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<font color=darkbrown>Child Health & Care , and Health Tips</font>
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1. R.F., Mumbai

*I am 22 years of age. I forget things very fast, I can say short term memory loss. it is not that I do not remember anything. Most of the times I forget what has been said. As  I am young  I am very  scared about this.

** Most of us express dissatisfaction with our memory, especially when we want to recall some detail and we can not. Some examples are, an address or a telephone number, the time of a meeting, somebody's name, etc. Even people who we assume have an excellent memory, complain that they forget things. In most of these cases, perhaps the mind refuses to be cluttered with a detail which does not seem important to us at the time. Later, for some reason, when we to contact that person, and we can not recall the name or other details of that person.  

Memory works like a bank. We can get to it, only if we deposit it there. If we did not  put it, we can not collect it when we need it.   

A lot of people insist, "My memory is terrible, or "I can't remember anything." In most of the cases, their memory is fine. The power to remember is certainly there. They just need to take the time to learn ways to "register" the events more clearly, so they can 'recall" them more successfully, later. Here are few hints that might help to improve the memory: 

i. Positive expectation. Believe that you have a good memory. If you believe you have a poor memory and you can't remember anything, your mind will do everything to prove you right. It is better to think that your memory is basically good. When you learn better memory techniques, you will have a better memory. The reason that someone you know has a better memory is that he or she, knowingly or automatically, is using better memory techniques. 

ii. Interest and importance: Recall of a particular event or detail depends on the interest we take and the importance we assign to that detail or event, at the time when it is taking place. We remember so much more about people, places, and topics which fascinate us. When you are greatly interested in a subject, you pay close attention and your brain releases chemicals to form deeper "imprints" on the cells that store memory. Those can literally become "long lasting impressions" 

iii. Pay attention: If you want to recall something, pay close attention to it at the time. The problem may not be memory, the problem may be one of attention. People who have a good memory, pay close attention to events as they happen. Also, you may well know that the level of interest and importance we assign to a person or an event, determines how much attention we are going to pay it at the particular time it is occurring. 

iv. Memory is an active process. The more active attention you pay, the more details you observe, the more you think, reason, and comprehend, the more associations you make of what you know with what you are trying to learn, the more you will retain and be able to recall, later on. Good memory is a state of the active mind. 

v. A relaxed mind helps memory: Learn with a relaxed mind. Recall the learned material with a relaxed mind. Let's take as an example a situation where you misplace your car keys. If you get too agitated with yourself in trying to recall something, as is the case in this example, you are in for frustration. But, if you relax your mind, and calmly go through the events backward, you are more likely to remember where you left them. 

vi. Reduce anxiety. While mild anxiety can increase interest and attention, high anxiety can impair attention and concentration, and therefore, limit the recall of learned material. That is why, if we are too anxious during a test, we forget what we earlier knew very well. Actually, your memory is okay but anxiety is interfering with it. Management of test anxiety has helped many students in their test performance.

vii. Monitor depression: Depression can impair the interest and joy in the events  surroundings us. As a result, too little energy is left to recall anything. Some depressed persons become more anxious and depressed thinking, "I have lost my mind. " Once depression is treated, memory as a general rule, returns to the normal. 

2.H.D., UK

*Iam 19 years of age. I am suffering from hypermobility in both my arms,which makes me impossible to write, typing. I am studying 1st year at university. The pain is sometimes very acute and have  swelling. Wearing wrist support eases pain a bit, not great amount of comfort. Please let me me know what is the best solution. Physiotherapy is not helping.

** I presume you are having what is known as benign hypermobility joint syndrome. It is a common source of joint or muscle complaints by children and young adults. Benign hypermobility describes looseness of joints that may be associated with daytime pain, nighttime awakening, or discomfort  after games or exercises. People with the condition generally report prolonged pain. In the past, this type of general pain often was called  growing pains.

Children or young adults with hypermobility usually complain of joint pain and occasionally mild swelling during the late afternoon, at night, or after activity. 

Girls tend to have more mobility (looseness) of the joints than do boys of the same age. Younger children tend to report more pain. Teenagers may have fewer symptoms because their muscles and joints tend to become tighter and stronger as they become older and because they better understand the relationship between increased activity and discomfort.

When large groups of school children are tested, benign hypermobilty joint syndrome is found in as many as 40% of them. About 10% of these children have hypermobility that can lead to pain after activities or at night. No one knows why some children develop discomfort, while others with equally loose joints do not have pain or swelling.

