Does It Really Improve Your Sexual Performance Before Bringing You Any Consequences?

2nd June 2022/in Allergy, General Health /by Miri Yeo

Convenient, effective and cheaper? Sounds too good to be true?

It probably is. After all, nothing is easier than to launch your favorite shopping app and key in health supplements and you are presented with a myriad of choices of health supplements purporting to cure or treat various ailments and you can compare prices too!

However, some of these online suppliers are faceless and if you do encounter problems with the supplements you will find it difficult to get support. Also, some manufacturers who supply these “health supplements” may add a potent western medicine to their products, but the dose they add far exceeds the recommended dose sometimes by 10-100x the recommended dose. Finally, the manufacturing of these potent western medicines addictive are not likely to conform to strict quality control like those from reputable companies so there may be toxic products mixed in or other impurities. All this means that you are putting your life and your well-being at risk.

So buyers beware! Isn’t your health and well-being worth more? Remember, you deserve good quality supplements or medicine.

For more questions, please contact us or email us at hello@dtapexpress.clinic to make an appointment today.

Detox Teas – Do They Work?

27th July 2020/in Family Medicine, General Health /by Miri Yeo

Detox teas are a controversial topic. For thousands of years, humans have been trying to rid their bodies of what they believe are toxins. Some historic “detox” practices include bloodletting, enemas, sweat lodges or saunas, fasting, and drinking herbal preparations. Some of these practices were even accepted as medical treatments before the advent of modern medicine. In the age of social media, you might have seen celebrities or even your friends posing with a pack of detox-tea on Facebook or on Instagram.

Detox teas are usually a mixture of tea leaves and other natural ingredients like berries, fruits, spices, herbs and roots.

Do detox teas actually help to detox the body?

Tea is generally considered healthy. Multiple studies over the years have shown an association with tea and health benefits including cardiovascular health, blood pressure regulation, mood regulation, mental performance and maintenance of weight and energy levels too. Tea contains tea flavonoids, polyphenols, in particular catechins and epicatechins and antioxidants which health benefits are still being studied and validated. Whether or not teas slapped with a detox label does what it actually says – remove toxins – is still very debatable.

The additional natural ingredients may also have health benefits. Many ingredients of traditional medicine are currently being investigated scientifically, and some of them have been shown to have health benefits.

Real weight loss or just a loss in water weight?

Most of these detox teas do contain tea leaves, and tea does have caffeine. Caffeine is known to be a stimulant which can raise your metabolism. Caffeine can also act to suppress your appetite. Through such a mechanism, you might enter a caloric deficit by burning more calories, and eating less. This kind of weight loss is true weight loss.

However, certain detox teas do contain supplements which act like laxatives, or medical laxatives itself. The effect of these laxatives are claimed as colon cleansing, which is often recommended as part of a detox plan. Such laxatives can cause cramping, bloating, nausea and vomiting. Dehydration and electrolyte loss can also be a concern. Such a weight loss is mainly water weight loss, and is not healthy, nor sustainable.

Side effects or dangers of detox teas?

The detox teas that are conservative mixes of tea leaves and natural products are usually not more dangerous than regular teas. However some detox teas may include, in large amounts, natural products that have a prominent biological effect on our body. Some brands may also have additional chemical ingredients that could harm your health.

As mentioned above, diarrhea could be a side effect of these teas. These may be from the laxative effect of natural plant-based sennosides, or actual laxative medications. Excessive diarrhea can lead to dehydration and electrolyte loss, which may leave you lethargic and weak. Some compounds, including caffeine, are also diuretic, which can cause you to pass more urine than normal. Severe diarrhea and dehydration has led to death, so this is a side effect of concern.

Appetite suppressants or stimulants like caffeine are commonly found in detox teas. Ingesting too many stimulants may leave you irritable, unfocused and jittery, similar to when you drink too much energy drinks. You may also suffer from insomnia if these teas are taken too late in the day. Illegal stimulants like ephedra and medications such as ephedrine have been found in detox teas. These may trigger heart attacks, strokes, seizures and cause even death, especially in people with pre-existing medical conditions.

Diabetic medications that lower your blood sugar level have been found inside detox teas. People who are on detox teas may also be eating less, contributing to a lower blood sugar level. Such a situation can lead to hypoglycemia, where the sugar level in your blood is dangerously low. This can lead to sweating, confusion, shaking, loss of consciousness and even death.

