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Dr. C.G. Dharma

M.Sc - Trauma and Orthopedics

Orthopedist, Pune

32 Years Experience  ·  400 at clinic
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Dr. C.G. Dharma M.Sc - Trauma and Orthopedics Orthopedist, Pune
32 Years Experience  ·  400 at clinic
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Personal Statement

To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies....more
To provide my patients with the highest quality healthcare, I'm dedicated to the newest advancements and keep up-to-date with the latest health care technologies.
More about Dr. C.G. Dharma
Dr. C.G. Dharma is one of the best Orthopedists in Camp, Pune. He has helped numerous patients in his 32 years of experience as a Orthopedist. He is a qualified M.Sc - Trauma and Orthopedics . You can meet Dr. C.G. Dharma personally at Dharma Orthopaedic Centre in Camp, Pune. You can book an instant appointment online with Dr. C.G. Dharma on Lybrate.com.

Lybrate.com has top trusted Orthopedists from across India. You will find Orthopedists with more than 28 years of experience on Lybrate.com. You can find Orthopedists online in Pune and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

Info

Specialty
Education
M.Sc - Trauma and Orthopedics - University of London, - 1985
Languages spoken
English
Hindi

Location

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Dharma Orthopaedic Centre

#120, Sterling Center, M G Road, Camp. Lanmark: Opp. Hotel Aurora Tower, PunePune Get Directions
400 at clinic
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I am 35 years old and in an accident I got a fracture at my ankle before two month ago and it had been operated at both side. My question is how long time it will take to recover and can I walk properly like before?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me post operative x rays. You should not put weight on the fractured bones until union takes place.
1 person found this helpful
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My mother is aged 54yrs. she is having pain on both hands elbow. On the joints of the hands inside there is swelling. Why it is happening like that. What is the treatment for that?

FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
It might be of rheumatoid arthritis otherwise of some pathological reasons for pain do consult musculoskeletal physiotherapist and take ift and vacuum therapy treatment for 12 days and give hot water and cold water fomentation thrice a day for 7days of 15 minutes duration each time or can consult me in private via lybrate for further information
1 person found this helpful
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I have pain on the right side of head to neck and shoulder. I feel very irritating and perplexed.

DHMS (Hons.)
Homeopath, Patna
I have pain on the right side of head to neck and shoulder. I feel very irritating and perplexed.
Hello, Lybrate user, You might be suffering from spondylitis causing headache, shoulder pain. A part from medication, you need to consult a physiotherapist to get relief. Tk, Homoeo medicine:@ Lanchenenthes 200-6 pills, thrice. Avoid, junk food, lifting weight. Report, wkly. Your feedback matters for further followup, please. Tk, care.
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What precautions should be taken after an epidural treatment of slipped disc pain relief? What type of exercise should be done to heal the slipped disc.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
What precautions should be taken after an epidural treatment of slipped disc pain relief? What type of exercise shoul...
Bhujang Asana -- Lie flat on your stomach, keeping the palms out, bend the neck backward, take a deep breath and while holding it for 6 seconds, raise the chest up. Release breath and relax your body. Repeat the exercise 15 times twice daily. Core Strengthening Exercises- Straight Leg Raised With Toes Turned Outward, repeat 10 times, twice a day.
2 people found this helpful
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Sir from last few days I am having back pain and I am unable to read by siting on my desk please tell me what should I do.

BHMS
Homeopath, Delhi
Sir from last few days I am having back pain and I am unable to read by siting on my desk please tell me what should ...
Hello, you can take homoeopathic medicine Rhus Tox 30 ( 4 drops in little water) thrice a day for a week and revert.
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I am a 34 year married female with 2 caesarian kids. I have a severe pain in my right leg and knee. My weight is around 95 and height 5'7.

Advanced Aesthetics
Ayurveda, Gulbarga
Ur height and weight should be 60-65 is the medium frame. So you're weight is more, loose some weight. For pain ayurvedic medicines tab shallaki. 2 times a day. And apply mahanarayana oil massage. At that joints.
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I am 24 years female, I have pain in my lower vertebrate of my spinal cord and I am over weight too what should I do?

