8 Myth About Hair Loss

Hair loss is nothing new to us. Since the dawn of ages up until the present day, hair loss has been an issue troubling both men and women alike, but mostly men. Along the way, tons of myths about hair loss have been created. Without further ado, let us look at eight common myths about hair loss.

Hair loss only happens with age

Myth about Hair Loss #1

Androgenetic alopecia, also known as male or female pattern balding, knows no age. It is genetically predetermined, and while it tends to happen in older people, can happen in those as young as their teens or early 20s.
According to the American Hair Loss Association, two-thirds of American men will have some degree of appreciable hair loss by age 35, and approximately 85% of men have significant balding by age 50.
Regenera Activa for pattern hair loss treatment: Regenera Activa uses your own hair that contains cells that help to activate the follicles around the balding area. In other words, it uses your own body’s ability to procedure new hair.

Masturbation causes hair loss

Myth about Hair Loss #2

Good news, guys! There is absolutely no scientific evidence linking masturbation to hair loss, or even hair health in general.
Our body requires protein for the growth of new body tissues, and this includes hair growth as well. So it has been postulated that as semen contains high levels of protein, frequent ejaculation causes a reduction in protein levels, therefore contributing to hair loss. The truth is, the average male produces just 3.7 millilitres of semen per ejaculation, and the amount of protein lost in each ejaculation is very insignificant compared to the amount of protein consumed daily.

You’re losing your hair due to stress

Myth about Hair Loss #3

It is true that excess stress and anxiety can lead to certain types of hair loss, namely telogen effluvium and alopecia areata. These conditions are often temporary and after the stressful period is over, the hair usually grows back. Male pattern balding, however, is a long-term condition and is not due to stress.

Direct sunshine is bad for your hair

Myth about Hair Loss#4

Sustained exposure to sunlight does not contribute to hair loss. Also, direct heat from using a hairdryer does not cause hair loss if used correctly. It is important to keep the dryer at an appropriate distance from the scalp and avoid using high heat mode too frequently. Also, direct the dryer towards the tip of the hair instead of the scalp and roots.

Elevated testosterone levels are causing you to lose your hair

Myth about Hair Loss #5

People believe that raised testosterone levels, in turn, leads to increased levels of dihydrotestosterone (DHT), which is the hormone responsible for androgenetic alopecia. However, high testosterone levels does not necessarily mean high levels of DHT.
The amount of testosterone that is converted to DHT varies from person to person. Even if a man has high DHT levels, it still does not automatically lead to male pattern balding. Ultimately, it depends on how sensitive the hair follicles are to DHT.

Using loads of hair products is bad for your hair

Myth about Hair Loss#6

Hair products, no matter how much or how often you use them, will not lead to male or female pattern balding.

Shampooing your hair is causing you to go bald

Myth about Hair Loss #7

Using hair shampoo when showering helps to clean your scalp and keep the hair healthy. It certainly does not cause you to lose hair. It is perfectly normal to see some fallen strands of hair when shampooing. These are hairs that have reached the end of its cycle and it was likely time for them to fall out anyway.

Wearing a hat too often suffocates your hair

Myth about Hair Loss #8

Some people think that wearing a hat does not allow your hair to “breathe” and over time can cause hair loss. While this is completely untrue, if your hat is very dirty and has not been washed for some time, dirt, dust and bacteria can accumulate. This can lead to scalp irritation or infection.

If you want to speak to us about hair loss & hair loss treatment, please call or visit our clinics or drop us an email at hello@dtapclinic.com.sg

7 Things you need to know about Chickenpox vaccination

Chickenpox or primary Varicella infection is a disease caused by the Varicella-zoster virus (VZV).

The VZV is the same virus that causes Shingles or herpes zoster, while both chickenpox and shingles are caused by the same virus, they are clinically distinct. Chicken pox is a primary infection of the VZV meaning it occurs when the individual is first exposed to the virus.

Shingles on the other hand is a reactivation of VZV, this happens in individuals who have already had chickenpox because after the resolution of the chicken pox, the VZV continues to lay dormant in the system. Understanding the distinction between the 2 forms of varicella infection is important because the vaccine against Chickenpox is not the same as the one for Shingles.


Stages Of Infection

The natural history of a chicken pox infection can be thought of in 3 stages – viral prodrome, eruption of vesicular rash and resolution of rash. From the point of infection, it takes about 2 weeks before the distinctive vesicular rash of chickenpox appears. During these 2 weeks, individuals report prodromal symptoms of malaise, sore throat, loss of appetite and fever. The eruption of fluid filled vesicles generally starts after 2 weeks and stops within 4 days. The rash mostly starts at the face and progresses to the trunk and then to the extremities.  After another 6 days, the lesions will crust over and “shed’ off the body. The clinical manifestations of chickenpox tend to be milder in children but more complicated in adolescents, adults and immunocompromised individuals.

The chickenpox vaccine is a Live Attenuated Vaccine. This means that the vaccine was made with an inactivated form of the VZV. This form of vaccine is almost akin to getting a natural infection but in a controlled manner. Once this inactivated VZV is introduced into the system, the immune system is able to gradually build antibodies against a true form of the VZV thus allowing the body to fend off any further VZV infections.

While there are studies that recommend universal varicella vaccination, there are some groups that can be seen as a priority. These groups include teachers exposed to young children, non-pregnant women of child bearing age and healthcare workers. This is particularly the case if individuals are shown to not have any antibodies against VZV – which means they either have not had chicken pox before or have not had a vaccine against VZV.

The vaccine is given in 2 doses, 4 – 8 weeks apart and is generally well tolerated.


