Men, Matrimony & Masculinity

Men, Matrimony & Masculinity

April 28, 2022   Return

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Patrick Cheng   Licensed & Registered Counsellor & Life Coach, KIN & KiDS Marriage, Family & Child Therapy Centre

Johann Wolfgang von Goethe, the 19th century German writer and statesman, was recorded as having said, “One cannot always be a hero, but one can always be a man.”

But what does being a man mean? If we subscribe to the stereotypical notions of masculinity, it often translates into oozing confidence, competency, and success. Whether we are talking about a rugged cowboy or a dashing gentleman, the man is master of all he surveys. Any sign of emotion or an admission of vulnerability is considered a weakness – “unmanly”. Real men don’t cry, after all.

The consequences of silence

Patrick Cheng, a licensed counsellor, disagrees. He points out that when a man keep his emotions bottled up inside, his frustrations would still be manifested in other ways, often through his actions. He may end up with a short fuse, with the tendency to lash out at his partner, children or subordinates at work. This would lead to all kinds of friction which would only worsen the situation, a downward spiral in motion.      

Manly Problems

  • Sex. Patrick finds that, in his experience, the most common aspects of a man’s sexual dysfunction in a marriage are pornography and masturbation addictions, which can affect his relationship with his spouse.
  • Competition. It is common for a man to feel threatened or insecure by what he perceives to be a threat, especially in the workplace. If left unchecked, such pent-up feelings of jealousy or frustrations could lead to workplace friction.
  • Failure. The concept that a “real man” has to be successful in everything he dabbles in has been ingrained into the psyche of many men today; so, any failures (real or perceived) in areas such as providing for the family, sexually gratifying his partner or earning a promotion could lead to a disproportionately great loss of self-esteem and a sense of inadequacy.

Talk it out

If the man can open up and talk to a counsellor, he would discover that a counsellor can be a great supporter and ally. Patrick says that a counsellor never judges a client – no response is “immoral”, “wrong” or “too shameful” in a session.

A counsellor does not tell the client what to do. Patrick explains, “The counsellor empowers the clients to seek answers within themselves by asking probing questions and offering emotional support. That way, when you realise that you have it in you to do the right thing for yourself, you will feel good about yourself. You will also realise how strong you can be.” He adds that a couple who go for counselling together often discover new things about themselves that strengthen their relationship.

If the client has problems finding ways to express what is in his brain and heart, Patrick uses music and even play-acting to help him open up. For example, in couples therapy, he has used Karyn White’s song Superwoman to allow the wife to express her frustrations at being taken for granted by her spouse. Elvis Presley’s version of Always on My Mind can be a beautiful catharsis for men who wish to express remorse at having failed (or believe that they have failed) their partner.

These days, Patrick is involved in a men’s group, where men of all walks of life come together to share their problems. “Men’s groups work because this concept allows members to know that they are not alone. Other people have the same problems too,” he explains. This knowledge alone often lifts a great weight off their shoulders and compel them to open up and share their feelings too. Such groups are usually small, and membership is by invitation only, in order to create a safe environment for sharing one’s issues and supporting one another.

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Patrick is keen to form a new men’s group. Space is limited to about 8 members. Interested parties can contact him at patrick@kinandkids.com for a “try it and see” experience of being in such a group. “There is no obligation to commit until you are absolutely sure that you want to be part of the group,” he says. “But if you need someone to talk to, please join us. Hopefully, we can help you heal and make positive changes in your life.”

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A Conceivable Dream

A Conceivable Dream

April 28, 2022   Return

 

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Dr Wong Pak Seng    Fertility Specialist

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Mr Aaron Chen Jang Jih     Pre-implantation Genetic Testing Scientist

Jill Smokler said it best when she said, “Being a parent is dirty, scary, beautiful, hard, miraculous, exhausting, thankless, joyful and frustrating all at once. It’s everything.” The journey of parenthood is undoubtedly no easy feat. I believe any parent can attest to that. I have even overheard some parents saying how simple it was to conceive their child; the tough bit was actually caring for them after they had made their entrance into this world. However, the same cannot be said for all parents.

For many couples out there, conceiving a child can be a difficult journey in itself. Years of struggling with infertility issues, recurrent miscarriages or the fear of passing on an inheritable genetic disease to their offspring can be very disheartening to any couple. But now, thanks to the advances in fertility treatment, couples are now much, much closer to realising their dreams of having a healthy child (and a happy family) of their own.