Some of the herbs that are inside detox teas may have drug-drug interactions with the medications that people are currently taking, raising the levels of the medication in your body to toxic levels. Some herbs themselves if ingested in large enough quantities, may also put strain on your kidney and liver. This has the opposite of detoxing your body, poisoning your body instead.

Are there any benefits to detox teas?

Not all detox teas are harmful. Tea itself does have health benefits. The other natural ingredients (in conservative amounts) may also serve to improve your health. But please use it with caution and moderation. These teas, if used, should be incorporated into a healthier lifestyle.

Is it healthy to consume detox teas long-term?

The manufacturers themselves do not recommend taking detox teas in the long run. If you do decide to try out a detox tea, stick to the recommended serving guide, and be vigilant about any side effects that may occur. If these side effects are causing you any discomfort, it is recommended that you stop.

What are some recommendations for detoxing the body in place of consuming detox teas?

The human body is more than capable of clearing out waste products for the vast majority of us. This is what our bodies have evolved to do to keep us alive. Our kidneys, liver, cardiovascular system, gut and skin are all working hard every day to process all of the substances that we come in contact with, and they do a good job at it. The best thing to do is to not add additional burden to the body.

The very fact that you are considering a detox tea means that you are willing to do something to change your lifestyle for the better. Use this motivation to kick start good habits. The detox tea can be the spearhead in the charge to a better you.

Also read: Weight Loss Treatment

An overall healthy and balanced diet with whole grains, fish, fruits and vegetables, and less red and processed meat is a key component to a healthy life. Processed foods have been shown to be poor in nutrition, laden with salt and fat and contribute to obesity and cardiovascular disease. Unprocessed and minimally processed foods on the other hand are packed full of nutrition, keeps you full for longer and is essential for your bodily functions. Try and limit the frequency and amount of processed foods to a minimum.

Physical activity and exercise is just as important as the quantity and quality of food. The Health Promotion Board of Singapore recommends 150 minutes of moderate intensity, or 75 minutes of vigorous intensity physical activity a week. Health benefits of regular physical activity include a 20 – 50% reduced risk of premature death, incidence of coronary heart disease, type 2 diabetes, depression, stroke, high blood pressure, colon cancer and breast cancer, to name just a few. If you are just starting to get into more physical activity, it is always advisable to start slow and ramp up your physical activity slowly. This will help minimize musculoskeletal injuries. The lack of time should not be an excuse to pass on both healthier food options and exercise

It is also advisable to drink lots of water. Water makes up about 60% of our body weight and is essential for our survival. Water gets rid of wastes through urination, perspiration and bowel movements. It keeps your temperature normal, lubricates and cushions joints, protects organs and tissues and maintains the electrolyte balance in our body to name just a few. This is the form of detox that definitely has no opponents.

Getting enough sleep every night is essential as sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health and quality of life. Sleep is the time where the body and brain heals itself and recharges for the next day. Sleep deprivation has been shown to be associated with chronic diseases, decreased mental and physical performance and even reduced immune function.

Just remember that there are no shortcuts to a healthy lifestyle. That however should not stop you from living the best life.

*Parts of this article were first published in CLEO.

Swallowing Semen: What You Should Know

4th June 2020/0 Comments/in General Health /by Miri Yeo

What is semen made of?

Semen consists of several fluids which are produced by various glands. Actual sperm cells make up only a very tiny portion of semen volume. The bulk of semen is made up of prostatic fluid, secreted from the prostate gland, seminal fluid which contains fructose, proteins and fatty acids and bulbourethral fluid from the bulbourethral glands. Semen contains protein and a multitude of other components such as fructose, citric acid, zinc, cholesterol etc.

What is the usual color and consistency of semen?

Normal semen may have an off-white or slightly yellow tint. It is usually jelly-like in consistency, but may be slightly clumpy or more liquid in nature. But semen with a pronounced yellow or green colour may indicate an infection and a visit to your doctor is warranted. If there is blood in your semen (red or brown) please see a doctor as well.

Is semen safe to ingest?

All the components in semen are fully edible and digestible, so semen is generally safe to ingest. However, swallowing semen could prove dangerous if you suffer from a rare allergy to semen (known as “human seminal plasma hypersensitivity”), in which case you could develop a bad or potentially even life-threatening reaction.

What happens if you swallow semen?

Swallowed semen is digested by the digestive enzymes in your gastrointestinal tract, the same as any other food which you ingest. Contrary to some urban myths, there is no risk of pregnancy from swallowing semen.

What does semen smell or taste like?

