What is Rheumatoid Arthritis?

Rheumatoid arthritis is a disease of the joints, usually the smaller joints of the body. Many people believe wrongly that this is always a disabling, severe condition. In fact, it may be mild and can be well controlled using modern medicine. It is not infectious, but no one is able to say what triggers it. There is no cure for this condition, but all patients can be treated.

WHAT ARE THE SYMPTOMS OF RHEUMATOID ARTHRITIS?

Rheumatoid Arthritis symptoms will vary a great deal from person to person, as well as from day to day. However, some of the common symptoms include:

·       Stiffness and tenderness of the small joints, especially of the wrist, hands and feet (the base of the fingers, thumbs or toes can be affected; less commonly it can affect the larger joints such as the knee, shoulder, ankle and neck)

·       Tiredness

·       Morning stiffness

In summary, the main symptoms are pain, stiffness and swelling of the small joints.

HOW IS RHEUMATOID ARTHRITIS DIAGNOSED?

After being suspected by the doctor upon examination, rheumatoid arthritis can usually be diagnosed by tests, including x- rays of the hands and special blood tests.

HOW COMMON IS THE PROBLEM?

About 2 persons in 100 suffer to some extent from rheumatoid arthritis. It is more common in females. Most sufferers are between 40 and 60 years of age, but the disease can affect people in any age group, even in juveniles (Juvenile Rheumatoid Arthritis or JRA). However, the majority of patients have little or no long- term problems and only 1 patient in 10 is severely affected.

WHAT ARE THE RISKS OF RHEUMATOID ARTHRITIS?

In severe cases the swollen and deformed joints may become partly or completely dislocated, causing considerable discomfort and problems with walking if the knee or foot joints are affected. The tendons may become so weak that they can snap. A special problem is the neck, which can become unstable so that manipulative procedures can be dangerous and cause paralysis.

Difference between Osteoarthritis and Rheumatoid Arthritis

WHAT IS THE TREATMENT FOR RHEUMATOID ARTHRITIS?

EXERCISE

It is important to keep fit. Walking and swimming are to be encouraged. Many local councils and physiotherapists offer swimming and other forms of hydrotherapy in heated pools. Home exercise routines to prevent muscle weakening can be provided by your physiotherapist or doctor.

REST

Rest is important and depends on how you feel. It must be sensibly balanced with exercise. If an exercise causes pain, it should be altered or reduced.

JOINT MOVEMENT

Each joint affected should be put through a daily full range of motion to keep it mobile and to reduce stiffness. Protect any weakened joints or tendons by lifting gently and smoothly rather than in a jerking motion.

HEAT AND COLD

For stiff joints a hot-water bottle, warm water or a heat lamp can help. For morning stiffness an electric blanket or a warm shower can be helpful. Sometimes cold packs or water are appropriate, for example over a hot, tender joint.

DIET

There is no special diet. No specific food has caused arthritis and no specific diet will cure it. However, a nourishing and well-balanced diet including adequate fibre will promote health and a sense of well-being. Maintain a normal weight to lessen the burden on your joints.

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RHEUMATOID ARTHRITIS MEDICATION

There are many effective pain-killing and anti-inflammatory drugs available to treat rheumatoid arthritis. The basic drug is likely to be aspirin in high doses, but it can cause ringing in the ears and other unpleasant effects. Your doctor may have to experiment for a time before finding the best drugs for you.

SURGERY

Occasionally surgery may help if a particular joint is severely inflamed by removing the inflamed lining called the synovium. In later stages it may be possible to replace a badly damaged joint with an artificial joint.

SUPPORT

Excellent leaflets and practical help are available from the Arthritis Foundation in your city. These include information about and access to a wide range of inexpensive equipment and tools that can assist your daily living.

Please seek Medical attention as soon as possible if you are unsure of you or your family's health condition.

Management of Joint Pains & Gout

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Back Pain and Your Brain: William S. Marras at TEDxOhioStateUniversity

Ph.D., CPE. William S. Marras holds the Honda Endowed Chair in the Department of Integrated Systems Engineering at the Ohio State University. He serves as the director of the Biodynamics Laboratory and is in the process of developing the Spine Research Institute at The Ohio State University. Dr. Marras also holds joint appointments in the Departments of Orthopaedic Surgery, Physical Medicine & Rehabilitation, as well as Biomedical Engineering.

