Q: I like to avoid breakfast as I feel it is unnecessary. I also think I am more likely to lose weight in this way.
A: Many studies have shown that 40 minutes of exercise followed by a healthy breakfast is the best way to kickstart your day. It prevents "mid morning blues" and reduces the craving for food and hence the total consumption of calories during the day.
Dog bite bother
Q: I got bitten on the cheek by my neighbours dog. They say that they were unable to complete the schedule of immunising the dog.
A: Dog bites are dangerous as they can transmit rabies. The safest course of action is to clean the wound thoroughly with soap and water and then leave it open. Take a single injection of tetanus toxoid and then proceed to take the anti-rabies injections as per schedule of the injection package. The newer vaccines are given in the arm. They are safe and produce fewer side effects than the older vaccine which was given around the umbilicus. The vaccine is freely available. You need not go to a government hospital for treatment as earlier.
Better safe than sorry
Q: I was told that only the semen contains disease causing organisms, and so using a condom just before ejaculation is enough to prevent diseases like AIDS.
A: During sex the skin of the vagina is in close contact with that of the penis even before ejaculation. Small abrasions are enough to transmit infection. Be safe. Use a condom from the beginning of the intercourse. You have only one life. Why endanger yourself?
Q: My wife has just had a baby. How soon can we have intercourse? I dont want another child before 3-4 years. Can we use the i-pill?
A: Intercourse can be resumed six weeks after childbirth, provided the attending physician hasnt advised otherwise. You need to use contraception even if your wife doesnt begin menstruating after six weeks or if she is breast feeding. You can use condoms, or opt for the insertion of an IUCD (intrauterine contraceptive device), also called a loop, or take regular injections (every 12 weeks) of a long acting progesterone or take progesterone only pills daily. Combined (estrogen-progesterone) pills are not advisable for breast feeding mothers.
The i-pill is intended only for emergency contraception. It is not meant for use on a regular basis.
Q: My one-year-old son developed rashes on both his cheeks. The doctor said it is allergy to cow milk. Although Ive stopped giving him milk, the rash has not improved. How is that possible?
A: What you are describing is eczema, an allergic skin reaction. You may have stopped giving him milk but he may be receiving milk indirectly in biscuits or pre-packaged ready to eat weaning cereals. This may perpetuate the problem.
Help, Im fat
Q: I am 32 years old and weigh 97kg. I calculated my BMI and it is 37. I read recently that if the cholesterol values are high, it is not possible to lose weight no matter what you do. This is very discouraging.
A: You do urgently need to lose weight and this cannot be achieved by diet alone. You need a sensible low fat 1,500-calorie diet and at least an hour of exercise. Brisk walking is probably sufficient. Consult your physician for your cholesterol values and appropriate treatment. Safe medications are now available to lower cholesterol and also to control appetite.
Q: What are the chances of having twins? The number of twins seems to be increasing in general and I am worried.
A: Twins occur in around 30 out of 1,000 pregnancies. The percentage may seem to be high. In fact, pregnancies after fertility medication or in vitro fertilisation (test tube babies) are more likely to be multiple.
Your chance of having twins is greater if there is a family history of twins.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at firstname.lastname@example.org