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Flu Subsidy Scheme eligible for Singaporeans & PRs (Pay subsidized rate of $10 for Consultation and Treatment) & Merdeka Generation /Pioneer Generation seniors (Pay subsidized rate of $5) for patients diagnosed with Acute Respiratory Infections (ARIs). Please make your appointment at Tel: 6694 1661.
AIPC is part of MOH's Swab & Go Home programme. Our clinic can carry out the COVID-19 Swab test for anyone who meets the MOH medical criteria. From 1 Jul 20, all individuals aged 13 and above, diagnosed with ARI will be COVID Swab-tested. Cost of Swab test to be borne by Ministry of Health Singapore.
AIPC is 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).
Up to $400 per Medisave Account per year can be used for Vaccinations under the National Adult Immunisation Schedule - Influenza, Pneumococcal (PCV13/PPSV), Human Papillomavirus (HPV2/HPV4), Hepatitis B, Tetanus, Diphtheria & Pertussis (Tdap), Measles, Mumps & Rubella (MMR) and Chickenpox (Varicella).
Snoring & Obstructive Sleep Apnoea FAQ
Question: What is the cause of snoring and should someone be concern about his/her snoring problem?
Snoring is a common problem that we see in our clinical practice. Often times, it is the sleeping partner’s (usually the wife) complaints and frustrations that brought this problem to the patient’s attention.
Snoring occurs when there is vibration of tissues in the throat and can be a symptom of partial upper airway obstruction causing noisy breathing during sleep. Sometimes, this partial obstruction can progress to complete upper airway obstruction, and in this instance, patients will have a high chance of suffering from Obstructive sleep apnoea (OSA). OSA occurs when there is recurrent complete or near-complete obstruction of the upper airway when the person is asleep resulting in frequent arousals, lower oxygenation in the blood, and poor-quality sleep.
Question: How prevalent is OSA and what are the risk factors for someone to develop OSA?
The prevalence of OSA in our adult population is estimated to be about 15%. The risk factors associated with OSA include obesity, increased age (generally from middle age & older), male patients, and those with facial & jaw abnormalities.
Common areas of Airway obstruction
In our clinical evaluation of patients with snoring, it is important for us to differentiate those with just Simple snoring (i.e. not associated with OSA), and those patients that could have OSA. This differentiation is important for 2 main reasons:
(1) the medical consequences & complications; as well as
(2) the treatment approach for these 2 groups are different.
Question: Other than snoring, how do you diagnose someone with OSA?
Besides very loud snoring, patients with OSA will usually have one or more of the following symptoms:
us to definitively diagnose and quantify the severity of OSA, we would do an
overnight sleep study for patients whom we suspect clinically to be suffering
from this condition. The sleep study is a non-invasive diagnostic test during
which parameters such as breathing effort, blood oxygen levels, heart rhythm
and muscle activity are monitored during sleep.
Question: Are there any consequences of not treating someone who has OSA?
We know as a fact that Undiagnosed and Untreated OSA can lead serious medical consequences and complications over time. These include high blood pressure, heart attack, irregular heart rhythm, memory loss, stroke and even sudden death. It is therefore very important that we take the treatment of OSA seriously to prevent the onset of complications.
Excessive Daytime Sleepiness
Question: How do you treat someone with snoring and OSA?
When it comes to treatment for snoring and OSA, establishing the diagnosis and severity is important because the approach can be different.
For patients with Simple Snoring, the treatment usually starts with more conservative measures such as weight loss, avoidance of alcohol & sedative medications, relieving nasal obstruction & congestion, and advising patients to sleep on their side rather than on the back. If the problem persists, then surgery of the soft palate and/or the nasal septum & inferior turbinates (to improve nasal airflow) can help our patients.
As for the treatment for OSA, it largely depends on the severity.
Sleeping on your side
for Sleep Apnoea & Snoring
Continuous Positive Airway Pressure
- CPAP Therapy
Question: So, how do you treat OSA with different severity?
