Read This Before You Reach for Your Snacks This FIFA World Cup Season

WORDS LIM CHAIN YIN

LIM CHAIN YIN
SEA Nutrition Lead
Mondelēz International
TIP 1
Portion Out Your Snack
  1. Be sure to pace yourself throughout the equal halves.
  2. Once you’ve decided what you want to eat, portion it out. This can help you slow down, so that you enjoy your snack.
  3. Check in with yourself to see if you’re full and satisfied before having another portion.
  4. To keep tabs on how much you eat, always check the serving size per package on the label and put your snack in a bowl or on a plate.
TIP 2
Alter Your Choices

If you’re watching the game late at night, you might have a craving for something to eat. Remember that your body works harder when it’s sleeping, so try to snack on something light that will give you energy to keep going, but won’t make it hard for your body to digest.

TIP 3
Enjoy Every Bite

Snacking while engaging in other activities—in this case, watching the game—can easily lead to unconsciously eating more than you should.

  1. Take a moment during the interval to savour your snack with all of your senses. To fully enjoy your snacking experience, pay attention to the smell, taste, texture, shape, and colour of your food.
  2. Take small bites and chew slowly and be sure to finish one bite before starting the next.
TIP 4
Put Your Snacks Out of Reach

When watching a game in your living room, make sure your snacks are beyond arm’s reach. That way, you will be less likely to keep going back for more and inadvertently grab more than you need.

TIP 5
Drink Water, Lots of It!

Your brain tends to trick you into wanting to snack more, but you might just be thirsty. So, drink a glass of water and wait for a couple of minutes before deciding whether or not you’re hungry.


Snacking mindfully is a simple way to tune into your body’s needs. It can be practised by anyone, anywhere, and at any age. It is a great habit in cultivating a positive relationship with food by making deliberate and conscious choices to promote your well-being as well as keeping a balanced lifestyle. But habits take time to build and change, so taking small steps is a good way to start out!

Keep the Hope of Pregnancy Alive in Spite of Breast Cancer

WORDS LIM TECK CHOON

DR CHRISTINA LAI NYE BING
Consultant Clinical Oncologist
Sunway Medical Centre
DR HOO MEI LIN
Consultant Gynaecologist and Fertility Specialist
Sunway Medical Centre
WHY IS BREAST CANCER SO PREVALENT AMONG YOUNGER WOMEN THESE DAYS?

Aside from unhealthy diet and exposure to cancer-causing chemicals or carcinogens in the environment, Dr Christina Lai Nye Bing shares that one possible factor is that women are choosing to marry and have children at a later age.

This somewhat paradoxical concept can be explained by the link between breast cancer and the female sex hormone oestrogen.

“Breast cancer is a hormone-related cancer, and high levels of oestrogen in the body increases the risk of breast cancer as it encourages cancer cells to grow by promoting cell division and reproduction,” Dr Christina explains. “Women in the previous generation who get married and have children earlier have a lower risk of breast cancer, as the oestrogen in their body decreases when they are pregnant and choose to breastfeed.”

IS PREGNANCY IMPOSSIBLE AFTER CHEMOTHERAPY?

Given that chemotherapy plays a big part in the treatment regime of many women with breast cancer, this raises the concern of whether the dream of having a family in the future an impossible one for them.

The unfortunate truth is that chemotherapy affects a woman’s fertility, with a 40% to 80% chance of early menopause.

The ovaries stop producing eggs upon menopause, so with that, the dream dies… or does it?

While Dr Hoo Mei Lin admits that the damage to the ovaries due to chemotherapy is irreversible, there is still a glimmer of hope.

“Patients can plan ahead, as conservation methods such as embryo freezing, egg freezing, and ovarian tissue freezing are available to enable patients to fulfil their wish of having children,” she shares.

Egg and ovarian freezing are suitable options for women that do not have a partner prior to having to undergo chemotherapy.

KEEP THE DREAM ALIVE

Dr Hoo advises breast cancer patients to have an open mind about their future and even consider having children.

After all, breast cancer patients under the age of 45 have an 80% survival rate after treatment!

“With the rapid advances in medical technology today, there is hope for breast cancer patients and survivors to plan their future. Technologies like egg and embryo freezing gives them the opportunity to have children in the future,” she says.

When it comes to cancer diagnosis, the focus is often about treating it, making fertility an afterthought. However, with the advancement in medical technology, surviving a cancer diagnosis is becoming increasingly successful hence, it is important to speak to your doctor as there are ways to help preserve fertility.

5 Ways to Eat Healthily and Merrily During Deepavali

WORDS GURSHARON KAUR GILL

GURSHARON KAUR GILL
Dietitian

With Deepavali being around the corner, the thought of delicious, mouth watering dishes comes to mind for most Malaysians.

Be it the sweet delicacies or the main dishes, festive food is known to be a crowd favourite. It is during festive seasons, that most people let go of their healthy eating habits and indulge in more than their usual food portion. Because, who doesn’t love their mutton curry, chicken varuval or pineapple tarts?