His research is centered on musculoskeletal causal pathway investigations including occupational biomechanical epidemiologic studies, laboratory biomechanics studies, mathematical modeling, and clinical studies of the spine. His findings have been published in over 200 peer reviewed journal articles and numerous books and book chapters including a recent book entitled "The Working Back: A Systems View." Professor Marras was the past Chair of the Board on Human Systems Integration at the National Research Council (NRC). He is currently Editor-in-Chief of Human Factors, Deputy Editor of Spine, and has been elected to the National Academy of Engineering (the National Academies).

Part of the National Influenza Sentinel Surveillance programme with MOH. If you have a fever of > 38 degrees with a cough, our clinic is able to test for COVID-19. For children below 12 years old with clinical diagnosis of HFMD (eg fever, oral ulcers, rash), our clinic can test for Hand Foot & Mouth Disease (The tests are for surveillance purposes only).

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Health Assessment & Screening Packages

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Dominic D'Agostino: Metabolic Therapies: Therapeutic Implications and Practical Application

Metabolic therapies that induce a state of mild ketosis from caloric restriction or the ketogenic diet offer neuroprotection against a wide range of pathologies, and continues to be an emerging strategy for the metabolic management of cancer. Severe dietary restriction of calories or carbohydrates is typically needed to produce a level of ketosis that achieves therapeutic benefits. Interestingly, the strategy to use exogenous ketones as an alternative fuel has not been exploited therapeutically. When administered orally in controlled dosages, ketone esters and other ketogenic agents can lower glucose and elevate plasma ketone levels comparable to levels achieved by the most rigorous ketogenic diets. Metabolic therapies in the form of ketone supplementation offer a safe, convenient, and versatile new treatment approach for a variety of diseases, including seizure disorders, neurodegenerative diseases and cancer.

Dominic D’Agostino is an Assistant Professor at the University of South Florida’s Morsani College of Medicine. Dr. D’Agostino teaches in the Department of Molecular Pharmacology and Physiology with an emphasis on such topics as Biochemistry, Neuropharmacology and Nutrition. His research is focused on developing and testing nutritional strategies for promoting healthy weight loss and enhancing cognitive and physical performance. In addition, his research aims to develop and test specific metabolic therapies and supplements for neurological diseases and cancer. Dr. D’Agostino’s research is supported by the Office of Naval Research (ONR), Department of Defense (DoD) and private foundations.

Healthy Diets for Optimal Health

Vitamins & Nutrients for a Well-functioning Immune System to Protect against COVID-19 & other Viral Infections

(Ref: Nutrients. 2020 Apr 23;12(4). pii: E1181. doi: 10.3390/nu12041181 Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections Calder PC¹, Carr AC², Gombart AF³, Eggersdorfer M⁴.

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Pain Management

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Groups at Higher Risk for Severe Illness in a COVID-19 Infection

Comorbidities & Underlying Health Conditions in COVID-19 Patients with Complications

·       Hypertension

·       Diabetes mellitus

·       Cerebrovascular disease

·       Cardiovascular disease

·       Chronic lung diseases including COPD

·       Chronic Kidney disease

·       Asthma

·       Dementia

·       Chronic Neurological Disorders

·       Cancer

·       Rheumatological Disorder

·       Obesity

·       Smoking

·       Chronic Hematologic disease / Haemoglobin Blood Disorders

·       Liver disease / Hepatitis B Infection

·       Malnutrition

·       Immunodeficiency / Immunocompromised eg HIV AIDS

·       People aged 65 and older

(Ref: https://www.nature.com/articles/s41430-020-0642-3.pdf, Dailymail.co.uk, https://pubmed.ncbi.nlm.nih.gov/32320003/, Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis https://erj.ersjournals.com/content/early/2020/03/17/13993003.00547-2020

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Co-infection of COVID-19 with other infectious diseases is possible.

Reduce your risk of getting sick with COVID-19

• Make sure your vaccinations are up-to-date. People older than 65 years, and those with many underlying conditions, such as those who are immunocompromised or with significant liver disease, are recommended to receive vaccinations against influenza (Flu 2021/22) and pneumococcal disease (PCV). Click here for Vaccination schedules (NAIS/NCIS).
  
• Do not delay getting medical care for your underlying condition because of COVID-19. MD International Medical Centre has contingency MOH infection prevention protocols to protect you from getting COVID-19 if you need care for your underlying condition.
• Continue your medications and do not change your treatment plan without talking to your doctor.
• Make sure that you have at least a two-week supply of your chronic disease medications.
• Call MDIMC @ Tel: 6694 1661 for a medical appointment if you have any concerns about your underlying medical conditions or if you get sick. Our clinic is a PHPC-accredited medical clinic. Under the MOH Swab & Go Home programme, our doctors can do a COVID-19 PCR Swab test if you meet the MOH medical crtieria.

