A book written by clinicians for clinicians that presents a broad view
of the clinical applications of opioids; it covers the pharmacology
of opioids and its clinical application in a wide range of situations
from acute to chronic cancer and non-cancer pain across ages from
paediatric to geriatric populations.
It also covers the socio-historical, ethical, legal and criminal aspects
related to the use of opioids, and includes the limitations of opioids
as well as recommended precautionary measures when prescribing
these drugs. For the busy clinician who has to manage pain either
as a generalist or a specialist, this is a very handy text to keep within
Did You Know?
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Health screening and vaccination are two key types of adult preventive care.
Health screening serves to detect certain conditions before symptoms arise. This is ideal as early detection and treatment can result in better outcomes, reduced risk of complications and cost savings compared to delayed treatment.
Vaccination is the administration of a vaccine (orally or through injections) to build a person's resistance to specific infections. Common vaccines include the flu vaccine, chickenpox vaccine, pneumonia vaccine, hepatitis B vaccine and MMR (measles, mumps and rubella) vaccine.
If you have questions on either health screening or vaccination such as: At my age, what health screening tests I should go for? Or isn't natural immunity better than vaccine-induced immunity?
Here's your chance to ask Dr Wong Ann Mei, Senior Staff Registrar with the department of Post-Acute and Continuing Care (PACC) at
Sengkang Community Hospital (SKCH), which is under
SingHealth Community Hospitals (SCH), a member of the
This forum is open from
1 Apr to 27 Apr 2020.
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Kindly note: Your question will go live/appear when the doctor answers it
I'm 65 this year. Please advise what tests need to be included in my annual health screen and where / how often shall i go for my flu vaccination? Thanks!
Answered by Dr Wong Ann Mei, Senior Staff Registrar, Post-Acute and Continuing Care (PACC), Sengkang Community Hospital (SKCH) under SingHealth Community Hospitals (SCH)
Hi Oauth 2, if you are a Singaporean with no specific health risk or disease, you are recommended to do the subsidised general health screening under the Health Promotion Board’s Screen for Life programme at the polyclinics or GP clinics. This programme includes screening for high blood pressure, diabetes, obesity, high cholesterol and colorectal cancer. For females, an additional test will be included to screen for breast cancer and cervical cancer.
You may also like to screen for osteoporosis as this test is recommended for seniors age 65 years old and above. This is not included in the HPB Screen for Life programme and the cost will vary across institutions.
If you have specific health risks based on your medical history and lifestyle, there are various disease-specific tests as well. I will advise you to have a chat with your family doctor to assess your medical history and lifestyle before recommending any further tests.
Adults are recommended to take a single dose of influenza (flu) vaccine once a year. You may get the vaccine at any polyclinic or GP clinic near you.
Yes, I know about the flu vaccination recommended for the seniors. What about the chickenpox (varicella) vaccine? Does the senior need to be vaccinated?
Hi Fred, the varicella vaccine is recommended for all adults without evidence of immunity, especially if you are a healthcare worker or is in regular close contact with people with weakened immune systems, such as cancer and transplant patients.
More importantly, seniors aged 60 years and above are recommended to get a single dose of zoster vaccine to prevent shingles, which is a viral infection that causes a painful rash.
These vaccines are widely available at most GP clinics and all polyclinics in Singapore.
Dear Dr Wong
I am 60 years old and had suffer a heart attack in 2014, so it has been over 5 years already and I am currently under a Cadio Doctor in Ng Teng Fong General Hospital with review every 6 months.
Currently, I am consuming the following medicine:
- OMEPRAZOLE 20mg (1 Capsule daily)
- ATORVASTATIN 40mg (1 daily)
- TELMISARTAN 40mg (1 daily)
- ASPIRIN 100mg (1 daily) Cardiprin
- BISOPROLOL 2.5mg (1 tablet - 3 times a week)
- EZETIMIBE 10mg (1 tablet - 3 times a week)
At my age, what health screening tests should I go for? I have not taken any healt screening for the last 5 years.
Thank you very much and I look forward to your advise.
Hi Alex, with your medical history of a previous heart attack, cardiovascular-related screening tests will be recommended at least annually. These tests would include ensuring that your blood pressure and cholesterol levels are under control with the medications that you are on. Regular screening for diabetes will be good as well.
For your age, you can also get subsidised screening for colorectal cancer under the Health Promotion Board’s Screen for Life programme.
Hello, I had rubella when I was about 30 years old and shingles when I was about 53 years old. Do I still need measles and shingles vaccinations now? Thank you.
Hi lean_suan, rubella and measles are not the same illness. You will not have immunity for measles if you have not had the vaccine or disease before. Therefore, I will recommend you to get the MMR (measles-mumps-rubella) vaccine if you have not received the complete vaccination before.
Seniors aged 60 years and above are also recommended to get a single dose of zoster vaccine to prevent shingles, which is a viral infection that causes a painful rash.
Hi Dr Wong.
My baby is due for his 4th month immunisation vaccine soon and he needs to complete it by mid May 2020. In view of this COVID situation, should I postpone the upcoming polyclinic clinic to May, before the deadline? Thank you.