However, the brunt of all the overindulging comes about after the festive season. You might start seeing some extra pounds in your weight and perhaps even spikes in your blood sugar level from all that over indulging. So, why not make your festive season this time a little healthier by following some of my simple tips below.

TIP 1
PREPARE YOUR OWN DISHES & SWEETS

This allows you to modify the recipe to make it a healthier version, such as by reducing the amount of ghee or oil used in the original recipe.

Alternatively, you may also switch from ghee, which contains high amount of saturated fats, to vegetable oil, which contains unsaturated fats and is hence more friendly for your heart health.

You can also reduce the amount of sugar or condensed milk by half from the original recipe for the sweet items. This method helps to reduce the overall calorie of the food items.

TIP 2
PRACTICE PORTION CONTROL

While it can be hard to resist the mouth watering festive food, it is still important to practice portion control.

When it comes to your favourite festive food like jalebi, kesari, pineapple tarts or muruku, practice sharing these food items with family or friends.

You can also practice portion control by limiting to only 1-2 pieces of these food items onto your plate, so that you avoid over indulging, more so if you have multiple houses to visit!

Another trick is to avoid eating cookies straight out of the cookie jars, as this usually causes one to lose track of how much they have eaten.

TIP 3
KEEP AWAY FROM SUGARY DRINKS

Sugary drinks like cordials or packet drinks are commonly served at open houses. However, these drinks are just loaded with sugar without providing your body with any nutrients.

Hence, it is advisable to limit your intake of sugar sweetened beverages to no more than 1 to 2 servings per day.

It is very easy to over consume these sugary drinks as you go about visiting from one house to the other or even while catching up with family and friends. Hence, for those hosting open houses this year, some healthier options to consider would be lower-calorie drinks. Great examples that are also simple to prepare are:

  • Ginger lemonade, with half the sugar from the original recipe
  • Infused water; you can always replace plain water with sparkling water for that extra fizziness in the drink

And for those visiting, if there is no other option of lower-calorie drinks, opt for plain water!

TIP 4
EAT MINDFULLY

Mindful eating helps you to listen to your body for hunger and satiety cues. This is important as it prevents you from mindless eating that adds up to your daily calorie intake.

Over-indulging is common, especially if you are busy catching up with family and friends, and unknowingly end up eating more than you need to. Hence, check in with yourself to identify your hunger and satiety cues is helpful.

Always remember to stop eating before you feel full, as your brain takes 20-30 minutes to register the feeling of fullness.

Tip 5
APPLY THE MALAYSIAN HEALTHY PLATE PRINCIPLES
The Malaysian Healthy Eating Plate. Click on the image to view a larger version.

It is always back to basics when it comes to eating healthily during festive season. The Malaysian Healthy Plate concept encourages the suku-suku-separuh (quarter-quarter-half) method, which helps to ensure a balanced meal with less sugar, salt and fat intake.

This concept simply means filling:

  • ¼ of your plate with grains (preferably whole grains)
  • ¼ of your plate with low fat protein sources (chicken, fish, mutton, eggs, prawns)
  • ½ of your plate with vegetables
HOW YOU CAN PRACTICE THE HEALTHY PLATE CONCEPT DURING DEEPAVALI 
EXAMPLE 1
  • Grains: Idli (2 small pieces)
  • Protein sources: Chicken varuval (1 palm-sized lean chicken)
  • Vegetables: Stir-fried cabbage with turmeric (2 handfuls of veggies)
EXAMPLE 2
  • Grains: Thosai (1 piece)
  • Protein sources: Mutton Curry (4 matchbox-sized pieces of lean mutton)
  • Vegetables: Stir-fried bhindi masala (2 handfuls of veggies)
EXAMPLE 3
  • Grains: Jeera rice (2 to 3 flat rice scoops)
  • Protein sources: Chicken peratal (1 palm-sized lean chicken)
  • Vegetables: Stir-fried bittergourd with turmeric (2 handfuls of veggies)

The bottom line is, you can definitely enjoy the festive food that usually comes about only once a year. However, the key is to practice moderation when consuming them. That way, you get to enjoy the good food and yet not have to deal with untoward health problems after the festive season is over!

Minister of Health Officiates New Child Health, Safety, and Well-being Programme

WORDS LIM TECK CHOON

On September 15 2022, our Minister of Health YB Tuan Khairy Jamaluddin officiated the launch of Healthy Little Bloomers programme and the roll-out of its maiden campaign Junior Germ Busters. 

The Healthy Little Bloomers programme aims to promote child health, safety and well-being through a network more than 30,000 early childhood care and education centres nationwide, potentially benefiting more than 800,000 children.

