HEALTH FOLIO

This blog provides basic information on health in simple english for lay people.

Friday, July 28, 2006

What is Cancer?

Fig: Normal Human Cell. Note the position of Nucleus

Fig.2: This is Human Karyotype. The 22 pair of choronmosomes vary in their shape and sizes. They are given numbers from pair 1 to pair 22. Sex chromosomes are named as X and Y.


Fig.3: This is an imaginative figure of normal human cell. Note the positionof Nucleus, the chromosomes, the double helix of DNA and their base pairs.

Cancer is an age-old disease affecting mankind. It was recognised by ancient Egyptians as early as 1600 BC. Even ancient Indian Doctors like Sushrutha and Charaka identified this disease and named it as arbuda. It is increasing in an alarming pace from last 50 years because of rapid Industrialization, Urbanization and Modernization.

Our body is made up of billions of cells. Cells unite to form tissues. Tissues form organs. Organs form Organ systems, which finally form what we call whole body and life.

All the cells have same plan of construction but vary in certain aspects depending upon the organ where they are present and the function they are doing. A red blood cell is saucer shaped cell-carrying Oxygen and supplying to each and every cell of the body. A muscle cell is spindle shaped helping in locomotion. A nerve cell has an elongated structure helping in conduction of electrical impulses and participating in communication.

The billions of cells of the body that are the result of a single cell called zygote, which is the product of fusion of sperm with Ovum. Zygote multiplies repeatedly to form the whole body. Each and every cell has a nucleus (exception: Red blood cells). In the nucleus, there are 23 pairs of chromosomes. Each chromosome has several genes and each gene is made up D.N.A, which is made up of several base pairs, which are nothing but various Chemical molecules!

Genes are the blue prints of our life. All the details concerned with the various functions of the body including re-productions are present in the form of specific codes in these genes. The genes you pass along with your spouse decide whether your child will have blue eyes, curly hair or fair colour. Also some diseases are transmitted to offspring through genes.

A cell is predetermined as to how many times it has to re-produce in its lifetime. Cancer develops when cells in a part of the body begin to grow out of control. This is an abnormal feature resulting in the formation of abnormal cells. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells.

Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out or dying cells and to repair injuries.
Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells. Cancer cells develop because of damage to DNA. Most of the time when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. Many times though, a person’s DNA becomes damaged by exposure to something in the environment, like smoking.

Cancer usually forms as a tumour. Some cancers, like leukaemia popularly known as Blood Cancer, do not form tumours. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow.

Often, cancer cells travel to other parts of the body, where they begin to grow and replace normal tissue. This process is called metastasis. Regardless of where a cancer may spread, however, it is always named for the place it began. For instance, breast cancer that spreads to the liver is still called breast cancer, not liver cancer.

Not all tumours are cancerous. Benign (noncancerous) tumours do not spread to other parts of the body (metastasize) and, with very rare exceptions, are not life threatening.

Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer.

Cancer is curable if it is detected early. Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking and eating a better diet. The sooner a cancer is found and treatment begins, the better are the chances for living a productive life for many years.

- Dr.N.Someswara

Wednesday, July 26, 2006

RECOMMENDED HEALTH SCREENINGS

Health is Wealth. Health is a rare commodity. You can not buy it. No money can buy you good health. Hence you have to maintain your health.

One way of maintaining your health is to undergo periodical medical check ups. You have to undergo a set of medical tests and examination so that you can identify the beginning of disease and eradicate it completely before it gets its foot-hold in your body. After evaluaating your medical records and your physical examination, your Doctor will suitably advise you to modify your life style so that you can avoid diseases and promote your wellbeing.

The following article gives you a birds eye view of various tests and medical examinations that you may have to undergo periodically at different age times. This is only a general guideline. Your Doctor is the best person to select appropriate tests required for you and your family. In the following article, I have not mentioned general tests like Hb%, routine blood counts, routine Urine tests and routine stool tests and others. These are manadatory tests for any general medical examination. Hence I have not included. I have emphasized more on special tests. Now Go ahead! Read!! Get benefit from the same. You may write to me for any clarification.



Recommended Screening Procedures
-Ages 18-29

Its never too early to start taking care of your body. In addition to not smoking, eating right, maintaining a healthy weight, and exercising, following the screening recommendations on this chart can help you enjoy a healthy future.

