Moisturising In A Humid Climate

Although humid locations have plenty of water in the air, that doesn't mean you don't need to moisturize. Even if you have oily skin, you still need to use a daily moisturizer -- oil seals in moisture, but it doesn't replace the moisture you lose each day. But be sure to use a non-comedogenic moisturizer -- meaning it won't clog pores -- because when dirt, oil and dead skin clog pores, your skin can break out.

Moisturizers that contain humectants work best in humid areas -- they absorb water from the air and require a high level of humidity to be effective. Look for urea, glycerin or alpha hydroxy acids on the ingredient list. You may also want to try a moisturizer that contains sunscreen. Whenever your skin will be exposed to the sun -- even on cloudy days -- you should wear a sunscreen with a sun protection factor of at least 15.

This article was originally published in health.howstuffworks.com.

Don't Skip the Cooldown! Why It Makes All the Difference

It may be tempting to not cool down after a workout, but it shouldn't be up for debate. The sheer ritual of a cooldown is good for mental clarity because it promotes a healthy sense of accomplishment, but these few minutes of low-intensity exercise also help to support and strengthen muscles, helping prevent injury.

When you skip the stretch after a workout, those muscles that were just working so hard can tighten up, increasing your risk of experiencing an injury. For serious athletes and marathoners, cooling down is even more essential since it helps regulate blood flow throughout the body, bringing it back to a balanced state.

If you're using a programmed workout on a cardio machine, your cooldown will most likely be built into the workout. In this case, all you have to do is make sure you stay on the machine! But if you press "quickstart" from the get-go or you're enjoying the weather outdoors, these tips will help you create a healthy cooldown.

Make it gradual: Suddenly stopping or slowing down too quickly is not the right way to bring your body back to center. Doing so can cause dizziness, and in serious cases, lead to blackouts. Once you've completed your workout, start decreasing your pace incrementally over a period of three to five minutes to bring your heart rate back to normal and promote healthy blood and oxygen flow.

Don't skip the stretch: Stretching after cardio may feel like a luxury on a busy day, but this is the time to work on your flexibility since your muscles are already warmed up from your workout. Try this five-minute cardio cooldown. It targets your legs, back, hips, and shoulders, some of the most common places where serious tightness occurs.

This article was originally published in FitSugar.com

Prenatal vitamins

Prenatal vitamins are a complement to a healthy diet and not a substitute for good nutrition. Folic acid supplementation before and for the first three months of pregnancy is recommended as it reduces the risk of neural tube defects. An increase in calcium and iron is important for bone and red cell development.

Prenatal vitamins are supplements intended to provide nutrients that may be lacking in pregnant women or women who are trying to conceive diet. They are recommended for women who do not consume an adequate diet such as those on special diets, vegans, those who have lactose intolerance or multiple gestations. Well-nourished women may not need prenatal vitamins to satisfy their daily requirements. However, in the absence of a careful evaluation by a nutritionist, prenatal vitamins are recommended.

An adequate balanced diet for an expectant mother would include eating plenty of fruits, vegetables, whole grains and lean protein. In addition, fortified cereals are good sources of folic acid and calcium.

The vitamins prescribed before and during pregnancy are similar. Folic acid reduces the risk of neural tube defects. Calcium and iron are important for bone and red cell development.

A typical prenatal vitamin should contain at least 400 micrograms of folic acid, 30 milligrams of Iron and 250 milligrams of calcium. There is no difference between the dosage between the different trimesters.

If an expectant mother is allergic to vitamins she should avoid taking them and it would be prudent to see a nutritionist to assess and advice her on her diet. Taking the vitamin at night or with her preferred snack may help keep them down.

Expectant mother can purchase their prenatal vitamins can be obtained over-the-counter in pharmacies or at your doctor’s clinic. While they are generally similar, your doctor may recommend one that is specifically suited to your needs.

This article was contributed to Tab A Doctor by,

By Dr. Lubna Harharah, Specialist in Obstetrics & Gynaecology, The Obstetrics & Gynaecology Centre, a subsidiary of Singapore Medical Group.

What You Need to Know about Knee Pain

Knee pain is a really common pain and complaint for many people. There are several factors that can lead to pain in one’s knees, so having awareness and knowledge of their causes can lead to a more accurate diagnosis.

