Too thin is not in
Q. I am very thin and friends poke fun at me because of this. I eat a lot, both vegetarian and non-vegetarian food, but it does not seem to help.
A: Being thin or fat is a perception. Before you decide you are underweight, calculate your BMI (body mass index). This is your weight divided by height in metre squared. The normal value is 23. If your BMI is less than this and you feel you are eating a lot, you need to consult a physician to rule out metabolic diseases such as diabetes and hyperthyroidism. If your BMI is 23 or more, maybe you only need to improve your physique with weight training and aerobic exercises like jogging.
Constipated baby
Q: My four-month-old baby is breast fed exclusively and passes stools only every three or four days. Is this normal?
A: Breast milk is almost completely digested so there can be very little solid waste to eliminate. The frequency of stools in a breast-fed infant can vary. Some do it soon after a feed. That’s because of an active “gastrocolic reflex”. In others, it may happen only once in three or four, or even seven days. Both ends of the spectrum are normal. The stool in breast-fed infants is a golden yellow in colour. If there is a sudden change in the frequency or colour, or if it contains blood, consult your paediatrician. Changes may occur in the colour, consistency and frequency of stools once you start weaning foods.
Condom use
Q: Are condoms safe for long-term use? Do they cause side effects? Is the liquid used in them safe?
A: Condoms are safe for long-term use. It’s a male contraception that must be used from the beginning to the end of intercourse. However, it has a failure rate of around 15 per cent. So if the woman misses a period, she should do a pregnancy test.
There are no side effects unless the person is allergic to latex, the substance of which condoms are made. The liquid in them is a lubricant. It may be silicone, water or a spermicidal agent.
Post menopausal bleeding
Q: I attained menopause six years ago. For the last six months, however, I had a little bleeding. It’s just a few drops, and then it stops. Do I need to take it seriously?
A: What you are describing is post menopausal bleeding. This is any kind of bleeding or spotting that may occur after you have not menstruated for a full year. It occurs in 30 per cent of women. It could be harmless, due to weight gain or hormonal changes. Or it could be due to the endometrium (lining of the uterus) suddenly and inexplicably beginning to grow (endometrial hyperplasia). This needs evaluation as it can progress to cancer. You need to consult a gynaecologist.
Aortic valve disease
Q: My father developed a peculiar chest pain brought on by climbing stairs. He was evaluated by echo and doppler studies and found to have a “calcified aortic valve”. He is 79 years old.
A: About 4 per cent of the elderly develop stenosis (narrowing) or regurgitation (leaking) of a deformed calcified aortic valve. In either case, the work of the heart, particularly the left ventricle, increases as greater effort is required to pump blood through the defective valve. Moreover, since the coronary vessels – which supply the heart muscle – arise very close to the aortic valve, it can compromise blood supply to the heart muscle. Aortic valve disease can, therefore, cause fainting or chest pain with exercise. In your father’s case, the effort involved in climbing stairs may be too much.
Surgery, either to relieve the narrowing or replace the valve, has been successful in many elderly people and considerably improved their quality of life.
Hole in the heart
Q: My son was diagnosed with a hole in his heart. A doctor cured it with medicines when he was a year old. Now he has a persistent cough. Another doctor says that’s because of the hole and that it remains.
A: About 2 to 5 per cent of children have “ventricular septral defect” at birth. In 90 per cent, the hole closes shortly after birth. If it does not and continues to remain large, surgical intervention is recommended.
Source: The Telegraph ( Kolkata, India)
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