Eye Health

Night

by Clinical Associate Professor Goh Kong Yong

NIGHT BLINDNESS OR nyctalopia is not a disease but an underlying abnormal eye condition where one’s eyes refuse to function at night or in low light conditions. This has severe consequences for the sufferer as it means a loss of mobility at night.

What causes night blindness?It can be caused by the following eye conditions: • Cataracts – The increasing opacity

of the human lens causes blurring of vision even in daylight and worsens in dim light or at night.

• Severe short-sightedness (high myopia) – Night blindness may be a symptom of undiagnosed or progressive myopia.

• Diabetes affecting the retina (diabetic retinopathy) – Diabetes affects the small blood vessels in the retina, causing damage to the photoreceptors which are responsible for receiving visual images. In dim conditions, the photoreceptors

Blindness

What happens at an eye specialist visit?At the Eye Specialist clinic, you will be given a comprehensive eye examination which comprises a visual acuity check, intra-ocular pressure measurement as well as a refractive error check. A retinal examination is then performed to detect any retinal diseases. Sometimes, a night adaptation test may be performed to assess the severity of the condition.

How can night blindness be treated?The mode of treatment for night blindness depends on its cause. It may be as simple as prescribing a new pair of glasses, to surgically removing the cataract. For diabetic patients, advice on a low sugar level diet will help stabilise their visual condition.

Night blindness caused by Vitamin A deficiency is easily treatable by prescribing Vitamin A supplements or encouraging the consumption of food rich in Vitamin A such as sweet potatoes, carrots and dark green leafy vegetables.

Mdm Minah had been healthy and independent all her life until her fifties, when she noticed she had difficulty seeing at night.

“I used to go out at night to buy supper for my boys who would come home hungry after their afternoon shift. But lately, I realised that everything outside the house seemed so dark. I dismissed it simply as age catching up and perhaps, all I needed was just a new pair of glasses.”

One evening, she had a nasty fall while venturing out alone to run an errand. Her two worried sons took her to her family doctor. After treating her injury, the doctor checked her vision and was appalled that she could only see silhouettes in dim lighting, although her daytime vision seemed perfectly normal. An eye specialist diagnosed it as retinitis pigmentosa, a condition in which vision drops sharply at night, resulting in night blindness.

Normal night vision Diminished night vision (Notice the loss of details)

Clinical Associate Professor Goh Kong Yong is a Senior Consultant Ophthalmologist at Dr Goh Eye Neuro-ophthalmic and Low Vision Specialist, Mount Elizabeth Novena Hospital, Singapore.

function even more poorly.• Vitamin A deficiency – Vitamin

A is necessary to keep the retina healthy. However, a deficiency in this vitamin is rare.

• Retinitis pigmentosa (usually hereditary) – This is a rare and untreatable condition. This ailment tends to run in the family and may plague both the young and elderly.

Am I at risk of developing night blindness?Think about the following questions:

1. Do you take a long time making out images at night?

2. Do you have any family member with night blindness?

3. Do you have short-sightedness above 700 degrees?

4. Do you have diabetes mellitus?

If you answer “Yes” to any of the above, it is advisable to see an eye specialist at least once yearly.

To date, no active treatment is available for retinitis pigmentosa, although recent studies on the use of oral valproic acid have reported an improvement in visual function.1

Does LASIK cause night blindness?A number of my patients who have had their LASIK procedure done are concerned about LASIK causing night blindness. I assured them that although LASIK may initially cause nocturnal visual disturbances like “haloes”, such “halo” disturbances usually subside after a month.

Footnote:1 J Ocul Pharmacol Ther. 2014 Sep; 30(7):580-6).

Are you in the dark?

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MARCH 2015 | ezyhealth 27www.ezyhealth.com

Dr Michael Soon is a Consultant Orthopaedic Surgeon, practising at the Centre for Orthopaedics, located in Mount Elizabeth Orchard, Mount Elizabeth Novena and Parkway East Hospitals.

THIS IS AN extremely common scenario. With more people maintaining an active lifestyle, injuries to the knee become more common. Knee injuries can affect people of all ages, and can be broadly divided into accidental/traumatic causes and those due to overuse.

Accidental CausesAccidental causes are usually easy to appreciate.

NaggingKnee Pain

What’s the cause?

by Dr Michael Soon

seven kilometres, it goes up easily to 10000 steps a day.

