Hand, Foot & Mouth Disease in Children

Hand, Foot & Mouth Disease in Children

Hand foot and mouth disease (HFMD) is typically a common illness among infants and children (up to the age of 10 years) caused by a group of viruses called Enterovirus especially Coxsackie A16 or enterovirus 71. It has become an important public health concern because it is very contagious and can cause large outbreaks among children especially in nursery and schools.

What are the symptoms?


The disease is characterised by rapidly ulcerating vesicles (blisters) in the mouth, tongue, palate and on the palms of hand and soles of the feet.  It starts with non-specific symptoms such as fever, sore throat and generally feeling unwell before the blisters develop 1-2 days later.  It can range from being mild or severe with loss of appetite.

How is the virus transmitted?

The most infectious period is the first week of illness and the virus is transmitted by contact with the nasal discharge or saliva, fluids from the blisters and stools of an infected child. As such, it is important that any infected child is kept away from school and other children.  Avoid close contact like sharing toys, pillows, towels or eating utensils and touching objects or surfaces that could have been contaminated by the virus.  Any nursery or school which has an infected child is often advised to close for a short period to allow sterilisation of the school premises and prevent virus spread.

Image Source: Wikipedia

How serious is HFMD?

Majority of the children get a mild illness with no complications. Younger children are at risk of getting weak or dehydrated because they  may refuse to eat or drink due to the painful mouth ulcers. Rare complications occur when the virus (in particular, enterovirus 17 strain) has spread to the brain causing meningitis or encephalitis or to the lung and heart causing pulmonary oedema.

What is the treatment for HFMD?

Bed rest, paracetamol and sponging for fever and keeping the child hydrated is sufficient. Most children recover within 7-10 days without requiring any medication. However, if the child is getting dehydrated or weak, it is better to admit the child to the hospital for intravenous fluids and observation by the doctor. The child should remain away from school for at least 10 days since the onset of the disease or until certified free from disease by the treating doctor.

Statistics of Reported Hand, Foot and Mouth Disease Cases in Malaysia (Source: Kementerian Kesihatan Malaysia)

What are the danger signs of HFMD?

Take your child to see a doctor when the child has the following symptoms:

  • Not taking enough oral feeds or fluids
  • Not passing much urine
  • Persistent high fever (>38oC) more than 48 hours
  • Weak or drowsy or refusing to play
  • Having shallow rapid breathing
  • Irritable or having some jerky movements (fits)

How should a parent look after the infected child?

Let the child stay at home (away from school) and isolate the child away from the other siblings. Do not let them to share beds, pillow, towels, eating utensils and toys.  It is best to have one person looking after the child to ease the discomfort like giving:

  • Paracetamol for fever. Applying a cool towel over the forehead may be comforting
  • Cold treats like Popsicles or milk shakes/smoothies for the sore throat
  • Oral Aids for mouth ulcers
  • Soft diet as it is easier to swallow

Image Source: Pexels

How to prevent the virus from spreading?

Ensure good hygiene by washing your hands after caring for the infected child as well as disinfecting objects or surfaces touched by the child to prevent spreading the virus to other inhabitants in the house.

CHOMEL Antibacterial Range

Dettol Disinfectant Spray Crisp Breeze

Against 24 Disinfection

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Common Contraception Myths

Common Contraception Myths

We have all heard about different ways to prevent pregnancy from friends, family and the social media. Every culture across the world has their own traditional methods of pregnancy prevention. We take a look at some of the common myths.

1. The contraceptive pills makes you fat

Multiple studies have shown that there is no difference in weight gain compared to women on the pill and those who are not taking it.

2. The contraceptive pill causes cancer

Women on the pill have a 50% reduction in the risk of uterine and ovarian cancer. There is a very small increase in the risk of breast cancer but this risk goes down to normal levels when the pill is stopped.

Image Source: Big Stock

3. You don’t need to be on any contraception if you are breastfeeding

Breastfeeding is only a reliable mode of contraception in the first 6 months after delivery if it is exclusive breastfeeding and no return of periods. Breastfeeding does reduce a woman’s fertility but unless these requirements are met, there is a significant risk of getting pregnant. If you do not fit in this criteria, then another method of contraception is advised.

