PW Health Clinic

[Glioblastoma]

i will do these tests .. any idea on its cost at private labs ?
there are some semi private type of organizations as NORI who also do tests at reasonable rates .. (almost 30-5- %) cheaper then private on some tests.. any idea of cost at such organizations.

after taking naproxen pain is reduced a bit but still there .. i have a feeling in the knee ''like the feeling AFTER hot water is poured on it.. yani garm pani knee pa paiknay ka baad jo feeling hothi hai.

any affect by daal mash , daal mong and palak ? or any palak or daal cooked in gosht ? savour rice/paulao ?
what about dahi / lasi ? do they increase uric acid.
i am doing a night shift duty and every menu has some sort of meat in it .. i can get above options or i should take special home made meal..

I do not know the cost neither do I know about nori or other organizations testing at lesser rates, only doctors in your vicinity can tell whether its a good lab or not.

The warmth in knee you are describing is seeming close to gout but does it occur with swelling of your knee. If yes then its pretty likely gout. Want to get it confirmed if it is gout or not then you can skip all the tests I told and go for joint fluid aspiration and cytology called arthrocentesis but most clinicians are reluctant in doing it. Wait for you doctor to come back and lets see whats his decision, will he go for the tests I told or arthrocentesis you can present to him what I told. Pain will take time to go away. My first priority will be to confirm if it is gout or not lets see what your doctor says.

Palak is totally safe. But yes all pulses daals milk lassi can aid in elevated uric acid levels but not that quickly so they are pretty safe as well, but do control on them as well. Meat however it readily increases the uric acid levels its another discussion why. So I am not saying do not eat meat just decrease it, for example if you ate meat in food two times like in evening and night and that also 3 boti per meal I will decrease it to alternate days of meat and that also in controlled amount like 1 small boti per meal. You can separate the daal or palak out and leave the meat behind, best is if you take food yourself alternate days.

[asjdsm]

I do not know the cost neither do I know about nori or other organizations testing at lesser rates, only doctors in your vicinity can tell whether its a good lab or not.

The warmth in knee you are describing is seeming close to gout but does it occur with swelling of your knee. If yes then its pretty likely gout. Want to get it confirmed if it is gout or not then you can skip all the tests I told and go for joint fluid aspiration and cytology called arthrocentesis but most clinicians are reluctant in doing it. Wait for you doctor to come back and lets see whats his decision, will he go for the tests I told or arthrocentesis you can present to him what I told. Pain will take time to go away. My first priority will be to confirm if it is gout or not lets see what your doctor says.

Palak is totally safe. But yes all pulses daals milk lassi can aid in elevated uric acid levels but not that quickly so they are pretty safe as well, but do control on them as well. Meat however it readily increases the uric acid levels its another discussion why. So I am not saying do not eat meat just decrease it, for example if you ate meat in food two times like in evening and night and that also 3 boti per meal I will decrease it to alternate days of meat and that also in controlled amount like 1 small boti per meal. You can separate the daal or palak out and leave the meat behind, best is if you take food yourself alternate days.

Nori is nuclear medical research Institute by pakistan atomic energy.
I forgot to mention that I use warm salt on my knee it really soothes it. I will wait for my doctor and check with him while keeping all the points that you highlighted in mind

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[Glioblastoma]

What is the cause of diabetes?

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Which one are you talking about Type 1, Type 2, Gestational diabetes, MODY, Prediabetes, LADA. I am listing the causes in simplified forms:

Type 1= autoimmune destruction destruction of pancreatic B islet cells.

Type 2= genetics and family history and many other factors causing tendency towards insulin resistance and hence causing pancreatic B islet cells failure/exhaustion.

Gestational Diabetes= pregnancy hormones causing insulin resistance.

Prediabetes= this Condition can lead to type 2 diabetes as its the start of insulin resistance

MODY(maturity onset diabetes of young)= Mutation in genes. Always occurs <25 years of age.

LADA(Latent autoimmune diabetes in adults)= slow pancreatic B islet cells failure due to autoantibodies so age is older as compared to type 1 patients. Very rare hence mostly being misdiagnosed as type 2 diabetes.

