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Dr. Rajaram D

Anesthesiologist, Chennai

100 at clinic
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Dr. Rajaram D Anesthesiologist, Chennai
100 at clinic
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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. Rajaram D
Dr. Rajaram D is a trusted Anesthesiologist in Tondiarpet, Chennai. You can meet Dr. Rajaram D personally at Dr Narmathas Ram Nursing Home in Tondiarpet, Chennai. You can book an instant appointment online with Dr. Rajaram D on Lybrate.com.

Lybrate.com has an excellent community of Anesthesiologists in India. You will find Anesthesiologists with more than 31 years of experience on Lybrate.com. You can find Anesthesiologists online in Chennai 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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English

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Dr Narmathas Ram Nursing Home

#777,T H Road, Tondiarpet. Landmark:Near Tondiarpet Police Station, ChennaiChennai Get Directions
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I am a degree student, i am 19 years old, am suffering from back pain since 2 years what can I do?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am a degree student, i am 19 years old, am suffering from back pain since 2 years what can I do?
Kindly show me a photograph of the affected part. Rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. If it does not give relief in 4-5days, contact me again. Do not ignore. It could be beginning of a serious problem.
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I have body since 2 months. What can I do? Especially spinal chord pain is more. Please suggest some medicine.

MBBS
General Physician, Faridabad
I have body since 2 months. What can I do? Especially spinal chord pain is more. Please suggest some medicine.
take protein diet, green vegetable diet, dal, paneer, cheese, fruits, eggs etc, drink 3-4 litre of water daily, take cap autrin 1 cap od 1 hr walk daily,take tab dolo 1 tab sos it will help you,thank you
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Dengue Vaxia

M.B.B.S,C.C.A,D.C.A,AASECT,FPA,AAD,M.I.M.S
General Physician, Gorakhpur
Dengue Vaxia

Dengvaxia - first vaccine against dengue

Dengvaxia is a vaccine used to help protect adult or children against dengue disease caused by dengue virus serotypes 1, 2, 3 and 4. Dengvaxia is given to adults, adolescents and children 9 through 45 years of age living in endemic areas.

Read more:

Dengue symptoms and what to do if you think you have denguedengue fever - remedies using papaya leaf juice

Full prescribing info - dengvaxia

Contents

Dengue tetravalent vaccine (live, attenuated).

Indications / uses

Dengvaxia is a vaccine used to help protect adult or children against dengue disease caused by dengue virus serotypes 1, 2, 3 and 4. Dengvaxia is given to adults, adolescents and children 9 through 45 years of age living in endemic areas.

Dosage / direction for use

The patient will receive 3 injections of 0.5 ml each at 6-month intervals.

The first injection will occur at the chosen or scheduled date; the second injection, 6 months after the first injection; and the third injection, 6 months after the second injection. Dengvaxia should be used according to the local vaccination schedule.

If the patient forgot an injection of dengvaxia: if the patient missed a scheduled injection, the physician will decide when to give the missed injection.

It is important that the patient follows the instructions of the physician, pharmacist or nurse regarding return visits for the follow-up injection. If the patient forgets or is not able to go back to the physician, pharmacist or nurse at the scheduled time, ask the physician, pharmacist or nurse for advice.

Administration: dengvaxia is given by the physician or nurse as an injection underneath the skin (subcutaneous route) in the upper arm.

Contraindications

Do not use dengvaxia if the patient is allergic (hypertensive) to the active substances or any of the other ingredients of dengvaxia listed in description (see description); has developed an allergic reaction after prior administration of dengvaxia. Signs of an allergic reaction may include an itchy rash, shortness of breath and swelling of the face and tongue; is suffering from a disease with mild to high fever or acute disease. In this case, the physician will postpone the administration of dengvaxia until the patient has recovered; has a weakened immune system, for example due to a genetic defect, hiv infection or therapies that affect the immune system (for example, high-dose corticosteroids or chemotherapy); is pregnant; is breastfeeding.

Use in pregnancy lactation: dengvaxia must not be given to pregnant or breastfeeding women.

