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  • Paragon Medical Singapore
    and popular American actress Lucille Ball It was a vascular condition called Aortic Aneurysm which is the enlargement of the largest artery of the body the Aorta to more than 1 5 times of its normal diameter The condition is extremely dangerous especially when the Aneurysm is bigger than 5cm At this size the risk of it rupturing is much higher than the risk of surgically repairing it The dangerous thing about Aortic Aneurysm is that it is very insidious Most of the time there are no signs or symptoms until the vessel bursts By then it s usually too late explains Dr Cheng Shin Chuen consultant vascular surgeon at the Pacific Vein and Endovascular Center Once it bursts we re looking at a 90 death rate before the patient reaches the hospital As for the 10 who are lucky enough to make it to the hospital it s likely that half of them will die Repairing An Aortic Aneurysm Traditionally major surgery is required to repair an Aortic Aneurysm However major surgery brings with it a high risk of stroke heart attacks and other serious complications Fortunately with the advancements in technology surgeons are now able to replace the open surgery with a minimally invasive procedure called Endovascular Aneurysm Repair EVAR EVAR involves small cuts in the patient s groins and through these cuts the stent device is deployed in the patient s Aneurysm to seal it off and to prevent it from rupturing If the patient is suitable the whole procedure can even be done percutaneously and under local anaesthesia meaning there will be no cuts on the groin and patients can have a quicker recovery The advantages of EVAR says Dr Cheng is that it can minimise ICU stay time speed up recovery time and decrease complication risks that may occur The treatment can also be extended to patients who are older and less fit as compared to open surgery It s still a high risk procedure with about 5 risks For elderly patients with multiple medical problems the risk increases to 10 But we need to bear in mind that these patients cannot go for open operation so there is only one treatment option available Patients need to weigh the risks procedural risks of 10 versus 95 if the vessel bursts Dr Cheng states Patients with a family history hypertension high cholesterol high blood pressure and those beyond the age of 65 have a higher risk of developing this condition Unfortunately Dr Cheng adds there is no medication available to prevent Aortic Aneurysm from happening Early Detection Is Key The key to beating Aortic Aneurysm is through early detection and treatment The only thing that can change the outcome is to get screened find it early and get it treated early In Asia unfortunately there is very little awareness and Asians generally do not like getting any invasive procedures done Patients tend to delay and wait longer Dr Cheng is one of less than 10 trained

    Original URL path: https://www.paragonmedical.com.sg/articles/care-for-arteries-and-veins (2016-01-30)
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  • Paragon Medical Singapore
    work by restoring lost collagen for areas such as nasolabial folds folds next to the nose tear trough or nasojugal grooves groove lines under the eye marionette lines lines running from the corner of mouth to the chin and malar groove groove under the cheeks Fillers can also be used for volume augmentation of the chin and cheek as well as to enhance the shape of the lips and nose Newer methods of injection can also affect a facelift Hydrolifting and tightening of the jowls which are popular with patients who want to see an immediate lifting result without surgery On the other hand there are injectables like botulinum toxin that work by temporarily weakening the over contracted muscles that cause the skin surface to look old and stressed so that the skin relaxes and wrinkles and lines become less noticeable This injection is widely used in facial enhancement such as for elimination of frown lines and forehead wrinkles unfolding crow s feet smile lines around the eyes marionette lines lines from corners of mouth to chin bunny lines nasal scrunch excessive sweating palm armpit etc facial contouring square jaw chemical brow lift hypertrophic orbicularis prominent lower eyelid perioral lines What can I expect during and after the treatment Injectable treatments are fast to do are typically performed with topical anesthetic cream for patient comfort There might be temporary bruising at the injection site which can be concealed if necessary How long will the results last How long the results last depends on the type of injectable used and the area that is being treated Botulinum toxin usually lasts between 4 6 months while fillers can last up to 2 years Thermage Thermage is the only FDA approved non invasive treatment proven to tighten loose or saggy skin producing a

    Original URL path: https://www.paragonmedical.com.sg/articles/non-invasive-facial-rejuvenation (2016-01-30)
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  • Paragon Medical Singapore
    appearance Dental Implants An implant comprises 3 parts The first part or fixture which is made of titanium is placed within bone The second part or abutment emerges through the gums and is used to carry the 3rd part which is the crown bridge or denture depending on how many teeth are missing After decayed or fractured teeth are removed the implant is surgically placed in the jawbone and allowed to heal During this time temporary teeth are provided After 3 months the abutment as well as the final crown bridge or denture is then connected In some patients when the quality of the patient s remaining bone is good the same day teeth concept can be used to allow the patient to resume his normal day to day lifestyle almost immediately If the remaining bone is insufficient we can still place implants after bone regeneration Same day Teeth Implants are often used to replace fractured or extracted teeth and in general it takes three months for the bone to grow around the implant in order to anchor it firmly in the jaw During this waiting period temporary bridges or dentures are used With the advent of medical science and technology it is possible to reduce this waiting period Implants can be placed immediately into extraction sites for patients with missing front teeth though it is not always possible for back teeth If the implant lies firmly within bone it is possible to even allow partial loading immediately after the surgery In combination with the latest computer assisted techniques it is possible to deliver aesthetic looking temporary teeth in selected cases within 3 hours after the surgery The patients are however advised to avoid chewing on the implant especially in the initial weeks after the initial surgery when the original

