Hi @Kai there are many possible causes of this and I would recommend a review with your family physician in-person, as they will need to examine you to narrow down possible causes to direct testing or treatment for you accordingly.

A hard lump in the breast is of concern.
I would advise you to consult a doctor for proper examination and evaluation. 

Good evening @BusinessJing this is not true. Although it may appear that the virus has varied lethality based on differing reports of patients (e.g. those from the west versus those in China/other parts of Asia), this may largely be due to the varying quality of operational responses (like contact tracing/ lockdowns) and healthcare systems (as what you alluded to). There has been no evidence to confirm new strains yet.

The confusion is due to the different terminology for a new "strain" versus a new "isolate" (sample from a person). For a new strain to be confirmed, genetic tests and other laboratory reports of the virus itself are also required (aside from reports of patient outcomes). These will take some time given that it is a new infection. 

Although some reports have emerged that suggest different "strains", these actually refer to different "isolates" that have minor genetic variations with no confirmed change in the nature/properties of the virus. These are expected  variations, that can be seen with different "isolates" of a given virus that are taken from people that are spread across time and space. This can happen with viruses that "reproduce" by a method called RNA synthesis which sometimes makes these errors in their genetic code.

Whether or not these genetic variations confer new biological properties to the virus is what usually determines whether it should be labelled as a new "strain". Examples of these properties include new surface binding proteins that make it more lethal/contagious (which would justify it being termed a new "strain"). This requires more work to be confirmed (e.g. to differentiate phenomena such as "founder effect" from true selective pressure), and there is no conclusive evidence of new "strains" to date.

Hi, thank you for the question. There is no medical evidence or medical reason linking drinking cold water/ eating cold food and menstrual cramps. Having said that, sometimes what you experience and what medical evidence and reason says might be different. Everyone's body and mind responds differently to different stimuli. So if you personally notice and experience a correlation between drinking cold water / eating cold food and making your menstrual cramps worse, then do avoid it and drink warm water and take warm food.
Soaking in a warm bath and applying a warm water bottle to your lower abdomen might help ease your menstrual cramps.

Hi, thank you for the question. Eczema and hives (urticaria is the medical term) are 2 separate conditions, although some patients suffer from both. Some patients do have chronic hives (urticaria) which means they can have it for months, or have frequent relapses without antihistamine medications (eg cetirizine).
If you get frequent relapses of your hives after stopping cetirizine, I will advise you to continue taking cetirizine daily for a few weeks and then slowly try cutting down. Cetirizine is a safe medicine to take long term.
A small portion of patients with hives have underlying conditions like liver problems, thyroid problems and other organ problems. But these are rare.
Do consult a doctor if your condition persists. 

Dear @Joseph ,

Thank you for your question. I am sorry to hear that you have been troubled by low back pain for a few years. Low back pain is a very prevalent problem across the world. There are may causes of low back pain. We would need more information about your symptoms. This coupled with the signs that we find on physical examination would then allow us to make an informed diagnosis. Since you have been troubled by the pain for a few years now, I would encourage you to see a doctor. Details on the following will be very useful for the attending doctor:

1. How did the pain start?

2. Was there any trauma/injury?

3. Is it a sharp pain or dull ache?

4. Where in the back is it located?

5. Has it always been there or does it ‘come and go’?

6. At its worst, how bad is the pain from a scale of 0-10?

7. At its best, how bad is the pain from a scale of 0-10?

9. Does the pain shoot down either leg?

10. Do you have any numbness or weaknenss in either leg?

11. Do you have any trouble passing urine or motion?

12. Is your walking affected?

13. Is your sleep affected?

The most common cause of low back pain is usually an injury to muscles or ligaments of the back which usually recovers with rest and physiotherapy. With age, the spine undergoes degeneration (lumbar spondylosis) and this can cause pain too. 

 

I hope the above information is helpful. For a start, avoid lifting heavy weights and observe good posture and back care habits. You can do some core strengthening exercises (easily found off the web) as well as stretching exercises for the back while waiting to see your doctor. Take care!

