Hand, foot and mouth disease (HFMD) is an uncommon infection to be diagnosed in adults.
We present a case of a 32-year-old immunocompetent man with HFMD. This case report
highlights the importance of identifying a common childhood disease that could occur in an
adult. Recognition is important for possible role in notification, especially for outbreak
prevention and to consider potential differential diagnoses. The management and disease
prevention measures in a working adult in Malaysia and the shortfalls identified in management
guidelines are discussed.
Introduction: Sudden cardiac death is the most common medical cause of death in athletes.
The aim of this study was to identify the electrocardiogram (ECG) pattern changes and its
association with echocardiography among Malaysian footballers during a pre-participation
evaluation (PPE). Methods: A retrospective study was conducted on footballers attending a
PPE at a primary care centre. Secondary data collection was conducted and the proforma
included clinical history, physical examination, ECG, Echocardiogram and cardiovascular risk
factors assessment such as heart rate, blood pressure, lipid profile, fasting blood sugar and
creatinine. Data were extracted from the medical records, echocardiogram report and the
original ECG. The ECG patterns were analysed according to the International consensus for
ECG interpretation in athletes to determine physiological versus pathological changes. The
data was analysed using SPSS v24. Results: This study included 85 male Malaysian
footballers with a mean age of 20.1 ± 3.0 years. The mean resting heart rate was 55.2 ± 9.3
beats per minute. Abnormal ECG changes were found in 20% of the participants, which were
higher compared to that reported in other studies (14% – 17.3%). The normal ECG findings in
athletes were sinus bradycardia (76.5%), J-point elevation (68.2%), prolonged PR interval
(3.5%) and incomplete right bundle branch block (4.7%). The abnormal ECG changes were
multiple T wave inversions (5.9%), hypertrophy (2.4%), and deep Q-waves (8.2%). Four
abnormal ECGs were consistent with abnormal echocardiography findings and out of these,
two ECGs with hypertrophic changes were consistent with mild inter atrial septal bulging and
apical hypertrophy. Conclusions: Malaysian footballers have ECG changes that are
consistent with physiological changes in athlete’s heart. The positive association between ECG
and Echocardiogram findings are useful in confirming pathological ECG changes. Physicians
should be trained in PPE protocol and ECG interpretation in athletes in order to improve
identification of those at risk of sudden cardiac death.
Cigarette smoke produces more than 4,000 toxic chemicals and 53 of these chemicals can cause cancer. Smoking increases your health risks such as lung cancer, heart attack and stroke. In Malaysia, between 10% and 12% of causes of death are caused by smoking and this results in over 10,000 deaths a year. According to the National Health Morbidity Survey (NHMS) in 2015, the number of smokers aged 15 and above in Malaysia is estimated to be more than 5 million (22.8%). This alarming amount will lead to increased health costs. Smoking can also lead to a reduction in worker productivity and air pollution and the pollution due to cigarette smoke. Therefore, smokers need to be aware of the effects of smoking habits and the importance of maintaining a tobacco-free environment for the health and well-being of their families, friends and the community around them. To address this, Smoke Busters have created an innovation called Blue Ribbon Star Certification with an additional component of humanization into the TFI Buddies existing Blue Ribbon Certification. The main goal of this innovation is to make University of Technology MARA (UiTM) campuses 100% tobacco free. The first project at the Sungai Buloh Campus resulted in a decrease in the percentage of ‘hotspots’, whereby the number of cigarette butts was found to be greatly reduced. In addition, the percentage of staff with good knowledge and attitude on the effects of cigarettes increased. Feedback from users comprising staff and students also showed a very positive response. The direct impact on faculty and campuses include cost savings in terms of medical expenses and increase in staff productivity. The long-term effects include enhancing UiTM’s image nationally and internationally. From a social point of view, this in addition creates a more caring and responsible generation of colleagues and the environment.