Semen has been said to normally smell like ammonia, bleach, or chlorine due to the alkaline nature of semen. Semen can taste mildly sweet, salty or bitter. But the smell and taste can differ from person to person, and even from week to week, depending on your hydration status, hygiene, health and your recent food consumption.

However, if the semen smells or tastes abnormally strong, and is associated with discomfort on ejaculation or other urinary symptoms, it could be a sign of an infection, please see a doctor then.

Is it true that semen has dietary health benefits?

While semen does have a high percentage of protein for its weight, it is likely that you have to consume a large quantity in order for it to have dietary health benefits.

Semen also contains other components like sugar, sodium, citrate, zinc, chloride, calcium, lactic acid, magnesium, potassium and urea, but due to the small volume of semen, the dietary health benefits are likely insignificant.

Semen as a mood booster?

While there are no studies that can definitively make the link between ingesting semen and better mood, it is known that semen does contain trace amounts of endorphins, estrone, prolactin, oxytocin, thyrotropin-releasing hormone and serotonin, which can potentially affect your mood.

Rather than looking at semen as a mood booster, it is known that engaging in sexual activity in general is linked to a decrease in depression.

Will swallowing semen make you gain weight?

The amount of calories in semen is likely to be insignificant – containing less than 10 calories.

Does swallowing increase your risk of an STI?

When it comes to the risk of contracting STIs, it doesn’t matter whether you spit or swallow. Exposure to body fluids like pre-ejaculate fluid, semen, vaginal fluids or skin lesions like genital ulcers places one at risk of contracting STIs. This risk is further amplified if you have poor oral hygiene or wounds like cuts or ulcers in your mouth.

What are the common STIs that can be transmitted through oral sex?

STIs can be transmitted through skin-to-skin contact, which includes oral-to-genital contact, or through contact with infected mucosa membranes and body fluids. Here are some of the common STIs which one may be at risk of contracting through oral sex.

Chlamydia and Gonorrhea are two common bacterial infections that can be transmitted through oral. Someone with throat Chlamydia or Gonorrhea may experience a sore throat but some individuals may have no symptoms at all and can continue to spread this infection to sexual partners.

Syphilis can be transmitted during oral through contact with infected ulcers and if left untreated, can potentially affect multiple organs in the body including the brain and eyes.

Herpes (caused by the herpes simplex virus) can be transmitted either from an infected genital ulcer or oral cold sore or by skin-to-skin contact in an infected but asymptomatic individual. Genital herpes causes painful blisters and ulcers in the genital region.

Human Papilloma Virus (HPV) can be transmitted as well. Some strains of HPV cause genital warts, while others increase the risk of various cancers such as cervical cancer, oral cancer or penile cancers.

Many people tend to worry about HIV but the risk of HIV transmission through oral sex is actually extremely low, although unique circumstances like the presence or wounds or blood may increase this.

Is it possible to be allergic to semen?

Yes. Semen allergy or seminal plasma hypersensitivity is a rare allergic reaction to proteins found in a man’s semen. While it usually affects the person exposed to it, it can also been shown to affect the person producing it.

Some common symptoms of sperm allergy are redness, swelling, pain, itching, and a burning sensation in the vaginal area. Symptoms usually start about 10-30 minutes after contact with semen. They may not be confined to the vaginal area; they can occur in any area that has contact with semen, including the skin and the mouth. Symptoms can last for a few hours or a few days.

This allergy is rare. However, if you do experience such symptoms, speak to your doctor about it.

This article is written by: Dr Grace Huang & Dr Chester Lan

Also on this site: STD check, HIV Clinic Singapore

ESWT Treatment For Shoulder Pain

7th November 2019/in General Health /by Miri Yeo

Watch as Dr Edwin Ong, Former Resident Doctor, Dr Tan & Partners (DTAP clinic) talks about ESWT, Extracorporeal Shock Wave Therapy, as an effective treatment for shoulder pain.
Shock Wave therapy is a safe, quick and non-invasive treatment using energy from sound waves to activate the self healing properties of the body and accelerate the recovery process.
It does so in a number of ways:

Firstly, through a process known as cavitation, Shock Wave therapy stimulates the production of fibroblasts and tenocytes. These are the cells responsible for the healing of connective tissues such as tendons. The end result is tissue regeneration.
Secondly, the Shock Waves stimulate microscopic circulation and therefore metabolism within the treatment area, which promotes healing and the breakdown of calcification deposits, also known as spurs.
Lastly, Shock Wave therapy diminishes pain by over-stimulation of the nerves that send pain signals to the brain.

