Hi @JgS. Thank you for your question. I hope your recovery has been smooth so far and it must be tough for you. 

You are right to say that Fixcom can cause dizziness as it is a combination medication. But I would say that what is concerning for me is that you feel you are having a hard time to read which can indicate issues with eyesight. As some of the components of Fixcom can cause issues with your eyesight which are potentially sight threatening, I would recommend you immediately have your vision evaluated in this scenario. 

Dizziness has an extremely broad range of possible causes other than medication induced/ related to hypertension and it is possible to be due to slightly raised blood pressure. I would say it is extremely uncommon for a young man to have high blood pressure and you should be evaluated if this is persistent. The best way is to get a machine of your own and check every morning and night for a week and show it to a doctor. A single isolated reading of high blood pressure is insufficient for the diagnosis of high blood pressure. 

So in summary, do get your eyesight checked and evaluated further for your high blood pressure. 

Hope this helps!

Please do reply as fast as you can!

Hi Rachel. It is important not to exert yourself by carrying heavy loads or vigorous activities. You can try rest your back by lying down or standing up. Avoid prolonged sitting as the pressure on the back is greater when you sit. You can try lie on a warm compress to try alleviate the back pain. 

Withholding medications and surgery, you might want consider pick up swimming as that will help strengthen your back muscles too. Hope this helps!

Hi @WaterCh3ese . Thank you for your question!

Based on your picture and the history you have given it doe seem suspicious of psoriasis. I would say you should see your GP for evaluation and perhaps consider a trial of steroid cream of calcineurin inhibitor creams (tacrolimus) and see if it improves. Other possibilities include some types of eczema and fungal infection it can also be a result of excessive scratching causing the skin to overgrow (may have started as a simple insect bite and progressed). 

The evaluation typically requires more history and examination for other similar rashes. If treatment fails, we would usually refer your to a dermatologist who may do a wood lamp examination together with some other tests. 

Hope this helps! 

Hi @anonymousgirl , some variations in period cycles are expected during periods of stress during exam periods for example, however they shouldn't be less than 21 days or more than 35 days on a regular basis, and there shouldn't be large variations (>2 weeks) between your longer and shorter cycles. These would be features that require further assessment and potentially investigations to rule-out possible causes such as thyroid disorder or polycystic ovarian syndrome (PCOS).

You may not have anything to worry about based on your cycle and that one-off incident alone, however given the accompanying thinning of hair, you would benefit from further assessment to be assured that there are no underlying reversible causes such as thyroid disorder. I would recommend for your to speak to your parents about this and arrange a review with your doctor for a more detailed assessment. I hope this helps!

Hi @brontosaurus this sounds like a long-standing and persistent condition that needs to be evaluated.

Some variations in period cycles are expected during periods of stress for example, however they shouldn't be less than 21 days or more than 35 days on a regular basis, and there shouldn't be large variations (>2 weeks) between your longer and shorter cycles. These are features that require further assessment and potentially investigations to rule-out possible causes such as thyroid disorder or polycystic ovarian syndrome (PCOS).

You may not have anything to worry about, however given that you have some of those abovementioned features requiring further assessment, I would recommend for your to speak to your parents and/or arrange a review with your doctor for a more detailed conversation about this. 

Hi @curiousdaughter , it is generally safe to take panadol to relieve your menstrual cramps. Panadol is a safe medication as long as you keep to the dosage indicated - usually 2 tablets 3 to 4 times a day as needed. Panadol is prescribed even to young babies with fever, so it is a safe medication!
Panadol Menstrual contains panadol (paracetamol) and this component called pamabrom. Pamabrom is a mild diuretic, meaning it helps to relieve some water retention and bloating that can come during menstruation.
If your menstrual cramps worsen, I will advise you to consult a doctor. 

Hi @curious_explorer sorry to hear about this! Yes, bee stings, or any irritant for the matter, can result in inflammation and aggravate eczema. That said, it is quite atypical for the effects of one-off exposures like these to persist for months.

