Wednesday, November 03, 2010

Prevenar 13: Official launch and Charity Event



Prevenar 13, the latest vaccine in the prevention of pneumococcal disease was officially launched on 23 October. The company marked the launch by organizing a charity event where the new vaccine was given to underprivileged children. I was very honored to have been invited to be one of the volunteer doctors for the event.


Link to AsiaOne Website

The new pneumoccal vaccine will replace the old vaccine and provide an even broader coverage against the deadly pneumococcal disease.


Our Package of 3 jabs for the new vaccine is $405 nett if you are using cash or Babybonus.  If you are using Medisave, then the package is $450 nett   You are able to deduct $300 from your Medisave account to pay for the pneumococcal vaccine.

Tuesday, October 12, 2010

Latest Pneumoccocal Vaccine: Prevenar 13, now available at Karri Family Clinic

The latest Pneumoccocal vaccine, Prevenar 13 is now available at Karri Family Clinic.  Prevenar 13 is an updated version of Prevenar and includes a wider coverage and thus better protection for your babies.

You can now withdraw $300 from your Medisave account to pay for your Pneumococcal Vaccines at our clinic.  The package for 3 jabs is $450, nett.  We offer a further discount for those who are paying by cash or baby bonus.  The Babybonus/cash package for 3 jabs is $405, nett.  Individual jabs are $140 nett, payable by cash or Babybonus.

Parents with kids below 5 who have completed the course of Prevenar can opt to take one jab of the new Prevenar 13 to broaden the coverage for their kids.

Thursday, September 02, 2010

Doctor is my Child too Fat?: New BMI-for-age cut offs for children

Actually, not many parents come to the clinic worrying that their kids are too fat.  Most parents come to the clinic complaining that their kids are not eating well and are too thin.

I think that there needs to be a fundamental change in the thinking of parents concerning their children's weight.  In many Asian cultures, fat is seen to be good because traditionally, food is scarce, so only those who are really well off can afford to feed their kids well.  So fat kids are seen as a sign of properity.  However, in Singapore now, we are seeing an epidemic of kids who are really too fat.  Obese kids who grow up to be obese adults who run the risk of developing diabetes, hypertension, high cholesterol levels etc.

The Health Promotion Board has recently released new BMI for age charts which I have uploaded here on the website.  BMI is short for Body Mass Index and it is a way to determine if your child is over or underweight.  But unlike adults, kids of different age groups have different BMI ranges.  So that is why in order to find out if your child is indeed overweight, you need to first work out his BMI and then compare it on the BMI for age percentile chart.

So here is how to use the BMI for age charts:



Here is the chart for boys.:



Here is the Chart for Girls:



Once you have worked out the percentile you child is in, use this next chart to determine if he is over or underweight.  Then see what is the suggested advise for your child.



More information on www.knowyourbmi.sg/children

If you are concerned about your child's weight, do visit the clinic for a checkup.  Some kids are overweight because of underlying problems and these need to be excluded.

Reference: Understanding and Using BMI for age charts:  HPB, August 2010

Tuesday, August 24, 2010

Friday Morning clinic closed

I must apologize that we will need to close the clinic this Friday, 15 Oct, as I have been called up to serve my reservist duties and was unable to find a replacement doctor. 

The evening clinic will operate as per normal. 

Again, please accept my apologies for any inconvenience caused.

Monday, June 21, 2010

Power over Cervical Cancer: Special Package Price for Cervarix vaccine


In Singapore, one case of cervical cancer is diagnosed every two days and claims the life of more than one woman every 5 days.  Yet there is still very little awareness that you can reduce the chance of getting this cancer significantly by vaccination.

This vaccination is recommended for young women from 12 years of age onwards and is in fact part of the immunization program in US and UK. As part of the campaign to increase awareness of Cervical Cancer prevention, a new website has been launched where you can find out more about Cervical Cancer and also do a online evaluation to see your risk of getting cervical cancer.   Do have a look at it to learn more about how to prevent this disease.

