Important Advice to Stay Prepared During the Monsoon Season

WORDS LIM EN NI

LIM EN NI
Chief Pharmacist
Alpro Pharmacy

The Malaysian Meteorological Department (MetMalaysia) recently announced that Malaysia will experience continuous heavy rainfall from mid-November, leading to probable major flash floods in several states, and the monsoon season will last until early next year.

We would like to outline several precautionary measures for residents in flood-prone areas, from a community pharmacist’s point of view, to proactively mitigate flood damages ahead of the period and in the aftermath.

BEFORE A FLOOD
  • Closely monitor your surroundings and stay up to date on weather forecasts and warnings
  • Assemble disaster supplies, including long-term medications and first aid kits in water-proof bags in case of evacuation.
  • People, especially the elderly, with chronic diseases, are advised to visit their nearest pharmacy and bring along with their chronic medications, in order to keep a record in the pharmacy and have an up-to-date medication list; this will be useful should one lose the hard-copy of their prescription and face difficulties in retrieving their medication
AFTER A FLOOD
  • Due to poor sanitation and hygiene in flood areas, there is a high risk of flood-borne diseases such as leptospirosis, cholera, and dengue fever. Keep an eye out for general symptoms such as fever, headache, diarrhoea, muscle aches, and vomiting. In the case of any such symptoms, please visit the nearest healthcare centres immediately.
  • Alpro Pharmacy and DOC2US have launched the Life-saving Medication Care Programme, which provides a one-time supply of medications for up to 7 days for free. Those with contaminated or lost chronic disease medications can visit an Alpro Pharmacy outlet and speak to the pharmacist for more details. Note that a police report copy of the flooding is required for verification purposes.

Stay dry, stay safe!

How Breast Ultrasound & Mammogram May Save Your Life

WORDS LIM TECK CHOON

DR WINNIE NG NYEK PING
Consultant Clinical Oncologist
Subang Jaya Medical Centre
NO FAMILY HISTORY OF BREAST CANCER = NO PROBLEM? WELL, THINK AGAIN!

“Even if one has no known family history of cancer, external factors such as environmental exposures, prolonged exposure to female hormones and lifestyle features may contribute to an increased relative risk of breast cancer,” says Dr Winnie Ng, a consultant clinical oncologist.

“Aside from genetics, there are numerous underlying possible causes of breast cancer,” says Dr Ng
  • Alcohol intake
  • Smoking
  • Prolonged exposure to female reproductive hormones such as oestrogen, such as in women that reach menstruation at early age, women that have never been pregnant, women on oral contraceptive pills, women that experience menopause late, and woman that have their first full-term pregnancy at a later age
  • Postmenopausal women on hormone replacement therapy
  • Obesity

Theerfore, even if you have no family history of breast cancer, Dr Ng recommends that still going for breast cancer screening.

“The easiest method of screening is by self-examination of the breast,” she adds.

How to perform a breast self-examination. Click on this image to view a larger version.
AS WE STILL DON’T HAVE A CURE FOR BREAST CANCER, SCREENING REMAINS THE MOST PRACTICAL SOLUTION TO DETECT BREAST CANCER EARLY

Dr Ng recommends that

  • Women below 40 should undergo a breast ultrasound
  • Women above 40 are advised to go for a mammogram

You should consult your doctor about your risk factors and how often you should go for breast cancer screening.

 “A breast cancer diagnosis is not a death sentence. Self-tests and regular screenings can save lives,” says Dr Winnie Ng.

A Health-Centric Wishlist for the Malaysian GE15

WORDS ANWAR ANIS

ANWAR ANIS
Executive Director
ALTY Orthopaedic Hospital
FORMATION OF A LONG-TERM PARTNERSHIP BETWEEN PUBLIC & PRIVATE HEALTHCARE

Building upon the successful collaboration between public and private healthcare during the pandemic, a long-term policy on greater partnership will benefit both the government and the private sector, with all Malaysians being the key beneficiary.