Vaidya Visharad
Sexologist, Narnaul
I am 24 years female, I have pain in my lower vertebrate of my spinal cord and I am over weight too what should  I do?
Obesity is being more than one-fifth overweight as compared to the normal weight range. Obesity can be defined as excessive enlargement of body?s total quantity of fat .Excessive body fat is accumulated on the belly, buttocks, breasts and thighs. This may lead to diabetes, hypertension , arthritis , menstrual irregularities , kidney and bladder disorders and heart diseases.For further assistance and complete diet plan and treatment you can consult me privately.
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I have a pain in my left leg calf muscles (from knee to ankle) and it become quite heavy .It has been for last 10 yrs. X_ray, MRI done but no any result come, Please suggest the good treatment.

BPTh/BPT
Physiotherapist, Hyderabad
I have a pain in my left leg calf muscles (from knee to ankle) and it become quite heavy .It has been for last 10 yrs...
Purely it could be calf muscle tightness and adhesions. Please get released by musculoskeletal physio.
1 person found this helpful
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Hi All, My foot had a pain since last 1-2 years. It usually comes when there is long standing for some reason. Due to the feet, my leg also has pain, mainly during night times. Please help me!

Merrithew Stott Pilates, Bachelor of Physiotherapy
Physiotherapist, Bangalore
Hi All,
My foot had a pain since last 1-2 years. It usually comes when there is long standing for some reason. Due to...
Goodmorning I would suggest you to take a session of 1 week of physiotherapy. Tens treatment will help you to improve your strength. Do a couple of active exercises for your leg. Your pain should come down in a weeks time.
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In most cases back pain will improve in a few weeks or months, although some people experience long-term pain or pain that keeps coming back.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
In most cases back pain will improve in a few weeks or months, although some people experience long-term pain or pain...
Postural correction- sit tall, walk tall. Extension exercises x 15 times x twice daily. Apply hot fomentation twice daily. Avoid bending in front.
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Shoulder Joint Pain

BPTh/BPT
Physiotherapist, Gurgaon
Shoulder Joint Pain

Shoulder pain and injuries

The shoulder is a ball-and-socket joint that has three main bones: the humerus (long arm bone), the clavicle (collarbone), and the scapula (also known as the shoulder blade). These bones are cushioned by a layer of cartilage

The shoulder joint is a very mobile joint which makes it very susceptible to injury. It moves the shoulder forward and backward. It also allows the arm to move in a circular motion, and to move up and away from the body.

Shoulders get their range of motion from the rotator cuff. The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.
You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement. Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine of the neck, as well as liver, heart, or gallbladder disease.
You're more likely to have problems with your shoulder as you grow older. It is especially common after age 60. This is because the soft tissues surrounding the shoulder tend to degenerate with age.
Most shoulder pain problems are:

  •   tendonitis/bursitis, injury or instability of the joint, or arthritic disease.
  •   rotator cuff syndrome is a strain or sprain or tear of the tendons that make up the rotator cuff.
  •   rarely, tumors, infections, and nerve damage cause shoulder pain.
  •   much neck pain is caused by soft tissue damage due to injuries such as whiplash or wear and tear due to overuse.
  •   damage to spine joints and bones, such as cervical disk degeneration, arthritis, or traumatic injury can cause severe pain and disability.
  •   fibromyalgia (whole body pain syndrome) can contribute to neck and upper back pain. Poor posture while performing everyday activities can also cause significant neck pain. Rarely, infections or tumors will cause neck pain.
  •   pinching a nerve in the neck or shoulder, or breaking a shoulder or arm bone, are also causes of pain.
  •   a frozen shoulder is when tendons, ligaments, and muscles stiffen and become difficult or impossible to move.
  •   a dislocated shoulder is when the ball of the humerus pulls out of the shoulder socket. An injury due to overuse or repetitive use can cause injury


A work environment that's good for the body is very important. Most of us spend hours each day sitting in front of our computer.
The first step to creating an ergonomic workstation is to consider how you spend most of your time at the workstation.

I cannot fold my hands and legs properly if I sit down once I can't stand-up properly and their was saviour problem of folding hands and legs.

BPTh/BPT, MPTh/MPT
Physiotherapist, Noida
I cannot fold my hands and legs properly if I sit down once I can't stand-up properly and their was saviour problem o...
Piriformis Stretch 1. Lie on your back. ... 2. Cross your left leg over your right so that your left ankle rests on your right knee. 3. Use your hands to grab hold of your left knee and pull it gently toward the opposite shoulder. ... 4. Hold for 15 to 30 seconds. 5. Relax, and then repeat with the other leg. 6. Repeat this cycle 2 to 4 times.
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Hello friends. I am 27 male. I have been gyming since 3 years .after gyming first 6 month I realize some pain in my shoulder. I immediately left working out and went to a doctor who advised me some exercises. It was not helpful so I went to a physiotherapist and had treatment which helps and my pain was gone. Again I started gyming and after 3 months again shoulder pain was there. This time I went to a orthopedic and he also advised me some exercises but it was waste of time. I also did ct scan and MRI but results are normal and doctors are telling to do physiotherapy and exercise .i need some real help guyz. I know you all are experienced. I can not go to gym and it kills me. Plzz help.