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Get Vaccinated!

• COVID Vaccine & Booster
  
• Flu Vaccine
• Childhood & Adult Vaccine schedule (Refer to NAIS & NCIS)

Up to $400 per Medisave Account per year can be used for Vaccinations under the National Adult & Childhood Immunisation Schedule - Influenza, Pneumococcal (PCV13/PPSV), Human Papillomavirus (HPV2/HPV4), Hepatitis B, Tetanus, Diphtheria & Pertussis (Tdap), Measles, Mumps & Rubella (MMR) and Chickenpox (Varicella).

Asymptomatic patients may not display no symptoms of illness. Vulnerable people should get vaccinated against Influenza as the stop gap until the COVID vaccine is found. The Flu vaccine would protect susceptible people from, as well as exclude the Flu and H1N1 viruses should they start to show URTI or ARI symptoms.

- Latest Influenza Vaccine

The latest Influenza Vaccine is now available. It protects against the Flu and H1N1 Viruses. In the event that a person displays flu-like symptoms after the Flu vaccination, both Flu and H1N1 may be excluded in his diagnosis, and treatment can be sought quickly should the patient have contracted COVID-19.

Ministry of Health Safety protocols are adhered to at all times for the safe vaccination of you and your family.

* Latest COVID-19 Updates & Health Tips

* Importance of Keeping your Vaccinations Up-to-date

Singapore is free from vaccine-preventable diseases like poliomyelitis, diphtheria, tetanus and pertussis (whooping cough) because of our successful immunisation progamme.

Up to $400 per Medisave Account per year can be used for Vaccinations under the National Adult & Childhood Immunisation Schedule - Influenza, Pneumococcal (PCV13/PPSV), Human Papillomavirus (HPV2/HPV4), Hepatitis B, Tetanus, Diphtheria & Pertussis (Tdap), Measles, Mumps & Rubella (MMR) and Chickenpox (Varicella).

National Adult Immunisation Schedule (NAIS) Singapore @ MD International Medical Centre. Make your vaccination appointment at Tel: 6694 1661.

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COVID-19 SARS-CoV-2 Virus Information

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Sinopharm COVID-19 Vaccine in Singapore

Sinopharm COVID-19 Vaccine is now available @ MD International Medical Centre. Make a Vaccination or Booster Appointment at Tel: 6694 1661. Learn more about Sinopharm here.

Sinopharm BBIBP-CorV vaccine has now been approved for use by private clinics in Singapore against the COVID-19 virus under the Special Access Route. It is the first China-made vaccine to be approved by the World Health Organisation (WHO).

To date, more than a billion doses of the Sinopharm BBIBP-CorV have been administered. The vaccine has also been approved for use in over 50 countries around the world.

Inactivated vaccines are a tried-and-tested form of vaccine technology which is used in other well-established vaccines, such as the Flu and Hepatitis B vaccines.

If you would like to receive the Sinopharm vaccine or booster, please make your appointment at MD Int'l Medical Centre at Tel: 6694 1661.

Effects of COVID-19 on the Brain

Ministry of Health Recommendation :

• For persons who have already completed their Primary series with mRNA vaccines and are recommended to get a booster, but are unable to take another dose of mRNA vaccines for medical reasons, they may boost using one dose of Sinopharm vaccine. The booster should be taken six months after mRNA dose 2 (M-M-S).

• For persons who are unable to take the the 2nd dose of mRNA vaccines for medical reasons, they may complete their vaccination with the Sinopharm vaccine. 2 doses of the Sinopharm vaccine is recommended to complete the Primary series. The 2nd Sinopharm dose  should be taken 28 days after the 1st Sinopharm dose (M-S-S).

For recovered persons who had not completed a primary series before infection:

• For persons who have recovered from a COVID-19 infection but received 1 dose or none of COVID-19 vaccination prior, they may receive 2 doses of the Sinopharm vaccine (28 days interval between doses), 3 months after the date of infection to complete a primary vaccination series (Recovered-S-S or S-Recovered-S-S or M-Recovered-S-S).

• For persons who have recovered from a COVID-19 infection and had received 2 doses of Sinovac or Sinopharm vaccines prior, they may receive 1 dose of Sinopharm after 3 months from the date of infection to complete a primary vaccination series (S-S-Recovered-S).
  

