PW Health Clinic

[asjdsm]

Not available.

Any knowledge why they are not available? Or when can they be made available? Along with some longer acting meds for it?

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[Glioblastoma]

Any knowledge why they are not available? Or when can they be made available? Along with some longer acting meds for it?

Sent from my Nexus 5 using Tapatalk

No idea why they are not available. Usually all latest medications arrive late in pakistan. But big hospitals like AKU can import meds if they see a pt needs it. Someone living abroad can bring them for you but these are controlled substances so highly unlikely they will be available to them.

[Glioblastoma]

You seem to be right on target.

good thing is we already have been visiting dr ahsan shamim, consulting him for knee replacement. i will get an appointment from him in the morning

it is with one arm

Then most probably is one of the nerves in the arm.

[margallar]

hospital was giving appointment of december. going to find another doc

[Glioblastoma]

Salam all the Doctors!!!!

I had some problems going on in my Family 2-3 months back and those days were going quite tensed!!! After 2-3 days when that problem was over, i went to have all my Test's done (which i usually do, after every six months). Test Lab called me again to give Urine Sample again for rechecking, as they have found High Sugar Level in my Urine!

I checked with Gluco Meter at home and my BSR was 265 at that time, just 1 hour after breakfast!!! I went to Lab and gave Blood Sample for sugar test.... It confirmed that i am NOT Diabiatic (Point 5 - which is ideal) but BSR was still 260...... Go GTT done and it started from 76 and ended at 75 with highest upto 145.

I took special measures and stopped eating everything Sweet and it came to normal in next one week.

Now in Ramadan i was having swear pain Under my Foots when i wake up in the morning!!!! I went to Doctor and checked my sugar and it was 140 Fasting..... Now i have again stopped eating or drinking anything sweet.....

I am 27 Years old and Very Very Slim (Under Weight), married!

Need your view on the above, what should i do now?

Well your foot pain is highly likely not related to your sugar levels. This condition is very common called plantar fasciitis or rarely another condition tarsal tunnel syndrome. You can refer to my post 1078 on this thread I have described both in this thread. Visit an orthopedic Dr. Ahsan shamim at shaukat khanum is good.

As far as your sugar levels are concerned. They are on the higher side. To get confirmation instead of going for GTT you could have simply gone for HbA1C. If you have not got this test done get it done now share your result.

Does not matter your age or you are slim or underweight. You might have MODY or LADA type of diabetes rare but might be the case Refer to my post 1174 on this thread. If this issue of yours is recent 1-2 months MODY is unlikely and LADA might be the case. Please get the HbA1C test done it's a blood test and let's see the result we cannot label you diabetic just on basis of one reading.

And obviously 1hr random sugar will be high therefore standard for random sugar is 2hr so kindly do it after 2hr. And standard for fasting is 12hr do it after that.

[sjehsan]

Well your foot pain is highly likely not related to your sugar levels. This condition is very common called plantar fasciitis or rarely another condition tarsal tunnel syndrome. You can refer to my post 1078 on this thread I have described both in this thread. Visit an orthopedic Dr. Ahsan shamim at shaukat khanum is good.

As far as your sugar levels are concerned. They are on the higher side. To get confirmation instead of going for GTT you could have simply gone for HbA1C. If you have not got this test done get it done now share your result.

Does not matter your age or you are slim or underweight. You might have MODY or LADA type of diabetes rare but might be the case Refer to my post 1174 on this thread. If this issue of yours is recent 1-2 months MODY is unlikely and LADA might be the case. Please get the HbA1C test done it's a blood test and let's see the result we cannot label you diabetic just on basis of one reading.

And obviously 1hr random sugar will be high therefore standard for random sugar is 2hr so kindly do it after 2hr. And standard for fasting is 12hr do it after that.

Thanks for ur detail response. Hb1ac result was point 5 which is ideal or excellent control

[Glioblastoma]

Thanks for ur detail response. Hb1ac result was point 5 which is ideal or excellent control

Then it means you are not diabetic we are sure. Forget everything else. If single readings of random or fasting are on higher side no problem. HbA1C is single test to diagnose diabetes if it is above 6.5.

[zalamng]

I will suggest repeat from a different lab after a couple weeks! What would u say doc

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[Glioblastoma]

Can be done from a different lab but as ramzan has passed at least give 2 months before testing your sugar levels or else there is a possibility it will come low.

