Category Archives: Health Quaries

Some Health Quaries & Answers

Fungus on my nails :

Q: I think I have fungal infection of my nails. They are discoloured and break easily. I also have white patches on my skin that have been diagnosed as psoriasis.

A: Psoriasis can cause nail dystrophy. This means the nails may be pitted, discoloured or have ridges, and break easily, crumble or separate from the nail bed. Sometimes this can co-exist with fungal infection of the nail or secondary bacterial infection of the nail bed.

Psoriasis of the nails has no specific treatment. The nails should be kept short. Nail varnish or henna may be used to disguise the appearance. If the psoriasis is complicated by fungal or bacterial infection, specific treatment needs to be taken after consulting a doctor.

Cat bite :

Q: My neighbour’s cat bit me. Please advise.

A: People are aware of the dangers of dog bite and immunise their dogs. Unfortunately, they don’t do the same for cats although these animals are equally likely to transmit rabies.

The wound should be cleaned with soap and water. Then an antiseptic solution (not powder or ointment) must be applied. A dose of tetanus toxoid should be taken. Proceed to take anti rabies treatment. You will need three injections if the cat is alive and healthy after your third shot. If the cat is missing, ill or dead, you need five. The injections have negligible side effects.

Green diet

Q: How much of fruit or vegetables should I eat?

A: Four to six helpings daily is considered ideal and sufficient to provide the required amount of fibre and antioxidants. It also adds bulk to the food, filling the stomach and reducing total calorific intake. You might also try adding one or two tomatoes. Tomatoes contain large quantities of lycopene, a powerful antioxidant. Unlike the nutrients in most fruits and vegetables, lycopene retains its potency after cooking and processing.

Body odour

Q: My aunt has a strange body oder . She bathes daily but the smell is all pervading.

A: Body odour can be due to sweat or disease. If she is an elderly person, it might be worthwhile to arrange a complete physical examination for her to rule out any obvious infection or cancer. She also needs to be evaluated for diabetes, liver and kidney disease. These systemic illnesses can cause altered unpleasant body odour.

Sleepy baby

Q: My baby sleeps most of the time. I am worried she’s sleeping too much.

A: The sleep requirement of infants varies widely and can fluctuate from nine to 19 hours. Some parents complain their child never sleeps while others say theirs is always sleeping. If the baby is feeding well and gaining weight, and doesn’t have constipation or diarrhoea, you probably have nothing to worry about. After all, the sleep patterns of adults too vary from four to eight hours a day.

Sugar control

Q: I read that there are several new and improved diabetic medicines in the market. But my doctor insists on the same old metformin. My diabetes is not under very good control.

A: Good control of diabetes requires dieting and exercise. If you aren’t compliant, don’t eat in a measured way and refuse to walk or exercise, your diabetes will probably stay uncontrolled. Try to correct these factors first.

Metformin is a tried and tested medication. It does not cause the blood sugars to drop to dangerously low levels. The biggest advantage is it is taken after food. Indians tend to fast on certain days. If a person administers insulin or takes medication after fasting, the sugars may drop to dangerously low levels.

School shoes

Q: My son’s school issues “regulation shoes”. These give him painful shoe bites.

A: Ensure the shoes are of the correct size and are always worn with socks. Rub a piece of Lifebuoy or Hamam soap on the dry feet before wearing them. Do not wash it off. This will prevent shoe bites.

Source: The Telegraph ( Kolkata, India)

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Some Health Quaries & Answers

Getting Rid of Body O dour
Q: I have been suffering from body odour, particularly from the armpits, for the last two years. The problem is so severe that if someone around me coughs, sneezes or looks away, I feel it’s because of my body odour.

A:
You may be becoming self-conscious and attributing all actions of others to your odour. That may not be the case. However, to tackle the problem,

• Remove all the hair from your armpits and groin area

• Bathe twice a day using a loofah

• Use an antibacterial germicidal soap like Neko

• Wear only pure cotton clothes

• Apply body spray to the armpits after bathing

At work, if you feel particularly conscious, take a fresh shirt with you (buy two identical shirts, so no one will know you have changed). Change around 2pm after washing and spraying just your armpits.

Ear discharge
Q: My son has brown-coloured blood oozing intermittently from one ear. He does not have any pain or fever when this happens. We consulted a doctor but there was no discharge at that time.

A:
First, you have to be sure the secretion is actually blood. At times, the ear gets filled with brown wax, which can ooze out at times. But if it is blood, it’s a dangerous sign. It may be due to an infection, injury or a foreign body that the child may have inserted into his ear. If neglected, it can affect his hearing. Consult an ENT (ear, nose, throat) surgeon immediately.

