Ask the daoctor

How can I get rid of warts?Dear doctor;I have had a wart on my knee for several years. A fortnight ago, I visited a herbalist who advised me to apply ointment. I applied but the wart has instead turned into a wound. How can I get rid of warts, especially isolated one like this? Leonah, 23,

How can I get rid of warts?

Dear doctor;

I have had a wart on my knee for several years. A fortnight ago, I visited a herbalist who advised me to apply ointment. I applied but the wart has instead turned into a wound. How can I get rid of warts, especially isolated one like this? Leonah, 23,

Dear Leonah;

Warts are caused by human papilloma virus of which there are about 100 varieties. They usually subside by themselves though they take long to subside in adults compared to children. Warts usually spread from direct skin contact or from damp places like swimming pools or communal showers.   People handling raw meat are also likely to develop recurrent warts. Decreased immunity as in case of HIV positive individuals or diabetics with uncontrolled blood glucose  also predisposes to recurrent warts.

If the wart has persisted, it means the predisposing condition has been persisting. The ointment used would have contained some corrosive substance resulting in a wound which is now infected.

For the time being, take   an antibiotic like cloxacillin 1 gram, three times daily for five to seven days. Apply some antiseptic ointment locally over the wound. Once it heals completely then you can go for other options for treatment of the wart.

This includes use of ointment like podophyllin for three days, surgical curettage or cryotherapy (removing wart by cold application). Meanwhile, test to exclude conditions like diabetes and HIV/Aids.

What is wrong with a pregnant woman passing under an electronic scanner?

Dear doctor;

I am six months pregnant. Recently, we went shopping in town but the building has a security electronic scanner. When I passed under the machine, my friend said pregnant women are not supposed to pass under such machines but did not tell me why. Is this true? Jeanine, Kimironko

Dear Jeanine;

Your concern is valid but relax, your unborn baby is safe. There are two types of scanners. The radio-frequency scanner does not use ionising radiation hence poses no risk to pregnant women. The full body X-ray scanner  emits very low radiation, it just scans the body superficially to look out for hidden objects but does not penetrate internal organs. Even mobile phones, microwave ovens, laptop computers particularly with wifi emit radiation. With everything normal, no other risk factors for the pregnancy like diabetes, hypertension or uterine abnormalities, a woman still faces a 3 per cent  risk of birth defects and or miscarriage. But the scanner has certainly not harmed you or the baby in any form.

Can sitting a lot cause arthritis?

Dear doctor;

The last two days, a sensational pain has been burning inside my left knee. I am 32 years old but my work involves sitting a lot. Could this be a sign of arthritis? How can I know that I am being affected by the disease? Muyinda, Kigali.

Dear Muyinda;

The kind of pain described here seems to be due to compression of a major nerve or any of its branch supplying the thigh. It is not arthritis.  You have not mentioned whether you have had any trauma, whether the pain is persistent or whether there is reduced sensation at that site? This kind of entrapment neuropathy can occur due to prolonged  sitting  or  standing in the same position. Tight clothes and belts aggravate it. Presence of diabetes also predisposes this condition.

Prevention consists of avoiding sitting or standing for long. If  your work calls for a lot of sitting, endeavour to  at least move around for a few minutes after sitting for an hour or so.  Thigh hugging trousers and tight belts should also be avoided. Use of drugs like gabba pentin or carbamazepine(anticonvulsants) or antidepressants along with neurotropic vitamins like B1, B6 and B12  for two to four weeks can also help relieve the pain. 

Injection of an anesthetic agent at site of pain, or surgical removal of trapped nerve are other options if the pain persists.

Can lack of Vitamin D cause protruding of the lower rib?

Dear doctor;

My three-year-old daughter’s left part of the lower rib is a little protruded. But she does not have any pain or any other problem. We recently took her to a doctor who told us that it is due to lack of Vitamin D. Could this be so? Evaleano, Butare

Dear Evaleano;

Lack of vitamin D does cause softening and abnormalities of bones. But in a tropical climate with abundant sunshine, it is unlikely. Unless you keep the child covered 24 hours a day without exposure to sunlight.

However, there are certain conditions which can cause defective absorption of calcium  and minerals in the body resulting into abnormal and soft bones. This may be  due to viral or bacterial infections of the intestine or congenital  disease like sprue.  The deformity depends on the severity of malabsorption. But there are usually associated symptoms like weight loss, diarrhoea with foul smelling stool and signs of deficiency of other nutrients as well. Abnormalities of the parathyroid gland in the body can also manifest as defects in bones.

This bony abnormality if it persists can lead to abnormality in the backbone leading to abnormal posture, gait and breathing difficulty.

The child should get special formula feeds to correct the defect, which could be worked out by a dietitian or pediatrician. A complete course of suitable antibiotic will cure the condition if due to infection.  If it is only one rib it may correct by itself as the child grows.

Corrective surgery is done  for the defect if it persists. But this is usually done when the child is older and stable to prevent any relapse.

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