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Dr. Sashikala

Gynaecologist, Bangalore

200 at clinic
Dr. Sashikala Gynaecologist, Bangalore
200 at clinic
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My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more
My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.
More about Dr. Sashikala
Dr. Sashikala is a renowned Gynaecologist in AECS Layout, Bangalore. You can visit her at Columbia Asia Hospital in AECS Layout, Bangalore. Save your time and book an appointment online with Dr. Sashikala on Lybrate.com.

Lybrate.com has a number of highly qualified Gynaecologists in India. You will find Gynaecologists with more than 37 years of experience on Lybrate.com. You can find Gynaecologists 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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Columbia Asia Hospital

#150, 2nd Floor, OM Shree MNV Towers, AECS Layout, Sanjaynagar Main Road, SanjaynagarBangalore Get Directions
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I am 26 year old female, I am having cracked nipples and inflation around the nipples, I am currently feeding my baby. I have used couple of ointments sometimes the cracked nipple cure but again it happens. Please help.

MBBS, DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology
Gynaecologist, Delhi
I am 26 year old female, I am having cracked nipples and inflation around the nipples, I am currently feeding my baby...
Nipcare ointmnt, Vit E capsule oil, placentrex ointmnt locally applied several times may help, other wise use nipple shield to feed baby
2 people found this helpful
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After first time having sex without any protection, I took an ipill within 6 hours does it still leads to pregnancy?

MD-Ayurveda, Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Sexologist, Haldwani
Hello- You have taken the pill at right time. I pill success is assessed by vaginal bleeding following within a weeks time. If it happens, thn you are not pregnant, if not thn you have to think about some other alternative.
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Ia m having common cold? HOW to tackle that? I also want yo know how to avoid herpes?

MBBS
General Physician, Mumbai
For cold take tablet cetrizine at night and increase your immunity by taking Tablet folvite 5mg once a day for six months and tablet vitamin D3 60000iu once a week for six months
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I am new married couple, my wife is pregnant from 1 month. But I do not want baby. What should I do.

BHMS PGCGO
Homeopath, Hubli-Dharwad
I am new married couple, my wife is pregnant from 1 month. But I do not want baby. What should I do.
consult gynecologist. if pregnancy is with in 50days then will go by tab. other wise need to do d and c. as per me don't go for abortion. seen like who abort these first pregnancy will land up in infertility.
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AntiBiotic Resistance on the rise very fast

Post Graduate Diploma in Hospital and Healthcare Management, MD - Consultant Physician, Fellowship Critical Care Management
Internal Medicine Specialist, Faridabad
AntiBiotic Resistance on the rise very fast

In 5 Years, Threat Of Drug-Resistant Superbugs Doubles


A 72-year-old woman in Bengaluru consulted a hospital physician about a severe skin infection and fever. She had previously consulted a couple of general practitioners, who prescribed a course of penicillin for three days and fluoroquinolones—both antibiotics—for two days.

There was no relief.

So, the consultant ordered a culture sensitivity test of pus from the skin lesions to identify what was causing her ailment and figure out what antibiotics it would respond to.

Here’s what the report said:
Pathogen: Klebsiella pneumoniae
Susceptible to: No antibiotic
Resistant to: All antibiotics, including advanced drugs like fluoroquinolones, carbapenems and even the last resort combination usually reserved for severe cases of ICU infection, colistin-tigecycline.

With nothing to offer the patient, save a prescription for paracetamol to keep her fever in check, the doctor sent the patient home, and asked her to return after a week.

In such cases, sometimes, the body’s immunity kicks in and throws off the infection, the physician, Sheela Chakravarthy, consultant (internal medicine) at Fortis Hospital, Bengaluru, told IndiaSpend.

Sometimes, resistance to one or more drugs abates, allowing treatment to be resumed. Chances of that happening are greater at home, not in the hospital, which is a more infectious space where sepsis—a disproportionate and potentially life-threatening immune response by your body to an infection—could set in, she explained.

