The Amalgam Dilemma

The Amalgam Dilemma

May 8, 2022   Return

Dr Andrew Chan Kieng Hock

Consultant Oral Surgeon Private Dental Practice Klang, Selangor.

The debate over the safety of amalgam fillings has been going on for decades and has caused much confusion and anxiety among consumers. The presence of mercury in amalgam has often been blamed for ill-health by some misinformed groups or parties with personal interest in this matter, in particular manufacturers of tooth-coloured dental materials. Dr Andrew Chan Kieng Hock discusses objectively the toxic effects of mercury as an element and presents a holistic view on the safety aspect of amalgam in dentistry.

WHAT IS MERCURY?

Mercury is a naturally existing element in the environment. It is highly lipid-soluble and easily infiltrates nerve cells in our body. In high quantity, mercury can cause neurotoxicity (damage to the brain and nerves) and nephrotoxicity (damage to the kidneys). The World Health Organization (WHO) recommends that mercury is safe when the intake is less than 0.47 micrograms (µg) per kilogram body weight in a day.

There are three primary types of mercury:

  • Elemental mercury, which is found in the air as vapour and dental amalgam
  • Inorganic mercury compounds, for example mercuric chloride, mercuric acetate and mercury sulphide
  • Organic mercury compounds such as methylmercury.

Methylmercury is the most toxic mercury element and is found mostly in big fishes such as tuna, shark and swordfish. It is mainly absorbed through our gut when we eat those types of fish. Most of the mercury that we ingest is through our food.

Each person’s body processes these different forms of mercury differently with different levels of tolerance. Exposure to mercury can be an occupational hazard for people working with the element eg, factory workers in the manufacture of thermometers as well as dental health providers. However with good work practice in handling and proper disposal, mercury poses negligible health hazard to people.

 In fact, numerous scientific studies have shown that dentists and  their dental surgery assistants did not demonstrate any ill-effects clinically to their neurological, reproductive system and psychological functions. Ironically, further evidence have shown that children born to dentists have lower prenatal death and birth defects than the general population.

THE USE OF DENTAL AMALGAM

Historically, dental amalgam has been used as the main dental filling material for tooth cavities for more than 150 years. It has a good safety record compared to the newer tooth-coloured dental fillings, which consist of composite resin and glass ionomer cement. Amalgam is a suitable material for use in most situations especially in large cavities on the rear molars, decay below the gum margins or in areas that are difficult to keep dry. It is a very durable, easy to handle and relatively cheap treatment option for the general population.

It is my concern that due to misguided fears about the safety of amalgam, coupled with the more expensive filling options, this may cause ordinary people to forego essential dental care. To state that amalgam is somehow responsible for diseases such as neurological disorders, autism, Alzheimer’s disease, dementia and other chronic diseases is far-fetched. It is true that amalgam contains mercury, but when mixed with metals such as silver, copper, tin and zinc, they form a stable alloy for filling tooth decay. This mixture rapidly hardens into a solid and stable material in the cavity.

DENTAL AMALGAM IS GENERALLY SAFE

An analogy is drawn between sodium and chlorine, both of which are hazardous in their pure form. But, when combined, they form ordinary table salt! As far as I know, there has been no call for consumers to stop using table salt due to the hazardous nature of the individual elements of sodium and chlorine.

So it is with the mercury element in dental amalgam, which forms an inert compound after reacting with other metals. It is true that vigorous chewing and grinding can release minute amounts of mercury vapour from dental amalgam fillings, which are only 1 to 27 µg per day with an average of 5 µg per day (depending on the number and size of fillings) according to a WHO report in 2003. But there is no evidence for this extremely negligible quantity adversely affecting the health of patients.

The recognised safe limit for blood level of mercury is about 35 milligrams per litre in an adult. Nonetheless, some countries, such as Sweden, Norway, Denmark, Germany and Japan restricted the usage of amalgam on expecting and breastfeeding mothers due to political pressure from the public and also due to their high consumption of fish.

The US Food and Drug Administration (FDA) does not recommend removal of old and functional amalgam from teeth with air-rotor, for fear of releasing traces of mercury vapour into the lungs, if adequate water- cooling and aspiration are not used. Removing sound amalgam fillings will also result in unnecessary loss of healthy tooth structure and the procedure is quite expensive as well. However, individuals who are allergic or sensitive to mercury or any of the metals in dental amalgam are advised to replace them with alternative materials. Deciding on which type of filling material to use is best made between the patient and the dentist, after taking into consideration certain specific factors.

Recently, the American Dental Association (ADA) published a statement which conclude that “there is insufficient evidence to justify claims that mercury from dental amalgam has an adverse effect on the health of patients”. This is a strong statement by a dental body in a country with a highly litigious culture.

The only disadvantages of this material are its unsightly grey-metallic hue and its inability to bond directly to tooth structures like the tooth-coloured materials.

In conclusion, in spite of the mercury element, there is no doubt dental amalgam is a very safe, useful, durable and affordable filling material for the general population. HTDr Andrew Chan Kieng Hock

Consultant Oral Surgeon Private Dental Practice Klang, Selangor.

