A Neurosurgeon Discusses Trigeminal Neuralgia, the ‘Suicide Disease’

WORDS LIM TECK CHOON

FEATURED EXPERT
DR SYED ABDULLAH AL-HADDAD
Consultant Neurosurgeon
Sunway Medical Centre

Trigeminal neuralgia, also known as the ‘suicide disease’ or tic douloureux, is a rare and agonizing condition. While it is considered a rare disease due to its low occurrence among us, it has gained notoriety due to celebrities such as George Clooney and Salma Hayek revealing that they suffer from it.

It is more prevalent among women as well as people over the age of 50.

FACTS ABOUT TRIGERMINAL NEURALGIA
Causes a sudden, intense, stabbing, or electric shock-lain pain in the jaw or face

People with this disease can experience brief bouts of intense pain while carrying out daily activities that involve facial movements, such as chewing, talking, smiling, and more.

Dr Syed Abdullah Al-Haddad reveals that such painful episode can last from a few seconds to several minutes each time.

The pain is recurrent—one could experience a few to even a few hundred such attacks in a day!

He adds: “The intense, electric shock-like one-sided facial pain characteristic of this condition often leads to misinterpretation and misdiagnosis. Patients endure years of debilitating pain with one patient describing it as worse than labour pain.”

Commonly affects one side of the face

These bouts of pain commonly affect only one side of the face (the right side is more common). It is possible for both sides of the face to be affected, but such incidences are rare in an already rare disease.

It’s due to the disruption of the function of the trigeminal nerve

The trigeminal nerve transmits touch and pain sensations from our face and head to our brain.

There are 3 branches in the trigeminal nerve:

  • The ophthalmic branch transmits nerve impulses to the top portion of our face, including our forehead.
  • The maxillary branch transmits nerve impulses to the middle region of the face, including our cheeks, nostrils and upper lip.
  • The mandibular branch transmits nerve impulses to the lower portion of our face, including the lower lip and jaw area.
Causes of trigeminal neuralgia

One of the more common causes is a blood vessel causing pressure on the trigeminal nerve.

Another common possible cause is multiple sclerosis, which causes the myelin sheath, the coating of nerve cells, to break down and put the person with multiple sclerosis at risk of developing trigeminal neuralgia.

Other possible causes include the presence of a tumour or lesion that compresses the nerves and damage to the trigeminal nerve due to surgery, stroke, or injury.

However, it is also possible for some cases of trigeminal neuralgia to have no specific identifiable cause.

It is often misdiagnosed

Due to how it is often misdiagnosed, trigeminal neuralgia can cause those affected to live with the pain for a long time. Dr Syed Abdullah Al-Haddad shares that one of his patients had one whole side of his teeth taken out due to his condition being misdiagnosed as dental pain.

Leaves a profound impact on the lives of those affected by this disease

The disease can make it difficult for those affected to perform daily activities like eating and talking as well as affect their mental health and relationships with their loved ones.

Dr Syed Abdullah Al-Haddad adds: “As they endure the intense pain, some patients decide to stop talking or even living a normal life. The symptoms can also interfere with their ability to work, impact relationships as some believe that sufferers are ‘mad’ or exaggerating their pain and lead to depression and sleep problems.”

DIAGNOSING THE DISEASE

According to Syed Abdullah Al-Haddad, the biggest challenge here is getting an accurate diagnosis.

Frequently, the condition is misdiagnosed as dental problems or issues related to the ear, nose, and throat first.

This is why it is crucial for doctors to listen to their patient’s symptoms and understand the characteristic features of the pain. The pain often described by patients is crucial and can be a sign of the disease.

Trigeminal neuralgia is diagnosed through a combination of patient-reported symptoms as well as a thorough physical examination and a magnetic resonance imaging (MRI) scan to rule out other potential causes such as multiple sclerosis or tumours.

TREATMENT

Treatment options include medications to block pain signals and surgical methods such as stereotactic radiosurgery.

The latter is a non-invasive procedure that delivers focused radiation to the trigeminal nerve root, reducing pain signals with a shorter recovery time and surgery to relieve pressure on the trigeminal nerve.

BE AWARE OF THIS DISEASE

Dr Syed Abdullah Al-Haddad tells us: “With trigeminal neuralgia often being misdiagnosed, it is important for rare diseases such as this one to not only be in the minds of neurologists but all healthcare professionals from general physicians, dental, ENT surgeons to the public alike so these patients can get the help they need and do not need to suffer any longer in silence.”