Common Side Effects

Common side effects include fever, injection site pain and vesicular rash around the injection site. Because Chickenpox vaccine is a Live Attenuated Vaccine, it should not be given to immunocompromised individuals – undergoing chemotherapy, on immunosuppressants such transplant patients or HIV patients with a low CD4 (Cluster of Differentiation 4) count. Particularly for HIV patients, it is important that the CD 4 count be consistently above 200 cell/uL with appropriate viral suppression, the 2 doses should also be separated by 12 weeks in HIV patients.

In summary, the chickenpox vaccine is a safe and effective means of preventing a primary VZV infection. The vaccine should be considered in women planning to get pregnant and adults who work in facilities with populations likely to transmit the virus – childcare, schools, hospitals especially if they have not had chickenpox before.


Saxenda Weight Loss

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 Treatmentsplease call our Clinics or drop us an email at hello@dtapclinic.com.sg for an appointment with our doctors.

Ultra-Processed Food & Your Health

In May 2019, a small randomized controlled study by the US National Institutes of Health just showed that people eating a diet of ultra-processed food consumed more calories and gained more weight than those on a minimally-processed diet, despite meals being matched.

In the study, 20 inpatient adults underwent two diet phases. In the first phase of 2 weeks, 10 participants received ultra-processed foods and 10 participants received unprocessed diet. After 2 weeks, their diets were switched to the alternate diet. 3 meals were given a day, and meals were matched as closely as possible for calories, sugar, fat, fibre and macronutrients. The participants were also provided with snacks outside of their meals. They were told to eat as much or as little as they wanted. What they found was that the people on ultra-processed food ate about 500 more calories a day, as compared to people on unprocessed diets.

Also Read: Is More Rice Really Better?

On the topic of rice, another important thing to mention is the concept of Glycemic Index (GI). GI is a number assigned to carbohydrates in foods according to how they affect your blood sugar levels.

Industrialized Food System

There are benefits of ultra-processed foods: they are inexpensive, have a long shelf-life, are relatively safe from the microbiological perspective, provide important nutrients, and are highly convenient. You often just need to put a dish in the microwave and your meal will be ready in a few short minutes.

But if you look closely, you might notice that the rise in obesity, type 2 diabetes, hypertension and high cholesterol occurred in parallel with an increasingly industrialized food system. A large part of this system has dedicated considerable resources to making cheap, readily available ultra-processed foods. Ultra-processed foods have become more common worldwide, and now make up a significant portion of the majority of calories consumed in both developed and lesser developed countries. This, coupled with a sedentary lifestyle, has led to a variety of poor health outcomes.

Also Read: How Many Calories are there in CNY Snacks 

 

The NOVA Food Classification System

So what is ultra-processed food? There is a classification called The NOVA food classification system which categorizes food into 4 categories:

  1. Unprocessed and minimally processed foods,
  2. Processed culinary ingredients,
  3. Processed foods and
  4. Ultra-processed foods.

Ultra-processed foods include foods such as soft drinks, packaged snacks, reconstituted meat, and pre-prepared frozen meals. Ultra-processed foods also include ingredients like sweeteners, colours, preservatives and food-derived substances like casein, lactose and gluten.

 

Also Read: 7 Testosterone Boosting Foods That You Can Find In The Supermarket

 

What Ultra-Processed Food Can Do To YOU.

Ultra-processed foods may facilitate overeating and the development of obesity because they are typically high in calories, salt, sugar, and fat. Even in this study, the conductors of the study found that the ultra-processed meals differed substantially from unprocessed meals in the proportion of added to total sugar, insoluble to total fibre, saturated to total fat, and the ratio of omega-6 to omega-3 fatty acids.

Ultra-processed foods have been suggested to be specially created to have supernormal appetitive properties (make you hungry) that may result in pathological eating behaviour and overeating.

Furthermore, ultra-processed foods have been theorized to disrupt the normal pathways your gut communicates with your brain. This may “confuse” your brain, and even if you are full, the gut is unable to tell the brain to stop eating. This is independent of how the food tastes or how many calories it contains.

2 weeks after this article was published, 2 more articles were published linking ultra-processed foods with heart attacks, strokes and early death. Last year, a study linked ultra-processed foods with cancer.

 

So what does this mean for us?

If you want to curb your insatiable appetite, live longer and minimize your risk of cancers, heart attacks and strokes, please do cut down your consumption of ultra-processed foods.

Our bodies were evolved to consume unprocessed foods such as vegetables, fruits, whole grains, seeds, nuts and unprocessed meats. We were not designed to eat foods processed in a laboratory that can last 5 years sitting on a shelf. While I am still guilty of getting a burger and fries from a fast-food joint, or of going to a convenience store to get a microwavable meal, I try my best to limit myself to such foods to at most once or twice a month. We can opt for better options and dine at places where food is cooked with fresh ingredients. Even better still, dine with friends and family at home!

Home-cooked meals (heating up frozen foods like pizza or instant pasta is not counted) provide an ideal setting to have real food and real company.

Home-cooked food is usually more moderated in the addition of ultra-processed foods, fats, sugar and salt. Snack on a carrot stick or a baked vegetable chip instead of a pack of fried potato chips.

Opt for the healthier food option today!


Other Reads:

  1. What is Office Syndrome – Causes, Symptoms & Treatment
  2. What are the signs & symptoms of Nose Cancer
  3. Mycoplasma Genitalium (MG) – STD Screening, Testing & Treatment
  4. Chronic Pelvic Pain Syndrome Or Prostatitis
  5. 5 Ways to Fight Depression
  6. 8 Ways on How to Cope with Anxiety 
  7. 7 Common Causes of Knee Pain
  8. Trichomoniasis In Men And Women – Sexually Transmitted Infection
  9. De Quervain’s Tenosynovitis – Causes, Symptoms Treatment 
  10. Plantar Fasciitis – Causes Symptom Treatment
  11. Shoulder Pain – Cause, Symptoms & Treatment 
  12. Trigger Finger – Cause, Symptoms & Treatment
  13. Tennis Elbow & Golfer’s Elbow – What You Need to Know 
  14. STD Symptoms in Women, HIV Screening
  15. HIV Test Singapore

 

Trichomoniasis in Men and Women – Sexually Transmitted Infection

What is Trichomoniasis?

