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

Dear MaxyyLush. Thank you for your question. The vaginal area felt sore likely due to friction from the fingering. However it is hard for us to advise further as it is hard to interpret " did some things together".  The abdominal discomfort and loose stools the day after the sleep over can possibly be due to gastroenteritis or a result of other activities performed. I would suggest a private consultation with a doctor and physical examination to be performed to evaluate you better. Hope this helps.

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 @mrhealth, sounds like your back aches specifically come after carrying weights and resolves shortly with rest. In that sense, sounds like your back aches are acute in nature. Icing tends to work for acute injuries and could help in your case. 

Having said that, I would recommend that you get a proper check up for your back. Sometimes, the back aches you may be experiencing may be due to a less than ideal posture or inappropriate way of carrying the weights. Simple advice after a proper check up by a healthcare professional can help to uphold the long term health of your back!

Hi @SportsBoy, there are multiple causes of knee pain which occurs after running. The most common knee pain generators after running for young people include the knee cap, the menisci of the knee or some of the tendons around the knee joint. Acupuncture may only be useful for some of these conditions. 

Specific to acupuncture, my recommendation is to get your knee checked either by a qualified medical doctor or acupuncturist and let them determine if your knee condition is something which can be truly treated by acupuncture. A thorough assessment will include a proper history and physical examination. Sometimes, it may include some radiological tests as well. 

Based on the clinical diagnosis, sometimes, there may be other simple solutions which they may recommend, which can even include specific stretching and strengthening exercises!

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 @jeryzzz,

Thank you for your question! The pain must be very worrying for you. Firstly, carpal tunnel syndrome is a clinical diagnosis which is made after a clinical evaluation by a doctor. If the pain is severe and affecting your function, we would recommend that you consult a physician as soon as possible.

Carpal tunnel can be caused by repetitive strain on your wrist, causing compression on a nerve known as the median nerve. In diagnosing carpal tunnel syndrome, the distribution of pain and numbness, as well as the type of hand actions that are restricted/ weak are important clues in determining if the problem is really caused by the median nerve.

Other conditions to rule out includes nerve root compression from your neck, causing a shooting pain down your arm to your neck.

Given the severity of the pain and its impact on your function, we recommend that you consult a doctor as soon as you can to confirm the cause of the problem, so that you can be referred to receive the management you need.

During your consultation, as mentioned above, do note the distribution of the pain, types of actions that are limited, as well as exacerbating factors of the pain and provide these information to your doctor as it may assist him/her in getting a clearer clinical picture.

We hope this helps, and all the best!

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.

Hi Tofu_Biscuit. Thank you for your question. You might wish to consider increase the intensity and frequency of your weights training progressively. You might wish to reduce carbohydrate intake and increase your protein intake as these are building blocks for muscles. Hope this helps.

Stomach aches can be causes by a variety of disease processes. In our local context in Southeast Asia, the most common causes of stomach aches include gastroenteritis, gastritis and constipation. Dangerous causes of stomach aches can include appendicitis or a perforated organ in the abdomen or pelvis. 

Certain medicated oils may relieve stomach ache as a symptom. However, it will not resolve the underlying issue which is more important. If the stomach aches are severe, persistent or excessively frequent, it is advisable to visit a medical practitioner for a proper assessment and recommendations on the next steps of action. 

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 @palmer , thank you for your question!

This is definitely one of the more recent debates regarding COVID. Unfortunately there isn't enough information available for us to definitively say that the infections in Beijing are a result of salmon imports. It is largely a possibility. As stated in the article, the virus itself was found on chopping boards in the market which, in all honesty, could have come from the population itself. Once more information is available then we can probably get a better idea of safety. 

The virus itself has not shown definitive cross species infection to fish thus far so I would say it is unlikely that it would spread from humans to fish and then back to humans. 

If you're really worried, then I would advise just to stay away from Salmon imported from Europe. 

Hope this helps!

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