Recurrent tonsillitis
Q: My daughter is prone to tonsillitis. The doctor has to give her antibiotics at least five times a year, and these are usually sulfa drugs. Recovery, however, is hardly ever complete and she keeps coughing and complaining of pain for a long time afterwards. She has now been advised tonsillectomy.

A:
Tonsillitis is not always due to a bacterial infection. If it is because of a virus, antibiotics will not work. Bacterial infection in the tonsils is characterised by high fever and pain and difficulty in swallowing. Also, the sulfa group of drugs does not act against tonsillitis; you need to take penicillin or azithromycin. There are some age-old preventive measures for tonsillitis like regular gargling twice a day with warm, salted water.

Tonsillectomy is not advised unless one suffers from six or more attacks a year. Moreover, the child should preferably be over 10 years. The operation has its own dangers, drawbacks and after effects.

To shave or not
Q: My facial skin becomes black, rough and thick when I shave. My wife says it is because I do it with soap. Should I stop shaving?

A: Your wife is probably right. You need to use a shaving gel or foam containing a moisturiser. The latter will soften the hair and you do not have to scrape it off with a blade. An aftershave acts like an astringent and antiseptic. It will take care of any minor cut that shaving may produce. On the other hand, if you go out into the sun, any perfume in the aftershave may produce photosensitivity and darkening of the skin.

You can apply baby oil to your face at night. This will further soften the skin. Not shaving is often not a solution, because it may impart an unkempt and unprofessional look.

Sleepy child
Q: My granddaughter is an intelligent and active three-year-old. Every time she wakes up from sleep, she asks for her mother and is very slow and lethargic. It takes her about half an hour to become fully aware of her surroundings. Does she need an energising tonic?

A: Many children behave that way. When a child is sleeping, the brain is resting, and it needs time to adjust from zero activity to high activity. Just let your granddaughter make the transition slowly, hugging her for some time. Asking for the mother is normal. She does not need a tonic.

Tongue tie
Q: My son has tongue tie. He is now nine months old. He does not have any difficulty breast-feeding or eating. Relatives say he needs surgery. Which doctor should we consult and where should we have the surgery?

A: Tongue tie is serious if the infant cannot feed. If your son is able to chew and swallow, wait till speech develops. Sometimes tongue tie may be an impediment to speech. If that is the case, you can opt for surgery then. You can wait until he is six years old, as the condition might correct itself as the face, tongue and mouth grow.

Source The Telegraph (Kolkata, India)

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Some Health Quaries & Answers

Protection during breast-feeding
Q: I am breast-feeding my nine-month old baby. I have not had my periods and am not using any contraception. I was told that if you are breast-feeding, you will not get pregnant. Is it true?

A:
It’s a myth, an old wife’s tale. You can become pregnant as soon as you have intercourse, even if you are breast feeding and have not had your periods. You need to check with your gynaecologist and ask for a reliable method of contraception which you can use until you are ready to have your next baby.

There are several options: your husband can use condoms, or you can have an intra-uterine contraceptive device (IUD) inserted, take progesterone-only pills daily or take an injection of a long-acting form of progesterone once in three months.

Familial cancer :-
Q: One of my maternal uncles had lung cancer and another had stomach cancer that spread to the brain. What precautions should I take so that I do not develop cancer?

A: Some cancers can be genetic or hereditary. But in your case, your uncles seem to have had different types of cancer. To reduce your risk of developing the disease, in general, lead a healthy life with one hour of exercise daily. Maintain your BMI (weight divided by height in metre squared) at 23. Eat four to five helpings of fruits and vegetables everyday. After the age of 50, do a PSA (prostate specific antigen) test. The PSA level rises in prostrate cancer which is very common in men.

Still no baby
Q: We have no children even after seven years of marriage. My wife became pregnant four times, but each time the pregnancy ended in an abortion. We also tried to have a test tube baby but that too was unsuccessful.

A: Your wife seems to have no problem conceiving since she become pregnant naturally four times. The difficulty seems to lie in retaining the pregnancy and carrying it to term. This may be due to congenital malformations or tumours (like fibroids) in the uterus, or diseases such as kidney problems, diabetes and hormonal imbalance. There are several reasons which need to be investigated by an obstetrician. Investing in a test tube baby is not a solution unless you also plan to use a surrogate mother.

Sweaty palms
Q: I sweat excessively on my palms because of which am unable to shake hands with people or use a keyboard. I have tried several creams and lotions but to no avail.

A:
Sweating excessively on the palms is due to overdrive of the sympathetic nervous system and is independent of the temperature regulatory sweating that occurs on other parts of the body. You need basic blood tests to rule out thyroid and other endocrine malfunctions. These can be treated.