1.
Dental exam-Twice a year -To check for cavities and to have a cleaning, which may prevent gum disease

2. Eye exam-At least once between ages 20 and 39.

3. Skin exam-Every 3 years.

4. Skin self-examination-Monthly

  • To look for changes, growths, or sores that don't heal. They should be reported to your Doctor.
  • Here are the ABCD warning signs for marks on the skin :
  • A is for Asymmetry, one half is unlike the other.
  • B is for Border irregular, wavy, uneven border.
  • C is for Color varied, different shades or colors
  • D is for Diameter larger than a pencil eraser
  • Protect your skin. Unprotected sun exposure over time can lead to skin cancer, including melanoma, a potentially deadly form of skin cancer. Melanoma is the most common form of cancer in women aged 25 to 29; so don't forget to reduce your exposure to the sun and to protect your skin with appropriate sun protection (SPF - 15 or greater) products when outside. Examine your skin on a monthly basis for any changes in appearance, including your legs, arms, abdomen, back, and face.

5. Clinical breast exam-Every 3 years.

6. Breast self examination: Perform regular breast self-exams. Most breast lumps are found by women who check themselves during monthly breast self-exams. Ask your healthcare provider how to perform this important examination. Look and feel for changes in size, shape, contour, or skin texture. Call your healthcare provider if you notice any lumps or changes

7. Pap smear-Every year until 3 normal tests, then at a Doctor's discretion
Get a Pap test. You should start having Pap tests when you become sexually active or at age 18. Pap test screening, early identification and treatment can actually prevent the development of cervical cancer almost 100% of the time in younger women.

8. Pelvic exam-Every year.
Get advice about birth control and preconception care. The best time to prepare your body for a healthy pregnancy is long before you make a decision to become pregnant. This is called preconception care. Ask your doctor about a plan of action that is right for you. If you do not intend to become pregnant, ask your Doctor for advice on what form of birth control is best suited for you.

9. Sexually transmitted disease (STD) test(HIV, chlamydia, etc)-Whenever engaged in potentially risky behavior. Practice safe sex. Risky sexual behavior can include sex with new or multiple partners, inconsistent use of condoms, or unprotected sex with a partner who is not monogamous. Eighty-six percent of sexually transmitted diseases (STDs) eg, chlamydia, gonorrhea, genital warts, and HIV (the virus that causes AIDS) occur in people 15 to 29 years of age. HIV infection is among the top 10 causes of death in 15- to 24-year-olds. Always use a condom and get tested for STDs annually.

10. Cholesterol (total and HDL)-Every 5 years.

11. Blood pressure-At least every 2 years.

12. Immunizations: Tetanus boosters once in every 5 years. Get your immunizations. Protect yourself now by asking your healthcare provider about follow-up immunizations. Get vaccinated against hepatitis B, and make sure that you are up-to-date on your immunizations.

13. Osteoporosis prevention: Get enough calcium. Believe it or not, osteoporosis prevention begins now. So it's important to eat calcium-rich foods to build and preserve the strength and density of your bones. You need milligrams 1000 milligrams (mg) of calcium every day. You can achieve these levels by eating dairy products including non-fat, low-fat, and fortified. If you can't get enough calcium in to your diet, ask your Doctor to recommend a dietary supplement.

14. Chest-X-ray: PA View: There should be one base line chest x-ray of the chest. This functions as reference x-ray for your future chest problems. Just take one x-ray, at the age of 18 years! That is enough.

15. U/S pelvis & abdomen: A base line Ultra sound evaluation will give a lot of information about your internal structures like Liver, kidney, Uterus, Ovary and other organs. This should serve as a reference while your Doctoabdominal your abominal problems.

Recommended Screening Procedures -Ages 30-39

1. Dental exam-Twice a year: To check for cavities and to have a cleaning, which may prevent gum disease.

2. Eye exam-At least once between ages 20 and 39.

3. Skin exam-Every 3 years.

4. Skin self-exam-Monthly. To look for changes, growths, or sores that don't heal. They should be reported to your healthcare provider. Here are the ABCD warning signs for marks on the skin:

A is for Asymmetry-one half is unlike the other

B is for Border irregular-wavy, uneven border

C is for Color varied-different shades or colors

D is for Diameter-larger than a pencil eraser.


