Prof Au Eong Kah Guan

Have you ever imagined what it would be like without having an eye? There are many who are deprived of sight. This tiny little human organ is the most dominant sense. Like other body parts, eye sight tends to become feeble with age. While in most cases, it may be due to the normal physiological changes due to ageing, while others are due to disease and pathological effects. However as a layman it would be difficult to ascertain whether poor vision is due to normal ageing process or cause of some disease in eyes. Thus it is very important to consult a professional if you have developed symptoms of poor eyesight.

Diagnosing and undergoing treatment at an early stage will help in preserving the sight and prevent permanent blindness. It is healthy to get your eyes checked at regular intervals. This will be beneficial as eye disease may affect at the age of 40 and above when changes in vision begin to occur. If you have developed any symptoms of eye disease or other risks factors like diabetes, it is mandatory to consult an eye doctor.

Some common age related visual changes may be due to inability to focus distant or near objects, reduced clarity of vision, inability to distinguish certain colors, lack of contrast sensitivity, inability to judge distance and depth, and reduced capacity to focus on low light. The most common eye diseases are glaucoma, cataract, age-related muscular degeneration, red eye, retinopathy and pterygium.

While some are inherited and develop symptoms, various ethnic groups, diabetic and short sighted persons and smokers are prone to high risk. The age related eye diseases include glaucoma, AMD, cataract, and diabetic retinopathy. Glaucoma occurs due to damage in optic nerve by high fluid pressure inside eye, which can gradually lead to total blindness. Treatment is through medication, surgery or laser therapy. AMD affects a part of retina which gives you sharp vision.

There are two types of AMD, one being dry and the other wet. In dry AMD there is loss of vital cells in macula, whereas in wet AMD, there is bleeding and leakage of fluids due to growth of blood vessel below the macula.

AMD treatment includes thermal laser therapy, photo dynamic therapy, and injection of drugs into eyes. Cataract is clouding near the eye lens that blocks rays entering eyes, thus blurring the image. Surgery may be the only effective way to get rid of cataract. Diabetic retinopathy is the major cause of poor vision for working population. Leakage from blood vessels results in swelling of retina and lipid formation.

Diabetic patients are more prone to developing this eye disease and if you have diabetes, be sure to have retinal examination done once every year. Vision impairment may restrict you to enjoy a quality life by limiting freedom, mobility and clear vision.

Many of these eye diseases can be treated if diagnosed at an early stage. So if you have the desire to have sight for life, get your eyes checked at regular intervals.

Adjunct Associate Professor Au Eong Kah Guan is Medical Director and Senior Consultant in Ophthalmology at the Singapore International Eye Cataract Retina Centre in Mount Elizabeth Medical Center.

For more information, please visit www.eyecataractretina.com

Dr Lim Ing Ruen

Smoking is really a trigger that can ruin your nose and surrounding sinus tissues. Surprised! Well if you’re are smoker or there is someone from your family who smokes, it is better to come out of this habit if you really don’t want this to happen to you or your loved ones.

First, you may want to know what sinuses really are. Well, the sinuses are air filled bony structures on the inner walls of your nose. There are about four pairs of sinuses, with frontal pair located on the forehead, the sphenoid at epicenter of the skull, ethmoids in between eyes and the maxillary sinuses just below the cheeks. The sinuses respond with nose through a small outlet known as ostium. The sinuses are lined in a pseudo stratified pillared epithelium which consists of mucus secreted cup-shaped cells and ciliated cells. These sinuses are responsible for enhancing vocal resonance, lightening skulls and condition inhaled air. The major function is production of mucus, which has antimicrobial properties. According to American Academy of Asthma, Allergy and Immunology, almost 31 million of the population is affected by sinus infections every year. Tobacco smoke is alleged to release as much as 4000 toxins most of which are carcinogenic. The active smokers inhale and exhale the mainstream smoke. The side stream smoke wafts from cigarette ends, pipes and cigars.

The second hand smoke is amalgamation of side stream and mainstream smoke that non smokers are exposed to. Cigarette smoking has adverse effects on cilia function, resulting in stagnant mucus that gets collected in sinuses. As a result, the sinus ostia get blocked by dried mucus, restricting proper drainage of mucus. Cigarette smoking causes several airborne allergies, like nasal blockage, aggravated Asthma and running nose. Passive smokers may also be victims of Asthma and allergies. Exposure to cigarette smoke above critical levels may cause metaplasia in the upper lining of nose, which is just a start of carcinogenesis. Rhino sinusitis is an infection that affects sinuses and nose and usually begins as viral infection that normally takes three to four days to recover. Although chain smokers and second hand smokers are unable to recover and they might also be affected with bacterial sinusitis. In cases where viral flu takes more than five days to recover, it is best to consult a physician and take antibiotics. Saline douches may also help in cleansing the blocked mucus and moisten the nose lining. You may also opt for allergy tests to determine the root cause of such allergies, which may be due to dust, or from pollen and pests. Cancer of nose is threatening and its early symptoms are blood discharge and nasal blockages. Nasoendoscopy is suggested for people with chronic symptoms. This simple procedure helps in having proper treatments.

