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1 MAGAZINES, JOURNALS & TABLOIDS - WRITING

T I M E LY H E A LT H I N F O R M AT I O N & S T Y L E

C E L E B R AT I N G

DR YAP LIP KEE

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A GENTLEMAN’S PASSIONATE PURSUIT

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A C HAT W ITH K IT C HAN E D E N P U B L I S H I N G P T E LT D

72 H O U R S I N S E O U L 7 CO O L V E N U E S FO R PARTI E S

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TO BREAK THE RULES, YOU MUST FIRST MASTER THEM. THE VALLÉE DE JOUX. FOR MILLENNIA A HARSH, UNYIELDING ENVIRONMENT; AND SINCE 1875 THE HOME OF AUDEMARS PIGUET, IN THE VILLAGE OF LE BRASSUS. THE EARLY WATCHMAKERS WERE SHAPED HERE, IN AWE OF THE FORCE OF NATURE YET DRIVEN TO MASTER ITS MYSTERIES THROUGH THE COMPLEX MECHANICS OF THEIR CRAFT. STILL TODAY THIS PIONEERING SPIRIT INSPIRES US TO CONSTANTLY CHALLENGE THE CONVENTIONS OF FINE WATCHMAKING.

AUDEMARSPIGUET.COM

ROYAL OAK CHRONOGRAPH

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IN TITANIUM AND PLATINIUM

AUDEMARS PIGUET BOUTIQUES: ORCHARD ROAD LIAT TOWERS | THE SHOPPES AT MARINA BAY SANDS

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TO BREAK THE RULES, YOU MUST FIRST MASTER THEM. THE VALLÉE DE JOUX. FOR MILLENNIA A HARSH, UNYIELDING ENVIRONMENT; AND SINCE 1875 THE HOME OF AUDEMARS PIGUET, IN THE VILLAGE OF LE BRASSUS. THE EARLY WATCHMAKERS WERE SHAPED HERE, IN AWE OF THE FORCE OF NATURE YET DRIVEN TO MASTER ITS MYSTERIES THROUGH THE COMPLEX MECHANICS OF THEIR CRAFT. STILL TODAY THIS PIONEERING SPIRIT INSPIRES US TO CONSTANTLY CHALLENGE THE CONVENTIONS OF FINE WATCHMAKING.

AUDEMARSPIGUET.COM

ROYAL OAK CHRONOGRAPH

00519_1702_LE_BRASSUS_MEN_THIS_QUARTERLY_450x285_ENG.indd Toutes les pages

IN TITANIUM AND PLATINIUM

AUDEMARS PIGUET BOUTIQUES: ORCHARD ROAD LIAT TOWERS | THE SHOPPES AT MARINA BAY SANDS

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EDITOR’S NOTE Happy birthday to us THIS Quarterly turns seven! It has been our privilege all this while to keep you entertained and engaged with articles revolving around luxury lifestyle and wellness. We trust that you a e bene ed ro e one ay or ano er or i pe ia o a ion e have added a section in Chinese — this will be a regular feature of every u y Sep e ber edi ion ro no on a a bir day i ou a e ebra ion n i i ue e indu ge in a e e ebra ion- e ed ea ure u a ip p a e o ro par ie unique a ering er i e and y a ouri e a pread o e en unique bir day a e that were specially decorated by artisan bakers for our seventh anniversary. urn o page or i ou - a ering ea ure i e e e ar i e a ay and re er o e en you need in pira ion and idea or your o n e ebra ion don no abou you bu don ne e ari y need o par y i riend and a iy ene er y bir day ro around or er ain i e one be a e in ro pe i e and de ided o pend i e on y o n or o er o idayed quie y in oreign and o e i e a one o e i e i a oup e o o e riend you re i e e and need de ina ion idea e o er Seou and Portland in this issue. u ere er you de ide o go you u be on iou abou ygiene e pe ia y e e day en ba eria are be o ing in rea ing y re i an o an ibio i Spea ing o ba eria did you no a o e a i e in your ga roin e ina ra an po i i e y a e your o era ea ip o page o earn ore Gracing the cover of this special issue of THIS Quarterly is distinguished gynae o ogi r ap Lip ee o a been a no edged a e grand a er o aparo opy in i e d on e i o - po en de eanour oo you ei a passionate advocate of using keyhole surgery to help patients. ere

i

ing you

any our o en oy en reading our bir day i ue

Chua Kim Beng Editorial Director FIND US ON FACEBOOK facebook.com/ thisquarterly

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MEDICAL CONSULTANTS These are the specialist medical practitioners who make THIS Quarterly a strong and authentic healthcare and lifestyle publication appreciated by our readers. Before getting into the specialist topics inside the magazine, some of them offer up insights and nuggets of information about health and, sometimes, about life.

DR TAN SOO HEONG

DR HO KOK SUN

Hand Surgeon Hand, Wrist & Upper Limb Surgery

Colorectal Surgeon Ho Kok Sun Colorectal Pte Ltd

Smoking, stress and dietary imbalances (lack of protein or iron) can exacerbate hair loss.

DR CHONG CHEE KEONG

ADJ A/PROF LYNNE LIM

Breast Surgical Oncologist Maven Surgery

Ear, Nose & Throat – Head & Neck Surgeon Lynne Lim Ear Nose Throat & Hearing Centre (Child & Adult)

Patients with recurring bouts of diverticulitis have to be aware of changes in their bowel habits, because repeated infections can lead to scarring and narrowing of the colon.

DR WONG SU-NI

DR JULIAN TAN

DR KAREN SNG

Dermatologist Dr SN Wong Skin, Hair, Nails & Laser Specialist Clinic

Physician & Interventional Cardiologist The Heart Specialist Clinic

Plastic Surgeon The Plastic Surgery Practice @ Orchard

A/PROF LEONG KENG HONG

It is recommended that you seek medical attention as soon as possible if chest pain comes on suddenly.

Rheumatologist Leong Keng Hong Arthritis and Medical Clinic

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MEDICAL CONSULTANTS Because tear trough deformity is a part of one’s appearance, filling it can make one look unnatural. It is recommended for more extenuating circumstances.

DR SEE THO KAI YIN Obstetrician & Gynaecologist The See Tho Clinic for Women

DR ERIC HONG Cardiologist EH Heart Specialist Pte Ltd

Chronic pancreatitis can be challenging to treat. The goal is to relieve pain and make up for loss of function.

DR LESLIE KUEK

DR LEO SEO WEI

Plastic Surgeon Leslie Kuek Plastic Surgery

Ophthalmologist Dr Leo Adult & Paediatric Eye Specialist Pte Ltd

DR SEAN NG Orthopaedic Surgeon Ardmore Orthopaedic Clinic

It doesn’t take something as serious as a car accident for your neck to hurt. Some fairly innocuous activities, especially if done often and long enough, can be the source.

DR TAY KHOON HEAN

DR KELLY LOI

Hepatobiliary, Pancreatic and Advanced Laparoscopic Surgeon Tay Khoon Hean Surgery

Obstetrician & Gynaecologist Health & Fertility Centre for Women

DR FRANCIS SEOW-CHOEN Colorectal Surgeon Seow-Choen Colorectal Centre Pte Ltd

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MEDICAL CONSULTANTS

Addressing varicose veins is more than just an issue of aesthetics. The initial stages are usually asymptomatic, but aches and pains in the legs will soon develop.

DR JOHN TAN General & Vascular Surgeon The Vein Clinic & Surgery Pte Ltd

DR TAN KOK LIANG Orthodontist emBRACE Dental Surgery

DR MICHAEL WONG

DR ABEL SOH

Urologist International Urology, Fertility & Gynaecology Centre

Consultant Endocrinologist Abel Soh Diabetes, Thyroid & Endocrine Clinic

Ascertaining the exact cause of the stone formation is an important role of your urologist, so that dietary adjustments and oral therapy can be started early. DR LAU CHEE CHONG Ear, Nose & Throat – Head & Neck Surgeon Ear, Nose & Throat Centre CC Lau

DR COLIN THAM Plastic Surgeon Asia HealthPartners (Aesthetics)

Steroids may help to build muscles, but they can lead to the shrinking of both the testes and sperm count.

DR ANN TAN Obstetrician & Gynaecologist Women Fertility & Fetal Centre

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CONTENTS

T H I S Q UA R T E R LY ’ S MEDICAL C O N S U LTA N T S

WELLNESS & H E A LT H U P DAT E

F E AT U R E

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The specialists who provide accessible and up-todate health information.

The latest news, trends, updates and nding o keep you ahead of the curve.

Gut Instinct Understand the bacterial link between the gut and the brain.

ISSUE

COVER: DR YAP LIP KEE PHOTOGRAPHY: CHING LEE ART DIRECTION: CHRISSANDRA CHONG STYLING: KAREN KWA, ZECK YIN HAIR & MAKE-UP: DENNIS EE CLOTHES: COTTON SHIRT, WOOL JACKET & PANTS, AND TRENCH COAT, HUGO BOSS WATCH: PATEK PHILIPPE LOCATION: CAPSULE STUDIO

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C OV E R S TO RY

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A Gentleman’s Passionate Pursuit Soft-spoken gynaecologist Dr Yap Lip Kee is passionate about keyhole surgery.

F E AT U R E

F E AT U R E

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Exercise Myths: Working Out the Truth Two physical trainers bust some exercise myths.

The Nose Knows: What Bad Breath Says About Your Health Halitosis could be indicative of something more serious.

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CONTENTS F E AT U R E

40 Running High An internationally ranked athlete o er ad i e on stair running.

SPECIALIST OPINIONS

45 Your guide to uncomplicated health management, direct from our medical specialists.

LIFESTYLE

F E AT U R E

F E AT U R E

PERSONALITY

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82

90

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Products, experiences and indulgences for your after-work enjoyment.

7 Unique Ways to Cater in Style Intriguing options beyond the typical bu e ine

7 Unusual Party Venues Forget your condo function room — these are way cooler!

10 Qs with Kit Chan THIS Quarterly chats with this Singaporean songbird.

F E AT U R E

F E AT U R E

T R AV E L

T R AV E L

F E AT U R E

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106

110

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7 Local Brands Gone Global It’s no longer just Singapore Airlines!

Living Green Making sustainable living a way of life.

A Taste of Heaven Portland’s food carts are a huge draw.

72 hours in Seoul Our recommended itinerary for a three-day stay.

7 Amazing Birthday Cakes These beauties were specially created for THIS Quarterly’s seventh birthday.

145 本期年度特 汇集 和生活 时 , 性与 感性的 飨宴。

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EDEN PUBLISHING PTE LTD 60 Paya Lebar Road, #12-51/52 Paya Lebar Square, Singapore 409051 Tel: 65 6253 8660 www.edenpublishing.sg PUBLISHER

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Amanda Tan, Ching Lee, Dawn Neo, Dennis Ee, Elisabeth Lee, Fiona Chen, Hilda Chang, Josephine Ng, Kamaruzi Berro, Karen Kwa, Ken Chan, Lily Lee, Ng Ho Ton, Praise Poh, Regina Wong, Richard Sirrs, Sheralyn Tay, Siti Rohani, Sunuja Naidu, Zeck Yik THIS Quarterly is wholly owned by Eden Publishing Pte Ltd and contracted to be published quarterly by ThinkFarm Pte Ltd. No material may be reproduced in part or in whole without prior written consent from the Publisher. Views and opinions expressed in THIS Quarterly are not necessarily those of the Publisher or the Editors. Although reasonable care has been taken to ensure the accuracy and objectivity of the information provided in this publication, neither the Publisher and Editors nor their employees or agents can be held liable for any errors or omissions, nor any action taken based on the views expressed or information provided within this publication. Printed in Singapore by KHL Printing Co. Pte. Ltd. MCI (P) 093/06/2016.

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WELLNESS & HEALTH W H E N K I LLI N G TH E PAI N M AY H A R M T H E H E A R T A study published in the European Heart Journal: Cardiovascular Pharmacotherapy and conducted in Denmark has concluded that non-steroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen and diclofenac — increase the risk of out-of-hospital cardiac arrest (OHCA) by an average of 31%. “NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors,” says study author Dr Gunnar Gislason, a professor of cardiology at Copenhagen University Hospital.

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WELLNE SS & HE ALTH S AV E O U R FORESTS! Eco-warriors, here is more ammunition for you o u e in e g to preserve green spaces: there are pro en ea bene for what the Japanese call ‘shinrin-yoku’, or forest bathing. In a 2009 study by Nippon Medical School’s Professor Qing Li, subjects o ed igni an increases in NK cell

ANTIBIOTICS PROMOTE BOWEL P O LY P S

M E D I TAT E T H E PA I N AWAY If you decide to forgo NSAIDS, then take up meditation to relieve pain. The Journal of Neuroscience published a study on mindfulness meditation, which it claimed can reduce pain via a mechanism di eren ro e way opioids — such as oxycodone and codeine — work. All participants in the study were subjected to pain using a heat source and divided into four groups. One group, who meditated while on a drug that blocked ee e o opioid reported pain levels comparable to another group who medicated while on saline. The researchers say this shows that mindfulness meditation and opioids reduce pain ia di eren pa ay and suggest that combining the two approaches could lead o ore e e i e pain management.

The journal Gut has published a study showing that longterm use of antibiotics is associated with the growth of a type of polyp called colorectal adenoma. Adenomas are a type of polyp known to be precursors to cancer, although they don’t necessarily become cancerous. Nurses who had taken antibiotics for two months or more when they were aged 20–39 were more likely to get adenomas later in life compared

activity — which are associated with immune system strength and cancer prevention — in the week after a forest visit. e po i i e e e lasted up to a month after. Essential oils are secreted by the plants of the forest to protect themselves from germs and insects. They are termed phytoncide and inhaling them strengthens immunity.

to people who had not taken long-term antibiotics in their 20s and 30s; those who did the same during their 40s and 50s were even likelier to develop adenomas later in life. The study authors suspect that the adenomas were due to an altered gut microbiome after the intake of antibiotics.

ASTHMA DRUG GOOD FOR HIVES, TOO A drug normally prescribed to asthmatics has been shown to be effective against people who suffer from certain types of hives. Two clinical studies have shown that omalizumab is highly effective against itchy weals that develop in response to cold or friction (inducible urticaria). Results from these studies, conducted by Charité-Universitätsmedizin Berlin, have been published in the Journal of Allergy and Clinical Immunology. Omalizumab is licensed for use only in patients with traditional hives (chronic spontaneous urticaria), but the researchers are hopeful that the drug will be made available soon to both of these patient groups.

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NEW HOPE FOR DIABETICS

H AV E A C U P PA!

NAFLD: BIRTH WEIGHT A RISK FAC TO R Non-alcoholic fatty liver disease was brought sharply into focus recently when Charles Chong, Singapore’s deputy speaker of Parliament, had to undergo a liver transplant because of it. ere i e iden e published in The Journal of Pediatrics — that birth weight plays a part in this disease. “What our research found is that low and high birth weights were associated with the severity of liver disease, but in di eren ay ay e rey Schwimmer, MD, professor of paediatrics at UC San Diego School of Medicine and director of the Fatty Liver Clinic at Rady Children’s Hospital-San Diego. Prof Schwimmer adds that babies who do not fall under the normal weight category should have their metabolic health tracked more closely “to prevent obesity, liver di ea e and diabe e

Good news, coffee lovers! The Mayo Clinic website has announced that drinking this beverage is associated with decreased overall mortality — possibly even cardiovascular mortality. It cites studies that show the drink offers protection against Parkinson’s disease, type 2 diabetes and liver disease. Coffee also improves cognitive function and decreases the risk of depression. The article warns, though, that people with a specific genetic mutation that slows the metabolisation of caffeine are at some risk of heart disease. Drinking unfiltered coffee is also linked to mildly elevated cholesterol levels.

IS IT A COLD OR AN ALLERGY? As these two conditions have overlapping symptoms, such as sneezing and runny nose, they can be hard to tell apart. Knowing which is which is important, as the treatment regi e i di eren or ea A cold, which usually lasts between three and 10 days, needs cold remedies, such as a decongestant, and analgesic to combat aches and pains. Bed rest is also recommended.

Cough Aches and pains Fatigue and weakness Itchy eyes Sneezing Sore throat Runny nose S u y no e Fever

For an allergy, usually an antihistamine is prescribed, with perhaps a decongestant or a nasal spray. Here is a useful table to tell the two conditions apart: COLD usually sometimes sometimes rarely usually usually usually usually rarely

A new type of cell that secretes insulin has been discovered. It was always thought that new beta cells are generated by other beta cells dividing. Beta cells are contained in the islets of Langerhans in the pancreas; they detect glucose and secrete insulin to regulate blood glucose. A team from the University of California Davis has discovered another type of cell around the edge of the islets that looks like an immature beta cell. These cells can make insulin, but can’t detect glucose, so they can’t function as a full beta cell. They also saw alpha cells (which raise the blood glucose level) in the islet turn into immature beta cells, then into mature beta cells. “There’s much more plasticity in the system than was oug ay ea e ber Mark Huising. He adds that this discovery could help in developing stem cell therapies to treat both type 1 and 2 diabetes.

ALLERGY sometimes never sometimes usually usually rarely usually usually never

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WELLNE SS & HE ALTH

L O S I N G S L E E P, LOSING BONE n u ien eep an lead to bone loss. “The data suggest that sleep disruption may be most detrimental to bone metabolism earlier in life, when bone growth and accrual are crucial for ong- er e e a ea says Christine Swanson, assistant professor at the

University of Colorado in Aurora, USA, of a study in which she was lead investigator. The experiment studied the health consequence of sleep restriction combined with circadian disruption. It found that 27% of young men with sleep restriction and circadian disruption experienced a reduction in the level of P1NP — a blood marker o bone or a ion compared to 18% of older men. However, CTX, the bone resorption marker, was unchanged in both groups. According to Swanson, this creates a window of bone loss that could lead to osteoporosis.

THE MED DIET IS BRAIN FOOD The Mediterranean diet is a popular choice among those looking to trim their waistlines and improve their cardiac health, but research shows that it can do more. According to a study published online in Neurology, the medical journal of the American Academy of Neurology, older people who followed a Mediterranean diet retained more brain volume over a three-year period than those who did not follow the diet. So raise a glass and load up on the sardines, olive oil, tomatoes and beans!

PR E G NANT AF TE R M E N O PAU S E? The Genesis Athens Clinic in Greece has reportedly helped at least two menopausal women get pregnant! A team from the clinic, led by gynaecologist Kostantinos Sfakianoudis, attempted to rejuvenate the ovaries of 27 women between 34 and 51 years of age from across the world using a technique applied in sports injuries, which involves isolating healing molecules from the blood and injecting the plasma onto abnormal tissues. Of these women, 11 resumed their menstrual cycles. Those who hoped to get pregnant returned to their home countries for IVF. No one is quite sure why the technique worked. Some hypothesise that the plasma wakes up stem cells in the ovary; some claim that the plasma itself contains stem cells; others suggests that sticking a needle in the ovary changes the flow of blood, which may awaken isolated egg follicles.

B E AT G O U T WITH SOME BRAN o on y doe a ig - bre diet keep you regular, it can also help stave o y po o gou According to new research published in the Journal of Leukocyte Biology, die ig in bre or o encourage microorganisms in your gut to produce short-chain fatty acids, which help reduce in a a ion au ed by gout. Brazilian researcher Mauro Teixeira said, “By understanding the way foods interact with living organisms, we may be able to create diets that help people with the disease, as e a eir ea o era

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EX ERCISING AT NIGHT PREVENTS SLEEP It depends on your body clock. Exercise is great for reducing stress and anxiety, and is usually an effective sleep inducer. However, some people who work out too close to bedtime have problems nodding off later. It may be worthwhile for these folks to vary their exercise time to observe which slot gives them the most restful sleep.

MY THBUSTERS FOAM SOA P IS BETTER THAN LIQUID SOA P

A BREW M A DE FROM BL ACK TE A L E AV E S RELIEVES DIARRHOEA According to the MedIndia website, drinking a cup of strong black tea is effective in relieving watery stools. The tannins in black tea leaves impart an astringent effect on the mucous membrane of the intestines, helping the body absorb fluids and calming inflammation.

POMEGR A NATE JUICE SLOWS GROW TH OF PROSTATE CA NCER

A small study done at UCLA’s School of Medicine to compare foam and liquid soaps has concluded that the foam types are not as effective in reducing hand bacterial load. The bacterial count was conducted after a particular washing procedure. For foam, the average bacterial colony count dropped from 3.6 to 2.6; for liquid, it went from 3.8 to 1.2 — which is statistically significant.

According to the Mayo Clinic, there is some evidence that drinking pomegranate juice can slow the progress of prostate cancer. The juice slowed the doubling time of prostate-specific antigen (PSA) levels, even among patients who had undergone surgery or radiation for prostate cancer. Furthermore, in the laboratory, compounds in the juice impeded the growth of prostate cancer cells.

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FE ATURE

N

N WO RD S

JOSEPHINE NG

Did you know that there is a direct link between the gut and brain by way of trillions of bacteria? Keeping these bugs living in harmony in your gastrointestinal system is important to your physical and mental well-being. Have you consumed yogurt or a probiotic drink because you were e ced a ad cla c ld alle a e ch a l a a c a r d arrh ea re ch r d c reall d r r heal h As a nutritional therapist and functional medicine practitioner at The Nutrition Mentor (www.thenutritionmentor.com), I am glad to see a ere a been an e p o ion o ien i re ear in o e pro ound e e a ba eria residing in the human gastrointestinal (GI) tract have on health. To date, genetic sequencing a iden i ed ore an pe ie o bacteria in humans. In fact, our GI tract contains ore an ri ion ba eria and ere are i e ore ba eria gene an u an

genes. This begs the question of whether we are more bacteria than human! A gutful of bacteria Think of this bacteria population — or microbiome — as an ecosystem. Like all ecosystems, this needs to be in balance for us o reap i bene e - ended i robio e regulates our immune system, acts as a protective barrier against harmful substances or microorganisms, supports normal gut o i i y and de o i a ion o o in and helps to repair body tissues and renew cells. A healthy gut microbiome prevents cancer, regulates hormones, helps in the absorption of nutrients such as vitamins A and D, and produ e neuro ran i er i a e our moods and mental health) as well as vitamins (B group and K2).

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FE ATURE

Probiotic supplements can be used to replenish and rebalance gut bacteria; they are especially helpful after a course of antibiotics or any antimicrobial therapy. Dysbiosis happens when the delicate ba an e be een e di eren ype o bacteria is disrupted, or when there is an overgrowth of harmful microorganisms such as viruses, yeasts and parasites. We may then develop food intolerances and sensitivities, autoimmune conditions, constipation, diarrhoea, irritable bowel syndrome, in a a ory bo e di ea e u a ro n or ulcerative colitis), anxiety, depression, skin conditions (such as eczema), obesity and many more disorders. Eating your way to a healthy gut While a balanced gut microbiome is critical to robust health, there are other ways to achieve this besides consuming a commercially produced yogurt or probiotic drink. To me, the best way to a healthy gut microbiome is through eating whole foods, par i u ar y o e a pro ide o ub e bre sweet potato, yam, garlic, onions, leeks,

Jerusalem artichokes, chicory, apples, bananas, a eed ia eed pea bean and en i Fermented foods also support a healthy gut i robio e e e in ude dairy-ba ed one i e o i yogur and e r and non-dairy one i e auer rau i i a er e r o onu yogur o onu i e r and o bu a o e that fermented foods are not suitable for people with intolerance to histamine. o e- ade er en ed ood are be er options than most commercial ones, which often contain added sugar and additives, and may make matters worse if you already have dysbiosis. If you are not used to fermented foods, I would advise starting with a small amount (a teaspoon will do) and build up. Eating too much at once may result in bloating and gas as the bacteria from the fermented foods interact with the ones in your gut. The gut-brain link Did you know that our gut communicates with our brain?

BAL ANC ING GUT MICROBIOME THROUGH FO O D ✔

FOODS WITH SOLUBLE FIBRE

• Sweet Potato • Yam • Garlic • Onion • Leek • Jerusalem Artichoke • Chicory

• Apple • Banana • Flax Seeds • Chia Seeds • Peas • Beans • Lentils

FERMENTED FOODS

• Cow’s Milk Yogurt Co M lk Ke • Sauerkraut • Kimchi a e Ke • Coconut Yoghurt • Kombucha 20

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Our GI tract, like the brain, has a nervous y e and ore an i ion neuron a produ e a ea neuro ran i er in uding dopa ine and o our total serotonin (often referred to as the appy or one a o i are i por an or our en a ea u ba eria in uen e the development of the nervous system and the production of neurotransmitters. They in uen e our re re pon e urren re ear i oo ing in o o di eren rain o ba eria are able to do this. Stress management is also important. When the brain perceives stress, it sends signals to the gut to shut down the production of stomach acid and digestive juices. This makes it easier for pathogenic microorganisms to take up residence in our small and large intestines. Stress signals also slow down gut o i i y au ing a bui d-up o pu re ed ood This could lead to constipation as well as the feeding of harmful bacteria. i e o- ay o uni a ion i no a urpri e a peop e o u er ro abi ua constipation tend to be depressed as well. Protect the ecosystem Besides foods that are friendly to gut bacteria, there are other steps you can take to protect and nourish them.

antibiotics only when necessary, as • Use an ibio i i o bo ar u and bene

ia bacteria, paving the GI terrain for any opportunistic microorganisms to take hold. o no o eru e an i-a id edi a ion a o er- uppre ion o o a a id an au e an overgrowth of harmful microorganisms, particularly in the small intestine. The irony is a indige ion and a id re u are o en no due o o er-produ ion o o a a id and may be contributed by low stomach acid instead, among other factors. oid or redu e in a e o igni an y pro e ed and re ned ood i a our bad bugs such as yeasts. en ra e ing in e -de e oped oun rie drink only from safe sources of water and eat food that has been properly cooked. Probiotic supplements can be used to replenish and rebalance gut bacteria; they are especially helpful after a course of antibiotics or any antimicrobial therapy. These supplements contain good bugs, ranging ro genera a oba i u and bi do rain to highly specialised ones used for pe i purpo e So i no on y a you ea and do bu a o o you in and ee a in uen e e gu microbiome, which in turn impact your health in many aspects.

• •

When the brain perceives stress, it sends signals to the gut to shut down the production of stomach acid and digestive juices.

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COVER S TORY

C O T T O N S H I R T, COTTON-BLEND JACKET AND PANTS, SILK TIE AND L E AT H E R S H O E S HUGO BOSS C A L AT R AVA REF 5227 IN WHITE GOLD PAT E K P H I L I P P E

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A GENTLEMAN’S PASSIONATE PURSUIT

In speaking with Dr Yap Lip Kee, THIS Quarterly discovers that, beneath his soft-spoken exterior, the gynaecologist is a ea o s a vocate o eyho e s r ery an its enefits having taught and trained extensively for it. WOR DS

CHUA KIM BENG

PHOTOGRAPHY

CH I N G L E E ART DIRECTION

CH R I SSAN D RA CH O N G STYLING

KAR E N KWA & Z ECK Y I K HAIR AND MAKE-UP

DENNIS EE WATCHES

PAT E K P H I L I P P E

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COVER S TORY

You would expect someone who is a pioneer in a branch of surgery to have brash manners typical of many daring and innovative doctors, However, the distinguished-looking Dr Yap Lip Kee is almost too mild mannered to a fault as he arrives for this interview one rainy evening. Dressed in a pair of deep blue slacks and a long-sleeved shirt with tiny purple-and-white checks, the gynaecologist ushers this writer to the Delifrance café located on the second level of Mount Elizabeth Medical Centre, where his private practice is located. Unfortunately, all the indoor seats are taken, and the inclement weather makes it impossible to sit outdoors unless we are prepared to be soaked to the skin while shouting incessantly above the pitter-patter of the raindrops. We decide to skip the warm beverage and instead head to his clinic, Gynae Consultancy Pte Ltd. It would be a more conducive place for a chat, since it is about closing time. As we sit by his desk surrounded by charts, equipment, instruments and an examination table, the smell of disinfectant hangs in the air as a cleaner ipe do n e o e Socialist attitude towards medicine “I started training to be a gynaecologist in the late 1970s,

starting in KK Hospital, then berdeen Roya n r ary in the UK.,” he says in a quiet voice, adding that he was inducted into the Royal College of Obstetricians and Gynaecologists in 1984. “That was the time when we were acknowledged as a specialist and allowed to practise.” He started his own practice in 1990, “mainly due to push factors”. Having always had a “socialist attitude towards medicine”, he did not relish negotiating the political ine e d a i a pub i hospital. Working in the National Health Service during his years in Aberdeen reinforced his belief that everyone should have access to healthcare. It was also where he gained a di eren per pe i e o medicine. “The Scots are very pragmatic people, and their understanding of the economics of healthcare is that we aim for service to be good, fast and cheap. However, any economist will tell you that only two aims can be achieved at any one time. So if you want it fast and cheap, then be prepared to question the quality,” he quips. Noticing patient trends Dr Yap had initially wanted to pursue orthopaedics, but decided to specialise in obstetrics and gynaecology because he liked the idea of helping two people at once. However, he has given up delivering babies to concentrate on helping women with gynaecological problems. “The reality is that obstetrics is unpredictable, and I feel terrible

Any economist will tell you that only two aims can be achieved at any one time. So if you want it fast and cheap, be prepared to question the quality. each time I miss a delivery. It’s as if I have failed to deliver on a promise,” he admits. “And with much of my work being in the operating theatre, I have to ask colleagues to stand in for deliveries.” In addition, he is involved in chairing Singapore Medical Council Disciplinary Tribunals, which can last for hours and take weeks to complete. “With this, I felt it best to not commit to something I cannot literally deliver.” About half his patients see him for menstrual problems or abnormal uterine bleeding. “They are common all over the world,” he observes. Being a conscientious medical pro e iona e ari e “Actually, I should say that abnormal uterine bleeding is not a condition; it is a symptom. People see a doctor because of the symptom, but the causes vary.” While he has not noticed o en ro a pe i ra e

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C O T T O N S H I R T, WOOL JACKET AND PANTS, AND T R E N C H C O AT HUGO BOSS

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COVER S TORY

I think South and Southeast Asians tend to come forward earlier, while those who delay treatments the longest tend to be those of Chinese origin.

