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Dr. Krishna N Reddy

MBBS

Psychiatrist, Bangalore

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Dr. Krishna N Reddy MBBS Psychiatrist, Bangalore
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To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. Krishna N Reddy
Dr. Krishna N Reddy is a trusted Psychiatrist in Hombegowda Nagar, Bangalore. He has completed MBBS . You can meet Dr. Krishna N Reddy personally at National Institute of Mental Health and Neuro Sciences Hospital (NIMHANS) in Hombegowda Nagar, Bangalore. Book an appointment online with Dr. Krishna N Reddy and consult privately on Lybrate.com.

Lybrate.com has a number of highly qualified Psychiatrists in India. You will find Psychiatrists with more than 31 years of experience on Lybrate.com. You can find Psychiatrists online in Bangalore and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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I was addicted to ganja for three years. Now I stopped but sometimes trying once in a week. Due to this habit, I went in depression as I lost my engineering year. Now I want to quit completely and my parents are supporting me at all the levels but what is effective simple solution for this one to leave this habit completely and devoted myself for my studies and future?

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear, leaving the ganja habit usually requires will power or usually rehabilitation treatment. In your case, you should stop it fully and purely concentrate on your studies. Be serious about your education, set long term and short term goals, make time tables, manage time, play games and exercise rigorously, drink plenty of water and fruit juices, change the place you live etc. All these change in life style will provide a good boost to your quitting urge. Take care.
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I had been taking lithium for my sleep disorder and generalised anxiety disorder. I feel relaxed and focused after that. My psychiatrist provided this lithium. I want to know is there any sideeffect?

Reparenting Technique, BA, BEd
Psychologist, Bangalore
I had been taking lithium for my sleep disorder and generalised anxiety disorder. I feel relaxed and focused after th...
These are some of the known effects of using lithium. Incidentally, all psychotropic drugs have some side effects and so will lithium. Lithium can cause nausea, diarrhea, dizziness, muscle weakness, fatigue, and a dazed feeling. These unwanted side effects often improve with continued use. Fine tremor, frequent urination, and thirst can occur and may persist with continued use. Weight gain and swelling from excess fluid can also occur.
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Are there any mental screening tests to find out the extent of depression? I mean tests like brain imaging, MRI etc.

DNB (Psychiatry), DPM, MBBS
Psychiatrist, Mumbai
Are there any mental screening tests to find out the extent of depression? I mean tests like brain imaging, MRI etc.
Neuroimaging techniques like mri and ct scan are not very much specific for depression although they show some findings. Newer imaging techniques like fmri is much better for detecting psychiatric disorders but its very much expensive and currently used as a research tool and seldom as diagnostic tool.
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I am not able to concentrate on my studies I used to be a very good student but from past 2 months I am not able to concentrate on my studied. Please advise me?

MD - Psychiatry
Psychiatrist, Jaipur
Hi. Along with that if you are not able to concentrate other task as well as difficulty in falling asleep, pessimistic thought about future, impaired sleep and appetite or irritability you might be suffering from depression. If don't so still I advice you to see a psychiatrist. He would definitely help you.
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Hi doctor I am nizam and my question is how to lose our bodyweight, And how to increase our memory power?

M.S - counsellig&psychotherapy
Psychologist, Vijayawada
Very easy to reduce your body waight. First take strong decision on it. Daily look your physic in mirror get feeling slim, while eat something keep in your mind you want to became slim love it your feeling. Freqently chec your whight. Memory can increase by interest only. Medications wont work. Read and write, recall can help to increase memory.
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I am 25 yrs old and a student of gu. Sir can u suggest a medicine for improving my memory.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear , I can understand. You are just 25 and I just don' t see any impending problem to your memory. Please introspect. If you can recall the story of a popular movie you last seen, or if you can remember the names of your favorite friends, or if you can remember what you ate for yesterday' s break fast and dinner, possibly you do not have any memory problems. If you feel memory problems in your education, then the problem lies in your interest to the subject and the way you study. If you get bored while studying, naturally, you understand nothing, thereby no recollection. After going through the above two paragraphs, you please introspect, and come back if you still want to clarify something. Take care.
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I am 20 years old. I have bodyache since 2 days and small fever too. Can you tell me why?