The cartilage in your knee, which measures just 3 mm thick, protects you for today and the rest of your life. Much of its function is determined by how smooth this cartilage surface is. If you take two pieces of ice and move them together, you realise it is very slippery. The cartilage interface is four times that smoothness. Hence, once the cartilage loses that smoothness, it progress predictably towards wear, tear and eventually breakage. Once this occurs, this is known as osteoarthritis.

See a doctor if you notice these signs:• Inability to bear weight on the knee• Marked knee swelling• Inability to fully extend or flex your knee• Knee instablility

OveruseIn runners, overuse injuries are a lot more common. There are many causes, and can even be due to your running style, whether you have a flat foot, or the shoe that you use. Hence, assessment for knee pain in such cases will need to include examination of the entire lower limb, rather than the knee alone.

• Anterior knee pain is pain around the knee cap. This is usually due to stress on the cartilage under the knee cap. There may also be underlying problems that may need assessment by a specialist.

“Do I have to stop running?” was the thought that went through Janice’s mind. She had been running regularly about three times a week, for a distance of approximately seven kilometres. Everything was good initially but she noted that recently, her knee became stiffer after running. She also noted occasional ‘clicks’ and swelling.

• Ligament injuries like those affecting the ACL (anterior cruciate ligament) are especially common in soccer players and skiers. Such ligaments are important stabilisers of the knee joint. Once these are ruptured, it is unlikely that you can return to sports without treatment. Athletes like American World Cup alpine ski racer Lindsay Vonn return to full sporting performance only after surgery and rehabilitation.

• Tears of the meniscus can also occur at the same time when the knee is twisted. Think of people like Jeremy Lin (basketball) and Luis Suarez (soccer), who sustained tears of their meniscus. The meniscus is essentially the shock absorber of the knee. While it can take direct loading fairly well, it is much weaker with twisting motions. Hence meniscus tears occur more often in sports that involve change of direction and sudden stops and turns.

Small tears can be managed with a sports physiotherapist and non-surgical means. However, if the knee remains persistently swollen, locked or painful such that activity is restricted, treatment in the form of arthroscopic surgery may be required to regain full function.

• Cartilage injuries can occur from an acute injury or due to overuse. The cartilage is the smooth covering at the end of the bones, and in essence, it is the joint. A sedentary person takes about 3000 steps a day and if you run

• Pain above and below the knee cap – This can be due to inflammation of the patella tendon below the knee cap, or inflammation of the quadriceps, which is above the knee cap. The patella tendon connects the knee cap to the shin bone, and transmits the powerful muscle of your thigh (quadriceps) to straighten your knee. With the many repetitions in running, the tendon is “overused” and becomes inflamed. This can lead to pain both during and after running, and curtails speed and distance.

• Runner’s knee is a form of friction syndrome, where the ilio-tibial band (ITB) rubs on the outside of the knee. The ITB is a large and long muscle that spans from the hip to below the knee. This band rubs on

the bone during running. If the mechanics of the

lower limb are off, and this occurs with

poor running gait or poor muscle control (especially at

the hips) or even being flat footed, this friction is increased and leads to pain on the outside of the joint.

This was the case with Janice. After obtaining corrective arch support to treat her flat foot, and directed physiotherapy, her runner’s knee recovered and is now the bee’s knees.

Pull the Plug on Pain!Treat pain by:

1. Physiotherapy – stretching, specific strengthening, pain management and

stability exercises. This should be maintained at home too.

2. Methods such as running on a softer surface (e.g. grass or indoor running track)

3. Changing your type of shoes

4. Having adequate rest

5. Cross-training – Change your activity to spread the stress. You can run, cycle, swim or use an elliptical trainer on different days. This allows rest for the injured region to heal.

26 ezyhealth | MARCH 2015 www.ezyhealth.com

Health

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Alternative Medicine

EVERY DAY, ADVERTISING billboards and television bombard us with images depicting the current ‘desirable’ body shape. How can we achieve our weight loss goals, in the face of wide-spread obesity?

Obesity is defined as “increased body weight caused by excessive accumulation of fat”. People are considered obese if they weigh 20% or more above average for their height and build.

In Traditional Chinese Medicine (TCM), good health consists of the body’s systems acting in harmony according to the individual’s constitution. If all is working well, there will not be any weight problem.

