Must Read Books by Dr Edward Nazareth (Konkani)
Child Health & Care , and Health Tips
More details - Click Here
1. I.P. Mangalore
*I am a man of 39 years. I have high blood pressure-150/90 mm of Hg. I do not want to take tablets. Can I control it with food restriction. If yes, then how? What are the foods to be avoided and which one can be taken?
**Hypertension is the name of a condition in which blood pressure is persistently elevated (it stays high for a long period of time). Once diagnosed as hypertensive, blood pressure remains high unless it is treated with suitable medicines. Diet and exercises help in reducing hypertension and maintaining normal pressure, but medication is a must. High blood pressure can not be controlled by diet or by certain food items.
Persistent high blood pressure puts undue stress on the heart, blood vessels and other organs. Optimal blood pressure is 120/80 mm Hg. Till 130/85 mm Hg it is considered normal and above that level requires intervention.
The causes of high blood pressure are a bit of a mystery. Only about 5% of patients requiring hypertension treatment can trace their high blood pressure to a physical cause such as kidney disease. But for remaining 95% of patients who undergo hypertension treatment, the causes of high blood pressure are unknown. Diet and stress are suspected as prime contributors to hypertension, but medical experts are not exactly certain of all the mechanisms involved. Hereditary association is not always present.
There are no specific symptoms of the problem. Although some patients complain of dizziness, headaches or blurred vision, most patients only discover they need hypertension treatment when their blood pressure is checked by some medical personnel.
High blood pressure is a serious health risk for many people. Hypertension can cause hardening of the arteries, heart attacks and strokes. Heart and kidney disease, as well as hardening of the arteries, have been attributed to hypertension. Fortunately, hypertension treatment is well researched and now readily available.
There are several risk factors that appear to contribute to hypertension. Most of these risk factors are related to the lifestyle. Few of the risk factors are:
Excessive body weight
Lack of physical activity
High cholesterol level in the blood
Excessive salt intake
To make matters more complicated, many of the risk factors vary from individual to individual. Some people thrive under stress levels that cripple others. People react to different foods in different ways: while researchers are certain that fat- and cholesterol-rich foods contribute to hypertension, other elements in our diets may also play as yet undefined roles.
Here are few guide lines that may help you to remain healthy even with increased blood pressure:
You may have to stop smoking and or using tobacco in any other form strictly. Tobacco users with high blood pressure have more risk of complications than the non-smokers.
Exercises are important in the management of raised blood pressure. The general physical exercises like brisk walking, swimming are better. Walking seems to be a good exercise that can be followed by people of all ages with or without raised blood pressure. For people with high blood pressure walking is one of the best physical exercises. Start with moderate walking may be for 30 minutes initially, gradually increases it and make it a routine to have brisk walk for one hour per day, at least five days in a week.
You will have to chose one physician and go to him regularly for check-up and to see that your blood pressure is always under control. The complications of high blood pressure are found only in those whose blood pressure is not under control.
Please remember, high blood pressure always needs medication to keep it under control. Diet and lifestyle modification may help in the pre-hypertension stage, not once the hypertension had set in.
You should never discontinue or change the dosage of the medicines without your doctors suggestion. Alteration or discontinuation may lead to complications.
Salt restriction does not mean stopping the use of salt. One should avoid excess salt and salty food items like pickles, dried and salted nuts etc. Moderate amount of salt is required for normal body functions.
There are people with known high blood pressure for decades that are healthy otherwise. They only require regular BP check-up and proper treatment. Some doctors may advise occasional ECG recordings. It is not bad to check blood sugar, cholesterol, triglycerides once in a year regularly.
2. P.M.D., Mangalore
* My son who is 3 years of age is having problems in passing motion. I consulted may doctors but of no use. He passes motion but little by little. While passing, I feel he is scared and tries to avoid passing motion. If I put suppository or give enema, he passes motion. How to solve this problem? Will using suppository or enema affect his health?