Trichomoniasis (also known as “trich”)  is a very common sexually transmitted infection caused by a parasite (a single-celled protozoan organism) called Trichomonas vaginalis. The US Centers for Diseases Control (CDC) estimates that about 3.7million people in the US have this infection.
Both men and women can be infected with trichomoniasis, although it is more common amongst women.

Only 1/3 of infected individuals actually develop symptoms and asymptomatic individuals can still transmit the infection to their sexual partners.

How is Trichomoniasis Transmitted?

Trichomoniasis is transmitted through sexual intercourse. The parasite commonly resides in the urethra in men (the urine tract), and the lower genital tract (including the urethra, vaginal canal and cervix) in women. Transmission occurs with genital to genital sexual contact. Sex toys may potentially be a mode of transmission if shared. The transmission does not occur through oral intercourse.
DidYouKnow:
Chlamydia, Gonorrhea, and Trichomoniasis are all common sexually transmitted diseases (STDs) that can cause infections in the genitals, rectum and throat. These diseases are easily spread by having vaginal, anal, or oral sex with someone who is infected with the disease. See: Gonorrhea Symptoms 

What are the Symptoms of Trichomoniasis?

In men, the symptoms of trichomoniasis may include:

  • Discomfort, itching or an irritation along the urine tract
  • Dysuria (pain) or discomfort when passing urine
  • Penile discharge
  • Discomfort or pain during or after ejaculation

In women, the symptoms of trichomoniasis may include:

Again, it is crucial to remember that less than half of infected individuals develop symptoms. As with many other STDs, feeling well does not rule out the possibility of trichomoniasis.


Learn More about Other STDs & Other STD Symptoms


What are the Possible Complications of Trichomoniasis?

Trichomoniasis infection in women has been shown to increase the risk of acquiring as well as transmitting HIV to partners.
In pregnancy, trichomoniasis increases the risk of preterm labour in pregnancy (going into early labour before the baby is due) and of the infant being of low birth weight.

How is Trichomoniasis Diagnosed?

In women, trichomoniasis can be diagnosed with a vaginal swab test or a urine test. In men, testing can be done with a urine sample, semen sample or urethral swab. Trichomoniasis is more easily diagnosed in women than in men. See: STD Screening
Test methods that involve nucleic acid amplification testing (NAAT) are highly accurate, while other methods like a culture (waiting for the parasite to grow on a culture medium) may potentially yield false negatives.

How is Trichomoniasis Treated?

Trichomoniasis is treated with oral antibiotics – either metronidazole or tinidazole. Both sexual partners should be treated so as to minimise the risk of the infection recurring.

How Can I Reduce My Risk of Getting Trichomoniasis?

Observing safe sexual practices can help reduce your risk of trichomoniasis – this includes the proper and regular use of condoms, reducing your number of sexual partners as well as ensuring both you and your partner get tested regularly for STDs, regardless of whether you have symptoms or not.
If you would like to find out more about Trichomoniasis Testing and Treatment, come down to any of our clinics for a consultation.
Also see: std test singapore

Why Should I Get My Allergies Treated?

A beginner’s walkthrough + secrets from the doctor on dealing with allergies…

There are many reasons and benefits to get your allergies treated. One of these reasons is to prevent the progression of the “allergic march”.

What is this allergic march you may ask? If the allergy is not diagnosed or treated, it can progress from sensitive skin (eczema), sensitive nose (allergic rhinitis) to food allergies or even sensitive lung (asthma).

This means that if we treat allergies early enough, you can save yourself the trouble from developing a sensitive nose, lung sensitivities or asthma.

All in all, this represents cost savings to you and your family, saving on doctor’s fees, medications, downtime at work or even precious time with your loved ones. Furthermore, the improvement in one’s quality of life, especially being able to enjoy your day at work or play without the spectre of allergies looming is immeasurably priceless.

There are many permutations how a life where allergies are treated and under control can play out – from getting a good night’s sleep without sneezing, to starting your day at the park with your family without feeling lethargic and drained to even enjoying a cherished and quiet moment with your loved one at a cafe without having to reach for a packet of tissue papers to stop a runny nose dripping mucus down your face.

Many studies have shown that treatments for nasal allergies and asthma are cost-effective. Cost-effective because of the monies saved from seeing the doctor or taking medications during a flare-up, cost-effective also from an improved quality of life.

Also Read: Doctor’s Overview Of Allergies & How To Help You And Your Loved Ones

Doctor, so how then can I get my allergies treated? Is there a permanent solution for this?

Well my discerning reader, I am glad you asked. Because there is a very permanent solution to treating and curing nasal allergies. But before I jump to that I will discuss steps you can take at home and natural remedies to improve your condition. We can then discuss a little about medical treatments available and last but not least, the permanent solution for allergies we brought up earlier.

See: Cure for Allergy (Sublingual Immunotherapy) 

 

Natural non-pharmacological treatments

Without further ado, we start with some tips on, non-pharmacological in helping improve your allergies. I break them down into 2 major points. The first of which is things you can do at home and the second of which is a way to build your tolerance to allergies

Things you can do at home

  • Dehumidify your house – low humidities have been shown to improve lung functions of patients with asthma
  • Get rid of dust mites by Sunning and drying your pillowcases and bedsheets under the warmth
  • Air purifiers that also have a HEPA filter (think Dyson, Xiaomi)
  • Dust protectors
  • Washing and vacuuming carpets and curtains regularly
  • Smoking cessation

When it comes to pets, current studies done have been conflicting to whether having a child exposed to a pet cat or dog in the first year of life would improve or worsen allergy sensitivities later in life, BUT if you do have allergies yourself (another good reason to get tested), there is a higher chance of your child inheriting the same genes which cause sensitivities.

