When circumcision is carried out as a necessary part of religious or cultural practice, the reasons against the operation may no longer apply.

For those parents who have gone ahead and had their sons circumcised, let me reassure them there is no evidence to indicate that this will cause any later physical or mental trauma.

If you do decide not to have your next son circumcised, then do not be concerned with what effect this will have on him when he discovers he is shaped differently from his brothers and his father. The new generation is more likely to have retained their foreskins and he should be in the majority at school.

There are some indications for removing the prepuce in children — recurrent infection under the foreskin, narrowing of the opening and inability to retract it in the older child.

Circumcision may be necessary in the adult, particularly in the elderly, if a tight foreskin is retracted and then compresses the shaft of the penis.

*26/71/1*

Roseola is an acute, infectious disease characterized by a high fever followed by a rash. It is not known which virus causes the disease. Roseola occurs almost exclusively in children between the ages of six months and three years. The incubation period – the time it takes for symptoms to develop once a child has been exposed to the virus – is seven to 17 days. One attack of roseola provides lifelong immunity.

Signs and symptoms

Roseola begins suddenly with a fever of 40°C to 41 °C. It is one of the more common causes of convulsions with fever, which occur at the onset of the disease. It rarely produces any other symptoms, although sometimes roseola can cause a runny nose, mild redness of the throat, and minimal enlargement of the lymph nodes of the neck. Generally, the fever persists for three or four days and cannot be kept down consistently with aspirin or acetaminophen. Meanwhile, the child appears to be less ill than the degree of fever suggests. The fever disappears abruptly; at the same time, a splotchy, red rash appears on the trunk and spreads to the child’s arms and neck. The rash disappears in one or two days, and the child is well again. Complications are rare.

Roseola is difficult to identify until the fever drops and the rash appears.

Home care

Give aspirin or paracetamol and use lukewarm baths to help control the fever.

Precautions

• Another common illness that produces a high fever but few other symptoms is infection of the urinary tract. This is more common in girls.

• Coughing, vomiting, diarrhea, discharge from the eyes or ears, and extreme fatigue or collapse are not associated with roseola. If these symptoms occur, consult a doctor.

Medical treatment

The doctor will conduct a careful physical examination to rule out other illnesses which cause a high fever. The doctor may order blood or urine tests if he or she is concerned about other illnesses, but usually a few days’ observation will confirm the diagnosis of roseola.

*178/84/5*

What is it?

A condition characterized by excessive weight. It is generally accepted that the term obesity applies to people who are 30 per cent or more above their ideal weight-allowing for their frame size. About 15 per cent of 16-19-year-olds, and 54 per cent of men and 50 per cent of women aged 60-65, are thought to be overweight. Forty per cent of adult men overall and 32 per cent of adult women overall are overweight, with 6 per cent of men and 8 per cent of women truly obese.

Recent research has found that even being mildly overweight matters-it is not just the truly obese who are at risk. Weight is especially important to those with a family history of diabetes and heart disease and in those who already have high blood pressure. If you or your family have diabetes, heart disease or high blood pressure, it is especially important to watch your weight and that of your family.

Smoking is linked to weight too. Smokers tend to be less heavy than non-smokers but they are at greater health risk. Many people give up smoking and promptly put on weight but the hazards of smoking are greater than those of being overweight.

What causes it?

• Eating the wrong foods.

• Bad nutritional habits from the cradle.

• Too little exercise.

• Too much alcohol.

*198/72/5*