Doctor's Column: I am HIV positive, what is the best contraceptive to use?

Dear doctor, I need to get circumcised but I am worried that circumcision may make one’s penis tiny.
Engineer Kyaligonza

Dear Kyaligonza, some methods of circumcision remove too much skin up to the base inevitably making the penis look smaller. Other methods make the penis bend down or even shorter.You need to see a professional to circumcise you so that enough skin is left so that your penis neither grows shorter nor smaller.

Dear doctor, I bought a Vitamin E supplement at Shs150,000. Are such supplements useful or I have just thrown my money in a pit?
Jessica Kirumira

Dear Jessica, Tocopherols are compounds, which have Vitamin E activity. The best sources of the vitamins are natural, these include vegetable and seed or nut oils. Also, the vitamin is available in animal sources like, butter, egg yolk, milk fat, and liver.

The primary function of Vitamin E is to act as an antioxidant. Antioxidants are nutrients (vitamins and minerals) as well as enzymes that counteract the damaging effects of the so-called free radicals (charged molecules) on the body tissues.

The antioxidant activity is said to help prevent the development of such chronic diseases as cancer, heart disease, stroke, and arthritis. Further to that, without much evidence, the vitamin has been used as anti-aging method, apart from the claim to improve fertility and sexual prowess.

I am sorry that you used your Shs150,000 for a vitamin rumoured to carry lots of unconfirmed effects which you could have easily got cheaply in the said foods.

In Uganda, these foods are readily obtainable. Today, instead of Ugandans buying and consuming fresh fruits and foods that carry lots of value, they are copying the western world ways of taking daily food supplements whose consequences are long term and may be grave.

Dear doctor, I am a hypertensive person who is on and off drugs. What I have observed is that whenever I reach the time of my menstrual periods I feel the pressure rises. Why is this?
Julian Ssitenda

Dear Julian, more than 80 per cent of hypertension is from unknown causes hence the name, essential hypertension. Where the cause of hypertension is known, removal of the cause may lead to complete cure.

In essential hypertension, one will not remove a cause since it is unknown apart from involving lifestyle changes in treatment. This includes minimising salt and alcohol intake, exercising regularly and avoiding smoking. In many cases where lifestyle changes do not suffice to normalise the pressure, drugs have to be taken. Being on and off drugs then may lead to failure to control the pressure.

Many Ugandans will take drugs when they “feel pressure” and yet the pressure may rise without a person feeling the symptoms. What you feel as pressure may actually be the usual symptoms that may precede periods in what is known as pre-menstrual syndrome (PMS).

Though there are many symptoms associated with PMS, the most common are either emotional or behavioural (anxiety, mood swings, irritability) and physical (headaches, dizziness and feeling bloated).These can make anyone feel her pressure is up especially if she has only recently started suffering from the condition.

The fact that PMS is associated with some weight gain due to water retention related to the period hormones, it is envisaged that the same water retention may worsen pre-existing hypertension. Also feeling unwell and related stress alone can push pressure upwards.

Dear doctor, explain to me why children get malaria in the evening and yet they may play during the day. Do the parasites know it is night when our medical personnel are away?
Eddy Byankabya