[Glioblastoma]

Nori is nuclear medical research Institute by pakistan atomic energy.
I forgot to mention that I use warm salt on my knee it really soothes it. I will wait for my doctor and check with him while keeping all the points that you highlighted in mind

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Then it means Nori is respectable. As I was saying looks like gout but nothing can be said without further testing. Do share what the doctor said.

[margallar]

what is first aid for exposure of petrol to skin. we had to lay in petrol to change a leaking fuel pipe. skin is red with burning sensation

[nasirjavaid]

what is first aid for exposure of petrol to skin. we had to lay in petrol to change a leaking fuel pipe. skin is red with burning sensation

Nothing. I leave it as it is ...... maybe try petroleum jelly.

[Glioblastoma]

what is first aid for exposure of petrol to skin. we had to lay in petrol to change a leaking fuel pipe. skin is red with burning sensation

Not that big issue thoroughly wash with water and soap try to use dove soap or other moisturizing soap to clean the area they are less irritating for the skin.

Red skin means you are facing contact dermatitis, so better use a moisturizing cream like nivea, petroleum jelly or any other. Whenever you wash that area use above mentioned soaps. You can take if required fexet 60mg two times a day or rigix/zyrtec 10mg once a day.

This condition normally does not happen even with prolonged exposure in normal people, but because you have a history of allergic dermatitis (cholinergic urticaria) that's why you are more prone to developing contact dermatitis as well.

[margallar]

Doc, you are always helpful

[margallar]

I'm looking for a polio vaccination centre for my niece, we visited Jinnah hospital, but they were only offering vaccination for those people that were travelling abroad

anyone know a place in lahore?

[Glioblastoma]

I'm looking for a polio vaccination centre for my niece, we visited Jinnah hospital, but they were only offering vaccination for those people that were travelling abroad

anyone know a place in lahore?

You can buy it privately from any private hospital pharmacy or reputed pharmaceutical store and then visit a pediatrician so he can give it by his hand and then certify he has given it.

[margallar]

My mom used to say that somehow, ispaghol causes her pain in the joints (though i don't know of any connection), she avoided that, but we tried weetabix.

it is really effective stuff, eating one or two pieces of weetabix with milk a day, guarantee for a constipation free day.

i really recommend this

[nasirjavaid]

Who in the hell suggested this drug :mad:. Never used as 1st line treatment for ADHD has serious side effects until and unless the patient primarily suffers from bipolar disorder also having symptoms of ADHD and then also added to primary treatment of Bipolar never used as 1st line.

Always try methylphenidate, dextroamphetamine and then atomoxetine but never ever ever risperidone(vepridone) first.

Risperidone and other antipsychotics will reduce the anger issues and mood disruptions in ADHD patients but will never improve concentration and hyperactivity the two main problems. However if it is added to a child whose anger is not being controlled with methylphenidate or atomoxetine then it makes some sense but still for anger issues valproate(epival) or carbamazepine can be tried.

Get a second opinion from a good child or general psychiatrist either it is ADHD or some other psychiatric disease.

If you cannot find anyone try him at least he will give you a good suggestion Dr. Amer Ikram Doctors hospital lahore.

Zexa is memantine and persch is similar to vepridone that is risperidone, see the name written in bracket below brand name that what the drug contains.

Next time you go to your doctor ask, some doctor was asking why didn't you try methylphenidate or atomoxetine first. FDA has still not approved antipsychotics for ADHD treatment.

I would be waiting what she says may be it might increase my knowledge.

I will still advise you to get a second opinion.

Melatonin for sleep is fine.

Thank you sir, sure I would like to ask her same. We went to her on recommendation of our child specialist who first discovered signs of ADHD and somewhat autism related as my son lacked eye contact since very young age.
We though as she is professor so will give good advice
I will be thankful if you can recommend someone. I will also visit doctors hospital.
My son is now 4 years and main issue is hyperactivity and anger. His speech therapy is being done from Lahore Children Center and is showing remarkable improvement in speech recovery but ADHD is not being controlled yet.