C O T T O N S H I R T, SILK JACKET AND TIE, AND WOOL PANTS HUGO BOSS ANNUAL CALENDAR CHRONOGRAPH REF 5905 IN WHITE GOLD PAT E K P H I L I P P E

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or region getting particular conditions more than usual, he concedes that women with African ancestry are more prone to abnormal bleeding due o u erine broid “It is most likely a genetic predisposition,” he surmises. Another interesting trend he mentions has more to do with social engineering than a medical condition. He could ne er nd a andida e in ina on whom to demonstrate corrective surgery for stress incontinence, which is leakage of urine when a woman coughs or laughs. This usually occurs after a woman has given birth normally. In discussions with local experts, he learnt that this was because of the onechild policy in China, which meant parents wanted perfect children — opting for birth by caesarean section seems to ensure that situation. “When you have a C-section, the birth canal does not undergo the stresses of vaginal delivery. This results in lack of damage to the bladder and supporting structures, hence no bladder weaknesses.” Whatever gynaecological problems they have, he observes that oriental women tend to come forward more slowly. “I think South and Southeast Asians tend to come forward earlier, while those who delay treatments the longest tend to be those of Chinese origin.” Establishing his reputation Dr Yap discloses that he usually gets patients via word of mouth or referrals from colleagues. These patients

usually need endoscopic or keyhole surgery. “I established my reputation in fertility and endoscopic surgery,” he adds. In fact, he is a little embarrassed when he reveals that he has overheard colleagues referring to him as the “grandfather of laparoscopy”. Laparoscopy is another term for keyhole surgery. He feels the title is un u i ed or o rea on or one, I am not a grandfather yet!” Dr Yap is married to Rachael, an anaesthesiologist, and they have three adult children. The other is that he feels there are more senior doctors who deserve the title more than he. “I would be happy to be acknowledged as ‘one of the pioneers of operative laparoscopy’,” he says with a smile. He confesses that he always aimed to be among the best, but not necessarily e r or any pro edure i i be au e e r end to make mistakes for others to learn from. “I am happy watching and adopting the best practices,” he says. And he learnt from the best in the world during the 1980s, such as the late Professor Kurt Semm in Kiel, Germany, and Dr James Daniel in Nashville, Tennessee, USA. But what was it about laparoscopy that fascinated him? “Here was a whole new type of surgery that allowed us to operate by introducing ne in ru en roug a punctures to do precision surgery aided by cameras, gi ing u a ig y agni ed

view of the female pelvis,” he marvels. In contrast, the alternative was traditional surgery, which meant making cuts big enough for surgeons to put their hands into the female pelvis and abdomen to remove organs or carry out repairs with traditional instruments and i ou agni a ion o e area being operated on. Steep learning curve “When laparoscopic surgery was starting out, we were very clear in our minds that this would be the way to operate in the future,” Dr Yap says. “But only if we could master the skills that allow us to avoid complications.” Such complications usually mean damaging nearby organs, most commonly the intestines and blood vessels. He reveals that many do or ound i di u o retrain themselves from looking and operating on the target organ directly to operating on an organ viewed on a screen. “This is like playing a video game; you have to look at the screen and try not to look down at your hand controls,” he describes. “When that barrier was overcome and safe techniques were introduced and learned, laparoscopic surgery became the accepted method of surgery for most procedures.” Dr Yap gives the example of ectopic pregnancy in KK Women’s and Children’s Hospital. In 1990, less than 5% of ectopic pregnancies were rea ed by aparo opy e years later, 50% were treated by laparoscopy while the remaining had open surgery.

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COVER S TORY

C O T T O N S H I R T, SILK-BLEND JACKET AND PANTS, AND L E A T H E R B E LT HUGO BOSS ANNUAL CALENDAR CHRONOGRAPH REF 5905 IN WHITE GOLD PAT E K P H I L I P P E

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This is like playing a video game; you have to look at the screen and try not to look down at your hand controls. By 2000, 95% of ectopic pregnancies were treated by laparoscopy, making it not only the gold standard, but the only acceptable method of treatment. International recognition In 2003, when Dr Yap had just turned 50 years old, he became the youngest president of the International Society for Gynecologic Endoscopy. He was also the o ie y r ian pre iden “I had been approached to stand for the post by my mentor, Dr James Daniel, with whom I had been running operative demonstrations in India, Malaysia, Singapore and Thailand,” he recalls. The nomination was uncontested because Dr Daniel had the support of a majority of the members, most of whom had attended an event organised by the Obstetrical & Gynaecological Society of Singapore in 1997 — Dr Yap was chairman of the organising committee and hence was a recognisable face. “I wish to think it was my operative skills that caught the eye, but it was more likely as recognition of organisational abilities. I did not think much abou being e r ro ia apart from the thought that it was an honour long overdue,” he shares.

DR YAP DELIVERS Diagnostic vs operative laparoscopy Introduced by general surgeons to Singapore in the early 1960s, diagnostic laparoscopy was used to ‘look and

Still an active member of the International Society for Gynecologic Endoscopy, he is involved in its Training Committee, especially for Asian countries. He was made an Honorary Member in 2016. Travelling advocate Dr Yap has travelled extensively to give seminars and demonstrate the use of laparoscopic surgery. It is still the best way to promote its use. “Doctors tend to only believe what they see, hence operative demonstrations in their local hospital is the o e e i e ay o ge ing the message across that this surgery can be done, and safely,” he insists. “Videos and live telecasts are poor substitutes.” He feels blessed that he has a supportive and understanding family, which allowed him to travel as frequently as he did. In fact, his medical travels a e rubbed o on Ra ae and their ophthalmologist daughter, Zhu Li: they both contribute their skills on overseas medical mission trips. “While the children were young, at least one parent was always around, but now that they are young adults, we are able to travel more together, and not just on professional assignments.”

Towards the end of the 1980s, laparoscopic

gynaecological theatre to the general surgery theatre and

I concentrated on developing and advancing

press as advances in gynaecological laparoscopy represented evolving technology, whereas laparoscopic

Limited role of the robot Traditional laparoscopic surgery accounts for 98%

Open surgery is still an option

result is likely to be as good, albeit without the advantages

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MOUNT ELIZABETH HOSPITAL SPECIAL

COMPLEX AND HUMANE ALTHOUGH IT HAS MADE A NAME FOR ITSELF AS A CENTRE FOR COMPLEX SURGERIES, MOUNT ELIZABETH HOSPITAL STRESSES EXCELLENCE IN SERVICE, TOO. ITS CEO REVEALS MORE ABOUT THIS TWO-PRONGED APPROACH.

“W

e have performed and continue to perform some of the most complex surgeries in Singapore. Our key strength lies in complex surgeries and critical care, including organ transplantation, surgical oncology, advanced cardiac surgeries, minimally invasive procedures, robotic surgeries and fertility treatments,” reveals Mr Phua Tien Beng, CEO of Mount Elizabeth Hospital.

At home with complex surgeries In fact, the hospital, located just off Singapore’s iconic shopping belt of Orchard Road, has numerous achievements and firsts it can boast of: ABO-incompatible kidney transplants, highest number of living donor kidney

transplants in Singapore, paediatric flipped liver transplant, liver transplant for patients with Klatskin tumour (which used to be contraindicative to transplants), trans-oral endoscopic thyroidectomy, and youngest patient to be implanted with the Left Ventricular Assist Device. “The list goes on,” says Mr Phua, before attributing these accomplishments to “having a large team of multi-disciplinary specialists under one roof”. This is an advantage because complex cases require an expert team-based approach from a number of fields. These specialists — about 1,400 of them — constantly scan the horizon for the latest healthcare developments and medical breakthroughs to enhance the hospital’s already considerable number of world-

class services and evidence-based treatments. “The latest immunotherapy for cancer treatment, optical coherence tomography for our cardiovascular lab, and MRI fusion prostate biopsy are examples of the hospital at the cutting edge of medical technology and surgical procedures,” assures Mr Phua. At the moment, the three most indemand specialties at Mount Elizabeth Hospital — not in any particular order — are Cardiology, Orthopaedics and Oncology.

Care beyond clinical excellence Mount Elizabeth Hospital has worked hard to achieve a reputation as a patient-centric and service-oriented hospital.

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“Mount Elizabeth is known to have an excellent clinical track record and the latest facilities in the Asia Pacific region,” shares Mr Phua. “Our doctors are able to provide personalised attention and relevant information for patients to make an informed decision regarding treatment options open to them.” But besides providing cutting-edge equipment and competent medical staff, the hospital also offers patients comfort, ease of mind, and an awardwinning experience. For example, it has a cashless service that allows eligible patients to receive treatment and care at the hospital without having to fork out cash before admission. The hospital provides rooms for caregivers or family members and offers concierge services. “We also help them with the warding process, which can be daunting to many,” says Mr Phua. “We have a group languages, making our international patients feel at home during their stay and ensuring that all their needs are met.” In addition, for its overseas patients, Mount Elizabeth Hospital has Patient Assistance Centres across Asia providing door-to-bed services. “Travel and accommodation arrangements are patients to concentrate on recovery and their families to focus on caring for their loved ones,” adds Mr Phua. This combination has impressed many past patients, who then spread the word among family, friends and business associates. “Word of mouth is our strongest marketing device,” says Mr Phua. “Many become our patients through the recommendation of customers from almost 40 years of distinguished service.”

Maintaining the award-winning edge Mount Elizabeth Hospital has been acknowledged often for good customer experience. It was named Asia Pacific Hospital of the Year for the second consecutive year at the 2017 Asia Pacific Healthcare & Medical Tourism Awards. It also took home three other awards (Singapore Hospital of the Year, Cardiology and Neurology Service Provider of the Year). For three consecutive years (2013–15), the hospital picked up the Singapore Experience Award.

Mr Phua highlights that these accolades are due to the hospital’s insistence on excellence from the very first step. “Proper recruitment criteria and processes ensure staff are service-oriented. Through effective in-house training and a robust framework to encourage and recognise good service, our staff are well-equipped to continue Mount Elizabeth’s fine tradition of providing exceptional customer service,” he says. The hospital is not resting on its laurels, and is busy preparing for medical issues of the near future. One area is the rise of chronic diseases, and not just traditional ailments like diabetes and hypertension. “Hospital stays will become shorter with advancements in less invasive surgical techniques and better drugs. Treatment and disease management will become less hospital-based,” Mr Phua predicts. He also foresees IT playing an expanding role in healthcare. “Mount Elizabeth Hospital was one of the first to embark on electronic medical records, making it easier and more convenient for our doctors and nurses to care for our patients. More importantly, it lays the foundation for patients to empower themselves and better manage their own healthcare choices,” he discloses. He also sees telemedicine as a way to forge closer bonds with overseas patients beyond hospital visits.

“THE HOSPITAL WAS THE FIRST IN SOUTHEAST ASIA TO PERFORM ABO-INCOMPATIBLE LIVING DONOR KIDNEY TRANSPLANTS.” Mr Phua Tien Beng CEO, Mount Elizabeth Hospital

MOUNT ELIZABETH HOSPITAL 3 Mount Elizabeth Singapore 228510 24-hour hotline: 6250 0000 WhatsApp appointment: 8111 7777 www.mountelizabeth.com.sg

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FE ATURE

EXERCISE MYTHS:

WORK NG OUT THE TRUTH Even if you’re motivated to begin an exercise programme, contradictory myths and beliefs about physical activities could eave yo con se an a ect yo r progress. Gain clarity about these eight exercise myths from two certifie hysica trainers WO RD S

SITI ROHANI

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A report released by the National University of Singapore’s Saw Swee Hock School of Public Health last year stated that, based on projections, 34% of people aged 24 to 35 can expect to be diabetic by the time they are 65. Professor Chia Kee Seng, the school’s dean, said obesity rates were rising at a faster rate for people below 40, and a big reason for this is the “big drop in physical activity” once people start working. Coupled with a fast-ageing society, where the number of citizens aged 65 and above is expected to increase to 900,000 by 2030, it’s high time we take a serious approach to our health by exercising regularly and watching what we eat. But before you embark on an exercise routine, it’s important to know the truth about some common exercise myths.

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FE ATURE

MYTH RUNNING ON A TREADMILL PUTS LESS STRESS ON YOUR KNEES THAN RUNNING ON HARD GROUND. It’s true that treadmills are designed with a built-in suspension system to absorb some of the shock and impact from running, but that does not mean you should just let loose and run for hours on a treadmill. “Other important factors like wearing the orre oe and a ing e rig running gai a o a e a di eren e en i o e o re on your nee ay a n g ne rainer and o ner o Rep i ne

MYTH DOING CRUNCHES WILL GET RID OF FLABBY TUMMIES. Crunches do help tighten the abdominal muscles, leading to what looks like a smaller waist, says Dawn. However, no matter how many crunches you do, you will not achieve washboard abs without also changing your diet and pairing it with cardio exercises.

MYTH WOMEN SHOULDN’T LIFT WEIGHTS BECAUSE IT’LL MAKE THEM LOOK BULKY. Lifting weights will help build muscles, but the truth is that women won’t be able to gain bulk as quickly as men do because of a lack of testosterone. Dawn explains why this myth persists: “When you lift weights without watching your food intake or incorporating regular cardio exercises, you do not reduce your body fat content. So, while that remains the same, you do build a little bit of muscle, which can give the appearance of being bulky.”

MYTH

Sweating is a good indication of how hard you’re working out. This is not necessarily true a e eryone i di eren “Sweating is a result of the body preventing itself from overheating; it could also be caused by environmental factors,” says Andrew Lau, a personal trainer with eight years of experience.

MYTH THE OLDER I GET, THE LESS EXERCISE I NEED. i y i de ni e y bu ed be au e e oppo i e i rue e o der you are, the more important it is for you to get regular exercise to help maintain mobility. According to Dawn, certain exercises help to improve and strengthen the cardiovascular system, building a stronger heart and lungs. Exercises that increase bone density and build muscle mass are also important to prevent osteoporosis. Andrew adds that as you get older, your metabolism slows down, so it’ll be harder to keep to your ideal weight without regular exercise.

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GE T CRA CKING! Even though you’re now better informed about MYTH I DON’T NEED TO EXERCISE IF I’M ALREADY AT MY IDEAL WEIGHT. Achieving your ideal weight is a great accomplishment, but you may not stay there for too long if you continue eating a e a e ra e i ou burning o e e ra a orie ay Andrew. Another thing to note: numbers on a scale are not always an indication of health, says Dawn. Someone at their ideal weight could still have a higher-than-ideal percentage of body fat, which could lead to health issues later on in life.

MYTH

It doesn’t matter what exercise I do; I just need to continue for a long time to see results. While there’s a grain of truth to i a e en ndre ari e a e er i ing e e i e y i let you see results much faster”. Dawn concurs: “Depending on your goal, what type of exercise you do matters when it comes to achieving results.”

MYTH AS LONG AS I EXERCISE DAILY, I CAN EAT WHATEVER I WANT. No matter how much we wish for this to be true, Dawn spells out the cold, hard truth: “No amount of exercise can counter a bad diet.”

exercise myths, it won’t do you any good if there’s no motivation to get moving. Here are three steps to overcome your inertia. SET A GOAL We often tell ourselves that the goal of exercise is something lofty and vague, such as “good health” or “a better body”. But what does it mean to be in good health to you? And what shape should your body be before you acknowledge that it is good enough? Without having these in mind, exercise can become meaningless.

tangible and — most importantly — achievable. Each goal should hold some meaning for you, whether it is to lose 10 pounds, gain two inches on your biceps, or the ability to run 2.4km non-stop. REWARD YOURSELF As mentioned earlier, many times we set vague exercise goals such as “good health” or “a better body”. However, just about to start an exercise routine, it may be better to promise yourself a real reward — such as a slice of carrot cake — after each session. This extrinsic form of reward will go a long way to make your new exercise behaviour routine. In time, your brain will associate sweating and straining with the release of endorphins, making the process intrinsic. MAKE YOURSELF ACCOUNTABLE Sign a contract in front of witnesses that commits you to your exercise routine. This is your promise to yourself. Make it as detailed as possible (how many weeks does the contract last, how many sessions a week, how long per session, etc). Better yet, add a penalty clause, such as contributing $5 to the SPCA each time you miss a session. Another method is to make yourself accountable buddy, would you? Alternatively, you could hire a personal trainer or sign up for an exercise class.

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FE ATURE

THE NOSE KNOWS: WHAT BAD BREATH SAYS ABOUT YOUR HEALTH So you have halitosis. If it persists even after taking corrective oral hygiene action, you may wish to consult your doctor — this is because bad breath can be a symptom of more serious conditions. WOR D S

HILDA CHANG

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“An apple a day keeps the doctor away” is a saying almost everyone has heard. But are you familiar with the follow-up? “An onion a day keeps everyone away!”

Having bad breath may be a source of anxiety for some people, and can lead to conditions such as depression.

d re erred o a b d br i o en a ribu ed o er ain ood in one die e ou odour an be ade or e by poor den a abi and r un oi e a ing bad brea ay be a our e o an ie y or o e peop e and an ead o ondi ion u a depre ion n e o er and i ay no ee a big o a dea o o er ye i an be o e un o or ab e or e peop e around e n e o o ing page ere are no on y ip or ge ing rid o bad brea bu a o in or a ion on a o er ondi ion you ou d a e ou d in rea ed ora ygiene pro e ine e i e

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FE ATURE

How to tell if you have bad breath? near y i po ib e o iden i y e prob e on our o n n ere r a e ing u n d e i you a e bad brea A k o eone n ea y o u ion ou d be o ge o eone o be one i you abou your brea u ar oo - n u o e er you n ur d n during your ne i i e or e ou d be ab e o e a ua e e r e i ed r your u B ea e n o you cu e n a ead brea and n up your and o er your no e nd ur ou rea e ou

TYPES OF BAD BREATH As explained, bad breath may not simply be the result of poor oral hygiene — it could be a sign of something more serious. In addition, d ere a a d de the foul smell emanating from your mouth can give doctors a clue to what you a e er r

DIRTY DIAPER BREATH When bacteria and debris get stuck in your tonsils, a malodorous tonsil stone may form in the crevices. However, this particle can be easily removed with a swab or foreceps.

FISHY BREATH Kidneys that are not functioning well can cause a build-up of nitrogen, which causes the body to give off a fishy odour. In this case, it may be time to arrange for a kidney function test.

FRUITY BREATH A fruity-smelling breath is caused by the production of ketones and is a telltale sign of diabetes. Individuals with with a fruity breath should get a blood test done.

roug your ou and deep y you br or ore a a rea up

o y and in a e qui y ou d b b your ura e re u brea e in o

L ck u L your r i dry r e e ond en a ea i i e o en i e en your brea probab y e bad no er ay o do i i o gen y rape your ongue i a ngu r r n e oo er pungen bad br i ue n prob e u Sr au e

an ea ing ood no n or eir e o e er did you no a an be a ign o under ying ea a bad brea an b au ed by a e no ing o do i ur ng a ay r b r dn nd n n an roni b d br

MOTHBALL BREATH If your breath smells like mothballs, it usually indicates allergies, sinus or a postnasal drip. It may also be caused by bacteria in the mouth as a result of poor oral hygiene.

SOUR MILK BREATH This odour can be a result of a highprotein, no-carb diet, which can reduce the body’s efficiency in breaking down protein. Sour milk breath can also be a sign of lactose intolerance.

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a a e e cau e o b b ea u d n bru nd o r gu r d d br an r n n ur u and be o e nouri en or odour- au ing ba eria en e bru a ea i e a day and a ea on e a day er ip are a ai ab e in e idebar o e er i any unu ua e per i i ay be i e o ee your do or i i be au e e odour o ing ro your ou ou d be au ed by ore eriou ondi ion Alle g e u u ra y r d a en and in u br

r r rg b d br ay a i r u no e nd r u r br d ng gr und r na y g r n e i ina ing rg u ien a i a enab e ba eria o

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FE ATURE

RUNNING HIGH WORDS

FIONA CHEN & RICHARD SIRRS

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When it comes to stair running, the sky’s the limit. Richard Sirrs, an internationally ranked stair runner based in Singapore, provides the lowdown on how to do it right. Stair climbing has been gaining traction in Singapore. After all, the Lion City has an abundance of skyscrapers, so there is no shortage of training opportunities for the budding stair climber. Similarly, there is no lack of racing opportunities, with vertical marathons fast becoming a common sight on local sporting calendars. Interest in such races remains high: the last Swissotel Vertical Marathon, held in November 2016, attracted more than 2,000 participants. Stair running is no walk in the park — some peop e nd i e au ing o e en onquer a e ig o air o e er i i a por a a any bene e o a i ree a more, health regulators around the world are na y ge ing i e o e po en ia ea bene o air i bing

In February this year, researchers from McMaster University in Canada found that just 30 minutes of stair running a week increased ardiore pira ory ne a ar er o onge i y This discovery is echoed by Dr Harvey Simon, associate professor of medicine at Harvard Medical School, who said that stair walking or running is one of the best-kept secrets in preventive medicine, burning calories at twice or even thrice the rates of activities done on level ground. Winning by accident For Richard Sirrs, a world-ranked Englishman based in Singapore, his entry into the sport was a bit of an accident. He was volunteering in Cambodia as an ng i ea er a er eeing e ra ra e in ng and e quip en e oo a or

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FE ATURE

a a ion in ang o ere e u b ed on a poster advertising a vertical marathon to be e d a e anyan ree o e a - orey building and one of the tallest in the Thai capital. Sirrs was intrigued by the idea of ra ing in a air e a in a bodia e chanced upon yet another advertisement for a vertical marathon. To him, it was a sign, and he immediately registered for it. His competitive streak awakened, he embarked on an intensive training regimen, consisting of doing steps repeatedly on a bench in the communal area at his accommodation, much to the amusement of his fellow volunteers. Sirrs also started running e ree o P no Pen i e or paid o e on de pi e i being i r air running race. That was how his stair running career began, one that would eventually see him being invited to numerous races around the world, including the prestigious elite-only La er i a e de a our i e in Pari Upon his return to England, he set up a stair running club called Orchard Park Stair Runners — named after the council estate they trained in — with his friends. The club is on hiatus now after his relocation to Singapore, but the members are still training in their respective locations. Stair-climbing basics e g again gra i y i no o be a en lightly, according to Sirrs. “Some say climbing

a y raper a peed require ore gri and determination than completing a traditional marathon,” he says. However, as with all athletic pursuits, progression is paramount in order o ay a e i e e ending your enjoyment of the sport. The key is to pay attention to increasing intensity and volume before eyeing that 65-storey building across e road ro your o e e er e e er i a be e o are made of concrete or glass and steel, you can ea i y ea your ee y ne regi en in order to prepare yourself to race against the or d be a a o a er i a ara on ere is some advice from Sirrs: • egin i a ee y raining e ion ascending 12 storeys 10 times. • or e r e a en bri a ing is recommended so as not to overwork yourself. Practise the two fundamental e nique a epara e a pro ro a beginner: take two steps at a time, and use your arms to pull yourself around the railings. • or e ne e a en prin e r i orey and re o er on e anding or o e ond be ore prin ing e na i orey radua y redu e e re o ery i e ai ing or e ond a your ne improves. you gain on den e and ne e peri en by in rea ing your ee y oor climbed and sprint intervals.

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Stair-climbing tips Love the rail Proper rai e nique i a ey e e en o air running i a epara e e beginner ro the professionals. Pulling on the rail takes a lot o re o e eg i e p you ip around the stairwell and push you up e ne ig Save your single stepping for he ce oo Stair running is all about doing doubles. Taking two steps at a time will always be qui er an a ing e singly, and the lunge position you nd your e in en double-stepping engages the whole posterior chain — glutes, a ring and quadri ep o prepare to feel the burn there. Descend with care The eccentric muscle contractions when descending stairs are a common cause of muscle soreness, and may cause injuries, so do watch out. Always warm up i any renuou a i i y i i por an o properly prepare the body for such physical demands. For stair climbing, walk several ig o ge e b ood pu ping en do o e dyna i re ing e er i e a o u on the hips, legs and arms.

As with all athletic pursuits, progression is paramount in order to stay safe while extending your enjoyment of the sport.

Where to run in Singapore a are idea for taking those tentative r ep o ard be o ing a air running a ionado i a bo i era y around e ery orner ere no or age o training opportunities. For reference and something to aim for, an internationally ranked stair runner is able o a end a ypi a - orey b o in e ond n e you e a ered e - orey on ider o ing on o e o er o a re iden e e Pinna e u on in an ong Pagar — and test your mettle against its e pe ia y eep and ung-bu ing oor No more excuses i ea y o nd e u e or no e er i ing in e gy u a e pen i e ee and e a o nearby a i i ie u no o in a oun ry dominated by high-rise buildings with access to stairwells, insists Sirrs. “In England, I had to drive many miles to the nearest town with a building with more than 10 storeys. Now that in Singapore i a a ed a o an train virtually anywhere,” he shares. ie e i a i e y preparing or i up o ing ra e Sirr u i a e drea i o e up a stair running club in Singapore, based in the skyscraper capital that is the Central u ine i ri ere e or e ay hope to encourage more people to pursue this sport and to show just how convenient and easy it is to take it up.”

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FE ATURE

NTU’S National Vertical Marathon Singapore This brainchild of Nanyang Technology ni er i y por ub a ad a ri i ory since its inception in 1994, with previous races a ing p a e in bui ding u a ia Square and Ra e P a e no n o be un and ibran i year ra e oo p a e in ay a e ne y opened Sou ea o er

Swissotel Vertical Marathon At 226m tall, the 73-storey Swissotel The Stamford has hosted this annual race since 1987, en i a no n a e e in S a ord i regarded a one o e or d o o pe i i e air ra e La year S i o e er i a ara on inner Pio r Lobod in i a ed e oor in a re ar ab e inu e and 55 seconds. Containing a heli-pad, the rooftop of the Swissotel provides unrivalled views of Singapore that is worth the climb. The event a e p a e around e a quar er o e year The Swissotel Vertical Marathon is part of e o er Running our a grand pri poin based competition that takes place in some o e or d a e and most iconic structures, in uding e i e Tower, Taipei 101 and the massive uang ou Tower.

STAIR RACES AROUND THE GLOBE Bangkok Vertical Marathon o ed by e u uriou - orey anyan ree o e i ra e e d i 18th edition in February this year. After climbing a total of 1,093 stairs up the di in i e bui ding par i ipan i be g ad o nd e e e a e reno ned er igo and oon ar no re re ed by e drin on o er ey ou d be in igora ed by e a a ing ie o e i y o nge ro a e e e urren re ord i i inu e e ond

Vertical World Circuit e annua er i a or d ir ui a e ab i ed in or e ir ui has lined up a series of 10 races, including a new one in Osaka, Japan (Abeno Harukas). The circuit began on 3 March in Dubai (Jumeirah Emirates Towers), and i ra e o London o er Pari our ir e or ne or d rade en er ani a S angri- a a e or ei ing ina or d Su i ing Sydney Sydney o er ye and S ang ai o S ang ai n erna iona inan e en re be ore u ina ing on e e ber in ong ong n erna iona o er e en re ere a an e ibi ion ra e in Seou Lo e or d o er in pri i year o no i ay be o e a per anen part of the circuit in the near future.

The Climb to Abu Dhabi This is one of the latest tower runs to be organised. Held under the auspices of the Abu Dhabi Sports Council, the inaugural race was held in January this year at Etihad o er e pro i a e o o er a oor a 1,617 steps), while those in the community categories (amateurs, families and schools in a variety of individual and ea re ay need on y o p e e oor or ep Pri e oney o S a up or grab e e en a o o ered par i ipan ree raining e ion days before the race.

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BREAST SURGICAL ONCOLOGY

Dr Chong Chee Keong

EAR, NOSE & THROAT

64

OBSTETRICS & GYNAECOLOGY

Adj A/Prof Lynne Lim

49

Dr Ann Tan

54

Dr Karen Sng

58

Dr Lau Chee Chong

72

Dr Kelly Loi

57

Dr Colin Tham

61

Dr See Tho Kai Yin

74

Dr Leslie Kuek

65

CARDIOLOGY

Dr Julian Tan

48

Dr Eric Hong

60

COLORECTAL SURGERY

ENDOCRINOLOGY

Dr Abel Soh

68

HAND SURGERY

Dr Ho Kok Sun

52

Dr Francis Seow-Choen

73

PLASTIC SURGERY

Dr Tan Soo Heong

OPHTHALMOLOGY

Dr Leo Seo Wei

RHEUMATOLOGY

53

ORTHODONTICS

50

Dr Tan Kok Liang

A/Prof Leong Keng Hong

70

VASCULAR SURGERY

69

Dr John Tan

66

HEPATOBILIARY SURGERY DERMATOLOGY

Dr Wong Su-Ni

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Dr Tay Khoon Hean 46

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ORTHOPAEDIC SURGERY

Dr Sean Ng

UROLOGY

62

Dr Michael Wong

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14/6/17 12:41 PM


SPECIALIST

OPINIONS DERMATOLOGY

Hair today, gone tomorrow The horseshoe that crowns the head of some men is a dreaded sign of hair loss. Understand why this condition occurs and when to seek help. Hair loss — medically known as alopecia — is a common problem in men, women and, less frequently, in children. As people age, their rate of hair growth slows. This is known as involutional alopecia and is a natural condition when hair follicles enter a resting phase while the remaining hairs become shorter and fewer in number. Hair loss may also be caused by a range of underlying conditions. These include autoimmune disorders, hormonal disorders, dietary deficiency, and diseases of the scalp. Hair loss can also be due to a condition called trichotillomania, which refers to self-inflicted hair pulling.

Hair loss may also be caused by a range of underlying conditions. These include autoimmune disorders, hormonal disorders, dietary eficiency an iseases o the scalp.

Bald issues

Dr Wong Su-Ni Dermatologist Dr SN Wong Skin, Hair, Nails & Laser Specialist Clinic 3 Mount Elizabeth #07-09 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6733 3629 www.drwongsuni.com.sg

The most common cause of hair loss is androgenetic alopecia, or male or female pattern hair loss. This genetic condition is more common in men, but can also affect women. It results in the distinct M-shape of male pattern hair loss and can strike as early as one’s teen years. In women, it is known as female pattern hair loss and occurs typically from the age of 40. Women experience thinning over the crown, front and sides with finer hair; unlike men, they do not develop a bald pate. Alopecia areata results when the immune system attacks hair follicles, causing patchy hair loss in children and young adults. The condition can occur suddenly, may affect eyebrows, eyelashes and hair elsewhere

on the body, and may sometimes progress quite quickly to near-baldness. While single small patches of alopecia areata may resolve spontaneously, more extensive or worsening alopecia should be seen quickly by a dermatologist for diagnosis and treatment. In most instances, the process may be halted and the hair regrows within months to two years. Scarring alopecia is the permanent loss of hair due to inflammatory skin conditions such as acne, skin infections (cellulitis, folliculitis) and other skin disorders (such as some forms of lupus). Hairstyles that exert pressure on the hair roots (such as tight braids or ponytails) can also result in permanent hair loss.

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Nutritional deficiencies (such as iron deficiency), thyroid disorders, stress to the body (such as severe illness, after childbirth and surgery) and some medications can lead to general thinning of the hair. Damage to the hair shaft, such as fungal infection of the scalp and excessive heat or chemical treatment to hair, causes hair to break easily. This results in apparent hair loss.

Hair loss prevention Not all causes of hair loss are preventable. Genes and hormones play a big role in determining hair growth. However, some risk factors are avoidable. For instance, one should stay away from excessive chemical treatments (colouring, perming, straightening) as the constant application of heat and chemicals on the scalp and hair may weaken hair or damage the scalp. Lifestyle choices, too, can contribute to hair loss. Smoking, stress and dietary imbalances (lack of protein or iron) can exacerbate hair loss.