    Original URL path: https://www.paragonmedical.com.sg/articles/same-day-teeth (2016-01-30)
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  • Paragon Medical Singapore
    well as bones Some of these are caused acute injuries but quite a number are more progressive and chronic in nature A common feature in all of these conditions is doing too much too soon and being seen by a doctor too late Why would someone be too late in seeking medical treatment The most common reason I am given is that they were afraid that I would tell them to stop their exercise or sport Another reason is that of being too busy and hoping the ache or pain would take care of itself What steps do you take in managing such conditions or injuries A systematic 5 steps that all start with a C CONFRONT Many people are a little scared to know what the injury or condition is or can t accept that it is something of significance So the first step is to convince them that if the ache or pain has lasted for more than 2 weeks and is affecting daily or exercise activity there is a real issue that needs to be taken care of CLARITY This involves understanding what might have caused the condition or injury as this helps make the correct diagnosis and sets the stage for providing injury prevention advice later The diagnosis is based on a detailed discussion of the problem being faced and then a careful physical check on the aching painful or injured area CONFIRMATION With some conditions a final confirmation of the diagnosis may need some form of medical test This ranges from Xrays and diagnostic ultrasound scanning all the way to MRI scanning These can be helpful in not only making the diagnosis but determining the severity of an injury as well CONFIDENCE The next step is then to develop a good plan of treatment This

    Original URL path: https://www.paragonmedical.com.sg/articles/managing-aches-and-pains (2016-01-30)
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  • Paragon Medical Singapore
    is shaped like a tear drop less full in its upper pole and more full in its lower pole Fig 2 The round implant tends to produce additional fullness in the upper pole of the breast that a natural breast does not have Fig 3 On the other hand the anatomical implant is shaped more like a natural breast therefore it produces a natural profile in the upper pole of the breast without excessive fullness Most of the fullness is in the lower pole of the breast just like in a natural breast Fig 4 In fact in recent years breast augmentation has undergone a paradigm shift with the emphasis now on shape rather than just volume thanks to the availability of the tear drop shaped anatomical silicone implant Anatomical implants have given an unprecedented degree of versatility because for each size volume there is a wide range of shapes available Three dimensions determine the shape of the implant width height and projection Each of these parameters can be varied so that the implants selected can be highly customized for each patient according to her own unique breast and chest wall anatomy Furthermore this versatility allows us to correct asymmetries between right and left sides much more effectively than before Fig 5 To each her own Everybody is different which is why we have created a unique Matrix of implants to complement individual height weight and body shapes You can choose from twelve different implant styles in three different heights and four different projections each with a range of base widths All of this choice means that you can meet patients expectations with even greater confidence How do we decide on size and shape Preoperative planning and implant selection are key steps in determining a successful outcome In this detailed

    Original URL path: https://www.paragonmedical.com.sg/articles/breast-augmentation-choosing-the-right-implant (2016-01-30)
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  • Paragon Medical Singapore
    Two days after surgery she was back at work and other than a little tearing she was back to her routine alas with perfect vision I was jealous I wanted to experience it too I have been wearing glasses from 11 years old From 17 I started to wear gas permeable hard lenses So for over 3 decades when I took my gas permeable lenses off I was legally blind And wearing my think glasses wasn t really an option I have always been very sporty enjoying my various sports swimming and running regularly I golf year round and snow ski in the winter Wearing my gas permeable contact lenses allowed me to enjoy my activities but not without occasional difficulties Skiing in winter with contact lenses would leave my lenses feeling like potato chips by the end of the day This year I am looking forward to the freedom of being able to see with my own eyes again I have never really considered Lasik first of all my myopia was relatively high so doing Lasik with high myopia requires quite a bit of corneal tissue The excimer laser would have to work hard and vaporize quite a bit of my corneal tissue leaving me with a very thin layer left over I was never really a big fan of having a flap on both my eyes particularly since I did such active sports While the flap does heal it never really heals fully and this has the possibility of separating with blunt trauma to my eye Not a great idea when you ski downhill at 80 km hr So when I heard about Relex I was intrigued Dr Eugene Tay introduced this technology to me and he was very passionate about it He felt that it had many superior attributes compared to the other available refractive procedures No Flap Less Dry Eyes less corneal nerves affected as no flap is cut Stronger cornea One step Hence I made the ultimate decision to proceed with my surgery on the 30th of Oct 2014 The day of my Surgery The numbing eye drops didn t feel like much Once I was rolled into the theatre and positioned onto the surgical bed Everything seemed to proceed like clockwork I was positioned under the warm blue glow of the visumax machine Dr Tay moved the lens into position under my right eye and slowly lowered the lens onto my cornea Once contact was made with my cornea all I saw was a blinking green light There was absolutely no sensation whatsoever No pain no discomfort nothing You see a water mark slowly enlarge till it fills your vision and then suction is activated Again nothing Dr Tay activated the laser and your vision gets increasingly blur till the blinking green light barely appears in the distant All it took was approximately 20 seconds for me but it really depends on your degrees of correction Once the auction was disengaged the lens retracts

