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September 2017

Harnessing innovation in public health

A contributed article by Dr Heidi Larson, Director and Dr Neisha Sudaram, Research Fellow of The Vaccine Confidence Project (VCP) at the London School of Hygiene & Tropical Medicine, UK outlined the role of innovation in healthcare by giving the example of how vaccines have helped tremendously in medicine. As part of the article, the authors referenced the 2nd Raffles Dialogue, which they had participated in. The event was hosted last week by the National University of Singapore schools of medicine, public health and public policy, and NUHS, and focused on "The Critical Role of Innovation" in the context of the broader theme of "Human Well-being and Security in 2030".



August 2017

Is acute aortic dissection the most dangerous heart disease

Professor Tan Huay Cheem, Director of the National University Heart Centre Singapore shared about acute aortic dissection, symptoms of the disease and how to diagnose and treat this cardiovascular disease. According to a study, the main cause of acute aortic dissection is hypertension and the average age of patient is 62 years old.


The Heart of Service

As part of NUP’s recruitment campaign, Dr Chua Ying Xian was profiled and he elaborated on his experience as a family physician at Pioneer Polyclinic and why it is rewarding.


Putting Singapore on map of medical advances

Prof Lee Eng Hin, Chief Advisor for NUHS’ Summit Research Programmes contributed an article about the current Singapore research environment in Singapore and how it is conducive for nurturing clinician scientists. He gave examples of how the formation of academic medical centres such as the National University Health System (NUHS) and research initiatives like NUHS’ Summit Research Programmes have created an environment for clinician scientists to thrive. He urged young talent to take up the clinician scientist role and lead the charge in building a healthier future.  


Found - Molecule that stops heart from self-healing

Scientists from A*STAR’s Genome Institute of Singapore (GIS) and the National University Health System (NUHS) have discovered a chemical compound in mice that prevents heart muscle cells from repairing themselves. If it can be blocked, heart muscle cells can regenerate, like skin cells, and the heart may be able to heal itself. The study was led by Associate Professor Roger Foo, principal investigator at GIS, and at NUHS' Cardiovascular Research Institute as well as senior consultant at the National University Heart Centre, Singapore.


Caring for patients at home through the phone

Hospitals, polyclinics turn to remote services to better track their conditions, reduce visits by their patients. The National University Health System (NUHS) plans to add to its existing services to monitor patients' medical conditions in their own homes later this year.



Love of food, lack of activity leave Singaporeans vulnerable to diabetes

Assistant Professor Mary Chong and Associate Professor Rob M van Dam, from NUS Saw Swee Hock School of Public Health, wrote a commentary on diabetes and the possible reasons Singaporeans were may be particularly vulnerable to diabetes. They opined that this was due to the abundance of easily accessible and mostly affordable food and physical inactivity.  


Use of alternative medicine does more harm than good: Studies

Two studies acknowledged the use of complementary and alternative medicine (CAM) by patients to get well and concluded that CAM may sometimes do more harm than good.  One of the studies is led by Dr Chong Wan Qin, an Associate Consultant Oncologist with the National University Cancer Institute, Singapore (NCIS) shows that if there are decision aids, it may reduce the use of CAM among cancer patients and encourage them (the patients) to discuss the use of CAM with their oncologists, while undergoing chemotherapy treatment.


He quit smoking after finding out he had cancer

An NCIS patient, Mr Koh Teck Hoe, a colorectal cancer survivor, adopted a healthier lifestyle and quit smoking after finding out that he had cancer. Dr Tan Ker Kan, a consultant with the division of surgical oncology (colorectal surgery) at the National University Cancer Institute Singapore, advised  people to go for early screening as it would improved survival outcomes.

Thryoid Cancer

Dr Ngiam Kee Yuan , Consultant, Division of Surgical Oncology (Thyroid and Endocrine Surgery), NCIS shared about thyroid cancer and its treatment options.


July 2017

Chemo at home helps cancer patients cut disruptions to daily life

APN (Dr) Lee Yee Mei, Assistant Director of Nursing and Assistant Nurse Clinician Chen Litang shared about our chemotherapy home-care programme. A patient’s caregiver, Mdm Syaida also shared her positive feedback regarding the programme. 


Exercise Therapy Centres to be set up in hospitals

An Active Centre will open next year at Alexandra Hospital. This is a partnership between SportSG and NUHS, providing exercise therapy for patients from its chronic and metabolic disease clinics to complement the usual medical treatment.