MBBS, cc USG
General Physician, Gurgaon
I am 20 years old. I have bodyache since 2 days and small fever too. Can you tell me why?
kindly follow advises given below Avoid exertion, Take Tablet Paracetamol 500 mg after food as and when required for Fever more than 99 F (maximum 3 tablets with gap of 8 hr can be taken in a day) for 3 days, lot of fluids to be taken, Take proper diet homemade food like moong dal dalia, chapati etc Avoid wearing synthetic and tight cloths.. Consult If Symptoms persist or worsen
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EMPOWERING YOURSELF - YOU CAN CHOOSE NOT TO BE SAD

Post graduate in counselling psychology
Psychologist,
EMPOWERING YOURSELF - YOU CAN CHOOSE NOT TO BE SAD
1. Avoid thinking about the people who has hurt you

Another person’s hurting words and actions can certainly trigger sad thinking and feelings but remember over thinking on those words will lead you nowhere. Putting your energy to think another people’s actions and behaviour, on which you have no control, can lead you in a state of sadness, self-compassion and hopelessness. Psychologist Shivani Misri Sadhoo suggests on such conditions when another person hurts you, remember yourself that you have no control on another person’s actions and mindset, be it good or bad. So don’t waste your time or energy thinking about the incident. Instead of that, focus on inner conversations, self-analysis and put efforts to improvise things in your life and its goals.

2. Embrace optimism in your life:

Often when people get hurt they explain things to themselves in a pessimistic way. AVOID that. Remember very often pessimistic thinking approach leads to self-isolation, depression and withdrawal. What is required rather - being optimistic, try to adopt a way of thinking like, “the person talked to me roughly, did I wrongly intervene in his/her personal space? , I should take care of this next time”, or “something might not be right at that person’s end and his/her rough behaviour is an outcome of that situation”. Such kind of thinking style will always help you to become a better observer of life and will improve your interpersonal skill and the way you handle yourself.


3. Friends and relatives VS Telephones Mobiles and computers

Sitting in front of TV, Mobile and laptop screen for hours reduces brain stimulation. Remember humans are designed to do whole body movement, to move our muscles that stimulate our cerebellum, which in turn stimulates our cortex. So tell yourself if you want to be happy in life, then choose family outings, relative visits, friend gatherings, exercises over TV, mobile and PC.
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All About Parkison's Disease

MBBS, Master In Health Science
Neurologist, Mumbai
All About Parkison's Disease

* Should I be afraid of talking to the doctor?
No. Every doctor wants his/her patient to recover as soon as possible. If patients have the right knowledge, they are able to interpret and report their symptoms better. Having this knowledge prevents unnecessary anxiety and greatly facilitates diagnosis and treatment.

It is the duty of every doctor to provide the right information to the patient, and every doctor tries to do this to the best of his/ her ability. Sometimes it is not possible to provide thorough information and answer all questions of a particular patient, because then the doctor will not be able to give adequate time to the next patient. Th is is the main reason behind writing this book. In many cases, patients do not want to talk to their doctor because they are afraid of knowing more about their illness. This is the wrong approach. Knowledge is power. I assure you that having the right knowledge will decrease your anxiety and help you get better.

I do have one suggestion: before going to the doctor, write down all your questions on a piece of paper. Almost all doctors will be very happy to answer your questions if you ask them efficiently.

* Why should I pay attention to my symptoms? just run some tests and you will know what disease I have...
Tests can be helpful, but they cannot diagnose all diseases. Often, no test can detect the small short-circuits in the brain that are responsible for causing seizures. Until very recently, there was absolutely no test that could diagnose parkinson's disease. Tests cannot tell the doctor how you are responding to the medication. For example, in parkinson's the doctor may ask you how you feel in the morning, how long the eff ect of medication lasts, do your arms or shoulders jerk after you take medication, and so on. Each symptom is important for the correct diagnosis and treatment of your condition. You and your immediate family members can provide the doctor with this essential information. If you have difficulty remembering your symptoms, you should note them in a notebook. If you have difficulty describing some of your symptoms, you should make a video recording for 3-5 minutes using a smartphone or digital camera (android, Iphone etc). Such recordings are tremendously helpful for diagnosis and treatment.


* What are the common tests used to diagnose brain diseases?
The three tests most commonly used are:
Mri, ct scan and eeg. Other specific tests have been described in the relevant chapters.
(i) Mri (magnetic resonance imaging) scan:
An mri scan is probably the most important test for diagnosis. It can diagnose many diseases such as a stroke, tumor and inflammation. Mri scanning is done in a big tube shaped machine which is attached to a bed. Th e patient sleeps on the bed for 30-45 minutes. Th e bed slowly moves back and forth through the machine. During this time the machine clicks very detailed pictures of the patient's brain.

Please note that during the scan you may hear some loud whooshing and clicking sounds. Th ese are just the sounds of

Magnets and motors inside the machine, and there is no need to be concerned by these noises. Some people may feel anxious because of the small space within the scanner, and a few people may need medications to decrease this anxiety. Mri scanning is extremely safe; there is usually no health risk. Before the scan, please inform the doctor about any metal inserts or implants (e. G. Heart defi brillator) In your body.

Mri test machines are of various strengths such as 1.5 tesla, 3 tesla and so on. Mri machines with a higher number (for example 3 tesla) take better pictures. This book was written in 2015, at this time the highest resolution mri available in india was 3 tesla.