In support of this awareness campaign, our clinic is offering a very special package of three Cervarix vaccinations for $320 which is $100 off our normal package price.  This package is only valid till 22 July 2010 and packages have to be fully paid by cash or nets.

For more information on Cervical Cancer, please visit:  www.pocc.sg.

Thursday, May 27, 2010

Latest Recommendations on influenza vaccination

Many parents have been asking me about whether they need to give their kids the influenza vaccine.  Well, according to the latest edition of The Singapore Family Physician, we are following the 2009/2010 recommendations from the American Academy of Pediatrics which recommends annual influenza immunization for:

1.  All children from 6 mths to 18 years
2.  Household contacts and care providers of children placed at high risk and healthy children less than 5 years. ie nursery teachers, nurses etc
3.  Health care professionals, ie people like me
4.  Pregnant women in mid trimester of pregnancy onwards

The schedule for kids is

6mth to 36mth, two 0.25ml doses, 4 weeks apart
36mth to 9 years, two 0.5ml doses, 4 weeks apart
>9 years one 0.5ml dose

Children who have had the influenza vaccine in previous years require only one dose.

The current trivalent influenza vaccine is currently available in our clinic and priced at $30 nett

More information found here

Monday, May 24, 2010

Latest Flu Vaccine is currently in stock!

We now have stock of the latest Flu Vaccine (3 in 1) which includes both H1N1 and H3N2 strains.  The cost of the vaccine is $30 nett.

Monday, April 26, 2010

Would you feed your kids ice cream that does not melt?


Last Sunday, there was an article in Sunday Times which talked about an unmeltable ice cream from Ya Kun.  I don't know about you, but I am very concerned about this.  As you can see, the ice cream retains it shape for an hour instead of melting into a liquid like most ice cream should. In the article, it is explained that this is because the manufacturers added emulsifiers and stabilisers to the ice cream to prevent it from melting.  According to them, the amount of stabilisers used is in compliance with the US FDA requirements so it is safe for human consumption. Remember that they also told us that Trans Fats were safe!

I don't know about you, but as a concerned parent, I have told my kids that we will avoid eating the Ya Kun ice cream toast until I can be convinced that it is safe.  In other countries, such "ice cream" would not be called "ice cream" but "ice confectionery" to differentiate it from real ice cream.  I think we as consumers need to be better informed so that we can make a decision whether to eat it or not.

We as consumers need to demand safer and better food or else we will be given whatever is cheaper and easier to handle.  I spoke with a friend of mine who runs a Cafe and he tells me that even with butter, there are cheaper ones with plenty of stabilizers or more expensive ones which have natural ingredients.  We need to reward those places who serve healthy food and voice our concerns to those who compromise on food quality. 

Ya Kun "ice cream" toast does not behave like ice cream!

What do you think?  Are you concerned  about this?  If you are, please write in to voice your concern!  You can write directly to Straits Times Life! at stlife@sph.com.sg and directly to Ya Kun at info@yakun.com.  The people selling food must be made to feel responsible for the food they feed us and it is up to us to make sure they know we care.

Monday, April 19, 2010

Parents beware of High Fructose Corn Syrup!

Article by Dr Suren Baskaran

High Fructose corn syrup(HFCS) is a combination of fructose(in high quantity) and glucose, that is manufactured from corn.  The controversy is that critics say that HFCS unlike table sugar (sucrose) is more damaging to our health. However others oppose this opinion saying that there is no evidence that HFCS is worse than sugar.

HFCS was only produced in the 70s. The fact is, since 1970 we are eating much more HFCS than ever before in human history.  This is because it is cheaper to produce and very versatile.  HFCS is so ubiquitous, it is virtually impossible to avoid.  It is found in soft drinks, packaged biscuits, condiments, jams, fast foods, low fat packaged food, cereals etc.