Protect your skin. Unprotected sun exposure over time can lead to skin cancer, including melanoma, a potentially deadly form of skin cancer. So reduce your exposure to the sun and protect your skin with appropriate sun protection (SPF >15) products when outside. Examine your skin on a monthly basis for any changes in appearance, including your legs, arms, abdomen, back, and face.

5. Clinical breast exam-Every 3 years.

6. Breast self-exam-Monthly. Most breast lumps are found by women who check themselves during monthly breast self-exams. Ask your healthcare provider how to perform this important examination. Look and feel for changes in size, shape, contour, or skin texture. Call your healthcare provider if you notice any lumps or changes.

7.Pap smear-Every year until 3 normal tests, then at a healthcare provider's discretion.

8. Pelvic exam-Every year: Get advice about birth control and preconception care. The best time to prepare your body for a healthy pregnancy is before you make a decision to become pregnant. This is called preconception care. Ask your Doctor, about a plan of action that is right for you. If you do not intend to become pregnant, ask your Doctor for advice on what form of birth control is best suited for you.

9. Sexually transmitted disease (STD) test(HIV, chlamydia etc): Whenever engaged in potentially risky behavior Practice safe sex. Risky sexual behavior can include sex with new or multiple partners, inconsistent use of condoms, or unprotected sex with a partner who may not be monogamous.

10. Cholesterol: Cholesterol (total and HDL)Click to learn more about understanding and controlling your levels. Every 5 years.

11. Blood pressure: At least every 2 years Check for high blood pressure, which can increase the risk of serious conditions like Stroke & Heart attack.

12. Immunizations: Get Tetanus boosters every 10 years.

13. Osteoporosis prevention: Get enough calcium. It's important to eat calcium-rich foods to build and preserve the strength and density of your bones. You need 1000 to 1500 milligrams (mg) of calcium every day. You can achieve these levels by eating dairy products including nonfat, low-fat, and fortified. If you can't get enough calcium into your diet, ask your Doctor to recommend a dietary supplement.

Recommended Screening Procedures -Ages 40-49

1. Dental exam-Twice a year. To check for cavities and to have a cleaning, which may prevent gum disease.

2.Eye exam-Every 2 years . To check vision and look for other conditions such as cataracts and glaucoma.

3. Skin exam-Every 3 years.

4. Skin self-exam-Monthly. To look for changes, growths, or sores that don't heal. They should be reported to your healthcare provider. Here are the ABCD warning signs for marks on the skin:

A is for Asymmetry-one half is unlike the other

B is for Border irregular-wavy, uneven border

C is for Color varied-different shades or colors

D is for Diameter-larger than a pencil eraser.

5. Mammogram-Every 1 to 2 years. To look for changes in the breast that can't be seen or felt. Start having regular mammograms. Why? Because breast cancer risk increases as you get older, starting at age 40. Women should have a mammogram and a clinical breast exam performed by a healthcare provider every 1 to 2 years. Early detection of breast cancer using mammograms may be lifesaving

6. Clinical breast exam-Every year.

7. Breast self-exam-Monthly. Most breast lumps are found by women who check themselves during monthly breast self-exams. Look and feel for changes in size, shape, contour, or skin texture. Call your Doctor, if you notice any lumps or changes.

8. Pelvic exam-Every year .

9. Pap smear- Every year until 3 normal tests, then at a Docotors discretion.

10. Sexually transmitted disease (STD) test(HIV, chlamydia, etc):
Whenever engaged in potentially risky behavior. Risky sexual behavior can include sex with new or multiple partners, inconsistent use of condoms, or unprotected sex with a partner who may not be monogamous.

11. Lipid profile: Once a year.

12. Blood pressure: At least once a year. High blood pressure affects your health. Check for high blood pressure, which can increase the risk of serious conditions like stroke and heart attack.

13. Diabetes screening: Once a year. Experts recommend that adults older than 40 be tested for adult onset diabetes, a condition in which blood sugar levels are too high. Millions have it and don't even know it because symptoms usually don't occur in the early stages. Obesity, or having excessive body fat, is a major risk factor for adult onset diabetes. Other risk factors include family history of adult onset diabetes, high cholesterol, high blood pressure, and a history of diabetes during pregnancy.

14: ECG in 12 leads: Once a year.

