Road safety

If I were the Minister of Transport, I would enact a law that ban a person from using phone for life if he's ever caught using phone while using a vehicle on the road. It's outrageous.

Is it a trend now ? Driving on the road, and playing with the phones? It's intolerable.

#roadsafetyissimpleasABC

Not to mention the car drivers who use their mobile phones while driving, I saw three consecutive incidents where the motorcycle riders were using their phones with one hand, leaving only one hand to manoeuvre the vehicle on my 5-minute drive back to home. Isn't it dangerous?

The question is : Is that worth it ?

Is a Wechat or Whatsapp message or whatsoever chat that you're involving on the phone worth risking your life on the road. Using the thumb to hold the button and speak to the phone while driving. This is NOT cool. Obviously, it is NOT a life or death moment that you must use the phone.

Almost off-balance when trying to answer the phone while avoiding the car coming ahead. You may be lucky one time , two times and many more times. But. it may only take ONE time to ruin everything in your life.

And, it is unfair to the other road users as well. It's an offence, risking their lives and putting your own at stake. Is you think about this, nothing is more important than your life. And, you should take the responsibility for your life by NOT doing the risky thing.

Be considerate. Be responsible. Be respectful.

If you really need to take that call or reply the messages. You can just simply stop by the roadside and do it before you continuing on your journey.

Seriously, there is no excuse for you to use phone while you're driving on riding a vehicle.

Do not use phone on the road. It's not trendy at all. It's a perilous ride.

Road safety comes first.

#safetyissimpleasABC

The mass media has been actively promoting road safety, and increase the awareness of the public. We should take this seriously. Everyone takes a small step, it will eventually make a big change.

Love Life. Take the change. Just do not use the phone while you're driving.

Oral thrush

A young child came in the pharmacy with his dad. His dad asked him to open his mouth and showed me his tongue. Creamy white patches on his tongue as well as the inner cheeks. The tongue uncovered with the whitey spots looks red and inflamed. He complained about the difficulty in swallowing the food.

Oral candidiasis, also commonly known as oral thrush.

It is not uncommon to have oral thrush in young babies and elderly as well as those people whom immune system is under the par. Don't need to worry too much.

Oral candidiasis (oral thrush) is a yeast infection, caused by Candida albicans. In common, Candida albicans is part of the healthy microflora in our mouth. However, the overgrowth of this species in the mouth lead to oral thrush. There are also vaginal thrush whereby this species thrive in the vaginal area.

Smokers are also more prone to oral thrush (So, consider quit smoking! The advantages are much more than preventing oral thrush).

Typically, oral thrush can be easily diagnosed by the signs and symptoms:-
1. creamy white (cottage-cheese-like) appearance, could also looked yellow of grey
2. the lesions are slightly raised, present most commonly at your tongue and inner cheek. Can be spread to the roof of mouth, gums, tonsils or even the esophagus.
3. you can easily scrape off the white lesions, leaving red, inflamed, tender areas. Sometimes, it may cause mild bleeding when you do scrape them off.
4.you feel painful, sticky feelings, hard or uncomfortable to eat or swallow. You may even experience loss of taste, simply because the overgrowth yeast population cover your tastes buds from the food.

WHY our family members or friends experience oral thrush?

It is unusual for adults to have oral thrush unless they are under stress or having certain medical conditions or taking certain medications.

A note for healthcare team: DO ask those customer come in with oral thrush if they have any medical condition or currently taking or have taken any medicines recently.

For instances:

1. For those who take oral corticosteroid such as prednisolone due to its hyperglycaemic effects.

2. For those who use corticosteroid inhaler such as budesonide owing to the failure of rinsing their mouth properly after use.

3. For those who are taking or have taken antibiotics recently, the bacterial microflora in the mouth is disturbed leading to the overgrowth of the yeast populations.

4. For those who have uncontrolled diabetes, the high sugar level favor the growth of yeasr, out-populating the bacterial microflora.

5. For those who are immunocompromised such as HIV/AIDS or cancer patients, the weakened immune system increase the risk of oral thrush.

6. For those who have dry mouth, there is a higher risk to have oral thrush. Dry mouth may be caused by medication use.

What should we do to treat oral thrush ?

For uncomplicated oral thrush, antifungal medicines can be obtained from the doctors or the pharmacists.

FOUR is the magic numbers in treating your oral thrush using nystatin drop.

