R-Ppi-L 75Mg/20Mg Capsule falls under a class of medication known as antipsychotic (also familiar as neuroleptics or tranquilizers) medicines. It is mainly used for mental disorders such as hallucinations, schizophrenia, bipolar disorder, anxiety disorder, vertigo and irritable bowel syndrome. Recently it has also come to be used in the treatment of premature ejaculation as it is believed to be a cause of both psychological as well as organic shortcomings.
On using R-Ppi-L 75Mg/20Mg Capsule the associated side effects that you may suffer from are lightheadedness, insomnia, irregular menstrual periods, fatigue, abdominal pain, drowsiness, lowered sexual desire, rapid or irregular heartbeat. In certain severe cases you may experience fever, uncontrollable sweating, gynecomastia (a disorder of the endocrine system where there is an enlargement of the male breast size). In the latter case it will be necessary for you to seek medical attention. Before using this medication it is advised that you consult your doctor and tell him/her if you:
The dosage of R-Ppi-L 75Mg/20Mg Capsule will be as prescribed by your doctor as per the severity of your condition, your age, gender and overall medical history. But commonly a dose of 25 mg of R-Ppi-L 75Mg/20Mg Capsule is prescribed which needs to be taken three times in a day. Results may start to show within an hour or two of using. In case of drug overdose notify your physician right away.
The intervertebral discs are made-up of two concentric layers, the inner gel-like Nucleus Pulposus and the outer fibrous Annulus fibrosus. As a result of advancing age, the nucleus loses fluid, volume and resiliency and the entire disc structure becomes more susceptible to trauma and compression. This condition is called as degeneration of the disc. The disc then is highly vulnerable to tears and as these occur, the inner nucleus pulposus protrudes through the fibrous layer, producing a bulge in the intervertebral disc. This condition is named as herniated disc. This can then cause compression to the spinal cord or the emerging nerve roots and lead to associated problems of Sciatica radiating pain from back to legs in the distribution of the nerve. Other symptoms could be a weakness, tingling or numbness in the areas corresponding to the affected nerve. Sometimes bladder compromise is also present, which is made evident for urine retention and this need to be taken care as an emergency.
Excessive weight, bad postures, undue movements, improper weight lifting and other kinds of traumas may weaken the intervertebral discs. When this occurs the pulpous nucleus will bulge against the annulus, or even be squeezed through it (extruded disc).
The first steps to deal with a herniated or prolapsed lumbar disc are conservative. These include rest, analgesic and anti-inflammatory medication and in some cases physical therapy. At this point, it is convenient to have some plain X-rays done, in search of some indirect evidence of the disc problem, as well as of degenerative changes on the spine.
If in a few days these measures have failed, the diagnosis has to be confirmed by means of examinations that give better detail over the troubled area, as the MRI, CT which will show the disc, the space behind it and in the first case, the nerves. In some instances, the EMG (electromyography) is also of great value, as this will show the functionality of the nerves and muscles.
Once the diagnosis has been confirmed, one of the best alternatives existing today is the Ozone Discolysis as the results obtained are excellent and practically has no complications. This novel treatment avoids the use of surgery in 80% of those who needed it. In most patients left with painkillers as the only treatment, the symptoms eventually disappear, only that this could take weeks to months. Ozone speeds up these developments, see the same result in a few weeks. The problem has to be seen and approached integrally and frequently the combination of therapies has to be used, most frequently physiotherapy. Also, it has to be known that those who had a herniated disc have 10 times more chances of having another herniation than the rest of the population.
If despite the ozone therapy the symptoms persist, Drill Discectomy/ Laser Discectomy are good alternatives before open surgery (Discectomy) which has to be contemplated in those true emergencies, as mentioned above, this is possibly the first choice.
Once the conservative treatment fails:
Early aggressive treatment plan of pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only 5% of total LBP patients would need surgery & 20% of discal rupture or herniation would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then.
Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon pt`s pathology & response to treatment.
Using precision diagnostic & therapeutic blocks in chronic LBP, isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.
LESI: Lumbar Epidural Steroid Injection
Indicated in – Acute radicular pain due to irritation or inflammation.
ESI Treatment Plan
Compared to interlaminar approach better results are found with a transforaminal approach where drugs (steroid+ LA/saline +/- hyalase) are injected into anterior epidural space & neural foramen area where herniated disc or offending nociceptors are located. Whereas in interlaminar approach most of drug is deposited in posterior epidural space.Drugs are injected total 6-10 ml at lumbar, 3-6 ml at cervical & 20+ ml, if caudal approach is selected. Lumbar ESI is performed close to the level of radiculopathy, often using paramedian approach to target the lateral aspect of the epidural space on involved side. Cervical epidural is performed at C7-T1 level.
SNRB- Selective Nerve Root Block
Fluoroscopically performed it is a good diagnostic & therapeutic procedure for radiculopathy pain if
Provocative Discography - Coupled with CT
A diagnostic procedure & prognostic indicator for surgical outcome is necessary for the evaluation of patients with suspected discogenic pain, its ability to reproduce pain(even with normal radiological finding), to determine type of disc herniation /tear, finding surgical options & in assessing previously operated spines.
