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Sir my father is suffering from acute ischemic brain stroke from 7 months. He is using the medicines specially for brain stroke are prexron plus, aspirin, atorvastatin and a medicine neurlin which is combination of vitamin b6+vitamin b12+folic acid. I want to know, should a medicine prexron plus which is combination of two elements i.e. Citicoline and piracetam be used till now. My father is already using this medicine from 7 months. Old Dr. Suggests to continue this medicine but a new doctor don't. He suggests to take only and only one medicine in morning which is combination of aspirin and atorvastatin. Medicine name is ecosprin av 75. Is this medicine enough to treat acute ischemic brain stroke and as a future stroke protector? please sir advice me as soon as possible. Thanks.

DM - Neurology, MBBS, Diploma in Child Health (DCH), DNB, Diploma in Developmental Neurology
Neurologist, Thodupuzha
Ecospirin and atorvastatin are essential in preventing ischemic stroke. Further medication is required based on the presence of intracranial blood vessel occlusion, presence of atrial fibrillation (rhythm abnormality of heart) etc. Which can be commented only after getting results of ct angiogram/mri tof ,ecg and echo of heart. You can upload the details for a detailed opinion.
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Heart Failure - 4 Possible Causes Behind It!

DM - Cardiology, MD - General Medicine, MBBS
Cardiologist, Indore
Heart Failure - 4 Possible Causes Behind It!
Heart failure, which is also known as congestive heart failure, occurs when the heart muscle fails to pump sufficient blood as well as it should. The narrowed arteries in one s heart or high blood pressure make the heart too weak to pump sufficient blood into the system. Heart failure can be prevented if people are aware of how to keep a check on the conditions which cause failure of the heart, like high blood pressure, diabetes, obesity.


Heart failure can be of two types, either chronic, which is an ongoing one or acute, one which starts suddenly. The signs and symptoms may include:

Dyspnea, which refers to the shortness of breath when a person exerts himself too much.

There can be fatigue and weakness.

There could be noticeable swelling in the legs, ankles and feet.

A person may not be able to do his exercises on a regular basis.

You can feel the need to urinate at night more often.

As fluid gets retained in the system, that results in rapid weight gain.

Chest pain can also take place, in case heart failure is caused as a result of heart attack.

Causes Behind Heart Failure

Heart failure can occur after certain conditions have led to the damage or weakening of the heart. Even when the heart becomes too stiff, that can lead to failure of the heart. This situation involve the left side of the heart, right side or even both the sides but usually heart failure begins with the left side, especially the left ventricle, the heart s main pumping chamber. Some of the most common causes behind heart failure are discussed below:

Heart attack and coronary artery disease: The most common form of heart disease is coronary artery disease, which is also the primary reason behind heart failure. The disease comes up from the build up of fatty deposits in the arteries, which lead to the reduction of blood flow, hence resulting in heart attack.

High Blood Pressure: Heart has to work harder to circulate blood throughout the body, if the rate of blood pressure is high.

Faulty heart valves: The valves of the heart help to keep blood flowing the proper direction. Now, when the valves get damaged due to heart attack, it forces the heart to put extra effort, hence leading to weakening of the valves over time.

Heart Arrhythmias: If the heart rhythms are abnormal, causing the heart to beat too fast, can in turn lead to heart failure.


Treatment can take certain forms, which can help people live longer and stay healthy. The different forms of treatment could be through medications, wherein medicines like enalapril, lisinopril, losartan, valsartan could help widen blood vessels and hence lead to lowering of blood pressure, thus improving blood flow.

Inravenous medications like inotropes can help improve the heart pumping function and keep a check on blood pressure.

Other than medications, doctors could take the help of coronary bypass surgery to allow smooth flow of blood through the heart. They could even make a patient undergo heart valve replacement, wherein excess valve tissue is removed and hence the leaflets can close tightly.

In case you have a concern or query you can always consult an expert & get answers to your questions!
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Question to doctor pediatric neurologist, my son 10 years getting stroke .presently taking medicines keppra 100 mg syrup 2.5 ml,epilex oral solution syrup 5 ml daily twice, with tablet oxetol 150 tablet 11/2 one & half .we are using since 1 year now the boy weight has increased, now the boy getting stroke for a few seconds. I request to give a better suggestion for medicines.

