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Dr. N.b. Shivakumar

General Physician, Bangalore

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Dr. N.b. Shivakumar General Physician, Bangalore
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I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care....more
I'm a caring, skilled professional, dedicated to simplifying what is often a very complicated and confusing area of health care.
More about Dr. N.b. Shivakumar
Dr. N.b. Shivakumar is an experienced General Physician in Sampangiram Nagar, Bangalore. You can consult Dr. N.b. Shivakumar at Vijaya Clinic in Sampangiram Nagar, Bangalore. Book an appointment online with Dr. N.b. Shivakumar on Lybrate.com.

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Vijaya Clinic

Cotton Pet, Milll RoadBangalore Get Directions
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I am not getting sleep in the night. I will be not active during my day. Will get exhausted by 4pm. Lack of energy. Please advise. I think I should get my sleep cycle right. Can anyone help me with this issue.

MSc
Dietitian/Nutritionist, Hyderabad
I am not getting sleep in the night. I will be not active during my day. Will get exhausted by 4pm. Lack of energy. P...
1. Keep a food diary. 2. Add it up. 3. Focus on quality, not quantity. 4. Eat more frequently. 5. Snack smart. 6. Eat before bed. 7. Drink it down. 8. Adjust your exercise routine. 9. Set attainable goals. 10. Get support.
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Know Everything About Pancreatitis!!

MBBS, MD - General Medicine, DM - Gastroenterology, MNAMS
Gastroenterologist, Faridabad
Know Everything About Pancreatitis!!

What is Pancreas? 

The pancreas is an organ placed behind the stomach in abdomen. It produces: digestive juices (produce by exocrine pancreas, it help in digestion of food) as well as digestive hormones i.e. insulin and glucagon (produce by endocrine pancreas) which help in regulation of the level of glucose (sugar) in the blood. 

What is pancreatitis? 

Pancreatitis is abnormal swelling and inflammation of the pancreas. Once the gland becomes inflamed, the condition can progress to swelling of the gland and surrounding blood vessels, bleeding, infection, and damage to the gland. Normally, digestive enzymes secreted by the pancreas do not become active until they reach the small intestine. But when the pancreas is inflamed, digestive juices become trapped and start "digesting" the pancreas itself. If this damage persists, the gland may not be able to carry out normal functions. 

What Are the Types of Pancreatitis? 

Pancreatitis may be acute (new, short-term) or chronic (ongoing, long-term). Either type can be very severe, even life-threatening. Either type can have serious complications. 

  1. Acute pancreatitis usually begins soon after the damage to the pancreas begins. Attacks are mostly very mild, but about 20% of them are very severe. The onset of acute pancreatitis is often very sudden. The inflammation usually clears up within several days after treatment begins. An attack lasts for a short time and usually resolves completely as the pancreas returns to its normal state. Some people have only one attack, whereas other people have more than one attack, but the pancreas always returns to its normal state unless necrotizing pancreatitis develops and becomes life-threatening. 
  2. Chronic pancreatitis begins as acute pancreatitis. If the pancreas becomes scarred during the attack of acute pancreatitis, it cannot return to its normal state. The damage to the gland continues, worsening over time. Pancreatitis can come and go quickly, or it can be a chronic problem. Treatment will depend on whether your pancreatitis is acute or chronic. 

What are the causes of pancreatitis? 
Alcohol abuse and gallstones are the two main causes of pancreatitis, accounting for 80% to 90% of all individuals diagnosed with pancreatitis. 

  1. Gallstones form from a buildup of material within the gallbladder, another organ in the abdomen (please see previous illustration). A gallstone can block the pancreatic duct, trapping digestive juices inside the pancreas. Pancreatitis due to gallstones tends to occur most often in women older than 50 years of age. 
  2. Pancreatitis from alcohol use usually occurs in individuals who have been long-term alcohol drinkers for at least five to seven years. Most cases of chronic pancreatitis are due to alcohol abuse. Pancreatitis is often already chronic by the first time the person seeks medical attention (usually for severe pain).
  3. The remaining 10% to 20% of cases of pancreatitis have various causes, including the following:
    1. medications, 
    2. exposure to certain chemicals, 
    3. injury (trauma), as might happen in a car accident or bad fall leading to abdominal trauma, 
    4. hereditary disease, 
    5. surgery and certain medical procedures, 
    6. infections such as mumps (not common), 
    7. abnormalities of the pancreas or intestine, or 
    8. high fat levels in the blood. 
  4. In about 15% of cases of acute pancreatitis and 40% of cases of chronic pancreatitis, the cause is never known. 

