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1.R.S. Kolkata

*I am married  for 2 years. I have one baby boy of 7 months now, We had  physical  many times after my baby’s birth and now I came to know that I am 5 months pregnant. What should I do now?

** My sincere advice is to continue with the pregnancy and never think of terminating it now. Though possible, terminating the pregnancy of 5th month can lead to complications. That apart, morally it is not good. Terminating pregnancy at any time is killing an unborn baby. Do not kill your own baby, which is so  weak and defenseless. You are its protector and it is your moral and biological duty to save it, allow it to come alive to earth.  What you would have done if you had twins in the previous pregnancy? Consider the unborn baby as one of the twins and continue with the pregnancy. God has definite plans for you, and the baby now in your womb must be  God’s gift to you. Accept it.

After the childbirth, many of the women may not get periods as long as they breast feed the baby but that can’t be taken as guarantee for non-conception. The couple who desire not to have the next baby so soon should take enough precautions to avoid conception.

2. J.D. Dubai 

*I am a man of 27 years of age. I have lots of hair on my body. Particular in chest, back and shoulders. It is thick and long. I feel shy to remove the shirt in front of others. Kindly give me permanent solution to remove unwanted hair from my body.

** It may not be very easy to permanently stop growth of the body hair when it is so abundant and all over the body. Removing the hair by wax or shaving can be temporary solution. Waxing can be painful, but it is quite effective at reducing body hair growth. Since the hair is removed from the root, the hair grows back finer, thinner, and slower. You can either buy wax to apply yourself at home or go to a spa or salon to get a professional wax treatment. Alternatively  you can also remove the hair  by shaving. Although there is a persistent myth that shaving makes hair grow back thicker and faster, there is no scientific fact behind this claim.  

As nothing  may be  possible to avoid the growth of the hair permanently, you should accept it positively. Most of the time, people are not bothered  about others’  look, they are more concerned about their own appearance.

3. S.R., Mangalore

* Our marriage is 9 years now. My husband has no interest in sex. hardly once in 2 months we get physical, that also only for 5-10 minutes. For the past 9 years I never had experienced satisfaction in sex from him. I love my husband very much and I don't even hurt him by asking.  I love sex. Please guide me how to over come with this, what is the solution

**The issues between you and your husband can not be solved unless he is involved and cooperative. Initially you need to discuss the problem with your husband and he has to be convinced about the need of therapy.

Once that is done, your husband can consult an urologist for assessment of the problem. He might treat your husband or if needed may refer to a proper councelor for further management.

4. A.M., Mangalore

*I am 22 years of age and last year I was diagnosed with Hbsg positive. I had jaundice and total bilrubin  was 27, SGPT 2000, SGOT 1200. Last year my HBV DNA was 920 iu.  E antigen was negative. Later I took ayurvedic medicine for 3 months. and I cleared LFT with normal values. Now when I checked Hbsg. It is negative in card test. They checked it for two times, they got negative. Later they referred Elisa test to confirm, it was weakly positive. What does it  mean weakly positive?  Am I cured Hbsg?

** If you had hepatitis B infection and jaundice it is unlikely that your body can be freed of the virus. Most common cause of jaundice is hepatitis A infection, which is self limiting and in most of the individuals without any complications. As the tests results are negative it is unlikely that you are having hepatitis B. To be sure, you may consult a gastroenterologist and get further assessed about the problem.

5. C. D’S, Kuwait

*I am 57 years of age. My sexual organ is bending on erection. This problems for the past 5 years; earlier it was as normal. I can't enjoy with my wife in sexual activity, she is also not getting satisfied. I masturbate twice a week. I am diabetic on treatment.

** You seem to be having a condition known as Peyronie's  disease. It is the development of fibrous scar tissue inside the penis that causes curved, painful erections. In some men having a curved erection is common and is not necessarily a cause for concern. However, in some men, Peyronie's disease causes a significant bend or pain. This can prevent a man from having sex or might make it difficult to get or maintain an erection (erectile dysfunction). Though not due to diabetes, Peyronie’s disease is more common in men with diabetes. In a small percentage of men, Peyronie's disease goes away on its own. But in most cases, it will remain stable or worsen. You may consult an urologist for proper treatment.

