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Dm Lef 10Mg Tablet Health Feed

My mother was diagnosed with Rheumatoid arthritis 19 years back, all her test results are normal, just that lefumide or lefra has stopped helping in easing the pain, but steroids like Defza 6 or Dezacore help. Her doctor has asked her to start using biologics. I have done my research, and the side effects I've come to know of are alarming, more so, biologics are too expensive. Isn't there any other alternative? She is 46 years old.

Dr. Nilesh Nolkha 93% (428 ratings)
DM - Rheumatology, MD - General Medicine
Rheumatologist, Mumbai
My mother was diagnosed with Rheumatoid arthritis 19 years back, all her test results are normal, just that lefumide ...
Biologics are very good drugs, if used judiciously and has changed the way RA can be treated. You can technically use leflunomide, methotrexate etc, but many times they are intolerable. RA is a disease which makes you miserable, which is sometimes more worse than cancer which either kills or gets cured (I have put it simply and morbidly but unfortunately people will spend anything for cancer even if they are dying, but will see side effects of biologics and not use them, hence the comparison). Yes, biologics are expensive. But they have been used safely in may patients for more than 30 years now. There is no guarantee that your mother will respond to that, but at least that is an option to consider. Don't fear side effects, you should not be using steroids like defza also then. Defza will make her feel a bit better though even if she has a lot of damaged joints, if things are not controlled joints will further get damaged, and it will only worsen things. Also, the more uncontrolled RA is, it can affect internal organs and be life-threatening, You have to think all of this before thinking that biologics have side effects. The side effects of biologics are far lesser than RA disease itself. They are standard of care in most developed countries for a reason. A good rheumatologist should be able to address your concerns including cost considerations, buts sometimes there are so far and few in between, so they always find it difficult to counsel well in a busy clinic. But I hope I have been helpful. Best wishes Regards.
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Hello i'm 53 years old. Im suffering from rheumatoid arthritis for past 12 yrs. Im taking hcqs (daily) and folitrax (weekly once) for first 10 years. Now im taking lefno10 (daily) and folitrax (weekly once) for past 2 years. My liver function test SGOT (124) and SGPT (205) So doctor asked to stopped taking above medicine from past 10 days. My question is wil folitrax and lefno increase SGPT and SGOT levels? Is it good to stop lefno suddenly?

Dr. Jyoti Prakash 88% (37 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery, MS - Orthopaedics
Orthopedist, Kolkata
Hello i'm 53 years old. Im suffering from rheumatoid arthritis for past 12 yrs.
Im taking hcqs (daily) and folitrax (...
Folitrax par se will mainly cause bone marriw aupression but increased sgot n sgpt may be there. Lefra should nt be stoppes immediatly but by gradually decreasing dose Thanks.
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I am 50, have Psoriasis (mainly scalp and back) and PSA. Should I take methotrexate with Arava or only Arava as I fear methotrexate will harm.

Dr. Shailender Dhawan 92% (3578 ratings)
Bachelor of Ayurveda, Medicine & Surgery (BAMS)
Ayurvedic Doctor, Faridabad
I am 50, have Psoriasis (mainly scalp and back) and PSA. Should I take methotrexate with Arava or only Arava as I fea...
As you are 50 and suffering from psa and psoriasis. Psoriasis is genetic disorder triggered due to street and irregular life style. We are treating psoriasis using ayurvedic medicines. Psoriasis has three stages. First stage is when disease remain in skin and here are scaly patches. Second stage comes when there is pitting in nails and in last stage it enter the joints and there is pain in small joints. We can start ayurveda and wait for methotrexate. You should use 3 gms of haldi with milk and sit in sun for 15 minutes it helps. We are using external ayurvedic oil and ointment for application and internal blood purifying herbs which will solve your problem. We are capable of giving amazing results in very first month of treatment.
2 people found this helpful
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My left leg bone is broken and had gap in it which is not filled and we can see bone easily because of wound so please lef me know the best

Dr. Abhimanyu Singh 88% (197 ratings)
MBBS, M. S. Orthopedics, M.ch. Orthopaedics, MD - Sports Medicine
Orthopedist, Delhi
Presuming it was a open fracture. it requires treatment. i suppose it must have gone for non union. x rays should be posted with the condition of the wound for further comments.
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Cleft Lip and Cleft Palate Surgery - Why It Is Done?