Critics of HFCS point out that there is an increase in diabetes and obesity which correlates with the rise of HFCS use.  There are several studies in rats and humans that suggest that HFCS increases obesity and have worse blood tests outcomes compared to sucrose.  Some suggest that HFCS when taken does not give a sensation of fullness and so we can consume more of it.  However the studies are not conclusive and many studies also come up with different conclusions.  The American Medical Association says that the evidence of HFCS being worse than sucrose is not confirmatory and more research is required. 

Whether or not it is worse than table sugar is not that important.  There is no dispute that HFCS is bad news.  We take so much of it daily that it causes a major shift of our lipid levels to the dangerous form which includes high triglycerides.  Such a lipid profile increases the risk of heart attacks and stroke.  HFCS can cause liver abnormality, called `fatty liver' or NAFLD (non alcoholic fatty liver disease).  We now know that NAFLD can be a serious disease than can causes scarring of the liver and liver dysfunction.  HFCS also causes insulin to be less effective (insulin resistance) and a condition called metabolic syndrome.  Even gout is an effect of HFCS.

Too much of HFCS and even glucose has caused so much preventable health problems.  I urge you to look after yourself and your family by avoiding foods with HFCS such as sugared drinks, fast food, processed biscuits and sweets.  Read food labels. 

For more info on HFCS, please click here.

Wednesday, March 31, 2010

Easter Opening Times

The clinic will be closed on Good Friday.

Clinic hours as usual on Saturday and Sunday.

We wish all Christians a Blessed Easter!

Sunday, March 28, 2010

Chickenpox: Update on the boy with complications



Chickenpox Scarring

Remember the boy who suffered from the severe case of Chickenpox?  The good news is that it did not turn out to be meningitis, but the Chickenpox did leave him with a very bad scar to remind him of the entire ordeal.

He had spent one week at KK Hospital where various tests were done to determine the severity of the infection.  The pox just in front of the ear had gotten infected, so he had to be put on antibiotics and they had to perform ultrasound imaging to see the extent of the infection which had caused him not to be able to turn his neck.

After one week at KK, he was discharged but still had to be followed up by the paediatrician and had to be continued on antibiotics.  This picture is taken recently, one month after the initial Chickenpox infection and I have just certified that he was able to return to school.

I had another Chickenpox case recently where a distraught mom  recounted how she had left her child with the in-laws while she was overseas and during the time, her in-laws had another grandchild who had chickenpox and purposely exposed her child to the affected kid.  Subsequently, her child had chickenpox which left her with some scarring!

Please remember that though Chickenpox is a mild disease most of the time, it can still cause serious infection.  So please don't endorse the idea of Chickenpox parties and subject your child to the disease thinking that it is a way of getting them immne naturally to Chickenpox.  You will never forgive yourself if your child landed in hospital because of severe complications.  A better and far safer method is to give your child the Chickenpox vaccine and do also consider giving your child a second dose of the vaccine if you want to confer an higher level of protection.

Tuesday, March 23, 2010

Rotarix: HSA assures us that it is safe

By now you might have heard of the news of the concern over the Rotarix Vaccine containing some pig virus. Both GSK, the manufacturer and all the leading authorities have looked at the matter and assured us that despite containing the virus, the vaccine is still safe for consumption.

Of course, I know that a lot of parents will still be very concerned about this issue. I would too.

I have spoken to the people at GSK and the way I interpret the situation is as follows. The virus concerned is normally found in pigs and is even found in the pork that is sold for consumption. Due to some new methods of surveillance, they detected fragments of the virus in Rotarix. The scientists are currently investigating how this viral fragment got into the manufacturing process since there is no use of animal parts.

Rotarix is not a vaccine that is injected into the body, but rather taken orally. We know that consumption of the virus does not affect humans, since we would also inadvertantly eat the virus when we eat pork. In fact the virus is not known to cause any disease in pigs or human. Furthermore, it is not the whole virus that is present, but only a fragment of the virus. So if you follow this logic, it should still be safe for babies to be given the vaccine.

