Category: Top to Toe

1. WORDS RACHEL SOON

   Kundur, salai, parangi, dhup, shallaki, cunnampu… depending on which part of Asia you’re in, Indian frankincense is known by many names. Prized as incense in religious ceremonies, as perfume, and as a healing herb, this sweet-smelling resin from an ancient tree species has caught the eye of researchers as a possible answer to painful joints.

   Besides Boswellia serrata, a few other closely related tree species also produce frankincense. Boswellia carterii grows throughout the Arabian Peninsula, and traditional Chinese medicine makes use of its resin, known as ru xiang (‘fragrant milk’). Boswellia frereana or Coptic frankincense is more local to Somalia and parts of Northeast Africa.

   Boswellic acids—a solution for anti-inflammation?

   The key component seems to be what scientists have named boswellic acids. For one thing, they’ve been shown to slow down the production of cytokines in the human body.

   Cytokines are little bits of protein that normally tell the body to cause inflammation in a particular spot; while this is normally meant to help heal the body, cytokines can sometimes go overboard, causing too much inflammation and hurting the body instead.

    

   More than 12 different kinds of boswellic acids have been found, but two in particular: acetyl-11-keto-β-boswellic acid and 11-keto-β-boswellic acid (abbreviated to AKBA and KBA, respectively) seem to have the strongest anti-inflammatory effects so far.

   Helps with joint pain?

   It seems to! According to a team of scientists from the Cochrane Network—one of the largest independent reviewers of published scientific research—there’s a moderate level of evidence to suggest that Boswellia serrata extract, taken orally, can help with osteoarthritis symptoms.

   They took a look at three different studies and found that groups of people with osteoarthritis who took 100 mg of Boswellia serrata extract daily seemed to report reduced pain and improved joint function after a 90-day period, compared to a parallel group who were taking placebos.

   As a caveat, though, they noted that the studies they looked at involved only a few dozen participants, and there were multiple other studies that couldn’t quite prove the same level of benefit. Still, it’s an area of research that “warrants further investigation, in light of the fact that the risk of adverse events appears low.”

   Safe to use?

   Boswellia is generally believed to be safe, though there haven’t been extensive studies into its safety and toxicity. So far, the most frequent side effects have been mild nausea and gastric reflux, so caution is advised if you’re taking it while gut troubles are around.

   Some small studies in India have also noted that the resin might be capable of inducing abortion—an effect also noted in traditional literature—so it’s not advised for pregnant women.

   References: 1. Siddiqui, M. Z. (2011). Boswellia serrata, a potential antiinflammatory agent: an overview. Indian J Pharm Sci. 73(3):255-261. 2. Ammon, H. P. T. (2016). Boswellic acids and their role in chronic inflammatory diseases. Adv Exp Med Biol.;928:291-327.  3. Ammon, H. P. T. (2006). Boswellic acids in chronic inflammatory diseases. Planta Med.;72(12):1100-1116. 4. Cameron, M., & Chrubasik, S. (2014). Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev;5:CD002947. 5. Basch, E., et al. (2004). Boswellia: an evidence-based systematic review by the Natural Standard Research Collaboration. J Herb Pharmacother;4:63-83.

1. WORDS DR SIEW TUCK WAH

   The skin of our hands age just like that of our face and neck. Furthermore, our hands are often exposed to the ravages of environment—heat, cold, pollutants, germs, and more—so much so that it is said that people can tell our true age by looking at our hands! Despite this, many people still overlook their hands when it comes to their personal care regime. 

   In this article, let’s take a look at some good personal care and aesthetic regimes to address the issue of ageing hands.

   As we age, our hands undergo visible changes in appearance.

   DRY SKIN

   The skin of our hands has fewer sebaceous glands compared to the skin on other parts of our body. Sebaceous glands produce a waxy, oily substance that lubricates the skin. Due to having fewer of these glands, the skin of our hands tend to dry up fast. Furthermore, as we age, the skin on our hands increasingly loses its ability to retain moisture.

   Consequently, as the years pass, our hands will have a higher tendency to become dry and wrinkled.

   THIN, CREPEY SKIN

   The skin loses collagen and elastin as we age. These are proteins that help our skin retain its structure while remaining elastic in order to allow for movement. The loss of these proteins results in the skin of the hands taking on a thin and finely wrinkled appearance that resembles crepe paper.

