a brief descriptions and information regarding major health problemsin India.This content will help to the B.sc Nursing 4 th year students as per syllabus in community health nursing
The negative impacts of adolescent sexuality problems among secondary school ...lukeman Joseph Ade shittu
This study was conducted to focus on the negative health outcomes related to sexual behaviour in adolescents and young adults attending public school in the Oworonshoki region of Lagos, Nigeria, Africa. Since, there is a relative dearth of knowledge on adolescents who face unique and challenging economics, health and education problems in our society. Data on the socio-demographic characteristics, prevalence and knowledge towards STD including HIV/AIDS, prevalence of sexual abuse practice/sexual behaviour, family planning awareness and acceptance including abortion practice were sorted out using self structured questionnaires and administered to 60% of student’s population using a stratified random sampling technique. 55.8% lived with both parents. While, 50.3% of the mothers had basic secondary school qualifications, 72.4% of them are traders. 61.5% had sex education were from misinformed friends/peers while 51% had no basic knowledge about sexual behavioral practice and attitude towards STDs/AIDS (HIV). STD has a prevalence of 34 and 41% of boys used condoms for preventing STI/HIV transmission and unwanted pregnancies. One out of every five sexually active teenagers has experienced forced sex, especially among the circumcised girls who were more sexually active than the uncircumcised girls. 60% of girls between ages of 12 and 18 years had more than one unsafe abortion with severe vaginal bleeding (haemorrhage) as the chief complication. However, 65% of the girls did abortion for fear of leaving school and financial hardship as the reasons.
Abstract—Adolescents are the future resources for any country to progress and prosper. According to Census 2001, in India, adolescent constitute one-fifth of the total population. Adolescent AGs are one of the important segments of the population for they are the future mother whose nutritional status affects that of the newborn baby. Anemia being a major public health problem among adolescent girls, a study was conducted with the objective to determine the socio-demographic correlates of anemia among girls. Methodology: A cross-sectional study was conducted among 467 adolescent AGs in Ahmadabad city during May 2011 to august 2012 in Adolescent Friendly Health Services clinics. Results: Prevalence of anemia among adolescent girls was 85.9%. Highest prevalence was observed during mid-adolescence phase. As the age of girls increases, Hemoglobin tends to get on the lower side. A statistically significant association was observed between anemia and nutritional status. No association was observed between anemia and religion, birth order, type of -family, education of parents and occupation of parents. Conclusion: Association between anemia and under-nutrition has been reported earlier in numerous studies; however present study highlights the fact that it is not common to have anemia among girls who are over nourished or obese. Hence, special efforts should be made to address this issue among girls by doing dietary modifications.
a brief descriptions and information regarding major health problemsin India.This content will help to the B.sc Nursing 4 th year students as per syllabus in community health nursing
The negative impacts of adolescent sexuality problems among secondary school ...lukeman Joseph Ade shittu
This study was conducted to focus on the negative health outcomes related to sexual behaviour in adolescents and young adults attending public school in the Oworonshoki region of Lagos, Nigeria, Africa. Since, there is a relative dearth of knowledge on adolescents who face unique and challenging economics, health and education problems in our society. Data on the socio-demographic characteristics, prevalence and knowledge towards STD including HIV/AIDS, prevalence of sexual abuse practice/sexual behaviour, family planning awareness and acceptance including abortion practice were sorted out using self structured questionnaires and administered to 60% of student’s population using a stratified random sampling technique. 55.8% lived with both parents. While, 50.3% of the mothers had basic secondary school qualifications, 72.4% of them are traders. 61.5% had sex education were from misinformed friends/peers while 51% had no basic knowledge about sexual behavioral practice and attitude towards STDs/AIDS (HIV). STD has a prevalence of 34 and 41% of boys used condoms for preventing STI/HIV transmission and unwanted pregnancies. One out of every five sexually active teenagers has experienced forced sex, especially among the circumcised girls who were more sexually active than the uncircumcised girls. 60% of girls between ages of 12 and 18 years had more than one unsafe abortion with severe vaginal bleeding (haemorrhage) as the chief complication. However, 65% of the girls did abortion for fear of leaving school and financial hardship as the reasons.
Abstract—Adolescents are the future resources for any country to progress and prosper. According to Census 2001, in India, adolescent constitute one-fifth of the total population. Adolescent AGs are one of the important segments of the population for they are the future mother whose nutritional status affects that of the newborn baby. Anemia being a major public health problem among adolescent girls, a study was conducted with the objective to determine the socio-demographic correlates of anemia among girls. Methodology: A cross-sectional study was conducted among 467 adolescent AGs in Ahmadabad city during May 2011 to august 2012 in Adolescent Friendly Health Services clinics. Results: Prevalence of anemia among adolescent girls was 85.9%. Highest prevalence was observed during mid-adolescence phase. As the age of girls increases, Hemoglobin tends to get on the lower side. A statistically significant association was observed between anemia and nutritional status. No association was observed between anemia and religion, birth order, type of -family, education of parents and occupation of parents. Conclusion: Association between anemia and under-nutrition has been reported earlier in numerous studies; however present study highlights the fact that it is not common to have anemia among girls who are over nourished or obese. Hence, special efforts should be made to address this issue among girls by doing dietary modifications.
