PW Health Clinic

[faheemakbar18]

AoA

I have fixed exotropia (right eye turned outside). since birth
I dig the internet and most people say it cant be 100% fixed. through surgery
there are some eye exercises like beeds prism etc . which is the good method to get accurate result (and watch 3d lol)

BTW im male/22 now.

thank you

[DR.Faisal]

FHeem bhai. Its not appropriate to give any opinion based on ur history. Any good eye surgeon can see and give opinion after u have visited him. Exotropia can be corrected. But we ha e to examine the patient first.

[nasirjavaid]

@Glioblastoma
Unfortunately most of the drugs used to treat add are not yet available in pakistan.

Any idea if jumex can be of any help?
It certainly is of some help to me..
Its more mild and less damaging then other first line of drugs.

@nasirjaved
Bro keep such medicine away from children. If you suspect him to repeat it then use sugar tablets that has no active substance.. But them being inert kid will take other meds assuming that they do nothing.

He might be hungry at that time?

Sent from my Nexus 5 using Tapatalk

Yes sir agree with you 100% and we try our best to keep such things away from him but there are minor chances when one can skip. And believe me this kid has some special qualities of searching stuff for him ....... he even opens the locked fridge to get his needed things.

But yes we have to be 200% cautious for him..

[nasirjavaid]

Sorry to disagree but on the contrary most medications used to treat adhd or add are available in pakistan. Those not available are only three clonidine, guanfacine and amphetamines.

Majority of adhd or add patients are controlled on atomoxetine or methylphenidate. For aggressiveness antipsychotics or other drugs can be used. If patient is doing fine on particular drugs no need to change them. Children are children they will do these sort of things now and then this does not mean instantaneously change drugs. Drug effects vary from person to person. Personally do not think jumex is mild if you know the mechanism of action and the precautions needed while using it.

As from past one year we have seen remarkable improvement in his behaviour. Initially he was 0% responsive to our calls and commands and kept doing his stuff (which I assume are related to autism). But know he is 70% responsive to calls and commands and learns new words easily and also making small sentences. Asks for what he needs.
Initially he had no control on toilet and used to pee or poo at any place even on drawing room but now he asks us when he needs to go to bathroom (like he says "shish" when to urinate and "Poty" when to go for poop)

So I think autism related signs are going away very fast and so plan to visit his initial doctor for further advice if she can change vepridone to methylphenidate as I think now only his behaviour issue is major thing that remains to be treated.

Please share your thoughts sir @glioblastoma

Also the Amir Ikram said that if vepridone produces symptoms like runny sliva from kids mouth and kid being too much sluggish then we consider vepridone's reaction is much but if kid is normal and active then we can continue.

the kid is super active even after taking vepridone... but yes a bit calm.

Thanks.

[Glioblastoma]

As from past one year we have seen remarkable improvement in his behaviour. Initially he was 0% responsive to our calls and commands and kept doing his stuff (which I assume are related to autism). But know he is 70% responsive to calls and commands and learns new words easily and also making small sentences. Asks for what he needs.
Initially he had no control on toilet and used to pee or poo at any place even on drawing room but now he asks us when he needs to go to bathroom (like he says "shish" when to urinate and "Poty" when to go for poop)

So I think autism related signs are going away very fast and so plan to visit his initial doctor for further advice if she can change vepridone to methylphenidate as I think now only his behaviour issue is major thing that remains to be treated.

Please share your thoughts sir @Glioblastoma

Also the Amir Ikram said that if vepridone produces symptoms like runny sliva from kids mouth and kid being too much sluggish then we consider vepridone's reaction is much but if kid is normal and active then we can continue.

the kid is super active even after taking vepridone... but yes a bit calm.

Thanks.

So it means he is doing good continue the therapy. Yes Risperidone has side effects like what Dr. Ikram told, these are signs to stop this particular drug and shift to another, he does not have them so continue therapy. The saliva from mouth and sluggish thing are called extrapyramidal symptoms and the most severe form of it is called tardive dyskinesia, this particular condition is the sign to stop the drug. You can read more about this on the net, search the two terms I told.

Instead continuing Dr. Ikram you can try Dr. Mouquit at ittefaq hospital or Dr. Qasim bashir at shaukat khanum can be tried, if you want.

But continue therapy with that lady doctor.

[faheemakbar18]

FHeem bhai. Its not appropriate to give any opinion based on ur history. Any good eye surgeon can see and give opinion after u have visited him. Exotropia can be corrected. But we ha e to examine the patient first.

thank you
can you suggest me some good Dr. in lahore.

[nasirjavaid]

So it means he is doing good continue the therapy. Yes Risperidone has side effects like what Dr. Ikram told, these are signs to stop this particular drug and shift to another, he does not have them so continue therapy. The saliva from mouth and sluggish thing are called extrapyramidal symptoms and the most severe form of it is called tardive dyskinesia, this particular condition is the sign to stop the drug. You can read more about this on the net, search the two terms I told.