The Roots of ObesityObesity was first mentioned in Chinese medicine in the Yellow Emperor’s Classic of Internal Medicine: “When treating exhaustion syndromes, sudden syncope, hemiplegia, atrophy, or rapid respiration conditions that occur in obese patients, recognise that these are usually due to overindulgence in rich foods.”

As early as in the Han dynasty, TCM practitioners recorded the symptoms, mechanism and risk factors of obesity. The Suwen (Book of Basic Questions) states: “If obesity occurs in the nobleman and rich people, they must be over-consuming heavy and greasy foods.” Similar to the modern understanding of obesity, associated risk factors include undesirable eating habits, under-exercising, body constitution and mental state.

The ancient Chinese also knew that obesity has close links with metabolic disorders such as diabetes and other conditions such as stroke or chest pain.

Four Main Types of ObesityIn TCM theory, obesity is believed to be the result of many factors. Careful observation over many centuries allows Chinese medicine to say that there is not just one type of overweight or obesity, there are many.

Weighty IssuesTCM solutions for obesity

by Dr Leslie Ong Kwee-Nam

TCM classifies overweight and obesity into four main types:

1. Excessive Internal Phlegm and DampnessPhlegm is an important concept in TCM, indicating not only mucus from cough or nose discharge, but also stagnant body fluid. The spleen is said to be at the root of all phlegm production.

When the spleen becomes damaged, such as when one eats too many sweet foods and gets too little exercise, it will fail in its duty to move and transform waste fluids and foods. Instead, these metabolic wastes will gather, collect and transform into dampness. If dampness evils endure, over time they will congeal into phlegm, and become fat tissue.

The excessive internal phlegm manifests itself as:• Excess weight• Tiredness• Body heaviness• Chest and/or stomach distension• Poor appetite, in some cases • Slimy covering or ‘fur’ on the tongue

This type of obesity is generally due to an eating disorder, or secondarily by some other illness.

Treatment revolves around sweeping away phlegm and removing stagnation. Once the phlegm is swept away, the qi (vital energy) can move smoothly and easily. This promotes the movement of phlegm and reduction of fat with the ultimate result of decreasing obesity.

2. Stagnation of Qi and BloodPatients exhibiting this condition may suffer from:• Irritability or low motivation• Chest or breast fullness• Insomnia• A dreamy state• Menstrual disorder or amenorrhea (absence of menstruation) • Infertility• Headaches in some patients• Dizziness and numbness of the four extremities • Tongue may turn dark red with a thin white fur or a thin and

greasy fur

TCM, by its holistic focus on the body

and its systems, provides a key to long-term

healthy weight maintenance.

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Alternative MedicineThis is because the movement of blood is not smooth or easily flowing. Stasis obstructs the vessels and inhibits the qi mechanism. Therefore, fat and dampness collect and accumulate within the vessels, making the blood more viscous. If this continues over time, obesity and arteriosclerosis (thickening and hardening of the arteries) will result.

The principle treatment is to speed up the blood flow and remove stagnation.

3. Yang Deficiency of Spleen and KidneyThe third type is yang deficiency of the spleen and kidney.

Common symptoms for people in this category include:• Feeling exhausted or fatigued• Lower back and knee weakness• Shortness of breath• Impotence or low libido• Tongue is pale and without any fur covering

Genetic factors can play a part in this condition. It may also be the result of other illnesses, stress or an unhealthy lifestyle.

Treatment involves fortifying the spleen and rectifying the kidney deficiency.

4. Liver StagnationLiver stagnation caused by prolonged strong emotions or depression leads to disharmony between the spleen and the liver and gives rise to fluid retention. Due to the liver being depressed, the gall bladder is also depressed and exhausted, the ebb and flow of these organs become unbalanced, and the qi does not flow freely. Hence, there is difficulty in transforming fat. Over time, this leads to obesity.

People in this category may experience:• Excessive fatty material deposited in the abdomen• Bloated physique • Feeling drained of energy• Excess sputum secretion• Dizziness• Vertigo • Retching• A dry mouth• Lack of desire for food or drink • Discomfort in the chest and abdomen• Tongues are usually covered by a white glossy or greasy coating

Treatment involves improving liver function, unblocking the gall bladder and removing stagnation.

TCM TherapiesSince the nature of each type is different, the treatments are also different. Today, we are using many TCM therapies, such as herbal medicines, acupuncture, as well as diet combined with exercise to treat obesity. With these treatments, most patients can lose 5 – 10 kg per month.

