PW Health Clinic

[Glioblastoma]

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)

At least all the medications he is on are correct. Except metformin which is debatable. But other than that I see no problems. If insulin is given in proper combination I think his sugar levels will be controlled easily. Blood pressure is on borderline it should be lower than this as he is on three antihypertensives. Go to a endocrinologist an expert one For karachi or lahore:

Lahore endocrinologist Shaukat khanum Dr. Syed abbas raza

Karachi Endocrinologist Aga khan Dr Muhammad Qamar Masood

For cardiologist Lahore shaukat khanum and ittefaq hospital Dr. Faizur rehman practices at both places and shaukat khanum only dr. nauman naseer.

For Karachi cardiologist Tabba heart institute Dr. Bashir hanif or Dr. Asad Pathan, National medical center Dr. zia yaqoob, south city hospital dr. sajid dhakam.

My sincere advice would be to get him admitted in shaukat khanum so they can review his medication and also do angiography as required.

[Horse_rider]

My ALT is 102 ref max 42, while HB 17.2 ref max 16. They told me that your blood is thick. O2 defusion shows 95%. US shows fatty lever. Drink more water is advised, while I am not smoking and drink a lot of water.

Sent via tapatalk

[Glioblastoma]

My ALT is 102 ref max 42, while HB 17.2 ref max 16. They told me that your blood is thick. O2 defusion shows 95%. US shows fatty lever. Drink more water is advised, while I am not smoking and drink a lot of water.

Sent via tapatalk

Did you get your viral markers done, HBsAg, HCV antibody. If not get them done. Fatty liver is a common disease which can lead to severe liver damage. Most commonly related to obesity but there are other causes as well. What is your BMI. A more common form worldwide of this disease is called alcoholic fatty liver disease in people who drink alcohol. But in our country its other form non alcoholic fatty liver disease is more common due to obesity and other causes. Here is some literature to read regarding it.

Nonalcoholic fatty liver disease Causes - Mayo Clinic
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/Default.htm
http://www.medscape.com/viewarticle/757336_3

The blood problem you are telling high hemoglobin is called Polycythemia but it occurs if it is greater than 18 so I think you are fine. Keep drinking water for it. Also better if you can donate blood once in three months that is the best way to control it. It is common in people who are smokers or alcoholics or are professional athletes if they are doping. But I do not think these problems are with you.

If you smoked previously then try to quit and it will normalize with the passage of time. But there are also many other causes of polycythemia and it is a extremely lengthy chapter so try searching it.

[ahmed2396]

My mother is on Extor 10/160 amlodopine valsartan, she is hyper tension patient from last 12 yrs and is constantly on hypertension pills but still her bp is around 150/90 160/90, ecg echo ett all are good, recently had all her checks done from afic rwp Maj Gen Shahab Naqvi commadant afic/nihd

[ahmed2396]

Did you get your viral markers done, HBsAg, HCV antibody. If not get them done. Fatty liver is a common disease which can lead to severe liver damage. Most commonly related to obesity but there are other causes as well. What is your BMI. A more common form worldwide of this disease is called alcoholic fatty liver disease in people who drink alcohol. But in our country its other form non alcoholic fatty liver disease is more common due to obesity and other causes. Here is some literature to read regarding it.

Nonalcoholic fatty liver disease Causes - Mayo Clinic
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/Default.htm
http://www.medscape.com/viewarticle/757336_3

The blood problem you are telling high hemoglobin is called Polycythemia but it occurs if it is greater than 18 so I think you are fine. Keep drinking water for it. Also better if you can donate blood once in three months that is the best way to control it. It is common in people who are smokers or alcoholics or are professional athletes if they are doping. But I do not think these problems are with you.

If you smoked previously then try to quit and it will normalize with the passage of time. But there are also many other causes of polycythemia and it is a extremely lengthy chapter so try searching it.

one of my cousin had this issue he used to be well hydrated around 12-14 glasses a day and donated 2 bottles blood every two months and he was good

[Glioblastoma]

My mother is on Extor 10/160 amlodopine valsartan, she is hyper tension patient from last 12 yrs and is constantly on hypertension pills but still her bp is around 150/90 160/90, ecg echo ett all are good, recently had all her checks done from afic rwp Maj Gen Shahab Naqvi commadant afic/nihd

Well if the BP is not controlled on two medications a third is usually added to lower the BP.

