[saket77]

My mother in law (53) slipped from stairs yesterday. In an attempt to avoid a fall, she took it on her right shoulder and arm. X-ray reveals a fracture of 'greater trochanter' of right humeral head (in the arm). Doctor has advised for surgery but we are seeking a second opinion.
Will be great if anyone from the ortho fraternity can let us know if the following X-rays look bad enough to command a surgery?
Thanks in advance.

Another view .

[dre@ms]

Recently received a Whatsapp message about the below,

Once the prescription is obtained goto 1mg site, input the medicine prescribed. Check for substitutes and choose the one which is cheaper.

I have done this for known medicines, but is this practice recommended for all diseases?

[archat68]

Originally Posted by dre@ms

Recently received a Whatsapp message about the below,

Once the prescription is obtained goto 1mg site, input the medicine prescribed. Check for substitutes and choose the one which is cheaper.

I have done this for known medicines, but is this practice recommended for all diseases?

Don't go for medicines manufactured by unknown companies or small companies however cheap they may be. Efficacy may be an issue.

[dre@ms]

Originally Posted by archat68

Don't go for medicines manufactured by unknown companies or small companies however cheap they may be. Efficacy may be an issue.

We are good to go with renowned brands then? I am basically looking at recommendation for this practice of choosing the medicine with the same composition. Like Okacet and Cetrizine wherein Cetrizine is the primary composition.

[archat68]

Originally Posted by dre@ms

We are good to go with renowned brands then? I am basically looking at recommendation for this practice of choosing the medicine with the same composition. Like Okacet and Cetrizine wherein Cetrizine is the primary composition.

Yes substitution from a reputed manufacturer is OK.

But you should look for carefully into the composition. Like
Metformin 500mg tablet and Metformin 500 mg extented release/sustained tablet are not same. In this case the components and strength are same but the formulation is different. The first one is designed for absorption in your body as soon as it get dissolved whereas the later is designed for release for a extended period of time say 12/24 hour depending on the formulation.

BTW from my experience 1mg does not allow substitution. They will supply only whatever written on the prescription as as per Indian Law, pharmacist can not supply substitute in place of whatever is written in prescription.

My doc prescribed me a medicine which was not available in 1mg but the alternative was available. So I ordered the alternative. But my order was cancelled as they can not supply alternative.

[dre@ms]

Originally Posted by archat68

Yes substitution from a reputed manufacturer is OK.

But you should look for carefully into the composition. Like
Metformin 500mg tablet and Metformin 500 mg extented release/sustained tablet are not same. In this case the components and strength are same but the formulation is different.

This explanation helps. Thanks for the clarity

[veyron_head]

My son (6yrs old) has got nearsightedness and has a power of -2.5 in his left eye. The lab guy told me that there is another test pending to accurately identify the power. This test would involve application of eyedrops that would blur his vision for the next couple of days.

No one in my immediate family has ever worn glasses so have no clue how this works. My questions:
a.) Is -2.5 too high for a 6 yr old?
b.) Is the second test necessary? I know I may sound naive here, but I really dont want my son go through this if there is anyway he can do without it!
c.) Can someone please suggest a Senior eye doctor in Bangalore. All the folks in major hospitals seem to be recent passouts and I am really not confident!

[civic-sense]

Originally Posted by veyron_head

My son (6yrs old) has got nearsightedness and has a power of -2.5 in his left eye. The lab guy told me that there is another test pending to accurately identify the power. This test would involve application of eyedrops that would blur his vision for the next couple of days.

No one in my immediate family has ever worn glasses so have no clue how this works. My questions:
a.) Is -2.5 too high for a 6 yr old?
b.) Is the second test necessary? I know I may sound naive here, but I really dont want my son go through this if there is anyway he can do without it!
c.) Can someone please suggest a Senior eye doctor in Bangalore. All the folks in major hospitals seem to be recent passouts and I am really not confident!

-2.5 isn't high, but it could increase with age. I started with -4.5/2.5 and got to -9/7 by 18 years.

The test is a routine one. Its not blurring, but pupil dilation. Means, after applying the drops the pupil will not close so that the doc can see inside clearly. Pupil is the thing that will open and close depending on the ambient light. Aperture in cameras? So, you would not be able to look at bright light while dilated. Your son would be fine inside the house, and would be back to normal in a few hours, max by next day.

