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1. J.K. Mangalore

*We have been using coconuts for everything except may be for tea and coffee!. Recently I read in an article that coconut/tender coconuts have cholesterol. Some of my colleagues also say that coconut oil is not good even for hair. Is this true?

** Coconuts do not contain cholesterol. Only animal products have cholesterol. Plants and plant products are naturally cholesterol-free. Although coconut has no cholesterol, it contains a fatty substance known as phytosterols. Even cholesterol is one of the fatty substances. But phytosterols, which occur only in plants, may have some health-promoting effects. 

All vegetable oils are pure fat, and all are combinations of saturated and unsaturated fatty acids. Fatty acids vary in their degree of saturation and in the length of their molecules. Depending on this they are classified as saturated and unsaturated.  Saturated fats come chiefly from animal sources, such as meat and whole milk. Three vegetable oils- coconut, palm, and palm kernal- are also highly saturated. There are mainly two types of unsaturated oils- mono unsaturated and polyunsaturated.  Olive, peanut, and canola oil are made up chiefly of monounsaturated fatty acids. Corn, safflower, soybean, and sesame oils are largely polyunsaturated. Fish and nuts are also rich sources of mono- and polyunsaturated fats. No fat or oil in our diet is made of just one kind of fatty acid. Even olive oil is about 20% saturated fatty acids; butter is about 65% saturated fatty acids, with the rest mono- and polyunsaturated. 

Cholesterol is a fat-like substance found in all animal cells and also in humans. It is essential to life. The human body manufactures all the cholesterol it needs-thus we can live without eating any cholesterol. Cholesterol is attached to protein packages called lipoproteins, which are assembled in the liver and circulate in our bloodstream. Two of the better known types of lipoproteins are HDL (high-density lipoprotein), the "good" type that carries cholesterol out of the system; and LDL (low-density lipoprotein), the "bad" or "lousy" type that deposits cholesterol in arterial walls, where it can build up and narrow arteries. High blood cholesterol is a known risk factor for heart attack.

There is much mis-information and misunderstanding in the medical community and media regarding the effects of natural saturated fats in the diet. Tropical oils in particular have received much undue criticism in large part because of economic motivations of the American oil industry. Now it is believed that within a limit the tropical oils may in fact actually help in reducing the cholesterol and thereby prevent Coronary Heart Disease (CHD). For instance, a study showed that the Thai islanders with high intakes of coconut oil had insignificant raise of cholesterol levels. When these groups migrated to New Zealand, had lowered their intake of coconut oil, their total cholesterol and LDL cholesterol increased, and their HDL cholesterol decreased. 

Other studies on populations consuming coconut oil on a regular basis indicate that even though coconut oil is rich in saturated fats, it did not raise blood cholesterol levels.  This may be due to the fact that compared with other saturated fatty acids; coconut oil is predominantly made up of medium-chain triglycerides (MCT).  These are thought to have no appreciable cholesterol-raising effect.  Also these types of fats are easily digested, absorbed, and transported; therefore, they serve as immediate sources of energy.  Hence, for healthy individuals moderate quantity of coconut oil can be used in the diet.

The saturated fat in coconut, medium-chain triglycerides (MCT) is known as lauric acid. Approximately 50% of the fatty acids in coconut fat are lauric acid. Lauric acid is a medium chain fatty acid, found naturally in mother's milk. Lauric acid has the beneficial function of being formed into monolaurin in the body. Monolaurin is the antiviral, antibacterial, and antiprotozoal monoglyceride used by the body to destroy lipid-coated viruses such as HIV, herpes, and influenza.

One of the real culprits in Coronary Heart Disease is in fact trans-fatty acids, found in hydrolyzed vegetable oils. Ironically when fast food chains and bakers were forced to discontinue using tropical oils, hydrolyzed vegetable oils were their replacement. Mainstream medical research still believes that tropical oils are not any more healthful though and continue to propose that the most healthful cooking oils available today are vegetable oils like canola, olive, etc. (made largely of monounsaturated fatty acids). But there is a problem; when these types of vegetable oils are heated to a high temperature their molecular structure changes for the worse making them unhealthy for the body. Tropical oils, on the other hand, are much more stable when heated.