Well sir now you told in detail which has cleared my misconception about your child, sorry if I was a little harsh then your psychiatrist is looking on the right path.

This is mainly Autism spectrum disorder with some influence of ADHD like symptoms. For this case now I can say risperidone is good but epival(valproate) or carbamazepine can also be tried for hyperactivity and anger. For Speech yes main thing is speech therapy. So again your diagnosis is autism spectrum disorder with ADHD like symptoms so in such a case there is no fixed drug methylphenidate or atomoxetine can be tried along with the drugs I mentioned above, so treatment is basically is trial and error method we use drugs which suits the particular patient best. Not like pure ADHD in which 1st we use methylphenidate and atomoxetine and then some other drugs.

Hence we usually treat autism cases mainly under supervision of psychiatrist and neurologist so take advice from neurologist I told.

Hope it helps.

No problem.

Cannot tell how long it will take to become normal it varies from patient to patient and obviously its a specialists job. What you can do is call the reception and ask if the particular doctor deals in autism and ADHD cases. But I am definite that he will see this patient and try to help you, as in the US such cases are very common and hence US neurologists are trained for these cases.

Or you can also try Dr Moquit Usman Ittefaq Hospital www.ittefaqhospital.com.pk/consultants.php.

Both Dr. Amer and Dr. Moquit are really good depends who is nearer to you and who is easily available.

Hello sir, you may remember from previous posts about this.

got my son checked up by dr. Amer ikram (doctor's hospital) as he was just back from vacations. He checked and said almost same as previous doc told that he has ADHD + mild autism like symptoms. He said there are side effect of Vepridone but we need to give him as there is no other solution.

So I think I will have to continue this medicine and therapy. I am seeing lot of improvement in him with time. When we stopped vepridone for sometime, his behavior was really disturbing but now he is better with the drug.

Apart from it he was like typical doctors not explaining in detail as Dr. Nazish used to explain each and everything or you describe here. It was hardly a 10-15 minutes session in which didn't even bothered to check the assessment provided by the therapist - isn't it strange.

One confusion I have that as this drug is given is so minute quantity (0.25ml) so for how long we can use same bottle after opening? till the end date printed on bottle or just couple of months?

Thanks

[asjdsm]

My mom used to say that somehow, ispaghol causes her pain in the joints (though i don't know of any connection), she avoided that, but we tried weetabix.

it is really effective stuff, eating one or two pieces of weetabix with milk a day, guarantee for a constipation free day.

i really recommend this

Well taking isbaghol coincides with my knee pain as well but I have took it only for few weeks two tables spoons twice a day.

I also suspect magnesium and vitamin k2..
Because I had no pain after a little mishap on bike for 4 to 5 days.. It started after that. And I was taking all of above for few weeks..

It all might be waham

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[asjdsm]

Hello sir, you may remember from previous posts about this.

got my son checked up by dr. Amer ikram (doctor's hospital) as he was just back from vacations. He checked and said almost same as previous doc told that he has ADHD + mild autism like symptoms. He said there are side effect of Vepridone but we need to give him as there is no other solution.

So I think I will have to continue this medicine and therapy. I am seeing lot of improvement in him with time. When we stopped vepridone for sometime, his behavior was really disturbing but now he is better with the drug.

Apart from it he was like typical doctors not explaining in detail as Dr. Nazish used to explain each and everything or you describe here. It was hardly a 10-15 minutes session in which didn't even bothered to check the assessment provided by the therapist - isn't it strange.

One confusion I have that as this drug is given is so minute quantity (0.25ml) so for how long we can use same bottle after opening? till the end date printed on bottle or just couple of months?

Thanks

@doc is low Testo also a cause of add or adhd..

I am taking jumex. 5mg half capsule for my add. Not as effective as ritalin but certainly better then ndri sndri nri class of drugs.

Last year tak jtni bhi add ki drugs registered hovi hain sari try ki hain. Nothing except ritalin works. But jumex keeps me calm and functioning all day.