Treatment for  this condition is based on child’s overall health, medical history, severity of pain or discomfort, and presence of other symptoms. It can include exercises, joint protection and medication.

You may consult your doctor again and try to get some solution to the problem.

3.S.M.I., Bangalore

*I am 29 years of age. I am married for 2 years. I have a kid as well. But now I am using condom because I want to delay my 2nd kid. Is there any harm in using the condom? What is the better method?

** Condom may not be a safe method for prolonged use. The incidences of failure are high. If you are planning to postpone the next pregnancy for a shorter duration of one year or so, using the pills may be the best option. Present day pills are safe and normally do not have significant side effects. You may consult a gynecologist for proper prescription. Pills are the best temporary methods for spacing the child when couple is together for a shorter duration. 

The next alternative would be loop insertion. Loop is a better option to space the arrival of the next child for three years or more.  Loop or intrauterine devices (IUDs) are small flexible devices made of plastic that prevent pregnancy when inserted into the uterus. Nearly 15 percent of women of reproductive age—approximately 160 million women—currently use IUDs. Much of their popularity stems from their effectiveness combined with their long duration. IUDs are a safe and effective method of reversible, long-term contraception for most women. They do not affect breastfeeding, interfere with intercourse, or have hormonal side effects; only some gynecologic and obstetric conditions and infections preclude use of the method. One drawback of IUDs is their tendency to cause heavy menstrual bleeding. Loop is normally inserted soon after the cessation of menstrual flow. It has to be inserted by a gynecologist or trained para-medic. 

4. S.D., Mangalore

*I am 24 weeks pregnant. As per gloucouse test my sugar level is showing 132, How can I control my sugar level , Please advice

** The detection of increased blood glucose level in mother during pregnancy is known as ‘gestational diabetes’. Gestational diabetes(GDM) is glucose intolerance of variable degree with onset or first recognition during the present pregnancy. 

The growth and maturation of the fetus are closely associated with the delivery of maternal nutrients, particularly glucose. This is most crucial in the third trimester and is directly related to the duration and degree of maternal glucose elevation. Gestational diabetes is pathophysiologically similar to type II diabetes. Approximately 90% of the persons identified have a deficiency of insulin receptors(prior to pregnancy) or a marked increase in weight that has been placed on the abdominal region. The other 10% have deficient insulin production and will proceed to develop mature-onset insulin-dependent diabetes later.

The diabetic status has to be brought under control to prevent various maternal and foetal problems. Your doctor must have advised you what precautions to be taken, how frequently blood sugar levels are to be evaluated. Nutritional counseling is the mainstay of therapy for the gestational diabetic woman. The optimal dietary prescription would be one that provides the calories and nutrients necessary for maternal and fetal health, results in normal blood sugar level,  prevents diabetic complications and results in appropriate weight gain. One of the difficulties with dietary prescription for women with GDM is the difference between lean and obese women. Obese women with GDM may benefit from a low calorie diet and weight reduction to reverse the metabolic disturbances, but proper nutrition is needed to assure fetal growth and development.

If diet is not successful in maintaining relative normal blood glucose level, then insulin therapy is recommended. To identify the women who will require insulin, circulating glucose levels should be monitored at frequent intervals.

At present your blood glucose level (presuming it was done on fasting) is not very high. You may check the blood sugar level approximately 2 hours after meals and at random. If the blood sugar is really above the normal, then try with dietery restriction. The doctor will decide if you are to be put on  insulin. Consult your gynecologist and follow her/his advice.

5. L.V., Mangalore 

*I am really worried a lot. I am a nurse working in gulf. When I was giving insulin injection to a patient who has type 1 diabetes came for incision and drainage of an infected abscess, the needle accidentally pricked my hand after the injection was given.Commonly, there is no blood test conducted to the patient in this country for their citizens to find out is there any hepatitis or HIV. Only CBC was done.Patient got discharged next day. I am worried that any chance of spreading contamination through insulin needle. I squeezed the injury part and washed after 2 minutes.

** You may be aware that the person from whom you had needle stick injury may not be having any of the diseases that spread through direct prick. Even if the person has the disease the chances of infection through needle prick are not 100%. It is  estimate that after an injury in workplace situations from a needle contaminated with hepatitis B virus, there is a 6 to 30% chance that an exposed person will be infected. In a similar situation with HIV, there is about a 0.3% chance of infection, and there is about a 2% chance of infection for hepatitis C. Considering all this, you can stop worrying and go for a test after 3 to 6 months if you are really scared.

