what do you want guys?

[steve]

I am a medical doctor. some members are also medical doctors I think. So I can't do wrong things. They will point out if I send a wrong message here. That's good.

Ok, first of all, what do you want to know? But dont ask me about birth control pills or sexual health what I dont know. Ask me about your brain, heart, lungs, kidney problem. OK?

[AungMyoHan]

ဆရာမသမီးဗိုက္ထဲက ေအာင့္ေအာင့္ေနလို႕ (အယ္ မဟုတ္ပါဘူး) အကိုေမးၿပီဗ်ာ။ ကၽြန္ေတာ္ရင္ဘတ္ထဲက တစ္ခ်က္တစ္ခ်က္ေအာင့္တယ္ဗ်ာ။သူေအာင့္တယ္ဆိုတာထက္ စူးစူးႀကီးျဖစ္တာဗ်။ အဲလိုျဖစ္ခ်ိန္ဆိုရင္ အသက္ရႈလို႕ မရဘူး အသက္ရႈရင္ ပိုၿပီးစူးတယ္။ တစ္ခါျဖစ္ရင္ ၃ မိနစ္ေလာက္ၾကာတယ္။ ဘာျဖစ္တာလဲသိခ်င္တယ္ဗ်။

[steve]

I need to know
Your age?: (20s, 30s, 40s?)
Site of the pain? from cente of chest or from side?
any tenderness, when you press your chest?
When did your pain start? How long? days or months?
How did it start? itself? after some physical activities? After Shingles?
How much severe? 1/10 to 10/10
How frequently a day?
What especially worsens your pain? (you said when you take a deep breath)
What helps your pain? any pain killer? any special position?
Have you been coughing?
Any feverish?
Is this the first time?
Any joint pain?
Any palpitation?

If you are young, no cough, no other problem, it could be neuromuscular pain, or it could be inflammation of some bone. These are common.
For the time being, you need to take Paracetamol 1g (500mg x 2 tablets) 4 times a day for a week. If not getting better, you can add Codeine 10 to 30 mg 4 times a day.

I still need your answers.

Best wishes

[ခ်စ္သူေမာင္]

steve said:

I need to know
Your age?: (20s, 30s, 40s?)
Site of the pain? from cente of chest or from side?
any tenderness, when you press your chest?
When did your pain start? How long? days or months?
How did it start? itself? after some physical activities? After Shingles?
How much severe? 1/10 to 10/10
How frequently a day?
What especially worsens your pain? (you said when you take a deep breath)
What helps your pain? any pain killer? any special position?
Have you been coughing?
Any feverish?
Is this the first time?
Any joint pain?
Any palpitation?

If you are young, no cough, no other problem, it could be neuromuscular pain, or it could be inflammation of some bone. These are common.
For the time being, you need to take Paracetamol 1g (500mg x 2 tablets) 4 times a day for a week. If not getting better, you can add Codeine 10 to 30 mg 4 times a day.

I still need your answers.

Best wishes

ဆရာဆရာကို႕ဆရာလုပ္တာဟုတ္ဖူး တေန႕4 gmဆိုတဲ႕ ပမာဏကမမ်ားဘူးလား ခင္ဗ် ေဘာ္ဒီ၀ိတ္နဲ႕
တြက္ေပးယင္ 2mg/day ေလာက္ပဲေကာင္းမယ္ထင္ပါတယ္ Para အစား Diclofence sodium 50mg
ကို BDေသာက္ခိုင္းပါလား ကိုဒင္း 30mgေလာက္ဆိုေကာင္းခ်င္သြားၿပီေနာ္ဆရာေရ :P :P :P
ကၽြန္ေတာ္စတာပါခင္ဗ်ာ ေနာက္ၿပီးသိကၡာခ်တာလည္းမဟုတ္ပါ ပါရာ 4 ဂရမ္က မ်ားလို႕ပါ
၀င္စြက္ဖက္တာထက္ အႀကံေပးတာပါ

ခင္မင္ေလးစားစြာျဖင္႕
ခ်စ္သူေမာင္

[ko tay]

ခ်စ္သူေမာင္ said:

steve said:

I need to know
Your age?: (20s, 30s, 40s?)
Site of the pain? from cente of chest or from side?
any tenderness, when you press your chest?
When did your pain start? How long? days or months?
How did it start? itself? after some physical activities? After Shingles?
How much severe? 1/10 to 10/10
How frequently a day?
What especially worsens your pain? (you said when you take a deep breath)
What helps your pain? any pain killer? any special position?
Have you been coughing?
Any feverish?
Is this the first time?
Any joint pain?
Any palpitation?