Instead continuing Dr. Ikram you can try Dr. Mouquit at ittefaq hospital or Dr. Qasim bashir at shaukat khanum can be tried, if you want.

But continue therapy with that lady doctor.

Yes he is not sluggish with resperidone so I plan to continue it after discussing with his psychiatrist if we can switch to methylphenidate or not.

[Glioblastoma]

thank you
can you suggest me some good Dr. in lahore.

In lahore you can visit Dr. Shaukat Yousuf Khan in Ittefaq hospital or Dr. Zahid Kamal At Shaukat Khanum. Take opinion from both of them.

[Glioblastoma]

Yes he is not sluggish with resperidone so I plan to continue it after discussing with his psychiatrist if we can switch to methylphenidate or not.

Do not think she will be eager to change the drugs, as I mentioned he is doing good. But do discuss it, lets see.

[nasirjavaid]

Do not think she will be eager to change the drugs, as I mentioned he is doing good. But do discuss it, lets see.

If there are no much side affects then I think we can continue vepridone as we have reduced its dosage from twice a day to once a day due to not much behavior issue... he is good with this also.
Will discuss with her about further plans as the kido has now improved 70%..

[hassan918]

Hello,

I had water in my ear while swimming and one of my ears are seem to be not working , it has water and I hardly listen anything from one of my ears. Please suggest me anything which help me, any ear drops or anything else which can help me?

[Bilalicious]

Go visit an ENT specialist immediately!!!

[butwhy]

try to clean your ear with sharp pointy objects, like toothpick or knife or screw driver etc. If blood comes out from ear, it means you have to do it harder. Keep going till it comes out from the other ear. Now your ear canal is clean.

[margallar]

try to clean your ear with sharp pointy objects, like toothpick or knife or screw driver etc. If blood comes out from ear, it means you have to do it harder. Keep going till it comes out from the other ear. Now your ear canal is clean.

A friend was stupid enough to try a phillips screwdriver....he was.lucky his ear survived....his pain was of such intensity that painkillers would not work

[Glioblastoma]

Hello,

I had water in my ear while swimming and one of my ears are seem to be not working , it has water and I hardly listen anything from one of my ears. Please suggest me anything which help me, any ear drops or anything else which can help me?

Please ignore the insanity and follow as Bilalicious and margallar are saying. Kindly visit an ENT asap. In short what has happened is when water went into your ear the previously lying around wax in your ear absorbed the water and hence got swollen. So this swollen wax is blocking your ear only way is to remove it, that only a ENT specialist can do.

Any good ent specialist can clear it in a matter of minutes. You can soften it using liquid paraffin drops or drops of olive oil and then go to an ENT. Or you can go straight away, if I were you I would go straight away. Good ENT specialist in lahore are Shaukat khanum Dr. Kashif iqbal and Dr. M. Mujeeb and ittefaq hospital Dr. Shahid Masood khan.

[anj3m]

Age: 63
Gender: Female

Medical history
Cholesterol and high Blood Pressure (not severe), taking medicines for both and all is under control. All tests results are within specied range.

Problem 1
The left shoulder started to pain six months ago and now its getting stiff.

It has almost no backward and upward movement. If it's moved in these two directions, stiffness and severe pain is felt.

This occurs more especially, while resting or lying on bed. I read earlier here about correct postures, which is being implemented.

Painkillers and Ibuspray (pain killer sprays) provide temporary instant relief.

Problem 2.
Pain in this gastrocnemius heads area.
http://www.freefitnessguru.com/Anatomy/images/legs%20back.jpg

Respectable Doctors, @anj3m @invincible_doc @epigenius @glioblastoma

Please shed some light on it.

I'm very sorry that I've not replied or been active. I'm back in the UK so will be mainly offline til I'm back! Hope its all sorted now, though!
Sorry again!!

[nasirjavaid]

From Have you tried a Salt Lamp? : Dr. Leonard Coldwell.com

The air is filled with negative and positive ions. To maintain a healthy atmosphere, these negative and positive ions must remain in balance. However, technology today, like electronic devices, motor vehicles and our heating & cooling systems produce so many positive ions that our air is thrown off balance; resulting in stress, sleep disorders, migraine headaches and allergies to name a few. For example, most of our televisions run on a frequency of about 100-160 Hz. However, our brainwaves only vibrate at around 8 Hz. The television vibrates at a rate of more than twenty times faster than our brainwaves! Is it any wonder why we have so many diagnosed with ADHD, nervousness, and insomnia? It also causes the body to produce free radicals that can cause cancer, among other things. Placing a salt lamp besides the television and other electronics will help increase the amount of negative ions (which are the good ones). I remember when I first put salt lamps throughout the house, my mom came to visit and asked if I had drugged the kids! She couldn’t believe that the lamps had made that much of a difference. Trust me, in a house full of eight kids, you notice when they calm down. Three of them had a diagnosis of ADHD and it really did make a difference in their behaviors and their ability to concentrate.

