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Dr. Asis Kumar Misra's chamber

General Surgeon Clinic

54D,Sarat Bose Road,Bhowanipur, Kolkata Kolkata
1 Doctor
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Dr. Asis Kumar Misra's chamber General Surgeon Clinic 54D,Sarat Bose Road,Bhowanipur, Kolkata Kolkata
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Customer service is provided by a highly trained, professional staff who look after your comfort and care and are considerate of your time. Their focus is you....more
Customer service is provided by a highly trained, professional staff who look after your comfort and care and are considerate of your time. Their focus is you.
More about Dr. Asis Kumar Misra's chamber
Dr. Asis Kumar Misra's chamber is known for housing experienced General Surgeons. Dr. Asis Kr Misra, a well-reputed General Surgeon, practices in Kolkata. Visit this medical health centre for General Surgeons recommended by 62 patients.

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Sarat Bose Road Kolkata, WestBengal
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How Homeopathy Helps Prevent Body Odour?

BHMS, MD - Homeopathy
Homeopath, Delhi
How Homeopathy Helps Prevent Body Odour?

It is perfectly normal to have body odour after a hard day’s work. However, it can get downright embarrassing and alarming if such body odour persists, even after a good warm shower. This medical condition is a symptom of hyperhidrosis or excessive sweating.

What causes body odour?
When the body bacteria combine with sweat, a chemical decomposition occurs that lets out a stinky and pungent smell from certain body parts, especially the feet and the armpits. Working outdoors or being subject to high stress levels over a prolonged period of time can result in this condition. An inclusion of excessive amount of garlic, onion and other spices in your regular diet can trigger body odour as well. Excessive alcohol consumption, conditions such as obesity and diabetes mellitus can also lead to body odour.

Below is a list of some of the most effective homeopathic treatments for body odour:

  1. Silicea: This homeopathic preparation is effective to remedy feet odour. The concerned person might also show symptoms of excessive sweating in the feet along with the appearance of cracks in between the toes.
  2. Hepar Sulph: This homeopathic preparation is effective to address a pungent body odour occurring due to excessive physical or mental stress. Additionally, this preparation is also effective to cure body odour that emerges from the armpits and tends to leave a yellow stain around the region. If the pungent body odour persists even after a proper bath, the homeopathic preparation Rheum can be an effective remedy.
  3. Psorinum: This homeopathic preparation is extremely beneficial to address foul smell in combination with the symptoms of excessive sensitivity to cold weather, an unhealthy /dirty looking skin, and excessive sweating.
  4. Baryta Carb: This homeopathic preparation is effective to cure feet odour, especially in children. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Skin Regime for Dark Skin

MD - Dermatology , Venereology & Leprosy, MBBS
Dermatologist, Delhi
Skin Regime for Dark Skin

Hyperpigmentation is the discolouration or increase in the natural colour (pigmentation) of the face. Although it occurs without any symptom, it is of high cosmetic concern and can result in psychological stress. Most of the causes of hyperpigmentation are attributed to exposure to the sun’s harmful uv rays and the hormonal and other bodily changes one undergoes at the time of pregnancy.

A number of other factors which lead to hyperpigmentation, either in patches or in entirety, include ageing, hormonal changes, pollution and in some cases, genetic factors.

Some easy skin care methods for hyperpigmentation are as follows:

Aloe vera gel: fresh aloe vera gel is popularly recommended for the treatment and reduction of patches of hyperpigmentation. Overnight use helps lighten the intensity of the spots. Pure, unadulterated aloe vera is readily available from the chemist.
Lemon juice: being a natural bleaching agent, lemon juice is known to lighten the skin without any side effects. The lemon juice is extracted into a bowl and cotton balls are used to soak the juice and then applied on the patchy areas, after which it is washed with cold water.
Milk: milk contains an acid called lactic acid which can be used to improve hyperpigmentation. Raw milk should be applied directly to the affected area and the results would be visible after few weeks.
Honey: application of honey on the darkened patch for around 20 minutes, 4 days a week can produce visible lightening of the darkened skin patches.
Yogurt: yogurt works perfectly for patchy skin caused due to environmental factors. It is capable of reducing age spots too. It can also be applied on the skin in combination with tomatoes.
Vitamin-e oil: vitamin e is a highly beneficial nutrient for the skin. The affected area should be massaged with oil of vitamin e which would help in the circulation of blood, thereby resulting in better looking skin.
 