To begin with, try soaking your hands in boric acid solution twice a day. Then apply an anti perspirant roll or deodorant. Wipe your palms frequently. Also, you could use a “plastic skin” on the keyboard to type.

Some doctors prescribe anti cholinergergic tablets, beta blockers or sedatives. However, these have side effects — such as dry mouth and sleepiness — which are usually more distressing than the disease. Surgery can be done to remove the nerve ganglia responsible for the problem. But this should be the last resort.

Migraine attack
Q: I suffer from migraine. The headaches are incapacitating and I lose several working days every month. I do not want to keep on taking tablets.

A:
Migraine can be treated in one of two ways. Some patients are able to accurately predict the onset of an attack. They do very well with stemetil, phenergan, codeine or sumatryptan, which have to be taken before the headache is well-established and vomiting starts.

In others, the headaches are frequent and unpredictable. They need preventive medication like propanalol or amitryptiline, which must be taken daily. Sometimes regular physical exercise combined with relaxation techniques in yoga reduces the frequency and severity of the attacks. Accupressure applied to specific sites at the onset of the headache may help.

Right weight
Q: I am 38 years old and have two children. I am a little plump, not fat. What should my correct weight be?

A: After the age of two, a person’s ideal weight is determined not by age but by calculating the BMI. It is a good indicator of the body fat. Ideally, the BMI should be 23.

Based on this calculation, figure out how many kilograms you need to lose. Exercising one hour everyday should work off about 350 calories. You can tailor your diet so that every day you have a calorific deficit of 500 calories. A 3,500-calorie negative balance will result in a kilogram of weight loss.

Source
: The Telegraph ( Kolkata, India)

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Some Health Quaries & Answers

No saccharin, please :
___________________
Q: I am diabetic and use a branded sugar substitute in coffee, milk and juices. I am breast feeding and want to know if it is safe for my baby.

A:
Any medication or chemicals that you consume crosses over into the breast milk and reaches the baby. Common artificial sweeteners such as saccharin and aspartame are classified by the US Food and Drug Administration as class “C”. This means they should not be used during pregnancy or lactation unless they are absolutely essential to the health and survival of the mother. This is not the case with artificial sweeteners. Human beings are very adaptable. You may try unsweetened coffee, tea and juice. That is healthier for you as well as the baby.

Thyroid pill
:-
____________
Q: I was not conceiving and then was diagnosed as having hypothyroidism. Once I started taking Eltroxin, I became pregnant. Do I need to continue the medicine?


A: Eltroxin needs to be continued all your life as your thyroid gland is not producing enough eltroxin for your own needs. The blood hormonal levels need to be monitored during pregnancy. Eltroxin can cross the placenta to the baby. Too little will affect you adversely and too much will be harmful to the baby. Your baby needs to have a thyroid test soon after birth. The eltroxin you are taking will not affect the baby’s test results.

My feet burn :-
______________


Q: The soles of my feet burn every night. I leave them uncovered but that does not help much. My sleep is disturbed and I am left feeling irritable all day.

A: Diabetes can cause burning feet. So can a disease in the blood vessels, kidney or liver failure, vitamin deficiency or alcoholism. Remove your shoes and socks as soon as you return from work and soak your feet in tepid water. Take calcium and vitamin supplements. If there is no improvement in a week, consult a physician.

Hearing loss

______________
Q: I feel that my son is becoming deaf. He does not respond when he is called. He seems to live in a world of his own. The problem started after we bought him a new mobile phone.


A: The new mobile phone may have an MP3 player which might be the reason your son is glued to it. If he has been using “in-ear” earphones at a high volume for long periods of time, it is possible he has developed some hearing loss. The condition can be evaluated.

Your son may become socially withdrawn as he has his music and SMS friends. This is now an international social problem. Encourage him to be more physically active. Also, you can consider spending more time talking to him and listening to what he has to say.

Obstetric care :-
_____________
Q: My wife is pregnant with our first child and I am at a loss as to how to deal with things. I want a good hospital so that the mother and child are safe.

A: Before choosing a hospital (and an obstetrician) you need to scout a few places to see where you are likely to receive the best care. Preferably, there should be several duty doctors following a “shift” system. A single doctor, however good, cannot be “on call” night and day. If he or she is tired or busy, you might wind up with an unnecessary Caesarian section. Also check if the hospital has a paediatrician.

Ear block
:-
___________

Q: My left ear gets blocked whenever I swim. I have had the ear checked and there is no wax blocking it.