Knee joint

Our knee joints are made of four bones connecting – the femur (thigh bone), the tibia and fibula (the two bones of the calves) and the patella (the kneecap). The knee is divided into four compartments: medial and lateral tibiofemoral compartments, the patellofemoral compartment and the superior tibiofibular joint. Each of these compartments’ components can suffer from repetitive strain injury or disease.

What are the common injuries that cause knee pain?

Some of the injuries that causes pain in our knees include the following:

• Sprain (Ligament sprain)
• Medial collateral ligament
• Lateral collateral ligament
• Anterior cruciate ligament
• Posterior cruciate ligament
• Tear of meniscus
• Medial meniscus
• Lateral meniscus
• Strain (Muscle strain)
• Quadriceps muscles
• Hamstring muscles
• Popliteal muscle
• Patellar tendon
• Hamstring tendon
• Popliteal tendon

What are the common diseases that cause knee pain?

Some of the diseases of cause of knee pain include:

• Knee osteoarthritis
• Chondromalacia patella
• Baker's cyst
• Meniscal cyst
• Discoid meniscus
• Osgood-Schlatter disease
• Larsen-Johansson disease
• Knee rheumatoid arthritis
• Osteochondritis dissecans disease
• Synovial chondromatosis disease
• Tumors
• Ankylosing spondylitis
• Reiter's syndrome
• Tuberculosis arthritis
• Septic arthritis (Pyogenic arthritis)
• Osteomyelitis
• Hemophilic arthritis
• Gout (Gouty arthritis)

What are the common inflammations that cause knee pain?

• Bursitis of the knee
• Prepatellar bursitis - Housemaid's knee (most common)
• Infrapatellar bursitis - Clergyman's knee (Superficial infrapatellar bursitis and Deep infrapatellar bursitis)
• Semimembranosus bursitis
• Tendinitis
• Patellar tendinitis (Jumper's knee)
• Hamstring tendinitis
• Popliteal tendinitis
• Synovitis of the knee

What are the common deformities of the knee?

• Genu varum
• Genu valgum
• Genu recurvatum (Knee hyperextension)
• Knee flexion deformity
• Bipartite patella

Syndromes

• Patellofemoral pain syndrome (Runner's knee)
• Plica syndrome
• Iliotibial band syndrome

Fractures

• Femoral fracture
• Tibial fracture
• Patella fracture

Dislocations

• Patella dislocation
• Knee joint dislocation (Tibiofemoral joint dislocation)

Referred knee pain

Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is where if a patient has a heart attack but feels the pain in his neck, shoulders and back instead of his heart. Likewise, there can be pain that is referred to the knee that is related from another part of the body – the pain can come from one’s ankle, foot, hip joints or even lumbar spine (lower back).

Cold-induced Pain In Knees

A study in China concluded that knee pain is significantly more prevalent in people working in cold stores than in those in normal, non-cold temperature.

Another study concluded that 17% of adolescents with anterior knee pain (a common condition though mildly self-limiting) reported that their pain is associated with cold temperatures and cold weather. In the same study, the main activities that are associated with pain are sporting, stair climbing, walking and sitting. Some people also reported pain in their knees when it’s colder…and they also wear extra tights and warm pants in winter.

Cold-induce pain in the knee can also be caused by tenosynovitis of knee tendon, where exposure to cold can be either a causative or contributing factor. To add to this, there is also a known hereditary disease, which is the FCAS which is the familial cold autoinflammatory syndrome which often demonstrates pain in the knee. Cold weather may also aggravate pain in the knee which already has osteoarthritis, rheumatoid arthritis and fibromyalgia.

Pain due to immobility/lack of movements

People who are more sedentary or involved in lesser physical activity and work environment is yet another reason for developing pain in the knees. What happens is that decreased activity and movement weakens one’s knee muscles, and the lax muscles are unable to support the knee structure, causing increased bone-to-bone impact. Blood vessels may be compressed as well, causing painful conditions in the knee. As we grow older, the movement of the knee joint causes higher friction with nearby tissues and cartilages.

As age progresses the movement of the knee joint involves higher friction with adjacent tissue and cartilages.

Other causes of pain in the knees

• Ligamentous laxity
• Fat pad impingement
• Knee effusion
• Deep vein thrombosis
• Peripheral vascular disease

Implications for Physiotherapy and Deep Tissue Release / Sports Massage Therapy

It’s important that an accurate diagnosis is made for all knee-related pain and injuries, and physiotherapy and deep tissue release therapy to start as soon as possible. Treatment techniques may include specific strengthening to correct muscle imbalance, soft tissue massage, joint mobilization and ultrasound therapy. Other electrotherapy procedures such as heat therapy may also be used to accelerate healing and provide pain relief.