4. Taking the contraceptive pill or any hormonal contraception will make it harder to get pregnant in the future

All hormonal contraceptives have temporary effects on fertility. Fertility will return with cessation of the contraception, the timing depending on the type of hormonal contraception used. There are no long term effects on fertility.

Image Source: Pregnant SG

5. Accidentally get pregnant while on hormonal contraception (including the pill) will cause birth defects to the baby

There is good evidence that shows hormonal contraceptives (including the pill) does not cause birth defects.

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Types of Contraception

Types of Contraception

Emergency Contraception

Emergency contraception is for all those ‘oops!’ times when something unforeseen has happened, for example like when a condom has broken, when you have unprotected sex or a missed pill. It should NEVER be used as a regular method of contraception as pregnancy risks increase if used repeatedly.

There are 2 types of Emergency contraception:

A) Intrauterine Contraceptive Device has a success rate of 99% and can be used up to 5 days after intercourse. It can also be left in place and used as long term contraception.

B) Hormonal Emergency Contraception Pills can be used up to 3 or 5 days after intercourse, depending on the type of pill used.

Types of contraception

There are up to many types of contraception available, which means there is definitely one right for you! So discuss with your doctor to help you get the most suitable one.

Image Source: Shutterstock

The Pill

  • The Pill consist of synthetic hormones with an effective rate of around 91%.  It also helps to regulate periods, especially those with heavy or painful periods
  • Side effects: headache, nausea (feel like vomiting) and breast tenderness.
  • Not suitable for women with history or family history of blood clots in the veins

The Injection (Progesterone only Injectable Contraceptive Methods)

  • Effective rate is around 94%
  • Side effects: Return to fertility may be delayed between 6 months to 1 year

The Intrauterine Device

  • Small T shaped device placed into the uterus by a doctor at the clinic.
  • Effective rate is around 97-98% and safe to use for 3 or 5 years, depending on type and dose
  • Side effects: Periods may be heavier or more painful in the first few months

The Implant

  • Implant is one of the most effective contraceptive methods available.  It consists of synthetic hormone in a small plastic capsule that is placed under the skin of the upper arm. The procedure is done by a doctor at the clinic.
  • Effective rate is almost 100% for up to 3 years
  • Side effects: Periods may be irregular, less than usual or no periods.


  • Rubber (latex) cover that is placed over the penis during sex and must be removed immediately after ejaculation
  • Ideal for protection against any sexually transmitted diseases
  • Effective rate is around 75%

DUREX Together Easy-On

Durex Extra Safe

Durex Close Fit

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Why Do You Need Contraception or Family Planning

Why Do You Need Contraception or Family Planning

In 2008, 41% of pregnancies in the world were unintended while in Asia, the rate was 38%.  Some of the reasons for unintended pregnancies were:

  • Substantial unmet need for family planning services.
  • Poverty and lack of education
  • Not using or incorrect use of contraception
  • Socio economic, regulatory and religious conditions

Many still oppose to the use contraception because of perceived side effects of contraception and thinking infrequent sex did not require contraception.

Global research has shown that unintended pregnancy results in one of 3 outcomes:

  • Abortion (48%)
  • Miscarriages (38%)
  • Unplanned live birth (14%)

How many of us use contraception?

Image Source: Pexels

The Contraceptive Prevalence rate (number of women using contraception) in Malaysia is between 50 to 55 %.  In comparison, more people in our neighbouring countries of Thailand, Vietnam, Singapore and Indonesia at 72%, 78%, 62% and 61% respectively use contraception methods.

Provision of Contraceptive Provision and Services in Malaysia

Contraceptive services are provided by Ministry of Health, Family Planning and Development Board as well as The Federation of Reproductive Health Association Malaysia. In addition, contraception methods are available in private hospitals, pharmacies as well as private clinics.

Why do you need contraception?

Many women don’t realise how easy it is to get pregnant. There are 16.7 million unplanned pregnancies around the world every year which could have been prevented with the correct use of contraception.  It doesn’t matter whether it’s your first time, you only occasionally have sex or you only have sex on the so called ‘safe days’.

Image Source: Pexels

The message is, if you are having unprotected sex, you can get pregnant.