MBBS, MD - Anaesthesiology, FIPM, Fellowship in palliative medicine, certificate in interventional pain management
Pain Management Specialist, Pune
Hello friends.
I am 27 male. I have been gyming since 3 years .after gyming first 6 month I realize some pain in my s...
In conditions like yours where shoulder pain is not responding to physiotherapy, you should consult a pain specialist. You need to undergo ultrasonography of shoulder and intervention can be planned accordingly. In your case an injection known as Suprascapular nerve block will relieve the pain. This injection is given with help of ultrasound or X ray guidance in operation theatre to block pain transmission from shoulder joint. After pain relief you will be able to undergo effective exercise therapy. For further queries, consult.
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I am 56 years old and I am having severa pain my my bag side of the leg (kuthiangal) while walking. Pl. Advice me for curing this disease.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Kindly show me digital x rays of affected part.(knee) rule out diabetes & vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick matress are harmful use no pillow under the head. Do hot fomantation. Ibuprofen 200mg od & sos x 5days bio d3 max 1tab od x10 do neck, back & general exercises. It may have to be further investigated. You will need other supportive medicines also. Make sure you are not allergic to any of the medicines you are going to take. Do reply back for detailed treatment plan. Do not ignore. It could be beginning of a serious problem.
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I am 38 year old I am having problem with my knee if I sit long time in office knee start burning and pain even if I stand long time same please suggest me

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Obisity &oa could cause pain knee. Physiotherapy along with medicines will help. Rule out diabetes, vit. D deficiency or any other metabolic disorder. Sleep on a hard bed with a soft bedding on it. Any way take caldikind plus (mankind)1tab odx10days paracetamol 250mg od & sos x 5days do knee exercises. Gradually develop your walking stamina. It may have to be further investigated make sure you are not allergic to any of the medicines you are going to take.
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I am a 79 year old man, with reasonable health. I practice yoga asanas on alternate days and walk in the morning on other days. From one year I feel I am loosing balance and I stoop forward unconciously while walking. My knees do not seem to be strong enough and wobble a little early in the morning. I dont have sugar or high b. P. From a few months I feel I get tired very quickly. Any remidy for this?

MD - Diabetology, Membership of the Royal College of Surgeons (MRCS), MBBS
Endocrinologist, Kochi
For a 79 year old, your health is not just" reasonable. It is remarkable! keep going. Sleep well, continue to exercise & you will be fine.
1 person found this helpful
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Osteoarthritis - Homeopathic Treatment For It!

BHMS
Homeopath, Kolkata
Osteoarthritis - Homeopathic Treatment For It!

Osteoarthritis (OA) is a degenerative disease that affects the various bone and joints health, leading to painful movement and thereby limiting the patient's mobility.  Knees, hips, joints of hands and legs are affected.

Symptoms of OA

The symptoms revolve around the bones and joints including:

  1. Pain and stiffness of the joints
  2. Swelling of the joints
  3. Inability to form a clench
  4. Difficulty holding things 
  5. Stooped posture 
  6. Weakness of legs and hands
  7. Reduced height over time

Treatment options in allopathy are limited to nonsteroidal analgesics to control pain and in severe cases, surgical correction, in case of OA.  However, homeopathy takes into account the triggering symptoms, the associated symptoms, and the status of the immune system before deciding on a treatment regimen.

With this holistic approach, homeopathy achieve the following:

  1. Reduce the pain, swelling and stiffness
  2. Slows the pace of further degeneration
  3. Improves mobility of the affected joint(s)
  4. Improves the body's overall immune system, thereby allow the body to promote healing on its own
  5. Homeopathic intervention in the early phases is particularly helpful, as it will arrest disease progression
  6. It also enable better absorption of minerals and nutrients essential for bone health. This allows healing of existing bone fractures and avoids further bone damage by strengthening the bones
  7. Homeopathic treatment also enables the body's chemical state to withstand stress and illnesses better
  8. It vitalizes the body's natural healing and ability to repair itself, to create a better state of health and well-being

Some of the popular homeopathic medications based on areas and associated symptoms are listed below:

Knee joints:

  1. Bryonia Alba: Pain worsened with movement, relieved with rest; associated with swelling and stiffness of the joints; difficulty in climbing stairs.
  2. Calcarea Carbonica:  Swelling and pain that is worsened when getting up from a seated position. The joints feel cold and painful.
  3. Sulphur: Worse with climbing stairs, prolonged standing, feeling of warmth in the knees. 

