Monday, 7 September 2015



      1.       What is acne?
Acne is a skin condition in which the sebaceous or oil glands of the skin become inflamed.  At first, the sebaceous glands become blocked by white and blackheads.  Then they become inflamed and can lead to red bumps called papules and yellow heads called pustules and even deep and tender cysts.

Acne is a very common condition in adolescence.  It occurs in young men aged between 13 and 18 and worsens between 18 and 19 years old.  It is less common in girls and common around 14 years old and worsen especially around period time.  It usually settles by the age of 20, but may continue longer in severe cases.
Acne often appears on the face, but can extend onto neck, chest, shoulders and back.
2.      What causes acne?
Acne is related to an increase in the levels of male hormones during puberty in both sexes. Although the increase in the hormone levels is normal, some people are more sensitive to it. The rise in the hormone levels stimulate the growth of bacteria that live on our skin. This causes the blockage of the sebaceous glands and release fatty acids which in turn irritate and inflame our skin, hence causing acne formation.
3.      Important facts about acne:
a.      Acne is usually not affected by diet.
b.      It is not caused by oil hair or hair touching the forehead.
c.      It is not infectious from one person to another.
d.      Ordinary chemicals including chlorine in swimming pools do not make it worse.
e.      Blackheads are not dirty and they will not dissolve in hot or soapy water.
f.       Acne may flare up more with stress and emotional upsets.
4.      Advice to parents:
a.      Your son or daughter hates acne and finds it embarrassing, so be supportive.
b.      Acne is not due to the ways the skin is washed or what is eaten.
c.       It will not help if you are over-anxious or nagging your children about it.
d.      Be supportive and understanding.
e.      Follow your doctor’s advice and instructions in acne treatment.
5.      What is the treatment for acne?
a.      Diet:  avoid foods that seem to aggravate your acne, such as chocolate and milk.
b.      Soap and washing:  use normal soap and gentle skin washing.
c.      Cosmetics:  avoid oily or creamy cosmetics and all moisturizers. Water based lotions
   and cosmetics are preferred. Use cosmetics sparingly.
d.      Hair washing and shampoos:  these make no difference to acne.
e.      Blackheads removal:  this is not recommended.  Avoid picking or squeezing acne.
f.       Exercise:  this has no proven value to the treatment of acne.
g.      Ultraviolet:  this can be beneficial.  However, avoid extreme exposure to sunlight and
   avoid sunburns.
h.      Lotions, creams and gels:  these can be useful, such as Sulphur, salicylic acid,
   benzoyl peroxide and retinoic lotions
i.       Antibiotics:  these have proven value to acne treatment. Oral antibiotic course and
   topical antibiotic preparations are effective.  Please consult your doctor for further
j.      The pill:  some specific contraceptive pills are very effective in treating acne in


