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Dr. Ram Kinkar Shastri

Cardiologist, Hyderabad

450 at clinic
Dr. Ram Kinkar Shastri Cardiologist, Hyderabad
450 at clinic
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. Ram Kinkar Shastri
Dr. Ram Kinkar Shastri is one of the best Cardiologists in Banjara Hills, Hyderabad. You can meet Dr. Ram Kinkar Shastri personally at Star Hospital in Banjara Hills, Hyderabad. Book an appointment online with Dr. Ram Kinkar Shastri on Lybrate.com.

Lybrate.com has a nexus of the most experienced Cardiologists in India. You will find Cardiologists with more than 34 years of experience on Lybrate.com. Find the best Cardiologists online in Hyderabad. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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8-2-120/120/1/70, Road Number 10, Nandi Nagar, Banjara Hills, Landmark: Opp Karvy Centre, HyderabadHyderabad Get Directions
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My whole chest pains too much in winter what is the reason and what should I do to get rid from these.

MD - Alternate Medicine, BHMS
Homeopath, Surat
My whole chest pains too much in winter what is the reason and what should I do to get rid from these.
You need to chest exercises and have warm water for 3-4 times in a day. And take Sulphur 30 one dose daily for 3 days. This will give you a lot of relief. Take care :)
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I have chest pain in left side. Please help me and give me some suggestions. Thanking you sir.

MBBS
General Physician, Mumbai
I have chest pain in left side. Please help me and give me some suggestions. Thanking you sir.
For pain take tablet paracetamol 650 mg with rantac and get your vital parameters of the body checked
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I have cholesterol of 208 is it serious and what all methods to control it? i'm 22 years old.

MBBS, MD - Internal Medicine
Internal Medicine Specialist, Faridabad
I have cholesterol of 208 is it serious and what all methods to control it? i'm 22 years old.
High cholesterol can cause atherosclerotic heart disease or narrowed coronary arteries in the heart can cause the symptoms of angina, when theheart muscle is not provided with enough oxygen to function. Decreased blood supply to the brain may be due to narrowed small arteries in the brain or because the larger carotidarteries in the neck may become blocked. This can result in a transient ischmic attack or stroke. Peripheral artery disease describes gradual narrowing of the arteries that supply the legs. During exercise , if the legs do not get enough blood supply, they can develop pain , called claudication . Other arteries in the body may also be affected by plaque buildup causing them to narrow, including the mesenteric arteries to the intestine and the renal arteries to the kidney. Avoid fast foods,oily foods,junk foods,alcohol,smoking,fatty foods, non-veg.,avoid stress, take green veg., whole grain.garlic,. Take anti cholesterol medicines .
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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,
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

13 people found this helpful

I am taking razel 10 from last 2 months for cholesterol but I got to know that taking this for longer is not good so just want to know whether taking this medicine for about 4 months will have any diverse effect on my health.

MBBS, PG Diploma In Clinical Cosmetology (PGDCC)
Cardiologist, Purba
I am taking razel 10 from last 2 months for cholesterol but I got to know that taking this for longer is not good so ...
no if any side effect occurs it occurs in first few weeks. on long use there may be development of Diabetes. do regular check up
2 people found this helpful
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What are the symptoms of tuberculosis. I have cough for more than 2 weeks and chest pain also . Have I tuberculosis.

MBBS
General Physician, Cuttack
What are the symptoms of tuberculosis. I have cough for more than 2 weeks and chest pain also . Have I tuberculosis.
Symptoms of tb 1. Evening rise of temperature, night sweat1.2. Coughing that lasts for more than 3 weeks 3. Coughing up blood 4. Chest pain while taking breath or coughing5. Loss of weight, fatigue get your blood examined for esr/crp, cbc, do mantoux test, sputum examination for afb (3 samples), x ray chest and consult physician with report for advice and treatment. Contact nearest dots center for free advice/investigations and treatment.
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My father is heart patient. His heart work only 25%. There is pain on every night in his right chest. There is mind of vomiting but it doesnot come. Very weak. Pain in legs. Diabetes is well. What should we do? please anyone give genuine solution?

