I had a root canal done now I am in pain?

Question: I had a root canal done about a month ago. I was supposed to return to the dentist 2 weeks later but because of covid-19, they cancelled. I started getting a bit of pain in the area where the root canal was done and a bad taste in my mouth. I called my dentist and they called in a prescription for amoxicillin. One week later, nothing had changed. I called the dentist and they had me come in. The dentist prescribed me Clindamycin 4 times a day for 10 days. I’m currently on day 4 of taking this. The taste has gone away. The pain is not fully gone but better. My tongue still has a light film on it. I have spina bifida and while showering yesterday, I noticed I have 2 hive like welts near where the spina bifida cyst is.  (picture attached) Also the lymph node near my groin area is tender. I don’t feel sick or have a fever so I’m wondering if these things could be side effects of the Clindamycin?

Answer: Hi. I have received and read your question. Based on the information you have provided I believe this may be be caused by the Clindamyci. I would recommend you speak to your Dentist once more and discuss with him/her the possibility of using an alternative such as cephalexin, azithromycin or clarithromycin. If situation persists you should consult with your primary care physician.

Here Is some more information:

Common Clindamycin side effects may include:

  • nausea, vomiting, stomach pain;
  • mild skin rash; or
  • vaginal itching or discharge;

Side effects requiring medical assistance:

– any change in bowel habits;

– severe stomach pain, diarrhea that is watery or bloody;

– little or no urination; or

– a metallic taste in your mouth (after clindamycin injection).

Dr. Deepak Patel

I hit my head on a wall.

Question: I hit my head on a wall. I am feeling pressing sensations in my left temple. Just recently I feel much smaller sensations in my right temple. Not painful just pressing. What is going on?

Answer: A blow such as the one you have received may have no consequences whatsoever. Using pain relief medication such as Acetaminophen (Tylenol) may help with the pain. Please avoid using ibuprofen (advil) for such an injury. You will need to consult if you have subsequent symptoms. Immediate medical attention is required if you experience symptoms such as bruising behind the ears or around the eyes (raccoon eyes). These can potentially indicate a severe or life-threatening injury. If you experience these symptoms, a CT scan will be required to further evaluate the situation. Sometimes a blow to the head may produce a concussion. These are difficult to diagnose. And the consequences vary. Most concussions or mild traumatic brain injuries (MTBI) symptoms will go away without treatment. So please continue to monitor your situation and should symptoms worsen please consult for more investigation.

Additional Information:

Head injury can be either closed or open (penetrating).

  • A closed head injury means you received a hard blow to the head from striking an object, but the object did not break the skull.
  • An open, or penetrating, head injury means you were hit with an object that broke the skull and entered the brain. This is more likely to happen when you move at high speed, such as going through the windshield during a car accident. It can also happen from a gunshot to the head.

Head injuries include:

  • Concussion, in which the brain is shaken, is the most common type of traumatic brain injury.
  • Scalp wounds.
  • Skull fractures.

Head injuries may cause bleeding:

  • In the brain tissue
  • In the layers that surround the brain

Common causes of head injury include:

  • Accidents at home, work, outdoors, or while playing sports
  • Falls
  • Physical assault
  • Traffic accidents

Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to require a stay in the hospital.

I woke up this morning with sudden back pain?


I woke up this morning with sudden back pain and a low grade fever?


If the fever does persist for more than 2 or 3 days, this may be due to a more serious infection or underlying condition which will require a doctor consultation. An imaging test will then be required as well as further testing after examination. In the meantime if symptoms worsen today or tomorrow, I recommend you visit an ER just to be on the safe side.

Below is a more comprehensive answer:

Causes of back pain and shortness of breath include:

Muscle strain

Muscle strains respond well to rest, ice or heat, and over-the-counter pain relievers, such as ibuprofen or acetaminophen.

A muscle strain typically goes away after a few days, but if it lasts longer, the doctor can prescribe stronger medications, such as a muscle relaxant, to help relieve the discomfort.


Either a virus or bacteria can cause pneumonia. If the pneumonia is bacterial, a person may need antibiotics to clear up the infection completely. Some people may require hospitalization and supportive care to prevent further complications.

Excess Weight

Being overweight means the muscles of the back have to work harder to support the basic activities of daily life. Having extra fat around the chest or back can also make it harder to breathe or take a deep breath.


