Obesity, particularly abdominal obesity, is associated with insulin resistance (where your body is resistant to the effect of insulin and requires higher levels of insulin to maintain the same level of glucose) and this often leads to the development of diabetes. The definition takes into account a few parameters, namely your glucose levels, triglyceride levels, good cholesterol levels , blood pressure and waist circumference. Smoking, high carbohydrate diet and lack of exercise are a few of the factors that increase your risk of having metabolic syndrome.

Thank you for your question. There can be many reasons why someone would experience excessive daytime sleepiness. As the potential causes are varied and have been well-covered by both Dr Tze Yong and Dr Ethan, I shall not be repetitious. One of the most common cause of excessive daytime sleepiness (if you do not have poor sleep habit, sleep deprivation, insomnia and medical problems or are on medications that disrupt sleep) is Obstructive Sleep Apnoea or OSA.

There can be other causes for raised PSA other than cancer, like prostate inflammation, infection, benign enlargement or perineal region trauma. The first step is to rule out all these reasons that may be causing the elevated PSA. Should there be a need for more advanced measurement of PSA parameters, your physician can further advise. It would be good for you to see a urologist for a full clinical consultation and examination before proceeding further.

Dr Theng has given a wonderful answer. Oral sex is generally considered safe but there is a low risk of transmission if there are some open wounds which may not be obvious.

Just to add to Dr Quan's answer, an enlarged spleen is a definite "No" to playing contact sports. You see, if the spleen is enlarged and struck during contact sports, it can cause significant bleeding and pain. In fact, it could lead to shock. This is a concern in younger patients who develop splenomegaly after illnesses such as glandular fever. I hope this helps.

My answer, to your question in brief is that it’s worth a shot (pun not intended). From your details, you clearly fall into what doctors term “expert patients”. Ie. you’ve done a significant amount of online reading into your problem, and possible solutions. Not to mention, sought the advice of multiple specialists. So please take my online reply for what it is – an extremely limited internet source (without the requisite examination, investigation results, specialist opinions and detailed questioning that a doctor seeing you in person would have).

Sorry to hear that there is a fragment left behind at the extraction site. I do agree with Dr Gerald that it sometimes happens to even the best of us. While trying to extract a tooth, sometimes it makes more sense to leave a small little fragment behind, than to scour and cause more damage to the surroundings. Generally if the fragment is small and uninfected, problems shouldn’t arise from it. After a year (since your surgery was at March 2017), we have to weigh the pros and cons of removing the fragment especially if it’s firmly embedded and hard to access.

A genetic predisposition is one of the most important risk factors for the development of melasma (Melasma: A Clinical and Epidemiological Review; An Bras Dermatol. 2014). However, no definite clear pattern of inheritance has been identified so far. Most studies in various populations around the world in patients with melasma cite a positive family history and at least one relative with melasma, as high as 97% of first-degree relatives. However, there are other factors at play too, such as female gender, as you rightly pointed out, hormonal influence, pregnancy, and skin type/colour.

From the sounds of it, you're most worried about cancer (which I can understand, given your father' s colorectal cancer) so let's address that first. Dull pain near tailbone -> anal pain - could it be cancer?

Thank you for asking this question that will benefit a lot of readers. I can imagine that you would be worried about a lump over your chest. An ultrasound is usually ordered by the GP or specialists to tell us more information about a lump. For me, I am a family physician, usually we will write a letter that will allow you to be scanned in a neighborhood location. Usually costs about a hundred. There are some GP clinics that have an ultrasound machine. But I'm not very sure of these clinics locations at the moment. Usually the doctor has to agree that a scan is required.

Simply put. There are benign causes and worrisome ones. If the frequency is unusual and lasting longer than a minute or two, I would advise you to get it checked. At the A&E, our practice would be to first examine where the bleeding occurs, if it’s at the front and easily seen it’s usually due to mucosal injury be it nose digging or blowing your nose very hard. Some medicines like acne medications can cause dry mucosa, as can cold weather and climates.

I am sorry to hear that you are experiencing sinus infection (medically known as sinusitis) every 1-2 months. It is important to determine if the "sinus infections" are indeed sinusitis. Common symptoms of a sinus infection includes: Blocked nose Facial congestion or pain Coloured nasal discharge/mucous (yellow, brown, green or even blood stained) Postnasal drip Reduced sense of smell A sinus infection usually last longer than 10 days or continues to worsen on day 5 of your illness.

In general BP monitors around the upper arm are more accurate than those around the wrist, although the latter are certainly more convenient to wear and easier to access. It might be worth checking your matching against a reading from one taken at a clinic, so that you know if there is a degree of error. For the arm machines, please remember to use the correct size cuff - this depends on your arm size. Hope this helps.

Thanks for your question - really relevant to many people in Singapore. For mildly elevated cholesterol, I would suggest first trying dietary changes together with exercise, provided you don’t have any other significant cardiac risk factors such as high BP, diabetes or a family history. You might benefit seeing a dietician, a sports physician or an exercise physiologist to help you. They can advise on diet and set up an exercise program for you based on broad principles. After about 3-6 months of this, it would be worthwhile rechecking to see if things have improved.

Light headed sensation when standing up from sitting or lying position may be quite normal for a lot of people, especially young female. This is called postural hypotension. Management usually consists of being aware of the issue and more cautious when standing up. Some people may feel light headed (or even faint) AFTER exercise or after prolonged standing still. This is called vasovagal attack.