
Depression
Traumatic brain injury
Sedentary lifestyle
Social isolation
Mid-life hearing impairment
Air pollution
“The more risk factors a person has, the higher their chances of getting dementia,” Dr Teh says.
TEN EARLY WARNINGS OF DEMENTIA TO WATCH OUT FOR
Memory loss
Difficulty performing familiar tasks
Problems with language
Disorientation to time and place
Poor or decreased judgement
Problems keeping track of things
Misplacing things
Changes in mood and behaviour
Challenges understanding visual and spatial information
Withdrawal from work or social activities
WHERE TO SEEK HELP IF YOU BELIEVE THAT YOUR LOVED ONE MAY HAVE DEMENTIA
It is fine to consult a general practitioner or GP, who can refer your loved one to a specialist if necessary.
A geriatrician is a specialist that can help with dementia in older persons, and other types of specialists such as neuropsychologists and psychiatrists may also step in to help.
DEMENTIA CAN’T BE CURED, BUT IT CAN BE SLOWED DOWN
Dr Teh shares that there is no cure for dementia at the moment.
However, she assures us that there are many measures or strategies to slow down the progress of the disease and provide both the affected person and their caregivers a better quality of life.
“The most important part of dementia care is to get diagnosed early and get professional advice on the management plan,” says Dr Teh. “Every person with dementia is unique and the approach should be individualized. The basic principles of care include understanding the disease pattern and the struggles or difficulty they are facing, providing a supportive environment, maximizing their strength and minimizing their loss due to cognitive decline.”
GOOD NEWS FOR MALAYSIANS THAT REQUIRE FINANCIAL ASSISTANCE TO UNDERGO KIDNEY TRANSPLANT
The National Kidney Foundation (NKF) of Malaysia has launched its Kidney Transplant Subsidy.
This subsidy aims to help underprivileged patients and organ donors with their financial burden of kidney transplantation.
The subsidy will cover various costs from pre- to post-kidney transplantation, including income loss replacement for the workup and recuperating period.
“The subsidy accounts for the many costs that are prevalent in the process of transplantation, which can discourage organ donors and patients from following through especially for those that are underprivileged. With over 8,000 Malaysians being diagnosed with kidney disease annually, it’s imperative that we help facilitate transplantation to the best of our ability,” says Khor Xin Yun, the Chief Executive Officer of NKF Malaysia.
WHAT THE KIDNEY TRANSPLANT SUBSIDY COVERS
BEFORE THE KIDNEY TRANSPLANT
Blood tests
Traveling expenses for out-of-town patients
Lodging expenses for out-of-town patients
Income loss replacement during organ donor’s workup
Other pre-kidney transplant workups, should services/facilities are not available at government hospitals and are needed in private settings
Other areas, where the need for kidney transplant screening is not available in government hospitals or being referred by government hospitals to private medical centres
DURING THE KIDNEY TRANSPLANT
Traveling expenses
Lodging expenses for the patient, organ donor, and carer
Subsistence for the poor, from pre to post-kidney transplant, as needed
Income loss for the organ donor during the recuperating stage
AFTER THE KIDNEY TRANSPLANT
Traveling expenses for follow-up
Lodging
Subsistence
Income loss
HOW TO APPLY FOR THE KIDNEY TRANSPLANT SUBSIDY
Government or university hospitals
To apply for the kidney transplant subsidy, the consultant nephrologist from a government hospital refers and recommends a patient along with a detailed medical summary and a list of items required for the subsidy.
If a government or university hospital does not have the capacity to tend to the patient
The nephrologist can refer the patient to a private hospital for pre-transplant screening and workups under the subsidy. However, the subsidy does not include the cost of surgical fees, as government hospitals have the capacity to perform kidney transplant surgery and provide immunosuppression therapy.
For more information about the NKF Kidney Transplant Subsidy, visit their website (link opens in a new tab) call 03-7954 9048 ext 208.
Continuous glucose monitoring (often abbreviated as CGM) is basically a system that allows one’s blood glucose levels to be monitored automatically.
HELPS TO IMPROVE YOUR DIABETES MANAGEMENT
This system opens up a world of opportunities for better blood glucose management for people with type 1 diabetes as well as those on type 2 diabetes that require insulin.