The debate over the safety of amalgam fillings has been going on for decades and has caused much confusion and anxiety among consumers. The presence of mercury in amalgam has often been blamed for ill-health by some misinformed groups or parties with personal interest in this matter, in particular manufacturers of tooth-coloured dental materials. Dr Andrew Chan Kieng Hock discusses objectively the toxic effects of mercury as an element and presents a holistic view on the safety aspect of amalgam in dentistry.

WHAT IS MERCURY?

Mercury is a naturally existing element in the environment. It is highly lipid-soluble and easily infiltrates nerve cells in our body. In high quantity, mercury can cause neurotoxicity (damage to the brain and nerves) and nephrotoxicity (damage to the kidneys). The World Health Organization (WHO) recommends that mercury is safe when the intake is less than 0.47 micrograms (µg) per kilogram body weight in a day.

There are three primary types of mercury:

  • Elemental mercury, which is found in the air as vapour and dental amalgam
  • Inorganic mercury compounds, for example mercuric chloride, mercuric acetate and mercury sulphide
  • Organic mercury compounds such as methylmercury.

Methylmercury is the most toxic mercury element and is found mostly in big fishes such as tuna, shark and swordfish. It is mainly absorbed through our gut when we eat those types of fish. Most of the mercury that we ingest is through our food.

Each person’s body processes these different forms of mercury differently with different levels of tolerance. Exposure to mercury can be an occupational hazard for people working with the element eg, factory workers in the manufacture of thermometers as well as dental health providers. However with good work practice in handling and proper disposal, mercury poses negligible health hazard to people.

 In fact, numerous scientific studies have shown that dentists and  their dental surgery assistants did not demonstrate any ill-effects clinically to their neurological, reproductive system and psychological functions. Ironically, further evidence have shown that children born to dentists have lower prenatal death and birth defects than the general population.

THE USE OF DENTAL AMALGAM

Historically, dental amalgam has been used as the main dental filling material for tooth cavities for more than 150 years. It has a good safety record compared to the newer tooth-coloured dental fillings, which consist of composite resin and glass ionomer cement. Amalgam is a suitable material for use in most situations especially in large cavities on the rear molars, decay below the gum margins or in areas that are difficult to keep dry. It is a very durable, easy to handle and relatively cheap treatment option for the general population.

It is my concern that due to misguided fears about the safety of amalgam, coupled with the more expensive filling options, this may cause ordinary people to forego essential dental care. To state that amalgam is somehow responsible for diseases such as neurological disorders, autism, Alzheimer’s disease, dementia and other chronic diseases is far-fetched. It is true that amalgam contains mercury, but when mixed with metals such as silver, copper, tin and zinc, they form a stable alloy for filling tooth decay. This mixture rapidly hardens into a solid and stable material in the cavity.

DENTAL AMALGAM IS GENERALLY SAFE

An analogy is drawn between sodium and chlorine, both of which are hazardous in their pure form. But, when combined, they form ordinary table salt! As far as I know, there has been no call for consumers to stop using table salt due to the hazardous nature of the individual elements of sodium and chlorine.

So it is with the mercury element in dental amalgam, which forms an inert compound after reacting with other metals. It is true that vigorous chewing and grinding can release minute amounts of mercury vapour from dental amalgam fillings, which are only 1 to 27 µg per day with an average of 5 µg per day (depending on the number and size of fillings) according to a WHO report in 2003. But there is no evidence for this extremely negligible quantity adversely affecting the health of patients.

The recognised safe limit for blood level of mercury is about 35 milligrams per litre in an adult. Nonetheless, some countries, such as Sweden, Norway, Denmark, Germany and Japan restricted the usage of amalgam on expecting and breastfeeding mothers due to political pressure from the public and also due to their high consumption of fish.

The US Food and Drug Administration (FDA) does not recommend removal of old and functional amalgam from teeth with air-rotor, for fear of releasing traces of mercury vapour into the lungs, if adequate water- cooling and aspiration are not used. Removing sound amalgam fillings will also result in unnecessary loss of healthy tooth structure and the procedure is quite expensive as well. However, individuals who are allergic or sensitive to mercury or any of the metals in dental amalgam are advised to replace them with alternative materials. Deciding on which type of filling material to use is best made between the patient and the dentist, after taking into consideration certain specific factors.

Recently, the American Dental Association (ADA) published a statement which conclude that “there is insufficient evidence to justify claims that mercury from dental amalgam has an adverse effect on the health of patients”. This is a strong statement by a dental body in a country with a highly litigious culture.

The only disadvantages of this material are its unsightly grey-metallic hue and its inability to bond directly to tooth structures like the tooth-coloured materials.

In conclusion, in spite of the mercury element, there is no doubt dental amalgam is a very safe, useful, durable and affordable filling material for the general population. HT

Pew! Pew! Pew! Die, Lung Cancer, Die!

Pew! Pew! Pew! Die, Lung Cancer, Die!

May 8, 2022   Return

WORDS PANK JIT SIN

DrAnand

Dr Anand Sachithanandan
Consultant Cardiothoracic Surgeon
President of Lung Cancer Network Malaysia

DrTho

Dr Tho Lye Mun
Consultant Clinical Oncologist
Vice President of Lung Cancer Network Malaysia

 

How is precision achieved? When it comes to cancers, no two are the same. We tend to think that each cancer is the result of a mutation. However, as the cancer grows, more and more mutations may appear in the mass of cancer cells. Over time, the dominant type of mutation changes, and therefore, someone on treatment and who is seemingly under control can suddenly deteriorate. It is due to the change of dominant cancer cells in the tumour.The field of cancer treatment, especially that of lung cancer, is rapidly evolving. Gone were the days when a diagnosis of lung cancer was a definite death sentence. Nowadays, new advances in techniques and medicines are turning lung cancer diagnoses into something less lethal. Dr Anand Sachithanandan, a consultant cardiothoracic surgeon and Dr Tho Lye Mun, a consultant clinical oncologist, discuss the advent of personalized medicine and what it means for the future of lung cancer treatment.