Cure for hepatitis B around the corner

Prof Lim Seng Gee (Senior Consultant, Division of Gastroenterology & Hepatology) shared an opinion article on the conditions and cure for hepatitis B, and how a cure was close at hand. Prof Lim commented on the spread and dangers of the disease and how a research study at NUH is seeking 2,500 volunteers with chronic hepatitis B to help gain better insights on the disease. A panel of blood tests, ultrasounds and other scans are provided at no cost to the patients for five years.


Coffee, a health drink or an unhealthy addiction

Associate Professor Rob M van Dam from NUS Saw Swee Hock School of Public Health, a member of the National University Health System, wrote a commentary on the pros and cons of coffee consumption. His expert opinion comes on the back of the findings of a recent study showing that those who drank about three cups a day tended to live longer than non-coffee drinkers.



New Polyclinic in Jurong lives up to its Pioneer name

The newly opened Pioneer Polyclinic - the first new polyclinic to open in more than 10 years - featured several pioneering features. These new features included an automated pharmacy registration process, and a system to pair its patients with chronic diseases, like diabetes, with a dedicated care team to improve the care that these patients receive. Dr Lew Yii Jen, Chief Executive of National University Polyclinics said that the polyclinic was ramping up the number of care teams to take care of as many as 30,000 patients with chronic conditions in about three years’ time.

New way to detect heart failure that’s hard to diagnose

A local study by the NUHCS on about 657 women and men, discovered the thymosin beta-4 (TB4) protein is elevated in women with a form of heart failure called preserved ejection fraction or HPpEF. The protein could also be used clinically as a biomarker in the future to predict if a patient is responding to treatments.

Assistant Professor Chester Drum, Consultant Cardiologist, NUHCS, is the lead investigator in this study.



Blood tests may not detect cancer earlier

Many people have the misconception that they need to do cancer or tumour marker tests to screen for cancer. A blood-cancer marker is a substance produced in the body by cancerous cells. It is also made by some normal cells, although the levels tend to be much higher when there is cancer. 

However, such tests are generally considered to be of uncertain value. Dr Lim Siew Eng, a senior consultant at the haematology-oncology department at the National University Cancer Institute, Singapore, shares why blood test should preferably  not be used in place of recommended screening tests for cancer.





June 2017

Breast, Prostate Cancers rising sharply in Singapore

Breast and prostate cancer incidences have risen two-fold and five-fold, respectively over the past 40 years, based on the latest cancer registry report. However, better treatment regimes have also resulted in better survival rates for breast cancer patients. Overall, colorectal cancer is still the top cancer in Singapore. Dr Tan Ker Kan, Consultant, Division of Surgical Oncology (Colorectal Cancer), NCIS, is quoted sharing that colorectal cancer is affecting patients younger than 55 years old. Dr Tan’s study on “Young colorectal cancer patients often present too late” was shared with the Straits Times. Dr Tan explains that there is an urgent need to raise awareness among younger adults and it is possible to have colorectal cancer at a younger age and to seek medical help earlier, as early detection means better outcomes. 


“Should you eat before you exercise”


Conventional advice tells us to eat before exercising. However, many believe that working out on an empty stomach promotes fat burning, and consequently more effective weight loss. Medical experts in physiology and nutrition as well as fitness trainers explain that while exercising in a fasted state does help with burning fat, it is crucial to have adequate food intake prior to a workout to ensure that the body has enough energy to sustain itself – this is especially so for intensive workouts. The key to effective weight loss lies in controlling one’s food intake while taking the type of workout and the energy spent as a guide.


The latest guide to preventing and treating hyperlipidemia

防治高血脂症的最新指南 (The latest guide to preventing and treating hyperlipidemia)

Professor Tan Huay Cheem, Director of the National University Heart Centre Singapore, shared the latest guide by MOH on prevention and treatment of hyperlipidemia and urged readers to follow the MOH guidelines if they are unsure.

He cautioned readers not to trust "false news" on the internet from the many so-called “medical authority” advocating heart disease patients not to take statins to control their cholesterol levels. Many of these “false news” exaggerate the side effects of statins which claim to lead to kidney failure, dementia and so on.


There are numerous large-scale clinical studies which have confirmed that statins are prescribed for patients to lower their total cholesterol levels and reduce their risk of a heart attack or stroke. Their side effects are generally well tolerated.





May 2017

Private health sector urged to digitise records

Speaking at the National Health IT Summit 2017, Health Minister Gan Kim Yong urged the private health sector to speed up digitising patients' health records and be part of a national scheme to share patient information with other doctors when needed. In his speech, he also praised NUHS for using data to identify cost- effective clinical practices, reduced unnecessary variations and improved both cost and clinical outcomes. Associate Professor James Yip and Dr Keith Lim lauded at the event, winning the award for NUHS Value Driven Outcome in the category IT Excellence : Beyond Quality to Value. 



