Tuesday, December 22, 2009

Anti Aging: Red Bull? Try some Testosterone instead!

Men, as you get older, are you feeling that you are always tired and that your body isn't performing as well as it was when you were twenty one? Well, one of the things that happen as you age is that your testosterone levels drop and that might be the cause of your problem.

Dr Suren specializes in this area and we are starting Anti Aging Clinics where we can help you maintain vitality as you age. Of course we will also be looking at menopausal issues and helping women age gracefully, but for today, we will talk about men first.

Below is an article by Dr Suren on what happens when men age.

Testosterone: It is not just about SEX

Testosterone is the main sex hormone produced by the testes. Testosterone together with it's derivatives, estradiol(E2) and dihydro testosterone (DHT) act directly on diverse target organs such as the sex organs, bones, muscles, blood-forming tissue, the brain,skin and hair. Thus, testosterone has a vital role in proper function of multiple systems in our body.

As men age, the levels of testosterone will fall. At age 70 the testosterone level is only 30% of the peak at age 25. Late onset hypogonadism, also known as andropause usually starts after age 40. It is characterized by symptoms such as fatigue, lack of energy, low mood. There can be loss of muscles, increase of fats especially in the abdomen, decreased exercise capacity and endurance. Of course there can be loss of sexual interest and erection difficulties.

Andropause is now recognized as a serious health problem. The good news is that we are able to treat it and reverse many of the above problems.


Prevalence of hypogonadism ( Low levels of testosterone)

The prevalence of andropause is from 6 to 13% in those aged between 40 – 69 years old. Prevalence increases with age. (1)


Testosterone deficiency is associated with Diabetes

Testosterone deficiency plays a central role in the cause of Type 2 diabetes, Metabolic Syndrome and Insulin Resistance. It contributes to the accumulation of abdominal fat. This abdominal fat is an active endocrine organ producing chemicals (cytokines) that cause inflammation such as causing abnormal lining of the blood vessels. Testosterone treatment of hypo gonadal men improves diabetes.(2)


Testosterone restoration improves muscle strength

Replacement of testosterone increased fat-free mass, muscle size and strength in hypo gonadal men. (3) Oral testosterone treatment in diabetic men with deficiency improves body composition, decrease abdominal fat, improves glucose homeostasis and improves erectile dysfunction. (4)


Optimal testosterone levels associated with better cognitive function

One study showed that older men with high testosterone and low estrogen level performed better in several tests of cognitive function. (5)


Low testosterone is associated with poor cholesterol and potential risk to heart health

Low testosterone is associate with high total and bad (LDL) cholesterol. The lining of the blood vessels are also slightly damaged, making it prone to accumulate fatty plaques. Also due to the association with obesity and poor glucose control, low testosterone can affect the heart health.(6)


Should you have testosterone restoration?

There is convincing evidence of the benefits of testosterone replacement. Before starting we recommend that you speak to us, so that we can ascertain that you do indeed have andropause. We will then do a blood test of your hormones for confirmation.


Are there any risks of restoration?

Some researchers have warned that restoration can be a risk of aggravating prostate cancer. As we become more familiar with testosterone replacement we belief the risk of prostate cancer is very low. There is no scientific evidence that testosterone supplement increased the risk of prostate cancer.(7) Nevertheless we will still do a blood test before and after treatment to make sure that we do not put the patient at any risk.

Testosterone restoration can also increase the red blood cell count. This is easily detected and effectively treated without any risk to the patient.


What do I do now, if I want to check for andropause?

Dr Suren Baskaran now conducts special clinics for this condition. If you wish to check for andropause, just call us for an appointment.


References

1. Araujo Ab et al. Prevalence and incidence of andropause deficiency in middle aged and older men. J Clinical Endocrinology Metabolism 2004 Dec;89(12):5920-6.

2. Traish. The dark side of testosterone def II. J Androl 2009;30:23-32.

3. Bhasin S. et al. Testosterone replacement increases fat-free mass and muscle size in hypo gonadal men. J Clin Metab. 1997 Feb;82(2):407-13.

4. Boyanov MA et al. Testosterone supplementation in men with T2D, visceral obesity and partial androgen deficiency. Aging Male. 2003 Mar;6(1):1-7

5. Barrett-Connor E et al. Endogenous sex hormones and cognitive function in older men. J Clin Endocrinology Metab 1999 Oct;84(10):3681-5

6. Traish et al. The dark side of Testosterone deficiency III. J Androl 2009;30:477-94

7. Morgentaler A. Testosterone replacement therapy and prostate risks. Can J Urol.2006 Feb;13 Suppl 1:40-3

Tuesday, December 08, 2009

H1N1 Vaccine is now approved for kids from 6 months of age

MOH has just approved the use of the H1N1 vaccine for children from 6 months onwards.

Children from 6 months to 3 years of age will need 2 half doses one month apart.

Those from 3 yrs to 10 years will need 2 full doses one month apart.

We currently have stock of the Panvax H1N1 vaccine which is the individual shots that do not contain mercury. These are $30 nett. The Panvax H1N1 vaccine is the one that the MOH has approved for use in children as they are satisfied with the safety of the vaccine.

You can read more about the announcement on Channel News Asia.

Thursday, December 03, 2009

H1N1 Vaccine: New Stock has arrived

By now you would have heard that the H1N1 vaccine has been approved for 10 year olds and above and the good news is that our new stock of vaccines have just arrived so we have enough for walk in patients.

There has been some concern about the safety of the vaccines. This pertains to the older 10 doses per vial vaccine. The vaccine we stock is Panvax from CSL labs which is the individual vaccine that does not contain mercury. So far, we have received little complaints from our patients. I personally have administered the vaccine to my own left arm and all I had was a bit of pain over the injection site for 2 days. (Yes, I did it Rambo style and injected myself)

The other question that often gets asked is whether you should take the seasonal flu vaccine or the H1N1 vaccine. The best answer is that you should take both. Both vaccines can be given at the same time. If you have to choose one, I would advise young adults to take the H1N1 vaccine because there has been some concern that the H1N1 virus is somehow more virulent amongst young adults with several deaths occurring amongst otherwise fit young adults.

Our price for the Panvax is $30. Do ring up first to check for stock availability.


Wednesday, November 25, 2009

Hari Raya Haji Opening Times:

We wish all our muslim friends a very good Hari Raya Haji.

Our clinic will be opened on Hari Raya Haji from 8.30am to 12.30pm.  The night clinic will be closed.

The opening hours on Saturday and Sunday are unchanged.