Hip Joints:

  1. Colcynthis: Cramping pain improved by pressure.
  2. Rhus Toxicodendron: Pain when getting up from a seated position.
  3. Pulsatilla Nigricans: Associated with muscle stiffness and cramping.

Finger joints:

  1. Antimonium Crudum: The pain pain gets worse in cold weather, improved by applying something warm) 
  2. Benzoic Acid: There is an associated crackling sound when the fingers are moved or if there are nodes in the area of joints. . The urine is highly offensive in these people. 
  3. Calcara Fluorica:  There are stony hard nodes formed in the joint area, greatly reducing the mobility.

These medications are safe, completely natural, do not induce habit formation, and are approved by FDA.  They don't just treat the symptoms but help manage the patient as a whole.  This justifies why homeopathy is definitely a good option in treating osteoarthritis. If you wish to discuss about any specific problem, you can consult a Homeopath.

5980 people found this helpful

Postoperative Care for Spinal Fusion Surgery!

MBBS, Cerebrovascular and Micro neurosurgery fellowship, MS - General Surgery, MCh Neurosurgery
Neurosurgeon, Jaipur
Postoperative Care for Spinal Fusion Surgery!

Spinal surgery becomes inevitable when back pain cannot be managed with medications and/or exercise. This is a major decision and requires planning for many things before, during, and after the surgery.

Before a spinal surgery- This preparation will help in smooth recovery, especially if you do not have a full-time caretaker.

  1. Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.

  2. Prepare for blood loss: Most people experience some blood loss, but not excessive.

  3. Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.

  4. Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).

  5. Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.

  6. Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used.

  7. Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.

  8. Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.

After Surgery- Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects overall quality of life, so psychological preparation is required.

  1. Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail

  2. Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.

  3. Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.

  4. Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain.

  5. Smoking and alcohol should be completely stopped, as healing can be hampered.

With some preparation, spinal surgery can be sailed through smoothly. Consult an Expert & get answers to your questions!

1736 people found this helpful

My wife is having shoulder / knee pain. After taking MRI scans, they have observed little bulge in knee but none of the medicines relieved the pain. Doctor suspected vitamins defiencines and lab report also suggested vitamin d & b12 deficiencies. Pls suggest any supplements to remedies the problem.

Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
My wife is having shoulder / knee pain. After taking MRI scans, they have observed little bulge in knee but none of t...
. we suggest you can do hot water fermentation and ice therapy at home. If you have shoulder pain then the stiffness will develop more that might make the arm to have less improvement which might make you to feel more pain the arm. And also cervical pillow can be used which might make you to have better posture of the shoulder neck and arm We also suggest patients to do shoulder mobilization exercises ie. general shoulder movements/neck movements which will help you to improve the blood circulation.or knee pain you have to do the strengthening exersises .for eg 'keep towel under the knee press for a while count up to 10,then keep a towel at the ankle press as the same
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Dengue Vaxia

M.B.B.S,C.C.A,D.C.A,AASECT,FPA,AAD,M.I.M.S
General Physician, Gorakhpur
Dengue Vaxia

Dengvaxia - first vaccine against dengue

Dengvaxia is a vaccine used to help protect adult or children against dengue disease caused by dengue virus serotypes 1, 2, 3 and 4. Dengvaxia is given to adults, adolescents and children 9 through 45 years of age living in endemic areas.

Read more:

Dengue symptoms and what to do if you think you have denguedengue fever - remedies using papaya leaf juice

Full prescribing info - dengvaxia

Contents

Dengue tetravalent vaccine (live, attenuated).

Indications / uses

Dengvaxia is a vaccine used to help protect adult or children against dengue disease caused by dengue virus serotypes 1, 2, 3 and 4. Dengvaxia is given to adults, adolescents and children 9 through 45 years of age living in endemic areas.

Dosage / direction for use

The patient will receive 3 injections of 0.5 ml each at 6-month intervals.

The first injection will occur at the chosen or scheduled date; the second injection, 6 months after the first injection; and the third injection, 6 months after the second injection. Dengvaxia should be used according to the local vaccination schedule.