6. P.P., Mangalore

*I am 33 years. I am losing my hair. Tried applying shampoos of different types. Can you please tell me the remedy to stop hair fall or which food is good to stop hair fall as my hair has become very thin.

** 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 cure for this. You have to consult a skin specialist for proper assessment and treatment. In milder forms  local application of minoxidil is used. It may be used as per the prescription of skin specialist.

There are various other options available to conceal the hair loss. At some centers surgeries like hair grafting are available. The cost of such cosmetic surgeries has to be weighed at the benefits of concealing baldness.  

7. S.F., Kuwait

* I am 29 years  of age. It is going to be 5 years for our marriage. But still no kids. We are trying our best, maintaining health. My  periods are regular and on time. My husband has no bad habits like drinking, smoking;but still no result.

** Its high time that both of you consult specialists. Your husband may go to an urologist and you may consult a gynecologist.  You are already 29, and there is no point in waiting further for pregnancy in the normal way. 

8. D.A., Brahmavar

*I am 50 years of age. I am suffering from uneasy/discomfort in a small area just below the left shoulder blade for the past 2 years. I have undergone IFT, ultrasound and heat moist therapy as per orthopaedic surgeon's instruction. Also for some time done ayurvedic oil massage. All these gives a temporary relief but not permanent. X-rays shows normal and uric acid within the limit. Is there any test available for proper diagnoses  and treatment to have permanent cure. I am a diabetic but under control.

** You may consult another orthopaedic surgeon or a neuro-surgeon and probably you may require some more tests to rule out involvement of nerves. 

9. M.M., Mangalore

*I am 27 years. I came to know abot my preganancy at the end of October.I was having spotting in the last week of October which settled.It has started again since in the first week of November. I do have irregular periods.My LMP was on the 21st of September.It is normal to bleed? I am worried about it.Please opine,I was told not to do an ultrasound until the end of November as the doctor was not sure about the no of weeks

** I presume by the time you read this you would have undergone ultrasound test. I chose to answer the question to inform the readers that any symptoms like bleeding or pain during pregnancy sholud be alarming and requires consultation with the specialist immediately. Ultrasound test doesnt cause any harm to the mother or baby and it can be done any number of times. However in a normal situation it is not frequently done and that was the reason your doctor advised not to go for it.

10. I.Y., Udupi

* My 1 year old girl baby doesnot have teeth. Is it normal?

** The eruption of teeth in  the infant will vary and may be 10 to 12 months from the average ranges and still be normal. Every baby's teething schedule will differ. Some children will get their teeth earlier while others later. The significance of early or late eruption may mean that those children whose teeth erupt later will have a slightly higher resistance to decay than those children whose teeth erupt earlier. This is explained by the fact that teeth that stay under the gums longer will pick up the fluoride from the body and become more resistant to decay. However  permanent non-eruption of teeth can be associated with certain  group of diseases called syndromes. You may consult your child’s specialist for further assurance.

11. R.P. KSA

*I am 51 years of age, married for 16 years. My wife is 40 years of age. My wife feels like having sex only once in a month (5-6 days after period). I am feeling like having sex at least once in a week. This is causing lot of tension between us. Is lack of interest in physical intimacy is common among women at this stage? 

** Low sex drive in women is not a simple issue. After all, there is no objective way to measure sexual desire or pleasure in man or woman, and everyone has to define for themselves whether the libido is adequate or not. 

In polls, many women over age 40 tend to report their sex drive as being “below average.” In other words, the majority of women older than 40 believe they are in the minority (below the average) and more importantly may believe there is something wrong with them. Just as the factors that contribute to each woman’s sexuality are complex and unique so too are the possible causes of low sex drive. Sometimes lowered sex drive is prompted by an underlying condition, but often it’s a normal part of aging. Women nearing  menopause stop ovulating. And since ovulation often prompts a surge in sexual interest, women may feel that their libido flatten out as menopause nears. Other physical changes associated with menopause like hot flashes, lack of sleep, vaginal dryness can also impact a woman’s desire to have sex.

Medical problems, stress and aging are just some of things that can lead to problems with sex drive, or libido. Female sexual problems are very different from male sexual problems, but both men and women are influenced by hormonal changes that could affect their interest in sex. 

For most of the couples, there is an inevitable decline in the initial attraction which brought them together. Time moves along and familiarity may not bring contempt, but it can bring a host of other things: habitual patterns, tiredness from the demands of a busy life, and a move away from the early courtship behaviour that bonded them.