Health Problems in India by Preeti ThakurSMVDCoN ,J&K
India has huge burden of Health problems .In India health problems are discussed under six major headings as commonly seen in the country.
1.Communicable Disease Problem
2. Non-Communicable disease problem
3.Nutritional problem
4.Environmental sanitation problem
5.Medical care problem
6.Population problem
Prevalence of iron deficiency anemia among adolescent girls and its risk fact...eSAT Publishing House
IJRET : International Journal of Research in Engineering and Technology is an international peer reviewed, online journal published by eSAT Publishing House for the enhancement of research in various disciplines of Engineering and Technology. The aim and scope of the journal is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high-level learning, teaching and research in the fields of Engineering and Technology. We bring together Scientists, Academician, Field Engineers, Scholars and Students of related fields of Engineering and Technology.
The home visit is a crucial responsibility of family doctors. By doing home visits the physician and the team become more aware of the nature of the illness and other factors that playing role in either increasing the burden or decreasing the severity of the disease 9Such as the home environment, the family members interactions, and others...)
Non-Communicable Disease (NCDs) or Chronic Diseases and youth health in Bangl...Jahid Khan Rahat
In this slide you will learn about what is Non Communicable Diseases (NCDs) or Chronic Diseases,its risk factors, disease burden and statistic, effect of NCDs in children, its result, cure of diseases, development implications etc.
Health Problems in India by Preeti ThakurSMVDCoN ,J&K
India has huge burden of Health problems .In India health problems are discussed under six major headings as commonly seen in the country.
1.Communicable Disease Problem
2. Non-Communicable disease problem
3.Nutritional problem
4.Environmental sanitation problem
5.Medical care problem
6.Population problem
Prevalence of iron deficiency anemia among adolescent girls and its risk fact...eSAT Publishing House
IJRET : International Journal of Research in Engineering and Technology is an international peer reviewed, online journal published by eSAT Publishing House for the enhancement of research in various disciplines of Engineering and Technology. The aim and scope of the journal is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high-level learning, teaching and research in the fields of Engineering and Technology. We bring together Scientists, Academician, Field Engineers, Scholars and Students of related fields of Engineering and Technology.
The home visit is a crucial responsibility of family doctors. By doing home visits the physician and the team become more aware of the nature of the illness and other factors that playing role in either increasing the burden or decreasing the severity of the disease 9Such as the home environment, the family members interactions, and others...)
Non-Communicable Disease (NCDs) or Chronic Diseases and youth health in Bangl...Jahid Khan Rahat
In this slide you will learn about what is Non Communicable Diseases (NCDs) or Chronic Diseases,its risk factors, disease burden and statistic, effect of NCDs in children, its result, cure of diseases, development implications etc.
The Metropolitan Police Office [MPO], Ranipokhari, Kathmandu was established in 2006 AD. as the primary law enforcement agency for Kathmandu, Lalitpur and Bhaktapur districts of the Kathmandu Valley.
Financial Advisor Placement Services is the premier financial advisor recruiting firm, which specializes in placing only financial advisors. There is no cost to the Advisor!
For more details, visit: http://www.financialadvisorplacementservices.com/
We represent broker dealers who will go out of their way to support the financial advisor and to acccomodate both commission and fee-based products within retirement accounts. They understand that the advisor needs extra support during the chaos caused by the new DOL standards.
Financial Advisor Placement Services is the premier financial advisor recruiting firm, that specializes in placing only financial advisors. There is no cost to the Advisor!
Introduction: The objective of this work is to study the epidemiological and clinical aspects of erectile dysfunction in a population of diabetic patients in the Thies region.
This talk was presented at the Working with Men network meeting held in Hobart as part of Men's Resources Tasmania's 2017 AGM.
It was delivered by Glen Poole, Development Officer of the Australian Men's Health Forum (AMHF) and examines the social determinants that shape men and boys' health and wellbeing in Australia, with a particular focus on boys' education; involved fatherhood; male employment; social isolation and male-friendly services.
Day 3- Thursday 19 March 2015: Preparing for our Individual Challenge
Transformation & Technology Track: Wellness in the Workplace. Presented by Dr Vanessa Govender, Medical Doctor, Health and Wellness Executive, Aveng Limited.
#astdza2015
Health Spectrum is a Monthly Health Magazine published by Medi Media to create health awareness in our society and to bring doctors/health professionals and patients together. This magazine is being published from New Delhi, National Capital of India. Health Spectrum covers all aspects of Health and Medicine. We are also covering various activities and achievements of different organizations, Institutes, centres, Govt. departments, hospitals & Research Institutes. This Periodical are being circulated among the various central ministers, members of parliaments, Medical professionals, entrepreneurs, doctors, health workers, researchers, health activists, journalists and writers, students, academicians, libraries and general people,
Daylamis GonzalezDiscussion 4Prepare a 350 word draft of.docxedwardmarivel
Daylamis Gonzalez
Discussion 4
Prepare a 350 word draft of a clinical problem that you would like to use for your Research project. There should be an introduction to the problem (as to why it is a problem) that is documented with literature, a clear problem statement (one declarative sentence that begins with "The problem is...", and a purpose to your project. Post this as your Initial response. (Essential I-IX).
