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Hi @hojichatealatte 
The recurrence of the lesion on ur middle finger seems disturbing. I would advice seeing a doctor to confirm the diagnosis as it sounds like it is a wart versus callus however it is best for a doctor to see the lesion and confirm the diagnosis.  
Dr. Jeanel G
In the absence of Covid-19, sewage is usually considered odorous in general. It should be not a major concern with regards to increasing your risk of exposure to covid-19. 
Dr. Jeanel G
space doctor
Dear @Placesfaces thank you for your question! It must be difficult for your to continue your lifestyle given such disruptive sleep patterns. 

Unfortunately poor sleep can have a wide variety of causes though most cases are physiological/environmental compared to organic causes (i.e medical related illness). After eating massive meals the body does tend to become more "relaxed" or what we refer to as a "post-prandial state" which could explain why you are able to sleep better. Though this may be the case, I would not recommend having large meals and then immediately lying down/sleeping as this can potentially lead to troubling gastric related problems. If you do this, do remember to lie down after at least 1-2 hours to prevent gastric complications. 

Further, there have been multiple studies on Vitamin B itself (as a supplement) and unfortunately there isn't any conclusive data to say that it can help with insomnia. Though, low levels of vitamin B can lead to significant weakness/tiredness instead. So I can't really comment on why your sleep was better when you first started taking vitamin B. Perhaps there were other factors during this time that went unnoticed ? 

In general, it is important to rule out organic causes for poor sleep. The most common would be sleep apnea. Do you frequently wake up choking? Does your husband notice you snoring a lot and occasionally catching your breath at night? These are some questions that a doctor may ask to ascertain a potential medical cause. Other common causes include stress/anxiety/depression which can come with other unnoticed symptoms. It is also frequent in people who tend to work shifts. 

As this seems to be bothering you for a long period of time, I would recommend you consult your doctor as soon as you are able. Most medication available are merely temporizing and I would not recommend long term use for sleep unless prescribed by a psychiatrist. You could try some simple medication such as melatonin (can be bought over counter) as it has shown some benefits for sleep and has no addictive potential.  
Dr. Adnaan S
space doctor
Hi, 
I'm not a doctor but what you have sounded like UTI, better go and check it will damage your kidney if you don't. 
@Marina
Dear @Kevin . Thank you for your question! It does sound like a troubling time for you; I do hope that everything remains well for you and your family especially with the number of cases in America. 

I would say that it is appropriate for you to sleep in a spare bedroom. Beyond that ensure to always use gloves when you are working, wash your hands thoroughly during working hours as well as before you leave for home and before you enter your house. It would not be out of the question to even shower before going home. As it has been found that a small proportion of people can remain asymptomatic with the virus and still spread it around, it would not be out of the question to stay somewhere else entirely. It would be best to limit your contact with your wife and especially your younger child. Though the number of serious cases amongst children have not been very high, they are at higher risk given their physiological state (poorer reserves) compared to adults.  

These measures are necessary as COVID tends to linger on surfaces as they are unable to remain suspended in the air. Hence it is more likely for you to get it from touching an "infected surface" followed by touching your face or eyes/eating/sharing food or drinks with colleagues. I hope your company has thoroughly disinfected the premises as well. 

Wishing you and your family all the best!
Dr. Adnaan S
space doctor
Dear Tan, 

What you’re describing sounds like what we call a globus or sensation of something in the throat. There are various causes and indeed, it may be due to the recovering sore throat that you felt after GA, since it seems to be a new problem and given your recent history.

Other common causes include post nasal drip or  reflux . I would advise you to watch it for now if it is not causing you too much discomfort, difficulty breathing, eating or speaking. 

However, if it persists , it would be advisable to see a doctor or even do a nasoendoscopy (can be done as a quick bedside procedure in a clinic by ENT Doctors) to have a look. Just in case there are dangerous causes. 

Hope you get better! 
Dr. R T
Hi @Tofifee yes belly fat and measures such as waist circumference (WC) have described associations with body mass index (BMI) and abdominal obesity (AO). These translate to poor long-term health (TL;DR for the medical jargon: increased long-term risk of mortality and metabolic syndrome-related conditions such as heart disease). 

Therefore, there are plenty of health reasons to address this. Fortunately, you are young and have the opportunity to gradually work on this issue over time. Unless you have any underlying medical issues, I would start with dietary modifications to increase fruits/vegetables and decrease oily food/animal fat. If possible, incorporating some exercise in your daily routine 3-5 times a week would also be helpful, perhaps regular sessions with your friends at the gym, cycling, or group activities like team sports.

I understand you are also concerned about the cosmetic aspect of this issue. There are certainly options such as "fat freeze" which will depend on your body profile - you can speak about this in greater detail with an Aesthetic physician. However, these procedures have not been proven to help address the underlying health risks associated with this problem. Therefore, given your young age, my recommendation would be to give the diet and activity modifications a good try as these will also improve your overall health, even if you chose to proceed with cosmetic procedures in tandem.
Dr. Dinesh G
Hi @Concerned thats a common question! The warmer temperature in Singapore this past week is a possible cause if you may have been outdoors or perspiring from activity often. Other common causes include changes in diet, perhaps if you may have been consuming more preserved food with all the social distancing measures in place. That being said, with the gastric and bloating issues, are there other symptoms like loose stools or giddiness? Other possible underlying conditions that are less likely include early onset diabetes.

