5 Popular Dengue Myths Debunked by a Family Medicine Specialist

WORDS LIM TECK CHOON

Myth 1
YOU ONLY CATCH DENGUE ONCE IN YOUR LIFETIME 

Unfortunately, no.

“There are 4 dengue serotypes,” says Associate Professor Dr Verna Lee Kar Mun.

Serotype is a word used to describe a strain of microorganism, which means that there are 4 different types of the dengue virus that can infect us.

This means that each of us can get infected up to 4 times, once with each serotype, and achieve total immunity to dengue only after being infected with all 4 serotypes!

“However, before you start thinking it’s a good idea to get infected four times, bear in mind that subsequent infections are likely to be more serious than the first,” warns Assoc Prof Dr Verna, “and each infection only increases your chances of getting severe dengue.”

Myth 2
YOU’RE GETTING BETTER WHEN YOUR FEVER GOES AWAY

Well, things are not so simple.

You see, according to Assoc Prof Dr Verna, there are 3 different stages of dengue fever.

  • Febrile phase: 1 to 2 days of high fever that begins suddenly. During this time, we’re likely to have experience aches, headache with pain behind the eyes, flushed faces, and sometimes blotchy skin or rashes.
  • Critical phase: the fever subsides, and we may feel that we are getting better. However, these 1 to 2 days are also a period when our blood capillaries may leak plasma, leading to a sudden drop in blood pressure and sending us into shock.
  • The next phase will depend on the outcome of the critical phase. We may get better after receiving proper medical treatment and proceed to the recovery phase, or we may get worse and experience severe dengue instead.

“Many viral illnesses such as dengue are self-limiting, which means they will naturally subside,” Assoc Prof Dr Verna shares. “In most cases, patients only need self-care at home, and the most important thing to remember is to take plenty of fluids to prevent the dehydration that comes with plasma leakage.”

“Anyone who gets dengue fever should aim to drink at least 3 litres of water daily for the first 3 days,” she adds.

Myth 3
DENGUE IS ONLY A SMALL CONCERN; AFTER ALL, YOU CAN GET BETTER FROM PRACTICING SELF CARE AT HOME

Not necessarily true.

“An estimated 1% of patients will experience severe dengue, also known as haemorrhagic dengue, which will require hospitalization,” says Assoc Prof Dr Verna.

She goes on to explain that one may begin to experience bleeding during the febrile phase, usually in the skin or gums. If the bleeding weren’t managed well, the dengue will worsen during the critical phase, forcing us to be admitted into the hospital.

“Those with a healthy immune system usually recover in 2 days, but if there is inflammation affecting the organs such as the heart, liver or brain, it can take up to a week, longer if there are other complications,” she goes on to say.

Myth 4
YOU SHOULD ONLY TEST FOR DENGUE AFTER 3 DAYS 

“It is true that the initial symptoms are vague, as a fever can be a sign of many different illnesses,” says Assoc Prof Dr Verna.

However, with dengue, the high fever usually comes suddenly.

“The S1 dengue rapid antigen test can detect dengue from the first day, so don’t delay seeking medical advice if you suddenly develop a high fever,” she advises.

Delay in getting tested may lead to severe consequences, as we will enter the critical phase 1 to 2 days after catching dengue—a time when our condition can suddenly take a turn for the worse!

Myth 5
ONCE YOUR NEIGHBOURHOOD HAS BEEN FOGGED, THERE IS NO NEED TO DO ANYTHING ELSE TO PREVENT DENGUE

Not true.

Assoc Prof Dr Verna reveals that while fogging helps to kill adult mosquitoes and getting rid of stagnant water in public drains and other places helps to prevent breeding sites, this method are only partially effective.

To illustrate, millions are spent on fogging efforts every year—an estimated RM777 million was spent on fogging efforts in the 2009 to 2010 period—but dengue remains prevalent to this day. There is even evidence that mosquitoes have grown resistant to the common insecticides used in fogging!

“On a personal level, all of us can do something at home to help prevent mosquito bites and breeding sites. We need to make a bigger effort to protect ourselves and our loved ones by making sure our home environment is clear of any breeding sites, covering up exposed skin and using mosquito repellents, especially during sunrise and sundown,” she advises.