DM- Neurology, MD Medicine, MBBS
Neurologist, Delhi
Question to doctor pediatric neurologist, my son 10 years getting stroke .presently taking medicines keppra 100 mg sy...
Your child seems to have seizure disorder. To be certain, you'll have to share his reports alongwith. Keppra, epilex, oxetol all are antiepileptic medicines. Share the reports and detailed history and lets see how can we help him. Feel free to give an audio or video call for the same.
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My husband ia taking nexito ls tablet, can he stop tablet? Last month he had minor stroke and had diabetic. Please suggest can he stop nexito ls .it is escitalopram with clonazepam .can he stop directly or he has to tapered dose .then how many days it will take to stop completely after tapering dose?

DM- Neurology, MD Medicine, MBBS
Neurologist, Delhi
My husband ia taking nexito ls tablet, can he stop tablet? Last month he had minor stroke and had diabetic. Please su...
There is no harm in giving nexito tab even after a stroke. Its probably given for some anxiety issues. But if he does not need it anymore, it can be discontinued safely.
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My husband ia taking nexito ls tablet, can he stop tablet? Last month he had minor stroke and had diabetic. please suggest can he stop nexito ls.

DM - Neurology, MD (Gold Medal), MBBS (Honours, Gold Medal)
Neurologist, Durgapur
My husband ia taking nexito ls tablet, can he stop tablet? Last month he had minor stroke and had diabetic. please su...
Nexito is an mood elevating agent, stroke are an important cause of low mood, in this stressful situation its better not to stop it, but you are welcome for a private opinion. I think this will help you. Stay home, stay safe.
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My father is diagnosed with heart failure & his ef is 45% .he is also a ckd patient. Doctor here want to perform angiography but I hv heard that kidney patient are at a high risk to undergo angiography. Please suggest!

MBBS, Basic Life Support (B.L.S), Advanced Cardiac Life Support, Fellow of Academy of General Education (FAGE)
General Physician, Delhi
My father is diagnosed with heart failure & his ef is 45% .he is also a ckd patient. Doctor here want to perform angi...
I am sorry to hear about your concern, but I will be happy to assist you. Patients who have chronic kidney disease are at increased risk for kidney damage related to invasive procedures, such as coronary angiograms, that require the administration of intravenous contrast material, commonly called dye let's connect over a call so that we can discuss your concern in details and make a suitable treatment plan for you.
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My mother 85 years suffered 2nd stroke on 21st march 2020 and not able to swallow n speak (earlier 6 years back paralysis left arm / leg. She is on nasal food pipe since then n regular bp and blood thinner medicine. Now she is facing mucus problem as she is not able to spit or swallow although we r giving mucinac 600. Kindly advice on the issue and also time to replace nasal food pipe.

MBBS, MS - General Surgery, MCh- Neuro Surgery
Neurosurgeon, Chennai
Cerebrovascular accident or stroke affects different parts of the brain. As per your history, it looks like your mother has brain stem infarct. And she has developed aspiration pneumonitis. At 85 years all these can be critical. Kindly follow the neurologist advise. It would be better to do chest physiotherapy and frequent position changes to clear her chest. Ryle's tube through which food is given can be changed once every 6 weeks or if it gets obstructed. Hope she gets well soon.
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Brain Stroke - Know Forms Of It!

DM - Neurology, Fellow in Child Neurology
Neurologist, Moradabad
Brain Stroke - Know Forms Of It!
A stroke, also called cerebrovascular accident (CVA), cerebrovascular insult(CVI), or brain attack, occurs when a part of the brain is deprived of blood flow. When the brain cells are deprived of oxygen they begin to die. When brain cells die, the functions controlled by that part of the brain also stops, which results in different types of disabilities among stroke survivors.

There are two types of strokes

Ischemic stroke
The first is caused when a brain aneurysm or a weak blood vessel bursts. Most of the time, this type of stroke leads to death. The second one happens when a clot blocks the flow of blood to the brain. Patients suffering from stroke suffer from various side-effects, the most common ones being paralysis or loss of feeling in a certain part of the body, the problem in understanding or talking and loss of vision in one side. The side-effects start showing up regularly after a person has had a stroke.

In certain conditions, blood flow to a certain part of the brain stops for only some time and hence the body suffers stroke-like symptoms which only last a couple of hours before disappearing. This is known as a transient ischemic attack (TIA). Unfortunately, the effects of a stroke can be debilitating and also permanent. Hence it's important to know the symptoms of a stroke and rush the patient to a doctor as soon as possible. Sometimes early treatment can save a lot of damage.

