VACCINATIONS FOR ADULTS & SENIORS

Are you or your loved ones over 65 years old?

Are you or your loved ones a smoker or on long term medications like steroids?

Do you or your loved ones have chronic diseases like heart disease, diabetes, asthma, chronic bronchitis or liver disease?

If so, the following vaccinations are strongly recommended:

1) Pneumonia (Pneumoccocal 13 & 23 vaccinations) *updated
- single dose each

2) Shingles (Herpes Zoster vaccination) 
- single dose

3) Diptheria, Pertussis and Tetanus (DPT vaccination) 
- single dose every 10 years

4) Flu (Influenza vaccination) 
- single dose every year, preferably at end of the year before the northern hemisphere winter season

ALERT: INFLUENZA A/H7N9 & NOVEL CORONAVIRUS

Recently, there are news regarding new viruses infecting human hosts:
1) influenza A/H7N9 in China and 
2) novel coronavirus (NCoV) in the Arabian Peninsula and Middle East.

When traveling to affected areas, the public are advised to take note of the following:

• Avoid direct contact with poultry, birds or their droppings, and if contact is made, wash hands thoroughly with soap and water;
• Cook poultry and eggs thoroughly before eating;
• Wash hands frequently with soap and water (e.g. before handling food or eating, after going to toilet, or when hands are dirtied by respiratory secretion after coughing or sneezing);
• Avoid crowded places and contact with sick people with fever; and
• Wear a mask when you have respiratory symptoms or are feeling unwell.

Most cases of infected patients have signs of pneumonia (lung infection). Any person who has history of travel to or residence within the last 14 days at affected areas must observe for symptoms like fever, cough and shortness of breath. 

And they should seek medical attention at the Emergency Department of TTSH (Tan Tock Seng Hospital). Or they should visit their family doctors for any signs and symptoms of flu.

Currently there are no vaccines for the above viruses. However, the seasonal flu vaccine should be considered if traveling overseas, particularly to affected areas. 


References
http://www.moh.gov.sg/content/moh_web/home/pressRoom/pressRoomItemRelease/2013/moh-statement-on-first-confirmed-h7n9-case-in-taiwan.html

http://www.who.int/influenza/human_animal_interface/faq_H7N9/en/

http://www.who.int/csr/disease/coronavirus_infections/faq_dec12/en/index.html

MEDISAVE FOR ALL CHILDHOOD VACCINATIONS

Ministry of Health has approved the use of Medisave for ALL childhood vaccinations under the NCIS (National Childhood Immunisation Schedule). This change will take effect from 1st JUNE 2013.

At present, only three of the vaccinations (Hepatitis B, Pneumococcal disease and Human Papillomavirus) is payable via Medisave.

The use of Medisave for vaccination will not be subjected to the $30 deductible and 15% co-payment of the remaining bill under the Medisave400 Scheme.   

Parents can also continue to pay for the vaccinations with the child’s Baby Bonus cash gift.

All our clinics provide childhood vaccinations for newborns from the age of 1 month.

*NEW - OneDoctors YISHUN (Opening on 1st November 2012)

We are pleased to announce we will be opening a new clinic at YISHUN on 1st November 2012.

OneDoctors Family Clinic (Yishun)

Blk 846 Yishun Ring Road #01-3611 Singapore 760846

(opposite Khatib MRT) Tel: 6257 8980

DR Norman Koh

DR Kok Zi Yin

DR Daniel Lim

DR Toh Sheng Cheong

OneDoctors NOVENA Closing (Last day on 31st October 2012)

NOTICE

Dear Patients and Friends

You may have been informed that Novena Ville has been sold as a collective sale and will be demolished next year. We regret that after a few months of searching and planning, we are unable to find a replacement premise that is a viable alternative to re-site the practice.

Hence, we will have to move out and 
our last day of clinic operation at Novena will be 31 October 2012.

We thank you for the privilege of being your physicians and hope you will be able to see us at our other clinics. Until then, thank you and take care.

Best Wishes for your good health

The Doctors and Staff

OneDoctors Family Clinic
NOVENA

October 2012

OPENING OF ONEDOCTORS @ HOLLANDV

Our new clinic at Holland Village, OneDoctors Family Clinic, starts consultations on

Monday, 2nd April 2012.

OPEN DAILY

Mondays - Saturdays, 9 am - 10 pm
Sundays, 5pm - 10 pm (Only)

Public Holidays - OPEN 
(*Edit: 1st Nov 2012)

OneDoctors Family Clinic

253 Holland Avenue #02-01

Singapore 278982

Tel - 6469 8938

*NEW* - OneDoctors @ Holland Village

We are pleased to announce that we are opening a new OneDoctors Family Clinic at Holland Village.