A: After getting out of the pool, tilt your head to the left and hop on the left leg a few times. This usually does the trick. If that doesn’t work, hold your nose, close your mouth and breathe out through the nose.

Fractured collar bone:-

___________________
Q: My four-year-old grandson fell down a couple of stairs and fractured his collar bone. The doctor says it will heal and gave him just a cloth sling. Is this enough?

A: Collar bone fractures are common in babies, children and adolescents. The only treatment is rest, a figure-of-eight bandage, a sling and analgesics for the pain. Healing usually takes around 12 weeks but a painless bump may persist for many months.

Active brain :-
_____________
Q: Is there any way I can keep my brain active? I am scared of dementia.

A: Several studies show that memory games, memorising poetry and regularly doing Sudoku puzzles keep the mind active and prevent deterioration of the grey matter. Most newspapers regularly feature puzzles. You can also access them on the Internet.

Source: The Telegraph (Kolkata, India)

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Some Health Quaries & Answers

Sensitive to sunlight :-

Q: I develop blotchy red patches on my arms and face which tingle and burn within 10 minutes of exposure to the sun.

A: Some people are inherently sensitive to sunlight, while others develop the problem as a reaction to medication like tetracyclines, sulpha drugs or even common painkillers and anti histamines. If you are on medication, consult your doctor about changing or stopping it.

In any case, try to avoid exposure to sunlight by leaving early to work and returning after sunset. Use a black umbrella to block the sun’s rays whenever you go out. Wear long sleeved, dark coloured clothing and covered footwear. For the exposed areas like the face, neck and hands, apply a sunscreen with an SF (sun filter) factor of 15 or more.

Prostate surgery :-
Q: I had prostrate surgery two years ago, after which I developed erectile dysfunction. It persists, causing me great anguish.

A: About 80-90 per cent men have erectile dysfunction after prostatectomy. It is usually temporary and one recovers in 12-18 months. A small percentage does have a long-term problem, especially if the surgery is for cancer. That’s because the nerves in the area may have been cut during the operation. Consult the urologist who performed the surgery and discuss your options.

Corns on feet :-
Q: There are two corns on the sole of my foot, which are very painful. What should I do?

A: A corn is actually a thickened area of skin which develops because of uneven pressure. The commonest causes are faulty gait or ill-fitting footwear. But first confirm the diagnosis by consulting a dermatologist. A bony swelling, wart or abscess may appear like a corn to the untrained eye. If the swellings are really corns, you may use corn plasters to remove them. Follow the instructions on the packet. Corn plasters shouldn’t be used if you have diabetes; the corns will recur unless the causative factor is treated.

Burning skin :-
Q: I have lumbar spondylosis. Whenever I sit in the office or watch TV, I feel an uncomfortable burning sensation on the skin along the right side of my abdomen. It disappears upon moving.

A: Sometimes nerves leading to the skin become trapped as they leave the vertebral column. The pressure on the nerve causes it to tingle and burn, producing the uncomfortable sensation you mentioned. The abnormal curvature of your spine owing to the spondylosis is probably responsible. First, try conservative treatment with —

• Weight reduction, if obese

• Spinal exercises. These can be learnt from a physiotherapist or yoga teacher

• Learning proper postures

• Walking for 40 minutes a day.

Usually there is an improvement in three months which can be sustained if the lifestyle modifications are continued. If there is no improvement and the symptoms are incapacitating, you might need to consider surgery to correct the spinal deformity.

Anal fissure :-
Q: I have had chronic anal fissure for the last six months. Every time I go to the toilet, I experience severe pain. An ayurvedic physician has guaranteed a cure but insists I allow him to perform surgery first.

A: A fissure occurs usually as a result of straining and then passing a hard stool. It is difficult to heal as the pain causes a spasm in the anal sphincter perpetuating the cycle of straining and constipation.

Conservative treatment with a sitz bath (sitting in a basin of hot water), applying a local anaesthetic cream (xylocaine, lignocaine) before and after passing stool, drinking four litres of water a day, eating a high-fibre diet, and using a stool bulking agent like isapgol cures the problem in 90 per cent of cases.

If the difficulty persists, consult a qualified surgeon who can perform an anal dilation or actually cut the anal sphincter. This has to be done carefully as otherwise you may not be able to control your bowel movement. I do not think an ayurvedic physician is licensed or qualified to perform the surgery.

Small big query :-
Q: I am an 18-year-old man and would like to know what type of underwear I should use.

A: You have to make a choice depending on your comfort level. Underwear that is too tight may cause chaffing of the groin area. This can lead to secondary bacterial or fungal infection. It can also raise the temperature of the testicles, which can marginally lower your sperm count. Boxer shorts are most comfortable. But ensure it is made of a natural fibre.