** Healthy bowel movements are very important for the well being of the baby, but more important than that is for parents to recognize the difference between healthy and unhealthy bowel movements, something where most parents falter. There could be one baby passing stool once every day and another one who does so twice and yet another one, who passes stool every alternate day and they all could be equally healthy with normal bowel system as the others. It is important for parents to understand that the frequency of passing stool and the timings of doing so do not matter as much in deciding the health of the baby, as the consistency and the effort required to pass stool does.
Each baby has his or her own unique system and pattern of eating and excreting, which slowly develops with time, to follow the routine- we adults call as normal. A baby can be termed as suffering from constipation when he/ she is straining unsuccessfully to pass motion, which ideally should be soft, but appears hard when finally excreted. There are various kinds of constipation seen in babies.
While there are some medical causes of constipation, such as Hirschsprung's disease, cystic fibrosis and hypothyroidism, most children who are constipated are normal, without having detectable medical condition.
One of the things that is frustrating for parents is trying to understand why their child is constipated. Although many parents understand the role that too much cow's milk, a diet low in fiber and not drinking enough fluids have in contributing to constipation, they may have other children with the same diet who are not constipated.
In addition to the child's diet, the other main factor that contributes to constipation is having fissures in the anal region. This often occurs after a child has had a large, hard and painful bowel movement, which can occasionally occur in anyone. After this, because he may associate having a bowel movement with pain, he will try to hold his stools. This creates a viscous cycle, where bowel movements are painful, so he holds them in, causing his stools to be even larger and harder, which causes more pain when it finally does pass. Many parents mistake the behaviors that children develop to hold in stool as straining to have a bowel movement, but they are usually stiffening their muscles or fidgeting as an attempt to hold their stool in and avoid a painful bowel movement due to an anal fissure.
Another factor that can contribute to constipation and infrequent stooling is having a bad experience with potty training.
The ultimate goal in treating constipation is for the child to have a soft bowel movement each day. One of the main ways to prevent and treat constipation is by modifying the child's diet. This includes decreasing foods that are constipating, including cow's milk, bananas, yogurt, cheese, cooked carrots and other foods that are low in fiber. For children that drink a lot of cows milk, soy milk is a good alternative, as it is usually much less constipating than cow's milk.
Another important dietary change is increasing the amount of fiber in the child's diet. The usual recommendation is that children should have 5-6 grams of fiber plus their age in years each day. So a 4 year old should have 9-10 grams of fiber each day.
Vegetables that are particularly high in fiber include beans, peas, turnip greens and raw tomatoes. It is also important to increase the amount of fluids that the child is drinking. He should have a minimum of 2-3 glasses of water or fruit juices each day.
It is better to consult the pediatrician of your child before you continue with enema or laxatives. These may be habit forming and your child may need them everyday later. Let the pediatrician decide whether your child needs laxatives and if at all needed how long those can be continued. If the baby has anal fissure, he may be advised to see a surgeon. Normally anal fissures in children are treated without surgery.
3. R. M. Mangalore
*I am 28 years of age and I work abroad. My marriage is planned next year. I am scared to get married because my organ is very small. It is about 2 to 3 centimeters. What can be done?
** The size of the penis is a common cause of worry in many of the young men. It is not difficult to find out about the size of the average male member - there are lots of surveys on the internet and in scientific journals, and one can easily work out the average size ranges. But how reliable are these figures? The answer seems to be - not very! When you ask men to measure their own penis, they consistently get longer results than when doctors or nurses measure it! So, taking all the surveys, working out the average, and then adjusting the results in favor of those where measured by others the guys' penises, here are the most reliable figures: Average soft (flaccid) penis length = 3.3 inches (8.4 cm) Average erect length = 5.9 inches (15.0 cm).