If the patient is of child-bearing stage, the patient should take the necessary precautions to avoid pregnancy for 1 month following administration of dengvaxia; is pregnant or breastfeeding, the patient thinks may be pregnant or is planning to have a baby, ask the physician, pharmacist or nurse for advice before receiving dengvaxia.

Special precautions

Inform the physician, pharmacist or nurse before receiving dengvaxia if the patient is taking an immunosuppressive treatment (prednisone or equivalent to 20 mg or 2 mg/kg for 2 weeks or more). The physician will postpone administration of dengvaxia until 4 weeks after the treatment is discontinued; has experienced any health problems after prior administration of any vaccines. The physician will carefully consider the risks and benefits of vaccination.

As with all vaccines, dengvaxia may not protect 100% of persons who have been vaccinated. Vaccination with dengvaxia is not a substitute for protection against mosquito bites. The patient should take appropriate precautions to prevent mosquito bites, including the use of repellents, adequate clothing, and mosquito nets.

Fainting, sometimes accompanied by falling, can occur (mostly in adolescents) following, or even before, any injection with a needle. Therefore inform the physician, pharmacist or nurse if the patient fainted with a prior injection.

Adults above 45 years of age: adults above 45 years of age should not receive the vaccine.

Driving and using machines: no data are available on the effects of dengvaxia on the ability to drive or use machines.

Use in children: children less than 9 years of age should not receive the vaccine.

Side effects

Like all medicines, dengvaxia can cause side effects, although not all patients get them.

Serious allergic reactions: if any of these symptoms occur after leaving the place where the patient received an injection, consult a physician immediately: difficulty in breathing, blueness of the tongue or lips, a rash, swelling of the face or throat, low blood pressure causing dizziness or collapse.

When these signs and symptoms occur they usually develop quickly after the injection is given and while the patient is still in clinic or physician's surgery.

Serious allergic reactions are very rare (may affect up to 1 in 10, 000 people), after receiving any vaccine.

Other side effects: the following side effects were reported during clinical studies in children, adolescents and adults (from 9 to and including 60 years of age). Most of the reported side effects occurred within 3 days after the injection of the vaccine: very common (may affect more than 1 user in 10): headache, muscle pain (myalgia), generally feeling unwell (malaise), feeling of weakness (asthenia), injection site pain, fever.

Common (may affect up to 1 user in 10): injection site reactions: redness (erythema), bruising (hematoma), swelling, and itching (pruritus).

Uncommon (may affect up to 1 user in 100): infections of the upper respiratory tract, dizziness, sore throat (oropharyngeal pain), cough, runny nose (rhinorrhea), nausea, skin eruption (rash), neck pain, hardening of skin at the injection site (injection site induration).

Additional side effects in adults (from 18 to and including 60 years of age): uncommon (may affect up to 1 user in 100): swollen glands (lymphadenopathy), migraine, joint pain (arthralgia), flu-like symptoms (influenza-like illness).

Additional side effects in children and adolescents (from 9 to and including 17 years of age: uncommon (may affect up to 1 user in 100): itchy rash (urticaria).

Reporting of side effects or any suspected adverse event: if the patient experiences any side effects after vaccination, advised to seek immediate medical attention.

By reporting side effects, it can help provide more information on the safety of the vaccine.

Click to view adr monitoring form

Interactions

Using other medicines and dengvaxia: dengvaxia may not have an optimal effect if it used at the same time as medicines that suppress the immune system such as corticosteroids or chemotherapy.

Inform the physician, pharmacist or nurse if the patient is taking or has recently taken any other vaccines or any other medicines, including medicines obtained without a prescription.

Caution for usage

Before administering any biological, the person responsible for administration must take all precautions to prevent allergic or other reactions. As with all injectable vaccines, appropriate medical treatment and supervision must always be readily available in the event of an anaphylactic reaction following the administration of dengvaxia.

Epinephrine (1: 1000) and other appropriate agents used to control immediate allergic reactions must be available to treat unexpected events such as anaphylaxis.

Dengvaxia must not be mixed with other medicinal products in the same syringe.