More recently researchers have recognized that the ratio of LDL to HDL is more important than the number by itself. There are studies to show that a diet including coconut oil while having a higher level of LDL, it is counter balanced by a higher level of HDL. Trans fatty acids on the other hand decrease HDL and increase LDL- a dangerous effect.

However, too much coconut may not be good for humans. Within a limit it may be acceptable. Though there are studies favoring as well as discouraging the use of coconut, it may be better for us to remain moderate in its use. The excess use of coconut may not increase the cholesterol, but we tend to put on weight. Most of the raised cholesterol comes not from cooking oil but from the animal fat we consume. Increased body weight and raised cholesterol, whatever may be the source-is bad for health. If you are worried about cholesterol, get it checked. But remember the heart attacks are not exclusively because of cholesterol. Raised cholesterol is one of the risk factors for coronary heart disease. There are other risk factors like smoking, obesity, physical inactivity, raised blood pressure, diabetes mellitus. Worrying only about cholesterol and neglecting other risk factors can be dangerous.

2. N.S.N., Udupi

*My daughter aged 3 years 2 months, after sitting for a few minutes especially while watching TV, is telling that her legs is tingling (like the jhum jhum feeling in our legs after sitting in crossed legs by adults for long time). Is it a normal thing for her age just like it happens to adults or is it a sign of any disease? 

** It is difficult to opine what exactly is the problem unless the child is examined. The child may be getting the leg pain which she may not be able to describe properly and must be expressing as numbness. The leg pain is a common symptom in children and in most cases it is not an indication of any serious cause. However, persistent or severe pain should not be ignored , it is better to be shown to a child specialist. 

Growing pain is the most common cause of pain in children. It is a term that is commonly used for nighttime leg pain in young children without any apparent cause. It usually occurs in young children between the ages of 3 and 12 years, is not localized to any part of the leg, does not affect the joints, and usually affects both the legs. It is most often felt in front of the thighs, calves, or back of the knees as a throbbing or aching pain. The exact cause is not known but it may be due to overuse of the muscles of the leg, especially in hyperactive children. The pain is not associated with a limp and occurs only in the late evening or at night and disappears the next day.  Rarely  small children may try to seek attention of their parents by mimicking the symptoms which are normally expressed by adults. This can not be concluded unless examined by the specialist.

3. J.D., Mangalore

* I am 27 years of age. I had spondylosis 6 years ago. As a precaution I was asked not to bend too much, carry heavy things etc. I am also told to do certain stretching exercises. Now there is no much problem, but sometimes I feel swelling from hip to down the leg. My question is there any risk to my health if I play shuttle and ride bike?

** Spondylosis is a degenerative(wear and tear) condition of the joints of the vertebrae which are commonly seen after the age of 40. At your age intervertebral disc disorders can be the cause of pain and what you feel now may be due to irritation of the nerves by the disc. Specific exercises to strengthen the back muscles can prevent the recurrence of the problem. If the back muscles are not strong, precautions are required in day today activities including in riding the vehicles and also while playing. An orthopaedic or spine surgeon or even a  physiotherapist can help you to learn the back muscle strengthening exercises and  can guide you about taking care of your back.

|4. L.S., Mumbai

I am 40 years of age. My temper flares up very fast if somebody annoys me. I get totally out of control, my breathing increases, blood pressure increases and so heart beats. It puts me totally awkward position and later when everything is fine I really regret for losing the temper. Please advise me how I can control my temper.

** Anger is a completely normal, and usually healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems: problems at work, in your personal relationships, and in the overall quality of your life. And it can make you feel as though you're at the mercy of an unpredictable and powerful emotion. 

Anger is an emotional state that varies in intensity from mild irritation to intense fury and rage. Like other emotions, it is accompanied by physiological and biological changes; when you get angry, your heart rate and blood pressure go up, and so does the level of your energy hormones, adrenalin and noradrenalin. 

The instinctive, natural way to express anger is to respond aggressively. Anger is a natural, adaptive response to threats; it inspires powerful, often aggressive, feelings and behaviors that allow us to fight and defend ourselves when we are attacked. A certain amount of anger is necessary to our survival.

