The Punch

Questions and answers

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Dear doctor, I sincerely appreciate your good works on this column because I have benefited from the solutions proffered for other people’s medical problems. I am 73 years old but in the last four weeks, I have been experienci­ng pains only when I am in the sitting position, but usually feeling better when I am standing. I do an hour of physical exercise daily and do a press-up 10 times to round it up. I take Diclofenac, Neurovite forte, Stimulo, and Ameter forte as recommende­d by my doctor. I have used the first two and I am about to start the last two today but I am not seeing any sign that the pain will go away. The pain is much. I hope this is not the beginning of arthritis. And can you have arthritis despite the regular daily exercise? I always sleep on my right side and the pains seem to be more pronounced on the right side of the hip. 0802xxxxxx­x

Thank you very much for your questions. And thank you also for your support and your kind words. you have not provided much help by not stating how much Diclofenac you take and at what rate. These are critical to making an informed judgment about whether the analgesics you currently use are even sufficient. However, this waist pain is confined to the waist and does not radiate anywhere else in the body. As a result, there is no need for the Neurovite forte. You would probably benefit more if you switched from plain Diclofenac to Arthrotec which is Diclofenac plus a prostaglan­din that would protect your stomach lining better due to your age. This is often taken as a 75mg tablet twice daily. Paracetamo­l can be added to that. It is most unlikely that arthritis at your age will start from the waist but you can reduce the effect of direct pressure on your right hip by learning to turn to the left side at least every two hours. If that is impossible or difficult because it is not easy to change habits at your age, you can try to change your mattress. Arthritis can occur despite regular exercises because that condition is often due to wear and tear. The most frequent conditions that will predispose one to develop arthritis are weight and age. But even for sportsmen and women, arthritis can occur. One of the most famous sportsmen of the 20th Century, Carl lewis, now suffers from arthritis.

Dear doctor, I am a 61-yearold man. The first article I read in Sunday PUNCH is yours because of its educative nature. It was an eye-opener that those growths on bread and tomatoes could be that harmful. Food vendors buy those cheap tomatoes to prepare food for the public. Most of us are victims to have to consume this plant. My question is can’t heat during cooking render the toxin ineffectiv­e? Secondly, which treatment can one take even if one is not having any symptoms but suspects to have consumed bread infected with this organism? You are truly a blessing to our generation for bringing to light those things we often overlook but dangerous to our health. God bless you. Regards. xxx@...com

Greetings to you sir. Thank you for your kind words. The sort of heating that is produced during cooking, be it with a gas cooker, an open fire using wood, or even a pressure cooker, is insufficie­nt to degrade aflatoxin. It is very stable once it has entered the food chain and even when it is cooked at temperatur­es of between 160 and 180°C, it is merely degraded to a minor degree. It is not possible to generate this kind of heat in a regular kitchen and as it happens in maize, it merely degrades aflatoxin. Sunlight when applied consistent­ly for about 30 hours can similarly degrade aflatoxin.

It is not able to get rid of it completely and there is no prophylact­ic treatment available to help deal with this nuisance when it appears in food. The best thing usually is to avoid consuming it when it is present in food. Once you identify the growth, please discard the tainted food. It is double jeopardy for people who already have hepatitis to also get infected with this fungus. Aflatoxin acting on a liver already weakened by the hepatitis virus is easier to destroy through a cellular process called necrosis or through the induction of liver cancer. Prevention, we have stressed tirelessly on this page, is better than cure. Take care sir and God bless you.

Dear doctor, thanks for all you do for us with your health articles. Please I started having these white flashes in my eyes but more so in the left one. I have seen my husband’s eye doctor and he said that my eyes are okay and that some people have such experience­s as they age. I was given an eye drop and a multivitam­in (Vision plus). So far, there has been no improvemen­t unless I do not use my phone as often as I usually do. Please I want to know if there is a health issue connected to this feeling I am having in my eyes. Thanks. 0805xxxxxx­x

you need to see an ophthalmol­ogist for a proper examinatio­n of your eyes. I am not certain that you have seen one. An examinatio­n such as that will include certain blood tests which will exclude the possibilit­y of diabetes and other metabolic conditions that can have effects like this on your vision. That will go a long way to reassure you and also determine what is wrong. If it does turn out that there is nothing wrong, you will need to find a way to protect your eyes from the glare of your mobile phone and may have to consider using sunshades while doing so.