The unit will be at the 2-storey shophouses where the various commercial banks are located. It is next to the Holland Village MRT exit.

We are planning to start consultations in April 2012. (*edit)

OneDoctors Family Clinic
253 Holland Avenue
#02-01 Singapore 278982

Tel - 6469 8938

OSTEOARTHRITIS, KNEES

Osteoarthritis (OA), also known as degenerative arthritis, is a condition of the joint that worsens with time. It is the most common type of arthritis and there is no cure.

It is caused by wear and tear due to excessive use over the years or to old injuries in the affected joints. It commonly affects people over 60 years of age. It mostly affects the large weight-bearing joints like the knees, hips and spine, causing pain and stiffness which is worst at the end of the day. The affected person may have difficulty in walking, climbing stairs, squatting or kneeling.

RISK FACTORS

• Family History

• Sex ( Females are at higher risk)

• Obesity ( 66% of obese people are at risk for Knee OA )

• Age ( higher risk above 45 years old)

• Joint Injuries

• Physical Activities ( repetitive trauma to joint)

• Ethnicity ( Asians are at higher risk )

FEATURES

Typical features include :

1. narrowed joint space

2. cartilage loss and damage

3. bone spur formation

SIGNS AND SYMPTOMS

Signs and symptoms include :

1. Joint pain and swelling

2. Cracking sounds in joint

3. Stiffness

4. Difficulty in movement

70% of OA cases are that of Knee OA.

25% of sufferers are unable to perform major activities of daily living.

TREATMENT OPTIONS

1. Lifestyle modification ( weight loss, decreased weight-bearing activity etc)

2. Physiotherapy ( strengthening of the muscles around the joint )

3. Oral supplements ( e.g glucosamine)

4. Painkillers ( side effects of medications need to be managed carefully )

5. Joint Injections ( steroids, viscosupplementation)

6. Surgery ( for severe cases when all other treatments have failed to provide relief)

LATEST UPDATES

Viscosupplementation is indicated for the treatment of pain in patients with Knee Osteoarthritis, who have failed to respond adequately to conservative therapy and painkillers. It involves an injection into the affected knee joint. It basically replaces damaged joint fluid with a substance similar to healthy joint fluid, in order to reduce pain, improve the knee joint's natural shock-absorbing qualities and to improve mobility and function.

The response to this injection varies from patient to patient, but relief from pain is felt from 1 week to 6 weeks post-injection. Pain-relief with this injection can last from 6 months up to 1 year.

Patients can opt for either the one-time injection or the series of 3 injections on Day 1, Day 8 and Day 15. The effects of both are similar.

Prices are around $840 for the single injection,

or $280 per injection for the series of 3 injections.

References: http://www.hpb.gov.sg/diseases/article.aspx?id=568

PNEUMOCOCCAL DISEASE

Pneumococcal Disease (PD) describes a group of illnesses caused by the bacterium Streptococcus Pneumoniae, also known as Pneumococcus.

There are more than 90 sub-types of this bacterium. It affects both children and adults and is a major cause of morbidity and mortality worldwide. Serious pneumococcal infections are a global health problem but are vaccine-preventable.

Worldwide, a million children die from PD each year. In Singapore, up to 70 per 100,000 children less than 5 years old are affected by PD. Pneumococcus is also the most common cause of community-acquired pneumonia (CAP) accounting for 19-25% of all cases.

TRANSMISSION

It is commonly found in the nose and throat of healthy children and adults, with as many as 4 serotypes carried at once. While not all individuals will get sick from Pneumococcus, anyone in whom the bacteria has colonized is a carrier, and can potentially infect others through airborne particles.

Although anyone can get PD, some are particularly at high-risk for the disease. They include infants, the elderly and individuals with chronic medical illnesses or weakened immune systems.

EFFECTS

After Pneumococcus colonizes in the upper respiratory tract, it can cause

• Bacteraemia/Sepsis (infection of the blood),
• Meningitis (infection of the membrane of the spinal cord or brain)
• Pneumonia (infection of the lungs),
• Otitis Media (infection of the middle ear) and
• Sinusitis (infection of the sinuses).

TREATMENT

Prompt treatment with antibiotics is usually effective. In recent years due to the emergence of antibiotic-resistant strains, particularly to penicillin, the treatment of PD has become more challenging and may need a longer hospital stay along with expensive alternative therapy.

