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Take montilucast + cetrizine twice day for 15 days do regular gargling twice day & plain water steam inhalation get cbc esr & xray chest.

It's some time natural and very from person to person. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. It has probably affected every man at some point in his life. Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines. In many cases premature ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve how well they can control ejaculation.

Dengue fever is a painful mosquito-borne disease. It is caused by any one of four types of dengue virus, which is transmitted by the bite of an infected female aedes aegypti mosquito. Common symptoms of dengue include high fever, runny nose, a mild skin rash, cough, and pain behind the eyes and in the joints. However, some people may develop a red and white patchy skin rash followed by loss of appetite, nausea, vomiting, etc. Patients suffering from dengue should seek medical advice, rest and drink plenty of fluids. Paracetamol can be taken to bring down fever and reduce joint pains. However, aspirin or ibuprofen should not be taken since they can increase the risk of bleeding. The risk of complications is in less than 1% of dengue cases and, if warning signals are known to the public, all deaths from dengue can be avoided. Malaria on day 1 of fever besides cbc, can do smear for mp & / rapid malarial antigen or rma test. Ensure the card test is a combined test for all relevant plasmodium species as some cards are only p falciparum specific. Card test can remain + ve for a week or more despite adequate antimalarial rx. Hence a febrile pt with rma test +, & h/o treatment taken with smear negative needs no further antimalarial rx. Dengue ns1 best test is ns1 cannot be false +ve is + from day 1 to 7 ideally. If on day 1 is -ve, repeat it next day. Always ask for elisa based ns1 tests as card tests are misleading.

High grade fever with chills & alternate day use mosquito repellent cream or net primaquine tab is used as preventive medicine.

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Managing a hectic schedule is part of our daily lives. Our lives revolve around work, home and social life and the little time we get is used to relax. Due to this round-the-clock schedule our health suffers. With a little bit of planning and time management, we can certainly move towards the 'healthy-route'. Here are a few easy tips that you can incorporate in your daily routine to not only stay fit, but also be more energized while you’re at your daily activities.
1. Go for a walk - If you live close to your workplace then quit taking your two or four wheeler to work. Better still, even a public transport is a strict NO. Either ride a bicycle or simply choose to walk down the lane. While at work, avoid sitting for consecutive hours at your workstation. Take a break and walk in your office complex after lunch with friends. When at home, avoid being a couch potato. Head for an early morning walk to the nearby park. You may even take a leisure-walk in your garden area or in the street nearby post dinner. Walking is indeed the easiest way to stay fit!
2. Replace the elevator with stairs - Use the stairs instead of the elevator. You don’t waste any time and you don't have to go out of your way to work on your health! At places with escalators, walk up the stairs it's no harm. It's easy and can be done daily.
3. Simple Exercises - Spending a lot of time in front of the television or desktop? Why not utilize it with some stretching exercises. While you're at home do some yoga, stretching or sit ups and during your office hours, simply do some eyes, legs, wrist and neck rotation exercises. This way, you will keep yourself distracted and at ease.
4. Use music as a stress buster – Music keeps your brain relaxed making you more energetic and lively. Have some fun while doing your daily chores at home and work. Play some peppy music and dance to those tunes. Not only will your mood be elated but this will also help you burn some extra calories. While at work, its best to put on your headphones and bid work-load stress goodbye. This will calm your nerves and will help you focus better!
5. Don't outsource house work - You can start doing more of high energy things like washing your car, getting a cup of coffee/tea from the office cafeteria, digging the garden or reorganizing the closet to include physical activity in your lifestyle! Usually you have someone to help you with these little home and office chores. However, if you chalk out some time and do these simple things, not only will you save on money but also add a really healthy practice in your schedule.
Now that you have these smart tips, include them in your lifestyle and prepare for a better and healthier future!

Dr Jayesh Pavra. (M D Medicine)

If you have not heard, the reshape integrated dual balloon system has recently been approved by the fda. The reshape is the first non-surgical weight loss procedure for people with mild-to-moderate obesity.
Feel uneasy about the idea of having balloons in your belly? rest assured, balloons have been used in medicine--specifically heart and cardiovascular procedures--for decades.

