Ask the doctor

Your drugs: How does Panadol work? Acetaminophen belongs to a group of medicines called analgesics (pain relievers) and antipyretics (fever reducers). It works quickly to relieve pain caused by conditions such as headache and osteoarthritis, and to reduce fever caused by infection. Unlike acetylsalicylic acid, which is also an analgesic and antipyretic, acetaminophen does not reduce inflammation.Acetaminophen is used by itself as well as in combination medication products for cough, cold, and pain relief.Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.Do not give this medication to anyone else, even if they have the same symptoms as yours. It can be harmful for people to take medication without a doctor’s prescription.Acetaminophen can be used by all age groups in recommended doses.Children (general): 10 to 15 miligrammes per kilogramme of body weight, every four to six hours, to a maximum of 65 miligrammes per kilogramme in 24 hours. Children should not take more than five doses in 24 hours unless advised by a doctor. For children under six months of age, consult a doctor.Adults: 325 miligrammes to 650 miligrammes every four to six hours to a maximum of 4,000 miligrammes in 24 hours.-------------------------------------Why do I have chest pain while breathing?Dear Doctor;I am a 22-year-old student suffering from shortness of breath. When I breathe pain occurs in the left chest and it has started four months back for five days. This started four years ago. Michael.Dear Michael, The pain that occurs whenever you breath sounds like pleuritic chest pain. It refers to inflammation of “pleura,” the membranous coverings of the lungs. They normally move along with the lung with every breath and you are unaware of the sensation due to the lubricating action of pleural fluid. However, when there is inflammation in the pleural space, the movement with each breath is longer painless. The acute onset of fever , pleuritic chest pain is indicative of pleuritis. Whether, this is bacterial or viral, is difficult to tell from the supplied information. I am not sure which side of your belly the surgery was done, it is very unlikely the above mentioned surgery is related to your present pleural effusion after a long gap of 4 years. TB pleuritis is unlikely given the presence of “low lymphocytes” though it would be good to know the absolute number of WBC’s and the distribution of monocytes, lymphocytes, eosinophils. It would be good to know the other chemistries also (total protein, Albumin, RBC’s etc. It would be good to know whether it was a small, moderate or a large effusion. I am assuming that you do not have any other major medical conditions like lupus, rheumatoid arthritis etc. With the limited information supplied, it would be good to obtain a repeat chest X-ray in a month from now (to look for the resolution of the pleural effusion). If the symptoms resolve and the pleural effusion resolves in a month from now, it would be safe to assume it was a self limiting process like viral pleuritis.------------------------------------What causes knee joint pain after exercising?Dear Doctor;I am 42. I just started running, jogging and mild exercises after a gap of six years. After a week, I started experiencing right knee joint pain. Initially, it was in lower right side of the knee. Due to knee pain, I have stopped running and exercising. For the last five days, I am feeling severe pain in my right knee and cannot stand for more than 10 minutes. After massaging, I feel better and I am able to walk a distance. Now I am feeling stiffness of muscles. How can my knee joint pain be managed? Francis.Dear Francis, Your symptoms are suggestive of generalised osteoarthritis, including spine and knee joints. Your right leg pain might be due to compression of nerves in the lumber region resulting in radiating pain in the leg. To confirm that and to find any other cause, you are advised to consult a rheumatologist or a neurophysician, perhaps a MRI of lumbosacral region will be required to ascertain the possibility of nerve compression. Alternative causes can be internal knee derangement, muscle pull after doing the exercises. Please contact doctor as advice above for full check up.------------------------------------I have a painless swelling under the jaw, near my earlobeDear Doctor;For the last two months, I have been noticing some swelling under the jaw, below my ear lobe. There is no pain or itching. I consulted an ENT (ear, nose and throat) expert who prescribed some medicines for 12 days but there hasn’t been any improvement. Mukamusoni, 27.Dear Mukamusoni, Painless swelling under the ear lobule may be from the tail of parotid gland. These glands are present on both sides of the face and produce saliva. Fine needle aspiration cytology from the swelling can give an idea about the pathology of the swelling. In bacterial infection the swelling is painful so painless swelling is unlikely to respond to antibiotic. Other possibilities are reactive hyperplasia of lymph node, benign cyst or tubercular pathology. A fine needle aspiration cytology by pathologist can help in the diagnosis.------------------------------------How long do HIV symptoms take to surface?Dear Doctor;I want to know the difference between window period and symptom period with respect human immunodeficiency virus (HIV) infection. I have read that skin itching is not the sole but a very common symptom of HIV. Is this true? How long do HIV symptoms take to surface? Edwin, 43.Dear Edwin, Window period is the period during which the HIV infection is present in the body but the antibodies against this virus are not detectable in the blood test. There is no term like Symptom Period. What you probably mean is the Incubation Period, which refers to the time period between entry of HIV in the body and appearance of symptoms of AIDS. This period can vary from two years to 12 years. Itching alone is not a symptom of primary HIV infection.-------------------------------------Is my wife at a risk of abortion?Dear Doctor;My wife experienced heavy bleeding after removing Copper-T. She is pregnant. We consulted a doctor who suggested some medicines. A scan revealed that the baby’s condition was good. I have a fear that there might be a possibility of problem if she continues pregnancy. My first child (now six years old) was born with delayed milestones and still he is unable to speak fluently. Should my wife continue her pregnancy? Worried Man.Dear Worried Man, Regarding continuing the pregnancy you need to decide between you and your wife. Medically, the pregnancy may continue if bleeding stops. The intrauterine contraceptive device (IUCD) inside can increase risk of abortion and infection. Copper T does have a two to three per cent risk of failure and pregnancy. You can also wait it out if the fetal heart is seen–and let nature take its course for few days, after which picture will get clearer. If there is any fever your doctor may need to start antibiotics.--------------------------------------Why do I get recurrent miscarriages?Dear Doctor;I had a miscarriage six months back because there was no cardiac pulsation. Now I have conceived again. I got my last period three months back. As I skipped my periods and was experiencing pain in the lower abdomen, but internal sonography test shows there is no heartbeat. I am worried and don’t want to go through that trauma again. Lindah, 26.Dear Lindah, You will need to have a urine pregnancy test done and a repeat scan after two weeks to look for heart beat, maybe along with a Doppler detection of heart beat to be sure that it is present or absent. If the heart beat is present- the same medications can continue, along with bed rest and avoidance of coitus. If it is absent, then maybe a repeat miscarriage has occurred and it can be ended by the use of medications like prostaglandins, to end the pregnancy remains, or by a surgical D & C, depending on availability and patients choice. Follow up to find cause of miscarriage and repeat planned pregnancy will need to be done through care in a high-risk pregnancy unit.