Source: The Telegraph (Kolkata, India)

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Some Health Quaries & Answers

Mum’s milk, please   :-breastFeeding
Q: I had a caesarian for my first pregnancy. I plan such a delivery for my current pregnancy too. Last time I was unable to breast-feed the baby. I do not want that to happen again.

A: If you are committed to breast-feeding, you will surely succeed. It does, however, take a little longer for the milk flow to become established after a caesarian. Ask for the baby and hold him or her as soon as possible after birth. Establish skin-to-skin contact and give the baby a chance to nuzzle at your breast. Try to breast-feed early and often. Take only non-sedating painkillers for the postoperative pain, because if you are drowsy you will not be able to hold the baby properly.

Violent child:-Epilepticchild
Q: My 12-year-old son develops a blank stare and then starts to attack everyone around, beating and biting. Later he seems to have no recollection of what happened.

A: Your son may be having seizures (epilepsy). Unfortunately, people associate seizures with violent movements of all four limbs and loss of consciousness. This is not the case. Seizures may take many forms and manifest themselves as repetitive, incomprehensible, unrecollected actions. Consult a neurologist who may advise an EEG to record the electrical signals from the brain. Seizures can be treated and controlled with proper medication.

Nodes in neck :-neck_nodes
Q: I developed swellings on the right side of my neck around two years ago. It was diagnosed as tuberculosis (TB). I underwent treatment as prescribed for four months. The swellings have reappeared. They are not painful. I am scared it might be cancer.

A: TB is very common in India. Any part of the body can be affected. The nodes in the neck are frequently infected. The diagnosis is made with fine needle aspiration cytology, by taking a little fluid from the swelling with a syringe. The appearance of TB is fairly typical and very different from cancer. The infection usually requires short-term intensive chemotherapy for six months. In the first two months isoniazid, rifampicin, pyrazinamide and ethambutol or streptomycin is given, followed by isoniazid and rifampicin for the next four months. The rifamicin has to be taken first thing in the morning on an empty stomach. Not a single dose of medication can be missed. Some patients need to have the nodes removed surgically despite adequate medication. Also, you seem to have taken the medication only for four months instead of six. That may explain the recurrence.

Pain in scrotum :-Epididymitis
Q: I am 25 years old. I have pain in my scrotum on one side. I went to the doctor and he said it is “epididymitis”. He also asked a lot of questions about my sex life. Since I am not married I was embarrassed and did not go back.

A: Epididymitis is common in young men between 20 and 40. It is caused by bacterial infections, TB or STDs (sexually transmitted diseases). It can occur after a urinary tract infection. That is the reason for the queries on your sex life. Depending on your answers, he needs to make a selection of antibiotics for treatment. The important thing is to take the entire course of antibiotic in the dosage prescribed.

Fit but fat :-bmiScale
Q: I am very fit but everyone says I am fat. My weight is 88 kg. My height is 1.54m.

A: Weight divided by height in metre squared should ideally be 23. Yours seems to be around 37. Though you may be fit and energetic, technically, you are obese. Unless you lose the extra weight, you are in danger of eventually developing other illnesses like diabetes, heart disease and arthritis.

Loosing weight is an uphill task. The important thing is persistence. You need to have a negative calorific balance to lose weight. Eat a diet of 1,500 calories. Exercise by walking for two hours a day. Do some yoga and other core strengthening exercises. This way, you will lose around 700 calories a day. To lose 1 kilo, you need a negative balance of 7,000 calories.

Anal fissure :-rectum
Q: I developed recurrent painful swellings near my anal opening. They burst and now discharge pus. The doctor said it is a fissure and that I need surgery. Please advise.

A: Fissures tend to recur because the drainage of the pus from the initial lesion is never complete unless the entire area is laid open surgically. Medicines (allopathy or homeopathy) will not cure the problem. Until a date is fixed for surgery, take sitz baths morning and evening. Make sure you are not constipated — eat four to five helpings of fruit and vegetables every day. Also take isabgol husk — two teaspoons dissolved in a glass of water — every night.

Source: Tne Telegraph  (Kolkata, India)

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How Much Sunshine is needed to Make Enough Vitamin D?

Vitamin D deficiency is quite common, and a growing list of diseases and conditions are being linked with it. Regular sun exposure, without sunscreen, causes your skin to produce vitamin D naturally. But how much sun do you need?
Sunbath
You’ve probably seen some vague guidelines, recommending “a few minutes every day.” But these recommendations are far too general to be useful. The amount of sun you need to meet your vitamin D requirements varies hugely, depending on your location, your skin type, the time of year, the time of day, and even the atmospheric conditions.

