For the first time in Singapore, doctors are able to treat a form of congenital heart defect without open heart surgery.

A specially designed heart valve is delivered into the patient via a leg vein near the groin instead to treat Tetralogy of Fallot, a defect that affects the functioning of the valve.

This procedure has been successfully carried out on two patients here since August by a team of congenital heart specialists from the National University Heart Centre, Singapore (NUHCS) and the department of paediatrics at National University Hospital (NUH).

In this minimally invasive procedure, doctors insert a thin, hollow tube containing the heart valve into the vein and push it up into the heart. The valve is crimped into a small size but expands with the help of a balloon once it is in the right position .

The procedure takes a few hours and helps to improve heart function so that the need for open heart surgery can be delayed.

Tetralogy of Fallot affects about two in 1,000 live births here. Among other problems, the defect affects the normal functioning of the pulmonary heart valve, which controls blood flow from the right chamber of the heart to the lungs.

While this defect can be picked up early during pregnancy, those born with the condition often have to undergo multiple surgical operations throughout their lifetime.

This is because a patient’s valve is usually replaced by a synthetic tube or blood vessel from a human cadaver early on in life, but this is prone to become leaky or narrowed due to wear and tear.

As a result, patients typically have to undergo a repeat surgical operation every 10 to 12 years, said Dr Edgar Tay, senior consultant at the department of cardiology at NUHCS.

“It (repeat surgery) is almost unavoidable because this is not nature’s gift of a normal vessel,” said Dr Tay, who added that the new procedure will reduce the risks of repeat surgery.

He said: “Patients’ families will tell you that it reduces the psychological stress of repeat surgery.”

Otherwise, patients would have to undergo two open heart surgical operations with the uncertainty about the outcome of the surgery, he added.

While the new procedure was first done in Singapore only in August, it was first performed in London in 2000.

Studies so far have shown good results. For instance, the valves of almost all patients who went through the procedure were free of leakages for up to five years.

While the new device costs $30,000, Associate Professor Quek Swee Chye, head and senior consultant of the division of paediatric cardiology at NUH, said he hopes the new treatment will prove to be cost-effective in the long run.

“If you look at the total package – with a shorter hospitalisation and costly device, it may still be cheaper than a long-term hospitalisation plus the expensive surgery and the manpower to look after the patient post-operatively,” he said.

“Hopefully if proven to be good, some day there will be subsidy from the ministry,” he added.

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One patient who has tried the new procedure is Mr Gary Cheng.

The 21-year-old underwent his first surgery to have his heart valve replaced when he was just two.

About a year ago, however, Dr Tay realised that his heart function had started to deteriorate.

As his parents were not keen for him to go for another surgery, he decided to go for the new procedure in August.

“The procedure wasn’t painful and I can resume my normal activities now,” said Mr Cheng, who is a trainee at a sheltered workshop at voluntary welfare organisation Movement for the Intellectually Disabled of Singapore.

He is now able to pursue recreational activities such as badminton, without worry that his heart might fail.

This article was first published on Nov 22, 2016.
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On November 18, The Straits Times reported that exports in Singapore had been disappointing in October 2016, with non-oil domestic exports sinking 12 per cent versus economists’ expectations of only a 3 per cent decline.

Coupled with the fact that on October 14, OCBC bank announced that Singapore’s economy slumped 4.1 per cent between July and August 2016, this raises the probability of Singapore tipping into a technical recession in the immediate term or even a full-blown recession in 2017.

When the working-class face uncertainty – consistently bombarded with stories of weaker growth outlooks, see their pay packets stagnate in the face of rising prices and start to fear for their job security – they will react by saving more for the future.

No one in the right mind would hope for a recession to occur as it brings about a period of slow-to-no growth and a lot of uncertainties for people and businesses. However, as more people start saving more and consuming less in the present, because they are fear for their futures, that is exactly what may happen – the economy spiraling into a self-fulfilling “recession”.

Often, before we reach experience the hard landing of a full-blown recession, there is a technical recession.

Remind me, what is a technical recession again?

To understand this, it is important to know how economists define technical recessions:

“An economy that experiences two consecutive quarters of negative economic growth as measured by a country’s GDP”

Singapore’s GDP at 1960 was $7.6 billion (based on market price). Fast-forward 55 years later it is $391.3 billion. That gives us a compounded annual growth rate (CAGR) of 7.3 per cent for the last 55 years.

Simply speaking, if you had put $1,000 into a bank account that gave you a CAGR rate of return of 7.3 per cent, after 55 years, you would have approximately $47,500 in your account. It’s quite staggering.

So can Singapore continue to growth indefinitely? Logically speaking, yes. As long as the human population is growing, investment capital is growing and there are technological improvements to increase productivity and spur innovation. This is, of course, contingent on Singapore continuing to produce goods and services with decent demand at the global stage.

Why is a technical recession indicator important to me?

This indicator forms the basis of how companies, big or small, plan their annual expenditure going forward. When the country is in technical recession, companies tend to head into their emergency room, brush the dust off their “let’s start restructuring our expenditure book” and implement cost cutting measures.

People who are in the following industries have got to be more concerned with this technical recession benchmark:

1. Manufacturing,

2. Construction,

3. Wholesale and retail trade, and

4. Accommodation and services.

What should I expect in this period of uncertainty?

Bonus

Once the economy hits technical recession mode, many companies will already be facing pressure to produce good results and even those that have done well will try to be more conservative and prudent. What all this means is that workers should not be optimistic over bonuses this year.

We can see it from two ways: Firstly, companies will say that it is a bad year and despite your stellar performance, we need to be conservative, or secondly, companies will just use the technical recession card to pull back bonus payouts.

