Q I am a 24 yr old female who is always tired and "out of it". No matter how much sleep I get, energy drinks/vitamins I take I am always exhausted, have no motivation, distracted, cranky and not myself. I am limited in the foods I can eat because of food allergies and have been feeling these effects since the 2 years since I was diagnosed with allergies. Can you suggest anything to help? I want to feel like a normal human being again.

The cause of your condition may be due to excess intake of caffeine or alcohol, excess physical activities etc. Irregular food habits, some medical conditions related with liver, lungs, anaemia, diabetes are associated with these. Psychological conditions as anxiety, stress may cause your symptoms many times. As you have got food allergy try to cope up with your diet first. May be due to the allergy you are unable to take sufficient and proper diet. Consultation with a dietitian may be helpful. Regular exercise may help you better. If sleeping is not causing comfort for you learn better ways to relax. Try yoga or meditation. Maintain a reasonable work and personal schedule.

Q What is the true cause of trichotillomania aslo known as severe obsessive compulsive hair pulling?

The cause of trichotillomania is unclear. But like many complex disorders, trichotillomania probably results from a combination of genetic and environmental factors. Also, abnormalities in the natural brain chemicals serotonin and dopamine may play a role in trichotillomania. While the underlying biology is not clearly understood at this time, we do know that people with trichotillomania generally have a neurologically based predisposition to pull their hair as a self-soothing mechanism. The pulling behavior serves as a coping mechanism for anxiety and other difficult emotions. It does not hurt and they are not trying to damage themselves. While the average age of onset is 11, trich can be found in children as young as one year old. Onset of trich can be triggered by simple sensory events, such as itchy eyelashes, or by stressful life events, and it can occur quite suddenly. For example, it may be a tingling feeling that can only be relieved by pulling. ny relief that comes with hair pulling usually only lasts for a moment. The urge almost always returns. Thats because when the mind becomes used to giving in to the powerful urges that go with compulsive behaviors, the behavior is reinforced, and then becomes a habit. The mind gets trapped in a cycle of expecting to have the urge satisfied. The longer this goes on, the harder it can become to resist the urge.

Q How fast are calories absorbed?

The calories absorption depends on the physical and mental well being of the person. It also depends on the age, sex, occupation, environmental factors etc. It varies from person to person. Some one doing heavy physical work spend the calories early than other one who does relax work in the office.

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 Can i catch HPV from oral sex or kissing?

Yes. Sexual contact including oral sex and deep kissing can cause transmission of HPV from one person to another.

Q What is natural family planning?

Natural Family Planning ( NFP) is the term for certain methods used to achieve and avoid pregnancies. These methods are based on observation of the naturally occurring signs and symptoms of the fertile and infertile phases of a womans menstrual cycle. Couples using NFP to avoid pregnancy abstain from intercourse and genital contact during the fertile phase of the womans cycle. No drugs, devices, or surgical procedures are used to avoid pregnancy.

Q How can I tell when Im ovulating?

Ovulation usually occurs 12-15 days before your period starts. So if your periods are regular, you can easily determine your ovulation period by subtracting 14 days from the expected date of the next menstrual cycle. One in 5 women experience mild abdominal cramps when they are ovulating. You can also use a basal body thermometer to check your basal body temperature which shows the lowest reading followed by a sudden rise when you ovulate. During ovulation, your cervix becomes softer and gives out more discharge (mucus) than normal. You can also buy ovulation kit available in chemist to determine your ovulation.

Q What kind of diet is not advisable for when you have pain in neck and shoulder?

Unhealthy diet and lifestyle are on second rank when it come to pain in body like neck and shoulder pains. Modern food habits are actually producing harmful effect on body by promoting accumulation of toxins in body. These type of food include: chocolates, ice-creams, food containing caffeine, highly processed food, canned or preserved food specifically with MSG, junk food or fast food, food high in sodium and sugar, high fat dairy products, meat, cigarette, wine, beer or any other alcoholic drink etc. These type of food in diet put your body under constant metabolic stress and promote production and accumulation of unhealthy chemicals or toxins in your body. This combined stresses, irritate and spasms nerves and skeletal muscles resulting in pain. So, healthy way to avoid or reduce neck and shoulder pain is to eat healthy, well cooked, preferably home made and fresh food including lots of veges and fruits.

Q Can a girl get pregnant without inserting? Just touch outside her vagina.

A girl can get pregnant only when the sperms enter the vagina. But this can happen even if you ejaculate near her vaginal opening. Please do not take any unnecessary risk. Either use a condom or stay as far from the vagina as possible.

Q My two year daughter fell from the slide this morning. In evening she passed white stool with bad smell.

Episode of fall and the white stool does not seem to be connected. But at the same time white coloured stool can not be ignored. Stool gets its normal yellow- brown colour due to bile. White colour stool indicate that either the bile is not produced or it is obstructed. Hence it should be evaluated by the doctor. Consult your family physician at the earliest.