 6. J.V. Mangalore

* I am 26 years of age, unmarried. I have testicular vericocele. Will it will create any problem in future like infertility? Should I get surgery now?

**Vericocele is a common problem and it is found in about 40% of infertile men 20% of all men in the general population.  Urologists often diagnose and surgically repair vericocele. However, correcting a vericocele (surgical procedure) often does not improve the semen quality enough to result in pregnancy for the couple. The success of the surgery largely depends on the sperm count prior to surgery. For example, if the count is under about 5 million per cc, or the motility below about 30% prior to surgery, it is unlikely that the semen quality will improve enough after vericocele repair to result in pregnancy.  Studies suggest that men with counts that are just slightly low (15-20 million) may be more reasonable candidates for vericocele surgery. You may consult an urologist and get opinion from him. 

7. C.A., KSA

* What is the benefit of drinking cinnamon water. Does it help in  reducing high  cholesterol level or diabetes?

** There are several diets, recommendations of these type for various ailments without any definite proof. Diabetes mellitus, high cholesterol levels require definite diet, medication and exercises as recommended by the physician. Cinnamon water or similar diets may not cause any harm but their role on health is not  yet proved to be of any help. 

8. L.M., Mangalore

*I am 28 years of age. Me and my husband are trying  for a baby  for the past 4 months. My periods  were regular till past two months. But last month I had severe pain in abdomen and  back  for one week prior to period. I went to the doctor she advised pregnancy test and it came weak positive; and after two days started bleeding. The test repeated after one week as per doctors advice. It came negative. Now this month also I had pain for 4 days  then it reduced. I thought may be implantation pain, but on 18th started bleeding with severe abdomen and back ache. The bleeding was like menstrual bleed. No clots  and changes in color. I am worried about this. Please suggest why this irregular period? Does it affect in my pregnancy?

**You may consult a gynecologist and get proper assessment. It appears  you had a miscarriage once. It may be better to wait for  two to three months to plan pregnancy after a miscarriage. Your gynecologist will assess your condition and guide you accordingly. 

9. A.D., Mangalore; V.C. Dubai

*I am 29 years of age. I got married  recently and right from the beginning of my marriage I am having the problem of premature ejaculation. What may be done?

** It is not uncommon to have premature ejaculation at the early part of marriage which usually settles down within few weeks. Anxiety and fear  of failure are the main cause for persistence of the problem. At present there are medicines available to solve the problem of premature ejaculation. You may either consult an urologist or a psychiatrist for proper assessment and treatment.

10. S.H., Mangalore

*I am 24 years of age.  I am working in abroad. Here I don’t get proper food to eat. Here most of the time I prefer eating is bread. I have lost my weight around 8 kgs in a month. Now when I want to eat healthy food I do not feel like eating. I just eat little food and leave it. I do not get proper digestion also these days. And I feel pain in my abdomen. What is the solution for this?

** Eating bread is not the cause of losing appetite. It appears that you have some infection/infestation in your digestive tract. You may consult a physician and get proper treatment. 

11. M.D., Udupi

*I am 41 years  of age  and my husband is 5 years elder to me. I want to conceive for the third baby now. Can I conceive at this age,  is it safe? 

** Most women over age 35 have healthy pregnancies and healthy babies. However older mothers have some risks increased. The risks of late pregnancies include conception difficulties due to falling fertility; a higher risk of deformation of the fetus and genetic diseases and difficulties during labor, especially for overweight or unfit women. All these risks can be diagnosed early and managed effectively.

The advances in medical care can now help women in their late 30s and 40s to have safer pregnancies than in the past. However, women should be aware of the risks associated with later childbearing so that they can make informed decisions about their pregnancies.

Women generally have some decrease in fertility starting in their early 30s. Women in her mid-thirties or older takes longer time to conceive than a younger woman.

At any age, a woman should consult her gynecologist before trying to conceive. A preconception visit helps ensure that she is in the best possible physical condition before conception. This visit is a good time to discuss any concerns a woman and her partner may have about the pregnancy. A preconception visit is especially important if a woman has a chronic health problem, such as diabetes or high blood pressure. These conditions are much more common in women in their late 30s and 40s than in younger women and can endanger the pregnant woman and her developing baby.