The primary symptoms of stroke are as follows:

Confusion and problems with talking and comprehension
A headache along with alteration of consciousness or vomiting
Numbness of the face, arms or legs, especially on one side of the body
An issue with seeing, in one or both eyes
Inability to walk with stability, including disrupted coordination
Problems with the bladder and bowel control
Acute depression
Body temperature fluctuates, and pain worsens with movement
Paralysis on one side of the body along with fatigue
The problem in expressing or controlling emotions
Risk Factors:

Increased Cholesterol
Sedentary Lifestyle
Diagnosis of stroke

Several tests are carried out to determine the type of stroke acquired. They are:

Physical examination, which involves observing the patient's overall condition.
Blood tests
CT scans
MRI scans
Cerebral angiogram
Stroke is a fatal brain disease and can cause permanent damage to your system so its best to check with your doctor to know how you can prevent it.
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Heat Intolerance - Know More About It!

MD - Internal Medicine, MBBS, Nephrology
General Physician, Roorkee
Heat Intolerance - Know More About It!
Heat intolerance is prevalent in many people. Although the heat intolerance is not a disease but can be a sign of the underlying condition, the people affected with heat tolerance may find it challenging to cope up with the heat even if other people are feeling comfortable. They have a significant response to hot temperature, even when the temperature is moderate and not very high. They sweat a lot and cause anxiety.

What are the Symptoms of Heat Intolerance?

The people with heat intolerance have severe responses than others. They feel extra hot and uncomfortable than others. The symptoms of Heat intolerance are:

Too much sweating


Change in the mood


More prone to heatstroke


Muscle cramps

Less concentration

Rapid breathing

Apart from the symptoms mentioned above, some people also face problems like cold intolerant and less sweating.

What Causes Severe Heat Intolerance?

Those with the problem of heat intolerance have a dysautonomia disease which causes the autonomic nervous system. The nervous system is responsible for the response of the body towards heat. The autonomic nervous system is built to regulate one's body system to response towards heat and cold. In the case of dysautonomia, the function of the body decreases and the heat intolerance increases. The medical conditions that can cause dysautonomia are:


High blood pressure

Alcohol addict

Parkinson's disease

Mitochondrial disease, and many more

Apart from dysautonomia, heat intolerance can be caused due to other factors including:

Age of the person

The on-going medication he is being administered to

Some neurological conditions


Sensory problems like autism

Can Anxiety Cause Heat Intolerance?

Anxiety is the response of the body towards extreme conditions. In theory, heat tolerance leads to anxiety, but stress cannot cause heat tolerance. To overcome the feeling of anxiety and heat tolerance, you can visit your doctor and take some medical advice. Anxiety and heat tolerance can affect the nervous system leading to rapid heart rate and increase in blood pressure. These conditions lead to heart failure and stroke in some cases. Hence, it is advisable not to neglect the symptoms and get medical investigation for better treatment.

Is Heat Intolerance a Symptom of Lupus?

Heat tolerance is the result of dysautonomia condition, while lupus is an autoimmune disease that results in inflammation in the body and causes a wide variety of problems. The main symptoms of lupus are fatigue, fever, vomiting, hair loss, change in weight, and joints problem. The effect of lupus in the body of the patient varies. But heat tolerance is not one of the identified symptoms of lupus. However, there are chances that any symptoms may lead to the condition of heat tolerance in the patients. The early signs of lupus are not recognizable and can be similar to any other state.
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Brain Stroke - Who Are At Risks?

DM - Neurology, Fellow in Child Neurology
Neurologist, Moradabad
Brain Stroke - Who Are At Risks?
A brain stroke can affect anyone at any point in time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements.

What are the different types of strokes?

There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage. Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below).

What are the common symptoms of a brain stroke?

The symptoms of brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?

Anyone is at risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

Treatment depends on the type of stroke.
Ischemic strokes can be treated with 'clot-busting' drugs.
Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
The most effective way to prevent strokes is by maintaining a healthy lifestyle.
What is TPA?

TPA is a thrombolytic or a Clot Buster drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER.
Endovascular procedures

Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention

The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including

High blood pressure,
Cigarette smoking,
Atrial fibrillation and
Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control.

The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.
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