This is an initiative led by the Malaysian Paediatric Association (MPA) in collaboration with 10 prominent early childhood care and education organisations from both private and government sectors. These organisations are Jabatan Kemajuan Masyarakat (KEMAS), ECCE Council, Malaysian Association of Professional Early Childhood Educators (MAPECE), Persatuan Tadika Malaysia (PTM), Jabatan Kebajikan Masyarakat (JKM), Persatuan Pengasuh Berdaftar Malaysia (PPBM), National Association of Special Education, Malaysia (PPKK), Majlis Kebajikan Kanak-Kanak Malaysia (MKKM), Persatuan Tadika Sabah (PTS) and Association of Kindergarten Operators Sarawak (AKO).

In his speech during the launch, YB Tuan Khairy highlighted the following:
  • Young children, especially those under the age of 5, are vulnerable to health and safety threats, such as infectious diseases, injuries, abuse and neglect
  • Children who are overweight or obese are 5 times more likely to become overweight and obese adults
  • Child abuse survivors are at higher risk of becoming abusers or getting involved in abusive relationship during adulthood
  • Unmet emotional and mental health needs during childhood will lead to difficulties and problems during adolescence and adulthood
PROGRAMME IN STEP & LINE WITH MALAYSIAN GOVERNMENT DEVELOPMENT GOALS

YB Tuan Khairy is pleased with the launch of Healthy Little Bloomers because, as he puts it: “Children are the nation’s future. Therefore, addressing their health, safety and well-being needs holistically is one of the government’s key priorities. It has been part of the Malaysian government development goals since the 1960s and outlined in our latest Child Health 2021-2023 national framework”.

He applauds the campaign as an initiative that brings together MPA and partner organisations for bringing together medical professionals and early childhood care and education experts in a systematic and potentially long-term collaboration to help bring to fruition the goals of the government.

This is a vital programme as many young children spend most of their waking hours in kindergartens and children centres every week, abd studies have shown that health promotion intervention in kindergarten and childcare centres can be effective, especially if parental engagement is involved.

THE PROGRAMME IN MORE DETAIL

Professor Datuk Dr Zulkifli Ismail, Chairman of Healthy Little Bloomers, shares that the programme is meant to be cover all key domains and aspects of child health, safety and well-being in a holistic manner.

He further elaborates that the programme will take an annual thematic approach.

WHAT THE HEALTHY LITTLE BLOOMERS PROGRAMME OFFERS
  • Training for early childhood care and education operators and personnel
  • Fun, exciting, and interactive lessons for children; the programme is inclusive and will cater to children from various population segments, including those that are underprivileged and with special needs
  • Information and educational materials for parents and primary caregivers; available in Bahasa Malaysia and English
  • Roadshows to cater to less advantaged children, featuring activities that will consider the needs of those with hearing or vision impairments.

Visit healthylittlebloomers.my to get more information as well as free educational materials.

Here’s What You Should Know About Osteoporosis & Ageing

 

ASSOCIATE PROFESSOR (C) DR G RUSLAN NAZARUDDIN SIMANJUNTAK
Consultant Orthopaedic,
Arthritis & Sports Surgeon
ALTY Orthopaedic Hospital

Osteoporosis is a disease that weakens your bones, making them more prone to fractures.

Often, there are no symptoms. Many people only learn that they have osteoporosis after they experience a fracture and see a doctor.

Because fractures are potentially life-threatening when they occur to older persons, it is good to take steps to prevent this disease from quietly ‘sneaking up’ on you.

YOU CAN GET SCREENED TO FIND OUT HOW HEALTHY YOUR BONES ARE
If you are 65 or older, you should consult your doctor on getting screened for osteoporosis.

Tests such as bone mineral density (BMD) test will provide useful information about your bone health.

Blood profile tests help to detect presence of health conditions that can weaken the bones and increase your risk of osteoporosis.

WHEN SHOULD YOU SEE A DOCTOR AFTER A FALL?
  • When you experience severe pain that don’t improve after taking over-the-counter painkillers
  • When you are unable to move after your fall

After you are admitted, you will be given an imaging test—typically X-ray and, if necessary, magnetic resonance imaging (MRI)—to determine the location and extent of the fracture.

HIP FRACTURES CAN BE COMMON AMONG OLDER PERSONS
Hip fractures usually occur on the long bone of the thigh, called the femur (see image).

A surgery, called hip replacement, helps to address this problem.

A total hip replacement replaces the socket (acetabulum, see image) and the head of the femur.

A partial hip replacement replaces only the femoral head (see image). This is usually an option for older persons with more limited mobility.

The surgery takes place within 2 hours, and you’ll stay in the hospital for around 3 more days. During this period, a physiotherapist will guide you on the exercises that you can do to restore the range of motion of as well as to strengthen your hip.

WORK WITH YOUR HEALTHCARE TEAM TO REMAIN INDEPENDENT & MOBILE
For example, you may use a walker or wheelchair to remain mobile, and you may need to master new techniques (such as for using the toilet, bathing, dressing, etc) that take into account your condition.

 

If you have problems traveling to see your physiotherapist, consult your healthcare team on the possibility of having the physiotherapist visit your home instead.