Wednesday, 2 September 2015

Prostate - Your Prostate

Prostate – Your Enlarged Prostate
1.       What is the prostate gland?
The prostate is a brownish gland about the size of a walnut.  It surrounds the opening of the bladder and about the first 2.5 cm of the urethra which is the urine tube passing from the bladder to the penis.  The prostate produces substances that make up a small part of the semen in the ejaculation.
2.       What causes the problem with the waterworks?
The trouble with the waterworks is usually caused by the enlargement of the prostate gland. Almost every man over 45 years of age will have some degree of the prostate enlargement in which the majority is due to benign prostate hypertrophy (BPH).  Some medications, such as alcohol, medications used to treat depression, Parkinson’s disease, irregularity of the heart beats and over the counter ephedrine-like compounds for cough and colds can cause or exacerbate prostate enlargement.  Although prostate enlargement is common in men over 45 years old, it rarely causes any problems before the age of 50.  About 50% of men over the age of 55 will have waterworks trouble. This proportion increases to 80% for men over 80 years old. Serious waterworks trouble affects 2 in 10 elderly men.
3.       What are the symptoms?
·         Frequency of urination.
·         The urge to urinate without warning.
·         Waking up at night to urinate.
·         Difficulty with the start of urination.
·         Poor stream of urine.
·         Tendency to dribble at the end of urination and the needs for double voiding to empty
  the bladder.
·         Abdominal pain and blood in the urine are uncommon symptoms in BPH.
4.       What are the risks?
BPH is not dangerous, but it can causes problems with your normal waterworks function as described in the above symptoms. More serious problems are the urine infection, sudden acute blockage of the urine, called acute urine retention, and slow blockage of the urine, called chronic urine retention. If this is to occur, a urinary catheter can be inserted by your doctor to relieve severe urine obstruction.
5.       What tests can be done for your prostate?
When you see your doctor for a prostate check-up, your doctor usually asks you a number of related medical questions regarding to your prostate.  Your doctor will then perform a prostate examination with a gloved finger to feel your prostate through the back passage. After that, your doctor may choose to order a prostate blood test called PSA.  All of the related medical history, examination as well as the blood test will help your doctor to determine the state of health and condition of your prostate. It is highly advised that you should have a regular prostate check-up if you are a middle aged man or older and have any waterworks trouble, or have a personal or family history of prostate problems, or if you are taking medications that can affect your prostate.
6.       What is the treatment?
a.      General measures:
·        Avoid or minimise alcohol intake with and after evening meals.
·        Avoid fluids for at least 3 hours before retiring.
·        Get up immediately at night if you need to urinate.
·        Visit the toilet when you need to go and don’t hold your urine.
b.      Medications:  
There are many medications available to relieve and improve the flow of your urine. Your doctor can advise you about these appropriate medications accordingly.
c.       Operation:  
About 1 in 10 men may need a prostate operation.  It is usually done through the penis using an instrument to remove the obstructive prostate tissue. The operation is called Trans-Urethral Resection Prostatectomy (TURP).  TURP is usually done by your prostate specialist.

Peptic Ulcer Disease

Peptic Ulcer Disease
1.      What is peptic ulcer disease?
Peptic ulcer disease is a medical condition in which there are small ulcerations in the lining of the stomach or the duodenum(the first, small part of the bowel).  Most ulcers are in the duodenum (duodenal ulcers) and a smaller number develops in the stomach (gastric ulcers).
2.      What causes peptic ulcer disease?
Our stomach produces lots of acidic juices which help to digest foods that we eat.  This stomach acid juice can erode the lining of our stomach and duodenum if it is excessively produced.  As a result, stomach or duodenal ulcers are formed.