Gastroesophageal reflux disease occurs when stomach acid backs up into the esophagus and causes chest pain, heartburn, or a sour taste in the mouth.

Simple home remedies, such as not eating before lying down and avoiding common triggers can also help prevent GERD. Potential triggers include acidic foods, citrus, chocolate, coffee, and alcohol.

Gallbladder Disease

If a person has gallbladder stones, they may need surgery to remove the stones or the entire gallbladder. Someone who is susceptible to developing stones should avoid eating fatty foods, which can worsen bile production and increase the likelihood of developing stones.

Aortic Dissection

An aortic dissection occurs when there is a tear in the aorta, causing blood to leak into the vessel walls. This is a very rare condition but causes severe back pain, shortness of breath, chest pain, weakness, and sweating.

An aortic dissection is a life-threatening event that requires immediate treatment. Depending on where the dissection is, emergency surgery may be necessary.

Other Causes Include:

  • Cancer of the spine: A  tumor on the spine may press against a nerve, resulting in back pain.
  • Infection of the spine: A  fever and a tender, warm area on the back could be due to an infection of the spine.
  • Other infections: Pelvic inflammatory disease, bladder, or kidney infections may also lead to back pain.
  • Sleep disorders: Individuals with sleep disorders are more likely to experience back pain, compared with others.
  • Shingles: An infection that can affect the nerves may lead to back pain. This depends on which nerves are affected.
  • Cauda equina syndrome: The cauda equine is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. There are sometimes bowel and bladder function disturbances.

All Americans must start wearing masks right now!

What are Americans waiting for?

People in Asian countries have adopted the use of masks for years now. During the corona virus covid-19 outbreaks in Asia, everyone was obliged to wear a mask (and in some areas still are obliged to do so). That’s how they beat it! The use of a mask is NOT necessarily to protect the user from the virus but to PREVENT the user from spreading the virus to others! It is a very simple and intelligent thing to do. Common sense.

I don’t want to get into the reasons why North American and European governments do not promote the use of masks – that is a political issue – probably due to the fact that too much money is spent on military hardware and little to nothing spent on biological warfare or pandemic protection. Maybe it is because there is no available mass production of masks in America or not an integral part of the American culture – but that’s another issue altogether. So my advice is – WEAR A MASK, WEAR A MASK, WEAR A MASK.

Dr. D. Zluf

Dr. D. Zluf

Pain on lower right side?


Wife has a pin that’s tender to the touch under right side of belly button, feels like a knot or something under there



I have received and read your question. Several conditions can cause an abdominal mass. If your wife is also experiencing pain, vomiting, fever or discoloration, to be on the safe side , it would be preferable you seek out immediate attention such as an ER or emergency clinic. But if that is not the case then the type of mass you are describing may just require a visit to your Doctor. A Right-lower quadrant mass can be a caused by a number of conditions:  hernia, hematoma, cyst, tumour.

Generally speaking a mass needs to be examined by your Doctor. An imaging test will be required – CT scan, Ultrasound, or X ray – depending on symptoms, and where the mass is located and how it feels, your Doctor will recommend the appropriate  imaging test. The results will indicate further course of action.

Below is a more comprehensive answer:

Located on the right lower abdomen are – Bowel, Kidney, Ovary.

Abdominal masses can be the result of a number of factors, including an injury, cyst, benign tumor, cancer, or other disease.

A cyst is an abnormal mass in the body that’s filled with fluid or infected matter. It is sometimes to blame for an abdominal mass.

Cysts that commonly cause abdominal masses include ovarian cysts, which are cysts that form in or around the ovaries.

Cancers that often cause abdominal masses include: colon cancer, kidney cancer, liver cancer, stomach cancer

Certain diseases may also cause abdominal masses. These diseases include:

  •  pancreatic abscess a pus-filled hollow in the pancreas
  • diverticulitis inflammation or infection of the diverticula, common pouches that form in weak places in the intestines and colon
  • hydronephrosis an enlarged kidney due to the backup of urine
  • enlarged liver
  • splenic enlargement
  • IBD Inlammatory bowel disease that causes inflammation of your digestive track lining,
  • abdominal aortic aneurysm, enlargement or protrusion of the large blood vessel that supplies blood to the abdomen, pelvis, and legs


Dr. John Claude

I have been diagnosed with peripheral neuropathy


I have been diagnosed with peripheral neuropathy and my neurologist ordered some blood work to see if there is any cause for my neuropathy. He said there is nothing in my test that shows the cause of my neuropathy. However I see that a couple of my white blood cell counts are high. Is this any cause for concern? Thanks.



