Doc, why are my nails discoloured, disfigured?

Dr Flo,
Some of my finger nails have a dark colour and look disfigured. I have been this way for the past one year. What could have caused it? Is it possible for my nails to go back to normal?
Juma

Dear Juma,
There are many causes for disfigured and discoloured nails such as infection, chronic diseases of the lungs, heart, intestines or liver, deficiencies of zinc or iron, diabetes, thyroid disease, inflammatory diseases, injury, poisoning some cancers and chemotherapy.
However, the most common cause is fungal infection of the nail. Usually, the infection is very stubborn, and can last for a long time, even years. Treatment is with anti-fungal tablets and some medication for applying on the nails. The treatment itself may take long, and it is sometimes broken into phases, otherwise known as pulsing. You should visit a doctor, to determine whether it is a fungal infection, or a result of an underlying disease. If the cause is another illness, then that should be managed. In most cases, if it is a fungal infection or a deficiency, the nails can be treated and go back to normal.

Dr Flo,
One of my testicles did not descend to its proper position. It has been this way since childhood. What could be the problem?
James

Dear James,
The testicles are formed within the abdomen and go down to the scrotum during the last three months of pregnancy, so most baby boys are born with both testicles in the scrotum. If the testicles have not descended by the time of birth, in most boys, they will come down within the first six months. If both testicles are not in the scrotum by six months of age, then at that point a specialist should be seen (paediatric urologist), so that this can be corrected. In most cases, the missing testicle or testicles are trapped in the path between the abdomen and the testicles or within the abdomen and surgery can be done to bring the testicle down and make sure it does not go back up again. Rarely, a testicle may be missing because it has shrunk, disappeared or it never formed in the first place.
You are at risk of undescended testes if your father or brother also has this or if you had a low birth weight, or if you were born prematurely.
If the undescended testes are not corrected within the first year of life, there is a risk of reduced fertility (though fertility is almost normal for those with one testicle) and there is also a higher risk of developing testicular cancer. Therefore, it is advisable for you to visit a urologist for examination. A scan may be done to try and determine the location of the missing testicle and surgery may be done to place it correctly or remove it completely depending on where it is found and the condition it is in. In older adults, surgery may not be done, but you will require regular check-ups.

Dr Flo,
For a few weeks now, I have been experiencing muscle cramps in my legs at night and, sometimes, they are very painful. I have been using Deep Heat to massage the legs, which helps a bit. What can I do about this?
Chebet

Dear Chebet,
Muscle cramps are caused by sudden tightening or contraction of a muscle and they last for a short time. Sometimes you may see a swelling of muscle under the skin. It may be caused by overexercising or injury to the muscle, not stretching the muscles before you start exercising, standing or sitting for long, putting the legs in an uncomfortable position while you sleep, dehydration, deficiency of minerals like calcium, magnesium or potassium, poor blood flow to the area, nerve compression, diabetes, liver disease, kidney disease, thyroid disease and also the use of some medication such as antipsychotic drugs, steroids, some blood pressure medication, some cholesterol lowering medicine and contraceptive pills. In many cases, the exact cause may not be known.
When you get a muscle cramp, walk around or move your leg, you can stretch the muscle, and then massage it; take a warm bath; use a hot or a cold compress such as a hot water bottle, a towel dipped in warm water or an ice pack wrapped in a towel. You can also take pain killers or muscle relaxant, prescribed by the doctor.
To prevent muscle cramps, take a lot of fluids, reduce alcohol intake, take a balanced diet to get all the nutrients you need, stretch the muscles before and after exercise and before going to bed. Also, keep your bed sheets and blankets loose on the bed. If the cramps are persistent despite all this, visit a doctor to find out if there could be an underlying medical condition that requires treatment. You might also need mineral supplements if you have any deficiencies.

Dr Flo,
I have noticed that my son, who is two years old, snores a lot at night and sometimes you can even hear him ‘snoring’ when he is awake. He constantly catches a cold and we always have to take him to the hospital. During the previous visit, an X-ray showed he has adenoids. What exactly are those? Is there any medication that can cure them? Please help.
Winnie

Dear Winnie,
The adenoids are a small mass of tissue at the back of the nose. They usually grow during the first 10 years of life and then they start shrinking. If they overgrow, what is called adenoid hypertrophy, then they cause blockage of the nasal passage. This causes difficulty breathing and breathing with the mouth open; snoring, sometimes even when awake and voice changes. If the blockage is severe, it can cause interference with the child’s sleep, because they have to keep waking up to breath. Adenoid hypertrophy can also lead to recurrent infections of the ear, changes in how the face develops and even lung and heart problems.
The problem is best dealt with by an ear, nose and throat specialist. If there is an ongoing infection, then antibiotics will be useful. Nasal drops and nasal sprays may also be used. If the symptoms are severe, then surgery can be done to remove the adenoids. This is sometimes done together with removal of the tonsils if they are enlarged.

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