We also know that a bacteria in the stomach called Helicobacter pylori can exacerbate the ulceration of our stomach or duodenal lining in the presence of the stomach acid juices, hence accelerating and enhancing the formation of peptic ulcer disease. 
Other common causes of peptic ulcer diseases are heavy alcohol consumption, heavy cigarette smoking, stress, anxiety and depression. Another common modern cause is the use of drugs to treat arthritis pain known as non-steroid anti-inflammatory drugs (NSAIDS).
3.      What are the symptoms?
The common symptoms of peptic ulcer disease are upper abdominal pain, heart burn, indigestion, “hunger pain” with an empty stomach, pain relieved by antacid and milk. Other uncommon symptoms are back pain and vomiting up blood or bleeding in the bowel motions. Some people may present with anaemia and tiredness.
4.      Who is prone to have peptic ulcer disease?
a.    Men.
b.    Young to middle aged people.
c.      Patients who constantly take certain medications, such as aspirin, cortisone and
d.     Heavy cigarette smokers.
e.     Heavy alcohol drinkers.
f.      Heavy coffee drinkers.
g.      Patients who suffer from stress, anxiety and depression.
5.      What are the risks?
Most patients with peptic ulcer disease are relatively easy to treat or control.  However, if left untreated, bleeding can occur, resulting in an emergency situation and anaemia.  Perforation or blockage of the duodenum can occur. Cancer can also occur with stomach ulcers.
6.      What are the tests available?
The diagnosis of peptic ulcer disease can be made based on the symptoms and signs that you have trial treatment medications.  The definitive investigation for it is a gastroscopy which involves a camera going down your throat and through your oesophagus, entering your stomach and small bowel to visualize the ulcerations of the stomach and duodenal lining.  This is done by a specialist under light anaesthetic medications.  It is usually a simple day procedure.  Other tests include a breath test for helicobacter pylori and blood tests.  You should see your doctor to have an assessment and these tests organized and get treated.
7.      What is the treatment?
Effective treatment for peptic ulcer disease is available these days.  This treatment regimen is ranging from self-help measures to medical treatment.
a.      Self-help measures:
·       Do not smoke.
·        Drink alcohol in healthy moderation.
·         Do not take aspirin or arthritic medications unless really necessary.
·         Have a normal regular healthy diet with three balanced meals a day.
·         Do not skip meals or have late night snacks.
·         Avoid foods or drinks that make symptoms worse, such as hot and spicy food.
·         Relieve everyday stress and keep it under controlled.
·         Take antacid medications or medicines to relieve symptoms.
b.      Medical treatment:
Peptic ulcer disease is now very treatable with modern medications.  You should see your doctor for assessment and treated.  Antacids may not be enough and there are other medications which are very effective in treating and controlling peptic ulcer disease.  An appropriate antibiotic course can also help eradicate the stomach bacteria, Helicobacter pylori.  If all of these fail, then an operation can also be very successful.


1.      What is osteoporosis?
Osteoporosis is a common medical condition which leads to the thinning of bones so that bones become weak and brittle and prone to fractures.  Osteoporosis is found mainly in middle aged and elderly women after menopausal.
2.      Why do women get osteoporosis?
Women at greatest risk of osteoporosis are those who:
·        Are of Caucasian or Asian racial origins.
·        Are thin and slight.
·        Heavy cigarette smokers.
·        Heavy alcohol drinkers.
·        Heavy coffee drinkers.
·        Get little exercise and highly sedentary.
·        Lack of calcium in their diet.
·        Menopausal which leads to low hormone levels.
·       Take steroid or corticosteroid medications.

3.      What tests can be done to find out osteoporosis?
Most women do not know that they have osteoporosis. It is often first found out when a bone breaks, usually in the hips, wrists or spine.  A simple X-ray may give us some basic information about osteoporosis, especially if the bone loss is reaching 50%. The best test for osteoporosis is the DEXA bone densitometry scan of the spine and neck or femur.  Your doctor can organise these tests for you when you see them.
4.      What can you do if you have osteoporosis?
·      Take regular weight bearing exercise, such as brisk walking for 30 minutes, 4 times a week.
·      Stop smoking and cut down your alcohol and coffee intake to healthy moderation.
·     Have enough calcium intake in your diet:  1000-1500 mg a day and 1500 mg if you are menopausal.  Eat calcium rich food, such as milk, yoghurt, cheese, fish, citrus fruits, sesame and sunflower seeds, almonds, Brazil nuts and hazelnuts.
·       Vitamin D supplement.
·       Medications are available for osteoporosis and can be prescribed by your doctors.
·    Please see your doctor regularly so that he or she can assess your risk for osteoporosis, organising appropriate tests and discussing your diet, calcium supplement, vitamin D supplement, hormone tablets and other medications that are available for the treatment for your osteoporosis.
5.      How can falls be prevented?
Falls tend to cause fractures in people with osteoporosis.  They can be prevented by:
·         Removing loose or worn carpets and scatter rugs.
·         Wearing low heel shoes.
·         Holding onto hand rails when using stairs.
·         Installing safety bars in the bathroom.
·         Using night lights to provide better visibility.
·         Being careful with taking medications, such as sleeping medications.
·        Having good eye sight and maintaining regular eye check-ups with
your optometrists for glasses.