Monday, November 23, 2009

H1N1 Vaccine: Individual Vaccines Now Available

Thank you for your patience.

We have received our batch of H1N1 vaccines today.

These are the Panvax H1N1 Vaccine manufactured by CSL Ltd and as previously discussed, these individual vaccines do not contain the preservative thiomersal.

The vaccines are $30 nett and includes the vaccination fees.

If you have booked your vaccine, please call in to confirmed that you are still coming for the vaccine.  If you don't claim the vaccines by 30 Nov, we will release them to the other patients.

Wednesday, November 18, 2009

Submit a photo of your baby and win a set of Baby IQ DVDs!



I am running a competition to give away 10 Baby IQ DVD sets. Every set comprise of 5 DVDs designed to encourage talk naturally in an interactive learning experience for parent and child. The DVDs are filmed in HD and the music is performed by the London Symphony Orchestra. Each set is worth $100 and more information about Baby IQ can be found here.

In order to win a set of this DVD, all you have to do is to submit a photo of your baby and tell us why you and your family choose Karri Family Clinic to look after your family's healthcare needs.

Here are the competition details:

1. Submit a photo of your baby resized to 1000 pixels
2. Write in 100 - 150 words why you choose Karri Family Clinic
3. Send your entry to leslie.tay@gmail.com
4. In the title write "Baby IQ contest"
5. The closing date is 6 Dec 2009
6. The ten winners will be notified by email
7. Winners will collect their DVD sets at the clinic.
8. The photos of the babies and the comments may be subsequently published on this website
9. This competition is opened to all patients of the clinic with young children. The photo can be one taken when your child was a baby.

I look forward to seeing your photos!

This competition has been made possible through sponsorship by Abbott.

Monday, November 16, 2009

The seasonal flu vaccines are now available

We have just received our latest batch of flu vaccines. This is not the H1N1, but the normal flu shots. So if you wish to take your flu shots before you leave for your vacation, please drop by the clinic.

Monday, November 09, 2009

H1N1 Vaccines: Single Dose vs 10 Dose Vials

We have many inquiries about the H1N1 vaccine and it is understandable that everyone is quite anxious about taking the vaccination as early as possible especially since the school holidays are just around the corner.

Currently, the only ones that are available in the market are the 10 dose vials. The single dose vaccines will only be available later in the month. Our clinic does not stock the 10 dose vials because I feel that it is better to wait for the single dose vaccines.

The main difference between the 10 dose vials and the single dose vaccine is that the 10 dose vials contain Thimerosal which is a substance containing mercury. The US FDA assures us that it is safe to use but I know that there are many people who will not want to take the vaccine if it contains mercury. So I have decided not to order the 10 dose vials and wait for the single dose vaccines to become available.

If you really need the H1N1 vaccine urgently, please go to the polyclinic and have your vaccination. But if you can wait for another 2 weeks or so, the single dose vaccines should be available. If you have already booked your vaccines with us and wish to cancel, just give us a call to cancel your order.

Monday, November 02, 2009

The H1N1 Vaccine



The H1N1 Vaccine will be available soon at our clinic.

The H1N1 vaccine will offer protection against the H1N1 virus but not the seasonal flu. It is highly recommended for high risk groups like the elderly or those who suffer from chronic diseases. It is also recommended for pregnant women in the 2nd and 3rd trimesters.

Currently, they are still doing the trials for children so the vaccine is not approved for kids yet.

Since it is based on the same technology as the flu vaccine, it has the same safety profile as the flu jab. People who have egg allergies or have reaction to the flu vaccines should not take the jab.

The price of the vaccine is $30 nett and includes the consultation fee.

Because stocks are limited, please ring up to place your orders with our staff. Tel: 67850311. Please leave your name and contact number so that we can inform you when stocks come in. I will also update the website when stocks arrive.

For more information on the H1N1 vaccine, please click here.

Wednesday, October 21, 2009

IMFed: Help for kids who don't want to eat

One of the most common concerns amongst parents is that their child is not eating well. Parents do have a natural instinct that senses that something is wrong when a child is not eating or putting on weight. This is a good thing as the inability to eat is sometimes a sign that something is wrong.

On the other hand, some parents are overly concerned just because their child is not as chubby as the neighbour's kid. I often have parents coming into the clinic asking for their child to be weighed and measured. I have to say that most of the time, after checking the growth charts, I reassure the parents that the child is OK.

However, there are occasions when there is something wrong and the important thing is to make a correct diagnosis of the problem. Sometimes the child is simply picky while at other times the child might actually have a fear of eating. Some kids might be sensitive to certain foods, while others actually have something more sinister, like an underlying disease which is is causing the child to be unable to eat.


IMFed Kit found in the waiting room

Now there is a new tool available at our clinic called the "IMFed" which stands for Identification and Management of feeding difficulties. (It's pronounced "I am Fed") This is essentially a simple questionaire where you as the parent can identify the set of problems that you face when trying to feed your child. Once the form is completed, it is fed into another tool where the doctor can help to explain the problem and advise on the appropriate management of the problem.

So for example, you might find that your child refuses to eat because of the smell, taste or texture of the food and eats only very limited number of foods. Using the tool, the diagnosis of Sensory Food Aversion is made. Sensory Food Aversion is basically a heightened sensory sensitivity in kids and the way to handle the situation is to use a strategies like trying to eat "new foods" in the presence of the child without offering any. The tool makes it very easy for the doctor, together with the parent, to identify and help manage eating difficulties.

So, if you think your child has difficulty eating, do look for the IMFed box at our counter and just fill it up and we can look at the management options together.

Wednesday, October 14, 2009

Dr Tay to be featured on Channel U



There will be a TV program featuring Dr Tay, the clinic and his food blog on Channel U on 20 October at 9.30pm and 11.30pm. So do remember to tune in and watch what your familiy doctor gets up to in his free time!

Friday, October 09, 2009

Pneumococcal Vaccine slated to be in the National Immunization Program

You might have read in the news that the Pneumococcal Vaccine will be added into the National Immunization program soon. Health Minister Khaw made this surprise announcement in Parliament last month.

I say "surprise" because having been part of a group of doctors that have been rallying for its inclusion, this announcement still seemed quite far off at the beginning of this year. And when Minister Khaw made the announcement in response to MP Fatimah Latiff, everyone was quite taken aback. But whatever it may be, we are all happy that the Ministry of Health has eventually made the decision to join a long list of developed nations around the world to include this into their immunization program.