(ii) Ct (computerized tomography) scan:
The CT Scan machine looks just like the mri machine. It has a bed that moves back and forth slowly while the machine takes a picture of your brain.

CT scan has a few advantages over mri:
(i) It is less expensive. An mri may cost around 5000-7000 rupees, while a ct scan usually costs around 1000 inr (indian rupees).
(ii) It can be done very quickly. An mri may take 1 hour or more, but a ct scan can be completed in 10-15 minutes.

Unfortunately, CT scanning has some significant disadvantages:
- The picture obtained by a ct scan is not as clear as that obtained by an mri. The difference in quality is striking: it is like the diff erence between a black-and-white tv from the 70s and the new lcd televisions available today.

- CT-Scan exposes your body to radiation.
Radiation is bad for your body, and especially a baby's body. Therefore, pregnant women should never have a ct scan. Ct scan is commonly used during emergencies. When a patient comes to the emergency room, a rapid ct scan may be done to look for emergencies which may need immediate surgery such as bleeding inside the brain. An mri is usually done the next day, when the patient is more stable.

If you have already had an mri, then usually you do not need a ct scan. Th ere are a few rare conditions (e. G. Calcification in brain) which are seen better on a ct, but these are very uncommon.

(iii) Eeg (electro-encephalo-graphy):
Our brain functions because of electric currents traveling from one place in the brain to another. An eeg measures this electric current.

To do this test, small pieces of wire are stuck to the head using glue. These wires are then connected to an amplifi er and the electrical activity in the brain is recorded. The machine itself does not send any current to the brain. It only records current. Therefore, there is no pain or discomfort, and this is an extremely safe test. Anyone can have this test, including pregnant women, babies and very sick patients. Th is test is most often used for evaluating seizures. An eeg is also used in cases where the patient is unconscious for a long time, without a clear reason.


1. Doctor, my hand keeps shaking. It stops shaking only at night. Why is this happening?
The shaking of your hands is called a tremor. There are many causes of hand tremor. Th e most common causes are essential tremor and parkinson's disease. If you have essential tremor, your hands will shake more when you try to do something. For example, writing may become very diffi cult or water may fall down when you try to drink form a glass.

If you have parkinson's disease, the tremor is maximum when your hands are resting and doing nothing. For example, when you are sitting on a chair and watching tv comfortably, the hand starts shaking. Besides these common causes, there are other causes. For example, shaking of the hand (s) can begin after a small stroke near an important part of the brain called the red nucleus or in a condition called dystonia which causes contraction of the hand muscles without any clear reason some medications (see list), severe anxiety and very excessive tea/coff ee can cause hand shaking. Finally, there are diseases that have symptoms exactly like parkinson's disease.

Therefore, I need to examine you carefully. Based on observing you so far, I think there is a possibility that you may have parkinson's disease.


2. Parkinson's! I have heard this is an extremely serious illness! is this disease fatal?
No. Parkinson's disease is not fatal. Yes, but it is important to treat parkinson's disease promptly. Th e diagnosis of parkinson's disease is often missed. If not treated on time, patients with parkinson's disease are significantly restricted in their day-to-day activities, practically becoming disabled if treatment is delayed for a long time.

Secondly, if left untreated, patients with parkinson's disease can have frequent falls causing serious injuries including fractures and head injuries. Hence the diagnosis and treatment of parkinson's disease should be done as soon as possible.


3. What causes parkinson's disease?
Our brain runs on electricity and chemicals. If there is too much or too little of a particular chemical in your brain, it causes a disease. Parkinson's disease is caused by the reduction of a chemical called dopamine in our brain.

Dopamine is produced in the back of our brain, in a part called the mid-brain. It is then transported forwards and is widely distributed throughout the entire brain. It fi res up the movement centers of our brain, and helps them communicate better with one another. In parkinson's disease the cells in the midbrain producing dopamine gradually

Die. No one quite understands why this happens. Then effect is that the movement centers of the brain don't Communicate well with one another, and this produces the various symptoms of parkinson's disease.


4. Ok so what are other symptoms of parkinson's?
You already know one symptom shaking of the hands while resting. There are many other symptoms in patients with parkinson's disease and recognizing them is often very easy:
- Their muscles are often stiff and become inflexible, but they often do not complain about it. Th ey may complain that they are not able to do some things such as comb their hair.
- They are very slow in doing everything. They walk very slowly. They often bend forward while walking.
- They have difficulty turning around when they are walking.
- Sometimes they can get stuck in one position. Often this happens while walking, but may happen while doing something else.
- In later stages, they can fall frequently.
- Their friends may notice that their face has become expressionless and they just appear to stare off without blinking into distant space.

All patients do not have all of these symptoms. Some patients experience just the shaking of hands; other people experience just the muscle stiffness and so on. Often as people get older, more and more of the dopamine producing cells are destroyed and patients start developing more symptoms. But it takes years for this to happen and it may not happen in all people. In some patients, parkinson's disease remains restricted to just a few symptoms.