1.      What is osteoarthritis?
Osteoarthritis is a medical condition in which the joints become inflamed, stiff, painful and uncomfortable.  It is the most common type of arthritis in the aging population in our society.  It is due to the wear and tear process of our joints, therefore is also called degenerative joint disease.  The smooth cartilage that covers and protects the ends of our bones at the joints are slowly worn away.  As a result, the joint becomes rough and stiff and then inflammation develops.  Osteoarthritis occurs in 1 in 10 people over the age of 40, and becomes more common and present in almost all people who are 60 years old and above.
2.      How does osteoarthritis begin?
The most common reason for the loss of the cartilage is the wear and tear due to aging, but many people never notice it. It commonly develops in joints that were injured earlier in life and joints that have been overworked. It mostly affects the weight bearing joints, such as the spines, knees, hips, shoulders and elbows. The joints at the base of the thumbs as well as fingers are also common sites.
3.      What are the symptoms?
The severity of osteoarthritis varies. The common symptoms are pain, swelling, stiffness of the affected joints. Stiffness is usually worse in the morning. Pain is worse after excessive or prolonged activities, such as walking, jogging and running. Movement at the joints may be difficult and can interfere with our normal every day activities. Osteoarthritis seldom becomes a serious problem and is not a life threatening condition. However, it can cause bad pain, stiffness and discomfort and affect the joint range of movements and our physical being in severe cases.
4.      What is the treatment?
There is no cure for osteoarthritis.  There are many ways and treatment that we can make our life better  and comfortable with osteoarthritis:
a.   Diet:  keep your weight down to avoid unnecessary wear and tear on the joints.  There is no particular diet has been proven to cause or improve osteoarthritis.
b.  Exercise:  keep a good balance of adequate rest and sensible exercise can be beneficial for osteoarthritis.  Moderation of walking, cycling and swimming can relieve pain, stiffness and discomfort caused by osteoarthritis.
c.   Walking aids:  shoe inserts, good footwear and a walking stick can help painful knees, hips and feet.
d.  Heat:  hot water bottles, warm baths or electric blankets can soothe the pain and stiffness in osteoarthritis.  Cold weather, especially in winter can worsen the symptoms.
e.   Fish oil  can help alleviate the pain and discomfort in osteoarthritis by reducing the joint inflammation in mild cases.
f.  Special equipment:  can help to increase your independence at home.  A wide range of inexpensive equipment and tools that can help with cooking, cleaning and other household chores.  Walking sticks, crutches and walking wheel frames can also be very beneficial for your mobility.
g.   Medications:  aspirin and Panadol are effective in mild osteoarthritis.  Stronger anti
inflammatory medications can be prescribed by your doctor with care and precautions, depending on your medical  history profile.
h.  Joint injections:  new lubricant can be injected into the joints to help osteoarthritis.  Some steroid injection can also be beneficial.  You should consult your doctor for these options of treatment.
i.   Operations:  can help to improve the pain, stiffness and functions of your joints in severe cases. Common operations are knee and hips replacement that can be done by your bone doctors.

