Molluscum contagiosum is a common viral skin infection. It is most common amongst children, but can also affect adolescents and adults. It is spread via direct skin contact with an infected person. The incubation period can be up to 2 months.

Clinical features

Molluscum contagiosum is characterised by clusters of small pinkish lumps with pits in the centre, which contain a hard, cheesy substance. They vary in size, but can reach up to 5 mm in diameter. They are usually found on the face, neck or buttocks.

This infection usually clears up naturally after a year or two but, because of its contagious nature, it is wise to discuss treatment with your doctor. The simplest procedure is freezing the lumps with liquid nitrogen, or simply piercing the centre with a sterile needle and squeezing out the contents. The latter should be done by your doctor. The use of benzoyl peroxide solution can help to prevent spread.

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The benefits to the child of spending time with his grandparents are enormous. He may learn values and priorities from them that he cannot learn from his parents. They may encourage him to be aware of certain important cultural and family traditions, broadening his outlook, and providing him with a sense of his place in history. Besides all this, grandchildren and grandparents can simply have a lot of fun together!

Sometimes disagreements can occur between parents and grandparents about various aspects of the child’s upbringing. It is best if these issues are resolved early on in order to avoid ongoing tension.

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One husband said, “I noticed at every hotel we stayed at that the women would be reading books more than the men. Just taking time to read nonfiction was a major step, but to read my novel and hers and discuss the same books was a first for us. I got so I felt I was reading along with her when I read the book she underlined.”

“I found it that way, too,” responded his wife. “The worst part was finding time to read. We had to struggle with that, but as you said, that was part of the sig, to use the reading requirements as a test of whether we would make the time for each other.”

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You avoid getting dumped by not getting too involved, and always watching for the slightest sign of preparatory dumping. When you see it coming, dump first and fast. It is also wise to tell the dumpees that they are being dumped for their own good. This is called the “therapeutic dump,” and is supposed to feel better than other forms of dump. Some of these are:

The Dirty Dump: You have found someone better, have known about it for some time, but have been staying with the dumpee as insurance against your own dumping. Once you are safe, dump.

The Dumb Dump: This occurs when someone gives you false information, probably in order to move in on your dumpee once you have done the dumping. You dump too soon, and you have been fooled into a dumb dump.

The Dangling Dump: This is a highly skilled dumping involving a built-in safety factor. You provide some hope, usually false, that you will take the person back following the dumping. This is done in case your new partner dumps you or your old partner starts to look much better compared to the new one.

The Delayed Dump: This is done when you know far ahead of time that you are going to dump someone, but delay the actual dumping until after a scheduled family event, dance, or other occasion at which people might ask, “Whatever happened to . . . ?” Dumping is easier than explaining.

The Devious Dump: This is done when you know you are going to dump someone right from the start of the relationship, but are too lazy to look for a better match right now. You pre-plan the dump for a personally convenient time, maybe when your work schedule is easier and you have time to deal with the dumping hassle.

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It is more common in girls and usually makes its appearance in the 10 to 12 years age group.

Once it develops it may rapidly progress and lead to a severe deformity so that the girl is dwarfed and hunchbacked.

However, it can vary from mild to severe, but, because of the rapid progress, it warrants early diagnosis and energetic treatment.

Regular and frequent examination is necessary. This will include X-rays to determine the degree of curvature and how fast it is progressing. Once spinal growth is complete then the condition is stabilised and will not change.

This deformity may not be obvious when first looking at the child, but may become obvious if she is asked to bend forward to touch her toes.

The S curve of the spine and the hump on one side of the back or the chest will then show up.

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As soon as the cortisone treatment is reduced or stopped, the rash flares again and is difficult to treat. It appears to be more common in young women, but why is unknown. It responds to the use of small doses of the antibiotic tetracycline given over a long period.

This same treatment has long been used to treat acne. It now appears that the old-fashioned hydrocortisone, which is usually less effective than the newer, more potent, cortisone derivatives, is better to use on the face than potent ones.