How is hyperpigmentation treated at dermatologist clinic?

The dark patches are quite stubborn, and regular treatment under dermatologist is recommended. The treatment options can be divided into:

Topical creams: there is a range of cost-effective yet stronger creams available under prescription like skin-lightening medicines, antioxidants, hydroxy acids, retinoids, and steroids.
Oral medications: besides topical medication, certain oral medications like tranexamic acid are also under trial. Iron and vitamin supplements are prescribed if needed.
Chemical peels: biweekly peels under dermatologist supervision are recommended in recalcitrant cases. Peels help by exfoliating the pigment-containing cells in the epidermis and also help in rejuvenating your skin. There are hundreds of peels available today. Your dermatologist will decide which is best for your skin type.
Lasers: they can be used for resistant dark patches. However, the results are still under scrutiny.
All said and done! the bottom line is that dark patches might not fade away completely or recur even with the best of treatments unless sun protection is practised as prescribed by your dermatologist.

2 people found this helpful

Hereditary Angioedema And It's Treatment!

MBBS, Diploma in Venerology & Dermatology (DVD), DDV, MD - Dermatology , Venereology & Leprosy
Dermatologist, Pune
Hereditary Angioedema And It's Treatment!

Hereditary Angioedema is a rare skin related disorder and as the name suggests it is also a genetically inherited condition. This condition mainly afflicts the throat, abdomen and the limbs of the patient, with a certain kind of swelling. This swelling can become fatal if not treated on time. Here is everything you need to know about the condition and its treatment.

Causes: A rare genetic mutation of the SERPING1 gene can cause this condition. Usually, this gene is known to produce C1 esterase inhibitor, which is a kind of blood protein. This blood protein is an important element of one’s immune system and is usually involved in the biochemical reactions that control the body’s response to inflammation causing elements. This is done when the blood protein produces a hormone known as Bradykinin. If this blood protein does not function in a normal manner, then there is excessive production of this hormone, which leads to swelling and inflammation.

Type one: There are various types of Hereditary Angioedema that can affect various parts of the body. Type one is one of the most common kinds and can be found on the face, hands, abdomen, throat, as well as feet and genitals of the patient. The severity and frequency of attacks cannot really be predicted and the patient may suffer from attacks throughout his or her life. The best way to treat this type of Hereditary Angioedema is with the help of antihistamine drugs and prednisone which can fight allergic attacks.

Type two: This kind of Hereditary Angioedema has the same symptoms as type one and is caused by a malfunction of the C1 inhibitor, rather than the Bradykinin hormone as one can see in type one. This condition can also be treated with anti-allergy drugs.

Type three: This is very rare kind of Hereditary Angioedema. In fact, medical science is yet to find a conclusive body of knowledge that can point to the exact causes and symptoms of this condition. Coagulation is one of the main causes recognised so far. This condition is much more common in women than it is in men, and it usually shows up as facial swelling.

Timely treatment: While there is no cure for this condition, one can prevent a flare up of the symptoms by taking C1 inhibitors and Bradykinin receptors as well as enzyme inhibitors. It is important to get early treatment for the symptoms and to have constant access to a hospital and its emergency unit. One should also keep track of attacks and symptoms and get regular check-ups done by a doctor to detect the earliest signs of the same to avoid fatalities. If you wish to discuss about any specific problem, you can consult a dermatologist.

5 people found this helpful

Sunblock - Does It Prevent Skin Aging?

Dermatologist
Dermatologist, Delhi
Sunblock - Does It Prevent Skin Aging?

Can Use of Sunscreen Reduce Skin’s Aging?

Skin aging is a natural process. While it cannot be stopped or reversed, certain measures can certainly slow down the process of aging. One such measure is regularly using sunscreen to keep the skin protected from skin damage.