The Vitamin D/UV Calculator
Scientists at the Norwegian Institute for Air Research have devised a calculator that will take all those factors into consideration and estimate how many minutes of exposure you need for your skin to produce 25 mcg (the equivalent of 1,000 International Units) of vitamin D.

It’s not the most user-friendly interface and it is very easy to enter the wrong information. But once you get past the technicalities, it’s very interesting to see how much the answers change when you vary the input.

It is also not written for US cities so you can go to this page to find out latitude and longitude of many cites and enter the numbers manually. The easiest way may be to simply google “altitude of [your town]“. Remember to convert it to kilometers. One kilometer is about 3300 feet.

If your latitude is 39 S, enter -39. If your longitude is 76 W, enter -76.
You’ll also need to enter the time of day you are going out in the sun, expressed as UTC (Greenwich Mean Time). Here is a converter that will convert local time into UTC. The calculator uses a 24 hour clock, so hours from 1 PM to midnight are expressed as 13 to 24.

The calculator also wants to know the thickness of the ozone layer. I suggest just setting this one to medium.

Be sure to click the radio button next to the entries. They are often not automatically selected when you fill in the values.

Keep in mind that the exposure times given are considered enough to maintain healthy vitamin D status. If you are starting out with a vitamin D deficiency, you might need more.

Resources:

Nutrition Data August 10, 2009

CNN October 4, 2009

Times Online October 10, 2009

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Some Health Quaries & Answers

Eating out, a lot :-..Eating out
Q: I eat in restaurants very often as my nature of work requires a lot of travel. Some of the places look unhygienic. What should I do?

A: To protect yourself, drink only mineral water. Preferably carry your own water. Do not eat salads and uncooked vegetables. Immunise yourself against typhoid and hepatitis (jaundice). Protection against hepatitis A requires two injections six months apart. Protection against typhoid requires one injection every three years

Sleep interrupted :..Sleep interruption
Q: I have to get up in the night several times to urinate. Even when I have finished, I feel there is more urine. That is really not the case as no matter how much I try, there is no more flow. I am 62 years old.

A: You may have an enlarged prostate. The organ is situated at the neck of the urethra, the pipe through which urine is passed. As age advances, it can increase in size obstructing free voiding of urine. The problem is usually benign prostatic hypertrophy or BPH, which is not cancer.

Your doctor can verify the diagnosis by examining you, doing an ultrasound and a blood test. As you wait for the results, you can ease your symptoms by avoiding caffeine and alcohol, passing urine regularly before you actually feel the urge, and staying away from antihistamine medicines.

HPV vaccine
Q: My wife is 32 years old and we have one child. I read about the cervical cancer vaccine and would like to know if she will benefit from it.

A: The guidelines for the human papillovirus vaccine (HPV) advise routine administration for all girls between the ages of nine and 11 years. The decision to vaccinate an older woman should be taken after assessing her risk for previous HPV exposure. There is no test to prove or disprove exposure to the virus. It depends on the woman’s sexual history and that of her male contacts. If she is already exposed, then any benefit from immunisation is likely to be minimal.

Hepatitis B
Q: I live with my aunt and I recently discovered she is hepatitis B positive. What should I do?

A: Check your hepatitis B status by doing a blood test in a recognised laboratory. If you are negative, immediately start on a course of vaccination. The dosage schedule is 0, 28 and 180 days. The injection has to be given in the arm and not the buttocks. But if you are already infected with hepatitis B, consult a hepatologist or gastroenterologist.

Breast lump
Q: My 23-year-old niece has a lump in her breast. The doctor said we could wait and see. But I am worried.

A: Breast cancer is commoner in older women, but it does not mean a young woman cannot develop it. Particularly those women who may be carrying the BRAC1/2 genes, which are linked with a higher incidence of breast cancer, are at risk. If your niece has a lump in the breast, it is better to have it evaluated by another surgeon. She needs an ultrasound / mammogram / biopsy depending on the size of the lump. A “wait and watch” approach is not logical or scientific until the preliminary tests are done.

Milky discharge
Q: My wife has milky discharge from both her nipples. It is seven years since the birth of our last child. She fed him for a year and a half and then the milk stopped by itself.

A: Discharge from both nipples is unlikely to be due to cancer. It can be a side effect of medications like perinorm or domperone. One of the pituitary hormones called prolactin triggers the production of milk. Some pituitary tumours cause excess prolactin secretion and this can lead to milky lateral nipple discharge. Thyroid disorders can also cause the same symptoms. Your wife’s condition needs evaluation.

Extra bones
Q: I have pain in the arms. It has been diagnosed as “cervical rib”.