Hi Macde, it is important for your baby to receive his immunisation vaccine on schedule. Do make an appointment with the polyclinic and reach the polyclinic on time to minimise any waiting time.
Posted by Z Golf
Hi, May I enquire the cost of the following items:
Hi Z Golf, you can approach the polyclinics or GP clinics to check on the availability and pricing of the above-listed tests.
Posted by M Lim
I am male age 67 and currently a diabetic high blood and high cholesterol all on medications and under control. What types of health screening as well as vaccinations should I do?
Hi M Lim, you should be going for regular reviews to ensure that your health conditions are under control with the medications.
There are disease-specific screening tests that you can do. For instance, diabetics are recommended to be screened for diabetic retinopathy and peripheral vascular disease annually. There are also blood and urine tests that can screen for kidney disorders in diabetics.
Please approach your doctor for advice if you have not had such tests in the past year.
In addition, seniors above the age of 60 years can get subsidised screening for colorectal cancer under the Health Promotion Board’s Screen for Life programme.
Taking your medical history into consideration, I will advise you to get the Influenza and Pneumococcal vaccine at any GP clinic or polyclinic.
Hi Dr Wong, I have been diagnosed with IBS two years ago and did a colonoscopy back then as I always have diarrhoea, results for any digestive illness or cancer were negative. I'm 31 now, am I in higher risk of having colon cancer with ibs? Was wondering if I need to do yearly screenings? Recently I discovered some clear mucus in my stools, should that be a cause for concern. Hope to hear your advice, thank you!
Hi Minmint, IBS has not been linked to bowel cancer (cancer in the colon or rectum). Patients with IBS do not need to undergo any additional testing beyond the initial evaluation of a colonoscopy unless they experience alarming symptoms such as blood in stools, worsening abdominal pain, loss of weight or has family history of bowel cancer.
Would be most grateful for your advice about the following questions:
1) I know that vaccinations are recommended for seniors, but for very old seniors aged 96 and above, can their bodies still be able to take and tolerate pneumococcal vaccination and also influenza vaccination?
2) Because they are very old, is there a high risk that they may suffer from serious side effects after having vaccinations?
3) Are there any reported cases of very old seniors who pass on after suffering from side effects of vaccinations?
4) Which is a better option for very old seniors aged 96 and above? - to rely on their immune system to protect against pneumonia and influenza, or to have vaccinations but risk having side effects after vaccinations.
5) For seniors, do they have to take a blood test first before signing up for hepatitis B vaccination?
Hi Jun90zy, vaccines do not cause illness but act as an effective tool to prevent illness instead. Hence, even the older elderly are recommended to take the pneumococcal vaccine and influenza vaccine.
There is currently no evidence that vaccines lead to a higher death rate among the elderly. In fact, vaccines protect the elderly from disease complications and mortality.
Individuals at high risk of Hepatitis B infections are advised to do prevaccination testing. Please consult your family physician to determine your risk profile prior to Hepatitis B vaccination.
I am a male, chinese, 26 years old, currently looking to start becoming sexually active after marriage next year. I would like your advice on whether or not to get the HPV vaccine? I have read online that males should get it as well. However, in Singapore, only females seem to be the target of marketing for the HPV vaccine. If males should get it too, which one should we get, and what are its potential benefits and dangers? In your opinion, is the cost-benefit of getting the vaccine worth it? As males have no subsidy for the vaccine in Singapore, nor are we allowed to use Medisave.
Hi Talkingcat88, the tetravalent HPV vaccine (which protects against four HPV strains) offers the most optimal protection for the prevention of HPV infection and genital warts in men aged below 25.
Males who are 25 years old and above may also benefit from the HPV vaccination. I will advise you to consult your family physician to determine your risk profile and discuss the benefits of the HPV vaccine in detail.
Hi Dr Wong
Both my wife & I are 57 years old. At this age, what types of vaccinations are needed & what are the possible side effects? My wife is generally healthy while I have a metal valve implanted 3 years ago & I am on warfarin
Hi Id1615, I will recommend you to get the Influenza and Pneumococcal vaccine at any GP clinic or polyclinic.
For your wife who is healthy, she is recommended to get the Influenza vaccine now and the Pneumococcal vaccine when she turns 65 years old.
I'm in my 50s and a few friends have shingles which is so painful. I'm afraid that I might have it too. Can I go for any vaccination against shingles?
Hi smurfy, seniors aged 60 and above are recommended to get a single dose of zoster vaccine to prevent shingles, which is a viral infection that causes a painful rash.
Thank you for this opportunity.
I have been doing the flu vaccinations every year / every other year.
Is it really necessary to keep going for flu vaccinations again and again? Can I skip a year and still be safe/ covered?
It gets a bit tiring to keep going and going.
I'm in my 50s...
Hi Healthynuty, it is commendable that you have been taking the flu vaccination regularly. The Influenza vaccine is different each year as it is updated according to the prevalent Influenza strains. Therefore, I will advise you to continue getting vaccinated yearly.