PW Health Clinic

[nasirjavaid]

Get yourself tested directly for HBsAG and immediately go for a vaccine afterwards LFT is your choice.

Thanks , i heard there are many types of vaccinations available but korean one is best. If i remember its name was something like injrsis B. can you tell from where to vaccinate wiich use 1 number?
I normally get tests from chughtai lab jail road. Will they vaccinate too? And any after affects like temperature etc?

[Farhansa]

Foracort inhaler contains steroids which can cause such symptoms but because you are taking it in inhaler form so its highly unlikely. Only steroids taken orally can cause such symptoms, so as I said no chance the inhaler is the cause.

By the way why are you taking this inhaler are you a diagnosed asthmatic or any other respiratory problem?

Do get those tests done which I mentioned.

will try to do tests after ramzan. btw are these blood tests??
An I am taking inhaler due to respiratory problem. wheezing and sometimes short of breath.

[Glioblastoma]

Thanks , i heard there are many types of vaccinations available but korean one is best. If i remember its name was something like injrsis B. can you tell from where to vaccinate wiich use 1 number?
I normally get tests from chughtai lab jail road. Will they vaccinate too? And any after affects like temperature etc?

Best is ENGERIX by glaxosmithkline. Any lab person who knows how to draw blood or here in karachi even good pharmacy stores vaccinate people themselves. Or go to any person who knows how to give IM injection, I repeat any person who can give IM injections.

Side effects are those standard for any vaccine, but do not worry about them they are extremely rare and kids get vaccinated all the time. If you get fever take panadol thats it.

But do get yourself tested before vaccination.

[Glioblastoma]

will try to do tests after ramzan. btw are these blood tests??
An I am taking inhaler due to respiratory problem. wheezing and sometimes short of breath.

Yes they are blood tests. Repeating here for your convenience CBC, Thyroid tests (TSH, Free T3, Free T4).

My question was not why are you taking this inhaler, but have you been diagnosed with any disease. I wanted to know disease name. Wheezing and shortness of breath are symptoms not a disease. Please get yourself properly diagnosed of what disease you have so best management can be implemented.

For shortness of breath and wheezing we usually start diagnosing people by doing following tests, they are written according to most important test to least important: chest X-ray(AP and Lateral view), Pulmonary function test, CBC with differential count(this is same as above mentioned test), blood IgE levels, ECG, Echocardiogram

[nasirjavaid]

Best is ENGERIX by glaxosmithkline. Any lab person who knows how to draw blood or here in karachi even good pharmacy stores vaccinate people themselves. Or go to any person who knows how to give IM injection, I repeat any person who can give IM injections.

Side effects are those standard for any vaccine, but do not worry about them they are extremely rare and kids get vaccinated all the time. If you get fever take panadol thats it.

But do get yourself tested before vaccination.

Thanks brother, will sure get my tests and then vaccinate myself with Engerix soon. Is one vaccination enough for whole life of it needs to repeat after some time?

[bradleo555]

Great post!

[bradleo555]

Assalam o Alaikum Doctor, Hope you're doing good. I've been dealing with very basic level of haemorrhoid, on on-and-off basis from the last couple of years(usually in summers). Whenever I feel itchy or slight bit of pain then I increase my water intake and it goes off. From the last 3-4 days I'm felling really irritated because of it. Although after Aftari, I try to increase my fluids intake as much as possible but may be because of the whole day without water and the hot whether, the problem remains the same. Please suggest me any medicine or cure for it. Your advice will make my fasting a whole lot easier.
Age: 25years

[Glioblastoma]

Thanks brother, will sure get my tests and then vaccinate myself with Engerix soon. Is one vaccination enough for whole life of it needs to repeat after some time?

Total of three doses of Hep b vaccine required. After the first dose, second dose is given after at least a gap of 1 month and third dose is given after a gap of at least 2 months from second dose.

This is CDC recommendation:

The second dose should be administered 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose).