Low-level light or laser therapy has been shown in clinical trials to be si nificant y ore e ective than dummy devices in increasing hair count in treated areas for both male and female pattern hair loss.

Hair loss treatments Apart from the avoidance of risk factors, seeking timely medical advice can retard the progress of hair loss. A dermatologist will enable a comprehensive assessment of the underlying issues for hair loss to diagnose the cause and determine a route of treatment. Treatment may include: • Cortisone injections • Topical medications • Prescription pills • Immunotherapy • Low level light/laser therapy • Hair transplantation In general, prescription pills are more effective than topical treatments for androgenetic alopecia, and are more effective for men than women. For those not keen on pills or messy sprays, lowlevel light or laser therapy has been shown in clinical trials to be significantly more effective than dummy devices in increasing hair count in treated areas for both male and female pattern hair loss. A hair transplant is a surgical procedure to graft healthy hair follicles, taken from other parts of the scalp that are resistant to balding, to cover up bald or thinning areas. These hairs retain the characteristics of the donor site and will thus be more coarse and have a longer ‘life span’.

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SPECIALIST

OPINIONS CARDIOLOGY

Chest pain: 3 heartrelated sources Although chest pain can arise from problems with other organs, this article concentrates on three conditions related to the heart.

A discomfort occurring anywhere between the upper abdomen and neck is commonly referred to as chest pain, although terms such as ‘chest pressure’ and ‘chest tightness’ are also used. The type of pain can vary. Popular words used to describe the sensation include ‘dull’, ‘burning’, ‘spiky’, ‘stabbing’, ‘crushing’ and ‘squeezing’. It is recommended that you seek medical attention as soon as possible if the chest pain comes on suddenly, or if it persists even after you have taken anti-inflammatory or pain-relieving medications. When a person experiences chest pain, the first thing that usually pops into his mind is that he is having a heart attack. In truth, a pain manifested in the chest region could arise from a problem with organs and tissues other than the heart, such as the lungs, oesophagus, muscles, ribs, nerves and tendons. Here are three common heart-related issues that can lead to chest pain:

1 2 Dr Julian Tan Physician & Interventional Cardiologist The Heart Specialist Clinic 3 Mount Elizabeth #14-09/10 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6235 8733 www.juliantanheart.com

3

A pain manifested in the chest region could arise from a problem with organs and tissues other than the heart.

Heart attack / Angina The classic image of chest pain is an older gentleman clutching his chest due to a heart attack, which occurs when blood flow through the heart is severely reduced or blocked. This can lead to the heart muscle cells dying. The crushing pain usually happens in the centre or left side of the chest, and is often accompanied by weakness, sweating, nausea and shortness of breath. Resting does not help. Angina is a less severe form of heart attack, in that the reduction of blood flow to the heart is not as drastic. During either a heart or angina attack, the crushing pressure in your chest can spread to the shoulders, arms, back or jaw.

Pericarditis Pericarditis is an inflammation or swelling of the sac covering the heart. When this condition strikes, it can cause pain in the centre of the chest similar to that caused by angina. In pericarditis, the pain is usually sharp and steady along the upper neck and shoulder muscle. Some patients have described their symptoms worsening when they breathe, swallow food or lie on their back.

Aorta wall tear The aorta is the main artery of the heart that carries blood to the rest of your body. When the wall of the aorta tears, a situation referred to as aortic dissection, a severe and sudden pain in the upper back and chest can be expected.

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EAR, NOSE & THROAT

When the room starts to spin The sensation of giddiness can be induced through ear-related or about both. Vertigo is the sensation of the room spinning around; more often than not, it is caused by an ear-related problem. In another condition called non-specific giddiness, sufferers have described it as feeling woozy, faint or lightheaded, or as if they were swaying. This feeling of instability is common in older patients, although the problem can arise at any age. As these attacks are unpredictable, they dramatically restrict one’s lifestyle and activities, increase accidents and falls, and can lead to depression.

Non-ear-related causes About 70% of all cases of giddiness fall under this category. Problems that could induce the sensation include medications, dehydration or overheating, low blood sugar or anaemia, poor vision, orthopaedic and heart disease, strokes, brain tumours or injuries and even a sedentary lifestyle. Children may have giddiness from minor epileptic attacks or migraine attacks without headaches. Patients can concurrently have overlapping causes of giddiness.

Adjunct A/Prof Lynne Lim Ear, Nose & Throat – Head & Neck Surgeon Lynne Lim Ear Nose Throat & Hearing Centre (Child & Adult) 3 Mount Elizabeth #17-07 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6737 7787 1 Farrer Park Station Road #15-02 Farrer Park Medical Centre Singapore 217562 Tel: 6702 0990 www.drlynnelim.com

Ear-related causes The ear balance system consists of three semicircular canals that detect rotational head movement, and two sacs that detect horizontal movement and vertical acceleration. When any portion of this ear balance system is affected by disease, it can lead to vertigo. Common causes include: • Benign paroxysmal positional vertigo (BPPV) About half of all older adults experience this. In younger patients, it usually follows infections and head injury. A brief, intense spinning happens when the patient changes head position (getting out of bed, at an exercise class). Although the recurrence rate can be as high as 40%, most

cases resolve with a particle repositioning manoeuvre in the clinic. Inner- or middle-ear infection This condition often accompanies a flu or cold. Meniere’s disease Besides vertigo, this disease causes hearing loss. The patient sometimes ‘hears’ ringing and feels a sense of fullness in the ear. Ear balance nerve disorder This problem could arise due to a viral infection or tumour. Perilymph fistula This happens when there is a leak of innerear fluid, which is associated with diving, head injury or physical exertion. Mal de Debarquement syndrome This is defined as the feeling of continuous bobbing after sea travel.

The patient should consult a doctor who is enthusiastic about getting to the root cause and pays careful attention to case history. Careful testing for positional vertigo of all three semicircular canals — not just the posterior canal — is needed. Also to be evaluated are neck-spine and neck-brain circulations, as well as blood pressure changes when lying and standing. In recalcitrant cases, a full spectrum of tests — such as the vestibulonystamography (VNG) test, video head impulse test (VHIT), vestibular evoked myogenic potential (VEMP) and even rotatory chair tests — is usually needed. Oral anti-vertigo and anti-nausea medications are used in acute giddiness, while injection of gentamicin or steroids into the middle ear may be considered. For uncompensated giddiness, rehabilitation therapy helps. Surgery is reserved for debilitating cases.

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SPECIALIST

OPINIONS

HAND, WRIST & UPPER LIMB SURGERY

Understanding nerve injury in the hand Here’s what happens when your body’s information superhighway is not functioning normally.

Have you noticed that when you accidentally touch something scalding hot, your hand retracts almost instantaneously? In those few milliseconds, sensory nerves in your hand carry messages from the body to the central nervous system (CNS). Then, motor nerves convey signals relayed back from the CNS to the muscles so that your hand pulls away from the hot object. In that way, nerves have been likened to telephone cables that transmit information to and from the brain.

Major nerves of the hand and wrist Five major nerve roots arise from the neck to form a complex network and produce three major nerves running down the upper limb, called median, ulnar and radial nerves. • The median nerve provides sensation to the palm, thumb, the index, middle and part of the ring fingers. It supplies muscles that allow the wrist, thumb and other fingers to flex. • The ulnar nerve provides sensation to the inner border of the hand, the other part of the ring and little fingers. It supplies the smaller muscles in the hand needed for fine movements such as writing. • The radial nerve provides sensation to the back of the hand. It supplies muscles that extend (straighten) the wrist, fingers and thumb.

When nerves are injured Peripheral nerves may contain three components. The sensory component carries sensation back to the CNS. The motor component relays nerve impulses from the CNS to muscles for movement, and the autonomic component is responsible for regulating body processes such as sweating and blood flow. Nerve injury will affect the function of one or all components. Excessive pressure, stretching, cuts by knives or broken glass, or fractures can damage nerves. Nerve injuries are classified into: • Neurapraxia This is due to a conduction block of the nerve impulses; the nerve is otherwise structurally intact. This usually occurs after a direct blow to an area. People usually experience a tingling sensation or weakness. Rapid and full recovery is expected, although it may take awhile. Surgery is usually not needed. The numbness experienced after a local anaesthetic injection during tooth extraction is another example. • Axonotmesis In this type of injury, the tiny nerve fibres are stretched so much that they break. However the covering of the nerve fibre remains intact. It often occurs after a severe crush or stretch injury that may involve a fracture or dislocation of bones and joints. Recovery is slow and variable, and dependent on the extent of the nerve damage. Surgery may be necessary for recovery. • Neurotmesis This is the most severe type of injury because the nerve is cut or disrupted. Surgery is required for nerve recovery.

Dr Tan Soo Heong Hand Surgeon

If a nerve is injured, signals to and from the brain will either transmit slowly or not at all. We may experience numbness, loss of sensation, loss of muscle power or neuropathic pain in the affected area, all of which cause difficulty in movement, clumsiness or weakness. These symptoms will vary depending on the nature of the injury, its severity and the nerves affected.

Hand, Wrist & Upper Limb Surgery 3 Mount Elizabeth #07-01 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6737 0177 www.hand.com.sg

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Diagnosis and treatment Your doctor will take a thorough history and do a detailed neurological examination. X-rays may be prescribed to look for bony injuries or foreign objects after an injury. Scans may also be recommended. Your doctor may send you for neurophysiological tests to assess the function of the affected nerves. If there is an open wound with signs of injury affecting the underlying nerve, surgery is the best option to examine and repair the damaged nerve using an operating microscope. It is important to remember that the best chance for nerve recovery is during the first surgery. Delay in treatment may affect nerve recovery. In closed nerve injury, your doctor may decide to observe and wait for nerve recovery as these may be either neurapraxia or axonotmesis types of injuries. Progress of nerve recovery will be monitored. Generally, as nerve fibres grow at the rate of one inch a month, healing is a slow process. If there is no progress or if the progress stalls after initial recovery on follow up, surgery may be required.

Things to note while healing After a nerve injury, patients can do several things to aid healing: • Keep joints flexible through therapy so that they do not stiffen. • If the injury involves a sensory nerve, take extra care to avoid burning or cutting the fingers because there is no sensation to protect the affected area. • If you experience burning pain or unusual sensation in the affected nerve, tell your doctor; it may be neuropathic pain, which should be treated early.

enera y as nerve fi res row at the rate o one inch a onth hea in is a s ow rocess there is no ro ress or i the ro ress sta s a ter initia recovery on o ow s r ery ay e re ire

The extent of recovery following nerve injury is related to the patient’s age, the nerve affected, and the location and type of injury. With timely and proper treatment, there’s a higher chance of the hand regaining normal function.

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SPECIALIST

OPINIONS COLORECTAL SURGERY

Bulges and pockets Diverticulitis is the infection or that form in the intestine wall. Learn more about its symptoms and treatment options. People 40 years and older often develop bulges in their intestine wall that can lead to the formation of pockets. This condition is known as diverticulosis, while each pocket is called a diverticulum (diverticuli is the plural form). When the diverticulum does not present any symptoms — which is quite common — there is no need for anything to be done. However, these pockets can get inflamed or infected, in which case diverticulitis has occurred.

Why bulges form The medical fraternity still can’t pinpoint why bulges and pockets form. Doctors speculate that a key factor is a low-fibre diet. The theory is that such a diet leads to a lack of bulk in the stool, causing the colon to work harder. The stress may lead to weak spots along the organ, leading to the formation of pockets. Doctors suspect that the inflammation or infection arises from the bacteria growing in the pockets. Switching to a high-fibre diet after the formation of diverticuli will not reverse the condition.

Symptoms of diverticulitis

Colorectal Surgeon

Lasting between a few hours and a week or more, these include: • Pain over area of inflammation (usually in the lower left side) that worsens sometimes when you move • Fever • Bloating and gas • Loose stools • Nausea and vomiting • Lack of appetite Severe infection can cause perforation and abscess that require hospitalisation and perhaps surgery. Sometimes, the perforation reaches the adjacent organs such as the bladder. This could lead to a fistula — which is an unusual connection between the colon and the bladder — and thus the passing of flatus and/or faeces out with the urine. Patients with recurring bouts of diverticulitis have to be aware of changes in their bowel habits, because repeated infections can lead to scarring and narrowing of the colon.

Ho Kok Sun Colorectal Pte Ltd

Treatment of diverticulitis

Dr Ho Kok Sun

3 Mount Elizabeth #12-09 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6737 2778 www.hkscolorectal.com.sg

• Mild: antibiotics usually prescribed • Medium: may require hospitalisation, bowel rest and intravenous drip, in addition to antibiotics • Severe: where there is a perforation or an abscess, emergency surgery to remove that segment of the colon may be required; people with recurring episodes of diverticulitis may also require surgery

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OPHTHALMOLOGY

Mummy, I can’t read Get a handle of common eye

Lazy eye, strabismus and myopia are common eye conditions found in children. ‘Lazy eye’, or amblyopia, refers to a decrease in the child’s vision that can happen even when there is no problem with the structure of the eye — something has interfered with normal brain cortical visual development. It usually only affects one eye, but if both eyes are deprived of good, clear visual images for sustained periods, the condition can arise in both eyes. The three main causes of lazy eye are strabismus, vision deprivation and refractive errors (abnormal spectacle power): • Strabismus refers to eye misalignment. One eye may turn in, out, up or down. When this happens, the corresponding part of the brain ‘switches off’ the eye that is not straight, and vision subsequently drops in that eye. • Deprivation amblyopia develops when media opacities (e.g. cataracts, vitreous haemorrhage, droopy eyelids) ‘deprive’ young eyes of visual experience. This can affect one or both eyes. • Refractive amblyopia happens when there is a large or unequal amount of refractive error (glasses strength/degree) in a child’s eyes. Usually the brain will ‘switch off’ the eye that has more refractive error. This type of amblyopia is frequently undetected until the child has a vision test as the eyes look normal and the child functions well. In myopia, close objects are seen clearly, but objects far away appear blurry. Parents should be vigilant and take their child for eye checks promptly so that problems can be diagnosed and treated early. A delay could lead to poor vision and even blindness.

Signs to watch out for

Dr Leo Seo Wei Ophthalmologist Dr Leo Adult & Paediatric Eye Specialist Pte Ltd 3 Mount Elizabeth #10-04 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6737 8366 www.drleoeyespecialist.com

Children with lazy eye often do not complain of poor vision; a problem is usually first noted when vision in both eyes is tested, such as during school visual screening. Occasionally, parents will notice a squint (strabismus) when one eye appears to be misaligned. Signs of strabismus are unusual head tilting or face turning, squinting, closing one eye when gazing intently at something, clumsiness, or the appearance of not looking directly at the object of regard. Children do not outgrow strabismus; left alone, it can result in loss of depth perception, double vision or permanent loss of vision when the child grows up. Under certain conditions (e.g. where there is strabismus, droopy eyelid or obstruction to the visual axis), your doctor may need to screen your child regularly for amblyopia.

Myopic children may complain of problems seeing distant objects, such as oncoming bus numbers, whiteboard in class, or television. They may also tilt or turn their head, or narrow their eyes to see better. It is important to take steps to slow the progression of myopia because — as the child grows and his myopia worsens — the likelihood of developing complications (retinal detachment, macular degeneration, cataracts, glaucoma) increases. Spending more time outdoors can delay its onset and progression, while the use of atropine eye drops can help control the condition.

Prevention is better A comprehensive paediatric eye examination can be carried out at any age. As long as the child’s visual behaviour is abnormal, or if the eye does not seem to be fixing well, the child needs to be evaluated by an eye specialist. Eye screening is strongly recommended over the course of childhood to detect amblyopia early enough to allow successful treatment. Infants are examined for the ability to fix and follow and whether they have strabismus. Parents are advised to send all children for a complete eye examination at least once between the ages of three and five. If the child is too young to speak, special techniques are used to measure visual acuity. Refraction (checking eye power) can be done using a method such as cyclo-retinoscopy, which does not require the child to read. Timely treatment of lazy eye is crucial. If there is abnormal spectacle power, the child needs to wear appropriate spectacles. Treatment of strabismus depends on its type, and includes patching, exercises, glasses and/ or surgery. The child needs to be encouraged to use the lazy eye. This is usually done by patching or covering the good eye, typically for several hours per day. Treatment may take years, and is often more effective when it is started earlier. When amblyopia is detected too late, it may not be possible to reverse the visual damage.

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53 SOA Dr Leo Seo Wei V3.indd 53

14/6/17 1:06 PM


SPECIALIST

OPINIONS OBSTETRICS & GYNAECOLOGY

Infertility: the men get it! When couples fail to conceive, it seems like the woman is always the even though the problem could just as easily lie with her partner. Half of a baby’s genetic makeup comes from the father and yet, sperms are often taken for granted.

Sperm A man’s biggest contribution to conception is sperm: he must be able to produce healthy sperms in order to impregnate his partner. This process extends all the way back to his childhood, when his reproductive organs mature through puberty. Not only must one of his testes be functioning, his body has to produce the right mix of hormones to signal his testes to make these sperms. The sperms then have to move into the semen via delicate tubes before they are ejaculated out of the penis. Let’s take a closer look at aspects of sperm that affect a man’s fertility:

1 2 3

Sperm count According to a 2010 criterion by the World Health Organization, a normal male’s semen should contain at least 15 million sperms per millilitre; he is judged to be subfertile if his sperm count is lower. A normal volume of semen produced at ejaculation is at least 1.5ml.

Sperm motility After semen is ejaculated, sperms have to make their way through the cervix to meet the egg in the fallopian tube. If the sperms have poor motility, they will not survive the journey. More than 50% of the sperm must be motile to be considered normal.

Sperm morphology Even the form of the sperm matters. If it is oddly shaped, it will not be able to penetrate the outer layer of an egg. At least 4% of the sperm have to be of the correct shape and size to be considered normal.

Dr Ann Tan Obstetrician & Gynaecologist Women Fertility & Fetal Centre 3 Mount Elizabeth #11-12 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6734 8188 www.anntan.com.sg

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54-55 SOA Ann Tan V6.indd 54

14/6/17 1:09 PM


Sperm production is sensitive to heat, so it’s not a good idea for a man intending to have a child to hang around places with elevated temperatures. Hence, it is best to avoid hot tubs and saunas.

4 5

Non-production of sperm This usually occurs because of testicular failure or birth defects. Azoospermia occurs in about 5% of infertile men. The condition could happen because of an obstruction, such as an absent vas deferens (the tubes that carry the sperm), or there is a problem with sperm production. As there could be usable sperm in the testes, an ultrasound scan of the scrotum and testes may help in the diagnosis, and a testicular aspirate would be the diagnostic test to determine the presence of usable sperm within the testes.

Sperm DNA integrity DNA fragmentation (DFI) in sperms has been used as a predictor of male fertility. When there is a high degree of fragmentation, successful pregnancy is less likely. When DFI is under 15%, pregnancy should be easily achieved if the woman is fertile. However, when it is above 30%, the success rate drops significantly. Hyaluronic Binding Assay (HBA) is a measure of how effective the sperms are at attaching to the egg, which is the first step towards fertilisation. A HBA score of more than 85% is considered normal, whereas lower scores imply the sperms have difficulty in attaching to the egg.

Besides defects in his sperm, a man can become infertile through other medical routes, such as illness. Environment and lifestyle factors also play a part.

Medical conditions Medications for ulcer, fungus, cancer and various other problems may lead to reduced sperm production. Male infertility can arise from a problem with the testes; even a hormonal imbalance that affects the hypothalamus, pituitary, thyroid or adrenal glands can lead to infertility. Some infections can interfere with sperm production or sperm health, or cause scarring that blocks sperm movement. Besides inflammation of various parts of the testes, other such culprits include sexually transmitted infections like gonorrhoea or HIV. Even a simple respiratory tract infection or viral flu will reduce the quality of the semen.

Environmental factors Sperm production is sensitive to heat, so it’s not a good idea for a man intending to have a child to hang around places with elevated temperatures. Hence, it is best to avoid hot tubs and saunas. Constrictive clothing and even working with a computer on your lap can have adverse effects on your sperm quality. Cycling or running for long periods can also lead to overheating and reduced sperm quality. To maintain fertility, men should keep exposure to radiation (X-ray), heavy metals and industrial chemicals (pesticides, herbicides, organic solvents) to a minimum.

Lifestyle choices Stick to a healthy diet and maintain a weight that’s proportional to your height, as being overweight causes hormonal changes that could interfere with fertility. Do not abuse alcohol and illegal drugs. Excessive alcohol reduces testosterone levels and decreases sperm production; it also leads to liver damage, which affects fertility. As for drugs, steroids may help to build muscles, but they can lead to the shrinking of both the testes and sperm count. Stay away from cigarettes and second-hand smoke — both adversely affect sperm quality and count. And try not to let the act of conception stress you out — long-term stress produces hormones that interfere with sperm production.

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54-55 SOA Ann Tan V6.indd 55

14/6/17 1:09 PM


SPECIALIST

OPINIONS HEPATOBILIARY &

LAPAROSCOPIC SURGERY

Pancreatitis: signs and symptoms Sharp abdominal pain is a symptom

Located behind the stomach, the pancreas has a role in converting food into fuel. The tubeshaped organ secretes powerful digestive enzymes into the small intestine to break down carbohydrates, proteins and fat. It also releases two hormones, insulin and glucagon, into the bloodstream to ‘digest’ sugar.

Pancreatic attack! The pancreas can become inflamed due to several reasons. One of the most common is alcohol abuse. Alcohol changes the composition of proteins secreted by the pancreas. This causes protein ‘plugs’ to form and block the pancreatic ducts, leading to swelling. Pancreatitis can also be caused by the formation of gallstones, certain medications and — rarely — infections, trauma or surgery of the abdomen.

Dr Tay Khoon Hean Hepatobiliary Surgeon Tay Khoon Hean Surgery

Acute or chronic? Inflammation of the pancreas can be acute or chronic. Acute pancreatitis refers to an isolated and short-term episode, and symptoms include a sharp upper abdominal pain that travels through the back that may be aggravated by eating. The abdomen may swell and be tender to the touch. It can be treated with supportive

management of pain and intravenous fluids. In a small percentage of cases, severe pancreatitis can lead to failure of other organs, such as the heart, lungs or kidneys. In these cases, surgery may be needed to remove parts of the gland that have been irreversibly damaged. Acute pancreatitis can also lead to chronic pancreatitis. Chronic pancreatitis is a long-term disease. The inflammation may no longer be active, but the damage has been done and flare-ups could recur. In chronic cases, the pancreas develops scar tissue called fibrosis, calcium deposits and inflammation of its ducts.

Chronic complications Chronic pancreatitis can lead to serious complications, such as loss of pancreatic function leading to an inability to absorb nutrients. Damage to the insulin-producing cells in the pancreas may also lead to diabetes. In fact, almost half of those with chronic pancreatitis will develop diabetes. Chronic pancreatitis can be challenging to treat. The goal is to relieve pain and make up for loss of function. To improve nutrition and address metabolic problems, patients may be given pancreatic enzymes and insulin. In some instances, surgery may be needed to remove blockages of the pancreatic ducts.

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56 SOA_Tay Khoon Hean.indd 56

14/6/17 1:11 PM


OBSTETRICS & GYNAECOLOGY

3

classes of contraceptives From condoms to IUDs, there several short- and long-term ways to prevent an unplanned pregnancy. Choose a method that’s right for you.

When choosing a birth control method that is right for you, consider factors such as its ease of use, protection from STDs, as well as your age, health condition, and whether you would like to get pregnant in the future. The following list is not exhaustive, and the non-permanent contraceptive methods fall into three categories.

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2

Dr Kelly Loi Obstetrician & Gynaecologist Health & Fertility Centre for Women 290 Orchard Road #18-06 Paragon Medical Suites Singapore 238859 Tel: 6235 5066 www.healthfertility.com.sg

3

Physical barriers Among barrier contraceptives such as male and female condoms, diaphragms and cervical caps, the most commonly used barrier method used in Singapore is the humble male condom. It is widely available at retail stores and, when used correctly, is 97% effective in preventing pregnancies. Condoms work by keeping sperm out of the uterus, and is the only form of birth control that reduces your chances of contracting HIV and most sexually transmitted diseases (STDs). However, they can fail if worn incorrectly, or if they slip off, break or are used with inappropriate lubricants. Also, some people are allergic to latex condoms.

Hormonal methods There are various forms of hormonal contraceptives available on the market, including pills, patches, implants and injections — containing a combination of synthetic progesterone and oestrogen, or just progesterone. They are designed to either suppress ovulation or prevent a fertilised egg from implanting itself in the womb. In some cases, the extra dose of hormones thickens the cervical mucus to prevent sperm from reaching the egg. Depending on the formulation, these birth control methods are 99.5–99.9% effective in preventing pregnancies. However, the duration of efficacy is different for each method: • Oral contraceptives (pills) must be taken daily • Contraceptive patches need to be applied once a week for three weeks at a time — on the fourth week, monthly bleeding will occur • Implantable contraceptives (small flexible rods placed under the skin) can last up to three years • Contraceptive injections are done four times a year — once every three months • A NuvaRing (a small, flexible vagina ring) is worn for three weeks and removed, then replaced with a new one a week later

Intrauterine devices (IUDs) IUDs are small T-shaped devices that are inserted into the uterus to prevent the implantation of an egg in the womb lining. They are available in the form of progesterone-releasing or plain copper IUDs, and can only be inserted and removed by a doctor. Recommended for women who have already had children, each device can last between three and five years, with an efficacy of between 99.2 and 99.4%. Progesterone-releasing IUDs work in the same way as the hormonal methods described above, while copper IUDs cause a chemical change that affects the sperm and egg before they meet. The latter can prevent a pregnancy if inserted within five days of unprotected intercourse.

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57 SOA_Kelly Loi V3.indd 57

14/6/17 1:12 PM


SPECIALIST

OPINIONS PLASTIC SURGERY

Considering breast augmentation? Before going under the knife to augment your breasts, make sure you discuss with your plastic surgeon all options so that you can make an informed decision.

There are many women whose breasts are disproportionate in size to the rest of their body. In Singapore, such women usually have breasts smaller and less developed relative to their frame.

3 things to consider Increased awareness and acceptance of cosmetic procedures to address such imbalances have led many women to consider breast augmentation. However, if you are indeed contemplating such a procedure, there are a few factors to consider:

Dr Karen Sng

1

One has to be realistic about what can be achieved, be it via fat or implants. For example, fat grafting is only possible if you have sufficient fat, and are seeking only a modest increase in breast size. If you require a significant increase in volume in a single surgery, implants are the ideal option, especially if you have a slim frame.

2

While size is important, the shape of the breasts matters as well. The natural breast tends to be fuller and rounder in youth, but breast tissue settles to a more teardrop shape with maturity. A breast implant will help to shape the breast, so consider which shape you prefer. In addition, consider how the augmentation is going to affect your lifestyle. For example, if you exercise frequently, breasts that are too wide or large may not be ideal.

Plastic Surgeon The Plastic Surgery Practice @ Orchard 3 Mount Elizabeth #12-02 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6235 7565 www.karensng.com.sg

3

Pick the right type of implant, which are silicone- or saline-filled. Silicone implants tend to be more popular in recent times due to their softer and more natural feel. Teardropshaped implants have also seen increasing popularity as they impart a more natural look to the breast.

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58-59 SOA Karen Sng_V2.indd 58

16/6/17 6:24 PM


3 new developments For years, breast augmentation has been achieved by surgically inserting silicone or saline implants behind the breasts. Here are more recent developments in this area:

Fat grafting from body to breast Fat grafting is an exciting option for breast augmentation. Liposuction is used to remove fat from the body — abdomen, thighs or buttocks. But instead of throwing the fat away, it is processed and injected around the breasts, resulting in a fuller look. Because the procedure yields only a small volume of augmentation with each session, it is ideal for women seeking only a modest increase in breast size; the sessions can be repeated to achieve a greater overall volume. Fat grafting is suitable for women with a moderate amount of fat that can be removed and transferred — consider it a two-in-one procedure to reduce fat and boost breast size! Fat grafting is also ideal for women who have had breast implants and wish or need to remove them. Injecting fat to replace some of the volume prevents breasts from looking ‘deflated’ after implant removal. Some women actually prefer the feel of their breasts after implant removal and fat grafting, and may return for additional fat grafting to further increase their breast size.

New and improved gel implants Cohesive gel and Progressive GelTM implants are the result of research and development to improve silicone within the implants. Cohesive gel implants are sometimes called ‘gummy bear’ implants because the gel ‘sticks’ to itself. This gel maintains the shape of the implant — hence the breast — better. Progressive GelTM implants are yet another new development in which the gel adapts it shape after implantation in response to gravity to give a more natural look and feel to the breast.

Composite breast augmentation This technique marries the traditional surgical breast implant augmentation with fat grafting. The implant is placed behind the breast, and the fat is injected above the breast. For patients with thinner tissue over the breast, this option enables the surgeon to ‘pad’ the tissue covering the implant, giving the breast a more natural feel. Another use of this technique is to inject the fat between the breasts to enhance the cleavage and avoid the breasts looking too far apart. Not surprisingly, this method is gaining popularity.

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58-59 SOA Karen Sng_V2.indd 59

16/6/17 6:24 PM


SPECIALIST

OPINIONS CARDIOLOGY

Scans: PET vs SPECT a cardiac PET scan and a cardiac SPECT scan? This article compares and contrasts these two cardiac imaging techniques.

Cardiovascular disease is the single largest cause of death in the world. There has been a striking increase in the prevalence of obesity and type 2 diabetes mellitus in Asia. In particular, patients with type 2 diabetes mellitus exhibit accelerated progression of coronary artery disease (CAD), which may account for the increased signs, symptoms and death rates in these patients. Another area of concern is the expected increase in the longevity of post-menopausal women. Pre-menopausal women benefit from oestrogen, which protects them against atherosclerosis and heart diseases. Postmenopausal women have low oestrogen levels, which increases their cardiovascular risk profile. Hence, it is important to detect heart problems effectively so that treatment can be instituted and lifestyle changes enforced. Among the more advanced technologies for this is the cardiac PET (cardiac positron emission tomography) scan.

What is a cardiac PET scan?