If you have developed nasal allergies, it is better to safeguard against ecological exposure to allergens and using steroid sprays and prior to surgery or radio therapy it is better to have a CT scan done.

Dr Lim Ing Ruen is a Ear, Nose and Throat surgeon at the Singapore Medical Specialists centre. For more information , please visit www. Sgsmc.com

Research. Due to its medical research preeminence, Johns Hopkins Medicine, employing groundbreaking clinical scientific training models different from the existing approach to Singapore’s, was approached by the Singapore Government in the 1990s, in its aim to develop unparalleled life sciences presence in the country, to build and develop a hospital here.

Education. Alongside the research arm underwritten by the Singapore Government was an oncology clinical unit, a state-of-the art ‘hospital within a hospital’, in partnership with the National University Hospital, that treated a wide range of cancers. Besides cancer research, oncologists at Johns Hopkins Singapore benefit from the knowledge of renowned expert oncologists in Johns Hopkins Medicine in the US.

Patient care. Johns Hopkins Singapore International Medical Centre, the first Singapore private hospital to receive the Joint Commission International (JCI) accreditation in August 2004, completed the Medical Intensive Care Unit (MICU), which assured the patients of international-level care and a safe and well-run facility.

With the growing need for space and facilities for both inpatient and outpatient treatment, Johns Hopkins moved to Tan Tock Seng Hospital in 2006.

The Johns Hopkins Singapore IMC, which continues to focus on cancer treatment, serves not only Singaporeans but also foreign patients. The centre, a 30-bed licensed medical oncology facility, is a joint venture between the National Healthcare Group and Johns Hopkins Medicine International and the only fully branded Johns Hopkins facility outside the US.

Patients from neighboring regions have sought treatment at Johns Hopkins Singapore. One of them is Mr Roby Budiono, a cancer patient from Indonesia, who has been seeking inpatient treatment for three months and appreciates the doctors’ efforts.

His physician, Dr Akhil Chopra, explains that clinicians at Johns Hopkins Singapore are compassionate, adhere to the highest ethical standards of judgement and conduct, and are indubitably intellectually curious. They unceasingly acquire new skills and knowledge in their aim to improve their practice and to contribute to medicine.

According to Dr Chopra, in Southeast Asia, cancer incidence and the cancer patients’ biology and response to standard cancer treatment vary from those in the West. Moreover, there are many factors, ranging from viral to genetic, for this, and it is difficult to narrow down to one reason. Along with his colleagues, he hopes to use their skills to help cancer patients in this region.

June Yang, who is the Chief Operating Officer, emphasizes that Singapore Medical Speicalists (SMSC) provides unparalled service for anyone who needs medical screening and a consultation with regards to their overall health.

Ms. Yang, who has 20years of service experience in healthcare, says that patients from as far away as New York or many European cities can fly into Singapore for a health screening in the morning and receive a report for their screening the very same day. In many cities, even high-quality medical facilities can take as long as a week to furnish a patient with this type of report.

Ms. Yang believes that offering premium service entails the synchronization of highly skilled professionals working as a team as well as facilitating screenings in express time. She believes offering care and services in a timely manner is a key component for any medical facility wishing to hold the distinction as a premier provider in healthcare today.

If you’re a professional who has a schedule that doesn’t allow for a surfeit of time, then the Singapore Medical Specialists Centre (SMSC) in Singapore will provide you with a level of service that can’t be surpassed in the industry.

Ms. Yang as well as the doctors at SMSC believe in the need to respond to patients with empathy as well as give them premium care. This involves health screening, consultation and the dispensing of medicines in a quick and efficient manner.

The philosophy at SMSC is based on in-depth caring for the patient. According to Ms. Yang, the patient’s care doesn’t stop with the diagnosis and the doctors at the Centre support this viewpoint. Doctors impart their expertise by discussing a diagnosis with a patient and teaching him something about his disease or illness. They are empathetic as to the patient’s feelings and concerns in this regard.

If you’re looking for medical professionals who are sensitive to your needs and service that is the ultimate in quality, you don’t have to look any further in the world today than the Singapore Medical Specialists Centre in Singapore. Ms.Yang assures clients that they will receive medical attention and healthcare services that are second to none.

