Category Archives: Medicine & Health 疗池

PLASTIC AND AESTHETIC SURGERY IN TODAY’S WORLD

Dr. Lee Kim Siea

Consultant Plastic and Aesthetic Surgeon


Plastic Surgery is a sub-speciality of general surgery, it deals mainly with forms and functions of the whole body. The word plastic is derived from the Greek word ‘plastikos’ which means ‘fit for molding’, it has nothing to do with the plastic wares that we know about, plastic materials are certainly not used in the surgery.

make-up-vs-cosmetic-surgery.jpg

There are two main division of plastic surgery, reconstructive surgery and aesthetic or cosmetic surgery.  Reconstructive surgery deals mainly with repair and restoration of the loss or damaged tissues. Tissues such as bone, flesh and skin can lost or damaged in trauma, burns or surgeries to remove cancers, the resultant defects can be repaired and restored using various type of tissues from nearby or other parts of the body with various surgical techniques. The restoration of the defects give back the form and functions to the patients, allowing them to live more normally. Imagine the loss of lower jaw from surgical removal of a cancer without reconstruction…. Hand and microsurgery is an integral part of plastic surgery.

Aesthetic / cosmetic surgery concerns with improving the physical forms of the person. Patients are usually well physically, however, they are driven by dissatisfaction of the physical appearance of certain part(s) of their body.  In severe cases, they can be totally unhappy with their whole body. This dissatisfaction can result in minor or severe psychological disturbance affecting self-esteem to the extent of affecting their life. Improving the appearance thus restores their self- confidence resulting in improvement of their life. As society becomes more affluent, people are looking to more than just basic needs, money is spent to make themselves more beautiful; clothing, hairdo, accessories are made more and more expensive and attractive. Some will venture into changing or improving their appearance with aesthetic/cosmetic procedures.

Plastic surgery is not new, the history can be dated back to 15th century when there was an epidemic of syphilis resulting in many disfigured people. Plastic surgery was performed to restore the appearance of these people. The most notable procedure was the nose reconstruction which was recorded in many parts of the world including Europe and India. Procedures than were painful with many complications, even death, results were unsatisfactory by today’s standards, it has evolved through many advances in techniques, better understanding of the processes and importantly availability of more advanced materials and tools.

Aesthetic procedures can be surgical or nonsurgical. Surgeries are what plastic surgery is well known for, this involves operations to improve the appearance of the patients who are otherwise healthy; facelifts, nose operations, eyelids operations, body contouring operations, breast augmentations and fat grafting are some of the well- known examples.

Nonsurgical procedures are done without or with minimum incisions. Among the well- known ones are laser/light and energy based devices, injectables like BOTOX and fillers, thread lifts, medical skin cares and recently stem cell treatment. The aim is to beautify and rejuvenate without using the scapel.  This is the field that is growing rapidly; the affordability, the fear of surgery and minimum down time have made these procedures extremely popular. However, they are not without problems and complications, it is important to look for a qualified doctor like plastic surgeon to perform these procedures.

Beauty is a concept, it has no universal criteria. Beauty is in the eyes of the beholder. It is influenced by many factors including media. There are, however, a number of parameters that make a person’s appearance pleasing to the eyes- symmetry, proportions and harmony are important. Everyone has his/her own unique appearance and attractiveness, it is up to a plastic surgeon to enhance the attractive features and minimize the short comings in order to bring out the best in the person. The plastic surgeon must have an eye for beauty, ability to appreciate beauty and be able to visualize the results before even doing the procedure. It is both art and medicine. My philosophy is to enhance the natural beauty and not to change the person’s appearance. Although the concept of extreme makeover is being  promoted, I see it being too dramatic and too risky as the complication rate is too high; besides, it is too costly.

Plastic surgery/aesthetic procedures are not just for women. There is an increasing number of men looking for plastic/aesthetic procedures, a man with big eyebags, frown furrows, saggy face and a pot belly would not make as good an impression to clinch that crucial deal against a younger looking, more energetic appearing competitor.