In marital sexual relationship the size of the penis matters very little. Marital sexual act is not a mechanical union. There are lots of (mental) feelings that are involved and the size of the organ hardly matters for proper physical union. There is one more interesting thing is that most penises are very much the same size when erect. The man whose non-erect organ is smallish will usually achieve about 100 per cent increase in length during sexual excitement, while the man whose non-erect penis is on the largish size will probably only manage about a 75 per cent increase. In round figures, this means that the great majority of men measure between 15cm (6") and 18cm (7") in the erect position, with the average figure being about 16.5cm (6 ½").
The size of the male organ can not be altered by any medications, local applications, exercises or even by plastic surgery. Men with small organ can perform as effectively as with the men having larger than average penis.
4. D.K., Mangalore
*I am 51 years of age. I get irritation and burning on the inner side of my organ. I have consulted many doctors, some say it is inflammation and others suspected herpes. I have undergone VDRL test which is negative. I do not know what to do.
** You may consult a skin specialist to know why exactly you are having the problem. Genital herpes may be the common cause of irritation and burning. Although the initial symptoms of genital herpes clear up, the virus remains dormant (inactive) in a nearby nerve. The virus may be reactivated from time to time, travelling back down the nerve to the skin and causing recurrent outbreaks.
Symptoms of a recurrent outbreak may include a tingling, burning or itching sensation around the genitals, followed by painful red blisters that soon burst to leave sores around the genitals.
Recurrent outbreaks are usually shorter and less severe. Though it is difficult to cure the problem, there are medicines that may reduce the severity of the symptoms.
There may be other skin conditions causing burning sensation. Consult a skin specialist for treatment.
5. B.K. Mangalore
*I am 33 years of age. We have a 3 year old son and now we are planning to have second child. We are trying from past one year. My wife conceived first child within 6 months of the marriage. But now it is more than a year, we are not successful. What may be the cause...is the sperm count reduces as the days pass?
** When a couple with a previous pregnancy is unable to get a child despite frequent, unprotected sex for at least a year in women under age 35 or six months in women age 35 and older, the problem is termed as secondary infertility. Secondary infertility shares many of the same causes of primary infertility.
Among the possible causes of secondary infertility are:
Impaired sperm production, function or delivery in men
Fallopian tube damage, ovulation disorders, endometriosis and uterine conditions in women
Complications related to prior pregnancies
Changes in the risk factors, such as age, weight and use of certain medications
You may have to go for medical evaluation. A woman's gynecologist or a man's urologist can help determine whether there is an issue that requires treatment.
*I am 26 years. I have pain while passing urine, especially at the end. I do not have any other problem. What may be done?
** It appears that you have urinary tract infection. You may consult a physician and get your urine examined in a laboratory. It is a curable condition.
7. L.F. Mangalore
*I am 36 years of age and I am suffering from hypothyroidism. About 2 years ago I did blood test and the report was normal and the doctor said there was no need of medication. I checked about a month ago and the doctor again said there was no need medication. But I feel I have been losing weight. I was 55 and I have come down to 53. Should I go for thyroid specialist or not. Please suggest.
** You have not mentioned since how long you were hypothyroid and what were the medicines you were on. Usually, once diagnosed hypothyroidism is a lifelong problem and it does not disappear by itself. It can be only controlled by suitable hormone replacement. Normally people with hypothyroidism gain weight and losing weight is often a great challenge in them. If your thyroid hormones are within normal limits, you need not go for medication.
There are several other causes of losing weight and reduction of two or three kilograms of weight over a period of two three months may not be significant. However, if your diet habits have not altered and have not on any weight losing programme like exercises, dieting but still have lost weight within a short span then you may require to see a physician.
8. R.DS, Bahrain
* After having sex, whatever gone inside all is coming out from her part; we have 8 year old son but we want a girl this time, we are afraid by the above.
