House Call - medical questions

Ebony, June, 1999

`What Are The Benefits And Negatives Associated Circumcisions?'

SHOULD BABY BOYS BE CIRCUMCISED?

Q I'm a new mother with a young son, and I want to be sure that I'm doing everything right for him. Some people say I should make sure that he is circumcised and others say the procedure is not really necessary. What are the benefits and negatives associated with circumcisions? M.M., St. Louis

A The seemingly continuing and sometimes heated debate about circumcision--the cutting away of the foreskin of the penis--recently was turned up a notch when the American Academy of Pediatrics recommended that the procedure be considered medically unnecessary. Even so, doctors still say there are benefits. Between 7 and 14 of every 1,000 uncircumcised babies under the age of 1 experience urinary tract infections during their first year of life, compared with 1 or 2 of 1,000 circumcised boys. In addition, medical researchers say circumcision reduces the risk of cancer of the penis, a rare disease that affects only about 1 out 100,000 men. And circumcised men are one-third to one-half as likely as uncircumcised men to become infected after exposure to HIV or other sexually transmitted diseases. (Doctors are quick to point out, however, that circumcised males are by no means immune to HIV.)

The drawbacks associated with circumcisions, doctors say, include pain--sometimes accompanied by bleeding and inflammation--and loss of some sensation at the tip of the penis.

Although circumcision continues to be an important ritual in the Islamic and Jewish communities, doctors say medical benefits from the procedure aren't significant enough to recommend it for all boys. If the procedure is performed, though, the Academy of Pediatrics stresses that a form of adequate pain relief (analgesics) should be used.

THE BENEFITS OF FOLIC ACID

Q I try to take care of myself and make sure I get the proper nutrients. There has been a lot of talk about folic acid and its benefits. What is it and what's the best way to consume it? E.M., Los Angeles

A Folic acid, a B vitamin, is being hailed for a number of benefits. Among other things, folio acid matures red blood cells and contributes in the production of an essential building block of DNA, thymidine. Doctors say it also helps prevent the body from making homocysteine, a chemical that damages the blood vessels.

It is especially important that pregnant women get the daily recommended requirement of folio acid (200 to 400 micrograms) because research shows that it can greatly reduce the chance of a baby being born with neural tube defects by helping to make sure that the spine develops properly.

The best source of folic acid is through a well-balanced diet that includes such items as fresh, leafy, green vegetables, fruits, dried yeast, liver and other organ meats. To supplement the diet, some doctors recommend taking a multivitamin that includes folio acid.

IDENTIFYING AND TREATING RINGWORM

Q My 8-year-old son has what I believe is a case of ringworm on his scalp. He hasn't started to lose hair in the area, but the area does itch, and he has what appears to be dandruff-like scales. What exactly is ringworm and what's the best way to treat it? C.Y., Dallas

A Ringworm is a fungal skin infection that's caused by several different fungi, and it's generally classified by its location on the body (foot ringworm, groin ringworm, body ringworm, nail ringworm). It appears that your son is experiencing a common case of scalp ringworm, which is highly contagious among children. If left untreated, it can produce a patch of hair loss, sometimes without a rash.

The fungus that causes most cases of ringworm on the scalp lives in the hair shaft and topical treatments may not be effective. Your doctor can prescribe an oral antifungal medication, to be taken daily for a few weeks. After the ringworm disappears, make sure that your son practices prevention by not sharing combs, brushes or caps with other children.

Q I'm a 42-year-old mother with two teenage sons, one who is 15 and the other is 13. They are good kids but are easily influenced. My concern is that they might decide to do what some other teenagers are doing--inhale household and other products to get high. To persuade them to stay away from this kind of activity, what can I tell them about the dangers of inhaling these products? J.S., Atlanta

You can tell them that such activity can be--and often is--deadly. According to the National Inhalant Prevention Coalition, about 250 people have died since 1996 as a result of "huffing," the act of sniffing products like typewriter correction fluid, nail polish remover and paint thinner to get high.

A Researchers rank huffing fourth among all forms of substance abuse by teenagers, and they point out that the procedure can be deadly, even during the first experience. The more than 1,000 household and other products that are being sniffed to get high are not only easier for teenagers to obtain, but the high is also easier for them to conceal than the high associated with alcohol or marijuana.