   PIGMENTATION ISSUES SUCH AS AGE SPOTS

   These are caused by prolonged exposure to ultraviolet (UV) light, which is present in sunlight as well as certain artificial light sources.

   LOSS OF VULUME

   Ageing can cause our hands to appear bonier, with the veins on the hand becoming more prominent. 

   REVITALIZING OUR HANDS

   Use a good sunscreen to protect our hands from UV damage.

   Consider using antioxidant serums on the hands. My personal favourites are vitamin C, vitamin E, and ferulic acid.

   Moisturize hands regularly with a strong and rich moisturizer. Ingredients such as hyaluronic acid and ceramides are beneficial in retaining moisture and repairing skin barrier.

   What are the available aesthetic treatments for ageing hands?

   AGE SPOTS

   Chemical peels. A chemical solution is applied to the top layer of the skin, removing dead skin cells and allowing new skin cells to regenerate. The skin that grows back after a chemical peel is smoother and younger-looking.

   Microdermabrasion. A special device with an abrasive surface is used to gently remove debris from the outer layers of the skin. This treatment works even better when combined with other procedures such as lasers, chemical peels, and LED light therapy.

   Laser skin resurfacing. This technique employs an intense beam of laser light to remove the top few layers of skin. This will promote the growth of new, younger-looking skin. There are several types of laser treatment available—we can consult an aesthetic medicine specialist on the type most suitable for our needs. 

   DRY SKIN

   Skinboosters, which are tiny injections made into the skin to restore hydration and improve skin elasticity. 

   LOSS OF VOLUME AND PROMINENT VEINS

   Biostimulating fillers, when injected into hands, can restore volume and reduce the prominence of veins. The biostimulatory effects of these fillers will also improve the skin texture of our hands.

1. WORDS HANNAH MAY-LEE WONG

   Being diagnosed with diabetes may change your life. Yes, it can be overwhelming at first. Chances are, you’re navigating through a sea of new information and don’t know where to begin. 

   Don’t worry. With a few key changes to your diet and lifestyle, you can still enjoy a healthy and active life.

   Create a healthy eating plan

   As diabetes is a metabolic disease, one of the first things you must do is to understand how different foods affect your blood sugar levels. If you need help with this, work with a dietitian to help you create a healthy meal plan. Your new diet should have plenty of vegetables, fruits and whole grains. While you can still enjoy most of your favourite foods, it’s important keep portion control in mind and limit your intake of food that are high in sugar and fat. 

   Get into a workout regime

   Exercise helps control diabetes by bringing down blood sugar levels and helping you maintain a healthy weight. If you haven’t been active, it’s never too late to start. However, consult your doctor before embarking on any strenuous exercise programmes.  All you need is 30 minutes of physical activity a day that makes you sweat and gets your heart rate up. This can be easily achieved from a brisk walk, a cycling session, a swim or whichever sport you prefer. 

   Don’t stress yourself   

   Stress affects blood sugar levels and can demotivate you from making positive changes. Find ways to manage your stress by doing relaxing activities like yoga, journaling or any hobby you truly enjoy. 

   If you’re still feeling anxious or lost, join a diabetes support group. Support groups can offer motivation and useful advice to set you on the right track.

   Stay in touch with your doctor

   You’ll need to see your doctor to get your cholesterol, blood pressure and blood sugar levels checked. You doctor would also be the best person to track your progress and make sure you’re on the right path in your diabetes management plan.

   Reference: WebMD. (n.d.). 6 Lifestyle Changes to Control Your Diabetes. https://www.webmd.com/diabetes/diabetes-lifestyle-tips

1. WORDS LIM TECK CHOON

    

   1. Turn up early for the appointment. (about half an hour before the appointment time).
   2. Wear loose clothing that allows doctors to easily access your shoulder.
   3. Remember to bring your mobile phone with your MySejahtera ID and your NRIC.
   4. A briefing and verification of your identity. You will need to scan several QR codes with your mySejahtera app.
   5. There will be a short counselling session by a doctor who will review your medical history such as past medical problems, allergies, etc.
   6. If this is cleared, you will need to sign the consent form saying that you are agreeable to the vaccine. This is only during the first dose.
   7. You can then proceed to vaccination. It is better to be injected on your non-dominant hand, as most people experience soreness and pain at the injection area.
   8. You will need to stay for observation for 30 minutes. You will be monitored for any severe reactions.
   9. You will receive a notification for your second dose (between 2-3 weeks after). The second dose will be much faster as there will be no counselling or briefing session.
   10. After the second dose, you will be given a card to verify that you have received both doses. This card will also be available in your mySejahtera app.