[margallar]

i took my mom to doctor Ghulam Abbas (doctor's hospital). He diagnosed de quervain's disease and recommended surgery, 50k charges for operation and hospital care, separate charges for medicines.

Doc asked for x rays, cbc, uric acid levels. He asked whether my mom was diabetic or had blood pressure issues (she has blood pressure).

should i go for a second opinion. he said if it was carpal tunnel, the fingers would be numb

[Glioblastoma]

i took my mom to doctor Ghulam Abbas (doctor's hospital). He diagnosed de quervain's disease and recommended surgery, 50k charges for operation and hospital care, separate charges for medicines.

Doc asked for x rays, cbc, uric acid levels. He asked whether my mom was diabetic or had blood pressure issues (she has blood pressure).

should i go for a second opinion. he said if it was carpal tunnel, the fingers would be numb

Obviously I did not examine the pt so definitely I could not be sure as I said, if it was carpal tunnel or not. But if it is de quervain tenosynovitis he must be correct.

Always go for a second opinion. I am forwarding you some material to read. Non surgical interventions must first be tried in such cases, you can read more about them in the articles. Surgery is undertaken when all else fails.

http://orthoinfo.aaos.org/topic.cfm?topic=a00007
Medscape: Medscape Access
Medscape: Medscape Access
de Quervain Syndrome - Description, Causes, and Best course of treatment
Houston Methodist

You can visit Dr. Arif at ittefaq hospital lets see what he says or wait for dr. ahsan shamim. By the way in the mean time a neurologist can also be helpful Dr. Mouquit at ittefaq can also be tried as he is not a surgeon he would try to treat it medically.

[inara72]

hi pakwheelers , lidocaine 9.6 % is the medicine name used for local anesthetic ,i want to know is this available
in pakistan and what is the brand name
Thank You

[margallar]

i got free from a major challange that had pushed me to my limits, i had been thinking that my stomach was disturbed due to stress (to some extent it was). but it still isn't good enough now, i get constipation with mild diarrhea , too much gas (which often takes a while before it gets released), immediately after meals i sometimes burp and can feel acid in my throat.

i did some searching and i feel that my stomach may not be sufficiently acidic. Now i want to properly treat this, might this issue be related with my cholinergic urticaria?

I just recently got free so now i will be visiting the doctor.

[butwhy]

I found a 5% :

Xylocaine. By BARRETT HODGSON. It's in gel form.

btw, you could simply go to any pharmacy and ask for the molecule name and they'd tell you all the brands they have available...

here's the website for all your drug brand name searches :

Online Drug Information System

pretty useful website....

[Glioblastoma]

i got free from a major challange that had pushed me to my limits, i had been thinking that my stomach was disturbed due to stress (to some extent it was). but it still isn't good enough now, i get constipation with mild diarrhea , too much gas (which often takes a while before it gets released), immediately after meals i sometimes burp and can feel acid in my throat.

i did some searching and i feel that my stomach may not be sufficiently acidic. Now i want to properly treat this, might this issue be related with my cholinergic urticaria?

I just recently got free so now i will be visiting the doctor.

Your burping and acid in throat is a condition called GERD(Gastroesophageal reflux disease) also commonly called heartburn, this is not at all due to increased or decreased acid but more commonly it is due to the lower valve(sphincter) of esophagus which is a one way valve has decreased its tone, hence whenever the stomach is full it throws some of the contents back into your esophagus which are obviously acidic. There are other mechanisms as well but this is the main pathology behind this disease. The treatment usually consists of acid suppressing agents along with medications that increase stomach motility. Some reading material is as follows:

Medscape: Medscape Access
What Is GERD? Pain, Symptoms, Causes, Remedies, and More
GERD: MedlinePlus

The other constipation and diarrhea thing you are complaining about is most likely IBS(irritable bowel syndrome) increases when you are stressed. For details on this condition refer to my post #1285 on this thread. Reading material for this condition is available on links on that post.

For both of your conditions you must visit a gastroenterologist like doctors hospital Dr. Anwaar A. khan or any of the three gastroenterologists at shaukat khanum.

[nasirjavaid]

Hi doc, 3 days ago my nephew got electric shock on his left hand while he was inserting laptop plug. He then suffered from arm pain for some time and then I subsided.
Yesternight he was complaining pain again on left side of he chest and left arm which went off in morning as he was slept. Today again he felt same pain which subsided after half hour.

Is there anything to look for? What are precautions after shock? I heart the person should not drink liquid for sometime after shock... is it true?

