Dengue Fever Update: Cases around Blk 869

This is another reminder for everyone who lives around Blk 869 especially in the lower levels.  We have several patients who have tested positive for dengue and one of our patients reported that a neighbour of hers in the block has passed away from dengue.  So please take the necessary precautions and seek medical attention if you develop a fever.

Dengue Fever: New Outbreak around our neighbourhood

One of our patients living in block 867 has just been confirmed to have Dengue fever.  We would like to remind all our patients to take extra precaution.  The dengue mosquito likes to bite 2 hours after sunrise and at dusk and they like to bite indoors.  So do take the necessary measures to protect yourself and your family.

If you have a high fever and severe bodyache, please seek medical advise. We are now able to do a blood test that can detect Dengue from the first day of the fever if necessary.


Characteristics of Dengue Fever:

• Fever that lasts for 2 to 7 days
• Severe muscle ache, headache and joint pains
• Rash appearing after the fever subsides usually after the 5th day. The rash may look like a measles types rash. There may also be some pin point red spots known as petechiae that may appear.
• Abdominal discomfort

Sometimes the Dengue Fever causes the platelet levels (component of the blood responsible for clotting) to drop dramatically. When the platelet levels are low, the body loses its ability to repair any bleeding blood vessels. This might result in uncontrolled bleeding in the body which is the condition known as Dengue Haemorrhagic Fever. (Haemarrhage means to bleed) Dengue Haemorrhagic Fever is the main cause of death when the patient contracts Dengue.

What happens when you are diagnosed with Dengue?

• If you have a fever for 5 days and the blood test reveal that your platelets have dropped to less than 150.000 you will need to do daily blood tests to monitor your platelet levels.
• If your platelets continue to fall below 80,000, you may need to be admitted to hospital
• Most patients will not need admission. Dengue can be managed at home with daily visits to the clinic.

What you should do when you are diagnosed with Dengue.

• Make sure you get your blood checked daily
• There are no antibiotics that can be given with Dengue. It is mainly bed rest and fluids until the patient recovers.
• If the platelets are low, you should avoid any vigorous exercise or situations that may cause an injury.
• Check around your home for possible mosquito breeding sites and eliminate them
• Although you cannot infect another person directly, it is possible that a mosquito that bites you can in turn bite another person and transmit the disease that way. So it is important to make sure you do not give mosquitos a chance to bite you.

Conclusion

Dengue can be a deadly disease. It is important to recognize the symptoms of Dengue so that you can present yourself for a blood test. The most important way to to avoid contracting Dengue is to ensure that you don't get bitten by mosquitoes by taking the usual precautions.

More info on Dengue from MOH can be found here

Cervical Cancer Vaccination Packages

MOH recommends that girls aged 9 to 26 be vaccinated against the HPV virus infection which has been linked to the development of cervical cancer later in life.  So do get yourself and your loved ones vaccinated as soon as possible.

You can now pay for the vaccines through Medisave.  Please check at the clinic for further details. The vaccination is taken at 0, 1 and 6 months.

ECHO: Register for your Health Screening now!

Tampines ECHO Video from CGH CA on Vimeo.

For those of you who have not had Health Screening done before, now you can do it for as low as $2 as part of the Eastern Community Health Outreach initiative.  Its time to do some maintenance work!

More info can be found here:  http://echohealth.com.sg/

For those who want a more comprehensive package, we also offer packages starting from $60 at our clinic.  Do come by the clinic and have a chat with our doctor who can cater a package to your needs.

Hep A outbreak in Malaysia: Protect yourself with the Hep A vaccine!

There has recently been a report of an outbreak of Hep A in Terengganu, Malaysia.  If you are planning a trip to the region, please get yourself vaccinated with the Hep A vaccine.  You will need two jabs over six months, but even after the first jab, you will get 85% protection by 2 weeks and 100% protection by 3 weeks.

Hep A is easily contracted through exposure to contaminated food and water and is highly recommended for visitors planning to travel to regions like South East Asia and South Asia.

The Hep A vaccine is available at our clinic at $110 nett.

Kids to get two MMR vaccines at 12 and 15 months

MOH has announced that from 1 Dec 2011, all children will need to have 2 MMR vaccines at 12 and 15 months.  Currently, they are only required to have one at 15 months followed by a booster at primary one.

The reason for this is because there have been measles cases reported in Singapore.  By completing the 2 courses, the child will have earlier protection against measles.

It is also advised that older children who have already taken the first MMR also complete the course instead of waiting till primary one.