    

   About the Expert

   Prof Dr James Koh Kwee Choy is the Associate Dean, Academic Affairs, and Infectious Diseases Consultant of International Medical University.

1. 

    

   WORDS HANNAH MAY-LEE WONG

    

   As the nation continues its long-haul battle against COVID-19, it is our responsibility as good citizens to do the best we can to protects ourselves, our loved ones, and our community from the virus.

   With time, more knowledge on COVID-19 is uncovered, leading to more effective prevention measures.

    

   BE EXTRA CAUTIOUS IN INDOOR SPACES

   More evidence shows that COVID-19 is an airborne virus. This means that it can spread rapidly in enclosed spaces where air circulation is limited. High-risk areas include offices, buildings, and public transportation.

   Masks help protect against the virus. If it is possible, opening the windows can help also air circulate.

    

   IF YOU GET AN AIR PURIFIER, LOOK FOR ONE WITH HEPA FILTERS

   Air purifiers can help clean indoor air and improve air quality at home. Those equipped with HEPA filters can help filter out viruses, preventing them from recirculating in the air. Some air purifiers come with UV light that help destroy viruses.

    

   DOUBLE MASK

   The Malaysian Ministry of Health recommends double masking. To double mask, wear a fitted cloth mask on top of a surgical mask.

   “Because the COVID-19 virus is airborne, it can enter through the sides of your mask. The idea behind double-masking is to ensure your mask fits the sides of your face snugly. That said, even if you wear a single mask that fits nicely to your face, it will still protect you against COVID-19,” explains Prof Dr James.

   Other methods such as knotting your mask straps or using mask extenders to improve the fit of your masks are also recommended. For children, it’s best to buy masks that are suitable for their size.  

    

   USE 3-PLY SURGICAL MASKS

   Prof Dr James advises that you should only buy masks that are labelled “surgical masks” or “masks for medical use”. Your masks should also be 3-ply.

    

   What about KN95 or N95 masks?

   According to Prof James, these masks are effective at filtering airborne particles. However, they can be uncomfortable to wear and may cause breathing problems for the elderly or those that have respiratory issues.

    

   DO NOT REUSE YOUR MASKS

   Disposable masks must be thrown away immediately after each use. Prof Dr James explains that masks are designed to trap droplets that may contain harmful substances like viruses and bacteria.

   “Don’t keep used masks in your car or leave them lying around. Any viruses that are trapped on masks can recirculate in the air. If you keep your masks long enough, you risk other things growing on them such as bacteria and fungus,” he adds.

    

   ADHERE TO SOP EVEN AFTER GETTING VACCINATED

   Many of you may have been lucky enough to get vaccinated. However, Prof James reminds that the number of unvaccinated people far outnumber the ones that are vaccinated.

   If you are vaccinated, continue wearing your masks and practise social distancing. Vaccination protects you against getting severe illness from COVID-19, but you can still be infected with the virus and pass on the infection to others.

    

   REMEMBER THE BASIC RULES

   Lastly, don’t forget to adhere to the SOPs that have been with us from the beginning:

   • Wash your hands regularly
   • Avoid touching your eyes, mouth, and nose
   • Practise social distancing
   • Stay at home as much as you can—only go out for essential tasks.

1. 

    

   WORDS LIM TECK CHOON

    

   YOU SHOULD SELF-TEST WHEN YOU HAVE BEEN IN CLOSE CONTACT WITH A POSITIVE CASE

   •  ‘Close contact’ means that you have been in very close proximity to a person who tested positive for a significant period.
   • The virus is most contagious during 2 days before and 3 days after a confirmatory test. If your friend tested positive on Thursday, and you were in close proximity with your friend 2 days before and 3 days after, which is Sunday, you are likely to have had significant risk of catching COVID-19.

    

   SELF-TEST 3 TO 5 DAYS AFTER YOUR LAST CONTACT WITH THE INFECTED PERSON

   • If you self-test too early, there may not be enough viruses in your body for the self-test kit to detect.
   • Minimise your movement or contact with others while waiting for the time to get self-tested.