Malaysia’s First Women Ophthalmology Forum Commemorates International Women’s Day

WORDS LIM TECK CHOON

On 7 March 2024 Roche Malaysia Sdn Bhd launched the inaugural Empowering Visions: Malaysia Women Ophthalmology Forum in conjunction with International Women’s Day.

Moderated by talk show host Freda Liu, the forum featured the following prominent panelists:

  • Datuk Dr Nor Fariza Ngah, Deputy Director of Health, Research & Technical Support
  • Dr Tara Mary George, a consultant ophthalmologist
  • Dr Shamala Retnasabapathy, a consultant ophthalmologist

The panelists covered a multitude of relevant topics such as breaking barriers and overcoming stereotypes, patient care, the importance of interpersonal skills, the significance of continuous education as well as the professional development of women in the medical profession.

WOMEN BRING VALUE THAT CAN ELEVATE THE MEDICAL PROFESSION

According to Datuk Dr Nor Fariza, women bring a distinct perspective that enriches the profession and elevates patient care.

“In a domain where empathy, communication, and meticulousness reign supreme, women’s inherent strengths make them indispensable contributors,” she said during the forum.

She added: “Moreover, diverse representation ensures healthcare systems are attuned to the varied needs of patients, including those specific to women. By championing and empowering women in ophthalmology and healthcare at large, we not only advance gender equality but also enhance the caliber and efficacy of healthcare provision for all.”

A COMPASSIONATE APPROACH TO OPHTHALMOLOGY

Dr Tara Mary George said: “It is the compassionate approach commonly associated with us women which can significantly enhance patient care. Through empathetic communication and understanding, we can alleviate fears, clarify treatment plans, address patient concerns with as much sensitivity and understanding as possible, and cultivate a supportive environment where patients feel valued and heard.”

FAMILY SUPPORT VITAL FOR WORK-LIFE BALANCE

This key point was brought up by Dr Shamala Retnasabapathy, who said, “The supportive role of family is pivotal in achieving work-life balance, contributing to the empowerment of women in their professional endeavors.”

For her fellow women in the field of ophthalmology, she advised no to neglect continuous education and professional development, as these are essential when it comes to staying abreast of the latest advancements.

“This is another way of showcasing our commitment to providing the highest standard of care to their patients while contributing to the advancement of the field as a whole—and how we pave the way for greater inclusivity, diversity, and progress within the profession,” she added.

AN INITIATIVE TO CHAMPION DIVERSITY & INCLUSION

Choong Mei Chen, who is the Ophthalmology Country Disease Area Lead for Roche Malaysia, Vietnam, Philippines and Indonesia, told us that initiatives such as the Empowering Visions: Malaysia Women Ophthalmology Forum send a resounding message of support and empowerment.

“Together, let us boldly challenge the status quo, dismantle barriers, and pave the way for a future where every individual, regardless of gender, enjoys equal opportunities to excel!” she said.

A Breath of Fresh Hope For Women Against Lung Cancer

A panel discussion titled ‘A Breath of Fresh Hope’ was held on 7 December 2023. This was a collaboration between the pharmaceutical division of Roche (Malaysia) Sdn Bhd and the Lung Cancer Network Malaysia (LCNM).

This panel discussion highlighted the alarming prevalence of lung cancer in non-smoking Malaysian women, the related medical implications of this prevalence, and the social stigma surrounding this cancer.

“Over 2.2 million lung cancer cases were reported in 2020 globally, and more than 770,000 of them were in women. Lung cancer is the third top malignancies seen in the global female population, after breast and colorectal cancers,” said Ms Deepti Saraf.

SHIFTING PUBLIC PERCEPTION OF LUNG CANCER
FEATURED EXPERT
DR ANAND SACHITHANANDAN
Consultant Cardiothoracic Surgeon and Co-Founder of Lung Cancer Network
Malaysia

“The majority of lung cancer cases affect smokers. Having said that, we are now starting to see increasing numbers of cases of lung cancer in non-smokers, of whom women are overrepresented,” said Dr Anand.

Lung cancer does not affect smokers only; there are other risk factors that could put one could be at risk.

Dr Anand Sachithanadan revealed that fewer than 2% of Malaysian women smoke, but lung cancer is one of the main cancers that affect women in Malaysia.

Thus, contrary to popular perception, lung cancer does affect people that do not smoke, as outlined below.

Common lung cancer risk factors. Click on the image for a larger, clearer version.

BE AWARE OF THE SYMPTOMS OF LUNG CANCER—EVEN IF YOU DO NOT SMOKE
FEATURED EXPERT
DR JENNIFER LEONG
Consultant Clinical Oncologist
Sunway Medical Centre

Dr Jennifer Leong told us, “Many women harbour the preconceived notion that because they don’t smoke, they are not at risk of lung cancer. At times, even when displaying typical symptoms, they can easily miss out on these symptoms and do not get the required medical attention in the earlier stages of disease, affecting their chances at longer survival.”