This month’s Special Report takes you into the world of genetic screening as Associate Editors Wong Jie Ying and Lim Teck Choon sit down with Fertility Specialist Dr Wong Pak Seng and Pre-implantation Genetic Testing Scientist Mr Aaron Chen to discuss all things fertility – from genetic and chromosomal abnormalities to inheritable disorders to the various types of screening available such as pre-implantation genetic diagnosis and post-conception screening.

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The Design of Our Genes

The Design of Our Genes

April 28, 2022   Return

Our body is divided into several main systems – circulatory, digestive, endocrine, immune and more – and in each system, there are so many functions taking place, often at the same time. The marvels of our body can fill up volumes of medical textbooks. Through it all, what controls our beautifully complex body functions?

If you think that it is your brain, well, that is not always true. Some instinctive or reflex actions (such as breathing) are controlled by the nerves in our spinal cord, without involving the brain. So what is telling our body what to do, when to do it, how to do it and when to stop?

The answer lies in our very cells. Believe it or not, a structure in most of our cells, called the nucleus, carries an entire library of information needed for our body to function properly. This library is passed down from our parents, and we will pass down half of the information contained in the library to our children. This library is our genome.  

What’s in the library?

Our genome consists of about 20,000 to 25,000 information segments called genes. The actual number will change as we learn more about these genes, and what is more important here is what genes do. These genes are carried in molecular structures called deoxyribonucleic acid, more famously known as DNA.

“Wait, everything boils down to some … tiny molecules?” you may be wondering by now.

While it may seem implausible that such significant importance hinges on something as very microscopic as DNA, our body has a complex system based on a simple premise that works very well.

Different genes direct the production of different proteins that would act as ‘workers’ to carry out specific body functions. What happens is as follow – you can refer to Diagram 1 for a visual representation of what happens in your cell.

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Diagram 1: How our cells create proteins from the information in our DNA.

Step 1: Let’s Get to Work!

Let’s say that our body needs more red blood cells to help us carry more oxygen from the lungs to various parts of our body. Our body recognises that we need more red blood cells, and our kidneys, getting this message, release a hormone to tell the relevant part of the body that make red blood cells (in this case, our bone marrow) to get to work.

Step 2: Let’s Work on the DNA.

In each nucleus within the bone marrow cells, work begins. It is like a factory in motion. Specific molecules, whose job is to read the DNA, quickly scan the long strands of DNA to identify the gene that contains information on how to make the necessary framework for red blood cells. (They are really good at their job, and can locate the correct gene very quickly!)

Step 3: From DNA to mRNA.

Special worker molecules in the cell then use the information in the gene to create a strand-like molecule called the ribonucleic acid (RNA). The RNA contains a modified version of the information found in the gene. Another group of worker molecules then work on the RNA, producing a more refined version called the mRNA (‘m’ stands for ‘messenger’).

Step 4: We’re Almost There!

Next, a special group of molecules called ribosomes work on the mRNA, using the information in that strand to create the protein parts that would be needed to form red blood cells. Once enough red blood cells are made, the body would then signal the bone marrow cells to take a short break. Until next time!

This same mechanism works for every other important body function. It is an incredible system – deep, complex and yet so simple in its basic design. It is perhaps unsurprising that even Bill Gates was moved to say, “DNA is like a computer program but far, far more advanced than any software ever created.”

What can go wrong?

In very rare cases, mistakes may arise in the above process. Information in the DNA or mRNA may be incorrectly read and the resulting abnormal protein may have function differently, possibly resulting in breakdown of the body process that it is involved in.

In other cases, factors from the environment and our diet may change the information present in the gene. This can also give rise to the formation of abnormal proteins.

These changes – called acquired mutations – usually happen in certain types of cells rather than all the cells in the body. As long as these mutations do not occur in the sperm or egg cells, they would not be passed down from parent to child.

As we learn more about our genes, research progresses into the possibility of modifying problematic genes to remove gene-related problems from our lives. Recently, the new technology called CRISPR is showing promise in ‘turning off’ genes that are responsible for making us sick. It may also be used on the plants and animals that we eat! While this technology is still being worked on, it opens up a whole world of possibilities … and also spurs heated debates on the ethics of what some people perceive as humans trying to play God.