On the other hand, we can't physically lash out at every person or object that irritates or annoys us. Laws, social norms, and common sense place limits on how far we should let our anger take us. 

People use a variety of both conscious and unconscious processes to deal with their angry feelings. The three main approaches are expressing, suppressing, and calming. 

Expressing the angry feelings in an assertive -- not aggressive -- manner is the healthiest way to express anger. To do this, we have to learn how to make clear what our needs are, and how to get them met, without hurting others. Being assertive doesn't mean being pushy or demanding; it means being respectful of yourself and others. 

Another approach is to suppress anger and then convert or redirect it. This happens when you hold in your anger, stop thinking about it, and focus on something positive to do instead. The aim is to inhibit or suppress the anger and convert it into more constructive behavior. The danger in this type of response is that if the anger isn't allowed outward expression, it can turn inward--on oneself. Anger turned inward may cause hypertension, high blood pressure, or depression. 

Unexpressed anger can create other problems. It can lead to pathological expressions of anger such as passive-aggressive behavior (getting back at people indirectly, without telling them why, rather than confronting them head-on), or a perpetually cynical and hostile attitude. People who are constantly putting others down, criticizing everything, and making cynical comments haven't learned how to express their anger constructively. Not surprisingly, they aren't likely to have many successful relationships. 

Finally, one can calm himself down inside. This means not just controlling the outward behavior, but also controlling the internal responses, taking steps to lower the heart rate, calm oneself down, and let the feelings subside.

Some people are really more 'hotheaded' than others; they get angry more easily and more intensely than the average person. There are also those who don't show their anger in loud spectacular ways but are chronically irritable and grumpy. Easily angered people don't always curse and throw things; sometimes they withdraw socially, sulk, or get physically ill. 

People who are easily angered generally have what some psychologists call a low tolerance for frustration, meaning simply that they feel that they should not have to be subjected to frustration, inconvenience, or annoyance. They can't take things in stride, and they're particularly infuriated if the situation seems somehow unjust: for example, when they are corrected for a minor mistake. 

What makes these people this way?  A number of things. One cause may be genetic or physiological; there is evidence that some children are born irritable, touchy, and easily angered, and that these signs are present from a very early age. Another may be how we're taught to deal with anger. Anger is often regarded as negative; many of us are taught that it's all right to express anxiety, depression, or other emotions, but not to express anger. As a result, we don't learn how to handle it or channel it constructively. 

Research has also found that family background plays a role. Typically, people who are easily angered come from families that are disruptive, and not skilled at emotional communication. 

If you feel that your anger is really out of control, if it is having an impact on your relationships and on important parts of your life, you might consider counseling to learn how to handle it better. A psychologist or other licensed mental health professional can work with you in developing a range of techniques for changing your thinking and your behaviors. 

When you talk to a prospective therapist, tell her or him that you have problems with anger that you want to work on, and ask about his or her approach to anger management. Make sure this isn't only a course of action designed to help you 'get in touch with your feelings and express them' that may be precisely your problem. 

With counseling, psychologists say, a highly angry person can move closer to a middle range of anger in about 8 to 10 weeks, depending on the circumstances and the counseling techniques used. 

5. J.K., Udupi

I am 24 years of age. I have got warts on my thumb, index and the little finger (right hand), I went to the doctor, she just put some freezing spray and asked me to come after 14 days, and she repeated the same thing, there is no cure till now, it’s going to be almost a month now. As I am an engineering student, I have so much to write which I am not able to do, after every 5 minutes; I have to pause because it becomes very painful to hold the pen. Doctor could you please specify some fast cure for it. 

**Warts are actually benign tumors of the epidermis caused by a virus, known as human papilloma virus.

They only grow in the top layer of skin, the epidermis. They do not have roots. Warts normally grow out of the skin in cylindrical columns. On thicker skin, the columns fuse and are packed tightly together giving the surface the typical mosaic pattern. Warts can occur in people of all ages, but occur most commonly in children and young adults. They spread by direct contact, simply by touching the wart. Warts normally resolve spontaneously but the time it takes for this resolution is variable. Most warts resolve within weeks or months, but some may take years. It appears that a person's susceptibility to warts and the time it takes for them to go away is related to the individual's immune system.