We are used to hearing about chemotherapy in the treatment of cancer. Chemo denoting chemical, and therapy denoting treatment, simply means using chemicals to kill cancer cells. Chemotherapy is considered to be a ‘shotgun’ treatment as it kills other cells in addition to cancer cells. This is the reason why patients suffer hair loss, nausea, weight loss and many other symptoms during treatment. Newer treatment options, such as immunotherapeutic and immune system modulating agents, are bringing the fight to a whole new level. In some cases, persons on cancer treatment suffer little to none of the devastating side effects seen during our parents’ and grandparents’ time.

“Newer treatmentoptions, such as immunotherapeutic and immune system modulating agents, are bringing the fight to a whole new level. ”

Dr Anand says we now know more about the biology of tumours and the individual’s immune system and have the tools to properly identify a few major types of mutations found in lung cancers. By the use of genetic or molecular profiling, doctors can identify the major mutations that exist in a tumour and prescribe the best medication for it. The common actionable mutations found in lung cancer have funky names like EGFR, ROS1, ALK and PD-L1. Actionable mutations are those of which we have drugs to treat. In order to test for the existence of these mutations, a biopsy or tissue sample will be taken and sent to the lab for testing.

Current imaging methods are also able to capture and differentiate cancer from non-cancerous cells. The use of fusion positron emission tomography/ computed tomography (PET/CT) is the best way to determine the size, location and spread of the cancer, or if it is even cancerous to start with. Tissue biopsy testing and imaging will help
to determine the stage and existence of actionable mutations, if any.

lungcancerstaging

  • Stage I: The cancer is localized in the lung and has not spread to any of the lymph nodes.
  • Stage II: The cancer is found in the lung and the lymph nodes nearby.
  • Stage III: The cancer is found in the lung, nearby lymph nodes and middle of the chest.This is also known as locally advanced disease.
  • Stage IV: This is considered the most advanced stage of all cancers, and is sometimes known as advanced disease. The cancer has spread or metastasized to both lungs, or faraway parts of the body such as bone, breast, liver, and brain.

adapted from www.lungcancer.org/find_information/ publications/163 lung_cancer_101/268-types_and_ staging.

Downstaging

Knowing the cancer mutations, its size and stage, will allow doctors treating the disease to tailor treatment according to the individual. For instance, if the tumour is too big or too close to major blood vessels, medication can be given to shrink it to a smaller size to allow surgical removal (resection). This is called downstaging. Downstaging allows
a surgeon to remove the tumour completely and safely, with less risk of damaging the nearby blood vessels or vital structures. The treatment done before surgery is called neoadjuvant treatment. It’s just a fancy name for “before definitive therapy,” in this case “before surgery.” According to Dr Anand, advances in chemoradiotherapy or recently, the emergence of targeted therapy and immunotherapy allows surgeons to perform curative surgery as part of multi-modality therapy for tumours that were once considered inoperable.When we talk about lung cancer, most times people refer to non-small cell lung cancer (NSCLC). It is the most common and most treatable lung cancer accounting for 85% of all lung cancers.

While stage IV disease is considered to be the last stage of lung cancer, doctors can still offer some help and provide treatment to prolong life. Dr Tho says it is important to realize that treatment is no longer seeking to cure, but rather to improve the patient’s quality of life and prolong it.

With modern targeted therapies and immunotherapies, the 5-year survival of some advanced disease patients can be as high as 25%. For comparison, before targeted therapies were available, the average survival time for lung cancer patients with advanced disease was only about 12 months. However, one big drawback is the hefty cost associated with targeted therapy treatment. Some of these can be found in the public hospital setting but doses are limited.

Seek out various opinions

Both doctors agree it is very reasonable and wise to seek out other opinions. There are also many different types of subspecialty oncologists (interventional, clinical, surgical, radiation, and more). It is in the best interest of patients to seek out one or two professional opinions and discuss their treatment options before deciding on the one they are most comfortable with.

What is important is that once the decision is made, is to trust the doctors and follow through with the planned treatment.

The entire process of diagnosis through treatment can be summarized as such:

  1.  Doctor appointment
  2.  Biopsy
  3.  Profiling/Staging
  4. Possible use of tyrosine kinase inhibitors (TKI) to downstage the cancer
  5. Surgery
  6. Adjuvant treatment (eg, chemoradiotherapy or immunotherapy)
  7. Surveillance: regular followup at 3-6 monthly intervals with blood tests (eg, tumour
  8. biomarkers) and CT-PET scans as appropriate, for a minimum of 5 years.

Could the vapour from wokfrying be linked to lung cancers?

Dr Tho discussed about a unique population of lung cancer patients— these are Chinese women, never smokers and usually in their 40s and 50s. They basically have little to no risk factors for developing lung disease and yet they do develop lung disease.