Plastic surgery is simply not just for the rich and famous or the vain selected few. We seek improvement in all areas of our life, for example our physical health and mental well- being; many of us spend hours in the gym, even a manicure/pedicure takes hours; we spend lots of money on our dressing and accessories. Plastic surgery or aesthetic procedures are just an extension of this to improve our appearance, it gives a tremendous boost to our self- confidence. A lady beautifully dressed with expensive clothing and accessories would not have the same impact if her face looks old and haggard. Plastic surgery/aesthetic procedures in today’s modern world enhance our life style, it is more and more accepted as a way to enable us to look our best at whatever age.

LEAKY GUT SYNDROME

by Dr Mecherl Lim

MD (MA) Naturopath (ND),  Holistic Kinesiology


Lets us understand WHAT CAUSES LEAKY GUT SYNDROME?

INTESTINAL PERMEABILITY

A possible cause of LEAKY GUT is increased Intestinal Permeability or Intestinal Hyperpemeability.

That could happen when tight junction in the gut, which control what passes through the lining of the small intestine, don’t work properly. That could let substance leak in the bloodstream.

People with Celiac Disease & Crohns disease experience this. Example,  Toxins in form of Medications, like Steriods, Antibiotics, Advil, Acid reducing drugs and environment toxins like Mecury, Pesticides & BPA from plastic. Stress and Age might also contributes to a Leaky Gut.

Digestive issues include Bloating, Gas, Diarrhea, Irritable Bowel Syndrome (IBS), Cramp, Food Sensitivities, Aches & Pains.

Leaky Gut Sydrome aren’t unique. They are shared by other problem too. Leaky Gut often overlooked as a condition when under disgestive stress, and almost completely ignored if you have been diagnosed with another disease.

However, it is often a root cause of many health concerns,when the gut cannot properly digest nutrients.

WHAT ARE THE SYMPTOMS OF A LEAKY GUT SYNDROME?

A number of symptoms can arise from Neurological, Endocrine and Metabolic eg: Mood Changes, Memory Lapses, Irritable Bowel, Cancer, Loss of Energy, reduced

in Immune Response, Arthritis, Malnutrition, Bloatedness,

Chronic Fatigue, general Seasonal Allergies, Food Allergies, Intolerences, Skin Rashes (related to inflammation), Nutritional deficiencies, (improper absorption),

weakend immune system (from overexertion), Candida Over Growth, Constipation, ongoing Diarrhea, Atopy, Chronic Uticaria, Ulcerative Colitis, Acute Gastroenterities, Cystic Fibrosis, Exocrine Pancreatic Defects, Poor Digestion, Iron Deficiency, Bowel Cancer, Rheumatoid Arthritis, Ankylosing Spondylitis and Maldigestion.

When your immune system attacks particles that escape into the blood stream, regardless of whether they are harmful or not, the killer cells inadvertenly attack healthy cells in the process creating more inflammation thoughtout the body.

Symptoms may spread body wide, but still be attributed to other lifestyle factors. Gaps from intestinal lining widen from inflammation.

Leaky Gut Syndrome

Untitled-2.jpg

MANY WAYS OF MANAGING LEAKY GUT AND REDUCING SYMPTOMS

  • We could support Liver Function to improve Detoxification such as 1st Phase MHT 5 Days Detoxification programme and followed by 2nd Phase MHT Detoxification as we need to check yeast infections and parasites as the person may be suffering from Achlorhydria, Lactose Intolerance and Pancreatic Insufficiency (refer http://www.drmecherlherbs.com)
  • Reinoculating the bowel with beneficial colonic bacteria, by supplementing with good bacteria count such as Proflora A.
  • Restabilising the gut epithelium to normal function.
  • Eliminate or reduce the insult to the gut barrier from xenobiotic or food allergies.
  • Follow an elimination diet or eliminate substances that produce toxic insult to the gut. 80% of individuals who have food allergens or intolerences have LEAKY GUT SYDROME.
  • Limit the uses of Alcohol, Antibiotics, Aspirin, and NSAIDS as they damage the gut barrier.
  • Reduce exposure to exogenous xenobiotics eg: pesticide, insecticides, and irritant chemicals, by eating more organically grown vegetables.
  • Increase the intake of high fibre foods, slippery elm, bananas and cabbage.
  • Increase intake of fish, cod, tuna, salmon or their oil.
  • Support the liver with supplements on phase II as above mentioned.
  • Glucosamine and Glutamine improve the bowel wall integrity and reduce bowel leakiness.
  • Improve digestion by supplementing with digestive enzymes

