Q: I'm having a relationship with someone for about a year. I'm 25 years old and have just completed my bachelors and he is about 38 and married. We are also distant relatives. After we met each other he used to be curious about me and was madly attracted to me and asked me out seriously. First I thought he was not serious but after some time I started taking him seriously too. Initially I tried to show him the facts that he is married, but in spite of all this he finally persuaded me that he loves me and I believed him. He promised me that no matter what he would never end this commitment; I believed him and fell in love and we started a relationship. The relationship was going steady but his wife started to suspect that something was up between us, although things got back to normal. Then recently he started avoiding me saying that he is very busy with work, now he is saying that I should forget him and end everything. I tried to know if there's anything wrong because of me but he has ended all contact. I miss him a lot! He also knows that I want nothing from him except his love. I don't even want to marry him. I try to talk to him but he doesn't answer and he misbehaves with me. I'm unable to keep myself away from him. Please suggest what should I do? I just want him to be with me. Ayesha, Karachi
A: What I'm about to say is probably not what you want to hear but it has to be said. This man has made it very clear that his marriage is his priority. He took advantage of your young age and vulnerability to get his way with you and after some time, he got bored. That is the plain truth. It's also very possible that there are other women in his life, no matter what he says. And irrespective of that, the bottom line is that he's made it clear to you that he's no longer interested. He's avoiding you. Forget about him! You're being very selfless in saying that all you want is his love and that you don't even want to marry him but my question to you is why on earth would you want that? Don't you want to love someone who can be yours and only yours? You can do so much better than slimy older married men. Just cut him out of your life completely, block his calls, ignore his presence and even if he comes crawling back to you, just turn the other way. Once you realise that his professions of love were nothing more than a ruse to pass time with you, you can move on to better things. A loving and sincere person like you can do much better than this. And even if it seems impossible right now once you come to terms with the truth, you will find the strength within yourself to forget him and move on.
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Dermatologist
Dr Shah Hussain

Q: My son has had eczema since he was born 2 years ago. My doctor has suggested 'patch' testing. What does this involve and where can I get it done. Sadia, Lahore
A: Some general physicians have a special interest in allergy testing and your doctor could refer you to one of those doctors if he or she was unable to do the testing for you. Alternatively your doctor could refer you to see a specialist for further testing. The patch test involves applying several common allergens to the skin. These are usually applied in batches to the skin on the child's back. The skin is then inspected within a few days to detect if any reaction has occurred on the child's skin. If the child is allergic to any of the allergens, an area of inflammation develops at the point where the particular allergen was applied. Once the allergen has been identified it may then be possible to avoid the child being exposed to that agent in the future, which should help to prevent further relapses of eczema. The theory behind patch testing is very sound but in practice it is often discovered that the child has multiple allergies to very common ubiquitous agents that cannot be easily avoided.

Q: I am 24 weeks pregnant and have developed this intense itching from my wrist to shoulder and across my upper back. My doctor has advised me to take an antihistamine to relieve the itch. Will this condition ever go away? It is seriously affecting my everyday life. Please help. Beena Ali
A: Itch is a very common symptomcity during pregnancy and in many cases it can persist until delivery takes place. Assuming that you don't have a rash since you did not mention in your question. If a rash were present then that would raise the possibility of a dermatological cause for the itch. However, it is worth mentioning in passing that many dermatological conditions, including eczema, actually improve during pregnancy. Since you have only recently developed this itch and you are now coming close to the third trimester of pregnancy it might be worthwhile having a liver function test performed to measure the level of bile in your blood. There is a condition that occurs during pregnancy that is known as cholestasis, which means that the level of bile acid in the blood increases due to the effect of the changed oestrogen levels. This increase in bile can cause intense itch. There is a specific treatment available for this condition that can be safely taken for the remainder of the pregnancy. It is probably a bit early for cholestasis to occur but given the intense level of the itch and the fact that it is of recent origin it might be worth testing. If the bile levels are normal then you have to try to manage the itch as best as you can. Emollient bath additives may help in addition to the antihistamine that you are already taking. Antihistamines can particularly be helpful at night when their mild sedative effects can assist sleeping, which can be a great problem for many women suffering from severe itch during pregnancy. Some women find that talcum powder and moisturising creams also give relief.
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General Physician
Dr Sadqa Gul
Q: I have an itch around the anal area. I have tried various over-the-counter remedies and have regularly taken hot salt baths but it still keeps returning. Any ideas please? Rohail, Karachi
A: Anal itch or pruritus ani is a very annoying condition and can be very persistent. It can be associated with various anal conditions such as piles or infection of the skin surrounding the anus. Sometimes the itch persists even after the original cause has disappeared because the person keeps scratching the area. However, in my experience the person with this condition is usually quite healthy and no disease is present. I suspect that many cases are due to lack of attention to hygiene. Avoid using antiseptics on the area and use a simple non-perfumed soap or shower gel.