    

   THERE ARE 2 TYPES OF SELF-TEST KITS

    

   Polymerase chain reaction (PCR) self-test kit

   • Recommended for people with symptoms or have been in close contact with a positive case.
   • Uses nose swap as sample.
   • Highly accurate in detecting viral genetic material.
   • Can be costly.
   •  Results may take 24 to 48 hours to be available.

    

   Antigen Rapid Test Kit (RTK-Ag)

   • Recommended for people that have no symptoms or close contact with positive cases.
   • Uses saliva or nose swap.
   • Detects spike proteins present on the coronavirus.
   • Less invasive than PCR self-test kit, hence more comfortable to use for some people.
   • Generally costs less than PCR self-test kits.
   • Results take under 20 minutes to be available.
   •  If the result is positive, you should do a PCR test to confirm that you are indeed positive.

   Note that different types and brands of self-test kits have different rates accuracy when it comes to detecting the presence SARS-CoV-2, the virus that causes COVID-19. Talk to your doctor or pharmacist for more information.

    

   TIPS TO IMPROVE ACCURACY WHILE SELF-TESTING

   • Rinse mouth at least 30 minutes before taking the test
   • Choose a well-ventilated and clean environment.
   •  It’s best to do this alone so that you can focus on the task at hand. If you need assistance, make sure the other person is fully protected (mask, face shield, PPE, gloves).
   • Have all the proper devices and equipment ready beforehand. Typically, you will need a timer, sanitizer, gloves, apron, and a disposal bag.
   • Read the instructions properly before opening the test kit. Watch a how-to video beforehand, if such a video is available online.

WORDS Malaysian Endocrine and Metabolic Society (MEMS)

The risk factors for severe COVID-19 and death include advancing age (over 60 years old), diabetes, hypertension, kidney problems, heart disease and obesity. The more risk factors are present, the more it will be like living with a ticking time bomb!

Diabetes is a main contributor to severe COVID-19 morbidity and mortality. High blood glucose impairs the immune function and reduces our ability to fight infections.

As such, individuals with poorly controlled diabetes prior to COVID infection will be at greater risk for severe COVID-19 disease, pneumonia, intensive care unit (ICU) care, and death.

They are not more likely to catch the infection as anyone else.

However, once infected, they are 3 times more likely to develop severe COVID-19 pneumonia, other end-organ damage, and to die. 1 in 4 people with diabetes who were admitted to ICU for COVID-19 ended up dying.

Obesity is another major COVID-19 risk factor. It was initially thought to be an innocent bystander because of its close association with diabetes, hypertension and cardiovascular disease which are known to predict risk of severe COVID-19.

However, recent data from large studies has confirmed that obesity is a strong and independent determinant of increased risk of severe COVID-19.

In fact, obesity is thought to shift the risk of severe COVID-19 to younger age groups. That means a younger overweight or obese person aged below 50 is more likely to suffer severe COVID-19 infection.

IF YOU HAVE DIABETES, PREVENTION IS ESSENTIAL!

As social restrictions get lifted and people start travelling, it is imperative that you maintain all the precautions to avoid catching and developing severe COVID-19.

Remember to maintain physical distancing, wear a face mask, and wash and sanitise your hands frequently. This is even more important when interacting with unvaccinated family members, such as your grandchildren.

Get vaccinated against COVID-19 if you have not yet done so. Research has confirmed that the currently used vaccines in Malaysia are effective, including for people with diabetes.

Unfortunately, as with most vaccinations, the protection is NOT 100%. You may still get infected after getting vaccinated (breakthrough infection), but chances of severe disease and mortality is significantly reduced.

TAKE EXTRA GOOD CARE OF YOURSELVES

People with diabetes need to pay attention to their glucose control as it can significantly reduce their risk of severe COVID-19 infection and related mortality. 

So, take your medications as prescribed, watch your diet, stay physically active, and monitor your glucose regularly.

Also, be sure to manage your blood pressure and other chronic health conditions, and reduce overweight/obesity.

Last but not least, attend your medical follow-ups without fail.