So why is this vaccine important? Well, in short, pneumococcal disease forms the biggest proportion of vaccine preventable disease in the world. Despite the introduction of the vaccine, there are still proportionately more people suffering from this disease compared to other vaccine preventable diseases.

However, rather than providing it free for Singaporean children, the minister has announced that he will be allowing parents to pay for it from their Medisave account. Currently, these vaccines can also be paid from the Baby Bonus account.

But please don't wait for the govenment to make it compulsory before vaccinating your child. Pneumococcal disease is most devastating in babies less than 2 years of age. I have written about one mother's ordeal in an earlier post, so this is not something that you should allow price or government legislation to dictate whether you give the vaccine to your child. It is recommended that babies start the vaccination at 2 months of age in order to gain the most benefit from the vaccine. By starting the vaccine early, you have the opportunity to prevent the bug from colonizing the child's nose and throat. Some of us already carry the bugs in our nose and throat and most of the time it lies domant. However, one day it might just become aggressive and start attacking the body's organs. So preventing the bug from colonizing the nose and throat is an important aspect of preventing the disease.

I just returned from giving a talk on Pnuemococcal disease prevention to the Polyclinic Doctors and Nurses and found out that the retail price for the vaccine at the Polyclinic is $170 plus a $4 injection fee. Because I feel strongly that all babies should get the vaccination, our clinic has packages which work out to $155 per jab for babies in their first year of life who require 3 to 4 jabs. For those in the 2nd year of life, the jabs are $170 nett and we waive any consultation or injection fees. At the present moment these can be paid with the Baby Bonus card. I have been asked many times why we are able to charge less than the polyclinic and the answer is simply that we want to encourage parents to give the jabs early so we lower our margins to make it easier for families to protect their children.

So since it is going to be compulsory to protect your child from Pneumococcal Disease, do consider to do it now rather than wait for MOH to announce it later. Early prevention is very important.

Link to news article on the announcement by Minister Khaw
Link to my previous articles on Pneumococcal Disease

Thursday, October 01, 2009

Get rid of Body Odour once and for all!

I am going to share with you a little secret that the manufacturers of deodorants would never want you to know.

You can get rid of body odour once and for all rather than having to use roll ons and sprays everyday.

This is how it works. Body odour is often caused by bacteria residing in your armpits. Because the armpit is a moist environment, bacteria thrive and cause that smell which make people shift seats in the MRT.

So the trick is to get rid of the bacteria.

This is what you do. Go to the pharmacy and pick up a bottle of iodine. Then go pick up a soft brush, the type that you buy to scrub the toilet floor, but a soft one. Then the next time you shower, apply the iodine to your armpit and scrub away! Leave the iodine for a few minutes and carry on with your shower. Do it for a few days and very soon, you can throw your roll on and sprays away!

So if you have a friend or a colleague at work who has BO, but you have never struck up the courage to tell him, perhaps you can send him this post as a subtle way of saying: "Hey, its time to do something about your BO!" Soon the air in the office would smell like the meadows during springtime.

Good luck!

Thursday, August 20, 2009

Latest Developments in the prevention of Pneumococcal Disease



I recently attended an Asia Pacific conference highlighting new developments in the prevention of Pneumococcal Disease.

Pneumococcal Disease remains the most common preventable deadly disease in children. Every year, 1.6 million die from it. Yet, there is a vaccine available and a large proportion of these deaths could have been avoided.

One of the take home message is that Pneumococcal Disease affects kids most severely under the age of 2. Therefore it is important to start the vaccination regime from birth. By doing this, you have the added advantage of preventing nasal carriage in the child. The bacteria normally resides in the nose of individuals and by 6 months, a lot of unvaccinated babies would have this bug residing in their noses. Most of the time the bugs are law abiding citizens who cause no problems. But once in a while some become terrorists and wreak havoc by invading the brain, ears, lungs, blood, bones and some eventually get severe enough to cause death.

Although there are antibiotics against Pneumococcal Disease, there is recently been a rise in antibiotic resistance and so there is no guarantee that antibiotics are effective against the disease. The best way is still to prevent the child from getting the disease through vaccination.

Another advantage of vaccinating your child is that it also protects the rest of the family from getting the disease. The research has shown that since the introduction of the pneumococcal vaccine in year 2000, not only has the death rate from the disease been reduced in the infants being vaccinated, there has also been a corresponding decrease in the number of elderly being affected by the disease. This demonstrates what is known as the "herd effect" which basically means that by vaccinating babies, we decrease the number of persons affected by the bug in the general population because there is a higher level of immunity in the population.

Many exciting things are happening in vaccine development which we should see next year in Singapore. There are going to be new and more effective vaccines being introduced which means better protection for your loved ones.

However, you should not wait to vaccinate your child from Pneumococcal Disease. The best time to vaccinate is now because vaccinations are like insurance. The earlier you buy the better and you hope you never have to use it.

Wednesday, August 05, 2009

Dr Tay's National Day Message

Aiyah, PM got National Day Message, so I thought I also can give my own National Day Message.

Actually the message is very simple.

Our opening hours during the National Day Long Weekend are as follows:

Saturday 8 Aug, 8.30am to 12.30pm
Sunday 9 Aug, CLOSED
Monday 10 Aug, 8.30am to 12.30pm

Have a very good Long Weekend and don't forget to catch "Buzzing Cashier" on Channel 8 on 10 Aug at 8pm. I will be taking off my stethoscope and assume my role as a food critic in the TV series.

Flu Kits and Tamiflu now available in our clinic

There has been a recent surge in the number of cases of flu like illnesses in our clinic which is reflective of what is happening around us.

As a result we have brought in the Influenza A and B test kit. With this test kit, we can take a sample from your nose and be able to determine if you have Influenza A or B within 15 minutes. The test is not specific for H1N1, but since H1N1 is a subtype of Influenza A which is now the predominant strain, we can say that anyone who is tested positive for Influenza A has a high chance of having H1N1. The test kit is just a convenient way for our patients to know their condition on the spot instead of having to wait for the results if we have to send it to the lab.

If you are diagnosed with Influenza A or B, our patients can now have the option of taking Tamiflu. Tamiflu should be used only in the more serious cases so not everyone will be given Tamiflu if they are tested positive.

As an additional precaution, our staff are masked and patients will be required to wear masks and wait outside the clinic if they are having a fever and/or flulike symptoms.

These are measures that we need to put in place during this time. We hope that you will bear with us as it might be a little uncomfortable and the waiting times will be a little longer than usual.