A: Cervical ribs are extra bones attached to the neck vertebrae. They are present in 0.5 per cent of the population. They may cause no symptoms at all. In some individuals, these bones may compress the blood vessels and nerves to the arms. There may be tingling numbness and weakness of the muscles of the hands, particularly at the base of the thumb. In many individuals, it is possible to keep these symptoms at bay with regular exercise. Others may require surgery to remove the extra rib.

Scanty beard
Q: I have a scanty beard and want a thicker growth.

A: If you are genetically Oriental it is unlikely that your desire to grow a thick beard will meet with much success. Also, look around at your male relatives. Hair distribution on the face varies from family to family. Just to make sure everything is normal, check your testosterone levels. If that is normal, it means you are out of luck and destined to sport the clean-shaven look.

Source: The Telegraph (kolkata, India)

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Some Health Quaries & Answers

Q: I have male pattern baldness and want to correct it by some cosmetic procedure. I am in my twenties and not married yet. The baldness makes me look older.

….male pattern baldness

A: There have been rapid strides in the treatment of baldness. Tired of applying minoxidil daily — which is often unsuccessful — people are increasingly turning to surgical solutions. Hair can be transplanted from the sides and back of the head to the front by micro hair transplantation. This is only an outpatient procedure, with local anesthesia. Otherwise a procedure called scalp reduction is used where strips of bald skin are surgically removed.

Phantom swelling :-

Q: I have a swelling in one scrotum which appears when I stand up and disappears when I lie down. This phantom swelling is not painful.

A: It looks like you have a “reducible inguinal hernia”. A part of the contents of the abdomen is sliding into an area called the inguinal canal. As long as the to and fro movement is free, there will be no pain. However, the contents can suddenly get stuck. And this is painful and dangerous. Before this occurs, consult a general surgeon who will surgically repair the hernia.

Jock itch:-Jock itch

Q: I have uncontrollable itching and redness in my groin area. I sometimes have to leave the room in the middle of a meeting to scratch.

A: It sounds like you have “Jock itch” or Tinea cruris, a fungal infection of the skin in the groin. This is more common in men and aggravated by diabetes and obesity. It can be treated by bathing twice a day using a soap such as Neko, drying the area well and then applying anti-fungal creams like terbafine or clotrimazole (which contain no steroid). Clotrimazole powder can be applied after using the cream. The infection takes around two weeks to heal, but the application should be continued for about a week after that to prevent a recurrence. Avoid wearing many layers of clothing, change sweaty clothes immediately and dry yourself thoroughly after a bath. Steroids either applied or ingested aggravate the infection.

Irritating cough :-Irritating cough

Q: I am on Enalapril for the treatment of my hypertension. Ever since I started this, I have had an irritating cough. No matter how many different antibiotics I take, nothing works.

A: Antibiotics will not help in a cough unless it is caused by a bacterial infection. A constant cough without fever is more likely to be due to an allergen. Avoid mosquito repellents (mats, coils and liquids), room fresheners, agarbattis and camphor. Sometimes Eenalapril too can cause a cough. Try having vitamin C (500mg), half a tablet in the morning and evening. This often cures the cough.

Fair baby

Q: I am getting married soon and I would like to have a fair baby. What can I do?

A: Instead of concentrating on skin colour, it makes more sense to think “how can I have a healthy baby?” All girls should be immunised against hepatitis B (three doses) and rubella (German measles) before marriage. They need to take folic acid (5mg) every day to prevent defects in the baby’s brain and spinal cord. Walking or jogging for 40 minutes a day will build up stamina and strength in the legs, both of which are required for normal childbirth.

Painful periods :-Painful periods

Q: I have severe pain during periods. What can I do?

A: Dysmenorrhoea is the medical name for painful periods. Some women suffer more than others. The tendency to develop pain runs in families. To tackle this, have an ultrasound examination of the pelvis to make sure there is no correctable cause for the pain. If everything is normal, taking medication like Mefenemic acid (500mg) three times a day for the first two or three days brings relief.

Regular diarrhoea :-

Q: My daughter has bloody diarrhoea all the time. Her paediatrician has given her a seven-day course of metronidazole, an antibiotic, and a single dose of albendazole.

A: The diarrhoea may be because of milk allergy. This is common and often undiagnosed. Check her stool for reducing substances. If this is positive, you have hit the nail on the head. Then try stopping milk completely for 48 hours and see if there is an improvement.

You may click to see:->Understanding and Managing Acute Diarrhoea in Infants and Young Children

Itchy skin :-Itchy skin

Q: I itch and scratch all over my body after a bath. What can I do?