Oral Health Tips From a Dentist for People With Diabetes

WORDS DR LAU LAKE KOON


Most people with diabetes or those that have someone close to them that have this disease will know that the disease can harm many organs in the body—such as the eyes, nerves, kidneys, heart, and more.

DO YOU KNOW THAT DIABETES CAN AFFECT THE TEETH AND GUMS AS WELL?

People with diabetes are more likely to have:

  • Periodontal or gum disease
  • Persistent bad breath
  • Tooth decay or cavities
  • Oral fungal infections
  • Oral ulcers
  • Loss of teeth
Diabetes can cause increased levels of glucose in the blood as well as saliva
Progression of gum disease, from gingivitis to the more serious periodontitis. Click on the image to view a larger, clearer version.

The increase of glucose in the saliva encourages the growth of bacteria in the mouth and together with food particles can build soft sticky whitish layer called plaque.

Plaque is the yucky smelly stuff that you can scrape off from your teeth if you haven’t been cleaning them properly. It is the main cause of bad breath.

If left unchecked, the persistent plaque buildup can cause tooth decay and harden to form tartar.

Persistent plaque or tartar buildup causes irritation to the gums

The gums can become red and swollen, and bleeding may occur.

This is the first warning sign that it’s time to visit the dentist.

Comparison of normal tooth and a tooth with periodontitis. Click on the image for a larger, clearer version.

Otherwise, the infection will go deeper under the gums, causing infection of the bone structure supporting the teeth. This is periodontitis, the second stage of gum disease.

The gums will start to recede, trying to pull away from the tartar formed. Over time the teeth will become unstable, and one may experience pain as a result.

At the final stage of gum disease, the teeth will become so infected and painful that it may need to be removed

In poorly controlled diabetic cases, the gum disease may progress much faster. The severity of the condition may be worse, which is why it is important to visit the dentist early to resolve the issues.

Diabetes and certain drugs can reduce the production of saliva in our mouth

Our saliva contains minerals to protect our teeth from tooth decay, mucin to keep the teeth moist and slippery, antibacterial substances to eliminate potentially harmful bacteria, and it also has the ability to neutralize the acids produced by bacteria in our mouth.

Without the presence of saliva, there is a higher risk of tooth decay and gum disease.

Dry mouth can increase the risk of developing fungal infections called thrush, which are painful white patches in the mouth.

In denture wearers, the dryness can decrease the suction effect of the denture and increase abrasion against the gums, leading to ulcers and mouth sores.

Smoking will worsen the condition further.

In severe uncontrolled diabetic cases, some people can develop burning mouth syndrome—a continuous burning sensation in the mouth that will alter taste and sensation.

HOW THE DENTIST CAN HELP YOU
Gingivitis or periodontitis

The dentist will need to carry out deep cleaning of the teeth and gums, in order to decrease the bacterial load and to allow the gums to heal.

However, the dentist can only do so much—you have to also keep good oral hygiene and use of mouthwash daily.

Fungal infections

Your dentist may prescribe some medications to kill the fungus responsible for the infection.

If you use dentures, they will be checked to ensure that they are still fitting properly. You must keep them clean in a disinfection solution at night.

Dry mouth

For most non-severe cases, the simplest solution is to keep your body well hydrated at all times. Drinking water regularly also moistens the mouth.

Only in severe cases are saliva substitutes prescribed.

Burning mouth syndrome is usually more complicated and will require specialist attention.

HELPFUL TIPS
  • A well controlled blood glucose level as well as a healthy diet and lifestyle are key to reducing and preventing oral health problems. Keeping your mouth healthy will also prevent diabetes-related health problems such as heart disease and kidney disease.
  • Good oral hygiene will keep your gums and teeth healthy. Brushing twice a day every day, and use a floss or water floss daily.
  • Visit your dentist regularly for a routine checkup. Please make sure you tell your dentist if you have diabetes. Keep your dentist updated about any changes to your health and blood sugar levels.
  • For denture wearers, make sure your dentures fit properly, and clean them by soaking them in denture disinfectant at night.
  • Quit smoking. Smoking will worsen gum condition and overall health.