Miconazole oral gel is the commonly used OTC medicine for oral thrush.
Apply 2.5 mL (half measuring spoon) in the mouth , FOUR times daily after food. Hold the gel as long as possible before swallowing.

Candizol oral gel 

Daktarin oral gel 

Nystatin drop could be the alternative
- Use one mL (one drop) FOUR times daily after food, usually for 7 days (continue for 48 hours after the lesions have resolved) 

Nystatin oral drop

Mystatin-OS 

NOTE : When the symptoms disappear, continue the treatment for at lease another two days.

If you are immunocompromised, seek medical help as oral anti-fungal medicine is needed.


Lifestyle advice:

Good oral hygiene is very important. Brush your teeth at least twice a day.

**Some choose not to brush teeth during oral thrush, as it may be uncomfortable or painful to do so. It is not encouraged. You should brush your teeth softly and use recommended mouth wash. ***
However,  DO NOT overuse mouthwash (especially antibacterial mouth wash) because it may worsen your condition.

If you're using steroid inhaler, do rinse your mouth properly each time after use. You can even brush your teeth after use.

If you're taking or have taken a course of antibiotics, let the doctor or pharmacist know and discuss with them.

If you're diabetic, keep your blood glucose in check is the best way to reduce all the complications including oral thrush.





References:
Pharmacy Today Healthcare Book
WebMD
Mayo Clinic

Travel now or never !

Browsing through the facebook newsfeed, often you will see your friends traveling here and there. Envy or not, they looked fantastic, amazing, enjoyable on the photos they posted. Nice food, nice weather, nice view. I am sure it will kindle the fire in your heart, wanting to go for a vacation right now. And then, you switch your mode back to the reality whereby you still need to focus on your studies or works. Life seems so unfair to you ! For those who love traveling, that's the painful moments to face the screen but nothing you can do about it, except keep scrolling through your newsfeed.

Traveling is fun. But you do need to make a lot of preparations before you actually start your journey. A random trip is exciting and full of surprises. But, it is only applicable to short, local vacation. If you are going somewhere far, good planning is a must. 

Just like writing an essay, your travel should have an aim. Casual and free ?  Family vacation ? Friendship bonding time ? Are you going to travel alone? Duo ? Trio ? A big group ? 

Go research about the places you are interested to visit. The correct timing ensure you enjoy the views you dream of,especially those countries with four seasons. Let say you plan to go to Asia countries. The late March to early April is the best time you go to Japan for Sakura (cherry blossom season). If you are flowers lover, spring is the best time to visit countries like Taiwan, Korea etc. 

Next step, grabbing cheap flight ticket definitely keep your budget in check. In fact, avid travelers always pay attention on the promo offered by the airplane company. Some said grab the flight ticket as early as possible to get the cheapest ticket. However, this is only partly true. You can still get a cheap price about half year before your trip. It is good that is you plan your trip earlier, however, it is often difficult to get your off days early. It's ok. As long as you get a break after the long days and nights work, it's ok to tamper yourself! 

Planning an itinerary could be a nightmare for somebody like me. In the beginning, I just did not know where to start. The three big "problems"  need to be settled - accommodation, transportation and foods.Here are some of my suggestions.

1.  Use google as our best friend - simply type in the key words - eg Two days itinerary in Osaka , Japan

2. Ask your friends who visits the places before ( I found this indeed very helpful, especially you will get some really awesome food and desserts recommendations from your friends who have the same taste buds as you :) ) - they will share their experiences with you. This make your travel much easier 

3. Read other traveler's blog (you are doing it now ? Lol) they talked about their experience, and even offer the tips to get cheap and nice accommodations , transportation, food, coupons etc

4. Search with traveler's apps such as  KAYAK, TripAdvisor, Airbnb,Trivago, Hotels.com etc. In fact, when you start searching it, the online artificial intelligence will display the related ads, promos on your social media. You can even join Couchsurfing (the website I mentioned in the previous post before), the locals not only can offer you accommodations, but also show your around, killing two birds with one stone. 

With a good head start, you will definitely relish the moments of traveling. 

Travel now or never !!!

Mouth ulcer (Canker Sore)

We all experience this at some points during our life. More often, we experience at least two or three times a year. 

Mouth ulcer. Medically, it is known as canker sore. 

It can be annoying due to the painful sensation. Can't even eat and drink properly. And, you lose your appetite. Yet, you have to bare with it miserably until it heals.