** Most of the semen flows out of vagina after intercourse in all normal fertile couples and it is normal. This does not affect the fertility. Semen contains millions of sperms. A very small amount of semen needs to enter the uterus, and only a single sperm is responsible for conception to take place. Rest/most of it is expected to flow out of vagina in all normal fertile women. Conception takes place in spite of this happening. Semen is expected to flow out of vagina after intercourse. This simply cannot be the cause of infertility in your case. There are several causes of secondary infertility as answered in the 5th question of this column. Your wife may consult a gynecologist for assessment, and if required you may be advised to see an urologist.
9. L.R. Mangalore
*I am 51 years, I was getting continues cold and throat irritation from last 2 years.( from 2012 Sept). I am based in Dubai. I have undergone all the tests and doctors were telling it was due to allergy and every time I was given heavy antibiotics(almost 6 months). My problem did not solve. Then I was referred to an ENT surgeon. Again all the tests were made; reports were normal and told that problem was due to dust allergy. Finally I was referred to a gastro-enterologist.
When endoscopy was done(June 2013) it was confirmed that I had antral gastritis. I had throat irritation, feeling like throat is getting blocked. Every time I had to struggle to make the throat alright. Slight plum was coming through mouth continuously. I had to keep the tissues in my hand all the time. Another problem when I lay down, within 5 minutes I will get some snoring sound( for 2 sec) in my chest and because of that sound sleep was getting disturbed. I am on medication but it does not help me. Doctor is telling me at least I will have to continue treatment for 2 years. My main worry is sound in chest. I was operated for sinus about 25 years ago. My one nostril is still blocked. Why am I getting plum if my problem were gastritis? Earlier, I was getting hard plum with green color. Now it has turned into white color and not hard like earlier.
** By the details given by you, it appears that you are having allergy of the upper respiratory tract and also gastro esophageal reflux disorder. The sound you feel may be because of obstruction in the air passage due to allergic inflammation. If it were from chest you would have got other symptoms like breathlessness, severe cough etc. You have not got relief because your problems are unlikely to be cured by allopathic medicines.
Most of the medicines that are available are to treat the symptoms of allergy and there are hardly any treatments that can effectively treat and cure the problem. Prevention may be the best option than treatment for dust allergy. While most of the preventive measures are intuitive, like removing carpeting, reducing or eliminating ones exposure to pet animals, and ensuring that ones living space is as dust free as possible, having a humidifier in ones living space can also improve ones allergy symptoms. Encasing pillows and mattresses in special covers that prevent dust mites and other allergens that congregate in these areas from being liberated into the air can be helpful also. Vacuuming ones mattress and opting for non-feather/down filled pillows (choosing synthetic fibers instead) is another, potentially less uncomfortable strategy.
The antral gastritis is most common sequel gastroesophageal reflux disorder. Gastroesophageal reflux disease (GERD) is a chronic digestive disease that occurs when stomach acid or, occasionally, bile flows back (refluxes) into the food pipe (esophagus). The backwash of acid irritates the lining of the esophagus and causes GERD signs and symptoms. Though there are medicines to control the symptoms of GERD, again it can not be cured. Eating smaller meals, avoiding triggers such as fatty and fried items, alcohol and smoking, lying down with elevated head portion of the bed may help in reducing the symptoms of GERD.
There are reports that some people with above problems are benefitted by homeopathy medicines. You may try them if you wish.
10. C.D. Mangalore
*I am a lady aged 23 years and not married. Me and my would be had a physical contact, there was no ejaculation. Since then I had missed period, and this is the third month on. Since the first missed period I have been checking to know if I were pregnant. I have checked nearly 7 times on different occasions but all the results show negative results even till date. There is a little nausea, and giddiness. Please do help me to know what to do next and whom to consult.
** As you have repeatedly tested and found negative, pregnancy may not be the cause of failure to get the periods. However the fear of pregnancy must be causing lot of stress on you and it can be the cause of amenorrhea, that is failure to get periods. Mental stress can temporarily alter the functioning of the hypothalamus an area of the brain that controls the hormones that regulate the menstrual cycle. Ovulation and menstruation may stop as a result. Regular menstrual periods usually resume after the stress decreases. Mean time, you may consult a gynecologist to know if there are any other causes. If there are no detectable causes, you may be advised to take a short course of hormones that induce periods.