High Cholesterol

High Cholesterol
1.      What is high cholesterol?
People have high cholesterol when they have a fasting blood test which shows a high level of cholesterol parameter.  There are two types of cholesterol: good and bad cholesterols.  The good cholesterol is HDL and the bad cholesterols are cholesterol, LDL and triglyceride. Please see your doctor for results of your cholesterol after you have a blood test. Your doctor can explain to you in details about your cholesterol profile.
2.      What problems can high cholesterol cause?
High cholesterol can cause clogging up of your blood vessels, from a high content of fat circulating in your blood.  High level of bad cholesterols often cause that problem. When your blood vessels are blocked up, it can cause heart attack or stroke.
3.      What are the symptoms of high cholesterol?
The majority of the cases, high cholesterol has no symptoms. When people have a heart attack or stroke, your doctor often test your blood and find that they have high cholesterol.  That is why you should see your doctor regularly and have regular check-ups and blood test for your high cholesterol and diabetes.  High cholesterol is one of the major risk factors for heart disease and stroke.
4.      How to treat high cholesterol?
High cholesterol can be treated by diet control and regular exercise via sensible general life style. There are also many medications available in Australia that are used to treat high cholesterol.
a.      Sensible general life style measures:
1.    Diet control:  a low fat diet will help bring down your high cholesterol.  Please see the table below for some common foods that have high cholesterol and you should avoid and some suitable foods.
2.     Regular exercise:  regular exercise with moderation not only helps reduce your bad cholesterols but also helps to increase your good cholesterol.  Regular exercise with moderation is good for your heart and your mind and your sleep.  It also helps to lose weight.
3.    Other healthy life style options:
·       Keep to your ideal weight.
·       Take high fibre diet.
·       Have more fruits and vegetables.
·       Eat fish at least twice a week.
·       Beware of fast food and avoid deep fried foods.
·       Always trim fat off meat.
·       Avoid biscuits between meals.
·       Drink more water.
·       Do not smoke.
·       Moderation in alcohol intake (1-2 standard alcohol drinks a day).
·       Healthy rest and sleep and keeping your everyday stress level under control.

b.      Medications:
There are many medications available to treat high cholesterol.  Your doctor should be able to advise and prescribe you appropriate medications for it. Once you are on cholesterol medications, make sure that you take your medication regularly and do not stop unless advised by your doctor.  You should also have regular blood tests to monitor your cholesterol profile until it is under control as recommended by your doctor. Once your cholesterol profile is within a healthy level, you can have regular cholesterol check-ups once or twice a year as advised by your doctor accordingly.
5.      The low cholesterol diet
Foods to avoid
Suitable foods
Whole eggs, egg yolks
Egg whites
Whole milk and its products – butter, cream, cheese, ice cream, yoghurt, condensed milk
Low fat milk, skim milk and its products – cottage and ricotta cheese, butter milk, non-fat yoghurt
Organ meats
Brain, liver, pate, liverwurst, kidney, sweet bread
Prawn, squid, calamari, fish roe, caviar, fish fingers, canned fish in oils such as sardines
Fresh fish, scallops, oysters, canned fish in water, lobster, crabs (small amount)
Fatty meat – bacon, ham, sausages, salami, canned meats, pressed meats, meat pastes, hamburger mince
Rabbit, veal without fat, lean cut beef, lamb and pork in moderation
Duck, goose, skin chicken and turkey, pressed chicken
Chicken, lean turkey without skin, preferably free range
Bakery food
Pies, pasties, pastries, cakes, doughnuts, biscuits
Bread, crumpets, crisp breads, water biscuits, home-made pies with proper ingredients
Fast food
Fried chicken, chips, fish, dim sims, spring rolls, hot dogs, pizza, fried rice
Cashew, macadamia, coconut, roasted nuts, brazil nuts, peanuts, peanut butter
Pecan nuts, hazelnuts, walnuts, almonds, seeds in moderation
Fruits & vegetables
All types of fruits and vegetables
Oils and fats
Saturated fats – lard, dripping, suet, copha, hard cooking, margarine, coconut and palm oils, mayonnaise
Poly-unsaturated fats – margarines, salad dressings, vegetable oils – olive, walnut, corn, soya bean, sun flower, safflower, cottonseed all in moderation
Gravies, potato crisps, caramel, chocolate, butterscotch, futch, coffee whitener, cream substitutes, toasted breakfast cereal especially with coconut
Rice, pasta, cereals, jelly, herbs, spices, canned spaghetti, vegemite, tea, coffee, honey, jam, alcohol in moderation
Cooking methods
Frying, roasting in fat
Vegetable oils, baking, boiling, grilling, stewing