There still are waiting lists for procedures in the public hospitals, and these can certainly be reduced if there is a structure long term arrangement for the private hospitals and centres to assist in reducing and maintaining a short wait time, especially for elective procedures which can greatly enhance an individual’s productivity, although it may not be life threatening.

GREATER FOCUS ON AN AGEING SOCIETY

These include the necessary social safety nets, proper care facilities and also post hospitalization care and support.

Here, the government should consider partnering the many physio and home care organisations to ensure patients have good compliance to post hospital care, including physio, wound care and others.

An aging population also typically means reduced mobility due to various issue—for example orthopaedic-related issues, where it can be address with proper intervention, and where needed surgery.

Government subsidy for implants, such as knee and hip implants can reduce the burden for the uninsured (which is a large majority of those who need such care) – and thus ensuring they have good mobility and thus independence even as they age.

INNOVATION IN HEALTHCARE WITH ROBOTICS, 3-D PRINTING & OTHER NEW TECHNOLOGIES

The government should consider encouraging the adoption of such technologies especially in healthcare.

Grants or even personal subsidies to access such health technologies where appropriate can propel the adoption and perhaps even development of such tech.

For example, 3-D printed casts or prosthesis will improve recovery and long-term quality of life. The regulatory framework also needs to support the faster adoption of such health technologies, to ensure Malaysia is able to maintain its advantage as a healthcare travel destination.

COMPETITIVE & FACILITATIVE IMMIGRATION POLICIES

Competitive and facilitative immigration policies, for healthcare travellers especially, will allow Malaysia to be serve a greater no of patients, which in turn lowers the cost of investment in health-related technologies and equipment, thus enabling more Malaysians to access it as well.

Some of our neighbouring countries continue to attract patients from a number of different countries, despite being less competitive overall than Malaysia, primarily due to the ease of arriving into the country.

Thus, they are able to invest in technologies such as thehealthy  Proton beam, as fee paying foreign patients ensure there is a sufficient volume of patients for these advanced and latest modalities.

Invasive Mold Infections: A Rare but Deadly Fungal Disease

WORDS DR LOW LEE LEE

DR LOW LEE LEE
Infectious Disease Physician
Sultanah Bahiyah Hospital
FUNGI: OUR FRIENDS & FOES (IT’S COMPLICATED)

Fungi are found naturally in our environment. There are many different types of fungi, over 2 million species however about 600 fungi have caused diseases.

Invasive fungal infections typically manifest as a severe and aggressive form of the disease, leading to corresponding to high prevalence and death rates if left untreated.

These infections include invasive mold infections.