The problem is falls among elderly and its relation with their health problems and surrounding environmental factors. Falls are one of the most common problems in the elderly around the world. A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or at another lower level. Currently, there is no numerical criterion that classifies people as "elderly." However, the United Nations has determined that the age of 60+ should be used to refer to people as being "elderly. This is in spite of the fact that most developed countries take the chronological age of 65 years to define the ‘elderly. In the United States, falls are a leading cause of morbidity and mortality among mature adults. It is the second leading cause of accidental or unintentional injury/death after road traffic injuries. For example, of the 11 million adults aged 65 years and over living in the UK, around 30% of community-dwelling mature adults fall at least once in their lifetime. It was found in a study conducted in the Eastern Mediterranean Region that 30%–40% of adults older than 65 years residing in the community fall each year. The rates were higher in hospitalized patients and nursing home residents. Moreover, the incidence of falls rose steadily from middle-age onward peaking in persons older than 80 years.
Falls may be associated with various contiguous environmental hazards such as carpets and rugs. Most falls (72.8%) occur at home. Women represented 80.2% of fall injury victims. Not surprisingly, perhaps, the most common location for fall injuries in the home is the bathroom (35.7%). Other environmental hazards include poor stairway design and disrepair, inadequate lighting, clutter, slippery floors, unsecured mats, and the lack of nonskid surfaces in bathtubs. There is a paucity of literature on the important topic of falls amongst the elderly in the Kingdom of Saudi Arabia. However, our study will focus on estimating the true extent of falls among the elderly within the community alone and examine the relationship between the health status of elderly people as well as the impact of the environment on their propensity to experience falls.
References
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701–7
Research Chair of Health Education and Health Promotion, The College of Medicine, HTTPs://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774040
Maritza Leon
Urinary Tract Infections in the Elderly
Prepare a 350-word dra.
HSC PDHPE Core 1: Health Priorities in AustraliaVas Ratusau
Class of 2017 - updated PowerPoint presentation that includes current data, updated syllabus & content.
Includes class activities & examination style questions
Health Promotion Strategies and Methods Third Edition is the essential guide to developing effective health programs for the Australian population. The book presents the key principles of health promotion and demonstrates how they can be applied. This new edition provides a structured approach to devising health programs by focusing on planning, development and implementation. It also clearly explains the differences in individual, group and mass population approaches to health intervention and prevention programs. This is a practical introduction for health practitioners and students in public health, health sciences, medicine, nursing and epidemiology. Key features: • thoroughly revised and updated to reflect current health practices and incorporating the latest references • focuses on developing targeted strategies and techniques • written by Australian authors who are leaders in the field • useful tips, summaries and case studies throughout • concise and accessible style.
Health Promotion Strategies and Methods 3e - sample chapters
40-49 Health Dossier V5
1. HEALTH DOSSIER
HEALTH IN THE
BALANCE
From third world to first,
Singapore has garnered
many accolades – the
Republic is ranked by US-
based research institute
Business Environment
Risk Intelligence as
the top investment
destination globally and is
recognised by the World
Economic Forum as the
most competitive in Asia
in terms of efficiency.
Rising standards of living, the
availability of good housing, safe
water supply and sanitation,
and access to high-quality
medical service have helped
to significantly boost the health
of Singapore residents. We are
eating better, earning more and
living well. Today, Singapore’s
life expectancy is at an all-time
high of 82 years, up from 72
years in 1980.
But much like other
developed East Asian urbanised
Affluence brings better nutrition, greater awareness about
health and better medical therapies. But it also brings
lifestyles which are not all good for us. We speak with eight
leading medical specialists from various disciplines, who
share what’s happening and what we can do about it.
societies like Japan, Taiwan and
Hong Kong, strong economic
growth and increasing affluence
have brought about a set of “first-
world” issues. In addition, our
declining birth rate – due to later
marriages and married couples
choosing to delay parenthood
– coupled with a rapidly ageing
population have created a
unique class of health conditions
that need to be tackled.
In fact, the available data tells
a sobering tale of the state of
Singaporeans’ health. According
to the Health Promotion Board,
one in four Singaporeans in
their 40s has at least one or
more of these chronic diseases:
diabetes, hypertension and high
blood cholesterol.
Even though the risk of
contracting chronic illnesses
increases with age, doctors
agree that the rising rate is
attributable to our increasingly
stressful, sedentary and
unhealthy lifestyles. A close
WORDS
QUINTELLA
KOH
40
2. witness to this shift are
specialists – from fields such
as cardiology, ophthalmology,
rheumatology, ENT, hand
surgery, urology, obstetrics and
gynaecology – who are noticing
clear trends. They are almost
unanimous in concluding that
our diets and lifestyles are
largely to blame.
Contracting chronic
diseases is a serious matter as
many of them, if unchecked
and uncontrolled, lead to other
major illnesses. Cardiologist
Dr Ruth Kam notes that
hypertension can lead to health
complications such as heart
attack, heart failure, stroke,
kidney failure, atrial fibrillation
and dementia. Cardiologist
Dr Eric Hong, who specialises
in multimodal imaging (MMI),
echoes this, reporting that he is
seeing more acute and chronic
heart failures, arrhythmias
(irregular heartbeat) and
structural heart diseases.