What are the risk factors for pancreatitis? 

The major risk factors for pancreatitis are excessive alcohol intake and gallstones. Although the definition for excessive alcohol intake can vary from person-to-person, most health-care professionals suggest that moderate consumption is no more than two alcoholic drinks a day for men and one a day for women and the elderly. However, people with pancreatitis secondary to alcohol intake are usually advised to avoid all alcohol intake. Other risk factors include: 

  • a family history of pancreatitis, 
  • high levels of fat (triglycerides) in the blood, 
  • cigarette smoking
  • certain inherited disorders such as cystic fibrosis, and 
  • taking certain medicines (for example estrogen therapy, diuretics, and tetracycline). 

What Are the Symptoms of Pancreatitis? 

Most people who have acute or chronic pancreatitis experience upper abdominal pain as their primary symptom. Some of those who have chronic pancreatitis may show inflammation on imaging scans, but otherwise may show no symptoms. Symptoms of pancreatitis may include: 

  • upper abdominal pain: pain that wraps around the upper body and involves the back in a band-like pattern 
    • Pain associated with pancreatitis may last from a few minutes to several hours at a time. 

In severe cases, discomfort from chronic pancreatitis could become constant. Your pain is likely to increase after you eat or when you’re lying down. Try sitting up or leaning forward to make yourself more comfortable. 

Severe acute pancreatitis is a medical emergency. Severe acute pancreatitis may cause dehydration and low blood pressure. The heart, lungs, or kidneys can fail. If bleeding occurs in the pancreas, shock and even death may follow. People who have chronic pancreatitis may also experience steatorrhea, or fatty stools that give off a foul odor. Steatorrhea can be a sign of malabsorption. This means you’re not getting all of your essential nutrients because your pancreas doesn’t secrete enough digestive enzymes to break down your food. 

How pancreatitis is diagnosed? 

Your doctor will likely use a combination of blood tests and imaging scans to make a diagnosis. If you have acute pancreatitis, blood tests may show a rise in your level of pancreatic enzymes. During acute pancreatitis, the blood contains at least three times the normal amount of amylase and lipase, digestive enzymes formed in the pancreas. Changes may also occur in other body chemicals such as glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the person's condition improves, the levels usually return to normal. Ultrasound, MRI/MRCP, and CT scans can reveal the size of your pancreas and whether you have a blockage of the bile ducts. 

How to treat pancreatitis? 

Treatment for acute or chronic pancreatitis often involves hospitalization. In acute pancreatitis, the choice of treatment is based on the severity of the attack. If no complications are present, care usually focuses on relieving symptoms and supporting body functions so that the pancreas can recover. Treatment for acute pancreatitis includes intravenous (IV) fluids, and medications for pain, nausea and vomiting.

  • The pancreas is key to your digestive process and needs to rest to heal. No food or liquid should be taken by mouth for a few days. This is called bowel rest. By refraining from food or liquid intake, the intestinal tract and pancreas are given a chance to start healing.
  • For this reason, you may receive fluids and nutrition intravenously or through a tube that goes from your nose directly into your jejunum (part of small intestine), which is called a nasojejunal feeding tube. Restarting an oral diet depends on your condition. Some people feel better after a couple of days. Others need a week or two to heal sufficiently. 
  • If needed, medications for pain and nausea are prescribed. 
  • Those people who are having trouble breathing are given oxygen. 
  • Antibiotics are given if the health-care professional suspects an infection may be present. 
  • Some people may need a nasogastric (NG) tube. The thin, flexible plastic tube is inserted through the nose and down into the stomach to suck out the stomach juices. This suction of the stomach juices rests the intestine further, helping the pancreas recover. 
  • If the attack lasts longer than a few days, nutritional supplements are administered through an IV line. 
  • Surgery is sometimes needed to treat complications 
    • If your doctor diagnoses gallstones or other blockages of the bile ducts, you may need surgery to correct these problems later on. 

What are the complications of pancreatitis? 

Some patients may develop complications. These complications are rare, but they’re more common in people with chronic pancreatitis: 

Can pancreatitis be prevented? 