Dr Eric Hong Cardiologist EH Heart Specialist Pte Ltd 3 Mount Elizabeth #03-09 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6736 1068 www.eheartspecialist.com

PET is a nuclear medicine imaging technique that produces a 3D image of the functional processes in the body by detecting pairs of gamma rays emitted indirectly by a positronemitting radiotracer. This non-invasive imaging technique evaluates blood flow to the heart muscle. When blood flow to the heart is reduced in the narrowed/diseased coronary arteries, the reduction in oxygen supply to the involved heart muscle produces symptoms such as chest discomfort or shortness of breath. The cardiac PET scan is a functional test that assesses the patient’s heart function as well as blood flow in coronary arteries; this helps clinicians to risk-stratify their patients. A small amount of radiotracer, Rubidium-82 (Rb-82), is administered intravenously during the test. The amount of radiation exposure is extremely low compared to the quality of information gained from the PET scan. The uptake of Rb-82 by the heart muscle is related to blood flow — areas of the heart with adequate blood flow would have more Rb-82. A PET scanning camera takes 3D images of the Rb-82 uptake by the heart when it is at rest and when it is stressed. This is done with the help of pharmaceutical agents that dilate the blood vessels. The reason why doctors want to observe a stressed heart is to see if there is adequate blood flow to the heart when it has an increased workload. Further analysis of these images helps to identify the location, severity and extent of reduced blood flow to the heart muscle (ischaemia).

What is a cardiac SPECT scan? Another functional test commonly used is the SPECT (single photon emissison computerised tomography) myocardial perfusion scan. SPECT is similar to PET in its use of radioactive tracer material and detection of gamma rays. However, the tracers used in SPECT emit gamma radiation that is measured directly; PET tracers emit positrons (particles with the same mass as electrons but bearing an opposite charge) that neutralise electrons with the emission of gamma photons (electromagnetic radiation), which are what the PET scanner detects. SPECT imaging performed after stress reveals the distribution of the radiopharmaceutical and therefore the relative blood flow to the different regions in the myocardium. Diagnosis is made by comparing images of the heart when stressed to a set of images of the heart at rest. In both PET and SPECT studies, the stress test uses each individual patient as its own control.

Cardiac SPECT vs PET Increasingly, cardiologists prefer cardiac PET scans to SPECT scans for the following reasons: • PET scans offer a higher spatial resolution and accuracy than SPECT scans. Diagnostic accuracy in identifying cardiac coronary artery disease for PET and SPECT is 95% and 83% respectively. • A SPECT scan may not detect vascular disease at the micro-circulatory level of the coronary circulation, or early stages of coronary artery disease when there are no symptoms. A PET scan can detect early functional abnormalities of the coronary circulation, which may be a precursor of ensuing coronary artery disease. • Exposure to radiation is much lower for the PET scan compared to the SPECT scan due to the short half-life of Rb-82 (75 seconds). • A PET scan lasts 30–40 minutes; a SPECT scan takes at least 6–8 hours to complete. Doctors often also use the non-invasive coronary CT angiogram to visualise the coronary arteries, especially for evidence of atherosclerosis. This may be indicated by calcification with mild to moderate blockages, although the patient may have no symptoms and end up confused. But physiology trumps anatomy: if a patient has a partial blockage, but a functional test shows no evidence of reduced blood flow, then coronary intervention procedure may not be necessary and avoided.

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60 SOA Eric Hong V5.indd 60

14/6/17 1:22 PM


PLASTIC SURGERY

Defying age: 4 facelift techniques innovations are here to recapture its

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Conventional facelift This surgery gives the most lasting and dramatic results. It involves making a U-shaped incision from the hairline at the temples and down to the lower scalp. The surgeon then drapes, tightens and lifts any loose underlying fat or muscle. Excess skin is repositioned and trimmed. For those with ‘turkey’ necks, a second incision may be made under the chin. All the incisions are hidden in the hairline and contours of the face. Downtime: two to three weeks Duration: effects last seven to ten years

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Silhouette threadlift This is a minimally invasive procedure performed under local anaesthetic to lift sagging skin from the face or neck. A thin needle is used to place special surgical threads with cones under the skin. These threads are pulled in different directions; the attached cones lift and tighten underlying tissue along with the skin. This technique is especially useful for sagging cheeks, nasolabial folds (laugh lines), marionette lines, jowls and ‘turkey’ necks. Downtime: four to five days Duration: effects last three to five years

Dr Colin Tham Plastic Surgeon Asia HealthPartners (Aesthetics) 304 Orchard Road #05-06 Lucky Plaza Singapore 238863 Tel: 6235 8411 www.colintham.com.sg

3

Brow lift These procedures focus on correcting sagging foreheads, brows and upper eyelids. It can be performed as an open

classic lift or, more commonly, as a minimally invasive endoscopic lift. An open brow lift involves a continuous incision at or behind the hairline. An endoscopic lift involves five short cuts within the hairline through which an endoscope is inserted to separate and pull up the sagging forehead skin. Downtime: five to seven days Duration: effects last seven to ten years

4

Ulthera The only FDA-approved device for noninvasive facelifts combines focused ultrasound with real-time imaging of facial tissues to accurately target the layers of the skin responsible for contouring the face. Ultrasonic waves delivered at precise depths act as a trigger to tighten the skin. Over several weeks, new collagen forms in the treated areas, resulting in more dramatic lifting, tightening and contouring. Ulthera is effective in correcting heavy brows, hooded upper eyelids, crow’s feet, mild eyebags, as well as drooping cheeks and jowls. Downtime: none Duration: effects last about two years, depending on strengh and area of treatment

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61 SOA Colin Tham V2.indd 61

16/6/17 10:20 AM


SPECIALIST

OPINIONS

ORTHOPAEDIC SURGERY

Pain in the neck! You can be hurt in this part of your body even without it receiving direct impact.

It doesn’t take something as serious as a car accident for your neck to hurt. Some fairly innocuous activities, especially if done often and long enough, can be the source.

Activities that lead to neck pain For example, the pain could arise if you tend to hold your head in an awkward position while watching TV, chatting on the phone or working on your laptop computer. Another common factor is sleeping on a pillow that is too high or too soft. Activities that require you to raise your arms — such as painting the ceiling — can lead to neck pain too. If you are stressed, sometimes tension develops along the muscle leading to the neck.

Treatment options You may wish to try commercial products, such as neck pillows, hot pads and ice packs. There are also neck stretching exercises that could be beneficial. You could also try alternative treatments such as acupuncture. More conventional treatments, depending on individual cases, could range from heat/ cold applications and traction to physical therapy (ultrasound, massage, manipulation) and topical anaesthetic creams or painrelief patches. More serious cases may require injections of cortisone or surgical procedures.

Injuries that cause neck pain Direct blows to the face or to the back or top of the head can lead to neck pains. But even when there is no direct contact with the neck, minor accidents such as trips and falls, and sports injuries can cause neck pains due to sudden and excessive motion in that part of the anatomy. Whiplash, which typically occurs in car accidents, is an injury caused by a severe jerk to the head.

Other conditions Chronic conditions (fibromyalgia, rheumatoid arthritis, ankylosing spondylitis) and agerelated conditions (cervical spinal stenosis, the narrowing of the spinal canal, and arthritis of the neck) are possible causes of neck pain. An infection or a tumour in that area could also be a culprit.

Symptoms

Dr Sean Ng

The pain is due to either strain, which is an overstretched or overused muscle, or sprain, which means the ligament is injured. The pain could spread to the shoulders and upper back, and make the neck stiff or tender. Movement may make you feel worse.

Orthopaedic Surgeon Ardmore Orthopaedic Clinic 6 Napier Road #07-07 Gleneagles Medical Centre Singapore 258499 Tel: 6475 7177 Hp: 9631 7637 www.ardmoreorthopaedics.com.sg

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62 SOA Sean Ng.indd 62

14/6/17 1:25 PM


TQ.indd 4

8/1/16 1:35 PM


SPECIALIST

OPINIONS

BREAST SURGICAL ONCOLOGY

Breast reconstruction surgery:

3

recent advances

1

Breast cancer surgery traditionally meant the removal of the whole breast, leading to physical disability and emotional stress in some women. Numerous techniques have been developed in the last few years to minimise the impact of such surgeries. Here are three.

2 Dr Chong Chee Keong Breast Surgical Oncologist Maven Surgery 38 Irrawaddy Road #07-49 Mount Elizabeth Novena Specialist Centre Singapore 329563 Tel: 6355 5285 319 Joo Chiat Place #02-05 Parkway East Medical Centre Singapore 427989 Tel: 6344 0340 www.mavensurgery.com.sg

3

Breast conservation surgery This is the commonest way to preserve a breast that has developed cancer. The procedure involves removal of the tumour with a cuff of normal breast tissue to achieve clearance. The resulting cavity can be filled by either re-arrangement of the remaining gland, lipofilling, or even mobilisation of omentum (the intra-abdominal fat) from the abdomen. The other breast may need to undergo a size reduction surgery to achieve balance in both breasts. The decision for breast conservation is determined by a few factors: • Favourable tumour-breast relative size After achieving complete clearance of the tumour, the cavity — if less than an eighth of the total volume — can be filled by re-arranging the breast tissue. If more than 25% of the total breast volume is removed, the patient will need either reduction mastectomy of the contralateral breast or having the void filled with omentum. This is the preferred method as it achieves the best aesthetic result. • Acceptance of radiation and recurrence risk Radiation eradicates any undiscovered satellite lesions after surgery. Still, the risk of recurrence after breast conservation surgery with radiotherapy is slightly higher than a full mastectomy. If the cancer returns, a full mastectomy is recommended. Given the recurrence rate is higher in the breast conservation group, women requesting this procedure must accept the risk. Fortunately, long-term survival is similar for patients in both groups.

Skin-sparing / nipple-sparing mastectomy In this method of surgery, the breast tissue is completely removed as in traditional mastectomy, but the overlying skin is preserved, with or without the nipple. The further the lesion is from the nipple, the higher the chance of conserving the nipple. The result is a pocket that allows reconstruction with either breast prosthesis or tissue flap, or both. Removal of the breast tissue can now be achieved using endoscopic instruments, thus optimising cosmetic outcomes while achieving resection with a tumour-free margin and sentinel node biopsy. This procedure is not yet a mainstream option because of a lack of clinical evidence comparing the oncological outcomes of endoscopy surgery and open surgery.

Cryosurgery This is a minimally invasive procedure that uses extreme cold to destroy tissues, including cancer cells. A thin hollow probe is guided into the tumour using imaging techniques, with the tip super-cooled to the desired temperature via a connection to liquid nitrogen. The destruction of cells is achieved by: • Formation of ice crystals that disrupt cell metabolism • Interruption of blood flow by coagulating the blood, thereby causing cell death • Induced cell death Cryosurgery causes minimal pain and scarring, and offers faster recovery time. It can be repeated multiple times to achieve good clearance while keeping the complication rate low. Despite such benefits, cryosurgery is not a mainstream option, and is considered an experimental method compared to statistically proven open surgery.

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64 SOA Chong Chee Keong_V4.indd 64

14/6/17 1:27 PM


PLASTIC SURGERY

Tear trough deformity Although not really a deformity, this groove extending from the inner corner of your eye can make you look tired and old.

A tear trough is the groove on the skin that begins at the inner corner of the eye and angles down and out towards the cheek. Although named as such, the groove is not a deformity, but a natural contour due to its location on the rim of bone encircling the eye. However, deeper grooves tend to make a person appear haggard and older. Worsening the effect is the appearance of dark eye circles (Panda eyes), which is usually caused by genetic predisposition, lack of sleep, dehydration or discolouration of the skin. In addition, the patient could have eye bags from fat prolapse and loose skin.

• Ultrasonic or radiofrequency collagen stimulation

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ec o

Some patients may only require an HA filler injection to rejuvenate and lighten the condition. The method works by plumping the lower eyelid muscles, then enhancing the effect with a thin layer of lighter HA material, such as Restylane Vital or Vital-Light, directly beneath the skin. This way, fine lines and shadows around the area are reduced. If the patient has eye bags as well, lower eyelid or eye-bag surgery may have to be performed first before the HA filler injections are applied.

3 non-surgical solutions

Dr Leslie Kuek Plastic Surgeon Leslie Kuek Plastic Surgery 38 Irrawaddy Road #05-41 Mount Elizabeth Novena Specialist Centre Singapore 329563 Tel: 6472 2972 www.lesliekuek.com.sg

Keeping the area around the eye hydrated will improve the fine lines around the organ. Also, stimulating collagen growth in that area will result in the skin there firming up. Unfortunately, over-the-counter skincare products will not be able to help correct tear trough deformity. Doctors treat this condition via: • Hyaluronic acid (HA) filler injection • Eye-brightening serums

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Because tear trough deformity is a part of one’s appearance, filling it can make one look unnatural. It is recommended for more extenuating circumstances, such as when • the groove has deepened with age • the eye bag has grown so large that it makes the groove obvious • the groove in a deep-set eye creates dark shadows

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65 SOA Leslie Kuek V7.indd 65

14/6/17 1:28 PM


SPECIALIST

OPINIONS VASCULAR SURGERY

You’re so vein Understanding, preventing and treating varicose veins.

Thanks to one-way valves, veins are able to transport blood from the leg to the heart. In varicose veins, these valves have spoilt; this causes blood to flow down and pool in the legs, resulting in bulging veins. Addressing varicose veins is more than just an issue of aesthetics. The initial stages are usually asymptomatic, but aches and pains in the legs will soon develop. In advanced cases, leg ulceration could result.

Preventing varicose veins You can adjust your lifestyle to help prevent or slow down the development of this condition. The following are some suggestions: • Engage in exercise (walking is great for the legs) to get your circulation going • Conversely, never stay in one sitting or standing position for long periods • Lose weight to take the pressure off your veins • Go on a low-salt diet to prevent water retention • Avoid tight clothes from the waist down and high-heeled shoes • Elevate your legs above the level of your heart (for example, lie down with your legs resting on some pillows) a few times each day • Don’t sit crossed-legged

Treating varicose veins

Dr John Tan General & Vascular Surgeon The Vein Clinic & Surgery Pte Ltd 290 Orchard Road #11-08 Paragon Medical Suites Singapore 238859 Tel: 6245 6666 www.theveinclinic.com.sg

Should lifestyle modification fail to prevent the condition from forming, there are numerous treatments available. A lot of people have heard of and are wary of stripping surgery. However, this highly invasive procedure is considered obsolete. There is foam sclerotherapy (foam is injected into the varicose veins to seal them off) and local avulsion (the varicose veins are removed using small incisions that don’t require stitches), but both have high recurrence rates. The following two methods use newer techniques and technologies, with more long-lasting results. Endovenous Laser Treatment (EVLT) is a minimally invasive procedure that uses a laser fibre to deliver a precise amount of energy onto the vein walls. This offers optimal therapeutic effects without much collateral damage — no need for surgery, anaesthesia or hospitalisation. The patient can walk immediately after treatment (usually a session lasting less than an hour), and there are no scars once the needle marks have healed. VNUS Closure is a modification of EVLT: instead of ablation via laser, radiofrequency (RF) is employed. A catheter is inserted into a diseased vein and heated by temperature-controlled RF energy. This causes the vein wall to collapse, thus closing the vein. Blood is naturally rerouted to healthy veins. This procedure leaves little to no scarring. The latest modification to this treatment, called Venaseal, involves the use of medical grade superglue to close and seal the veins. As this method does not use heat and is not painful, it does not require multiple local anaesthetic injections to numb the veins prior to closure.

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UROLOGY

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ways to treat kidney stones Fear not. There are non-invasive and minimally invasive techniques available.

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Pass it out If the kidney stones are small enough (less than 4mm) and there are no signs of infection or obstruction, you can wait for them to pass naturally through the urinary tract with the help of oral medication to dilate the ureter. This could take from a few days to six weeks. Large stones may cause bleeding, kidney damage, and an increased risk of urinary tract infection. They should therefore be removed through one of the following procedures.

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Extracorporeal Shock Wave Lithotripsy (ESWL)

Dr Michael Wong US Fellowship-trained urologist with an international standing Associate Editor at British Journal of Urology Deputy Director at Asian School of Urology International Urology, Fertility & Gynaecology Centre 3 Mount Elizabeth #10-09 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6838 1212 www.drmichaelwong.com

This is the most common method used to treat kidney stones up to 20mm in diameter and ureter stones up to 10mm in size. The lithotripsy machine first scans the kidney region to pinpoint the location of the stones, then sends pulses of high-frequency shock waves to break them into tiny pieces so that they can be passed out through the urine. The process takes about 45–60 minutes, and the patient can go home on the same day. In about 10% of the time, more than one session is necessary to treat the kidney stones. The key to a successful ESWL lies in how soft the stone is. Stone density needs to be measured before deciding on ESWL.

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Percutaneous Nephrolithotomy (PCNL) This is a minimally invasive keyhole surgery recommended for larger kidney stones (larger than 2cm in diameter). During the operation, the urologist inserts a tiny telescope and instrument into the kidney through a small, 0.5cm-long incision in the patient’s back or side. The instrument is used to break up the stone and suction out the fragments. As this is a surgical procedure, the patient will need to receive general anaesthesia and be warded in the hospital for around two days.

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Ureteroscopy (URS) with Laser Lithotripsy This is a procedure in which the urologist passes a thin, flexible tube fitted with a camera through the urethra — the tube through which urine is passed — and into the bladder to access the ureter or kidney, where the stone is located. Performed with the patient under general anaesthesia, this operation can be used for stones up to 20mm in diameter. Once the stone is located, the doctor will use other instruments, such as a laser, to blast it into pieces that are small enough to be passed out naturally during urination.

Conclusions Preventing stone formation is equally if not more important than treatment. Ascertaining the exact cause of the stone formation is an important role of your urologist, so that dietary adjustments and oral therapy can be started early.

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SPECIALIST

OPINIONS ENDOCRINOLOGY

Safe pregnancy: test your thyroid Are you pregnant? Did you know that a little gland at the base of your neck your unborn baby?

When it comes to fertility and pregnancy issues, the focus is often on the man’s sperm and testes or on the woman’s eggs and menstrual cycle. However, there is a gland far removed from the sexual organs that can adversely affect the health of a woman and her unborn child.

The thyroid This is a butterfly-shaped gland located at the base of the neck. It secretes hormones that control how the body uses and stores energy. These chemicals regulate heart rate, body temperature, weight and metabolism. During pregnancy, they regulate fetal growth and development. In hyperthyroidism, the gland produces too much hormones, and the body’s functions become faster than normal. The reverse happens in hypothyroidism.

Hyperthyroidism in pregnancy When a woman becomes pregnant, the cells in the placenta begin to produce the hormone human chorionic gonadotropin (hCG). Peak levels of hCG occur during weeks 8 and 14 of pregnancy, and can cause the thyroid to become overactive. Should the hCG become too high, it could also trigger hyperemesis gravidarum — severe nausea and vomiting — that can lead to dehydration and weight loss. Another common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which a particular type of antibody stimulates the thyroid to overproduce thyroid hormones. Symptoms of hyperthyroidism in pregnancy can include a fast heartbeat, increased sweating, and failure to gain weight. How does this condition affect mother and baby? If it carries on unchecked, the following could occur: • miscarriage • pregnancy-induced hypertension • premature birth • low birth weight baby • stillbirth • congestive heart failure

Hypothyroidism in pregnancy The most common cause of hypothyroidism is also an autoimmune disease: Hashimoto’s disease. In this case, the thyroid is ‘attacked’ by another type of antibody, leading to inflammation and diminishing its ability to produce hormones. Mother and baby face some of the same dangers as in hyperthyroidism, such as miscarriage premature birth, and low birth weight baby. In addition, the baby may have a lower intelligence quotient (IQ) if hypothyroidism is undetected in the first three months of pregnancy, when thyroid hormone is necessary for the development of the brain.

Thyroid dysfunction and fertility

Dr Abel Soh Consultant Endocrinologist Abel Soh Diabetes, Thyroid & Endocrine Clinic 3 Mount Elizabeth #12-11 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6262 2008 www.abelsoh.com

Thyroid dysfunction in women can lead to irregularities of the menstrual cycle and may lead to infertility. Women with either hyperthyroidism or hypothyroidism can have fertility issues, although it is possible to have these diseases and still get pregnant. In addition, both men and women with untreated thyroid disease often have reduced sexual desire (libido). Thyroid dysfunction is also a cause for male infertility as sperm development requires normal thyroid hormone levels. Couples who have difficulty conceiving should have their thyroid hormone levels checked via a blood test to exclude thyroid dysfunction as the cause for infertility. If hyperthyroidism or hypothyroidism is found, then treatment should be started to normalise thyroid hormone levels and improve chances of conceiving.

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ORTHODONTICS

Brace yourself: 5 options When it comes to straightening teeth, patients now have a variety of options.

It used to be that there was little choice when it came to braces; most wearers would have had to put up with unsightly metal brackets on their teeth for an extended period of time. These days, patients have options — a range of braces that make it a lot less uncomfortable to f lash that winsome smile.

1 2 3 4 Dr Tan Kok Liang Orthodontist emBRACE Dental Surgery 360 Orchard Road #01-14 International Building Singapore 238869 Tel: 6235 6325 www.embrace.com.sg

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Metal braces When you think of conventional braces, these are what usually come to mind. They are made from high-grade stainless steel and are the most common type used. Pros: They are the least expensive. Cons: They are the most noticeable of all types of braces and the least aesthetically pleasing.

Ceramic braces Ceramic braces are the same size as metal braces, but they have tooth-coloured or clear brackets that blend into teeth. Pros: Less noticeable than metal braces; move teeth much faster than clear plastic aligners. Cons: More expensive than metal braces.

Lingual braces They comprise metal brackets that are bonded to the tongue side of the teeth, making them practically invisible as they cannot be viewed from the outside. Pros: They are invisible and suitable for working adults or people reluctant to reveal that they are undergoing orthodontic treatment. Cons: Initial discomfort with lingual braces affects mastication; speech takes longer to adjust — about two to four weeks — compared to less than one week for traditional metal and ceramic braces; unsuitable for people with short teeth or certain bites.

Non-ligating bracket system (by Innobrace Orthodontics) Comprises bracket slots made of titanium alloy, which keeps them flexible, unlike those used in typical braces. When force is applied by the wire during orthodontic treatment, the bracket slots flex. Pros: They cause less discomfort and straighten teeth more quickly than conventional braces. Cons: They are expensive compared to other types of braces.

Invisalign A near-invisible, removable set of teeth aligners that do not require metal wires or unsightly and uncomfortable attachments to achieve the same result. Pros: Lightweight and transparent; can be easily removed when you eat so you can brush your teeth as usual; safe to wear during sporting activities such as diving and contact sports. Cons: Not suitable for everybody, such as those with short crowns.

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16/6/17 10:26 AM


SPECIALIST

OPINIONS RHEUMATOLOGY

Psoriatic arthritis: n a e k n an joints double whammy of having symptoms in both the skin and joints.

According to the Centers for Disease Control and Prevention in the US, more than one-third of adults who have arthritis complain that their condition interferes with work and leisure activities. Up to 25% of them also reveal that it is a big source of pain, giving it a score of seven or higher on a 10-point scale. Inflammatory arthritis refers to the inflammation of one or more of your joints. The most obvious symptoms are pain, swelling and morning stiffness in the affected joints. Arthritis exists in myriad forms — there are more than 100 types of arthritis and related diseases. The most common ones include rheumatoid arthritis, osteoarthritis, gout, fibromyalgia and psoriatic arthritis. All of them cause pain in different ways. This article focuses on the condition known as psoriatic arthritis (PsA).

What is PsA? When you see the word ‘psoriatic’, you probably suspect that the condition has something to do with psoriasis, a non-infectious condition that leaves the skin itchy and scaly, occurring most commonly on the scalp, knees and elbows. It could also make the nails crumbly. Psoriasis is an autoimmune disease, meaning the patient’s immune system is turning on his own body, thus causing inflammation and pain. A portion of psoriasis patients goes on to develop psoriatic arthritis, when the body’s immune system starts attacking the joints. Most of these patients develop the skin condition first before their joints start to hurt. Research shows that about a third of people who have psoriasis will go on to get psoriatic arthritis, usually when they are between 30 and 55 years of age. PsA is an equal-opportunity condition, and is just as likely to strike a man as a woman, unlike many other autoimmune diseases, which affects women more frequently.

5 Types of PsA

A/Prof Leong Keng Hong Rheumatologist Leong Keng Hong Arthritis and Medical Clinic 6 Napier Road #04-18 Gleneagles Medical Centre Singapore 258499 Tel: 6472 4337 www.leongkenghong.com

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Symmetric Many PsA cases fall under this particular type. The term refers to the fact that joints on both sides of the body are affected at the same time. This type of PsA is similar to rheumatoid arthritis. Asymmetric This term is used when different joints are affected on each side of the body. This often milder form of PsA occurs in about 35% of PsA sufferers. Distal This type causes inflammation and stiffness near the ends of the fingers and toes. Toenails and fingernails could also be affected by pitting, white spots and lifting from the nail bed. Spondylitis In this type of PsA, pain and stiffness in the spine and neck are common signs. Arthritis mutilans This is the most severe of the five and affects about 5% of PsA patients. It deforms the small joints at the ends of fingers and toes, and can destroy them.

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Symptoms of PsA • Joint pain, often coupled with swelling Psoriatic arthritis usually affects the toes, ankles, knees, fingers and lower back.

• Dactylitis A sausage-like swelling — dactylitis — along the entire length of a finger or toe can form. This is the easiest way to distinguish PsA from rheumatoid arthritis, which is another form of arthritis caused by a faulty immune system. In rheumatoid arthritis, swelling and inflammation occurs only at affected joints.

• Enthesitis People with psoriatic arthritis often experience pain at the tendon and ligaments, most commonly in the elbow or at the heels. This is another distinguishing sign and symptom of psoriatic arthritis.

Causes of PsA While scientists are still not sure what causes PsA, many believe genetic predisposition plays a large part. Studies show that family links are strong for this disease compared to other autoimmune rheumatic diseases. According to the Arthritis Foundation, 40% of people with PsA have family members affected by the same disease.

Diagnosing PsA This can get rather tricky as PsA resembles many other forms of arthritis such as gout, rheumatoid arthritis and osteoarthritis.

A rheumatologist, who specialises in arthritis and musculoskeletal diseases, should be consulted. He will usually base his diagnosis after doing the following:

• Medical history He will take the patient’s medical history, such as noting down the pain description and location.

• Physical examination He will take a close look at the inflammation and swelling of the joints and observe the signs of psoriasis.

• Diagnostic tests He may order scans and tests, such as an X-ray (to check for changes in the bone) and blood tests (to check for the presence of a rheumatoid factor and other antibodies — usually negative in people with PsA; should it be positive, rheumatoid arthritis should be suspected instead).

Treatment options Some medications available for treating PsA treat the symptoms only: for skin problems, topical medication is applied directly to the scaly spots; for joint problems, nonsteroidal anti-inflammatory drugs (NSAID) can be used. It is more important to start the patient on disease-modifying anti-rheumatic drugs (DMARD), which modifies the immune system to control the illness.

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SPECIALIST

OPINIONS EAR, NOSE & THROAT

The silent e u Many patients know of GERD where acidic stomach contents are often with a burning sensation in

symptoms of heartburn. This is

Because most people do not realise that reflux can occur without heartburn, LPR is often under-diagnosed or misdiagnosed as other conditions with similar characteristics. In LPR cases, the acidic stomach contents are returned beyond the oesophagus, reaching the throat and back of the nose, causing various problems in these areas. The pharynx and larynx serve as a passageway for air to reach the lungs and for food to reach the stomach via the oesophagus. At each end of the oesophagus is a muscular ring (sphincter), which prevent regurgitation of the contents of the stomach. When these sphincters are incompetent, acidic stomach contents can regurgitate back into the oesophagus, sometimes reaching the throat and back of the nose. This commonly occurs when an LPR patient lies horizontally, such as while sleeping. The regurgitated contents include stomach acids that irritate and burn the sensitive larynx. Saliva is alkaline and the lining of the oral cavity and throat are resistant to alkaline media, but not to acidic media. LPR patients usually do not experience heartburn because the oesophagus is more resistant to acid than the larynx. LPR is common in infants and children because their oesophageal sphincters are underdeveloped, they have shorter oesophagus, and they are often lying horizontally. Snoring and obstructive sleep apnea can predispose a patient to LPR.

Common symptoms

Dr Lau Chee Chong Ear, Nose & Throat – Head & Neck Surgeon Ear, Nose & Throat Centre CC Lau 3 Mount Elizabeth #14-11 Mount Elizabeth Medical Centre Singapore 228510 Tel: 6235 9535 www.entcentrecclau.com.sg

• Excessive throat clearing and hoarseness • Chronic cough that worsens at night and wakes one up from sleep; even mild airway infections or irritants can trigger violent coughing fits in throats already sensitised by LPR • Throat discomfort, dryness or soreness, made worse by swallowing saliva • Sensation of a lump in the throat • Excessive phlegm in the throat • Bitter taste at the back of the throat • Exacerbated asthma, bronchitis or upper airway infection

Potential complications In infants: • Subglottic narrowing • Ulcer or inflammatory polyps in the larynx • Regurgitation and vomiting • Middle ear inflammation In adults: • Ulcers, polyps and granulomas in the larynx

• Increased risk of cancer of the throat and oesophagus

Diagnosis • LPR is often misdiagnosed and incorrectly treated as chronic cough, sinusitis, pharyngitis, tonsillitis, allergy, or as psychosomatic • Videorhinolaryngoscopy often reveals congestion and inflammation, and — in severe cases — granulations, ulcers and polyps • pH monitoring

T e me : l e

le mo

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o

• Small and frequent meals; avoid heavy meals • Stop eating and drinking two to three hours before bedtime • Avoid spicy food and carbonated or acidic drinks, eg citrus juice and vinegar • Elevate the head of the bed by four to six inches • Avoid tight-fitting clothes around the waist • Lose weight (obesity increases LPR) • Manage stress (stress raises gastric acidity) • Chew gum (it increases saliva production, which neutralises acid) • Get treated for snoring and obstructive sleep apnea

Treatment: medical and surgical • Antacids • Anti-acid medications (eg proton pump inhibitors) • Prokinetic agents such as Motillium (to promote gastric emptying and increase oesophageal sphincter pressure) • In severe cases, surgery to tighten the lower oesophageal sphincter may be considered

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COLORECTAL SURGERY

Good colon function, good health Understand the function of the colorectal tract and learn how its

The colon is part of the gastrointestinal tract, which is the part of the body concerned with the ingestion of food, digestion of nutrients, and excretion of indigestible waste. The colorectal tract, or large intestine, starts at the end of the small intestine and ends at the anus. The main function of the large intestine is to absorb water. Each day, about two to three litres of fluid from the small intestine pours into the large intestine and, as waste matter passes through, the colon and rectum absorb 95% of this fluid, leaving about 100–150ml of water in the expelled faeces. A problem with this absorption mechanism results in watery stools (diarrhoea). This symptom may indicate inflammatory bowel diseases, food poisoning, or irritable bowel syndrome. It could also signal anxiety or a dietary intolerance. The opposite condition, constipation, can be caused by a wide variety of reasons, such as illness, intake of certain drugs, dietary habits, colorectal cancers or painful anal growths such as piles and fissures. These examples reveal the connection between physical and emotional health and colon function, and showcase how closely the various systems in the body are related. Of course, many diseases of the lower gastrointestinal region are linked to other diseases. Consider familial adenomatous polyposis (FAP), a genetic mutation that causes thousands of colonic polyps. The danger is not limited to the colon; these growths are liable to affect many organs throughout the body, including changes in the eye, thyroid cancer, sebaceous cysts, benign bone growths (osteomas), gastric and duodenum polyps, bile duct cancers, and other tumour growths. Even a small abscess in the perianal region (the area around the anus), for example, is not ‘just a pimple’. It can cause not only pain for the patient, but also interfere with his ability to sit, stand and sleep. It goes to show that there is no such thing as good colon health without a healthy body itself; in the same way, the colon cannot be healthy if the body isn’t.

