Why did my scar swell?

Monday January 13 2020


By Dr Vincent Karuhanga

As a baby, I was burnt by porridge and now the scar is swollen. I would like to go for circumcision but I am worried the same thing will happen to my penis. What can I do?


Dear Morris,
Although scratching can introduce germs whose skin infection may lead to a boil-like swelling, it is likely that you developed a scar called a keloid which can develop months or a few years after a wound has healed.
Keloids can grow on any skin area, from any cause of injury including burns, surgical scar, skin injury and acne. Keloids, usually become larger and more raised than the original injury that caused the scar.
Much as these scars are not cancerous, they can hurt or itch, when they are growing, but usually these symptoms stop when the keloids stop growing.
Keloids are more common in blacks, run in families and affect certain parts of the body including the central chest (over the breast bone or sternum), ear lobes, back and shoulders more and rarely affect the penis after circumcision. They also commonly affect children (10-20 years) making it imperative that circumcision while one is an infant will reduce the risk of keloids on the penis after circumcision.
Since your fear of circumcision stems from having a bad scar, and yet circumcision has a lot of medical benefits including a decreased risk of sexually transmitted infections and HIV, you should consult your doctor before carrying out the operation.
Traditional circumcisions where too much skin is removed might cause a bigger scar and keloids requiring that you do a medical circumcision instead. Here a medical circumcision clamp may be ideal.

Can an impotent man have a child?

I am impotent. I have tried all sorts of treatments including visiting the US for treatment but have failed to erect at all. Now I want to have a child, can it be possible?



Dear Harry,
Impotence or erectile dysfunction is the inability to get or maintain an erection hence making it difficult to have sexual intercourse and children the natural way.
Provided you are able to produce sperm, the sperm can be retrieved from your testes and In Vitro Fertilization (where sperms can be used to fertilise eggs in a lab and the resulting embryo inserted in the womb) or artificial insemination (in which sperm are injected right into the cervix or uterus) can be done to help you get offspring.
You need to discuss the procedures or any other help with your urologist or your wife’s or girlfriend’s gynaecologist.

Am I allergic to milk?

I come from Mbarara and I am therefore accustomed to taking cow’s milk. However, whenever I do, my stomach bloats and sometimes I get diarrhoea. Should I stop taking milk? Boaz

Dear Boaz,
Milk is a whole food the reason breastmilk can be given to an infant exclusively for up to six months. Cow’s milk is also a good source of nutrition for adults.
Reactions to milk take two forms. Milk allergy whereby one reacts to a particular protein in milk and intolerance to lactose, a sugar found in milk.
Allergy to milk is one of the most common food allergies and it usually happens in children below one year who in many cases outgrow the allergy. The allergy is most likely to persist into adulthood in children who have high levels of cow’s milk antibodies in their blood, especially in those who have a family history of milk or other allergies.
Blood tests that measure these antibodies can help a doctor determine whether or not a child is likely to outgrow a milk allergy. Reactions to milk can range from mild to severe and can be life-threatening. Milk allergy is usually confused with lactose intolerance which worsens with age and involves lack of an intestinal enzyme lactase that helps digest a sugar lactose found in milk or its products.
As a result, lactose-intolerant patients are unable to digest these foods and may experience symptoms such as nausea, cramps, gas, bloating and diarrhoea.
Avoiding milk or other dairy products can be useful but people with an intolerance can take in little or diluted amounts of diary or lactose-free milk or diary.

Am I pregnant?
I missed my period two days ago but a pregnancy test was faintly positive. Is it negative?


Dear Anna,
Pregnancy test kits test for presence in urine of a hormone Human Chorionic Gonadotrophin (HCG) produced by a developing placenta. In normal pregnancy, this may be detected as early as seven to 10 days after pregnancy has taken place.
A positive test if one has used a test strip will show two coloured lines, the intensity of the colour depend on the concentration of the HCG. In case of doubt, early morning urine (which may have a higher concentration of HCG) can be used or a repeat test say after about a week can be done. If you cannot wait to check for pregnancy, a blood BHCG can be done and if elevated or is serially increasing, it might mean pregnancy.
In a normal pregnancy, the HCG level doubles every 48-72 hours but in ectopic pregnancies, HCG levels usually increase less though this may not be differentiated by faintness of urinary tests.
That said, some women may have urine tests that are positive when they are not pregnant. Women on fertility treatment that have received shots of HCG or gonadotropins, improper testing, especially when one has not read the manufacturer’s directions before taking a home pregnancy test can lead to false positive results.
Some tests will produce a faint positive test result due to the so-called evaporation lines, if read after the instructed time which is usually advised by the manufacturer (usually three to five minutes). False positives may also appear on tests used past their expiration date, not properly kept sealed or kept in a deep freezer. Some women in menopause may show faintly positive pregnancy tests because they may have a slightly elevated blood HCG.
If a woman got pregnant and the baby did not develop, or there was an early pregnancy loss, certain rare medical conditions such as gestational trophoblastic disease, bladder cancer, lung cancer or after a blood transfusion, certain medications including, Phenergan or Librium can also give a false positive pregnancy test
A gestational (pregnancy) sac can be seen as early as the fifth week of pregnancy or three weeks after pregnancy but this may be too early to show whether you are pregnant or not or whether the pregnancy is in the tubes or not.

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