5. Ok doctor, thankfully I seem to be having just the hand shaking at this time. But other than the symptoms you just described, I am having other symptoms. I am always constipated, I cannot sleep well, and my saliva keeps dribbling from my mouth. Is it possible that these symptoms are also related to parkinson's disease?
Yes. It is not just possible but very likely that all these symptoms are due to parkinson's disease. Parkinson's disease is recognized by all doctors as a disease affecting movement. But in addition to movement problems, patients can have many other problems.

These are frequently not recognized, even by physicians, and therefore left untreated. If recognized and treated (and simple treatments are available for many of these symptoms), their resolution can significantly improve the patient's quality of life. It is important that your doctor should think about other diseases too. For example

If you have back pain, it is important that the doctor should think about arthritis of the back, if you have impotence your doctor should think about diabetes etc. But in many cases, no other cause can be found - these problems are due to parkinson's disease. About 10-20 years ago, even doctors did not know about these complications of parkinson's disease. It is a matter of great pride for me that I had the opportunity to receive training from the world-famous indian professor who is at the forefront of research regarding these symptoms: Dr. Kallol ray chaudhuri at king's college hospital in london.


6. How can you be sure that I have parkinson's disease?
A better patient history and examination will help me to confirm my diagnosis. We need to rule out other problems which look like parkinson's disease. Certain drugs may produce symptoms that are very similar to parkinson's disease (see list). Make sure you are not taking these medications, and avoid these medications in the future.

There are a few other diseases which have almost the same symptoms at parkinson's disease. Their names are complicated! these include diseases such as progressive supranuclear palsy (psp), multiple systems atrophy (msa) and cortico- basal degeneration (cbd)! th names are not very important the important thing is that there are other diseases that look just like parkinson's disease. Some of these diseases are identified by your doctor by looking for small clues on your exam: such as your blood pressure and the way your eyes move. Now let me tell you something very frankly even after a very detailed history and meticulous examination, the diagnosis may not be clear in some patients, even to the best of doctors in the best of institutions.


7. So isn't there a test for parkinson's disease?
Unfortunately, there is no test for parkinson's disease which can prove it with 100% accuracy. An mri (see information for everyone section) can be helpful to rule out some other diseases e. G. Multiple strokes, and 
Therefore many doctors get an mri in patients with parkinson's disease. There is one test that can be helpful. It

Is called the dat scan. The dat scan is abnormal in parkinson's disease, but it is also abnormal in some other diseases that look like parkinson's disease! therefore it is helpful only in certain cases. There are a few other tests like a cardiac scan (mibg scan), but these are only available at a few research centers, and again, do not help to completely rule out other diseases.


8. But. That is very concerning. What you are saying is that in some patients the diagnosis remains unclear?
You are correct. In most cases, the diagnosis of parkinson's disease can be made with certainty. But about 10% of patients have an uncommon mixture of symptoms so that no doctor, no blood test, no investigation can confidently determine if the patient has parkinson's disease or if he/she has another, similar disease. In such cases, most doctors explain the situation to the patients, and give them anti- parkinson's medications such as levodopa. Usually, a dramatic improvement is seen if the patient has parkinson's disease. If a patient takes an adequate quantity of Levodopa for 4-6 weeks and there is no clinical improvement, it is very unlikely that he has parkinson's disease.

These medications cause clinical improvement in about 1/3rd of all patients with the other diseases such as msa, psp etc. However, this improvement is not as dramatic as the improvement seen in parkinson's disease and frequently does not last as long. As the years go by, other symptoms develop (such as urinary problems, eye movement problems and falling) and a more definite diagnosis can be made on the basis of repeat examination.

9. Hmm. Doctor, there must be several medicines for parkinson's. If the parkinson's is caused by a lack of dopamine, shouldn't consuming dopamine help to reduce the symptoms of the parkinson's?
Yes, there are many medications and yes you are correct providing extra dopamine to the brain is one of the best ways to make the symptoms better. I have provided a list of these medications, but it is worth highlighting two of them: levodopa is the oral form of dopamine. It is converted into dopamine when it goes inside the brain. Th is is usually the fi rst medication that is started. It is available in standard, dispersible and extended-release

Preparations. Young patients with very mild symptoms of parkinson's disease are given a diff erent kind of medication initially. These medications are called dopamine agonists. Th ere are 3 dopamine agonist medications: pramipexole, ropirinole, and rotigotine. Th ey are available in standard and extended release preparations.