This article is brought to you by ALTY Orthopaedic Hospital.

 

4 Things Everyone Should Know About ACL Injuries

 

DATO’ DR BADRUL SHAH BADARUDDIN
Consultant Orthopaedic,
Arthritis & Sports Surgeon
ALTY Orthopaedic Hospital

The anterior cruciate ligament (ACL) helps hold the bones called femur and tibia together at the knee joint.

ACL INJURIES ARE ONE OF THE MOST COMMON TYPES OF KNEE INJURIES
They are common among people that perform activities involving regular heavy use of the knees, such as avid football, futsal, and badminton players.

When the ACL is said to be ‘injured’, what really happens is that there is a tear in the ACL. This tear cannot be repaired in the conventional sense—the doctor cannot ‘sew’ or ‘glue’ back the torn ACL.

Instead, a surgery called ACL reconstruction will be necessary.

SOME COMMON SIGNS THAT YOU MAY HAVE AN ACL INJURY
Your ACL may be torn when there is a ‘pop’ sound as your knee is injured. Pain and swelling will occur at the affected knee but may resolve within one or two weeks.

If your ACL is not functional due to a tear, you will feel an instability in your knee.

Be alert for this instability, which will be especially noticeable when pressure is exerted on the knee during activities such as moving and standing.

This instability may be present even when there is no pain, and it could be a sign of an ACL injury.

When this happens, see a doctor to have the knee examined.

ACL INJURIES NEED TO BE ADDRESSED BY AN ORTHOPAEDIC SPECIALIST
If left untreated, continuous use of a knee with a torn ACL may damage surrounding tissues such as the meniscus and cartilage.

This would not only make movement more difficult and even painful, but the treatments involved would be more complex and hence more expensive.

Furthermore, ACL injuries can lead to significant loss of cartilage tissue in the knee and increases the risk of osteoarthritis.

The current recommendation for people with ACL injuries, of any age, is to undergo ACL reconstruction as early as possible (provided they do not also have concurrent osteoarthritis of the knee), especially in active persons.

This is to restore their knee function and to avoid developing further complications in the future.

ACL RECONSTRUCTION INVOLVES THE CREATION OF A NEW ACL TO REPLACE THE TORN ONE
The new ACL can be made from tendons taken elsewhere from your own body or from another person, or from synthetic materials.

Latest advances allow the use of a thin, flexible tube with a camera at one end (called an arthroscope) to guide the surgeon in performing the reconstruction more efficiently.

For the next few months after the surgery, you will be working closely with a physiotherapist to regain full use of your knee.

How soon can you walk and exercise after an ACL reconstruction?

You may walk the next day after surgery (using with crutches), cycling within 6 weeks, and run on a treadmill within 3 months. Sports can resume after 6 months, but contact sports such as football is advisable only after 9 months or 1 year.


This article is brought to you by ALTY Orthopaedic Hospital.

Rise of the Superbugs

WORDS LIM TECK CHOON

PROFESSOR CHIN BEEK YOKE
Associate Dean
School of Health Sciences
International Medical University

Superbug is a term coined to describe multi-drug resistant bacteria.

Medications that are usually effective on them, such as antibiotics, just don’t work as effectively anymore. “These are bacteria that circumvent the effects of antibiotics and proliferate or multiply uncontrollably in the host,” explains Professor Chin Beek Yoke.

EVERY BACTERIAL SPECIES CAN BE A SUPERBUG

Any species of bacteria can develop a resistance to antibiotics and become a superbug.

“Bacteria are very smart. They will mutate to overcome antibiotics. Once bacteria has the resistance gene in them, they can duplicate and combine with different species of bacteria. That’s how bacteria propagate their multi-drug resistance in nature,” Prof Chin shares.

WE HAVE A ROLE IN CREATING SUPERBUGS

According to Prof Chin, a key reason why superbugs are prevalent is the unnecessary and over-prescription of antibiotics.

GOOD HABITS TO ADOPT
  • Take antibiotics only when necessary. Diseases that are not caused by bacteria do not require antibiotics!
  • Complete your full course of antibiotics—finish all the antibiotics your doctor gave you. Don’t stop just because you think you are feeling better.
  • Avoid using unapproved or black market antibiotics that are not at full strength and do not work as effectively as genuine ones
IMPROPER DISPOSAL OF ANTIBIOTICS MAY ALSO PLAY A ROLE

People tend to dispose of antibiotics incorrectly, and this can be a problem.

“We pour it down the drain, or throw it into the trash. The excess antibiotics then get into our ecosystem, in the soil, or may end up in rivers and water bodies,” says Prof Chin.

GOOD HABIT TO ADOPT
The correct way to dispose of the extra antibiotics is to bring them to your nearest pharmacy. Many pharmacies are equipped to dispose of extra medicines in the appropriate manner.
THEN THERE’S THE ISSUE OF ANTIBIOTICS IN ANIMAL AND FISH FEED…

Another cause is the use of antibiotics in feed for domestic animals or fish. When humans consume the meat from these animals and fish, they also consume the residual antibiotics present in these products.