If there are no other symptoms and you feel otherwise well, you may want to consider hydration and rest to observe for some time. However, if you are having other symptoms such as those highlighted above, or if the thirst/ gastric symptoms persist or progresses, you should have a physical review with a doctor. One of the tests they may consider is a fasting blood glucose test. So if you do proceed for a review, try to see them early in the morning and fast for 8 hours from the night before (avoid oral food/drink intake apart from plain water) in case they assess you and determine that you may need to go for testing.


Dr. Dinesh G
Dear someone, covid-19 may present with mild symptoms initially. If you still feel unwell after 5 days of MC and still has some runny nose symptoms. It will be advisable to visit the same doctor who saw you previously. Do call for 995 if you have any breathing difficulty. Hope this helps.
Dr. Yan Y T
space doctor
Hi @Lucas great question! Unfortunately, this is untrue and there is no basis for that recommendation. The modelling techniques are flawed and do not reflect real-world events as they unfold, as techniques like these are purely experimental. Whereas in the real-world, there are many other considerations and factors influencing behaviour that can affect the epidemiologic "curve" and behavioural responses to measures like Quarrantine.

Such an extensive, and prolonged quarrantine  can have many unintended effects. For example, it may place many casual workers and daily-wage individuals in a desperate financial situation, in which they may choose to overlook symptoms and continue working in an effort to feed families (presenting late - spreading to more people along the way). This will be detrimental to essential public health efforts such as contact tracing to fight the infection.

Ultimately, public health measures (like quarrantine/social distancing) are most essential to "flatten the curve" - that is primarily to reduce the RATE of new infections and not the NET NUMBER when the former gets too high. The reason for this is that health systems have fixed capacity to attend to cases at any one time. If the RATE is too high i.e. people are disseminating the infections quickly and the new cases are presenting quickly and all at the same time, healthcare services will be quickly overwhelmed.

To achieve their intended effect, public health measures need to be tailored based on many factors about the target population, some of which may be dynamic in the context of an unfolding outbreak (e.g. daily inter-city transport/mobility of the population, capacity of existing healthcare services, availability of financial support, proportion of incident cases identified through contact tracing, etc). Quarrantine is a targeted measure to reduce spread from high risk individuals, however more evidence is required to justify prolonging beyond the 2 weeks, given the potential detrimental effects of extended quarrantines. More important is for individuals to be empowered in being responsible and present early to medical professionals once they are symptomatic.

For instance, quarrantine measures or even a temporary lockdown for the duration of 2 weeks (covering the incubation period reported in over 90% of reported cases) applied at the time that infections are rising quickly can be a timely response to help to reduce the RATE of infection and thereby the speed of incident cases as they turn symptomatic in the following two weeks, in certain populations. These can help to regulate the case load such that the health system would be better positioned to attend to those that are falling ill. More about this at this link: https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section11.html
Dr. Dinesh G
space doctor
Hi @lynn . Thank you for your question!

I would say that you should definitely go down to see your GP. It is important to establish a timeline in cases where we are suspecting a possible drug allergy. In general, rashes relating to allergies can occur anytime between 24-72 hours after ingestion of the offending agent. In rare cases, a medication of which you previously had no allergy against can cause an allergy only a few months after. 

In this situation i would recommend review for 2 reasons
(a) If related to metformin it would require your to stop and possibly change to another drug temporarily (depending on the severity of your diabetes) 
(b) Itchy rashes around the breast or any skin folds can often be mistaken for allergies and can turn out to be bacterial/fungal infections instead or a form of eczema. Given that you are diabetic, you are at higher risk for these easily treatable skin infections. 

At times it may be difficult to discern if the rash is related to a drug or infection and most physicians would consider stopping the drug and treating at the same time. 

If Any alarm symptoms for severe allergy are present such as difficulty breathing/throat swelling/extreme eye swelling or hand/leg swelling/palpitations/chest pain, please go directly to the AnE for management as these could be suggestion of anaphylaxis (severe allergy) 

hope this helps!
Dr. Adnaan S
space doctor
Hi @Stefsz . Thanks for your question! It is definitely a concern and quite interesting. 

In general I would say that you should practice good hygiene and possibly choose to disinfect the box/container/goods even if you receive them for a local supplier. Packages often go through the hands of multiple people and can be considered as a vector for transmission (fomites). As per CDC recommendations, COVID droplets are too heavy to be suspended in the air and tend to drop onto surfaces. Hence if someone was unwell while handling you package, it is possible for it to act as a vector for transmission theoretically. However given that this is often an unsuited environment for the bacteria to remain, the risk is much lower. Unfortunately the duration that COVID remains on surfaces is difficult to determine and can range from a few hours to several days. 

Overall, practice good hand hygiene, do not touch your face when handling the product initially and be sure to dispose of the boxes appropriately and you should be good to go!