10. So, what you are saying is that the dose of parkinson's medications does not stay constant throughout life?
You are correct. Parkinson's disease often progresses as patients grow older. Some symptoms change and become less prominent but on the whole the symptoms become more severe. Th is progression is probably caused by gradual death of more and more cells producing dopamine. Very few people have side eff ects due to these based on the symptoms that develop, the medications. Often, parkinson's disease dose of parkinson's medication may need progresses as patients grow older and new to be changed, or new medications may be given. For example, if you have trouble sleeping at night, then the doctor can ask you to take an extra levodopa pill at night or an extended release ropnirole pill. If the benefi cial effect of levodopa is not lasting for as long as it used to, the doctor may ask you to take entacapone with the levodopa. If you have constipation the doctor will prescribe a laxative and so on. Sometimes it may take a few trials of different medications over 1-2 weeks to find the right combination that works for you. Parkinson's is not a deadly disease. Th ere are many medications for parkinson's. Th e doctor needs to have precise information about the patient's symptoms in order to prescribe the right medications. In parkinson's disease, the doctor needs help from his/her patient. It is essential to record your symptoms accurately and visit your doctor regularly, every 3 to 6 months.


11. Doctor, you are saying that frequently the dose of levodopa needs to be increased. But what happens if too much levodopa gets into the person's brain?
Yes, this can happen but it is not life-threatening. When there is excessive dopamine in the brain, the body starts moving too much. Often there are small jerks in the neck, shoulders and sometimes in the leg. If you are a fan of michael jackson, you have seen break-dancing. Th ese excessive movements look like break-dancing. Th e medical term

For these excessive movements is dys-kinesias. It is very important for you to be aware of them and remember the word: dys-kinesias. Often, dys-kinesias are at their maximum 1-2 hours after you take levodopa. If you have trouble recognizing these movements, you should take a video of any suspicious movements on your smartphone and show it to your doctor. In the early stages of parkinson's disease, dys-kinesias are only seen when the

Levodopa dose is very high. But in more advanced stages, they may be seen at lower doses and giving the patient an adequate dose of levodopa without producing dyskinesias may become diffi cult. At this stage, some dyskinesias may need to be tolerated. If you are suff ering from dyskinesias, you can reduce the dose of levodopa that you are

Taking. But this may result in some of the symptoms of parkinson's disease (slowness, rigidity, freezing etc) to reappear. Another way in which dyskinesias may be reduced is by giving you amantadine.


12. I am getting it now, doctor. This is like a weighing scale isn't it? too little levodopa causes the parkinson's disease symptoms to come back, and too much levodopa action causes dyskinesias.
Yes! th at is absolutely right. In the initial stages, balancing this weighing scale is very easy. But after 10, 15 or in some cases 20 years, balancing this scale becomes diffi cult. After taking levodopa, many patients improve but also get dyskinesias. It becomes impossible to fi nd a levodopa dose that causes improvement without producing dyskinesias. Th erefore, at this stage, some dyskinesias may need to be tolerated as long as you are able to function satisfactorily.


13. So doctor, you told me what happens when there is too much dopamine action in the brain. What if the there is too little dopamine action in the brain? What if levodopa just stops working?
Levodopa never stops working. But it may become less effective, and its effect may become short-lived. Th ere could be many reasons for levodopa to become less eff ective. These are listed separately the most important reason is that the patient may not be taking the levodopa on an empty stomach. As parkinson's disease advances, the eff ect of levodopa lasts for a shorter duration of time. Here is a somewhat typical story from such a patient. Remember, this happens only in few cases:
Taking the tablet helps me only for a short time. When I wake up in the morning, my feet contract, twist and become painful.


14. I understand. It must be difficult at that stage to find the right combination of medications. What if the situation worsens further?
Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to find the right combination; sometimes even 3-4 trials of diff erent combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health.

Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's

Patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. Th en I take my morning dose of levodopa

And feel good. Sometimes I get some dyskinesias, but I don't complain about them because I am feeling good. But only an hour or 1.5 hours later, the symptoms of parkinson's disease start coming back. I become slower and slower, and then freeze. I get better again when I take levodopa, but I can't keep taking levodopa every hour!

I understand. It must be difficult at that stage to fi nd the right combination of medications. What if the situation worsens further?

Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to fi nd the right combination; sometimes

Even 3-4 trials of different combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health. Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. A proper mixture of medications may help this situation as well. I had given you an
Example of this earlier: entacapone can prolong the eff ect of levodopa.


15. Doctor. Brain surgery? are you kidding me? this is a big deal. By the way, what is this surgery called?
I know brain surgery is a big deal. This surgery is called deep brain stimulation, or this is a brain surgery, but a relatively dbs

If your symptoms are well controlled with medications, no doctor in their right mind would recommend you to have surgery. But in a few patients, medications no longer produce adequate improvement. Either the improvement lasts for a very short time, or the medication produces such dramatic dyskinesias that giving an adequate dose is impossible.

Approximately, 70% of such patients benefit from this surgery. The improvement is very significant, but dbs does not make all symptoms of parkinson's disease magically disappear. It is very important to have realistic expectations from the surgery. The improvement seen after surgery is batteries last for about 5 years, and can be Replaced when required.