For patients with mild OSA, we would generally advise similar treatment measures as mentioned above for snoring. In addition, we would monitor our patients closely to assess its effectiveness and also for progression of OSA or onset of complications. Depending on clinical response and treatment compliance, we would discuss other therapeutic options (such as jaw/tongue exercises, dental appliances or surgery) with patients.
For patients with Moderate or Severe OSA, we would also recommend a medical device called Continuous Positive Airway Pressure (CPAP). What CPAP does is to deliver room air to the nose and back of the throat at a slightly elevated pressure to prevent the airway from collapsing during sleep. Effectively, it works like an “air-splint” to keep the airway open. CPAP is safe, highly effective and generally well-tolerated. Notwithstanding, we understand some patients may have concerns and experienced initial hiccups using the CPAP, but it is important to persevere and work with your care providers to optimize the use of CPAP.
Question: What if the patient, despite trying very hard, still cannot tolerate or unable to use CPAP effectively?
understand that despite best efforts, there are some who may not tolerate CPAP
well or may have conditions (such as nose block) which makes it difficult to
use the CPAP effectively. For this group of patients, surgery may be an option
to consider. However, I must also highlight that surgery for the upper airway
to treat OSA is complex and it is best to speak to your ENT specialist to
discuss the options available and work out an appropriate treatment plan.
Question: What are the different types of surgery for patients with OSA?
In general, the various types surgery for OSA would include the following:
(a) Nasal surgery - this is mainly to correct deviated nasal septum and enlarged inferior turbinates. This would help to address the problem of nasal obstruction.
(b) Palatal surgery - surgery to the soft palate, tonsils and the immediate surrounding areas with the aim to enlarge the narrow airway at the palatal level.
(c) Hypopharyngeal and Base of tongue surgery - surgery in this region is quite complex. This will involve removing tissue in the hypopharynx, reducing the tongue size and increasing the tension on the tongue to give the airway more room and space.
(d) Skeletal or bone surgery of the jaw - these are complex and aggressive surgical procedures. It generally involves forward movement of the lower jaw and the mid-face to create more space for the tongue. This helps to open up the upper airway and prevent its collapse during sleep.
Question: For someone suffering from significant snoring problem, what would be your advice?
If your snoring is persistent and possibly getting worst, I would advise you to see an ENT specialist to have a proper evaluation and to exclude OSA. We know that OSA if left undiagnosed and untreated, can lead to serious medical complications. If you do suffer from OSA, it is best to discuss with your doctor about the treatment options available and work out a treatment plan which is suitable for you.Dr Kang Wee Lee - ENT (Visiting Consultant)
· MBBS(NUS), MMed(ORL), MRCSEd, FAMS(ORL), DFD(CAW)
Co-infection of COVID-19 with other infectious diseases is possible.
Reduce your risk of getting sick with COVID-19
Vitamins & Nutrients for a Well-functioning Immune Systems 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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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.
Dr Don V H LAU Chairperson of AMDA Singapore
MBBS (Monash), B.Med.Sc.(Hons) (Monash), Grad.Dip.Derm.(Wales,UK)
AMDA International Peace Clinic is a part of AMDA (Association of Medical Doctors of Asia). We are part of the network of AMDA Peace Clinics & Friendship Hospitals around the world. We dedicate part of our profits to AMDA's worldwide Emergency Disaster Aid Relief missions, Social Development projects and Vaccination programmes.
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Tel : 65-6694-1661 Fax : 65-6694 1771
Email : firstname.lastname@example.org
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Please contact us at Tel: 66941661 to make an appointment.
MBBS (Monash), B Med Sc (Hons) (Monash), Dip Pract Derm (Wales, UK)
Chairperson of AMDA Singapore
MD (Duke-NUS), PhD (Glasgow), M Sc (UK), DLSHTM, B Med Sc (Birmingham)
Doctor of Chiropractic Southern California University of Health Science
The Chiropractic Association Singapore, Japan Chiropractic Register, American Chiropractic Association, California Chiropractic Association
Physiotherapy-trained NBCE The National Board of Chiropractic Examiners
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
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