Damage caused due to exposure to the sun is the leading cause of skin aging. The harmful rays of the sun known as UVA and UVB have a tremendous impact on the health of skin and speed up the process of skin aging. It also affects those with fairer or lighter skin more due to the lack of melanin in their skin.

Regularly wearing sunscreen has proven to reduce skin aging by keeping it protected from sun damage. Studies have shown that those who inculcate a habit of wearing sunscreen at all times while stepping out during the day have younger and healthier looking skin than those who don’t. The sunscreen acts as a layer of defense against sun radiation and keeps it from causing any damage. Skin is, thus, protected from accelerated aging.

How to correctly use sunscreen to reduce skin aging

There are certain specifics that need to be kept in mind while using sunscreen in order to increase its potency. Some of these are as follows:

• The right product must be carefully chosen. It is necessary to use sunscreen that has a SPF rating of 30 or more.

• It must be applied at least 15 minutes before stepping out into the sun.

• It must be reapplied every few hours as sunscreen gets easily washed away due to sweating and exposure to moisture.

• The habit of using sunscreen must be started early, preferably from childhood.

• Sunscreen must be used even on cloudy and overcast days.

The adoption of these measures while using sunscreen has been proved effective in reducing skin aging and preventing the early formation of wrinkles, discoloration and sagging skin. If you wish to discuss about any specific problem, you can consult a dermatologist.

28 people found this helpful

I have lots of spots on my face. Does laser treatment will clear it? If not them what should I do.

MBBS, Diploma in Venerology & Dermatology (DVD)
Dermatologist, Delhi
I have lots of spots on my face. Does laser treatment will clear it? If not them what should I do.
Scars and marks can be removed by chemical peels and and microdermabrasion which can be done fortnightly and usually 6-8 sittings will clear the face. You should consult a dermatologist to suggest you the best treatment as per your skin type and problem.
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How Ayurveda Helps In Skin Care?

Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Ahmedabad
How Ayurveda Helps In Skin Care?

Summer often brings in a host of problems the scorching heat can sometimes burn and tan your skin. The humidity can cause you to sweat, making your skin accumulate grime, dirt and increase your chances of getting skin infections. Avoiding the sun by staying indoors or using an umbrella is a good option, but not always a practical possibility. According to Ayurveda, summer is the season when the sun is strong and increases heat in the body, which is one of the main causative factors of skin problems. So you not only need to beat the outside heat, but find a way to keep your body cool from the inside heat too. Some of the common problems in summer include sunburn, redness, irritation, rashes and acne outbreaks. Here are some ways Ayurveda can help:

Start by knowing your skin type in ayurveda:

  1. Vata skin: This is characterized by dry, thin, delicate skin that is cool to touch and easily gets dehydrated. It can be flaky and has a tendency to age faster.
  2. Pita skin: This is characterized by skin that is fair, sensitive, soft and warm. It is prone to freckles and moles and can break into rashes, acne or sunspots when out of balance.
  3. Kapha skin: It tends to have all the qualities of water and earth, it can be oily, thick, pale, soft, cool and more tolerant of the sun. On the flip side, people with kapha skin may have dull complexion, excessive oil, pimples and suffer from water retention.
  4. Combination types: Can include Vata-Pitta (both dry and sensitive) Kapha-Pitta (oily and sensitive) and Vata-Kapha (dry with some oily zones).

Remedies: 

  1. Go for aloe vera sun screen: If you can't avoid the sun, then the next best thing to do is protect yourself. According to ayurveda, increased exposure to hot, sharp and penetrating rays of the sun causes Pitta Dosha and prolonged exposure also leads to increase in Vata, which causes drying of skin. To prevent this, buy a good quality aloe vera sunscreen.
  2. Try herbal tea for hydration: During summer, it goes without saying that you need to stay hydrated throughout the day with a good 8 glasses of water. But other than that, you can up your intake of warm liquids like herbal tea made of ginger and lemon which will keep you digestion healthy and skin glowing. A number of flavored herbal teas are available in the market too. From peach to hibiscus, each flavor offers a good set of benefits.
  3. Try herbal deep oil massage: Time to take your skin's hydration to the next level. An oil massage is the best remedy for dry skin. Apricot oil applied 2-3 times a week at night can make your skin smooth and supple. Turn on the "heat" by asking your partner to give you a full oil massage which can improve blood circulation, lymph drainage and your romantic life for sure. If you wish to discuss about any specific problem, you can consult an ayurveda.
4 people found this helpful

I want to remove a single alphabet tattoo can you please tell me how many sittings are required and cost for them?