If you are young, no cough, no other problem, it could be neuromuscular pain, or it could be inflammation of some bone. These are common.
For the time being, you need to take Paracetamol 1g (500mg x 2 tablets) 4 times a day for a week. If not getting better, you can add Codeine 10 to 30 mg 4 times a day.

I still need your answers.

Best wishes

ဆရာဆရာကို႕ဆရာလုပ္တာဟုတ္ဖူး တေန႕4 gmဆိုတဲ႕ ပမာဏကမမ်ားဘူးလား ခင္ဗ် ေဘာ္ဒီ၀ိတ္နဲ႕
တြက္ေပးယင္ 2mg/day ေလာက္ပဲေကာင္းမယ္ထင္ပါတယ္ Para အစား Diclofence sodium 50mg
ကို BDေသာက္ခိုင္းပါလား ကိုဒင္း 30mgေလာက္ဆိုေကာင္းခ်င္သြားၿပီေနာ္ဆရာေရ :P :P :P
ကၽြန္ေတာ္စတာပါခင္ဗ်ာ ေနာက္ၿပီးသိကၡာခ်တာလည္းမဟုတ္ပါ ပါရာ 4 ဂရမ္က မ်ားလို႕ပါ
၀င္စြက္ဖက္တာထက္ အႀကံေပးတာပါ

ခင္မင္ေလးစားစြာျဖင္႕
ခ်စ္သူေမာင္

ဟားဟားဟားဟားဟားဟားဟား...ကိုခ်စ္သူေမာင္ပံုစံက ၃၀ မီလိဂရမ္နဲ႔ဘာမွျဖစ္မယ့္ပံုမေပၚဘူး။ဟားဟားဟားဟား

[steve]

Thank you for your comment.

But that is routine treatment for normal adult in England. But there are some exceptions in patients with liver problem.

For the children,
10 mg/kg for under 3 months,
60-120-mg for 3 -12 months,
120-250 mg for 1-5 years,
250-500mg for 6-12 years
above dose is very 4-6 hourly

We don’t normally start Diclofenac in first instance as it has got more side effects than Paracetamol.

Yes I understand that in Burma, normally people take 500 mg tablet. I must admit I had to change only when I arrived in the UK.

Toxic dose of paracetamol is over 7.5 gram. I mean if you take over 15 tablets altogether, it is toxic, causing liver and kidney problems. Some may die.

Logically, if 4 g/day is harmful for general people, probably, Britain would have funerals everywhere. the body of British people are not big like Americans or Scandinavians generally. I have been working eveywhere in England. My height 5 8 is just average.

More educated comments welcome.

[ခ်စ္သူေမာင္]

Yes sir I want to say about toxic about para. ကၽြန္ေတာ္တာ၀န္ထမ္းေဆာင္ခဲ႕စဥ္က အဲဒီေက်ာက္ကပ္နဲ႕အသည္းျပႆနာခဏခဏျဖစ္လို႕ေျပာတာပါဆရာ ရန္ကုန္ ျမန္မာကလူေတြ
ေနာက္ပါရာရဲ႕အရည္ေသြးျပည္႕မွီမႈမရွိတဲ႕ ဒီႏိုင္ငံကိုပဲေျပာရမလား ကၽြန္ေတာ္ျပႆနာရွာတာမဟုတ္ပါ
ေတာ္ပါၿပီေဆးေလာကအေၾကာင္း ဘေလာ႕ဂင္းလုပ္လိုက္ယင္ဘေလာ႕ဂါ
ဆိုဒ္ေက်ာ္မရခြမရျဖစ္ေအာင္ဘန္းခံရဦးမယ္

အစဥ္ခင္မင္ေလးစားလွ်က္
ခ်စ္သူေမာင္

[steve]

OK, my question is how you did prove that Paracetamol cause the liver and Kidney problem frequently. I know very well about situation in Burma as I used to work in Rangoon General Hospital and Mandalay General Hospital. You cant say easily like that. If you are a doctor, let's talk about evidence based.