Shoulder Pain

It works for a variety of causes of shoulder pain including rotator cuff tendinitis and frozen shoulder.

Rotator cuff injury

Repetitive overhead arm movements, heavy lifting or other forms of trauma can strain the rotator cuff tendons and lead to tendinitis. Tendinitis can also develop due to chronic degeneration. The pain is felt mainly when raising the arm outwards and upwards from the body. When tendinitis is present, there is an increased risk of a rotator cuff tear occurring. The tear can be partial or complete and results in weakness when trying to raise the arm.

Frozen shoulder

Also known as adhesive capsulitis, this is a condition in which the movement of the shoulder becomes severely restricted due to the growth of abnormal bands of tissue (called adhesions) between joint surfaces and a lack of synovial fluid to lubricate the joint. Frozen shoulder commonly occurs between the ages of 40 to 60 and can occur after a rotator cuff impingement, a tendon tear, or even minor injury. The problem usually resolves on its own, but this can take up to three years.
To conduct the treatment for shoulder pain, we place the treatment probe over the affected area and deliver the required number of shocks. The treatment for shoulder pain is tolerable. Most patients will need about 2 to 3 sessions each 2 weeks apart.
If you are suffering from shoulder pain and requires tratment for shoulder pain, speak to your Doctor and ask if Shock Wave therapy is right for you.
Please call or drop us an email at hello@dtapclinic.com.sg for an appointment.

A Case of HIV from Vampire Facial

8th October 2019/in General Health, HIV & AIDS, HIV PEP /by Miri Yeo

Our clinics recently diagnosed a case of HIV from a vampire facial.
A Vampire Facial is a type of cosmetic treatment that was made popular by celebrity Kim Kardashian.
The treatment involves taking the patient’s own blood and spinning it down until the cells separate out of the liquid portion (plasma). Small needles known as micro-needles are then used to make multiple small holes in the patient’s face. The plasma is then poured over the face so that it soaks into these holes.
Two cases of HIV infection from such treatments were reported earlier this year in Albuquerque, New Mexico in the US. https://www.medscape.com/viewarticle/912436
Vampire Facial treatment is NOT approved in Singapore.

What Can You Do to Protect Yourself?

Before undergoing a treatment, ensure that the establishment has all the proper local licenses required.
Ensure that the therapist conducting the treatment has all the training certifications required.
Do not undergo any treatments in non-medically licensed establishments that involves blood or body fluids.
For treatments that involve puncturing or breaking the skin, ensure that the instruments used are properly packaged and sterilized.
Insist on seeing the operator open the sealed package in front of you.

If you feel you might have been exposed to an infection, see your local Doctor immediately for a discussion on HIV PEP and screening for other blood-borne infections like Hepatitis B and Hepatitis C.

Learn More about Other STDs & Other STD Symptoms

Dengue Fever Symptoms? Dengue Fever What You Need to Know

4th September 2019/in General Health /by Miri Yeo

Dengue Fever symptoms are divided into 3 phrases – the Febrile Phase, the Critical Phase and the Recovery (or convalescent) Phase.

What is Dengue Fever?

Dengue fever is a mosquito-borne viral infection and is endemic in Singapore. It is carried by the mosquito, Aedes aegypti and its related species, which are abundant in tropical countries. The dengue virus (DEN) comprises 4 serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) which belong to the genus Flavivirus.

The viruses are passed on through the bites of an infective female Aedes mosquito, which mainly acquires the virus while feeding on the blood of an infected person.

Also Read: Why the recent resurgence in Dengue Fever in Singapore?

What are the Symptoms of Dengue Fever?

The incubation period, which is the time between acquiring the infection and appearance of symptoms ranges from 3 to 14 days and symptoms typically develop between 4 and 7 days after the bite on an infected mosquito.

There are 3 Phases of Dengue Fever:

Febrile Phase

Dengue Fever symptoms – This phase is characterized by a sudden high-grade fever (usually 38.5 degrees C or more) and is accompanied by headache, nausea, vomiting, poor appetite, tiredness, muscle aches, joint pains, rash and pain behind the eyes, called retro-orbital pain.

Bleeding manifestations may occur during this phase.

Critical Phase

Dengue Fever symptoms – At the time the fever resolves, the infection enters the critical phase. It is known as the critical phase because potentially, a small proportion of individuals develop complications such as fluid leakage within organs such as around the lungs, abdomen and also bleeding.