Of course, we believe the former will outweigh the latter, hopefully, but that does not mitigate the fact that our pockets will be lighter this year.

Job security

If we look at Singapore’s headline unemployment rate, it is one of the lowest in the world. Something we should be proud of.

Nonetheless, if we look deeper into this, the area with lowest unemployment belong to the lower-skilled jobs. PMETs (professionals, managers, executives and technicians) are the ones facing the brunt of the disappointing economy. This is because labour in Singapore is really expensive and PMETs are usually the most expensive sort of labour.

With productivity still in the realms of uncertainty, we should all be prepared for potential headwinds ahead.

Is it easy to hire and fire labour in Singapore?

Unlike popular belief, firing labour is not as simple as it seems because it is expensive to hire or rehire, and no firms want to be in the bad books the Ministry of Manpower (MOM) or the workers’ union (NTUC).

If we try to think from an employer’s perspective, hiring is an extremely expensive activity, especially in Singapore. They have to first source for candidates, which may take them as long as one year to get the suitable person onboard. Even after hiring the best candidate, they need to take a bet that the person will deliver what is required. Lastly, companies cannot expect the person to come in and immediately deliver results. There will usually be a period of acclimatisation lasting a couple of months to get everything in place before the employee gets down to real work.

Of course, certain jobs have seasonal demands – such as increase in the demand for salespeople during Christmas period and the MOM/NTUC would not interfere with how a company operates. Nonetheless, they would provide advice and intermediate when it comes to the labour hire/fire practices.

What can we do in this period of uncertainty?

We try not to sound naggy when it comes to this issue, but we always encourage people to have at least six to 12 months of their monthly average expenditure in their bank deposits. This will enable us sail through periods of unexpected unemployment when it occurs.

What if we do not have one now? Do not worry, simply start saving now!

Remember, we do not need six to 12 months of our monthly salary, it is average expenditure – so hopefully we are not spending more than we earn, else we can never build this buffer required during rainy days.

DollarsAndSense.sg is a website that provides bite-sized and relevant articles to help Singaporeans make better financial decisions.

Madam Theresa Tok probably knows more about one Singapore shopping landmark than most.

She has been working in the same shop at the same mall since 1979.

The 57-year-old optician has seen Plaza Singapura (PS) undergo two major revamps during 42 years she has been there. And she’s still there for its latest new look.

“It used to have the nickname ‘Orchard Yaohan’ when Yaohan was still around,” said the 57-year-old.

“It was also a popular place for Japanese tourists back in the 90s. Nowadays, we see more local youngsters and families.”

ANNIVERSARY

To mark its 42nd anniversary, the mall is organising activities such as Bring Home a Piece of PS and showcasing a wall mural – a depiction of the history of the mall and the Dhoby Ghaut area.

The wall mural makes Madam Tok, who works at Paris Miki, nostalgic.

Farewell, Funan

Click on thumbnail to view photos. Source: 

The Straits Times, The New Paper, AsiaOne

While she thinks the mall looks more modern now, “I still prefer the previous exterior of the mall, which was more structured” she said.

“The new one is a little too wavy for me.”

How did she come to work there for so long? It was because of her customers, she said.

“I witnessed my customers grow from a kids to adults. It’s really heartwarming,” she said.

“Sometimes they would even wait one to two hours so that I could serve them.”

The mall, which was revamped recently, will conduct woodworking workshops for shoppers to create a hand-carved wooden trinket dish using recycled wood from the mall’s recent refurbishment efforts.

All shoppers need to qualify is a minimum of $30 in a single receipt.

This article was first published on November 22, 2016.
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KUALA LUMPUR – Malaysia’s central bank is expected to leave its benchmark rate unchanged on Wednesday, at its first policy meeting since Donald Trump’s win in the US presidential election battered the ringgit.

The ringgit has shed more than 5 per cent since his victory, hitting a 13-month low of 4.435 on Tuesday (Nov 22).

It also fell to its weakest level in since last September against the Singapore dollar, with one Singdollar fetching RM3.11, The Straits Times reported.

Bank Negara Malaysia (BNM) cut its overnight policy rate by 25 basis points to 3.00 per cent in July, and some analysts earlier expected another trim this year to try to boost weakening domestic demand. But the tumble in the ringgit since Trump’s win ensures no cut on Wednesday, they say.

Also read: Malaysia’s ringgit may keep tumbling amid the market’s Trump tantrum

All 13 economists polled by Reuters forecast no rate change on Wednesday, on concerns it would put more pressure on the ringgit.

HSBC thinks BNM is likely to cut the key rate by 25 basis points in the first quarter of 2017. “Low inflation, particularly over January and February, will provide scope for easing,” the bank said in a Nov. 18 research note.

July’s rate cut, the first in seven years, came less than two weeks after Britain’s Brexit vote.

The recent ringgit slump has overshadowed a surprise turnaround in Malaysia’s economy, which reported 4.3 per cent annual growth in July-September, ending a five-quarter decline in the expansion pace.

In January, the government trimmed the 2016 growth projection to 4.0-4.5 per cent from 4.0-5.0 per cent.

Nomura says BNM is likely leaning towards a possible 50 basis point cut to its statutory reserve requirement ratio (SRR) to deal with growing financial imbalance risks.

With the weakening ringgit, cutting the SRR is a “more viable option” than the benchmark, it said in a Nov. 21 note.

In January, BNM unexpectedly cut the SRR to 3.5 per cent from 4.0 per cent to add liquidity to the banking system.

The Royal Bank of Scotland (RBS) cautioned against an SRR cut on Wednesday. It said loan growth averaging 5.9 per cent over the first three quarters against overall deposit growth of 0.2 per cent “sets up conditions for a liquidity squeeze”.