Expert Coalition to Educate Malaysians & Prevent Another COVID-19 Surge

PRESS RELEASE
COVID-19 IS STILL A THREAT

As we welcomed 2023, China reported a huge spike in daily COVID-19 cases during the end of year holiday seasons 2022.

After a period of pandemic fatigue and indifference, the event sparked sudden and short-lived fear and caution among the global as well as Malaysian community.

The news triggered some Malaysians to be up in arms, calling for a ban on travellers from China and reinforcement of pandemic SOPs such as the mandatory wearing of mask in public areas.

Nonetheless, the interest soon died down as other headlines made their way in the news.

It appears that it is only when crises are about to hit our shores that we react.

In fact, as highlighted by the World Health Organisation (WHO), we need to always be prepared and cannot afford to be reactive.

On January 27, 2023, it announced and reminded member countries that COVID-19 remains a public health emergency of international concern.

WHO compared 28-days data between Dec 5, 2022 to Jan 1, 2023 and Jan 2 to Jan 29, 2023.

It found that although the number of cases reported decreased by 78%, the number of deaths increased steeply by 65%.

This result is mainly due to the large wave of cases and deaths in the Western Pacific Region, especially in China.

WHO further states that the numbers may be an underestimation due to the reduction in testing and delay in reporting in many countries.

STAY VIGILANT & PROTECT THE VULNERABLE

3 years into the pandemic, Malaysia has reported more than 5 million cases and over 36,000 deaths.

In 2021, it became the main cause of death in Malaysia, overtaking heart disease.

The risk of death is higher among:

  • Those above 60 years
  • Individuals with underlying health conditions
  • Unvaccinated individuals

According to MOH data between Jan 1, 2022 to July 31, 2022, 75% of COVID-19 deaths were among individuals 60 years and above, and 86% of deaths were among those with at least one underlying health condition .

Compared to the first year of pandemic, we are now more prepared to curb COVID-19 due to advancement in preventive measures, rapid diagnoses, and management tools such as vaccination, rapid test kits (RTK) as well as early treatment with antivirals.

These tools are important particularly to prevent severe COVID-19, keeping individuals especially those with risk factors away from hospitalization, intensive care unit (ICU) admissions and ultimately death.

Nonetheless, these tools will only be useful if they are being utilized optimally.

While Malaysians were quick on the uptake of primary COVID-19 vaccination doses, the uptake of booster doses are very poor with only 49.7% uptake of the 1st booster and a mere 1.6% of the 2nd booster (as of Feb 7, 2023) .

While no concrete data is available, there are good reasons to believe that due to pandemic fatigue, people are now less likely to test and seek treatment for COVID-19.

It is also important to note that antiviral treatment needs to be taken within the first 5 days of symptom onset. Thus, speed is of the essence.

We cannot risk another surge of COVID-19 globally or locally as it would put a toll on our healthcare system and risk overwhelming it.

In addition to COVID-19, we are also facing the threat of other respiratory illnesses such as influenza and respiratory syncytial virus (RSV).

As it stands, we are currently experiencing overcrowding in Emergency Departments.

Hence, it is crucial that we answer the calls of WHO and the Ministry of Health Malaysia to continue urging the public especially those who are in the high-risk groups (older persons, individuals with underlying medical conditions) to take precautions against COVID-19.

OUR CAMPAIGN

The Malaysian Society of Infection Control and Infectious Diseases (MyICID) in collaboration with the Family Medicine Association Malaysia (FMSA) and Malaysian Medical Association (MMA) are organising an educational campaign themed COVID-19: QUICKLY TEST & TREAT.