MBBS, MD - Internal Medicine
Internal Medicine Specialist, Faridabad
My father is heart patient. His heart work only 25%. There is pain on every night in his right chest. There is mind o...
CONTROL ACIDITY..AND NEUROPATHIC DISORDER.. TAB. EMESET-4MG BBF.. SYP.ULGEL-A 15 ml tds. cap. neurokind plus od afer meal. do test---LFT,CPK-MB.HBA1C,
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I have pan in chest sometime that can't be absorable. After some time that will normal. Please tell me what is the reason?

MBBS, MBA (Healthcare)
General Physician, Delhi
I have pan in chest sometime that can't be absorable. After some time that will normal. Please tell me what is the re...
take aciloc 150 mg 2 times a day for 2 weeks. do ecg, x ray chest pa . inform report. consult physician.
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I am Ashok Jindle from Bathinda Punjab. In my urine 3 proteins are shown and it was informed that due to this my urine passes out slowly. This problem is for the last 4-5 months. Earlier my sugar level was 130 but now it is 103. I have high BP problem but it is in the range of 90-140 with daily dose of one tab. Of Amtas M 50. Please suggest me the possible remedy for 3 proteins in the using.

Dip.Diab, Fellowship Diabetology (Gold Medallist), MBBS
Endocrinologist, Thane
I am Ashok Jindle from Bathinda Punjab. In my urine 3 proteins are shown and it was informed that due to this my urin...
Slow passing of urine is not due to proteins in urine. It may be a sign of prostate. You will need a usg (sonography) with residual urine to rule out prostate. Urine proteins suggest either infection or slight kidney damage due to diabetes or blood pressure. Please do 2 tests s. Creatinine and microalbumin to rule out these pathologies.
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Dear Dr, I am 26 male. I was having high for which blood test was done and my cholesterol was 215 and triglycerides was 191. Dr. advised to take orvas ft for 1 month. Will I have to continue this tablet for life time? What are its side effects? Will this medication cause Erectile dysfunction? Thanks!

MBBS, MD - Internal Medicine, DM - Cardiology, Cardiac Device Specialist (CCDS - Physician )
Cardiologist, Delhi
Dear Dr,
I am 26 male. I was having high for which blood test was done and my cholesterol was 215 and triglycerides w...
Kindly consult with your complete lipid profile report. Medication need not be started at this age. First begin with diet modifications (take a detailed diet consult) and begin exercising, start gradually and increase to 45 mins daily. Quit smoking and drinking. Repeat levels after 6 weeks of these measures. If levels still high you may need medications.
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I have pain in chest When I eat or drink and My mouth taste is burning When I eat.

MBBS, MD - General Medicine
General Physician, Delhi
I have pain in chest When I eat or drink and My mouth taste is burning When I eat.
Could be acidity with reflux disease. May need medicine. Have proper diet at proper time. Do not lie down immediately after food. Eat frequent small meals.
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cholesterol

B H M S, MD
Homeopath, Thrissur
cholesterol
For increased cholesterol which will lead to heart problems, an easy home remedy is pure coconut oil (it should be pure strictly) taken 10 to 15 ml a day in empty stomach in the morning for 2 months will relieve.
1 person found this helpful

My dad have high pressure. 80-140 level. please give me the solution to maintain the pressure.

BAMS
Ayurveda, Ambala
My dad have high pressure. 80-140 level. please give me the solution to maintain the pressure.
To control & maintain BP normal these are best methods to follow:.• Do physical exercise like jogging, running or brisk walk for atleast 20-30 minutes. • Maintain your cholesterol level to normal & eat least amount of butter, cream or fatty things. • Eat less amount of pickle, salt and fast food as they contain high sodium levels. • Avoid drinking alcohol and smoking. • Take less amount of caffine containing coffee, tea or cold drinks because caffine causes increase BP. • Drink 8 to 10 glass of water daily • Take 6 to 8 hrs of sleep daily. Do not take too much stress. • Do long breathing pranayams (Anulom- Vilom, Bhramari) daily for 10 - 15 minutes. It will reduce your stress level in your body. • Eat healthy diet such as green leafy vegetables, fruits. • Take 5 ml of GULAB Jal added in a glass of water daily once a day.
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My mother bp details are upper is 185 and lower is 125. Suggest me what should I do.