High white blood cell count is of course a matter of concern. This indicates there is some other underlying problem. Although the problem may NOT be related to the peripheral neuropathy or causing it.  High white cell count usually indicates your immune system is working to fight off an infection. This could be one of many things. On the other hand, finding the cause of the high count may establish some kind of link to your condition.

It would be a good idea you send us your lab results (your pdf attachment was empty). You should also consult with your primary care physician for a complete check up to try to identify the problem causing the high count.

Below is a more comprehensive answer.

There are many causes of peripheral neuropathy, including diabetes, chemo-induced neuropathy, hereditary disorders, inflammatory infections, auto-immune diseases, protein abnormalities, exposure to toxic chemicals (toxic neuropathy), poor nutrition, kidney failure, chronic alcoholism, and certain medications – especially those used to treat cancer and HIV/AIDS. In some cases, however, even with extensive evaluation, the causes of peripheral neuropathy in some people remain unknown – this is called idiopathic neuropathy.

Other test that can be done to determine the cause of your high white blood cell count are:

  • Bacterial infection: a culture of the affected area (e.g.,urine culture, sputum culture, blood culture), strep test
  • Viral infection: tests for mononucleosis, Epstein-Barr virus
  • Inflammation: CRP (preferred),ESR
  • Autoimmune diseases: ANA
  • Allergies: Alllergy tests
  • Leukemia: B

Dr. John Claude

Will a person suffering from Crohn’s disease be more pre disposed to get MND?


Hi I have become paranoid that my boyfriend is going to develop MND at some point In his life and it’s not that rare and I think because he has crohn’s disease that it will make him more pre disposed to get MND. But if he has a disease already will it make it less likely to happen?


There is no reason to believe that because your boyfriend has Crohn’s disease that there is necessarily a greater chance of developing MND. There is a 1 in 300 risk of getting MND across a lifetime. It can affect adults of any age, but is more likely to affect people over 50. MND often begins with weakness of the muscles in the hands, feet or voice, although it can start in different areas of the body and progress in different ways. It is in hereditary in about 10% of the cases as far as the remaining 90% due to a number of factors including auto immune response issues, exposure to viruses, toxins and ageing of motor neurons. Unless there are existing symptoms which may lead you to believe your boyfriend may suffer from MND, I would not focus on that and stop thinking about it.

Here are some additional factors for your information:

The physical effects of motor neurone disease can include:

  • muscle aches, cramps, twitching
  • clumsiness, stumbling
  • weakness or changes in hands, arms, legs and voice
  • slurred speech, swallowing or chewing difficulty
  • fatigue
  • muscle wasting, weight loss
  • emotional excess – for example, where a slight upset can cause an exaggerated response, such as crying or laughing
  • cognitive change (changes in thought processes)
  • respiratory changes.

Doctors often find it difficult to diagnose MND in the early stages as it can resemble other conditions, such as mutiple sclerosis  (MS). If a doctor suspects someone has MND, they will refer them to a neurologist, who will take a medical history, do a thorough examination, and may suggest other tests, such as:

1. Blood and urine tests: These can help a doctor rule out other conditions and detect any rise in creatinine kinase, a substance that muscles produce when they break down.

2. MRI brain scan: An MRI cannot detect an MND, but it can help rule out other conditions, such as stroke , brain tumour, or unusual brain structures.

3. Electromyography (EMG) and nerve conduction study (NCS): An EMG tests the amount of electrical activity within muscles, while a NCS tests the speed at which electricity moves through muscles.

4. Spinal tap, or lumbar puncture: A doctor will look for changes in the cerebrospinal fluid, which surrounds the brain and spinal cord. It can help rule out other conditions.

5. Muscle biopsy: This can help detect or rule out a muscle disease.

The doctor will normally monitor the individual for some time after the tests before confirming that they have MND.

Dr. Javez Ernesto

We received a Procalcitonin test of 1.6 which appears to be positive. We are not sure how to interpret this result?