ခ်စ္သူေမာင္ said:

Yes sir I want to say about toxic about para. ကၽြန္ေတာ္တာ၀န္ထမ္းေဆာင္ခဲ႕စဥ္က အဲဒီေက်ာက္ကပ္နဲ႕အသည္းျပႆနာခဏခဏျဖစ္လို႕ေျပာတာပါဆရာ ရန္ကုန္ ျမန္မာကလူေတြ
ေနာက္ပါရာရဲ႕အရည္ေသြးျပည္႕မွီမႈမရွိတဲ႕ ဒီႏိုင္ငံကိုပဲေျပာရမလား ကၽြန္ေတာ္ျပႆနာရွာတာမဟုတ္ပါ
ေတာ္ပါၿပီေဆးေလာကအေၾကာင္း ဘေလာ႕ဂင္းလုပ္လိုက္ယင္ဘေလာ႕ဂါ
ဆိုဒ္ေက်ာ္မရခြမရျဖစ္ေအာင္ဘန္းခံရဦးမယ္

အစဥ္ခင္မင္ေလးစားလွ်က္
ခ်စ္သူေမာင္

[steve]

"Logically, if 4 g/day is harmful for general people, probably, Britain would have funerals everywhere. the body of British people are not big like Americans or Scandinavians generally. I have been working eveywhere in England. My height 5 8 is just average."
I was trying to say 4g/day is fine for average people in Burma. But I don't get your point. sorry.

ခ်စ္သူေမာင္ said:

ေနာက္ၿပီးကၽွၽြန္ေတာ႕အရပ္က၆'၂"ပါ

[ခ်စ္သူေမာင္]

ဆရာစိတ္မဆိုးပါနဲ႕ခင္ဗ်ာေတာင္းပန္ပါတယ္လက္လြတ္စပယ္ေျပာတာမဟုတ္ပါဘူး ကၽြန္ေတာ္က
အယင္ကNYGH (Jica)Poisin ward
ကပါ ပိုလို (ၾကမ္းပိုးသတ္ေဆး) ေသာက္ယင္ကယ္လို႕ရေပမယ္႕ ပါရာေသာက္တာကေတာ႕ ရွင္ဖို႕လမ္းနည္းပါးပါတယ္ အဓိကကေတာ႕ Liver transplant မလုပ္ႏိုင္လို႕ဆံုးရံႈးရတာမ်ားတာပါ.....အဲဒီလို
သက္ေသေတြနဲ႕ ကၽြန္ေတာ္ပါရာအမ်ားႀကီးမေပးရဲတာပါ....ေက်းဇူးပါဆရာ
steve said:

OK, my question is how you did prove that Paracetamol cause the liver and Kidney problem frequently. I know very well about situation in Burma as I used to work in Rangoon General Hospital and Mandalay General Hospital. You cant say easily like that. If you are a doctor, let's talk about evidence based.

ခ်စ္သူေမာင္ said:

Yes sir I want to say about toxic about para. ကၽြန္ေတာ္တာ၀န္ထမ္းေဆာင္ခဲ႕စဥ္က အဲဒီေက်ာက္ကပ္နဲ႕အသည္းျပႆနာခဏခဏျဖစ္လို႕ေျပာတာပါဆရာ ရန္ကုန္ ျမန္မာကလူေတြ
ေနာက္ပါရာရဲ႕အရည္ေသြးျပည္႕မွီမႈမရွိတဲ႕ ဒီႏိုင္ငံကိုပဲေျပာရမလား ကၽြန္ေတာ္ျပႆနာရွာတာမဟုတ္ပါ
ေတာ္ပါၿပီေဆးေလာကအေၾကာင္း ဘေလာ႕ဂင္းလုပ္လိုက္ယင္ဘေလာ႕ဂါ
ဆိုဒ္ေက်ာ္မရခြမရျဖစ္ေအာင္ဘန္းခံရဦးမယ္