The following recommendations may help to prevent further attacks or to keep them mild: 

  • Completely eliminate alcohol because it is the only way to reduce the chance of further attacks in cases of pancreatitis caused by alcohol use, to prevent the pancreatitis from worsening, and to prevent the development of complications that can be very serious or even fatal. 
  • Eat small frequent meals. If in the process of having an attack, avoid solid foods for several days to give the pancreas a chance to recover. 
  • Eat a balanced diet high in carbohydrates and low in fats because may help individuals decrease the risk for pancreatitis since it is likely these actions will decrease the risk of gallstones, a major risk factor for pancreatitis. 
  • If pancreatitis is due to chemical exposure or medications, the source of the exposure will need to be found and stopped, and the medication will need to be discontinued. 
  • Don't smoke 
  • Maintain a healthy weight 
  • Exercise regularly. If you wish to discuss about any specific problem, you can consult a Gastroenterologist.
2956 people found this helpful

What are the precautions a patient is need to follow when they are suffering from AIDS?

MBBS
General Physician, Cuttack
He should avoid unprotected sex, donating blood,sharing of razor,tooth brush,nail cutter with others,inform dentist and doctor about his HIV status prior to any dental procedure and handling of blood etc
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I have the problem of headache from last five years. So what I can do so that I get relief from this problem. Many doctor have suggested me to use obstacles. Does it useful or not?

MBBS
General Physician, Mumbai
I have the problem of headache from last five years. So what I can do so that I get relief from this problem. Many do...
Check your eye sight for refractive error and also rule out sinusitis or migrane as the cause of headache and Take a flow of steam (of plain water only ) over the forehead through a crescent steam inhaler, eight hourly
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Which fruit and vegetables contain protein? How much gram of protein it contain in gram or percentage.

Post graduate Diploma In Dietetics And Applied Nutrition, B.Sc. - Dietitics / Nutrition
Dietitian/Nutritionist, Mumbai
Which fruit and vegetables contain protein? How much gram of protein it contain in gram or percentage.
Hey lybrate-user, fruits and vegetables do not contain proteins. Proteins is only available through milk and milk products, meat fish egg and pulses. Thanx.
1 person found this helpful
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I am suffering from head ache frequently and my lips getting drier even I am drinkingore water what can I do for this problem.

PG Diploma in Emergency Medicine Services (PGDEMS), Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Alternate Medicine
Ayurveda, Ghaziabad
I am suffering from head ache frequently and my lips getting drier even I am drinkingore water what can I do for this...
Hi Take ½ glass of carrot juice + Add ½ glass of spinach juice + Mix well + Drink this juice to cure headache 1-1 drop of cow ghee in both nostrils at night time before sleep. Take pranacharya no tens capsule 1_1 twice a day. Take shirshooladi vajra ras twice a day with honey. Avoid tea and coffee.
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Respected doctors my age 56 heart disease and diabetic and have thyroid but all are in very good control my sincere query is my sugar levels are around 120 before food after food around 130 I am taking Gemer I MG tablet in the morning even after eating sweets like 2 pieces of doodpeda my sugar level stayed constant and never hiked so can I stop taking medicines or do I have to consult a endocrinologist I walk briskly for one hour daily.

MBBS, CCEBDM, Diploma in Diabetology
Endocrinologist, Hubli-Dharwad
Respected doctors my age 56 heart disease and diabetic and have thyroid but all are in very good control my sincere q...
Mr. lybrate-user, Thanks for the query. It is good to know that blood glucose is well controlled and does not go up even after eating "2 doodh pedha" It wolud be better if you check HbA1c% and see if it is <5.9% then one can say you have no diabetes now. Whether you should stop medication is a difficult question to answer. My suggestion is maintain your healthy lifestyle, including diet and regular exercise, then stop the medication for about 2 weeks and check the blood glucose levels. If levels remain within normal limit then probably one might conclude there is no diabetes. Do try and come back after wards. Thanks.
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I m 30 and I m addicted masturbation now. My penis is too short and testis became also short, what should I do now please advice me.

MBBS
General Physician, Mumbai
I m 30 and I m addicted masturbation now. My penis is too short and testis became also short, what should I do now pl...
Increase your self confidence and take Tablet folvite 5mg once a day for six months and tablet vitamin D3 60000iu once a week for six months and get your self involved in some kind of work
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I have been on Suboxone for the past 2 years. It was prescribed for chronic pain from Fibromyalgia and Sciatica. What medication can help me to get off this medicine? I have heard that Clonidine can help with this issue. Is that true? Where can I find a Dr. to prescribe or whatever medication that will help?