Common-sense tips for health

Dr Francis Seow-Choen Colorectal Surgeon Seow-Choen Colorectal Centre Pte Ltd 290 Orchard Road #06-06 Paragon Medical Suites Singapore 238859 Tel: 6738 6887 www.colorectalcentre.com

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Eat what you like and avoid what you do not enjoy. But do this in moderation and enjoy the occasional festive feast or special occasion.

Engage in light or moderate exercise to improve stamina and cardiovascular fitness. Unless you are an elite athlete and have the proper supervision, avoid excessive physical exertion.

Get adequate rest and sleep. Chronic lack of sleep leads to fatigue and lowered immunity, increasing your susceptibility to viruses, bacteria and other pathogens.

Avoid excessive stress by learning to live one day at a time. Remember that some stress is important for normal bodily function, so manage your stress levels.

Accept your past, look forward to your future, and be at peace with the present.

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SPECIALIST

OPINIONS OBSTETRICS & GYNAECOLOGY

The urge to pee just embarrassment when such moments occur. Learn what

the condition arise.

Dr See Tho Kai Yin Obstetrician & Gynaecologist The See Tho Clinic for Women 6 Napier Road #07-11 Gleneagles Medical Centre Singapore 258499 Tel: 6472 2283 www.seethoclinic.com

Urinary incontinence is defined by the International Continence Society (ICS) as the involuntary loss of urine that represents a hygienic or social problem to the individual. It should be thought of as a symptom, not a disease, as the causes are many and often multifactorial. Urinary incontinence affects men and women differently through the various age groups. This article will cover incontinence affecting women in the reproductive age group and beyond. This symptom in women is not a recent medical and social phenomenon.

Types of urinary incontinence The three common types of incontinence affecting women are stress urinary incontinence (SUI), urge incontinence, and a combination of both. SUI is characterised by the leakage of urine associated with increased intra-abdominal pressure from coughing, sneezing, laughing, exercising and, in extreme cases, walking. Urge incontinence is the involuntary leakage accompanied by or immediately preceding the urge to urinate. The anatomical defect in SUI in women is hypermobility of the urethra (the urine outlet) secondary to poor pelvic support. Pregnancy is arguably the most comon cause of SUI. It can occur even during pregnancy as a result of pressure of the enlarging gravid uterus on the bladder coupled with the softening of the supports of the bladder (and uterus) due to increased hormone production. Reassurance of such patients is all that’s required — the majority of them will recover soon after delivery or after two to three months. Vaginal delivery leads to stretching and, often, tearing of the supports of the bladder and uterus. Prolonged and difficult instrumental deliveries are especially harmful and should be avoided where possible. Prevention is key to the management of SUI in women after childbirth. Precise repair of vaginal and perineal tears and lacerations, proper bladder regime in the pueperium, and diligent pelvic floor exercises are the more important preventive measures. Other important causes of urethral hypermobility are menopause, surgery (especially hysterectomy), pelvic trauma, obesity, chronic constipation, and chronic cough from smoking or other respiratory disease. Urge incontinence is commonly due to urinary tract infection, which causes painful urination. The overactive bladder

(OAB) as a cause of urge incontinence is now seen more frequently in practice. In this condition, the detusor (muscle of the bladder wall) is hypersensitive. The aetiology of this hypersensitive state, though often unknown, may be attributed to excessive coffee consumption, smoking, and excessive water intake. Atrophic vaginitis in post-menopausal women and chronic medical conditions (e.g. diabetes) are common causes. The management of urinary incontinence in this group of patients is complex. Good history taking to determine the extent of the problem, clinical and pelvic ultrasound examination, followed by counselling and medical treatment, should form the basis of management in the first instance. Even if surgery is the definitive treament, adjunctive medical treatment will be helpful.

Managing urinary incontinence The approach to management is key to the type of incontinence: • Stress Urinary Incontinence — surgery, pelvic floor exercise, medication • Urge Incontinence — changes in diet, behavioural modification, pelvic floor exercise, medication • Mixed Incontinence — medicine and surgery The first choice of treatment should ideally be the least invasive one. However, in specific situations, minimally invasive surgery may be the most effective modality in the management of urinary incontinence. Of all the surgical procedures available for the treatment of urinary incontinence, none has been more researched and documented than Tension-Free Vaginal Tape (TVT) in the surgical management of stress urinary incontinence in women. The tape is non-absorbable and the cure rate, depending on patient profile, varies between 80 and 90% even after 10 years.

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LIFES T YLE A B S O L U T E LY G O R G E O U S Established in 1987, Liuli Gongfang revived the pâte-de-verre technique of glassmaking, an art form that was popular in China during the Han Dynasty, but whose methods was lost subsequently. The company is headquartered in Taiwan and it has 70 galleries spread across the world, Its products were once given to VIP members of panels that bestowed the Academy Awards and the Grammy Awards. a ed e b o u e e rea ion pi ured ere re a e in ni y y bo e e e o ri ing a er a rea ed by ring iu i granu e o ariou i e Layered liuli streams and dense bubbles symbolise the indescribable depth o e o ean piri and ee o re e a ine e aying Superior ir ue i i e a o a er i bene a bu on end i none

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LIFE S T Y LE

R E J U V E N AT E B O DY, MIND & SPIRIT The next time you plan to visit Bali, make sure you visit the hillside town of Ubud, where the Alaya Resort Jembawan is located. Opened earlier this year, the resort is super-exclusive, boasting a total of only 37 rooms. Throw in design-driven elegance and heartfelt service that Alaya is renowned for and you’re guaranteed a pleasurable time.

Designed to get you to slow and and smell the roses, the resort provides facilities that rejuvenate the body, mind and spirit. Besides F&B outlets that provide nutritious meals, there are Ayurvedic specialists and yoga instructors on hand. If you’re eager to visit local tourist attractions, the Alaya Resort Jembawan is a stone’s throw ro e on ey ore Sa uary e bud Market as well as the Royal Palace.

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A S M A R T P H O N E - A C T I VAT E D LOCK Did you know that the combination lock has been around for almost 140 years? It’s about time that something new comes along. ir o i e or d r ue oo -enab ed ar travel lock whose primary function is to be a deterrent against theft. But it can make your journey so much more pleasant! For one thing, it doesn’t matter if you lose your key or forget the number combination — you unlock it via an app on your smartphone. AirBolt also boasts a feature that helps you locate your luggage by allowing you to see the ‘last seen’ location on your phone — this is important, as more than 24 million pieces of luggage were mishandled or lost in 2014 alone! Even if you lose your phone or your phone battery dies en route, the AirBolt can still be unlocked by either using the companion app from another compatible phone or by entering a button combination on the AirBolt that you can programme. Get an AirBolt or two and make your next trip completely care-free.

T O M A R K E T, T O M A R K E T a or a year pi urean ar e arina ay Sand annua ood and ine e ra agan a i e o un your a e bud o er three gastronomic days (11–13 August 2017). In that time, you get to savour signature dishes made famous by the integrated resort’s award-winning restaurants, such as Bread S ree i en by ordon Ra ay by o gang Pu and a u in by e uya a uda n addi ion you be pri y o o e of these chefs’ culinary secrets by signing up for masterclasses. There will also be a farmer’s market, featuring fresh produce sourced from markets around the world. This year, the highlights are charcuterie and desserts by Épicerie Boulud as well as The Cheese Artisans’ products. And if you need to wash all that down, there are plenty of wine labels to sample from before deciding on the best deal for you.

HAIR CARE Are you a conscientious consumer who refuses to use personal care products containing ingredients that are harmful both to you and the environment? Then you will love Ashley & Co’s new a poo and ondi ioner Peppy Lu en a Lo and Peppy Lu en So Lo Both items contain crushed mint, lemongrass stalks and blackcurrant buds; what’s omitted are ingredients such as sodium laureth sulphate, parabens, mineral oils, colourings and synthetic fragrances. This makes Peppy & Lucent products perfect for pregnant women, young children and people with delicate skin. S o your o e for Mother Nature by purchasing this pair of hair care products from Ashley & Co.

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LIFE S T Y LE

SOPHISTICATED CITY DWELLING you re oo ing or a o e a rig in e ear o Singapore business district, yet near historical sites, cultural attractions and ran por node oo no ur er an e ara Singapore This hotel is a welcome respite for the business traveller, thanks to its well-appointed rooms — all 392 of them — each of which in ude a or a ion p one and oi e ai a - reen and o p i en ary i- i e o e a o pro ide a u ine Centre. And if you reserve a Club Room or suite, you will enjoy plenty of other privileges, such as use of the Club Lounge, butler service and late check out. you re in ing abou o ding an e en e ara Singapore has four function rooms as well as a column-free Grand Ballroom that can hold up to 500 people. Of course, the hotel can provide catering, even for guests requiring halal food. e ara Singapore a e era ou e a i ui your appe i e o e er big or a n e ground oor are e en a bu e - y e re auran a pro ide di e ro ariou region and Café Oriental, a 24-hour establishment designed to look like a radi iona o ee op er ing o a pe ia ie n Le e are Si Road and Thanying, restaurants providing provincial Chinese and Royal Thai cuisines respectively.

e o e i rig ne o a u - edged opping a providing guests a veritable array of retail, dining and lifestyle op ion i a o o a ed near do en o bar and re auran a e a a ra ion u a ina o n ian o eng e p e Sri aria an e p e and Lau Pa Sa e i a ar e e ing o o a ion ur er a ay i a bree e a e ara Singapore i near ree R a ion an ong Pagar green ine e o yer b ue ine and Chinatown (purple line). a e er you re oo ing or in a o e ere a good an e a e ara Singapore a i

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SANCTUARY FO R YO U R S K I N

S O A K YO U R C A R E S AWAY Have you wondered why the Japanese are partial to soaking in hot springs? Not only are they taking advantage of their natural resources, but the traditional practice of visiting an onsen can reinvigorate the body. Lo a ed a a ang a e a uno ori n en Spa i ere you an e perien e an authentic Japanese onsen right here in the Lion City. Open from 10am to 11pm daily, you an a e your i e o e perien e e di eren ype o ba e Soda Spa ea uring technology imported directly from Japan, features water enriched with carbon dioxide. This can help improve circulation and reduce ig b ood pre ure Soa ing in e e a will subject you to powerful currents of water that massage your stresses away. Other baths in ude e n en a Si a Bubble Bath and Cold Bath. or e en ire on o u y uno ori n en Spa i e ebra ing anaba a a uri a festival celebrating the meeting of deities ri i e and i obo i y no i i en and see the spa festooned with colourful streamers and other paper decorations?

Right in the heart of the business district is a new sanctuary where you can pamper your precious skin back to a healthy glow. Porcelain Signa ure e ird and arge spa by Porcelain — is located on e ground oor o uo o o er and o er bo be po e and high-tech treatments — including award-winnning treatments such as Proionic, Illuminate, Cryotherapy, yRe i e and Sun Re ue a ia — for a range of skin issues, from pigmentation to acne to dehyration and more. The beds here come with memory foam mattresses to guarantee maximum comfort and support, while treatment rooms are illuminated with LED lights to ensure optimal comfort and visibility without the glare. In addition, this skin sanctuary o er oug u ou e such as charging points for your communication gadgets as well as a range of beverages.

RELAX IN A GARDEN i en e e Spa Experience’ Award by the Singapore ouri oard in 2006, the year it started operating, Aramsa The arden Spa i a de ig u lifestyle experience set within its own garden in the middle of Bishan Park. Testament to its ou anding er i e e e i e rea en and on i en y in qua i y i e a a e pa a a na i or e a e a ard e o o ing year a grea abou ra a i a i a erapy roo a an a o oda e couples, so you can enjoy luxurious treatments with a special someone — should you so desire. The spa infuses universal natural remedies with botanical extracts from the earth and sea, and the lush setting simply enhances that ambience. ra a e arden Spa a o boa a pe - riend y a a e a a air a on thus providing clients an all-round experience.

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HOUSE OF SEAFOOD SPECIAL

SEAFOOD CHAIN BUILDS NEW HOUSE FAMED FOR ITS SINGAPORE-STYLE CRAB DISHES, HOUSE OF SEAFOOD HAS PARTED THE BAMBOO CURTAIN AND SET UP SHOP IN CHINA.

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s a food-crazy Singaporean, we bet you’re familiar with House of Seafood. After all, they were voted to have the best pepper crab in Singapore! But long before achieving that milestone, House of Seafood has been delighting foodies on this little red dot since the establishment’s early days, when it was located in a remote part of Yio Chu Kang Road. There are now two branches, one in Punggol and one in Upper Serangoon.

Local delivery Led by its youthful founder and CEO Dato’ Francis Ng, House of Seafood has jumped on the food delivery bandwagon, and has partnered since 2016 local food delivery companies such as Deliveroo and Food Panda. There are plenty of advantages for you, the consumer: whatever you order, your items will be delivered within the hour, no matter where you’re located; heat warmer technology ensures your food arrives fresh and warm; it’s convenient, whatever the occasion; and it provides value for money and attentive customer service in the form of a phone call requesting feedback.

Sealing in the deliciousness “I was keen to explore the export market and bring my brand to other cities,” says Dato’ Ng. This was why he was so invested in developing a way to seal in the deliciousness of signature dishes from House of Seafood, such as chilli crabs. In this way, he could test the waters in an overseas market without splurging on an actual brick-and-mortar restaurant. He has since developed a vacuum-pack technique that even picky food reviewers approve of.

Building a House in the Middle Kingdom While it has already set up a branch each in Malaysia and Cambodia,

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Dato’ Ng is keen for House of Seafood to head further afield. As such, it is establishing a foothold in one of the biggest markets in the world: China! In May 2017, Dato’ Ng announced that the Sino-Singapore Guangzhou Knowledge City (SSGKC) will be House Kingdom, and is slated to begin operating around July/August 2017. He decided to venture into China after taking part in the inaugural China Ready Programme, a signature event of IE Singapore. The programme combines go-to-market curriculum and also provides access to industry experts as well as market mentors. Participants got to attend a three-day workshop in Singapore and a twoweek market immersion in Guangzhou, China. This exposure gave Dato’ Ng a deeper understanding of how Chinese enterprises operate — from company insurance and taxation. Being armed with this knowledge greatly boosted his

Dining on Singapore-style crabs in China With so many Singaporeans working and visiting China, this new venture will surely

come in handy when they get homesick, especially for well-known dishes such as chilli crab, black pepper crab and salted egg crab. These delicious iterations of the crustacean are so renowned that they are gaining popularity even among the people of China, as can be seen by the rise in number of restaurants serving Singapore cuisine. These establishments inevitably have these crab dishes on their menu. Ordering online has become such a norm, especially with computer and smartphone penetration rates in China. Taking advantage of this, House of Seafood has partnered Alibaba, one of the biggest online shopping portals in this part of the world. Dato’ Ng points out that House of Seafood has an advantage, thanks to the vacuum-pack technology he helped develop. “Our technique ensures that freshness and taste are not compromised,” he assures. “Even though no preservatives are added, the crabs can be kept for up to six months and still taste as yummy as freshly prepared ones.” In addition, these ready-to-eat crabs can be ready for consumption within 10 minutes! All you have to do is to pop it into the microwave. Shiok!

Dato’ Francis Ng CEO House of Seafood

HOUSE OF SEAFOOD 3 Punggol Point Road #01-01/02 The Punggol Settlement Singapore 828694 Tel: 6466 9000 Opening hours: Mon–Sun 11am–2pm & 5pm–11pm 756 Upper Serangoon Road #03-33 Upper Serangoon Shopping Centre Singapore 534626 Tel: 6285 9711 Opening hours: Mon–Sun 11am–2pm & 5pm–10:30pm Sat 11am–3pm & 5pm–11pm www.houseofseafood.sg

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UNIQUE WAYS TO CATER IN STYLE

Whether you are planning a simple and sassy get-together or a big celebratory bash, there are options beyond the typical et ine WO RD S

DAWN NEO

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When Sylvia Cardim de Melo entertains at home, she wants to be a part of the action — outside the kitchen. She says, “We love hosting at our house, but e h a d a d fi d r el e spending more time in the kitchen than around the dinner table with our friends.” That is why she has started hiring private chefs through a service such as Clubvivre for her dinner parties. If, like her, you are looking to have a relaxing and memorable experience at your next party, let the professionals take care of the epicurean side of things.

Meat Smith You can have any item from Meat Smith’s regular menu delivered to your doorstep, but for an American-style barbecue party, get them to set up a live grill station in your backyard. Items such as suckling pig and beef brisket will be smoked at the restaurant for up to 12 hours, en ni ed in a por ab e o en and ar oa grill pit by a chef right in front of you. Wine pairing re oy er and er i e a an be arranged. When you order the on-site barbecue experience, it includes transport, equipment and the chef’s fee.

www.meatsmith.com.sg

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Scoopy’s and Cream Imagine the surprise on the faces of your guests when a vintage ice cream van shows up at your party venue. Scoopy’s and Cream dishes out whimsical, old-world charm alongside its creamy gelato, served from the side window of a Volkswagen Kombi. For indoor get-togethers, e o pany o er obi e i e rea i e stations that freeze the icy treats on-site with liquid nitrogen. Choose from a variety of a our in uding on- rend ai i e ea and coconut, or request for something customised. Also available are popular brands such as Häagen-Dazs and Ben & Jerry’s, and halal options such as non-alcoholic rum-andraisin ice cream. The ice cream van can be hired in three-hour blocks. Both the van and the cart come with a minimum of 60 servings.

www.scoopysandcream.com

Clubvivre For the price of dining out, you can hire a professional chef through Clubvivre to whip up epicurean treats for your guests à la minute in the comfort of your home — the maestros even clean up the kitchen afterwards! This bespoke experience starts the moment you browse Clubvivre’s website to customise the menu to your taste and budget. Meal options span over 50 cuisines and the chefs include familiar names such as Eric Low, Devagi Sanmugam and Beppe de Vito of Il Lido. Add-ons such as tableware and butlers can be booked online too. The minimum group size is six people.

www.clubvivre.com

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Drinkdings Why fret over your guests’ beverage needs when there are professionals who can bring a mobile bar, complete with bartender, equipment, glasses, ice and — most importantly e boo e e a ro rin ding i set up, serve and clean up afterwards, leaving you free to mingle with your guests and enjoy your party. Besides concocting cocktails and mocktails, they will also top up glasses with champagne, wine and beer. You can also ge e o upp y nger ood on e ide or organise games and performances.

www.drinkdings.com

Paul Best known for its classic French pastries and confections, Paul Singapore a ar ed o ering curated sets of canapes and baked goods via its online store. With just a few clicks, you can order party packs for 10 to 26 people, which include ini qui e and ou pu a come in sweet and savoury forms. For a bespoke experience, the catering arm of the company is able to customise the menu and event set-up based on your requirements, right down to venue decor, butler service and live stations — pasta, crêpes and fresh oysters can be prepared on-site by its chefs. This customised catering service requires a minimum of 30 people. For live stations, separate charges apply for the chefs.

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Grain Riding on the wave of fast-casual healthy food, Grain now de i er rea i e bi e- i ed anape and ood er ed bu e style, in addition to the wholesome bento box meals it is no n or e a a - er i ed ood pur eyor o abora ed with chefs — such as Hajah Maimunah from the Michelinstarred restaurant of the same name, and Woo Wai Leong of the MasterChef Asia TV series — to design menus that are big on a our ye ind to your arteries. The bu e enu i a i o global cuisines such as Japanese chicken curry, Swedish chicken meatballs and Italian linguine al pesto. You can choose either the seven- or 11-course bu e bo require a minimum of 30 people.

www.grain.com.sg

Saybons If casual French fare is what you are after, consider a mobile crêpe station from Saybons. Cooked to order by a chef at the griddle, you can choose the toppings for either sweet or savoury crêpes — or go for tried-and-tested pairings such as chocolate and strawberries or a and ee e Saybon a o o er i e stations for soups, eggs and paella. You will need to have a minimum of 30 people, and additional fees apply for the on-site chef.

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MONTBLANC SPECIAL

“TO CONTINUE ENGAGING CONTEMPORARY, STRONG AND SOPHISTICATED WOMEN, MONTBLANC HAS CREATED THE BOHÈME LADIES’ WATCH COLLECTION, COMPLEMENTING THE BOHÈME LINE OF WRITING INSTRUMENTS.”

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FOR THE FAIRER SEX LONG KNOWN FOR ITS DECIDEDLY MASCULINE PRODUCTS, MONTBLANC HAS, IN RECENT YEARS, BEEN WOOING THE LADIES WITH A SOFTER TOUCH.

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ontblanc has always projected a strong, masculine image. After all, the long-time face of the Swiss luxury brand is the hunky Australian actor Hugh Jackman, known for his energetic action roles, such as Wolverine in the X-Men movie franchise.

Catering to ladies However, Montblanc wishes to court the fairer sex these days. “More than 35% of our clientele worldwide are ladies,” reveals Jérôme Lambert, Montblanc International CEO. “We do believe there is an opportunity to bring them along to the maison.” Products for women now make up 20% of Montblanc’s inventory, he adds. To continue engaging contemporary, strong and sophisticated women, Montblanc has created the Bohème ladies’ watch collection, complementing the Bohème line of writing instruments for women. These seven lines of exquisite timepieces — Exotourbillon, Perpetual Calendar, Moongarden, Day & Night, Date Automatic, Moonphase, and Date — are the height of feminine aesthetics, featuring leaf-shaped hands and Arabic numerals in an elegant floral typeface.

Key products The model that best epitomises the contemporary Bohème spirit is the Bohème Perpetual Calendar Jewellery. This grand complication is the highest expression of the Montblanc watchmakers’ expertise and experience. If that does not intrigue the wearer, then perhaps she will be more enchanted by the bezel, which is set with 60 Top Wesselton diamonds of 0.906ct each. Despite its soft charms,

this watch is one tough cookie. Besides scratchresistant sapphire crystal, it features a power reserve that can last approximately 42 hours, and can withstand pressures of up to three bars. Another key timepiece, the Bohème Day & Night, was conceived as the perfect constant companion to the Bohème lady, thanks to its unique day and night indication, which allows the wearer to know what part of the day it is. Ladies will surely be attracted to the 72 Top Wesselton diamonds of 0.533ct each on the bezel and a silvery-white guilloché dial. As with the Bohème Perpetual Calendar Jewellery, the indulgent design of the Bohème Day & Night belies an inner strength, such as a scratchresistant sapphire crystal, a 42-hour power reserve, as well as the ability to withstand pressures of up to three bars.

Female global ambassador An indication of how serious Montblanc is about engaging women is the fact that the brand has appointed a yin to Hugh Jackman’s yang: Charlotte Casiraghi’s appointment as the female global ambassador of Montblanc was announced in early 2015 at the Salon International de la Haute Horlogerie in Geneva, Switzerland. Seventh in line to the throne of Monaco, Casiraghi is the offspring of Caroline, the older daughter of Prince Rainier III and American actress Grace Kelly. However, Montblanc did not appoint her just for her royal lineage, but because she displays all the attributes of a Bohème lady: independent, sophisticated, inspired, talented and pioneering, with an uncompromising commitment to

perfection in everything she does. “Her beauty, allure and charisma are matched by her fascinating personality and her many accomplishments, from sport to business or philanthropy,” assures Lambert. Her achievements include co-founding magazines Above and Ever Manifesto, as well as Swoon Productions, a Monacobased company that produces videos, documentaries and short films.

Montblanc’s Bohème ladies’ watch collection has seven lines: • • • • • • •

Exotourbillon xotourbillon Perpetual erpetual Calendar Moongarden ongarden ay & Night Day Date ate Automatic Moonphase oonphase Date

MONTBLANC OUTLETS Montblanc Ngee Ann City 391 Orchard Road #01-34 Takashimaya S.C. Singapore 238872 Montblanc Raffles City 252 North Bridge Road #01-37A Raffles City Shopping Centre Singapore 179103 Montblanc Marina Bay Sands 2 Bayfront Avenue B2-71/72 Canal Level The Shoppes at Marina Bay Sands Singapore 018956 www.montblanc.com Instagram: @montblanc_sea

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UNUSUAL PARTY VENUES Want an out-of-the-ordinary location to celebrate a special occasion? These seven spots are hard to beat for their cool factor. WOR DS

SITI ROHANI

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The perfect venue can make all the d ere ce e ee a a ar a da a e e e ha e le ll al a r h c e he her re cele ra a e a e e a r hda a edd re e r r c he r h ar he fir e ard a re r h d a cce

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ON A YACHT Sipping champagne on board a yacht while enjoying the soft caress of the sea breeze on your cheeks — that’s an image worthy of Instagram. Making this dream a rea i y i a air y i p e a air a ere are any ar er o panie o oo e from. Singapore Island Cruise, Marine Bookings, Lloyd Marine, Blue Star Yachting and Neo Yacht are some of the options. Prices depend on the type of vessel you want, how many people you need it to hold and how long you want it for. www.islandcruise.com.sg, www.marinebookings.com, www.lloydmarine.com, www.bluestaryachting.net, www.neoyacht.com

The good news is that our tiny red dot has no shortage of cool party locations where you can gather dozens or even thousands of your nearest and dearest to your event. From the wide-open sea to the tops of super-trees, here are seven of the coolest party places to pick from.

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SINGAPORE FLYER CAPSULE At 165m high — that’s roughly the height of a 42-storey building — holding your do at the Singapore Flyer is made even more special with the gorgeous Marina Bay skyline as your backdrop. The Flyer is perfect for weddings, birthdays and even product launches. Each ap u e an peop e i a u ro a ion taking half an hour. There’s a selection of canapes, pastries, wines, champagne and non-alcoholic beverages to choose from. www.singaporeflyer.com

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S.E.A. AQUARIUM Want to regale your guests with some under-the-sea magic? Invite your guests to the S.E.A. Aquarium, where they will be surrounded by ou and o agni en marine creatures. There are three venues to choose from: Ocean Gallery is perfect for large-scale events, Ocean Dome is suited for more intimate gatherings, while Ocean Restaurant is a great place to enjoy exquisite cuisine and cocktails. www.rwsentosa.com

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THE SCREENING ROOM Despite its name, you’re not limited to only throwing movie screening parties at this Ann Siang Hill venue. There’s a rooftop bar if you want to party al fresco, a studio room for small corporate events, and an actual screening room in case you do want to throw a movie screening party. Housed in a beautiful heritage building, your party will have a decidedly cosy and casual vibe here. www.screeningroom.com.sg 93

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TANJONG BEACH CLUB Condé Nast Traveller calls it one of the world’s best beach clubs. Whether you’re looking to accommodate 500 or 5,000 people, this is the place for you. The enue o er odern uropean ui ine but they also serve Asian and vegetarian di e e andard ree- o drin package consists of beer, liquor, soft drinks and juices. There’s a minimum spend for F&B; if you don’t meet that, you’ll incur a venue charge to make up e di eren e e e perien ed e en team can help you plan your party. www.tanjongbeachclub.com

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FABER PEAK SINGAPORE With spacious al fresco dining as well as an air-conditioned dining room and an e egan pri a e dining area i enue a er o e era di eren par y ibe and crowds of between 30 and 200 people. Hold your dream wedding, birthday bash or an anniversary party here and be privy to grand vistas of the harbour. www.onefabergroup.com

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SUPERTREE BY INDOCHINE Where else can you party hearty at the top of a tree? SuperTree by IndoChine is the only establishment at Gardens by the Bay’s Supertree Grove, making it a unique celebration spot. Perfect for weddings, corporate events and product launches, the restaurant can accommodate up to 400 people. Choose between the al fresco rooftop bar and the air-conditioned lounge. www.indochine-group.com

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Q’SON KITCHEN EQUIPMENT SPECIAL

SATISFYING DISCERNING TASTE BUDS WHEN PROFESSIONAL-LEVEL AND INDUSTRIAL-SCALE KITCHEN EQUIPMENT IS NEEDED TO SATISFY HORDES OF FOODIES, Q’SON HAS THE RESOURCES TO HELP.

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eople living in Singapore are known to be particular about what they eat. They will gladly travel to obscure or inaccessible corners of the island just so they can sample what are reputedly the most delicious culinary creations in the land — it doesn’t matter whether they are economical hawker fare from food hotspots; it also doesn’t matter if the queue is long. Knowing this, professional kitchens will need quality cooking equipment that can help them create their signature dishes to an acceptable standard every time discerning foodies taste them.

For its business acumen, Q’son won the Entrepreneur of the Year Award in 2013 and the Spirit of Enterprise Award in 2014.

Wide-ranging clientele Q’son has more than 1,500 customers in Singapore. They consist of hotels, factories, central kitchens, and even private homes. Some blue-chip and familiar names include Banyan Tree, Shangri-la Hotels and Resorts, Singapore Airlines, and Crystal Jade. Q’son has also made its mark overseas, in establishments such as Hard Rock Café in Malacca and Montigo Resorts in Batam.

This is why more and more F&B establishments have been turning

Entrepreneurial spirit Established in 1996 as the operating arm of listed company Singapore Kitchen Equipment Limited, Q’son provides industrial and commercial kitchen equipment that can be easily integrated to

So whether you’re setting up a business in the F&B sector or renovating an industrial kitchen, or even if you’re just a serious home cook keen to work with professional equipment, consult Q’son

Q’SON KITCHEN EQUIPMENT PTE LTD

situations. Today, it is the leading provider of one-stop solutions for

To meet growing demand, Q’son has set up manufacturing facilities in Johor that use state-of-the-art fabrication machines. This enables it to deliver reliable products, from simple units to complex structures. In addition, Q’son also distributes products from brands such as Imperial, Berto’s and Qoolux.

Blk 115A, #01-27/28 Commonwealth Drive Singapore 149596 Tel: 6472 7337 Fax: 6472 6497 Email: sales@qson.com.sg www.qson.com.sg

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PERSONALIT Y

QS WITH KIT CHAN THIS Quarterly chats with one of Singapore’s most successful pop stars to find out what motivated her to join the corporate sector for a spell, and what she does to protect her most precious commodity.

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While I worked a lot overseas, Singapore remained my home. It gave me a sense of rootedness and anchor, which I needed.

1.