Herbal Treatment TCM believes that Chinese medicine possesses certain properties and that every medicinal substance has its strengths as well as shortcomings. Chinese preparations are complex recipes combined according to particular TCM theories. Medicinal substances (usually herbs) are carefully balanced in quality and quantity, in order to accentuate the health restorative actions while reducing side effects.

Classic herbal preparations dealing with this problem have been passed down for centuries. The plan for treatment will be based upon each individual’s constitution and differentiation of syndromes.

Besides the individual’s physical state, a TCM physician also takes into account the geographic location, sex,

age, lifestyle patterns and past medical and family histories. As a result, the therapeutic methods are comprehensive and are customised to an individual’s condition.

Acupuncture TreatmentAcupuncture therapy affects the autonomic nervous

system and regulates energy metabolism by stimulating the qi flow in the body’s meridians. Acupuncture is often most effective for stubborn stagnation problems in the meridians. It can also prohibit appetite and increase the metabolic rate of obese individuals.

TCM has a lot of experience with obesity. Chinese medicine and acupuncture are alternative treatments to help control weight problems. Besides these treatment methods, individuals must also exercise and practise good dietary habits. Chinese medicine and acupuncture combined with exercise and food therapy can greatly enhance the treatment of obesity and help individuals manage their weight.

TCM, by its holistic focus on the body and its systems, provides a key to long-term healthy weight maintenance. It is important to consult a qualified TCM physician to help you select the most appropriate formula to meet your needs.

Dr Leslie Ong Kwee-Nam is a Doctor of Medicine (Nanjing University of Chinese Medicine). He has a Bachelor Degree in TCM (Singapore College of TCM) and Bachelor Degree in TCM (Nanjing University of Chinese Medicine). He is a registered TCM Physician of Singapore and practises at Si En TCM Medical Clinic.

DECEMBER 2015 | ezyhealth 63www.ezyhealth.com www.ezyhealth.com

Myth Busters

“LOW FAT IS better.” “I’m too fat! I need to eat oily foods.” “I should cut fats from my diet completely.” Sound familiar? You’ve probably heard people around you utter these words before, or you may have thought them yourself. Here’s a heads-up: these statements may not only be untrue, they are also potentially dangerous! Get the facts on fats here.

62 ezyhealth | DECEMBER 2015

Getting by Kelly Ng

Fats RighttheWill you flunk the “fats facts” test?

The more fat I eat, the more weight I put on.Again, the amount of fat we eat does not impact our weight, cholesterol levels, or risk of heart disease, nearly as much as what kind of fat we eat. Most unsaturated fats – found in vegetable oils, avocados and peanuts – are good for you, but saturated fats are bad in excess. This is why olive oil, which is 100% unsaturated fat, is healthier than pancake mix, which contains 11% saturated fat. That said, trans fat is an artificially created type of unsaturated fat which increases our risk of heart disease by increasing bad cholesterol and lowering good cholesterol in our bodies (a double whammy). Steer clear of trans fat by avoiding items with “partially hydrogenated” fats in their ingredient lists.

The healthiest diet is one without fats.Research has shown that the total amount of fat in the diet isn’t really linked with weight or disease. What really matters is the type of fat and the total calories in the diet. Also, just because the label says “fat-free” does not mean it is low in calories. To make up for the lack of taste and texture in certain “fat-free” foods, some food makers tend to pour other ingredients – especially sugar, flour, thickeners, and salt – into their products. Some of us tend to eat more “non-fat” and “low fat” foods because we think there’s no way to get fat eating these. The truth is, the calories still add up. Before getting your next “fat-free” food, check its ingredient list and make sure it isn’t loaded with sugar or additives.

Fat is bad for our bodies.Not true. Our bodies need a certain amount of fat as it serves as an energy store, a cushion for vital organs and a transport system for fat-soluble vitamins. Our brain, nerves, and immune system need omega-3, a type of fatty acid. Omega-9 helps lower bad cholesterol, helping to keep your heart healthy. We need fat and to make hormones. We also need fat during digestion to absorb the fat-soluble vitamins A, D, E, and K. Without fat, these valuable vitamins will be lost!