MBBS, F.E.M-RCGP(UK)
General Physician, Gurgaon
I have been on Suboxone for the past 2 years. It was prescribed for chronic pain from Fibromyalgia and Sciatica. What...
Get Vit B12 & Vit D3 done if you can afford, otherwise take on lin consultation. TSH is must. Blood investigation after 10 hours of fasting.
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I suffer from fever. Pl tell how can I check my self to control my temperature Gave me suggestion about this.

BAMS
Ayurveda, Bangalore
I suffer from fever. Pl tell how can I check my self to control my temperature Gave me suggestion about this.
Hi, Take tab. Sudershana Vati 1-1-1 after food for 1-2 days. Keep recording your temparature. If it is too high, do tepid sponging. Wear loose cotton garments. Drink plenty of fluids. Consume light and easily digestable food. Drink boiled and cooled water.
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Sir I have a problem that I can last long on bed. I cannot fulfill the excitement of my partner she dosent tell me about that but I will understand that she dosent like to sex with me because I can not satisfy her. What should I do sir please help me. And sir I am addicted of cigarette I will smoke daily 7 cigarette is there any reason behind it.

BHMS
Homeopath, Raebareli
Sir I have a problem that I can last long on bed. I cannot fulfill the excitement of my partner she dosent tell me ab...
Please use -- Natural aphrodisiacs which can improve your libido and prevent premature ejaculation. This would include carrots, fennel seeds, celery, bananas, garlic, onion, ginger, shellfish, lettuce etc. - Including these foods in your daily diet will ensure that you remain free from sexual problems, including premature ejaculation. Also take a dose of Acid Phos 1M/single dose and revert after 2 weeks. Avoid watching porn. You should reduce smoking Continue treatment.
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My penis is abit curved downwards. Due to this I face problems during various sexual positions. Can this be cured. If yes how? Thnx.

BAMS, MD Ayurveda
Sexologist, Lonavala
My penis is abit curved downwards. Due to this I face problems during various sexual positions. Can this be cured. If...
Try the following remedy it will surely help you take one table spoon of untamed rose hips, add a pair of glasses of boiling water, boil it for ten minutes and let it sit for 2-3 hours. Take 1/4 - 1/2 of the extract 3-4 times each day with honey. Mix one a part of fresh raw juice with one part of honey. Take 1/4 glass of the combination three times on a daily basis. Take one table spoon of untamed rose hips, add a pair of glasses of boiling water, boil it for ten minutes and let it sit for 2-3 hours. Take 1/4 - 1/2 of the extract 3-4 times each day with honey. It will surely help you.
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Hello Doctors. I am suffering from premature ejaculation. please suggest me. And one thing mujhe father banned me koi problem nhi hone chahiye.

MD - Psychiatry
Psychiatrist, Chennai
Hello Doctors. I am suffering from premature ejaculation. please suggest me. And one thing mujhe father banned me koi...
Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration or foreplay. 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. 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. Consult a psychiatrist online or in person Your doctor will discuss your medical and sexual history with you. He or she will do a thorough physical exam. Your doctor may want to talk to your partner also. Premature ejaculation can have many causes. So your doctor may order lab tests to rule out any other medical problem. 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. Your doctor may recommend that you and your partner practice certain techniques to help delay ejaculation, as well as medications are there to help. All the best.
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Recently I have body pain in general and feeling tired. I am 63 years old and at home. I am a diabetic and BP under control.

Diploma in Diet and Nutrition, B.Pharma, MD - Alternate Medicine
Dietitian/Nutritionist, Gurgaon
Recently I have body pain in general and feeling tired. I am 63 years old and at home. I am a diabetic and BP under c...
you weight needs to be reduced by 10 kilos so that you feel energized. I can guide on food and nutrition to improve energy
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I am 61 years of age high BP and diabetic normal office work what should be my normal diet.

