Q What is "Selective Mutism"?

Selective mutism is a condition in which a person who is normally capable of speech is unable to speak in given situations or to specific people. Selective mutism usually begins in childhood. It usually co-exists with shyness or social anxiety. Its important to understand that when the mutism happens, the child is not voluntarily refusing to speak but is literally unable to speak, feeling frozen. In time, they learn to anticipate the situations that provoke mutism and do all they can to avoid them. Example: selective mutism while interacting with the opposite sex. Other attributes of children or adults with selective mutism are nervousness, socially awkward, clingy, excessively shy or withdrawn, stubborn or aggressive. Behavioral therapy forms the mainstay of treatment with medications used in a few older patients. Most children will work their way through SM with sympathetic support, although they may remain reserved and anxious in social situations.

Q I have been suffering from hyper-acidity as a result of antibiotics. Please advice.

Hyper-acidity is a common side effect of most antibiotics. Most physicians will prescribe an antacid or a H2 blocker along with antibiotics to circumvent this side-effect. If your physician hasnt done so, please visit him and ask him to prescribe the same. If you are on long term antibiotics, a multivitamin will help. As a home measure, include plenty of cold milk and yogurt in your diet to counteract hyper-acidity.

Q What is multiple personality syndrome?

Dissociative identity disorder or multiple personality disorder is a very rare mental disorder. It is characterised by at least two distinct and relatively enduring identities or dissociated personality states that alternately control a persons behavior, and is accompanied by memory impairment for important information not explained by ordinary forgetfulness. It is one of the most controversial psychiatric disorders with no clear consensus regarding its diagnosis or treatment.

Q What can you tell me about Borderline Personality Disorder?

Borderline personality disorder (BPD) is a Mental Health disorder that generates significant emotional instability. This can lead to a variety of other stressful mental and behavioral problems. When you have borderline personality disorder, you often have an insecure sense of who you are. Your self-image, self-identity or sense of self often rapidly changes. You may view yourself as evil or bad, and sometimes you may feel as if you dont exist at all. An unstable self-image often leads to frequent changes in jobs, friendships, goals and values. This is because people with borderline personality disorder often have difficulty accepting gray areas; things seem to be either black or white. The common symptom of borderline personality disorder are overwhelming feelings of distress, anxiety, worthlessness or anger, difficulty managing such feelings without self-harming, for example by abusing drugs and alcohol or taking overdoses, difficulty maintaining stable and close relationships, sometimes, periods of loss of contact with reality, in some cases, threats of harm to others. Treatment may involve a range of individual and group psychological therapies (psychotherapy) carried out by trained professionals.

Q Are growing pains real?

Growing pains are seen in children of the age group 5 to 12 years. Thses always concentrate in the muscles, rather than the joints. Most kids have pains in the front of their thighs, in the calves, or behind the knees. The children with growing pains can be helped by massaging the area, stretching or by placing a heating pad on the area.

Q Is it possible to raise your IQ?

Intelligence is mostly hereditary. Intellectual ability grows until about age 16, and after that changes very little. Practicing various skills which are tested on IQ tests will increase your IQ score some, but it is not likely to increase your intelligence. Intelligence is basically the abilities to learn, to reason, to remember, to think abstractly, to problem-solve, etc. These abilities are very difficult to improve once you are an adult, though you may improve specific skills. E.g. you can improve basic mathematical skills by practicing them often and learning certain mathematical shortcuts, or you can learn to read faster by pushing your reading speed and learning to scan for meaning. Generally, the best way to improve your performance in specific work tasks is to do those tasks a lot. When you do that, you gradually learn the best possible techniques to efficiently and accurately complete that work, in the minimum necessary amount of time.

Q What are the symptoms of kidney failure?

Symptoms may vary form person to person. Usually kidney failure is asymptomatic in early stage but as disease progresses symptoms become prominent. Sign and symptoms include nausea, vomiting, loss of appetite, fatigue, weakness, changes in urine output, fluid retention, swelling over ankles and feet, shortness of breath, persistent itching, hiccups, high blood pressure, difficult concentration, abnormal heart rhythms, sleep problems. If left untreated life threatening circumstances may develop.

Q What is the golden hour in treatment of heart attack?

The available oppurtunity (first 60 minutes to 120 minutes) after the onset of a heart attack is considered as the golden hour. In this time period, maximum fatality and damage to the heart muscles occur. Thus, an available oppurtunity in offering a logical treatment reduces the after-effects and impact of heart attack, increases the survival rate and lessens complications to an individual. Thrombolysis with clot buster " medications" during this hour when the patient is able to recieve emergency care give excellent results. Nowadays it has been substitued with PAMI i.e., Primary Angioplasty Myocardial Infaction after heart attack in a cardiac care centre. Thus immediate hospitalisation of the patient in a cardiac health care centre is important for his chances of recovery are very high.

Q Are condoms 100% effective?

No condom can be effective in preventing pregnancy or sexually transmitted diseases (STDs) 100% of the times.n Condoms fail to provide protection sometimes from infections spreading from sores on the skin uncovered by a condom, for eg. at the base of the penis or scrotum. But a properly used condom can protect against STDs better than anything else. Some factors to consider in order to ensure the efficacy of condom are: check date of expiry, use latex, keep them away from heat, use water-based condoms, open carefully to avoid tearing, remove holding at the base of penis, choose condom with reservoir tip to hold semen after ejaculation. Consult a doctor if the condom breaks or slips off. Although not 100 % perfect, condoms are the best way of protection if one is going to have sex.

Q I am 43 year old man and my wife 41 year we have 4 year and 6 month daughter. We are very confused whether to go for second child as my only daughter feels very lonely. Can you advice?

First, determine whether you and your wife are physically, mentally and financially ready to have a second child. It is definitely possible to conceive at this age; however there are many factors that you should take into account before arriving at a decision. A womans fertility decreases drastically in her forties so there is a major possibility that your wife may have to use donor eggs to achieve pregnancy. The risk of complications during pregnancy such as diabetes and high blood pressure increases. Moreover, there are higher chances of premature and still births. You may need to use assisted reproductive techniques thus escalating costs. I am not trying to discourage you, but giving you the facts. On the other hand, some women do get pregnant well into their 40s, and many of them have complication-free pregnancies and healthy babies. Both of you should make an informed decision after knowing all the pros and cons. For any further clarification, visit a gynaecologist who will brief you about all available options. Do consider the possibility of adoption too.