BAMS
Ayurveda, Ambala
My mother bp details are upper is 185 and lower is 125. Suggest me what should I do.
To control & maintain Blood pressure to normal these are best methods to follow:.• Do physical exercise like jogging, running or brisk walk for atleast 20-30 minutes. • Maintain your cholesterol level to normal & eat least amount of butter, cream or fatty things. • Eat less amount of pickle, salt and fast food as they contain high sodium levels. • Avoid drinking alcohol and smoking. • Take less amount of caffine containing coffee, tea or cold drinks because caffine causes increase BP. • Drink 8 to 10 glass of water daily • Take 6 to 8 hrs of sleep daily. Do not take too much stress. • Do long breathing pranayams (Anulom- Vilom, Bhramari) daily for 10 - 15 minutes. It will reduce your stress level in your body. • Eat healthy diet such as green leafy vegetables, fruits. • Take 5 ml of GULAB Jal added in a glass of water daily once a day. You can consult me privately for more medicine treatment and doubts.
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I have measured my blood pressure it is 146/96 so pls guide me what to do my age is 35.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), M.D in Ayurveda, Ph.D
Ayurveda, Hyderabad
I have measured my blood pressure it is 146/96 so pls guide me what to do my age is 35.
Take only salt free diet, and take one tab of metoprolal 50 mg then examin bp if not controled to narmal morning one tab and evening one tab is advisable.
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Hello, I have heart palpitation from last two years. My heartbeats stops for one or two seconds. This problem does one and two time in a day. I have done all blood test. ECG shows first degree heart block. Echo cardiograph and treadmill test are normal. So can I need any treatment. Thank you.

DM - Cardiology
Cardiologist, Navi Mumbai
Hello, I have heart palpitation from last two years. My heartbeats stops for one or two seconds. This problem does on...
If you smoke or chew tobacco, first you have to stop that. No need of medicines. Don't take any ayurvedic preparations.
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I a student and I have a lost of pressure to study. Tell me something about realize my pressure.

MBBS
General Physician, Mumbai
I a student and I have a lost of pressure to study. Tell me something about realize my pressure.
I will suggest you to do suryanamaskar pranayam daily as per your capacity for a minimum of six months.
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I have to store cholesterol, how does I removed my cholesterol?

MD - Internal Medicine, MBBS
Endocrinologist,
I have to store cholesterol, how does I removed my cholesterol?
high cholesterol can cause atherosclerotic heart disease or narrowed coronary arteries in the heart can cause the symptoms of angina, when theheart muscle is not provided with enough oxygen to function. Decreased blood supply to the brain may be due to narrowed small arteries in the brain or because the larger carotidarteries in the neck may become blocked. This can result in a transient ischmic attack or stroke. Peripheral artery disease describes gradual narrowing of the arteries that supply the legs. During exercise , if the legs do not get enough blood supply, they can develop pain , called claudication . Other arteries in the body may also be affected by plaque buildup causing them to narrow, including the mesenteric arteries to the intestine and the renal arteries to the kidney. you should be avoid bad habits ,fatty meal/oily foods/junk/fast foods/alcohol/smoking/noo-veg. take whole grain meal/oats/dalia/green veg./fruits/juice/ use garlic . you can take also cap. ecosprin gold-10 at night. and consult cardiologist.
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I am a 29 years old female with 4 kids. I have given birth to all 4 with caesarean section. I have hydronephrosis which is under control. An my blood pressure is around 100/70 to 80/60. I always feel dizzy? What could be its cause.

PDDM, MHA, MBBS
General Physician, Nashik
The cause seems to be hypotension. When dealing with low blood pressure, it is usually suggested to increase your salt and fluid intake. Before increasing yoursalt consumption, do check with your doctor. Also, cut down on alcoholic beverages and high-carbohydrate foods such asbread, rice, pasta, and potatoes.
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I am suffering cough hard from last 2 weeks and I have pain chest hard whenever I cough hard can you suggest what should do it.

PGDHHM, MBBS
General Physician, Delhi
I am suffering cough hard from last 2 weeks and I have pain chest hard whenever I cough hard can you suggest what sho...
Take over-the-counter cough syrp if dry cough-antitussive. Do lukewarm water gargles twice a day. If productive cough ,do steam inhalation twice daily. Take adequate rest. Eat healthy diet. Hope this helps u. If required, consult
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