Considering this population of women is more likely to be stay-at-home mothers, and therefore cook more often, the link is too obvious to miss. There is research to show a
link between stir-frying and lung cancer.1,2

There is also evidence to suggest that it is likely due to stir-frying of meat rather than just any type of stir frying. Does this mean we should stop the practice of stir-frying? No,
says Dr Tho. Instead, we can take precautions such as installing an extractor fan, wearing a mask when stir frying or perhaps cooking in an open, ventilated area. Perhaps switching to healthier cooking methods such as steaming, or stewing will help to reduce the risk of lung cancer among people who cook regularly.

Dr Anand adds, it is important for people to realize that lung cancer is not just a disease that affects men and smokers. Unfortunately, more and more cases are being detected in non-smoking women. HT

Please visit LCNM’s website to access their patient education materials. 

References: 1. Xue, Y., et al. (2016). Association between cooking oil fume exposure and lung cancer among Chinese nonsmoking women: a meta-analysis. Onco Targets Ther.;9:2987–2992. 2. Seow, A., et al. (2000). Fumes from meat cooking and lung cancer risk in Chinese women

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THINGS TO KNOW ABOUT BREAST CANCER

THINGS TO KNOW ABOUT BREAST CANCER

May 8, 2022   Return

WORDS HANNAH MAY-LEE WONG

According to the Malaysian National Cancer Registry Report (2012-2016), there has been a rise in cancer cases in recent years, with breast cancer being among the most common cancers in Malaysia. More alarmingly, it was reported that 63.7 per cent of breast cancer cases were diagnosed at stage III and IV.

In conjunction with breast cancer awareness month, consultant oncologist Dr Hafizah Zaharah Ahmad and consultant breast and endocrine surgeon Dr Suziah Mokhtar highlight some important things to know about breast cancer.

 

Go for regular screening

Going for regular screenings helps identify breast cancer early. Early detection and early treatment can provide breast cancer patients with more treatment options.

 

Do breast self-exams at home

A breast self-exam can be done at home to look for unusual signs in the breast tissue. Dr Suziah stresses that women should perform this test regularly.

She reminds that women should also remember to check the whole breast area, including the upper chest and armpits.

Signs to look out for during a breast self-exam include:

  • Lumps
  • Changes in the size or shape of the breasts
  • Dimpling of the skin on the breasts
  • Changes in the nipples (nipples pulling/turning inward)
  • Unusual nipple discharge
  • Pain or tenderness

 

Risk factors for breast cancer

Dr Hafizah explains that there are certain risk factors for breast cancer that are unavoidable. These include:

  • Increasing age.
  • Having family history of breast or ovarian cancer.
  • Reproductive factors. Getting menstruation periods at early age (before 12) or starting menopause at an older age.
  • Genetic mutation, including mutations of genes BRCA1 and BRCA2.

On the other hand, there are external lifestyle risk factors that can be changed. These include:

  • Smoking.
  • Not being physically active.
  • Dietary factors. Having a diet rich in animal fats.
  • High consumption of alcohol. Having more than two drinks per day.
  • Consumption of medicines containing hormones.

Thus, Dr Hafizah and Dr Suziah advise all Malaysian women to adopt healthier lifestyle habits to reduce their risk of breast cancer. That includes having a healthy and balanced diet, exercising regularly and being more cautious when it comes to taking medications that contain hormones.

Consultant oncologist Dr Hafizah Zaharah binti Ahmad and consultant breast and endocrine surgeon Dr Suziah Mokhtar are affiliated with Sunway Medical Centre Velocity.

PNEUMONIA: STILL A THREAT IN THE TIME OF COVID-19

PNEUMONIA: STILL A THREAT IN THE TIME OF COVID-19

May 8, 2022   Return

dr-ariza

 

WORDS LIM TECK CHOON

 

In a time when COVID-19 is still at the forefront of our minds, we should not overlook other infectious diseases that are still a threat to our health—diseases that can be easily prevented or have their severity reduced through appropriate vaccinations.

 

Pneumonia is the Second Leading Cause of Death in Malaysia over the Last Decade

According to the Department of Statistics Malaysia (DOSM), in 2019, it contributed to approximately 12.2% of deaths in the country.

During a recent ceremony in which Merck Sharp & Dohme (MSD) donated pneumococcal vaccines in support of several hospitals and non-governmental organizations, Professor Dr Ariza Adnan shared that the bacteria responsible for pneumonia, Streptococcus pneumonia, cause the air sacs or alveoli of the lungs to fill up with fluid and pus. This makes it difficult for the individual to breathe, thus causing blood oxygen to drop to dangerously low levels.

 

Certain Groups at Higher Risk of Catching This Disease

Professor Ariza said, “Advancing age is one of the primary risk factors for pneumococcal pneumonia. Adults 65 years or older are over 10 times more likely to be hospitalised for the disease than adults aged 18 to 49.”

She added, “Having comorbidities also increase the risk; individuals with diabetes, heart disease, and lung conditions are up to 3, 4 and 9 times more likely to suffer from pneumococcal pneumonia, respectively.”

 

3 Ways to Prevent Pneumococcal Pneumonia

  • Practicing good personal hygiene
  • Lead a healthy lifestyle. Avoid smoking as well as second-hand smoke from cigarettes.
  • Get vaccinated. Talk to your doctor for more information.