Also Read: How Do I Stop Sneezing? – Allergy From Cleaning

Building your tolerance to allergies

A well-described study 10 years ago listed the following tips which may help build a tolerance to allergies. There were some impractical suggestions such as taking unpasteurized milk or living on a farm but we will focus on the more practical solutions we can adopt in our daily lives

Read: How Do I Know If I Have An Allergy

 

Consumption of probiotics

  • Increase in outdoor physical activities and time in nature
  • Taking more fresh fruit and vegetables
  • Consumption of healthy diets – the Mediterranean diet has often been mooted as a healthy paradigm

PS: Of course, this list is not exhaustive and it serves as an adjunct to treatment.

Where possible, we always advocate medications when necessary.

 

What are The Causes of Allergy?

 

Medications

Antihistamines

The first line of treatment comes in the form of tablets known as antihistamines. They are useful in providing relief for mild allergies, but most of the time, for those who have moderate to strong allergies, the relief is often short-lived and minimal.

Furthermore, there is an effect known as tachyphylaxis where over time, there is a diminishing response to the medications. Some antihistamines are also unfortunately drowsy, good for sleeping at night but not good for those who need relief in the day during their work.

Examples of antihistamines include – Loratidine, Zyrtec, Diphenhydramine, Chlorpheniramine, Telfast

Decongestants

The next set of medications that are useful for allergies are decongestants. They act by constricting the mucous membranes in the nasal passages, decreasing the symptoms of a blocked nose and are available either as nose sprays or tablets.

Examples of decongestants include Iliadin nose drops, Fedac, Clarinase, Zyrtec (D) and Telfast (D)

For nose drops such as iliadin, preparations for infants and babies are also available, but caution is advised as these cannot be used for more than 5 days as it causes a rebound blocked nose. However, for short term use, they are safe and effective.

Nasal rinses (Salt water nasal washes)

For many patients with allergies, a thick layer of mucus or even allergens can get trapped in the nasal mucosa surfaces.

If using nasal spray medications such as decongestants or intranasal steroids, these medications can fail to get to where it is needed for absorption if the nasal passages are clogged with mucus.

Furthermore, some allergens may remain trapped on these airway mucosal surfaces resulting in the recurrence and unremitting of symptoms.

There are many nasal rinses that are available over the counter from pharmacies – from Nettipot to Sinusrinses. BUT again caution is advised that these rinses have to be done with Saline (salt water) and not normal water otherwise it would not work! Also, the saline comes as sachets which you mix water with, and these come together with the sinus rinse / nettipots as a package.

Anti-leukotrienes

This fancy sounding tablet medication blocks the chemical reactions that can lead to  inflammation in the airways. This medication is relatively new, only introduced in the last 10 years and is used in both sensitive nose and sensitive lungs. It can be taken with antihistamines and it improves symptoms. It is also safe and well-tolerated for children (with a chewable form with a nice flavour)

Examples: Montelukast, Singulair

Nasal Glucocorticosteroids

People are often worried about the negative connotations behind steroids as treatment. In fact, low doses of steroids especially targeted at the nose are found to be extremely effective for allergic nose symptoms.

These are very well tolerated but usually, need at least 1 week for a cumulative effect to build up and subsequently see the manifestation of its benefits.

Common examples of this include Nasonex and Avamys.

Inhaled Glucocorticosteroids

In treatment and prevention of asthma, inhaled steroids – often known as the brown, red or purple inhalers, help reduce and prevent airway inflammation and subsequent asthma symptoms.

Examples of this include Symbicort, Seratide and Beclomethasone.

In asthma, inhaled corticosteroids are used for moderate to severe asthma. Again, because of the life-threatening incidences of asthma, it is always advisable to keep asthma under control and prevent flare-ups.

Whether it is inhaled steroids or nasal steroids, at recommended doses which is targeted, they are very safe, even for children and have NO long term or negative effects on children and adults.

Oral Glucocorticosteroids

In adverse situations where asthma control is poor, tablet steroids are given as a short course over a few days to quickly reduce the inflammation in the airways. These have their own short term side effects such as risks of gastric ulcers or causing blood sugars to rise in those with diabetes, and your doctor will balance the pros and cons of this treatment, including the necessary precautions before prescribing this.

Examples of this medication include prednisolone, hydrocortisone.

Topical steroids

For conditions such as eczema, topical steroids such as creams or lotions are effective in the short term reducing the inflammation and irritation on the skin. But long term usage causes the skin to thin and may resultantly interfere with the skin’s repair.

For the skin’s natural barrier repair and protection, we always advocate using moisturizers instead.

Common examples of topical steroidal preparations include hydrocortsone, elomet, clobetasol, desowen.

Doc, you’ve rattled on and on about different medications I can take for my allergies, but what about the long term, the permanent solution you were talking about?

Well, if you have read on this far, let me cut to the chase.

The definitive way of treating allergies is ultimately to target the root cause. And at Dr Tan & Partners (DTAP Clinic), we offer a2 step solution in identifying the root cause and treating it.

Step 1: Allergy Testing

This is either done with a Skin Prick Test – suitable for children and adults. And whilst skin prick does sound scary, rest assured that it is well tolerated by children where a plastic prong is used to introduce a small amount of allergen onto the skin, thereby eliciting a response.

More on that in our allergy testing video

How Does Skin Prink Test Work?

This procedure is PAINLESS but ITCHY. The downside about skin prick testing is that the choices for testing are limited and not as vast as blood testing. Some patients do prefer a simple and quick blood test where others preferred to be spared the pain of a blood test. Whichever your choice, knowing your allergy is half the battle.

