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Thread: Medical Question with Answers.. 2

  1. #11
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    How can I be sure whether or not I am HIV positive?


    Q. I am 29 years old and had unsafe sex with a friend and later I came to know that she was HIV positive. I took a course of n-PEP (non-occupational post-exposure prophylaxis) for 28 days. I got HIV DNA PCR test done 2 months after exposure and 1 month after taking PEP and the result was negative. I got RIBA test done, a month after the previous test and result was negative. I got the RIBA test done again 2 months after the previous test and the result is as follows: HIV 1 Gp 120 – negative, HIV 1 Gp 41 – negative, HIV 2 envelope peptide – negative, HIV 1 p31 – negative and HIV 1 p24/HIV II P26 - positive. Interpretation: indetermine. The doctor has asked me to get a CD4 count, CD8 count and a viral load test done. Am I really HIV positive? My doctor says no, until the confirmatory test is done. I want to know what are my chances? My doctor told me if the viral load is less then I can be cured permanently. Is this true?


    A. First, I must tell you that every sexual exposure with a HIV positive person does not result in acquiring HIV infection. Secondly the unfortunate fact is that false positive HIV tests are not uncommon and as your doctor has rightly told you, a confirmatory test must be done with all HIV positive reports. I suggest that you wait until six months have passed since the risk exposure and get an ELISA test done from any reliable testing centre. If the report is negative, accept the result and forget about it. If it is positive allow your treating physician advise you. Do not rush into anti-retroviral treatment at this stage

  2. #12
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    Does recurrent cold cough in childhood stay lifelong?


    Q. I have a 2 years old son. He always has a cold and cough. When he gets a cold, cough also starts. From 2 years he has been facing this problem. Some doctors say that this will go away after 4 years. But some doctors say it will never go and can stay lifelong. Is this true? What is the problem? It is asthma or bronchitis?

    A. Most of these babies who suffer from recurrent cough & cold have allergic coughs and it can also be named as Childhood Asthma. Many of these babies outgrow this by the age of 6 - 8 years. However, some babies may carry this into adulthood.

  3. #13
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    What is Primary hypotrophic osteoarthropathy?


    Q. I am 34 years old and been living with swollen extremities and limited flexibility, although no pain, for the past 3 years. After numerous x-rays, a bone scan and MRI, an orthopaedic doctor has diagnosed me with a rare disease called Primary hypotrophic Osteoarthropathy (HOA). When viewing the x-rays, the fibula and tibia on both legs do not have a defined shape to them rather they appear much thicker than a normal persons. My fingers also look much larger than a normal persons hand. This condition of enlarged bones also occurs from my elbow down to my wrist. Accompanying symptoms include swelling of extremities due to water retention, which gradually gets worse as the day goes on. If I am able to raise my feet while sitting or lying down, the condition is not so severe, however if I do not, at the end of the day they become quite swollen. The doctor says that longer observation of the bones is needed in order to treat the condition. I haven't been able to find sufficient information on the topic. Can you please give me more information, including examples of this condition and where to look for information? The water retention is very uncomfortable and unsightly. Is there a treatment other than just lying down and waiting for the water to drain? Are there any medications that can aid in the easing of this retention, which causes reduced flexibility and limited movement?

    A. Primary hypotrophic osteoarthropathy is a rare condition, which is seen in some persons. The cause of this is not clearly understood, however, the presentation is as you have explained. There is no definite treatment for this. Most patients are able to manage without significant disability. If you have gross swelling then you may need to consult a physician (not an orthopaedic surgeon) to manage the swelling without having to take recourse to a bed rest and elevation. The details on this condition are available on the net however all of them would be too technical for a lay person.

    As far as recent advances are concern there are some reports that Biphosponates help in some patients. Another drug used in breast cancer Tamoxyfen has been reported to be useful in two patients. These are all anecdoted reports not supported by solid evidenced based research. Do consult a Physician (Rheumatologist) for further advice.

  4. #14
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    Am I suffering from OCD?


    Q. I am a 28 years old male and a teacher by profession. My problem is that I don’t have any control over myself. I do nonsense things even though I know they are wrong, for example, I take ten to twelve cups of tea, eat a lot of outside food, and never concentrate on my work. I feel that there is no coordination between my mind and myself. I always go against my mind. I feel that I am controlled by some one else. Doctors told me that it is obsessive-compulsive disorder (OCD). But I doubt that it is OCD or simply lack of will power. Please help.

    A. Since I cannot diagnose your problem from the brief details, here is what I can tell you that might be helpful.

    People with OCD (obsessive-compulsive anxiety disorder) often do just the kinds of things that you describe yourself as doing. You need to get yourself examined by a competent mental health professional to make a correct diagnosis to see if your symptoms are caused by a different illness. If the examination is negative for other illnesses, it is a good bet that you have OCD.

    OCD is a specific type of anxiety disorder. Many people with OCD have other anxiety symptoms as well, but some OCD patients bind their anxiety so effectively with their obsessions, compulsions, and rituals, that they have no other anxiety symptoms; the OCD does the trick.

    There are two different approaches to treating OCD, and they can be combined.

    One is high dose of a Selective Serotonin Reuptake Inhibitor (SSRI). These medicines usually have few side effects, and will significantly reduce OCD symptoms such as the ones you describe.

    The other treatment is Cognitive-Behavioural psychotherapy. This, too, is effective, and does not depend on use of medication. Both treatments tend to be more effective if the patient and the treating mental health professional work first to understand the source of the anxiety. In some individuals the anxiety can be traced to stress in childhood or adolescence. In others, the main cause is genetic; coming from a family in which many members are anxious. But in either case, one of the above treatments is likely to be needed.