Lifestyle
choices
The root of the problem?
Singaporean residents
simply exercise too little and
eat too much. The National
Health Survey (NHS) found
that a staggering 54% of
Singaporean residents aged
18 to 69 did not participate
in any leisure-time physical
activity, compared to
countries like the US (41%)
and France (33%).
As a renowned foodie
heaven, Singapore is seeing
the level of obesity rising.
The NHS found that one
in 10 Singaporeans were
considered obese, more than
twice the number in 1992.
Obesity can not only lead to
diabetes, hypertension and
high cholesterol, it can also
be a prelude to arthritis and
certain classes of cancer.
For example, people who
have hypertension or who
are obese are more prone to
developing bladder stones.
Left untreated, these can
cause discomfort, bacterial
infections and prevent urine
passing from the body,
explains Urologist
Dr Michael Wong.
Singapore has also seen a
slight uptick in the number of
people smoking, which has
led to an increase in throat
and tongue cancers – seen
not only in the elderly but
also the young and females,
says A/Prof Luke Tan,
Ear Nose Throat - Head and
Neck Surgeon.
And while the serious hand
injuries from use of heavy
machines in the 70s and 80s
have become less frequent
as Singapore went high-tech,
today’s hand injuries are
mostly the result of lifestyle
and recreational activities like
sports and computer use,
notes Hand Surgeon Dr Tan
Soo Heong.
Stone treatment
technology has
leapt forward
in the last five
years, as have
techniques
for tackling
male infertility
along with IVF
capabilities.
DR MICHAEL WONG
Associate Editor of the
British Journal of Urology and
Deputy Director of the Asian
School of Urology
54%OF
SINGAPOREANS
AGED
DID NOT PARTICIPATE
IN ANY LEISURE-TIME
PHYSICAL ACTIVITY*
18-69
The bad news is that
urinary stone incidence
has risen in the past 20
years due to changes in
diet and obesity, while
male fertility is a larger
concern due to delayed
marriage and more
second marriages. Female
urinary incontinence
has risen with an ageing
population, as have
prostate enlargement
and cancer. The good
news? Technological
advancements in the form
of better instrumentation,
use of lasers and
robotics and more
targetted medication are,
collectively, tackling these
issues head-on, resulting
in faster recovery, shorter
hospital stays and
improved odds for fertility.
41
A/PROF LUKE TAN
Ear, Nose & Throat – Head
and Neck Surgeon
The general state of
ENT health has improved
significantly over the past
few decades as a result
of education, access to
primary healthcare and
improved medicines.
Thyroid cancer and
thyroid nodular diseases
are on the rise due to
early screening. On the
flipside, the common
issues are predominantly
allergy and sinus-related.
One common trend is
the increased prevalence
of smoking among the
young and in particular,
females.
In the West, there is a
rising trend of sexually
transmitted human
papilloma virus-related
throat cancers, which
would probably reflect
in some way here as
trends in smoking and
sexual activities change
in tandem.
I recently
diagnosed a
20-year-old
motherwith late
Stage 4 tongue
cancer. She
had symptoms
for about six
months.
* Finding from National Health Survey (NHS), a first of its
kindwhichcapturedinformationontheprevalenceofmajor
non-communicable diseases and related risk factors. It
also revealed information on chronic disease screening,
use of primary healthcare services, mental health and
self-rated overall health. It was conducted in 2010; the
next NHS is due in 2016.
3. HEALTH DOSSIER
Age-related
challenges
Singapore also has to contend
with the rising onset of age-
related conditions such as
infertility, osteoporosis
and myopia.
It is well-known that
Singaporeans are delaying
parenthood – marrying
later, pursuing career goals,
treasuring freedom – but
less well-known is how
the ageing process affects
fertility. Obstetrician and
Gynaecologist Dr Ann Tan
explains, “Fertility potential
peaks in the 20s when desire
(to have children) is low, and
then reverses. Fertility potential
is lower when desire is higher.”
Women may reach
menopause on average
at 51, but the deterioration
starts in the late 20s. After 35,
the female’s fertility drops
dramatically with diminishing
number and quality of eggs.
The spotlight tends to fall
on female infertility, but it is
also male pressing in males.
Urologist Dr Wong says more
people delaying marriage or
entering second marriages
mean that men are older and
sperm quality poorer. Male
infertility issues constitute
about 60% of cases.
Like infertility, the incidence
of osteoporosis is
likely to increase
dramatically as
the city-state’s
median age
pushes towards
47 come 2030
(from 39 in 2011).
Characterised by
decreasing bone
mass and density,
osteoporosis is
a progressive
condition that
results in weak,
brittle bones. It is
most common in
post-menopausal
women following the decrease
in estrogen, a female sex
hormone that protects bones
in women.
Rheumatologist A/Prof
Leong Keng Hong points out
that osteoporosis creeps into
a person’s life undetected as
there are often no symptoms
until fractures occur. “If not
treated, it can result in fractures,
particularly of the wrist, spine
or hip. These occur after little or
no trauma, such as falling down
while walking, and often result in
life-changing disability, ”
he explains.