For more information, please visit www.sgmsc.com

“There is no wonder drug that will improve a smoker’s libido,” Dr Tan said. His advice for smokers is to subscribe to a healthy lifestyle, which means quitting smoking and taking up activities such as exercises that will help to improve libido.

There will be no symptoms till the fourth decade. Initial symptoms may be palpitations due to irregular heart rhythm and breathlessness on exertion. Those symptoms may eventually develop to swelling of legs, cough with frothy blood stained sputum, and even stroke due to clot formation of heart.

Once symptoms occur, it is important to perform imaging on the heart to plan for treatment. If the valve stiff due to deposit of calcium salts, surgery is recommended. Alternatively, PTMC (Percutaneous Transvenous Mitral Commissurotomy) or balloon valvuloplastry, is a semi-invasive procedure where a balloon is used to dilate the narrowed mitral valve.

How is PTMC done?

This procedure can only be carried out through the groin approach. Both the femoral vein and artery will be punctured and one sheath will be inserted through each vessel. A long pigtail catheter will be positioned in the left ventricle the same way as a coronary angiogram. Then a long puncture needle will be placed at the right atrium through the femoral vein. A long coil is then passed to the left atrium through the hole punctured. A balloon-tipped catheter (Inoue balloon) is then guided through the hole created to the left atrium and from there passed through the mitral valve.

The Inoue balloon is inflated several times to stretch the narrow segment of the mitral valve. The entire balloon, catheter, coil and other foreign bodies will be removed. The hole created will usually close off by itself. Even if it is not sealed, such a small hole shouldn’t cause any problem to the heart. Patient will need antibiotics before and after the procedure.

A common symptom is progressive memory problem. There may be decline in language or ability to do tasks that he or she was able to do, such as dress or feed one. Decision making and planning may be affected as well. This may include changes in mood and personality, wandering behavior, sleep disturbances, repetitive questioning, agitation as well as delusion and hallucinations.

At this point in time, there is no cure for dementia. However, there is effective treatment that includes medication as well as behavioral management. There are medications to control sleep problems, agitation, mood disturbances as well as delusion and hallucination. There are also new medications that slow down the progression of the disease.

In Singapore (2003), the overall prevalence of dementia in those aged 65 and above was 6%. Consistent with other populations, the study showed that the prevalence rates of dementia increases with age and the prevalence rates of dementia was higher in female as compares to male.

Cultivated cordyceps is fed to the chicken which lay corcydeps eggs. The cordyceps eggs contain bio-active compounds that support healthy lung and kidney function. Cordycepins is believed to be able to have anti – ageing properties and boosts immunity.

Besides that, Chew’s eggs are 30% lower than in cholesterol value as compared to conventional eggs. They have a smooth bouncy white texture, a sweeter yolk, and rich in protein and vitamins A, B, D and E. Vitamins A and E have anti – aging properties while vitamin D aids bone formation and prevents osteoporosis.

Chew’s Designer eggs go beyond conventional nutrition to provide value – added nutrients for consumers. Chew’s Designer eggs have met the nutritional guidelines set by the Singapore Health Promotion Board as a Healthier Choice.

We can arrange for interviews with a doctor in general practice to share more about the tool and how it has aided in diagnosis, treatment and management of feeding difficulties among young children. We can also arrange for visuals for publication.

For further information, please contact 65515436/97413793.

Thank you.

Ms Chua, a housewife, tries to keep herself healthy by exercising. Her quest for good health led her to benefit from the Singapore Cancer Society (SCS)’s free Faecal Occult Blood Test (FOBT) kit distribution program which has been running for the past two years. The FOBT kit is used for colorectal cancer screening.

Every March, Ms Chua will look through the newspapers for announcements on Colorectal Cancer Awareness Campaign (CCAM), during which SCS will distribute free FOBT kits. In March 2008, Madam Chua took the kit again without giving much thought to it as her previous tests had turned up negative. Understandably, she was dismayed at being told that her latest test was positive. After the shock has worn off, the support of her family helped her to come to terms with the diagnosis. She received swift guidance from SCS staff, who instructed her to report to Jurong Medical Centre, where doctors arranged for her to undergo colonoscopy.

Colonoscopy just takes around less than an hour and the doctor extracted around three polyps from her intestinal area, for which the largest was about one centimetre. The polyps were later tested and found to be non-cancerous. She was relieved to hear that the final result was negative, who has to return for follow-up colonoscopy in the next two years. She said that CCAM was beneficial to the public, as it helps to raise awareness about colorectal cancer. Her experience has led her to encourage friends and family to undergo colorectal cancer screening.

“In fact, some of them have already gone for it,” she said.

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