The disease may progress to shock and dysfunction of the organs. This phase may last from 24 to 48 hours. Patients may also develop other warning signs during this stage (please see below on “When is dengue fever considered to be severe?”).

It is important to maintain good hydration during this phase (please see below for general advice).

Recovery (or convalescent) Phase

Dengue Fever symptoms – This is the phase during which fluid leakage and bleeding resolve, and vital signs (e.g. blood pressure) and blood tests improve. This can last 2 to 4 days. However, some individuals may still feel fatigued up to weeks after recovery before returning to normal.

What Blood Tests are Usually Performed in Suspected and Established Dengue Fever?

In suspected cases, a dengue antigen (NS1) and serology tests (IgM and IgG) are done to confirm the diagnosis. The NS1 antigen is usually positive during the first few days to a week of illness where as the IgM and IgG tests are typically positive on the fourth day and at 10 to 14 days of illness respectively.

After dengue fever is confirmed, a full blood count is drawn to assess the white blood cells, platelets as well as the haematocrit (measure of the percentage of red blood cells) levels. The platelets are cells in the body that help to form blood clots when bleeding occurs.

A simple example is when an individual sustains a cut on the arm, a complex process involving platelets help to form a clot and heal the cut. If the platelet count in the body is low, there is a tendency for bleeding and slower healing of cuts.

Liver function tests may also be performed as occasionally, the virus can cause inflammation of the liver, called hepatitis which can manifest as abdominal pain and tenderness.

In dengue fever, the white blood cell and platelet counts tend to drop where as the hematocrit may rise which reflects thickened or concentrated blood, a result of fluid leakage and shifts which can occur during the critical phase of dengue fever.

Dengue Fever Test & Dengue Vaccine (Dengvaxia) is available in all our clinics.

What is the Recommended Follow-up of the Individual with Dengue Fever?

The individual is usually advised to return for daily to once in two day follow-ups for repeat full blood count tests to assess the trend of platelet and haematocrit levels.

When is Dengue Fever Considered to be Severe?

Based on the WHO 2009 classification, there is a syndrome called dengue with warning signs and these include:

Abdominal pain or tenderness
Persistent vomiting
Fluid leakage (around the abdomen causing distension and around the lungs causing breathing difficulty)
Bleeding
Lethargy or restlessness
Enlarged liver
Increase in haematocrit concurrent with a rapid decrease in platelet count

There is also a syndrome called severe dengue which is dengue fever with at least one of the following:

Severe fluid leakage leading to shock and fluid accumulation with respiratory distress
Severe bleeding
Severe organ involvement (liver, impaired consciousness or any other organ failure)

If any warning signs or signs of severe dengue are present, the clinicians will advice the individual to attend the hospital emergency department as soon as possible.

What Can an Individual Do When He or She Has Confirmed Dengue Fever?

There is no cure for dengue fever. Treatment is usually supportive with careful hydration and monitoring of symptoms and signs of complications. A good indicator of adequate hydration is the colour of urine. If the urine is pale yellow, then hydration is adequate; where as if it is dark yellow and concentrated appearing, then more hydration is needed. Once the dengue fever is in the recovery phase, there is no need for increased hydration.

Most individuals do not develop complications. However, there are those who are at higher risk of developing dengue fever with complications. These are typically elderly individuals or those who have had dengue fever in the past and get infected with a different dengue virus serotype.

Regardless, complications can still occur in any individual and it is imperative that an early review by a clinician is performed to avoid further deterioration at home.

Can Dengue Fever Be Prevented?

Yes. Avoidance of mosquitoes that carry the virus is the best way to prevent dengue fever. This can be done by staying indoors during the day, when mosquitoes that carry the virus are most active, putting up screens and using air conditioners, wearing covered shoes, long-sleeved shirts and long pants and a hat to go outside and using mosquito repellant containing DEET (but do not use DEET on babies younger than 2 months of age). Clothes that are sprayed with a chemical called permethrin can also help.

Lastly, it is important to drain any standing water at home such as wading pools, buckets and potted plants with saucers as mosquitoes breed in standing water. Standing water even the size of a 20 cent coin can encourage mosquito breeding.

Everyone plays a part in dengue fever prevention in the community. Remember that Dengue Fever is deadly. If you suspect that you have the symptoms dengue fever, please visit your doctor for proper danger fever testing. Dengue Vaccine is available in all our clinics.