14. Immunizations: Get Tetanus booster opnce in every 5 years.

15. Osteoporosis prevention: Get enough calcium. It's important to eat calcium-rich foods to build and preserve the strength and density of your bones. You need 1000 to 1500 milligrams (mg) of calcium every day. You can achieve these levels by eating dairy products including nonfat, low-fat, and fortified. If you can't get enough calcium into your diet, ask your Doctor to recommend a dietary supplement.

16. Chest X-ray PA View: Just repeat another base line Chest X-ray at the begining of of your 40's.

17. U/S of Pelvis & abdomen: It is better to repeat once U/S of abdomen at the begining of your 40's.



Recommended Screening Procedures - over 50 years.

1. Dental exam-Twice a year. To check for cavities and to have a cleaning, which may prevent gum disease

2. Eye exam-Every 2 years . To check vision and look for other conditions such as cataracts and glaucoma.

3. Skin exam-Every year.

4. Skin self-exam-Monthly. To look for changes, growths, or sores that don't heal. They should be reported to your Doctor. Here are the ABCD warning signs for marks on the skin:

A is for Asymmetry-one half is unlike the other

B is for Border irregular-wavy, uneven border

C is for Color varied-different shades or colors

D is for Diameter-larger than a pencil eraser

5. Mammogram-Every year. Early detection and treatment of breast cancer may be lifesaving.

6. Clinical breast exam: Every year .To look for any changes and feel for any lumps.

7. Breast self-exam- Monthly. Most breast lumps are found by women who check themselves during monthly breast self-exams. Look and feel for changes in size, shape, contour, or skin texture. Call your healthcare provider if you notice any lumps or changes.

8. Pelvic exam- Every year.

9. Pap smear- Every year until 3 normal tests, then at a Doctor's discretion.

10. Sexually transmitted disease (STD) test(HIV, chlamydia, etc): Whenever engaged in potentially risky behavior. Risky sexual behavior can include sex with new or multiple partners, inconsistent use of condoms, or unprotected sex with a partner who may not be monogamous.

11.Lipid profile: Every year.

12. Blood pressure: Every year, One out of every 10 in their 50s have some degree or some type of heart disease. In Weman, when estrogen levels decrease, the risk of heart attack is similar to that for a man. Your Doctor can assess risk factors you may have, such as high blood pressure, high cholesterol, diabetes, and family history of heart diseases and develop an effective plan for good heart's health.

13. Diabetes screening: Once a year. Check for fasting and post prandial blood sugar levels.

14. Tread meal test (TMT): Once at the begining of 50th year which should serve as reference for future evaluations. Then depending up on your blood pressure, Diabetes, your weight, your physical activity, your stress level and family history, your Doctor will deside the frequency of this test.

15. Echocardiogram: Once at the begining of 50th year. This will serve as a baseline reference. It may repeated at the discretrion of your Doctor.

16. Immunizations: Get booster dose of Tetanus every 5 years. Pneumococcal vaccine once after age 65 and Influenza vaccine every year if 65 or older.

17. Fecal occult blood test- Every year. To test for blood in the stool, a possible sign of colon or rectal cancer.

18. Colorectal cancer tests (sigmoidoscopy, colonoscopy): This cancer is comparatively rare in Indians when compared to westerens. This may be done at the discretion of the Doctor once in every 5 to 10 years. Eating lots of fresh fruits, vegetables, and whole grains may reduce your risk of developing colon cancer.

19. Osteoporosis screening (bone mineral density test): As determined by your Docotr. It measures the density of your bones, can show if you have osteoporosis, and can predict your risk of spine and hip fractures. Your healthcare provider can discuss your risk factors with you and determine if you should have this test.

20. U/S of the pelvis & abdomen: This is done at the begining of the 50th year which will serve as a base line reference. Then this may be repeated every year at the discreation of your Doctor. This helps in early detection of BPH (Beningn Prostatic Hypertrophy)

21. Thyroid profile: Thyroid disease is common in women. An underactive thyroid (hypothyroidism) can cause fatigue, sensitivity to cold, weight gain, and other troubling symptoms. An overactive thyroid (hyperthyroidism) may cause rapid heartbeat, weight loss, and dizziness. A simple blood test done for thyroid-stimulating hormone (TSH) may detect a thyroid problem.

- Dr.N.Someswara

Let us Invest....




Let us Invest......