A systemic review and meta-analysis study found that 19% of patients with COVID-19 had co-infections, and S. pneumoniae was the second most common bacteria that was found among patients with co-infections. This study included data that came from China, European countries as well as the United States of America.

“This is why, despite the push for COVID-19 vaccination, the World Health Organisation and leading experts also recommend high risk individuals to consider pneumococcal prevention,” Prof Ariza concluded.

Visit https://pneumoprotect.ifl.my to learn more about pneumococcal pneumonia and protecting yourself against it.

 

Reference: Musuuza, J. S., Watson, L., Parmasad, V., Putman-Buehler, N., Christensen, L., & Safdar, N. (2021). Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: A systematic review and meta-analysis. PloS one, 16(5), e0251170. https://doi.org/10.1371/journal.pone.0251170

Check, Please!

Check, Please!

May 2, 2022   Return

Previous
Next

Falling sick can be very expensive these days. With the current economic slowdown coupled with rising healthcare costs, falling ill is the last thing you want to happen to you. Who is going to take care of your loved ones when you are too sick to work or run your business? Imagine spending so much of your hard-earned money on getting well! 

Ladies, how are you?

E_120990898

Dear ladies, when was the last time you went for a health check? It is important for you to go for health screenings regularly. You need to be healthy in order to take care of yourself as well as your loved ones. You are in charge of your health, after all.

Whether you are single or married, there is always something seeking your attention. It can be so easy to forget, or to put “taking care of myself” at the bottom of the list over other priorities. It should not be this way. After all, if you cannot love and take care of yourself, how can you love and take care of other people? So, let’s make your health a top priority!

Ladies do it for themselves

Here are some relatively quick and simple self-examinations that you can do in the comfort of your own home. You can consult a doctor for more information.

Weight.

We all know that obesity is a weighty problem these days. As we lead increasingly sedentary lives and our busy schedule often sees us taking “short cuts” such as eating fast food and skipping work-outs, it is important to do some DIY checks to see whether our weight is healthy. Knowing your weight helps you take measures to reduce/increase it to within healthy range, thus reducing your risks of conditions such as diabetes and heart conditions.

It’s not that hard, you just need a scale and a measuring tape!

– BMI

When to do it: Once a year.

How to do it: Just take your weight and height, and use any free online BMI calculator app to help you calculate your BMI. They will also let you know whether your BMI is within the healthy range.

– Waist circumference

The ideal waist circumference should be 35 inches or less for women (40 or less for men). 

When to do it: After the age of 30

How to do it:

  1. Place a measuring tape at the top of your hip bone and bring it all the way around, ensuring that it is level with your belly button.
  2. Make sure the tape is straight and not too tight.
  3. Take down the measurement. You do not have to hold your breath while measuring.

Breasts.

Examine your breasts in front of the mirror every month, one week after the first day of the period. Early detection of lumps and other abnormalities (possible signs of breast cancer) can lead to better recovery – it can even save your life.

Vaginal matters.

If you experience abnormal discharges, disruptions to your period cycle or unusual sensations (itch, et cetera), do not just suffer in silence. Consult your doctor, as these may be symptoms of a disease or condition that require medical attention.

Go for a health screening

How often you go for health checks mostly depends on your age and how healthy you are. You can talk to your doctor for advice on the tests that you need and when you need to do them. Please turn to page 46 for a list of health screenings you should consider.

So, ladies

Let’s start a health revolution for the sake of your own health, as well as for your friends and family. Take charge of your health and your body will thank you for it!

Guys, get checked!

E_98921738

You have heard many times before, that “prevention is better than cure”. So, are you making an effort to manage your health? Let’s find out.

As men, we can have odd priorities in life sometimes. We are prompt to get our cars serviced regularly, getting our gadgets and apps updated, or for that matter, even replacing them. But what about our body and health?

Compared to women, we men are more likely to smoke, consume alcohol, make unhealthy lifestyle choices or put off regular healthcare appointments. For many of us, there is a stigma attached to attending routine doctor’s appointments, which can delay treatment for several serious health issues, such as prostate cancer, testicular cancer, heart disease and mental illness.

As a result, there is a tendency to wait for symptoms to arise before even thinking of going for a check-up. By the time that happens, there is a possibility that the disease has reached an advanced stage and treatment becomes harder and more expensive, or, worse, is no longer effective.

You are never too busy for health screenings

Ask a guy why he neglected his health screenings and you may get responses such as no time, health screenings are unnecessary or that certain health issues may somehow “just fade away on their own”.

The honest truth is that these are just excuses. The benefits of health screenings far outweigh any perceived bother in going for them. 

The goal of any preventive health screening is to find problems, if any, early before they manifest themselves as signs, symptoms or disease that are more critical. In reality, we are most likely to survive heart disease, cancer and other common killers if we set time aside to visit a doctor for regular health screenings. Furthermore, we will be better able to care for the people we love and enjoy more time with them.

There are a variety of screening tests that can be done to empower us to start taking better control of our physical and mental health. See the next page for more information.