Studies suggest that women over 35 are twice as likely as women in their 20s to develop high blood pressure and diabetes for the first time during pregnancy. Similarly women at the age of 40 and older were almost three times as likely to develop diabetes, and almost twice as likely to develop high blood pressure as women in their 20s during pregnancy. This makes it especially important that older mothers get early and regular prenatal care. With early diagnosis and proper treatment, these disorders usually do not pose a major risk to mother or baby.

The mothers over 35 are more likely than women in their 20s to have difficulties in labor if it is their first pregnancy. The fetal distress and a prolonged second stage of labor are more common in older mothers. This may account, in part, for the increased rate of cesarean sections among women over 35.

The risk of bearing a child with certain chromosomal disorders increases as a woman ages. The most common of these disorders is Down syndrome, a combination of mental retardation and physical abnormalities. It is recommended that women with singleton pregnancies who will be 35 or older at the time of delivery should be offered prenatal testing (with amniocentesis or chorionic villus sampling) to diagnose or, more likely, rule out Down syndrome and other chromosomal abnormalities. About 95 percent of women who undergo prenatal testing receive the reassuring news that their baby does not have one of these disorders.

Once the woman is aware of possible risks of late pregnancies she will be able to take more precautions during pregnancy and delivery. Pregnant women who are 35 or older face some special risks, but many of these risks can be managed effectively with good prenatal care. 

12. R.S., Mangalore

*I am 27 years. I have been observing that from the past few months when I get stressed or when I get too much hyper  or angry  I get head ache and my full body get tampered and body starts shivering too much and heart beat increase I feel so that I cant communicate with others at that moment nor I can control on my shivering.

** Your problem can not be treated by medicines. Ideal treatment can be yoga therapy. You may consult experts in yoga and follow that.

13. L. P.,Mangalore

* I am a lady of 32 years. My left eyelid often twitches a lot. It is not painful at all but is very irritating. Is this a serious problem that Ii need to look into? 

**Twitching of the eyelids may not be due to any definite illness. You can consult an eye surgeon to know whether it can be reduced.

14. J.C., Mangalore

* I am 25 years of age. I just wanted to know from which month or day the duration of the pregnancy is counted? Is it from the day we have intercourse or from the day   the lady starts vomiting? 

** The unborn baby spends around 38 weeks in the uterus (womb), but the average length of pregnancy, or gestation, is calculated as 40 weeks. This is because pregnancy is counted from the first day of the woman’s last menstrual period, not the date of conception which generally occurs two weeks later. Vomiting or other symptoms vary, in some of the women these may not be found at all.  

15. S. S., Bangalore

* I am 31 years of age.  My problem is my F.S.H. blood test result 21.94 mlu/ml ( Normal limit - 1.7 to 12.0 mlu/ml) My urologist  informed me that  it is difficult to get my wife pregnant; he  suggested me go for test tube baby. In my family no one has this problem. Is there any other treatment available? I do not want to go for test tube baby. 

**Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are called gonadotropins. because they stimulate the gonads - in males the testes, and in females, the ovaries. These two hormones are secreted from cells in the anterior pituitary. The pituitary gland is situated underneath the brain. They are not necessary for life, but are essential for reproduction. Physiologic effects of the gonadotrophins are known only in the ovaries and testes. Together, they regulate many aspects of gonadal function in both males and females. 

Elevated blood levels of gonadotropins usually reflect gonadal dysfunction. Removal of the gonads from either males or females, as is commonly done to animals, leads to persistent elevation in LH and FSH. In humans, the excessive secretion of FSH and/or LH most commonly the result of gonadal failure or pituitary tumors. In general, elevated levels of gonadotropins per se have no biological effect. 

You have not mentioned whether you were subjected to any other tests to find out the cause for raised FSH. Have you undergone the assessment of the fertility functions? They may be essential before you are directed artificial conception like test tube baby. You may consult an endocrinologist for further assessment of the hormonal dysfunction. 