16. Well. How is this surgery done?
This is a brain surgery, but a relatively minor one. A metal frame is usually attached to the patient's head. A very small hole (approximately 1 cm in diameter) is made in the head, and a thin (1 to 1.5 mm thick) wire is inserted through it. The wire is pushed into a very particular part of the brain called the sub-thalamic nucleus. Th e same process is repeated on the other side and another small wire is inserted. These wires are then connected to a small battery (a square of approx. 3 inch) that is kept in the skin below the chest. No part of this device can be seen from the outside, and any scars on the head are usually covered by hair in a few weeks. Th e device is usually turned on 4 weeks after the surgery. On an average, most.


17. I see. Doctor, does DBS cure all symptoms of parkinson's disease?
No. DBS surgery improves only those symptoms which improve after levodopa.

- Dbs surgery prolongs the eff ect of levodopa, decreases dyskinesias, improves slowness of movement, hand shaking, muscle stiff ness and in general makes the patient much more functional. However, symptoms that do not get better after levodopa such as freezing and falling usually do not get better after dbs.

- Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body. Other symptoms that we talked about e. G. Sleep problems may get better after dbs. I conducted an audit of sleep symptoms after dbs during my time in london at king's college hospital, and found that there is

Significant, but non-dramatic, improvement in many patients.

Two problems can become worse after DBS:
(i) Severe psychiatric problems such as severe depression and hallucinations and
(ii) Severe diffi culties of thinking and memory. If any of these problems are severe, dbs is usually not off ered to the patient. If a patient has severe psychiatric problems and is under treatment, dbs may be considered in the future if they completely resolve.


18. Okay doctor, what are the risks of this surgery?
Th ere is a small amount of risk involved in any surgery. Since dbs surgery is relatively minor, the risk is low but is not non- existent.
- The risk of death is less than 1%
- Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body.
- A few patients have minor problems such as problems in wire connections or a non-functioning battery. Th ese are easily corrected. In short, about almost 90-95% of patient do not have any complications during or after the surgery, and the risk of death or permanent problems is very small (lts 2%).


19. Can the doctor guarantee a significant benefi t after DBS surgery?
No. No doctor in the world can guarantee Improvement after dbs. Th at being said, improvement happens in most patients as long as they are carefully selected. Before off ering you option of surgery, the doctor will give you a large dose of levodopa and make sure that your symptoms improve significantly. He/she will tell you that this is the maximum benefit that you may get after dbs, and try to set realistic expectations so that you are not disappointed after the surgery. Often the surgery is followed by a period of temporary improvement, even before the battery is switched on. This improvement Goes away in a few weeks. Th is is expected and you should not be disappointed - this is a good sign. After the battery is switched on, it may take between 3-6 months to achieve the optimal balance between your dbs and medications. During this time, your symptoms will improve gradually. But you should be patient if your symptoms

Have not improved within 1-2 months there is a good chance they will improve with further dbs adjustments. Most patients improve after dbs surgery, but a few people do not improve. Th e reason why these people do not benefit from dbs surgery is unknown, and this is being vigorously researched in the us, uk and other countries. Read more here

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Hello sir I have heavy body pains how to control the pains n how to relief from it.

MBBS
General Physician, Cuttack
Hello sir I have heavy body pains how to control the pains n how to relief from it.
1.Take paracetamol 500mg,1 tablet sos after food up to a maximum of 3 tablets daily, 2.Drink plenty of water 3.Take rest
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He is alcoholic and takes alcohol in the morning afternoon and whole day. He is not taking family responsibility and not earning much. He had lost his weight also very short tempered.what to do

Reparenting Technique, BA, BEd
Psychologist, Bangalore
Admit him to a rehabilitation immediately. He should be admitted for at least 6 months and after that, he needs to be on continuous for at least three years in that condition. He will need to attend aa meetings in his town, and the family has to attend al-anon meetings too to work their own issues in relation to the alcoholic and be prepared how to handle his return.
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6 Tips for Happiness

Hypnotherapist, DCS, BSIC, Advanced Trainee of Transactional Analysis, Advanced Skills in Counselling
Psychologist,
6 Tips for Happiness
6 TIPS TO HAPPINESS.(KEY CONCEPTS OF POSITIVE PSYCHOLOGY)

1. Give yourself permission to be human. When we accept emotions ? such as fear, sadness, or anxiety ? as natural, we are more likely to overcome them. Rejecting our emotions, positive or negative, leads to frustration and unhappiness.

2. Happiness lies at the intersection between pleasure and meaning. Whether at work or at home, the goal is to engage in activities that are both personally significant and enjoyable. When this is not feasible, make sure you have happiness boosters, moments throughout the week that provide you with both pleasure and meaning.

