Hi @AmberD. Thank you for the interesting question. For ear infections, evidence supporting alternative therapies is limited. There are some suggestions that acupuncture may help with ear fluid clearance and hence resolution of ear infections, but these are merely postulations and have not been proven conclusively yet. Also, you may want to avoid ear candling, as there have adverse events reported from this practice.  

Antibiotics are indeed effective for clearing ear infections but there are side effects as you mentioned. You may consider non-quinolone based topical ear drop antibiotics (if you have no other contraindications), as this is a topical treatment that avoids the complications of systemic treatment with oral antibiotics. 

Regardless of your eventual choice of treatment, it would be best to get your infection sorted out as soon as possible, even if you do not have much pain or symptoms currently. This is because serious complications can arise from prolonged untreated ear infections such as mastoiditis etc. 

Take care and all the best!

Hi @brainyCamel521, thank you for your question. There is some ongoing research on the use of alternative therapies such as herbal medicine and acupuncture etc in the treatment of colorectal cancer, but the evidence has been limited and equivocal so far. The best advice would be to continue regular follow up with CEA and periodic endoscopic surveillance assessments as advised by the specialist. All the best and hope your family member recovers well! 

Hi @ThankYou sorry to hear about your mother's ordeal! Unfortunately this is a condition she needs to seek a medical review with a doctor for early. It cannot be treated symptomatically until potential serious causes are excluded by an examination and further tests if needed. These causes include lymphedema, which can be an indication of problems affecting the lymph nodes that may progress/worsen if she delays. Please encourage her to at least go for a check up.

Hi, hypnosis is indeed a real science and some uses in fields such as pain management, psychosomatic problems etc. 

Hi @sickboiboi! Acupuncture is a safe and acceptable form of treatment for chronic back pain with no obvious anatomical origin of the pain. It can be used in conjunction in other forms of conservative orthopaedic treatment. 

If you have decided to consult an acupuncturist, it will be good to inform your primary treating medical practitioner that you will be starting on acupuncture treatment. All the best!

Hi @truffle2014 , congratulations on reaching 37 weeks of pregnancy! Almost there. The cervix examination is commonly done towards the end of pregnancy. The obstetrician does this to assess the condition of the cervix and see how soon the delivery will be.
37 weeks of pregnancy is considered full-term pregnancy. So you might go into labour any time from today till 40 weeks pregnancy.
Rest assured that the obstetrician will not induce labour by doing a cervix examination. Do share your concerns with your obstetrician at the next check-up. 

Dear Wenda, a person's baseline body temperature may fluctuate quite a bit, depending on time of day, activity level, where the temperature was taken and the type of thermomter used!  However, T 38 is a fever, and there are so many causes: maybe viral, bacterial infections, or even some forms of cancer. 

I would strongly advise that someone with a fever (especially now with Covid-19), to please check for the nearest PHPC clinic, and call ahead to make an appointment. The attending doctor will need to assess, take a history, do a physical examination, and then advise accordingly. 
Stay well!

https://www.gov.sg/article/i-am-showing-respiratory-symptoms-where-should-i-go

https://www.flugowhere.gov.sg/

Hi @cyeap this indicates sensitivity to light and possibly photophobia. If you experience this in association with fever or headache, you should go for a review with your doctor for an examination.

Otherwise, other possible causes include problems with your vision or inflammation in the eye. A review with an Optometrist or Ophthalmologist for an examination would be a good place to start to get to the bottom of it. Hope this helps!

Dear @curiousdaughter I am sorry to hear about your mum's condition.
For a more thorough answer, please accompany your mother to the next appointment with the medical oncologist (not the surgeon) and ask the doctors directly. (Disclaimer, I'm a surgeon!)

Briefly, Tamoxifen and Letrozole are both suitable medications for patients with ER+ breast cancer. Only Tamoxifen may be used in a woman who still has menses. Once a lady has stopped having any menses, the oncologist may continue the patient on Tamoxifen, or may recommend a switch to letrozole. 
There are other consideration to side effects of both medications, such as abnormal bleeding from the womb, clots in the deep veins of the legs and bone loss. 