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MD International Medical Centre

Medical Services available :

• General Medicine / General Practice
• Minor Surgical Procedures
  
• Dermatology - Skin Problems (Eczema, Acne, Rash, Boils, Dermatitis, Pigmented or Dry Skin, Mole/Skin Tag/Wart Removal)
  
• Dermoscopy - Non-invasive Detection of Skin Cancer, Pubic lice & Scabbies
• Treatment of Insect Bites & Stings
• Infectious diseases & Virology (COVID-19. Dengue, Flu, Hepatitis B)
• Respiratory Medicine - Cough, Wheezing, Shortness of breath
  
• Obesity / Weight control
• Stomach ache
  
• Respiratory Lung Diseases
• Liver Diseases
• Kidney disease / Kidney stones
  
• Eye Health / Opthalmology
  
• Ear Nose Throat / ENT -
  Nose Bleed-Epistaxis /Snoring & Sleep Apnoea /Verigo & Dizziness
• Removal of Ear Wax
• Personal Health
• Allergies Test & Management
• Treatment of Allergic Rhinitis
  
• Asthma Management
• Vaccinations / Immunization (eg Flu vaccination)
• Depression / Anxiety / Stress Management
• Management of Chronic Diseases (eg Diabetes / Hypertension)
• Treating Prediabetes, Diabetes & Insulin Resistance
  
• Heart Disease / High Cholesterol Management
• Health Management
• Men's Health
• Women's Health - Osteoporosis, Heavy Periods, Breast lumps, Urinary Tract Infection, Anaemia, Tremors
  
• Child Health & Nutrition / Pediatrics
• Elderly / Senior Health
• Dementia Screening
• Neurological Disorders
  
• Treatment of Gout
• Pain Management (eg Arthritis, Back Pain, Migraine)
• Sports Injuries
  
• Travel Health (eg Vaccinations / Travellers' Diarrhoea)
  
• Health Screening / Blood tests
• Pre-Employment check-up
• Work Permit / Employment Pass / Student Pass / Driving License Check-up
• Blood Disorders
  

Public Health Preparedness Clinic

National University Health System Primary Care Network

Singapore Ministry of Health Chronic Disease Management Programme (CDMP)

The information provided in this website is for knowledge purposes only. It does not constitute medical advice.

Should you encounter any medical problem that you are unsure of, always consult your doctor or health care provider for assistance and medical advice.

MD International (Singapore) Pte Ltd

Follow us for COVID Updates & Health Tips!

MDIMC Medical Team

Together, Being here for you.

Doing Our Best in the COVID-19 Pandemic!

“Do all the good you can,
By all the means you can,
In all the ways you can,
In all the places you can,
At all the times you can,
To all the people you can,
As long as ever you can.”
― John Wesley

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Get your Sinopharm Vaccine / Booster or Latest Flu Vaccine - Make your appointment at Tel: 6694 1661.

Risk Factors of COVID-19 Complications

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COVID-19 Singapore Public places visited by cases in the community

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COVID-19 : Country cases, Deaths, Recovered & Vaccinated

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For Medical Professionals

Learn from the China Experience on COVID-19 Prevention and Treatment

9 Taman Serasi #01-11, Botanic Gardens View

Tel : 65-6694-1661  Fax : 65-6694 1771

Email : contact@mdimc.sg

Clinic hours:

Monday to Friday: 9am-12.30pm / 2pm-6.30pm    Saturday: 9.30am-1pm

*Last registration is 30mins before the closing time

Closed on Sundays & Public Holidays

- Cashless service with most International Insurance companies and Insurance Medical cards are accepted

- Japanese & Mandarin-speaking Doctors and Medical staff

Please contact us at Tel: 6694 1661 to make an appointment.

OUR MEDICAL TEAM

Dr Don Lau – Medical Director

MBBS (Monash), B Med Sc (Hons) (Monash), Dip Pract Derm (Wales, UK)

Fujiwara Takanori DC

The Chiropractic Association Singapore, Japan Chiropractic Register, American Chiropractic Association, California Chiropractic Association

Physiotherapy-trained NBCE The National Board of Chiropractic Examiners

YAMAGATA Chihiro 山懸千尋

Registered Psychologist

Dr Lee Sao Bing – Opthalmologist (in-house Specialist)

MBBS, MMed(Ophth), FRCSEd(Ophth), MD, FAMS

Dr Pang Yoke Teen – ENT (Visiting Consultant)