MBBS, Diploma in Venerology & Dermatology (DVD)
Dermatologist, Delhi
I want to remove a single alphabet tattoo can you please tell me how many sittings are required and cost for them?
Tattoo can be easily removed with Qswitched Laser in merely 3-4 sessions. The cost per session vary from 1000-8000 depending upon the inked area to be removed. Kindly upload your pic to help us give you the apt suggestion.
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I have scar of chickenpox on my face .but have drag like on my nose n ob forehead. It make me look not so good. Wht should I fo for remove thm n fill those drag.

MBBS, M.Ch - Plastic Surgery
Cosmetic/Plastic Surgeon, Ahmedabad
I have scar of chickenpox on my face .but have drag like on my nose n ob forehead. It make me look not so good. Wht s...
Lasers, fat grafting, subcision etc. May be indicated once a qualified dermatologist or plastic surgeon examines you.
1 person found this helpful
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Sir please say a skin whitening cream. My skin is oily and black spot on my face.

MBBS, Diploma in Venerology & Dermatology (DVD)
Dermatologist, Delhi
Sir please say a skin whitening cream. My skin is oily and black spot on my face.
Typically, the skin darkens when exposed to sunlight because it produces a substance, called melanin, to protect itself from the harmful solar radiation. Its advisable to use sunscreen every time you go outside. As far as skin whitening products, you can try creams and soaps that contain kojic acid, glutathione, aplha-arbutin, licorice extract, mulberry extract, and Vitamins C, E, and B3. You can also go for lightening creams containing hydroquinone, but make sure that the concentration does not exceed to 2%. Its best to consult your dermatologist to find out which of these options is best for your skin type.
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I am young 26 years old bt ì hv many wrinkles on my face at side of my eyes how can I remòve them.

MBBS, Diploma in Venerology & Dermatology (DVD)
Dermatologist, Delhi
I am young 26 years old bt ì hv many wrinkles on my face at side of my eyes how can I remòve them.
Topical retinoids that you apply to your skin may reduce fine wrinkles, splotches and skin roughness. Because retinoids can make your skin burn more easily, you'll need to use a broad-spectrum sunscreen and wear protective clothing daily. Retinoids may cause redness, dryness, itching, and a burning or tingling sensation. It is advisable to use such creams under the observation of dermatologist. A variety of skin-resurfacing techniques, injectables, fillers and surgical procedures are available to smooth out wrinkles. You may also take help of Microdermaabrasion, chemical peel, botox, soft tissue fillers, face lifting techniques. Please upload your pic and consult on a private chat to help us suggest the best therapy as per your skin requirement..
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What is the best treatment for whole body to be fair? I am a black complexion girl.

BHMS, Dietitian/ Nutritionist
Homeopath, Pune
What is the best treatment for whole body to be fair? I am a black complexion girl.
Use basins fairness cream regularly. Take berberisaquefolium liquid 10 drops each daily in water. Will improve complexion. Take twice daily.
3 people found this helpful
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Hello doctors I am 17 years old boy mere lips bahut bade hn mujhe bataiye ki inko patla krne ke liye koi tarika ya koi Ayurvedic lip reduction surgery ke liye mere family allow nhi kr rhi please solve my problem.

MBBS, Diploma in Venerology & Dermatology (DVD)
Dermatologist, Delhi
Hello doctors I am 17 years old boy mere lips bahut bade hn mujhe bataiye ki inko patla krne ke liye koi tarika ya ko...
You can use facial yoga workouts for lips in that case. Yoga is a complete system of exercises and you can use one of those for your lips. These exercises include various lip movements a certain way. You can get help for Internet yoga; Web browsing will let you know the different yoga exercises.
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Dear siri am suffering with dark spot on my fore head since last three year. Kindly suggest the treatment to reduce dark spot. Thankssanjay.