INVASIVE MOLD INFECTIONS AT A GLANCE
  • Usually caused by Aspergillus (giving rise to invasive aspergillosis) but can also be caused by other rarer molds such as Mucormycetes (giving rise to mucormycosis).
  • These molds produce spores; most of us encounter these spores every day without getting ill, but people with compromised immune systems may develop complications as a result of these spores.
  • Despite invasive aspergillosis and mucormycosis being relatively uncommon, invasive mold infections are often life threatening. If left untreated, the mortality rates can reach 100%!
  • Various parts of the world reported superinfections of invasive aspergillosis and mucormycosis in patients with COVID-19, which are associated with increased risk of death. COVID-19 likely increases the risk for fungal infections because it weakens the immune system or due to certain therapies used for treatment such as steroids.
  • There are no specific symptoms, as symptoms can vary depending on the type of infection. This makes diagnosis an infection a challenging and sometimes complicated task!
Invasive Aspergillosis
Aspergillosis and how it affects our lungs. Click on the image for a larger, more detailed version.
  • Invasive aspergillosis is uncommon and occurs primarily in immunocompromised people.
  • Commonly seen in people that have undergone stem cell and other organ transplants (especially lung transplant), as well as in patients with blood-related cancers such as acute leukemia.
  • Typically affects the lungs, but it can also spread to other parts of the body.
Mucormycosis
  • Mucormycosis is rare and estimated to affect approximately 10,000 cases worldwide, barring India. If India is included the numbers rise to 910,000 cases annually!
  • Typically occurs in the sinuses of the nose or lungs; however it can spread to the brain and other organs as well.
COMMON SYMPTOMS OF A POSSIBLE INVASIVE MOLD INFECTION
  • Typical pneumonia symptoms including fever, chest pain, cough, coughing up blood, and shortness of breath
  • Sinus infection, which may be painful
  • Pain, tenderness, swelling and pressure around the eyes, cheeks, nose or forehead
  • One-sided facial swelling
  • Headaches
  • Nasal or sinus congestion
  • Black lesions on nasal bridge
HOW TO REDUCE YOUR RISK OF AN INVASIVE MOLD INFECTION
  • When performing activities that involve close contact with soil and dust, such as yard work or gardening, take care to wear shoes, long pants, and long-sleeved shirts
  • Whenever possible, avoid dusty areas like construction or excavation sites; wear a N95 mask when you have to visit these areas
  • Keep your house dry and mold-free
  • Avoid staying in a moldy home (even while it is being cleaned)

GETTING REAL ABOUT RABIES

GETTING REAL ABOUT RABIES

October 22, 2020   Return

WORDS LIM TECK CHOO

Facts about Rabies

  • It can come from a bite. The rabies virus is spread through infected saliva. When an infected creature bites through your skin, the virus can enter the body through infected saliva.
  • It’s bad for the brain—really bad. Once it enters the body, the rabies virus can quickly move via the bloodstream to the brain, where it can cause swelling and inflammation. If left untreated, this can be fatal. Most deaths from rabies occur among children.


Does Your Dog Have Rabies?
In popular media, a dog with rabies is often portrayed as foaming excessively around the mouth, but things are a little more complicated in real life. It may not be easy to tell from a glance whether a dog has rabies. There is a window of time after infection when an infected creature will not show any symptoms of illness, but could still infect other mammals in the meantime.

We can get a clue that something is wrong with our canine pet, though, if it begins to behave in a strange manner. For example, they may become more timid and move more slowly. In fact, it is more common for dogs with rabies to behave this way, compared to the stereotypical aggressive, barking behaviour shown in popular media!

The rule of thumb here is to bring our pet to a veterinary physician for a check-up if we suspect that it may be infected by rabies.

Alternatively, vaccinate our pet every year with the rabies

vaccine, and we’ll have nothing to worry about!

If we spot any stray dogs behaving strangely, especially during a rabies outbreak, we should report them to the city council. In our report, we should include description (colour, species, etc) as well as location of the stray.

 

How to Protect Your Dog from Rabies during an Outbreak

  • Vaccinate your dog.
  • Keep your dog isolated in your house compound (no going out!), so that it will not come into contact with potentially infected dogs. Isolation is necessary even after receiving a vaccination, as a dog still needs some time after a jab to build up the necessary immunity against rabies.

What If Your Dog Has Rabies?
Unfortunately, at this time there is no effective cure or treatment for rabies. Rabies is almost always fatal; infected dogs will succumb to the disease less than a week after showing signs of infection.

Prevention is the only way to protect our dogs. The vaccine offers protection for about a year, so the rabies vaccine should be given to our dogs once every year.

 

What to Do If You Had Been Bitten by a Rabies-Infected Dog
Don’t panic. Health experts say that the most important

thing to do is to clean the wound with soap and running water for 10 to 15 minutes.

Then, visit the hospital right away, and inform the doctor that you have been bitten by a dog.

Children may not voluntarily inform adults that they have been bitten by a dog, so if you suspect that their injury is a dog bite, ask them for confirmation first. Wash the wound as described above and send them to the hospital immediately after.