After all, with information of their blood glucose levels that can be obtained immediately, they can make quick informed decisions about their food choices and the dosage of their insulin as well as when to administer it.
LETS YOU ANTICIPATE A POTENTIAL INCOMING MEDICAL EMERGENCY
The ability to observe the pattern of the rise and fall of their blood glucose also allows them to be alert of the possibility of a hypo- or hyperglycaemic episode, and take prompt measures accordingly.
NOT JUST FOR PEOPLE WITH DIABETES
Additionally, continuous glucose monitoring can also benefit people with kidney problems as well as pregnant women worried about gestational diabetes.
RECOMMENDED BY EXPERTS
It’s really not surprising, therefore, that the 23rd Hong Kong Diabetes and Cardiovascular Risk Factors—East Meets West Symposium reported a growing consensus on the definitions and targets of continuous glucose monitoring metrics to allow healthcare professionals and people with diabetes to make full use of this system in diabetes management.
Indeed, the United Kingdom has already taken steps to do this.
All in all, this is a remarkable example of how technology is making diabetes management, which can be complex and confusing to some people, considerably easier to figure out and implement correctly!
Continuous glucose monitoring is a feature in certain types of blood glucose monitor or glucometer. You can talk to your doctor or your pharmacist for more information on continuous glucose monitoring and whether you can benefit from using a glucometer that comes with this feature.
Reference: Oliver, N., Chow, E., Luk, A. O. Y., & Murphy, H. (2023). Applications of continuous glucose monitoring across settings and populations: report from the 23rd Hong Kong Diabetes and Cardiovascular Risk Factors – East Meets West Symposium. Diabetic medicine : a journal of the British Diabetic Association, e15038. Advance online publication. https://doi.org/10.1111/dme.15038
Rabbits are pack animals that have many predators, so they are conditioned to always be alert and wary. Therefore, when you adopt a pet rabbit, it may take a while for the rabbit to become familiar with its new home and to feel safe.
Wild rabbits live in warrens—underground homes interconnected by tunnels. Therefore, even tame rabbits have this urge to dig with their paws. Therefore, line your rabbit’s new home with something that it can dig on.
Rabbits answer the call of nature in the same spot as much as possible, so minimize the risk of predators tracking them down. Therefore, tame rabbits can be trained to do their business in the same place every day.
A rabbit’s tooth never stops growing throughout its life, and a wild rabbit keeps its teeth to manageable length by chewing down on rough parts of plants. Therefore, give your pet rabbit things that it can always chew on, so that its teeth won’t become overgrown.
A rabbit tells you that it is not happy with you by thumping its rear feet. It may also bite, although fortunately rabbits are usually not aggressive to humans.
YOUR RABBIT’S IDEAL HOME
Keep your rabbit in a well-ventilated cage—such cages are sold in pet shops. Avoid putting rabbits in closed “houses” or glass cases, as these often lack ventilation.
Rabbits may develop sore hocks, with its feet becoming raw and inflamed, when they spend too much time on wire flooring, so make sure that the wire flooring has a mesh size that is as small as possible (1 x 2.5 cm should be good).
Have a solid and smooth area for the rabbit to rest on, such a wood or Plexiglas surface, so that it can take a break from moving around on the wire flooring.
Grass hay makes good bedding for the rabbit, as it is comfy and also provides a nice snack for a hungry rabbit!
HEALTHY RABBIT MUNCHIES
A rabbit needs plenty of dietary fibre to keep its digestive system healthy. Unfortunately, most commercial-available pelleted diets sold in stores do not provide enough fibre for the needs of an older, non-breeding, and physically inactive house rabbit.
Usually, such rabbits will need to their pellets supplemented with grass hay, leafy green vegetables, and a small amount of treat foods (rolled oats, stale bread, fruits, etc). Therefore, discuss with a veterinarian (that’s an animal doctor) on how to best meet your rabbit family member’s nutritional needs.
Make sure that your rabbit always has clean and fresh water to drink. If you have an inverted sipper bottle for your rabbit, check often to make sure that the drinking or ‘straw’ part of the bottle is not blocked.
TRIPS TO THE VET
Ideally, have the vet examine your rabbit once a year to check for lice, parasites, and tooth problems as well as signs of diseases.