This unintended consumption of antibiotics may modify the bacterial environment in our bodies and render us susceptible to future bacterial infections.

GOOD HABIT TO ADOPT
Purchase foods that are obtained from sources that are free of antibiotics.
HOW TO MINIMIZE POSSIBLE CONTACT WITH SUPERBUGS

Multidrug resistant bacteria are everywhere, but we can do a few things to reduce coming in contact with them.

PRACTICE GOOD HYGIENE
  • Wipe surfaces and clean items that come into our household
  • Wash all fruits and vegetables after purchase, before storage, and before cooking. This will prevent the bacteria from propagating
  • If you wish to try fruits from stalls and supermarkets in order to ‘test before buying’, wipe them first with a wet wipe
  • Wear shoes and socks when travelling in areas where contaminated soil or water is prevalent
DON’T PANIC TOO MUCH ABOUT COMING IN CONTACT WITH SUPERBUGS, HOWEVER!

Prof Chin explains that having them on your skin alone doesn’t mean that you will become infected and suffer.

“Your skin is a very good protective organ,” she says. “Bacteria or pathogens can only enter when there is a cut. So, if you don’t have a cut or laceration, you will be fine. Just make sure to wash your hands and feet or any exposed areas.”

The same goes for the times when you ingest bacteria. “You will usually have enough stomach acid to kill these superbugs, and most of the time you have enough innate immune cells in your body to fight them off,” she explains.

However, people with health conditions that weaken their immune system should take precautions to reduce their odds of contracting bacterial infections; they should consult their doctor on the best ways to do this.

Let’s Talk about Monkeypox

WORDS LIM TECK CHOON

PROFESSOR DR JAMES KOH KWEE CHOY
Head of Division of Medicine
School of Medicine
International Medical University
FACT 1
MONKEYPOX IS CAUSED BY, YES, THE MONKEYPOX VIRUS
This virus belongs to the same family (Poxviridae) as the smallpox virus.

“The monkeypox virus was first isolated from a colony of monkeys in the 1950s, hence the name. Although it is called ‘monkeypox’, monkeys and humans are incidental hosts,” explains Professor James Koh Kwee Choy, an infectious disease consultant. “The actual reservoir is unknown, but is likely to be certain rodents.”

What we know it that the virus can be transmitted from animals, such as primates and rats, to humans. From thereon, the virus can be spread by humans to other humans and even other animals.

FACT 2
MONKEYPOX IS NOT A NEW DISEASE, AND IN FACT USED TO BE PRETTY RARE… UNTIL 2022, THAT IS
Monkeypox was first identified as a cause of disease in humans in the 1970s, when it was detected among certain populations in the Democratic Republic of Congo (at that time, the country was called Zaire).

Because outbreaks were rare and the spread was limited outside of the African continent, in the years after researchers assumed that the virus spread to humans in an ‘inefficient’ way.

Well, that assumption was definitely challenged in the May 2022 monkeypox outbreak!

“This outbreak is unusual because, in the past, the number of cases were small,” shares Prof James. “This time around, there is a wider and faster spread, and the symptoms or presentations are also different.”

In light of the outbreak, the WHO has since declared monkeypox an ‘evolving threat of moderate public health concern’.

YOU MAY HAVE MONKEYPOX IF YOU…
  • Develop a rash at or near your genitals or anus; other possible locations for the rash include your hands, feet, chest, face, and mouth
  • The rash may look like pimples or blisters, but will go through several stages (including scabbing) before healing
  • The rash can be painful or itchy
  • Some people may also have symptoms such as fever, swollen lymph nodes, aches in their muscles and back, headaches, coughing, sore throat, etc
  • Symptoms can vary from person to person; some may develop a rash first before other symptoms, while others develop the symptoms first and rash later, or they only develop a rash with no other symptoms
FACT 3
MONKEYPOX ISN’T ALWAYS FATAL, BUT THAT DOESN’T MEAN WE SHOULD TAKE IT LIGHTLY

Monkeypox has a recorded fatality rate of 1% to 10%.

Without any treatment given, the disease can usually resolve on its own between 2 and 4 weeks.

However, some people with monkeypox may develop severe complications, especially if they have existing health conditions or are undergoing treatments that weaken their immune system. These people will need hospitalization and close medical care.

FACT 4
MONKEYPOX CAN BE SPREAD THROUGH CLOSE & PROLONGED SKIN-TO-SKIN CONTACT

Prof James emphasizes that it is important to remember that transmission requires prolonged exposure to the infected person.

Brushing against someone in a crowded place, for example, or quickly kissing someone are unlikely to cause transmission.

So, what are the more likely means of transmission that we should be aware of?