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    Is it safe to take medicines during pregnancy?


    Q.
    I am 20 years old lady, three months pregnant. I am suffering from cough and vomiting. I am on Omez, Mucaine gel, Pregnidoxin, Grilinctus cough suppressant. I just want to ask are these medicines safe during pregnancy?

    A. I am afraid, Omez (omeprazole) is contraindicated (not permitted) during pregnancy and hence should not be used. Pregnidoxin (due to presence of meclizine) should also not be taken during pregnancy. Mucaine Gel (due to presence of oxethazine) should not be taken during the first and second trimester of pregnancy. Grilinctus (due to presence of dextromethorphan) should also not be taken during pregnancy. One should avoid all medicines during the first three months except mandatory agents such as folic acid which must be taken to prevent birth defects. For vomiting the only permitted medicine is Queezy (which contains doxylamine and vitamin B-6). The dose is 2 tablets at bedtime; if required one more tablet the following morning and one in the afternoon. For cough it is better to rely on steam inhalation.

  6. #16
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    How safe is tobacco laced toothpaste?


    Q. A toothpaste by name IPCO is being marketed by a company in Gujarat. This toothpaste contains tobacco. It is being advertised as a solution to stop smoking. I want to ask how this affects the health of a prolonged user?

    A. IPCO (Indubhai Patel & Co) Creamy Stuff is not a toothpaste but tobacco in another form claimed to be less harmful than chewing tobacco. Since it is not classified as a medicine, its claims on safety and efficacy have not been verified by any independent authority. One should be extremely cautious in patronizing such untested agents since their long term effects are not known. In any case there are approved drug therapies to help stop smoking such as Zyban.

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    How long does lymphadenitis take to subside?


    Q. I am 31 years old male. I have a lymph node inflammation on the right side of the neck since the last 5 days. I went to an ENT who confirmed that it’s a lymph node inflammation and is treating it as lymphadenitis - non-specific cause. He has put me on Allegra 120 mg tablets and paracetamol tablets for 3days. ENT examination was normal. There is no pain when I turn my neck to the left side but very slight pain when I turn to the right and try to touch my shoulder blade with my chin. I want to know how long will it take to subside?

    A. The commonest reason for lymph nodes to appear is as a reaction to a local infection, thus called reactive lymphadenitis. In most cases this will subside over a few days to weeks, although one may be still left with a small soft enlarged node. In such a case, no further treatment is required. If it does not settle, gets bigger, painful or if new nodes appear, further investigations may be advised.

    We advise you wait for a little while and have it re-examined. If at that stage there is any doubt, the easiest thing to do first is an ultrasound and guided FNAC (fine needle aspiration cytology), which will give you more information.

  8. #18
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    Is sugar free Natura safe for pre-diabetics?


    Q. I am a 59 years old male. I am pre-diabetic, mildly hypertensive and have had a CABG, 12 years ago. Currently, I am on Lorvas SR, Simvotin 10 and Colsprin. I take 200 ml of Tropicana orange juice without sugar every morning for the last 10 years and lead an active life with 5 km brisk walk and half hour yoga every morning. The orange juice has stopped the frequency of colds that I used to get earlier. I would like to stop the orange juice and replace it with lemon and sucralose based sugar free. How many lemons do I need to take for the same Vitamin C intake? Is sugar free Natura OK?

    A. Fresh orange juice not only tastes great, but has numerous health benefits. The nutrients found in citrus juices have very beneficial effects on the human immune system. The vitamins and minerals found in orange juice, including vitamin C, folate, fibre, and potassium all help reduce the risk of diseases like cancer, heart disease, and birth defects. Since you are having pre packed juice some of the benefits may be reduced as it is not freshly squeezed. You should try and have freshly squeezed juice instead.

    If you would like to replace the orange juice with lime juice the juice of one lime in a glass of water would suffice. Add 1/2 a teaspoon of honey instead of an artificial sweetener. To gain maximum Vitamin C, try having a guava everyday. It is one of the richest sources of vitamin C, having much more than orange or lime. Or you could have amla juice everyday which is also an excellent source of Vitamin C.

    Since you are pre diabetic, make sure you control your carbohydrate consumption during the day. Please speak to a registered dietician who can personalise a plan for you.

  9. #19
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    Why does my vision get blurred while reading?


    Q. I am 26 years old, suffering from blurred vision. Sometimes, while reading books, my vision gets blurred and I have to close my eyes at that time before proceeding further. Though this happens only sometimes, I have been facing this problem since my childhood. The doctor said that this might be due to vitamin deficiency. Otherwise, I have a good vision. Please advise.

    A. You either have slight hypermetropia (long sightedness) or extraocular muscle weakness, which decompensates after some time and gets better after some rest. See an optometrist or an eye specialist and you may need some glasses, which will control this condition.

    In any case, it is not serious and you don't need to worry about it.

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    What does my father's Echo report indicate?


    Q. My 51-year-old father underwent an Echo test. His report says no LVRWMA, no LVDD, mild MR, sclerotic AOV, trivial AR, good LV function, EF=60% and his TMT is positive at 4.6 mets. What does this mean?

    A. TMT positive at 4.6 mets generally indicates decreased blood supply to the heart due to blockages in the arteries. If the patient is asymptomatic, it is wise to have a double check with stress thallium test.

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