For women in midlife who may be entering into menopause, there are now physical changes that can make the physical intimacy more daunting. While these scenarios are normal and happen to most of the couples, if left unattended, it can strain the relationship.

Serious relationship issues may require professional counseling, but for those that have simply been on the back burner for too long, some of the suggestions might help.

• Your relationship with your wife may be the main issue. If her needs are not being met in the relationship, if the two of you do not deal with problems openly and constructively, if she is not treated with respect and fairness, if you are self-absorbed or self-destructive – these common patterns destroy the intimacy and trust that keep sexual desire alive over the long term.   

• Stress is an enormous factor. The body naturally puts survival ahead of pleasure. The over-burdened adrenal glands can rob  the body of the building blocks it uses to make certain hormones, which are vital to desire and sexual response. Changes in her routines, a new form of creative self-expression, help from you, working on unresolved problems, time you devote to her – the positive effects can be profound

• Open communication is so important in a relationship and this is especially true during this confusing time. Be open and share the feelings that seem beyond your control. Offer your help and be a part of the solution by asking for patience and encouragement while you both work toward becoming healthy and balanced.  Be sure to show your love in other ways that have been meaningful to both of you. Facing this issue with openness and respect for each other will foster a mutual understanding and bring you closer.

12. K.S. Kuwait

* I am 35 years of age. I am married and my wife has delivered about 50 days ago. Since she delivered we had no physical union. Can you suggest me when can we have intercourse and is it safe? 

**This is a common concern for new parents. The number of weeks one should wait before having sex varies depending on the specific circumstances. If your wife had an episiotomy, you should wait at least 3 to 4 weeks before having sex so it can heal. If she had a Cesarean section you should wait at least 4 weeks so that the incisions can heal. Because it takes approximately 6 weeks for the uterus to return to normal after the child birth, many providers recommend waiting a full 6 weeks. The hormone levels may take even longer to return to normal, especially if your wife is breast-feeding. 

Remember that even if your doctor tells you that you can have sex again after a certain number of weeks, it does not mean that your wife will feel like having sex or that it will not hurt at all after that period of time. Recovery time varies from woman to woman. It takes time to completely heal and feel like having sex again. Changes in the hormone levels after delivery and while breast-feeding, often lower the sexual desire in woman. You may be concerned if a set time has passed and your wife is still do not feel ready. You may be especially anxious considering sex during the pregnancy has been awkward and less frequent. Be watchful that the pain will go away eventually and your sex life will return to normal. 

Even if both of you want to get back to your normal sexual activities as soon as possible, your wife may have some problems at first. 

• She may still have some pain while having sex for weeks or months afterward, even after the incisions or tears have healed. 

• The vagina may be drier than normal, especially if she is  breast-feeding. 

• She may feel too busy, anxious, and tired while she adjusts to the new baby, especially if it is your first baby. She may also be afraid of getting pregnant again. 

While she is waiting for her body to return to normal, use these tips to help make sex more enjoyable. 

• Use a lubricant, such as K-Y, until her hormone levels are back to normal and the vagina lubricates itself. 

• Talk to each other about how you feel and let you know what hurts her so you can be gentle, especially if she had had an episiotomy. 

• If she is breast-feeding, the milk may let-down during sex. Nothing to worry about it.

• Try to use a sexual position that puts less pressure on her stomach and sore areas. If she is on top, she may have better control over movements that cause pain. 

Sex after birth does have its benefits. The hormones that are released during sex will help your uterus return to its normal shape. 

If you start having sex before the post delivery medical check-up, it is a good idea to use some form of birth control, such as a condom, until the doctor can discuss all your options.  About the best method that suits you, you may discuss with your doctor.  

13. W.P.Bangalore.

*I am a young man of good health. I wanted to become a good priest; somehow I could not join the seminary. One priest told me that if I had the vocation I could try later on after two years. I feel that I should become a good priest now also. Right now I am not staying in the seminary but I stay outside in a flat and I am working for the last two years. I am confused because sexual feelings are very strong. Sometime I feel very uncomfortable about my feeling towards sex. I am having friends who are having pre marital affairs.

When I see that I do not know what to do? I am confused.  I am trying my best to control these feelings. My concern is what God’s will is for me.

Sometime I go to the beauty parlour for massage and I want to know how this can be avoided.