  1. Direct contact with the rash or body fluids of someone with monkeypox—note that this includes not just oral or penetrative sex but also touching, kissing and other face-to-face contact, hugging, massaging, and other intimate acts with the infected person
  2. Prolonged contact with items that are or have been used by someone with monkeypox, such as clothing, bedding, towels, etc.
  3. Prolonged exposure to the person’s respiratory secretions, which are produced when they talk, sneeze, cough, etc
  4. An infected pregnant woman may spread the virus to the child she is carrying
  5. It is also possible that one may contract monkeypox from eating poorly-cooked meat of infected animals, or from scratches and bites of infected animals

Someone with monkeypox can spread the virus from the time they develop their symptoms until the rash is fully healed.

FACT 5
MONKEYPOX IS NOT A ‘GAY PERSON’S DISEASE’—IT CAN AFFECT ANYONE AND EVERYONE

While it is certainly true that monkeypox currently affects a large population of men who have sex with men (MSM), it will be a mistake to assume that it is a disease that affects only these men.

As we have seen, the virus can spread through other means other than sex, so people that don’t engage in acts of intimacy with members of their own sex shouldn’t be complacent and assume that they are safe from it!

FACT 6
YES, THE SMALLPOX VACCINE MAY HELP, BUT THINGS ARE NOT SO STRAIGHTFORWARD

While smallpox and monkeypox are two different diseases, Prof James notes that the smallpox vaccine can help reduce the risk of catching the monkeypox by up to five times.

“Most Malaysians born before 1980 are vaccinated against smallpox as part of the National Immunisation Programme of that time,” Prof James notes.

Unfortunately, smallpox vaccines are not readily available. Therefore preventive strategies are important.

Click on the image to see the large version.

References:

  1. Ladnyj, I. D., Ziegler, P., & Kima, E. (1972). A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo. Bulletin of the World Health Organization, 46(5), 593–597. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2480792/
  2. Thornhill, J. P., Barkati, S., Walmsley, S., Rockstroh, J., Antinori, A., Harrison, L. B., Palich, R., Nori, A., Reeves, I., Habibi, M. S., Apea, V., Boesecke, C., Vandekerckhove, L., Yakubovsky, M., Sendagorta, E., Blanco, J. L., Florence, E., Moschese, D., Maltez, F. M., Goorhuis, A., … SHARE-net Clinical Group (2022). Monkeypox virus infection in humans across 16 countries – April-June 2022. The New England journal of medicine, 10.1056/NEJMoa2207323. Advance online publication. https://doi.org/10.1056/NEJMoa2207323

Breaking Depression’s Spiral

Breaking Depression’s Spiral

May 8, 2022   Return

Words Lim Teck Choon

Paul Jambunathan
Consultant Clinical Psychologist & Senior Lecture

Decoding Depression

Depression = Cannot Cope?

Some people experience depression because they are unable to cope with life-changing events, such as financial problems, unemployment, broken relationships, the passing of a loved one and more. Of course, most people will be affected by such events, but people with depression will experience symptoms that will prevent them from functioning normally, and this will persist for a longer period of time than normal.

Other Medical Conditions Can Cause Depression Too

Do you know that our mood can be affected by the levels of certain hormones in our body? Specifically, our thyroid, adrenal and pineal glands, as well as the glands in our sex organs produce hormones that have links to our mood. Therefore, it is possible that any medical problems involving those glands can give rise to depression. In such cases, these problems will have to be addressed in order to help the person overcome his or her depression.

The Depression Gene

Research suggests a strong possibility of a depression gene that can be passed on from parent to children, leaving these children more at risk at developing depression. If you have family members who developed depression, you should be more aware of the symptoms and get help if you have them, as well as practice good stress management techniques (there are books that can offer advice and tips on this). You should also get enough sleep and be physically active every day to keep your spirits up.

As You Can See, Depression Is Not Simply Because You Are Weak

Depression can be an inability to cope with life’s many stresses and pressures, or it could also be a result of a medical condition, or perhaps even a hereditary condition. Or, it could be caused by a combination or all of these factors! Therefore, if you believe that you may have depression, don’t be ashamed. Seek help from a qualified mental health professional instead.

Do You Have Depression?

Mr Jambunathan points out that, according to the latest (fifth) edition of The Diagnostic and Statistical Manual of Mental Disorders (the authoritative reference used by mental health professionals worldwide), someone is diagnosed as suffering from depression if he or she shows at least five of the following symptoms for nearly every day.

Depressed Mood
Feels irritable most of the day, nearly every day for more than two weeks. The person may appear sad, empty or tearful to the people around him or her.

Lack of Interest
The person shows decreased interest or pleasure in most activities, including activities that he or she previously enjoyed, most of each day.

Significant Weight/Appetite Change
Medically, a weight change of five percent (gain or loss) may be an indication of depression.

Change in Sleeping Habit
Some people may have problems falling asleep (insomnia), while others may sleep more excessively than normal (hypersomnia).

Fatigue 
The affected person seems listless and lacking in energy most of the time, often showing little inclination to snap out of the mood.

