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Thread: Medical Questions with answers.. 3

  1. #91
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    What is the treatment for a lump in the breast?


    Q. My wife is 37 years old. Seven months back she developed a large moving lump in her left breast just after her monthly period. We got a mammography done, but the results were negative. The doctor advised some hormonal medicines and all was ok. Last month my wife took some medicines to postpone her periods. Just a day after her period this time, the same lump appeared. There is water discharge from the nipple (no blood). The doctor advised a needle biopsy test. She was in pain just after her periods but now it is receding. Is it possible that the mammogram could not detect malignancy in case the lumps are large? Can we wait till next month for the needle test? This is because I want to get it done in Mumbai instead of Jamshedpur where I am now. Please advise.

    A. Let me answer your question serially.
    Mammography is used to detect small, impalpable (which cannot be felt) breast cancers. There is no way, at least there are no published reports, that mammography can miss large breast tumours.


    Going by the history of your wife, the lump does not appear to be malignant because breast cancers are almost always painless to start with. However, there is no harm in getting a FNAC (needle test) done. You can also repeat a mammography supplemented by an USG of the breasts. Since there is a nipple discharge, a cytology of the fluid can also be done before a needle test is performed.
    Most likely your wife is having fibroadenoma of the breast, which is essentially benign, but can turn malignant in rare cases. If a fibroadenoma is diagnosed and she is symptomatic, then it can be surgically removed and the lump can be subjected to pathological examination.

  2. #92
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    How can I make my child stop biting nails?


    Q. My daughter is four years old and goes to school. She has developed a habit of biting nails. I get complaints from her class teacher that she eats erasers, pencils and chalks. I am a working mother. What steps should I take to kill this habit?

    A. There are several possible reasons for your child's behaviour.
    She may have worms, so first give her some deworming medicine, on the advice of a doctor on dosage, etc.


    She may be deficient in calcium. This may be taken care of by giving calcium tablets and making sure she has milk products in her diet.


    She may be anxious, because the school is new or the children unfriendly or the school work is difficult.
    I am not happy with your use of the phrase "kill the habit". Helping your child will not require violence, but love and patience. Please do consult a Pediatrician before you decide on the course of action.

  3. #93
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    Is my MCH level normal?


    Q. My mean corpuscular haemoglobin (MCH) is 32.3 pg. What does this mean?

    A. Current haematology analysers generate a large number of parameters pertaining to red blood cells, white blood cells and platelets, the three types of cells present in our blood. This result is called a complete blood count (CBC).

    Among the red cell parameters (or indices) generated is the mean corpuscular haemoglobin or mean cell haemoglobin (MCH). It is a measure of the average amount of haemoglobin present in a red blood cell. The normal value of MCH is about 26 to 34 pg and it changes with the change in the size (or volume) of a red cell. Small red cells (microcytes) contain less haemoglobin while larger red cells (macrocytes) contain more haemoglobin. The MCH value is interpreted along with other red cell indices and a peripheral smear examination to help classify anaemias.

  4. #94
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    How effective is Acetec 25 for the treatment of psoriasis?


    Q. I am a 39 years old female. I have been prescribed Acetec 25 for the treatment of psoriasis. How effective is that?

    A. Acetec (acitretin) is indicated in only severe, extensive, intractable and refractory cases of psoriasis not responding to other therapies. Babies born to women who have consumed this drug can be defromed; hence effective contraception is mandatory. Two forms of contraception should be use to make sure that if one method fails, the other prevents conception. The drug has large number of side effects such as dry skin, sticky skin, dermatitis, erosion of mucosa, erythema, pruritus, palmar and plantar exfoliation, inflammation of nose, nose bleed, nail fragility, conjunctivitis, dry eyes, bullous eruptions, vulvo-vaginitis, drowsiness, sweats, gingivitis, loss of hair, granulomatous lesions. Severe headache, GI upset, taste disturbances, eye disturbance (withdraw immediately and refer for neurological examination), decreased night vision. Liver toxicity, change in serum lipids. Muscle and bone pain. Psychiatric symptoms. Pancreatitis. Photosensitivity. Rigors. Cardiovascular effects. Paraesthesia, hyperesthesia. Hypervitaminosis A syndrome. Hence it should be prescribed by dermatologists with experience in the use of this drug.

  5. #95
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    How should I tackle my husband's demise?


    Q. I have an 8 years old son. He lost his father 3 weeks back. His father meant everything to him and he is not able to digest the fact about his death. He didnt cry for the first two days after his death. On the funeral, he cried for 2 minutes. He went in to a state of shock, whereby the left side of his body started shivering. Because of this, he had to be rushed to the hospital, where he was declared fine. After this episode, all our family members and friends showered their affection and love on him. He seems to have gotten back to normalcy. At the same time, he seems to have got more attached to me and fears my absence. Before my husbands demise, I played the role of the disciplinarian and it was my husband who used to pamper him. Can you tellme the possible psychological effects of this loss on my son and how I need to handle these changes? Will my pampering spoil him? How should I treat him? How should I bring him up without making him feel too important or deprived of his fathers attention?

    A. You are handling your own bereavement with admirable courage, I think. Your son will feel the loss. That is the reality. At various stages in his life, he is likely to miss his father. You should let him keep his fond memories and encourage him to talk to you and others in the family.

    You use the word, pampering but I am not sure of what is meant by it. I think you could drop it from your vocabulary, to an advantage. Some people also use the word spoiling the child when any tenderness is shown. Being very affectionate to the child is the best treatment you can give him. Once in a while you can let him have his own way, breaking a rule, like staying up later than usual or seeing a show on TV. At most other times you can suggest that he should follow the rules that he has agreed to. Discuss things with him and make him see the reasonableness of your discipline. There is no need to stereotype yourself as the disciplinarian. You must do what is good for the child, taking him into confidence where possible. He needs the affection and concern of the entire family and tenderness from you and all of them. There is no harm if he feels important. He is important and let him feel it. In the course of growing up, he should also be helped to see other peoples point of view and the understand their feelings. He will grow up to be a support to you. Be as cheerful as possible and let there be some space for humour in your dealings with the child.

  6. #96
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    What is the procedure involved in circumcision?


    Q. What is the procedure involved in circumcision? Do women prefer circumcised partners? Why is the frenulum not cut in the surgery?

    A. The method of circumcision is as follows: the doctor administers local anaesthesia, and cuts the skin close to the skins attachment to the glans. Then the doctor applies 4 to 8 stitches to control the bleeding. I doubt that girls have any preference. A circumcised penis is more hygienic, but hygiene is not by itself enough reason to undergo circumcision. I would recommend regular cleaning for the sake of hygiene rather than circumcision. The frenulum is cut to the extent required.

  7. #97
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    Is it okay to have packed juices?


    Q. I am in the 27th week of my pregnancy. I take fruit juices (which contain citric acid) from the market. Is it ok to have them or should I have the ones without preservatives?

    A. Have the ones without added sugar and preservatives. Citric acid is fine. As far as possible, try to prepare juices at home; a freshly squeezed juice has many more benefits than those from a pack.

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