References:

1. Dorjee, K., Kim, H., Bonomo, E., & Dolma, R. (2020). Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients. PloS one, 15(12), e0243191.https://doi.org/10.1371/journal.pone.0243191
2. Prattichizzo, F., de Candia, P., Nicolucci, A., & Ceriello, A. (2021). Elevated HbA1c levels in pre-Covid-19 infection increases the risk of mortality: A sistematic review and meta-analysis. Diabetes/metabolism research and reviews, e3476. Advance online publication. https://doi.org/10.1002/dmrr.3476
3. Zhu, L., She, Z. G., Cheng, X., Qin, J. J., Zhang, X. J., Cai, J., Lei, F., Wang, H., Xie, J., Wang, W., Li, H., Zhang, P., Song, X., Chen, X., Xiang, M., Zhang, C., Bai, L., Xiang, D., Chen, M. M., Liu, Y., … Li, H. (2020). Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell metabolism, 31(6), 1068–1077.e3. https://doi.org/10.1016/j.cmet.2020.04.021
4. Bud, E. S., Vlasa, A., & Bud, A. (2021). Diabetes mellitus is associated with severe infection and mortality in patients with COVID-19: A systematic review and meta-analysis. Archives of medical research, 52(3), 356. https://doi.org/10.1016/j.arcmed.2020.11.003
5. Fadini, G. P., Morieri, M. L., Longato, E., & Avogaro, A. (2020). Prevalence and impact of diabetes among people infected with SARS-CoV-2. Journal of endocrinological investigation, 43(6), 867–869. https://doi.org/10.1007/s40618-020-01236-2
6. Gregory, J. M., Slaughter, J. C., Duffus, S. H., Smith, T. J., LeStourgeon, L. M., Jaser, S. S., McCoy, A. B., Luther, J. M., Giovannetti, E. R., Boeder, S., Pettus, J. H., & Moore, D. J. (2021). COVID-19 severity is tripled in the diabetes community: A prospective analysis of the pandemic’s impact in type 1 and type 2 diabetes. Diabetes care, 44(2), 526–532. https://doi.org/10.2337/dc20-2260
7. Kass, D. A., Duggal, P., & Cingolani, O. (2020). Obesity could shift severe COVID-19 disease to younger ages. Lancet (London, England), 395(10236), 1544–1545. https://doi.org/10.1016/S0140-6736(20)31024-2

WORDS HANNAH MAY-LEE WONG

The endothelium is a single layer of cells that are found between the lumen (the hollow space where blood flows through) and the smooth muscle cells in the blood vessels.

WHY IS THE ENDOTHELIUM SO IMPORTANT FOR HEART HEALTH?

The endothelium releases an important chemical called nitric oxide. When nitric oxide is released, blood vessels relax and expand, and this improves blood circulation.

“The endothelium is the only cellular network in the entire cardiovascular system that is capable of producing nitric oxide, and so it is essential to maintain a healthy endothelium,” Dr Ignarro elaborates.

“Increased nitric oxide results in increased blood flow to the organs, which supports healthy blood pressure and a healthy cardiovascular system. But for all this to happen, the production house of nitric oxide—the endothelium—needs to be supported,” he adds.

TIPS FOR KEEPING THE ENDOTHELIUM HEALTHY

Exercise regularly

Research shows that moderate intensity exercise improves the function of the endothelium, which increases nitric oxide levels in the body and promotes the relaxing of the blood vessels.

Supplement with foods that increases nitric oxide levels

Eating a healthy and balanced diet is key to good heart health. Additionally, some studies have shown that there are certain foods that can help increase nitric oxide levels in the body. These include grapes, black and red berries, green and black teas, cocoa, and food that contain omega-3 fatty acids such as salmon or tuna fish.

Keep a healthy weight and lower stress levels

Keeping stress levels low and maintaining a healthy weight are important for heart health and contribute to endothelium health.

References:

1. Vallance, P., & Chan, N. (2001). Endothelial function and nitric oxide: clinical relevance. Heart (British Cardiac Society), 85(3), 342–350. https://doi.org/10.1136/heart.85.3.342

2. Goto, C., Nishioka, K., Umemura, T., Jitsuiki, D., Sakagutchi, A., Kawamura, M., Chayama, K., Yoshizumi, M., & Higashi, Y. (2007). Acute moderate-intensity exercise induces vasodilation through an increase in nitric oxide bioavailiability in humans. American journal of hypertension, 20(8), 825–830. https://doi.org/10.1016/j.amjhyper.2007.02.014

3. Auger, C., Said, A., Nguyen, P. N., Chabert, P., Idris-Khodja, N., & Schini-Kerth, V. B. (2016). potential of food and natural products to promote endothelial and vascular health. Journal of cardiovascular pharmacology, 68(1), 11–18. https://doi.org/10.1097/FJC.0000000000000382

WORDS HANNAH MAY-LEE WONG

Lung Cancer Network Malaysia (LCNM) in collaboration with the National Cancer Society Malaysia (NCSM), supported by Pfizer, rolls out our country’s first digital lung cancer patient guide.