You now have the option of including the chickenpox vaccine as part of the MMR vaccination.  The combined vaccine is called MMRV and contains Measles, Mumps, Rubella and Chickenpox vaccines.  It is a convenient way of protecting your children against an additional disease.  Our package for your child's 2nd year vaccines include 2 MMRV at 12 and 15 months and the 5 in One booster at 18 months.  The package costs $340nett and includes the consultation fees.

The MMR vaccine without chickenpox is also available at our clinic.

Read the ChannelNewsAsia article.

Cervical Awareness Month: Protect your daughter against Cervical Cancer

It's Cervical awareness month again. So here is a timely reminder for all parents that you can protect your daughter against Cervical Cancer by giving her a vaccine when she reaches 9 years of age.

The vaccine is actually already in the National Immunization program for girls from 9 to 26 years of age. So you can withdraw $300 from Medisave to pay for the vaccine if you wish. The price for the Medisave Package is $420

If you are able to pay by cash or nets, we are giving you a further discount and the package is $390 nett. This special price is valid while the current stocks of vaccines last.


Medisave price is $420

What to do when you get a Burn

Burnt with hot oil

When I was a kid, I remember playing hide and seek with my friend and I hid under my father's writing desk. Unfortunately, our helper had kept her hot iron under the desk too and I suffered a burn to my left arm. The first thing she did was to put toothpaste on the wound. I only have a vague memory of what happened after that, but that 8 cm scar is still visible on my left arm to remind me of what happened.  It's a good thing it wasn't my face or I might be given the nickname, "Scar".

This is a very short post to tell you one thing. When you get a scald or a burn, the first thing you should do is to put the affected area under running tap water for 10 to 15 mins. Once the pain subsides, go see the doctor. Of course if it is just a small burn about the size of a coin or two, then you may not need to see the doctor. But if it is relatively large and especially if it affects any of the joints or has blistered, then it is advisable to seek medical help.

Would you all please instruct your home helpers, viz maids, grandma, grandpa and whoever is looking after your child about this today so that they know what to do.

Safety of Seafood from Japan

I have written an article on radiation and how it affects the food we eat. 

In essence, because of the stringent controls in place, we can be confident that the food imported from Japan is safe. The article will also explain the different types of radiation and how radiation causes cancer.

Click here to read.

Common Bicycle Accident in Kids: Parents please be careful!

Common Bicycle injury in kids

I just saw another case of this type of bicycle accident where the child is riding in front of the bicycle and inadvertently got his leg trapped in the spokes of the spinning wheel.

May I remind parents to be extra vigilant when you have kids riding in front of the bicycle.  Here are some things you might want to do:

1.  Make sure the child wears proper shoes and socks.  This child was wearing a pair of slippers only.  If he had a proper pair of shoes and thick socks, the injury would not have been so bad.

2.  Please make sure you have one of those bicycle seats where the child can place his legs inside the plastic foot rests.  Make sure that the seat is big enough such that the child can stretch his legs past the seat into the spokes of the wheel.

3.  Seating the child at the back of the bicycle is better than in front as it lessens the chance of the leg getting caught in the spokes of the wheels.

4.  Always remind the child that riding a bicycle is potentially dangerous and he must sit still and not play around while the bicycle is in motion.

5.  Not many people do this in Singapore, but it is always safer if you can wear a helmet.  In Australia, this is compulsory.  I have come across one case where the child fell from a bicycle and hit her head against the drain.  She subsequently had to have an emergency surgery to evacuate a blood clot in the head.

Japan drug panel finds no link between Vaccinations and Deaths of Children

You might have heard the news that there have been some concern In Japan about the pneumoccocal and Act-Hib vaccines.  The latest report published by the Japanese drug safety panel has stated clearly that following investigations, they have found no link between five infants who died this month and the Pfizer vaccine Prevenar 7 as well as the Sanofi vaccine Act Hib.

I have been assured by the Pfizer representative here in Singapore that our batch of vaccines are different from the ones used in Japan.  We are currently administering the latest Prevenar 13 vaccines which are manufactured in England whereas the Japanese Prevenar 7 are from the US.

So far Prevenar has been in the market for the last decade and there has not been any major safety concerns after 360 million doses have been distributed.  In Japan alone, 2 million doses have been distributed and this is the first time there has been any concern about the vaccine. Japan has suspended the use of the vaccines in order to find the root cause.  But as far as their drug safety panel are concerned, there is no link between the vaccinations and the deaths.

All the other countries who are administering Prevenar 13 will continue to administer the vaccine.  In Singapore the HSA has not issued any warnings about using the vaccine.

Parents should be rest assured that the vaccine is safe.

I will continue to keep you posted on any future developments.

Link to news article.

New pneumococcal vaccine launch

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.

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

Power over Cervical Cancer: Special Package Price

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 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.

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