In the 1960s, Today,

• Fats and oils supplied Americans with ~ 45% of calories

• ~ 13% of adults were obese • < 1% had type 2 diabetes

• Americans consume ~ 33% of calories from fats and oils

• 34% of adults are obese • 11% have diabetes, most with type

2 diabetes

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So…how much fat do I need?

Fat should make up about 25% to 30% of our total

energy intake. Based on a typical 2000kcal diet, the

total fat allowance is about 55 – 65g a day. It’s easy

to exceed this allowance if one is not mindful – if

you have a curry puff for breakfast, a bowl of laksa

for lunch and a plate of chicken rice for dinner,

you would have already consumed 70g of fat.

Opt for more “good” fats, such as:• monounsaturated fat (from olives and avocado) • omega-3 polyunsaturated fat (from oily fish, walnuts and linseed) • omega-6 polyunsaturated fat (from fish, linseed, margarine and

sunflower oil)

The amount of fat we eat does not impact our weight,

cholesterol levels, or risk of heart disease, nearly as much as what kind of fat we eat. Most unsaturated

fats – found in vegetable oils, avocados and peanuts – are good for you, but saturated

fats are bad in excess.

DO YOU FEEL an urge to munch on something whenever you sit down to unwind in front of the TV? Does stress send you into an insatiable frenzy for a chocolate bar? Can you choose a salad over fried chicken? Find out how much self-control you have over your eating habits!1. What are the drinks and

snacks that typically sit on your desk at work?

a. A bottle of water, no snacks, but I keep a jar of baked almonds or a muesli bar in my drawer if I feel peckish or miss breakfast.

b. Nothing. I drink water from the water cooler whenever I feel thirsty.

c. Water/a soft or caffeinated drink (for an afternoon pick-me-up) and yummy butter cookies that the cleaning aunty kindly brought for everyone.

d. No space for those chocolate bars and packets of crisps on the desk! They’re stashed away in my emergency rations drawer.

2. You’re at a buffet. How do you help yourself to the food?

a. Finish a hearty serving of salad before moving on to the hot foods. I’m usually done in two rounds – I don’t have much room left for dessert.

b. Order á la carte. Buffets aren’t my thing.

c. Try to make space for everything! My plate usually ends up looking like a sloppy Leaning Tower of Pisa.

d. The kiasu Singaporean in me is ignited! I create my own mini buffet by taking platefuls of every single item. Better take more of my favourite dishes before others do!

Are you a

What your food habits say about you

by Sylvy Soh

self-controlguru?

Now score yourself!

3. Your boss unexpectedly assigns you not one, but two major work assignments on top of your already heavy workload. How do you react?

a. Groan inwardly and grouse about the news to a trustworthy colleague.

b. Groan inwardly and get down to work.

c. Stomp out for a second tea break. You’re gonna need more coffee – and maybe a few slices of kaya and butter toast – to fuel up for the long night ahead. A chocolate bar for good measure wouldn’t hurt either.

d. Ransack the pantry. There’s bound to be something in there... oh wait, there’s my emergency stash of snacks too. Life is hard, why suffer more by not indulging?

a – 4 points b – 3 points c – 2 points d – 1 point

If you scored…16 – 20 points: Congratulations, you’ve got this self-control act down pat! While you’re good at managing your food cravings, you know when to indulge and let loose too. Food is your friend: you make mostly healthy choices because you know what’s good for your body.

10 – 15 points:Aren’t you the guru! Your impeccable ability to control your urges (if you have any at all) is great, but it’s ok to lighten up at times. If snacking isn’t your thing, make sure you’re eating enough at mealtimes, and that your meals are well-balanced. Opt to have small meals throughout the day so your blood sugar doesn’t dip too drastically, or have low GI snacks like almonds, bananas or wholemeal biscuits.

5 – 9 points:Ah, this probably describes most of us; we use food to satiate our emotions. It wouldn’t hurt to practice some restraint – and discernment – in your food choices. Learn to feed your body what it needs when it needs it, not what it craves as and when. Don’t keep unhealthy snacks within easy reach. Don’t pile food on your plate, because you’ll probably end up eating more than you should. To cope with stress without resorting to eating, drink up! Water keeps you hydrated and your cortisol levels in check (cortisol is the hormone responsible for feelings of stress). You’ll be less hungry too.