Tuesday, July 28, 2009

New Vaccine that combines Chickenpox with Measles

Our clinic has started stocking the MMRV vaccine which is used for your child's second year vaccinations.

MMRV stands for Measles, Mumps, Rubella and Varicella (Chickenpox). In the 2nd year of life, kids are required to take the MMR vaccine as a compulsory vaccine. The Chickenpox vaccine is optional, but many parents are choosing to vaccinate their children against this infectious disease because of the risk of scarring and severe disease

With the MMRV vaccine, you can now reduce these two jabs to one. Normally, we would advise children to take the Chicken pox vaccine at 12 mths and MMR at 15 mths. With this new vaccine, both are combined into one jab and can be given from 12 mths onwards. So this is very convenient for our busy parents. The price of our second year package which includes the MMR, Chickenpox and 5-in-One vaccines remain unchanged at $210 if you choose to use the new MMRV vaccine.

The MMR and Chickenpox vaccines are still available separately.

Read my article on why you should vaccinate your child against chickenpox here.
Listen to me discuss the importance of chickenpox on 938live here.

Wednesday, July 15, 2009

The Flu Vaccine is in Stock

Thanks for all who were patiently waiting for the current Season Flu vaccine to come in. We are pleased to announce that we managed to obtain a batch of the Flu vaccine. Stocks are limited, so please call in to reserve the vaccines for your family.

The H1N1 vaccine will not be available at least till the end of the year. So in the meantime, it is important to vaccinate your family against the flu. In particular, the elderly, pregnant moms in their third trimester, kids with asthma or respiratory problems and people with chronic diseases should have their Flu vaccines done.

Please note that if you are going overseas, you need to take your flu shots at least 3 weeks before departure. A lot of patients have the mistaken idea that it should be done as close to the date of departure as possible. The body needs time to develop immunity after vaccination, just like yeast needs time to rise. So you need to wait at least 2-3 hours for the dough to rise. Similarly, you need 3 weeks for the body to develop immunity after any vaccination.

Sunday, July 12, 2009

H1N1 update: The latest from MOH

With the prevelence of the H1N1 in so many countries. WHO has stopped publishing the table of affected countries. So that means that the H1N1 is everywhere now. In Singapore, H1N1 is now estimated to comprise 28% of all cases of influenza like illness in the community. As such please note the following:

1. Contact tracing and Quarantine Orders are generally no longer required. So it is no longer necessary to send people to Pasir Ris.

2. Diagnostic tests to confirm H1N1 is only required for severe cases. So even if the Dr suspects you have H1N1, you are no longer required to have a lab test to confirm.

3. Pregnant women and persons who are immunosuppressed will have to be treated under new guidelines which stress social distancing and specialist treatment.

4. We will continue to take your temperature when you come to the clinic and ask those who have fever and flu symptoms to wear a mask and sit outside the clinic. This is necessary to avoid spreading the virus.

In a nutshell, H1N1 is amongst us and its almost like how we treat the normal flu except for a few special precautions.

Friday, July 10, 2009

H1N1 update: Protect your family! Vaccinate against Pneumococcal and Flu!

As from today, they have stopped taking temperatures at the checkpoints because the H1N1 virus is now considered endemic ie it is prevalent within our society. There is no point in trying to prevent the virus from getting into Singapore since it is already spreading around within the country.

So, what can you do to protect yourself and your family?

The most important thing is of course to take the necessary precautions. Basic things like avoiding crowded places, eating healthy foods like lots of fruits and vegetables and doing regular excercise will go a long way to keep your immune system in it's peak condition.

In addition, there are some vaccines which you might want to give your loved ones.

The first one is quite obvious and that is the Flu Vaccine. Many patients have asked me why they should take the Flu Vaccine even though it does not specifically protect against H1N1. Well, the way I see it, if you happen to get the seasonal flu now, the symptoms are exactly the same as the H1N1 flu and it might still result in home quarantine for a week. At the moment, it is not compulsory to send every suspect case of H1N1 to TTSH anymore. So if you have Flu-like symptoms and it is not serious, then you will be simply sent home with 1 week MC. So as you can see, even having the seasonal flu is going to mean a lot of disruption to your life.

The second and perhaps not so obvious is the Pneumococcal vaccine. Recent studies have looked at the real cause of death in the Flu pandemic of 1918 and the evidence is that many of the deaths were caused not by the Flu virus itself but by secondary infection caused by Bacteria like Pneumoccocus.

What happens is that the Flu Virus enters the body and damages the lung tissue. This is like "tilling the soil", making it very easy for Bacteria to then infect the tissues. Pneumococcus is the major cause of Pneumonia and in many cases, the Flu Virus creates the condition where it is very easy for Pneumococcus to come in and cause a full blown pneumonia and eventually death.

So another thing you can do for your family is to vaccinate them against Pneumococcal disease. There are currently two such vaccines in the market. One is specifically for children from birth to 9 years of age. Kids, especially babies are most susceptible to this Bacteria which often cause really devastating disease and death. The good news is that this is preventable. In fact, in 42 countries around the world including US, UK and Australia, the pneumococcal vaccine is already administered to babies as part of the National Immunization Program. However, in Singapore, it is still an optional vaccine.

It is important to realise that by vaccinating your kids, you are in fact reducing the chances of the bacteria circulating within your family circle so the chances of the elderly getting the bacteria is reduced.

For elderly folks, there is also a pneumoccocal vaccine which can be administered to prevent pneumonia. This vaccine is in fact recommended by MOH for those 65 and above. One vaccination will last for 5 years.

We got good news. Although Flu Vaccines are short in supply, we just managed to get another lot in. So if you are wanting to vaccinate your family, you should come soon to the clinic. The pneumococcal vaccines for both kids and the elderly are also available.

Wednesday, July 01, 2009

H1NI update: New measures to manage the outbreak

When the WHO declared the H1N1 a pandemic on 11 June 2009, Singapore adopted a containment strategy in order to prevent new cases from being imported into Singapore. This is what we are all experiencing now with strict procedures to identify passengers coming in from overseas and sending them on an extended holiday in Pasir Ris.

However, despite the measures that have been put in place, the H1N1 still managed to spread within our community. Since there is no point in trying to contain the spread anymore, Singapore will soon move into the "mitigation" phase. This essentially means that since the virus is already among us, we will try to minimise the number of people getting the disease and the number of deaths.

We are not yet in the "mitigation" phase. But when that happens, what that will mean for you is that when you come to the clinic. Our doctor will examine you and if you show symptoms consistent with H1N1, then you will be given one week MC to recover at home. You will no longer be required to be taken by ambulance to Pasir Ris and we will do blood tests only in severely ill patients. Tamiflu will only be given to severely ill patients.