11. B.L. Belgaum
*I am 55 years of age. I am having high triglyceride level. The reading ranges from 250 to 300 mg/dl. I am taking a 5 mg tablet at night every day for the past one year; also I am doing diet restrictions and exercise. My weight is within normal range. I dont smoke, drink alcohol in moderation. Still my triglyceride level is not coming down. My doctor says it is hereditary.
** Triglycerides and cholesterol are separate types of lipids that circulate in the blood. Triglycerides are an important measure of heart health. Triglycerides store unused calories and provide the body with energy, and cholesterol is used to build cells and certain hormones. Having a high level of triglycerides may be an indicator of an increase risk of heart disease. However, the same lifestyle choices that promote overall health can help to lower the triglycerides.
When we eat, our body converts any calories it does not need to use right away into triglycerides. The triglycerides are stored in the fat cells. Later, hormones release triglycerides for energy between meals. If one regularly eats more calories than he or she can burn, particularly "easy" calories like carbohydrates and fats, excess calories are converted into triglycerides and person will go into hypertriglyceridemia.
A simple blood test can reveal whether your triglycerides fall into a healthy range.
Normal Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)
Borderline high 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
High 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
Very high 500 mg/dL or above (5.7 mmol/L or above)
Familial hypertriglyceridemia is a genetic condition that causes the triglyceride levels in the blood to get too high. This relatively common condition is inherited in an autosomal dominant pattern. About 1 in 500 people in the United States has this condition. It is important to note that many people with high triglyceride levels do not have familial hypertriglyceridemia.
Some common reasons for high triglycerides include:
Being overweight or obese
Drinking too much alcohol
Eating too much fat or refined carbohydrates
The American Heart Association (AHA) recommends that a triglyceride level of 100 mg/dL (1.1 mmol/L) or lower is considered "optimal." The AHA says this optimal level would improve the heart health. However, the AHA doesn't recommend drug treatment to reach this level. Instead, for those trying to lower their triglycerides to this level, lifestyle changes such as diet, weight loss and physical activity are encouraged. That's because triglycerides usually respond well to dietary and lifestyle changes.
12. J.M.S., Jeddah
*I am 59 years. I have problem while urinating. The flow is not normal. Also I get a frequent urinating urge. During the medical test last year the doctors diagnosed enlarged prostrate (slightly). I think enlargement of prostrate is normal at this age. What are the foods to control the growth of prostrate.
** The risk of an enlarged prostate, also called benign prostatic hyperplasia or BPH, increases about 4 percent a year after age 55. By age 60, half of men will have BPH. That number jumps to 95 percent by age 85. A recent article in a medical journal looked at the effects of diet and supplements on prostate health. The article found that the following lifestyle factors were associated with a lower risk of BPH:
High level of physical activity and no "belly fat".
A low-fat diet
Five or more servings of vegetables a day
Restricted use of alcohol
Healthy lifestyle seems to help in reducing the risk of many ailments of middle age and prostatic hyperplasia is one of them.
But many people with enlarged prostate may need treatments. There are medicines available which are to be taken regularly. These reduce the prostate hyperplasia and the symptoms of difficulty in passing urine.
*I am 52 years. I was just diagnosed having diabetes (104mg/dl). Please advise me what are the medicines I have to take and what type of food I should restrict to keep my blood sugar under control. It has been a year since I stopped using sugar in my tea; I use rice very rarely.
** Diabetes mellitus is a chronic disease that requires long-term medical attention both to limit the development of its devastating complications and to manage them when they do occur.
There are two main types in diabetes mellitus-type 1 and type2.
