Q Hi, I sometimes get a "twinge" in my left chest, sort of in the crease of my breast. It doesnt happen after exertion but at any time, even at night in bed - Im scared theres something wrong with my heart.

Twinge or sudden sharp pain is very common presentation of chest pain and most of the times it is not related to heart. Very rarely this pain indicate coronary artery disease. Moreover since the pain is not related to exertion and comes anytime, it is less likely related to heart conditions. One probable cause for your pain could be indigestion. However it is advisable that you get yourself examined by your family physician once to rule out anything serious.

Q How to avoid dandfuff?

There are many reasons for dandruff - Stress, nutritional deficiencies, excessive dryness of the scalp, fungal infection, vitamin C deficiency, pregnancy, long illness, thyroid imbalance, as well as hair damage caused by procedures like hair coloring/dyeing, bleaching, straightening, perming, etc. You can do following things to prevent hair loss: Getting proper nutrition is essential for healthy hair. Water, protein, biotin (part of the vitamin B complex), vitamins A, B6, B12, C, copper, iron, omega 3 fatty acids, zinc, calcium, folic acid, and magnesium all play a part in maintaining a healthy scalp, skin, and hair. Using your fingertips to massage your scalp will increase circulation in your scalp which is important for hair growth. Take 10-12 jaswand (hibiscus) flower +200gm methi (fig) seeds soaked in coconut oil for 7 days then boil it sleeve it and use it daily for head massage it prevent hair loss, promote new hair growth and hairs become thick and restrict dandruff formation. In a week massage your scalp with yoghurt(curd) or aloe-Vera pulp or neem leaves paste which has antibacterial properties which help to clear dandruff formation. Instead of using chemical shampoo, use rita to wash the hairs; take 7-8 rita soaked for whole night boil in the morning in water gently massage and wash the hairs with this mixture.Gentle combing or brushing of your hair will help break up hardened oils that clog your pores. It is recommended that you comb or brush 100-200 strokes in the morning and at night. Avoid excessive wind, sun, and heat (such as from hair dryers, hot showers, and curling irons) on your hair. Tight fitting caps and hats will cause poor circulation in your scalp and will also cause buildup of sweat and grime. Take plenty of water keep yourself hydrated. Take care.

Q I am 69 year old, my hands start trembling whenever I am writing any thing which medicine should I take? what is parkinsons disease?

Trembling or shaking of hands is called as tremors. There are variety of tremors found and so variety of causes are there for its occurance. If you are suufering from tremors only when you write something, then these can be: Intentional tremors that occur at the end of any purposeful movements, Cerebellar tremors represented as intetional tremors, postural tremor that occur in particular posture of hand or leg against gravity, benign essential tremors occuring at older age and are inherited from family, tremors due to increased thyroid functioning, tremors due to reduced blood sugar levels, tremors as a result of alohol withdrawal or due to alcohol consumption, it can be a side effect of certain medicines, or it can be a task specific tremors. To prescribe you any medicines, it is necessary to evaluate your symptoms in more detailed way including evaluation by physical examination, which will be best achieved if you see your physician or a neurologist. Perkinsons disease is a degenerative disorder of central nervous system, where brain cells and nervous tissue undergo degeneration, resulting in dopamine deficiency in a patient. If you are trying to link your tremors with parkinsons, then the main differentiating point is parkinsons tremors are observed at rest and not at the time of movements. Further evaluation is needed for proper management.

Q Is non-vegetarian food safe during pregnancy?

There is no harm in consuming non-vegetarian food during pregnancy. Infact eggs, chicken, fish etc are packed with nutrients which are beneficial for you as well as your baby. But care should be taken to maintain the highest standards of hygiene because non-vegetarian food is liable to become contaminated easily. Make sure you eat only well cooked non-veg food. Avoid anything that is raw or under cooked. Avoid fish which are high in mercury such as mackerel, swordfish, tuna, etc. As long as you follow these guidelines, you can safely consume non-vegetarian food.

Q Hi, My son is 5 years old. About a year ago he had adenoidectomy and insertion of grommet in his ear for ear infection. Now one of the grommet is coming out and he is complaining of ear pain. Can you advise if he needs repeat surgery?

If the grommet is coming out and he is complaining of ear pain, there is need of reinsertion of grommet. My advise to you is revisit your ENT surgeon, who have operated your son. Because he is in a better position to advise you and do further management.

Q For Depression, Phone Therapy May be an Answer?

Depression is a mental disorder in which the person may feel to be alone and dont want to see anyone around him. In this case, phone therapy can play a important role to consult with the patient without going to disturb him. No third person come to know about the disease and the treatment. The patient can feel comfortable at home and feel free to discuss the problem in private. The patient may feel comfortable by avoiding the dressing to go to the clinic, travelling and waiting for consultation etc. But, it should not be considered as a complete treatment. And one has to limit the time period during the call.

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 How does aids kill cells in immune system?

The AIDS is caused by the virus HIV, which attacks the CD4 cell (T-cells) of the immune system. Because, CD4 cells have a specific protein for the HIV. The HIV also affects other cells like B cells and macrophages which are the main part of the immune system. Thus, limiting the action of the immunity of the affected individual. Due to decreased immunity, the individual is prone to any infection leading to further decline in the health status of the individual. In most of the cases, the individual dies due to some other infection to the AIDS patient.

Q Hello I am 28 years newly married .i am sexually weak ,the time duration is not enough .what can i do??

What you face is called as performance anxiety. It is common among newly married mens. The reason behind it is nervousness in front of your partner or doing the act in hurry. For most couples the duration of sex is betwee 3-7 mins. So if you are in this category you need not worry. How ever you can follow these simple measures to improve your time. Pace slowly. Give more time to foreplay. Do not hurry. Try to do sex more often. Over a period of time it will improve. If not planning for pregnancy then use a thick condom. It will delay the sensation to your penis and will help you to last long. You can also practice stop-start method. Divert your mind to non sexual thought the moment to feel you are about to ejaculate and once you are relaxed restart again.

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.