So, what should you do?

At this point in time, Rotarix is not a compulsory vaccine, so the decision to give or not to give it is up to the parents. Since the first dose of Rotarix needs to be given before 14 weeks of age, if your baby is still very young, you can perhaps wait for further news on the subject before deciding. On the other hand, one has to still keep in mind that Rotarix has been very useful in preventing severe diarrhoea in babies and so its benefits still outweigh the risks.

I will keep everyone informed of the news about this subject as it unfolds. In the meantime, you might also want to check out the press release by GSK by clicking here.

Monday, March 22, 2010

MMR Vaccine does not cause Autism

The Measles, Mumps and Rubella (MMR) vaccine which was introduced in the 70's has resulted in the dramatic decrease in what used to be the very common childhood diseases of Measles, Mumps and Rubella. I even remember having Measles and Mumps as a child myself, but nowadays you don't see kids with these conditions in the clinic.

Over the past decade, there has been concerns about a possible link between the MMR vaccine and Autism. This was the result of a paper published in 1998 in the British Journal "The Lancet" It has since been shown that the whole thing was a sham. Here is the excerpt from Wikipaedia:


Claims of a connection between the vaccine and autism were raised in a 1998 paper in the respected British medical journal The Lancet.[3] It was later discovered that Andrew Wakefield, the paper's lead author, had received major funding from British trial lawyers seeking evidence against vaccine manufacturers.[4] Ten of the paper's twelve coauthors retracted its interpretation of an association between MMR vaccine and autism.[5] It was also discovered that Wakefield had previously filed for a patent on a rival vaccine using technology that lacked scientific credibility, and that Wakefield knew but did not publish test results that contradicted his theory by showing that no measles virus was found in the children tested.[6] In 2009, The Sunday Times reported that Wakefield had manipulated patient data and misreported results in his 1998 paper, creating the appearance of a link with autism.[7] A special court convened in the United States to review claims under the National Vaccine Injury Compensation Program ruled on February 12, 2009 that parents of autistic children are not entitled to compensation in their contention that certain vaccines caused autism in their children.[8][9] The Lancet fully retracted the 1998 paper on February 2, 2010.[10]

Following the 1998 publication, there has been many large epidemiological studies conducted to look into the safety of the MMR vaccine. All of these studies concluded that the MMR vaccine was safe. I recently read one of the papers published by the Cochrane Collaboration in 2008. This paper reviewed all the previous studies conducted on the safety of the MMR vaccine and concluded that there was no link between MMR and Autism. The following the summary of the paper:



I hope this short post will give parents a better understanding of issues behind the MMR/Autism link. I think there is very good evidence to show that the MMR vaccine is safe and benefits far outweigh the risk. At this point in time, there is no reason to believe that giving the MMR vaccine will cause the child to develop Autism.

Thursday, March 11, 2010

Dadsforlife: Photography workshop for Dads



Karri Family Clinic's philosophy is to look after the family in a holistic manner. That means that we don't just treat your family's health problems, we also want to promote family harmony and values.

So I am now supporting the Dadsforlife movement which serves to spur all daddies to be even better daddies. Dadsforlife has organized many events during the upcoming holidays, but I want to highlight one which I am personally involved in.

If you have been wanting to learn to take better photos of your kids, do sign up for the free workshop during the school holidays from 19 to 21 March organized by Dadsforlife.sg with the support from Canon, Singapore. I will be the instructor for the events on 19th and 21st March.

Fathers can bring the children down to one of the three locations during the holidays where you can attend the seminar and then put your new skills to work taking photos of your kids! At the same time, there will be professional photographers around where you can have a free portrait taken of you with your children!

Details:

19th Mar at Fort Canning Park, 1.30pm (My session)
20th Mar at Marina Barage, 1.30pm
21 Mar at Singapore Discovery Centre, 1.30pm (My session)
Admission: Free but seats are limited so please register early

You can register by clicking here.
More information at Dadsforlife.sg website here.

