Ask the Doctor

Why do I have sores on the tongue?Dear doctor;The back of my tongue towards the right jaw got bruised on its own. I feel a lot of pain when talking and swallowing food. I was given septrine tabs at a local pharmacy but for five days now, I do not realise any change. Previously, such bruises would heal in two to three days, but this one seems to be taking longer to heal. What could this be? Francois, 32, Kigali.Dear Francois, Wounds over the tongue usually heal spontaneously because it has a very rich blood supply that aids the healing process. Delayed healing could be due to poor oral hygiene or conditions reducing immunity like diabetes or HIV/Aids infection. Delayed bruise healing can also be caused by constant irritation caused by a loose tooth. It can also be an ulcer of the tongue caused due to much spicy food. Take some anti-inflammatory drug like ibuprofen for two to three days along with antibiotic. Use an antiseptic mouth wash to rinse the mouth. Try to brush your teeth every after a meal. Along with these measures, get blood glucose done to exclude diabetes. The wound will definitely heal with these measures. My son’s from sleep-walking is becoming chronic and scaryDear doctor;My son has been sleepwalking frequently of recent. He is 11 years old. He talks, walks, cries and sometimes gestures.Is he suffering from any psychological disorder, considering the rate at which he is doing it? Jacquline Uwamahoro, Remera-KabezaDear Jacqueline, I understand your concern. Sleep-walking is caused by several factors. For a child of 11 years, it could be due to stress(bullying at school, and tension of performance in exams among others), irregular chaotic sleep schedules, full bladder or use of antiallergy drugs. A strong genetic component also underlies sleep-walking. A first degree blood relative is more likely to sleep walk. A sleep-walker does so during profound sleep and usually has no memory of what he has been doing while asleep.But there is nothing to worry about because children outgrow this condition. Make sure the child is not stressed at school or home. Regulate his sleep and waking hours. Avoid giving him liquids about two hours before he sleeps. Watch him for a few days. The moment he starts sleep-walking, gently lead him back to bed. Few minutes before the sleep-walking starts, you can wake him up, gently talk for few minutes then coax him back to sleep. These measures may gradually reduce and stop this habit. Equally important is keeping him out of danger.Make sure he does not hurt himself while sleep-walking. Never discuss this or be critical about it during day time.How can I determine the cause of diabetes?Dear doctor;I have been diagnosed with type 2 diabetes. I want to know the cause of diabetes? Is it due to less production of insulin or insulin resistance? The treatment should be in line with the cause, that is injecting insulin or taking medicines that make the body respond to insulin. I have been prescribed insulin injections. I am not sure whether this is correct treatment since I am not aware of the cause. Edwin Gatare, 43.Dear Edwin;Type 2 diabetes usually occurs due to resistance to endogenous insulin. It mostly occurs due to hereditary factors such as alcoholism, tobacco use, lack of exercise, central obesity and physical and mental stress. One or more of these factors may be present. Diseases of the pancreas, drugs such as corticosteroids, diuretics, can also cause diabetes. For a middle-aged person, treatment is usually by dietary restrictions from your physician, weight reduction, regular exercise and oral drugs. Insulin is usually used if the blood glucose levels are very high, if there is some complication due to diabetes like kidney or eye problems, if there is some serious infection or when there is no response to oral drugs. Insulin would have been started for any one of these reasons.How can my friend treat persistent running nose?Dear doctor;My 24-year-old friend has a problem of running nose. It intensifies during cold weather. He has taken medicines but the problem persists. Now, he is depressed and unable to interact with friends. Why is he suffering from a running nose? He has been looking for a treatment for the last few years but could not find a better option. Anna.Dear Ann, Your friend is most likely suffering from allergic rhinitis, that is to say,running of nose due to allergy. The allergy could be to dust, fungal spores and pollens, among others present in the environment or something being used on the body or consumed as food. This condition usually runs in families and one may have associated asthma or skin rashes. Unfortunately, there is no root cure for this condition. Recurrent cold carries risk of congestion and inflammation of air sinuses in brain, known as sinusitis. Hence it is vital to keep it under control. Anti allergy drugs, nasal sprays are available to relieve the symptoms. Regular steam inhalation is also useful. Breathing exercises of yoga are also beneficial.In some cases, recurrent running of the nose can be due to a slight deviation of the nasal middle bone. This condition can be corrected by a minor surgery. But there is no need for one to feel depressed or cut social activities due to allergic rhinitis. It is a fairly common condition globally and is rising due to increasing environment pollution and use of chemicals in various forms.