However, use all medicines only as prescribed, by the person for whom they were prescribed, and only for the original condition. This may take all the fun out of being your own doctor, but is safer.

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In 1960, a study showed more than 90 per cent of TSluldren had active dental decay, yet the recent survey showed less than 25 per cent in the same community were now affected.

The researchers attribute this to the better nutrition of the children and the widespread use of, initially, fluoride tablets and then fluoride in the water supply.

The World Health Organisation has stated that fluoride is a naturally occurring substance in many water supplies, and, provided the content of artificially-placed fluoride is carefully monitored, the advantages appear to be overwhelming.

Despite this evidence, the anti-fluoride lobby continues to decry the process and, recently, the propaganda has been that fluoride can cause cancer.

There is no valid scientific evidence to support such a connection, but when the charges are repeated often enough it can worry the layman.

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Controlling or preventing hot flushes is not easy, but some things make them worse, so:

• try to cut down on smoking, coffee and alcohol

• avoid hot spicy foods

• try to avoid stress

• ask your doctor if any tablets you are taking could be making the flushes worse

• wear cool, loose clothing made of natural fibres, especially in hot weather

• have a tepid shower whenever possible

• if you decide to stop HRT, do it as slowly as possible, and not during hot weather or times of stress

‘I stopped taking HRT to see if my ovaries would start working again without it, but they didn’t, and the hot flushes came back. So I went back on the HRT and feel much better now. I am 52.’

‘I bought some special “calcium tablets for women” from the health food shop for my flushes, but they didn’t help at all.’

The first of the two women quoted above doesn’t understand that once ovaries have stopped ‘working’ after the menopause, they won’t start up again. And the second has been misinformed about calcium tablets; they will help your bones, but not hot flushes.

Herbal remedies can sometimes help hot flushes; instead of just buying something over the counter at the chemist or health food shop, you might get a remedy that is more appropriate for you if you visit a medical herbalist or an aromatherapist. A homoeopath may also prescribe a suitable remedy. Bear in mind, though, that these remedies are not oestrogen, so will not prevent osteoporosis; however, many women And that alternative medicines can help other aspects of coping with the menopause.

Unlike vaginal and bladder problems, and osteoporosis, hot flushes will eventually pass for almost all women. They can be embarrassing and uncomfortable, and they may make you want to disappear into a hole in the ground, but they don’t last forever. If you are lucky, they will be over in about two years or even less, and if these are your only symptoms you may well feel that HRT is not necessary for you; if you are one of the unlucky ones, the hot flushes may still be with you in 20 years, and HRT may be the only effective solution.

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Dangerous blood clots (thrombosis), which may lodge in any part of the body, can occur after surgery. Risk factors for thrombosis include being overweight and heavy smoking. If a hysterectomy, myomectomy, or endometrial resection is not urgent, it should be deferred in women who are overweight and who smoke until they have taken off excess kilos and quit smoking.

Surgeons can also help prevent thrombosis during major surgery, such as hysterectomy, by artificially stimulating the calf muscles to contract during the operation. This does no harm. Another technique is to inject an anticoagulant, such as heparin, to reduce the clotting activity of the blood. This has the disadvantage of increasing the amount of bleeding that occurs during surgery, but is generally considered preferable to the formation of a blood clot.

Women having any form of surgery should be able to recognise the early signs of thrombosis in the legs or a blood clot (embolus) in the lungs. The middle of the calf may become tender at rest or sore when moved, or the ankle may swell. An embolus in the lung may cause pain on breathing, a dry cough, shortness of breath, and soreness or pain in the chest If any of these symptoms occur, it is important to tell your doctor or nurse promptly. An early diagnosis nearly always averts further problems.

Paradoxically, there is some evidence to suggest that women who smoke are less likely to have a hysterectomy. The reasons for this are unclear but it may be related to the suppression of oestrogen by some of the toxic components of cigarette smoke. It is presumed that smoking keeps the oestrogen required for fibroid growth under control.

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