Most patients, however, succumb to the infection.

Chakravarthy faces situations where she has nothing to offer patients, not because they are suffering from terminal illnesses, such as some forms of cancer, but even when they present with what should be curable infections, “almost every day”, she said.

What Chakravarthy described is the consequence of rampant, inappropriate consumption of antibiotics, spurring the development of superbugs, as the recently released State of the World’s Antibiotics Report 2015 affirms.


India is fast becoming home to superbugs

Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus are three of the deadliest pathogens facing humanity, according to the World Health Organisation (WHO). And India is gradually but increasingly becoming home to multi-drug resistant strains of these pathogens, according to the State of the World’s Antibiotics Report 2015.

Escherichia coli is notorious for causing food poisoning and urinary tract infections.

In 2010, 5% of Escherichia coli samples in India were resistant to carbapenems, last-resort antibiotics for bacteria that are resistant to first-, second- and third-line drugs. By 2014, 12% of E. coli samples were similarly resistant.


Klebsiella pneumoniae causes pneumonia, septicaemia and infections in the urinary tract, lower biliary tract and at surgical wound sites, to name a few.

While 29% of Klebsiella pneumonia isolates were resistant to carbapenems in 2008, this increased to 57% in 2014.

For comparison, fewer than 10% of Klebsiella pneumoniae infections in Europe are carbapenem-resistant.

Staphylococcus aureus can cause skin and soft tissue infections, bloodstream infections, pneumonia and surgical site infections. A particularly nasty strain of, methicillin-resistant Staphylococcus aureus (MRSA), is common in India and increasingly hard to treat.

MRSA was responsible for 40% of post-surgical site infections, according to a 2013 study by the Jawaharlal Nehru Medical College and Hospital, Aligarh.

Between 2009 and 2014, the incidence of MRSA in India has risen from 29% to 47%.

People with MRSA are 64% more likely to die than people with a non-resistant form of the infection, according to the WHO.

How ignorance is spurring the development of superbugs

“My understanding of antibiotic is that it stops bacteria growing in body…I think amoxicillin is for throat infection.”

–An urban participant of a study of perceptions about antibiotic use and resistance among urban and rural doctors, pharmacists and public in Vellore.

Mox, short for amoxicillin, has become a household word across India.

A little knowledge, however, is a dangerous thing. It encourages self-medication, even when medicine is unnecessary, such as when people suffer viral infections—against which drugs are ineffective. Most viral fevers dissipate on their own after a few days with rest, hot fluids and a check on the fever.

Consuming too many antibiotics contributes to pathogen drug resistance.

“Resistance is an outcome of accumulated use,” said Ramanan Laxminarayan, vice president, Research and Policy, Public Health Foundation of India, and director and senior fellow, Centre for Disease Dynamics, Economics & Policy, US, and co-author of the State of the World’s Antibiotic Report 2015.

Indians often rely on corner pharmacists, whose knowledge of dosages may be limited.

Here’s what a rural pharmacist participant of the aforementioned Vellore study said: “Amoxicillin, 6 tablets is to be taken [for full course].”

Amoxicillin’s full course depends on the kind and severity of bacterial infection.

When an antibiotic of lower strength or fewer pills than needed is prescribed, the body cannot fully eradicate the pathogen. Sensing it has come under attack, the bacterium responds by evolving into more resilient, antibiotic-resistant strains.

But with a course of antibiotics, say generic Amoxicillin, costing about Rs 160, close to a day’s wage in many states, and a doctor’s consultation costing anywhere between Rs 100 and Rs 1,000, more than a day’s wage in most places, patients are bound to cut corners.

Another Vellore study participant summed up the situation thus: “If I have money I go to hospital. If not, I get medicine from pharmacy shop. If I get better, I stop and keep for future use.”