This article was contributed to Tab A Doctor by,

Ms Louise Yow, Hon. in Physiotherapy
Urbanrehab Pte Ltd
22 Malacca Street, Royal Brother Building,
#03-03 (RB Capital Building), Singapore 048980

8 Reasons to Drink Dandelion Root Tea

Next time you’re feeling bloated after a particularly heavy meal; make a glass of dandelion tea. This detoxifying delight will cleanse your liver and aid digestion! It's packed with loads of benefits like,

1. Improving digestion and aids weight loss.
2. Eases congestion of the liver.
3. Assists in purifying the bladder and kidneys.
4. Reduces the risk of urinary tract infections.
5. Contains calcium, magnesium, iron, zinc, potassium, vitamins B and C.
6. Helps to purify the blood, regulate blood sugar and improves blood circulation.
7. Eases bloating and aching joints.
8. Helps to cure skin conditions.

Pick up a box of this lovely tea at your nearest supermarkets or organic health food store, and drink it as a coffee substitute. You can even add in some unsweetened almond milk and cinnamon to taste.

Managing expectations in cosmetic surgery

Performing cosmetic procedures is an art, and part of the artistry actually comes down to understanding your patient well. It is not just the technical and surgical aspects of a case that are important, but the whole psychosocial wellbeing of the patient. One can do the most amazing treatment and the results may be flawless, but a patient may still feel inadequate or deem the subjective outcome unsatisfactory for a number of reasons.

The most common of these are patient psychological factors. I ask myself, "why did this patient seek a cosmetic treatment in the first place?" Was she or he insecure because other people, notably friends and family, levelled some criticism about his or her looks? If the need and motivation for a cosmetic treatment was grounded in what we call an 'external locus of control', the patient is more likely to be unsatisfied by the results. This means that the patient's need to look good is a result of wanting to please others around him or her, and his or her self-confidence is significantly determined by society at large. So to have the best result, you preferably should want to do the treatment to please YOURSELF, not someone else.

Next, I ensure that I 'under promise and over deliver'. This principle is often mentioned and is truly the best way to make patients happy.

In my experience, if I share medical knowledge with in a forthright and professional way, without embellishment or promotion, my patient is most likely to very happy post-procedure, sometime wildly happy.

I firmly believe that being frank about what they can achieve and even telling them outright that certain procedures are not suitable for them, results in a more loyal patient who will trust what you say and be happy with what you do for them. I often show them photos of average results rather than the most amazing results I have achieved.

This is important to adhere to the concept of 'under promise and over deliver'.

I take time to explore the patient's expectations. I would explain to my patients that everyone is unique, and what can be achieved in each person is hence also different. If an obese 60 year old lady comes in to my clinic and says she wants to look like a supermodel, red flags wave vigorously! If a patient has severe stretch marks post-pregnancy and expects a procedure to erase all of them, that's unrealistic. If the same patient understands that some improvement is possible but that stretch marks are relatively permanent, I would say that she is realistic. An example of realistic expectations in a liposelection patient, would be their hope that they would improve their body shape by 50% and fit better into their existing clothes.

It is a rather fine line though, and every cosmetic treatment from botox to a facelift has different results. If one treads carefully and presents options honestly, patients with unrealistic expectations will understand what they can achieve and can make an informed and hopefully, realistic choice.

In my clinical experience with about a thousand liposelection operations, the vast majority of patients are really reasonable and are excellent patients. So if you are a patient thinking of doing a cosmetic procedure, please start by looking inwards and understanding yourself better. Then find a doctor who you click with, has good credentials and extensive experience, and discuss your options in an open a frank manner. Both the doctor and the patient will benefit immeasurably by 'being on the same wavelength'.

This article was written for Tab A Doctor by:

Dr Kevin Teh, Medical Director, Singapore Lipo, Body & Face Centre, 

a subsidiary of the Singapore Medical Group 

Aesthetic Procedures Amongst Singaporean Men

I have had male patients from the age of 19 to 55 years old. The most common however are patients between 30 to 40 years old. They are from varied walks of life and are representative of middle-class Singapore society. They are often white collar workers and professionals. High powered executives, bankers and businessmen are not uncommon, but so are conservative civil servants, and even a smattering of students. They are often very well groomed and take much effort to upkeep themselves well.