DocTalk: Zipper malfunction translated into cures

Associate Professor Allen Yeoh, discussed about childhood leukaemia and chemotherapy drug, mercaptopurine.


First-degree relatives must do early colonoscopy

First degree relatives of cancer patient are at increased risk of colorectal cancer as compared to the general population. Colonoscopy rates amongst the first degree relatives remain dismal. The study by Dr Tan Ker Kan, Consultant, Division of Surgical Oncology (Colorectal Cancer), NCIS explores the various issues amongst the patients and their first degree relatives precluding their adoption of screening colonoscopy.




April 2017

Prevention is always better than cure when it comes to your heart

You have signed up for a marathon and you aim to complete the race. You have set your targets and that should include going for pre-participation screening (PPS).

PPS is important as it aims to detect heart conditions that are potentially life-threatening, especially during physical activities.


New treatment extends the life of late-stage stomach cancer patients

NCIS has come up with a new treatment, using Intraperitoneal Chemotherapy for patients with late-stage stomach cancer. Under this targeted treatment, the chemo fluid will be inserted directly into the stomach area. Of the 22 patients who participated in the clinical trial, more than half of the patients had their lifespan extended more than 16 months, which was comparatively longer than the usual three to six months for such patients undergoing the traditional treatment. Prof Jimmy So, Head & Senior Consultant, Division of Surgical Oncology, National University Cancer Institute, Singapore (NCIS) will share more details here.


Science Briefs - Cardiac Disease-Dementia link found

A team of cardiovascular and brain researchers from the NUHS have uncovered a link between cardiac diseases and tiny brain lesions commonly found in patients with cognitive impairment or dementia. They found that the presence of tiny brain lesions, called cerebral microinfarcts (CMIs), was strongly associated with cardiac disease and blood cardiac biomarkers - molecules or genes linked to the condition. Associate Professor Christopher Chen, director of NUHS' Memory Ageing and Cognition Centre said the findings suggest that the development of these tiny brain lesions, which are closely linked to diseases like dementia, may be caused by chronic heart problems and vascular disease. Apart from signalling problems with the heart, cardiac biomarkers are also indicators of injury to circulatory and blood vessel systems in other organs, for example the brain, said Prof Arthur Mark Richards, director of NUHS' Cardiovascular Research Institute.



March 2017

Drug combo doubles myeloma survival rates

A first-of-its-kind multi-centre, multi-country clinical trial on multiple myeloma cancer established by the National University Cancer Institute, Singapore (NCIS), has produced positive outcomes, benefiting patients not just in Singapore but in Asia. The first clinical trial, which is called AMN 001, is initiated by NCIS is for patients who failed available standard treatment. The results of the trial showed that about 50% of the patients have their survival rates prolonged to 14 months or longer. This is more than double their previous average survival rate in this type of patients.


Making it harder for youth to light up

Prof Chia Kee Seng, Dean, Saw Swee Hock School of Public Health, commented on how youth are more susceptible to nicotine dependency and supported the move to raise the minimum legal age for smoking from 18 to 21. The Health Ministry outlined several reasons for taking this step, including the fact that regular tobacco use is usually established between 18 and 20 years of age.  


zbNOW carried an advertorial by the Ministerial Committee of Ageing (MCA) on understanding dementia. It also carried an accompanying article on how the onset of dementia can be prevented or delayed through a balanced diet, regular exercise, regular social interaction and maintaining an active mind. Prof Kua Ee Heok, Senior Consultant Psychiatrist, NUS Yong Loo Lin School of Medicine, and Dr Ng Li-Ling, Senior Consultant, Psychological Medicine, Changi General Hospital (CGH) emphasised the importance of early prevention and intervention to lower one’s risk of dementia. 


Research based on data from the Singapore Chinese Health Study, with over 37,000 Chinese male and female participants, has found that participants consuming the highest levels of dairy products were 7% less likely to be diagnosed with hypertension than those consuming the least, and daily milk drinkers (mostly one glass per day) were 6% less likely than people consuming no milk, to be diagnosed with hypertension. The study, led by Prof Koh Woon Puay from Duke-NUS Medical School and NUS Saw Swee Hock School of Public Health, was published in the February 2017 issue of the Journal of Nutrition.