But if it is not controlled on three BP lowering meds than we should rule out secondary causes of hypertension although all are rare but can be present like pheochromocytoma, conn's syndrome, renal artery stenosis to name a few.

My sincere advice would be get her medications reviewed now by a different doctor, here is a list of qualified general physicians at shifa international:

Maj. Gen. (R) Dr. S. Tauqeer A. Shah
Wajid Yar Khan
Shahzad Khan Siddique
Aamer Nazir Ahmad
Mian Amjad Sohail
Mazhar Ali Mufti

Or if you are looking for a good cardiologist here are some good ones at shifa international islamabad Dr. Habib ur rehman, dr. yusuf hassan, Dr. muhammad asad ali saleem.

[ahmed2396]

Well if the BP is not controlled on two medications a third is usually added to lower the BP.

But if it is not controlled on three BP lowering meds than we should rule out secondary causes of hypertension although all are rare but can be present like pheochromocytoma, conn's syndrome, renal artery stenosis to name a few.

My sincere advice would be get her medications reviewed now by a different doctor, here is a list of qualified general physicians at shifa international:

Maj. Gen. (R) Dr. S. Tauqeer A. Shah
Wajid Yar Khan
Shahzad Khan Siddique
Aamer Nazir Ahmad
Mian Amjad Sohail
Mazhar Ali Mufti

Or if you are looking for a good cardiologist here are some good ones at shifa international islamabad Dr. Habib ur rehman, dr. yusuf hassan, Dr. muhammad asad ali saleem.

she has visited most of them you listed and dr habib ur rehman too. I guess her anxiety and depression elevates her bp. normal bp for her on good day is 150/90 i never saw her lower number 80 or 85. and what are chances that a person will get hypertension if his both parents have hypertension and grandparents too.

[bradleo555]

Doc, I fell from the bike two months back and immediately got tetanus shot. Yesterday I was in a construction site and I got hit slightly from a rusty iron in the foot. There was few drops of blood too, but I immediately washed it. After 18 hours, I went to doctor and he said I should get tetanus shot immediately and gave me antibiotic along with Mycitracine to apply in the wound. The wound had developed puss which I cleaned and applied Mycitracine. I've again got the tetanus shot and took only I capsule (500mg) till now. I forgot to tell the doctor that I already had tetanus shot a couple of months back. These antibiotic course is too strong for me. I just read in internet that one tetanus shot is good enough for 5 years. Please guide me asap. JazakAllah

[s55]

Guys, I need to know the possible proven remedies to reduce the pain caused by Rheumatoid Arthritis (RA) and to slow down RA. The patient has been taking Methotraxate injections 15 mg/week for the last few years and but for the last few months having a lot of pain in the whole body, pain killers are not helping much. I was thinking that the doctors are doing what they can but there must be some other ways to treat RA as well. Like I am looking for Tib-e-Nabvi regarding this. I saw one study regarding the effectiveness of Nigella Sativa oil capsules on RA patients (Effectiveness of Nigella sativa oil in the management of rheumatoid arthritis patients: a placebo controlled study. - PubMed - NCBI).
Please share your personal experiences and anything that could help. I am very worried. Thank you!

[saddiqbhatti]

hello Guys,
i'm from lahore.and i have a big eye-site number.i'm searching a dr. / a hospital where i go for refractive surgery.then i reached Amanat Eye Hospital LAhore.and i proceed my procedure from amanat eye hospital.now i'm fine and my vision 6/6.i'm very happy without facing any issue.i'm very lucky that i found amanat eye hospital.now i don't need glasses and live without glasses.i shared my expeiriance with others.
thanx to AMANAT EYE HOSPITAL.:)

[Glioblastoma]

she has visited most of them you listed and dr habib ur rehman too. I guess her anxiety and depression elevates her bp. normal bp for her on good day is 150/90 i never saw her lower number 80 or 85. and what are chances that a person will get hypertension if his both parents have hypertension and grandparents too.

If it runs in the family then one must monitor it regularly and high chances it might develop sometime.

That value is too high 150/90 it should be less than 150/90 if she does not have diabetes and chronic kidney disease.

I think matter must be discussed with some expert to add another antihypertensive. Here is something for you to read:

New Blood Pressure Guidelines | Berkeley Wellness
http://bestpractice.bmj.com/best-practice/monograph/1071.html

[ahmed2396]

If it runs in the family then one must monitor it regularly and high chances it might develop sometime.

