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Dr. Ashish

Pediatrician, Pune

400 at clinic
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Dr. Ashish Pediatrician, Pune
400 at clinic
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My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well....more
My experience is coupled with genuine concern for my patients. All of my staff is dedicated to your comfort and prompt attention as well.
More about Dr. Ashish
Dr. Ashish is a popular Pediatrician in Sadashiv peth, Pune. Doctor is currently associated with Shaishav Clinic in Sadashiv peth, Pune. Don’t wait in a queue, book an instant appointment online with Dr. Ashish on Lybrate.com.

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English
Hindi

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Shaishav Clinic

695/A,Laxmi Road, Sadashiv Peth. Landmark: Opposite Vijay Cinema Theater, PunePune Get Directions
400 at clinic
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‬Recent Changes in Tuberculosis Guidelines 2016

MBBS
Pediatrician,
‬Recent Changes in Tuberculosis Guidelines 2016

1.3 new goals – cure, prevent resistance and break chain of transmission.

2. Introduction of daily regime.

3. Definition and treatment of mono and polyresistance apart from mdr and xdr tuberculosis.

4. Treatment in cat 1 – 2 (hrze) + 4 (hre): continue ethambutol in continuation phase too.

5. Treatment in cat 2 – 2 (hrzes) + 1 (hrze) + 5 (hre).

6. Introduction of bedaquiline as a new drug. Atp synthase inhibitor specifically targets myc. Tb. Indicated in age more than 18 years. Contraindicatef in pregnancy and those taking hormonal ocp. It may be given in patients with stable arrythmia.

7. Definition of presumptive tuberculosis. Duration > 2 weeks etc.

8. New algorithm to diagnose tuberculosis – pulmonary, extrapulmonary, drug resistant.

9. Introduction of newer molecular methods like cbnaat and line probe assay in diagnostic algorithm apart from smear microscopy and chest xray.

10. Diagnosis of tuberculosis based on x-ray will be called as clinically diagnosed tuberculosis.

11. Sputum should be around 2ml and preferably be mucopurulent.

12. Follow up – new and previously treated drug sensitive pulmonary tuberculosis – no need to extend intensive phase, sputum microscopy at end of ip and end of treatment, weight monthly, chest x-ray if required.

13. Follow up – mdr tuberculosis – sputum smear monthly 3, 4, 5, 6, 7 months in intensive phase and at 3 months interval in continuation phase 9, 12, 15, extend ip phase by maximum 3 months total of 9 months.
Some more additions to it, adding here which might help to pg students. 
1) monitoring health status of tb treated patients (for recurrence of tb) for 24 months after treatment 
2) online monitoring of treatment adherence through 99dots programme (currently it is on pilot basis running for tb-hiv patients)
3) intensified tb case finding in clinically, socially and geographically vulnerable population. It's a provider initiated activity. 
4) now'tb suspect' term is replaced by'presumptive tb case.
5) in diagnostic algorithm sputum examination along with chest x-ray is recommended. 
6)'nsp' term is replaced by'microbiologically confirmed case'
7) nsn and others r called now onwards'clinically diagnosed tb' case. (terms replaced) 
8) definitions of cured, defaulted, treatment completed, failure, failure to respond, loss to follow up are somwhat changed. 
9) cat i, cat ii, cat iv terminologies r obsolete n replaced by drug sensitive (new or previously treated) and drug resistant tb categories.

5 people found this helpful

Common Insulin Alternatives

DDF, FCCP, MD , MBBS
General Physician, Delhi
Common Insulin Alternatives

Insulin is the most common treatment prescribed for people affected with diabetes. Diabetes is condition where high amounts of glucose prevail in the blood for an extended period of time. However, there are some drugs that offer an alternative to insulin in treating diabetes, which are:

  1. Liraglutide: Liraglutide is a glucagon-like peptide-1 (GLP-1) drug that causes the body to release greater amounts of insulin so as to facilitate the movement of glucose from the blood to the cells. People with type 2 diabetes generally use this treatment. It slows the digestion process and can cause symptoms of headache and nausea
  2. Pramlintide: It's an artificially produced version of amylin. It is taken by both type 1 and type 2 diabetic patients, facilitates slower digestion of food and therefore, controls release of sugar in the blood. It can cause tiredness and nausea.
  3. Dulaglutide:This treatment is for people affected with type 2 diabetes and it is administered once a week. It causes more insulin to be released and pass the glucose to the cells. It can cause loss of appetite, nausea and abdominal cramps as side effects.
  4. Albiglutide: This treatment facilitates pancreas to release insulin and limits the glucagon hormone production. It is used by type 2 diabetes patients who have not taken well to other treatments. The side effects are skin reaction, respiratory tract infection and nausea.
  5. Exenatide: It is a drug that causes pancreas to release insulin that facilitates movement of glucose to cells. It is a treatment for type 2 diabetes and it restricts release of glucagon in the body. The possible side effects are acidity, constipation and vomiting.