Coitus interruptus (withdrawing before ejaculation) is not as safe as you think. In fact, it is the least effective contraceptive method with 22 in 100 women who practice this method getting pregnant every year (that’s 22% failure rate!).

And remember, if your period is 2 weeks late, regardless of whatever contraception you are using, talk to your doctor. You may consider doing a pregnancy test. Pregnancy is ALWAYS a possibility.

Clearblue Pregnancy Test

Dip n Tell Midstream Pregnancy Test

Things to remember while on contraception

Certain methods of contraception may affect your periods and this will be explained by your doctor. Consult your doctor should you have any unexpected changes.

Certain medications (including some herbal supplements) may reduce the effectiveness of your contraception. Please inform your doctor if you are taking any medications or supplements.

Image Source: Cleo

Many women are worried about excessive weight gain, headaches or mood changes while on contraception. These side effects are not common and often occur because of many reasons other than your contraception. Consult your doctor to see if there are other underlying problems or if you require a change in your contraception method.

Consult your doctor before stopping or changing your contraception.  Wrongly timed contraception cessation or change may result in an unintended pregnancy

The health risks and side effects of an unintended pregnancy are far greater than any method of contraception. Always use contraception if you do not intend to get pregnant.

For more information on contraception, click on the link below:


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Hepatitis C Screening Campaign – How’s Your Blood

Hepatitis C Screening Campaign – How’s Your Blood

Hepatitis Free Malaysia (HFM) has launched the How’s Your Blood? Campaign, a nationwide Hepatitis C awareness campaign to educate the public, especially high-risk groups, about Hepatitis C and the importance of blood test for early detection and timely treatment.

Hepatitis C is a type of liver inflammation that is caused by the Hepatitis C Virus (HCV) and can lead to cirrhosis or liver cancer, if left untreated. In Malaysia, there are at least 380,000 people living with HCV and the vast majority are unaware that they are infected. Globally, there’s an estimation of 70 million people who have chronic Hepatitis C and over 80% of liver cancer deaths are caused by Hepatitis B or C. The number of deaths caused by viral hepatitis have surpassed chronic infectious diseases such as human immunodeficiency virus (HIV) and tuberculosis (TB).

The success of Hepatitis B vaccination showed significant reductions in Hepatitis B virus infection and death rates. Unfortunately, there is no vaccination for HCV which makes early detection the key to preventing the spread of HCV and for those who are infected to receive timely treatment.

The How’s Your Blood? Campaign’s key goal is to encourage the public, especially high-risk groups, to get tested for Hepatitis C and help Hepatitis C patients to receive timely treatment. Along with the campaign partners, HFM has teamed up with doctors, including general practitioners (GPs), clinics and blood test centres around the country to encourage high-risk groups to get tested.

How can Hepatitis C be detected?

80% of people who are infected with HCV do NOT develop any symptoms. Even if symptoms develop, these symptoms are non-specific such as:

  • Fever
  • Fatigue
  • Dark urine
  • Vomiting
  • Loss of appetite
  • Nausea

The only way to know for sure whether you have Hepatitis C is to get your blood tested.

What are the blood tests to diagnose Hepatitis C?

  1. Hepatitis C Virus (HCV) antibodies. If your blood shows the presence of HCV antibodies, it means you might have been exposed to HCV and will need a 2nd blood test to confirm if the virus is still present in your bloodstream.
  2. A second blood test is required to confirm the presence of HCV in your bloodstream by testing:
    a) HCV RNA Nucleic Acid Test (NAT): This test detects HCV RNA in serum or plasma and determines if the infection is active.
    b)  HCV Core Antigen (HCVcAg) Test: This test detects the protein produced by HCV. It can detect HCV infections about 40-50 days earlier, compared to other test

What should you do next?

Find the nearest blood test centre, medical centre or clinic to have your blood tested.

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How Much Should We Exercise Daily?

How Much Should We Exercise Daily?

For normal healthy people, the general recommendation is for at least 30 minutes of physical activity every day. Regular aerobic activity, such as walking, bicycling or swimming, can help you live longer and healthier. If you want to lose weight or meet specific fitness goals, you may need to exercise more.