Then there are the
eyes. Myopia, according to
Ophthalmologist Dr Leo Seo
Wei, has reached “epidemic
proportions” with 90% of adult
Singaporeans facing it. “The
earlier the onset of myopia,
the higher the degree of it.
The higher the degree, the
higher the risk of developing
complications leading to
reduced vision and blindness.
These risks are for life,”
she says.
Young people,
especially
women, are are
susceptible to
autoimmune
diseases such
as lupus,
psoriasis,
schleroderma
and Sjogren’s
syndrome, with
onset usually
between 20
and 50.
A/PROF
LEONG KENG HONG
Rheumatologist
In 2010, MOH did a study on
disability adjusted life years
or DALYS. This measures
years of life lost not just
due to premature death but
also to living with disability.
Rheumatoid arthritis was
No. 12 and osteoarthritis
was No. 16 on the list.
Arthritis is due to
either wear and tear
or inflammation. Left
untreated, the patient has
disability such as being
unable to walk or use
the hands. Autoimmune
diseases arise when
a trigger causes the
body’s immune system
to attack the body’s
own tissue. There are
treatments to control the
underlying causes, and
surgical replacement
of hips and knees, but
there are no specific
preventive measures we
can take to reduce the
risk of contracting these
conditions.
80%OF 18-YEAR-OLD
SINGAPOREANS
ARE MYOPIC
28%OF ASIAN CHILDREN
ARE MYOPIC
SINGAPORE
MYOPIA
ALERT!
42
4. Preventive
measures, early
detection
The good news is that most of
the conditions that affect our
population are also among the
most preventable.
In the case of chronic
diseases such as diabetes,
hypertension and high
blood cholesterol, a few
simple lifestyle tweaks can
significantly decrease the risk
of contracting these diseases.
The Health Promotion Board
recommends that the average
adult Singapore resident gets
150 minutes of physical activity
a week.
Subtle adjustments to
diet are another way to stave
off diseases. For instance,
a moderately active male
should only consume 2,590
calories each day, while
a fairly active female only
needs 2,035 calories. The
tired adages hold true – more
fruits and vegetables, whole
grains instead of processed
carbohydrates, smaller
portions, less sugar and salt.
Explains Dr Leo: “Many eye
diseases are linked to chronic
diseases. Exercise can help
keep them at bay or limit
their impact if they do occur.
Exercise has also been shown
to lessen the risk of age-related
eye diseases such as diabetic
retinopathy, age-related
Singapore has one of the
highest rates of myopia –
short-sightedness –
in the world.
Child myopia is suspected
when they can’t see things
well in the distance. Other
signs include children
going up close to the TV
to watch shows. “Myopia
is not just about wearing
glasses. LASIK or refractive
surgery may get rid of the
need to wear glasses but it
does not decrease the risk
of blinding complications
associated with myopia.
A study of six-year-old
Chinese children shows
that myopia rates are 29%
in Singapore but only 3%
in Sydney. The primary
difference? Children in
Sydney enjoy 14 hours
per week outdoors while
Singapore children get by
with only three.
Risk factors: excessive
reading, writing, computer
use and lack of time
outdoors in sunlight, which
causes the release of
dopamine in the retina and
prevents excessive eye
growth and myopia.
Myopia has
reached
epidemic
proportions in
Singapore, with
90% of adults
facing it.
DR LEO SEO WEI
Ophthalmologist who sub-
specialises in paediatric
ophthalmology
Good cardiac
health results
from habits
which must
be inculcated
from childhood.
Narrowing of the
arteries occurs
over many
years and bad
dietary habits
are difficult
to change
once they are
ingrained.
DR RUTH KAM
Cardiologist
In stable coronary heart
disease, the symptoms
are predictable. They
occur only after a certain
threshold of activity, such
as exercise, after a meal,
after getting angry and so
on. It is also relieved after
the activity stops.
In unstable coronary
heart disease, the
symptoms become
unpredictable. They occur
at rest or with increasing
frequency and intensity
until they become
persistent, unrelieved
by the usual rest or
medication, culminating in
a heart attack when a part
of the heart muscle dies
because its blood supply
is cut off.
macular degeneration
and glaucoma.”
Consistency is key to
maintaining an active lifestyle,
and sudden intense spurts
of physical activity should
be avoided. “What has been
popular in recent years are
short-distance weekend
triathlons which attract middle-
aged working adults who tend
to be ‘weekend warriors’,” Dr
Hong notes. These amateur
athletes can be prone to
sudden cardiac death – a
condition where seemingly fit
individuals suddenly collapse
and die. “In older athletes
above 35, the main cause
of sudden cardiac death is
coronary artery disease.”
In addition to exercising
moderately and regularly,
Dr Hong advises individuals,
especially those who are keen
on endurance sports, to have a
proper heart screening to avoid
sudden cardiac death. “Be
mindful of your heart,” he says.
“The consequences of sudden
cardiac death go beyond
yourself; they affect your loved
ones. Sudden cardiac arrest is
not rare, but surviving it is.”