Step 2: Allergy Treatment

Allergy Treatment would then involve “priming” the body on a daily basis to recognize and eventually stop reacting to the exact cause of the allergy. This treatment is also known as Sublingual Immunotherapy or SLIT.

A mix of low dose allergens are created in a spray, this spray is taken once a day under the tongue for 3-5 years. Another preparation specifically for dust mite allergies also come as an under the tongue tablet for adult patients. For those with dust mite allergies and frequently on the go, this might be a better option of SLIT rather than the spray.

This 2 step approach has brought lots of success for allergy sufferers and usually, patients start to see an improvement of their symptoms at 6 months

Improvements such as lesser frequency and or severity of symptoms, lesser usage of medications, effects of cure lasting long even after treatment has been completed.

In fact, 2 large medical bodies have further supported the benefits of SLIT. The World allergy organization describes the benefits of SLIT as follows: besides controlling symptoms, SLIT has the potential to completely cure such allergies for good and or even prevent them from developing at all (allergic march).

Singapore’s Ministry of Health has also released recommendations that SLIT should be considered for children over 5 that have poor control of their sensitive nose (repeated attacks and symptoms) even with maximum oral therapy and also for those children who are unable or will not take medications. In simple terms, SLIT is good for children who do not like taking medications or when medications are no longer effective.

And if you are a parent, worried about your child’s allergies, you would be pleased to know that across numerous studies, SLIT significantly reduces their nasal symptoms and has a nearly 4x likelihood of NOT developing asthma. For those children who already have asthma, SLIT also shows a reduction in asthma and the associated lung allergies.

Safety and side effects

To sum everything up, it is also important to know that SLIT has an extremely good safety profile. In more than 60 studies done in the year 2006, more than 1 million doses of SLIT were administered across more than 4000 patients with ZERO life-threatening reactions.

However, just like all medical treatment, there were still some side effects which occurred in 14 out of the million doses. These included itchiness and swelling over the mouth, lips or throat. Stomach pain, discomfort, nausea, asthmatic symptoms.

 

If you wish to speak to our doctors about the above allergy testing and allergy treatment, please email us at hello@dtapclinic.com.sg. You can also walk-in or call our Holland Village or Raffles Place branches for Skin Prick Testing or Sublingual immunotherapy (SLIT) Allergy Treatment.

 

Other Read:

  1. How Do I Stop Sneezing? – Allergy From Cleaning
  2. How Does Skin Prick Test Work?
  3. How Do I Know I Have Allergies?
  4. Why Should I Get My Allergies Treated?
  5. Doctor’s Overview Of Allergies & How To Help You And Your Loved Ones

Tag: allergy test singapore

 

Is HPV Vaccine Necessary for Males?

HPV is a virus that can infect both males and females of all ages. HPV infections may lead to diseases such as skin warts, genital warts, vaginal/vulvar cancers, cervical cancer, penile cancer and anal cancer. There are hundreds of subtypes of HPVs, with about 40 known to affect the genital area. Of these, there are high-risk types known to cause cancer and low-risk types which may cause genital warts. Vaccines against some of these high and low-risk types are available today.

 

Most HPV infections clear naturally, but there is no way to predict who can clear the virus on their own, or who will carry the virus and potentially spread it. The virus itself cannot be treated. However, some of the diseases it causes can be managed. For example, if a person infected with HPV presents with a wart, we can use medications to treat it or use various techniques to remove it, but the virus itself is not eradicated from the body. That is why vaccination is so important for everyone so that the virus will not take root in the body.

 

HPV vaccinations have been available since 2006, and the vaccination has seen high uptake in many countries as they have been introduced into their national immunization schedule. HPV vaccination, along with pap smears and HPV testing, has been the cornerstone in reducing the burden of cervical cancer in women. In fact, we are already starting to see the benefits of this vaccine in reduced precancerous lesions of the cervix among countries with high uptake of this vaccine.

Read: Counterfeit HPV Vaccines (Gardasil 9) In Hong Kong

The vaccination in its early introduction largely left out males. The U.S. Food and Drug Administration has recently approved the use of Gardasil 9 for both males and females ages 9 to 45. The HPV vaccination is also now recommended by the U.S Center for Disease Control for men through age 21, for men who have sex with men, transgendered people, or those who have a compromised immune system (including HIV) who are ages 26 and younger. In the UK, from September this year, boys aged 12 and 13 would be offered the shots as part of a government health programme.

Read: HPV Vaccination for Men-Who-Have-Sex-With-Men

HPV has been linked to more than 99 per cent of cervical cancers, as well as 90 per cent of anal cancers, about 70 per cent of vaginal and vulvar cancers and more than 60 per cent of penile cancers. The protection against female cancers has already been proven. It also appears that vaccinated boys will receive some protection against anal and penile cancers as well.

 READ: Perianal Warts (Peri-Anal Warts) & Anal Warts Removal

 

There are 3 different types of HPV vaccines available in Singapore. Cervarix, which protects against 2 high-risk HPV types – 16 and 18. Gardasil 4, which protects against the high risk 16 and 18 and 2 more low-risk types 6 and 11. And Gardasil 9, the only vaccine used in the United States now which protects against 9 subtypes (6, 11, 16, 18, 31, 33, 45, 52, and 58). The vaccination schedule is 3 doses; one on your first visit, one 2 months later and the last one 6 months after the first dose (0,2,6) Other dosing schedules may be suitable depending on your age.

So should you as a male get vaccinated? Speak to your doctor about it to discuss the pros and cons. As for myself as a male – I’m already vaccinated.

HPV Vaccination is available in all our clinics in Singapore & Malaysia


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  14. 10 Common HIV Related to Opportunistic Infections

Why the recent resurgence in Dengue Fever?