Type 1 diabetes generally occurs in young, lean patients and is characterized by the marked inability of the pancreas to secrete insulin because of autoimmune destruction of the beta cells, the cells of the pancreas those produce insulin. This is also known as insulin dependent diabetes. The diabetes seen in children (Juvenile diabetes) belongs to this type. The distinguishing characteristic of a patient with type 1 diabetes is that they require insulin to keep the blood sugar under control.
Type 2 diabetes typically occurs in individuals older than 40 years who may be having family history of diabetes. In the recent years this type is also seen in some obese individuals of age less than 40 years. Type 2 diabetes is characterized by peripheral insulin resistance with an insulin-secretory defect that varies in severity. There is insufficient production and utilization of insulin. These defects lead to increased glucose production in the liver, which results in fasting hyperglycemia.
Most patients (90%) who develop type 2 diabetes are obese, and obesity itself is associated with insulin resistance, which worsens the diabetic state. The patients with type 2 diabetes retain the ability to secrete some endogenous insulin. Therefore, they are considered to require insulin but not to depend on insulin. Moreover, patients with type 2 diabetes often do not need treatment with oral antidiabetic medication or insulin if they lose weight by successfully adhering to a physician-directed weight loss program including strict diet control and exercise
At your age, type 2 diabetes is seen in many people without a definite family history. These days diabetes is seen in many affluent and rich people. Physical inactivity and obesity are the main causes precipitating this illness.
In diabetic individuals the treatment depends on each ones diabetic status. A diabetic patient, always require the help and guidance of a doctor for control of the disease and to avoid complications. It is not easy to suggest about the diet restriction or medication in this column. Your doctor will be the proper person for such an advice. The road to good health begins with a diabetes control plan. You and your doctor will come up with one-probably with the help of a dietician, who can help you make the best food choices for managing your blood sugar.
The basic steps for keeping your type 2 diabetes under control are eating right, getting enough physical activity, and managing your weight. Changing your eating habits and increasing your physical activity are usually the first steps you'll take to try to bring blood sugar levels down. Reducing body weight, quitting smoking will also help you to get your cholesterol under control and always helps to lower blood sugar levels, at least in the short term
14. N.H. Bantwal
* My wife is of 27 age. She has the habit of teeth grinding in sleep. Is there any solution for this? This is really disturbing others and looks very awkward when we stay in our relatives house.
** Most people probably grind and clench their teeth during sleep from time to time. Occasional teeth grinding, medically called bruxism, does not usually cause harm, but when teeth grinding occurs on a regular basis, the teeth can be damaged and other complications can arise, such as jaw muscle discomfort or TMJ pain.
Although the causes of bruxism are not really known, several factors may be involved. Stressful situations, an abnormal bite, and crooked or missing teeth appear to contribute.
Teeth grinding can be prevented with the use of a mouth guard. The mouth guard, supplied by a dentist, can fit over the teeth to prevent teeth from grinding against each other. Your wife may consult a dentist for more information about this. Stress reduction and other lifestyle modifications, including the avoidance of alcohol and caffeine, may also be helpful.
15. S.S.S., Dubai
*I am 36 years and I am 26 weeks pregnant for my second child. My first child is now 3 years 5 months delivered by C- section. During my first pregnancy I had high blood sugar, after delivery 4- 5 months I checked again there was no sugar. This time I did my glucose tolerance test in 24 weeks, its showing high-(fasting pre glucose 106mg/dl, 1 hour post glucose 249 mg/dl, 2 hour post glucose 230mg/dl. Now doctor suggested me to take glucophage 500mg tablet thrice daily. I am taking this tablets and also on diet. I am checking my sugar level daily & it showing pasting between 93 - 114mg/dl and after 2 hours 76- 128 mg/dl. My question is 1) is there any harm for baby by taking these medicines? 2)if I am taking insulin is there any harm for baby & myself? 3) what is the sugar levels during pregnancy? 4) In the first pregnancy I had c-section, is there any chances this time natural birth?
