How can I overcome dizziness?

Dear Doctor: In 1998 when I was in Primary Six and sweeping the school compound, I suddenly found myself kneeling down because of dizziness and I was taken to hospital. All recommended tests I took between 1998 and 2005 turned out to be negative. But when I was in Senior Six, I felt the same dizziness again.

It happened in 2009, and again this year. The dizziness does not throw me down but my heartbeat will change from normal to fast. When this happens, my eyes see everything moving. After new tests, the doctor told me I have electrolyte imbalance in me that require a lot of fluid and prescribed Vitamin B complex. My dad also gets similar dizziness which I believe I inherited from him. Our family is epileptic-free and I take alcohol occasionally. How do I deal with this? Please advise.
Reader

Dear Reader: Dizziness is a symptom of other disorders the reason why it may be difficult to tell outright the cause of your problem. A doctor can diagnose your condition and its underlying cause by taking your medication history and performing a physical examination.
Apart from testing your eyes and ears, observe posture and perform tests to check your balance.

The causes of dizziness include hunger, low or high blood pressure, dehydration, disturbed electrolyte balance (like in your case) lack of blood, being under hot conditions, drugs, ear and eye conditions, and stress among many others.
Once the cause of your dizziness is determined, treatment becomes easy to undertake.

Your father could be having high blood pressure or may be on medication which does not necessarily mean the problem is inherited. The fact that your dizziness takes ages to strike back is indication that its cause is harmless and can easily be checked and treated.

Please visit your doctor again for investigation and treatment. Tests like brain CT scan may be necessary to rule out a brain cause.

Dear Doctor: Recently it was said that diabetes is on the increase among the population, and I have heard of many people who suffer from it. Does it mean that since diabetes is a disease usually associated with the rich, Ugandans are getting richer?
Kasiita

Dear Kasiita: Diabetes mellitus is a disorder in which blood sugar (glucose) levels are abnormally high. This is because the pancreas does not produce enough insulin or the insulin is there but not effective to adequately remove the glucose from blood and channel it to other parts of the body that need to utilise it.
There are two major types of diabetes. Type 1 whereby the pancreas is completely destroyed and therefore requires insulin injections to treat since protein insulin will be destroyed if taken orally. This is also known as insulin-dependent diabetes and is common among children.

In type 2 diabetes, insulin is present but it may be inadequate or not working properly because the target areas are resisting it. Here, genetic factors play a big role though obesity, age and pregnancy may determine its development.
Treatment is by diet, exercise, and tablets, but in many people, insulin injections are given.

The fact that type 2, which affects majority of people is associated with affluent lifestyle (eat too much and are sedentary) is not surprising because it has generally been tagged to be a disease of the rich.

The majority of Ugandans are not living the western world lifestyle (of high fat intake and being sedentary that also causes obesity), but unfortunately live below the poverty line. It is however surprising that these people are increasingly getting diabetic.

The likely cause of this malnutritional or type 3 diabetes seems to be poverty, stress, poor feeding, and drugs especially for HIV. Poor feeding in Uganda hinges on poverty and ignorance. A lot of people feed on foods such as cassava, which may unknowingly destroy the pancreas apart from many children suffering from protein deficiency (kwashiorkor).

Dear Doctor: My wife who is 35 years old has failed to have a baby after her left tube was cut out to an ectopic pregnancy. But the right tube was found to be normal after an x-ray. What could be the problem?
Emmanuel Kyasanku

Dear Emmanuel: An ectopic pregnancy is one that takes place outside of a normal womb, usually in the fallopian tubes, but it may also occur in other areas including the ovaries. Ectopic pregnancies can lead to internal bleeding in the abdomen and once this happens, they require immediate surgical attention to stem blood loss and death.

Though any woman may get an ectopic pregnancy, there are several factors that put women at risk of getting it.
In Uganda, the biggest problem is sexually transmitted infections (STIs), which narrow the tubes so that the smaller sperms can pass and fertilise the bigger eggs which then grow in the tubes. The tubes may not accommodate the growing baby hence ending up bursting and causing internal bleeding.
STIs may damage the hairs (cilia) inside the fallopian tubes. Lack of cilia to propel the eggs will leave only the tailed sperms to move in and fertilise the egg in the fallopian tubes where the baby will remain and grow.

Since your wife got an ectopic pregnancy in one tube, she risks getting another in the tube that the x-ray has shown to be normal.

X-rays may show the remaining tube to be patent yet the hairs may be gone. That said, many women who have had ectopic pregnancies, and one of their tubes cut out can go on and have babies. You and your wife need to visit a doctor for further tests since there may be other factors affecting her ability to conceive.

At 35, your wife is less fertile apart from fertility having been theoretically reduced by 50 per cent due to the loss of one tube. Also, you may be having a fertility problem like low sperm count which may not have been evident in a younger age.

Dear Doctor: I have taken a lot of antibiotics for Urinary Tract Infections (UTIs), but each time tests show pus cells. However, I do not feel any pain. What can I do to stop this?
Sera Among

Dear Sera: A urinary tract infection (UTI) is an infection that affects the urinary system (any part of kidneys, ureters, bladder and urethra). Both women and men can develop a UTI, however, because the bacteria laden anus is closer to the urethral opening and associated short urethra, the risk is higher among women. The most offending germs here come from the gastrointestinal tract (E.coli).

The infections in women are much more common during pregnancy, and after menopause. UTI is common among sexually active women, but not because a sexual partner has an STD.

Though your husband may not be complaining, you need to go with him for tests to make sure he does not have the infection without symptoms and to erase all infidelity doubts.
Antibiotics are used to treat UTIs but may fail when wrong or fake ones have been used. Also, there could be other factors increasing the recurrence of the infection which you need to address.

Apart from women being most at risk, using certain types of birth control (diaphragms, spermicides), having urinary tract abnormalities or blockages (big prostate, strictures), and having a suppressed immune system (diabetes, HIV) increases chances of getting UTIs.

Sometimes UTIs may not have symptoms and can only be detected after a routine test of an early morning urine sample whereby the presence of bacteria, protective white blood cells (pus cells), nitrite, and protein may indicate infection. Even when all symptoms of a UTI are gone or even the infection itself completely cured, pus cells may take long to disappear completely.

In your case, doing a urine culture and sensitivity test after avoiding antibiotics for at least two weeks can help determine whether there is still an infection, its type and the most effective antibiotic treatment you may need.
Drinking plenty of liquids, wiping from front to back after toilet, emptying the bladder soon after sex can help prevent UTIs.