[Glioblastoma]

Assalam o Alaikum Doctor, Hope you're doing good. I've been dealing with very basic level of haemorrhoid, on on-and-off basis from the last couple of years(usually in summers). Whenever I feel itchy or slight bit of pain then I increase my water intake and it goes off. From the last 3-4 days I'm felling really irritated because of it. Although after Aftari, I try to increase my fluids intake as much as possible but may be because of the whole day without water and the hot whether, the problem remains the same. Please suggest me any medicine or cure for it. Your advice will make my fasting a whole lot easier.
Age: 25years

Well permanent solution is to go for surgery. For surgery these two surgeons at shifa international seem good Dr. Arif malik, Dr. Mussadiq khan

Increase your fiber intake and soften your stools, prevent constipation, take 2 table spoon ispaghula in water with every meal, increase banana and milk intake. If you want you can use stool softeners like milk of magnesia, duphalac but do not use them long term.

Sitz bath can be used to relieve the pain and itching sit in in warm(NOT HOT) water for 15 min. Xylocaine ointment can be applied to area, petroleum jelly can be used, all of them after a bowel movement.

Found two very good articles read them:

Hemorrhoids Treatment: Creams and Other Relief Options

Hemorrhoids and what to do about them - Harvard Health

[zalamng]

Dear Dr Sahab
Problem with right shoulder and upper arm. Limited abduction and external rotation. X-ray showed mild calcification. Damn doc injected cortisone twice to no rescue. Oral diclofenaccccc or voltran not helping.
What shall ne next recourse it is getting quite incapacitating;(
Thanks

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[ab6666]

self edited

[altisdualvvti]

Docs I have a query I m turning 20 this august but the Problem is I m under weight my weight is only 50kgs when is way less then what it should be at this age and also my wrists r v slim I m thinking to join a gym will it help? And plz suggest me how to increase weight as I want 15-20kgs more weight

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[nasirjavaid]

Total of three doses of Hep b vaccine required. After the first dose, second dose is given after at least a gap of 1 month and third dose is given after a gap of at least 2 months from second dose.

This is CDC recommendation:

The second dose should be administered 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose).

Thanks Sir, Noted.

[nasirjavaid]

Docs I have a query I m turning 20 this august but the Problem is I m under weight my weight is only 50kgs when is way less then what it should be at this age and also my wrists r v slim I m thinking to join a gym will it help? And plz suggest me how to increase weight as I want 15-20kgs more weight

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I too used to think same when I was 20 - and now I think how can I reverse the weight back to that time - lol
If you are fit then I think its no big issue. I was 53 in 20s and this greatly helped my in gymnastics and karate practice plus climbing trees

Baqi to dr sab hi mashwara dein ge

[margallar]

I too used to think same when I was 20 - and now I think how can I reverse the weight back to that time - lol
If you are fit then I think its no big issue. I was 53 in 20s and this greatly helped my in gymnastics and karate practice plus climbing trees

Baqi to dr sab hi mashwara dein ge

You have had an amazing childhood

[nasirjavaid]

You have had an amazing childhood

Thanks dear, really miss it now. And feel sorry for the kids of today are not able to play like that.

[Glioblastoma]

Dear Dr Sahab
Problem with right shoulder and upper arm. Limited abduction and external rotation. X-ray showed mild calcification. Damn doc injected cortisone twice to no rescue. Oral diclofenaccccc or voltran not helping.
What shall ne next recourse it is getting quite incapacitating;(
Thanks

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The shoulder pain you are talking about can be due to multiple causes, so lets try to deal with them as follows:

Is there any neck pain or feeling like that neck pain is radiating to the shoulder or arm? If yes then this is most probably nerve compression in the cervical area. This is investigated using plain x-ray first then an MRI. Treatment is neck exercises along with pain killers and muscle relaxants and physiotherapy.