PREVENTION

The best way to protect against PD is through vaccination. Vaccines are generally safe and effective.

A single dose of PPSV (Pneumococcal Polysaccharide Vaccine) is protective against 23 of the most prevalent strains of the bacteria in adults. Vaccination with PPSV is recommended for:

• People aged 65 years and above
• Those who have a chronic medical illness such as Diabetes, heart, lung and liver diseases
• Those who have asthma or smoke cigarettes

• Those with a weakened immune system due to human immunodeficiency viral (HIV) infection or cancer
• People without a functioning spleen and those with sickle cell disease
• Residents of long-term care facilities such as nursing homes

VACCINATION
For adults aged 65 and above
2 injections, at least 1 year apart are recommended.

Children younger than 2 years old
are at a higher risk for serious PD than older children, hence vaccination with PCV (Pneumococcal Conjugate Vaccine) is recommended for them. The number of doses and the intervals between doses depend on the child’s age. It is also part of the childhood vaccination schedule recommended by the National Immunisation Registry of Singapore.

CONCLUSION

Pneumococcal disease is a preventable disease with the current vaccines covering up to 90 percent of disease-causing pneumococcal strains, including the six serotypes that most frequently cause invasive drug-resistant pneumococcal infections among children and adults.

The chances of your child or parent getting infections like meningitis, pneumonia and sepsis can be greatly reduced.

Please check with our doctors for further information.

References :

http://www.hpb.gov.sg/diseases/article.aspx?id=8314

http://www.cfps.org.sg/sfp/36/362/362_unit5.pdf

CERVICAL CANCER VACCINE

WHAT IS CERVICAL CANCER?
A woman’s cervix is located at the lower part of the womb. Changes can occur in these cells and in many cases, the cells return to normal on its own. However, in some cases, the cells change in an abnormal way and develop into cervical cancer. Cervical cancer can be prevented if these abnormal changes are detected and treated in its early stages. In Singapore, about 200 women are diagnosed with the disease each year, and 80 die of it, most likely because it is discovered late.

HOW CAN CERVICAL CANCER BE DETECTED?
Cervical cancer can be detected by a Pap smear. It is a screening test to check for changes in the cells of your cervix whereby cells are collected from your cervix. The process takes only a few minutes. The cells are then smeared onto a glass slide and sent to a laboratory for further processing and examination under a microscope.

Pap smears are recommended for sexually-active females from age 18 onwards. The frequency of screening is from 1-3 years, depending on risks. Most family clinics should be able to provide this service.

THE LINK BETWEEN CERVICAL CANCER AND HPV
Some types of Human Papilloma Virus (HPV) can infect the cervix, causing the cells to change. In about 90% of the infection cases, the virus clears by itself and the cells return to normal. In some cases, the infection can persist and cause the cells to grow in an abnormal way, developing into cervical cancer. Specifically, HPV types 16 and 18 causes about 70% of the cervical cancer cases worldwide.

WHAT IS THE HPV VACCINE? The HPV vaccines are targeted for use in females aged 9 to 26 years old. They are most effective in protecting against infection by the selected HPV types if given before first sexual exposure. Vaccination does not substitute for cervical cancer screening by regular Pap smears. However, new evidence shows that the vaccinations are effective in women up to 45 years of age.

It is important to know that the vaccine is not designed to protect against other HPV types (i.e. non-type 16 or 18) that cause about 1 in 3 cases of cervical cancer. It is also important to remember that the vaccination works by preventing infection by the specific HPV types – it does not treat existing HPV infections.

The vaccination schedule is 3 doses at 0, 1-2 month and 6 month interval. The Expert Committee for Immunisation in Singapore has recommended that HPV vaccinations be included in the national childhood immunisation programme.

In summary, HPV vaccinations are strongly recommended for girls and ladies from the age of 10 onwards, in particular teenagers and young adults. It should be considered for at-risk females up to 45 years of age as well.

Do drop by our clinics for any enquiries or a detailed consultation to find out more.

References :
http://www.hpb.gov.sg/diseases/cervicalcancer.aspx
http://www.hpb.gov.sg/healthscreening/article.aspx?id=8766 http://www.hpb.gov.sg/hpb2/qnahpb_faqmain.asp?strItemChoice=200511803814&strSubItemChoice=20051180393&action=SHOWTOPICS&m_strTopicSysID=2008430144324#20051180393 http://www.healthxchange.com.sg/News/Pages/Cervical-cancer-jabs-covered-by-Medisave.aspx