[Docjunaid]

Lidocaine comes in following formulation and strengths in Pakistan

Gel 2 %; Inj 1 %; 2 %; Jelly 2 %; 5 %; Oint 2 %; 5 %; Soln Top 4 %.

Many brand names like
Xylocaine
Anacaine
Epocain
Grenocin
Km-lidocaine
Licain
( reference pharma guide 2015 )

[margallar]

Your burping and acid in throat is a condition called GERD(Gastroesophageal reflux disease) also commonly called heartburn, this is not at all due to increased or decreased acid but more commonly it is due to the lower valve(sphincter) of esophagus which is a one way valve has decreased its tone, hence whenever the stomach is full it throws some of the contents back into your esophagus which are obviously acidic. There are other mechanisms as well but this is the main pathology behind this disease. The treatment usually consists of acid suppressing agents along with medications that increase stomach motility. Some reading material is as follows:

Medscape: Medscape Access
What Is GERD? Pain, Symptoms, Causes, Remedies, and More
GERD: MedlinePlus

The other constipation and diarrhea thing you are complaining about is most likely IBS(irritable bowel syndrome) increases when you are stressed. For details on this condition refer to my post #1285 on this thread. Reading material for this condition is available on links on that post.

For both of your conditions you must visit a gastroenterologist like doctors hospital Dr. Anwaar A. khan or any of the three gastroenterologists at shaukat khanum.

the acid in throat problem is not very frequent, it just happens at times, i just mentioned it because after going through some websites, i felt it might be relevant. the real issue is the IBS.

i barely eat one roti (usually its not even a full roti) and then i can not eat anymore....feel too full for the next hour.

it takes too long to digest...i am eating almost 40 percent less than i used to.

trying some weight lifting and cardio.

drinking ORS seems to be helpful.

these days i am free so i want to get as fit as i can get

during exams it was the worst, sometimes i would feel nauseous, salt would provide almost immediate relief from nausea, those days i also did one course of flagyl, i got normal for a few days with that

there is absolutely no pain at all.

[Glioblastoma]

the acid in throat problem is not very frequent, it just happens at times, i just mentioned it because after going through some websites, i felt it might be relevant. the real issue is the IBS.

i barely eat one roti (usually its not even a full roti) and then i can not eat anymore....feel too full for the next hour.

it takes too long to digest...i am eating almost 40 percent less than i used to.

trying some weight lifting and cardio.

drinking ORS seems to be helpful.

these days i am free so i want to get as fit as i can get

during exams it was the worst, sometimes i would feel nauseous, salt would provide almost immediate relief from nausea, those days i also did one course of flagyl, i got normal for a few days with that

there is absolutely no pain at all.

I can understand that it is worse during stress especially during the exams. It is very common problem amongst the young people. Better visit a good gastroenterologist soon. He will give you some anticholinergic medications most probably and they make a lot of difference, have seen patients on anticholinergics with improved quality of life and even during stressful situations they do seem to be helpful. Also probiotics can be used. Eating healthy helps a lot as well but exercising not to such an extent.

Flagyl providing relief sounds strange in IBS can provide relief in IBD, as I said promptly visit a GI specialist from ones I named or any GI specialist you know of.

[Glioblastoma]

Hi doc, 3 days ago my nephew got electric shock on his left hand while he was inserting laptop plug. He then suffered from arm pain for some time and then I subsided.
Yesternight he was complaining pain again on left side of he chest and left arm which went off in morning as he was slept. Today again he felt same pain which subsided after half hour.

Is there anything to look for? What are precautions after shock? I heart the person should not drink liquid for sometime after shock... is it true?

I do not think there is anything to look for. The pain he is having is because the current damages muscle cells hence there is pain. Not to drink water after shock is ridiculous. You must drink more water because muscle cells damaged by electric current release their protein myoglobin. This protein although not harmful but in large quantities can block the kidney tubules hence causing renal failure but this happens in high voltage injuries. So to prevent this IV fluids are given in high voltage injuries so myoglobin doesn't blocks the kidney tubules and is cleared out constantly.

So drink more fluids. There are tests that can be done a list of it, do not think they are required but if you want you can do them for patient satisfaction ECG, CBC, BUN and Creatinine, CPK levels, Electrolytes(sodium, potassium, calcium), urinalysis. Also do visit a specialist if you think it's necessary or pain does not subside. Here is everything you want to know about electrical injuries, workup segment has all the tests listed.

Medscape: Medscape Access