Addressing the unmet needs of high risk cholesterol patients

The Dyslipidemia International Study (DYSIS), which was carried out in thirty countries worldwide, looked at the level of low-density lipoprotein cholesterol (LDL-C) target attainment in patients on lipid-lowering therapy. DYSIS II, which was also carried out in Singapore, studied LDL-C targets achievement in patients with acute coronary syndrome (ACS) and stable coronary heart disease (CHD).


Associate Professor Dr Poh Kian Keong, who was one of the investigators of DYSIS and Clinical Director of Research, Department of Cardiology, National University Heart Centre (NUHCS), comments on the results of DYSIS and what this means for patients in Singapore. This may call for more effective lipid lowering therapies, such as combination therapy in order to improve patients’ outcomes.



February 2017

Torching food popular, but overcooked food is harmful

A new health campaign in the United Kingdom seeks to raise public awareness  on how browned food generally contains cancer-causing chemicals and poses health risks. As the trend of torching food catches on in Singapore, Professor Jeyakumar Henry, Director of the Clinical Nutrition Research Centre, a collaboration between the A*STAR’s Singapore Institute for Clinical Sciences and the National University Health System, explained to readers the science behind charred foods, its possible effects on health, and gave advice on eating healthier.



It is important for women with a family history of cancer to go testing early and identify if they have a BRCA mutation, so that they can go for regular screening and intervene necessarily.  According to Dr David Tan, Consultant, Department of Haematology-Oncology, National University Cancer Institute, Singapore (NCIS), genetic testing was beneficial not only for the patient, but also for the patient’s family. This is because if a person is tested to have a BRCA mutation, her children will also have a 50% chance of having the mutation as well. In such cases, it would be ideal to have early screening and detection to minimise the onset of cancer.


A shot in the arm for HFMD vaccine research

Singapore is one step closer to developing a vaccine against hand, foot and mouth disease (HFMD).

 Thanks to a comprehensive study of the HFMD virus, enterovirus 71, led by Assoc Prof Justin Chu of NUS Yong Loo Lin School of Medicine, who uncovered how the virus replicates within cells.

 The findings pave the way for vaccine development against the disease, which is highly prevalent here. In 2016, 42,154 people have been affected by HFMD. From the start of the year until 11 Feb, a total of 3,421 people have contracted the virus.



According to Prof Tan Huay Cheem, Director of National University Heart Centre, Singapore, treating cardiovascular disease will have new changes with subcutaneous injection of drugs soon. Subcutaneous injection of drugs for heart diseases will be more convenient and it can be developed into a "painless" state, easier for patients to adapt. There will be new generation of stents and pacemakers which will be safer and more innovative for patients to use too. 


Silver Linings, even as childhood cancer rates rise

Childhood cancer has been on the rise in Singapore cancer and experts have referred to the theory of ‘ delayed infection’ hypotheses . It states that delayed exposure to infections due to an increasingly hygienic environment may affect how children’s immune system mature. Fortunately, progress made in cancer treatments  have made it possible for young patients to receive a more personalised treatment regimen with less side effects but an improved survival rate. 



January 2017

Babies with eczema at higher risk of tooth decay

A recent GUSTO (Growing Up in Singapore Towards healthy Outcomes)  study led by the NUS Faculty of Dentistry, and the Singapore Institute for Clinical Sciences (SICS) of the Agency for Science, Technology and Research (A*STAR), uncovered the association between eczema in infants and the increased risk of tooth decay in early childhood. Tooth decay and eczema are among the most common childhood diseases, and the findings will give parents and caregivers of babies with eczema early warning in order to minimise the incidence of tooth decay in these children.


The Wonders Of Medical Research

Medical research may pave hope for acute leukaemia patients, thanks to stem cell transplants.  Dr Michelle Poon, senior consultant at the Department of Haematology-Oncology, National University Cancer Institute, Singapore, shared that with more research and selfless donors coming forward,  acute leukaemia patients may receive the priceless “gift of life” .



Dr Ivan Tham, Head and Senior Consultant, Department of Radiation Oncology, National University Cancer Institute Singapore (NCIS) provided answers to a Lianhe Wanbao reader’s questions about lung cancer. The reader asked about the treatment for her 52-year-old husband, who was diagnosed with lung cancer, and if smoking and lung cancer were related.


与糖尿病作战 从自身开始

The article, written by Prof Tan Huay Cheem, Director of NUHCS, is the second part of his column about curbing diabetes and how diabetes can be linked to heart diseases. He shares that diabetes is caused by long-term bad eating habits and unhealthy lifestyle. Making adjustments to lifestyle changes such as more exercises, diet and weight control are the most basic aspects to combat diabetes. Diabetic patients with any suspicious cardiac symptoms, should seek medical advice as soon as possible.