Pet rabbits can be neutered when they are 3 or 4 months old to keep them from being aggressive.
IF YOU NEED TO LIFT & CARRY THE RABBIT AROUND IN YOUR ARMS
Grasp your rabbit family member gently by the scruff of its neck to keep it docile.
Cup its hindquarters with your other hand to keep it from kicking you with its rear legs.
Then gently pick the rabbit up, keeping it in a vertical position.
Alternatively, once you have grasp the rabbit’s scruff gently, you can place its head under your other arm (be gentle, don’t squeeze!) and use that arm to support its hindquarters.
On January 17, 2023, Malaysian Osteoporosis Society (MOS), the Academy of Medicine Malaysia, and our Ministry of Health launched their jointly-published 3rd Clinical Practice Guidelines (CPG) for the Management of Osteoporosis.
In the media briefing held in conjunction with this launch, our Director General of Health Tan Sri Dato’ Seri Dr Noor Hisham Abdullah shares that:
Malaysians are now growing older and living longer. As a result of this, many of us will be affected by age-related non-communicable diseases, which includes osteoporosis.
Osteoporosis results in bone fractures, which are associated with disability and premature death.
An illustration of osteoporosis. Click on the image for a larger, clearer version.
WHY IS OSTEOPOROSIS SUCH A CONCERN?
A 2020 study revealed that all people with hip fractures, upon treatment and discharge from the hospital, need walking aids.
6 months later, only 24% (that’s about 1 out of 4 people) regain their mobility and their ability to live independently.
Another 26% die within one year after the fracture.
Tan Sri Dato’ Seri Dr Noor Hisham Abdullah voices his concern that osteoporosis is a serious disease that requires early detection, intervention, and management even at later stages.
This is especially relevant, as the incidence of hip fractures is projected to rise from 5,880 in 2018 to 20,893 in 2050, a 3.6-fold increase!
THE KEYSTONES TO IMPROVING THE AWARENESS OF & TREATMENT OUTCOME OF OSTEOPOROSIS
Dr Yeap Swan Sim, the current President of the Malaysian Osteoporosis Society, states that the cornerstone principles in ensuring that Malaysians can age healthily and gracefully while minimizing the threat of osteoporosis are:
Understanding the disease
Taking preventive measures
Good management of osteoporosis
Knowing the appropriate surgical options, should these options become necessary
FRACTURES & OSTEOPOROSIS ARE NOT “NATURAL” AGEING PROCESS, SO TAKE THEM SERIOUSLY!
Dr Terence Ong Ing Wei points out that osteoporosis usually happens in older people and is almost as common as diabetes. “Diabetes evokes fear and concern, yet most people wouldn’t give osteoporosis a second though,” he muses.
Many people often assume that bones weaken and falls and fractures become more common because all these are a ‘natural’ part of ageing.
Dr Terence disagrees, stating that there is nothing natural about osteoporisis.
In fact, it is actually a very complex condition influenced by many factors. “Some things that we do not think too much about in our everyday lives have a huge impact on our bone health. These include physical inactivity, fad diets, cigarette smoking, and age-related hormonal changes such as oestrogen in ageing women and testosterone in men. All these increase the rate of bone loss at a time when strong bones are most needed.”
DIAGNOSIS AT LATE STAGE OSTEOPOROSIS FORCES DOCTORS TO RULE OUT IDEAL TREATMENT OPTIONS
Dr Yeap says, “We usually only see osteoporosis at its late stages—after a fracture has occurred. By then, the patient would have incurred significant amounts of bone loss. At that stage, it is no longer possible to offer treatments to replace the lost bone, which is the ideal scenario. Instead, treatment options will instead attempt to minimize the detrimental effects of a fracture experienced by the patient.”
“Clearly, we should be giving more emphasis to screening and early detection, followed by suitable interventions so that we can protect the most vulnerable persons from this terrible illness,” she adds.
EARLY DETECTION CAN ALLOW FOR EARLY PREVENTIVE MEASURES
Professor Emerita Chan Siew Pheng concurs with the other experts. “This is because mainly because you don’t even realise osteoporosis is there until you suffer from a fracture. So, the only way to know if you have osteoporosis before a fracture occurs, is by going for a bone density scan, also called dual-energy x-ray absorptiometry, DEXA or DXA.”
