My girlfriend is three months pregnant but she gets her period. When I asked her to visit a doctor she said the same happens to her sisters. Is this normal or is she aborting? Latima

Dear Latima,
Many times, when a woman misses periods even without tests to confirm pregnancy, she may be deemed pregnant. Sometimes a woman can miss periods when she is not pregnant and bleeding may be thought to be due to a miscarriage when in some cases it is not.

Bleeding in early pregnancy might mean the womb is threatening to miscarry or has already miscarried but some pregnancy pieces remain or if bleeding and abdominal pain have eased or stopped the products of pregnancy may have all been expelled.

When there is bleeding in pregnancy, an ultrasound scan should be done to make sure the baby is still alive. If the baby is alive, there are good chances even after repeated bleeding that the baby will survive. Many cases of bleeding that lead to miscarriage are caused by the death of a baby and the body obliges by causing a miscarriage.

Bleeding in pregnancy requires visiting an antenatal clinic for help because it can result in serious problems including bleeding to death or infections among many others.

Bleeding in pregnancy is not genetic and can happen to any woman. You need to go with your girlfriend for antenatal visits where tests will be carried out to determine what is wrong.

Every month just before my period I get candida, which I always treat. Surprisingly even without drugs, the itching may go but still come back. What can I do because I am tired of taking drugs?

Dear Cathy,
Menstruation happens when a woman sheds the inner membrane of the womb to prepare a new membrane to enable getting pregnant again. The build-up of the membrane is aided by oestrogen and progesterone sex hormones whose fall when a woman does not get pregnant leads to menstruation.

The fall of these hormones may lead to vaginal dryness that may lead to vaginal itching which goes away as oestrogen hormones build up during a period and period blood wets the dry itchy area.

Sometimes itching may be due to vaginal infections caused by an imbalance in the naturally occurring bacteria or fungi in the vagina. The imbalances may follow changes in the female sex hormones, bad vaginal cleaning practices or a fall of vaginal acidity towards periods.

Proper acidity keeps the natural bacteria and fungi in check so that they do not overgrow to cause infection symptoms, including itching. Overgrowth of candida will lead to dead milk discharge but this may improve without treatment after periods as acidity builds up again.

Overgrowth of the acid producing bacteria (Dorderleins lactobacilli) will create too much acidity which burns and itches but when the more alkaline period blood comes, it neutralises the acid leading to relief. As such, a woman should not use tampons but pads to leave blood cleanse the area.

Any woman with recurrent vaginal itching should visit her doctor for diagnosis because there could be other causes of vaginal itching which may affect the area alone or other parts of the body as well.

I get pain at the kameeme (epigastrium) which causes me to vomit or get back pain. A test for H.Pylori was positive and was given Pylokit which helped but not for long. When I returned to hospital, I was given Amoxyl, flagyl and omeperazole but still I keep getting the same problems. What can I do? Leticia

Dear Leticia,
Helicobacter Pylori is the cause of the majority of peptic ulcers whose symptoms may include meal-related upper abdominal pain, vomiting, sometimes blood, a gassy stomach and backache, all symptoms that you have.

The germ can be identified through checking blood, stool, breath or through an endoscopy examination.

Unfortunately, the blood tests which are easier to do are the ones usually performed yet they will remain positive even after successful treatment then requiring stool, breath or endoscopy tests to confirm whether the germ still exists after treatment or not. Endoscopy may also help identify the drugs that may be most suited for retreating the germ in case it has resisted treatment in what is called culture and sensitivity test.

Since culture and sensitivity is very tedious and expensive, doctors may instead give treatment usually prescribed for resistant germs.

Ugandans abuse flagyl, clarithromycin and amoxicillin so that today there is increased resistance by H.Pylori to these drugs (though this is less with Amoxicillin.The resistance together with lack of compliance to the treatment because of the many side effects of this so called triple treatment can even start during treatment. This is not helped by mostly substandard drugs on the market today.

Upper abdominal pain, nausea or vomiting, a gassy stomach are collectively called dyspepsia. Much as dyspepsia can be caused by peptic Ulcer disease can have other causes such as stomach cancer that need to be ruled out by more tests.

My one-year-old son has no teeth yet. Is it a sign of some other disease?

Dear Irene,
Teething is a normal part of a baby’s development during the first year of life with babies normally starting to teeth at around six months.

One in every 2,000 babies may be born with a tooth (natal teeth) which is usually in the lower gums. Natal teeth are usually wobbly because they have little root structure and easily fall out on their own, failure of which may require extraction to prevent complications such as falling out in sleep and blocking the airway.

Whereas the average time for babies to grow teeth is around six months, a few babies may delay growing teeth up to as late as 18 months. This delay is especially common in premature babies but to be sure that there is no underlying medical issue, please take the baby to a dentist or paediatrician for a checkup.

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