MMRV vaccinations
IPC’s Dr Mark Loh recommends vaccinating your child and yourself against common infections not limited to childhood.
A child’s maturing immune system makes them highly susceptible to contagious diseases. Common childhood viral infections such as measles, mumps, rubella (German measles) and chickenpox (varicella) still carry high morbidity despite high levels of medical care – and are only preventable through vaccinations. Also, women infected with either rubella or chickenpox during early pregnancy run the risk of miscarrying, or delivering a baby with severe birth defects. Millions of children in developing and developed countries succumb to the severe effects of measles every year. Mumps is less severe, but can create serious complications – such as inflammation of the brain lining, testes or pancreas. And while rubella is mild, it’s still highly infectious in kids. For the past 20 years, millions of doses of the MMR vaccine has been given to effectively reduced these diseases worldwide, especially when administered as two doses prior to a child attending school.
Although chickenpox is traditionally regarded as a mild childhood disease, in reality it’s serious and can even be deadly. Almost anyone can be affected by chickenpox at some point as the virus is highly infectious and can also reoccur as shingles later in life. The risk of shingles is reduced with immunisation, rather than natural infection, so a varicella vaccination is strongly recommended for both children and adults. A single dose is 95 percent successful in preventing infection in childhood and 85 percent successful in adolescents and adults. But to boost immunity and further reduce the occurrence, severity and length of breakthrough infections, a second dose is recommended – particularly for children aged four to six years.
The new combined MMR/Varicella vaccine (MMRV) – approved for use in many countries, including Singapore – is as effective as the two separate vaccines, but is delivered as one injection. It can also be safely co-administered with other vaccines such as diptheria-tetanus-pertussis. While a slightly higher incidence of low-grade fever is seen with the first dose of MMRV, high temperatures, rashes and general symptoms remain uncommon and comparable to separate vaccinations.
Dr Mark Loh, Paediatric Specialist
An Aberdeen University graduate, Dr Loh has worked in Nottingham, London and KK Women and Children’s Hospital in Singapore. His interests include emergency paediatrics, neonatology, asthma and infant nutrition and development.
Travel tips to reduce jet lag
IMC’s Dr Alex Hoyes-Cock lists travel tips for reducing jet lag.
Jet lag is caused by a disruption in your internal body clock that regulates sleep and wake time, temperature, blood pressure and hormone secretion. It commonly manifests as insomnia resulting in daytime fatigue, lack of concentration, temporary memory loss, anxiety, nausea, constipation, diarrhea, dehydration, headaches and irritability.
Jet lag can affect anyone who has travelled over more than four time zones, with the severity and duration varying according to your travel route. The most severe symptoms occur if you fly east – for example from London to Singapore – because you “lose” time, resulting in insomnia lasting several days. If you travel west, jet lag may be experienced within the first 24 hours, causing you to wake too early in the morning. The least amount of jet lag is experienced when flying north or south within the same time zone. Physical and emotional stress such as illness or a busy work schedule can further exacerbate jet lag.
How to avoid jet lag
1. If you have a medical condition that requires monitoring, such as diabetes or hypertension, consult your physician and plan a coping strategy including medication schedules and doctor’s appointments tailored to your destination’s time zone.
2. Board your flight in a relaxed, well-rested state.
3. Remain hydrated with nonalcoholic beverages. Avoid caffeine, it’s dehydrating and can disrupt sleep schedules.
4. Move about and be active or if seated, exercise your legs sporadically. You’ll revitalise and refresh your body, ward off stiffness, ease jet lag symptoms and reduce the risk of developing a blood clot.
5. Upon arrival, synchronise your watch to local time and adjust your meal and sleep routines accordingly. Expose yourself to natural, outdoor light as much as possible. Sunlight cues your brain to reduce the production of sleep-inducing melatonin during the day, resetting your internal clock.
6. Avoid sleeping pills. If this proves difficult, try melatonin, a naturally-produced, over-the-counter hormone which regulates your daily body rhythms. Doses between 0.5mg and 5mg should be taken one hour before bedtime. As the safety of melatonin use in children has not been established, do not give to children.
7. Use prescribed sleeping pills, such as zolpidem (Ambien) or diazepam (Valium), wisely. They may treat insomnia in the short term, but prolonged use results in dependence and you’ll be unable to fall asleep without them.
Dr Alex Hoyes-CockDr Alex Hoyes-Cock trained in anaesthetics and emergency medicine at the Singapore General Hospital for five years before moving to Singhealth polyclinics where he worked for 14 months, before recently joining IMC. He has a special interest in pain management, tropical medicine and endocrine disorders.
Brace yourself for a great smile
Dr VicPearly Wong of SMILEFOCUS reveals how today’s orthodontic treatments needn’t hamper your lifestyle or appearance.
Your smile is a reflection of who you are, which is why if you’re unhappy with your smile you may suffer from low self-esteem. But enhancing your smile is easy and a slew of options, including whitening, veneers and even orthodontic treatments, are now available.
Teeth and gums are essentially the same in adults and children, so an orthodontic treatment to realign crooked teeth or correct an overbite is appropriate for anyone, regardless of age. Correcting your bite can improve your smile tremendously and wearing braces no longer means compromising your appearance. While conventional metal braces are still an option, modern techniques and materials have given rise to more stylish options.
Your smile is a reflection of who you are, which is why if you’re unhappy with your smile you may suffer from low self-esteem. But enhancing your smile is easy and a slew of options, including whitening, veneers and even orthodontic treatments, are now available.Teeth and gums are essentially the same in adults and children, so an orthodontic treatment to realign crooked teeth or correct an overbite is appropriate for anyone, regardless of age. Correcting your bite can improve your smile tremendously and wearing braces no longer means compromising your appearance. While conventional metal braces are still an option, modern techniques and materials have given rise to more stylish options.
Modern braces have ceramic or clear brackets which are less obvious, blend naturally with your tooth colour and work significantly faster than conventional braces. An example is self-ligating braces with brackets that have a “trap door” to hold the wire, allowing your teeth to move more freely, quickly and comfortably due to less friction. This is significantly different when compared to conventional braces, which have metal ties holding the arch wire to the bracket. Another option is Invisalign or “invisible braces”. This series of individually-customised clear aligners gradually straightens teeth without metal or wires. Because they’re made from clear, strong, medical grade, non-toxic plastic they’re virtually unnoticeable when worn. Each aligner moves teeth incrementally and is worn for about two weeks, then replaced with the next in the series, until the final position is achieved. Length of treatment can vary – a simple alignment of the front teeth can be achieved in a few months, while substantially misaligned teeth may take up to 18 months or more to correct.
A beautiful smile can increase your self-confidence and sense of wellbeing. With orthodontics you’ll notice dramatic improvements in both your smile and profile. Look years younger just by straightening crooked teeth or correcting a misaligned bite. Consult your dentist for an assessment today. You’re never too old to wear braces and you deserve to enjoy your smile for the rest of your life!
Invisalign benefits
• Almost invisible Straightens your teeth inconspicuously.
• Removable Eat and drink whatever you desire. Brush and floss normally.
• Pretreatment guarantee Your virtual treatment plan gives you a sneak peek at your “new” smile, once treatment is completed.
Dr VicPearly Wong BDS (
FRACDS (
FAMS (
Dr VicPearly Wong specialises in surgical and non-surgical orthodontic treatment. She is trained in cleft palate management and surgical correction and also has a special interest in modifying and monitoring children’s dental development.
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