PMNL

Blood pressure tablets here in Thailand sold OTC so no need prescription.

However, if you have not been prescribed by doctor,then it is difficult to tell which medication is suitable for you.

Certain medication is simple but very effective such as HCTZ( diuretic), the side effect is tiredness,some decreased libido,hyperuricemia.

Beta-blocker ( atenolol, Bisoprolol,carraten etc -lo) is suitable for angina pectoris,not recommend in COPD,asthma and DM due to bronchospasm and mask symptom of hypoglycemia. Side effect : slow heart rate, heart block in certain degree heart block patients.

Calclum channel blocker ( Amlopine/norvasc -) is not recommended in hypertension with acute heart failure. Side effect : edema/swelling leg.

ACEI ( enapril,anapril,ramipril,rispril etc -il) is very good choice for hypertension. It keeps your arteries open,lower your blood pressure, reduce microalbuminuria in DM case, has heart remodeling effect on MI case, secondary prevention effect on ischemic/infarction stroke. It is the first choice ( compelling indication according to JNC7) to be used in patients who have DM and HTN. However the bad side is dry cough in some people,can not be use if you have renal arteries stenosis creatinine more than 2.5 mg/dl and potassium more than 5.5 mmol/L thus get these blood test now and again if you are on this group of tablets.

ARB : angiotensin recepter blocker ( Diovan, Losartan,irbersatan,..etc -tan) As good as ACEI but no dry cough side effect, more expensive obviosly.

Alpha1-blocker ; (doxazocin, cadura,prazocin,terazocin?) is suitable for HTN with BPH.

There plenty of combine medications in the market at the moment : diovan>> Co-diovan ( Diovan plus HCTZ) , aprovel >>> Co-aprovel ( Aprovel+HCTZ)

It is just drug maker are making money out of patients inconvinience of taking two tablets, so they put those two medication into one and sell them at rediculous price.

My point is, if you do not want to consult doctor, then get them to prescribe something for you and keep BP under control before you start buying your own medication. There are so many things that you need to check annually in order to make you that your BP and it friends ( Dyslipidemia, kidney problems etc) are under control.

For the pharmacy, can only tell ones in Chiangmai.

You are right about most adults had been exposed to HPV, but only certain type. They are still at risk of the others HPV.

However only 16,18 strain play critical roles in cancerous lesion while type 6 and 11 cause 90% of case of genital warts.

If one infected by HPV 6,he/she are still at risk of HPV 11,18,16,52 and so on...infection. The exposure rate however is lower with age.

You need to think about risk and benefit before getting one.

The price in thailand for gardasil is ~7000-12000/course.

This vaccine is only for children, correct? My understanding is that it is useless for adults who have alread been sexually active. Can our medical expert speak on this topic?

Not only children but the vaccine can be innoculated safely and effectively in women from 9-45 years old.

For those who had contacted HPV( already in sexually active period), the vaccine is still benefit in order to prevent another type of HPV infection.

According to the study(Future II study group) which carried out in the HPV infected patients (between 1-3 types) show that gardasil has 100% pevention rate over the other type of HVP infection.

In Australia, Ecaudor,Phillipines : The vaccine is recommended in female 9-45 years.

In men, the vaccine is effective in prevention of HPV type 6,11,16,18 ( Gardasil) infection over 85%,prevention of external genital warts, penile/perianal/perineal intraepithelial neoplasia(PPPIN) over 90%.

In Australia, NZ,Korea : The vaccine is recommended for boys 9-15 years to prevent HPV 6,11,16,18 infection.

Suan Dok ( Maharaj Nakorn chiangmai) is excellent hospital but you need to be able to communicate in thai and have plenty of time to waste on doctor visit.

The cost is the same as other govenment hospitals in thailand,extremely low.

This is abit off topic but It is very true what Elektrified said the government officers abuse the government insurance.

All government employees are entitled to get medical service from the government hospital for free and they can access all medical procedure as well as original (imported) medication for free. Obviosly those tablets are rediculous expensive for example, Pariet ( for GERD/severe gastric /duodinal ulcer) cost about 50-60 baht/tablets while generic omeprazole made by GPO costs less than one baht per tablets. Thai Kharachakarn (Govt. employees) will not use omeprazole even though the diagnosis was just simple gastritis, they would request the doctor to prescribe pariet. Many of them go to different hospital fake the symptoms and get prescribed original tablets then sell them to private chemists. Last week I found that there was an advertisement,on a well known thai website,for buying original tablets from patients. A few weeks ago, the government sued 18 government employees for abusing goverment insurance and one found guilty a few days ago.( he went to 4 hospitals in one month and get prescribed the same original medication)

You can find shoulder sling at any big chemist,pharmachoice, first drug.

