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Thread: Medical Questions with answers..4

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    Default Medical Questions with answers..4

    What is the ideal diet for my child?


    Q. My baby girl is 11 months old. Can I stop breastfeeding her? I am a little concerned about my health. Since the last month, I am not able to produce much milk. But it is very hard to give her formula milk as she can have a maximum of only 60 g per day. What is the ideal diet for my daughter?

    A. I am sure you must have given your baby girl semi-solids and now have progressed to solid foods. So, the trick is to feed her 3-5 small meals a day of semi-solid and solid foods and give her formula milk and breast milk in between. There may be a little adjustment problem initially, but it lasts for a maximum of only 2-3 days. Children are very smart and adaptable - once she has realised that this is what she will be fed no matter how hard and how long she hollers, she will settle down.


    Overall, remember she needs half the food per day that you consume - this is a rough but practical guide of how much to feed her. Second, remember she has to have more than three meals a day, as small divided meals are the key to feeding at this age.

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    How can I get rid of gastric ulcer?


    Q. I am 41 years old. I am suffering from gastric ulcer for the last 7-8 years. Every year I suffer from gastric pain nearly for 2-3 months. At that time I take antacid medicines. Please advise me a better solution to get rid of this gastric pain.

    A. You have mentioned that you are suffering from gastric ulcer for the last eight years. Also, I note that you have history of passing black stools. I would like to know how your diagnosis was made. Have you undergone an endoscopy or a barium examination?

    In fact, ulcer disease of stomach is now a completely treatable condition. Its diagnosis should be confirmed by an upper gastrointestinal endoscopy. If an ulcer is detected on endoscopy, then the doctor usually takes a biopsy from stomach to test for a bacteria called Helicobacter pylori. If the spot test is positive, then the patient is given an antibiotic course for 1-2 weeks along with acid suppressant drugs, which leads to complete eradication of the ulcer.

    For someone like you, I would suggest that a confirmation of the diagnosis be done by an endoscopy, and appropriate treatment given. Certain factors that lead to aggravation of ulcer symptoms need to be avoided. These include use of pain killers, smoking, spicy diet, etc.

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    How can I control my blood pressure?


    Q. I am a 36 years old male. I am having severe headache for past one month and recently my eyeballs also started paining. When I went for a check up I was told that my BP is 180/120 mmHg. What does 180/120 mean? What precaution do I take to control my blood pressure?

    A. Your BP is extremely high and needs urgent treatment to lower it. The bigger number is the pressure inside your blood vessels when the heart contracts and the lower figure is the pressure when it relaxes. Both the pressures are high in your case. You also need to be investigated especially to see if a kidney problem or a narrowing of one of its arteries is the cause of your high blood pressure. You need the following tests apart from drugs to lower your blood pressure quickly:
    Urine routine/microscopy


    Serum creatnine/potassium


    24 hours urinary metanephrines


    CT angiography for renal arteries and suprarenal masses or an ultrasound with renal Doppler for the same causes

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    How can my son's stools be softened?


    Q. My son is 13 months old and has the problem of hard stools. He is taking more of a liquid diet like milk. All other foods given to him are in the mashed form. His doctor has also diagnosed low haemoglobin by his appearance (not through blood test). Kindly give a proper diet plan and ingredients that should constitute his diet. What is the solution to his problem of hard stools?

    A. Please cut down on his milk (not > 400-500 ml/d) and increase cereals and fibre diet. You must give him khichdi, dalia, mashed vegetables, fruits like papaya, guava, sooji / besan halwa, etc. Honey is a good alternative for sugar. You can put him on Lactulose syrup to soften his stool. You need to visit your paediatrician who will provide you with these details

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    Do I need to discontinue metformin before contrast studies?


    Q. I am 44 years old male and want to ask that do I need to discontinue metformin a day prior to undergoing iodinated contrast studies.