Dengvaxia must not be administered by intravascular injection under any circumstances.

Syncope (fainting) can occur following, or even before, any vaccination as a psychogenic response to injection with a needle. Procedures should be in place to prevent injury from falling and to manage syncopal reactions.

Separate syringes and needles, separate injection sites and preferably separate limbs must be used if any other vaccine (s) or medicinal product (s) is/are concomitantly administered.

Dengvaxia is reconstituted by transferring all the solvent (0.4% sodium chloride solution) provided in the blue-labeled pre-filled syringe into the vial of freeze dried powder with a yellowish green flip off cap. The pre-filled syringe is fitted with a sterile needle for this transfer. The vial is then gently swirled. After complete dissolution, a 0.5 ml dose of reconstituted suspension is withdrawn into the same syringe. For injection, the syringe should be fitted with the new sterile needle.

The suspension should be visually inspected prior to administration. After reconstitution, dengvaxia is clear, colorless liquid with the possible presence of white to translucent particles (of endogenous nature).

After reconstitution with the solvent provided, dengvaxia must be used immediately.

Any unused dengvaxia or waste material should be disposed of, preferably by heat inactivation or incineration, in accordance with local regulations.

Do not throw away any medicines via wastewater or household waste. Ask a pharmacist on how to throw away medicines that no longer use. These measures will help to protect the environment.

Storage

Store in a refrigerator. Do not freeze. Keep the vaccine in the outer carton in order to protect it from light.

Description

After reconstitution, one dose (0.5 ml) contains 4.5-6.0 log10 ccid50* of each serotype of the cyd dengue virus** (1, 2, 3 and 4).

* ccid50: 50% cell culture infectious dose.

** produced in serum-free vero cells by recombinant dna technology.

The powder is a white, homogenous, freeze-dried powder with possible retraction at the base, and may form a ring-shaped cake.

The solvent (0.4% sodium chloride solution) is a clear, colorless liquid.

After reconstitution with the solvent provided, dengvaxia is a clear, colorless liquid with the possible presence of white to translucent particles.

Excipients/inactive ingredients: essential amino acids including l-phenylalanine, non-essential amino acids, l-arginine hydrochloride, sucrose, d-trehalose dihydrate, d-sorbitol, trometamol, urea, sodium chloride, water for injections.

Mechanism of action

Dengvaxia contains dengue virus serotypes 1, 2, 3 and 4 that have been weakened. Dengvaxia works by stimulating the body's natural defenses (immune system), which produces its own protection (antibodies) against the viruses that cause dengue disease.

Dengue is a viral infection transmitted to humans through the bite of an infected aedes mosquito. Dengue is not transmitted directly from person-to-person. Nevertheless the virus which replicates in an infected individual can be transmitted to other humans through mosquito bites for 4-5 days (maximum 12 days) after the first symptoms appear.

Dengue disease results in a wide range of symptoms including fever, headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen glands or skin rash. Symptoms usually last for 2-7 days. Dengue disease can also be asymptomatic.

However, occasionally dengue can be severe and potentially lead to hospitalization and in rare cases to death. Severe dengue is characterized by high fever and any of the following symptoms: severe abdominal pain, persistent vomiting, rapid breathing, severe bleeding, bleeding in stomach, bleeding gums, fatigue, restlessness, coma, seizure and organ failure.

Source:- http://www.mims.com/philippines/drug/info/dengvaxia

More information about dengvaxia - first vaccine against dengue

Sanofi awaits govt approval to launch dengue vaccine in india

Sanofi pasteur - dengue vaccine frequently asked questions

14 people found this helpful

My uric acid level is 6.2 and heels are paining too much. What should I do? any thing to avoid in diet?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
My uric acid level is 6.2 and heels are paining too much. What should I do? any thing to avoid in diet?
Requires detailed examination and investigation. Preliminary investigations suggested: hb, tlc, dlc, esr, blood sugar fasting & pp, uric acid vit d urine r/e x-ray of the affected part. Anyway it may be tried sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful use no pillow under the head. Do hot fomantation paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back, knee & general exercises. It may have to be further investigated. Do not ignore it. Let it not become beginning of a bigger problem. Make sure that patient is not allergic to any of the medicines that he/she is going to take. If it does not give relief in 4-5days, inform.
4 people found this helpful
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I am 20 years old. L have a pain on my right foot since 7 days. I think it would be serious. Pls consult as soon as possible.