အစဥ္ခင္မင္ေလးစားလွ်က္
ခ်စ္သူေမာင္

[steve]

Ok, Be scientific. Right? Toxic does is over 7.5 g (15 tablets of 500mg ) and above as a single dose. Toxic dose is not total 4 g after taking 1 g 6 hourly which is far away from toxic dose. But we dont give people with existing liver disease. Buy the way, are you MSC or MRCP in medicine? If so, we can discuss more about medicine in academic way in latest evidence base medicine. Thanks for you reply.

ခ်စ္သူေမာင္ said:

ဆရာစိတ္မဆိုးပါနဲ႕ခင္ဗ်ာေတာင္းပန္ပါတယ္လက္လြတ္စပယ္ေျပာတာမဟုတ္ပါဘူး ကၽြန္ေတာ္က
အယင္ကNYGH (Jica)Poisin ward
ကပါ ပိုလို (ၾကမ္းပိုးသတ္ေဆး) ေသာက္ယင္ကယ္လို႕ရေပမယ္႕ ပါရာေသာက္တာကေတာ႕ ရွင္ဖို႕လမ္းနည္းပါးပါတယ္ အဓိကကေတာ႕ Liver transplant မလုပ္ႏိုင္လို႕ဆံုးရံႈးရတာမ်ားတာပါ.....အဲဒီလို
သက္ေသေတြနဲ႕ ကၽြန္ေတာ္ပါရာအမ်ားႀကီးမေပးရဲတာပါ....ေက်းဇူးပါဆရာ
steve said:

OK, my question is how you did prove that Paracetamol cause the liver and Kidney problem frequently. I know very well about situation in Burma as I used to work in Rangoon General Hospital and Mandalay General Hospital. You cant say easily like that. If you are a doctor, let's talk about evidence based.

ခ်စ္သူေမာင္ said:

Yes sir I want to say about toxic about para. ကၽြန္ေတာ္တာ၀န္ထမ္းေဆာင္ခဲ႕စဥ္က အဲဒီေက်ာက္ကပ္နဲ႕အသည္းျပႆနာခဏခဏျဖစ္လို႕ေျပာတာပါဆရာ ရန္ကုန္ ျမန္မာကလူေတြ
ေနာက္ပါရာရဲ႕အရည္ေသြးျပည္႕မွီမႈမရွိတဲ႕ ဒီႏိုင္ငံကိုပဲေျပာရမလား ကၽြန္ေတာ္ျပႆနာရွာတာမဟုတ္ပါ
ေတာ္ပါၿပီေဆးေလာကအေၾကာင္း ဘေလာ႕ဂင္းလုပ္လိုက္ယင္ဘေလာ႕ဂါ
ဆိုဒ္ေက်ာ္မရခြမရျဖစ္ေအာင္ဘန္းခံရဦးမယ္

အစဥ္ခင္မင္ေလးစားလွ်က္
ခ်စ္သူေမာင္

[Myo Kyaw Htun]

I suffered Pneumothorax in late december 2007. After operation, I am still not feeling well and don't think like normal. Whenever I get chest pain, I go and check in hospital. It is still normal. But feeling tight inside chest is uncomfortable to me. Doctor always told me that it always happened to those who took operation. What I found myself is that I get chest pain (both side) whenever I get stress, feeling bad/sad and lack of sleep. Do you want to give me any suggestion?

my age: about to be 23
height: 5' 10"
weight: 57 kg
neither smokie nor drinker

p.s: I also checked heart. It is okie.

Regards,

Myo Kyaw Htun

[suelinnthit]

ဆူးလငး္ကေတာ့ စာေတြက်က္ရင္... မပင္ပန္းတဲ့နည္းပဲလုိခ်င္တယ္.. ျပီးေတာ့အမွတ္လည္းမ်ားမ်ားမေပးဘူး