The reshape is a dual balloon mounted on a flexible shaft that is inserted endoscopically in the stomach and filled with saline. It works by restricting food intake and slowing gastric emptying. Insertion is done during a 30-minute outpatient procedure and the balloon remains in the stomach for six months where it mimics the natural curvature of the stomach to enhance tolerability.
In the reduce clinical trials (n=326) looking at the reshape, the fda determined that the device was safe and effective based on a clinical trial involving 326 obese participants aged 22 to 60 years who had at least one obesity-related condition. One hundred eighty-seven participants randomly selected to receive the reshape dual balloon had lost 14.3 pounds when the device was removed at 6 months as compared to the control group, which lost 7.2 pounds on diet and exercise alone. The results showed a 2.3 times greater weight loss in the reshape group compared to the control group.
They had kept off on average 9.9 pounds of that lost weight at the end of the following 6 months. The remaining participants who underwent a sham endoscopic procedure without the insertion of the device lost on average 7.2 pounds after 6 months.
The dual balloon structure is designed to minimize the risk of migration or obstruction in the unlikely event of a balloon leakage or deflation. Comprehensive counseling and support services such as in-office sessions will be provided to patients during the six months of treatment and for six months after it is removed.

Who are reshape candidates?
It is intended for adults with a bmi of 30-40 kg/m2 who have one or more obese-related health conditions such as hypertension, dyslipidemia, or diabetes and have had unsuccessful weight loss with diet and exercise alone.
Patients may experience vomiting, nausea, abdominal pain, gastric ulcers, and feelings of indigestion once the device is in the stomach. Intestinal obstructions have been reported due to deflated balloons passing into the intestines and have required surgical removal. Death due to intestinal obstruction is possible and has been reported with other intragastric balloons.

Most people with diabetes – myself included – have things about their diabetes that they prefer to keep to themselves. But as a diabetes psychologist, one of the biggest challenges that I have in my practice is when I have a patient who prefers to keep their diabetes, and everything that it involves, a secret from people in their life. I’m not talking about details like their last A1c or what their blood sugar was the last time that they checked, but everything. When someone tells me that they prefer to hide diabetes from other people, it usually tells me that they aren’t taking care of themselves.

I don’t necessarily think that choosing to be secretive about having diabetes is necessarily a problem in and of itself. Everyone has the right to share, or not, anything about their health care, including what medical conditions they face. However I am a firm believer that behavior (which also includes the ‘act’ of not doing something) is functional. So when someone wants to be secretive about having diabetes, my question is ‘what function does this need for secrecy serve?’ Generally, it is one of 3 things:

Denial: A big reason that people with diabetes don’t tell others about their diabetes is because they are having trouble accepting that they have diabetes. By keeping it a secret, it helps them keep up the belief that there’s nothing wrong. Talking about having diabetes to others makes having diabetes seem more real. Not telling others about their diabetes lets them hold out hope that it will just go away (Spoiler alert: It won’t!)

Embarrassment: It’s really common for people to be embarrassed about having diabetes. This embarrassment usually comes from one of two places. First people may be embarrassed that they are not ‘healthy’ and feel like there is something wrong with them. Second, some people are embarrassed by the things they have to do to manage diabetes, like wear a pump, give themselves a shot, or check their blood sugar. They feel like diabetes makes them different and may have some affect on their relationships. To help them feel less embarrassed, some people keep diabetes a secret.

Burn-out: People tend to talk to their friends and family members about things they are excited about and that are important to them. If someone is keeping their diabetes a secret, it may be a sign that they are burned out and that diabetes isn’t a priority to them at that time. This is a normal feeling. What people forget sometimes is that keeping diabetes a secret from others can make it a lot harder to get support and encouragement.

While some people find that keeping diabetes a secret may work for a time, but it also usually causes other problems. First, keeping a part of you life hidden from those around you takes a lot of work and can be exhausting. Also, keeping diabetes a secret usually means people aren’t able to manage their diabetes very well, making them feel bad physically.

Before choosing to keep diabetes a secret from others remember to ask yourself what function does keeping it a secret serve. Your answer may surprise you!