Hi @Steve sorry to hear about your predicament! Sesamoiditis is inflammation of sesamoid bones at their attachments. Sesamoids are unique in that they connect with muscles via tendons, unlike most other bones that connect with each other at joints. Sesamoiditis is more common at the knee (patella/knee cap which is technically a Sesamoid, but sometimes also called tendinitis) and the bottom of the foot, although the hand has sesamoids in the region called the "Volar plate".

There are several possible causes of pain in the region you describe, apart from bony disorders like Sesamoiditis, there can also be soft tissue disorders (e.g. affecting muscle tendons or their protective layer/"tendon sheath") in the area. Common examples for the latter include trigger finger and De Quervains tenosynovitis, although one would expect the shots to have at least provided some temporary relief. You can read more about them here: https://www.health.harvard.edu/diseases-and-conditions/tendon-trouble-in-the-hands-de-quervains-tenosynovitis-and-trigger-finger

Unfortunately, it would not be possible to distinguish between them without first finding out more about your lifestyle, circumstances surrounding the start of your symptoms, aggravating factors, as well as performing an examination in-person of the affected area. However, these are fairly standard assessments and I trust your provider would already have done them, and likely came to the conclusion of sesmoiditis based on these and has offered surgery due to the lack of response to the shots.

Perhaps if there is still uncertainty surrounding this, you may want to discuss with your physician the option of performing an imaging scan such as an MRI to evaluate further. Hope this helps!

Hi @respect thats a great question! However this is still uncertain in the context of this new and ongoing pandemic. While researchers are fairly certain that the COVID-19 virus began as a zoonotic infection that likely started spread to humans from bats, it is not certain if it can spread to other animals and insects as mentioned. Ultimately, the best way to reduce your risk of catching the infection is through hand hygiene and wearing masks when exposed to others (or even animals) that are unwell.

The CDC echoes this uncertainty, and has also shared about a possible case of spread from humans to tigers/lions in a New York zoo here: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html

Hi @MANJU it is possible for mild contusions after the injury you describe, however one wouldn’t expect the pain to continue for so long in that nature. I recommend for you to see your doctor for an examination to determine if any further assessment may be required.

Hi @Pear yes that is likely, if you don't have any other symptoms or skin changes elsewhere, you can try some anti-fungal creams OTC such as miconazole - visit your local pharmacist at places like Guardian to show them your feet and they would be able to give you some recommendations.

If it doesn't improve, I would recommend a review with your doctor to evaluate why and whether there may be other causes. This can either be done at a GP clinic near your home, or potentially online via apps that provide video-based consultations, and the attending doctor would be able to prescribe medications and have them delivered to you. If you would like me to see you online for this, you can reach me via the Raffles connect or Doctorworld applications on Sunday/Monday morning. Here is a link that shares more about this: https://www.todayonline.com/brand-spotlight/doctor-will-see-you-next-app

Hi @Novi the problem you describe is a sleep disorder which requires further evaluation. Here are some measures recommended by the American Academy of Family Physicians that you can try to improve your sleep and regulate your sleep cycle,

If the condition persists or if it starts to affect your ability to function, I would strongly recommend to seek medical attention so your doctor can evaluate for any reversible causes of this and/or treat with medications where appropriate.

Dear @igotz99problemz ,

Thank you for your query. Was there any trauma or injury involved prior to you feeling this soreness and hearing the clicking sounds? How is your shoulder movement? Is it restricted? Some aches and pains can be a result of repetitive strains on the shoulder. Clicking without pain can usually be observed first but if you truly feel that the shoulder does not feel right and this problem has been going on for a while, then you should get a medical professional to examine your shoulder.

Hi @BusinessJing thank you for your questions! There's alot to unpack here and I will try to answer them one by one. With respect to the role of benzalkonium chloride/quat, I am not able to identify any robust studies that support these conclusions. Also, the claims of "self-disinfecting" coat that I could find from companies online also are not substantiated by any robust evidence as you rightly pointed out. 

With regards to re-infections, studies are being conducted locally and abroad to understand this risk. One consideration is that existing reports of re-infections from other countries are based on the use of early versions of COVID-19 tests that became available at the start of the outbreak. These are imperfect with high rates of false positives/negatives reported in various cross-validation studies. 