You are reprising your starring role in Forbidden City: Portrait of an Empress, which is being restaged by the Singapore Repertory Theatre at Esplanade Theatre from 8–20 August. What’s the appeal in repeating something that’s been so well received? Obviously, one of the appealing factors is that it has garnered many fans over the years, having been staged a total of three times. I’ve also come across people who have lamented that they had missed the shows and would love to catch it should it ever be staged again. Many of these were people who were still too young to have heard of i or ou d no a ord o go o the theatre then. It was last staged in 2006, more than a decade ago. Besides, it was one show I truly enjoyed performing in, and the role was challenging in many ways, and I always love a good challenge. I am curious to see how I would in erpre e ro e di eren y

2.

Is doing musical theatre and singing a role night after night more taxing than a regular concert, even a multi-night one? The answer is both ‘yes’ and ‘no’. Doing musical theatre is both easier and also much harder than staging a solo concert. First of all, it’s very much ensemble work even if you are in a starring role. It’s one of the most attractive things to me about being in a musical. The pressure is taken o e e in o e ay a the same time, you have to be very in tune with the entire cast. You have to be very sensitive and alert. Every night, someone is bound to do something di eren or o e ing ig happen and you have to respond to that. You cannot just be focused on your own thing. The continuous long run — in this case, nine shows a week — is extremely taxing physically and vocally, so I have to ensure I am healthy and disciplined in my daily living to ensure I do not fall ill.

3.

Between acting and singing, which do you like more and which takes you longer to prepare? I enjoy both, and I think they complement each other, which is why musical theatre is the perfect medium where the two can fuse seamlessly.

4.

How do you handle criticism? Has any review made you cry or made you consider throwing in the towel? I handle criticism pretty well, as a matter of fact. The ease comes with the knowledge and acceptance that I am far from perfect, and that performance and life is a constantly evolving game. You will never have it down pat. Part of the fun is the learning and discovery with each new role and experience. No, I have never had a review that made me consider giving up — come on!

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5.

A lot of people were surprised when you not only took a hiatus in 2004, but entered the corporate world with the PR H ll Kno l on e e you trying to make some sort of statement? If there was any statement to be made, it was to myself. I would have preferred to undertake that career switch in a completely anonymous way, but I suppose that was not possible. In a nutshell, after having been an artiste my entire adult life, I was feeling increasingly detached from the real world. The fact was, at that point, I was already over 30 and had not experienced a ‘normal’ life as a working adult. I went straight from school to being a recording artiste, and was fortunate enough to have made a success of it early on in my career. But that creates a bubble around you. While I had appeared on den on age and in public, I was not so in private — it’s hard to explain. Plus, I am naturally an introvert. So e u ay gured i e was not going to go very well down the road in terms of personal development and mental health and all that. I did think long and hard about the career switch. I always knew I would return to performing again. I just had to get out there and develop other parts of myself before it was too late. PR a u a oin iden e it could have been anything. I would have applied myself to it with equal enthusiasm and curiosity. I think that was the best thing I could have done for myself at that phase in my life. Now I feel complete, and anything is possible down the road.

6.

Were you surprised by how popular you were when you participated in the third season of the China talent show, I Am A Singer? How did you feel knowing that netizens there fiercely defended you on forums when you were eliminated? I was very surprised and, quite frankly, overwhelmed by the show of support from people and fans, many of whom did not know me before the show. I was never active in China before that. It moved me, and inspired me to keep staying true to who I am. It is easy to think we need to compromise or pander to certain standards in order to be liked or appreciated. That experience validated my belief that it isn’t true.

7.

When you were starting out, was there ever a time when you thought you had to try to forge a career overseas because of Singapore’s small population? What are your thoughts on this idea? When I was starting out in 1993, the only way out was to forge a career overseas! It is a well-known story. There was hardly a pop music industry, and the already-small market was not yet receptive to local music. In fact, the recording on ra a o ered a e with the condition that I had to be willing to relocate to Taipei for at least two years. I moved there in 1994 and stayed for four years. But in 1998 — coincidentally, that was the year I sang ‘Home’ at the National Day Parade — I decided I had to move back home. I felt I had paid my dues after having laid some foundation in Taipei and Hong Kong.

In the ensuing years, my work required me to travel extensively. While I worked a lot overseas, Singapore remained my home. It gave me a sense of rootedness and anchor, which I needed. While it was challenging to kick-start my singing career, I am honoured to have been given the opportunity to play a pioneering role in making local pop music acceptable to local audiences, and in bringing them to a wider audience in the region.

8.

How have your musical direction and image changed over the years? Would you ever go back to the music of your early years, even if that sound came back in style? My musical direction and image evolved very naturally, I think, according to the di eren p a e in y areer and y i e i eren a or e ind o in uen e I was exposed to, the collaborators I worked with, my own life experiences — all played a part.

9.

Between acting, singing and consulting, what would be your focus in the next couple of years?

This is a tough question! While I may be very focused when I am working on a project, I am actually quite spontaneous in the way I pick them. I’m not saying it’s the way to go for everyone, but serendipity has been a major theme in my life thus far. So let’s see what happens.

10.

How do you protect your voice and keep up your energy during the performance period? Lo o uid be i a er fruit juices, Chinese soups and tonics, etc. I try to get enough sleep because my o a ord rea y u er when I don’t. I also stay away from crowds, which means I have to avoid going to cinemas, theatres, crowded restaurants, etc. You might catch me with a mask on if I have to brave the crowds. I also avoid talking loudly or for long periods of time. Yes, I can be very paranoid and take a lot of precautions regarding my health and voice during the run of a show, but it’s all because I really want to be in the best condition to put on a good performance for my audience.

Forbidden City: Portrait of an Empress will be staged at Esplanade Theatre from 8 Aug 2017. Tickets are now on sale till 27 Aug 2017 via www.esplanade.com/forbiddencity

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Local Brands Gone Global August being Singapore’s birthday month, we celebrate the success stories of seven homegrown brands that now have a global footprint. WO RD S

DANG HUI LING

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BreadTalk Group Founder: George Quek In 2000, BreadTalk revolutionised the local bakery industry by introducing unprecedented concepts such as its signature pork o bun er a roaring ar and i ion o bun o d e o pany re ei ed o er in erna iona ran i e enquirie in a been year in e and e roup a e panded ar beyond our ore So e brand be o e da ed a er u year e an i ba and re a e u on inue earning and e peri en ing ay eorge ue ounder and air an o e roup Having built strong relationships with local networks — e pe ia y in ina e roup pre en e an be e in o a e around e or d i ore an ou e a ro eig brand in uding oa o in ai ung and ood Repub i ying e na iona ag ig e roup be a e e r Singapore brand o in ro ar e Re ai er o e ear a or d Re ai ard in Pari i on inue o a e ne eig read a p an o o abora e i g oba a er e and aun ne -genera ion on ep ore a e ebra e na ura ood and ba ing ar i ry

TWG Tea Founders: Taha Bouqdib, Maranda Barnes and Manoj Murjani id you no a ea a ounded o e ebra e Singapore i ory a a rading po or ea and pi e Sin e i ar in a ouri ed in o a u ury i e y e on ep a in orpora e re ai bou ique ea roo and an in erna iona di ribu ion ne or n opened i r o er ea ore in o yo Se en year on produ are di ribu ed in o er oun rie ie ea Sa on ou ique an be ound in i ie o ar e brand anni er ary a ag ip ore i a ed o open in London ne year e gro o ea a been a ee no e o a our a i a een our brand pene ra ing ar e u a ina ai an and ong ong i e re en aun o ea an ou er e are a o arge ing e or eri an ar e or our ne p a e o e pan ion ay a a ouqdib pre iden and o- ounder o e ore ee a e uropean ar e i ano er o ia a e i be onquering ur brand a gro n e ponen ia y o er e pa nine year and e are de ni e y ready or e ne de ade

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Spa Esprit Group Founder: Cynthia Chua eadquar ered in Singapore in e Spa pri roup i a o egro n brand i a por o io panning beau y and groo ing er i e pa and e ne er i e u o i ed aro a erapy pre iu a ia produ ne and a ua dining on ep ar i ana o ee and ood in erior and produ de ign and re ai anage en big par o e roup u e i a ribu ed o i o u on inno a ion and i na or e e u ing a paign a urn in o e a o e o n o da e e o pany ou e brand in uding ro au S rip S inny Pi a and ipp ing ub i ea a ering o e pe i need o i arge ar e and e odern on u er urren y e roup opera e ore an re ai ou e in nine i ie in uding London e or S ang ai and ong ong n par i u ar ro au a ai ed by in erna iona de ign and y e aga ine Wallpaper* a e u i a e go- o op or in erna iona ra e er o ge eir bro groo ed Charles & Keith Founders: Charles Wong and Keith Wong ar e ei a e ab i ed in i e i ion o pro iding y i oo ear ai ored o pe i e ian o en and bringing e o e a ion rend o e a e er e year i produ o ering a e bran ed ou o in ude bag a e orie and o u e e e ery S ar ing ro a ing e ore in Singapore ar e ei i no an e ee ed brand a ong oreign ouri and boa ore an ou e in ia-Pa i urope and e idd e a n re en year e o pany a a o ade oray in o ig -end re ai de ina ion u a a au e ene ian and pop-up ore in Pari a erie La aye e eeping up i anging on u er be a iour i on ine bou ique ar e ei o o er an e en i e e e ion and ip o o er oun rie n uppor o u ani arian and en iron en a au e ar e ei a or ed i in erna iona organi a ion u a ni ed a ion n i y or ender qua i y and e po er en o o en o en and ar our 103

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Tiger Balm Founders: Aw Chu Kin a began in e a e en u in a ine e erba i o or ed in e our o ina e peror rea ed a pe ia oin en a ou d re ie e a ind o a e and pain er e died i on oon a and oon Par oo e bu ine o Singapore and broug iger a o or d ide pro inen e oday e ine o ana ge i produ i o ned and anu a ured by o a orpora ion a Par ea are e ide ian oun rie u a a ay ia ai and and ong ong e S i a o one o iger a bigge ar e o ay re e an iger a a undergone a or anage en ange and a brand rein en ion e a i e agona bo e with a gold cap was redesigned while new produ u a o qui o repe en pa e and u e rub a e been in rodu ed o onger u a grand a er brand iger a i rea ing ou o young on u er by e eraging o ia edia

an e e u i e dire or o a Par ea are are eri age brand i no gro un e i qua i ie and reng an be u e u y arne ed and ran or ed o ee no on y e urren bu a o e e er- anging on u er i e y e a e a in rea ing y o pe i i e ene i require u rea i i y pa ien e and o u

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Banyan Tree Founders: Ho Kwon Ping, Claire Chiang and Ho Kwon Cjan e gene i o anyan ree ie in e i ion o i ree ounder o pur a e and ran or e par e o and a ou d e en ua y ead o Laguna P u e and e bir o e anyan ree brand ro a ing e bou ique re or in o a eading in erna iona o pi a i y brand a anage and de e op pre iu re or o e and pa anyan ree a e o ed in o a reno ned u i-bu ine a ard- inning opera or anyan ree or u a or u e o e ro genera ing di eren in o e rea par i u ar y in de e oping o p e en ary produ o ering by u i i ing i poo o re our e i ore an a o ia e o o er na iona i ie e di er i ed or or e e p ee e de and o anyan ree rapid g oba gro a o e and re or pa ga erie and ree go our e pread a ro oun rie on an y ee ing o pread i ing ur er anyan ree a up o ing pro e in oun rie u a ina uba ree e ndia and ndone ia o er e ne o year

Singapore Airlines o Singaporean ou d agree a e one o a brand e ou d be proud o i our na iona arrier Singapore ir ine S e ebra ing i anni er ary i year S or er y no n a a ayan ir ay Li i ed and a ay ia-Singapore ir ine debu ed i r ig on ay n ren ou urier Pierre a ain de igned e arong ebaya a a re ained a igna ure ou or e Singapore ir S a e r air ine o pro ide ree ead e or i in ig en er ain en y e ri or d a e a ea and be erage oi e or ono y a pa enger ro en on S gre ro reng and reng gaining in erna iona re ogni ion a i ee gre and rou e e ended S i a o e o -a arded air ine in e or d e pi e o a i e ue pri e and un er ain g oba e ono i ondi ion e air ine p an o on inue ying o ne de ina ion and i pro ing i pre iu produ and er i e o ering e i a o be ur er de e oping our por o io ra egy in i e a e in e en in bo u - er i e and o - o arrier

e panding our a o ia e air ine o er ea and going beyond our ore air ine opera ion o de e op ad a en bu ine e a bring in ne re enue re ea o oon P ong o S in i annua Sustainability Report

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LIVING GREEN What does living green mean to you? To the organic farmers at Trill Farm in England, it isn’t just about farming sustainably, but a way of life. WORDS

FIONA CHEN

Being green and sustainable is on trend these days, going by the skyrocketing interest in eco-consciousness, and buzzwords such as “locavorism” (a movement that champions local produce for myriad reasons, including minimised carbon footprint) and “farmto-table” (a concept that romanticises garden-fresh food). While many are happy to take small steps in doing good for the environment, such as taking extra care to recycle, some literally go the extra mile by volunteering in organic farms for an extended period for free, just to learn more about the secrets of the land. This volunteer placement is called Willing Workers On Organic Farms, or WWOOF. Who, what, WWOOF? As a WWOOFer, you provide labour to farms in exchange for accommodation and, usually, ree quare ea o nd u u ua y bene ia oppor uni ie one a o go roug a ing er i e u a e o ia WWOOF website, in return for a membership fee. WWOOF placement durations last anywhere between one to six months, which

is why it is particularly popular among the environmentally conscious and curious young adults looking for an eco adventure during their gap year or before plunging into working life. Eat, sleep and work green I decided to take a sabbatical from work in 2016 — I had been restless after working for more than a decade and was starting to take a serious interest in sustainability and food security because of Singapore’s reliance on imports. Taking with me the scant farming knowledge gleaned from a short stint at local organic farm Bollywood Veggies, I arrived at Trill Farm on a chilly March morning. I was to be at the organic farm collective in the south of England for a month before embarking on my next placement in Italy. Organic farming revolves around techniques to cultivate plants and rear animals in natural ways. These include a oiding gene i a y odi ed rop and ingredients, and synthetic substances such as chemical pesticides and fertilisers. This is the standard practised by all organic farms globally, and Trill Farm is no exception. What separates Trill Farm from the rest is that it consists of several independent 107

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Above: The herb garden in summer. Right: Volunteers have a cabin of their own.

businesses — owned by the founder of cult skincare label Neal’s Yard Remedies — including a restaurant and a cattle enterprise. e e ery di eren e ab i en or together to ensure that the farm as a whole is sustainable and self-reliant. The restaurant gets some of its greens from the vegetable farm; in return, the restaurant provides compost in the form of food waste. Soiled hay from the barn and chicken coop also go into the compost heap. Trill Farm’s green methods go well beyond standard protocols. It seems that environmental awareness is a pre-requisite to work there, even if you’re ba ed in e o e eir pa ion i n u a a in e pan o e o e ee o rong y about their causes that they are willing to give up creature comforts to pursue them. Bryony, an apprentice at the vegetable garden, lived in a caravan on the farm for six months, just so that she could receive an intimate education on sustainable farming methods. Waste not Needless to say, recycling and reducing wastage are serious issues at Trill Farm. Every item is meticulously sorted into its appropriate category; those that are non-biodegradable are upcycled into their second lease of life as far as possible. In the restaurant, not a single spiral of peel goes to waste — they all go straight into two wheelbarrows, one for the chickens and one for the compost heap. n ead o buying re ood ey are ga ered from the wooded areas surrounding the farm, and only from fallen wood. This was an eye-opening revelation for me. In Singapore, I have seen blue recycling bins

being tipped into the general rubbish trucks. Not that it mattered, for many Singaporeans have total disregard for recycling — I remember seeing my neighbours throw nonrecyclables into the blue bins. When prodded, they nonchalantly brushed i o ai ing a ey didn no e di eren e i a in ar on ra o e mentality at Trill Farm. I once threw an empty glass bottle into the recycling bin and was given a disapproving look by one of the farm a en ade o re rie e i Made for the seasons “To make sure we don’t take too much from the land, we must r earn o a e e be use of it.” This statement is a way of life routinely observed at Trill Farm. We have become so accustomed to having everything available at any time

Above: Spring lambs keeping warm in the straw. Below: Freshly picked salad greens.

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of the year that we forget to wonder how it is possible that we are feasting on strawberries in the dead of winter when the fruit is naturally in season in spring and summer. To counter this, they believe in producing and using seasonal produce, not just because it is more sustainable, but because they are more nutrient-packed than those grown all year round in greenhouses. And whenever the farmers experience a bumper crop, everything not eaten fresh will be preserved and consumed at a later date. Where do we go from here? After my three-month stint overseas, I returned and realised that Singapore — even with its many green campaigns and push for self-sustainability — has such a long way to go. There is much to be done in terms of education, right down to the basic knowledge of telling apart general waste from something meant for the recycling bin. Food wise, while it is heartening to see that more people are recognising the importance o being e - u aining e u r earn o respect our land and make the best of what we have — even if it means converting all of Singapore’s rooftops into farms. Below: Trill Garden’s staff and volunteers having an outdoor lunch.

OV ERHEARD AT TRILL FARM: COMMON TERMS DEMYS TIFIED Conservation grazing Conservation grazing is the use of livestock, such as cattle, to maintain and increase the biodiversity of natural or semi-natural habitats. When these creatures are allowed to graze freely, they consume different species of plants, creating a varied habitat. This is the natural equivalent of mechanical mowing or burning, and is a gradual process that allows wild animals and insects to thrive. Crop rotation Organic farmers ensure that there is a balance of nutrients, organic matter and microorganisms in their soil by practising crop rotation. This means no same crop is planted in the same spot for more than three years consecutively. Green manuring Instead of using discarded plant waste or compost to fertilise crops, green manuring is a method where a specific plant or crop is specially grown to be cut and ploughed into the soil to improve its quality. Green manure is extra beneficial in creating nitrogen, an essential nutrient required by plants, and it can generate twice or even thrice as much nitrogen when compared to, say, cow manure. Mulching There are many types of mulches available, such as sawdust or peat. They are applied over soil to prevent moisture loss and to inhibit weed growth. Seed saving This is a time-tested way of regenerating edible plants. Organic farmers selectively choose seeds from quality crops for future use. This not only protects biodiversity, but also ensures that future crops inherit its quality from the parent plant. Tinctures These are liquid herbal extracts, commonly in the form of a herb steeped in alcohol. They are usually medicinal in nature. For example, elderberry tincture is known for its flu-fighting properties.

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A TASTE OF HEAVEN From local to global, Portland’s food carts are the number one reason to visit this city on the Pacific Northwest of the USA. WOR DS

ELISABETH LEE

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Lefse with meatballs, sushi burritos, Pueblostyle chicken mole, laksa lemak, shrimp fritters, a raed d a ha d ade a a authentic chicken rice. Food cart galore! You name it and chances are there’s a food cart in Portland dedicated to serving you an excellent version of it. Little wonder then that writers and reviewers have been endlessly raving about the Rose City’s food scene. Famed US food critic Tom Sietsema spent more than two months criss-crossing the continent before naming Portland the best food city in America. And just this year, at the annual James Beard Awards (aka the Oscars of

food), three Portland chefs were among the contenders for the Best Chef gong, with Greg Denton and Gabrielle Quinonez Denton of Ox and SuperBite fame taking home the honour. On a recent trip there, I was pleasantly surprised by the depth and breadth of what a on o er i on y our days in the city, it was hard to know where to start and what to eat. Luckily for me, Brett Burmeister, who runs the Food Carts Portland website, carved out some time in his busy schedule to meet up for a quick overview of the food cart scene. e e a idbi (Southeast Division Street and 28th Place), one of the more recent additions to the food cart scene. Best

described as an American version of an outdoor hawker centre, it has more than 20 food carts spread out over 15,000sq.ft. Tidbit is pretty unique be au e i i e r to include a large, covered seating area. Plus, it serves beer. Over Brett’s tasty looking Dog Father (handcrafted hot dog with in-house baked bun, Italian sausage, marinara sauce, hot peppers, onions and provolone cheese) and my Macho Taco salad (all local ingredients and very refreshing), we did what most Singaporeans would do — talk about the next meal! One suggestion that cropped up time and again was to try a sushi burrito — think of a giant maki crammed full of interesting ingredients.

Despite its Frankenfood connotations, a sushi burrito i de ni e y a no e y or trying. At Tidbit, that means a abi P ango i Poke sushi burrito. I managed to squeeze one in and the garlicky fried onion dressing that accompanied it was truly to die for. The rest of my stay was spent in a blur of food and beer. Here are my faves: • Nong’s Khao Man Gai (khaomangai.com) Think superlative chicken rice, Thai-style, made with organic kosher chicken. Best of all, it’s part of the huge downtown food cart group near Pioneer Square, which makes it ultra-convenient for stopping by after a trip to the world-famous Powell’s City of Books.

Top: Some of the c l ar del h from the famous d car r la d h d like an American version of an d r ha er centre. Opposite: live music while ha a e

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FOO D CA R T E T IQ UE TTE Check online or call. The food cart scene in Portland is rapidly evolving, so check before you go. Don’t forget carts often open only for lunch. Cash is king. Some food carts take credit and debit cards, but not all. Don’t forget to tip. You’re still getting served, so leave something extra (5% to 10%) if you can. Don’t litter. Either dispose of your waste at the many rubbish and recycling bins or take your dishes back to the cart’s bussing station.

• Artigiano (artigianopdx.com) Think artisanal, traditional Italian food featuring fresh, local ingredients. Get the Chef’s choice surprise menu, which includes antipasti, primi (pasta) and secondi (meats) for just US$25 to US$45 per person.

• Chez Dodo (chezdodopdx.net) Mauritian food — with touches of African, Indian, Chinese and Creole cuisines — is a prime example of why the US is such a delicious melting pot when it comes to food. Don’t miss Shyamosa, a uge pa ry u ed i spicy potato and smothered in herb and chilli sauces.

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Opposite: her e d Top left: Deschutes Brewery’s l d ld ce r h Ore e c e ce a d d r Above: Small-batch wines showcase the Pacific r h e d er e cl a e a d varietals.

Beyond food Of course, there’s more to Portland than just food. Top of the list: drink beer. More than a dozen breweries opened last year, adding to the hundred or so already open. Don’t miss Deschutes Brewery — one of the originals — and its famous chocolatey, creamy Black Butte Porter. Other breweries worth checking out include Burnside Brewing Company (try the popular Too Sticky To Roll IRA and grilled octopus), and the classic IPA at Hopworks Urban Brewery. Portland is also home to a rapidly growing urban wine scene, inspired by the success

of its craft breweries and distilleries. Smallba ine o a e e be o e Pa i Northwest’s diverse climate and varietals. e ou n o inery rui y in ande or its meaty mourvedre, both of which are an excellent way to quench your thirst after a day spent exploring the leafy South East. And when you’re tired of eating and drinking, or i a o i a a ing our o i ori Portland, a cruise down the river or a day trip to Oregon Zoo or the fascinating Oregon Museum of Science and Industry. I had such a great time that I’m already planning another trip. And this time, I’ll be taking a food cart map with me.

P OR TLAND 101 Getting there: Your best bet is to fly to Portland via Tokyo. Alternatively, fly to San Francisco or Seattle and grab a quick connecting flight. Getting around: Portland’s local transit system (trimet.org) is cheap, clean and fast. It’s a great way to get to/from the airport and around the city. If biking is your thing, check out the bike share programme, which features more than 1,000 bikes spread out over 100 locations in downtown Portland (biketownpdx.com). Where to stay: The newly renovated Hotel Vintage (hotelvintage-portland.com), with its complimentary happy hour and convenient downtown location, makes an excellent base. Solo adventurers might prefer the luxury dorms at the hip Society Hotel (thesocietyhotel.com), while RiverPlace Hotel (riverplacehotel.com) might be your best bet for a tranquil waterfront getaway. Explore: One of the best ways to get a feel for the variety of food and carts on offer is to arrange a custom food cart tour with foodie extraordinaire Brett Burmeister, who runs the Food Carts Portland website (foodcartsportland.com). 115

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UOL SPECIAL

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A PLACE TO CALL HOME THE CLEMENT CANOPY TAKES ITS INSPIRATION FROM NATURE TO CREATE THE IDEAL HOME FOR REJUVENATION AND RELAXATION.

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esigned by award-winning architects, The Clement Canopy, a joint-venture by UOL Group and SingLand, boasts thoughtfully curated spaces accentuated by practical layouts and facilities. The three-tier landscaping and water feature design borrows inspiration from nature to create a beautiful and reinvigorating living environment. A host of exceptional amenities — such as waterfall pods, pools, wellness and fitness corners, and play areas for children — intertwines perfectly with the greenery, offering you a breath of fresh air whenever you come home. The 40-storey residential towers stand 43m apart from each other, which provides adequate space for landscaping and privacy. With 44% of the units facing the West Coast sea, these lucky residents get to wake up to a scenic view every day. Meanwhile, other homeowners can also enjoy the sights and sounds of the charming internal landscape. One of the top-five bestselling developments in March, The Clement Canopy’s 2-bedroom units are the most popular among buyers, thanks to the flexibility and efficient use of space that

these units render. Besides Londoninspired high ceilings, innovative Niche Kitchen designs, and well-appointed rooms, smart home features allow homeowners to control door locks and air conditioners remotely, as well as book facilities via their mobile phones.

Unparalleled convenience Strategically located in the middle of two major growth areas — Jurong and one-north — it is hardly surprising that both homebuyers and property investors covet The Clement Canopy. The development is only a few minutes’ drive from the one-north business park, which houses various established biomedical science, infocomm technology, physical sciences, engineering, and media companies. At the same time, it is a stone’s throw to Jurong Innovation District and Jurong Gateway Precinct, the biggest commercial hub outside the city centre, as well as the future terminal for the High Speed Rail from Singapore to Malaysia. Shopping, entertainment and dining needs can also be easily satisfied with the numerous options surrounding the estate — Jem, Westgate, Kent Ridge Park, Ayer Rajah

Market & Food Centre, Republic of Singapore Yacht Club, Sunset Way and Holland Village, just to name some. The icing on the cake would have to be The Clement Canopy’s close proximity to local schools (Nan Hua Primary School, Nan Hua High School, Anglo-Chinese School (Independent), National University of Singapore (NUS) High School of Math and Science), international schools (United World College, Japanese Primary School, Nexus International School, Tanglin Trust School) and tertiary institutions (NUS, Singapore Polytechnic, Ngee Ann Polytechnic). With such attractive internal and external features, The Clement Canopy is a gem of a place to build a cosy enclave for yourself and your loved ones.

THE CLEMENT CANOPY The show gallery is located along Clementi Avenue 1. Opening hours: 11am–8pm Sales enquiries: 6100 6518 / 6100 6582 www.theclementcanopy.sg

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72 HOURS

IN SEOUL There are so many things to do, eat and see in the South Korean capital. But if you only have three days in the city, cram all our recommendations into your itinerary. WO RD S

DANG HUI LING

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Day 1 Stop

1

Gwangjang Market Begin your day by sampling o a a our a Gwangjang Market e o de and one o e bigge ar e in e oun ry ide array o Sou orea a ou ree ood an be ound ere bu e one ing you a e o ry i bindaetteok (mung bean pan a e o e ery a e i bu our a ouri e is from Soon-hee Ne i oo ear y or makgeolli ri e iquor ean e your pa a e i radi iona orean be erage sikhye, a ee drin ade i a ed bar ey and ri e

Stop

Stop

3

N Seoul Tower i i N Seoul Tower in e e ening or e be o bo or d a panora i ie o e i y in day ig and a er un e Per ed on e u i o oun a an e and ar i a popu ar ing i e and ro an i da ing po

2

Myeong-dong er a u ing brea a ead o Myeong-dong e ear o o n i ro o op ea uring an e e i i o in erna iona and o a abe a e a e era Lotte a a a er o di eren age group you an op or any ing ere i i a o ere orean beau y brand a e ongrega ed you a e i e o pare ge a air a eo er a Juno Hair u in o and ade kalguksu ni e- u nood e and mandu du p ing a Myeongdong Kyoja ig er bu u a a i ying op ion i jeonbokjuk aba one porridge from Migabon or e per e n agra p o o ge e o e y ro e- aped i e rea from Milky Bee ra ing or ree ood obi e endor u ua y appear in e a e a ernoon

Clockwise from above: N Seoul Tower, Hongdae, Myeong-dong Below: Jjimjilbang

Stop

Stop

4

Hongdae a e your pi ro e nu erou in ri a e y de ora ed a e u a aA Design Museum Cafe S op and re auran open i a e o you an oa up Seou e i ing nig i e n oy a arao e e ion a Luxury Su Noraebang or dan e e nig a ay a popu ar ub u a NB2 erna i e y a ree per or an e a Hongdae Playground or i i e o a a Yeonnam-dong ere nig y pi ni a epa e

5

Jjimjilbang Jjimjilbang i a radi iona orean pa a open our a day Popu ar p a e i e Dragon Hill Spa and Itaewon Land are e equipped i a i i ie u a i n auna a age er i e ga e roo re ing area and an een or an e ra do e o un earn o od e a b o e a commonly seen in orean dra a

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Day 2 Stop

1

Tosokchon S ar your eri age rai i a u p uou bo o samgyetang gin eng i en oup a Tosokchon o on y i e ood de i iou you i a o experience dining in a hanok radi iona orean ou e on be daun ed by e queue e ai i no a e ong an o e ien er i e

Stop

2

Gyeongbokgung Palace e arge o e e grand pa a e bui during e o eon dyna y Gyeongbokgung Palace o er grea in ig in o e oun ry ri i ory o a e your i i e en ore e orab e ren a hanbok radi iona orean o u e ro Oneday Hanbok o a ed nearby d i ion o e pa a e i ree or i i or earing e hanbok

Stop

5

Samcheong-dong er re ing your ee a e a a ua ro o Bukchon Hanok Village in Samcheong-dong undred o an ien hanok a e been ran or ed in o ip op and a e i e o e re ain a re iden e r a ionado don i e beau i u ar i e ure and a ina ing e ibi ion a National Museum of Modern and Contemporary Art (MMCA) Above: Gwanghwamun Square Top right: Gyeongbokgung Palace Below: Dongdaemun Design Plaza

Stop

3

Gwanghwamun Square ro yeongbo gung Pa a e a o Gwanghwamun Square, ere you i nd e a ue o Se ong e rea e i e our and o re pe ed ing o e o eon yna y and e rea or of hangul orean a p abe

Stop

4

Insadong r ga erie ra ore and ou enir op ine e ree o Insadong and a e in riguing y de igned Ssamziegil a i your u y i a piping o hotteok pan a e i bro n ugar yrup ing a Sambodang or ry radi iona na a Shin Old Tea House a quain yetchatjip o d ea ou e

Stop

6

Dongdaemun Seou i a i y a ne er eep n Dongdaemun ere are ore an o e a e and re ai a a open i a nd you ne er a e o orry abou going ungry ood op ion in ude a ed eri an burger ain Shake Shack a Doota Mall and a - our dakgalbi pi y ir- ried i en op Yoogane along e ree i e you are ere e ou e a a adiddesigned Dongdaemun Design Plaza a - aped and ar a a an a a ing ea o L ro e a e roo op garden

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TR AVEL

Day 3 Stop

1

Han River ar y ri er an a e a orning a or y e a ong e Han River Re rea iona par a pan e eng o e a ri er u as Yeouido Park and Banpo Hangang Park o er bi e ren a er i e and ood io Clockwise from above: Han River, Garosu-gil, Gangnam COEX Mall, Noryangjin Fish Market

Stop

Stop

2

Noryangjin Fish Market n oy e re e ea ood and a i i a Noryangjin Fish Market o on y do you ge o oo e and buy e on e po you can also bring e ingredien o e ar e ea erie o ge e oo ed

4

Gangnam Gangnam i n u abou orean inger PS ira i i i e o u uriou di ri in Seou and o e o any depar en ore aun ing op de igner abe u a Loui ui on ane and er COEX Mall i i e bigge underground opping en re in Sou orea e en o an aquariu

Stop

Stop

3

Garosu-gil Sinsa-dong i o e o one o e rendie area in Seou Garosu-gil, i ean ree- ined ree ere e be orean abe o op from include Gentle Monster, 8seconds and Ă…land Snap a p o o i e gian p u bear in e LINE Friends Store & CafĂŠ dig in o a our o e ru n a Mr Holmes Bakehouse and a our a idday o ee ro Ikovox

5

Lotte World Tower e e r a ong your riend o i i Seou ne e y raper Li ed a e - a e bui ding in e or d e - orey ru ure boa e or d ig e ob er a ion de i aga oor er re ord-brea ing ea ure in ude e or d ig e i ing poo in a bui ding on e oor and a e e e a or i rea e e op o e o er in one inu e

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TO P 5 EAT S KOR EAN BB Q

We recommend: Wang Bi Jib, Maple Tree House C HI M A E K (C HIC K E N A N D B E E R )

We recommend: Kyochon, Two Two Chicken JJ AJ AN G M Y EO N ( B L AC K B E A N SAU C E NO O DL ES)

We recommend: Andongjang, Daehangak ST R EET FOO D

We recommend: Tongin Market, Myeong-dong PATB I N G SU ( S HAV E D IC E D ES S E RT )

We recommend: Sulbing, Meal Top

Closewise from top left: Patbingsu, Korean BBQ, Jjajangyeon, Korean fried chicken

TOP 5 BUY S BE AUTY PRO DUCTS

We recommend: CNP Laboratory, Laneige FASH IO N

We recommend: Beaker, Rare Market Closewise from top left: CNP Laboratory, Lotte Mart, Ssamziegil mall, Artbox

STATIO NE RY

We recommend: Artbox, MMMG H ANDMADE C RAFTS

We recommend: Insadong, Hongdae Free Market SOJ U AND SNAC KS

We recommend: Lotte Mart

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SULWHASOO SPECIAL

TOWARDS MORE YOUTHFUL EYES LUXURY KOREAN SKINCARE BRAND SULWHASOO INCORPORATES RED PINE EXTRACT INTO ITS PRODUCTS TO HELP THE SKIN AROUND YOUR EYES RESIST THE PASSAGE OF TIME.

