Q: My 31 years old male friend had a marble like round growth in the scrotum and the doctor diagnosed it as a cyst. It is a little painful if pressed. Sometimes his groin pains and feels a little hot too. Now he has pain in the whole body, mainly in bones, joints, cranium, backside and terminals of long bones. He feels weak and stressed. His HCG, LDH, AFP were normal; uric acid, urea, creatinine, glucose and LFT, etc. were normal too. He has weak musculature and deposition of sebum in ear is high. He has a little high haemoglobin F and A2 with a little anaemia. Iron profile is normal, ANA and anti DS antibody are normal too. The doctor says he has thalassaemia. He used to smoke earlier for 10 years but now has quit a week ago. He has marginal hepato- and splenomegaly. His brain CT scan was normal. Pain in joints and scrotum is disturbing. Please advise.

A:Your friend needs to do the following:

• See a urologist after getting an ultrasound scrotum. Most cysts in this area are harmless but can cause discomfort because of a stretching sensation and constant friction.
• Thalassaemia (Thal) minor does not need any treatment except folic acid supplementation. No role of iron supplements unless he is iron deficient. Thal minor will not reduce fertility but once he is married, the person's spouse would need to be tested for thal trait to prevent thalassaemia baby from being born.
• Most investigations have been done and normal. He can do CPK, ANA-IF, TSH, vitamin B12 levels, reticulocyte count additionally and discuss reports with a physician. There are number of medications available for chronic non-specific pains
• Needs a regular exercise routine to improve muscle tone and overall well being.