Most warts can be treated with simple over-the-counter remedies. For those that are resistant to these measures, other types of treatments are effective. There are different ways of removing warts, including: 

using prescription medications to put on the wart 

burning the wart off (using a light electrical current) 

freezing the wart with liquid nitrogen (called cryosurgery) 

using laser treatment (which works very well for plantar warts or other warts that are more difficult to remove) 

Within a few days after the treatment, the wart may fall off, but several treatments are sometimes necessary. Usually the warts are not cut off because it can cause scarring and the wart may return.

You may have to repeat the treatment, may be several times till the warts are completely cured. There is no other way to get rid off them

6. A.B., Mangalore

*I am 32 years old. For the past few months having some chest pain which comes while bending or moving. Also, not able to get proper sleep at night. Already done my ECG and treadmill test. The doctor says heart is fine. He says it is muscular pain, and will go away eventually. I am also on anti-psychotic drugs. Can this be because of the side effects of these drugs? Its been more than 3 months now and the chest pain has not gone? 

** You seem to be having a condition called gastro-esophageal reflux disease, in which acid juice from the stomach returns into the esophagus. This may lead to a harsh, burning sensation in the upper abdomen, moving through the chest, throat and to the neck.

The esophagus or the food pipe has a small ring of muscle called the lower esophageal sphincter (LES). This acts as a valve, opening during swallowing and closing immediately to prevent moving back of the contents from the stomach to the esophagus. When however, this valve fails to close adequately, the stomach acids may reflux back into the esophagus. The medicines that you are taking may not be the cause for the problem.

Though this condition can not be cured completely, it can be controlled by proper medication. You may consult a gastro-enterologist for proper evaluation and treatment.

7. R. J. Bangalore,

*I have read advertisements that certain herbs and foods increase testosterone in the body. Some people use synthetic testosterone injections. After the age of 30 can we increase the level of testosterone hormone naturally or by certain foods or by herbs? 

** Testosterone (otherwise known as androgen) is the most important sex hormone produced in the male body. It is the hormone that is primarily responsible for producing and maintaining the typical adult male attributes. At puberty, testosterone stimulates the physical changes that characterize the adult male, such as growth and enlargement of the penis and testes, growth of facial and pubic hair, deepening of the voice, an increase in muscle mass and strength, and growth in height. Throughout adult life, testosterone helps maintain sex drive, the production of sperm cells, male hair patterns, muscle mass, and bone mass. 

Testosterone is produced mostly in the testes and a small amount of testosterone is produced from the outer layer of the adrenal glands (called the adrenal cortex); in females, small amounts of testosterone are produced by the ovaries. 

Low testosterone affects the secondary sexual characters in younger men. The male type of development does not happen. Low testosterone production may reduce the development of body and facial hair, muscle mass, and genitals. In addition, their voices also may fail to deepen. There are a number of specific medical conditions that can cause low testosterone. Often, such conditions are most evident in younger men and men with extremely low testosterone levels. Some of these conditions are associated with diseases or abnormalities of the testes, pituitary gland and hypothalamus. Other men experience low testosterone levels as a result of various genetic factors.

Low testosterone level is not a common problem in grown up men. The signs of low testosterone may include decreased sex drive, poor erections, lowered sperm count and reduced fertility, or increased breast size. Lowered sex drive, premature ejaculation, delayed ejaculation and several such sexual problems of men are due to psychological causes. These men may have normal testosterone levels.  Rarely some men may have a prolonged and severe decrease in testosterone production. As a result, they may experience loss of body hair and reduced muscle mass, their bones may be more brittle and prone to fracture, and their testes may become smaller and softer. 

Whenever low testosterone problems are suspected, it can be confirmed by assessing the testosterone level in the blood by certain specific tests. The physician will ask for such tests and if low testosterone is the problem exact cause has to be established before giving testosterone supplements. 

Testosterone injection is used in to treat conditions caused by a lack of this hormone, such as delayed puberty, impotence, or other hormonal imbalances. In normal men it is not indicated and no way it can help in treating non hormonal sexual problems. It has lot of side effects and contraindications.