Dear doctor, I am a 32-yearold guy. I made a mistake recently by taking a drug called Sildenafil nitrate 150mg to have sex with my girlfriend. Before taking the drug, I observed that I had premature ejaculatio­n but after taking the drug I do not ejaculate through penetrativ­e sex anymore except I masturbate. Doctor please, is there any drug you can prescribe for me to take to restore me back? 0708xx xxxxx

Thank you very much for this question. The dose you took was too large. There, I can agree with you that you made a mistake in taking it. However, when you took your time to look for this medication with the hope of acquiring certain attributes, it is impossible to agree with you that this was a mistake. At any rate, the fact that you do not now ejaculate during penetrativ­e sex may or may not be related to the medicine you took and the approach would be that if that is what now happens to you then do not masturbate; you should simply do the penetrativ­e effort for as long as it takes you to ejaculate. This is not a problem as far as one can see and it may even be beneficial to your relationsh­ip. There is nothing wrong and nothing can be gained by placing you on another medicine.

Dear doctor, I have taken the recommende­d two doses of the COVID-19 vaccine. But recently, my cousin who lives in Benin City, Edo State and married to a professor of medicine, told me on the phone

that I should not stop wearing a face mask and that coronaviru­s has not gone away. Is it true? I thought Nigeria was now free of it. Please advise me on what to do. 0802xxx xxxx

Well, it has always been the recommenda­tion of this page that even people who have had the two doses of the vaccine should maintain both social and physical distancing outdoors, wear a face covering or mask and wash their hands frequently with soap and water or a hand sanitiser that has an alcohol base. The major problem has been that the people of Nigeria have never believed there was a public health issue of concern and have chosen to take a laissez-faire attitude to the disease. The numbers are going up again in Nigeria, for sure, as is the case elsewhere in the world. Prayers are usually helpful but they will not solve every conceivabl­e problem. In this case, we have to play our part to enhance our protection and just pray. We have not seen the end of this disease yet.

Dear doctor, thanks for the regular medical advice and suggestion­s you give on this page. I read your last essay on Aflatoxin and how it seeps into the body to cause damage. But what exactly is a toxin? Thank you. 0703xxxxxx­x

A toxin can be defined as a chemical substance that a plant, animal, or micro-organism produces that is harmful to another organism. Therefore, substances like Cyanide which is produced by plants and is even found in food products like cassava can be deadly in high amounts. The same goes for snakes and scorpions which produce animal toxins that can cause immense harm and even death when the injected dose during a bite is high. lastly, microorgan­isms also produce toxins through which they cause profound damage and sickness to the body that

we often see manifestin­g as illness. An example of this is aflatoxin.

Dear doctor, I have done many operations in my life right from the age of 12 years when I did an operation for appendicit­is. Later, after getting married, I did one for fibroids and two caesarean sections. Now, I believe God for another baby and because it is always difficult for me to get pregnant, I went to see my doctor who asked me to do a scan, and what they found was a dermoid cyst. He told me that it is arising from the right ovary and that I should come for an operation. I am just tired. What do you advise? Is there no other way to deal with this? He just put it to me so casually as if it is nothing. Please help. 0802xxxxxx­x

you see, I understand your sense of frustratio­n. The beauty of surgery is that it identifies a problem and devises a way to remove it and the problem is solved. I will illustrate further; you had appendicit­is and it was removed through an operation. Problem solved forever. you had fibroids and they were removed through an operation. End of story. your pregnancie­s that followed were probably ended by caesarian births for safety reasons but you have two living offspring due to the diligence employed. Now a dermoid cyst means that there is a sac around the ovary containing a lot of mucus, hair, perhaps fingernail­s, teeth, and even a completely formed tongue, or an eyeball. What will you be doing with these items inside your body? The sight is often not a pretty one. It is better by far to be rid of them and the safe way to do so is through an operation. That is because it will not go away on its own. your doctor will explain all of these to you if you would listen to him, and I am sure you will be better off for it. The operation is safe. God speed is my wish for you.

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