If there is only shoulder pain and as you are describing with limited abduction and external rotation. Then this could be either frozen shoulder or rotator cuff impingement also called rotator cuff tendinitis. So both of these are extremely difficult to distinguish the thing that does differentiate them it is a lidocaine injection in the area will cause relief in rotator cuff tendinitis whereas in frozen shoulder it will do nothing. Did the doctor do this test? If not he has missed the diagnostic point.

But as I can see this is looking more like frozen shoulder but can be cervical nerve compression as well. Do you have any of the following risk factor female gender, diabetes, age >40 years. So for both X-ray can be done and then an MRI. Treatment is pain killers with muscle relaxants and physiotherapy is the main thing. One of the treatment options include steroid injections to the area but that is temporary relief only as I mentioned all useless without physiotherapy.

You can write both frozen shoulder and rotator cuff tendinitis on google and there's a lot of material available.

[Glioblastoma]

Docs I have a query I m turning 20 this august but the Problem is I m under weight my weight is only 50kgs when is way less then what it should be at this age and also my wrists r v slim I m thinking to join a gym will it help? And plz suggest me how to increase weight as I want 15-20kgs more weight

Sent from my GFIVE G10 mini using Tapatalk

Good if your weight is less, because once it increases its very difficult to cut down. By the way what's your height, calculate your BMI it will tell whether you are under or normal weight. Many online BMI calculators are present.

Secondly if you are desperate about your physique join a gym do some light weight lifting exercises this will increase the muscle bulk hence wrists will be somewhat better. But please and I say please DO NOT take any supplements or powder protein shakes available at gyms or medical stores most of them contain steroids and they destroy your body as they have so many side effects.

There are drugs to increase hunger but that's a topic for another day. I advise not to consider them.

[margallar]

I think a normal guy should first adopt a routine of daily 1 hour brisk walk befire even considering weight lifting.

After a few days, you start feeling hungrier/ faster digestion.

But initially it is very tiring

[zalamng]

The shoulder pain you are talking about can be due to multiple causes, so lets try to deal with them as follows:

Is there any neck pain or feeling like that neck pain is radiating to the shoulder or arm? If yes then this is most probably nerve compression in the cervical area. This is investigated using plain x-ray first then an MRI. Treatment is neck exercises along with pain killers and muscle relaxants and physiotherapy.

If there is only shoulder pain and as you are describing with limited abduction and external rotation. Then this could be either frozen shoulder or rotator cuff impingement also called rotator cuff tendinitis. So both of these are extremely difficult to distinguish the thing that does differentiate them it is a lidocaine injection in the area will cause relief in rotator cuff tendinitis whereas in frozen shoulder it will do nothing. Did the doctor do this test? If not he has missed the diagnostic point.

But as I can see this is looking more like frozen shoulder but can be cervical nerve compression as well. Do you have any of the following risk factor female gender, diabetes, age >40 years. So for both X-ray can be done and then an MRI. Treatment is pain killers with muscle relaxants and physiotherapy is the main thing. One of the treatment options include steroid injections to the area but that is temporary relief only as I mentioned all useless without physiotherapy.

You can write both frozen shoulder and rotator cuff tendinitis on google and there's a lot of material available.

Many thanks for your insightful response Doc.
It seems more like tendinitis you mentioned and have gotten a cortisone shot 2nd time ( yuk painful) but has not done its full magic. I feel intense spasm in upper arm muscles while doing certain maneuver ;(
I have been referred next for physio therapy though as you have well proposed too;)
I have been a similar bursitis of right hip too that has painfully limited my daily walk and excercize activity and has resulted in some 10 pounds I wwant weight gain I want to gain my life and activity back asap.
I had undergone a couple of physio therapy sessions too.
On my last visit I was subjected to cortisone to the hip too that was darn painful and I should have avoided instead.
This was done with no X-ray or MRI THOUGH.
Any more advise and insight shall be much appreciated.
Thanks in advance

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