Like many other advertisements, the so called advertisements claiming natural way to enhance virility by taking herbs appears to be bogus. Testosterones are naturally produced and their production may not be enhanced easily. I have not come across any conclusive study report that the diet or certain herbs having any effect on testosterone, though several manufacturers claim that their products increase the virility.

8. A.K., New Delhi

*I am 26 years of age. Can I take medicine zenoxa 300 during pregnancy. I am pregnant of 8 weeks. Does it have any side effect on my child? I had taken the medicine for 4 weeks as I was not aware of my pregnancy. Can I continue taking it 9 months?

** You have not informed why you are on this medicine. Most of the medicines are not safe during pregnancy and are to be taken only if advised by a trained doctor who is aware of patient’s pregnancy. Some of the medicines may require to be taken by the mother even if they harm the fetus where the risk to the fetus is weighed against the absolute necessity of the medicine to the mother. At times the doctor can alter the medicine that may be less effective to the mother but safer to the baby. All these decisions can be taken by the specialist who treats the mother.

It is better to consult your doctor who has prescribed the medicine and get a proper advice. The medicine you are on is not very dangerous to the baby but better to be avoided if it can be.

9. M.S. Mangalore

 *I am 32 years of age. I have a white patches in few places of my body. I have consulted skin specialist, it was diagnosed as vitiligo. Please advise me is this disease curable? Where I can get treatment for this?

** Vitiligo is a pigmentation disorder in which melanocytes (the cells that make pigment) in the skin, the mucous membranes (tissues that line the inside of the mouth and nose and genital and rectal areas), and the retina (inner layer of the eyeball) are destroyed. As a result, white patches of skin appear on different parts of the body. The hair that grows in areas affected by vitiligo usually turns white.

The cause of vitiligo is not known, but researchers have several different theories. One theory is that people develop antibodies that destroy the melanocytes in their own bodies. Another theory is that melanocytes destroy themselves. People who develop vitiligo usually first notice white patches (depigmentation) on their skin. These patches are more common in sun-exposed areas, including the hands, feet, arms, face, and lips. Other common areas for white patches to appear are the armpits and groin and around the mouth, eyes, nostrils, navel, and genitals.

The goal of treating vitiligo is to restore the function of the skin and to improve the patient's appearance. Therapy for vitiligo takes a long time--it usually must be continued for 6 to 18 months. The choice of therapy depends on the number of white patches and how widespread they are and on the patient's preference for treatment. Each patient responds differently to therapy, and a particular treatment may not work for everyone. You may consult skin specialists in any of the major hospitals. They will be able to start on you an appropriate therapy..

10. S.D., Mangalore

*My son of 5 years age has the problem stammering. Please advice how to cure it.

** Stammering is a common speech problem. Research suggests that the disorder might be caused due to a 'neurological mistiming' during the act of speech which leaves the stammerer confused about when exactly to say the word he wants to say. Speaking involves the transmitting of electro-chemical messages from the brain to the appropriate muscle groups. For every one of us (non-stammerer and stammerer alike), this neuro-muscular system sometimes trips and fails especially during moments of inadequate emotional control. For the stammerer, this 'tripping' occurs much more frequently than it does for normal speakers. Whenever he faces what he perceives as a 'feared' situation, the stammerer adopts a mind-set which triggers off spasms of speech-blocks. Such fears can also center on certain speech sounds or even certain people.

In a stammerer the speech becomes disoriented, because of 'wrongly tuned' neurological speech-timing system. He experiences difficulty in maintaining a smooth forward flow of words in the sentences he speaks. Frequently repeated, these instances of stammering arouse fear in the mind of the child who stammers. With growing years, these fears keep snowballing until the stammerer begins to experience tremendous frustration, anxiety, shame, embarrassment, even guilt every time he opens his mouth to speak. He begins to recoil from speaking. In every other respect, except speaking ability, the stammerer is a completely normal human being. In fact most stammerer are sensitive and intelligent.