That value is too high 150/90 it should be less than 150/90 if she does not have diabetes and chronic kidney disease.

I think matter must be discussed with some expert to add another antihypertensive. Here is something for you to read:

New Blood Pressure Guidelines | Berkeley Wellness
http://bestpractice.bmj.com/best-practice/monograph/1071.html

She was taking two hypertensives 1) Extor 10/160 2) Calan 40
Calan has valsartan and extor also has valsartan but extor has multi ingredient amlodipine 10mg valsartan 160mg, and calan has valsartan 40mg so doctor said to quit calan.

[Glioblastoma]

She was taking two hypertensives 1) Extor 10/160 2) Calan 40
Calan has valsartan and extor also has valsartan but extor has multi ingredient amlodipine 10mg valsartan 160mg, and calan has valsartan 40mg so doctor said to quit calan.

I can understand what you are saying but let me correct you calan has verapamil not valsartan. Verapamil is a calcium channel blocker class of antihypertensive.

Extor has valsartan and amlodipine, amlodipine is also a calcium channel blocker that is why he stopped calan because both are same class of antihypertensive. Valsartan is angiotensin receptor blocker(arb) class of antihypertensive.

When I say a third drug should be added it means other than these two drugs that are present in extor i.e. valsartan(is an arb) and amlodipine(calcium channel blocker). There are many other class of antihypertensives like diuretics, adrenergic receptor blockers, vasodilators, aldosterone receptor antagonist, alpha adrenergic agonists, renin inhibitors to name a few.

So discuss addition of new class of antihypertensive drug with extor with your doctor.

[Glioblastoma]

Doc, I fell from the bike two months back and immediately got tetanus shot. Yesterday I was in a construction site and I got hit slightly from a rusty iron in the foot. There was few drops of blood too, but I immediately washed it. After 18 hours, I went to doctor and he said I should get tetanus shot immediately and gave me antibiotic along with Mycitracine to apply in the wound. The wound had developed puss which I cleaned and applied Mycitracine. I've again got the tetanus shot and took only I capsule (500mg) till now. I forgot to tell the doctor that I already had tetanus shot a couple of months back. These antibiotic course is too strong for me. I just read in internet that one tetanus shot is good enough for 5 years. Please guide me asap. JazakAllah

If he gave you another tetanus shot no problem. Don't worry.

Problem is antibiotic course only one capsule is too short. If wound has developed pus and the iron was rusty high chances of infection which can lead to sepsis, so the antibiotic course must have continued for at least 5-7days. By the way which antibiotic is it? What do you mean by too strong?

Continue applying the ointment.

[Glioblastoma]

Guys, I need to know the possible proven remedies to reduce the pain caused by Rheumatoid Arthritis (RA) and to slow down RA. The patient has been taking Methotraxate injections 15 mg/week for the last few years and but for the last few months having a lot of pain in the whole body, pain killers are not helping much. I was thinking that the doctors are doing what they can but there must be some other ways to treat RA as well. Like I am looking for Tib-e-Nabvi regarding this. I saw one study regarding the effectiveness of Nigella Sativa oil capsules on RA patients (Effectiveness of Nigella sativa oil in the management of rheumatoid arthritis patients: a placebo controlled study. - PubMed - NCBI).
Please share your personal experiences and anything that could help. I am very worried. Thank you!

Pain for rheumatoid arthritis(RA) if not controlled by methotrexate then next step in management is to move to anti-TNF inhibitor class of drugs. Either added with methotrexate or alone. But they are quite expensive.

If anti-TNF fails we can move to anti-CD20 mab, which have shown to be effective.

Regarding drug adjustment and changes please discuss what I have told with your physician and best if he is a rheumatologist. If you need a rheumatologist tell I can advise accordingly.

It might work nigella sativa oil as it is on pubmed but problem is finding it in pure form, get it imported from abroad like US, UK, AUS, Canada, Saudia arabia. But what I have experienced with osteoarthritis patients the natural remedy that works brilliantly is consume 1 tablespoon of tugh malanga aka tughm-e-balanga aka chia seeds 2- three times a day. Procedure is to soak 1 tablespoon in water for 20-25min. and then consume it. So far what I have read it should work for RA as well.

