PW Health Clinic

[Glioblastoma]

Salaam Doc
What will be current palliative treatment for shingles( H zoster)
Thanks
My mom who is 85 just came down along the right waste area

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First of all she should been given herpes zoster vaccine to get this prevented. But now she has it go to a infectious disease specialist in lahore there are some brilliant ones in shaukat khanum try anyone: Dr. Ashraf Ali Khan Dr. Faisal Sultan Dr. Yasser Hussain.

The usual treatment consists of anyone of antiherpetic medications: acyclovir, valganciclovir, famciclovir. But only an ID specialist well versed in using these drugs can prescribe correctly and knows how to manage such a case. Along with these pain killers, steroids (controversial use) and anticonvulsants (TCA can be used but is not an anticonvulsant) can be used.

Local treatment of rash consists of lotions and antiseptic creams.

Best advice go to infectious disease specialist immediately for proper management. Here are some articles to read:

Medscape: Medscape Access
Shingles Causes - Mayo Clinic
https://www.nlm.nih.gov/medlineplus/ency/article/000858.htm

If the acute phase has passed then the pain usually remains if the person was not properly treated in acute phase, this pain is called postherpetic neuralgia for that TCA's or anticonvulsants like gabapentin, pregabalin, phenytoin, carbamazepine can be used to decrease pain. Local capsaicin creams may benefit. Again go to a neurologist(dr. moquit usman ittefaq hospital or dr. qasim bashir shaukat khanum) or infectious disease specialist if this is the case.

[metalhead]

@glioblastoma
Thanks doc. for the detailed answer.
OK I will consult with the surgeon ASAP.
I have not seen or heard of a doctor that treat the gallstone by medication. All say to remove the gall blaster entirely. Why not take out the stones only? And why not to use any medicine to dissolve it?
The bladder is there for a purpose. Isn't it?
Can you please comment on this.
Thanks once again for your kind reply.

[Glioblastoma]

@Glioblastoma
Thanks doc. for the detailed answer.
OK I will consult with the surgeon ASAP.
I have not seen or heard of a doctor that treat the gallstone by medication. All say to remove the gall blaster entirely. Why not take out the stones only? And why not to use any medicine to dissolve it?
The bladder is there for a purpose. Isn't it?
Can you please comment on this.
Thanks once again for your kind reply.

The gallstones can be dissolved by medications and medications are available in the market, I also know of them but will never recommend you.

These medications are used when stones are too small and are not giving any symptoms or the patient due to some reason cannot undergo surgery. In such circumstances under expert care these medications are prescribed. You are young healthy have no contraindications to surgery and lastly the most important stones are giving you symptoms.

Why not remove stones only this has been tried and once a gallbladder has propensity to form stones it will do so very quickly again, so that is why to prevent people from undergoing continuous surgery it is removed once and for all. Also stones damage the lining of gallbladder and hence causing chronic inflammatory changes and hence predisposing to cancer of gallbladder(cholangiocarcinoma). Read this GALLBLADDER CANCER AND BILE DUCT CANCER: TYPES OF CANCER

The function of the gallbladder is to store bile only. If there is no gallbladder then bile which is produced by the liver cannot be stored in large quantities. So main function of bile is to digest fats. So without gallbladder the capacity to digest fats decreases but you can still digest them as bile is produced by the liver. So therefore after gallbladder removal you are advised by every surgeon not to consume large quantities of fatty and oily foods. In summary removal of gallbladder does not impact the functions of the body that much.

[metalhead]

Thanks again for such detailed reply.

[zalamng]

Unfortunately she was not vaccinated. Now I think the idea of vaccination is mute. Some local doctor there has already prescribed ACTCLOVIR for her plus some topical and pain killer!
Is ZOVIRAX Topical of any help?

First of all she should been given herpes zoster vaccine to get this prevented. But now she has it go to a infectious disease specialist in lahore there are some brilliant ones in shaukat khanum try anyone: Dr. Ashraf Ali Khan Dr. Faisal Sultan Dr. Yasser Hussain.

The usual treatment consists of anyone of antiherpetic medications: acyclovir, valganciclovir, famciclovir. But only an ID specialist well versed in using these drugs can prescribe correctly and knows how to manage such a case. Along with these pain killers, steroids (controversial use) and anticonvulsants (TCA can be used but is not an anticonvulsant) can be used.

Local treatment of rash consists of lotions and antiseptic creams.

Best advice go to infectious disease specialist immediately for proper management. Here are some articles to read:

Medscape: Medscape Access
Shingles Causes - Mayo Clinic
https://www.nlm.nih.gov/medlineplus/ency/article/000858.htm

If the acute phase has passed then the pain usually remains if the person was not properly treated in acute phase, this pain is called postherpetic neuralgia for that TCA's or anticonvulsants like gabapentin, pregabalin, phenytoin, carbamazepine can be used to decrease pain. Local capsaicin creams may benefit. Again go to a neurologist(dr. moquit usman ittefaq hospital or dr. qasim bashir shaukat khanum) or infectious disease specialist if this is the case.

Sent from my iPhone using PW Forums

[ehhaq]

Doc sir.. Any review about sovaldi (HCV medicane).. my mom is afraid of injection treatment so we have to adopt other available options..

[Glioblastoma]

Unfortunately she was not vaccinated. Now I think the idea of vaccination is mute. Some local doctor there has already prescribed ACTCLOVIR for her plus some topical and pain killer!
Is ZOVIRAX Topical of any help?

Sent from my iPhone using PW Forums

As I told you instead of local doctor go get treated by a infectious disease specialist. He will guide you better. But if she has been prescribed acyclovir orally then no need for topical acyclovir(zovirax).