16. M.A., Mangalore

* I am married few months ago. Is it good to indulge in oral sex? Does it have any side effects or health problems? 

** There is no harm in indulging in oral sex  as long as both the partners like it. Many of the couples in married life use oral sex as a method of foreplay-to prepare each other for  actual sex act. To have a healthy relationship, oral sex can be an addition to the normal act and should not substitute it. Indulging in oral sex alone may affect the marital relationship.

The risk of getting infection in oral sex is same as that of normal genital sex. The risks of getting STD (sexually transmitted disease) depends only if one of the partners is already having it. For example if  any one of the partners is having genital herpes, then the other partner who performed oral sex might get infected by the virus and get oral herpes; and instead if genital sex is performed might get genital herpes. There is absolutely no risk of getting any diseases when both are healthy.

17. S.S., Udupi

* I am 30 years of age. Now I am 7 weeks pregnant. On 6weeks 6th day I had bleeding.  Doctor did the scanning to check baby’s heart beat. Doctor took pelvis and transvaginal ultrasound. Is the transvaginal ultrasound safe? Will it cause any harm for the baby? 

** Ultrasound imaging, also called ultrasound scanning orsonography, involves exposing part of the body to high-frequency sound waves to produce pictures of the inside of the body. Ultrasound examinations do not use  ionising radiation or Xrays.. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels. Ultrasound imaging is usually a painless medical test that helps physicians diagnose and treat medical conditions. A pelvic ultrasound provides pictures of the structures and organs in the lower belly or pelvis. Vaginal ultra sound scanning also is a safe route to examine the condition of the baby. As there is no radiation, ultrasonography through whatever route is safe for moth the baby and the mother. 

18. A.S., Kuwait

* I am 37 years of age.  For the last couple of months I have mild to heavy back pain, I feel it more when I get up from the chair or I sit in the floor and getup or whenever I bend my back and straighten up. My work requires continues sitting in the chair, I don't do any form of exercise or physical work, except I play cricket every week. I have an average body structure (my height is 176 cms and weight 68 kilos). What are the exercises to get rid of this back pain? 

** The most common cause of repeated back ache in your age is due to strain at the lumbo-sacral region. You may be aware that our vertebral column is made up of multiple vertebrae which are bound to each other by ligaments. Each vertebra articulates with vertebra above and below through small joints. These joints are again surrounded by the ligaments. These ligaments are supported by the muscles of the back. 

In many people muscles of the back are weak because of lack of exercises. If a person with weak back muscles exerts or does some unaccustomed work, then the ligaments of the joints of the vertebrae and other ligaments of the back region get strained. This strain can cause severe pain, leading to inactivity and further weakening of the muscles. At times bad posture at work or at leisure may cause repeated minor strains- known as chronic strain.

You may consult an Orthopaedic surgeon to assess your problem. Rarely there can be some other cause for back ache. If the problem is due to strain at the lumbo-sacral region, you may be advised physiotherapy and pain relievers initially, then exercises to strengthen your back muscles The problem can be effectively and permanently relieved by proper treatment.

19. J.D’S, Mumbai

*I am 35 years of age, married and blessed with 2 kids. I have some excessive and unreasonable fear in certain objects. My mind is completely filled with thoughts of HIV/AIDS and the most of the time only those thoughts would keep my mind engaged. Though I never had extra-marital sex, even then whenever I heard or read about HIV/AIDS I go in to irrational fear even after knowing the real causes of the spread of deadly decease. Few years ago I heard in the television that HIV/AIDS can transmit through a shared needles or razor and I still in the fear that doctors / nurses are using shared needles in the hospitals for injecting the patient. The characteristic of my fear involves avoidance of hair cut in the saloons, injections in the hospitals in the fear of contaminated blood in the shared needles/razor. However, I am not sure whether the doctors are using shared needles in the hospital. Beside, I have also fear to drive in the highways after seeing couple of fatal road accidents. Is this fear is common with everybody? 