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Pop Quiz4. You’ve resolved to shed

a few pounds. Your friends suggest the latest Korean fried chicken joint for dinner. How do you respond?

a. Say you’re on a diet, and suggest a place with a variety of food choices so you can have a healthier meal.

b. Tell them flatly you’re on a diet, and that you’d rather not meet them at all.

c. Tell yourself “There’s always tomorrow!” and gleefully go along.

d. Call the restaurant to order the biggest platter in advance so you don’t have to wait. Come on, it’s fried chicken!

5. What comes to mind when you think of a snack?

a. Plenty! So many good food choices, like blueberries, dark chocolate, baked nuts, and granola. Sometimes, I feel naughty and indulge in my favourite potato crisps.

b. Snacks are for the weak. I thrive on a strict three-meal regime, no more, no less.

c. Anything that is salty or sweet, depending on my mood. Why not have the best of both worlds?

d. Why think about it when you can actually have it? I’m ahead of you on this one, dude. Remember my emergency stash?

Ahem! Attention please! If you’ve been on a

coughing roll and aren’t sure why, check out this list of oft-seen offenders.

Common Culprits of CoughsThere are two types of coughs

– productive and non-productive.

Productive coughs (or wet coughs) are

so-called because they produce phlegm, which

either drains from the nose down the throat (mucus), or

comes up from the lungs. A productive cough is your body’s way of getting rid of the

phlegm, so cough it up!

Causes of Productive Coughs• Viral illnesses, such as the common cold. Mucus

from the nose drips down the back of the throat.

• Infections, such as infection of the lungs or upper respiratory passages

• Chronic lung disease • Reflux from stomach acid – this is a possible

symptom of gastroesophageal reflux disease (GERD)

• Nasal discharge• Smoking – this is a common sign of lung damage or

throat irritation

Non-productive coughs, on the other hand, do not produce phlegm. They are hence also known as dry coughs and have the characteristic ‘hacking’ sound.

Causes of Non-Productive Coughs• Viral illnesses – a non-productive cough may linger

after other symptoms have cleared• Bronchospasm or spasms in the bronchial tubes

caused by irritation• Allergies such as allergic rhinitis• Breathing in environmental dust and

chemicals• Asthma• Certain medications,

such as for high blood pressure and allergies

Combat That Cough!Here are some tricks to try if you’re treating that cough at home:

1. Drink UpKeeping yourself hydrated helps with both wet and dry coughs. The extra fluids thin out the mucus or phlegm as well as keep your mucous membranes moist – a good idea when the weather is dry. So keep a bottle of water handy.

2. Suck It UpNumb your throat by sucking on a menthol lozenge. This will decrease your urge to cough to get rid of irritation. Another way to soothe your itchy throat is to sip warm tea with some honey in it.

3. Steam It UpTake a hot shower. You’ll definitely feel better after one – steam loosens mucus and phlegm. Alternatively, use a humidifier to keep your air from getting too dry, but be sure to keep it clean!

4. Clean It UpClear your air of scented products such as perfumes and sprays. Stop smoking, or if you’re a non-smoker, take care to avoid second-hand smoke.

5. Take MedicationsWhat else can you do if all of the above aren’t working

for you? Well, sometimes you just have to take your medicine. There are many over-

the-counter medicines that can help ease coughs. These are

mainly decongestants which work by clearing

your airways of mucus, cough

suppressants which help to soothe throat irritation, and expectorants which make mucus thinner and hence easier to cough up or

expel.

You should see your doctor

if your coughing spell goes on for

more than a month, or if you experience other

symptoms such as consistent weight loss or extreme tiredness.

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A productive cough is your body’s way of getting rid of the

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It’s your Move Get a jump on joint pain

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Let your body blossom

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How you look reflects the state of your health. When your body is out of balance, it shows – your skin looks dull and haggard, your hair becomes dry and your nails get brittle. Like a delicate flower, your body requires the right nourishment, protection and care to thrive.

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ew Year, new look! Begin the year with

a fresh outlook – erase skin imperfections with

Thermage, a facial treatment that targets specific problem areas. We talk to Dr Tan Tyng Yuan, Clinic Director of The Aesthetics and Hair Clinic, on this transformative treatment. Now you can put your best face forward and take on 2015!

How does Thermage work?Dr Tan: Thermage is a non-surgical radiofrequency treatment that works by stimulating our own body collagen. As we age, our body collagen gets depleted and gives rise to wrinkles and sagging jawlines, neck lines and nasolabial lines (‘laugh lines’). Thermage helps to firm and lift the face and also smooth out the fine lines.