Our objectives

This campaign aims to urge the public especially individuals who are at high-risk as well as their family members to continue protecting themselves and others from severe COVID-19 by:

  • Getting primary and booster doses
  • Testing immediately upon onset of symptoms
  • Seeking early treatment, within the first five days of symptoms

Our campaign’s panel of experts

  • Dr Alif Adlan Mohd Thabit Infectious disease physician
  • Dr Ang Peng Peng Infectious disease physician
  • Dr Suriani Sulaiman Family medicine specialist
  • Dr Balachandran S Krishnan General practitioner
THIS IS A PUBLIC COMMUNITY MESSAGE BROUGHT TO YOU BY

3 Tips to Work From Home Without Hurting Your Posture

WORDS DR LIM SZE WEI


While working from home does come with benefits but it also limits physical movements and takes a toll on our postures.

We started seeing a rapidly rising number of young Malaysian adults that are suffering with neck and back pain, especially those working from home and who work for long hours on their devices.

Consciously, we must remind ourselves to pay attention to the signs our back and neck is giving us, so that we can lower the risk of developing serious spinal conditions down the road.

TIP 1
CREATE AN OPTIMAL WORK AREA
  • Invest in a proper desk and office chair.
  • Ensure that the chair and desk you’re going to be working on is comfortable, supportive, adjustable, and ergonomically sound.
  • Pick a work desk with an optimal height so that the neck, shoulders, and arms remain at a neutral position.
  • Sett up your workstation perpendicular to the window and away from direct light, to minimize the strain on your eyes.
TIP 2
WORK ON YOUR POSTURE
  • Good standing or sitting posture involves having the body be symmetrical, weight evenly distributed and well aligned so it does not strain the neck and back muscles.
  • Use a monitor as a primary working computer instead of a laptop to help improve your posture. If that is not possible, use a book or laptop stand to raise the laptop, so it is at eye level.
  • While being seated, place a small pillow behind your lower back to maintain an arch to lean back in and relieve your back muscles.
  • Keep your forearms and hands leveled and straight by having the keyboard and mouse close to the laptop.
TIP 3
RELAX YOUR MUSCLES
  • The issue isn’t sitting or remaining still while working; It’s being stuck in one place for too long. The body accumulates stress between managing tight deadlines, budget demands, performance reviews, and even the everyday challenges of the day.
  • To keep the mind and, by extension, body healthy, you can combine basic stretches with breathing exercises and other relaxation techniques while you work.
  • Stretches, short walks, or even small bursts of exercise are a great way to get the muscles active and engaged throughout the day.
  • Set alarms or reminders throughout the day to get up and stretch. A 30-second “microbreak” is just enough to change your posture briefly and helps take the pressure off and relax.

Have Diabetes? Here’s an Improved Way to Track Your Blood Sugars

WORDS LIM TECK CHOON

Continuous glucose monitoring (often abbreviated as CGM) is basically a system that allows one’s blood glucose levels to be monitored automatically.

HELPS TO IMPROVE YOUR DIABETES MANAGEMENT

This system opens up a world of opportunities for better blood glucose management for people with type 1 diabetes as well as those on type 2 diabetes that require insulin.

After all, with information of their blood glucose levels that can be obtained immediately, they can make quick informed decisions about their food choices and the dosage of their insulin as well as when to administer it.

LETS YOU ANTICIPATE A POTENTIAL INCOMING MEDICAL EMERGENCY

The ability to observe the pattern of the rise and fall of their blood glucose also allows them to be alert of the possibility of a hypo- or hyperglycaemic episode, and take prompt measures accordingly.

NOT JUST FOR PEOPLE WITH DIABETES

Additionally, continuous glucose monitoring can also benefit people with kidney problems as well as pregnant women worried about gestational diabetes.

RECOMMENDED BY EXPERTS 

It’s really not surprising, therefore, that the 23rd Hong Kong Diabetes and Cardiovascular Risk Factors—East Meets West Symposium reported a growing consensus on the definitions and targets of continuous glucose monitoring metrics to allow healthcare professionals and people with diabetes to make full use of this system in diabetes management.

Indeed, the United Kingdom has already taken steps to do this.

All in all, this is a remarkable example of how technology is making diabetes management, which can be complex and confusing to some people, considerably easier to figure out and implement correctly!

Continuous glucose monitoring is a feature in certain types of blood glucose monitor or glucometer. You can talk to your doctor or your pharmacist for more information on continuous glucose monitoring and whether you can benefit from using a glucometer that comes with this feature.