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Meet the chromosomes

Our genome is a library, and our DNA comprises many, many books that contain valuable information. Like all libraries, there is some kind of shelving system that allows the genes to be arranged and – in the case of passing them on to our children – safely and easily transported. Our cells do this by packing our DNA into special structures called chromosomes.

A single DNA strand is very, very, very long as it contains many, many information – 6 feet long (almost 2 m) if fully unwound! Therefore, in order to fit it inside a nucleus (which is about 0.0002 cm), the DNA strand is very tightly wrapped around special proteins to produce a chromosome.

We human beings have 23 pairs of chromosomes. The pairs are mostly similar in males and females, barring the pair we call the sex chromosomes. Males have one X and one Y sex chromosome, while females have two X chromosomes. Whether we inherit one X and one Y chromosome or two X chromosomes from our parents determines our sex during conception.

Passing our genes to our children

A new life is formed when a sperm fuses with an egg. Biology makes sure that each sperm or egg cell contains only 23 chromosomes. That way, when the egg and the sperm cell fuses, the baby that is conceived has 46 chromosomes (23 pairs of chromosomes), rather than 92!

What can go wrong?

The chromosomes may become abnormal, such as becoming damaged, losing certain segments, having certain segments containing mutations and such. These changes usually arise when cells divide, such as when the body produces sperm or egg cells. When the sperm or egg cell containing abnormal chromosomes is involved in conceiving new life, the child will end up with every cell in his or her body containing these abnormal chromosomes.

Also, when sperm or egg cells are made, the coupled chromosomes are separated during the cell division process, so that the resulting two sperm or egg cells contain only 23 chromosomes. Sometimes, the separation does not occur properly, and one sperm or egg cell may end up with 46 chromosomes while the other one will have zero chromosome. When an abnormal sperm or egg cell is involved in conceiving new life, every cell in his or her body will have an abnormal number of chromosomes.

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A common example of this is when the 21st chromosome pair fails to fully separate during the sex cell division process, and the resulting sperm or egg cell has two copies of this chromosome instead of the usual one. When it is involved in creating new life, the offspring has trisomy 21 (three copies of the 21st chromosome, instead of two like normal people) – which gives rise to the condition we all know as Down Syndrome.

As you can see, it often takes genetic or chromosomal abnormality in a single sex cell in a parent to cause hereditary conditions in every generation down the family tree. Genetic screening helps to detect these abnormalities and allows us to prepare ourselves and make a decision that is most appropriate for our circumstances.

References:

Genetics Home Reference. Available at www.ghr.nlm.nih.gov

Specter, M. (2015). The gene hackers. Annals of Science, The New Yorker, Nov 16. Available at www.newyorker.com

[1] http://ghr.nlm.nih.gov/handbook/howgeneswork/makingprotein

[2] http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/genemutation

[3] http://www.newyorker.com/magazine/2015/11/16/the-gene-hackers

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Slowing the HFMD Epidemic

Slowing the HFMD Epidemic

April 28, 2022   Return

Words Dr Rakhee Yadav

Dr Rakhee Yadav

Consultant Paediatrician

 

Since April this year, there has been an increase in the number of hand, foot and mouth disease (HFMD) cases among Malaysian children. HFMD is a notifiable disease and the number of cases is closely monitored by the Ministry of Health (MOH) Malaysia. In fact, official reports from MOH claim there is an almost 30 percent increase in cases compared to last year. According to a statement by the Director General of Health, Datuk Dr Noor Hisham Abdullah, more than 40,000 cases have been reported nationwide so far. Every week, 73 new cases are reported nationwide, according to Health Minister Dr Dzulkefly Ahmad.

HFMD is a highly contagious disease that is caused by viruses from the enterovirus group, namely the Coxsackie A16 and Enterovirus 71 (EV71). However, this year there has been an increase in the number of cases from the EV71 virus. Those who have been infected by a particular strain may develop immunity towards it but they may still contract HFMD caused by other strains of viruses. It remains a myth that you can only develop HFMD once in a lifetime.

HFMD easily spreads through droplets which can be from an infected individual’s saliva, mucous, stool and even blister fluid. It commonly spreads via close personal contact with an infected individual, coughing, sneezing, touching contaminated objects or even indirect/direct contact with infected stool.

While HFMD is commonly seen in children below 10 years of age, those below five years have a higher risk as their immune system may not have matured to fight the disease. HFMD may also affect older children and even adults. Children who are frequently exposed to other children, for example in places such as daycare or school, have a higher risk as there is an increased degree of exposure.