[bradleo555]

If he gave you another tetanus shot no problem. Don't worry.

Problem is antibiotic course only one capsule is too short. If wound has developed pus and the iron was rusty high chances of infection which can lead to sepsis, so the antibiotic course must have continued for at least 5-7days. By the way which antibiotic is it? What do you mean by too strong?

Continue applying the ointment.

Doctor as soon as I cleaned the puss, The next day wound has got all normal (No pain, no itchy feeling), I mean it has healed. Antibiotic was Velosef 500mg and I only took 1 capsule. All the antibiotics are too strong for me. Makes me weak, sleepless, untimely hunger, restless etc.

[Glioblastoma]

Doctor as soon as I cleaned the puss, The next day wound has got all normal (No pain, no itchy feeling), I mean it has healed. Antibiotic was Velosef 500mg and I only took 1 capsule. All the antibiotics are too strong for me. Makes me weak, sleepless, untimely hunger, restless etc.

Wound becoming normal does not mean the infection has been cleared in depth or in blood. When you punctured your skin bacteria might have gone in the blood and that is why they need to be cleared. So these symptoms can be tolerated but the resulting sepsis if you have not completed the antibiotic course is a more grave situation.

So my sincere advice would be to complete the course.

[bradleo555]

Wound becoming normal does not mean the infection has been cleared in depth or in blood. When you punctured your skin bacteria might have gone in the blood and that is why they need to be cleared. So these symptoms can be tolerated but the resulting sepsis if you have not completed the antibiotic course is a more grave situation.

So my sincere advice would be to complete the course.

Doctor I just read your this message. I'm having nazla, zukam, galley mei kharash and mild pain in the teeth of upper jaw from two days. Coudn't start the antibiotic course. Had tetanus injection after 22 hours. Are these things related? Please tell me its not.
Secondly please advice me on another matter too. My right armpit is bit swollen compared to the left one. It causes slight pain occasionally. Its not swollen lymph node, as I got it checked from a specialist. Its been there from Ramzan. What it could be and how it can be solved? I use prickly heat powder too.

[Glioblastoma]

Doctor I just read your this message. I'm having nazla, zukam, galley mei kharash and mild pain in the teeth of upper jaw from two days. Coudn't start the antibiotic course. Had tetanus injection after 22 hours. Are these things related? Please tell me its not.
Secondly please advice me on another matter too. My right armpit is bit swollen compared to the left one. It causes slight pain occasionally. Its not swollen lymph node, as I got it checked from a specialist. Its been there from Ramzan. What it could be and how it can be solved? I use prickly heat powder too.

You are having fever and sore throat symptoms before or after you got the injection.

If before having the injection not to worry.

If after the injection, then it is very rare to have fever with this injection but can occur but person only gets fever. If sore throat and other symptoms along with fever it is likely a viral or bacterial infection and not related to your tetanus shot.

This swollen armpit of yours if not lymph nodes than it could be infection of glands but there will be warmth or redness or pain but you are not describing these symptoms, so most probably it can be a lipoma but cannot be sure at all without examination so go to a general surgeon for complete investigation.

[Horse_rider]

Did you get your viral markers done, HBsAg, HCV antibody. If not get them done. Fatty liver is a common disease which can lead to severe liver damage. Most commonly related to obesity but there are other causes as well. What is your BMI. A more common form worldwide of this disease is called alcoholic fatty liver disease in people who drink alcohol. But in our country its other form non alcoholic fatty liver disease is more common due to obesity and other causes. Here is some literature to read regarding it.

Nonalcoholic fatty liver disease Causes - Mayo Clinic
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/hepatology/nonalcoholic-fatty-liver-disease/Default.htm
http://www.medscape.com/viewarticle/757336_3

The blood problem you are telling high hemoglobin is called Polycythemia but it occurs if it is greater than 18 so I think you are fine. Keep drinking water for it. Also better if you can donate blood once in three months that is the best way to control it. It is common in people who are smokers or alcoholics or are professional athletes if they are doping. But I do not think these problems are with you.

If you smoked previously then try to quit and it will normalize with the passage of time. But there are also many other causes of polycythemia and it is a extremely lengthy chapter so try searching it.

Doctor, My HBsAg, Uric acid and HCV found to be in normal range, my BMI is 28.4 I smoked regularly back in 2006-2012~
Should I donate blood to control my HB?

Sent via tapatalk