Currently we are in the "Transition" phase. That means that when you come to the clinic, our staff will separate those patients with influenza like illness. You will be given a mask and asked to sit outside the clinic. This is essential to prevent cross infection. Patients suspected to have H1N1 infection will be issued MC for 7 days to recover at home. High risk patients like pregnant women, immuno-suppressed persons and renal dialysis patients will be referred to see their specialists.

So when you visit the clinic, please be socially responsible and ask for a mask if you are coughing and please let our staff know if you have flu like symptoms. If you have a fever, we will require you to be seated outside as a measure to prevent cross infection.

Thursday, June 25, 2009

Kiwifruit as part of a healthy Singaporean Diet

I recently delivered a talk on Kiwifruit as part of a healthy Singaporean diet. This was conducted during the launch of the Zespri Kiwifruit season which will last till the end of the year. In general we Singaporeans do not eat enough fruits and vegetables. Just look at a plate of Char Kway Teow, Chicken Rice and Fishball Noodles. There is hardly enough veggies in each dish to make up even one serving!

Here are the salient points of the speech I delivered. Remember that you need at least 2 servings of vegetables and 2 servings of fruits everyday and one serving is equal to around 100gms or one cupful. So remember to eat more fruits and veggies!



Children and adolescents are not eating enough fruits and vegetables

Children are unable to eat as much as adults, yet their nutritional requirements are higher than adults. Adolescents are eating lots of junk food and snacks which are high in sodium, saturated fats and low in nutritional value.

According to a study by LaChance(1), Kiwifruit was ranked #1 amongst a list of 27 popular fruits in terms of nutrient density. That means that for children especially, every mouthful of kiwifruit carries more nutritional value than if he was eating other fruits.

Since an apple a day keeps the doctor away, let’s compare Kiwifruit with Apple to get a sense of the nutritional density of the fruit.


Table 1: Kiwifruit vs Apple in terms of nutrition density

It is not easy to get kids to eat fruits and vegetables, so we want to make sure that every mouthful counts. Eating Kiwifruit is a practical way of getting as much nutrients into kids as you can.

Eating fruits and vegetables need to be cultivated from young.

In Singapore, it has been shown that amongst the Chinese adults, those who were eating the recommended number of servings of fruits and vegetables were three times more likely to have cultivated the habit during childhood. (2)

An adequate intake of fruit during childhood may protect the person from getting cancer in adulthood. It has been shown that childhood intake of fruit and vegetables were inversely associated with the risk of cancer in adulthood. (3)

Children are finicky eaters especially when it comes to fruits and vegetables. But it is often easier for them to enjoy fruits as they are often sweet and tasty. My kids love Zespri Gold Kiwi. It is so easy to eat, you just need to cut in half and scoop it out. I don’t have to force them to eat it, in fact, they have to ask for permission to eat the last one in the fridge.
Childhood asthma in Singapore and Kiwifruits

Asthma affects one in five children in Singapore and is a growing problem. Kiwifruits are very high in Vitamin C and it has been shown that children with a diet high in Vit C have less wheezing episodes. Vit C is also very important to keep the body’s immune system healthy which can help lower the risk of getting infections like the H1N1 flu.(4)


Table 2: Nutrients in Kiwifruit
Source www.whfoods.com

Cancer and Cardiovascular Disease


Cancer, heart disease and stroke are the principle causes of death in Singapore, accounting for almost 60% of all deaths in 2007.5 Heart Disease

Heart Disease accounts for 28.5% deaths in 2007.(5) It is clear in the studies that consumption of fruit and vegetables can protect against coronary artery disease. (6)

Kiwifruit is high in folate which possibly lowers blood levels of homocysteine, which is a risk factor in coronary heart disease. The high levels of potassium contained in Kiwifruit is beneficial for lowering blood pressure. It is also high in antioxidants, phytochemicals and Vitamin E. These have all be suggested to be cardio-protective. However, it Is interesting to note that Vit E supplements by themselves has not been shown to lower the risk of coronary disease.(7) However, taken together with the other nutrients in the fruit like the antioxidants and phytochemicals, it exerts its protective effect. So in other words, it is still better to take a good diet of fruits and vegetables rather than swallowing supplements if you want to protect your heart!

Cancer

Cancer accounted for 27.7% of deaths in 2007.(8) WHO expert panel estimated that low fruit and vegetable intake contributes to 5 to 12 percent of all cancers, and up to 20 to 30 percent of gastrointestinal cancers that may otherwise be preventable.(9) The protective effect of fruits and vegetables has been noted especially in relation to cancers of the gastrointestinal tract. In Singapore, cancer of the colon and stomach account for 25.1%.

It has been reported that the low intake of vegetables is associated with the increase risk of colorectal cancer in Chinese adults. (10) The protective effect of fruits and vegetables comes from a combination of antioxidants, phytochemicals and dietary fibre found in fruits and vegetables. Kiwifruit is very high in soluble fibre. It is shown that regular intake of Kiwifruit can promote regular bowel movement.11 The combination of high dietary fibre, together with the antioxidative properties of Vit E, Vit C and phytochemicals found in Kiwifruit can contribute significantly to a healthy cancer prevention diet.

References:

1. Lachance P, 1997, Journal of the American College of nutrition

2. Ling AM et al. Defining and measuring stages of change for dietary behaviors: readiness to meet fruit, vegetable, and grain guidelines among Chinese Singaporeans. J Am Diet Assoc 2000; 100:898-904

3. Maynard M et al. Fruit, vegetables, and antioxidants in childhood and risk of adult cancer: the Boyd Orr cohort. J Epidemiol Community Health 2003; 57: 218-25

4. Francesco F et al, Consumption of fresh fruits rich in vit C and wheezing symptoms in children, Thorax 2000:

5. Source: MOH http://www.moh.gov.sg/mohcorp/statistics.aspx?id=5526

6. Ness AR et al. Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol 1997;26:1-13

7. Yusuf S et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study investigators. N Eng J Med 2000; 342: 154-60


8. Source: http://www.nccs.com.sg/pbcation/canhelp/Dec05/focus1.htm

9. International Agency for Research on Cancer (IARC) Handbook of Cancer prevention. Lyon IARC, 2003

10. Seow A et al, Food groups and the risk of colorectal carcinoma in an Asian population. Cancer 2002;95:2390-96 11. Rush E. C. et al. Asia Pac J Clin Nutr. 2002, 11;164-8

Acknowledgments

This article is based on materials presented in the Dietary Guidelines for Children and Adolescents for the Healthcare Professional, Health Promotion Board 2007

Thursday, May 28, 2009

The H1N1 Flu is here but don't need to Panic!