Percutaneous Disc Decompression (PDD)
After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed
Ozone Discolysis: Ozone Discectomy a revolutionary least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no postoperative discomfort or morbidity and low cost.
Dekompressor: A mechanical percutaneous nucleosome cuts & drills out the disc material somewhat like morcirator debulking the disc reducing nerve compression.
Epidural Adhenolysis or Percutaneous Decompressive Neuroplasty for Epidural Fibrosis or Adhesions in Failed Back Surgery Syndrome (FBSS)
A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with epiduroscope.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Implementation and Benefits of Helios Laser
Hello! I am Dr. Latika Arya from LS Skin and Aesthetic clinic. I am a dermatologist and my main interests are in the treatment of pigmentary disorders, acne, lasers and anti ageing treatments. Today, I will be talking about a laser called Helios Laser. Helios is a Q switch ND:YAG fractional laser which has the latest and all the advanced innovations. This is basically used to treat pigmentary conditions like freckles, age spots, melasma, post inflammatory hyper pigmentation, burn marks, acne marks and for general skin toning. And, it is also used to treat birthmarks, pigmented birthmarks, etc.
It is also used to treat tattoos and it also has a mode in which collagen can be tightened thus it helps to improve pores and scars. This laser also bleaches the fine hair and therefore it helps in taking care of hair growth. This laser also has a use in treating toenail fungus which is very difficult to treat sometimes with medical therapy. So, the advantage of this laser is that it has got four hand pieces which is the very 1st time in any Q Switch ND:YAG laser. It has a proprietary 4g toning technology. Basically, it means that the toning of the skin occurs at four different levels from superficial to the deep, so that the pigments at all levels are targeted.
The most popular use of this laser is for laser toning. So what is laser toning? Basically it is the use of this laser to even out the skin complexion taking care of tan and the dullness. After a few sessions the skin becomes lightened, more glowing and reflectant. And the best part of this laser is that it has no down time. Being an advanced new laser (therapy) and a great technology safety is big advantage of this, there are hardly any side effects and it's very safe to use. Even over longer sessions there is no damage to the skin and the results are great.
Now I will just demonstrate to you how this laser is used and how comfortable the procedure is for the patient.
(Doctor says to patient), "I will be covering your eyes."
The patient's skin is already being cleaned and the patient is instructed how the laser is going to feel and now I am going to start the laser.
The laser is very convenient to use. The patient doesn’t feel any discomfort. This is a rejuvenating energy in which there is instant lightening and brightening . There is an immediate glow. The fine hairs are lightened and we can target the pigment areas. And the whole procedure is very quick, it hardly takes 10 to 15 minutes. There is not much down time. There is a mild redness which goes away in 15 minutes and the patient can go back to their normal routine.
(Doctor says to patient), "Are You comfortable"
(Patient's reply), "Yes Ma’m"
Incase you are interested to know more about this laser you can contact us through Lybrate or you can visit our clinic and schedule an appointment at LS Skin and aesthetics clinic, New Delhi. Thank you.
Hi, I am Dr IPS Kochar, a pediatric endocrinologist. I’m going to talk about puberty, precautions puberty or early puberty.
Puberty is a time when the child is growing in height and weight along with some feature which comes when a child matures. Now there are conditions when a child starts getting early features. If a girl starts getting breast before the age of 8 or if a boy whose testicle volume increases more than 4 ml before 9 years of age, these children are getting into early puberty. A girl if she starts getting pubic and underarm hair before the age of 8 body odour or there are lots of behavioural changes or she suddenly shot up in height. This child may be having early puberty. So these are the symptoms concerned in a girl.
In boys the testicle volume increases more than 4 ml, increase in height velocity, 6 to 8 to 10 cms in 1 year, hair on the lips and the arm, an underarm or pubic area in less than 9 years of age, behavioural changes, mood swings, the appearance of acne. The child may be going through early puberty or precautious puberty. These things they must keep in mind because there will be a change in growth pattern. Initially, the child will grow more but later the growth will be stunted. The child will not grow up to his final height. If these points are there one should be very careful. if there is early puberty you can always go to the doctor, examine the child. So, if a girl is having breasts before the age of 8 one should definitely find out what is happening with the child and same in a boy if there is an increase in testicle volume or breaking of voice or hair anywhere in his body you should always consult a doctor. There are certain specific tests which are done where lS and FSH when they can only make a diagnosis.
In a girl, you can go for ultrasound and in a boy, you can go for MRI as to know why it is happening. These are certain things that you should keep in mind especially if the boy is having breaking of voice pubic hair armpit hair, appearance of acne one should definitely go and find out what is happening. So in a girl if there is budding of breast, pubic hair and mood swings you should definitely find out what’s happening. Girls are getting early menarche at 9 and a half years and the growth is less.
So if your child has any of these symptoms you should see a pediatric endroconologist. I’m available at lybrate.com or you can come to my clinic.