Reference: Oliver, N., Chow, E., Luk, A. O. Y., & Murphy, H. (2023). Applications of continuous glucose monitoring across settings and populations: report from the 23rd Hong Kong Diabetes and Cardiovascular Risk Factors – East Meets West Symposium. Diabetic medicine : a journal of the British Diabetic Association, e15038. Advance online publication. https://doi.org/10.1111/dme.15038

Happy Chinese New Year Everyone & Here’s an Article About Rabbits

WORDS LIM TECK CHOON
PHOTO RAHIM SOFRI

UNDERSTANDING THE RABBIT
  • Rabbits are pack animals that have many predators, so they are conditioned to always be alert and wary. Therefore, when you adopt a pet rabbit, it may take a while for the rabbit to become familiar with its new home and to feel safe.
  • Wild rabbits live in warrens—underground homes interconnected by tunnels. Therefore, even tame rabbits have this urge to dig with their paws. Therefore, line your rabbit’s new home with something that it can dig on.
  • Rabbits answer the call of nature in the same spot as much as possible, so minimize the risk of predators tracking them down. Therefore, tame rabbits can be trained to do their business in the same place every day.
  • A rabbit’s tooth never stops growing throughout its life, and a wild rabbit keeps its teeth to manageable length by chewing down on rough parts of plants. Therefore, give your pet rabbit things that it can always chew on, so that its teeth won’t become overgrown.
  • A rabbit tells you that it is not happy with you by thumping its rear feet. It may also bite, although fortunately rabbits are usually not aggressive to humans.
YOUR RABBIT’S IDEAL HOME
  • Keep your rabbit in a well-ventilated cage—such cages are sold in pet shops. Avoid putting rabbits in closed “houses” or glass cases, as these often lack ventilation.
  • Rabbits may develop sore hocks, with its feet becoming raw and inflamed, when they spend too much time on wire flooring, so make sure that the wire flooring has a mesh size that is as small as possible (1 x 2.5 cm should be good).
  • Have a solid and smooth area for the rabbit to rest on, such a wood or Plexiglas surface, so that it can take a break from moving around on the wire flooring.
  • Grass hay makes good bedding for the rabbit, as it is comfy and also provides a nice snack for a hungry rabbit!
HEALTHY RABBIT MUNCHIES
  • A rabbit needs plenty of dietary fibre to keep its digestive system healthy. Unfortunately, most commercial-available pelleted diets sold in stores do not provide enough fibre for the needs of an older, non-breeding, and physically inactive house rabbit.
  • Usually, such rabbits will need to their pellets supplemented with grass hay, leafy green vegetables, and a small amount of treat foods (rolled oats, stale bread, fruits, etc). Therefore, discuss with a veterinarian (that’s an animal doctor) on how to best meet your rabbit family member’s nutritional needs.
  • Make sure that your rabbit always has clean and fresh water to drink. If you have an inverted sipper bottle for your rabbit, check often to make sure that the drinking or ‘straw’ part of the bottle is not blocked.
TRIPS TO THE VET
  • Ideally, have the vet examine your rabbit once a year to check for lice, parasites, and tooth problems as well as signs of diseases.
  • Pet rabbits can be neutered when they are 3 or 4 months old to keep them from being aggressive.
IF YOU NEED TO LIFT & CARRY THE RABBIT AROUND IN YOUR ARMS
  • Grasp your rabbit family member gently by the scruff of its neck to keep it docile.
  • Cup its hindquarters with your other hand to keep it from kicking you with its rear legs.
  • Then gently pick the rabbit up, keeping it in a vertical position.
  • Alternatively, once you have grasp the rabbit’s scruff gently, you can place its head under your other arm (be gentle, don’t squeeze!) and use that arm to support its hindquarters.