Guilt
The person feels an excessive or inappropriate amount of guilt over a past incident that triggered the depression. He or she may also feel helpless to change a situation, or feel that he or she is worthless to the people around him or her.

Lack of Focus
He or she has a reduced ability to concentrate or think, and is also indecisive.

Suicidal Thoughts
The thought of death or suicide frequently runs through his or her mind, along with ideas of how to carry them out.

Getting Closer to Happiness

Who to seek help from?

dep_2copy

There are different types of mental health professionals, and it will be good to know what they can (and cannot) do to help you.

  • Counselors are generally the ‘front line’ mental health professionals. They are trained to offer support and counseling to people with emotional problems.
  • Clinical psychologists have at least a Masters degree in clinical psychology. They can offer the services of a counselor as well as more specialized services such as cognitive behavioural therapy (CBT).
  • Psychiatrists are medical specialists who are better equipped to help people with more serious mental disorders such as schizophrenia and depression. Because they are medical doctors, they can prescribe medications when the need arises.

Mr Jambunathan says that it is perfectly fine to visit a counselor first. If the counselor believes, after assessing you, that you require the more specialized services of a psychologist or psychiatrist, he or she will refer you to the right person. “Often, you may also be requested to get a full medical check-up,” he adds, explaining that this is necessary to rule out any medical conditions that may be contributing to your depression. If such conditions exist, they will have to be looked into first.

Not Sure Where to Get Help?

Mr Jambunathan stresses that it is important to turn to qualified mental health professionals for help. Unfortunately, there are certain unscrupulous people who pose as counselors or psychologists, and they will do more harm than good. If you are unsure as to where to find legitimate mental health professionals, you can start at the following places:

  • Counseling services: Malaysian Mental Health Association at http://mmha.org.my/resources/directory-of-councelling-services/
  • Psychiatrists: Malaysian Mental Health Association at http://mmha.org.my/resources/directory-of-psychiatric-services-in-malaysia/
  • Another listing of psychiatrists: Malaysian Psychiatric Association at http://www.psychiatry-malaysia.org/listcat.php?cid=28&all=Y

Confidentiality Guaranteed

Don’t worry about people finding out that you are depressed. Mr Jambunathan assures that mental health professionals will not divulge your status to anyone (even your employer and partner) without your explicit permission. If you have any concerns about confidentiality, you can voice them out – most mental health professionals are used to (and even expect) such a discussion and thus, they will be glad to address your concerns.

What Are The Sessions Like?

Often, the client dictates the pace and nature of the session. The number of sessions depends on the client’s progress and the severity of his or her condition. For clinical psychologists such as Mr Jambunathan, sessions involve listening to the client and asking thought-provoking questions in order to empower the client into finding the determination and drive to make the necessary steps to overcome his or her depression.

Empower Yourself

Mr Jambunathan emphasizes that your recovery will be smoother if you take steps to empower yourself. Firstly, learn more about depression – the causes, the symptoms and the options available to overcome your condition. The knowledge will allow you to be more confident in making educated decisions when it comes to your recovery.

Furthermore, don’t hesitate to ask for second or third opinions if you have doubts about an initial diagnosis, and feel free to ask to be referred to another mental health professional if you are uncomfortable with the one you are currently seeing. Most mental health professionals will be happy to accommodate your request for a second opinion or referrals to another colleague; they will not take it personally, don’t worry!

In the second part of this series on depression, we look at anti-depressant medication and whether they are effective at treating depression. Look out for it in the following issue.

One Step Closer to Happiness

One Step Closer to Happiness

May 8, 2022   Return

Words Lim Teck Choon

Assoc Prof Dr Amer Siddiq Amer Nordin

Consultant Psychiatrist

Universiti Malaya Specialist Centre

All About Antidepressants 

Wait… medications?

Yes, sometimes medications are helpful in overcoming moderate-to-severe depression. Dr Amer explains that these medications, called antidepressants, are prescribed by psychiatrists, who are medical doctors specializing in mental healthcare or psychiatry.

Malaysia Has Good Psychiatric Care

Some of us may not know this, but Malaysia actually offers some of the best psychiatric care in this region. Dr Amer points out that many of the commonly prescribed and effective antidepressants used worldwide are available in Malaysia. Therefore, people with depression can find a good level of medical care in both government and private hospitals. It is only a sad kind of irony that awareness of both depression and its treatment is not widespread enough, causing a number of people with depression to either deliberately or unknowingly miss out on getting treatment.

Thus, if you suspect that you have depression or you believe someone close to you has this condition, Dr Amer gently recommends that you seek appropriate advice and help from a qualified mental health professional. The earlier the treatment, the better are the chances of recovery.