Stopping a course of drugs mid-way also contributes to antibiotic microbial resistance.

In a 2015 study in Chennai, 70% respondents confessed to stopping the medication when they felt better. Only 57% completed the antibiotic course.

“Less is more”: the key to preserving antibiotic efficiency

Educate health professionals, policy makers and the public on sustainable antibiotic use, says the State of the World’s Antibiotics Report 2015.

That is sensible advice.

Denmark and Sweden boast of low rates of antibiotic use and near-zero rates of antibiotic resistance because the risks of antibiotic overuse are widely known.

Instituting regulations on antibiotic use has reduced the proportion of MRSA in Europe and the US by about a fifth over the last eight years.

India requires more stringent regulations for antibiotic use.

It isn’t enough to tell physicians that they should prescribe antibiotics only when essential to cure bacterial infections. The right way is to order a culture sensitivity test, which costs money, and the patience to wait for the result.

“Patients want instant and cheap relief, and are willing to shop around for a doctor who obliges,” said Dr Himanshu Shekhar, medical director, SCI International Hospital, New Delhi.

“Some judge doctors on how fast the prescribed medicine cures. Practice pressures lead many doctors to prescribe advanced drugs, without getting a culture-sensitivity test done.”

So, it’s also not enough to have 24 advanced antibiotics, including third- and fourth-generation cephalosporins, carbapenems, and newer fluoroquinolones, under the ambit of Schedule H1 of the Drugs & Cosmetic Rules, 1945, with effect from March 1, 2014.

That means these drugs cannot be sold over-the-counter, but they are still freely prescribed.

Chakravarthy’s suggestion: “Make Schedule H antibiotics available only through hospitals and health centres.”

“Changing antibiotic usage behaviours is critical to preserve the efficacy of existing and new drugs,” proposed Laxminarayan.

India also sorely needs regulations to check antibiotic use in animals raised for human consumption, to meet the State of the World’s Antibiotic Report 2015 recommendation to reduce and eventually phase out sub-therapeutic antibiotic use in agriculture.

Sub-therapeutic use implies mixing antibiotics in animal feed to make them grow faster and to prevent infections from devastating the herd or flock.

India is among the world’s five biggest consumers of antibiotics for livestock. IndiaSpend has earlier reported increasing evidence of antibiotic-resistant bacteria in animals in India, and how this impacts humans.

“Using antibiotics to make animals fatter faster is a waste of a precious resource,” said Laxminarayan.

How surgeons contribute to antibiotic resistance

Surgical antibiotic prophylaxis refers to the prescribing of antibiotics before, during and after operations to prevent infection.

Between 19% and 86% of patients in hospitals in India receive “inappropriate antibiotic prophylaxis”, according to the State of the World’s Antibiotics Report 2015. A prophylactic is preventive treatment for a disease.

Ideally, antibiotic prophylaxis should be administered as a single dose within 60 minutes of the skin incision. However, a 2013 Mangalore-based study found timing adhered to in 22% of cases in a government hospital, 64.9% cases in a medical-college teaching hospital and 80.7% of patients in a tertiary care corporate hospital.

“Smart antibiotic prophylaxis also includes choosing narrow-spectrum antibiotics to target the organism most likely to present concerns based on the kind of surgery being performed, this avoids needless exposure to antibiotics for the other microbes and helps prevent resistance,” said Vimesh Mistry, assistant professor, Pharmacology, Baroda Medical College.

Staphylococcus aureus, which lives on the skin, is most likely to cause infection during surgery. But surgeons frequently make poor antibiotic choices.

“We found appropriateness of choice of antibiotic in 68% cases and 52% compliance with the in-house prophylaxis guidelines,” said Tanu Singhal, infectious diseases specialist, Mumbai, and co-author of another study on antibiotic prophylaxis conducted in PD Hinduja Hospital, Mumbai.

Other prophylaxis inaccuracies include the unnecessary prescribing of antibiotics, inaccurate dose and inaccurate duration of prescription.