An article was recently published in the Straits Times on 17th July 2019 titled “Weekly dengue cases hit 3 1/2-year high”. This is the latest in a series of news articles over the past few months reporting about the resurgence of dengue cases in Singapore. Make no mistake, dengue fever is back and it is on the rise.

The numbers so far..

According to figures released by the National Environment Agency (NEA), 666 dengue cases were recorded between 7th to 13th July 2019. This is the highest weekly total since January 2016, and brings the overall total to 7,374 dengue cases this year. This is a staggering five times more than the 1,481 cases recorded by this time last year. Sadly, dengue fever has also claimed five lives so far this year.
Our country has weathered dengue epidemics before in the past. A total of 14,209 and 8,826 dengue cases were recorded in 2005 and 2007 respectively. The highest ever single-year total was 22,318 cases in 2013, with eight fatalities. In contrast, dengue infections fell to a record 16-year low in 2017 with 2,772 cases, while 2018 had 3,285 cases.
Based on the number of cases so far this year, it is undeniably worrying that we could be heading towards another dengue outbreak.

Why the recent resurgence in Dengue Fever?

Experts believe that this is due to a combination of three main factors: The Aedesmosquito population, the strength of the virus, and immunity of the general population.
The Aedesmosquito population has been noted to be increasing over the past months, with the majority of breeding sites found in homes. Herd immunity is also generally low in Singapore and is likely to have further weakened given the low incidence of dengue cases in the past two years.

The link between Climate Change and Dengue Fever

On a larger scale, global warming may play a detrimental role in dengue transmission. A study was recently published in the journal Nature Microbiologyon 10th June 2019, stating that with rising temperatures, mosquitoes are able to thrive in places where they previously were unable to, thereby expanding the range of dengue fever. Also, warmer temperatures reduce the time taken for an Aedes mosquito to mature into a biting adult.
The study predicts that by 2050, parts of the world that may become dengue-suitable include coastal eastern China and Japan, southeastern USA, central Mexico, northern areas of Argentina, inland areas of Australia and southern Africa.
The study also forecasts that 2.25 billion more people will be at risk of dengue in 2080 compared to 2015, bringing the total population at risk to over 6.1 billion, or 60% of the world’s population.

A Recap of Dengue Fever

Dengue fever is a vector-borne disease caused by the dengue virus, and is carried and transmitted by the bite of an infective female Aedesmosquito. When a mosquito bites a person infected with the dengue virus, the virus enters the mosquito. Thereafter, it remains infective for the rest of its lifespan. Dengue fever does not spread from one person to another.
There are four types of dengue virus circulating in the world, including Singapore. This means that individuals can be infected with dengue up to four times. First-time dengue infections can be severe, especially among the elderly and those with pre-existing medical conditions. Repeat dengue infections are usually more severe, with high risk of developing dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), both of which can be fatal.

Signs and Symptoms

Up to 75% of dengue infections are asymptomatic. If symptoms do occur, they develop after an incubation period ranging from 3 to 14 days, and include the following:

  • Sudden onset high fever for 2 to 7 days
  • Severe headache with retro-orbital (behind the eye) pain
  • Joint and muscle pain
  • Nausea and/or vomiting
  • Skin rash
  • Mild bleeding of the nose and gums or easy bruising of the skin

Most people recover within about 1 week or so, but less than <5% of all cases, the symptoms can worsen and progress into DHF and/or DSS, which is a life-threatening emergency. They include the following:

  • Severe abdominal pain
  • Persistent vomiting with or without blood
  • Bleeding under the skin
  • Bleeding from the nose, mouth and gums
  • Black stools or blood in the stools
  • Clammy, cold skin
  • Restlessness or irritability
  • Fatigue

Diagnosis

Your doctor will take a detailed history, in particular, any recent travel history, as well as any contact you may have had with mosquitoes. Dengue fever is diagnosed via blood tests for dengue profile and full blood count.

Treatment

There is no specific treatment for dengue fever. Instead, treatment for dengue is mainly supportive and depends on the symptoms present. It is recommended to drink plenty of fluids in order to avoid the risk of dehydration. Those who are able to stay well hydrated, are passing urine, and otherwise feeling well, can be managed at home with daily follow-up. Paracetamol can be taken to alleviate pain and reduce fever, but non-steroidal anti-inflammatory drugs (NSAIDs) such as Naproxen and Ibuprofen should be avoided as they can increase the risk of bleeding complications.
Patients who have pre-existing health conditions, “warning signs” of severe dengue fever, or cannot manage daily outpatient follow-up, should be cared for in hospital. Intravenous fluid and electrolyte replacement, platelet and/or blood transfusions may be required.
 

Prevention

The key to reducing dengue fever transmission is by controlling the mosquito population and human exposure. On a national level, Singapore has teamed up with other countries to observe ASEAN Dengue Day, which is part of a concerted effort committed to reducing the burden of dengue fever in the region.
The NEA, various agencies and Town Councils are part of an Inter-Agency Dengue Task Force (IADTF), which works to remove potential mosquito breeding habitats containing clean, stagnant water sources in public areas and housing estates.
All members of the public are also strongly encouraged to do their part in preventing and removing such breeding habitats. The NEA advocates people to perform the Five-step Mozzie Wipeout, which is as follows:

  1. Turn the pail
  2. Tip the vase
  3. Flip the flowerpot plate
  4. Loosen the hardened soil
  5. Clear the roof gutter and place Bti insecticide inside

Some precautions that you can take to prevent getting bitten by mosquitoes are:

  • Stay in air-conditioned environment, and install structural barriers such as window screens or insecticide-treated netting
  • When in an area with mosquitoes, expose as little skin as possible by wearing a long-sleeved shirt, long pants, socks and shoes
  • Use mosquito repellent containing at least 10% concentration of diethyltoluamide (DEET), a substance that deters and repels biting insects

The above advice applies also to persons who have been infected with dengue fever.