MBBS, MD - Dermatology , Venereology & Leprosy
Dermatologist, Mumbai
Dear siri am suffering with dark spot on my fore head since last three year. Kindly suggest the treatment to reduce d...
There are many reasons why your skin would turn dark. Sun tan, overweight, pigmentation disorders like acanthosis or melasma, nutritional deficiency etc are some conditions. Unless someone examines you, we cannot know the cause. Unless we find out the cause it is difficult and pointless to treat. Please send photos with detailed history in private chat for proper treatment. Use a good sunscreen and start exercising. Take lots of fruits and green vegetables in your diet.
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Nutrition for Hair and Scalp

B.Sc, BHMS
Homeopath, Lucknow
Nutrition for Hair and Scalp
  1. Nutrition for Hair and Scalp

 

Nutrients

 

Role

 

Sources

 

 

Vitamin  A

 

 

 

 

 

Vitamin  B

 

 

 

 

Folic acid

 

 

 

 

 

Biotin

 

 

 

 

Vitamin C

 

 

 

 

Vitamin E

 

 

 

 

 

Prevents dryness of scalp by ensuring that body produces and controls enough supply of sebum, a natural oil required to keep scalp moist and healthy

 

 

 

Promote blood circulation in the scalp, hair growth; prevent premature graying, augment growth and repair of body tissues

 

 

Promotes hair growth by renewing the cells that grow hair. Its deficiency can lead to premature graying and hair loss

 

 

 

Promotes healthy hair growth and protects against dryness. It also increases the elasticity of the hair’s cortex, thus preventing breakage

 

 

Aids in improving scalp circulation. It is important to maintain capillaries that carry blood to the follicles

 

 

Increases oxygen uptake; this improves blood circulation to the scalp and growth of hair. Stimulates hair growth by enhancing the immune system

 

 

Orange and yellow coloured fruits and vegetables like orange, sweet lime, papaya, mango; green leafy vegetables like spinach, fenugreek (methi) leaves, also drumstick

 

 

Beans, peas, carrots, cauliflower, soybean, nutritional yeast, bran, nuts and eggs

 

 

Beans and legumes, citrus fruits, wheat bran, whole grains, poultry, liver, green leafy vegetables

 

 

 

 Brewer’s yeast, brown rice, green peas, lentils, oats, soybeans, sunflower seeds. Walnuts, saltwater fish, egg yolk, milk, legumes and whole grains

 

Indian gooseberry (amla), guava, citrus fruits, pineapple, tomatoes and green peppers

 

 

Nuts and legumes, wheat germ oil, soybeans, sunflower oil, safflower oil

 

 

Protein

 

 

 

 

 

Copper

 

 

 

 

 

 

    Zinc

 

 

 

 

 

    Iron

 

 

 

 

 

Selenium

 

 

   Silica

 

 

 

Omega-3

 

 

 

Omega-6

 

 

 

Essential for hair growth. Amino acids created from proteins can have constructive effects on the look and feel of your hair

 

 

 

Essential for hair structure and pigmentation of hair

 

 

 

 

 

 

Stimulates hair growth by enhancing immune function

 

 

 

 

Important constituent  of blood (haemoglobin); vital for adequate oxygenation of all tissues

 

 

 

 

 

Essential for normal thyroid function

 

 

Vital component of hair shaft, stimulates hair growth

 

 

Promotes a healthy scalp, regulates sebum production

 

 

Stimulates hair growth

 

 

Lean meat; pulses like whole moong dal, rajma, chickpeas (kabuli channa), soybeans; nuts, grains, soya, fish, eggs, dairy products

 

 

Mushrooms, spinach, sesame seeds, mustard greens, asparagus, cashews, peppermint, tomatoes, sunflower seeds, ginger, green, beans, potato

 

 

 

 

Legumes and nuts

 

 

 

 

 