You may want to have an in-depth review with your family physician or dermatologist that has been following up with you for this condition to try and assess why it may be worsening, or consider a video consultation online first to assess if you really need to make that trip down.

This can be done through one of the applications that provide medication delivery as well - more on this at this link: 
https://www.rafflesmedicalgroup.com/family-medicine/teleconsult

Dear Adena- braun. It is certainly frustrating to have an itchy and flaky scalp. You are likely to have eczema/ seborrhoeic dermatitis of  the scalp. They usually present with irritated, inflammed, red, itchy scalp.

You might wish to consider a change of shampoo to something gentle such as head and shoulder wash. Alternatively you may wish to consult a doctor and prescription medications such as anti fungal shampoo eg Pristine shampoo is useful for scalp eczema. Application of topical steroids such as clobetasol/ dermasone scalp lotion will also be useful for your condition. Lastly anti histamines such as cetirizine helps to reduce the itch.

You might find staying in air conditioned environment useful as hot and humid environment tends to trigger eczema and take note of any hair gel/ wax/ dye/ wash you apply to your hair/ scalp that could have irritated your scalp.

Hope this helps!

Hi @adena-braun , it is an interesting question. The term gynaecologist is sometimes understood differently by different people. The specialty itself is known as Obstetrics and Gynaecology (O&G). Obstetrics is the field of medicine dealing with pregnancy and childbirth. So when one is pregnant, she will consult a obstetrician.
A gynaecologist is a specialist dealing with problems related to menses, the womb, the ovaries and the woman genital area. So commonly, women will visit the gynaecologist for women problems like menstrual disorders, menopause, urinary incontinence, growths in the womb and ovaries etc.
To add on, since I am a family physician, many preventive women health issues are handled by family physicians - your friendly neighbourhood GP! Things like HPV vaccine to prevent cervical cancer, pap smear/HPV test to screen for early cervical cancer, oral hormonal contraception etc. Yes and of course we will assess your problem and discuss with you whether you need to be referred on to a gynaecologist - private or subsidized. Subsidized referrals to restructured hospitals (KKH/SGH/NUH) can be made via polyclinics or CHAS GPs (if you have a CHAS card of any colour).

Hi @gurlie, condoms are quoted in medical literature to be 98% effective in preventing pregnancy, provided they are used correctly. By correct usage, I mean that the condom has to be put on from the start to the end of sexual activity, including oral, anal and vaginal sex. Even before ejaculation, some semen might come out of the penis, so it is safer to put on the condom right at the beginning, and even if there is no penetration.
Condoms is not merely sufficient to prevent STDs. It is the only contraceptive that is effective in preventing STDs. All other methods - the oral contraceptive pill, arm implant, intrauterine device and injectable hormonal contraceptive do not prevent STDs.
To further decrease the chance of pregnancy, especially if there is penetration, you can use condoms together with another hormonal contraception.

Hi @mona0lisa! This certainly sounds like a problem which is causing alot of distress. Sometimes, people can experience certain parts of their bodies sweating more often (eg. palms, armpit, feet), or even 'generalised increased sweatiness'  just based on how one's body reacts to external stimuli. 

Specific to the feet, good foot hygiene is key! This would include ensuring proper washing of feet with soap every time a person takes a bath, thorough drying of feet, and sometimes even applying powder on the feet to absorb moisture (which can be from sweating). Wearing sandals and slippers can help at times as well. If your skin is sensitive to excessive sweating, this can cause itchiness. As such, proper

The problem is that when the feet are moist and warm, fungus and other microorganisms love to grow. We certainly do not want this situation to happen. So regular foot self-inspections can be helpful as well.

Itchiness can be mainly either due to the skin being too sensitive to excessive sweat and/or the presence of microorganisms/infections. As such, proper foot hygiene should be able to reduce at least some of the symptoms you are experiencing. If the symptoms remain persistent and/or are causing you significant distress, it will be advisable to seek attention from a medical doctor. 