Sport Injuries on the Knee Joint

By Dr Tan Boon Cheong, MBBS (MU), MS Ortho (MU)

Irrespective of the participating level, namely recreation or professional.  Injury is a constant treat. Of all the sports injuries in our body parts, sports injuries around the knee is one of the most commonly seen in orthorpeadic practice.

Sports injuries on the knee joint can involve the ligaments, meniscus, joint cartilage, bone or the muscles. But in this short article, we will discuss injuries we commonly come across namely ligaments injuries and meniscus injuries. The ligaments that usually injure are anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). (ACL and PCL are more commonly involve). We have 2 meniscus in our knee and they act as stress absorber.

Knee ligamental injury is one of the most common sport injuries. It usually happen in contact sports such as football and hockey, although other types of sports may also give rise to this injury when one fall with the knee in an arkward position. During this injury, the patient may experience the knee buckling or jumping out of space or may hear an audible “pop” sound. This patient may or may not be able to stand up or walk or he/she may need an assistant to carry him/her. The knee will swell within hours and the pain intensity will increase.

Meniscus injury are produced most commonly by rotation when the flexed knee move towards an extended position, thus it can happen during landing from a jumping position such as in badminton, basketball or volleyball game. The symptoms depends on the severity, the location and the type of the tear. It can be presented with pain, swelling and lock knee (bucket handle tear).

The initial management for knee injuries is RICE which is pneumonic for rest, ice compression and elevation. Immobilization of the affected knee may be necessary as part of pain management and also provide support to the knee. One should consult an orthopaedic surgeon for further evaluation on the extent of the injuries. A simple knee x-ray can be perform to look for any bony fracture or ligamental avulsion fracture but x-ray can not be used to visualize soft tissue such as ligaments, meniscus and cartilarge. Thus an MRI of the knee is needed as part of diagnosing ligamental and meniscus injuries. Once the diagnosis has been established, then a decision of conservative or surgical management can be made.

Irrespective of the mode of management, physiotherapist play a huge part in the management of sports injuries on the knee. During the acute phase of injury, physiotherapy helps to reduce pain and swelling. At the same time to maintain the range of motion and minimize muscle wasting and maintain muscle tone. After the acute phase, physiotherapy will help in rehabilitation of the affected knee to its pre-injury condition. For patient who undergo surgery, post surgery physiotherapy is a must for the knee to go back to its pre-injury functional or performance level.

Surgical Management

Torn ligament can’t heal by itself neither it can be suture end to end. Thus, it needs to be reconstructed. Ligament reconstruction surgery in this modern day is done arthroscopically (key hole surgery) rather than open surgery except LCL which lie outside the joint capsule. Thus the recovery period is shorter. Arthroscopy reconstruction using hamstring tendon, allograft or patella tendon is commonly perform for ACL and PCL tear.

Not all meniscus tear need to undergo surgery and not all meniscus tear which undergo surgery can be repaired. Depending on the severity, location and type of tear. The management can be varied. Stable tear with minimal symptoms, physiotherapy will do a good job with the patient will be able to return to normal activities. Not all patient who undergo meniscus surgery can have their meniscus repair as  some of the tear is irreparable thus the tear part which is not stable will be trimmed away (meniscectomy).

Having mentioned all the above, not all sports injuries will end up with ligaments or meniscus tear. Most of the time, the injuries are minor such as muscle sprain, bursitis, small tear on the muscle and etc which may be settled by good physiotherapy.