Hope this helps! 
Dr. Adnaan S
space doctor
Hi @Terrific4 thats a terrific question. Currently, front-line healthcare workers like myself are reusing masks on the basis of CDC's guidelines. The type with the elastic band that slips around the ear can be safely reused as long as it is not damp/ wet/ soiled. As an added precaution, avoid touching the mask and wash your hands thoroughly after handling it if and when you need to.

More information about this here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html

Hope this helps, and stay safe!
Dr. Dinesh G
space doctor
Hi @Mia , thanks for your question! 

I would say any symptoms of flu like illness should be evaluated by your doctor given the current situation. More so if you feel you are at higher risk I.e going out frequently/sick contacts/travel outside Sg or to high risk areas in Singapore.  I would advise against self medicating in the current climate. Also sore throat and shoulder pain are rarely linked and may present as separate issues ! 

Hope this helps! 
Dr. Adnaan S
space doctor
Hi @Jm , thanks for your question! 

From your explanation about your symptoms it does seem possible to be related to a form of reflux especially if it is lasting for such a long duration. To be honest what I find more concerning is that you are having loose stools persistently as well (I assume this happens several times a day). I would say your constitution of symptoms would require another review to look for other possibilities. Even more so if you have a significant family history of cancers/gastric issues such as IBD/IBS. At present it does sound like you are still able to carry out your daily activities though it is bothering you. Your GP may come wider referring you for a scope at a gastroenterologist. 

In terms of the gastric Illness, I do not see any alarming features that would warrant urgent ANE review which includes things such as vomiting blood/black tarry stools/bloody stools/significant abdominal pain/alternating bowel habits. 

Having said that given you are having persistent blocked nose in top of your throat itching cough and phlegm, this is inconsistent with a diagnosis of reflux (unless u have a history of sinus). Please discuss with your family doctor (after a physical exam) if there is an indication to send u for COVID testing! 

Hope this helps!  
Dr. Adnaan S
space doctor
Hi @GTH thank you for the questions here!

With respect to the cough issue, it does sound like reflux is the likely cause. However, given the failure of therapy you should have a review with a GP or consider a specialist to explore further testing. There are some causes of chronic cough that can progress and become debilitating if not addressed at the early stage. You could save some time to decide the best possible course of action throughh a detailed discussion using telemedicine - more on this here: https://www.todayonline.com/brand-spotlight/doctor-will-see-you-next-app

With respect to the left sided pain, this can have many possible causes from muscular strain to diving issues like the “bends” depending on the methods and depth of practice. I would recommend to review with a GP in-person for this (given that should any issue become severe while diving it could rapidly result in an emergency) so they can examine your abdomen/bladder and hip to determine if there are any issues that could impact diving.
Dr. Dinesh G
space doctor
Hi @BusinessJing unrelated clusters is consistent with the level of spread that has been announced. Fortunately for us in Singapore, the authorities have been very proactive about contact tracing, and our peers have readily adopted social distancing and hygiene measures which greatly helps to suppress the spread. Shampoo/soap are antiseptic substances that can be used to kill the virus, and therefore protect you in that situation.

In terms of the latest evidence - there is only proof of spread by respiratory droplets which can get into the body directly/indirectly via mucus membranes such as the mouth/nose/eyes. CDC has confirmed that there is no airborne spread as they are too heavy to remain suspended in the air and drop onto surfaces. This indirect spread occurs through contact of contaminated surfaces/items ("fomites") as you alluded to, or direct through projection when someone coughs or sneezes.

Therefore it is imperative to practice social distancing/hygiene, and for those that have such symptoms to wear masks to protect those around them. More information about this is available on MOH's health advisory and FAQ here: https://www.moh.gov.sg/covid-19/faqs
Dr. Dinesh G
space doctor
Hi @NIG . Thanks for your question!

In this situation if his symptoms are improved I would say it is alright for him to return to school. Given the onset of symptoms from last thursday, he would have been given 5 days MC if he saw a doctor which means it would have lasted until today (tuesday, return to school on wednesday). Though if he still has a slight cough, it may be prudent to bring him to see a doctor to get an MC for the next few days (given the current COVID situation).  Overall, the progression of his symptoms sound quite typical of the general flu at present. Hope this helps! 

Dr. Adnaan S
space doctor
Hi @NIG . Thank you for your question!

In this scenario it would be prudent to see a doctor for full examination. Patients often don't realise if they have weakness if it is very slight and this would usually require examination by a physician. Though, given the activity that you think might have caused it, it sounds very unlikely that there could be a nerve injury involved or at worst maybe a mild compression of one of the small branches of the nerve from pressure. 

Best to see a doctor early if it is bothering you for some reassurance! Hope this helps!
Dr. Adnaan S
space doctor
Hi @Suzanna, if your passenger was tested positive for COVID recently after coming into contact with you in your car, in view of the close and enclosed proximity there is a chance you may have caught the virus especially without wearing a mask. I strongly recommend adopting the precautions of social distancing/ hand wash/ wear a mask and to see a doctor immediately if you feel unwell. If the time period between the diagnosis and your contact with the patient was recent enough, you should have been contact traced too for quarantine 
Dr. Bryan K
space doctor