Symptoms and complications

Symptoms usually appear three to seven days after exposure to the virus. The disease is contagious in the first seven days and to make things more complicated, there sometimes may not be any symptoms during this period. HFMD is characterized by fever followed by blisters which usually occur over the hands, feet and in some cases extend to the body and genitals. These blisters may be painful and/or itchy. They may also have painful ulcers in the mouth or sore throat, leading some individuals to have poor appetite and dehydration.

There is a spectrum of symptoms in HFMD, with some children developing a mild form of the disease while others may develop its severe form with complications. Although uncommon, there have been reported fatalities amongst children with severe disease and complications. However, it is imperative to note that not all complications are fatal. Secondary infection due to scratching the blisters or dehydration caused by poor appetite are the most common complications encountered. These are treatable and result in better outcomes.

More uncommon serious complications are usually related to EV71 infection. EV71 may cause complications involving the:

  1. Nervous system, such as meningitis (inflammation of the protective lining of the brain), encephalitis (inflammation of the brain) or even paralysis.
  2. Heart, causing myocarditis (inflammation of the heart muscles).
  3. Lungs.

Pregnant ladies affected by the Coxsackie virus may develop complications during pregnancy. Their unborn babies may develop congenital abnormalities as there is a small chance the virus could cross the placental barrier.

Treatment and prevention

Treatment of HFMD is supportive. In healthy individuals, the disease resolves within two weeks without any complications. Most cases are treated symptomatically with fever medications and creams to relieve the itchiness. Some children are given mouth sprays or lozenges to relieve the pain from their mouth ulcers. A soft, cool diet consisting of soft foods and cool items (e.g. porridge, yogurt, ice cream) may be given if a child refuses to drink or eat due to painful ulcers. In some instances, a child might need to be admitted for intravenous fluids due to dehydration, closer monitoring or specific treatment of complications.

To date, there is no vaccine against HFMD. As such, it is very important to prevent the disease from occurring and reducing its spread. The MOH has urged all childcare centres and schools to always disinfect their equipment and appliances using the correct disinfectants, screening all children upon attending class, ensuring proper disposal of diapers and practicing proper hand washing techniques for staff and children under their care. Disinfecting using a solution of bleach has been recommended by the MOH in their guidelines.

Schools with more than two reported cases are usually ordered to be closed by the MOH for disinfecting purposes. Parents and guardians are advised to isolate or home quarantine their children with signs or symptoms of HFMD. This includes avoiding public areas (e.g. shopping malls, indoor/outdoor playgrounds, school, etc). Parents working in the government sector and certain private companies are allowed to apply for quarantine leave which lets them take care of their child at home.

Prevention is better than cure and this is truly the case when it comes to HFMD. Everyone must do their part in preventing the spread by doing all we can to ensure a clean environment and avoid bringing sick children or even adults out in public. As parents, we should be more responsible not only for our own children but for others. Only then will we see a reduction in the number of cases in our country.

We can prevent the spread of HFMD by practicing home quarantine: stay at home and do not place your child in daycare or school until you or your child is completely free from infection.

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Autism Spectrum Disorder – At a Glance

Autism Spectrum Disorder – At a Glance

 April 27, 2022   Return

WORDS HANNAH MAY-LEE WONG

Gan Huey Sien

Ms. Special Education, BCBA

 

It is estimated by the World Health Organization that 1-in-160 children worldwide has autism spectrum disorder. Over the past 50 years, this number seems to be increasing. In this Part 1, an expert explains the increase in prevalence can be attributed to factors such as improved awareness, better diagnostic tools and the expansion of diagnostic criteria.

In 2008, the United Nations General Assembly declared April 2nd as World Autism Awareness day. The reason behind this initiative was to reaffirm and promote the importance of equal rights, especially among those with disability. The end goal is the hope that all children and adults with autism can lead full and meaningful lives. Although awareness on autism spectrum disorder (ASD) has improved significantly over the years, stigma, discrimination and unmet health needs are still challenges that persist among those with autism. This month, we highlight ASD once more, as we have a chat with special education specialist, Gan Huey Sien.

It is estimated by the World Health Organization that 1-in-160 children worldwide has autism spectrum disorder. Over the past 50 years, this number seems to be increasing. In this Part 1, an expert explains the increase in prevalence can be attributed to factors such as improved awareness, better diagnostic tools and the expansion of diagnostic criteria.