First the checks, now some crosses

You can take small but significant steps to improve your quality of life by doing some crossing out of the following in your life:

  • Smoking
  • Alcohol

You don’t have to cut these out completely, but reduce and minimize them:

  • Salt
  • Deep-fried foods such as fries.
  • Carbonated beverages or other sweetened drinks

“Check” lists for him & her

E_276012929

Wondering which health screenings should be prioritized? Here is a comprehensive list, just for him and her!

FOR HIM & HER

What?

Why?

When and How Often?

Routine physical examination

An examination of height, weight, blood pressure and heart beat. Helps to detect any potential health problems, such as uncontrolled high blood pressure (which can cause life-threatening complications like stroke, heart attack and kidney failure).

Also, skin, ears, nose, lymph nodes and abdomen are checked for any abnormalities.

Every two years when 30 years of age and below.

Annually when above 30 years of age.

Blood cholesterol level check

High blood cholesterol is a major risk factor for coronary heart diseases and stroke. Early detection lets you take early measures to reduce the risk.

Every two years after the age of 35.

Annually after the age of 40.

Eyesight check

Can help to detect any vision corrections or nerve damages caused by age, diabetes or diabetes-induced high blood pressure.

Every two years after the age of 40.

Annually after the age of 50.

Depression screening

Mental changes are equally important as physical changes in our body. Depression can interfere with one’s life at work, home and overall quality of life.

As and when you feel depressed and low in life.

Lung screening

Periodic tests using chest x-ray or low-dose computed tomography (LDCT) can help to detect the onset of lung cancer and its associated risks.

Annually after the age of 50; especially for current or past smokers.

Bone health screening

The bone mineral density test can enable you to know your risk level of developing osteoporosis or osteoarthritis.

For women: Every two years after reaching menopause.

For men: Twice yearly after the age of 60 or if you have a history of osteoporosis or previously suffered from low-trauma fracture.

Diabetes Screening

Diabetes is a lifestyle and genetic-related disease with increasing numbers of adolescent diabetes. Periodic screening, including a Glucose Tolerance Test (GTT), can detect any potential of developing diabetes.

Every two years after the age of 40. Annually after the age of 50, especially if you have a family history of diabetes, are overweight, have vaginal yeast infection or lost weight recently.

Colonoscopy

Examination of the colonic tissues for any growth, inflammation or ulcers can help to identify any risk of colon or colorectal cancer early.

At least once after the age of 50. If you have chronic irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) or a family history of any cancers, you may need colonoscopy earlier.

Sexually transmitted diseases (STD)

Tests for gonorrhoea, chlamydia, syphilis, herpes, hepatitis and HIV are the STDs that are more rampant and need monitoring and control.

Every year if you or your partner indulges in risky behaviours like having multiple sex partners.

 

JUST FOR HER

What?

Why?

When and How Often?

Cervical Screening

Cervical cancer can cause early and untimely death. Pap smear test can detect cervical cancer in the early stages. Early detection and treatment improve survival.

Every three years at the age of 21 and older if you had sex before, or your previous results were abnormal.

Every year if you indulge in risky behaviours like having multiple sex partners or your spouse has multiple sex partners.

Breast Screening (Ultrasound & Mammogram)

Breast cancer can cause early and untimely death. In addition to breast self-examination, ultrasound and mammogram can detect breast cancer in its early stages. Early detection and treatment improve survival.

Every two years for ultrasound scan until the age of 45.

Every two years for mammogram after the age of 45.

 

JUST FOR HIM

What?

Why?

When and How Often?

Testicular Screening

Detects signs of testicular cancer; early detection improves chances of recovery and may even save your life.

Once every year after the age of 30.

Prostate Screening

To detect of prostate cancer; early detection improves chances of recovery and may even save your life.

Once every year after the age of 50.

 

E_275999423

 

References: 1. Everyday Health. Available at www.everydayhealth.com 2. Health. Available at www.health.com 3. WebMD. Available at www.webmd.com 4. Womenshealth.gov. Available at www.womenshealth.gov

References:

Chicago Health. Available at www.chicagohealthonline.com

BACAS. Available at www.bacasmd.com.

Screening Tests for Men: What You Need and When; Illinois Department of Public Health.

Men: Stay Healthy at Any Age (2014); U.S. Department for Health and Human Services; AHRQ Pub. No. 14-IP006-A.

HealthTeamWorks. Available at www.healthteamworks.org

Men’s Health Network. Available at www.menshealthnetwork.org.

Centres for Disease Control and Prevention (CDC). Available at www.cdc.gov.

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The Best Shots In Life: Give Yourself the Best Shot

The Best Shots In Life: Give Yourself the Best Shot

May 1, 2022   Return

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Dr Haji Hazlee Bin Abdul Hadi   Occupational Health Specialist & Medical Advisor, Prince Court Medical Centre

Life can be stressful at times, don’t you agree? High cost of living (the GST doesn’t make things any better), workplace blues, relationship woes… all of these can create a great deal of stress in our lives, and stress is closely linked to our physical and emotional health. If we are healthy, both physically and emotionally, we are in a better position to manage our stress and to take steps in getting closer to attaining that perfect work-life balance.

In this Mini Report, occupational health specialist Dr Haji Hazlee bin Abdul Hadi shares with us the simple little things we can do that are able to make a positive difference in various aspects of our lives – personal, work, love and family. Read on to learn how you can give yourself the best shots in life.   