[Glioblastoma]

Doc sir.. Any review about sovaldi (HCV medicane).. my mom is afraid of injection treatment so we have to adopt other available options..

There is nothing to be afraid about using injections. Sovaldi is a good medicine but only a specialist can tell which to use when. So most of the time it is not your choice what to use but the specialist will tell you what is better and he knows the best. So kindly do not delay treatment go to a good specialist and start treatment.

Since childhood children are given vaccine by injections and they cry then as doctors we shouldn't give them injections because they are afraid or they cry a lot? No never. We do what is best for the patient. So if specialist thinks injections is best for her she should start them if he thinks she must be on oral medications then she should start those.

So to summarize go to the above mentioned specialists at shaukat khanum and discuss the treatment options hopefully they will have oral medications as well, discuss everything and explain them your fears with injections hopefully a way would be found and the specialist can decrease your mother's fear regarding injectables better.

[Anyone]

Aoa,Which laboratory is best to get thyroid scan test in lahore.And what will be its cost? lahori members help plzzThanks

[butwhy]

There's many fun activities in lahore and places to visit such as :

-minar-e-pakistan
-badshahi mosque
-shalamar gardens
-jalo park
-wagha border

let's wait for what other members can share.....

[muradi]

There's many fun activities in lahore and places to visit such as :

-minar-e-pakistan
-badshahi mosque
-shalamar gardens
-jalo park
-wagha border

let's wait for what other members can share.....

He has not asked for a picnic point. He is asking for a laboratory for a Thyroid test. -_-

[muradi]

Get it done from an Agha Khan Laboratory. Cost is around 1500 i guess.

[Anyone]

^ bro that is t3,t4,tsh test which you are taking about,and that costs 2960 from agha khan.thyroid scan is another test.

[nasirjavaid]

Dear Doc, My son was having chest congestion since last week. Nablized him with Clenil C for a day and then with Ventoline.. Congestion is almost gone but since yesterday his body is warm and feeling temperature with some runny nose. So gave him Arinac 3 times a day but still its not better.

By looking at prescriptions of his doc since 3 years I found there are certain antibiotics repeated in these 3 years. Here is the list

• Bactizith + Cofcol Elixer + Tercica
• Cefim DS + Tercica
• Megaclor + Cofcol Elixer + Tercica
• Azomax + Brufen + T-Day
• Cefguard +Tercica

So can I choose a combination from above for him as today clinic was close. I am more inclined towards Bactizith combination. Or should I get him checked?

(Please note he is taking Vepridone 0.25ml twice a day for ADHD+mild Autism )

Thanks

Edit: He vomits any solid food

[Glioblastoma]

^ bro that is t3,t4,tsh test which you are taking about,and that costs 2960 from agha khan.thyroid scan is another test.

Get it done from shaukat khanum, for cost call them up find their phone on shaukatkhanum.org.pk

[Asifijaz]

@anyone

Thyroid Scan:
Options are
Anmol
Mayo Hospital
SKMCH
I have referred many patients to Anmol as well. Never had any complaints

@ ehhaq
SOLVADI:
New miracle treatment for Hep C. Effectively cures it in close to or above 90%. Since the marketing rights were given by Gilead to Ferozsons and the price is very very very low in Pakistan hence theses need to be prescribed by a Gastroenterologist or in some cases by a professor of medicine. You would need to submit the precription / request along with the copy of the ID card to the company at designated places or via your doctor. Medicine price is 33,000 per month. Associated meds (Ribavarin + Health supliments + etc) cost around 3000 to 4000 more. Tests need to be done regularly to monitor your kidneys, liver and atleast qurterly viral load is calculated. Keeping all in mind you would spent close to 40 - 42 thousand per month.
If you have Genotype 1, Genotype 2 or Genotype 4 of the virus then the duration of treatment is 12 weeks and in case of Genotype 3 the treatment is for 24 weeks. If your mom is scared of Injections then before you convince her otherwise first find out what genotype of the Hep C virus is she infected with... as its only with Genotype 1 and 4 that you need a wkly Interferon injection. Genotype 2 and 3 are more prevalent locally....and do not require interferon injection.
Bottom Line:
If you can afford it.. then Solvadi will surely cure you as success rate is close to or above 90%. No other treatment regimen gives you that much success rate

[ehhaq]

Thanks @asifijaz for this breif description. Mom is coming today to lahore for genotype test and sovaldi treatment afterward. She saw some patients with bad effect of injections that's why she is not accepting inj. We have mentlly prepared for sovaldi treatment.
Any idea after how much interval we have to go for checkup while having sovaldi treatment. Like 1week, 15 days, 1month??

[Asifijaz]

in start every week... after a month.. on a monthly basis..
its 3 months duration in most cases .. including every delay it will be a max 4 months duration... if possible keep her in Lahore. rest your call

[Anyone]

@asifijaz,Doctor recommended 2tests,one is t3,t4,tsh and other thyroid scan.t3,t4,tsh came out normal,so now should i go for thyroid scan or it is not necessary,?in the past i was hyperthyroidism patient. if i press my thyroid there is little cough.and can you tell me,how much a anmol charge for thyroid scan, ?many thanks

[Asifijaz]

cost is 2020 rupees Without the thyroid profile. if you had a thyroid profile a wk or two earlier... then take your reports along and mention it the desk clerk or receptionist that you only want thyroid scan.
Now should you go for a scan or not is a tricky question. Based upon your past history of hyper i would say go for it.if nothing else you would know the base values.