Speak to your doctor for more information or if you have any questions regarding Dengue Rapid Testing or other Dengue related topics: Dengue in the era of COVID, Dengue Fever Symptoms? Dengue Fever What You Need to Know, Why the recent resurgence in Dengue Fever?, ZIKA IS AN STD!! – Battling the STD Stigma

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Saxenda Weight Loss

8th August 2019/in General Health /by Miri Yeo

What is Saxenda?

Saxenda is the brand name for a prescription-only, injectable medication known as Liraglutide. It is a medication approved for weight management as an adjunct to diet and exercise. Liraglutide belongs to a group of medications known as glucagon-like peptide-1 receptor agonist (GLP-1 receptor agonist), also known as incretin mimetics. Saxenda is very similar to a GLP-1, a hormone that occurs naturally in the body which is released in response to food intake and acts as a physiological regulator of appetite and digestion.

GLP-1 that is produced by our body is rapidly broken down, resulting in a short half life of less than 2 minutes. Saxenda mimics GLP-1, but is much longer lasting, with a half life of about 13 hours when injected. Because of its long half life, it can act on the GLP-1 receptor for longer, exerting its physiological effects.

GLP-1 receptors can be found in several organs, including the brain, pancreas, gastrointestinal tract, heart, vasculature and kidneys. Saxenda works by binding to the receptors in the arcuate nucleus of the hypothalamus in the brain, where it stimulates satiety and inhibits hunger neurons. Because of this, you eat less, leading to weight loss.

What is the use of Saxenda?

If you are obese, or overweight with weight-related medical problems (such as high blood pressure, high cholesterol, or type 2 diabetes), this medication can help with weight loss, and keeping the weight off. Saxenda is meant to be used alongside diet control and exercise.

A study published in 2017 was conducted with 3731 patients followed up over 56 weeks. The patients either had a BMI of 30 or more without diabetes, or a BMI of 27 or more with at least one weight related-medical problem. These patients were split into two groups. Both groups were told to control their diet and exercise.

One group was given Saxenda and the other group was given a placebo. 1 of 3 patients treated with Saxenda achieved weight loss of more than 10%. Patients treated with Saxenda who completed the trial achieved a mean weight loss of 9.2% and kept the weight off for the one year follow up. Patients also experienced multiple improvements in cardiometabolic risk factors.

How to use Saxenda?

Saxenda is an injectable medicine usually given once per day. It is injected under the skin at any time of the day (usually in the morning), with or without a meal. There are a variety of places you can inject, but most commonly, it is injected into the skin around the abdomen. It comes in a prefilled injection pen with disposable needles. The doctor will teach you exactly how to inject this medication, and to use a different spot to inject each time.

How much does Saxenda Cost?

$129.00 per pen.

Who is suitable for use of Saxenda?

You are suitable if you are

overweight (BMI ≥27) with weight-related medical problems (e.g. high blood pressure, high cholesterol, or type 2 diabetes)
obese (BMI ≥30) with or without weight-related medical problems

Who should not use Saxenda?

If you are currently on insulin for treatment of Diabetes, Saxenda may not be suitable for you. The safety of Saxenda has not been studied when taken with other prescription, over-the-counter, or herbal weight-loss product. It is not known if Saxenda can be used safely in people who have had pancreatitis.

Saxenda is not recommended for use in children. The safety of Saxenda has not been evaluated in the specific treatment of Type 2 Diabetes (even though another medication known as Victoza has the same active ingredient).

Are there any side effects when using Saxenda?

The most common side effect of Saxenda are gastrointestinal and can include nausea, diarrhoea, constipation, vomiting, abdominal pain and flatulence. Some patients may get headaches, low blood sugar, dizziness, fatigue or changes in taste as well. It is generally well tolerated and doctors will gradually increase the dose over a few weeks to minimize risk of side effects

What are other weight-loss treatment options?

Diet control and exercise are the mainstays of treatment for weight loss. Even Saxenda is meant to be used as an adjunct to diet control and exercise for weight loss. There are other medications to suppress appetite and decrease absorption of fat or carbohydrates from the gut as well. You can find more information from this page https://www.dtapclinic.com/family-medicine/weight-loss-treatment/

What are the pros and cons of Saxenda as compared to other treatment options?

The main drawback is that Saxenda is an injectable medication. Most other weight loss medications are in the form of oral tablets. Having said that, we know that Saxenda is a powerful tool in weight management.

Discuss with your doctor about the suitability of the medications for you. If you are interested to find out more about Weight Loss Treatments, please call our Clinics or drop us an email at hello@dtapclinic.com.sg for an appointment with our doctors.