More about bone density scan Prof Chan explains that the bone density scan is a quick and painless X-ray procedure that allows doctors to find out whether osteoporosis is present.
It also allows doctors to predict the risk of future fractures in order to provide timely and suitable treatment. “This would save you so much trouble in the future!” she says.
According to Prof Chan, women aged 65 years or older and men 70 years or older should have a DXA scan done every two years.
Younger individuals may also need to be screened if they have certain conditions such as diabetes, thyroid disorders, nutritional malabsorption, eating disorders, rheumatoid arthritis, or are taking certain medications (like steroids) long term.
If you fall into any of these categories, you should consult your doctor for more information as to how you can benefit from a DXA scan.
With the right steps at the right time, osteoporosis can be effectively managed
Prof Chan explains: “There are effective medicines that can be tailored to suit all sorts of patients based on their disease stage and lifestyle. Moreover, whenever pharmacological treatment is necessary, the medications that are available in Malaysia can reduce the risk of fractures from 15% up to 70%!”
She adds that these anti-osteoporosis medicines are generally well-tolerated and effective.
THIRD-EDITION CLINICAL PRACTICE GUIDELINES LAUNCHED TO IMPROVE SCREENING, DIAGNOSIS, & TREATMENT OF OSTEOPOROSIS
Dr Yeap Swan Sim shares that this clinical practice guidelines, meant for healthcare professionals in Malaysia, consists of evidence-based statements intended to assist healthcare providers in optimizing patient care.
“We must first recognize the fact that osteoporosis is a multi-factorial condition,” she says. “Nutrition, age, hormone, lifestyle and the presence of pre-existing disease are some of the aspects that can affect bone health. All these requires not only input from one profession but multiple of them in order to provide patients with proper and effective care.”
She adds: “As such, the clinical practice guidelines had to be written by a panel of experts from all the related disciplines, such as nutrition, geriatrics, endocrinology, orthopaedic surgery, obstetrics and gynaecology, rheumatology, primary care and pharmacy. The wide variety of expertise involved in the writing of the clinical practice guidelines ensures extensive coverage so that the guidelines will be able to inform all types of healthcare professionals who would be involved in the screening, diagnosing and treatment of osteoporosis.”
The 3rd Clinical Practice Guidelines (CPG) for the Management of Osteoporosis was the fruit of the labour of the CPG Working Group comprising:
Dr Yeap Swan Sim (Chairperson)
Dr Terence Ong Ing Wei (Co-chairperson)
Associate Professor Dr Lim Lee Ling (Co-chairperson)
Professor Emerita Dr Chan Siew Pheng
Professor Datuk Dr Sabarul A Mokhtar
Interested healthcare professionals can download the 3rd Clinical Practice Guidelines (CPG) for the Management of Osteoporosis by clicking here. This link will open in a new tab.
DR CHAN YANJUN
Medical Director, Singapore & Malaysia
International SOS
“With forecasts indicating that our rainy season is far from over, Malaysians need to be prepared in case of floods,” advises Dr Chan Yanjun. “While there are many different actions people should undertake in a flood situation, the most important rule is do not try to walk, swim or drive through flood water. Cars and people can be swept away, so always remember safety first and to stay alert so you don’t get hurt.”
WHAT YOU SHOULD DO TO SAFEGUARD YOURSELF & YOUR LOVED ONES IN CASE OF A FLOOD
Identify flood or landslide-prone areas near you. Watch weather alerts and warnings.
Stock up enough water (ration roughly 4 litres per person per day) and dry food for 3 days.
Know your community’s evacuation routes and emergency shelter locations.
If you are stranded, injured or ill, contact your local emergency services department and wait for help.
IF A FLOOD HITS YOUR HOME, REMEMBER THESE POINTERS
Check the drainage system behind or outside your house to see the water levels. The higher the water level climbs, the more likely you will have to evacuate.
Switch off all gas, electricity, and water when electricity supply is down, water has entered your home, or before you evacuate. Make sure to unplug appliances to avoid electrical shock when power returns.
Move to higher ground. Only move to the roof if necessary.
If your family is advised to evacuate, do so immediately (lock gates and doors before leaving if possible).
WHEN YOU ARE ON THE ROAD DURING A FLOOD
Stay off bridges as they can be washed away in severe floods.