References:

  1. Jenkins J. R. (2001). Rabbit behavior. The veterinary clinics of North America. Exotic animal practice, 4(3), 669–679. https://doi.org/10.1016/s1094-9194(17)30030-0
  2. Crowell-Davis S. (2021). Rabbit Behavior. The veterinary clinics of North America. Exotic animal practice, 24(1), 53–62. https://doi.org/10.1016/j.cvex.2020.09.002

Highlights of the Safe Medication Disposal Practices Roundtable

WORDS LIM TECK CHOON

Alpro Pharmacy hosted an industry roundtable, called Safe Medication Disposal Practices in Malaysia–Past, Present & Future, on 15th December 2022 at Monash University Malaysia.

HIGHLIGHT #1
THE NEED FOR PROPER DISPOSAL OF MEDICINES
  • According to Foon Hwei Foong from Malaysian Community Pharmacy Guild, unwanted medications disposed into landfills are reabsorbed by water streams. This means that these medications eventually leads back to the water that we drink.
  • Dr Saw Pui San, a lecturer from Monash University Malaysia’s School of Pharmacy, cited how irresponsibly discarded contraceptive medicines ended up in our waterways and caused the sterilization of fishes.
  • Antibiotics are strictly regulated prescription medication, and many efforts were made to prevent antibiotic resistance. However, another often overlooked possible cause of antibiotic resistance is the leakage of improperly discarded antibiotics into our water systems.
HIGHLIGHT #2
THE POLICY IS THERE, BUT THE AWARENESS AMONG THE PUBLIC IS LACKING
  • Amrahi Buang, President of the Malaysian Pharmacists Society, stated that laws and policies are in place across all access points of medication distribution in this country, with the Malaysian National Medicines Policy (MNPP) clearly stating the measurements and governance in place for medication safety.
  • He opined that health and medication literacy is still lacking within the Malaysia public, hence the need for an pharmaceutical industry medium to act as an education platform for the public.
  • Furthermore, he stated that pharmacists are strongly encouraged to start working collaboratively with their colleagues as well as other key players in the pharmaceutical industry to educate on, implement, and practice safe medication disposal.
  • Ostwin Paw, the CEO of Alpro Foundation, called for leaders in the industry to kickstart the conversation on the impact and risks of unsafe medication disposal methods on the environment.
HIGHLIGHT #3
ALPRO PHARMACY HELPS TO LEAD THE WAY 
  • Lim En Ni, the Chief Pharmacist of Alpro Pharmacy, shared that Alpro Pharmacy launched the Safe Medication Disposal campaign in 2021 in a joint effort with several key pharmaceutical companies in the country.
  • To date, the initiative has safely disposed more than 1,000 kg of medication waste as well as garnered more than 100,000 signatures from the community pledging their support within 3 months since July 2022.
One of the key initiatives of the Safe Medication Disposal campaign is the placement of dedicated medication disposal bins at all Alpro Pharmacy outlets nationwide to collect excess medicines for proper and ethical disposal. For more information on this as well as on proper medical disposal, click here to visit the Safe Medical Disposal Campaign webpage (link opens in a new tab).

Hoping for a Baby? These Multivitamins May Increase Your Odds of Success!

WORDS LIM TECK CHOON

Data from a recent study conducted by Singaporean researchers suggests that multivitamin supplements that contain folic acid and iodine may be beneficial to women that are planning and hoping to conceive a child.

WHAT THE STUDY DID

The investigators interviewed 908 women between 18 and 45 years old that were trying to conceive. These women were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO).

As an aside, S-PRESTO is a large-scale study on the effects of nutrition, lifestyle, and maternal mood prior to and during pregnancy on the effects of the baby’s genetic materials and the presence clinically important outcomes of the pregnancy. This study is beyond the scope of this article, though!

Back to this study, the investigators were interested in 2 things:

  1. Fecundity, or the measure of the chances of successful pregnancy
  2. Time to pregnancy, or the time between the first moment when the woman tries to conceive and the time of successful conception
WHAT THE INVESTIGATORS FOUND
  1. Multivitamins containing folic acid and iodine improve the success rate of having a baby when compared to those that do not take these supplements.
  2. These multivitamins also are linked to shorter time to pregnancy.
  3. Vitamins D and E do not show any significant improvements to pregnancy success rate and time to pregnancy.
  4. On the other hand, consumption of evening primrose oil is linked to lower pregnancy success rate and slightly longer time to pregnancy, compared to those that do not take this supplement.
WHY FOLIC ACID?