Speech is one of our body's strongest habits and stammered speech is also a habit. Stammering is not a disease and therefore, it cannot be treated through medicines. The stammering child or adult has to be helped to develop a new, more fluent manner of speech through an intensive re-orientation program which focuses on modifying his physical manner of talking as well as changing his mental attitude towards the problem. This is possible by speech therapy.

Speech therapy is available in several centers in major cities in India and abroad. As it is just the beginning your child should be able to overcome this problem easily. In adults the yoga and meditation might help further in solving the problem of stammering. 

11. A.C., Muscat

* My son has been obsessed with washing machines. He could spend hours sitting in front of the washing machine watching it spin round. Recently he has begun watching YouTube videos about washing machines and toy washing machines. Couple of days back we found a toy washing machine which we bought for him. He has been constantly playing with it and watching those videos. Although he is playing with his other toys and going to pre-school. I am worried if this obsession is unhealthy and if we have encouraged it by buying him that toy.

** Many children develop obsessions or fixations, often between the ages of two and four. They love familiarity, order and routine, especially as they begin to encounter a big, somewhat scary world. They often use a fixation as a sanctuary to momentarily escape the confusing world about them. Watching and acting out the same DVD or playing the same game can give a child a sense of control, which can be reassuring if he/she is experiencing changes like starting preschool. Interestingly, boys are more likely to have a fixation, such as a favorite action character, who they want to exclusively dress up as and watch in DVDs over and over again. This is different to excessively and exclusively arranging objects or becoming hysterical over a letter like A or B etc. Little girls naturally have slightly better language, social, imaginative and adaptive skills, so they are less likely to fixate on one behavior unless it helps their play. Boys like action and outcomes, so obsessive play guarantees fun and allows play routines, when social and language skills might not be very effective yet. On the whole,  children of both sexes will usually grow out of their obsessions by age five.

You need not worry about this now. Once your child is regular to school, when fixations fade and when most  children grow out of obsessions.  

12. N.F. Udupi

* My husband 34 years has the problem of early ejaculation. We can’t spend more time in intercourse. Please suggest.

** There are medicines available for this problem now. Your husband may consult an urologist or psychiatrist for proper aseessment and medication.

13. A.D, Mangalore

*I am always having doubt on my husband. He was in love before marriage. Always in my mind getting scared that what is my husband doing now, going with any girls, chatting with any girls. After he returns from office, I have been asking so many questions. He is a very good person. He is keeps on telling me that I he was not doing anything. He even swear by God  that  how  he could do bad things. Then again if any message, phone call comes or if he is on face book then again my mind is upsetting. Again I quarrel with him asking questions. Because of this my daughter is getting upset. Our relationship also getting spoiled Doctor please  suggest me how can I believe my husband. I can't believe him. 

** You require counseling. It is not possible to give tips or suggestions here. There are marriage and family counselors in most of the marriage enrichment units of the diocese. You can approach them.

14. P.D., Honnavar

*I am 29 years. I am married for two and half years and we are planning for a baby now. My menstruation cycle changes every month. Like it is 40,38,38,33  and the latest is 26 days. From past 5 to 6 months we are trying but no luck so far. I would like to know why do my cycle vary, which day will I ovulate based on my cycle and which are the days should we have the intercourse?

** You may have to see a gynecologist first and get your reproductive health assessed. It may be normal to have irreggularly irregular periods, but it requires assessment before such conclusion. You may not be able to plan pregnancy now depending on ovulation method. 

15.F.S. Udupi

*I am in 40s, married  having 2 children. It wasn't a very happy childhood but I felt I have to take responsibility of my family. My inner wish was to find a strong person in my husband. Mine was arranged marriage but my husband although a good human has certain issues. The financial burden too fell on my shoulder. To add to it, there was no good physical relationship with us. There were no emotions. It was painful the first day and remained uncomfortable to all the years. I tolerated it with a flinching fist, thinking as a wife I am supposed to take that pain. But this wasn't my main problem, I just wanted to emotionally connect with and share my fear and joy. To find a companion in him. Because of what he is, he cant be that. He cant take responsibility of anything nor got much feelings. 