I am taking half tablet daily.

Left ritalin because of unavailability. Frequent dosages. Ineffectiveness with time. And after a year on it I was like zombie.. So had to take some ssri with it..

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[Farhansa]

If one is suffering from extreme fatigue, most of time spent lying on bed, weakness and loss of memory then where should he go?? General? Neuro? Or else
Also plz suggest a competent physician on the subject.

[Glioblastoma]

Hello sir, you may remember from previous posts about this.

got my son checked up by dr. Amer ikram (doctor's hospital) as he was just back from vacations. He checked and said almost same as previous doc told that he has ADHD + mild autism like symptoms. He said there are side effect of Vepridone but we need to give him as there is no other solution.

So I think I will have to continue this medicine and therapy. I am seeing lot of improvement in him with time. When we stopped vepridone for sometime, his behavior was really disturbing but now he is better with the drug.

Apart from it he was like typical doctors not explaining in detail as Dr. Nazish used to explain each and everything or you describe here. It was hardly a 10-15 minutes session in which didn't even bothered to check the assessment provided by the therapist - isn't it strange.

One confusion I have that as this drug is given is so minute quantity (0.25ml) so for how long we can use same bottle after opening? till the end date printed on bottle or just couple of months?

Thanks

Strange that Dr. Amer didn't tell you everything in detail next time try Dr. mouquit at ittefaq hospital if he is alos not good revert to your old physician. Continue vepridone because of autism spectrum coming with ADHD, ritalin might increase the aggression even though its the proper treatment that's why everyone is reluctant in using it. You can use the bottle up till the expiry date.

[Glioblastoma]

If one is suffering from extreme fatigue, most of time spent lying on bed, weakness and loss of memory then where should he go?? General? Neuro? Or else
Also plz suggest a competent physician on the subject.

Seems like signs of major depression. Can you tell the pt. age. Signs of major depression or minor depression(dysthymia):

S- sleep disturbance(usually loss of sleep insomnia)
I- loss of Interest in daily activities
G- Guilt/worthlesness
E- Decrease energy
M- Depressed mood
C- decrease concentration
A- appetite/weight loss
P- psychomotor retardation
S- suicidal ideation

Any four of these symptoms present for at least 2 weeks is mostly major depression. If severity of these symptoms is less and present for at least 2 years is minor depression or dysthymia. If sleep increased and weight and appetite increased along with some above mentioned symptoms atypical depression is likely. If pt. older than 65 then major depression can present as loss of memory.

Neurologists seems to be better but good GP can be good as well Dr. Mahmud majeed, Dr. mazhar ali mufti or dr. shahzad khan siddiqui seem to be good general physicians try them. But when treating for depression always remember takes at least 2-3weeks for meds to work.

[nasirjavaid]

Strange that Dr. Amer didn't tell you everything in detail next time try Dr. mouquit at ittefaq hospital if he is alos not good revert to your old physician. Continue vepridone because of autism spectrum coming with ADHD, ritalin might increase the aggression even though its the proper treatment that's why everyone is reluctant in using it. You can use the bottle up till the expiry date.

Yup somehow I can feel if a doc is really trying to help or just pushing time as routine chicken vaccinators do.
My child's doc was very helpful by explaining each and every thing same as you do here. He was the one who going out of way diagnosed it first time and referred to psychiatrist. But he is now gone Bahrain and I am having hard time finding his replacement.
Thanks for clearing confusion of expiry date.

[Cr33D]

Is there any dermatologist here on pakwheels? Need advise regarding scars left by chickenpox on face.

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[Glioblastoma]

If one is suffering from extreme fatigue, most of time spent lying on bed, weakness and loss of memory then where should he go?? General? Neuro? Or else
Also plz suggest a competent physician on the subject.

Forgot to mention, do get your thyroid hormones tested for hypothyroidism and get tested for anemia as well they also present as fatigue.

Thyroid hormones TSH, Free T3 and Free T4

For anemia CBC.

Along with the depression diagnosis I mentioned above keep that in mind as well.