What can I do to stop nail biting?Dear Doctor;I have a bad habit of biting my fingernails. Whereas I had always thought that it is a habit induced by boredom, I think it has become an addiction. Is there a way I can stop it? Lucien, 22, Nyamirambo.Dear Lucien,Why has my sister failed to stop bedwetting?You are right,  biting nails can be due to boredom and stress. But there are other reasons as well. Dryness of nails due to climate can cause dehydration and resultant flaking of nails due to separation of nail plates. Similarly excess moisture may also damage nail plates and cause peeling. Lack of biotin, and or sulphur, vitamin B.

complex, iron  and at times proteins can result in peeling of nails. Hormonal conditions like hypothyroidism, exposure to chemicals present in agents  for cleaning or pest control, fungal infections, trauma to nails can also cause brittittleness and peeling of nails.

To prevent this problem, you need to pre-occupy your self to ward off boredom. Take a diet full of fresh vegetables and fruits, use a good quality nail paint to prevent drying. If the problem persists consult a doctor to exclude fungal or other infections or hypothyroidism.’Dear Doctor;My 16-year-old sister has failed to end bed wetting and it is affecting her self-esteem. Is there a way she can be helped? Claire, 14.Dear Claire,Bedwetting at 16 is indeed a problem. You have not specified whether she has good bladder control during waking hours or not. Because if that is the cause,  she needs   to be examined by a urologist to exclude urethral or sphincter abnormalities.

Most common cause for bedwetting at this age is emotional stress like fear due to peer bullying or lack of self-confidence. It can also occur due to  deep sleep. Urinary tract infections can also lead to bedwetting.

Pin worm infestation can lead to night time itching as well as bed wetting. Get a urine and stool sample of your sister examined for infection. If positive, it is treatable. Be kind and supportive, not critical. Avoid giving her liquids to drink at least two hours before going to bed. 

Wake her up at a fixed time every night and make her sit in the toilet to pass urine. This shall help in conditioning of the bladder and gradually bed wetting will stop.What can I do to save my molar teeth?Dear doctor;I have lost almost all my molar teeth. I am remaining with only three and they are also infected. It has become hard to chew meaty foods. Should I just relegate myself to soft foods or could there be a way out? I am just 32. Concerned Man.Dear M;I can understand your concern to lose teeth at such a young age. Most likely, teeth loss is caused by poor oral and dental hygiene. Recurrent and chronic infections may also lead to infection of the gums,  dental root   and the supporting bone.

This causes gradual loosening of teeth and consequent falling out. Diabetes, and HIV/Aids also lead to  reduced immunity and increased susceptibility to dental infections, resulting in loss of teeth. Smoking  is yet another cause of tooth loss.You can prevent further teeth loss by improving oral hygiene. After eating anything, rinse your mouth with a good  disinfectant mouth wash. Brush teeth regularly and massage gums.  Avoid hard food substances that can hurt teeth. You can also have dental prosthesis inserted.Why does my girl friend pass urine during sex?Dear doctor;I have had a relationship with my girlfriend for more than four years but we have had sex only twice. She has, however, passed urine each time we have had sex.

I find this strange because I used to think that one cannot pass urine during sexual intercourse. I fear to talk to her about this bizzare occurence for fear of upsetting her. Could my girlfriend be having a problem? FrankDear Frank;Your girl friend may have passed some genital fluid during orgasm. It may not necessarily be urine. Like men, females also ejaculate, although not all the time. A woman can also pass urine during orgasm because the female urethra is not blocked by muscle spasm as is the case with men.

A woman may also pass urine involuntarily during orgasm due to severe cystitis or trauma to bladder sphincter during child birth. But there would be other signs of cystitis like frequency and urgency of urination during daytime.  If these are not present, there is no need to worry. Specialist-internal medicine-Ruhengeri Hospital