Prof Dr. Rizwan Ashraf

05/02/2023

06/07/2022

Case Presentation
A 55-year-old obese male known case of Type 2 Diabetes mellitus for last 12 years presented with complaints of profuse sweating while having his meals. According to the patient, he feels uncomfortable during social gatherings as the sweating is very severe and starts as soon he start eating. Patient slso complaints of burning and numbness of feet. Labs revealed FBS of 280 mg/dl and HbA1C of 8.2. Patient informed that his blood sugar remained uncontrolled mostly despite taking his prescribed antidiabetic medications.
The major concern of patient was profuse sweating. Lipid profile was advised ehich revlead elevated LDL and decreased HDL levels. The weight of the patient was 98 Kg. The patient was councelled about dietry modification and exercise and started on Insulin Aspart and Lantus combination along with oral antidiabetic agent Dapamet 5/1000 mg twice e a day along with Tab Rosuvastatin and Aspirin 75 mg once a day.. Although both FBS and RBS was found to be well controlled after initiating the current management, however the patient concern of profuse sweating remained unsolved. Diagnosis of Autonokic neuropathy was made and patient was councelled accordingly.

Gustatory sweating (GS)
characterized by profuse sweating during or immediately after ingestion of food and is known as a complication of diabetes mellitus (DM).
Gustatory sweating refers to facial sweating after ingestion of food or drink. Gustatory sweating may develop as a symptom of autonomic dysfunction in patients with diabetes. It is reported in long-standing diabetes mellitus with associated complications such as neuropathy.

06/07/2022

Dr Rizwan is now available for online consultation.
Contact details for appointment: whats up 03234457445

10/11/2021

Case
A young girl of 16 years presented with painful swollen bumps at the back of tongue for one day. She also gas sore throat for 2 days. On examination multiple swollen bumps seen at the back of tongue. Tonsils were also found to be enlarged and mildly inflamed.

What is the most likely problem?

Typically, small bumps (also known as papillae) cover the surface of the back part of your tongue. Between the papillae are your taste buds that help you taste foods. Usually, these papillae are pretty unnoticeable. But sometimes, they become enlarged and can cause you pain.

What Are Symptoms of Bumps on the Back of Your Tongue?

Depending on the condition that causes the bumps, other symptoms that may accompany bumps on the back of the tongue include:

Pain when eating or swallowing

White patches lining the cheeks, on the tongue, or on back of the throat

Redness inside the mouth without white patches

What Causes Bumps on the Back of Your Tongue?
Some common causes of bumps on the back of the tongue include:

Transient lingual papillitis
Very common
Usually a single painful raised red or white bump on the tongue
Commonly caused by local irritation or trauma to papillae.
Other possible triggers may include stress, hormone fluctuations, gastrointestinal upset, and certain foods.

What Is the Treatment for Bumps on the Back of Your Tongue?

Transient lingual papillitis
Most of the time, no treatment is needed as the bump will go away on its own within hours to days
Salt water mouth rinse
Drink cold fluids
Topical antiseptics
Anesthetic mouthwash
Topical steroids

08/11/2021

Trulicity (dulaglutide) is an injectable diabetes medicine used to control blood sugar levels. together with diet and exercise in adults with type 2 diabetes mellitus.

Trulicity is taken once a week.

Trulicity should be injected subcutaneously (under the skin) in one of the following injection sites: the abdomen, thigh, or upper arm.

22/05/2021

Feeling of a lump in the throat
(Globus Pharyngeus)

Globus Pharyngeus refers to the feeling of a lump in the throat. Some people describe this as a ‘tightness’ in the throat which is commonly felt when swallowing saliva. This is usually not associated with sore throat. They don’t experience any difficulty in swallowing food, in fact some people find that the globus symptoms are better while eating and drinking. This globus sensation is usually felt in the front of the neck and it can move up and down or sideways.

How common is Globus Pharyngeus?

It is reported by up to 46% of apparently healthy individuals, with a peak incidence in middle age. This condition is equally prevalent in men and women, though the latter are more likely to seek health care for this symptom.

Symptoms of Globus Pharyngeus

Feeling of lump in the throat
Throat clearing
Person experiences heart burn like symptoms
Post nasal drip – sensation of mucus trickling down the throat

What are the potential causes of Globus Pharyngeus?
Acid reflux – There is enough evidence to suggest that many patients with globus have concomitant acid reflux.

Potential causes of Globus Pharyngeus?

Acid reflux – There is enough evidence to suggest that many patients with globus have concomitant acid reflux and that there is a true association between acid reflux and globus.
The reflux of acid from the stomach causes irritation of throat which is felt as ‘a lumpiness’. The acid also causes an increase in tone at the upper oesophageal sphincter (UES) which results in an abnormal sensation in the throat (cricopharyngeal spasm).
Post nasal drip – (mucus runs from the nose into the back of the throat)
Stress and tiredness
Voice strain
Smoking triggers globus symptoms