5 Things to Know about Antidepressants

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  1. Dr Amer stresses that antidepressants are not the be all and end all of depression management. They work to reduce the symptoms of depression instead of curing the condition, and are only prescribed when necessary. Some people with depression may be able to overcome it without any need of medication at all.
  2. It may take a couple of weeks before you see the beneficial effects of the antidepressant you are taking. If you believe that you are not getting better even after taking the medication, don’t be too quick to assume that it does not work. Instead, talk to your psychiatrist about your options.
  3. It is, however, possible that certain antidepressants don’t work on you. The psychiatrist will prescribe another type after he or she has performed the necessary evaluation to confirm that your current medication is ineffective.
  4. Take your medications based on the recommended dosage and frequency, and do not stop without consulting your psychiatrist first. Some people stop on their own when they believe that they are getting better, and as a result, their depression comes back, sometimes more severely than before.
  5. Avoid drinking alcohol or taking illegal drugs while you are on medication. Some people believe that the ‘high’ from alcohol or drugs helps them feel better, but research has shown that these substances actually negate the benefits of your medications and can even worsen your depression.

How Antidepressants Work

There are different types of antidepressants available, and each type has its own unique ways of reducing the symptoms of depression. Generally, however, they all work by influencing the way the brain works.

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Our brain cells, or neurons, form a closely connected network called the brain circuit. All information is passed from one neuron to another, carried by substances called neurotransmitters. There are many different types of neurotransmitters, and some of them carry information that affect our mood – for example, serotonin, dopamine and norepinephrine. 

Generally, antidepressants help reduce the symptoms of depression by interrupting the transmission of specific neurotransmitters that trigger a depressive mood. Some work on a single neurotransmitter, while others may work on two or more.

The type of antidepressants prescribed depends on the symptoms and severity of your depression, other health conditions already present and whether you are pregnant or breastfeeding. Sometimes, a psychiatrist may prescribe a combination of two antidepressants for enhanced beneficial effects. If the need arises, additional medications such as mood stabilizers, anti-anxiety medications or antipsychotic medications may also be prescribed to help you better manage your symptoms.

Also, if you experience bothersome side effects, your psychiatrist may switch you to a different kind of medication. If you are also on medications for other health conditions, you should share them with your psychiatrist, as there is a possibility that these medications can react with an antidepressant to create potentially dangerous complications.

But Aren’t Antidepressants Addictive?

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No, not at all, says Dr Amer. Some patients experience withdrawal-like symptoms when they stop taking antidepressants, but this is not a sign that they are addicted to those medications. Rather, it is more likely due to the body needing some time to adjust once the medication is stopped, especially if it is stopped abruptly. These symptoms usually go away on their own. If you experience bothersome side effects, you should let your psychiatrist know. He or she will either offer options to address these side effects or switch you to another type of antidepressant.

Is It True that Taking Antidepressants Will Ruin My Sex Life?

Because antidepressants work by calming your mood and reducing your anxiety, one possible unwanted side effect is that you also become too ‘calm’ to respond in intimate situations. Some people (both men and women) find that their libido is decreased. There are men who also experience erectile dysfunction, while women may experience discomfort during sex due to reduced lubrication. Delayed orgasm may also be experienced by both men and women.

Fortunately, this does not mean that your sex life is ruined if you are on antidepressants. Sometimes these side effects go away on their own, after your body has become used to the medication. If they persist, there are ways to manage these symptoms, such as reassessing the dosage or, if you anticipate having an intimate moment with your partner, taking your antidepressants only afterwards. Switching antidepressants might also be an option if the above doesn’t work.

Don’t stop your medication because it is affecting your sex life, as this may cause your depression to worsen. Instead, talk to your psychiatrist about the issue; he or she will be able to help you in this matter.

Don’t Give Up!

Medication alone is often not enough to help the person overcome his or her depression. Overcoming depression is a day-to-day process, often requiring a lot of energy and focus. Recovery may not be as quick as the person wishes, and in the meantime, he or she may experience broken relationships, loss of jobs and other heartbreaking disappointments.

In such situations, some people may become overwhelmed and feel that they will never become better. They choose to give up instead, thus succumbing to their depression.

It does not have to be this way. While depression is often portrayed as a lone person’s struggle, Dr Amer points out that the road to recovery is often easier with support from the people around that person.

This is why, while he respects a patient’s desire for confidentiality, Dr Amer would advise the patient to let at least one trusted person in on the fact that he or she is trying to overcome depression. This person can provide a listening ear and a shoulder to cry on when the going gets tough for the patient. Additionally, that confidante is welcome to ask for advice from the patient’s mental health professional if the need arises.

Furthermore, support can be obtained from various support groups (either in real life or online at places such as Facebook and Reddit) as well as from various non-profit organizations dedicated to helping people with depression and other mental issues heal.

When the World Shuts You Out, We Are Still Open

That is the motto and rallying cry of the Befrienders, a nonprofit organization established to provide emotional support to those in need. If you need someone to talk to, call the Befrienders at 03-7956 8144 or 7956 8145
(they are available 24 hours a day) or email sam@befrienders.org.my. You can also arrange for face-to-face support by calling the numbers above.