Sunday, March 07, 2010

Karri Family Clinic is now on Facebook!

One of our patients pointed out to me that it would be very convenient if they could read my updates on facebook too. So I have now created the Karri Family Clinic Facebook page and invite everyone to join as a fan!

Karri Family Clinic

Promote Your Page Too

Tuesday, February 23, 2010

Chickenpox: Complications do occur, Parents please vaccinate your kids!



I had hope that I would never have to see a severe chickenpox case but it was only a matter of time before it happened.

This boy came to the clinic today with severe Chickenpox which had gotten infected. What is more serious is that he was also complaining of neck stiffness. So I had to send them immediately to KKH to investigate for possible Chickenpox meningitis.

To all parents who are reading this post. Please don't think that Chickenpox is something every child needs to get. If this child had been given the Chickenpox vaccine, there is a good chance that he would never get Chickenpox and in the 20% of cases where they still get Chickenpox after vaccination, it would never have gotten to this stage of severity.

I am following the case closely. If the KKH doctors also suspect meningitis, then they would do a lumbar puncture where a long needle is inserted into the lower back to extract some of the cerebro-spinal fluid to confirm if the virus has infected the brain. Please pray that this is not the case. Chickenpox meningitis can sometimes leave the child with some long term side effects with regards to mental ability.

Concerning the booster dose for Chickenpox. I have already written about this in my previous post. The 2nd dose of Chickenpox vaccine is currently the standard practise in the US, but the practise is not yet adopted in Singapore. Parents can still opt for a booster dose after the first dose in order to give your child a higher level of protection.

Again, parents, please be aware of this and make a wise decision for your child based on facts and not on hearsay.

Thursday, February 11, 2010

Chinese New Year Opening Times



We wish all our friends a very Happy and Prosperous Lunar New Year!

Our Clinic will be closed for the first 3 days of the New Year from 14 to 16 Feb.

Wednesday, February 03, 2010

Chickenpox: Does your child need a booster?

We are currently experiencing an outbreak of Chickenpox at one of the childcare centres in the area and a few of the children are experiencing breakthrough chickenpox even after they had their first Chickenpox vaccination.

Please note that no vaccine is 100% effective and evidence has shown that even after the first vaccination, approximately 2 in 10 kids may still contract Chickenpox. We call this "breakthrough" chicken pox. Breakthrough Chickenpox is often a milder form of the disease and usually does not last as long as compared to kids who have not been vaccinated.

Because of this, the US has been advising parents to give their kids a booster jab ie, the doctors in the US are now giving children 2 jabs instead of one. The second jab is to be given at least 3 months after the first one. In Singapore, the MOH has not recommended a booster Chickenpox jab yet.

*Note that even if the child has been exposed to kids with chickenpox, the vaccine has been shown to be effective if given within 72 hours of exposure.


Since it is less than 2 weeks to the Chinese New Year, many of our parents are very stressed since they have already made plans to go overseas or even just the fact that they will not be able to do their customary visitations.

If your child has not yet taken the chickenpox vaccination, please do consider bringing them to the clinic for a jab. If your child has already taken the first jab, you might want to consider taking a second one to give them a higher level of protection. After the first jab the protection level is around 80%. This increases to more than 90% after the 2nd jab.

Chickenpox is usually a mild disease, but it can be very stressful if it disrupts your travel plans! We even have mothers who are pregnant who have to make special arrangements to isolate themselves from their children!

You can read more about the recommendation from the US CDC by clicking here.

Friday, January 15, 2010

Job Vacancies available: Clinic Assistants

We are currently looking for Clinic Assistants who will be able to work the evening shift including Sunday evenings.

Applicants should have experience working in a family clinic, have good interpersonal skills and be familiar with registration and dispensing of medications.

If you are interested, please write to leslie.tay@gmail.com with your resume or call the clinic at 67850311