Mouth ulcers can be described as small sores, usually found in your inner cheeks, at the edge or under the tongue or inner lip. Usually, it appears either yellow or grey in colour, about 2-3 mm in sizes. Redness and swelling is common too. However, it usually do not result in scarring. 

What causes mouth ulcer?

The etiology is not truly known. However, it is often assosiated with stress, weakened immune system, hormone-related problems such as pre-menstruation and pregnancy. Or, it may be caused by physical damage such as accidental lips bite or sport injuries. Some studies even suggest that genetics may be the risk factor too. In other words, if your family members always have mouth ulcer, you prone to have it too.

Mouth ulcers can happen spontaneously due to the factors mentioned above. However, it could be resultant of medication side effects too. If the medicines you're taking cause dry mouth, it may lead to mouth ulcers. This is simply because your mouth gets too dry and the mucous membrane starts to break. (Dry mouth also can cause oral thrush too). 

Another reason may be the lack of certain essential vitamins and minerals such as folic acid, vitamin B12, zinc and iron. (Personally, I have recommended patients with mouth ulcers to take folic acid, and it does help in speeding up the healing of the ulcers). Not forgetting that all these vitamins and minerals play role in building new tissues, thus helping to repair the damaged mucous membrane. 

Usually, it is not a big deal having mouth ulcers apart from the fact that it could be extremely annoying when it comes to eating and drinking or even talking.

 Mouth ulcer heals within one to two weeks even you do not seek for treatment. Often, people seek medical help because they simply not wanting deal with the pain sensation which spoil their eating mood. Food is why. :P

You can get your mouth ulcer medical products from the pharmacy. There are different formulations available in the stores - gel, base , lotion etc. The products mainly contain active ingredients that ease your pain and inflammation as well as posses anti-bactericidal effects.

Some of the oral medical products which you can get from the pharmacy store:

Oral aid lotion 

Orabase

Dexaltin oral paste 

Kenalog dental paste

Bonjela Mouth Ulcer Gel

Pharmacist only medicine 
- Triamcinolone acetone 0.1% (Kenalog in Orabase) 
This is an oral paste that you can get from a pharmacist. 
- Dab a small amount of paste (6-8mm) on to the mouth ulcer(s), preferably at night, can use up to THREE times daily after meals. 
NOTE do not rub in or spread the paste to avoid granular gritty sensation. 

- It is safe for pregnancy and breastfeeding mothers (avoid in early pregnancy) 

- Ask the patient if they have tuberculosis, diabetes or peptic ulcer unless advised by the prescribers. 

- If not better in 7-days, then see pharmacist or doctor.

If you do not want to use any medicines. You can try to suck on the ices - this can soothe your pain. Avoid hot and spicy food, which can worsen the inflammation. My mum used to ask me to rinse my mouth with salt water when I had mouth ulcer. Surprisingly, it healed fast. 

How to prevent mouth ulcers? 

To prevent mouth ulcer keep bothering your daily life - changing your lifestyle is the key. For instance, reducing stress, having a good night sleep , eating fresh foods and vegetables. Avoid eating food when it is too hot. Or too spicy food. 

You can also consider to take vitamins and supplements to boost your immune system if your health condition is under the par. Good oral hygiene is important too - regular mouth wash, use of soft toothbrush etc.


Mouth ulcer is very common in our daily life. However, it can get tricky sometimes.

If you encounter the following situations, you need to be aware of that and seek for further medical advice
1. the mouth ulcer bleeds a lot
2. the ulcer is larde (>1cm)
3. many small mouth ulcers coalesce into a big ulcer
4.the ulcer is visible but painless (not painful at all)
5.you tend to get ulcer very frequently (eg. fortnightly)
6.it takes longer time to heal ( 3 - 4 weeks)
7. high body temperature and /or diarrhoea at the same time 
8. severe pain that cannot be alleviated by over-the-counter medicines or natural remedy
9. new sores appear when the old one does not heal yet

This is because frequent mouth ulcers may be the early signs of certain diseases such as inflammatory bowel disease, diabetes mellitus and HIVs. (usually, associated with weakened immune system) 

Talk to your doctor or pharmacist if you are not sure and have an uneasy feeling about the mouth ulcers.

Feel free to drop a comment and we can discuss together :)


References :

1. http://www.healthline.com/symptom/mouth-ulcers 

2. New Zealand Formulary