They often come because their busy work schedules and hectic lives have started taking a toll on their faces and bodies. Wrinkles on the face, sagging cheeks are very common. Some also want to have a stronger and more defined chin or jawline. Some come because they need help losing weight, as I provide specialised weight loss programs for my patients. In fact, I have lost 12 kg in the last 2-3 months following this programme myself (without surgery). Of course the most often asked about issue is the flabby bulges on their tummies and assorted bits and bobs. The second most sought after treatment is what we affectionately call 'moobs' or 'male boobs'. Often my male patients actually do work out regularly at the gym but can't see results. In some cases, they come seeking my expertise in a very special procedure called Hi-definition liposculpture that not too many doctors in the world can perform. This is where i precisely & artistically emphasise the guy's six-pack abdominal muscles and v-shaped torso.

One or two patients were quite unusual cos they came asking for their bums to be reduced in size cos they wanted to fit into swim pants and not look like a J.Lo wannabe. Another fellow was quite a funny because wanted his penis to be bigger and asked me to transfer fat from his tummy to his penis (I turned him down flat, as that is not a good treatment, and I practice quite mainstream conservative safe surgery). They mostly come themselves and are doing this for their own satisfaction.

I find that men in general, are actually MORE upfront about their procedures done than the women. Men are open and willing to speak about what they have done and often don't try to hide it from their family members or friends. In fact they often bring their wives or partners along for subsequent visits once they have tried one treatment and had good results. I have quite a number of male couples who do lipo as a pair in fact.

I think only a handful has tried to hide their treatments from the wife of girlfriend. As we often keep close contact with our patients & give them a follow-up phone call post-procedure, we had one male patient request us not to call his home at all because he didn't tell his wife. He would quietly come when his wife didn't know. I hope his wife didn't think he was having a clandestine affair!

That fellow was a rare exception, and I like many of my male patients because they are very open. They are also decisive when deciding on a treatment, and are often more motivated than the ladies to make sure they follow medical instructions. They are appreciative of the care that goes into their treatment and aim hard to maintain their results for the long-term.

Top three most popular procedures that men in their 20s and 30s request at the clinic:

• Hi definition VASER liposculpture for six-pack abs
• Chin enhancement
• Male breast reduction

This article was contributed to Tab A Doctor by:

Dr Kevin Teh, Medical Director
Singapore Lipo, Body & Face Centre, a subsidiary of the Singapore Medical Group
10 Sinaran Drive, #08-05/06, Novena Medical Centre, Singapore 307506

In-Vitro Fertilization (IVF)

In-vitro fertilization (IVF),

colloquially known as “test-tube baby”, is a form of assisted reproduction whereby the woman’s egg is fertilized by the man’s sperm in the laboratory. After fertilization, the resulting embryo is transferred to the woman’s womb.

While in theory IVF is not a complicated process, the couple has to be both physically and psychologically prepared as they are put through a strict regime to maximize the chances of successful fertilization and conception.

To begin the process of IVF, the woman will need to have daily injections to stimulate the eggs in her ovaries to grow. She will also need to undergo regular ultrasound scans and blood tests to monitor the growth of the eggs. When the eggs are matured and ‘ripe for picking’, they are retrieved from the woman’s body using a fine needle under ultrasound scan guidance. The eggs are then fertilized by the husband’s sperms. Successful fertilization will result in embryos. The embryos are in turn monitored for at least two days. Two, sometimes three under certain conditions, healthiest embryos are then transferred to the womb.

While IVF would seem to be an attractive proposition to many, IVF is definitely not a panacea to address all subfertility woes. It may not be suitable for some couples. Not only the medical indications for starting IVF must be valid, the couple must be both physically and emotionally strong enough to see each other through the journey with its attendant vicissitudes. Every stage of IVF is filled with anxiety for the couple. Depending on the outcome at every step, the hopes and mood of the couple may either be lifted high or plummet low, not unlike a psychological roller-coaster ride.

As the eggs are being stimulated, every single egg that is growing is a source of hope for the couple. However, not all eggs that grow in the ovaries will turn out to be matured eggs of good quality. Hence, the first dampener for the couple may be to learn that the number of usable mature eggs after retrieval may not correlate with the number of eggs being tracked on the scans.