If the patient forgot an injection of dengvaxia: if the patient missed a scheduled injection, the physician will decide when to give the missed injection.

It is important that the patient follows the instructions of the physician, pharmacist or nurse regarding return visits for the follow-up injection. If the patient forgets or is not able to go back to the physician, pharmacist or nurse at the scheduled time, ask the physician, pharmacist or nurse for advice.

Administration: dengvaxia is given by the physician or nurse as an injection underneath the skin (subcutaneous route) in the upper arm.

Contraindications

Do not use dengvaxia if the patient is allergic (hypertensive) to the active substances or any of the other ingredients of dengvaxia listed in description (see description); has developed an allergic reaction after prior administration of dengvaxia. Signs of an allergic reaction may include an itchy rash, shortness of breath and swelling of the face and tongue; is suffering from a disease with mild to high fever or acute disease. In this case, the physician will postpone the administration of dengvaxia until the patient has recovered; has a weakened immune system, for example due to a genetic defect, hiv infection or therapies that affect the immune system (for example, high-dose corticosteroids or chemotherapy); is pregnant; is breastfeeding.

Use in pregnancy lactation: dengvaxia must not be given to pregnant or breastfeeding women.

If the patient is of child-bearing stage, the patient should take the necessary precautions to avoid pregnancy for 1 month following administration of dengvaxia; is pregnant or breastfeeding, the patient thinks may be pregnant or is planning to have a baby, ask the physician, pharmacist or nurse for advice before receiving dengvaxia.

Special precautions

Inform the physician, pharmacist or nurse before receiving dengvaxia if the patient is taking an immunosuppressive treatment (prednisone or equivalent to 20 mg or 2 mg/kg for 2 weeks or more). The physician will postpone administration of dengvaxia until 4 weeks after the treatment is discontinued; has experienced any health problems after prior administration of any vaccines. The physician will carefully consider the risks and benefits of vaccination.

As with all vaccines, dengvaxia may not protect 100% of persons who have been vaccinated. Vaccination with dengvaxia is not a substitute for protection against mosquito bites. The patient should take appropriate precautions to prevent mosquito bites, including the use of repellents, adequate clothing, and mosquito nets.

Fainting, sometimes accompanied by falling, can occur (mostly in adolescents) following, or even before, any injection with a needle. Therefore inform the physician, pharmacist or nurse if the patient fainted with a prior injection.

Adults above 45 years of age: adults above 45 years of age should not receive the vaccine.

Driving and using machines: no data are available on the effects of dengvaxia on the ability to drive or use machines.

Use in children: children less than 9 years of age should not receive the vaccine.

Side effects

Like all medicines, dengvaxia can cause side effects, although not all patients get them.

Serious allergic reactions: if any of these symptoms occur after leaving the place where the patient received an injection, consult a physician immediately: difficulty in breathing, blueness of the tongue or lips, a rash, swelling of the face or throat, low blood pressure causing dizziness or collapse.

When these signs and symptoms occur they usually develop quickly after the injection is given and while the patient is still in clinic or physician's surgery.

Serious allergic reactions are very rare (may affect up to 1 in 10, 000 people), after receiving any vaccine.

Other side effects: the following side effects were reported during clinical studies in children, adolescents and adults (from 9 to and including 60 years of age). Most of the reported side effects occurred within 3 days after the injection of the vaccine: very common (may affect more than 1 user in 10): headache, muscle pain (myalgia), generally feeling unwell (malaise), feeling of weakness (asthenia), injection site pain, fever.

Common (may affect up to 1 user in 10): injection site reactions: redness (erythema), bruising (hematoma), swelling, and itching (pruritus).

Uncommon (may affect up to 1 user in 100): infections of the upper respiratory tract, dizziness, sore throat (oropharyngeal pain), cough, runny nose (rhinorrhea), nausea, skin eruption (rash), neck pain, hardening of skin at the injection site (injection site induration).

Additional side effects in adults (from 18 to and including 60 years of age): uncommon (may affect up to 1 user in 100): swollen glands (lymphadenopathy), migraine, joint pain (arthralgia), flu-like symptoms (influenza-like illness).

Additional side effects in children and adolescents (from 9 to and including 17 years of age: uncommon (may affect up to 1 user in 100): itchy rash (urticaria).

Reporting of side effects or any suspected adverse event: if the patient experiences any side effects after vaccination, advised to seek immediate medical attention.