Office Syndrome – Causes, Symptoms Treatments

31st May 2019/in General Health, joint pain /by Miri Yeo

What is Office Syndrome?

If you live in a big city and work in an office environment, chances are you may suffer from Office Syndrome even though you may not know it.
Office Syndrome is not a disease but instead refers to a group of symptoms related to the unhealthy sitting posture. The typical office worker spends hours upon hours sitting in the same position, toiling away in front of computer screens.
At first glance, one may not think much about such a lifestyle, but if left unaddressed, Office Syndrome can potentially lead to serious issues, especially for one’s muscles and spine.

What is the Cause of Office Syndrome

A poor working environment is a major cause of Office Syndrome. Inadequate table height and positioning of the computer and keyboard leads to an unnatural sitting position. Slouching or hunching over with rounded shoulders causes constant muscle contraction, gradually resulting in weak core muscles and increased tension in other muscle groups.
Dry eyes and headache can also result from long hours facing computer screens. Psychological symptoms such as depression, insomnia and fatigue may occur as well. All these also fall under the spectrum of Office Syndrome.

via GIPHY

What are the Symptoms?

Back, neck, shoulder pain and knee pain
Numbness of fingers, arms and feet
Muscle ache
Tendonitis such as De Quervain’s tenosynovitis and Tennis elbow
Headache
Dry eyes
Giddiness
Depression
Insomnia
Fatigue

What are the Treatments?

If you suspect that you are having symptoms related to Office Syndrome, speak to your doctor about it. Based on the symptoms as described above, investigations such as X-ray, ultrasound scan or blood tests may be recommended.
The treatment essentially depends on the symptoms and body part that is of concern, and commonly involves medications, physiotherapy and alternative therapies such as acupuncture.
However, as the saying goes, “an ounce of prevention is worth a pound of cure”, it is much easier to take measures to prevent Office Syndrome rather than have to deal with the problems when they develop.

Office work does not equal Office Syndrome!

How to Avoid Office Syndrome!

Not everyone who works in an office is destined to develop Office Syndrome. All that is required are some adjustments to the workplace and the development of good habits, and Office Syndrome can be easily avoided.

1) Practice proper posture.

Practice proper posture. Sit up straight with your shoulders rolled back and your chin tucked to elongate your spine. Good posture is always important, even when not at work.

2) Adjust your sitting position regularly.

Doing so every 1-2 hours helps to prevent muscle fatigue and subsequent slouching. You can also change the angle of your seat, and avoid sitting at the edge of your seat.

3) Try to exercise

Try to exercise for 30 minutes or more, at least three times a week. Focus on exercises that can strengthen your core muscle groups, which in turn can help with your posture.

4) Desk ergonomics.

Desk ergonomics. The computer mouse and keyboard should be directly in front of you, at a comfortable distance, with your arms properly supported. The computer screen should be an arm’s length away from you, and level with or slightly below your line of sight. Standing work desks are great, and nowadays there are even adjustable desks for both sitting and standing.

5) Take a break.

Remember to take a break. Take short breaks throughout the day to rest your eyes. This is also a good time to stretch or take a walking break.
Take care!

Constipation and When To See a Doctor

27th May 2019/in General Health /by Miri Yeo

An article published in the Daily Star (UK) reported that a woman lost ten years of her memory after straining on the toilet seat because of constipation. While it may seem rather comical that someone can forget themselves after straining, this is a real medical condition. The doctors that saw her suspected that one of the blood vessels connected to her brain was not functioning normally, and at the point of exertion, blood flow to the brain was compromised, leading to memory loss. This is, in essence, a mini-stroke. Fortunately for her, her memory came back. This is not the first case of someone’s brain being affected by straining because of constipation.

So why does this lady have to strain so hard just to defecate?

Bowel Movements and Constipation

Today, we will talk about bowel movements and constipation. Before we talk about what is abnormal, we need to know what is normal.

Everyone’s bowel movements are different and can change as you grow older. But in general, when defining diarrhoea or constipation, the general range is from three times a day to three times a week. Less than three movements per week are generally considered constipation, while three or more loose stools per day are considered diarrhea. As you grow older, your bowel movement slows down as well, and that is the reason why the elderly are more prone to constipation.

Having said that, what may be normal to someone may be abnormal for another person. If a person normally has two bowel movements a day, a sudden decrease to one bowel movement every two days can be considered as constipation for him. On the other hand, someone who has always had one bowel movement every two days might see two bowel movements a day to be considered as diarrhea.