Secondly, not all eggs that are fertilized will grow and develop into embryos. So the second reality check comes when the couple is told that the number of good embryos may be less than the number of eggs fertilized. The day the good embryos are eventually transferred into the womb is when the couple will likely be at the peak of mixed feelings. Having an embryo in the womb is the first step that the woman comes close to being pregnant even as the couple will pray very hard that the embryo will implant and grow. A positive result for pregnancy two weeks after the transfer of embryo in the womb will be the news the couple is hoping to hear.

Carrying twins is actually a high risk pregnancy that has many associated risks and complications. As the human body is more suited for the growth and development of one baby at a time, the main problem with conceiving twins is premature delivery. Premature delivery is defined as delivery before 37 weeks of pregnancy. On the average, twin pregnancies last 36 weeks before the mother goes into spontaneous labour.


This article was contributed to Tab A Doctor by By Dr Chee Jing Jye.

Prostate Cancer

"Prostate cancer is the 3rd most common cancer among Singaporean men. Prostate specific tumor antigen (PSA) blood testing can be done in men with symptoms suggestive of prostate cancer or in men at high risk of developing prostate cancer."

Causes

The cause prostate cancer is not clear.
A combination of factors may play a role in prostate cancer such as family history, ethnicity, hormones, diet and the environment.

Risk factors

The main risk factors include:

• Age. The risk of prostate cancer increases after the age of 50 years.
• Race or ethnicity. Dark skinned men have a higher risk of developing and dying of prostate cancer.
• Family history of prostate cancer increases the risk of prostate cancer.
• Diet. A high-fat diet and obesity may increase your risk of prostate cancer.
• High testosterone levels in men who use testosterone therapy.

Symptoms

In the early stages of prostate cancer, there may be no symptoms.
In the later stages, symptoms of prostate cancer may include urinary symptoms such as:

• Difficulty passing urine or slowing of the flow of urine to a trickle
• Decreased force in the stream of urine
• Blood in your urine or semen

Advanced prostate cancer which has spread to:

• Bones may cause bone pain, fractures and compression of the spine.
• Lymph nodes may cause swelling of the leg or discomfort.

Diagnosis

These include:

• Digital rectal examination (DRE) to detect any abnormalities in the texture, shape or size of the prostate gland.
• Prostate-specific antigen (PSA) test involves taking a blood sample from a vein and testing for PSA, a substance that is naturally produced by the prostate gland to help liquefy semen. High levels will warrant further investigation.
• Tran rectal ultrasound to detect any abnormalities in the prostate gland.
• Prostate biopsy involves taking thin sections of tissue from the prostate gland.

Additional tests include:

• Bone scan
• Ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)
• Lymph node biopsy

Complications

The typical complications of prostate cancer and its treatments include:

• Spread of cancer to nearby organs or travel through the bloodstream or lymphatic system affecting the bones or other organs.
• Pain when the cancer spreads to bones it can cause excruciating pain.
• Difficulty urinating (urinary incontinence).
• Erectile dysfunction (ED) or impotence.
• Depression after a diagnosis of prostate cancer or after trying to cope with the side effects of treatment.

Treatment

The most common treatments for prostate cancer include the following:

• External beam radiation therapy: uses high-powered X-rays to kill cancer cells.
• Radioactive seed implant: also known as brachytherapy, deliver a higher dose of radiation than do external beams.
• Hormone therapy: using drugs to stop the body from producing the male sex hormones testosterone, which can stimulate the growth of cancer cells.
• Radical prostatectomy: surgical removal of prostate gland is used to treat cancer that is confined to the prostate gland.
• Chemotherapy: uses drugs to destroy rapidly growing cancer cells.

Prevention

Prostate cancer cannot be prevented. In general, men are advised to make choices that benefit their overall health such as regular exercise, avoiding high-fat diets, and consuming fruits and vegetables rich in antioxidants.

The established risk factors are increasing age (>50 years), family history and ethnicity (African). So, men aged over 50 years with a normal risk of prostate cancer should discuss with their doctors the risks and benefits of prostate cancer screening. Men who have a strong family history, for example, a brother or father with prostate cancer should be aware of the symptoms of prostate cancer, and discuss management options with their doctor.

This article was originally published on http://www.hpb.gov.sg