Dr. Dhananjay K Mangal 89% (59 ratings)
MD - Paediatrics, MBBS
Pediatrician, Jaipur
Cleft Lip and Cleft Palate Surgery - Why It Is Done?

Cleft lip and cleft palate are the two most common birth defects affecting children all over the world. What happens in the cleft lip is that the upper lip is incompletely formed and in cleft palate abnormalities, we see babies with an incompletely formed roof of the mouth. Both these can be found individually or can occur together. These conditions can be severe or mild and affect one or both sides of the face.

Causes
The fEtus undergoes the separation of the upper lip and the roof of the mouth pretty early. In certain cases, this separation does not happen or happens incompletely and certain parts of the upper lip and roof of the mouth fail to form properly leading to cleft lip and palate.

Repair through surgery

  1. Plastic surgery is the only way to repair a cleft lip and/or palate. Both of these impair vital functions like speaking, eating, breathing, and hearing properly.
  2. Surgery is done to restore function and to make the affected child look more normal.
  3. Most cleft lip and palate surgeries are done on very young children usually 3 months to a year old.
  4. Before the actual surgery, a team of specialist define a course of treatment, including repair of the cleft using surgery, which means plugging the hole in the lip or the palate; speech rehabilitation and dental restoration, as the child usually has no teeth in the affected parts of the upper palate.

The specialists required are:

  1. Plastic surgeon
  2. Pediatric dentist
  3. Ear, nose, and throat specialist
  4. Auditory or hearing specialist

What happens during surgery?
Usually, cleft lip surgery happens in children as young as 3-6 months old. It has to be carried out under general anaesthesia. If the condition is severe, and the cleft lip is wide, special procedures like lip adhesion or a moulding plate are used to bring the two parts of the lip closer and it is fully repaired.

Cleft palate repair surgery is done at the age of 9-12 months only.
What happens here is that plastic surgeons bring together the muscles of the upper soft palate and rearrange them to cover the gaping hole in the roof of the mouth. The surgery is usually done under general anaesthesia and requires a short hospital stay.

  • Without a normal palate, the child can’t speak properly. So, surgery helps to improve and normalise speech.
  • And that’s not all. The child may require more surgeries as he grows older to treat these two problems.
  • This is because the child’s facial structure changes and he or she may require advanced surgeries like pharyngoplasty, which helps improve speech, or alveolar bone grafts to provide stability for permanent teeth.
  • A bone graft is usually done when the child is 6-10 years old and it closes gaps in the bone or gums near the front teeth. If you wish to discuss about any specific problem, you can consult a pediatrician.
4640 people found this helpful

How to Surgically Treat Cleft Palate

Dr. Deepti Jindal 93% (246 ratings)
MS - General Surgery, MBBS
General Surgeon, Guwahati
How to Surgically Treat Cleft Palate

Cleft palate or palatoschisis is a common genetic abnormality that leads to a horde of problems and is presently a growing challenge to medicine practitioners. The major developmental stages affected due to this particular irregularity include feeding, speech development, dentition and maxillofacial growth which are rather important to the normal overall developmental pace of an individual. Even though the cleft palate deformity was defined centuries ago, no fixed management algorithm exists for patients suffering from the condition in the present day scenario.

Cleft palate may be successfully fixed using reconstructive surgery. Multiple specialists are involved in the reconstruction surgery including plastic surgeons, otolaryngologists, nutritionists, oromaxillofacial surgeons and speech pathologists. Some hospitals also consider psychological therapy for the patient and the family to help get through the emotional trauma and the issues faced due to developmental backlogs.

The treatment for cleft palate usually begins around 9 to 12 months of age. If left untreated, it may cause major deformities. It takes about some years before the whole procedure is completed although it depends on the type and severity of the deformity.

The process involves the administration of anaesthesia after which the palate repair closes the inner, middle and final layers and at the same time realigning of the palatal muscles in a technique called anintravelarveloplasty is conducted. This ensures that the muscles are adjusted in a normal position which facilitates the best functioning of the palate during feeding, swallowing and speaking. It is possible that the child might require more than one surgery to completely close the palate.


Some of the risks involved during the process include:
1. Abnormal reactions to the medications
2. Bleeding
3. Problems in breathing
4. Need for more surgery
5. Infection

Although complicated and time consuming, cleft palate must be given immediate attention to avoid serious developmental issues. The reconstruction surgery and therapy combined ensures a normal development for the child in the longer run, given the surgery was done at the correct time. The child would be required to remain at the hospital for about 5-7 days. Complete recovery takes a time period of 4 weeks. Keeping the wound of the surgery clean is of the utmost importance and it should not be strained. If you wish to discuss about any specific problem, you can consult a specilized pediatrics and ask a free question.