3. Keep in mind that happiness is mostly dependent on our state of mind, not on our status or the state of our bank account. Barring extreme circumstances, our level of well being is determined by what we choose to focus on (the full or the empty part of the glass) and by our interpretation of external events. For example, do we view failure as catastrophic, or do we see it as a learning opportunity?

4. Simplify! We are, generally, too busy, trying to squeeze in more and more activities into less and less time. Quantity influences quality, and we compromise on our happiness by trying to do too much.

5. Remember the mind-body connection. What we do ? or don't do ? with our bodies influences our mind. Regular exercise, adequate sleep, and healthy eating habits lead to both physical and mental health.

6. Express gratitude, whenever possible. We too often take our lives for granted. Learn to appreciate and savor the wonderful things in life, from people to food, from nature to a smile.
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I was suffering depression from past almost six years. I had take medicine proper without gap but how much time will recover from this disease.

BHMS
Homeopath, Lucknow
I was suffering depression from past almost six years. I had take medicine proper without gap but how much time will ...
ajay you can take Kali phos 6x/TDS 4-4tab for 1months . arsenicum album 1M/ 2 dose at 1/2 an hour interval o only once but ajay please tell me about causative factor. coz homoeopathic treatment based on causative factor.. do yoga.share urself with ur family members & friends. go & see comedy .
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I am 23 year old. I am an OCD patient and it going worst day by day. Please give some suggestion.

BHMS
Homeopath, Faridabad
Hello. We can give you homoeopathic medicines to give you symptomatic treatment. So, share all the symptoms, each & every detail of your case for proper selection of medicine.
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I am 29 years, my son age is 12 years and second child Age is 10 years. But my problem is Regularly pain. I need for help.

MBBS, MD - Internal Medicine
Internal Medicine Specialist, Faridabad
I am 29 years, my son age is 12 years and second child Age is 10 years. But my problem is Regularly pain. I need for ...
take tab. Dolo 650 mg thrice a day after meal, tab. Pan 40 mg once a day for 3 days . if not ok then checkup b.p. ,uric acid, s.calcium, R A factor, cbc, blood sugar, and consult again. Thanks
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I am feeling depressed alot nowadays from last 1 year. Please suggest me some tips to come out of depression. please.

Ph. D - Psychology, Professional Certified Coach
Psychologist, Ahmedabad
I am feeling depressed alot nowadays from last 1 year. Please suggest me some tips to come out of depression. please.
In our current life style most of us are not equipped to deal with our mental and emotional processes. Due to constant out side pressure and expectations we doubt and question our abilities. Also in a age of super fast life we lean towards instant results, which at times are not possible. This again increase our stress level. The best way to deal with this is to build our resilience and learn to manage our strees level. Once you are able to manage your stress, your self confideance and your self esteem both will increase and you will be able to make better decisions and accomplish lot in life. Try following on a regular basis and in 2 to 4 weeks you will see some positive changes in your life. Stress is a by product of our modern life style. Due to chronic stress you have a negative chain of thought repeating in your mind. The wonderful new is that our mind could be wired to switch back to positive things and resilience building. When things does not happen as we wish or people do not behave as we expect that is when out of disappointment, frustration, loneliness, anger, sadness. Etc we react and our mind starts thinking negative thoughts. Changing this pattern of responding to stressful situation requires both persistence and patience. Also you will only be able to work on this out of love and kindness towards you. Strong motivation will go a long way. Writing a statement about how would you want to respond in a similar situation and how will your life and your happiness will change if you do learn to manage your stress and how to respond to it. Once that is clear. Try following things to learn relaxation response which leads to better coping mechanism on a daily basis. To begin with doing guided progressive muscular relaxation before sleeping will help you relax. You could google and download an audio file. I would also suggest you to take a multiple small break to take 3 nice and deep breath while keeping your eyes closed. You could do this while sitting or standing or while even walking or climbing stairs (keep your eyes open in that case). When you take a nice and deep break there is actual physiological change in your body. This will help you to activate parasympathetic nervous system which promotes relaxation and helps you calm down and think more clearly. This will also actually improve your performance in your work. Along with this exercise is one of the best way to relive stress and stay fit. Engage in any kind of physical activity at least 4 times a week. This also helps in stress reduction. Along with this some relaxation exercises as well as engaging in joyful activities such as music, singing, dancing, reading, being in nature, gardening, talking with friends or anything which you enjoy will help reducing stress and rejuvenation of your mind and body. Have good routine for sleep and eating. Lot of research has now proven that sugar is very harmful for our health. Reduce sugar and refined white floor in your diet as much as you could. Along with this also increase consumption of raw vegetables in the form of salad in both the meals of your day. If you are open for online consultation to work on individualized plan and strategies feel free to book an audio consultation with me. Hope this helps, wishing you very best,
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Hey Doctor, I have a problem while I go for study, when I m concentrating in study, I feel sleepy yawning comes, taking nap it is distracting my study. When I left books than doesn't feel sleepy. I m properly doing exercise in the morning. Please suggest me.