“While I wouldn’t say that lung cancer is preventable, it’s very much a curable disease provided that you can detect it early on,” she added.

On the other hand, ignoring or overlooking the early symptoms of lung cancer would lead one to seek medical treatment only when the cancer has advanced to a late stage, during which the chances of a positive outcome are far more diminished.

Dr Anand concurred with Dr Jennifer’s statement. He stated: “Lung cancer care has been revolutionized in the last four or five years, leading to significantly better outcomes for our patients as well as overall survival. Despite all these tremendous promises, the fact remains most patients are still being diagnosed late in stage.”

Common symptoms of lung cancer. Click on the image for a larger, clearer version.

WOMEN SHOULD PRIORITISE THEIR OWN HEALTH AS WELL AS THAT OF THEIR LOVED ONES
FEATURED EXPERT
ASSOCIATE PROFESSOR DR CARYN CHAN MEI HSIEN
Consultant Health Psychologist
Faculty of Health Sciences
Universiti Kebangsaan Malaysia

“Many women are expected to and are taught to prioritise the health of family, sometimes at the expense of their own health. Consequently, some women would ignore or dismiss their symptoms, or feel guilty when their medical treatments become a significant expense to the family,” said Associate Professor Dr Caryn Chan.

One unfortunate consequence of women putting the needs and well-being of others over their own is that they often neglect their own health.

Often, Associate Professor Dr Caryn Chan pointed out, they overlooked symptoms such as those of lung cancer, and seek medical attention only when their illness had deteriorated to an advanced stage.

This attitude on both the parts of women and society need to change. “Taking care of your health does not mean you are burdening the rest of the family,” Dr Caryn stated.

She also called for the family to come together to distribute caregiving and support responsibilities, typically delegated to a woman, across all capable family members. This way, a woman would have ample opportunity to also tend to her own needs and well-being.

BE MORE PROACTIVE IN DETECTING LUNG CANCER EARLY!
FEATURED EXPERT
MS. DEEPTI SARAF
General Manager
Roche Malaysia Sdn Bhd

“All of us have a part to play in raising awareness of lung cancer,” Ms Deepti Saraf reiterated while closing the panel discussion.

Be alert for symptoms.

If you, your loved ones, or your friends have symptoms, seek medical help.

If you are at high risk of lung cancer, consult your doctor.

The doctor can arrange for you to undergo regular screening to detect early the presence of cancer or other issues with your lungs.

This is an educational article brought to you by

A Dermatologist Addresses 3 Common Misconceptions About Dry Skin

WORDS LIM TECK CHOON

FEATURED EXPERT
DR FELIX YAP BOON BIN
Consultant Dermatologist
Sunway Medical Centre
MISCONCEPTION 1
DRY SKIN IS NOTHING SERIOUS.

Dr Felix Yap Boon Bin points out that this is not always true.

“Lack of water or skin dehydration will cause dry skin to peel, crack, irritate, itch and become sensitive,” he explains. “If we scratch the itch, it may lead to damage of the skin’s epidermis, causing it to become thinner or eventually recede away.”

Our skin consists of three layers: the epidermis, the dermis, and the subcutaneous layer. Click on the image for a larger, clearer version.

“When the epidermis is compromised, germs and dust can penetrate into the second layer of the skin or dermis, causing inflammation, in addition to causing other skin problems, such as eczema and psoriasis,” Dr Felix shares.

A comparison of healthy and dry skin. Click on the image for a larger, clearer version.

What causes dry skin?

Dr Felix says that being under the hot sun for a long period of time can cause dry skin.

Being in an air-conditioned room for long periods of time can also be a factor, as air conditioning can cause the skin to dry.

However, many cases of dry skin are due to genetic factors. “Some individuals are born without a protective skin layer, causing their skin to be easily dehydrated,” Dr Felix says. Therefore, it is possible for someone to develop this condition without spending much time under the sun or air-conditioning.

Additionally, the use of improper skincare products can lead to dry skin. Dr Felix cites the frequent usage of body scrubs or soaps with a higher pH level (pH above 7) as an example.

If you spend much time under the sun or in air-conditioned rooms, Dr Felix recommends, applying moisturizers regularly to ensure that the skin is healthy and has a good level of hydration. “However, if dryness is at a serious level, it is recommended to use medicated moisturizers,” he says.
MISCONCEPTION 2
ANY SKIN MOISTURIZER WILL DO.

Not true. 