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in Red Pine. This is why Sulwhasoo devised a complex procedure to extract, refine and concentrate this precious ingredient. steps. This is followed by Sulwhasoo’s proprietary Chuisongjeong method — one of Sulwhasoo’s POJE Optimizing ProcessTM — used to extract a highly concentrated form of DAA (up to 33 times more).

Other Timetreasure items

O

ne of the first places on your body that manifests the ravages of time is the delicate area around the eyes. There are several reasons why this is so. First of all, the skin around the eyes is seven to 10 times thinner than the rest of the face, so it really shows when collagen and elastin is lost through aging. Secondly, there are relative few sebaceous glands there — this lack of oil leaves that area vulnerable to line formation. One other factor is the number of times the eye blinks each day, which strains the skin. Fortunately, Sulwhasoo has created a product that can address these issues.

Timetreasure Renovating Eye Serum This is the newest member of Sulwhasoo’s Timetreasure line, a range of luxurious anti-aging products. Infused with De-Aging Active (DAA), an anti-aging substance found in Red Pine, this serum can help to firm the skin around the eyes. Other ingredients,

such as the saponin components of Red Ginseng and White Ginseng, can help to counteract wrinkles and dullness. This lightweight serum is easily absorbed, so it won’t leave behind any sticky residue. The Timetreasure Renovating Eye Serum is packaged together with a Golden Eye Care Massager. Plated in 24K gold, this massager in the shape of a stylised cloud is specially designed to energise the fragile skin around the eyes through ritual massages. The symbolism could not be clearer: Korean lore believes that gold helps to reduce lines and wrinkles, while clouds are one of 10 traditional symbols of longevity. Combined with Sulwhasoo’s eye massage routines, the serum will penetrate deeper.

The power of Red Pine As mentioned earlier, the Timetreasure Renovating Eye Serum contains a Red Pine extract called DAA, which Sulwhasoo discovered during its 50year research on medicinal herbs. There is only a small amount of this skinfortifying and age-defying substance

The Renovating Eye Serum is just one product in the Timetreasure line. The companion item to this serum is the Timetreasure Renovating Eye Cream EX. When the serum is layered with the cream, the combination is more effective at helping to calm puffiness, restore resilience and reduce wrinkles. Sulwhasoo’s Timetreasure products also include: • Timetreasure Extra Creamy Cleansing Foam • Timetreasure Renovating Water EX • Timetreasure Renovating Emulsion EX • Timetreasure Renovating Serum EX • Timetreasure Renovating Cream EX. Sulwhasoo’s Timetreasure Renovating Eye Serum (20ml, S$348) and Timetreasure Extra Creamy Cleansing Foam (120ml, S$80) will be available from July 2017 at all Sulwhasoo boutiques and counters in departmental stores island-wide.

SULWHASOO BOUTIQUES Sulwhasoo CAPITOL Boutique 15 Stamford Road #01-72/73 Capitol Building Singapore 178906 Tel: 6844 9766 Sulwhasoo ION Boutique 2 Orchard Turn #B2-02 ION Orchard Singapore 238801 Tel: 6509 9979 Sulwhasoo Westgate Boutique 3 Gateway Drive #01-28 Westgate Singapore 608532 Tel: 6266 2608 www.sulwhasoo.com

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FE ATURE

WHAT’S YOUR SCENT? From bold scents that embody the ideals of the ancient Greeks to romantic and lighthearted fragrances that’ll put a spring in your step, there’s something for everyone in this collection of fragrances. WO RD S

AMANDA TAN

Choosing the right perfume can be tricky. Apart from the numerous options available in the market, you’ll want something that won’t cause people to start sneezing — or worse! — when they get close. And because scents trigger memories and emotions, you should wear a fragrance that not only smells nice on you, but translates your personality and style into a positive olfactory experience. So what’s a girl (or guy) to do? Here, we’ve broken down some of the market’s hottest and a e o ering 126

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His and hers you oug a ing ou ere a y on ider per u e which are a more subtle alternative. Inspired by the Greek notions of the masculine ideal and the sacred feminine, Paco Rabanne’s Invictus Intense and Olympea Intense come in a rop y- i e bo e or i and a en uou round a topped with a crown for her. Within, the blends are equally representative of their respective personalities. Invictus Intense has a spicy and woody mix of ambergris accord, black pepper, orange o er and i y rea a ord i e y pea Intense complements Invictus with a cocktail of salty vanilla, i e pepper edar ood orange o er in i e a ber and grape rui o er Both fragrances are available at most major department stores and all Sephora stores. 127

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FE ATURE

Blue is the warmest colour In Singapore, we may not be familiar with the moment when we realise spring has arrived after a cold, harsh winter. But experiencing a sort of awakening, as characterised in Miu Miu’s description of walking in the street after a heavy downpour, or the realisation that the bad times are over, shouldn’t be too unfamiliar. And that’s what Miu Miu’s L’Eau Bleue is trying to capture. The Italian fashion brand’s latest fragrance comes in a lighter and airier version, with its signature lily of the valley, dew and honeysuckle encased in a glittering transparent bottle. 10ml rollerball and 30ml bottle are exclusive to Sephora outlets and Miu Miu boutiques respectively. The 50ml and 100ml bottles are available on counters.

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Elegance in two bottles Class and elegance can’t be bought, but the Armani Code Colonia comes pretty close. The perfume’s mix of citrus (bergamot, mandarin and pink peppercorns), aromatic (clary age ora no e and orange blossom) and powdery notes (woody, amber, tonka and heliotrope) bring to mind a masculine allure that is fresh and sensual, yet sophisticated. Its sister fragrance, Code Cashmere, oozes sensual e inini y i re ora spicy and heady notes, thanks to its mix of orange oil, ginger and cardamom, heliotrope, orange o er a ine sambac, almond milk accord, patchouli and labdanum. Cashmere is only sold in a 75ml bottle and as a part of a two-piece gift set with the 75ml Colonia. Available at Armani counters.

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FE ATURE

French love story A blush pink fragrance that evokes the colour of the setting sun and a bottle that’s inspired by the thousands of padlocks on the famous Pont des Arts in Paris, Chloe’s Love Story Eau Sensuelle opens with the sparkling fragrance of orange blossom. Its heart, e ep ano i a ine end an intoxicating, unforgettable a our i e e anda ood chord adds depth. Available at major department stores and all Sephora stores.

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Going to extremes As its name suggests, Ralph Lauren’s Polo Red Extreme is a powerful, masculine scent for the thrill-seeker. Each note is carefully selected by renowned nose Olivier Gillotin to represent peed adrena ine and po er e per u e dra you in a r i i pi y and i ru y no e o b ood orange red pineapp e and red ginger en you a in o b a o ee red a ron and red sage. The fragrance ends with black ebony wood, ambery woods and cocoa absolute, which is sure to leave a lasting impression. Available at Ralph Lauren counters.

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FE ATURE

7

AMAZING BIRTHDAY CAKES To mark THIS Quarterly’s seventh birthday, we invited seven talented cake artists to dream up bespoke birthday cakes specially for us. Join us as we delight in their beautiful creations. WO RD S

DAWN NEO 132

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There’s something special about the moment people gather around a candlelit birthday cake. Almost al a l lee a d a c a fill he r a he l h d a d he cele ra h r her chee l he c er ca dle To make such moments even more memorable, some folks gladly pay a premium to customise a centrepiece for their celebrations. After all, people may not recall how old you are, but they will probably remember — and photograph — a beautifully decorated cake. A quick browse for #birthdaycake on social media reveals an abundance of ideas for anyone looking for something more than radi iona a - opped a e ro u p ed edi nig o gra i yde ying o air ba oon e rea i i y on o i a e-in piring Exclusively yours The rise of social media and TV shows such as Cake Boss have whetted the public’s appetite for bespoke cakes. According to Annina Margaritha, head cake designer at Susucre, “Clients are no a are o e di eren po ibi i ie and a an be done i ugar pa e o ey an o a e per ona i ed de ign or example, some clients want us to replicate personal paintings, a e u o i ed gurine or in orpora e e de ign and ood of a venue.” e de and a in rea ed dra a i a y in e a e year u o er are be o ing ore pe i abou de ai in eir custom designs,” concurs E T Yew, head chef at Cake Avenue. So e ien reque or pe i ade o a e ou that they plan to wear or to recreate their favourite item in sugar paste.” Several pastry chefs we spoke to said guys usually go for por -re a ed or ar- aped a e i e adie pre er ora a e or a ion- e ed de ign or e i e one a e ea uring princesses, animals and rainbows are perennial favourites, says Grace Goh, founder of Little House of Dreams. Trending now n uen ed by or o ar o e a e ar i a e a en o painting on cakes. Goh notes that they can create “all sorts of di eren e e u a gi ding e broidery a er o our and e en gra i

e ide and-pain ed a erpie e o er ro d-p ea er in ude a e i e a i - o oured or e ured ur a e e urren ad i na ed a e ay oann in ay on o o a e the Cake. In a surprising twist, there has been a resurgence in buttercream icing, with some people opting for this retro frosting even for their wedding cakes. Yew observes, “Buttercream o er i in-piped pe a a oo a o rea i a big trend that originated from South Korea, but is now spreading worldwide.” or i o a ng e e u i e e a e ie bre e a ion o e o en i re rea - ni ed a e i o o a e drip a aron and o er u abou e eryone is doing them now,” he says. However, he cautions against the u e o er ain re o er on a e e o er o en a e pe i ide on e o o e o er are in eren y poi onou or may cause allergies. In the past, bakers would stick to a small range o edib e o er ugar o er or ar i ia i o er Nowadays, a lot of bakers, especially the newer ones, just use a e er oo pre y ro any o er op Sweet artistry e up e in de and or per ona i ed a e i a doub eedged sword, laments Ang. “Because of some cake shows on TV, o e peop e in a u o - ade a e are ea y and an be ade in a day or or er nd be au e any o e-ba ed ba er charge below market price for their cakes, customers also have e rong i pre ion abou e a ua o o ge ing a u o made cake,” he moans. u i a e i a o Su u i- arpen er ay e a o e p ain to clients why a bespoke creation costs more than one that you an nd o e e i peop e ou d ee a e e cakes take hours and hours of skill and artistry to put together,” she says. The next wave Loo ing a e e qui i e a ion- and ar -in uen ed on ep presented by these cake professionals for this seventh anniversary issue, it’s anybody’s guess what they would come up with next. Ang reveals that he has been “experimenting with electronics, adding things like light, sound and moving parts to cakes”. A blinking and moving R2D2 cake, anyone?

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FE ATURE

We’re going for a fashion-inspired concept, which is one of the styles we are famous for. It is also a theme that’s very popular for birthdays, especially among the younger female crowd.

Cake Artist: i o a ng e ie bre Design aesthetic: I love sculpting and carving unusually shaped cakes. I’m not fond of wedding cakes or typical tiered a e i o o o er bu a e o a e a a e oo i e something else — an animal, a bag, a bowl of ramen — and I’ll be all over that. I love to make people do a double take, when they can’t believe that what they’re seeing is actually a cake. Most memorable cake: e rea ed a - ong o agen o or Volkswagen at one of their events a few years ago. It weighed more than 400kg, oo ore an peop e o o e er ed o er peop e and o still our most expensive cake to date. One tool you can’t live without: a o be y ondan ro ing a ine a ro ou ondan o di eren i ne e our be in e en a i a e u a ton of time and energy. 134

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I had the idea to design this birthday cake based on what a lady would wear to a party, so I selected a dress from the Viktor & Rolf spring/summer 2017 collection. It is modern yet has that deconstructed vintage look that I love to work with.

Cake Artist: oann in ay on o a e e a e Design aesthetic: I like elegant cakes with clean lines and I’m known for my little details. My a e or i dren end o oo u e or adu lean towards feminine cakes with an emphasis on ugar o er be au e a y pa ion Most memorable cake: I must say all my cakes are memorable. I plan each project with the recipient in mind and I pretty much remember the stories behind them all. But the most memorable ou d be e S a e a did i later won a competition judged by Buddy a a ro ard o orge e pri e o a rip o e er ey One tool you can’t live without: My metal ball tool, which is primarily used for u p ing o er in e gu pa e pe a ou o a e e paper- in and oo ore na ura a o u e i o a e ri ru e or simply to thin and soften fondant to make it appear o y e pe ia y u e u en a ing abri e e 135

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FE ATURE

Cake Artist: E T Yew, Cake Avenue Design aesthetic: I’m comfortable with all styles of cake decorating, but I try to keep things simple and elegant where possible. I favour clean lines and a sophisticated design aesthetic. Most memorable cake: I’ve made too many memorable cakes, but my favourite has to be the one I made for my parents’ 40th wedding anniversary a year a a o- ier edding a e de ora ed with handmade sugar peonies, roses, orchids and ee pea in di eren ade o red in e i a eir ruby anni er ary en y paren got married four decades ago, they didn’t have a wedding photo shoot, a fancy wedding gown for my mum or even a wedding cake. So I was really happy to be able to give them a wedding cake — 40 years late, but something they will remember forever. One tool you can’t live without: My dresden tool. I u e i or ra ing ugar o er rea ing e ure on cakes and making all sorts of lines and patterns on most o y u o -de ign a e

I’ve designed many birthday cakes for men, women and children, but never for a magazine, so it was quite a challenge. Then inspiration hit and I decided to make a cake in the shape of a beautiful fashionista wearing a haute couture dress made up of THIS Quarterly’s pages and covers. I love the idea of reinventing the classic doll cake by giving it a modern silhouette.

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Breakfast is the most important meal of the day. So, to celebrate the magazine’s seventh anniversary, I’ve created a scene to depict what a reader might be enjoying — a healthy and hearty breakfast while reading THIS Quarterly!

Cake Artist: i a o Su u i- arpen er u i a e Design aesthetic: Artistic and playful, with a mix of modern and rustic elements. Most memorable cake: I had to make about up a e or an ndian engage en announcement and each one involved a lot of detailed beading. I was blind as a bat afterwards, but it was memorable because my team of e per u by e roug ou e a e nig and ao One tool you can’t live without: It’s hard to pick just one, but if I had to, then it would be the bench scraper that’s used to smoothen ea a e be au e an e en y ni ed ba e i e ounda ion o a creaseless fondant surface.

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FE ATURE

I wanted to create a sophisticated design with a modern accent, therefore I incorporated delicate sugar flowers with metallic drip.

Cake Artist: Annina Margaritha, Susucre Design aesthetic: At Susucre, we focus on delicate, light and sweet designs with a on e porary uropean ou ur a e are decorated with elegance, with centrepieces and focus decorations that are not cluttered. Most memorable cake: n e ade a ninetier cake for a couple who had their wedding at The Ri - ar on o e e a e a a er an any o u en e arried e ier o e de i ery e i e we realised that our shop door was not wide enoug en e e e a e up a e enue e found that it was too tall — we couldn’t reach the top tier, even with the ladder provided. I can say that this cake truly brought us to our limits, but it was beau i u en i na y a a e oge er One tool you can’t live without: My set of brushes ey an be u ed or o any di eren de ai en a ing de ora ion ro gurine o o er I use them to sculpt, create texture, indent and colour the sugar decorations.

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These seven items reflect the topics that THIS Quarterly covers. They represent a life that is successful and balanced.

Cake Artist: Grace Goh, with the team at Little House of Dreams Design aesthetic: I love sweet, pretty de ign e pe ia y in pa e o our a o like classy and elegant concepts if the occasion calls for it. Most memorable cake: e ad a orpora e order or a a e o be de ora ed i a go d- o oured p oeni and iger i was a challenge for the team because it was not our usual style. a a a ing o ee e gurine o e oge er bi by bi Everything was moulded, carved and assembled by hand — it was truly a work of art. One tool you can’t live without: ur and en ou ding gurine and are rea y i por an

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FE ATURE

We wanted to try something different from what we normally do. We love the idea of nature and colours, so we thought of combining amethyst crystals and the concept of acrylic painting on this one.

Cake Artist: Samantha Quek with Ernest Tan, Cupplets Design aesthetic: ur de ign are o y o our u i e y and uid o e dea ing with clay work and nature, and playing with o our roug pain ing and o er erea rne pre er y e ri a ini a and bo d- o oured de ign So e ry o combine our preferences in our craft. Most memorable cake: ur r e- ier a e or e Singapore n i u e o anage en anni er ary a ner e-ra ing o r ran por and en a e ayer ier by ier One tool you can’t live without: e a o e pa u a i necessary because of its many uses. It’s perfect for creating oo ni e on a e and i ab e o i and ig ea great for moulding sugar art. And it has given us a new way to rea e an a ry i pain ing e e on a e

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一次旅程更 ,体验与众不同的 享受 。

为 推 的新 念

本地各具特色 ,必

经典精品 表不 不 行,更 有日 多的 值。

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过30年 经 验, 了 产 医生 医生一身 定和 从 自 。1 9 8 0 年, 医 生 开 始 接受 成为 医生, 年后 得 国 家 产 医 院 院士 格,开启了他的行医之 。 回 新 加 坡 后, 医 生 加 医院,后来 国国 家医疗 体系格兰 ( ational Health Service Grampian) 的 家医院(Aberdeen Royal Infirmary) 。其后, 医生短 加入本地亚历 大医院,并在1987 年转 新加坡 医院当时 的 术 门。

: polo ,Tommy Hil ger 子, S 风 ,Hugo oss 、

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14

1990年, 医生自 门 ,于 医 心开 所。期间,他应邀 回 医院, 创 术 门,这个 人、 的 态 了 年。 他 :在 家医院的 年,对 我有 大的影 ,让我坚 每个人 应 得医疗 的机会。

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医生 , 行 术的能力 于 术、 、 。因此,开发 术、 能、 ,对外 医生十分 。 现代医 , 创 术已成为 门的 断与治疗 ,其优 在于 医生 多角度的视察、 、术后 快等。 医生是 镜术(laparoscopy)或 术( eyhole surgery)的先 之一。 1980年代 , 医生与 通外 医生Mohan hellappa联 行亚 首个 镜 切 术,此 成 让 他在之后的 年 亚 国家举办 。此外, 医生在50岁那年,当 国际 镜 会 International Society for Gynecologic Endoscopy 主 , 是 会 有 以 来 最 年 ,也 是 首 位 亚 人主 。过了 1 年, 医生 是 会 会 ,并 参与其 委 会的活动。 为 新加坡 镜术 的 医 生,对 有何感想 他直 : 首先,我 当 , 有 我 深 的医生更适合这个 ,我 感 , 不 当 不 何 术,我的目 一直是成 为最好的, 不是当第一个 。这是因为 当第一个 ,与其如此,我 可 前 医生 最佳 法, 像我 期 国外发展,通过观察其他医生,你能够 究与 定哪种 : 术最适合自己,以及 otton blouse 上哪 不好的 。 and culottes Marella 装,有 新 上术与必 具 性,许 多 外 Marella 医生 镜 术时 以适应, 因为医生一般已 开 时直接 视 官, 不 是 看 着 。不 过, 医 生

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的 术

能与安 术以 并发 的风 , 镜 术将成为 首 一 的治疗 。 他举 : 在1990年, 有少过 5 的异位 患者接受 镜 术 治 疗 。 年 后,这 个 加至50 , 其他患者 接受开放性 术。 了 21世 , 已上 至95 。 对 的

生命的

医生 , 断一直是医 界最大 , 的 断至 。为 保 断无 及 术 过 程,影 像 术 演 角色。 他解 : 所谓的 镜 像 机,是 安置在超音 机 的 机或 像 。 术 ,医生可 看 机 的影像,并 拍 片。 行 镜 术示 时, 通 过 机,也 可 让 术 外 的 人 观 察 过程与细节 。也 是 ,影像 能将 识与 术 更多人,从 让更多 患者受 。 医生透 ,他 有 台 与工作 的 机 。他对 影的兴趣,其 是 在工作过程 出来的。他 得 影 对 与医 着互 的作 日 的影像 术有 于 影 , 影 术 可应 于工作上。 他 解 : 以 前,我 经 像片 来 一个医 概念, 那 时。

现在我可以利 时 影(time lapse photography) 术快 呈现。 是 影爱好者, 医生自称自 ,不会一 最新 机 。 出国拍 生动物的他,身上 时 带 机,以 其 一个 灵。对动物 有 的 因,是 得 人类更多 化。 为了 精彩画 , 医生 不 里, 和南美 的 生动 物 。由 于 他 经 各地演 及 参加会 ,因此有机会 出一 时间 出外拍 。 他感 ,亚 的 , 了许多动物的自 息地 。不过,他最 的作品,竟是在新加坡 龙 一带 拍 的 ,这张 片也 在他出 的日历里。 , 医生会把日历售出的 项 国际 ,回 会。 他为 影 过最 的 事, 医 生 称是 以待 , 这同时也 他 心。 了 无人机和 行 拍,他也会 由工作 的 镜, 入地 拍 如 的 生物 。 这 具有 的放大 , 着 , 作也更简 。 了 自出 , 医生 也会与 子Rachael同行。他透 ,太太 和植物,自己 类和动物, 是 成 。 子长大后,一家人也会一 出国度 。他 : 我 有 我的家人。Rachael时 参加 工 团,她 行动 的 团队 国外,为有 的人 和 。 子 的 时 ,我 们 会 出 行, 以 保家里至少有一位家长在。大女儿 hu Li是 医生,她不时出国 工, 为 困人士 行 术,并 理。 在爱上 影之前, 医生认为, 片 无法 美 之 壮 观,所 以 看 享受。 现在的他 , 有 的 ,镜头更能够 和体验。旅行对以前的 医生来 , 是 一个分享 识的 台 。如今,他因 影出 大开 界,也因此对旅行与 生命有了更深 的体会。

16/6/17 11:21 AM


148 >>>

148-149 SOA OPENER V4.indd 148

16/6/17 11:23 AM


人为 生 自 以 , 对此 过 , 多 为 要是人 生 。 国 医文化 家 : 现在 多人并不是 于 疾病, 是 于不 动和不 的生活 。 此 题特 ,由日 生活 见的 题入 ,从头 解病 、 与治疗 法。 病的 在于 ,无论年 或 在的 因素, 日多 身体的变化, 未 的好 ,别等 病 身 命,也 得定期 身体 。 我们 来本地 位首 医 生,解 影 男 女 老 少 的 各种 见 视的疾病。 于治疗, 识、 长医 识, 能 患于未 。

148-149 SOA OPENER V4.indd 149

16/6/17 11:23 AM


1

>>>

刘晓薇医生 眼科专科医生

是人 也

之 , 觉之 所 知,所以 生活 的 变、 的增 、

见的 疾如 和 病视网 病变,在病发 期并 不会出现 。 许多人 了后期 发现患病,也因 治疗更 。 了 时多 视 变化,定期 行 有 于尽 发 现、 断并治疗各种 疾。这不 能 化,也可能 病 。 本的

包括 和 周 位。 此外,医生也会 、角 、虹 ,以 断有 出现 疾现象。 见的 包括:视力 、 反应 、 体 、周边视 、 前 分、 力 、 后 分等。 、

病 的 疾包括 不 、 视、 、 、 病视网 病变。 其 , 病视网 病变是由 病直接 引 的,也是最 见的致 疾之一。 本地 病患病 年上 , 病患者每年应 行至少 一次 , 及 视力 化。 病患者的 包括: 视力与视 度 ( 视、 视、 、老 )

150 TQC Leo Seo Wei V4.indd 150

于 色 拍

重要。

能力( 视、 体感) (色 ) ( ) 外 影像

由于 儿和年 儿童无法表达 的 ,甚至不 视力是 有 题,因此家长 以在 期发现病 。 子的视力在一 岁之间,变化发展得最快,一般视力在七岁 开始 定。 以

是家长应 的事项: 出世的 儿应 行 反 验,以 断是 患有 后 的异 和视 , 如先 性 和角 。 儿应 球是 具有 视和 目 的能力, 以及 视 。 至 岁的 童应 行至少一次 。 如 子 不能 表达,医生可 特 术,如 可通过 性视网 影法 行。 子在成长过程 定期 行 ,以 及 出 视 题,并 得有 治疗。 子 有出现异 , 亲也应当在 子入 前让他 行 细的 。

16/6/17 11:26 AM


<<< 1

1

林楔怡副教授

耳鼻喉专科

非 ,

,是

的情

鸣不是心理疾病, 是 在的神经系 病 。一般人 听 的 音类 、点 、 、 、 、 、 等。病 的患者, 鸣甚至会 影 活动与工作,并 成焦 、 动,以及 和 集 力 的 题。 风 包括:年长者、男性、 于 大 音与音乐的人。 此外,焦 、 、 和 力, 将加 病 。 鸣

客观性 鸣 b ective Tinnitus 是 了患者本身以外,别人 也听得 音 发病 因为 、 或 活动。不过, 客观性 鸣 少见, 鸣 有1 属于此类。 主观性 鸣 Sub ective Tinnitus 了99 ,其 达 80 是由于听力 大 处理 音 的 能受 所导致。 听力 主 与年 和 音有 ,也可能与病 感 、 Meniere s isease 、 病变和 。 听 和植入 人工 ,有 于 鸣、 听力系 并 通。 鸣其他 因包括: 力、气 性 如 、 行、 节 合 Temporomandibular oint ysfunction 、鼓 受 、 物 、 物作 、头 、颈 或 创 等。 、 、 疾病、自身 性疾病等也可能加 鸣 。

151 TQC Lynne Lim V5.indd 34

,个人感觉

头部与颈部外科医生

医生在了解患者病历与 后,必须 行 细的听力 ,并 鸣将 患者带来的 。医生 疗法时, 也会先排 其他可能 成 鸣的 在可治疗疾病。 鸣

因听力

对听力 能。

所导致,以

于分

的程度

患者

见的治疗

制,并具有

力,

性或

音的

行神经

节。

如认 念 鸣

行为疗法 ognitive ehavioural Therapy 、 程 Mindfulness based Stress Reduction 、 疗法 Tinnitus Retraining Therapy ,可 少 力和 感。

。 因及

精。适

患者。

16/6/17 11:27 AM


1

>>>

多 增多的

的是

的 有 种,一种细 ,分布于 身,主 能是排 及 节体 另一 种 大的 体(称为 )分布在 、 等特 地带,以 最多。 分 出来的 是无 的 体, 当 受 于 的细 分解 后, 会成为有 的 体, 称 。 多 (A illary Hyperhidrosis)患 者 对的是细 生的 题, 特别 , 成生活上 大的困扰。 如 你 时必须 ,或经 遇 浸 、 把 的 题,可参 mira ry 能 疗程。 mira ry 疗程由美国Miramar Labs公 发,是一种快 、 入性的治疗 术。 无创 术,把精 制的 能量 至 集分布的 位, 并 。 医生术前会 患者 ,并以 系 保 , 保疗程 适无痛。约60分 的治疗 过程 ,医生会 探头 行 治疗, 次 的探头可 感 风 。mira ry 系 不含 性或 性化 物质,对表 和周边 十分 和。 Miramar Labs 究,大多 患者在接受mira ry 治疗后,大 少排 量, 达82 。 一般来 ,疗程的 可见,排 量 得 之后,异 也 着消 。与 何医 程 一 ,治疗 因人 异。为达成最佳 , 行 次治疗(间 个月)。 因为 后不会 生,所以 具 性。人体含有 00多 ,其 2 位于 ,因此 并不会影 身体 节体 的 能。 接受疗程后,少 患者的 或上 会短 地感 不适,一般可 上 活动,一周 可 行 时的 动 。 与

152 TQC Wong SuNi V4.indd 34

多 其他治疗 在 时 制 ,或 Food and rug Administration) ,以及

及具有风 验证可

术。mira ry 是 少排 量并

一经美国 的

品 物 理 入性 术。

16/6/17 11:29 AM


1

疾病( ardiovascular isease,简称 )包括 动 或 性心 病、 疾病(如 风)、 、 心力 、风 性心 病等。心 疾病是 球第一 因,所有 因 30 。 于 国家,大 分亚 国家(新加坡、 国、日本、 国以外)具有 的 年 。 亚 亚