** The sexual feelings are natural and all normal men of your age are having them. These feelings are hormone dependant and there are no ways or means by which one can avoid them. All those youngsters who study for priesthood also get these feelings. Any youngster not having sexual feelings is abnormal and may have to undergo medical examination to find out the cause for this defect. Though it is dangerous and morally not fair, good number of youngsters indulge in pre-marital sex. Sexual urge is biological, natural and normal.

In the Catholic Church, the person who opts priesthood or the membership of any religious congregation is bound to observe celibacy. The person who observes celibacy also gets natural feelings of sex. Catholic religious persons require overcoming these feelings. In the years of formation for the religious life, they are taught how to control these feelings. 

What is your intention of visiting massage parlours? What types of massage parlours do you visit? If you know that the massage parlours are not good for you, you have to stop visiting. 

Before making a final decision to join the priesthood, it may be better for you to go for counseling to trained counselor, preferably a religious person. There are good many of them and you may seek the help of your parish priest to find a suitable counselor for you. You have to have clear ideas about priesthood and religious life before you opt it.

14. C. V. Mangalore

*My son aged 3 years is having two problems: his nose is bleeding quite often (once in a week) and apart from saying Mama, Dada and Bai he is not talking anything. Please suggest.

 ** Epistaxis in children is a common disorder that is usually due to local irritation. Nosebleeds, though often alarming usually are not serious. Many of the children have nosebleed as a consequence of an injury to the nose. Just inside the nasal cavity is a collection of capillaries (called Kasselbach's plexus) on the middle wall of the nose. This is the most common site of spontaneous nosebleeds in children. The most common disorders underlying epistaxis are local inflammatory diseases, infections, and trauma. Other causes including sinus and nasopharyngeal abnormalities must be considered systematically. When the child has repeated bleeds it may be ideal to rule out bleeding disorders.

As your child also having delayed speech it may be better to consult an ear-nose-throat (ENT) surgeon. He will be able to assess the cause for delayed speech and suggest the remedy. Most common cause for delayed speech in young child is the hearing problem.

15.G. D. Mangalore.

* I am 24 years of age. My problem is that when I play cricket and bowl or walk my ankle twists, this is in both of my ankles. What could be the reason?

**This problem is known as ‘recurrent ankle sprains’. The exact cause of recurrent ankle sprains is unknown. However, many factors may play a role. Following an injury to the ligaments of the ankle, proper protection is required for them to heal. If proper treatment was not given the ligaments may not heal anatomically. In some individuals the healing of the ligaments is lengthened due to scar filling in the gap between separated torn ends. This may be the primary cause for recurrent sprains. Furthermore, the weakness of the healed ligament may be due to the inherent weakness of the scar. Associated causes may be the weakness in the muscles acting on the ankle joint, hereditary hyper mobility. You may consult an orthopaedic surgeon for treatment.

16. J.K. Mangalore

* I am 27 years of age. The size of my organ is 3 inches normal & 5 inches when erect. I have habit of masturbating once in 2 days. Nowadays it does not stay erect even for 2 mins. I am planning to marry next year. Will this erection problem have effect on my married life? Will I be able have normal married sexual life? Any diet with which I can improve this?

 ** Though bit smaller than the average size for the men of your race, the length of your organ is within the normal range. Even then one should know that the length of the male organ has little or no effect on mutual sexual satisfaction. The famous sex researchers Masters and Johnson have concluded that size of the penis can have no true physiological effect on female sexual satisfaction. They base this conclusion on their physiological studies that show that the vagina adapts to fit the size of the penis. Because of this adaptation, they refer to the vagina as a potential space rather than an actual space. Thus, despite the worries of many males about the size of their sexual organs, Masters and Johnson concluded that any size penis will fit and provide adequate sexual stimulation to the female. In human beings sexual union is not a mechanical union. There are several factors influencing sexual satisfaction including such things as physical attractiveness of the partner, romantic feelings, love, and other things. 

As explained earlier in this column, masturbation has no effect on sexual life. Masturbation is a normal sexual habit.

As you are not married, it is difficult to opine whether you have real problem with erection. In young men of your age the main cause for loss of erection is psychological. In your case, the wrong notions about the length of the organ, fear of the so called ill effects of masturbation might have triggered this problem.

You have to convince yourself that you are normal. If required you may consult a psychiatrist to discuss the issues that worry you.

There is no diet that can solve sexual problems. Moreover your problems are psychological and they do not require medical treatment or diet regulation.