“For dry skin types, oil-based moisturizers are more suitable because the oil content will moisturize the skin and reduce itching or peeling,” Dr Felix explains.

He adds: “Individuals with oily skin can choose oil control moisturizers to prevent acne growth.”

For sensitive skin, Dr Felix recommended the use of specialized moisturizers, products without fragrance or chemicals produced by certified medical brands.

Hence, he reminds everyone to identify their own skin type before choosing their skincare products, in order to ensure that these products are suitable for long-term use.

MISCONCEPTION 3
DRINKING A LOT OF WATER AND EATING VEGETABLES REGULARLY CAN HELP THE SKIN STAY HYDRATED

Research has proven that this assumption is inaccurate.

“Lack of water in the body will certainly affect the quality of the skin, but drinking a lot of water at one time does not help the skin to stay hydrated,” Dr Felix elaborates.

“Also, consuming a lot of vegetables does not necessarily help to hydrate the skin. Healthy and hydrated skin requires a balanced diet, which includes a variety of nutrients and not just vegetables,” he adds.

BONUS: DR FELIX’S TIPS TO PROTECT YOUR SKIN

“The water content in our skin will also decrease as we age,” Dr Felix reminds us. “The protective layer will become thinner and its efficiency to trap water will also become lower when we reach between 40 to 50 years old.”

Therefore, he offers some tips to help us take care of our skin in order to avoid skin problems in the future.

  • Sleeping for 7 hours a day and have a consistent bedtime, preferably before 12 midnight.
  • Lead an active lifestyle to improve the immune system. Low immunity can cause skin diseases such as eczema.
  • Use moisturizers before going to bed, especially in rooms with air conditioning.
  • Apply sunscreen before leaving the house.

An Expert Spills the Bean on Lactose Intolerance & Your Kids

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ONG SIK YONG
Consultant Paediatric Gastroenterologist and Hepatologist
Sunway Medical Centre

According to Dr Ong Sik Yong, lactose intolerance is a common gastrointestinal condition caused by the inability to digest and absorb dietary lactose.

Lactose intolerance is the result of your small intestine not producing enough of an enzyme called lactase. Lactase helps to break down lactose or milk sugars into simple sugars for absorption by your body.

BLAME IT ON DECLINING LEVELS OF LACTASE

Dr Ong shares that newborns can digest about 1 litre of breast milk every day.

However, the enzyme lactase, which digests lactose, usually declines in levels once the child stops breastfeeding, a circumstance known as lactase non-persistence.

“Approximately 70% of the world population are affected by lactase non-persistence, which causes the condition called primary lactose intolerance,” Dr Ong reveals.

He adds that generally a child shows symptoms of primary lactose intolerance after they turn 5. However, some children may exhibit symptoms as early as 2 years old.

CAN ALSO BE DUE TO OTHER GUT ISSUES

In young children, lactose intolerance may also be caused by underlying gut issues such as:

  • Gut infection.
  • Cow’s milk allergy.
  • Celiac disease.
  • Inflammatory bowel disease.

Dr Ong further shares that sometimes a child may temporarily lose the ability to digest lactose during an episode of acute gastroenteritis. Once the child recovers, however, they can continue to consume milk without further issues.

SYMPTOMS OF LACTOSE INTOLERANCE

“Usually, symptoms begin about 30 minutes to two hours after consumption,” says Dr Ong.

He adds that the common symptoms are:

  • Abdominal discomfort.
  • Bloating.
  • Farting.
  • Diarrhoea.
  • Perianal skin irritations with raw lesions surrounding the anus, due to low faecal pH in the child’s stools.
MANAGING THE DIET OF A LACTOSE INTOLERANT CHILD

Dr Ong advises parents to feed dairy products with naturally lower lactose content to children that show signs of lactose intolerance.

“After a period of limiting food with lactose, the child can consume back small amounts of foods and drinks containing lactose,” he adds.

The child’s symptoms should be observed throughout this trial period and over time, the parents or even the child would be able to tell how much of lactose the child can take.

“Besides that, parents can also consider using lactase enzyme, which can be taken by the child prior to consumption of dairy products to reduce unwanted consequences from consuming lactose,” advises Dr Ong.

NUTRITIONAL CONSIDERATION FOR THE LACTOSE-INTOLERANT CHILD

Milk and other various dairy products are a major source of calcium and vitamin D.

“Hence, it is important to make sure children who has limited dairy product intake to have other non-dairy food which are rich in these nutrients, like fish with soft edible bones, such as salmon and sardines, as well as green leafy vegetables. They may also require calcium or vitamin D supplement for their growing bones,” Dr Ong says.