By reporting side effects, it can help provide more information on the safety of the vaccine.

Click to view adr monitoring form

Interactions

Using other medicines and dengvaxia: dengvaxia may not have an optimal effect if it used at the same time as medicines that suppress the immune system such as corticosteroids or chemotherapy.

Inform the physician, pharmacist or nurse if the patient is taking or has recently taken any other vaccines or any other medicines, including medicines obtained without a prescription.

Caution for usage

Before administering any biological, the person responsible for administration must take all precautions to prevent allergic or other reactions. As with all injectable vaccines, appropriate medical treatment and supervision must always be readily available in the event of an anaphylactic reaction following the administration of dengvaxia.

Epinephrine (1: 1000) and other appropriate agents used to control immediate allergic reactions must be available to treat unexpected events such as anaphylaxis.

Dengvaxia must not be mixed with other medicinal products in the same syringe.

Dengvaxia must not be administered by intravascular injection under any circumstances.

Syncope (fainting) can occur following, or even before, any vaccination as a psychogenic response to injection with a needle. Procedures should be in place to prevent injury from falling and to manage syncopal reactions.

Separate syringes and needles, separate injection sites and preferably separate limbs must be used if any other vaccine (s) or medicinal product (s) is/are concomitantly administered.

Dengvaxia is reconstituted by transferring all the solvent (0.4% sodium chloride solution) provided in the blue-labeled pre-filled syringe into the vial of freeze dried powder with a yellowish green flip off cap. The pre-filled syringe is fitted with a sterile needle for this transfer. The vial is then gently swirled. After complete dissolution, a 0.5 ml dose of reconstituted suspension is withdrawn into the same syringe. For injection, the syringe should be fitted with the new sterile needle.

The suspension should be visually inspected prior to administration. After reconstitution, dengvaxia is clear, colorless liquid with the possible presence of white to translucent particles (of endogenous nature).

After reconstitution with the solvent provided, dengvaxia must be used immediately.

Any unused dengvaxia or waste material should be disposed of, preferably by heat inactivation or incineration, in accordance with local regulations.

Do not throw away any medicines via wastewater or household waste. Ask a pharmacist on how to throw away medicines that no longer use. These measures will help to protect the environment.

Storage

Store in a refrigerator. Do not freeze. Keep the vaccine in the outer carton in order to protect it from light.

Description

After reconstitution, one dose (0.5 ml) contains 4.5-6.0 log10 ccid50* of each serotype of the cyd dengue virus** (1, 2, 3 and 4).

* ccid50: 50% cell culture infectious dose.

** produced in serum-free vero cells by recombinant dna technology.

The powder is a white, homogenous, freeze-dried powder with possible retraction at the base, and may form a ring-shaped cake.

The solvent (0.4% sodium chloride solution) is a clear, colorless liquid.

After reconstitution with the solvent provided, dengvaxia is a clear, colorless liquid with the possible presence of white to translucent particles.

Excipients/inactive ingredients: essential amino acids including l-phenylalanine, non-essential amino acids, l-arginine hydrochloride, sucrose, d-trehalose dihydrate, d-sorbitol, trometamol, urea, sodium chloride, water for injections.

Mechanism of action

Dengvaxia contains dengue virus serotypes 1, 2, 3 and 4 that have been weakened. Dengvaxia works by stimulating the body's natural defenses (immune system), which produces its own protection (antibodies) against the viruses that cause dengue disease.

Dengue is a viral infection transmitted to humans through the bite of an infected aedes mosquito. Dengue is not transmitted directly from person-to-person. Nevertheless the virus which replicates in an infected individual can be transmitted to other humans through mosquito bites for 4-5 days (maximum 12 days) after the first symptoms appear.

Dengue disease results in a wide range of symptoms including fever, headache, pain behind the eyes, muscle and joint pain, nausea, vomiting, swollen glands or skin rash. Symptoms usually last for 2-7 days. Dengue disease can also be asymptomatic.

However, occasionally dengue can be severe and potentially lead to hospitalization and in rare cases to death. Severe dengue is characterized by high fever and any of the following symptoms: severe abdominal pain, persistent vomiting, rapid breathing, severe bleeding, bleeding in stomach, bleeding gums, fatigue, restlessness, coma, seizure and organ failure.

Source:- http://www.mims.com/philippines/drug/info/dengvaxia

More information about dengvaxia - first vaccine against dengue

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Sanofi pasteur - dengue vaccine frequently asked questions

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