MBBS, MD Psychiatry, DNB Psychiatry
Psychiatrist, Nagpur
Hey Doctor, I have a problem while I go for study, when I m concentrating in study, I feel sleepy yawning comes, taki...
I hope you are having a relxing sleep at night. Follow simple suggetsions - donot study on the bed, try reading on a chair and table - if you donot mind, try keeping a pen in hand to write down things as notes to be used later on. - when feeling sleepy, revise something you already read. - take a hot water bath before you start studying - take a beak of 20 min after every 40-45 min spell of studying. If this is not working then you might need some medications to keep you focused and awake. Get back to me in that case.
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Hello Doctor My Husband have drinking habit, he has drunk a lot every day, when he want to have sex with me, my mood get off due to his drinking habit. This is effect on your relationship? What should I do?

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear lybrate-user, Welcome to Lybrate. Alcohol addiction also comes under abuse and addiction. If you’re ready to stop the substance and willing to get the support you need, you can recover from addiction and abuse —no matter how bad the addiction or how powerless you feel. The first step in treating addiction is accepting that you have a problem. Confronting an addiction and accepting responsibility for your actions isn’t easy. But it’s a necessary step on the road to treatment and recovery. You should then consult a psychiatrist / psychologist who fill follow this treatment. 1. Detoxification using medicines. 2. Behavior modification with the help of therapies. 3. Counseling. 4. Medication to sustain and 5. Long term support. These given steps are essential for any addict to get effectively rid of addiction. Therefore, you need to stick to the treatment plan and cooperate with your psychiatrist / psychologist. Take care.
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Hello doctors, I'm in 12th now. I have a girlfriend. So, my question is, if I have a limited physical relationship with her, what will be the effect of it on us physically as well as mentally?

M.Sc - Psychological Counseling, B.A ( Hons) - Psychology
Psychologist, Delhi
Hello doctors, I'm in 12th now. I have a girlfriend. So, my question is, if I have a limited physical relationship wi...
Hello lybrate-user, there are no side effects of having limited physical contact with other people, physically or mentally. Having too much of a physical contact on the other hand can lead to many problems, both, physical and mental. So, focus over your studies and engage in some outdoor sports. Good luck.
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5 Super Brain Drinks that Boost Your Memory

Masters in Nutritional Therapy, Lifestyle & Weight Management, Sport Nutritions, graduation in Nutrition & Dietics
Dietitian/Nutritionist, Delhi
5 Super Brain Drinks that Boost Your Memory

When it comes to the brain, simple yet easy to make juices can make a lot of difference. These juices not only improve your memory, but are of great help to the cognitive functions as well. While green tea is a known component of increased brain function, there are other drinks too, which can charge your brain over the long term if consumed daily:

  1. Beet juice: Apart from being a nutritional powerhouse, beet juice is a great source of nitric acid. The latter helps with blood flow in the body. A smooth blood flow, on the other hand, helps the brain in functioning properly. A study has found that people who consume beet juice have an increased circulation in the white matter resulting from an increased brain activity. This juice is sweet in taste and can be consumed every alternate day.
  2. Berry Smoothies: Acai is a fruit which has a South African origin and hits the top of the list when it comes to brain assisting food. It increases the flow of the blood and dilates the blood vessels. However, this is extremely expensive. Berries also have a similar effect on the brain, but they are less powerful in nature. What can be done is to mix a little ingredient of Acai in frozen berries juice and drink the same every day. Frozen berries retain the freshness and the nutritional benefits. This drink will improvise your brain and increase blood flow in the body.
  3. Pomegranate juice: Pomegranate is a great antioxidant and it very aptly limits the free radicals from damaging the brain cells. Antioxidants are also credited with increased blood flow and protection of the heart. A healthy cardiovascular system is synonymous to an increased brain function. What is surprising is the fact that Pomegranate has more antioxidant content compared to red wine and green tea. Pomegranate juice can be consumed daily during the morning or afternoon.
  4. Carrot juice: Carrot is known for its healthy components that are beneficial for the eyes. Recent studies have revealed that they are great for the brain too. Like other colored vegetables, they are a great source of antioxidant and have a high content of beta-carotene. Carrot juice can reduce the inflammation of the brain cells and improve memory. Carrot juice is not at all bitter and the same can be consumed every alternate day after your meal.
  5. Cocoa: A Harvard study revealed that two cups of cocoa on a daily basis greatly helps a person in improving memory. Cocoa contains flavanols that keep the blood pressure normal and relaxes the blood vessel linings. Cocoa is also known to be a great antioxidant agent that limits the free radical to affect the brain cells. Cocoa should not be overloaded with sugar and should be consumed hot before starting your day.
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