A Tips-Filled Bumper Article to Help You Sleep Better Featuring Four Experts

WORDS LIM TECK CHOON

FEATURED EXPERT
CELESTE LAU
Chief Dietitian
Sunway Medical Centre
ADD MAGNESIUM-RICH FOODS IN YOUR DIET

“Magnesium plays a crucial role in various bodily functions, such as muscle and nerve operation, protein synthesis, glycolysis, and blood pressure regulation,” says Celeste Lau.

She explains further that this mineral aids in the conversion of protein into chemicals that induce sleepiness, promote muscle relaxation, and maintain gamma-aminobutyric acid (GABA), a neurotransmitter responsible for promoting restfulness.

You should consume between 100 and 350 mg of magnesium daily for optimal sleep support.

Celeste recommends adding sources of magnesium such as walnuts, almonds, flaxseeds, salmon, and mackerel into your meals. It is recommended to consume between 100-350mg of magnesium daily for optimal sleep support.

“Additionally, refrain from consuming a heavy meal in the evening. It is recommended to have dinner 2 to 3 hours prior to your bedtime,” she adds.

FEATURED EXPERT
MICHELLE CHONG HUI YEE
Clinical Psychologist
Sunway Medical Centre
PRACTICE RESTFULNESS

Michelle Chong explains that restfulness is a deliberate act of nurturing yourself—physically, mentally, and emotionally.

It is characterized by a feeling of peacefulness and contentment, often accompanied by a sense of relief from stress, worries, tension, or fatigue.

Mentally, restfulness means quieting the mind, letting go of worries, and embracing a sense of mental stillness.

  • Learn to embrace mindfulness and relaxation techniques.
  • Grounding yourself in the present moment. This heightened awareness allows you to detach from worries about the past and anxieties regarding the future as well as to foster a sense of presence that can alleviate stress and enhance your awareness of immediate experiences.
  • Practice deep breathing exercises and progressive muscle relaxation (PMR) methods to heighten your body awareness and release muscle tension, focusing on achieving a state of ‘physical rest’.
  • Prioritize relaxation techniques that calm the mind before bedtime. “Activities such as mindfulness meditation and journaling can effectively declutter the mind and reduce stress hormones, creating a more seamless transition into sleep,” Michelle says.
FEATURED EXPERT
DR NURUL YAQEEN
Consultant Respiratory, Sleep & Internal Medicine Physician
Sunway Medical Centre Velocity
START SLEEPTIME RITUALS 
  • “Do not use your bed as an office to answer calls, respond to emails and avoid watching television in bed,” advises Dr Nurul Yaqeen.
  • Instead, reserve your bed for sleep. Remove electronic devices (televisions, computers, smartphones, etc), from the bedroom.
  • Try to start a sleep ritual as rituals help signal the body and mind that it is time to sleep. Some suggestions from Dr Nurul Yaqeen are drinking a glass of warm milk, taking a bath, or listening to calming music to unwind before bed.
  • “There is also the 10-3-2-1 method to help you rest better at night,” she says, “which is no caffeine 10 hours before bed, no food or alcohol 3 hours before bed, no work 2 hours before bed, and no screen time 1 hour before bed.” 
FEATURED EXPERT
Effendy Nadzri
Interior Designer
ENDO
Website
GET THE AMBIENCE RIGHT
  • “Keep your room cool at night,” says Effendy Nadzri. “The ideal temperature in the bedroom should be between 20º and 23º Celsius.”
  • If you have an air conditioner at home, he recommends switching it on at night to signal to your body that it is time for sleep.
  • Set the perfect ambience with dimmable or mood lighting to enhance your bedroom space and create the desired mood for a restful evening before you retire to sleep.
  • “You may want to have aromatherapy or essential oils that can help you relax at night,” Effendy adds.

 

Tuberculosis Cases Are Rising in Malaysia. An Expert Shares What You Should Know & Do About This

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ROSMADI ISMAIL
Consultant Interventional Pulmonologist and Internal Medicine Specialist
Sunway Medical Centre

Quite recently, our Minister of Health Dr Zaliha Mustafa revealed at the United Nations General Assembly High-Level Meeting that there was a concerning increase of 17% in tuberculosis cases in 2022 compared to 2021, along with a 12% increase in tuberculosis-related deaths during that time period.

In light of this development, Dr Rosmadi Ismail shares his thoughts with us about tuberculosis, its detection, treatment, and prevention.

Tuberculosis is an infectious disease that is caused by the bacteria Mycobacterium tuberculosis (MTB) infecting the lungs as well as certain other parts of the body.