PDDM, MHA, MBBS
General Physician, Nashik
I am 61 years of age high BP and diabetic normal office work what should be my normal diet.
Here is a sample diet to help you understand the diet. Early Morning: Green tea ( sugar less) Breakfast: non fried preparations/ whole wheat bread/ vegetable poha, upma, etc. / idli sambhar etc. Mid-Morning: Fruits ( avoid the carbohydrate rich fruits like grapes, banana, custard apple and watermelon) Lunch: 2 dry chapatti + sabji 1 katori + dal or skimmed curd – 1 katori + salad 1 katori Evening Snacks: Tea / Coffee sugarless + high fiber bis. OR Sprouts 1 katori Dinner: 2 chapatti + vegetable 1 katori + skimmed buttermilk 1 glass + salad 1 katori.
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Hi Doctor! My MOM is Diabetic and has suffered with tuberculosis pericardial effusion and has undergone pericardial tapping process 9 times in 5 different hospitals. She has completed the course (R Cinex, Moxif 400 Mg, Colchicine, Predmet, Pregaba-M, as suggested by the doctors from 26/01/2015 to 27/07/2016. She used to have some pain left side of chest and back side of left shoulder after the surgery Pericardiosynthesis. Doctor's comforted her by saying the pain slowly gets reduced but will take time, but from last 20 days she is getting trouble regularly with some pain in left side of chest and shoulder. We consulted a chest physician and found out there still some fluid visible in the X-ray. Doctor enquired about symptoms like Cough, Breathing Problem, Digestion etc. But she is not experiencing all those symptoms but has some pain and is comfortable with daily activities like walking, household work. Doctor told us there's no need to worry if there are no symptoms, but Me and my mom are not happy with this suggestion as she is experiencing the pain daily sometimes low and sometimes medium pain. She wants to get rid of that pain completely as she is suffering since 2 years and she is fed up with it. Kindly let me know how to relieve her from this pain, I will send the latest x-ray if needed. Thank You.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda,
If your blood sugar levels are normal do not worry because TB microbes remain dormant and flourish in favourable conditions. Tab tulsi 1 twice a day tab yastimadhu 1 twice a day 1 panch tikta gruth gugule twice a day mixture of (arjun+puskarmul+amalki+kutki+patol+nimba+draksha+haldi) each in equal quantity daily 1/2 tsf twice a day with water apply til taila +saindhv luke warm at back of chest and gently massage then have bath with warm water for fomentation be in fresh air in morning and sun bath before 10 am for 15 mins.
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I felt itching on my hip line because of too much sweat. Now its hurting while sitting, walking, lying, or driving. What should I do? It happens approx. From 1 month.

MD(EH)/AM/Accupressure
Acupressurist, Chandigarh
Dear Lybrate User Appky ice cube on the area thrice a day and at night coconur oil mixed with camphor you should apply.
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I am searching for a sustainable solutions of my sex problems preferably from a homeopathic or Ayurvedic doctor. I doubt if my early childhood masturbation has a connection to it, till I got married I fought with frequent night fall. Seldom did I practised masturbation during my 20's, however I always had great craze for sex. Now while I am married, I am facing these problem. 1. Muscles of my Penis (from where it originates) makes it left bended which makes me feel conscious on its appearance and performance. My partner never asked me of why is it left bended, though I fear of her as I feel she tries making it straight while doing hand job etc. Can it be reshaped, because while being an adolescent I remember it was almost straight. Need inputs from you on how to face it. Another thing, In normal position (a not erected penis) My left testis falls down than the right one, is it indicating some disease? 2. I gets full erection very easily though I loose it much easier because I gets Ejaculated within 1-2 mins after her continuous sensational behaviour, be it hand job or a simple attempt of sex. However a day after last Ejaculation, I tend to get a more sustained erection. 3. She had never complained it on my face but I can read her being so unsatisfied that now I tend to even ignore foreplay, because of fear of PE. Sperm in visibility is thick enough and I don't have any history of sex before marriage. Neither I am a smoker nor do I drink. I had a history of weak liver which often makes me low on energy and stamina. Thanks for being patient and listening me thoroughly. I've recently started with kejel exercises and workout in gym. Hope it will help. But Doctor please give me treatment. I also wants to conceive her and get a healthy baby. Many Regards:)

MBBS
General Physician, Mumbai
I am searching for a sustainable solutions of my sex problems preferably from a homeopathic or Ayurvedic doctor.
I do...
1) Bending of penis will not cause any problems and we cannot do anything for it and your testis seems normal 2)Increase your self confidence and Eat protein rich food and take tablet Nurokind-more 1-1 for a month and revert back after completion 3) I will suggest you to have fore play activity with your wife
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I am 25 years old, I've undergone with Appendicitis & Gall Stone Laproscopic operations in 2012 back by back months. Right now i'm suffering with Pancreatitis, is there any permanent solution for this.

Doctor of Homeopathic Medicine (H.M.D.)
Homeopath, Belgaum
Hi considering age your r suffering with major diseases very early need to analyze your health condition completely and try to find y is that your suffering such sufferings at so early age and can think how homeopathic can help you in recovering you in such condition.
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