Therefore, it is possible that the patient(s) in question may have had a false negative test, whereby subsequent testing was a true positive and may have wrongly led to the conclusion of re-infection. In other words, with studies still ongoing, it is still too early to make any conclusions about this. Fortunately in Singapore, we have taken a conservative approach to guard against this by only considering patients as "recovered" after multiple consecutive negative tests.

Long-term repercussions such as pulmonary fibrosis are driven by the disease rather than the context (aside from variations in national mortality rates), and will likely be the same in Singapore as they are elsewhere. The claim about vitamin D does not appear to be based on any definitive evidence that I can find.

Hi @Jo_c sorry to hear about this accident! De-roofing the blister yourself is not recommended due to the infection risk which can make things worse. Do take some pain killers and go for a review with a GP near your home as soon as you can, especially if there is no pain or decreased sensation. 

Before you leave, check your vaccination records and bring the latest ones along with you if you can (specifically check "Tetanus" vaccine or "DTP" vaccine if you have them). Hope this helps!

Hi! 

From what I can see on the image it does not appear to look like hives. Secondly I would avoid giving antihistamines like benadryl I'm a child less than 6 months. The safest antihistamine one can give at the age of 6 months can be fexofenadine or cetirizine which are second generation anti- histamines. 
I would suggest a visit to the pediatrician to have a better look at this rash. 

Dear @Jlynita_86 ,

Thank you for your query and I am sorry to hear that you are currently experiencing  these symptoms.

Intermittent numbness in both arms and hands can be caused by a few conditions. These can be anywhere in the course of the nerves traveling from the brain, to the spinal cord, to the major nerves and then to the smaller nerves in the hand. I would advise you to seek a medical professional for a full history and examination to exclude important causes. Once these have been excluded, you can then be referred to a specialist to be worked up for the rest of the conditions like cervical spondylosis (wear and tear of the neck spine which can result in compression of nerves) or other nerve compression syndromes like carpal tunnel syndrome. Please take care.

Hi @Saruri there are several possible causes for this, ranging from allergies to insect bites. Even the extent and duration of the rash, it would be best to have a discussion with a doctor to work this out and evaluate what medications you may require.

This can either be done at a GP clinic near your home, or potentially online via apps that provide video-based consultations, and the attending doctor would be able to prescribe medications and have them delivered to you. If you would like me to see you online for this, you can reach me via the Raffles connect or Doctorworld applications tomorrow morning. Here is a link that shares more about it: https://www.todayonline.com/brand-spotlight/doctor-will-see-you-next-app

 

Hi!

I'm sorry to hear about your occular stroke last month, I do hope you have managed to recover without much deficits. This full ache in your left calf sounds non specific, however as it is only isolated to your left calf and it has been there for a few days I would suggest you get this checked out. One possibility like you rightly pointed out is a blood clot.
 I would suggest you get an ultrasound scan done of your leg to rule out a blood clot and avoid vigorous exercise till you get the scan done.

Hi ladymouse 

Sorry to hear about your injury! The small joints of the finger can be quite prone to develop stiffness after an injury and tendon repair. It’s quite common not to be able to regain full function/motion after such an injury.

Nonetheless, if the result is not satisfactory, it might be worth getting an ultrasound scan done to look at how the tendon repair is doing and also how much excursion (sliding) of the tendon is possible. Options for adhesions can include more therapy, a steroid injection and manipulation of the joint and surgery for adhesiolysis. As for shockwave, I’m not aware of data that it’s useful though I don’t see how it can be harmful. 

Hope that helps!

Hi Lunarorbit,

Thanks for your detailed description! Whether an ankle ligament reconstruction (Brostrom) would benefit you or not, boils down to the assessment of whether your symptoms are due to ankle ligament laxity. 

A lot of times, we expect a torn ligament to manifest as a “loose” ankle that rolls over or gives way easily. 

However, that’s not always true and there are many people who instead have symptoms of an achy and sore ankle with activity instead. This is because the ankle joint mechanics is off due to the loss of ligament function. 

If you’ve had an MRI done already which shows the ankle is healthy except for the ligament tear and bone  avulsion, then there’s a pretty good chance your symptoms are due to the laxity and altered mechanics from the incompetent ligament. Another soft sign is if your ankle feels better or more secure when you wear a brace - this can also be an indicator that the symptoms are due to loss of ligament function.