    Original URL path: https://www.paragonmedical.com.sg/articles/difficult-decisions (2016-01-30)
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  • Paragon Medical Singapore
    implant to best suit their lifestyle aiming for the maximum accuracy current technology can provide Calculation of this artificial lens can be the most important link in the cataract operation akin to the icing on the cake to a successful surgery Individuals who had LASIK surgery before need more care from their surgeons when planning their cataract operations This is because calculations for their cataract surgeries are more complex after LASIK as their corneas had been reshaped Preferably the surgeon should have a full history of the LASIK surgery done before Even when this is available an accurate measurement of the dimensions of the eye is still vital to ensure a good outcome of the eye power after the cataract surgery Current equipment and calculation formulae to measure the dimensions of the eyeball for cataract surgery provide reasonably accurate results but results in eyes that had LASIK done cannot match virgin eyes In a scientific article that my team and I published in March this year 71 of eyes that had cataract surgery done after previous LASIK for short sightedness in Singapore had a result that is within 100 degree of target power compared to 85 in virgin eyes That is to say close to 30 of eyes that had LASIK before will have a shortfall of more than 100 degrees of eye power left after their cataract operations To some of these individuals who had sought sophisticated laser surgery in a bid for freedom from glasses or contact lenses this figure may pale in comparison to the level of precision they enjoyed after their initial LASIK operation In general LASIK operations yield a higher predictability with more than 93 achieving results that are within 100 degree from target based on a previous published report from a public institution in Singapore In order to improve the accuracy of eye power after cataract surgeries particularly in eyes that had previous LASIK operations as well as eyes that are of extreme of sizes overly small or long and other special cases careful calculation by using up to date methods is important Miscalculation can lead to further operations for instance to exchange the lens that had been implanted To improve the accuracy of lens calculation the Galilei G6 machine a next generation biometer a machine to measure lens power for cataract operations was recently introduced by the Singapore Medical Group at its newly established SMG Vision Center Gleneagles Hospital The only one in its class currently this device incorporates a 360 degrees measurement on both the front and back surfaces of the cornea using a technology called the double Scheimpflug and the overall eyeball length in one complete computation hence eliminating the need for multiple possibly incompatible devices The first in a private eye center the Galilei G6 measures approximately 100 000 points on the cornea compared to other more commonly used devices which measure either 6 or 32 spots on the cornea As a streamlined lens implant calculator the clarity that the

    Original URL path: https://www.paragonmedical.com.sg/articles/closing-the-gap-between-lasik-and-cataract-surgery (2016-01-30)
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  • Paragon Medical Singapore
    counterparts For this reason most Asian women should consider annual breast cancer screening beginning at the age of forty rather than to defer such measures till the age of fifty as is the common practice in the West The benefit of screening mammogram is well publicized and the level of awareness is fairly high in most countries More can be done nevertheless in persuading women to abandon the head in the sand attitude that ignorance is bliss and to come forward to accept regular breast cancer screening The option of breast cancer prevention on the other hand is much less publicized and not many women are made aware that as many as two out of every three cases of breast cancer can potentially be avoided Cancer causation involves a complex interplay of multiple factors and defies simplification made more complicated by the fact that many causes have yet to be elucidated One factor however stands out in breast cancer causation the role played by female hormones in the body Female hormones have a tendency to stimulate the growth of breast cancer This cause and effect relationship provides an opportunity to intervene in the natural process of breast cancer formation Breast cancer cells are transformed from normal cells in the breast Cancer cells are cells that have gone out of control The relationship between normal cells and cancer cells of the body is very much like the relation between normal law abiding people and terrorists When normal people go out of control they become terrorists and harm the rest of society When normal cells in the breast go out of control they become terrorist cancer cells and harm the rest of the body One of the possible triggers of this process of transformation is the binding of female hormones to the hormone receptors on the surface of the cell Hormone receptors are like growth switches on the cell surface Female hormones flick these switches to the on position allowing rapid growth and multiplication of the cell a necessary process in cancer formation Medications such as tamoxifen and raloxifene reduces breast cancer risk by blocking these growth switches from being turned on These have been in use for several years and effectively reduces the risk of breast cancer in women by fifty percent More recently in the last year or so a newer medication exemestane demonstrated the ability to prevent two out of three potential cases of breast cancer from developing when used in women after menopause For women after menopause though the ovaries have ceased producing female hormones two organs known as the adrenal glands sited above the kidneys continue to secrete female hormones Exemestane stops the adrenal glands from secreting female hormones thereby removing a potential stimulus for breast cancer formation What of patients like Ms T The window for cancer prevention has closed She has to contend with the risk of the lost of her life to cancer She has to contend too with the emotional trauma of body

    Original URL path: https://www.paragonmedical.com.sg/articles/breast-cancer (2016-01-30)
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