Stay inside your vehicle if you are trapped by rapidly moving water.
Move to the roof of your car if water starts to fill the interior.
WHAT TO DO AFTER THE FLOOD
Do not return home unless advised to do so. Wait for a signal by authorities or emergency services on the status of your housing area.
Look out for animals that may be inside your house. This includes snakes, lizards and even crocodiles.
Keep children and pets out of the affected area until clean-up has been completed.
Wear rubber boots, rubber gloves, and goggles during clean-up of affected area.
Remove and discard items that cannot be washed and disinfected (such as, mattresses, carpeting, carpet padding, rugs, upholstered furniture, cosmetics, stuffed animals, baby toys, pillows, foam-rubber items, books, wall coverings, and most paper products).
Remove and discard drywall and insulation that has been contaminated with sewage or flood waters.
Thoroughly clean all hard surfaces (such as flooring, concrete, moulding, wood and metal furniture, countertops, appliances, sinks, and other plumbing fixtures) with hot water and laundry or dish detergent.
Help the drying process by using fans, air conditioning units, and dehumidifiers.
Have your onsite waste-water system professionally inspected and serviced if you suspect damage.
After completing the clean-up, wash your hands with soap and clean water.
Wash all clothes worn during the clean-up in hot water and detergent. These clothes should be washed separately from uncontaminated clothes and linens.
Seek immediate medical attention if you become injured or ill.
DATUK DR CHRISTOPHER LEE
Consultant Infectious Diseases Physician
Member of the Malaysian Influenza Working Group
FLU FACTS THAT ARE NOTHING TO SNEEZE AT
On board the plane, you have an 80% chance of getting the flu if there is an infected person–who may or may not have symptoms–sitting one row in front or behind you, within 2 seats to either side.
Flu viruses can survive for up to 48 hours on certain surfaces, including your overhead compartment handle, seat-belt buckle, video screen, food tray, arm-rest, and control panel.
You can try disinfecting the items mentioned in the above point, but it would be impractical to disinfect everything you will touch when you land, such as your luggage bag, trolley, the toilet flush, car door handle and so on.
TRAVELING SOON? HERE ARE 2 SIMPLE TIPS
Tip 1: Follow the COVID-19 SOPs when possible
Masking, although no longer promoted in most countries, may help reduce the chances of catching the flu.
However, it is less effective when those around you are not masked. This is where the next tip comes in.
Tip 2: Get the flu shot
The additional protection conferred by the annual flu vaccination is therefore recommended to prevent the disease.
When injected, the vaccine introduces inactivated flu viruses into the body. These have been killed and are unable to cause disease.
Instead, they stimulate your body to produce antibodies that will spring to your defense if you happen to be exposed to the flu.
Allow 2 weeks to reach the desired level of immunity before flying off.
MORE ABOUT THE FLU VACCINE
It gives you a better shot at beating the flu and reducing your risks of heart problems
Flu vaccination helps prevent severe flu-related infection, hospitalization, and death . It is also associated with a 34% lower risk of major adverse cardiovascular events . There was also an 18% reduced risk of death reported in patients with heart failure .
In people with type 2 diabetes, flu vaccination has been associated with a reduced risk of heart failure by 22%, stroke by 30%, heart attack by 19% and pneumonia by 15% .
With the COVID-19, flu, & RSV triple threat in the northern hemisphere, the flu shot is a good bet
Noting that flu viruses mutate constantly, Datuk Dr Christopher Lee explains that currently available flu vaccines have been updated to effectively fight virus sub-types that are circulating in the northern hemisphere at this time.
“This will help reduce your risk of contracting the disease. The flu vaccination is recommended for those travelling abroad, especially high-risk groups as the importation of flu cases through air travel can result in the spread of flu within the community,” he adds. “So, if you have not been vaccinated against the flu, now is a good time to get it done. The annual flu vaccination is your passport to healthy holidays. Don’t leave home without it.”
This article was contributed by the Flu Prevention is An Act of Love campaign under Immunise4Life, a major initiative to promote life course vaccination by the Ministry of Health, Malaysian Paediatric Association, and the Malaysian Society of Infectious Diseases & Chemotherapy. Learn more at actoflove.ifl.my (link opens in a new tab).