A multifaceted approach
to healthy living not only
comprises exercise and a
healthy diet. Early detection
of diseases and timely
treatment can reduce the
chances of complications.
43
5. HEALTH DOSSIER
Early screening
& detection
HEART: Frequent chest
pain points to a likelihood
of coronary heart disease,
says Dr Kam. “Less common
symptoms include abdominal
pain, palpitations, giddiness,
shoulder pain and jaw pain.
These seem to be more
frequent in women who
also get it later, usually after
menopause,” she adds.
Recent advancements in
cardiac imaging technology
have made it possible to
diagnose more, earlier. “A
decade ago, it was common
to report as normal a scan
with findings suggestive of
‘low likelihood for adverse
cardiac events’. Today, we
know that many patients with
normal ECG could still have
extensive coronary artery
disease even though blood
flow through the arteries has
not been compromised yet,”
explains Cardiologist Dr Hong.
“Applying high-sensitivity CZT
crystal cameras over gamma
camera technology for heart
scans reduces scanning time
by 75%. And the 320-slice
cardiac computed tomography
reduces radiation in a heart
scan by 90%.”
Says Dr Kam: “Stents have
drugs in them that lower the
risk of restenosis – narrowing
at the same place – and some
components are biodegradable
and dissolve over time. The
metal scaffolding remains, and
becomes covered in cells so
that it is inside the vessel wall.”
EYES: Adults at 40 should get a
baseline eye disease screening
which can detect abnormalities
of the visual system and
evidence of systemic diseases
such as hypertension and
diabetes. Says Dr Leo, “Several
common eye diseases –
diabetic retinopathy, age-
related macular degeneration
In older
athletes who
are above 35
years old, the
main cause of
sudden cardiac
death is
coronary artery
disease.
DR ERIC HONG
Cardiologist
HEART
URINARY
TRACT
EYES
In older athletes who are
above 35, the main cause of
sudden cardiac death (SCD)
is coronary artery disease
(CAD). Greater attention
must be paid to individuals
with a history of it, including
those who have had heart
attacks, stents, coronary
bypasses or a known history
of reduced heart function
with chronic diseases
such as diabetes or kidney
disease. These conditions
account for 75 to 80% of
SCD in this age group. It is
very important to assess
one’s fitness to exercise.
In the past few years, there
have been tremendous
advancements in non-
invasive cardiac imaging
for more accurate
assessment of CAD. We live
in exciting times, with rapid
advances in imaging and
interventional cardiology,
which lead to better
patient outcomes.
44
6. and glaucoma – can impact
people above 40 without
them knowing it. With
intervention, these potentially
blinding diseases often have a
favourable outcome.”
URINARY TRACT: The
occurrence of urinary stones
in elderly people is high at
around 10%. Symptoms are
very obvious: abdominal
pain, abnormally coloured
urine, blood in the urine,
frequent urge to urinate and
inability to urinate. To detect
urinary stones, CT scanning,
ultrasound examination and
urine cultures test are viable
screening options, says Dr
Wong. Tests can indicate
urinary stones, their location
and whether they are causing
damage to the urinary tract.
THROAT: Conditions like
throat cancer can be difficult
to diagnose because the
symptoms can be vague.
They include change in voice,
swallowing difficulties, throat
soreness, persistent cough,
swollen lymph nodes in the
neck, ear pain and wheezing.
Targeted screening methods
such as a laryngoscopy (where
a long flexible tube with a
mirror and a light is inserted
down the throat) are required.
If abnormalities are found,
a tissue sample is tested
for cancer. “The focus is on
screening and early detection
as the treatment outcomes are
dependant to a large extent
on the stage at presentation,”
explains A/Prof Tan.
REPRODUCTIVE SYSTEM: Those
who have been trying for
a baby for a long time can
feel isolated and frustrated.
As treatment options are
wide-ranging – with timed
sexual intercourse, ovulation
induction, in vitro fertilisation
(IVF) and surgery – a specialist
is required so that the problem
can be identified and correct
treatment recommended.
Many delay this.
Says Dr Ann Tan: “I would
like to see men and woman
be more mindful of their
fertility potential and to have
the ability to safeguard their
healthy gametes to be used
when their situation allows
them to actualise their
desire to be parents. Then
we will definitely have less
fertility issues.”
Dr Michael Wong points out
that people worry needlessly
about success rates of
treatment options. “Techniques
for male fertility have improved
along with IVF capabilities.”
BONES: Conditions like
osteoporosis often go
undetected until an episode
occurs. Occasional symptoms
are backache, loss of weight
and a stooped posture.
“Many people think that
boosting one’s calcium intake
will help prevent osteoporosis
but calcium, vitamin D and
exercise can enhance bone
health but cannot arrest the
disease once it is there,” says
A/Prof Leong.
Regular health screening
is still recommended; early
detection improves the
chances of treatment, reduces
risk of premature death and
improves quality of life.
HANDS: Patients often ignore
symptoms until it is very late.
“Delayed treatment can lead
to severe consequences. Cat
bite injuries, if not cleaned,
dressed and accompanied by
antibiotics, can lead to severe
spreading infection affecting
bones, joints and soft tissue.