A: You can :—

• Purchase a “water treatment softening device” and fit it to your bath water supply. Fitting it for the whole house is expensive.

• Add a tablespoon of coconut oil to the bath water.

• Apply a mixture of five parts of coconut oil, five parts of sesame oil and one part of olive oil to your body. Wait for 10 minutes and then bathe.

• Use a mild soap like Dove

• Apply baby oil to the whole body after your bath.

Source: The Telegraph (Kolkata, India)

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Some Health Quaries & Answers


Q: My baby is six months old and sleeps for eight hours in the night. I do not know if I am supposed to wake her up and feed her. She is breast fed.

………………………..sleeping baby

A: Consider yourself lucky if your baby has adjusted so quickly to night and day. Breast-feeding should be on demand (by the baby). If she sleeps all night, let her do so. However, if she stops feeding even during the day, and is inactive or lethargic, you need to show her to a paediatrician.

Hygiene products
Q: Are sanitary pads dangerous? Do tampons cause cancer?

sanitary pads..ob-tampons

A: Sanitary pads are actually more hygienic than cloth as they are disposed of after use. They are not dangerous and do not impact body functions in any way. Tampons, which are inserted into the vagina, are preferred by many women as they are not bulky or messy. They should, however, be changed every four hours. If left for a longer period, bacteria belonging to the streptococci and staphylococci families can cause infection and release toxins. This can cause a fatal illness called toxic shock syndrome. Neither product has been associated with an increased incidence of cancer.

Unruly teen
Q: I have a teenage son who is very disobedient. Recently, he stopped attending classes. Subsequently, he was asked to leave school. He is also very suspicious and abusive towards his mother. I scolded him several times and even beat him on a couple of occasions. He reacted by attacking me with a stick. Is black magic the reason for such behaviour?
Parents Worst Nightmare
A:
It is better to look for a rational explanation than blame witchcraft or black magic. Your son is either a recalcitrant teenager or may be suffering from a psychiatric ailment. He needs professional evaluation, medication and counselling. With consolidated multi-faceted modern-day therapy, both problems can be tackled. He will probably do very well and be able to re-integrate into society.

Irregular periods
Q: I am 21 years old and have irregular periods, which occur once in 40-50 days. Is that dangerous? Can I make my periods regular?

….IRREGULAR PERIOD

A: Cycles are very individual, and can occur once in 24-60 days and you can still be normal. Keep a diary and track your periods. Check if they occur “regularly” at some odd interval like 33 or 52 days. They may seem irregular when in fact they are not. In that case, you need not worry. Ovulation occurs 14 days before the next period, so it is the first part of your cycle that is prolonged. You may be functioning normally but with a longer cycle. After maintaining records for six months, if you find that you still have irregular periods, consult a gynecologist. An ultrasound scan and a few blood tests to evaluate hormone levels are usually all that is necessary. If any abnormality is found, it can be usually be corrected with medication while you are still young.

Broken bones
Q: My son has osteogenesis imperfecta and his bones break frequently. He has had several surgeries, and his legs are now deformed. He has also not gained enough height. I have decided that natural therapy is best as it does not involve intervention, and have put him on calcium supplements alone. Will this work?
osteogenesis imperfecta
A:
Osteogenesis imperfecta is due to a genetic defect as a result of which bone collagen — or the building blocks of which bones are made — are ill formed and inadequate. The condition is not due to a deficiency of calcium. To manage it well, the individual deformities should be minimised and functional ability maximised at home and in the community.

Physiotherapy and functional aids like braces are useful to maintain mobility. Fractures and deformities, unfortunately, will occur and require surgical correction. Medications called biphosphates and calcitonin can be used to strengthen the bones. You need to follow the advice of your orthopaedic surgeon.

Adolescent exercise
Q: I am 15 and my height is 5 feet 4 inches. I exercise regularly in the gym and have developed arm muscles and a six-pack abdomen. But I am afraid I will remain short.
exercising
A
: Your lifestyle is commendable, considering the epidemic of adolescent obesity. Even 10 years ago, children and teenagers were not encouraged to do weight training. That’s because the ends of their growing bones are not yet fused, and any injury might prove costly. And gyms were not geared for teenagers. Supervision or training by qualified personnel was rare and there were no light weights. Now, however, the scenario is changing. Teenagers are advised to combine running, jogging, swimming and other forms of aerobic exercise with mild, supervised strength training. They should, however, avoid competitive weight lifting, power lifting, body building and maximal lifts until they reach physical and skeletal maturity (that is, at around 21 years). They can follow a general strengthening programme which should address all major muscle groups and exercise through the complete range of motion.

Source: The Telegraph (Kolkata, India)

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