For the physiotherapist you got PM.

Sripat special medical center has many urologists on their list.

One of the most competent doctor who has been talked about in CNX forum is DR. Pannakit.

The cost of surgery there is relative cheap compared to CNX RAM and BKK.

For Biopsy~ 15000 Baht

For TURP ~ 50000 baht

For more adcanced technique cost more.

Glad to hear there is someone there. My brother is taking summer class in CNX at the moment,will give you a ring when he get back to SSK.

Thanks.

Do you have any fever?

How big are those lump?

From what you said I would think that it is blocked sweat glands and are turning into infection.

If not improved in a day or two then make your trip.

It depends on what cancer you relative has and what type of chemo he/she is on.

The price at Sripat would be cheaper than Bumrungrad and RAM definitely.

However you can order chemo tablets directly from the menufacturer/suppliers and save 30-40%

Please PM if need more details.

There are no private shareholders at Sripat. RAM, Dr. Morgan, and Loi Roh Clinic are for-profit.

You are right, there are no shareholders at SRIPAT but it is a profit section of Suandok hospital.

Whatever you pay there apart from the tablets and room rates go to staff pocket.

Sripat was attacked by the univesity congress in BKK a few years ago because they use goverment facilities to make their own money.

No personal attack. I do use them and they are good( if you really know how to arrange appointment) but just want to clarify that they also FOR-PROFIT.

It is ultrasound lower abdomen which experienced radiologist can measure the prostate and calculated into cc.

Rabies jabs for city pets after woman dies from bite

Published: 21/02/2010 at 12:00 AM

Newspaper section: News

City Hall is preparing 400,000 doses of the rabies vaccine for dogs and cats in Bangkok to prevent the spread of the disease among animals during the hot season.

The move is aimed at allaying public fears after the owner of a pet shop at Chatuchak Weekend Market died from rabies on Feb 14.

The woman was a Public Health Ministry official and owner of the Take Care Pet Shop at the market. She died from rabies after being bitten by one of her dogs.

Apirom Puanghat, a veterinarian at the Bureau of General Communicable Diseases, said the victim bought dogs from a pet farm in Chiang Mai province to sell at the weekend market. She was bitten by a three-year-old Rottweiler. The dog later died, followed by another eight pets at the victim's house, Dr Apirom said.

Bangkok Deputy Governor Malinee Sukavejworakit said 400,000 doses of the rabies vaccine will be available free in Bangkok from next month to control the disease which is prevalent among dogs and cats during the summer. Strays will also be caught and injected, she said. Bangkok Governor Sukhumbhand Paribatra and Bangkok health authorities yesterday inspected pet shops at Chatuchak market.

MR Sukhumbhand said the vaccination campaign would allay public concern and boost confidence among owners of pet shops and customers buying pets. In the initial phase, at least 100 dogs and cats at the market would be vaccinated and certificates issued for pets vaccinated against rabies, he said.

He said authorities will also inspect pet shops to see if they have proper operating licences.

MR Sukhumbhand said pet owners can also bring their dogs and cats in for free rabies jabs at the market.

Aroon Sricharoon, director of Chatuchak market, said he would meet 300 pet shop owners to stress the importance of acquiring operating licences.

He said those who have no licences will be prohibited from selling pets in the market. A penalty for violators will be a 2,000-baht fine.

Phra Maha Vichai Akkhatecho, the abbot of Wat Weluwanaram in Lampang's Mae Tha district, where 400 abandoned dogs are looked after, said the death was worrying. He has asked district health officials to inject the dogs at the temple with the rabies vaccine.

So far this year six people have died from rabies, compared with 24 last year and nine in 2008, according to the Public Health Ministry.

People are urged to contact the BMA's hotline 1555 or call 02-245-3311 if they suspect their pets are infected with rabies.

From Bangkokpost

Does the lovely Thai doctor stick her finger up an old man's rear end? Male Thai doctors don't.

Misleading statement regarding medical procedures.

I found the post is mis-leading as you see another poster had the test done at Loi kroh clinic with the male doctor.

There are 3 tests to evaluate if one needs to go for biopsy to check if they have prostate cancer.

1. Digital Rectal Examination

2.Ultrasound Prostate

3. Blood Test for PSA

It seems that if the bite is in the face,ear,nose,finger and hand with severe laceration,then one would need the ERIC injection ( Passive immunization) around the bite site,tummy.