Dear @jaey  I totally feel you! I have never managed to make time to exercise while I was in training to be a specialist. Now ironically, even though I'm busier with a young family, a private practice, and other professional work- I find that I need to MAKE time, to maintain some minimal fitness s I enter middle age.

Most healthcare organisations advise, 30 minutes of moderate exercise 5 days a week.

I think the challenge is how to fit that into a daily schedule. May I list down some ideas for you to consider? Examples-

1. Walk down and walk up flights of stairs (as many as you can tolerate) daily
2. Walk more- eg from MRT to office, from office to buy lunch
3. At the desk: stand up and stretch every hour or so, try doing 10 squats as well
4. At home, can do 10-20 burpees before dinner

Whatever you choose, start slow, and slowly build up as you gain more confidence. All the best in your fitness journey!

Hi @alexis , yes I would heartily recommend all young ladies like yourself to get a HPV vaccine. Cervical cancer is a common cancer in ladies. Thankfully with the advent of pap smears and HPV vaccine, the cervical cancer rates and associated death rate have come down. It is one of few cancers that can be prevented with a vaccine. The reason is that most cervical cancers are caused by HPV. Thus preventing HPV infection will greatly reduce your risk of cervical cancer in future.
So yes you should get it done!
When? As soon as you are ready! The best time to get vaccinated is actually before you become sexually active. This is the reason why the HPV vaccine is offered to Secondary School girls today, and is part of the national childhood immunisation schedule. But even if you are already sexually active, it is good to get the HPV vaccine as soon as possible.
The vaccine series consist of 3 doses given at 0, 2 and 6 months.
There are currently 3 types of HPV vaccine in Singapore - Cervarix, Gardasil 4 and Gardasil 9. They differ in the number of strains of HPV the vaccine confers protection against. Gardasil 9 gives the greatest protection. However it is also the most expensive and is currently not Medisave claimable. Do talk to your GP to discuss and find out more.
The below HealthHub site gives a good summary of HPV and cervical cancer prevention.
https://www.healthhub.sg/programmes/157/cervical-cancer-screening

Hi @sky9929, this is a very interesting question that you asked. Tinnitus is defined as perceiving sounds despite there being no external source. In that context, the symptoms that you describe are compatible with tinnitus. The problem with tinnitus, as you mentioned, is that the cause is often hard to find and even harder to treat. 

While there have been many studies done to evaluate the use of acupuncture in tinnitus, the evidence has been equivocal and not convincing. Having said that, it might be worthwhile to give it a try as acupuncture is relatively safe with few side effects and treatment options for tinnitus are limited anyway. 

Your neck spasms and shoulder pain might not necessarily be related to your tinnitus, but nonetheless, acupuncture can be helpful for such musculoskeletal conditions. All the best and take care! :)

Hi Michuang,

Thanks for your query. Kneecap pain is very common in active young people and tends to affect ladies quite commonly too. It’s usually due to increased pressure on the kneecap cartilage as well as slight mal-alignment of the kneecaps. Sometimes, an area of cartilage damage can occur too, and this tends to lead to increased fluid swelling in the knee. From your picture, the knee looks swollen so it might be good to get it checked out at an orthopedic/sports clinic. Generally so long as the cartilage damage is not too bad, treatment will involve some physiotherapy and perhaps some reduction in your jogging for a while. Glucosamine and collagen are common supplements that are taken and you can certainly take some if you like too.

Hope that helps!

Hi @genevieve! You are not alone! Up to 30% of the adult population have flat feet, or what is known as pes planus. It is basically a loss in the medial arch of the foot.

As the foot is everted (turned outwards) due to the loss of arch support, this can cause a whole host of problems from the misalignment of your kinetic chain in movements such as squatting, or landing

from jumps.