Hi @mona0lisa I'm sorry to hear that this has troubled you! It is normal for there to be a slight odour, and for this to have slight variation throughout the menstrual cycle. An online search about this often yields results like vaginal douching or deodorants, however these products often cause more problems as they disrupt the body's protective mechanisms including the natural flora that help to ward off infections. Some rinsing of the external genital area with water and mild soap will suffice for regular care.

However, a strong odour or a "fishy smell", irritation, abnormal discharge, or pain/burning sensation are symptoms that can be indicative of more serious underlying problems. If ever in doubt, do have a review with your doctor for an examination to check for any potentially reversible causes that can be treated. Other considerations at your age include a HPV vaccination to reduce your risk of cancer, which you can also discuss with your doctor. This is most useful before you have your first sexual encounter, and you can find more information at this link: https://www.healthhub.sg/a-z/diseases-and-conditions/701/faqs-on-hpv-and-hpv-immunisation 

Hi @Flowerqueen that is not the case, there have not been any compelling evidence of this having an impact on future cycles. The main risks include transmission of certain infections, unplanned pregnancies, and others. Possible transmittable infections include HPV which can cause cervical cancer, and it would be good to have a HPV vaccination before the first sexual encounter. If this has been missed before the first encounter, there are options for 3 or 5 yearly screening based on age that one can consider. More about this at this link: https://www.healthhub.sg/a-z/diseases-and-conditions/701/faqs-on-hpv-and-hpv-immunisation Hope this helps!

Hi @demarcus thats an interesting question, and yes - infection/inflammation in the nasal passage can irritate the nerves in the area leading to activation of the sneezing reflex. Inflammation is mediated in part by the release of histamines, which can occur with mast cell activation. As you said, the histamine then triggers the release of other downstream inflammatory chemicals which together lead to vasodilation (increased blood flow) and immune/white blood cells in the blood stream being activated to the area.

If you're still curious to find out more about mast cells and histamine, heres a resource with more information:  
https://www.frontiersin.org/articles/10.3389/fimmu.2015.00620/full#:~:text=In%20the%20skin%2C%20antigens%2C%20via,this%20can%20lead%20to%20angioedema.

Dear @Xxx_ I'm a breast surgeon, but I can advise a bit on this common woman's health concern. From what you share, if recurrent, and you have seen several doctors, do make an appointment to see a gynaecologist. Off hand, I believe you will need a internal pelvic examination, maybe a PAP smear. Your doctor might also need to check for diabetes, and share tips on post-coital hygiene. Hope this helps!

Dear @cpqsa  I'm a breast surgeon, but I can advise a bit on this woman's health concern. From what you share, do make an appointment to see a urologist, or a uro-gynaecologist. Urge incontinence, or frequency has several causes- may be weak/sensitive bladder muscle, small stone, mild infection, or rarely, a kind of early bladder cancer. Off hand, I believe you will need some urine tests, and maybe even more specialist tests by the urologist. Your doctor might also need to check for diabetes.  If this info helps, I refer patients to Dr Shirley Bang, or Dr Tricia Kuo for such a condition. 

Hi @reed I'm sorry to hear about this! Yes you are right, these conditions can interact as the pattern of pain for these joints which are considered "weight bearing" often prompts the individual to adopt adaptive postures when standing/walking/exercising. While these relieve pain temporarily, they deviate from optimal biomechanics and can result in build of "over use"/strain related injuries or progression of underlying problems in other weight bearing joints in severe cases. 

In terms of determining what to do next, the progression in symptoms along with numbness/pain indicate potential worsening nerve impingement and requires a review with a trained orthopaedic specialist for an examination. It would be best to arrange a follow-up with your original doctor as they will be familiar with your condition. In the mean time until your review with them, do minimise strenuous activity and avoid carrying any heavy weights. Hope this helps!