My daughter (18h was admitted to the ER a week following surgery for a perilymph fistula repair, exhibiting signs of mental confusion and severe headache, with fear of possible meningitis or sepsis. She was placed on IV antibiotics and blood cultures were sent out. She recovered, although the cultures came back negative, with the procalcitonin test at < 0.2.
6 weeks later she was showing signs of confusion and severe headache again and was re-admitted to the ER, again for fear of infection. She was kept overnight and released after receiving one dose of IV antibiotics. The thought from her surgeon was that since the infection tests were negative the first time that they’ll likely be negative again so she was released. Today we got the tests back and the procalcitonin test was 1.6 which appears to be positive.
We are not sure how to interpret this result. Her surgeon said to contact her PCP and that he didn’t know how to read that test. She continues to have headaches.


Generally speaking a reading of 1.6 would indicate that there some kind of response to an infection or some kind of tissue injury. I would definitely proceed with further investigation to identify what is the cause and source of the problem. Although this does not appear to be an emergency since levels are less than 2. A complete examination by your family physician is needed with appropriate testing depending on the medical history of your daughter and if there are other symptoms present. Here are some other points that need to be considered.

1 : PCT levels may be elevated in patients who do not have sepsis. Plasma levels in these cases
usually are not very high (<2 ng/mL), but they may increase significantly in certain conditions, e.g.
following liver transplantation, during severe and prolonged cardiogenic shock, in patients with heat
shock, severe pancreatitis, and rhabdomyolysis (>2-10 ng/mL).


2 : depending upon the previous clinical history of the patient, labs should be done to determine whether any
clinical problem exists or not.
Nature of labs and investigation of patient should be according to previous clinical history of the
patient If any treatment or any surgery was carried out previously.

3 : if the Procalcitonin ( PCT ) level is less then 2 ( <2.0 ) it doesn’t indicate there is sepsis ( infection )
and thus its not any emergency to rush but it’s the sign that you should consider to have a complete checkup.

Doctor John Claude

I am concerned about having 2 polyps – a benign at 5 mm and a 10 mm Precancerous sessile serrated adenoma polyp?

I am a 65 year old female who just had a colonoscopy 2 weeks ago,  They found 2 polyps, one of which is benign at 5 mm.
The concerning one is 10 mm Precancerous sessile serrated adenoma polyp which was removed.  I read that this type is very serious and is a precursor to colon cancer.  It seems to act differently than most polyps in that it has a different molecular structure that is malignant?
I understand that there is a higher chance of getting colon cancer even if the polyps are always removed.  Is this the case.
Also, when should I have the next colonoscopy?   Any preventative measures?
My dr. is out of town on vacation and I am extremely nervous and worried about this.
Any assistance you can give me is well appreciated…Truth always helps so I can be prepared and ready to monitor etc.
Thank you,


Doctor Answer:

The 10mm polyp is a premalignant lesion of the colon so its not the sign of
cancer but of malignancy, results of biopsy and evaluating the surgeon’s notes are important to understand the risks, whether there is cancer and more aggressive treatments, if any,  are needed. This type of polyp is a little more difficult to deal with, BUT If the polyp was COMPLETELY removed during the procedure and there are no additional elements, just regular follow up colonoscopies will be required 0 the first within a couple of months. Please follow the advice of your Doctor and Oncologist.

Below is a more comprehensive answer.


A sessile serrated adenoma (SSA) is a premalignant flat (or sessile) lesion of the colon,
predominantly seen in the cecum and ascending colon.
SSAs are thought to lead to colorectal cancer through the (alternate) serrated pathway. This
differs from most colorectal cancer, which arises from mutations starting with inactivation of
the APC gene.


Complete removal of a SSA is considered curative.
Several SSAs confer a higher risk of subsequently finding colorectal cancer and warrant more
frequent surveillance. The surveillance guidelines are the same as for other colonic
adenomas. The surveillance interval is dependent on ;
(1) the number of adenomas,
(2) the size of the adenomas, and
(3) the presence of high-grade microscopic features.
Prevention strategy
The usual approach to primary prevention of CRC or neoplastic colorectal polyps is to alter
modifiable risk factors as well as utilize effective nutritional or chemopreventive agents.
While tobacco use is associated with the presence of SSPs, there is relatively little else
known about the primary prevention of SSPs.
The focus of secondary prevention is on high quality surveillance colonoscopy, complete
eradication of SSPs is finally on improving our recognition and understanding of SPS.