The guide aims to support lung cancer patients by helping them improve their knowledge and understanding of lung cancer. It includes easy-to-understand illustrations and information about lung cancer and addresses common questions, misconceptions and concerns that lung cancer patients may have when they are first diagnosed.

The digital guide is available in Bahasa Malaysia, English and Chinese. It also provides updated information on the latest treatment options for lung cancer that are available.

Filling in knowledge gaps

“A diagnosis of lung cancer is often unexpected and can be overwhelming. The vast volume of information available on the internet and social media these days can be confusing, daunting, and even misleading,” Dr Anand Sachithanandan says.

He adds, “We hope this guide will serve as a practical, easy-to-use clinical guide for anyone with a suspected or confirmed diagnosis of lung cancer. It provides comprehensive information in a clear and concise manner to help patients and their loved ones better navigate this cancer ‘journey’ of screening, diagnosis, staging, treatment and surveillance.”

To download a copy of the lung cancer patient guide, please visit www.lungcancer.net.my

Tonsils are the soft tissues you can see at the back of your throat, on the left and right sides. They help the body fight infection by filtering and trapping virus and bacteria. When children grow up, their immune system becomes stronger. As a result, their tonsils will usually become smaller. In most adults, their immune system takes over the function of their tonsils. 

Viruses such as the cold or flu virus as well as bacteria such as group A streptococcus can infect the tonsils, causing tonsillitis. As a result, the tonsils may end up getting infected and swollen. This condition is called tonsillitis.

 

Signs and symptoms 

Tonsillitis causes a very painful sore throat. You may also have the following symptoms: 

• Earache 

• Fever (above 38°C) 

• Cough 

• Headache 

• Feeling sick and tired 

• Swollen and painful lymph glands in your neck 

• Loss of voice or changes in your voice 

• Bad breath. 

Don’t be alarmed though as tonsillitis will usually run its course within three to four days and you’ll feel better. 

When you… 

• have symptoms for more than four days 

• can’t eat or drink because it’s too painful 

• have difficulty breathing, see your doctor quickly! 

At the clinic 

Your doctor will ask you to describe your symptoms and examine your throat. Then, you will be given painkillers and lozenges to soothe your sore throat. 

If there are white spots on your tonsils and you have swollen and tender lymph glands, you are most likely to have bacterial infection. Your doctor may prescribe antibiotics, which you have to take according to the dosage until it is finished. 

At home 

The two most effective home remedies for tonsillitis are drinking enough amounts of water and resting. 

To shower your tonsils with more TLC, you can do the following: 

• Gargle with warm, salty water 

• Eat cold foods like ice cream and jelly 

• Use a humidifier in your room. 

Serious cases 

In some children and adults, tonsillitis either keeps returning or lasts longer than a week. This condition is known as chronic tonsillitis. When this happens, a surgery called tonsillectomy may be recommended to remove the tonsils. 

Sometimes in rare instances, complications can happen. These include middle ear infection, collection of pus between the tonsils and the throat wall, and obstructive sleep apnoea (OSA). OSA can be serious as it causes the person to stop breathing during sleep resulting in poor sleep and daytime sleepiness. 

Other even more rare complications are: 

• Scarlet fever, which causes skin rash 

• Rheumatic fever, which causes heart disease, joint pain, rashes and abnormal body movements 

• Kidney problems. 

Preventing tonsillitis 

As virus and bacteria can cause tonsillitis, the infection can easily spread to others. It is important to prevent the infection from spreading. 

So when you have tonsillitis… 

• You should see the doctor quickly and take the medication 

• Stay at home and keep away from your loved ones until your symptoms have gone 

• Always sneeze or cough into a tissue and throw the tissue in the dustbin when you are done 

• Wash hands frequently especially before eating, after using the toilet and after coughing or sneezing. HT 

 

References: 

1. Mayo Clinic. Available at www.mayoclinic.org 

2. NHS Choices. Available at www.nhs.uk 

3. WebMD. Available at www.webmd.com

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