You do not need to do all the exercises in one session.  For example, if you can’t fit in one session of a 30-minute walk, try doing three 10-minute walks instead. The most important objective is to make regular physical activity part of your lifestyle.  Start at your own pace and gradually increase the pace and duration as your fitness level improves.  Try to avoid long periods of sitting.

Most people give up after a short period of time because of the lack of motivation.  These are some tips to improve your compliance by making exercise less boring.


Image Source: Medical News Today

  • Walk with friends or family. Having a companion means you have someone to chat with and this reduces the boredom of exercising alone. Make exercising a social activity
  • Start slowly and gradually increase the duration and pace of your walk
  • Take a dog for a walk. Pets are great walking companions
  • Listen to music or podcasts. When you are enjoying the audio entertainment, exercise become effortless
  • Take the stairs instead of the lift while at work
  • Try alternative form of exercise such as cycling, line-dancing, throwing a Frisbee or swimming. Do the activities involving movement which you enjoy

An average person walks around 3,000 to 4,000 steps a day (around 1.5 to 2km).  Try to aim for 10,000 steps which can help maintain a good level of fitness in your body.

How does your body respond to exercise?

Image Source: Dreamstime

Exercise involves movements of large muscles in your arms, legs and hips which causes you to breathe faster and more deeply to increase the amount of oxygen in your blood.  In response, your heart will beat faster to pump more blood to your muscles where oxygen will be delivered and waste products such as carbon dioxide and lactic acid are removed. The more you exercise, the more efficient this process becomes and your stamina will improve.

How does exercise improve your health?

  • Combined with a healthy diet plan, exercise helps you lose weight and maintain your ideal weight
  • Regular exercise increases your endurance (stamina) as the muscle becomes more efficient in extracting oxygen from your blood
  • Exercise keeps muscles strong and prevent wasting (atrophy) which helps maintain mobility as you get older. Weight-bearing exercises such as skipping or running reduces the risk of osteoporosis. Astronauts suffer from osteoporosis after being in space due to the lack of exercise.

Image Source: Women Fitness

  • Exercise increases your immunity so that you are less vulnerable to viral illnesses such as flu and the common cold
  • Exercise reduces the risk of many conditions such as cholesterol, obesity, heart disease, high blood pressure, type 2 diabetes and stroke. If you are already on treatment for these diseases, exercise helps you to control the condition better
  • Exercise strengthens your heart as it makes your heart pump faster and more efficiently
  • Exercise keeps your arteries clear by preventing narrowing due to cholesterol plaque thereby reducing the risk of heart attack and strokes
  • Aerobic exercise boosts your high-density lipoprotein (HDL), the ‘good’ cholesterol, and lowers your low-density lipoprotein (LDL), the ‘bad’ cholesterol

Image Source: Pexels

  • Exercise improves the mood such as depression by releasing neurotransmitters such as endorphins. It can also relax the muscles associated with neck, shoulder and back tightness caused by stress or anxiety
  • Exercise helps your mind stay sharp by protecting memory, reasoning, judgment and thinking skills (cognitive function) in older adults. It also reduces the risk of degenerative brains diseases such as dementia and Parkinson’s disease

Physical Activity Guidelines America 2015-2020


1) Moderate-intensity physical activity:

Aerobic activity that increases a person’s heart rate and breathing to some extent. On a scale relative to a person’s capacity, moderate-intensity activity is usually a 5 or 6 on a 0 to 10 scale. Examples include brisk walking, dancing, swimming, or bicycling on a level terrain.

2) Vigorous-intensity physical activity:
Aerobic activity that greatly increases a person’s heart rate and breathing. On a scale relative to a person’s capacity, vigorous-intensity activity is usually a 7 or 8 on a 0 to 10 scale. Examples include jogging, singles tennis, swimming continuous laps, or bicycling uphill.

3) Muscle-strengthening activity:
Physical activity, including exercise that increases skeletal muscle strength, power, endurance, and mass. Examples include strength training, resistance training, and muscular strength and endurance exercises. Do single set of exercises enough to tire your muscles which should be around between 12-15 repetitions.

4) Bone-strengthening activity:
Physical activity that produces an impact or tension force on bones, which promotes bone growth and strength. Examples include running, jumping rope, and lifting weights.

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Ms Ruha

Ms Ruha



Team Perfect Fit

Team Perfect Fit

Weight Management Specialist