Physiotherapy may potentially improve your flatfoot, and increase your capacity for exercise with less pain. To do so, you’d have to strengthen the muscles involved in maintaining the arch of your foot, which may include a muscle called the tibialis posterior, as well as the intrinsic muscles in your foot. Do check out this video by AthleanX, which provides a great explanation of how flat feet affects your workouts, and some exercises you can do to strengthen the relevant muscles. (​https://www.youtube.com/watch?v=U2BFe od_JMk​)

Orthotics which provide adequate arch support can also be helpful in alleviating symptoms of pain. Thus, do take special care when choosing shoes to use for your exercise. You may wish to consult a podiatrist if you would like more advice on suitable orthotics to use.

Lastly, if your symptoms do not improve with conservative management, causing it to affect your lifestyle severely, you may wish to consult an orthopedic doctor and possibly explore other treatment options like surgery. Hope this helps!

Dear Kurtlockman. The clicking sound that you described is crepitus. Not all joint crepitus is related to underlying disease. However if the crepitus is associated with pain or swelling, it can be suggestive of joint damage. Hope this helps.

Dear Slid. Thank you for your question. It is possible to have breakthrough bleeding when you just get started on oral contraceptive pills. I will recommend starting the 2nd pack of your oral contraceptive pills on the first day of your menses and take your medication daily at about the same time. Please use barrier contraceptives for the first 2 months of oral contraceptives to prevent unplanned pregnancy. 

Hi @Sweet3 , thank you for your question!

Finger twitching is rather non specific but you are right that it can be signs of early disease or complications related to diabetes (though unlikely). Most causes are likely just related to stress/anxiety/food products(caffine containing)/minor muscular sprains. 

It would require a bit more history to determine the cause but given the relatively short duration, I would not be too worried of a serious medical cause for now. 

However, if it persists for a long duration (> a month) or sudden worsening (such as inability to control your movements, clumsiness of hands, loss of sensation, weakness) I would advise you to see your medical practitioner for as such a complaint would often require a full consult and examination of your neurological status (nerves) at the very least. 

Hope this helps for now! 

Hi @wolfie94 ,

These are very good questions and pertinent at this point in time.

An aedes mosquito becomes infected after it takes a blood meal from a dengue-infected person. It becomes infective after an extrinsic incubation period of 8 to 12 days. The mosquito then remains infective for the rest of its lifespan. 

When a person is bitten by an infective mosquito, they may develop symptoms after an intrinsic incubation period of 4 to 7 days (ranges from 3 to 14 days). This is what we usually call as incubation period. 

Notably, up to 75% of dengue infections are asymptomatic.

As always prevention is better than cure. Please Follow the 5 step mossie wipeout and let’s all do our part to reduce the transmission rate. 

Hi @Raji ,

Thank you for your question.

High blood pressure and high cholesterol are both risk factors for cardiovascular illnesses such as heart attacks and stroke.

There are ways to reduce the occurrence rate of this or effectively control both of these.

Lifestyle factors

1) at least 30 mins of moderate exercise per day, minimum 5 days a week ( total of about 150 mins)

2) reduce the intake foods which are deep fried, containing high amount trans-fat, salty food and red meat

3) increase the intake of fresh fruits and vegetables

4) maintain a healthy BMI

Other factors

1) annual check up of blood pressure, cholesterol and sugar levels 

2) if already diagnosed , to follow up with your doctors regularly and follow the advise given - medications or not.

Hope this helps 

@JohnnyDoe  thank you so much for your interest that your chest pain is heart disease or not. All kinds of chest pain is not heart disease. It is caused by hyperacidity or anxiety or other stress like condition.Even though if you are anaemic, you can feel palpitation also.If your age is 26 then your age is not favourable for heart disease rather than any congenital anomaly such as tetralogy of Fallot’s.
If you have confusion then you can do investigations of ECG /Echocardiogram,Lipid profile.
Your resting heart rate 70 beat /minute and during jumping 90/100 beat /minute is completely within normal physiological limit.
Stay safe and healthy. If you have further question,can ask.Thanks a lot again.