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WHAT IS ASD AND WHAT ARE THE SYMPTOMS?

Autism is a developmental condition. It affects how a person communicates and how they relate to people. But, while people with ASD may all share similar characteristics, there are different levels of severity to autism. Thus, autism is named autism spectrum disorder. Common characteristics of people with ASD include difficulty in communication, delay in speech and language, and having problems with social skills. Some of them have challenging behaviours, but most of the time, these behaviours are a result of their inability to communicate and relate to people.

“THE EXACT CAUSE OF AUTISM REMAINS UNKNOWN”

It’s common for people with ASD to have repetitive behaviour, for example, hand flapping or rocking. Some may display peculiar play patterns, for example, liking to watch a certain part of a video repeatedly. Some kids with ASD who have less difficulty in language may perseverate, which is to talk about the same topic they are interested in over and over again.

WHAT CAUSES AUTISM?

The exact cause of autism remains unknown. However, we do know that it’s a combination of genetic and environmental factors. People who are born with certain genes are at higher risk of developing autism. Environmental factors such as advanced age of the parents when they conceive and exposure to certain medication or chemicals during pregnancy are risk factors of having a child with autism.

IS THERE A CURE?

There is no cure for autism, but there are treatment and intervention options available including: applied behaviour analysis and early intensive behavioural treatment. These can be done in-collaboration with occupational therapy and speech therapy, to overall help children with ASD get better at everyday tasks. That said, it is important that parents are aware whether the treatment and intervention methods chosen for their child is evidence based. For more information, check out: https:// asatonline.org. HT

References: 1. United Nations. World Autism Awareness Day. Retrieved from: http://www.un.org/en/events/autismday/background.shtml 2. WHO. Autism Spectrum Disorders. Retrieved from: https://www.who.int/en/news-room/fact-sheets/detail/autism-spectrum-disorders

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ABA and Autism

ABA and Autism

 April 27, 2022   Return

WORDS HANNAH MAY-LEE WONG

Applied Behaviour Analysis (ABA) is a therapy for autism, which applies the principles of learning and behaviour, to help reduce negative behaviour and increase positive ones in those with autism. Through the ABA, individuals with autism may improve in their language, social and living skills. Gan Huey Sien, a BCBA certifed special education specialist tells us more.

Every child is unique, and this also holds true for children living with autism spectrum disorder (ASD). As the name suggests, autism is a spectrum, which means each individual affected by it may: have a varying level of severity, display different symptoms, and have unique characteristics. Thus, treatment and intervention for autism is specific and should cater to each individual’s needs.

There is a variety of intervention options available for children with autism. These should help them lessen their symptoms and  learn to better their skills. Thus far, the ABA is one of the very few, and most widely accepted, evidence-based interventions for autism.

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AT WHAT AGE SHOULD A CHILD START THE ABA?

ABA is most effective when therapy starts from young. Most kids receiving therapy range between preschool to primary school age, but those beyond that age can still receive therapy.

It can be carried out at home or at school, either individually or as a group. It is quite intensive and time consuming, thus, therapy is often expensive. At Seed Autism, the centre which I run, the ABA program can range from 9 hours per week to 30 hours per week or more. Parents can also be trained to use the ABA method, so that they can carry on teaching their child and reinforce positive behaviours at home.

HOW LONG IS EACH PROGRAMME, TYPICALLY?

It depends on the needs and progress of the child. But we typically don’t have children stay with us for more than three to four years.

“THERE IS A VARIETY OF INTERVENTION OPTIONS AVAILABLE FOR CHILDREN WITH AUTISM”

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HOW ARE THE TEACHERS/THERAPISTS ACCREDITED?

The accrediting body for ABA is called the BACB (Behavior Analyst Certification Board). There are different levels of therapists who work with the kids. These include registered behaviour technicians (RBT), board certified assistant behaviour analysts (BCaBA) and board-certified behaviour analysts (BACB). This board exists to protect consumers, to ensure that qualified therapists practice ethically, and information disseminated is accurate. For more information, go to www.bacb.com.

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PLEASE TELL US HOW THE ABA PROGRAMME WORKS

Children planning to undergo the ABA programme are first put through a comprehensive assessment. Characteristics such as language, communication, social, play, self-help and leisure skills are considered during this assessment. Thereafter, each child’s designated therapist will work out a tailor-made lesson plan, which would be updated and re-evaluated as the child progresses.