Related Tip: "Living Well with Type 2 Diabetes"

3313 people found this helpful

Is the biscuits of Marie gold or crack jack salt biscuit. Which biscuit is better for baby to give first.

BHMS
Homeopath, Faridabad
Is the biscuits of Marie gold or crack jack salt biscuit. Which biscuit is better for baby to give first.
Hi, can give simple glucose biscuits like parle-g (the best option is whole grain biscuit otherwise).
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My wife deliver a baby girl on 22-02-2016. The baby face is small changes, nose are pretty (face and eye is small yellow colour) legs & hands are power less. The Baby tested TSH level is 10.9 at a birth time. The pediatrician saw the baby problem is down syndrome. Iam shocked, at the time of pregnancy state doctor UT scanned at 9 times for 9 months. But no problems are identified. She has no natural problems (weight, height, Age is 20). Dr. Please help me my baby treating these problems. She recover a natural life? Please inform the status of recovery at downs at a baby. Please help me.

DM - Neonatology
Pediatrician, Delhi
My wife deliver a baby girl on 22-02-2016. The baby face is small changes, nose are pretty (face and eye is small yel...
A syndrome essentially means involvement of differetn systems of one's body due to a common pathology. The range of involvement of different systems vary from patient to patient. All babies of down syndrome donot have bad outcome. The outcome varies from very good to worse. Your baby needs detailed clinical examination to see her neurological status, certain imaging and blood investigations to rule out other defects commonly associated with down syndrome and most important of all close follow up.
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I am a boy with 16 years Tell me about that ejaculation is good for me or not And is affect my health and my weight.

MD Paediatrics, MBBS
Pediatrician, Hyderabad
I am a boy with 16 years
Tell me  about that ejaculation is good for me or not
And is affect my health and my weight.
I hope you are referring to masturbation, though masturbation is not harmful but anything in excess will have its harmful effects, hence avoid ejaculation at this age.
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My baby is 6 months old. She is not taking full sleep at night we are giving juice or khichdi at night. Please suggest. And also pl let me know that mosquito liquids like good night or motion irritate the child?

MBBS MD DCH FRCP (LONDON), Dch
Pediatrician, Muzaffarpur
My baby is 6 months old. She is not taking full sleep at night we are giving juice or khichdi at night. Please sugges...
There is no need to start top milk but mothers milk and home made mashed easily digestible food should be gradually introduced. They are sufficient to meet the nutritional requirement of baby for proper growth and development. Introducing top milk in a breast fed baby at 6 months is MYTH.
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Hello. My son ws given painless vaccination (2.5 month. Still he cried a lot n had fever. And doctor said fo some children fever will come even though it is painless. Is it true?

MD - Paediatrics, MBBS, FISPN & FISPN - Pediatric Nephrology
Pediatrician, Delhi
Hello. My son ws given painless vaccination (2.5 month. Still he cried a lot n had fever. And doctor said fo some chi...
Yes the so called 'Painless" vaccines causes less fever, less pain and less swelling at the site of injection. But they still can cause all these reactions. And this can occur with any vaccination.
3 people found this helpful
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MD - Paediatrics, MBBS
Pediatrician, Faridabad
Dr. Sanjeev Kumar
6 days ago
Best way to keep small babies warm is to keep them curduled with mother.Small babies do not produce heat to keep warm,they get heat from outside.By keeping them with mother,they get heat from her.
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2 people found this helpful

My son age-5 before 1 Month he was suffered with chicken pox thats why he getting marks on whole body please give me some suggestion to remove stains from his body its looking very badly and got wholes also.

MBBS, Diploma in Child Health (DCH), DNB (Pediatrics), MNAMS (Membership of the National Academy), MRCPCH, Certificate in GI Endoscopy
Pediatrician, Delhi
My son age-5 before 1 Month he was suffered with chicken pox thats why he getting marks on whole body please give me ...
I believe you are talking about scars after chickenpox rash has faded. The dark spots on the body usually fades gradually but scars take longer to fade. Info unfortunately, there is no proven medicine to get rid of the scars. However, if your son find them cosmetically unappealing when he grows, he can get rid of the scars with dermatological procedures.
1 person found this helpful
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