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The Best Shots in Life : Health and Happiness Begin with You

The Best Shots in Life : Health and Happiness Begin with You

May 1, 2022   Return

The key to personal happiness is health. Family, wealth, career success – they mean nothing if we are too ill to appreciate them. Therefore, there are some healthy habits we can practise to keep ourselves in good health.

  • Eat balanced meals every day. This means eating a variety of food from every food group, in the right amount or portion.
  • Move more every day. Ideally, we should be physically active for at least 30 minutes daily.

However, even the most health-conscious of us sometimes overlook an important aspect of good health: getting vaccinated against infectious diseases.

“I got all my shots when I was a child, so what more do I need?” you may be thinking.

Well, there are vaccines that are very much relevant and important, even when we are adults. The Tdap vaccine is one such example.

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It’s a 3-in-1 Deal

In the past, the Td vaccine was given to protect against tetanus and diphtheria. In 2005, a new type of vaccine, Tdap, was recommended for use as this new vaccine confers protection not only against these two diseases but pertussis as well. It is a 3-in-1 shot that is… well, worth a shot!

Is Tdap necessary? Judging from the severity of the diseases it protects us against, the answer is yes.

“Tetanus is a disease that causes painful muscle tightening in the body. When the muscles of the head and neck tighten, the patient may find it very hard to open the mouth or even breathe,” explains Dr Hazlee. “Diphtheria is very contagious, and it causes breathing difficulties and, in severe cases, heart and nerve damage as well as paralysis. Pertussis is also very contagious, and it can lead to severe breathing problems that can be fatal, especially in infants. Since infants can be infected by adults such as their parents (who may not be aware that they have the disease), it is important that adults are vaccinated against pertussis.”

A single shot of Tdap confers a lifetime protection, and it can be given even if we have received the Td shot in the past. Dr Hazlee points out that the US Centers for Disease Control and Prevention (CDC) recommends that the following people should receive the vaccine:1

  • Adults aged 65 years old or older.
  • Healthcare workers who regularly come into direct contact with infected patients.
  • Caregivers of infants under 1 year old (such as parents, grandparents, babysitters, staff members of day-care centres).
  • Expecting mothers in their 3rd trimester (27th-36th week) – the vaccine confers protection to the newborn during the first months of life.
  • New mothers who have never received the vaccine before.

So, talk to your doctor about shots (including Tdap) that you are missing out on.

[1] US Centers for Disease Control and Prevention (CDC). Combined Tdap vaccine. Retrieved on 28 May, 2015 from http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/DTaP-Td-DT/Tdap.htm

[2] US Centers for Disease Control and Prevention (CDC). Td vaccine. Retrieved on 28 May, 2015 from http://www.cdc.gov/vaccines/hcp/vis/vis-statements/td.html

[3] US Centers for Disease Control and Prevention (CDC). Help protect babies from whooping cough. Retrieved on 28 May, 2015 from http://www.cdc.gov/Features/Pertussis/

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The Best Shots in Life: In Sickness and In Health

The Best Shots in Life: Making Work "Work"

May 1, 2022   Return

Your work is piling and the deadline looms dangerously close. And then it happens – your colleague, Mariam starts sniffling and coughing, Raju follows suit, and the next thing you know, you too are down with a horrible flu.

A flu attack is awful enough, with fever, sore throat, cough, body aches and tiredness being common symptoms. It can also affect our work performance. Too many sick leaves can increase our stress level as work piles up, and it may also be counted against us during the annual performance review – not a good thing if we are eyeing that promotion or pay raise!

“Flu is not the same as a common cold,” says Dr Hazlee. “Flu – which is short for “influenza” – is more than just a bad cold; it can lead to serious complications, including death.” The fact that it is an acute viral infection which can spread easily from person to person only makes things worse.

The flu bug has become a yearly “visitor” to our workplaces, but there is one simple way to protect ourselves from it – getting a flu shot.

A shot a year keeps the flu bug away

You may be thinking, “Wait, I need a shot every year?”

According to Dr Hazlee, right now a flu shot is effective only for a year because the flu virus can change its form (or mutate) over time. As a result, the flu virus that attacks during one particular period (or season) may not be the same one which came the previous season, or the one that would come the next season.[2]

“Each year, the flu vaccine is the result of a well-orchestrated worldwide effort to predict which virus strains would be prevalent, and which strains should be included in the flu shot,” explains Dr Hazlee.   

He adds that, currently, some researchers at the University of Melbourne, Australia and the Fudan University in Shanghai, China are collaborating on the possibility of developing a single flu vaccine that can provide lifelong protection.

Until that research bears fruit, let’s get a flu shot every year, preferably well ahead of a flu season.

So, ask your doctor about the tetravalent flu vaccine.

Other tips to stay ahead at work:

  • Work smart. Too many things to do and too little time to do them all? Prioritize and make lists. Plan your time carefully so that you finish what you can without having to spend so many late nights in the office.
  • Watch what you snack. If you grab a bite often to keep yourself alert at work, choose healthy snacks such as fresh fruits and plain crackers over sugary snacks.
  • Get enough sleep. Try to get at least 8 hours of sleep a day, so that you will come to work with a clear head and full of energy.