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

Find a doctor | Make an appointment


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Apakah Simtom HIV Dan STD?

Hai, Saya Dr. Taufiq dari Dr. Tan dan Partners, dan hari ini saya ingin bercakap mengenai simtom penyakit kelamin atau STD, dan HIV.

Doktor yang boleh berbahasa melayu


Apakah simtom HIV dan STD?

Penyakit kelamin atau STD berpunca dari beberapa jenis virus, bakteria atau kuman yang boleh menjangkiti seseorang melalui hubungan seks dengan pasangan yang sudah pun mempunyai jangkitan tersebut. Penyakit HIV pula berpunca dari virus yang dikenali sebagai Human Immunodeficiency Virus, dan ia juga tersebar melalui hubungan seks.


Simtom-simtom STD

Simtom-simtom STD boleh dibahagikan kepada tiga jenis – simtom semasa kencing, simtom pada kulit dan simtom umum. Simtom-simtom STD boleh mengambil masa yang berbeza untuk muncul – ada yang mungkin seawal 3 hari selepas hubungan seks, ada juga yang mengambil masa beberapa minggu atau bulan untuk menjadi jelas. Ada pula sesetengah orang yang dijangkiti STD, tetapi mereka tidak mengalami apa-apa simtom yang nyata.


Jangkitan Chlamydia dan gonorrhea (CGP)

Jangkitan Chlamydia dan gonorrhea (CGP) adalah penyakit STD yang paling kerap dijangkiti. Antara simtom 2 termasuk pengeluaran cecair dari kemaluan.

Ada juga yang dijangkiti tapi tidak menunjukkan apa2 simtom. Jangkitan ini juga boleh membawa kepada kemandulan.
Di klinik kami di somerset, ada meneyediakan khidmat pemeriksaan CGP pantas.

Anda boleh mendapat keputusan dalam masa 24 jam. Pengesanan awal dapat membolehkan rawatan awal.

Simtom-simtom HIV pula mungkin berbeza bergantung pada individu dan peringkat penyakit.


Simtom-simtom HIV

Bagi seseorang yang mengalami jangkitan HIV peringkat awal, mereka mungkin dapat melihat simtom-simtom tertentu dalam masa 2 hingga 4 minggu pertama.

Simtom yang paling ketara pada peringkat awal ialah selsema yang serius, yang selalu disifatkan sebagai “selsema yang paling buruk yang pernah dialami”.

Keadaan ini dikenali sebagai sindrom retroviral akut, atau ARS. Sindrom jangka pendek ini disifatkan dengan sakit tekak, ruam, keletihan, sakit-sakit badan dan sakit kepala. Simtom-simtom HIV boleh berlarutan dari beberapa hari hingga ke
beberapa minggu.

Selepas jangkitan HIV peringkat awal, simtom-simtom penyakit ini mungkin hilang. Tapi awas, jangkitan HIV mungkin sudah mara ke peringkat kedua yang dipanggil peringkat latensi. Pada peringkat ini, virus HIV membiak di dalam tubuh badan, tanpa menunjukkan apa-apa kesan yang jelas seperti simtom- simtom yang telah saya katakan tadi.

Peringkat terakhir jangkitan HIV dikenali sebagai penyakit AIDS. Pada peringkat ini, fungsi perlindungan dalaman atau sistem imun badan akan mula merosot.

Seseorang yang mempunyai penyakit AIDS akan lebih senang jatuh sakit, dan mungkin juga mati kerana sebab-sebab yang pada asasnya, tidak serius.


HIV Rapid Test

Untuk mengesan jangkitan HIV, ujian pantas HIV (HIV Rapid Test) hanya boleh diambil sekurang-kurangnya 14 hari selepas anda terdedah pada aktiviti berisiko tinggi.Ini adalah ujian generasi ke 4 dimana ia boleh mengesan HIV
seawall 14 hari.

Ujian generasi ke 3 pula memakan masa 90 hari selepas pendedahan sebelum boleh mengesan HIV.


PrEP dan PEP

PrEP (Pre-Exposure Prophylaxis) adalah ubat yang diambil untuk mengelak daripada menjangktii virus HIV. PEP (Post exposure Prophylaxis) pula adalah ubat yang diambil setelah terdedah pada virus HIV.

PrEP biasanya digalakkan bagi mereka yang berisiko tinggi untuk mendapat HIV seperti golongan yang mempunyai pasangan yang berbeza, lelaki yang berhubungan sesama lelaki lain.

PEP pula di galakkan bagi golongan yang terdedah pada HIV. Contohnya kondom yang pecah sewaktu bersetubuh, berhubungan dengan pekerja seks tanpa kondom dan pendedahan pada HIV melalui suntikan jarum. (needlestick injury).

Klinik kami di daerah Orchard Road di Somerset ada menyediakan kedua- dua jenis ujian HIV serta perkhidmatan PrEP dan PEP.


Apa itu HPV

HPV atau Human Papilloma Virus adalah sejenis virus yang merebak melalui sentuhun kulit. Ia boleh menyebabkan ketuat (warts) serta kanser pangkal rahim (cervix).

Kini ada vaksin yang bleh melindungi anda daripada 9 jenis virus HPV. Ia dinamakan Human Papillomavirus 9-valent Vaccine. Human Papillomavirus 9-valent Vaccine adalah satu-satunya vaksin yang boleh mengelak daripada kanser. Ia digalakkan bagi lelaki dan perempuan berumur 12 tahun ke atas.

Kami ada menyediakan khidmat vaksin Human Papillomavirus 9-valent Vaccine di klinik kami di daerah Orchard Road di Somerset.