[condor]

Originally Posted by veyron_head

c.) Can someone please suggest a Senior eye doctor in Bangalore. All the folks in major hospitals seem to be recent passouts and I am really not confident!

You can contact Dr Harish Nayak @ Cloud-Nine on Old Airport road. He is a paediatric opthalmologist.

https://goo.gl/VAAaFi

[veyron_head]

Originally Posted by civic-sense

-2.5 isn't high, but it could increase with age. I started with -4.5/2.5 and got to -9/7 by 18 years.

The test is a routine one. Its not blurring, but pupil dilation. Means, after applying the drops the pupil will not close so that the doc can see inside clearly. Pupil is the thing that will open and close depending on the ambient light. Aperture in cameras? So, you would not be able to look at bright light while dilated. Your son would be fine inside the house, and would be back to normal in a few hours, max by next day.

Originally Posted by condor

You can contact Dr Harish Nayak @ Cloud-Nine on Old Airport road. He is a paediatric opthalmologist.

https://goo.gl/VAAaFi

Thanks a ton guys.

@condor - Will get in touch with the Dr. Thanks much

[agambhandari]

Originally Posted by saket77

My mother in law (53) slipped from stairs yesterday. In an attempt to avoid a fall, she took it on her right shoulder and arm. X-ray reveals a fracture of 'greater trochanter' of right humeral head (in the arm). Doctor has advised for surgery but we are seeking a second opinion.
Will be great if anyone from the ortho fraternity can let us know if the following X-rays look bad enough to command a surgery?
Thanks in advance.

Another view .

The problem is not the damage caused, but rather the Age of the patient. At this age, the healing is slower and thus a surgery is needed for fixing the slipped fragment with the rest of the bone. That really is the minimum treatment required in all but children.

[saket77]

Originally Posted by agambhandari

The problem is not the damage caused, but rather the Age of the patient. At this age, the healing is slower and thus a surgery is needed for fixing the slipped fragment with the rest of the bone. That really is the minimum treatment required in all but children.

Thanks for the reply. Yes, age is a factor in this case as suggested by you. Surgery was advised by the doctor. But given her high asthma and allergic conditions we were little skeptical.
Took a second opinion from another doctor yesterday and he decided to put a cast and avoid surgery. The shoulder is also immobilised by a belt.
Let's see how it recovers. Thanks for your attention.

Regards.

[INJAXN]

A friend ( 31 Yrs - Male) has throat infection for 2 and a half weeks now.
He visited a doctor, chest X-ray was done and based on that HRCT( Thorax ) was suggested.
So obviously he got freaked out and called me. Since the doctor he visited is an MD, we decided to go for CT Scan.

Following is report snippet:
Few Prominent subcarnial and right para tracheal lyphs nodes are noted, larget measuring 11x6 mm in right paratracheal region. No Obvious e/o nercrosis / classification seen within lymph nodes. - likely of reactive etiology.

doctor has now given some medication and asked to wait for a week and see if coughing persists.

My question: Was CT scan necessary/ or is he just being looted?
He has no other complains except for coughing.

[wildsdi5530]

Originally Posted by saket77

My mother in law (53) slipped from stairs yesterday. In ..

Sorry for the late reply.
I am a Joint replacement surgeon in Bangalore, at Manipal Hospitals.
This is not a greater tuberosity fracture but a neck fracture, easily confirmed by CT scan.
However it is impacted well.
All this needs is a sling for 3 weeks followed by gentle movement exercises. Avoid lifting weights and overhead activities for 6 weeks.
Should heal uneventfully.

[saket77]

Originally Posted by wildsdi5530

Sorry for the late reply.
I am a Joint replacement surgeon in Bangalore, at Manipal Hospitals.
This is not a greater tuberosity fracture but a neck fracture, easily confirmed by CT scan.
However it is impacted well.
All this needs is a sling for 3 weeks followed by gentle movement exercises. Avoid lifting weights and overhead activities for 6 weeks.
Should heal uneventfully.

Thanks a lot. Reply may be late but it's reassuring.
Sometimes it became painful, esp during the first 3-4 days, so she took the prescribed pain killers, but getting slightly better with time. Thanks a lot for your expert opinion.

Regards,
Saket.