Not much qualified (8th) I tried to build a happy imaginary life for about 10 yrs but then my strength weakened. But I must say as a human, he is very good. Certain occasions my family too told me to separate from my husband, but generally they like him. Unknowingly I happened to meet a guy who cared for me. I fell for him wanted to marry him too, but couldn't hurt my husband. With him I realized I am capable of physical intimacy (till then I used to think I am not capable of enjoying sex). That person hurt me in his own way, in fact very badly. I used to think I will die without him. But somehow I managed to move away from him. 

This episode broke me down further. Its been few years I am living with 2 children and my husband works in gulf. I meditated, prayed, tried to make me strong but I could never be happy from then. Off late I am feeling suffocated, there are times its very difficult for me to control my urge of committing suicide. We have two wonderful kids, I am living for them. But that is also difficult. I am done with life. And once in a while, I get this feeling of separating from my husband, join an ashram. Or a distant dream of finding a person who can take care of me. I feel I too deserve some happiness. But to trust a man again is not easy. I don't want to hurt my husband. I care for him. He sends me whatever he earns now, but the overall responsibility is in him. When he is around he tries to come close, but I cant stand him coming to close to me. I am sinking into more and more depression. I know we talk about morals and sacrifice. Will medication help me ?

** You require to vent out your feelings with a family counselor. As answered in the 9th question of this update, they are available in most of the marriage enrichment units of the diocese. It is better you make up your mind and talk to them as early as possible.

16. R. A., Mumbai

*My daughter is 6 years  of age, her weight is 22 kg. and height is 132 cm. She started her menstruation cycle three weeks ago, No other puberty signs are seen visually. As per the abdominal ultrasonography report both ovaries are enlarged in size with normal in echo texture. The doctor suggested a treatment that she has to under go an injection every month till her age of 11 years to control this problem.  Does it cause any side effects? What is the root cause for this problem? Is there any alternative treatment?

** The condition is known as precocious puberty. Precocious puberty means having the signs of puberty (development of breasts, pubic and underarm hair; body odor; menstrual bleeding; and increased growth rate) earlier than usual. Precocious puberty is when the signs of puberty appear before age 8 in a girl or 9 1/2 in a boy.  It possible that your daughter might develop other  signs of puberty soon. Most cases of precocious puberty have no known cause. In some cases, the pituitary gland, which regulates the release of most of the body's hormones, signals the ovaries and testicles (in boys) to begin hormone production prematurely. Signs of puberty may also appear early because of ovary and testicle abnormalities. Your child's doctor might have done tests to find out if there is an underlying medical condition.

It may be better to follow the advice of your doctor regarding the treatment which is given to suppress the pubertal changes. 

It's always hard to be different, and developing an adult-looking body earlier than the peers can put a lot of pressure on kids. Both boys and girls can have a tough time when they go through pubertal changes early. Your child may be teased, and may have body image or self-esteem problems. They may also be confused about what is happening to their body, and may have unfamiliar emotions. If you are concerned about your child's behavior or coping, talk to your child's doctor or school staff, and consider getting professional counseling to help them through the difficult time. Make sure your child understands that everyone will go through the same changes, but that they happen earlier in some kids and later in others. Encourage your child to take part in regular physical or social activities and give them openings to discuss with you any worries or concerns. 

17. J.Pinto, Mangalore

*I am 30 years old. I have one and half year old baby. Six months back I stopped breastfeeding my baby but, when I press my nipple still the milk is coming out from my both breasts. There is no pain. What is the reason? Is it normal? 

** This is normal. Normally milk secretion continues if the breast sucking is continued. However it might take few months before the milk secretion stops completely.

18. G.Q, Mangalore

*I am married 3 years and working in gulf. I have one kid 10 months old, and my wife is once again pregnant. We do not want that because first child is very small. We want to terminate the pregnancy. Here in Gulf it is not allowed. We asked the doctors and pharmacy. We also tried with pineapple juice. Now one month is over. Please guide us.

**You have not mentioned whether the pregnancy is confirmed by tests. If your wife is pregnant, it may be better to continue with the pregnancy rather than opting abortion. There are no tablets with definite and safe abortificient action. Few of the tablets available in some part of the world are not used widely because of their side effects. These tablets instead of causing abortion might result in defects in the baby.