Several patients have walked into the clinic this morning asking about the implications of the H1N1 flu in Singapore.

At this point in time, do not panic. This H1N1 strain does not seem to be deadly and the three people are doing well. In terms of severity, it is like the normal seasonal flu that we experience year round.

So just go about your normal life, keep a good level of hygiene, eat plenty of fruits like Kiwifruit, oranges and papaya which are high in Vitamin C to keep your body's immune system in good shape.

Of course if you just came back from US, Mexico or other affected countries and you are experiencing flu symptoms of high fever, cough, runny nose and sorethroat then seek medical advise immediately.

Monday, May 25, 2009

Those Fever Pads can give Parents a false sense of security!



I saw two kids yesterday who came into the clinic with fever pads on their heads. I get really concerned when I see fever pads, because invariably when I take their temperature, it is going to be really high. And just as I predicted, both kids were having temperatures approaching 40 degrees.

I don't use fever pads for my own kids. When they get a fever, I feed them with paracetamol and use a wet towel to wipe them from the top of their head to the waistline and I keep doing it until the fever becomes manageable. The problem with the fever pads is that parents feel that just by putting on the fever pad, they have already done their job and neglect giving medication and sponging.

So what happens is, when the fever pad absorbs all the heat it can, it stops doing anything and consequently, the child's fever continues to escalate.

If you are a mom or dad, please don't be lulled by the clever marketing tactics of the fever pad companies. It is much cheaper and more environmentally friendly to use a wet towel and it works much better. The only thing the fever pad does is to lull you into a false sense of security.

Friday, May 15, 2009

The Flu Shot: New Stocks have just arrived

Our stock of the latest season Flu vaccines have just arrived! If you are planning to take your flu jabs, please call us to reserve yours because stocks are limited.

Friday, May 08, 2009

Clinic will be opened on Vesak Day

Our clinic will remain opened for consultation from 8.30am to 12.30pm.

We wish all our Buddhist patients a meaningful Vesak Day.

Thursday, May 07, 2009

Swine Flu: Influenza A (H1N1) not as devastating as originally thought

It seems that the Swine Flu or Influenza A (H1N1) virus was not as virulent as was feared.

It was initially thought that the fatality rate from Swine Flu was as high as 6% but after some reclassification and taking into account the underreporting of milder cases, it would seem that the fatality rate is not that high.

Our Ministry of Health will progressively downgrade our DORSCON Status from Orange to Yellow by 11 May. What that means is that when you visit the clinic on 11 May, everything should be much the same as before. That a big relief as I often have to show our younger patients how to stick out their tongues by demonstrating it myself!

However, parents are still adviced to be vigilant and to observe a good level of hygiene. Please do not send your child to school if they are having a fever. Everyone can do their part to control the spread of highly infectious diseases like Swine Flu.

We have managed to put in an order of Flu vaccinations which should be coming in next week. As there are limited stock, please call the clinic to reserve your vaccine and we will inform you when the stock gets in.

Sunday, May 03, 2009

Swine Flu: Safety precautions at the clinic

With the impending arrival of Swine flu on our shores, our clinic has implemented the necessary precautions to protect our patients.

If you are having a fever and flu symptoms, please let our staff know. You will have your temperature taken and if it is elevated, you will be required to sit outside the clinic. All this is necessary to prevent the spread of the disease.

So far there has not been any Swine Flu cases in Singapore, but it is only a matter of time before we get our first case. The global community is much better prepared after SARS and Bird Flu which might explain why this time round the impact of Swine Flu is not has devastating as expected. But we still need to be on our guard and look after ourselves and our family as well as the community around us by doing the necessary things to prevent the virus from spreading.

For a list of FAQ on Swine Flu, please click here

Do write in the comments if you have any pressing questions about Swine Flu.

Friday, April 24, 2009

Help! My child has difficulty sleeping!

Insomnia is a very common problem which we see often in the clinic. Most of the time it is caused by psychological problems caused by stress and anxiety. In general, kids have little problems falling asleep since there is relatively little stress in their lives. They don't have to worry about bosses, spouses, how to pay the bills and what is happening with their careers.

For young children, their world revolves primarily around their parents. I don't know whether you have come across the situation where the child gets upset when he see his parents quarelling. The child's survival instinct tells him that his parents are the source for everything, from food to shelter to love and affection. So, built into each child is a "Parental Bliss" alarm system which sounds off whenever the child feels that something is not right with Daddy and Mommy.

So it is vitally important for the child to know that everything is well between Daddy and Mommy and impetus is really up to us as parents to "Market" that to the child. Don't just take for granted that the child knows that you and your spouse are still in a loving relationship. You really do need to demonstrate it openly to the child. One of the things that you can do is to set aside some time each week for you and your spouse to be seen just talking to each other. This special "Togetherness Time" is a time when you and your spouse sit down and chat for maybe 10 or 15 mins and has to be a place where your child can see you but not interrupt. When the child sees that his parents are in a loving relationship, he will feel that his whole world is secure and life is good. That added sense of security might just solve that sleep problem!

My wife and I have been attending an excellent parenting course at a local church and this is just one of the many things that we learnt. So we have made a concerted effort to implement some of the things at home. It does make a difference for your child and for your family life as a whole.

If you have problems with your kids, maybe it is not your kids that need training, but you! The course I attend is conducted by Growing Kids Int'l and you can find more information at their webiste here.

Happy Parenting!

Sunday, April 19, 2009

First Malaysian-Singaporean Expert Group Meeting on Pneumococcal Vaccination



I just returned from an Expert meeting on Pneumococcal diesease over the weekend. This meeting comprised of a small group of Doctors from Malaysia and Singapore whose main goal is to provide a forum to enable experts from both countries to share and exchange knowledege, clinical experience and insights in order to improve the management of pneumococcal disease and vaccination.

Chairing the meeting was Assoc Prof Daniel Goh, Chief of Paediatrics from NUH's University Children's Medical Institute and in attendence were specialists from both countries in Microbiology, Epidemiology and Paediatrics. I was one of two GPs who have been invited to be part of the expert panel to share our experience of pneumococcal vaccination in the general practice setting.