An overview of the symptoms and preventive measures of tuberculosis. Click on the image for a larger, clearer view.

IS DETECTION OF TUBERCULOSIS GETTING BETTER?

Dr Rosmadi reveals that there are several innovative techniques currently undergoing clinical trials in a few countries.

These techniques, which include biosensing technologies and nano-diagnostics, promise quicker and more accurate results.

He shares: “Ongoing research focuses on innovative methods like computer-aided detection (CAD) through artificial intelligence, aerosol capture technologies, and antigen-based skin tests. They are poised to revolutionise TB diagnosis, enhancing efficiency and effectiveness in the future.”

In Malaysia, there are diverse methods employed to ensure accurate and timely detection of tuberculosis, such as:

  • Sputum smear microscopy, typically the first test for tuberculosis.
  • Culture and sensitivity testing to diagnose tuberculosis.
  • Nucleic acid amplification tests (NAATs) to facilitate the identification of tuberculosis cases.
  • Chest radiography and clinical tests like the Tuberculin Skin Test (TST) to confirming the infection.
TREATMENT OF TUBERCULOSIS

Treatment of tuberculosis in Malaysia follows the World Health Organization guidelines, which is the global standard.

Dr Rosmadi tells us, “The standard treatment for drug-susceptible tuberculosis in Malaysia involves a combination of four drugs administered for a duration of 6 to 8 months.”

Treatment utilizes the Directly Observed Treatment (DOT) strategy, which sees the patients receiving close supervision from healthcare workers to ensure that they complete their medication intake.

Currently, there are no new medications or treatments that show superior results over current ones when it comes to treating tuberculosis. Dr Rosmadi notes that treatment for drug-resistant TB involves a distinct medication regimen and extended treatment duration.

“This tailored approach has proven effective even in cases of drug-resistant TB, reinforcing our commitment to comprehensive patient care,” he says.

DR ROSMADI’S TUBERCULOSIS TIPS 
  • Stay clear of crowded places. It’s best to avoid crowds, especially if they’re poorly ventilated.
  • If you’re experiencing a persistent cough, fever, or unexpected weight loss, seek medical help promptly. This will help you get better and stop the disease from spreading.
  • Get checked if you’re at risk. If you have a weak immune system or have been around people with tuberculosis, consider getting tested. It’s a simple step that can catch the disease early if exposed.
  • If you’re diagnosed with tuberculosis, completing your treatment is essential. P
  • Preventive measures such as wearing a mask, covering your mouth and nose when you cough or sneeze, and disposing of tissues properly can help protect yourself and those around you.
  • If your job puts you in contact with many people, wear the proper protective gear as an added layer of safety.
  • Think about getting vaccinated. The current vaccine, Bacillus Calmette Guérin (BCG), offers partial protection to infants and young children against severe forms of tuberculosis. It doesn’t protect adolescents and adults that are the primary carriers of the tuberculosis bacteria, but it could help in the long run.

A Physician Explains How You Can Have a Safe and Happy Vacation with the Kids

WORDS LIM TECK CHOON

FEATURED EXPERT
DR NUR ELAYNI BORHAN
Consultant Emergency Physician
Sunway Medical Centre
BEFORE YOU LEAVE THE HOUSE

Make sure that you have at hand essentials such as the following:

  • Paracetamol for fever or pain
  • Oral rehydration solution for dehydration due to diarrhoea
  • Cough and cold medications
  • Inhalers if your children have asthma
  • Antiseptic wipes
  • Band-aids, adhesive tapes, and gauze for wound care
  • Thermometer
  • Your child’s existing medications, if any

“I would also advise to bring some topical medication such as antiseptic cream, mentholated or medicated topical ointment – anything you’re used to, from home,” Dr Nur Elayni Borhan adds. “You know your own children, so bring the things that you know would benefit them. Try to avoid bringing things that are new to them.”

WATCH WHAT YOUR KIDS ARE EATING!

Diarrhoea and vomiting are among the most common illnesses that affect children while they are on holiday.

Dr Elayni advises parents to ensure that their children are taught to follow safe food and water precautions.

Her other tips are:

  • Frequently wash hands to prevent foodborne and waterborne illnesses.
  • If you are breastfeeding your child, continue to breastfeed during the vacation.
  • Make sure that vaccinations for the whole family are up to date, as there is generally a higher risk for most vaccine-preventable diseases when travelling.

If your child—or any other family member—develops diarrhoea, Dr Elayni recommends consuming plenty of fluids.

“Oral rehydration solution may be used to prevent dehydration, especially if the child is also vomiting,” she further adds. “If your child appears to be dehydrated and/or has a fever or bloody stools, seek medical attention immediately.”