** Diabetes that develops during pregnancy is known as gestational diabetes. Gestational diabetes causes high blood sugar that can affect the pregnancy and the baby's health. The gestational diabetes can be controlled by eating healthy foods, exercising and, if necessary, using medication. Taking good care of self by mother can ensure a healthy pregnancy for her and a healthy start for her baby. As you are already taking enough precaution, you should not have any problem in pregnancy or in delivery, except that you may have to undergo caesarian section even this time.
In gestational diabetes, blood sugar usually returns to normal soon after delivery. For most women, gestational diabetes does not cause noticeable signs or symptoms. Rarely, gestational diabetes may cause excessive thirst or increased urination.
The gestational diabetes increases the following risks in baby:
Excessive birth weight: The baby may grow too large (macrosomia). Very large babies are more likely require a Caesarian section birth.
Early (preterm) birth
Low blood sugar (hypoglycemia). Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high.
Gestational diabetes may also increase the mother's risk of:
High blood pressure, preeclampsia and eclampsia. Gestational diabetes increases the risk of developing high blood pressure during pregnancy. It also raises the risk of preeclampsia and eclampsia two complications of pregnancy that cause high blood pressure and other symptoms that can threaten the lives of both mother and baby.
Future diabetes. The mother with gestational diabetes, it's more likely to happen again during a future pregnancy. She is also more likely to develop type 2 diabetes as she gets older. However, making healthy lifestyle choices such as eating healthy foods and exercising can help reduce the risk of future type 2 diabetes.
It is essential to monitor and control the blood sugar to keep the baby healthy and avoid complications during pregnancy and delivery. The treatment strategies may include:
Monitoring blood sugar: Regular monitoring and follow-up blood sugar checks are also important. Maintaining health-promoting lifestyle habits, such as a healthy diet and regular exercise, can help reduce the risk.
Healthy diet: Eating the right kinds and quantity of food is one of the best ways to control the blood sugar. Making healthy food choices can help prevent excessive weight gain, which can put mother at higher risk of complications.
A healthy diet often focuses on fruits, vegetables and whole grains foods that are high in nutrition and fiber and low in fat and calories and limits highly refined carbohydrates, including sweets. No single diet is right for every woman. It may be wise to consult a dietitian to create a meal plan based on the current weight, pregnancy weight gain goals, blood sugar level, exercise habits, food preferences and budget.
Exercise: Regular physical activity plays a key role in every woman's wellness plan before, during and after pregnancy. Exercise lowers the blood sugar by stimulating the body to move glucose into the cells, where it's used for energy.
Medication: If diet and exercise are not enough, you may need insulin injections to lower the blood sugar. Between 10 and 20 percent of women with gestational diabetes need insulin to reach their blood sugar goals. Some doctors may prescribe an oral blood sugar control medication, which are safe to the baby.
Close monitoring of the baby: An important part of the treatment plan is close observation of the baby. The doctor may monitor the baby's growth and development with repeated ultrasounds or other tests.
The medicines or insulin may not harm the baby. You require regular monitoring to keep the blood sugar under control. You may require caesarian section this time also, however your doctor is the best person to make the decision.
16. K.D. Mangalore
* For the past 1 year a creamy layer forms on the inner side skin of penis. If not washed it gives foul smell. I have not gone to the doctor so far.
**Small glands underneath the foreskin secrete an oily, lubricating substance. If these secretions accumulate and mix with dead skin cells, a cottage cheeselike substance called smegma forms. In an uncircumcised man, smegma can build up and lead to infections. Ideally, at least while taking bath, the foreskin has to be retracted and the area is washed with soap and water.
17. K.L. Udupi
*I am 28 years and married for 4 months. We are planning for a baby. I have the problem of premature ejaculation and all the semen moves out of vagina. Is there any chance for pregnancy?
**As explained in the answer to the 8th question of this column, most of the semen ejaculated moves out of the vagina after intercourse and it is normal. It is not a cause of infertility. If your wife is not able to conceive even after regular physical union for nearly six months, then you both may need to consult the specialist. Initially you may consult an urologist and get your semen analyzed in a laboratory. If you are found normal your wife may consult a gynecologist.