This meeting emphasized the need for more children to be vaccinated from the pneumococcal disease. Prof Daniel shared that the importance of vaccinating children from birth was important because by 6 months of age, a significant proportion of children will already have developed carrier status. That means that they carry the bacteria in their nose and throat where it might one day be activated and cause infections such as meningitis and pneumonia. By vaccinating the baby at 2 month, you reduce the risk of the child becoming a carrier.

A lot of information has been shared and these will be used in subsequent campaigns to educate the public on the importance of vaccinating kids with the pneumococcal vaccine.

Click here to read my last post on pneumococcal disease.

Sunday, April 12, 2009

Karri Family Clinic 4th Anniversary



Karri Family Clinic is four years old! We had our staff and family lunch today to celebrate our fourth anniversary.

We wouldn't be here if not for the support of all our patients. So a big THANK YOU for choosing Karri Family Clinic. We will do our best to continue to serve you and your family better.

Wednesday, April 08, 2009

Good Friday: Clinic will be closed

We wish all our Christian patients a very meaningful Good Friday.

Our Clinic will be closed on Good Friday.

We will remain opened on Saturday 8.30am to 12.30pm and Sunday 6.30pm to 9.30pm.

Monday, April 06, 2009

Woman dies from eating Rojak at Geylang Serai Temporary Market

In case you still haven't heard, it has been reported that a woman had died from eating rojak at Geylang Serai Temporary Market.

At the point in time, MOH/NEA has not informed us of the cause of death, but it does appear that only one stall was responsible for the outbreak and that is the Indian Rojak stall no. 320.

What I think might have happened is that somehow the rojak was contaminated by some bacteria and because the rojak is prepared beforehand and left to sit in the display cabinate for a length of time, the bacteria has time to grow and produce its toxins.

The lesson to be learnt here is to be careful when eating food that have been lying around for a long time. The safest food to eat are those which have been freshly prepared.

If you have recently eaten at the Indian Rojak Stall in Geylang Serai and are experiencing diarrhoea, vomiting or stomach cramps, please consult your family doctor immediately.

The story can be read here.

Sunday, April 05, 2009

The 938live Body and Soul Interview

In case you did not catch it on 938live, here are the podcasts of the interview I did with Daniel Martin last week on Body and Soul.



Tuesday, March 31, 2009

Dr Tay on 938live Body and Soul

Just in case you are interested to tune in, I will be speaking to Daniel Martin on 938live Body and Soul program on 2 Apr 2009 at 3.45pm. We will be talking about Chickenpox and why you should consider vaccinating your kids and yourself if you have not done so.

Friday, March 20, 2009

The Pneumoccocal bug is not to be trifled with!

I have been very affected by an email which I received from a distraught parent last week. She recounted that she had just lost her 2 year old son who succumbed to pneumococcal infection.

This pneumococcus bug can affect different parts of the body. Most commonly it can infect the brain, causing meningitis, the lungs (pneumonia), the ears (otitis media) or enter the bloodstream and cause widespread infection.

Having heard about this unfortunate case, I have been strongly urging every parent that comes to the clinic to consider vaccinating their kids from this disease. It was then that one parent also told me of another recent case of a pre-schooler who also died from the infection.

In retrospect, these tragedies might have been prevented if the kids had been given the pneumoccocal vaccination which has been available for the last few years. In Singapore it is not part of the list of compulsory vaccinations that all babies need to be given. So a lot of the time it is up to the doctors to inform their patients. In other countries like Australia for instance, all babies are required to be vaccinated from birth. I hope it is only a matter of time before the MOH adds this vaccine to the list of necessary vaccines for newborns.

In the meantime, it is up to you as parents to be aware and informed of the availability of the vaccine. A lot of information is already online, so I will not elaborate on the condition. However, I would like to let you know that these series of incidents has affect the way I look at this disease and so here are some of the things that I do now which I did not in the past:

1. Encourage parents to give the pneumoccocal vaccine from birth rather than let them wait till the age of two. The pneumoccoal vaccine is expensive, so at birth you need four jabs, but as the baby gets older, the number of jabs reduces till at two years of age, you only need one jab. I used to sympathize with parents concerning the cost of these jabs and so some parents decide to give later. However, I am now redoubling my efforts to educate and encourage parents to give it from birth.

2. In order to do this, I have decided to reduce the price of the vaccine to encourage parents to give it in the first year of life. So I have started to offer a package of 4 vaccines for $620 which works out to be $155 each. The normal price of the vaccine is $170. This price is nett so there is no GST or consultation charge if you only come to do the vaccination.

3. I am also now being extra vigilant in younger children who present with fever. There are some parents who are very resistant to the use of antibiotics and I agree that too much antibiotic use is not good. But we should also not go to the other extreme and let our children suffer from a prolonged fever. Pneumoccocal disease does respond to antibiotics, so a course of antibiotics given on suspicion of pneumoccocal disease does save lives and prevent severe disabilities. There was one instance of a 6 year old girl who did not present to the doctor until after 1 week of fever. By that time, the pneumococal bug had already got into the bloodstream and affected the kidneys. The girl is left with only 10% of kidney function and will need dialysis in the future. So as parents, a good general rule of thumb is to bring your kids to see the doctor if the fever lasts for more than three days or earlier if the child is really unwell.

So parents, if your child has not been vaccinated, please read up and be informed of the dangers of pneumoccocal disease and do let your friends know about it.

More info on pneumoccocal disease can be found here.

For info on other available vaccines, please click here.

Wednesday, February 11, 2009

Manual Therapy: We can call this Western "Tui Na"

When was the last time you suffered from a really bad back pain or neck pain?

I know a lot of patients who would visit a Chinese Sinseh for "Tui Na" (Manipulation and massage) whenever they suffer a back pain and then also come to the clinic for some painkillers and muscle relaxants.

"Tui Na" is a very effective way to release muscle spasms and re-align bones and joints which might be out of place due to pain and inflamation. However, finding a good practitioner is critical because a lot of harm can be done if the practitioner is inexperienced.

In modern medicine, we have a branch of physiotherapy that specializes in manual therapy which essentially does "Tui Na" but with a scientific understanding of the anatomy and physiology of the causes of backpain. Not every physiotherapist does manual therapy because these therapists have to go through a few more years of post graduate training in order to earn their Masters degree. In Australia, where I trained in medicine, manual therapy is a very well established practice. In Singapore, it is still in the developmental stage but there are more and more physiotherapists who are being trained to do manual therapy.

Our clinic has started referring such cases of back and neck pains to Core Concepts, a group of physiotherapists who specialise in manual therapy and sports injuries. I have asked Sylvia Ho, one of the senior physiotherapists to contribute the following article about Manual Therapy so that you are aware about this the next time you have a "pain in the neck".