Red meat, lever, fish, poultry, leafy vegetables, lentils, beans, dates

 

 

 

 

 

Nuts, meat, eggs, fish, lobster, carb

 

Green beans, cucumber, celery, asparagus, mango, strawberries

 

 

Flaxseed, walnuts, cabbage, beans, broccoli, squash, fish oil, olive oil and salmon, sardines, tuna

 

Evening primrose oil, safflower oil, sunflower seeds, hemp seeds, corn and pumpkin seeds

11 people found this helpful

घमौरियाँ का इलाज

Ayurveda, Delhi
घमौरियाँ का इलाज

घमौरियाँ का इलाज 

आइस पैक / ice pack:-

घमौरियाँ में ice pack काफी असरदार होता है । ice pack को इस्तेमाल करने के लिए इसे किसी cotton कपड़े में लपेट कर 5 से 7 minute तक घमोरी पर हल्के हाँथ से रगड़े। एक दिन में कम से कम 2, 3 time ice pack को घमोरी पर लगायें । बस इस बात का ध्यान रहे की ice को कभी भी direct घमोरी पर ना इस्तेमाल करे ।

नीम / neem:-

Neem के पत्तो में पानी को डाल कर उसे कुछ देर तक boil करे फिर उसे ठंडा कर के उससे स्नान करे । इससे घमोरियां ख़त्म हो जायेंगे ।

मुल्तानी मिट्टी / multani mitti:-

गर्मियों के दिन में होने वाली घमोरियों को मुल्तानी मिट्टी द्वारा भी ठीक किया जा सकता है।मुल्तानी मिट्टी को गुलाब जल या पानी में फुला कर उसका paste ready कर लें और फिर उस paste कोघमोरियों पर लगाएं । इससे घमोरी के फुंसियों मेंहोने वाले itiching और उसमें होने वाले जलन दोनों में भी राहत पहुंचता है।

हल्दी / turmeric:-

हल्दी में नमक(salt) के साथ मेथी को mix कर के पीस लें और फिर इसके लेप को स्नान करने से पहले पूरे body पर लगा कर 5 minute के लिए छोड़ दें और फिर स्नान कर लें । week में 1 times इसे लगा कर स्नान करने से घमोरी में आराम मिलता है ।

एलोवेरा (aloe vera):-

एलोवेरा के इस्तेमाल से भी घमोरी को ठीक किया जासकता है। एलोवेरा के अन्दर के गुद्दे को निकाल कर उसे घमोरियों पर लगाने से घमोरीयों के दाने धीरे धीरे ठीक होने लगते है।बेकिंग सोडा|2 कप cold water में 1tsp बेकिंग सोडा को mix कर लें । अब एक cotton कपड़े को उस पानी में डुबो डुबो कर घमोरियों पर रखें । इससे घमोरियों से जल्द हीं relief मिलता है ।

चंदन पाउडर / sandalwood:-

चंदन powder भी घमोरियों के लिए कभी beneficial होता है। चन्दन powder के paste को घमोरियों पर लगाने से घमोरियों का जलन कम हो जाता है।

परहेज / precaution· 
घमोरी होने पर ज्यादा tight fiting कपड़े नापहने ।

Body पर पसीना आने से बचे ।· 
घमोरी वाले जगह पर artificial jewellery ना पहने|
धुप से बचे कर रहे ।

5 people found this helpful

Can you tell me about the skin whitening treatment .about its cost and its side effects?

MD, MBBS
Dermatologist, Chennai
Can you tell me about the skin whitening treatment .about its cost and its side effects?
Undergo glutathione injection therapy. 9k per session. 8-9 session. 2-3 week gap, along with the following medicine. Please send photos of the affected part for accurate diagnosis and treatment. Consult on private chat or meet me in my clinic for detailed information and prescription.
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My wife has pain in right side breast ,she also feeding my 18 month old child, there is no smell in his breast milk ,shall it might due to milk blockage or some other reason.

MS - General Surgery
General Surgeon, Kanpur
She may need an ultrasound of breast to be done, she may stop feeding, if she has started menstruations then this pain may be physiological, so may take some pain killer and use comfortable breast support.
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Facing fissure problem, how to remove this pls help me. Facing itching & burning problem in anus.