Folic acid, or vitamin B9, plays a role in breaking down and reducing the levels of an amino acid called homocysteine in the body.

High levels of homocysteine can cause effects that can affect fertility, such as increasing the ageing rate of a woman’s eggs and triggering the death of trophoblasts, which are cells of the outer layer of the developing embryo that helps it to attach to the woman’s endometrium for further development, protect the embryo, and eventually form the placenta.

Hence, by reducing the effects of high levels of homocysteine, folic acid can help improve the chances of a successful pregnancy.

HOW ABOUT IODINE?

Past tests on animals suggested that iodine can help improve the regulation of ovulation, increase the odds of a successful fertilization of an egg by a sperm cell following sexual intercourse, and promote successful implantation of the fertilized egg into the endometrium of the woman for further development.

Iodine also plays an important role in the development of nerve and brain cells of the foetus.

HOWEVER, SOME POINTS TO NOTE BEFORE YOU RUSH TO THE PHARMACY!

The investigators noted that more research is needed before we can make any conclusive statements about the effects of folic acid and iodine on one’s hopes of a successful pregnancy.

For example, their study did not measure the exact amounts of these nutrients that will work best on a woman hoping to conceive, and more research would be needed to determine whether their results can be replicated.

However, they believed that women trying to conceive could potentially benefit from taking multivitamin supplements containing these two nutrients, when this is also done in conjunction with other beneficial lifestyle modifications such as being physically active and cutting down on smoking and alcohol intake.

Reference: Ku, C. W., Ku, C. O., Tay, L. P. C., Xing, H. K., Cheung, Y. B., Godfrey, K. M., Colega, M. T., Teo, C., Tan, K. M. L., Chong, Y. S., Shek, L. P., Tan, K. H., Chan, S. Y., Lim, S. X., Chong, M. F., Yap, F., Chan, J. K. Y., & Loy, S. L. (2022). Dietary supplement intake and fecundability in a Singapore preconception cohort study. Nutrients, 14(23), 5110. https://doi.org/10.3390/nu14235110

Important Advice & Tips to Plan & Prepare for a Flood

WORDS LIM TECK CHOON

DR CHAN YANJUN
Medical Director, Singapore & Malaysia
International SOS

“With forecasts indicating that our rainy season is far from over, Malaysians need to be prepared in case of floods,” advises Dr Chan Yanjun. “While there are many different actions people should undertake in a flood situation, the most important rule is do not try to walk, swim or drive through flood water. Cars and people can be swept away, so always remember safety first and to stay alert so you don’t get hurt.”

WHAT YOU SHOULD DO TO SAFEGUARD YOURSELF & YOUR LOVED ONES IN CASE OF A FLOOD
  • Identify flood or landslide-prone areas near you. Watch weather alerts and warnings.
  • Stock up enough water (ration roughly 4 litres per person per day) and dry food for 3 days.
  • Know your community’s evacuation routes and emergency shelter locations.
  • If you are stranded, injured or ill, contact your local emergency services department and wait for help.
IF A FLOOD HITS YOUR HOME, REMEMBER THESE POINTERS
  • Check the drainage system behind or outside your house to see the water levels. The higher the water level climbs, the more likely you will have to evacuate.
  • Switch off all gas, electricity, and water when electricity supply is down, water has entered your home, or before you evacuate. Make sure to unplug appliances to avoid electrical shock when power returns.
  • Move to higher ground. Only move to the roof if necessary.
  • If your family is advised to evacuate, do so immediately (lock gates and doors before leaving if possible).
WHEN YOU ARE ON THE ROAD DURING A FLOOD
  • Stay off bridges as they can be washed away in severe floods.
  • Stay inside your vehicle if you are trapped by rapidly moving water.
  • Move to the roof of your car if water starts to fill the interior.
WHAT TO DO AFTER THE FLOOD
  • Do not return home unless advised to do so. Wait for a signal by authorities or emergency services on the status of your housing area.
  • Look out for animals that may be inside your house. This includes snakes, lizards and even crocodiles.
  • Keep children and pets out of the affected area until clean-up has been completed.
  • Wear rubber boots, rubber gloves, and goggles during clean-up of affected area.
  • Remove and discard items that cannot be washed and disinfected (such as, mattresses, carpeting, carpet padding, rugs, upholstered furniture, cosmetics, stuffed animals, baby toys, pillows, foam-rubber items, books, wall coverings, and most paper products).
  • Remove and discard drywall and insulation that has been contaminated with sewage or flood waters.
  • Thoroughly clean all hard surfaces (such as flooring, concrete, moulding, wood and metal furniture, countertops, appliances, sinks, and other plumbing fixtures) with hot water and laundry or dish detergent.
  • Help the drying process by using fans, air conditioning units, and dehumidifiers.
  • Have your onsite waste-water system professionally inspected and serviced if you suspect damage.
  • After completing the clean-up, wash your hands with soap and clean water.
  • Wash all clothes worn during the clean-up in hot water and detergent. These clothes should be washed separately from uncontaminated clothes and linens.
  • Seek immediate medical attention if you become injured or ill.