What's Manual Therapy?

Article by Sylvia Ho

Manual Therapy is an area of manual medicine treating musculoskeletal conditions; conditions related to the muscles, bones, joints, connective tissues such as tendons and ligaments, spinal discs and the nervous system that enables them to all work together. Manual therapy covers a broad range of techniques and perhaps easiest to define as an approach not based on the use of electrical and/or electronic devices such as traction machines, TEN, EMG and shortwave diathermy machines.

As with most other areas of specialties, there are two broad areas of manual therapy – the techniques and the critical diagnostic analysis.

Manual Techniques

First, there are the techniques. These can range of myofascial trigger point release of tight muscles, spinal manipulation or mobilization to release tight joints, neuromuscular retraining correct the muscle activation pattern, sports taping to provide support to joints to something more basic like deep tissue massage. Manual therapy is not technique specific but rather includes a very broad range of technique to enable proper musculoskeletal functioning. This area is the most visible area and perhaps most familiar to the general public.

Critical Diagnostic Analysis

It is the second area that manual therapy comes into its own – critical diagnostic analysis. Determining what is the immediate cause of the pain is often straight forward such as a muscle strain in the back or a nerve impingement in the lumbar spine. Treatment in such cases using TENS machine on the area of pain or traction is simple and can be effective to address the immediate pain. But these treatments usually have no lasting effect as they do not address the 2nd or higher level causes of pain. It is like driving a car with a leaking radiator. The car overheats when there is no water in the radiator. Filling up the radiator solves the immediate overheating problem. But if the leak continues, the radiator will soon empty again and cause the engine to overheat.

So a manual therapist must probe further, “Why is the muscle strained?” Because of the musculoskeletal system in the human body are all interconnected, answers can sometimes be found rather far away from the pain site and not immediately intuitive. Here is an interesting case study of found at our online journal (MCR) – Mal-Aligned Rib .

Manual therapists usually work with a team of massage therapists and sports rehabilitation trainers to assist with the manual treatment and exercise rehabilitation once the root cause of the problem is diagnosed.

About Sylvia Ho

Sylvia graduated from the University of Sydney, Australia with a Bachelor of Applied Science (physiotherapy) in 1995 and subsequently obtained her Master in physiotherapy, specialising in manipulative therapy from University of Melbourne, Australia. Her current interests are in treating back and neck pain and improving sports performance through sport specific exercises. She is actively involved in educational talks to organisations such as JP Morgan, Ministry of Finance, clubs and fitness centres and is also a specialist advisor to MyHealthScanner, the region's first on-line real-time health screening tool for 27 major conditions.


You can visit Core Concepts website here
She is a regular contributer to Musculoskeletal Consumer Review

Friday, January 30, 2009

New Consultation Hours

Please be advised that with effect from 1 Feb 2009, our new consultation hours are:

Mon - Fri: 8.30am to 1pm, 6.30pm to 9.30pm
Sat: 8.30am to 12.30pm
Sun: 6.30pm to 9.30pm

Wednesday, January 21, 2009

Clinic Operating Times over Chinese New Year

We wish all our Chinese patients a very Happy and Prosperous year of the OX!

Please note that our clinic will be closed on New Year's Eve (25th Jan) till Tuesday (27th Jan). We will resume operations on 28 Jan.

May you all be in good health and remember not to eat too much Bak Kwa and pineapple tarts or I will have to see you after CNY for sorethroat!

Sunday, January 11, 2009

Vaccinations save Lives! So why are patients still so resistant?

I took my daughter to the playground last week and unfortunately Megan fell and hit her nose which started bleeding. Along came this very nice lady in her seventies who offered to help. She ran to the nearest house and got some ice and tissue paper for me and managed to comfort my little girl who was a little shocked from ordeal.

As she was comforting her, she recalled that her own daughter was as tiny as Megan was when she was in Primary 1. Of course, that daughter is now in her forties and living overseas. She came across as a really nice grandmotherly type person, so I asked how many grandkids she had. Regretfully she told me, she didn't have any. Then she went on to say that she had a son who died from chickenpox 10 years ago at the age of 36. He had caught the virus from his wife, but unfortunately for him, the chickenpox virus affected his lungs and he died from pneumonitis.

I felt saddened that such a thing could happened to such a nice lady. She told me her husband is still angry till this day and would still reminesce about the times he had with his son.

Nowadays, there is a chickenpox vaccine available, but a lot of parents are still hesitant to give their children the vaccination. The most common reason given is that they feel that chickenpox is every child's rite of passage. They themselves got chickenpox as a child, so they feel their kids should also go throught the same ordeal.

Just recently, I was also saddened to hear about the death of a 30 year old lady from Cervical Cancer. Her story can be found here. I do not know the details of her condition and it is not common for Cervical Cancer to affect such a young person so her situation may be an exception rather than the norm. However, for the general population, MOH has given the guidelines that sexually active ladies should have their Pap Smears done every 3 years so that Cervical Cancer can be detected early. And now there is also a vaccination that can prevent the girls from getting infected with the virus that can lead to Cervical Cancer. So again, this is another tragedy that could have been prevented with a vaccination.

But perhaps it is the elderly which are most often neglected when it comes to vaccinations. We all know that Pneumonia is one of the leading causes of death in the aged. This is why MOH recommends the elderly to be vaccinated with the Pneumoccal vaccine every 5 years and the influenza vaccine yearly. But the problem is that the elderly are often ignorant of this. And even if they do know about it, a lot of them do not wish to burden their kids for the extra cost of the vaccines. It really is a case of "Penny wise, Pound Foolish".

I guess some might say that life is unpredictable and that if it is your time to go, there is nothing you can do to stop it. That might be true, but for our dear granny at the playground, a simple chickenpox vaccination might just have nudged fate a little more to her side.

So the bottomline is this: Vaccinations saves lives, so make sure you and your family are up to date on all the available vaccines.

Wednesday, January 07, 2009

New Pricing for Cervarix: Cervical Cancer Vaccine

Who says prices keep going up and never come down?

We are happy to announce that the price of Cervarix which was $200 is now $148 and if you buy the total package for the 3 vaccines upfront, it now costs only $420 nett.

For patients who have already paid for the package previously, you will be reimbursed in the form of a credit note from us.

This is indeed good news as it now costs much less to have yourself and your loved ones protected against Cervical Cancer.

For more information please click here.

Please check our latest blog post for the latest promotion price.