“We logged 63% accuracy in prescription duration. Surgeons tend to prescribe antibiotics for too long fearing post-surgery infection,” said Singhal.

In the trade off between protecting the patient better and increasing the risk to society of a pathogen developing resistance, surgeons are choosing the former.

Needed: A back-to-the-basics approach to health

Reducing the need for antibiotics through improved water, sanitation and immunisation is another strategy recommended in the State of the World’s Antibiotics Report 2015.

“Vaccination against pathogens such as the diarrhoea-causing rotavirus and pneumonia-causing Klebsiella pneumoniae helps curtail antibiotic demand, thereby reducing the chances of resistant strains developing,” said Laxminarayan.

In Canada, the widespread use of pneumococcal conjugate vaccines for pneumonia in children has reduced the incidence of pneumonia caused by strains the vaccine covers.

However, just as antibiotic usage spurs the development of superbugs, vaccination is a double-edged sword.

Canada is seeing a rapid increase in the incidence of other strains of pneumonia not protected against by the vaccine.

So, it is better to focus on the basic constituents of health.

Making available clean drinking water and improving sanitation would prevent people from getting sick in the first place. India still has a lot to do on both these fronts.

Improving individual immunity is the best bet to ward off infections, and that is also achievable by healthier eating, exercising, healthier living and the better management of chronic conditions like diabetes and asthma that increase vulnerability to infections when they are not kept in check.


Dr Himanshu Shekhar
MD,Medicine
New Delhi
+919818433208
( Above Article , with My Inputs was published in a leading Health Magazine)
3 people found this helpful

When I have sex without condom with my wife she is always facing urine infection. Why?

MD - Psychiatry, MBBS
Psychiatrist, Patna
Dear,apparently your wife or you are suffering from urinary tract infection. Get urine cultures done for you and your wife. If needed you both should be put on some antibiotics for some days. Take plenty of water. You both always wash your genitals well with mild soap and water before sex, drink two glasses of water before sex, so that you both may flush out any bacteria well. I hope it will work for you both. I wish you all the best.
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My wife's esr level is very high which is 85. Does it effect in pregnancy? how can I reduce its level?

MD - Obstetrtics & Gynaecology
Gynaecologist, Chandigarh
Esr levels are physiologically raised during pregnancy and nothing can be commented upon it. If not pregnant, it can be due t any inflammatory condition of body. Like pelvic inflammatory disease or even tuberculosis. You need to rule them out.
1 person found this helpful
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Hello, my wife is not interested in sex after marriage. My wife is reluctant to have oral sex with me.

MBBS
General Physician, Chennai
Hello, my wife is not interested in sex after marriage. My wife is reluctant to have oral sex with me.
She is refusing to have only oral sex only as I understand each person has a like and dislike be patient do what she wants first and the she will co operate do nnot force things on her.
6 people found this helpful
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oral care for kids

BDS
Dentist, Jalgaon
oral care for kids
Now a days childers are getting used to fast food that affects overall growth and equally affects oral tissues and teeth. Junk food are sticky that gets embeded on tooth surface donot get cleaned easily. These food gets fermented by bacteria present in saliva and produce high amount of lactic acid that dissovles enamel and dentine and causes cavity in tooth. Food with high level of complex carbohydrate and sugars are responsible for cavitation. Balance and high nutritional diet is a very important part of childern life as it directly affects overall growth and health of kids. Restrict intake of junk food to once or twice a week. Soft drinks and airated drinks should be avoided too. Twice daily brushing in parents supervision. After intake of any sticky food gargle with warm water or brushing should be done. Regular visit to dentist can also help reduce dental problems in childern.
137 people found this helpful

I'm now 4 months pregnant I lost 2 kg In the first trimester what should I do and now what are the medicines I should take as i'm just taking realfol apart from it what should I intake? Also what to eat to gain weight? As i'm not hungry at all.