If the bitten wound is small and far from the nerve-rich area, then just shots on your arm are required.

My partner's uncle is about 50 years old and has been complaining of blood in his stools for the past 2 weeks. He says that there is no pain when passing the stool, (so don't think it is piles or anal fissure), and the blood is bright red. He says that he has a pain in the lower abdomen area. His local Issan hospital seemed rather uninterested and gave him some unknown pills to take and not to come back... The translation of what they said he was suffering from is 'chronic medcial problem'

From the symptoms, my complete lack of medical knowledge suggests to me that this could be a serious problem.

Are there are other symptoms that we could ask him about, which may help to eliminate certain ailments, or point to others?

RE : Did he loose weight? Fever/sweting at night?

Loss of appetite? feeling of going to toilet and nothing come out? (Tinismus)

Any mucus came out with blood?

all these are alarm sign for malignancy.

As the other poster mention, you should take him to see the specialist at proviacial hospital.

Good Luck for the uncle.

It is a series of 3-shots on your arm for pre-exposure inoculation.

It is a series of 5-shots for post-exposure(Bitten) vaccination.

You should get tetanus boots as well if out of date(more than 5-10 years) in case of post-exposure.

Yes and Pa cheng was arrested a few weeks ago for selling her miracle products.

they found that the eye drop she dispense contain millions of bacteria.

Thats so true what Sheryl said.

eventhough doctor explain to the thai patients what was the problem and how to dealt with it. They do not satisfy without pills to take home.

For example back strain, Told them to go for physiotherpy for deep heat ultrasound( at another place with schduled appointment)

told the patient to take celebrex with norgesic,apply NSAID cream,which he/she have them all at home so no need to prescribe anything.

The next day the patient told all the neighbor friends and family, the doctor is incompetent. so what the doctor react?? prescribe every single medication in house for thex next customer!

For doctor who does not put the name of the tablets on, they are afraid that the patient will go buy tablets from the pharmacy (well you can get almost everything over the counter here and some under the counter)and will not return to them.

Normally if you on alloperinol to reduce the uric acid and take just one 0.6 mg of colchicine, to prevent the acute attack while uric acid is still high, should not cause such a bad side effect ( running). When you have acute attack, like the othe poster mentioned, Nsaid is helpful.

As you know, it is not recommended to take in long term treatment.

Good luck

Yes you can buy from the big reputable chemist with the prescription.

on the recent notice to doctor and pharamacist said patient can get repeat prescription with occasional doctor consultant.

I doubt it very much that would happen.,occasionally doctor consultation....

The viagra now will be sold over the counter just like 3rd generation cephalosporin.

It is the hugr push by the big chemists ( as usaul again) so that they can dispense all this tablets eventhough they know it is risky for patients.

For those who have been on many tablets, specially with previous heart /high risk heart problem, make sure you talk to your doctor before starting the tablet.

Have you try the combination of B1-6-12 ( Neurobion, neubeeforte/LM) and nortyline/amitryptyline(25mg)?

You might want to discuss with your doc first how to take all these meds.

They work well with the NSAID, but try to get off the diclofenac if you can.

Long term side effects of kidney damage/elevated blood pressure and gastritis are common.

Avamys Nsal Spary? If so, yes they are available in Thailand.

It is OTC ( big Chemist of course).

Thanks all posters for all the useful advice !

Eek : no, she's not taking the pill.

PMNL : Yes, she told me that she sometimes vomits during these pain attacks. What could this mean in your opinion ?

It could be migraine as the other poster said but it could be something more serious than that such as intracranial mass/brain tumor.

You need to get the doctor to exam and see if she has any neurological defect e.g. double vsion, abnormal eye movement, if there is not it is most likely to be migraine in my opinion.

It seems to be a problem with ADHD medication in the US. If i remember correctly, the FDA announced precuation on using those tablet due to sudden death in the kids. The thai FDA then will suspend the import of the medication, they will only have supplies until October 2010. You may have a look at Sripat/Suandok hospital or at Suanprung or at any psychiatrist private practice.

Sorry, could not be more helpful.

Does the pain come just before/ around her period?

What is the character of the headache? Throbbing at one side of her head?

If she has all the symptoms, the most likely diagnosis would be migraine.

Does she has any neurological problem? blurred vision? double vision?vomit when severe pain/projectile vomitting?

If so, it is serious and should be evaluated bythe neurologist/neuro-surgeon.

I would recommend that you take her to any local clinic/hospital to seek professional medical advise before starting any medication.