I do not think the fruit juices or certain fruits act as abortificient agents.

You do not know what God’s plans are for you and your family.-the unborn baby might be a well talented child, and a blessing to your family. Accept His gift. God will definitely show the means by which you can bring up two small children. I agree there will be difficulties initially, but they will be rewarded later. If you are truly worried about the gap, just remember what you would have done if the previous pregnancy were of twins, and the present baby had born with the previous one itself.

After your wife deliver the present child, opt for a definite method of family planning. It is always better to plan the families and maintain a healthy gap between the children, than going for abortion.

19. F. F.,Muscat.

*I am 33 years of age. I want to know how the falling of the hair can be stopped. Is it possible to make the hair soft? I have very hard hair and it is thick. 

**Loss of hair is the common problem. The influence of genetically inherited factors and male hormone (androgen) on the hair follicle (root of hair) is the main cause for hair loss. Hair loss can begin at any time after puberty. There is no definite cure for this. If the hair loss causes baldness, various options are now available to conceal the hair loss. At some centers surgeries like hair grafting are available. One drug Minoxidil is available for local application. It may be used as per the prescription of skin specialist.

It is better to avoid repeated and frequent shampooing. Avoid using excessive use of oil on the scalp. 

Though there are temporary applicants available which might soften the hair, it can not be made soft permanently. At cosmetic centers textures of the hair can be altered, but this expensive treatment does not alter the texture of hair for life.

20. J.J.M., Udupi

* I am 60 years of age. My prostate has slightly enlarged. Residual urine is 32 ml - 15%. I am diabetic for the last 25 years & hypertensive for the past 4 years.  Please advise whether this enlarged prostate can be cured by medicine or require surgery.

** The prostate is a walnut-sized gland that forms part of the male reproductive system. There are no fixed dimensions for its size. Initially it is small and as the man matures, the prostate goes through two main periods of growth. The first occurs early in puberty, when the prostate doubles in size. At around age 25, the gland begins to grow again. Though the prostate continues to grow during most of a man's life, the enlargement doesn't usually cause problems until late in life. Prostate surrounds the urethra and as the prostate enlarges the gland presses against the urethra like a clamp on a garden hose. This condition is known as “Benign Prostatic Hyperplasia” or BPH. BPH is non-malignant condition. It is the problem of elderly men and it has certain symptoms. The symptoms of BPH vary, but the most common ones involve changes or problems with urination, such as

a hesitant, interrupted, weak stream 

urgency and leaking or dribbling 

more frequent urination, especially at night 

The size of the prostate does not always determine how severe the obstruction or the symptoms will be. Some men with greatly enlarged glands have little obstruction and few symptoms while others, whose glands are less enlarged, have more blockage and greater problems.

There are certain drugs now available which help in reducing the size of the prostate. You may consult an urologist or a general surgeon for assessment and prescription of the drugs. If the symptoms are not relieved by medication, surgical intervention may be required. 

The symptoms  of prostate enlargement can often be relieved by removing all or part of the prostate gland. This can be performed in a number of different ways, depending on the size of the prostate and the cause of the prostate enlargement. The three most common procedures for surgically removing the prostate to treat non-cancerous enlargement are transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and open prostatectomy. The decision regarding the type of prostatectomy to perform depends on the size of the prostate gland. Generally, for prostates less than 30 grams, TUIP is recommended. For glands bigger than 30 grams and less than 80 grams (this number depends on the experience of the surgeon), TURP is performed. 

Surgery is normally done to excise the enlarged portion of the prostate through a scope passed through the urethra. This surgery, known as trans urethral prostate resection is simple and safe

Dr. Edward Nazareth

Dr. Edward Nazareth

Dr. Edward Nazareth: Born December 28, 1958. Dr.Nazareth holds medical degrees - M.B.B.S. (1982 Mysore Medical College, Mysore), D.Ortho (1986 Mysore Medical College, Mysore) M.S.(Ortho.) (1987 Mysore Medical College, Mysore).

At present Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, Fr. Muller’s Medical College, Kankanady, Mangalore-575 002.

He is a resident of Kankanady.

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