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.

Q Are cigars less detrimental to health than cigarettes?

"No. Cigars arent less harmful than cigarettes in any way. Rather they contain more carcinogenic tars, which make them worse than cigarettes. Moreover, when one smokes stogy, excess nicotine and carcinogens are inhaled through the mouth, which could cause dental problems,lung diseases, and cancers.
The reason behind the false repute of cigar being less harmul might be that generally cigar smokers are "occasional" users, and while puffing, most of them don~t inhale the smoke into their lungs. Stay away from cigarettes, cigars, pipes etc if you want to live healthy."

Q Do men suffer from menopause like women?

The phase of life similar to menopause is called as andropause in men. It is marked by lethargy, sadness, weariness, lack of drive, irritability, poor concentration and sometimes loss of sexual desire in middle-aged men. This leads to boredom, lack of fitness, heavy drinking and lack of self-esteem.n Though, male menopause is controversial, as there isn~t any calculable fall in the levels of male hormones in middle age like females have fall in sex hormones drastically, yet it is advised that men experiencing the symptoms should exercise regularly and eat healthy, nurture a hobby, and have a peaceful mind and renew interest in life.

Q Will cystoscopy cause impotency??

Cystoscopy simply consists of viewing the urinary bladder through a scope. It is a very safe procedure with no major side effects. There is no evidence regarding cystoscopy causing impotency.

Q I want to know about fistula.

A fistula is an abnormal connection between an organ, vessel, or intestine and another structure. Fistulas are usually the result of injury or surgery. It can also result from infection or inflammation. often occur in the area around the genitals and anus (known as the perineum). It is connection between two body cavities eg. rectum and vagina. The symptom vary with the location of fistula.

Q Whats causing my palpitations and how can I get rid of them?

The causes for palpitations are - strong emotions such as anxiety, fear, or stress; palpitations often occur during panic attacks; caffeine, nicotine, alcohol, or illegal street drugs such as cocaine; some medical conditions, including thyroid disease, a low blood sugar level, anemia, low blood pressure, fever, and dehydration; hormone changes associated with menstruation, pregnancy or menopause etc. In most cases, palpitations are found to be harmless and often go away on their own. Treatment depends on the cause of your palpitations. Some lifestyle changes like exercise and yoga and quitting smoking and alcohol help a lot.

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 What are the risk factors for thyroid cancer?

The risk factor for thyroid cancer are - female gender, low iodine diet, exposure to radiation, family history, inherited genetic mutation.rnrn 

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 I get angry very often. How can I control my anger?

Getting angry is normal. One needs to concentrate not on "not feeling angry" or "controlling anger" but on how to manage that anger correctly. First of all try to identify the things, people, or situations that trigger anger. You can even keep a dairy. Note the ways in which you react to these situations. Then look for alternative ways of responding to the same situations. Practice this alternative adaptive response till it becomes a part of your nature. Recognizing anger and triggers, practicing alternatives and doing this persistently with positive attitude is the key.