Health is a state of physical, mental, social, sexual and spiritual well-being. Contrary to the popular belief, health is not a state of absence of diseases or deformities. By making conscious and mindful decisions, let us try to gain the best health in all areas of our life. This is the most important investment we can make in our life.

The choices we make about the way we live or lifestyle we adopt are important to our health. Here are some choices we can make to help our self to stay healthy:


Abstain from using any form of tobacco.
Eat a healthy diet.
Exercise regularly.
Drink alcohol in moderation, if at all.
Never use illegal drugs.
Practice safe sex.
Use a helmet while riding our bikes and fasten seat belts when driving in a car.
We must always consult our doctor regularly for preventive health care. This may be a test, or advice from our doctor.

Preventive health services can include the following:

  • Tests (also called screenings) to check our general health or the health of certain parts of our body
  • Measurements of weight, cholesterol levels and blood pressure etc.
  • Advice about diet, exercise, tobacco, alcohol and drug use, stress and accident prevention.
  • Immunizations for both children and adults.
  • Special tests at certain times in our life, such as during pregnancy and after the age of 50 years.

The most important aspect of well being is getting educated and being aware of our self, our health, fitness & well being. For this

v Let us learn and educate ourselves to become our own "second opinion" so that we can understand and practice with perfection all aspects of treatment that our health practitioners or consultants may prescribe to us.

v Let us reclaim personal responsibility for our own health and make it a priority. When we are sick, health becomes our #1 priority, because without it we have nothing. With total health and high energy we can accomplish our dreams and heart's desires.

v Let us take charge, make changes and do what it takes to enjoy the abundant rewards of total health & well-being.


This writing, I hope, will inspire us in educating our self and equip us to take care of the health of our family. I sincerely request you to invest in preventive health care in order to lead a total, complete & fruitful life.

-Dr.N.Someswara

SAFE USE OF MEDICINES




Safe Use of Medicines

Doctors, physician assistants, nurses, pharmacists, and YOU make up your health care team. To reduce the risks from using medicines and to get the most benefit, you need to be an active member of the team.

To make medicine use SAFER:·

Speak up·
Ask questions·
Find the facts·
Evaluate your choices dispense·
Read the label and follow directions.

SPEAK UP:

  • The more information your health care team knows about you, the better the team can plan the care that’s right for you.
  • The members of your team need to know your medical history, such as illnesses, medical conditions (like high blood pressure or diabetes), and operations you have had.
  • They also need to know all the medicines and treatments you use, whether all the time or only some of the time.
  • Before you add something new, talk it over with your team. Your team can help you with what mixes well, and what doesn’t.
  • It helps to give a written list of all your medicines and treatments to all your doctors, pharmacists and other team members.
  • Keep a copy of the list for yourself and give a copy to a loved one.
  • Be sure to include:· Prescription medicines, including any samples your doctor may have given you·
  • Over-the-counter (OTC) medicines, or medicines you can buy without a prescription (such as antacids, laxatives, or pain, fever, and cough/cold medicines)·
  • Dietary supplements, including vitamins and herbs·
  • Any other treatments· Any allergies, and any problems you may have had with a medicine·
  • Anything that could have an effect on your use of medicine, such as pregnancy, breast feeding, trouble swallowing, trouble remembering, or cost.
ASK QUESTIONS:
  • Your health care team can help you make the best choices, but you have to ask the right questions.
  • When you meet with a team member, have your questions written down and take notes on the answers. You also may want to bring along a friend or relative to help you understand and remember.
  • Use the Question Guide at the end of this pamphlet to help you get the answers you need from your health care team.
  • Before you and your team decide on a prescription or OTC medicine, learn and understand as much about it as you can, including:·
  • Brand and generic (chemical) names·
  • Active ingredients—to make sure that you aren’t using more than one medicine with the same active ingredient·
  • Inactive ingredients—if you have any problems with ingredients in medicines, such as colours, flavours, starches, sugars·
  • Uses (“indications” and “contraindications”)—why you will be using it, and when the medicine should/should not be used·
  • Warnings (“precautions”)—safety measures to make sure the medicine is used the right way, and to avoid harm·
  • Possible interactions—substances that should not be used while using the medicine. Find out if other prescription and OTC medicines, food, dietary supplements, or other things (like alcohol and tobacco) could cause problems with the medicine·
  • Side effects (“adverse reactions”)—unwanted effects that the medicine can cause, and what to do if you get them·
  • Possible tolerance, dependence, or addiction—problems that some medicines can cause, and what you can do to avoid them·
  • Overdose—what to do if you use too much· Directions—usual dose; what to do if you miss a dose; special directions on how to use the medicine, such as whether to take it with or without food·
  • Storage instructions—how and where to keep the medicine· Expiration—date after which the medicine may not work, or may be harmful to use.
    Your pharmacy, the library, the bookstore, the medicine maker, and the Internet have medicine information made for consumers.
  • If you have questions, ask your health care team.
  • EVALUATE YOUR CHOICES—Weigh the Benefits and RisksAfter you have all the information, think carefully about your choices.
  • Think about the helpful effects as well as the possible unwanted effects. Decide which are most important to you.