MBBS, MS - Obstetrics & Gynecology, Fellowship in Infertility (IVF Specialist)
Gynaecologist, Aurangabad
I'm now 4 months pregnant I lost 2 kg In the first trimester what should I do and now what are the medicines I should...
You should have healthy diet in terms of green vegetables, short and frequent meals as you are not feeling hungry, increase pulses in diet, milk, milk products.
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My grand daughter is 4 months old, she rejects breast feeding for last 10 days (nursing strike), kindly what can be the reason, what's the remedy?

Pediatrician, Pune
If you have started bottle feeding, then she has chosen the easier alternative and not taking breast feeds, giving breast feeds is the best option for babies at least till 1 yr of age.
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I experience severe stomach cramps during my period cycle. What is the solution for this problem.

BHMS
Homeopath, Faridabad
I experience severe stomach cramps during  my period cycle.  What is the solution for this problem.
Hello. We can minimize the pain during menses with diet and medicines (which are safe to take).. Diet: - Calcium is a mineral associated with building healthy bones and teeth. However, it may have some applications in minimizing the harmful effects of menstrual cramping. So,increase your intake by eating low-fat dairy products such as milk, yogurt and cheese or green leafy vegetables. - Your body uses vitamin B-6 to manufacture new red blood cells. When you lose red blood cells via menorrhagia, your body will need more to build new cells. Also, vitamin B-6 is required for your blood sugar to stay at healthy levels. This can help prevent menstrual cramping-related mood swings and fatigue. Vitamin B-6 is found in fortified cereals, bananas, spinach, sunflower seeds, avocados, tomato juice and salmon. - Just as foods can help reduce the symptoms of menstrual cramping and bleeding, foods can aggravate your symptoms. This includes eating excessive amounts of sugar -- such as cakes, cookies and pies. These are known to contribute to water retention, which make you feel bloated and uncomfortable. High-salt content foods -- french fries, pizza and other fried foods --- can also contribute to bloating. Caffeine-containing beverages like tea and coffee should be avoided as they can contribute to headaches, mood swings and trouble sleeping. - If you're craving chocolate, make sure it's over 70 per cent cocoa. This bittersweet treat will help you relax your muscles. - We all know fluids are essential when your body is cramping or bloating. Drinking two to three litres of water during your period is essential. - Tea is an easy way to replace your caffeine craving. Green tea to soothe cramps. now, even though green tea contains caffeine, try decaffeinated green tea instead — but be aware, you may lose some health benefits with a decaf version. Caffeine is another no-no. Drinking lots of coffee or pop during your period can increase higher levels of tension and anxiety. - Avoid anything that can damage your liver should be off the list. So, avoid alcohol. - Red meat, Smart says, is also know to cause stomach upsets and cramps. Medication: Start taking homoeopathic medicines - Mag. Phos. 6x and Colocynthis 200 - every 2 hrly. during the time of menses. And take Five Phos. and Alfaalfa Tonic - thrice daily for 1 month. Revert me back.
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My menstrual cycle starts on 18 and usually I get my periods 3 days early. I want to start my period early by 7 or 8 days. Are there any pills you can prescribe me.

MBBS, MD - Obstetrtics & Gynaecology, FMAS, DMAS
Gynaecologist, Noida
My menstrual cycle starts on 18 and usually I get my periods 3 days early. I want to start my period early by 7 or 8 ...
Hello, you may opt for progesterones for 5 days anyhow and then menses shall start in next 7 days, so I guess with your time frame, not possible. You can however delay your menses.
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I am suffering from irregular periods from 4 months I have been using postpone tablets for getting cycle pls could you help me out.