1732 people found this helpful

Cleft Lip Surgery And It's Benefits

Dr. Abhinav Likhyani 92% (51 ratings)
MBBS, DNB - Orthopedics, MCh Plastic Surgery
Orthopedic Doctor, Chandigarh
Cleft Lip Surgery And It's Benefits

Development of a fetus within a mother's womb is a complicated biological process and also involves many intricate chemical processes. One well known deformity that has been reported fairly regularly with infants is that of a cleft lip. A statistics of average states that one baby in every 2000 births will be born with a cleft lip.

This is a condition that is easily treatable through surgery.

What is a Cleft Lip?

A cleft lip, which more often than not comes with a cleft palate as well, is a deformity where the lips of the baby's mouth aren't joined properly to the face on the upper lip. It appears to be like a slit on the upper lip that runs to the nose.

In most cases this is accompanied by the cleft palate where the slit may have the shape not just superficially, but the roof of the mouth may also be carved out in a similar shape.

Causes behind cleft lip development

Some of the factors that may lead to cleft lip and cleft palate developments are mentioned below:

Genetic - In most cases these deformities are usually passed on from one of the parents to the baby.
Medicinal - If the pregnant mother takes certain anti-seizure or anti convulsing drugs it may contribute to the defects.
Infections - If the mother gets infected with certain diseases, it may also contribute to this deformity.

Benefits and need for Cleft Lip Surgery

While for some, cleft lip surgery may be an absolutely a cosmetic procedure, for others it may be essential for correcting other issues.

Some of the major benefits of cleft lip surgery are:

Issues with eating food - With cleft lip surgery, difficulties in eating and consumption of food will be reduced or completely eliminated as many patients have reported difficulties in this area.

Speech problems - By far the most number of complaints with cleft lip deformities have been with speech problems, which the surgery along with speech therapy, can definitely help to correct.

Reducing the chance of ear nose and throat infections - Children who have a cleft lip and palate are at an increased risk of ENT infections and thus, a cleft lip correction surgery can help reduce the chances for that.

Dental problems - Another area where surgery may help is with dental problems as a cleft lip and palate is known to cause deformities in teeth as well.

2762 people found this helpful

Benefits of Cleft Lip Surgery

Dr. Ajaya Kashyap 91% (662 ratings)
American Board of Plastic Surgery, , American Board Of General Surgery, MS - Dermatology, M.B.B.S
Cosmetic/Plastic Surgeon, Delhi
Benefits of Cleft Lip Surgery

Development of a fetus within a mother's womb is a complicated biological process and also involves many intricate chemical processes. One well known deformity that has been reported fairly regularly with infants is that of a cleft lip. A statistics of average states that one baby in every 2000 births is born with a cleft lip.  This is a condition that is easily treatable through surgery.

What is a Cleft Lip?
A cleft lip, which more often than not comes with a cleft palate as well, is a deformity where the lips of the baby's mouth aren't joined properly to the face on the upper lip. It appears to be like a slit on the upper lip that runs to the nose. In most cases, this is accompanied by the cleft palate where the slit may have the shape not just superficially, but the roof of the mouth may also be carved out in a similar shape.

Causes behind cleft lip development: Some of the factors that may lead to cleft lip and cleft palate developments are mentioned below:

  • Genetic: In most cases these deformities are usually passed on from one of the parents to the baby.
  • Medicinal: If the pregnant mother takes certain anti-seizure or anti-convulsing drugs it may contribute to the defects.
  • Infections: If the mother gets infected with certain diseases, it may also contribute to this deformity.