Numbness and weakness
can be due to carpal tunnel
syndrome which, with neglect,
leads to unremitting pain, loss
of finger sensation and loss of
control of thumb movements,“
explains Dr S H Tan.
REPRODUCTIVE
SYSTEM
BONES
THROAT
45
7. HEALTH DOSSIER
New frontiers
The boundaries of medicine
have advanced dramatically
in the last few years, making
it possible for more people to
receive treatment without fear
of complications.
Multimodal Imaging (MMI)
In the past, when considering
a condition like coronary
artery disease, the option
was ultrasound of the heart
followed by an invasive
procedure such as a
coronary angiogram.
With MMI, a technology
that has matured rapidly over
the last decade, specialists are
able to assess the severity of
blockages in the arteries non-
invasively. Imaging techniques,
when combined with
anatomical and physiological
data, can produce detailed
feedback that can differentiate
a 71% blockage from a
69% blockage.
“In some cases, the patient
might be wheelchair bound
or his functional status not
very good. So the question
is: do you really want to
do the conventional steps
– angiogram, diagnosis of
multi-vessel disease and heart
bypass surgery – when the
patient cannot take that route?
MMI allows us to individualise
medicine,” notes Dr Hong.
Minimally invasive surgery
MIS is now routine. Take urinary
stones, for instance. “No matter
how big or hard the stones,
we now have the tools to not
only remove them safely but to
even prevent them reccurring.
With increasing incidence in
urinary stones arising from age-
related changes, increased uric
acid levels related to obesity
and a dropping urine PH,
technology and techniques
have improved and offer MIS to
remove them,” says Dr Wong.
Today’s hand
injuries result
from lifestyle
and recreational
activities, strain
from repetitive
tasks, and
degenerative
hand conditions
related to
ageing.
DR TAN SOO HEONG
Hand Surgeon
Chronic disease is looming
large in Singapore. Not only
are more people suffering
from ailments linked to
diabetes and high cholesterol,
they are also getting younger.
Figures from the Ministry
of Health show that two in five
Singaporeans aged 20 years
and above are suffering from
at least one chronic condition,
the most common being
high blood pressure, high
cholesterol and diabetes. These
three illnesses increase the risk
of heart problems and strokes.
CHRONIC
DISEASES &
THE YOUNG2
5SINGAPOREANS
AGED 20 YEARS
AND ABOVE
ARE SUFFERING
FROM AT LEAST
ONE CHRONIC
CONDITION
MINISTRY
OF HEALTH
Hand lacerations with
cut tendons and nerves
during culinary classes,
tendon and pulley injuries
during rock-climbing
or rugby games, torn
ligaments during gym or
yoga classes and hand,
wrist and finger fractures
during cycling, mountain
biking skateboarding or
running are common.
Repetititve strain is also
more common, attributed
to sedentary lifestyles
and our keyboard and
gadget use. With ageing
come osteoarthritis of the
thumb and finger joints,
tendon inflammation
and progressive sensory
loss and muscle wasting.
Neuropathic pain and loss
of function are also to be
expected. These occur so
slowly and so commonly
that people attribute
them to “normal ageing”
and don’t get them
treated early.
46
IN
8. 3D printing
Robotics and 3D printing have
revolutionised many areas
of medicine including hand
therapy and limb retraining
and replacement. “Robotics-
assisted devices can help
in rehabilitation to monitor
and assist in hand therapy
and upper limb retraining.
They can be programmed to
perform specific functions for
the patient’s rehabilitation and
to train patients in daily life
activities,” notes Dr S H Tan.
3D printing technology
works like MMI. In 3D printing,
the patient’s body part is
scanned and the data used to
obtain the normal dimensions.
Implants are then crafted to fit
the patient’s specific profile. “In
the old days, implants came
in standard sizes and lengths,
which meant that during during
surgery, the body was altered
to fit the implants. 3D printing
allows for personalisation, done
much more quickly and at a
much lower cost,” he explains.
Regulatory changes
There are encouraging
changes on the regulatory
front with, for instance, rising
acceptance of social egg
freezing as a recognised form
of preserving eggs before they
are damaged or depleted. From
2012, the American Society
of Reproductive Medicine
declared that egg freezing
is no longer an experimental
procedure. Improvements in
freezing methods and culture
media have given many labs an
almost 100% freeze and post-
thawing survival rate.
In Singapore, egg freezing
is only available in the context
of those suffering from cancer
and desiring to store their
eggs before undergoing
chemotherapy. Egg freezing
is also an option at the post-
chemotherapy stage if they are
not able to consider pregnancy
The most urgent
issue facing
our population
would be the
dichotomy
between their
fertilitywants
and potential. I
would like to see
both men and
woman be more
mindful of their
fertility potential.
DR ANN TAN
Obstetrician and
Gynaecologist
at that time. But with countries
such as the US, Belgium
and the Netherlands already
permitting social egg freezing,
it is a matter of time before
Singapore must decide on her
stance for egg freezing. “For
childless women in their 40s
and beyond, the option will be
to have IVF performed with
their own eggs. They can also
use donor eggs if the former
procedure is not possible.If
unable to carry the pregnancy,
then there will be cause to
consider surrogacy,” Dr Ann Tan
points out.