Saya telah pun memberikan penerangan ringkas tentang penyakit STD, HIV dan AIDS.

Sebelum saya akhiri, saya ingin memberi beberapa pesanan.


Kesimpulannya

  • Pertama, saya ingin menegaskan bahawa simtom-simtom seperti selsema, sakit tekak, sakit badan dan sebagainya, sama seperti simtom-simtom untuk penyakit biasa. Jadi, janganlah tergopoh-gapah untuk menganggap bahawa awak telah dijangkiti penyakit HIV hanya kerana awak ada simtom-simtom tersebut. Pada masa yang sama, saya juga ingin mengingatkan bahawa ramai orang yang dijangkiti penyakit HIV tidak menunjukkan apa-apa simtom yang jelas dan nyata.

Jika awak berasa ragu tentang kesihatan awak, adalah wajar untuk berjumpa dengan doktor yang bertauliah untuk mendapatkan pemeriksaan dan kepastian.

  • Kedua, mujurnya, kini kita sudah boleh merawat dan mengawal penyakit HIV dengan lebih berkesan. Sekiranya anda mendapatkan rawatan untuk jangkitan HIV, anda mempunyai peluang untuk hidup dengan sihat, dan bebas dari simtom-simtom ini untuk masa yang lama.
  • Ketiga, anda hanya akan dapat mengesahkan penyakit HIV dan kesihatan anda melalui ujian khas, tiada jalan lain untuk mendapatkan kepastian ini.

Sekiranya anda bimbang tentang kemungkinan pendedahan, atau anda mengalami simtom-simtom STD dan HIV, sila lawati klinik kami untuk penilaian dan ujian yang betul. Kami sedia membantu untuk memberi nasihat dan rawatan yang diperlukan. Bicaralah dengan dokter Anda hari ini!


Tag: hiv test

Doctor’s Overview of Allergies & How to Help You and Your Loved Ones

Accept?, Avoid? or Act! – A doctor’s overview of allergies and how to help you and your loved ones


Stuffy or Runny Nose? 
Postnasal drip coughing? 
Itchy, watery eyes?
Itchy Rashes?
Sneezing, feeling tired, irritable and miserable?

Chances are if you or your child has faced any of the above symptoms, you likely are suffering from allergies.

Allergies are becoming more common worldwide. In our urban environments such as Singapore, industrialization and climate change has caused more people to become sensitive to allergens, developing new allergies or even getting worse symptoms from their present allergies.

Besides the persistence of symptoms, the indirect costs of an undiagnosed allergy pile up – medications that do not work, medication side effects, frustration, unable to enjoy a normal day and the list goes on…

Read: How Do I Know If I Have Allergies?

In the adverse situation, the allergy may worsen in the “allergic march”. If you or your child’s allergy is not diagnosed and treated, there is a chance the allergy will go from sensitive skin (eczema),  sensitive nose (allergic rhinitis) to food allergies to mild lung allergy (bronchial hyper-reactivity) and then to severe lung allergy (asthma).

The symptoms we described above can all be caused by a simple sensitive nose!

According to the World Allergy Organization (WAO)’s white book report, for those with allergies, more than half of adults, as well as 9 in 10 children, suffer from concurrent sleep problems. These sleep problems add up and cause daytime lethargy, tiredness and even decreased cognitive functioning. These further translate into behaviour and inattention problems in children and learning disorders in class.

Targeted and appropriate treatment for allergies prevents the “allergic march”. This can prevent future development of sensitive nose, mild or severe lung allergy, potentially saving families money and time.

Home remedies and medications such as antihistamines, decongestants, nasal sprays all help decrease allergies and their resultant symptoms. But they do not cure the problem. The symptoms often come back after the medications are stopped. 

The definitive way of treating allergies is ultimately to target the root cause. And at Dr Tan & Partners (DTAP Clinic), we offer a 2 step solution in identifying the root cause and treating it.

 

Step 1: Allergy Testing (Skin Prick Testing)

Allergy Testing involves a Skin Prick Test (itchy and painless procedure suitable for young children) or a blood test to determine the nature of the allergy. These allergens can be anything from house dust mites, cat or dog dander, pollen or even food such as eggs, peanuts, seafood!

Read more: How Does Skin Prick Test Work?

 

Step 2: Allergy Treatment (Sublingual Immunotherapy or SLIT)

Allergy Treatment then involves “priming” the body to stop reacting to the exact cause of the allergy. This treatment is also known as Sublingual Immunotherapy or SLIT. A mix of low dose allergens are created in a spray, this spray is taken once a day under the tongue for 3-5 years. Most patients see an improvement after 6 months and the best effects are usually seen after 4 years.

 

SLIT is currently produced for and useful for inhalant allergens only. (I.E unfortunately not useful for food allergens yet)

Studies have shown an improvement in symptoms, reduce reliance on medications and the lasting effects many years later even after treatment has stopped.

Overall this is a safe and effective treatment with no life-threatening reactions reported in over 4500 patients treated.

So if you have been nodding your head in agreement with the points I’ve shared in this article or even wonder if you have an allergy, speak to our doctors today to get your allergy questions answered once and for all!

If you wish to speak to our doctors about the above allergy testing and allergy treatment, please email us at hello@dtapclinic.com.sg. You can also walk-in or call our Holland Village or Raffles Place branches for Skin Prick Testing or Sublingual immunotherapy (SLIT) Allergy Treatment.
Other Read:

  1. How Do I Stop Sneezing? – Allergy From Cleaning
  2. How Does Skin Prick Test Work?
  3. How Do I Know I Have Allergies?
  4. Why Should I Get My Allergies Treated?
  5. Doctor’s Overview Of Allergies & How To Help You And Your Loved Ones


Tag: allergy test singapore