** You are having a condition known as ‘AIDS phobia’. It is not a psychiatric illness.  The fear of AIDS is found in many people, this is variously termed as AIDS phobia, pseudo AIDS, AIDS stress, AIDS hysteria. It consists of unfounded fears of having  contacted HIV, incorrect beliefs as to  how HIV spreads, producing bizarre attempts to avoid the illness. American Psychiatrists have even suggested the acronym FRAIDS or fear of AIDS.

Some recent examples  reported- a man who regularly immersed his penis and feet in undiluted bleach after entering public toilets; a young girl who gave up her piano lessons because she was convinced there was infected blood on the key board since her tutor's wife worked in the blood transfusion service. the AIDS phobic's lips were raw from continually being wiped, in case she had got someone else's spit on them; a woman who bathed only in darkness to avoid finding AIDS lesions on her skin; a man who operated all household gadgets with a sterile wooden stick to avoid catching AIDS from any surfaces; yet another man stopped eating and drinking altogether for fear of ingesting the HIV virus. 

Since all these people are physically completely healthy they are the 'worried well'. The term pseudo AIDS is used because these worries produce anxiety and depression which are associated with physical responses similar to AIDS symptoms, like weight loss, night sweats, malaise, lethargy, loss of appetite and headaches! These features reinforce the erroneous belief AIDS fear produces hyper-vigilance - a characteristic response to any fearful situation. This leads to a 'better safe than sorry' - 'you can't be too careful' approach. The fear of AIDS might disturb you even if you are convinced that the hospitals no more share the injection needles or syringes, and that there are strict rules that prohibit blood transfusion unless blood is tested for HIV and several other diseases like hepatitis.

A phobia is an unreasonable fear of a situation or an object. Some common  phobias are fear of social situations, fear of flying, fear of heights, and fear of snakes. There are many other kinds of phobias. People can develop an unreasonable fear of almost anything. People have reported  fear of AIDS, fear of the number thirteen, fear of peanut butter sticking to the roof of the mouth, and many other fears. Most fears have some basis in reality. For instance, if one knows someone with AIDS, he/she may develop a phobia about HIV and AIDS. Or if one almost drowned once, he may develop a phobia about water. If the father was afraid of enclosed spaces, the son may have learned that fear from him. A fear is not considered a phobia until it causes distress or it causes problems in the life somehow. 

There are many excellent treatments available for phobias. These usually involve specific behavioral techniques. These treatments are performed by mental health professionals with training in this area. You may consult psychiatrist for help. One type of treatment is called flooding. This involves practically overloading the person with whatever it is that person is afraid of. One technique is called exposure with response prevention, which is a milder version of flooding. Desensitization gets people slowly used to the idea of the feared object or situation. All of these involve teaching the person that he or she can be around the situation or the object. Usually, the fear reaches a certain point and eventually decreases. These techniques take advantage of that fact. Hypnosis can also be very helpful in treating phobias. Certain medications, called beta blockers, can help in treating social phobia. Other medicines are often used to control the anxiety people get when they confront their phobias. 

20. J.S., Dubai

* I am 30 years of age. I am expecting now 2nd baby now. The doctor prescribed me DUPHASTON™ but when I check the inside leaflet, its written that its not advisable for the pregnant lady; but the doctor is saying that it is for supporting for the uterus and it will not harm the baby , can I take this medicine? 

** Duphaston contains dydrogesterone, a synthetic hormone similar to the naturally occurring sex hormone, progesterone. It is used in a wide range of menstrual disorders that are thought to result from a lack of progesterone in the body. In women, progesterone is responsible for the development of a healthy womb lining (endometrium) that is necessary for pregnancy. The body produces progesterone at certain times of the menstrual cycle, causing the womb lining to flourish.. As dydrogesterone helps regulate the healthy growth and normal shedding of the womb lining, it may be used in the treatment of menstrual disorders such as absent, irregular or painful menstrual periods, infertility, premenstrual syndrome and endometriosis. By maintaining the womb lining, dydrogesterone is also useful in helping prevent miscarriage (spontaneous abortion) in women who have suffered repeated miscarriages or who may miscarry. Dydrogesterone is usually taken on selected  period depending upon the disorder that is being treated. Your doctor has given the proper medicine. There is no harm to the foetus if you follow your doctors advice strictly.

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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