DHMS (Hons.)
Homeopath, Patna
I am suffering from irregular periods from 4 months I have been using postpone tablets for getting cycle pls could yo...
Hello,  Tk, plenty of water to hydrate yourself ,to eliminate toxins diluting your blood to establish your flow.  * go for meditation to reduce your stress, anxiety to calm your nerve ,improving haemoglobin level. * your diet be simple, non- irritant, easily digestible on time to avoid gastritis  •TK, Apple,carrots, cheese,milk, banana,papaya, pomegranate, spinach, to improve your haemoglobin to release your flow, timely. • Tk, Homoeo medicine, being gentle, rapid & safe in administration. @ Pulsatilla 30-6 pills, thrice. * Ensure, sound sleep in d night for at least 7 hrs. •Avoid, caffiene,junkfood, dust,smoke, exertion •Your feedback will highly b appreciated for further, follow up.•Tk, care,
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I am female 42 years old, having normal periods .but, this month facing repeat periods within 20 days again. Is it normal. This month I go through with sexual relation several times.

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda,
I am female 42 years old, having normal periods .but, this month facing repeat periods within 20 days again. Is it no...
Due to stress or anxiety periods can be early than due date relax, have plenty of water and avoid spicy food.
1 person found this helpful
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I am not getting pregnant. We do not use any kind of safety such as condom pills etc. What could be reason?

MBBS
Sexologist, Panchkula
I am  not getting pregnant. We do not use any kind of safety such as condom pills etc. What could be reason?
You are not getting pregnant.I advise you to do semen analysis test of your husband after 4 days of abstinence from sex and tell me report for further guidance.
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Me and my wife had relation immediately after her period ends and now worried that we don't want baby sor early, my wife took contraceptive pills also but after 2 days and m worried now can you please help me regarding.

Diploma in Diabetology, Pregnancy & Diabetes, Hypertension, Cardiovascular Prevention in Diabetes ,Thyroid
Sexologist, Sri Ganganagar
Me and my wife had relation immediately after her period ends and now worried that we don't want baby sor early, my w...
THERE IS NO CHANCE AT ALL OF PREGNANCY BECAUSE IT IS SAFE PERIOD. FOR PREGNANCY IF WE DO SEX BETWEEN 11 th TO 18 th DAY THEN CHANCES OF PREGNANCY.
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Irregular periods every month and too much pain and very less flow minimum 2dayz.

International Academy of Classical Homeopathy, BHMS
Homeopath,
Irregular periods every month and too much pain and very less flow minimum 2dayz.
les, such as broccoli, cauliflower, and Brussels sprouts · greens, including red leaf lettuce and arugula · green and red peppers · beans and lentils · almonds · berries · sweet potatoes · winter squash · pumpkin inform me progres
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My girlfriend is missing her periods every month. Please tell me what is the reason behind that. I sometimes do finger fucking for pleasure, is that the reason?

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MD - Ayurveda
Ayurveda, Pune
My girlfriend is missing her periods every month. Please tell me what is the reason behind that. I sometimes do finge...
its due to hormonal imbalance Use warm water for drinking,take healthy ,warm food,fresh fruits,dry fruits,take proper rest,sound sleep,do regular exercise, yoga,pranayam. Avoid- chilled water,cold drink, foods kept in fridge,oily,spicy,outside food,water, avoid late night works, travelling ,overexertion during menstruation.
1 person found this helpful
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Three months ago V had unprotected intercourse n My wife took ipill say 25 hours after that. She got little bleeding after a week on her due date itself. Next month she got less bleeding. Last month she got a little more than normal bleeding. Now she is getting few chin hair say 6-10. She is very worried. Is she pregnant? Or whats all this?

MBBS, MS - Obstetrics & Gynecology, Fellowship in Infertility (IVF Specialist)
Gynaecologist, Aurangabad
Three months ago V had unprotected intercourse n My wife took ipill say 25 hours after that. She got little bleeding ...
hi lybrate user, ipill is known for hormonal imbalance. please first rule out pregnancy. as ipill is not 100% in preventing pregnancy.
15 people found this helpful
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