Master of Occupational Therapy (MOT), Bachelor of Occupational Therapy (BOT)
Occupational Therapist, Delhi
I am 20 years old. L have a pain on my right foot since 7 days. I think it would be serious. Pls consult as soon as p...
Do contrast bath therapy. Take hot water in bucket & in another bucket take cold water. First immerse your foot in hot water for 3min then immediately move to cold water for 1min, keep repeating for 20min. Do this twice daily. Do ankle pumps & isometrics
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I have back pain at my lower part when I drive bike for long journey or short journey when I stop my bike and when I stand I have a mild pain for minutes after that when sit mild pain occur at night when I got sleep no pain occur .this pain occur during or sitting time. I have checked my uric acid it is 7.2.and I hve done gym bt it is now stop for a year's.pain in left knee occur only when I go bathroom. Bt there is no pain when I walk or jogging. Pls suggest I am a student my age is 29.

BPTh/BPT, MPTh/MPT, Certified Manual Therapist, Certified McConnell Concept Practitioner, Certified Dry Needling Practitioner
Physiotherapist, Patna
I have back pain at my lower part when I drive bike for long journey or short journey when I stop my bike and when I ...
Hi Binod... Your complain reveals that you are having muscle tightness in your lower limbs. Do regular stretching exercises for hams, piriformis, calf, quads. Use hot fomentation on your back.
1 person found this helpful
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I have pain my back from few days what should I do for that and I am having pain in my shoulder because of hard workout what should I do for that will you suggest me about that pain.

BPTh/BPT
Physiotherapist, Mumbai
I have pain my back from few days what should I do for that and I am having pain in my shoulder because of hard worko...
Hi I can understand your problem. # relax & stay positive. # take hot and cold fomentation. # learn posture care exercise. # use lumbar support. # take break every 20 minutes. # do strengthening exercise of back and core muscles not all back pains are same. Do share investigation reports if you have any.
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Morning tiredness and neck pain, bones pain in small work from last 1 years .please suggest.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), MSC IN DIETETICS AND NEUTRITION,IGNU
Ayurveda, Delhi
Morning tiredness and neck pain, bones pain in small work from last 1 years .please suggest.
Plese do some tests like vit b12 .rh factor .ca .profile and hb test first. Second start to take almonds oil drop 2 daily in both your nostrils .after taking bath and at bed time.
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I am a 22 year girl. I have frequent headaches, backpain and feel weakness alot. What should I do?

Diploma in Nutrition
Dietitian/Nutritionist, Secunderabad
Know your diet and daily activities, accordingly have a proper nutritional food, physical exercise, adequate rest, relaxed mind.consult me privately
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Im 25 year male , for the past few years im suffering from knee pain when I sit for a long time or when ever I fold my knee while sitting I hear a audible "tick sound" and in some time while walking I can just feel "tick" sound in my legs but while walking or sitting its not paining but when I sit for long time and while im getting up its paining a lot.

BHMS
Homeopath,
Im 25 year male , for the past few years im suffering from knee pain when I sit for a long time or when ever I fold m...
I think you are suffering from osteo-arthritis. Which causes caries of bones. Synovial fluid dried. And inter articular joint space diminished that's why the tick sound. Cartilage also damaged. You need to take homoeopathic medicine. It's a chronic trtmnt you have to take it for 6 months-1 years atlst. In 2-3 months you will feel better than before. And continued the trtmnt. You will b able to walk normally.
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I am 28 yes old working in it comp usually after work I feel pain in my shoulder which intensify gradually I took pain Keeler's but it has no permanent relief.