[1] US Centers for Disease Control and Prevention (CDC). Flu symptoms & severity. Retrieved on 28 May, 2015 from http://www.cdc.gov/flu/about/disease/symptoms.htm

[2] US Centers for Disease Control and Prevention (CDC). Key facts about seasonal flu vaccine. Retrieved on 28 May, 2015 from http://www.cdc.gov/flu/protect/keyfacts.htm

[3] AAP. (2015, May 14). Australian researchers help target single flu shot for life. The Sydney Morning Herald. Retrieved on 28 May, 2015 from http://www.smh.com.au/national/health/australian-researchers-help-target-single-flu-shot-for-life-20150513-gh17l4.html

[4] Wang, Z. et al. (2015). Recovery from severe H7N9 disease is associated with diverse response mechanisms dominated by CD8+ T cells. Nat. Commun. 6:6833 doi: 10.1038/ncomms7833.

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The Best Shots in Life So, ready for a shot?

The Best Shots in Life So, ready for a shot?

May 1, 2022   Return

We hope this Mini Report have shown you that vaccinations are a vital component of your efforts to stay healthy. They are not merely for children – even as adults, certain vaccines can help protect us from infectious diseases that threaten our efforts to find fulfilment and joy with our loved ones.

Here is a summary of recommended vaccines for adults from the US Centres for Disease Control and Prevention (CDC). Please consult your doctor for more information.

Vaccine

Recommendation

Influenza

1 dose every year

Tetanus, diphtheria, pertussis (Tdap)

Substitute 1-time dose of Tdap booster for Td booster, then boost with Td every 10 years

Varicella (chicken pox)

2 doses

Zoster (shingles)

1 dose for adults over 60

Pneumococcal

1 dose for adults over 65

For adults below 65, recommended 1 dose if risk factors are present (consult your doctor)

Meningococcal

Compulsory to perform the Hajj in Mecca – get a shot at least 10 days before

For other adults, 1 or more doses if risk factors are present (consult your doctor)

Hepatitis A

2 doses if risk factors are present (consult your doctor)

The Ministry of Health Malaysia made it compulsory for children and teenagers to receive the following vaccines (for free, of course). If you missed out on any of these, consult your doctor on getting yourself vaccinated.

Vaccine

Recommendation

HPV

3 doses

Hepatitis B

3 doses

Mumps, measles, rubella (MMR)

3 doses

[1] US Centers for Disease Control and Prevention (CDC). Recommended Adult Immunization Schedule. Retrieved on 28 May, 2015 from http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf

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Healthy Mouth, Healthy Me

Healthy Mouth, Healthy Me

May 1, 2022   Return

Dr Budi Aslinie Bt Md Sabri   Senior Lecturer, Centre of Population Oral Health & Clinical Prevention Studies, Faculty of Dentistry

Oral health is essential to general health.  While most of us are aware that good oral health allows us to eat properly, adds to the attractiveness of our smile and contributes to our self-esteem and general well-being, many of us may not know that problems in our mouth can affect the rest of our body.

Having a “dirty mouth” or “bad-mouth” may not only be detrimental to your social health, but also to your physical health (pun intended!). Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:

  • Diabetes. Periodontitis and diabetes have a link that can result in a vicious cycle. Periodontitis (infection of the gums) can worsen diabetes as it impairs the body’s ability to use available insulin. High levels of blood sugar, a result of diabetes provides the ideal conditions in the body for infections to take place, so the worse the diabetes, the greater the chances of periodontitis will develop… which then, further worsen the diabetes!
  • Cardiovascular disease. Studies have shown that people with moderate or advanced periodontal disease are more likely to have cardiovascular disease than those with healthy gums. It has been suggested that inflammation in the mouth causes inflammation in the blood vessels, subsequently reducing the amount of blood travelling between the heart and the rest of the body and, increasing the risk of a heart attack.
  • Pregnancy and birth. Research suggests that the bacteria that cause periodontal inflammation can actually get into the bloodstream and target the foetus a woman is carrying, potentially leading to premature labour and babies with low birth-weight.
  • Alzheimer’s disease. Be careful about losing your teeth before the age of 35 – this is found to be a risk factor for Alzheimer’s disease! Tooth loss and inflammation related to periodontal disease may accelerate unintentional weight loss and muscle wasting, which in turn could accelerate the degeneration of brain cells (neurodegeneration) that can contribute to Alzheimer’s disease.
  • Other conditions. Periodontal disease may worsen pneumonia and chronic obstructive pulmonary disease, possibly by increasing the amount of bacteria in the lungs.

So let’s get down to it!

Now that you understand the intimate connection between oral health and overall health, here are 5 simple ways you can improve your oral health.

  • Brush for two to three minutes, twice a day, with a fluoridated toothpaste. Be sure to remove all food debris and plaque especially along the gumline.
  • Floss daily. Use the dental-floss or the inter-dental brushes regularly to clean between teeth (these are areas where normal brushes will not be able to reach). Using an antimicrobial mouth rinse can also help to reduce the bacteria in your mouth.
  • Eat a healthy balanced diet; reduce the frequency and quantity of your sugar intake. If you are still in need of your dessert, have it during meal times.
  • Carefully follow your physician’s and dentist’s instructions regarding your own healthcare, including using the prescribed medications, such as antibiotics (always do as directed).
  • Do not smoke. If you are a smoker, you can ask your dentist for help to quit smoking. Most dentists offer smoking cessation advice.   

Remember, a healthy mouth leads to a healthy body!    

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