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attributes of children or adults with selective mutism are nervousness, socially awkward, clingy, excessively shy or withdrawn, stubborn or aggressive.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 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 are the treatment options for menstrual migraines?

Treatment for menstrual migraines may vary from person to person. However generalized treatment include: anti-inflammatory drugs, trans-dermal patches of estrogen, use of hormonal pills containing ethylene estradiol. If all these dont help than consult your doctor to prescribe you NSAIDS and beta blockers.

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 Should my child drink alcohol?

Absolutely not. No person under the age of 18 should be allowed to drink alcohol.

Q how to do anal sex? does it creat any problem?

Anal sex is practiced by many heterosexuals, as well as homosexual couples. The anal area has many erotic nerve endings in both men and women. Because of this, many couples (heterosexual or homosexual) can derive pleasure from some form of bottom stimulation. Anal sex should be avoided by couples in which one of the partners has been diagnosed with an STI until the treatment has proven to be effective. In order to make anal sex safer, the couple must ensure that the anal area is clean and the bowel empty and the partner on whom anal penetration occurs should be able to relax. Regardless of whether anal penetration occurs by using a finger or the penis, the condom is the best barrier method to prevent transmission of STI. Since the rectum can be easily damaged, the use of lubricants is highly recommended even when penetration occurs by using the finger. Especially for beginners, using a condom on the finger is both a protection measure against STI and a lubricant source. Most condoms are lubricated and they allow less painful and easier penetration. Anal stimulation with a sex toy requires similar safety measures to anal penetration with a penis, in this case using a condom on the sex toy in a similar way. It is important that the man washes and cleans his penis after anal intercourse if he intends to penetrate the vagina. Bacteria from the rectum are easily transferred to the vagina, which may cause vaginal infections. When anal-oral cos ntact occurs, protection is required since this is a risky sexual behavior in which illnesses as Hepatitis A or STIs can be easily transmitted, as well as enteric infections. The dental dam or the plastic wrap[citation needed] are effective protection means whenever anilingus is performed. Anal sex has a number of health risks. Anal intercourse is the riskiest form of sexual activity for several reasons, including the following: The anus lacks the natural lubrication the vagina has. Penetration can tear the tissue inside the anus, allowing bacteria and viruses to enter the bloodstream. This can result in the spread of sexually transmitted infections including HIV. Exposure to the human papillomavirus (HPV) may also lead to the development of anal warts and anal cancer. Using lubricants can help some, but doesnt completely prevent tearing. The tissue inside the anus is not as well protected as the skin outside theanus. Our external tissue has layers of dead cells that serve as a protective barrier against infection. The tissue inside the anus does not have this natural protection, which leaves it vulnerable to tearing and the spread of infection. The anus was designed to hold in feces. Repetitive anal sex may lead to weakening of the anal sphincter, making it difficult to hold in feces until you can get to the toilet. The anus is full of bacteria. Even if both partners do not have a sexually-transmitted infection or disease, bacteria normally in the anus can potentially infect the giving partner. Practicing vaginal sex after anal sex can also lead to vaginal and urinary tract infections.

Q Shall I give my baby rotavirus vaccination?

Rotavirus vaccination is included in Indian Immunization schedule. So it is safe to give it to your child. The recommended age for the vaccination is 2 months, 4 months and 6 months. It is contraindicated in cases where the child has allergic reaction to rotavirus vaccine, has intussuception or sever combined immunodeficiency.

Q Having complain of white discharge and itching in vagina since 2 months my menstrual cycle is regular

The white discharge and itching in the vagina is suggestive of some infection in the area due to bacteria, virus or fungus. You have to take care of your hygiene. Wear cotton undergarments which increases air flow and decreases moisture. Wear loose-fitting clothing. Proper treatment of an infection is usually very effective. You must consult the physician to get the best possible 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 Why is babys head dropping when crawling?

Crawling is seen at the age of 6-9 months of the baby. During this period, the baby tries to hold his head high and try push ups to move forwards. Developing head control varies from baby to baby. Some may develop quickly while other may take time. But, if your baby is unable to hold at all, then you must consult your paediatrician to rule out the cause.