FRCS (ORL), FRCS(EDIN), (FRCSGLASG), FAMS, MBBS

MD International Medical Centre

Medical Services

• General Practice Family Medicine
• Minor Surgical Procedures / Laser Treatments
• Management of Chronic Diseases (Diabetes / Hypertension / Heart Disease / High Cholesterol Management)
• Pain Management (Joint pains, Knee Pain, Back Pain, Migraine, Sports Injuries)
• Shockwave Treatment / Deep Muscle Stimulator DMS Therapy
• Dermatology Treatments - Skin Problems (Eczema, Acne, Rash & Hives, Boils, Dermatitis, Pigmented or Dry Skin, Moles, Skin Tags, Corns & Calluses, Wart, Treatment of Insect Bites & Stings)
• Dermoscopy - Non-invasive Detection of Skin Cancer
• Allergies Test & Management / Treatment of Allergic Rhinitis / Asthma Management
• Vaccinations / Immunization (National Adult Immunisation Schedule / National Child Immunisation Schedule / Influenza)
• Infectious diseases & Virology (COVID-19, Dengue, Flu, Hepatitis B)
• Respiratory Medicine - Cough, Wheezing, Shortness of breath
• Eye Health / Ophthalmology (Conjunctivitis, Foreign body in the Eye)
  
• Ear Nose Throat / ENT Rhinoscopy (Nose Bleed-Epistaxis, Snoring & Sleep Apnoea, Vertigo & Dizziness, Removal of Ear Wax)
• Audiogram – Hearing test
• Personal Health (Stomach ache, Irritable Bowel Syndrome, Heartburn, Treatment of Gout)
• Elderly / Senior Health (Arthritis)
• Men's Health
• Women's Health (Osteoporosis, Heavy Periods, Breast lumps, Urinary Tract Infection, Anaemia, Tremors)
• Child Health & Nutrition / Paediatrics
• Travel Health (Vaccinations / Travellers' Diarrhoea)
• Health Assessment, Screening & Management / Blood tests
• Pre-Employment check-up / Work Permit / Employment Pass / Student Pass / Driving License Check-up
• Obesity / Weight control
• Neurological Disorders / Dementia Screening
• Depression / Anxiety Management
  
• Insomnia & Stress Management

Minor Surgical Procedures :

·       Injection for Supraspinatus or Bicipital Tendonitis / Epicondylitis / Trigger finger / Plantar Fasciitis

·       Tendon Sheath Injection

·       Excision of small Skin tumours / Lipomas / Nail bed / Ear lobe cysts / Meibomian cyst

·       Removal of Skin sutures / Skin tags / Sebaceous cysts / Various foreign bodies / Corneal foreign body

·       Liquid Nitrogen Therapy

·       Treatment of Plantar Warts / Calluses / Corns / Ganglions

·       Splinters under nails

·       Olecranon and Pre-patellar Bursitis

·       Ear syringing

·       Embedded earring stud

Medical Conditions Treatable with Therapy:  

• Head & Neck – Neckaches/ Spondylosis/ Wry Neck/ Whiplash/ Headaches/ Migraine/ Facial Palsy
• Back – Back Strain/ Slipped Disc/ Scoliosis/ Sciatica/ Spondylosis/ Spondylolisthesis/ Spondylolysis
• Shoulder – Frozen Shoulder/ Rotator Cuff Tear/ Impingement Syndrome
• Elbow – Tennis Elbow/ Golf Elbow
• Hip / Knee – Anterior Knee Pain/ Runner’s Knee/ Meniscus Injury/ Ligament Injury
• Foot – Plantar Fasciitis/ Heel Pain/ Metatarsalgia
• Joint – Arthritis/ Cartilage Wear & Tear/ Osteoarthritis
• Ligament – Sprains/ ACL Laxity/ Ankle Sprain
• Muscle – Strains/ ITB Tightness/ Hamstring Tear
• Tendons – Tendonitis/ Repetitive Strain Injury/ Tendinopathy
• Sports Injuries
• Obesity – Exercise & Meal Planning 
• Post Operation/ Hospitalization
• Fibromyalgia

OUR MEDICAL TEAM

Dr Don Lau – Medical Director

MBBS (Monash), B Med Sc (Hons) (Monash), Dip Pract Derm (Wales, UK)

Fujiwara Takanori DC

The Chiropractic Association Singapore, Japan Chiropractic Register, American Chiropractic Association, California Chiropractic Association

Physiotherapy-trained NBCE The National Board of Chiropractic Examiners

YAMAGATA Chihiro 山懸千尋

Registered Psychologist

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