General Health

Hi @Iamking Milk Thistle is a type of weed and is sometimes also called "Silymarin" which is a chemical derived from parts of the plant like its seed, and it is believed to help with liver related conditions, particularly with poisoning from some mushrooms that affect the liver ("Hepatotoxic"). However, medical-grade studies of it and the other "liver supplements" have not yielded any conclusive benefits.

That said, you're absolutely spot on! Healthy diet and exercise is the best defence for good liver health, not forgetting also the importance of managing alcohol consumption and drinking only in moderation. More about it at this link here: https://www.healthhub.sg/live-healthy/182/alcohol_health_setting_drink_limits

Other measures you can take to ensure good liver health include safe sex and ensuring your hepatitis vaccinations are up to date, these include hepatitis A vaccination if you are traveling to "high risk" regions. Speak to your GP about this especially if you're traveling to any rural regions or developing countries. Hope this helps!

@igotz99problemz You likely have this condition called cold urticaria. In patients with cold urticaria, the skin cells are sensitive to cold, and an exposure to cold triggers the release of chemicals such as histamine which causes redness and itchiness.
The treatment is simple:
1) Be careful of cold temperatures and environments eg. showering on a cold day, going swimming. Perhaps dip a hand or foot in the swimming pool and see if it causes hives before going into the swimming pool.
2) You can keep some oral antihistamines with you. Take an antihistamine pill before an exposure to cold OR when you develop hives. Common over-the-counter antihistamines are loratadine, cetirizine (Zyrtec) and fexofenadine (Telfast).

You should seek medical advice if your symptoms are persistent despite medication, or if you develop a serious reaction like eye swelling or breathlessness.
It is generally not a worrisome condition and most people learn to cope with it and lead normal lives. 

This website provides more information if you want to find out more.  https://www.mayoclinic.org/diseases-conditions/cold-urticaria/symptoms-causes/syc-20371046

It must be quite troubling to have rosacea symptoms. Have you consulted a doctor or dermatologist already?
Mixing Flagyl tablet with a lotion and applying it to the face is an interesting proposition. Personally, I do not think it is the same as applying metronidazole cream/lotion. 
The other topical cream that will help is called Skinoren cream. It contains Azelaic acid. Some studies show that it is superior to metronidazole cream. I am not sure how easy it is to obtain this cream in your country. I believe consulting a dermatologist is your best option.
Other than medications, identifying and controlling the factors that trigger your rosacea is important. Good skin care - applying a moisturizer regularly, gentle skin cleansing with a mild soap is important too. Applying sunscreen and avoiding sun exposure might also help.
I hope you find a solution to your problem.

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.

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. 

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.

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. 

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 @vermie 

Very unfortunate that you got a burn. Managed to see the pic. Hope you get better soon.

Did you run the hand under running cool water  after the burn ? That can potentially help.

As for the paste, I wouldn’t suggest it as it has chemicals in the whitening component which can be more harmful.

Aloe Vera and honey can be helpful home remedies.

From the retail pharmacies - you can request for a Silvin cream ( Burn cream ) and apply it twice a day.

If you notice increasing redness , swelling or feeling feverish or notice discharge , pls consult  your  doctor at the soonest.

Hope this helps. 

Hi.

Yes you are correct in a way to be experiencing some side effects if medicines like ella is taken twice in very short intervals.

But a good news is, ella has a half life ( the time taken for the drug concentration in the body to be halfed each time after consumption) is about 1 1/4 days ( 32 hours). So within 3-4 days, the drug levels should come down to negligible levels and you should be feeling back to normal.

As for your question whether Ella is harmful if taken  second time within 2 days, i would not say its harmful. There are instances where we do give it, though its rare. There is a high chance of contraceptive failure and the higher likelihood of side effects.

That being said, if you are still concerned about contraceptive failure, please look out for your menstrual cycle. If there are any signs that its being delayed, please see your family physician at the soonest possible.

Hi Celestine,

You are correct in that there could be multiple causes for hand or foot numbness after waking up from sleep. One of the more common causes would be nerve compression which can be exacerbated by certain sleeping positions. For example, carpal tunnel syndrome is a common cause of hand numbness which can be worse during sleep. Would suggest if it’s troublesome to get a consultation to reach a diagnosis.

Hi @SL 

Sorry to hear about your finger. It does sound bothersome. 
I would advise that you see a doctor to exclude infection in view of the symptoms you mentioned. 

Hi @Jayde sorry to hear that! The truth is, although this is suggestive for BPPV, it could be due to any of those causes, including other possibilities. Others include low sugar levels since you were exercising at the time, or other more severe problems involving parts of the brain such as the cerebellum that could be life-threatening. Unfortunately it is not possible to differentiate between them without performing a more detailed assessment. 

Therefore, I strongly recommend to seek medical attention for a more detailed assessment. I hope this helps!

Hi @Kenny 
In view of ur sore throat, I would advise you to see a doctor and also to monitor your fever. 

It is good that you took pictures of how the initial rash looked like- so u can monitor the progression. Often, we need to take some history (such as presence of itch?, any contactents? History or family history of eczema, occupation etc) in clinic to further evaluate the likely diagnosis. However, as a general piece of advice- use gentle soaps and avoid too harsh alcohol based hand rubs. And moisturise ur hands. Try not to scratch. 

Hope this helps! 

Hi @fair 

I’m sorry your family is going through a tough time. 

All procedures carry some form of risks, some may be common while some are rare. We always weigh the benefits versus the risks in deciding if the procedure is worth going ahead with. 
However, If you feel unsure about making a decision on which procedure to opt for, there is no wrong in seeking a second opinion from a cardiologist. 

My advise is: To bring the relevant records including past clinical investigations/reports and bring your mum for a consult with another cardiologist so that you can consider your options better. 

Take care >> 

Hi @Dan 
If your urticaria is well controlled on Telfast 180mg once a day dosage, u can up-titrate the dose by taking one and a half of the 120mg tablet to make it 180mg as a temporizing measure before your next clinic review. There are many anti-histamines that can be used in the treatment of chronic urticaria, but the choice of which depends on Clinical response and activity level (some may cause drowsiness). 

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.