If a child comes in with many challenging behaviours like screaming, tantrums, biting, pinching etc., the priority would be to work towards reducing these behaviours. Most of the time, we find that these behaviours happen because of a skill deficit. That means, it may be that the child can’t tell you when he or she doesn’t like something. It could be the TV playing too loud or they’re hungry.

We identify the reason behind each behaviour, bearing in mind that sometimes, kids do things just for attention—they may want mummy or daddy’s attention but don’t know how to get it. Therefore, we teach them appropriate skills for communicating what they want by using methods of reinforcement and prompting. For example, if a child sees that mummy is busy, we prompt the child to give mummy a tap on the shoulder (getting attention appropriately). Mummy then turns and looks at the child, and this reinforces the child because the child got what he wanted.

Once we reduce the challenging behaviours (also called barriers because these hinder the child’s development), we move on to the learning part. We build on their language, with a focus on communication. Note that not all kids with ASD can communicate vocally through words. They can communicate by showing you a sign, a picture or through gestures.

As the child gets older, things  get a little bit more complex. We teach them what kids at their age should be able to do, like asking for specific things, sitting in a group, sharing with their friends and more.

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WHAT ARE THE MAIN IMPROVEMENTS YOU HOPE TO SEE IN A CHILD WHO WENT THROUGH THE ABA?

We aim to teach them positive behaviours that are important, and skills that are socially significant, so that they can live a meaningful life. Lesson time is expensive, so we make sure we teach them things that are applicable. The end goal is that the child would be able to transition into a mainstream school, with as little assistance possible. However, this depends on the severity of ASD the child has. Transitioning to a mainstream school doesn’t happen for everyone, and each child’s pace is different. HT

Reference: 1. WebMD. Therapies for Autism Spectrum Disorder. Retrieved from: https://www.webmd.com/brain/ autism/ss/slideshow-autism-overview.

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Of Whiplash and Skullbreaker: Getting dumber and dumber

5 Facts About Obstructive Sleep

March 13, 2020   Return

WORDS PANK JIT SIN One of our readers forwarded us a video of three kids jumping, the ones on both sides then stopped and kicked the legs of the kid in the middle as he was mid-way jumping up, causing him to fall flat on his back and hit his head on the floor. It is truly painful to watch, and I can only imagine it must be more painful for the kid experiencing the fall. This is the newest Tik-Tok© challenge and might be the most dangerous to date. It is known as the Skullbreaker Challenge, for good reason. It can cause a multitude of injuries ranging from a simple bruise to concussion and possible death. The biggest concern is that the victim of a Skullbreaker Challenge will experience skull fracture or concussion. A fracture of the head is a medical emergency as the skull protects the soft brain form injury. A fracture of the skull is commonly accompanied by loss of consciousness, severe headache, nausea and vomiting, weakness, and cold sweat. Concussion is an injury to the head region which can lead to loss of awareness and alertness for a period of time ranging from minutes to hours.1 Due to the speed at which the head hits the ground and all the force transferred to the neck, the victim could also suffer from whiplash, an injury to the neck caused by a forceful jolt or snap due to trauma. Whiplash frequently happens to those in motor accidents and extreme sports, and of course, it can happen to someone falling suddenly on their head and back. The sudden jerking motion causes injuries to the joints between the neck bones, discs, ligaments, muscles, and nerves around the neck.2 These injuries tend to take a long time to heal and cause a great deal of pain and discomfort.1 shutterstock_1374685... We spoke to a few general practitioners (GPs) and doctors in government hospitals in the Klang valley and it seems the trend has not picked up as they have not reported any patients coming in with “skullbreaker” injuries. Checks at a local international school and a government school also turned up no evidence of the challenge taking place in schools. Let’s hope this trend never takes hold in Malaysia. Please warn your child to never get involved in such a challenge. In any case, if your child comes home complaining about nausea, vomiting, or headache, it is a good idea to ask if they’ve been a victim of the challenge or if they’ve experienced a knock to their head, and to quickly bring them to see a doctor and monitor their progress.

References:
Johns Hopkins Medicine. Head Injury. Retrieved on 19 February from https://www.hopkinsmedicine.org/health/conditions-and-diseases/head-injury. Cleveland Clinic. Whiplash. Retrieved on 19 February from https://my.clevelandclinic.org/health/diseases/11982-whiplash.