There are now treatments available to manage the problem of premature ejaculation. You may consult an urologist for further advice.
18. J. D., Udupi
*I am 38 years, married and having three kids. My family is in India and I am working in gulf. I have the habit of masturbation. Is masturbation in married men is normal? Is there any problem?
** It is not unusual for married men to masturbate. There is nothing wrong in that and there is no harm in practicing masturbation. Many of the men masturbate even after marriage for one or other reason. It all depends on their need and on the circumstances. There are study reports indicating that the people who have regular sex partners, live with their sex partners, and/or are married, are more likely to masturbate than people without sexual partners and/or who live alone. This disproves the notion that adults who masturbate are sexual failures who lack the social skills to find sex partners or that masturbation is a behavior only for individuals who don't have partners or who are otherwise sexually deprived.
The foremost reasons adults give for masturbation are to relieve sexual tension, to achieve physical pleasure, to have sex when partners are unavailable, and to relax. For older adults, masturbation may serve as the primary means for sexual expression especially if partners are ill or absent because of separation or other reasons. Masturbation is to be ignored just as a habit. It has no effect on the desire or performance in general.
People who have positive feelings about their bodies, sex, and masturbation are more likely to be able to protect themselves against sexually transmitted infections, unintended pregnancy, and sexual abuse. By increasing our awareness of the sexual preferences, capabilities, and personal limits, masturbation may equip one to make better and more responsible sexual choices for himself. There is absolutely no harm in masturbation.
19. A.DS, Mangalore
*My daughter who is 6 years of age is having too much dandruff. What is the cause for this ?Is there any treatment?
** The dandruff is a medical condition caused by an overabundance of an organism that normally exists on everyone's scalp - even people who do not have the condition. Dandruff is a minor infection of the scalp caused by an overabundance of a micro-organism called Pityrosporum ovale (P. ovale), a yeast-like fungus that is part of the normal skin flora.
The rapid growth of P. ovale often is triggered by an imbalance in environmental factors such as climate, heredity, diet, hormones and stress. As the body's natural defenses fight the excessive growth of this organism, the results are the symptoms of dandruff - flaking, scaling and itching.
While many of antifungal drugs have produced a good inhibitory effect on P. ovale, studies have shown that ketoconazole was the most powerful.
You may take your child to a skin specialist for proper assessment and treatment. Regular shampooing using Ketaconazole 2% scalp lotion twice or thrice weekly is effective for dandruff.
20. J.A. Bangalore
*I am 21 years. I get wet dreams almost twice a week and masturbates once in two weeks. Is there any way these wet dreams can be reduced? Does the frequency of masturbating needs to be increased?
** A wet dream is the uncontrolled ejaculation of semen during sleep. The fluid is creamy to clear in color. Wet dreams are caused by sexual excitement from dreams, and or by physical stimulation like rubbing against blankets, the bed, or a full bladder. It is very normal Almost all guys get them! When boys enter puberty a lot of hormonal changes occur. These changes will result in many, but not all boys experiencing episodes of spontaneous erections during sleep and wet dreams. If these episodes do occur there is no need to worry or feel guilty because they are part of normal sexual development.
Most boys experience wet dreams between the ages of 12 to 18. Generally boys have fewer wet dreams once they start masturbating or once puberty is over. Also if teenagers become sexually active will experience fewer, or no longer have wet dreams.
Wet dreams are a normal part of the many things that are changing in the body during puberty. If you do have a wet dream, it just means your body is maturing sexually, which is a step towards becoming an adult.
There is no treatment or medicines to stop getting wet dreams. Some traditional practioners give some medicines which do not work. Increasing the frequency of masturbation is not the treatment for wet dreams. Wet dreams may become rare if masturbation is done regularly and frequently. Again masturbation also has no bad effects on physical or sexual health.