Will soon visit Khewra salt mine with my children and plan to buy salt lamps from there for ADHD and Allergy IA

[faheemakbar18]

My father is type 2 diabetic. diagnosed in 2000 (15 year now)
Age 58
He was on glucophage some other meds and later on glimate 500mg with each meal. Until 2014 q1, he was ill and his sugar levels were high. Doctor increased glimate (metformin hcl) dose to 1000mg for a week but it didnt work. He then put him on neodipar 850mg (1+1) mixtard 30 penfill and settled units were 22 in morning and 18 in night. There were 2 sugar going down incident. In 1st he lost consciousness. in 2nd it was not that low and we went straight to emergency and again it was in control until now. Morning before meal is around 200 and post meal until night 300
Doctor has increased units to 35 morn 25 eve and again to glucophage (1+1+1)
But sugar aint going down. He feel weakness as well.
He is also treated for blood pressure. angina and angiography was recommended
His blood pressure was high as 170/100 avg but now after 3 weeks last reading was 140/80

Please suggest me what should be done to bring his sugar level down

Sent from my Infinix-X551 using Tapatalk

[Glioblastoma]

My father is type 2 diabetic. diagnosed in 2000 (15 year now)
Age 58
He was on glucophage some other meds and later on glimate 500mg with each meal. Until 2014 q1, he was ill and his sugar levels were high. Doctor increased glimate (metformin hcl) dose to 1000mg for a week but it didnt work. He then put him on neodipar 850mg (1+1) mixtard 30 penfill and settled units were 22 in morning and 18 in night. There were 2 sugar going down incident. In 1st he lost consciousness. in 2nd it was not that low and we went straight to emergency and again it was in control until now. Morning before meal is around 200 and post meal until night 300
Doctor has increased units to 35 morn 25 eve and again to glucophage (1+1+1)
But sugar aint going down. He feel weakness as well.
He is also treated for blood pressure. angina and angiography was recommended
His blood pressure was high as 170/100 avg but now after 3 weeks last reading was 140/80

Please suggest me what should be done to bring his sugar level down

Sent from my Infinix-X551 using Tapatalk

Well there are two important issues to address here lets do it individually:

1. High Sugar levels: The sugar levels are way above the limit meaning his insulin is not being titrated properly. In morning before meals i.e. fasting sugar must be less than 125 and 2 hours after meal less than 200. Best advice I can give you is go to a specialist endocrinologist. They are experts in this field. It would be very easy for them to adjust the dosage properly. I can suggest you very good ones in lahore, islamabad or karachi whichever is nearer. Usually in such patients a long acting insulin meaning it works for 24hrs and added with it after meals is regular or other short acting insulins. Strange that even on insulin the metformin has not been discontinued. But please do not discontinue it by yourself go to a specialist.

2. Blood pressure is too high. It should be lower than 140/90. So ace inhibitor or arb's are best treatment for hypertension in diabetics as they provide dual role of lowering BP and protection of kidneys slowing development of diabetic glomerulopathy.

In summary go to a specialist endocrinologist and a good reputed one. Also if angiography needs to be done go to a reputed hospital in Karachi lahore pindi/islamabad and in such a tertiary care unit they will be able manage the other problems as well.

[faheemakbar18]

Well there are two important issues to address here lets do it individually:

1. High Sugar levels: The sugar levels are way above the limit meaning his insulin is not being titrated properly. In morning before meals i.e. fasting sugar must be less than 125 and 2 hours after meal less than 200. Best advice I can give you is go to a specialist endocrinologist. They are experts in this field. It would be very easy for them to adjust the dosage properly. I can suggest you very good ones in lahore, islamabad or karachi whichever is nearer. Usually in such patients a long acting insulin meaning it works for 24hrs and added with it after meals is regular or other short acting insulins. Strange that even on insulin the metformin has not been discontinued. But please do not discontinue it by yourself go to a specialist.

2. Blood pressure is too high. It should be lower than 140/90. So ace inhibitor or arb's are best treatment for hypertension in diabetics as they provide dual role of lowering BP and protection of kidneys slowing development of diabetic glomerulopathy.

In summary go to a specialist endocrinologist and a good reputed one. Also if angiography needs to be done go to a reputed hospital in Karachi lahore pindi/islamabad and in such a tertiary care unit they will be able manage the other problems as well.

thank you doc.
lahore is 1 night drive from here. so is karachi. so I will have to arrange for this trip . I live in Rahimyar khan
his last Bp reading was 140/80 done today in evening

he is currently on following meds which his new physician gave
eziday 100mg (1 + 1)
nitromint retard 2.6mg (1+1)
concor 5mg (1+1)
lipirex 10mg ( 1 in night)
glucophage 500mg (1+1+1)
ascard plus (1 in morning)