    A. Radiological studies involving the use of intravascular iodinated contrast material can lead to acute alteration of renal function that can lead to lactic acidosis if metformin is currently being used. Hence metformin should be stopped at the time of the study and not recommended for 48 hours after the study and taken only after renal function has been re-evaluated and found to be normal.

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    Can my brother-in-law undergo kidney transplantation?


    Q. My brother-in-law, aged 30 years, has been suffering from grade three chronic renal failure due to hypertension since 40 days. He is on ventilators and every alternate day dialysis is being done. He is also suffering from pneumonitis in both lungs. His blood urea and serum creatinine values are ranging from 45 to 145 and 2.3 to 5.6 after and before dialysis with a urine output of 170 to 300 ml per day. Can he undergo kidney transplantation now?

    A. For kidney transplantation, an elective procedure, patient should be in a good medical, physical and mental condition. At this point of time, it seems your brother-in-law is quite sick with pneumonia and is on ventilator. He is at present too sick to be considered for transplant. He should be off the ventilator, pneumonia cured and as I emphasised earlier, medically fit for such a procedure. I do not think this is an option at this stage.

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    Is Wysolone safe for long-term use?


    Q. I am an asthmatic for last 18 years. I have taken vaccination in 2004 after having an allergy test but it did not improve. I am taking Wysolone (prednisolone) for last 3.5 years, every day. Is Wysolone safe for long-term use?

    A. As per evidence-based globally accepted clinical guidelines for the treatment of asthma, the first line therapy should be salmeterol via inhalation such as Salmeter. If this is not fully effective, then a steroid should be added but to be taken by inhalational route (such as Beclate inhaler). If three drugs are required, then montelukast (sold as Montair) by mouth should be added. Only as a last resort should one prescribe oral steroids such as Wysolone. Prolonged use of steroids by oral ingestion can lead to serious side effects such as fluid retention, high blood pressure, diabetes, increased risk of infection, osteoporosis, increased pressure in the brain etc.

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    How can I regularise my periods?


    Q. I am 25 years old. I got married last year. I have always had irregular periods. I got my last period three months back. I underwent urine pregnancy test twice, but both the times the reports were negative. I do not have any symptoms of pregnancy. I have the symptoms of getting my periods, but am not getting it. I took Mala D for five days at the end of last month and then stopped taking it. I usually do this to get my periods. If I take the tablets for five days and then stop taking them, I get my periods in five days. But this time it did not work. I have not got my periods till date. What should I do to regularise my periods?

    A. You need to get a scan done to see if the uterus and ovaries are normal and then take some progesterone tablets, i.e., if there is no pregnancy. Take the tablets for 5-7 days to get your period. You can take Primolut N 5 mg tablet once a day for 5-7 days. The period will come after 2-3 days of stopping the tablets.

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    How can I avail a cadaveric kidney transplant?


    Q. I am 30 years old. I want to know how I can avail of the facility of cadaver kidney transplant in India. How can I avail of the facility of home dialysis? Kindly advise.

    A. The nephrologist looking after you will guide you about cadaver transplant list and also about CAPD. This form of dialysis can only be home dialysis, and it is an excellent way of leading a good quality life till you get a suitable cadaver kidney. All the major hospitals in Delhi, Mumbai, Chennai and Bangalore have a cadaver transplant waiting list, but you have to contact the nephrologist of the hospital of your choice to go on the list. All the hospitals of a particular city have a coordinated list with a central authority to allot a cadaver kidney according to the tissue match and your position on the waiting list. The waiting period depends upon the availability of a cadaver. But on CAPD you can wait comfortably. Go with your treating doctor's advice.

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    Can tests detect physical defects in an unborn fetus?


    Q. I am 27 years old. Is it possible to detect any abnormality, mental disability or any vital defect of an unborn child during pregnancy? If yes, then what are the tests?

    A. There are ultrasound tests for detecting physical defects and certain maternal and fetal blood tests for other defects. However, these tests should be conducted only after consultation with an expert perinatologist, and discussing your individual case to find out if there is any need for them.

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