DHMS (Diploma in Homeopathic Medicine and Surgery), BHMS
Homeopath, Delhi
I am 28 yes old working in it comp usually after work I feel pain in my shoulder which intensify gradually I took pai...
hello bunty u may hving spondolytis..if works most of d time on laptop or pc than tk a break of for 5 mint.after every 1 hr. move ur shoulder,& neck than start,&dont tk pillow instead of that tk a role of sheey under ur neck.ur posture should be rt. homeopathy has gud result in ur problem kindly cotact me for further advice.
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Hi I am a 32 yr old male and in last 1 month I had mild pain in my right arm for about 1 min duration. This happened twice. I am an it professional and do mild exercise. I am having average personality. Please advice.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
It could be due to cervical spondylosis this is quite a common condition rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Use no pillow under the head. Any way take caldikind plus (mankind) 1tab odx10days paracetamol 250mg od & sos x 5days do neck & back (spine) exercises contact me again if need be. Make sure you are not allergic to any of the medicines you are going to take.
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Recently we were blessed with baby boy on June 8th. it was forceps through delivery happened. But my son back shoulder some shaping not clear so that he is turning head in one direction. Please advise.

Masters In Physiotherapy
Physiotherapist, Hyderabad
Recently we were blessed with baby boy on June 8th. it was forceps through delivery happened. But my son back shoulde...
Nothing to worry it will take some time and he will be alright chk with a pediatrician who was good at developmental delay problems.
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Sit I am suffering from back pain for last 1 month and a when I take some pain killer it stop for few minutes but still the problem is same what should I do please suggest.

DNHE, BPTh/BPT, weight management specialist
Dietitian/Nutritionist, Kolkata
Sit I am suffering from back pain for last 1 month and a when I take some pain killer it stop for few minutes but sti...
If there was no trauma or injury to the back, and also if you didn't lift any heavy weight and the pain started, then it could be due to posture related or mechanical backache. You can use a hot water bag in your back for 10-15 min and then apply some ointment like nice gel. Eventually you need to strengthen your back muscles by exercising (simple exercises) like pelvic lifting, static back etc, also some of the yoga asanas are also good for back like bhujangasan etc.
1 person found this helpful
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I am 26 yrs old female I have piles, asthma, migraine, cold, backpain, what should I do?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
I am 26 yrs old female I have piles, asthma, migraine, cold, backpain, what should I do?
For back pain only sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back knee & general exercises. It may have to be further investigated. Make sure you are not allergic to any of the medicines you are going to take. For emergency treatment contacts your nearest hospital or family doctor. If it doe s not give relief in 4-5days, contact me again. It may take care of your migraine as well.
4 people found this helpful
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Left leg ligament on March 2016 and till now it haven't got cured according to MRI report I need to go under surgery and I don't Wana do that so please suggest what should I do in order to cure naturally.?

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Left leg ligament on March 2016 and till now it haven't got cured according to MRI report I need to go under surgery ...
If partial tear then do laser therapy and ultrasonic therapy and quadriceps exercises in gradually process.
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I have worked in IBM in Hyderabad desktop job so getting a back pain so that is the best solutions tell me.

MD, MBBS
Pain Management Specialist, Vadodara
I have worked in IBM in Hyderabad desktop job so getting a back pain so that is the best solutions tell me.
Generally it is mechanical. Have a back support during your working hours. Have back exercises Do not sit contentiously , have some walk in between Just now take pain killer
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Sir, my mom is suffering for knee pain and she is not coming sleeping in the night daily please give me a suggestion.

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Sir, my mom is suffering for knee pain and she is not coming sleeping in the night daily please give me a suggestion.
Do take ift and vacuum therapy for 12 days followed by strengthening exercises from neuro physio best wishes.
1 person found this helpful
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Hiii , I am 18 years old. And I have backache from 1 years . Please give me some suggestion. My sleeping is midnight.

MPT - Orthopedic Physiotherapy, BPTh/BPT
Physiotherapist, Noida
Hiii , I am 18 years old. And I have backache from 1 years . Please give me some suggestion. My sleeping is midnight.
Posture correction must do physiotherapy treatment nw after relief do stretching exercise. Avoid long sitting toward bending and lifting weight.
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