17. M.S. Abudhabi

* I am 30 years of age. I have been married for 2 years and trying for a child for the last 5 months. Just few weeks ago I underwent a semen analysis. It was reported that my semen count was very low, i.e. less that 2 million/ml. I do not smoke & drink. There was also lot of pus cells found. Kindly advice me how can I increase my sperm count, what medication I should undergo. 

 **Though several causes are listed for low sperm count, in most of the men with this problem definite causes are not found. Some of these causes can be inherent and others are acquired. In some of the men engorged testicular veins-vericocele- can be the cause for low sperm count. Vericocele is treatable. Even exposure to excess heat in working places, tight undergarments, and exposure to certain chemicals, smoking, substance abuse, obesity and several other factors can reduce sperm count. 

You may consult an urologist to know if there is any treatable cause in you. There are certain medicines available which are used to increase the sperm count as well as the motility. The doctor might prescribe them if indicated.

18. R. D'Souza, Mangalore

*My husband (aged 42) has developed swelling above the knee cap recently. We have used several types of ointments /medicines which have shown no improvement.  Doctors here have told him to put on a knee support and walk. We have now been told that he has "fluid" in the knee. Please advise us what to be done, is it good to have this fluid surgically removed or will it subside with the medicines. We are greatly concerned as he is unable to walk at time / limping due to swelling / pain.

 ** By the description given by you it appears that your husband is having synovial thickening with effusion due to osteoarthritis of the knee joint. 

The normal knee joint is surrounded by a membrane (the synovium) which produces a small amount of thick fluid known as synovial fluid. The synovial fluid helps to nourish the cartilage and keep it slippery. The commonest cause for swelling around the knee is excess collection of joint fluid known as synovial fluid. Excess collection of synovial fluid is a common manifestation of inflammation. During inflammation, the synovium thickens and makes the joint puffy and swollen. The inflamed synovium causes warmth, redness, swelling, and pain, which is more common in conditions like rheumatoid arthritis.

Swelling around the knee with mild to moderate pain is common in osteoarthritis. Osteoarthritis is also known as "wear-and-tear" arthritis. Osteoarthritis is typically seen as a primary disease in older people but can occur as a secondary condition in younger people. Injury, occupation, excess weight, and genetics are among the factors which cause the cartilage of a joint to wear away. Many a times the initial insults may be a minor trauma, which is often forgotten or repeated minor injuries in sports like foot ball, volleyball etc.

Besides from weight reduction and avoiding activities that exert excessive stress on the joint cartilage, there is no specific treatment to halt cartilage degeneration or to repair damaged cartilage in osteoarthritis. The goal of treatment in osteoarthritis is to reduce joint pain and inflammation while improving and maintaining joint function. Some patients with osteoarthritis have minimal or no pain, and may not need treatment. Others may benefit from conservative measures such as rest, exercise, weight reduction, physical and occupational therapy, and mechanical support devices. Medications are used to complement the physical measures described above. Medication may be used topically, taken orally, or injected into the joints to decrease joint inflammation and pain. 

There can be several other causes for swelling around the knee joint. To get remedy for the problem you may consult an orthopaedic surgeon. All these problems can be effectively treated without surgery.

19.A. D’S Bangalore

*I  am 25  years old. I would like to know that if I start going to the  gymnasium,  will it affect my sex life. Or will it decrease the size of the sexual organs?

** Doing gymnastics or any such exercises have no effect on the sexual organs or sexuality. However, it is known that some of the body builders use hormones in the form of steroids which can have severe impact on sexual functions.

20.R. Q  Mangalore 

* I am married, having two children. I would like to go for the vasectomy.Please suggest the best doctor.

**Vasectomy is a minor operation that is usually done on an out patient basis.  As it is done under local anesthesia, person remains awake during the surgery, which usually takes no more than 30 minutes. In this surgery two small cuts are made  in the skin of the scrotum through which the tubes are gently lifted out. The tubes are cut, and a small piece of each is removed. The cut ends are tied or sealed with electric current. The openings in the scrotum are closed with small stitches. After a short rest (usually half an hour) person can go home. 

There is another popular method known as non-scalpel method. In this method of vasectomy, which was developed in China, scalpel (the instrument used to make incisions) is not used. After the anesthetic is injected, the doctor pierces the skin of the scrotum with a sharp instrument, then gently stretches the opening so that the tubes can be reached and blocked. No stitches are needed to close the tiny holes. There is very little blood, and fewer complications than when the scalpel is used. 

Any general surgeon is able to do vasectomy. No scalpel vasectomies are commonly done in government hospitals.