Can I go for Thermage if I have sensitive skin?

Dr Tan: In general, Thermage is a very safe treatment on sensitive skin, but do consult a doctor who carries out the procedure to evaluate your suitability.

Will there be any pain or discomfort during the procedure?Dr Tan: There is minimal discomfort with the procedure, which is made more comfortable by the application of a numbing cream beforehand. You will feel cooling and heating sensations during the procedure, and your physician will adjust the heat level for your comfort. Your skin may have a slight redness after the procedure, but you can resume your normal activities immediately after your treatment.

What results can I expect to see?Dr Tan: Thermage gives more definition to the jawline, improves saggy jowls, decreases the

appearance of nasolabial folds and eyebags and also smooths out neck lines and fine wrinkles.

How soon can I see results?Dr Tan: You can see the results anytime from immediately after the treatment to six months after the treatment.

How long will results last?Dr Tan: The effects of just one treatment continue to improve for up to six months after the procedure. The results last for up to two years and the treatment can be repeated yearly.

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Living Things and Their Life Processes

1C h a p t e r

Naughty Ari has been giving his milk to the plant!

Do you think the milk actually helped the plant to grow?

Well Ari, if you haven’t been drinking your milk, what have

you been doing with it?

What’s In This Chapter?

What Will I Learn?

I will:1. Know the life processes that humans and other animals undergo. 2. Understand that all animals need air, water and food to stay alive. 3. Know the life processes that plants undergo. 4. Be able to describe the differences between living and non-living

things using my knowledge of life processes.

Things

Life processes

Non-livingLiving

not ab

le to

carry

out

can be can be

able to carry out

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Biology

2

What Are the Life Processes in Humans and Other Animals?

Let’s do a show-and-tell! Bring a pet to school if you have one, or a photo of your pet. Share with your friends what you have learnt and noticed about your pet.

Here are some things you can share:

it recognises you?

if it does not get enough food or water?

Now you have heard your friends share about their pets.

babies have the same needs?

Observing, CommunicatingSkills!

Build Y

our

My pet moves about a lot,

just like me!

My pet loves to eat, just like me!

Hmmm... Rita, Ari, their pets and all of us are alike in some ways. We carry out similar activities every day! What do you

think these activities are?

The next time you visit a zoo, farm or national park, watch what the animals are doing. You may notice that some of the things they do are similar to the things you do!

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Living Things and Their Life Processes

1Chapter

Just like humans, animals carry out activities every day. Most of these activities are important to keep living

life processes.

Life processes include nutrition, movement, growth, sensitivity, respiration, excretion and reproduction.

NutritionLiving things need nutrition. Nutrition simply means eating! The food and water taken in by animals are converted to energy. Animals need energy to move and grow.

These giraffes get their food from tree leaves and water from streams or rivers.

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Biology

4

This bear has just caught a fish for lunch!

This crab is hiding in a hole in the sand.

This mouse is running from a cat. The cat wants to catch the mouse!

MovementHumans and other animals can move on their own. They require energy to move.

movement important?

to escape from danger.

Think about how you look for food, look for shelter and escape from danger in your daily life. Can you think of any other reasons why living things move? Discuss this with your friends.

Skills!Build

Your

Analysing, Communicating

Activity 1: How Do I Survive?Activity 2: Move It!

>> Workbook Activity

to look for food.

to look for shelter.

This girl is reaching up to pick a fruit from a tree.

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Living Things and Their Life Processes

1Chapter

1

You are given a challenge to survive on a faraway deserted island for seven days.

You are given a list of things that you can choose to bring with you.

a. Study the things in the list below and colour the stars below each thing according to how important it is in helping you survive on the island.

Not important — do not colour any stars Important — color one star Very important — colour two stars

Name: Class: Date:

Activity1 How Do I Survive?

Process skills: Comparing, Evaluating What do you need

to stay alive?

Things you may choose to bring

Pillow Fork and spoon Canned food

A story book 20 litres of water

Extra clothes

My favourite toy A picnic blanket Computer games

Matches and candles A chair Photographs of my family

Living Things and Their Life Processes

2 Chapter 1

b. From the list in ‘a’, choose the three most important things that will help you survive on the island. Explain why you chose them.

The things I will bring with me are... I chose this thing because...

1.

2.

3.

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