Consistency & Frequency

As doctors, we do not just look at the frequency of bowel movements (or the change in frequency), we look at the consistency as well. Are your stools soft and fluffy? Are they in one solid piece? Is it completely liquid?

In Singapore hospitals, we commonly use the Bristol Stool Scale to describe stool, and there are 7 types of stool that can be described. A change in consistency of stool may indicate to your doctor that there might be something wrong.

So What is Constipation Then?

It can mean that you are not passing stools as frequently as you are used to or you are unable to completely empty your bowel. Constipation can also cause your stools to be hard and lumpy, or unusually large or small. It can be painful or uncomfortable to defecate as well.

Common Causes of Constipation

There are many things that can cause constipation, and they can range from the benign to the life-threatening. The most common causes of constipation are diet and activity related. Changes to your diet can cause your gut to move slower. A diet that is low in fibre or fluids such as water can make your stools hard and therefore harder to pass.

Stress is a huge contributor to constipation as well. We do see some people get constipated during times of stress. If you are inactive and do not exercise regularly, you can be prone to constipation as well.

Medications that slow your gut such as cough syrups, iron tablets and some painkillers can lead to constipation. Overuse or dependence of laxatives can also slow your gut. Any mass lesion that obstructs the gut can lead to constipation as well and can range from the benign like pregnancy to dangerous like colon or pelvic cancer. Constipation may also be a sign of bowel obstruction. There are some neurological diseases that are associated with constipation, like Multiple Sclerosis and Parkinson’s disease. Certain metabolic conditions such as hypothyroidism can alter the movement of your gut too.

So Why Do We Have to Care?

First and foremost, constipation can be very uncomfortable. Defecation can be painful and if the stools are hard enough, they can cut the insides of your gut, leading to bleeding. People usually complain of a bloated abdomen and may report the feeling of incomplete evacuation of stool. Complications include conditions such as diverticular disease, haemorrhoids, anal fissures, fecal impaction and rectal prolapse due to the straining.

Thing You Can Do to Prevent Constipation

So knowing the above, there are some things we can do to try and prevent constipation. Eat a variety of fruits, vegetables and high fibre foods that can help bulk up your stool. Stay hydrated with lots of fluids and exercise regularly. Reduce your stress levels.

These will also add benefits to your general health! Avoid constipating medications such as codeine and iron supplements.

If the above fails, there are medications that can be given to assist in defecation. They can range from oral medications to suppositories. These can bulk up the stool, draw more water into the gut or stimulate the gut to move. But remember, dependence on these medications can lead to constipation too, so as far as possible, the lifestyle changes recommended above are the first line of treatment.

All in All

As mentioned, constipation may be a sign of something more ominous. If there is significant pain associated with constipation, this might be an acute bowel obstruction.

If there are any red flags like weight loss, per rectal bleeding, a sudden change in bowel habits, loss of appetite or an abdominal mass, it could possibly be something like cancer and further investigations might need to be done.

See your doctor if you have these warning signs.

Take Care!

How Many Calories in CNY Snacks

1st February 2019/in General Health /by Miri Yeo

Dong Dong Chiang!
Once again Chinese New Year is just around the corner!
It is time to take a break and catch up with your family and friends again.
Traditionally, the Chinese New Year is celebrated with delicious snacks and treats. From the delicious Pineapple Tarts to the mouth-watering Bak Kwa.
As famous as they are for their great tastes, these snacks are also notorious for their caloric content.

But exactly how many calories do Chinese New Year snacks contain?

We take a tongue in cheek look at how Chinese New Year snacks stack up against other foods in caloric content.

How Many Calories in Chinese New Year Snacks?

Let us do some comparison with some of the Favorite Fast food we all indulged in:

1) How many Calories are there in Bak Kwas?

3 Bak Kwas have the same amount of Calories as 1 “Big” Burger.

2) How many Calories are there in Pineapple Tarts?

6 Pineapple Tarts have the same amount of Calories as 1 “Big” Burger

3) How many Calories are there in Love Letters?

6 Love Letters have the same amount of Calories as 1 Hot Fudge Sundae

4) How many Calories are there in Shrimp Rolls?

15 Shrimp Rolls have the same amount of Calories as 1 Small Fries

5) How many Calories are there in 5 Kueh Bangkit?

5 Kueh Bangkit have the same amount of Calories as 1 Butter Corn

6) How many Calories are there in 2 Slices of Kueh Lapis?

2 Slices of Kueh Lapis have the same amount of Calories as 1 slice of Hawaiian Pan Pizza.

Take Care