Regulatory changes
have also made it easier for
Singaporean residents to effect
treatment for chronic conditions
as outpatients. The Medisave
Use for Chronic Disease
Many chemotherapy
agents whilst having the
ability to battle the cancer,
also have the ability to
impair the fertility of the
patient. Currently, when
treatments have improved
quality of life and life
expectancy, the notion of
being a parent has become
increasingly desired and
possible. It has been shown
that when fertility has been
preserved, the patient’s
prognosis improves. Fertility
preservtion can be in the
form of egg freezing for
single or embryo freezing
for couples. With breast
cancer, there is often a
window of opportunity
between diagnosis and
surgery/treatments. This
can be used to stimulate
the patient and have her
eggs retrieved prior to
any chemotherapy and its
harmful effects.
47
Management Programme,
launched in 2006, now includes
diabetes, hypertension, stroke,
osteoarthritis, osteoporosis and
rheumatoid arthritis.
Affluence alone clearly
does not guarantee one a
healthy life. What is needed
is a conscious combination
of good lifestyle and eating
habits and regular screening
and treatment. It also helps
to keep abreast of medical
advancements and regulatory
changes.
9. HEALTH DOSSIER
48
SPECIALIST ADVISORS
DR RUTH KAM
Cardiologist
RUTH KAM HEART AND
ARRHYTHMIA CLINIC
290 Orchard Road
#14-10 Paragon Medical
Singapore 238859
Tel: 6333 6866
www.arrhythmia.com.sg
Dr Ruth Kam provides general and
specialised services in cardiac
arrhythmias, while lecturing and
consulting for various hospitals
and medical institutions here and
overseas. She has a keen interest
in cardiology in women
and sportsmen.
DR TAN SOO HEONG
Hand Surgeon
HAND, WRIST & UPPER LIMB
SURGERY
3 Mount Elizabeth
#07-01 Mount Elizabeth
Medical Centre
Singapore 228510
Tel: 6737 0177
www.hand.com.sg
Dr Tan Soo Heong is one of a
small number of hand surgeons
in Singapore and has a special
interest in the possibilities
of robotics-assisted devices
and 3D printing’s potential for
personalising surgery.
DR ANN TAN
Obstetrician & Gynaecologist
WOMEN & FETAL CENTRE
290 Orchard Road
#20-01 Paragon Medical
Singapore 238859
Tel: 6887 1103
www.anntan.com.sg
Dr Ann Tan provides services
in prenatal diagnosis & care of
mother and foetus, and has a deep
interest in assisted fertility and
related issues. In her commitment
to raising awareness, she is
a regular contributor to local
publications.
A/PROF LEONG KENG HONG
Rheumatologist
LEONG KENG HONG ARTHRITIS
& MEDICAL CLINIC
6 Napier Road
#04-18 Gleneagles
Medical Centre
Singapore 258499
Tel: 6472 4337
www.leongkenghong.com
A/Prof Leong Keng Hong is a
consultant and lecturer with an
active interest in research. He has
a special interest in autoimmune
diseases such as arthritis and lupus,
and degenerative diseases such as
osteoporosis and osteoarthritis.
DR LEO SEO WEI
Ophthalmologist
DR LEO ADULT & PAEDIATRIC
EYE SPECIALIST PTE LTD
3 Mount Elizabeth
#10-04 Mount Elizabeth
Medical Centre
Singapore 228510
Tel: 6737 8366
www.drleoeyespecialist.com
Dr Leo Seo Wei treats all aspects
of ophthalmology, with a special
interest in strabismus surgery and
paediatric ophthalmology. She is
one of a few eye specialists here
performing bladeless, laser-
assisted cataract operations.
DR ERIC HONG
Cardiologist
EH HEART SPECIALIST PTE LTD
3 Mount Elizabeth
#03-09 Mount Elizabeth
Medical Centre
Singapore 228510
Tel: 6736 1068
www.eheartspecialist.com
Dr Eric Hong is an interventional
and nuclear cardiologist who
specialises in minimally and non-
invasive procedures and methods
to diagnose and treat diseases
of the heart.
DR MICHAEL WONG
Urologist
INTERNATIONAL UROLOGY,
FERTILITY & GYNAECOLOGY
CENTRE
3 Mount Elizabeth
#10-09 Mount Elizabeth
Medical Centre
Singapore 228510
Tel: 68381212
www.drmichaelwong.com
Dr Michael Wong, currently
Associate Editor of British
Journal of Urology International,
is recognised for expertise and
contribution to the field of Urology,
in particular minimally invasive
Endourology.
A/PROF LUKE TAN
Ear, Nose & Throat – Head and
Neck Surgeon
LUKE TAN ENT-HEAD & NECK
CENTER & THYROID SURGERY
CENTRE
3 Mount Elizabeth
#14-17 Mount Elizabeth
Medical Centre
Singapore 228510
Tel: 6474 6116
www.thyroidsurgery.com.sg
A/Prof Luke Tan is credited with
building up the first ENT teams
in some Singapore hospitals and
has a special interest in minimally
invasive thyroid surgery, and head
and neck cancers.