Benefits and need for cleft lip surgery: While for some, cleft lip surgery may be an absolutely a cosmetic procedure, for others it may be essential for correcting other issues. Some of the major benefits of cleft lip surgery are:

  • Issues with eating food: With cleft lip surgery, difficulties in eating and consumption of food will be reduced or completely eliminated as many patients have reported difficulties in this area.
  • Speech problems: By far the most number of complaints with cleft lip deformities have been with speech problems, which the surgery along with speech therapy, can definitely help to correct.
  • Reducing the chance of ear nose and throat infections: Children who have a cleft lip and palate are at an increased risk of ENT infections and thus, a cleft lip correction surgery can help reduce the chances for that.
  • Dental problems: Another area where surgery may help is with dental problems as a cleft lip and palate is known to cause deformities in teeth as well.
3528 people found this helpful

All About Cleft Lip and Palate Surgery

Dr. Yv Rao 89% (333 ratings)
MBBS, MS - General Surgery, M.Ch - Plastic Surgery
Cosmetic/Plastic Surgeon, Visakhapatnam
All About Cleft Lip and Palate Surgery

Cleft lip and palate repair surgery is a surgical procedure, which is used to fix problems of the upper lip and palate. A cleft may be a small patch on the lip or a complete furrow that extends all the way to the lower part of the nose. A child usually has one or both of these conditions at birth. This is a serious birth defect and can only be corrected with specialized plastic surgery techniques.

Why it is needed?

Cleft lip and palate surgery is necessary to correct abnormal development of upper lip in a child and to restore a normal appearance and function. The surgery can improve the child's ability to speak, hear and eat. In most cases the surgery is done when the child is between nine months to 1 year old, so as to allow the palate to change along with the growth of the baby.

Steps to be taken before the procedure

A therapist needs to be consulted before the surgery, as the therapist would analyze the best way to feed the child before surgery. The child must gain weight and has to be healthy before the surgery is performed. The health provider may do some blood tests and carry out a complete physical examination of the child. About 10 days prior to the surgery, it is necessary to stop giving the child aspirin, ibuprofen, warfarin and any other drug that inhibits the clotting of blood.

Risk factors

  1. Risks from anesthesia include breathing problems, reaction to the medicine, bleeding and infections in some cases.
  2. Problems caused by the surgery itself may include abnormal growth of the bones in the middle of the face and abnormality in the connection between the mouth and the nose.

Post surgical care tips

The child will be kept in the hospital for 5 to 7 days after surgery and complete recovery may require up to 4 weeks. The following tips need to be followed for quicker recovery:

  1. The surgery wound must be kept clean by washing it with soap, water or any other cleaning liquid.
  2. The wound must be kept moist with ointment.
  3. It is advised to prevent the child from picking at the wound by using arm cuffs and splinters.

Related Tip: "Benefits of Cleft Lip Surgery"

4885 people found this helpful

Cleft Palate - Know Risk Associated With It!

Dr. R.S. Rengan 88% (22 ratings)
MBBS, MS - General Surgery, DNB - General Surgery
General Surgeon, Chennai
Cleft Palate - Know Risk Associated With It!

Cleft palate or palatoschisis is a common genetic abnormality that leads to a horde of problems and is presently a growing challenge to medicine practitioners. The major developmental stages affected due to this particular irregularity include feeding, speech development, dentition and maxillofacial growth which are rather important to the normal overall developmental pace of an individual. Even though the cleft palate deformity was defined centuries ago, no fixed management algorithm exists for patients suffering from the condition in the present day scenario.

Cleft palate may be successfully fixed using reconstructive surgery. Multiple specialists are involved in the reconstruction surgery including plastic surgeons, otolaryngologists, nutritionists, oromaxillofacial surgeons and speech pathologists. Some hospitals also consider psychological therapy for the patient and the family to help get through the emotional trauma and the issues faced due to developmental backlogs.

The treatment for cleft palate usually begins around 9 to 12 months of age. If left untreated, it may cause major deformities. It takes about some years before the whole procedure is completed although it depends on the type and severity of the deformity.

The process involves the administration of anaesthesia after which the palate repair closes the inner, middle and final layers and at the same time realigning of the palatal muscles in a technique called anintravelarveloplasty is conducted. This ensures that the muscles are adjusted in a normal position which facilitates the best functioning of the palate during feeding, swallowing and speaking. It is possible that the child might require more than one surgery to completely close the palate.

Some of the risks involved during the process include:

1. Abnormal reactions to the medications

2. Bleeding

3. Problems in breathing

4. Need for more surgery

5. Infection

Although complicated and time consuming, cleft palate must be given immediate attention to avoid serious developmental issues. The reconstruction surgery and therapy combined ensures a normal development for the child in the longer run, given the surgery was done at the correct time. The child would be required to remain at the hospital for about 5-7 days. Complete recovery takes a time period of 4 weeks. Keeping the wound of the surgery clean is of the utmost importance and it should not be strained.

3431 people found this helpful