This is how you weigh the benefits and risks.


The expert advice from your health care team and the information you give the team can help guide you and your team in making the decision that is right for you.

READ THE LABEL AND FOLLOW DIRECTIONS:

  • Read the label to know what active ingredient(s) is (are) in the medicine. The active ingredient in a prescription or OTC medicine might be in other medicines you use.
    Using too much of any active ingredient may increase your chance of unwanted side effects.
  • Read the label each time you buy an OTC medicine or fill your prescription.
  • When buying an OTC, read the "Drug Facts" label carefully to make sure it is the right medicine for you.
  • Prescription and OTC medicines don't always mix well with each other.
  • Dietary supplements (like vitamins and herbals) and some foods and drinks can cause problems with your medicines too.
  • Ask the pharmacist if you have questions.
    Before you leave the pharmacy with your prescription, be sure you have the right medicine, know the right dose to use, and know how to use it.
  • If you've bought the medicine before, make sure that this medicine has the same shape, colour, size, and packaging. Anything different? Ask your pharmacist.
  • If your medicine tastes different when you use it, tell your health care team.
  • Read and save all the information you get with your medicine.
  • Read the label each time before you use the medicine.
  • Be sure it’s right in 5 ways:1. The right medicine 2. For the right patient 3. In the right amount 4. At the right time 5. In the right way (for example, swallow instead of chew a pill) follow directions on the label and from your health care team.
  • When you are ready to use the medicine, make the most of the benefits and lower the risks by following the directions.
  • If you want to stop a medicine your doctor told you to use or to use it in a different way than directed, talk to a team member.
  • Some medicines take longer to show that they are working. With some medicines, such as antibiotics, it is important to finish the whole prescription, even if you feel better sooner.
    When you stop using some medicines, you must reduce the dose little by little to prevent unwanted side effects.


REPORT BACK TO THE TEAM:
Pay attention to how you feel.
If you have an unwanted effect, tell your health care team right away. A change in the dose or a change in medicine may be needed.

QUESTION GUIDE:
Use this guide with your health care team to find out what you need to know about the medicines you use, and about the medicines you are thinking about using. Be sure to find the answers to these questions for any sample medicine your doctor gives you.·

What are the brand and generic (non-brand) names of the medicine?·

What is the active ingredient?·

Could I use a generic form?·

What is the medicine for, and what will it do for me?·

When should I start to feel better?·

When should I report back to the team?·

Will this medicine take the place of any other medicine I have been using?·

Should I avoid any drinks, foods, other substances, or activities while using this medicine?

Can this medicine be used safely with the other medicines and treatments I already use?

Does this include prescription and OTC medicines, vitamins, herbals, or other supplements, and other treatments?·

Should I avoid starting other medicines (prescription or OTC), dietary supplements (like herbals and vitamins) or other treatments while I am using this medicine?·

What are the possible side effects from this medicine? What do I do if I get a side effect?·

Is there any chance that I could become tolerant, dependent or addicted to this medicine?

What can I do to avoid this?·

How and when should I use the medicine, in what amount, and for how long?

Are there any special directions for using this medicine?·

Will I need any tests (blood tests, x-rays, other tests) to make sure the medicine is working, as it should? How will I get the results?·

What should I do if I miss a dose?

What should I do if I use too much by mistake?·

How and where should I keep this medicine? (Remember: Always put medicines out of the sight and reach of children and pets.)·

Where and how can I get more information about this medicine?


Remember: To reduce the risks of using medicines and to get the most benefit, you need to be an active member of your health care team.

-Dr.N.Someswara