IF YOUR CHILD HAS AN ALLERGY

Dr Elayni says, “Planning ahead is the key to making your trip safe and enjoyable.”

  • Always stay alert, take every necessary precaution, and carry all essential medications.
  • Bring a medical kit with your child’s medications, including their epinephrine pen. Do this no matter how near or short the trip is.
  • Not everyone can understand English or Bahasa Melayu, so get information about your child’s allergy translated to the native language of your destination. Written information about your child’s allergies, for example, can be very useful when ordering food for your child.
  • Take note of the allergy policies of the airline and at the hotels you will be staying at. Every airline or hotel is different, and they need advance notice to make accommodations.
  • Research restaurants or grocery stores at your destination that would carry products safe for your child.
OTHER USEFUL TIPS
If your child suffers from motion sickness:
  • Keep them hydrated.
  • Let them eat and drink in small amounts regularly instead of having heavy meals.
  • Avoid letting them read or us screen devices while traveling in a vehicle. Instead, encourage them to sleep or engage in conversations with other family members.
If your child experiences uncomfortable pressure in the ear:
  • Encourage them to swallow their saliva. Younger children can breastfeed or suck on a thumb while older children can suck on lozenges or chew gum to equalize the pressure,

General tips for a fun and safe vacation:

  • Bring along your child’s comfort toy or blankie.
  • If your child has an existing chronic condition, consult a doctor before traveling to destinations with different climates and altitudes. You may need to take special precautions, such as dressing your child appropriately for colder destinations and apply sunscreen at hotter destinations.
  • Discourage your children from swimming in non-chlorinated bodies of water (rivers, ponds, lakes, etc), as there is a risk of your child swallowing contaminated water.
  • Pack safe snacks and meals in case there are no appropriate restaurants for your child.
  • Identify important healthcare facilities at your destination. You can also seek advice on available local medical services from hotels or tour company representatives.
  • Include your child in any travel insurance policies bought for the trip, which should include medical repatriation if necessary.

What Parents Should Know About Heart Conditions in Newborns & Children

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ANG HAK LEE
Consultant Paediatric Cardiologist
Sunway Medical Centre
CONGENITAL HEART DISEASE IS THE MOST FREQUENTLY DIAGNOSED CONGENITAL DISORDER

Congenital disorder is an abnormal condition that is present at birth.

When a child is born with heart disease, therefore, they are said to have congenital heart disease or CHD.

Dr Ang Hak Lee explains to us: “The symptoms of this condition are often silent, but the risk increases significantly when there’s a family history of congenital heart disease.”

He shares that the risk triples if the mother has the condition; if the father has it, the risk doubles.

EARLY DETECTION OF CONGENITAL HEART DISEASE IS CRUCIAL

Dr Ang shares that, should congenital heart disease is not detected soon after birth, the child may not survive the first few years of life.

“One of the significant challenges the healthcare community faces are that symptoms in infants are usually subtle, making it easy to miss,” he says.

POSSIBLE SIGNS OF CONGENITAL HEART DISEASE
  • Feeding difficulties.
  • Poor growth.
  • Low birth weight.
  • Bluish discolouration of the skin and lips.
  • Nail clubbing, which is a deformity of the finger and toe nails—frequently, the nails curve down to look like an upside-down spoon.
  • The baby or child tires easily.

Parents often attribute symptoms of congenital heart disease to those of common illnesses, which can lead to delays in the child getting a proper diagnosis.

Further complicating matters is that not every child with congenital heart disease will show symptoms at birth. Some children only develop symptoms later in their childhood or even during adolescence.

FORTUNATELY, DETECTION METHODS HAVE BECOME MORE ADVANCED & MORE ACCURATE

“One of the major components for early detection a simple bedside test called pulse oximetry,” says Dr Ang.

A pulse oximeter measures blood oxygen levels and pulse. A low level of oxygen saturation could be a sign that you may have certain health conditions.

This test is painless and takes only a few minutes, as a device called pulse oximeter is used to gently clip onto a child’s toe or finger to measure the child’s blood oxygen levels.

“A low oxygen reading can be a sign of critical congenital heart disease,” Dr Ang elaborates.

He adds, “While this method doesn’t replace a complete history and physical examination, it can detect critical heart defects before oxygen levels become too low, especially for newborns with other major congenital disabilities.”

Other non-invasive imaging methods, such as echocardiograms, and advanced screening tools have allowed paediatricians to detect even subtle heart abnormalities. “Amazingly, echocardiography can be used to detect CHD while the baby is still in the mother’s womb!” Dr Ang points out.