Thinking of Traveling? Get These Tips to Keep Yourself Flu-free!

DATUK DR CHRISTOPHER LEE
Consultant Infectious Diseases Physician
Member of the Malaysian Influenza Working Group
FLU FACTS THAT ARE NOTHING TO SNEEZE AT
  1. On board the plane, you have an 80% chance of getting the flu if there is an infected person–who may or may not have symptoms–sitting one row in front or behind you, within 2 seats to either side.
  2. Flu viruses can survive for up to 48 hours on certain surfaces, including your overhead compartment handle, seat-belt buckle, video screen, food tray, arm-rest, and control panel.
  3. You can try disinfecting the items mentioned in the above point, but it would be impractical to disinfect everything you will touch when you land, such as your luggage bag, trolley, the toilet flush, car door handle and so on.
TRAVELING SOON? HERE ARE 2 SIMPLE TIPS

Tip 1: Follow the COVID-19 SOPs when possible
Masking, although no longer promoted in most countries, may help reduce the chances of catching the flu.

However, it is less effective when those around you are not masked. This is where the next tip comes in.

Tip 2: Get the flu shot
The additional protection conferred by the annual flu vaccination is therefore recommended to prevent the disease.

When injected, the vaccine introduces inactivated flu viruses into the body. These have been killed and are unable to cause disease.

Instead, they stimulate your body to produce antibodies that will spring to your defense if you happen to be exposed to the flu.

Allow 2 weeks to reach the desired level of immunity before flying off.

MORE ABOUT THE FLU VACCINE
It gives you a better shot at beating the flu and reducing your risks of heart problems 

Flu vaccination helps prevent severe flu-related infection, hospitalization, and death . It is also associated with a 34% lower risk of major adverse cardiovascular events . There was also an 18% reduced risk of death reported in patients with heart failure .

In people with type 2 diabetes, flu vaccination has been associated with a reduced risk of heart failure by 22%, stroke by 30%, heart attack by 19% and pneumonia by 15% .

With the COVID-19, flu, & RSV triple threat in the northern hemisphere, the flu shot is a good bet 

Noting that flu viruses mutate constantly, Datuk Dr Christopher Lee explains that currently available flu vaccines have been updated to effectively fight virus sub-types that are circulating in the northern hemisphere at this time.

“This will help reduce your risk of contracting the disease. The flu vaccination is recommended for those travelling abroad, especially high-risk groups as the importation of flu cases through air travel can result in the spread of flu within the community,” he adds. “So, if you have not been vaccinated against the flu, now is a good time to get it done. The annual flu vaccination is your passport to healthy holidays. Don’t leave home without it.”

This article was contributed by the Flu Prevention is An Act of Love campaign under Immunise4Life, a major initiative to promote life course vaccination by the Ministry of Health, Malaysian Paediatric Association, and the Malaysian Society of Infectious Diseases & Chemotherapy. Learn more at actoflove.ifl.my (link opens in a new tab).