人的风 因素和心 心 疾病发病

发展的

代 的主

能有别于 因。

人, 列为

着经 与 会发展,亚 人的 和 有 上 的 ,其现象在 国 为 。自 国 开放以来, 国人的 有了 大 变,因受 影 ,人们 少 , 出现更多 类 物和加工 品。 同时,工 化与 化快 发展, 成 国人的体力活动 。 如: 有 的人 于1990年代 2011年之间 大量 少,从每100 家庭 有150 300 , 至每100 家 庭 有77 家里有 视机的 也在过 20年大 加。 这 变化导致 国的 、 和2 病 发病 加, 以上 为心 疾病的 因。 也已 超 性疾病,成为 国人首 因。 与

世界 生 究 ,亚 人的 患病 于 美国人和 国人, 与 国家 , 引发心 疾病 和 风的机 。 东南亚的 (21 26 ) 于 美地区(67 70 ) , 其他 因素 : ( 和 国超过2 ,美国和 国为13 15 ) 吸 ( 度 亚为36.5 ,美国和 国为18 20 ) 体力活动( 来 亚 达51.6 ,美国和 国为35 0 ) 此外, 和 病病 在新加坡、文 、 来 亚和 国 多。值得一 的是, 心 患者当 , 病

153 TQC Eric Hong V4.indd 35

, 多 的 的

中 的

方祖德医生 心脏专科医生

系, 东南亚心

患者

属于消

病人。 和环境因素 得亚 的 患者 量有别于其他 大 。 了文 和新加坡,东南亚国家的吸 于 国家。 加上 动的 ,东南亚人的心 可 东南亚总人 超过 , 行病 示东南亚人因 疾病(主因是 )过 的 颇 。其 , (27.9 (2 .3 )、 国(2 .2 )的过 机 超过 国 (12 )。

美 。 性 )、

1951年至1980年间, 风是日本人的头 , 病如今 排在 、心 病和 之后。 风 大 度 , 于 日本 的 国性 与 制策 ,包括:推行 心 活动 将 转 至当地 所(以 发 物) 通过 体、公共医疗 和家访 士鼓励大众接受 ,并 少 分。 , 风 , 异 和 病发病 在 1980年代后,出现上 ,因 加了心 疾病的风 。 这个现象在 国也可见。 展

球 人 将 至2 3 0 , 2030年 人 的 35 。由于 球约一 的心 疾病 将出现在亚 ,因此 在 区 对于世界 生 为 。 为 化,亚 国家应 日本成 对 风的 子。 国和 度对 的 识 于 国家,所以有 举办 育与 策。此外,东南亚国家也 须推出鼓励 众 和 体力活动的公共 生 。 的医 、 能够 定 风 的 级保 系 、 策 等, 为亚 心 病患者 或甚至不接受治疗的 因。尽 如此, 应从个人 , 日保 好的生活 如定期 动、 、 制 、不吸 等。

16/6/17 11:32 AM


1 4 >>>

1 4 >>>

生活中

为重要, 受 ,

也是

都 的

。 也因为

度 , 陈素雄医生

感 发病 , 发现得 ,可以有 治 。大多 感 发生在 周 , 及 接受 当治疗,受影 的 位 快 能 能。 的体 , 能 许多 类 ,因此当 受 感 ,这 也将同时受 。如 治疗, 感 消 后, 可能出现 题, 如 、力量 ,及 、 、神经和 头的 受 。

是最 见的 感 , 周 ,包括 的 和 发 。外 、 、 不当和 , 可能引发细 感 。 期 为 、 痛, 后开始化 ,并可能 至 和对 的 。如 感 至 间 节、 或 ,可分别引发 性 节 、 或 性 头 等并发 。

手腕 关节与上肢手术医生

排列十分 ,发生感 时, 不 周 并 成 ,这 是 性 头 。 间的 力 加,可 导致 受 及 。 性 头 的经典 ,包括 个 感 痛、 。 期 , 生素、 和浸 有 于 解 。不过, 许多患者等 已经 成 医,届时必须通过 术治疗。 治疗,可能出现以 并发 : 、 性 节 、 与 、 ,以及神经 、 质和 受 。感 者甚至可能须 行断 术。 的是 合性感 或 创 后。受影 的 会出现 位有 痛感等 。许多病人在

一般发生于 、 能 、 展 时 感 度 痛。 治疗包括 生素, 病 在2 时 ,患者 必须 行 术(如引 术)。 最 见的 并发 是 。如 不 医,患者可能出现 、感 通过 神经或 神经, 至 或前 等 。

TQC Tan Soo Heong V3.indd 34

有一

生物,其 包括约 3种细 。不 是 ,所有 应 经过 和 创程 ,以及 风 。 此外, 者须 (如 影像) , 保 节和 无 。 ,

感 发现,治疗 断与治疗可能 其他

当 成,患者必须及 接受 术后应让 开放,并定时更 适当的 生素是必 于让医生了解病人 感 治 术、 太多 等

的。细 哪种

有 , 的机 、 加发病 ,甚至导致 术, 可将 。 物能够 生素。

认有

至最

生物,有

后,患者可 行 术,其 包括简 的 合 植或 术(当出现 的 )。 感 已 ,患者 接受 植、 植、 节融合术,或甚至 术治疗。

许多人 地认为,不应 导致 位 。 、制作 和 能

动受感 治疗 能 ,以让

的 或 , 这可 导患者 行 动 尽 能。

15/6/17 5:30 PM


1

、 都是个 能的 动 可能 并定期接受

。 重要的

定生育能力, 质变 、身 于 老化。因此,女性应当多 。

、 顾

精彩多姿的 年 ,别让异 量多或 痛的月经影 生活, 发现不 , 必尽 医。此外, 生有 于 和 感 时多 富含 生素 、 生素E和优质 质等的 物,也可保 身体 。 未生育的女性,应 行 能 ,以 过 最佳生育时机。如 月经不 ,或想了解更多 于生育和 孕的 息,可 产 医生。 人类 病 Human apillomavirus,简称H 可 可能导致子 颈 的 种H 感 疾病。在新加坡,H 经过本地 ,适 于九岁至26岁女性。 开始性活动前 H 能 其发 最佳作 , 性活 的女性 可受 于H 。如 你属于上 族 、年 超过

生活 。

、 ,

、 对

、 ,

陈善安医生 妇产专科医生

26岁、对 或 成分 感,或者患有 性感 性疾病、 出 性疾病等 题,最好先 医生 ,以 定你是 适合 接受H 。 孕的 女不 H 。 H 并不能 所有致 的H 亚 ,因此已 H 或有性生活的女士,应每 年 行一次子 颈 片 ap Smear , 能 分 子 颈 。 了事 日 成 的年 ,30岁以上的女性,应 子 异位 endometriosis 、 pelvic in ammatory diseases 和不孕不育 。 发现患病,应当 及 医并接受治疗, 未来出现更 的 题。 族 女性也 定期接受 ,以 断 是 。 与 产 医生 好 系,让其了解你的 与 , 可 你 快乐地度过这个 。 迈入 0岁的女性,患有 、子 颈异 、子 和 的风 将 。为了 保 年 受 行性疾病 , 年 的女性须多 。 女性 了 0岁,生 能力必 不如20、30岁, 有不少 女 力受孕。先 医 能 你达成生儿育女的 心 , 以 孕 事项也不 视: 、多 、 、 物、适当 动、定期 看 产 医生 等。保 好的生活 , 能 身体处在最佳 态。 了更年期的女性,在生理和心理上会出现许多变化。 经 期 (如 、 、 气 ) ,医生或推 素 代 疗法。你也可通过 质 、坚 、保证 、 、处理 等 ,应对其 感时期。 了大 子,也是时 享 。如 想 有精力 儿 乐、出国度 或 新 , 年 的女性 得保 身心 壮。 、 个人化 动、定期 等, 是 老、 力及保 生命活力的不 法门。

155 TQC Ann Tan V4.indd 156

16/6/17 11:36 AM


>>>

1

人的

,每

和直 合称大 ,是人体消化系 的最后一 分。 大 的最后15公分称为直 ,处于 。 直 是从 发病的。 的 续代 ,导致 的细 不断 , 每次 可能出现 因 变。 大 分有 变的细 会 体 细 发现与排 , 少 分 的 变细 能够 过 系 并继续 ,如 续 5次 变, 有可能 变。大多 的 会先从 的 变为 ,经过多年 变成 。 一般呈现为息 ,从 出 大的息 可能 因为其 量有个 ,像一 长在 。当 变, 细 将 入息 ,并 着 至 。 细 入 后, 可能通过 或 至其他 官。 如

你属于 列 人 ,应尽 医生 。 因所致的 直 所有 的5 以 ,这 患者 体 有异 因。 在新加坡,如 有家族病历,一生患上 的可能性是 2 。大约80 以上的患者年 超过50岁, 这并不 年 人 不会患上 。 如 有一位 亲( 、 )患有 ,你患上 的 风 将 加3 (6 ) 亲是在50 岁以前患病,风 为 10 。如 位 亲 患 ,风 约17 。如 位 亲 患有 ,风 达50 。 如 你 患有 息 ( 性)或 ,你患 的机 患有 多的息 ,机 。 年 患 , 患 的机会也 。 患有 性 病(如 性 、 病)的人,患上 的风 加,因此 长期治疗和 察。在 , 甚至 把 个 直 切 ,以 发生。

息 属

期 多时 是 有 的。 从 入 时 化, 分 吸 后 成 。由于 的 过 , 边的 一般 有 。许多 边 的患 者,一般 是因 (如 、 或 时感 气 、

156 TQC Ho Kok Sun V7.indd 156

,也是 头 )

何国申医生 结直肠专科医生

医。 边 的 成 ,因此如 因 , 会影 排 , 如: 把 过变 的通 ,因 产生 的感 。 通过,排 时像 ,因此出现 与 的 。 表 上见 , 一般为深 色。 直 的 可能导致排 不 的感 。 其他 见的 ,如 、 有 多 、体 等, 有可能是 引 , 大多 是另有其因。 痛不是 见 ,当 成 痛时,一般已属后期。定期 可及 发现 直 , 期 治 的机 。所有 直 的 验, 的 。 目前有 种 见的 : 变

镜是目前最 的 放入, 着 直 镜 时,一般患者 镜主 优 是可以切

法, 一 子,从 门 , 细 看 直 每个 分。 , 来时 镜已 。 的息 和 出细 活 。

门放入一 ,通过 子 入 ( 色 体) ,患者在 上回转,让 的每个 位, 后 通过 子让 出来。接着,医生通过 子,把 气 入 张, 并于不同位置拍 。患者在 过程 有 。 电

断 , 称 镜,是 的最新 。 时,放 医生在患 者 门放入一 ,并通 过 子 入约1 1.5公 的 气 张。患者 在 T ,并接受 行 ,其后 转至 姿 程 。 像 通过 体制成。

16/6/17 11:40 AM


1

富 。 而 成为

生活 多

, 排出体外。当 体可能 在 过多的 体, 痛风第一个发作的 包括 痛、发 、发 、 、 、 是

合以

、 制品) 会

痛风是可以 。 痛风

多。

的,如

。 所谓 病从 入 , 、 精,以及 物(如 患痛风的机 。

家人是痛风患者,你的患病风

与其他身体 病同时 断,包括 。痛风也可能加 其他疾病,如

加。

物(如利

梁景康副教授

的 富 ,

会在 分解,并经过 在 过量生产或 排 能不 , 、 、 和 节处。 节处沉 可引发 痛,称为痛风发作。 位通 是大 , 与 节 同, 、 。 了大 ,痛风也可影 、 等 节。

,出现痛风的风

痛风患者以男性 12 痛风 太多 类、 、 、

的 。

,是个 , 不

关节炎与内科医生

, 痛可 续加 长达8至12 时。受 的 节和周 因 痛 能, 通 一周 能 解。 间 期 痛风发作 息后,患者 入间 期。 期间,患者一般 会感 的 节 ,甚或 无 。 期 患者不接受治疗或 变生活作息,痛风可发展成 性痛风 性 节 。长期 的 ,可导致 发 的 痛风发作, 痛也 更长时间 会消 。 和 节 沉 大量痛风 头 gouty tophi 可 节 ,并 成 、 能 ,甚至 性 。 如

不想 受 ,患者必须及 医,并 处 物, 痛风发作。此外,保 体 和 变 也 十分 入 物、 、 不得过量、 多 以 排 、切 。自我 病 变化, 能 有 制疾病发展, 生活素质。

、 、 。

等)可导致痛风发作

期 这是痛风第一次发作前的 。 表 上 有 , 的 度 续上 , 节处也开始 来 多的 体。 期 性痛风性 节 一般是因为出现 发因素 如 ,导致 的 度大量上 。一 患者会在深 因 节痛

157 TQC Leong Keng Hong V4.indd 157

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1 8 >>>

刘晓薇医生 眼科专科医生

3 Mount Eli abeth 10 0 Mount Eli abeth Medical entre Singapore 228510 :6737 8366 www.drleoeyespecialist.com

陈素雄医生

手腕、关节与上肢手术医生

林楔怡副教授

耳鼻喉专科 - 头部与 颈部外科医生

王素霓医生 皮肤科专科医生

3 Mount Eli abeth 17 07 Mount Eli abeth Medical entre Singapore 228510 :6737 7787

3 Mount Eli abeth 07 09 Mount Eli abeth Medical entre Singapore 228510 :6733 3629 www.drwongsuni.com.sg

何国申医生

陈善安医生

3 Mount Eli abeth 12 09 Mount Eli abeth Medical entre Singapore 228510 :6737 2778 www.h scolorectal.com.sg

3 Mount Eli abeth 11 12 Mount Eli abeth Medical entre Singapore 228510 :673 8188 www.anntan.com.sg

1 Farrer ar Station Road 15 02 Farrer ar Medical entre Singapore 217562 :6702 0990 www.drlynnelim.com

结肠直肠专科医生

妇产专科医生

方祖德医生 心脏专科医生

3 Mount Eli abeth 03 09 Mount Eli abeth Medical entre Singapore 228510 :6736 1068 www.eheartspecialist.com

梁景康副教授 关节炎与内科医生

上 3 Mount Eli abeth 07 01 Mount Eli abeth Medical entre Singapore 228510 :6737 0177 www.hand.com.sg

158 TQC Doc info V2.indd 158

6 apier Road 0 18 Gleneagles Medical entre Singapore 258 99 :6 72 337 www.leong enghong.com

16/6/17 11:43 AM


<<< 1

分 生为 度, 不

1875

自我 品

术的态 。

年, 奥 ( ules Louis A u d e m a r s)与 爱 奥 特 ( Edward Auguste iguet) 创 士 级 表品牌爱 ,由此开始 精彩的制表 。 爱 艺与创新精神 此 了一个多世 , 至今 是一家 自主的家族 。继 者 创办人 开 的先 精神,以 一 的创 力, 品牌在制表艺术领 出一片 。 1972年,爱 制表 ,推出 无前 的 动 表 家 系列(Royal a ), 定了品牌的 地位。此系列 表以精 质与 特色, 以 表 风格,并 世界上最 的自动上 机 、以8 角 定的 角 表 、 Tapisserie 格 装 的 表 ,以及一体成 的 属表带与表 。 对爱 , 与 并 不可融合。精 地把 者, 可 生出众多 不凡的时 杰作、推动制表 不断推 出新,无 为现代 表 的主导品牌。

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1

>>>

每个人每

有 2 个 时, 每 个 人 这2 时的 不 同 。对 医 者 来 ,时 间 特 别 。心 医生 透 ,心 外 医生的目 ,是在患者 入 的90分 , 开 。 他解 : 心 病发作时,时间可以 人的生 。 心 病 患者在出现 的一 时 接受治疗, 会有 的生 机会。 一 过了 的 时 , 将 上 。 成为妙 回 的医生,必经过时间的 验。多年于医 院 , 、心 病 与 ,成 了今日的 医生。 他 : 在我的 生 ,我有 在爱 兰、 国、美国和 亚 国家行医,这 无 的经验,让我 得自己是世界公 。 时间无 对 医生十分 ,因此他 时会 表。他表示,因为自己历经多年的 成为 医生,所以 特别欣赏爱 如此历 的 级 表品牌。爱 能够 不 像无论哪个年代 受 的 家 时 表(Royal a hronograph)系列, 证了 品牌无与 的制表 术。 医生每日行程从一 的 开始,他 利 时间 身 25分 。定期 动让他 活力,并 保 性、 体 和精神保 在最佳 态。 因为不 时间,所以 医生 一定会把当 的 和 回 处理 。 外 医生 时 命 行 术,所以 现工作与生活的 是一大 。不过, 医生 有 他的家人, 亲 子时间 扰,他 是能够 享受 活动,并与家人 处。 已经当了20多年的医生, 医生 在工作 得 大 的 感。 年 一年,爱 不断创新,每推出新系列 表, 、精 精。 这也是 医生一直 的理念。 他分享,医生必须及时了解 治 术的最新动态,并时 识。 年, 和更 术、多 态影像融合 术等 有 的 。 他 期待可以在不 的未来,为心 病患者 更有 与 体性的疗程。

医生

159-161 ADV Audemars Piguet V7.indd 160

这 表是 为 家 系列 时 表 世20周年推出, 属表 经 处理 宝 表镜、 950 表 、表带 节转 ,以及 入 表 。 深 色表 Grande Tapisserie 大 格 装 , 色 表 、 质 体时 和 家 。自动上 时 通过 的自 动 得能量, 加 启动、停 和 时 能。

16/6/17 6:03 PM


<<< 1

1

医生 认 为,时 间 是 宝 ,无 法 后来 。她 ,及时治疗疾病十分 , 如 治疗儿 童 疾 可能导致不可 转的 。 医生 : 患有 的 童 不及 接受 术治 疗,可 引 发 视( 称 )或 视 力 。医 生 的 首 是为病人 性 理,并 具 感的医患 系。 对她来 , 分利 时间的 思,是 定优先事项, 并 行 的事 。与其无所事事, 医生 可时间 过得 。 会 无 的活动和分 工作人 , 可 自己的 与 力。 医生表示,家人和 所 理 的 与可 性十分 。她自称是 力工作、 的人, 时 了与 、 子、 、 物 联 感 之 外,探 美 、参 加 区 活动、 工、旅行等, 是她放 心 的 。 为 上时代 , 医生 举办和参加 会, 以及 和 医 期 。 发展为医 领 带来 无前 的变化 断 、 物 究与 术 术不断 创新 , 创 术和 术现已成为 受 的治疗 。 体加快了医生 与分享 术 、 、 见解等消息的 度,并 变医生与同 的 , 以及医生与患者之间的互动 台。 医生 , 最新 ,能让她为患者推 最合适的 与 理 。 日 生活 , 医生为了更好地与 少年儿女 通,她会 时事新 和时 。她 不 是 者, 是 当 表界的消息。对于 的 时工具, 医生 的不 是 表的 能和 工艺, 包括是 表和 时 所 的美好回 。她 的是 可以让人安心,也能让生活 简 及更有 的优质产品。

属表 经 处理 宝 表镜、 950 表 ,表 上 有 0 切 美 ,总 约0.73 , 这 表 优 。 性的 Grande Tapisserie 大 格 装 表 , 以 新呈现 表 上有 质 体 时 和 家 。 属表带 950 表带 节转 、 属A 表 画龙点 。精 机 装置的 性 合 机 , 佳的 时精度。

医生

541 Orchard Rd #01-03 Liat Towers Singapore 238881 电话:6836 4918 2 Bayfront Avenue #B2M-207 The Shoppes at Marina Bay Sands Singapore 018972 电话:6688 7595 www.audemarspiguet.com

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1

>>>

在这个机不 的时代, 无论 、出 、度 , 许多人 在 体 上 、分 享 动 态 。一 者看 , 不 具一格的 馆, 必让消 者 深 象。

162-166 Themed Eateries V3.indd 162

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1

加坡 为美 ,想 品 美 佳 并 不 。 不过,我们也发现本地 所 的 来 , 馆 是, 之 人 。 如 你 新 感,不 参 以 推 的新 馆,各具 不同主题与特色,保证你有 目一新的 体验

你是

发现 外

上的 , 了一 十分壮观的 好 影 出现的 ,因 此 有 人 把 称作 大 (Gotham ity uilding)或 国会 大 (The Hunger Games apitol)。 周 不 如 ( inston hurchill)、亚 (Abraham Lincoln)等历 人物 的 像,办公 也 有 联合 长国、奥地利、 的大 馆。今年3月,位于一 大 的 级 Atlas ar 开张, 别具装 艺术风格的 成为一大焦点。 色、 色、深 色为主的精 概念,成 。一 入 , 达 的 机 , 装 不 让人幻想置身于 影 《了不 的 》 (The Great Gatsby) 。当 ,一家优质 少不了 来自世界各地的 品, 如1910 年 、现代精 子 、 等 。此 外,你 无 须 心得 ,因 为 At l a s ar也 点心和 。

600 orth ridge Road ar view S uare Singapore 188778

为 文 。这 院。 这里 有 如

, 了一家 有文化气息的 馆, 于18 9年, 是新加坡第一间 文

, 有 心 的 自制 佳 , 、 、 达 文治、 点等。 色的 地 、 与 具,让 文 色 的风 。 从 外观看不出 有 , 经过 本地美 客的 , 馆在 时间 客 ,主 为 区的上 族爱 此 。

168 Telo Ayer Street Singapore 068619

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1 4 >>>

的Karma amet iner 馆,本地也出现了一 家类 的特色 馆。 于 利 的Knots afe and Living, 汇集 馆、家具 与 于一身。 主利 所 的 间, 工 装 风格, 了 的 、 的 ,布置 具 思。 、长 、 子、 具 、 以 制为主,为 间 加 素 时 的感 。有趣的是,所有 家具(包括客人 的 ) 售 。由于这里也 ,因此 总弥 着新 植物与 的 新 。 这 合一的概念 自 pressFlower创办人 S o h Ye e H o w 。 ,他在 看 一间 合植物 与 馆的 老 屋,因 受 启发并 定为客人 一个 适和 的环 境 你可以同时 、 物或家具,以及

160 aya Lebar Road 01 07 rion ayaLebar Singapore 09022

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1

有一家 主题 Kombi Roc s,其 、 家具,以及 、 机、 头 乐队 片的 , 得 的当年 透 屋。 是 合 现在 行的 风, 这里的 气息并不 作,反 是个 回 的 间。 多年前, Lim Tec Siew的儿子LimKoonKee 从十岁开始 位 。Tec Siew于 1 9 6 0 年 代 后, 儿子 为生并 子 。1971年,Koon Kee在位于 的新加坡公 乐 开 , 馆招牌 包 括 东 和 。 2006年, 馆 至 ,后来生 由 儿子接 , 成今日的Kombi Roc s。 了美 的 和 理,Kombi Roc s也 多 , 无 论 于 人 对、 或 活 动, 这 色彩 的 包 对 吸 。如 你 看 的 物 品 ,也 可 以 直 接 ,把 这 气 带回家

66 Yio hu Kang Road Singapore 5 5568

各地 年 兴风 , 在为老 事物或 入新生命。新加坡也不 外,文 达 一 受 保 的 老 屋, 日前 成 力 凡的多概念 馆。 馆 为 太(Sum Yi Tai) , 第 个老 , 1980年代老 格 。一 的装 张, 老 当 音乐, 让人回 不了 年代。 点的呈现 (Tapas), 门 包括 和 。 装 更 , 有 人包 ,适合 。这里 一般分量的 之外, 具 各 各 的 与日本 。 于 过 , 的屋 限 定, 合最 消 ,也 多 了 感 。不 是 士 、 或 , 十分 富。 一 的工作后, 好 一 在 品 ,是为一大享受也。

25 oon Tat Street Singapore 069622

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1

>>>

可爱、 象 的 (G u d e ta m a)及 世 界 最 具 值 的 (Hello Kitty) ,同属日本 (Sanrio)公 通人物。日前 家 分别以 和 作为主题的 馆 在 开 ,一度引 排队 。 位于新达 物 心的 馆 (Gudetama afe) ,无论是 、 装 、 、周 边 品, 处处可见 。 馆由本地 公 oe ough 和The Soup Spoon 联 开 , 点更 是经过 品 精心 ,视 、 具。 Hello Kitty ( rchid Garden) 在 机 第 客大 公共区 ,是 球 一2 时 的 主题 馆。 布置 放一片 目,各种 的 物和 必 你的 少女心

162-166 Themed Eateries V3.indd 166

馆 3 Temase oulevard 01 361 Suntec ity Mall Singapore 038983

, 点,

65 Airport oulevard Singapore hangi Airport 01 22 Terminal 3 Arrival Meeting Hall entral Singapore 819663

16/6/17 6:10 PM


人间大 美 <<< 1

,是 丰 、

艺术与 化 的生 ,以

工 法 ( ate de verre),在 艺 术界 创 出属于自己的一 片 。品牌 的作品系列各个精致细 ,体现其超凡工艺与东 优 元素的同 时, 不 现代美感与艺术 , 工 成为 球 艺术的代 。 品牌今年推出的《 美系列》 艺 术限量系列, 续着 工 与 族文化、大地 感 互 的 深 。 这 以各类 为创作灵感的系列,主 体现 个 : 族文化的深 美 、 对于 物 的 ,以及 未 来 、生机无限的 。 品牌2017年 年度力作《如大地之心》 是这 系列的 最佳代表作品。 此 球限量典 1600 的艺术精品 以 的 为主角,不 象 着 一年美好 的愉 心 ,也 着 爱的大地不断为人类 出 不 回 的 之心。 如 如 般自 的 色,也同时体现出自 物的 分 精彩,以及 的美感。 另一精美作品《 见 》 以 为主角, 发 富 ,无论是 在家 作为 ,或 好 、顾客 以 他们事 利, 是 不 的 。这 球限量典 80 的作品, 美 开的特 :外 片 , 在 的舞 , 可人 的 , 细致雕 的 ,每一 和 色也 ,大大 了 其观赏 趣和美观性。 这 系列当 少不了 人最爱的 。 素有 来 的 , 这 《气 》 作品,顾 思 , 代表着人生事 上加 的美好 。 此外,工 也特地 的 ,呈 献出 、 的表 ,以 生命 成 定的大 大 , 具 思。

167 ADV Liu Li Gong Fang V3.indd 167

化的

,品 。

大地 不断的 生命力,在这 彩色 扬的精致 作品 展 无 , 是品牌对于生命 美的最佳 。

290 Orchard Road #04-05 The Paragon Singapore 238859 电话:电 673 271 Facebook: LIULIGONGFANG SG & MY Instagram: @LIULISEA www.liuli.com.sg

14/6/17 4:57 PM


1 8 >>> 精

一 表,无 有 通 的能力, 是地位的象 、时 的 化身、生活的 。超凡的 与 的 制 表 工 艺,能 让 表 融 入 何 时 代, 并 放不 力。 与 艺 术 品 同, 精品 表属于长期 。这 项 不 有 回 ,所 带 来 的 自 感和身 感 具吸引力。 ,优质 表 可一代 一代,创 富含 值的 。

时间就是金钱 精 表 时, 回 见的

经典精品 表经得 时间 验, 尽 时代变 , 不 行, 有 日 多的 值。

参 。

素,有

值,所以限量

你的 表

值得 。 品 象 精表品牌不 其 ,历 的品牌如 力士 (Role )和 达 ( ate hilippe)因创新 精神、 特色和精 艺 ,受众多 者 ,称其为 续 值的 品牌 。

产品的 位 于品牌的分 网 , 表的 网 售 和 售 太多,将影 转售 值。一般 ,具有 值的 表不会 。

如 一 表经 ,或 与 人物、 活动有 ,或具 新 题,其 值 会 大大 。 之 把 装 子、 物品、 品证 。 表的外观和 能 对其 值有直接的 影 ,保 得 好 具 转 售 值 。因 此, 最好每 年或发现异象时,为 表 行 和 保 。

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1

屹立不倒

无论你是新 见,为你推

入门或想 ,我 们 集 最受 的精表品牌与 。

劳力士 Rolex

表爱好者的

力士可 是 球最 的 表品牌,对许多 望成为 家 的人 , 力士 表是不可或 的 。 力士最 门的 表 有 个共同点 不变的时 风格,以及经 。品牌历来最受 的 是 动 者 ,从其 称 上最 的 表来看, 的 量有多 ,在 上 有的 位有多举 。 本 为 爱好者 的 动 者 表, 装也一 人 。如今,这 表 为 表典 , 也是体 、好 演 、 等的 品。 自1953年 , 动 者 一 动 表 。 力士多年来不断对 系列 表 行 与更新, 尽 如此,前代 也一点也不 过时,这, 是 动 者 有的 力。

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想 体验 其这个 神 色彩 的 东 国 家, 不 过位于 其 格 (Goreme) 心的 多 亚 精品 ( appadocia ave S u i t e s )。 年前的 发, 了 多 亚现今 一无 的 特 地 , 当地 的 始 , 也 着时代的 , 成了 色 的 。

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新加坡美术馆以亲子家庭乐为主的 年 度 展 览《想 象 馆 :直 至 地 球 的 尽 头》 (Imaginarium: To the Ends of the Earth) , 今年迈入第七届,由九位当代艺术家联合 呈现一系列主张感官体验的互动性作品。 展览项 目包括装置艺术、艺术表演、由艺术家和策展人带领的导览、 每日短片播映会、亲子与儿童艺术工作坊等。 生动有趣的作品,让访客窥探我们身处的奥妙世界与 生态环境。展览希望透过艺术家视角,鼓励访客反思自己 对置身其间的地球与周遭环境究竟了解多少,并仔细观察 人 类 与 动 植 物 如 何 适 应 不 断 变 化 的 生 态 环 境,以 及 更 加 深切体会和欣赏世界的壮阔与美好。 想象馆:直至地球的尽头 展览日期:5月6日至8月27日

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新加坡国际艺术节(Singapore International Festival of Arts, 简 称 S I F A )始 于 1 9 7 7 年 ,致 力 发 扬 新 加 坡 多 元 种 族 文化所孕育的本地艺术。此活动由国家艺术理事会委托、 Arts House Limited主办,汇集本地与国际艺术家的最佳 杰作、公映优秀影片、各种精彩的舞蹈和音乐节目,邀男女 老少亲身共享艺术飨宴。 今年活动主题为Enchantmen( t 着 迷),将 呈 献 1 6 个 委约作品,核心在于新加坡艺术家与国际艺术家或团体的 合作。这次,新加坡国际艺术节也把焦点放在一般新加坡人 身上,让他们有机会在国际舞台上 表达想法与演出,总共推出超过90 个特别项目。通过融合创新概念和 互动性元素,观众将更能够与表演 产生共鸣。此外,有七个国际制作 将会是亚太区首演,值得期待。 新加坡国际艺术节 活动日期:6月28日至9月09日

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