MS - General Surgery, DNB - Surgical Gastroenterology, MBBS
Gastroenterologist, Ghaziabad
Take hot sitz bath that is take big pan and fill warm water in it and sit in it. Do it 3-4 times a day Apply annovate ointment after it.
2 people found this helpful
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Mantoux Test or Tuberculin Skin Test

MD - Pathology
Pathologist, Noida
Mantoux Test or Tuberculin Skin Test

Diagnosis of tuberculosis is based on a combination of clinical features, smear examination of sputum where available, tuberculin skin testing or Mantoux test, chest X-ray and Histopathologic / cytologic examination as appropriate. Common clinical features are weight loss, persistent fever and /or cough of more than 2 weeks duration and history of close contact with another Tuberculosis patient.

Mantoux test also known as Tuberculin skin test is used for the detection of infection by Mycobacterium Tuberculosis bacteria. The test consists of slowly injecting a liquid intradermally (superficially within the layers of the skin) on the forearm, leading to formation of a raised vesicle which should be easily visible to the naked eye. This liquid, used in India, is Tuberculin PPD RT 23 strain. Tuberculin is a glycerol extract of the Tuberculosis bacteria. This is one of the two WHO accepted standard tuberculins, apart from PPD-S. In India, where the prevalence of tuberculosis is high, the recommended dose of this liquid is 0.1 ml of 1 TU (TU stands for tuberculin units) .1 TU is the strength of the liquid mentioned on the vial. This liquid is usually administered by a very tiny syringe, usually of 26 gauge. (Needle diameter).

Please click on the link to watch a video  demonstrating  how this procedure is performed.

Test principle : The individual who has been infected with Tubercle bacilli responds with a hypersensitivity reaction at the test site in the form of induration. Induration is the palpable raised hardening of the skin, while erythema refers to redness of skin. Only induration is clinically significant and measured after 48 to 72hours following injection. Diameter of the Induration is measured by a scale in millimetres perpendicular to the long axis of the forearm.

Interpretation of the tuberculin test

  1. Size of induration 15 mm and above : - signifies infection with tubercle bacilli
  2. Size of induration 10-14 mm : - could be due to infection with tubercle bacilli, BCG induced sensitivity, or due to cross reaction with other environmental mycobacteria.

It is more likely to be attributable to infection with tubercle bacilli in case of history of contact with smear positive case of pulmonary TB, clinically confirmed TB OR X-ray consistent with active TB.

  1. Size of induration 5 -9 mm: usually non tuberculous in nature generally
  2. Size of induration <5 mm : indicates absence of any type of mycobacterial infection.

Precautions during this procedure :

  1. If a raised vesicle does not appear it means that the liquid has been injected too deeply, and the test should be repeated on the other arm. If the same arm is used the injection site should be should be separated at least 5 cm from the first injection site.
  2. Occasional patients may experience severe allergic reaction to the tuberculin PPD

Comments :

  1. Larger the size of the induration, higher the probability of presence of infection with tubercle bacilli.
  2. Almost all reactions with induration more than 15 mm maybe considered attributable to infection with tubercle bacilli.
  3. Formation of necrosis (ulcer) at the test site, indicates high degree of tuberculin sensitivity and suggests presence of infection with tubercle bacteria.
  4. Tuberculin reaction may be suppressed (falsely low) in presence of immunosuppressive states. Like HIV, malnutrition, patient on steroid therapy etc.
  5. Mantoux test is generally not recommended for infants less than 12 weeks old. If the test turns out to be positive, then it is significant, but if the test is negative, then the test needs to be repeated again.
  6. The tuberculin test detects only the presence or absence of tuberculosis infection. The presence of infection is not synonymous with disease. It simply means, that even if you have tuberculosis infection in your body, as detected by positive Mantoux test, it does not mean you have active Tuberculosis in your body and require anti tuberculosis drugs in all cases. The clinician will correlate your mantoux test result with other tests ( as mentioned at the top of the blog) to give you a final picture.  
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