What Do You Know about Alzheimer’s Disease? Find Out from a Geriatrician!

WORDS LIM TECK CHOON

FEATURED EXPERT
DR TEH HOON LANG
Consultant Geriatrician
Sunway Medical Centre

21 September is World Alzheimer’s Day. We’re pleased and really appreciative of the fact that, in conjunction with this day, Dr Teh Hoon Lang has graciously shared her insight on Alzheimer’s disease with us.

IS DEMENTIA THE SAME THING AS ALZHEIMER’S DISEASE?

Dr Teh explains that:

  • Dementia is a complex brain function impairment set that interferes with daily life.
  • Alzheimer’s disease is a common type of dementia.
  • It is a progressive brain disorder characterized by the buildup of abnormal proteins in the brain.
  • This buildup will lead to a gradual decline of memory, thinking, and reasoning skills.
  • This condition will get worse over time.

An overview of Alzheimer’s disease. Click on the image to view a larger, clearer version.

  • According to some studies, over 8.5% of Malaysians aged 60 and above have dementia, with a higher prevalence among women.
  • However, note that Alzheimer’s disease and other forms of dementia can also occur to people at a younger age. They should not be considered as merely ‘old people’s disease’.
WE SHOULD BE VIGILANT & KEEP AN EYE OUT FOR EARLY SIGNS

According to Dr Teh, symptoms of dementia can be mild and hence overlooked.

“Many people may assume these symptoms as part of the normal ageing process,” she adds.

COMMON EARLY SIGNS OF DEMENTIA (OF WHICH ALZHEIMER’S DISEASE IS ONE TYPE)
  • Recent memory loss, such as being unable to recall recent events or appointments.
  • Difficulties in planning and carrying out tasks or solving problems such as following a recipe, managing their finances, or managing their own medicines.
  • Difficulty in completing familiar tasks such as cooking, driving or using appliances.
  • Confusion about time and/or place—they may lose track of the date, time, or where they are. They may also get lost in familiar places.
  • Trouble understanding visual images and spatial relationships. This can manifest as difficulties in understanding maps, following directions, judging distances, determining the size of objects, etc.
  • Problems with languages, such as difficulty finding the right words or using the wrong words during a conversation.
  • Frequently misplacing things and losing the ability to retrace steps.
  • Decreased or poor judgement. They may make poor decisions, such as giving away large sums of money or insisting on driving when they are no longer fit to drive.
  • Withdrawal from work or social activities that they used to enjoy. They may also become isolated and avoid interacting with others.
  • Changes in mood or personality such as becoming depressed, anxious, or irritable. They may also experience personality changes, such as becoming more passive or withdrawn.
CERTAIN FACTORS CAN INCREASE ONE’S RISK OF DEVELOPING ALZHEIMER’S DISEASE & OTHER FORMS OF DEMENTIA

Dr Teh shares that common risk factors include:

  • Sedentary living—not getting regular physical activity.
  • Smoking and/or excessive alcohol consumption.
  • History of head injuries.
  • Infrequent social contact and isolation. This can lead to depression, a risk factor. Thus, we, especially the elderly, are encouraged to stay socially active no matter our age.
  • Less or low levels of education in early life, as this can affect cognitive reserve—the ability of the brain to maintain our cognitive function and withstand deterioration and damage.
  • Obesity, especially during one’s mid-life.
  • High blood pressure or hypertension.
  • Diabetes, primarily type 2 diabetes.
  • Hearing impairment or individuals with hearing loss. Hearing aids may help reduce this risk.
WHY EARLY DETECTION IS CRUCIAL

Any damage to the brain is irreversible; there is no way to treat or undo the damage.

“It is important to see a doctor for an assessment as soon as possible, as early diagnosis and treatment can help to prevent or delay irreversible brain damage,” Dr Teh states.

HOW ABOUT SCREENING FOR ALZHEIMER’S DISEASE?

“According to guidelines, routine cognitive screening isn’t recommended for everyone, it’s only recommended to screen people at risk,” Dr Teh shares.

She adds, “However cognitive screening is not 100% accurate, hence, it’s crucial to educate the public about the early warning signs of dementia.”

Furthermore, some conditions may resemble dementia, such as vitamin B12 deficiency and hypothyroidism, and these can be reversed by early treatment.

INNOVATIONS OF THE PHARMACEUTICAL INDUSTRY IN DEVELOPING A TREATMENT FOR ALZHEIMER’S DISEASE

In other news, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) has released a video highlighting the challenges and advances made by the pharmaceutical industry in finding means to slow the progression of Alzheimer’s disease. Have a look!

For more information, visit the IFMPA (link opens in a new tab).