How to get rid of chronic pain?

Hello Doctors. I am a 32 year old woman suffering from chronic back pain. I have been to several doctors as well as many specialists and there seems to be NOTHING wrong with me. This has been confirmed by numerous tests – cbc blood test, scans etc .  My question is: Please inform me as to what are my options. What can I do to get rid of this chronic pain I am suffering from? Thank you ahead of time. God bless you.

Hello. In response to your question I think it is important to underline some facts.

At times pain is not caused by anything physically. And it isn’t imagined either. It is real.

Pain can be purely psychological. It is often caused by psychogenic factors meaning pain that’s psychological in origin. It also is possible it starts from fearful thoughts…negative perceptions of ourselves.

There are 100 million Americans who suffer from chronic pain, with back pain, neck pain, fibromyalgia symptoms, or other forms of pain that have no diagnosed physical cause…none whatsoever.

It’s not that their pain is “in their heads.” The truth is much more nuanced: All pain can have both physical and psychological components. But the psychological component is often dismissed or never acknowledged.

Big pharma’s aggressive marketing of pills and the minimal training doctors get in pain medicine mean that for too long, the go-to treatment for many forms of chronic pain has been opioids. Yet opioids have proven to be not only largely ineffective for treating most chronic pain but also highly addictive and risky.

Other forms of therapy do exist for relief of chronic pain

Cognitive behavioral therapy

Cognitive behavioral therapy shows meaningful benefits on chronic pain — both for psychogenic pain, and for pain with a physical cause — according to systematic reviews of the research. There’s also promising research around mindfulness-based stress reduction and therapies inspired by it.

Yet pain psychologists are hard to find and hard to pay for, and most patients don’t even know they exist. “At the moment, they tend to be seen as a route of no hope for the hopeless, for people who have gone through everything else,” says Amanda Williams, a psychological researcher who conducted one of the reviews of studies on the effectiveness of psychological therapy for pain.

Doctors have long known that pain can exist in the absence of any physical harm.

Likewise, doctors have known that pain can be suppressed without any real medical intervention.

“Pain can be ‘real’ pain — and it can be caused by brain circuits,” says Tor Wager, a neuroscientist who studies pain at the University of Colorado Boulder. “We have to get over this concept that either the pain is real or it’s all in my head and I’m making it up.” It’s both. Pain, explained

Chronic pain may start off as an acute injury and then never go away. It could also be the result of nerve problems, or degenerative diseases like arthritis. Some people might be more susceptible to acute pain turning into chronic pain due in part to genetics. And there’s some evidence that differences in brain structure can predict who goes on to develop chronic pain and who does not.

Our thoughts, personalities, and learned behaviors can also influence whether our pain alarms get tripped. So do our emotions.

Overall, the takeaway is that “pain isn’t just something that happens to us,” says Beth Darnall, a professor of anesthesiology at Stanford University. “We are participating with pain by how much attention we give to it, by the contents of our thoughts, and our appraisal. How awful and negative is it? How helpless and hopeless do you feel about it? Do you feel as a victim; do you feel at the mercy of your pain?”

The power of the mind to self-heal.

You might be thinking: Isn’t this all a placebo response? Well, maybe. But don’t dismiss placebos’ healing power. Even powerful painkillers like morphine are much less effective when people don’t know they’ve taken them.

It could be that psychological therapy is kind of like a strong placebo, or that placebo is a weak form of therapy –

the power of healers to cure disease may in fact stem form the psychological effects healers exert on people’s own inner mental placebo effect.

The best evidence base for this is for cognitive behavioral therapy

Considering how dangerous and damaging the past decades of treating chronic pain with addicting opioids has been, and how risky and expensive surgery can be, they’re a worthy option, one that’s never sold to doctors by pharmaceutical representatives or advertised directly to consumers on TV.

The most common psychological treatment for pain, and the most well-studied, is cognitive behavioral therapy, or CBT. Overall, it’s one of the most rigorously tested and effective tools psychology has to offer. More typically, it’s used to treat anxiety, phobias, and mood disorders like depression. But it can also help some people manage their pain.

CBT “helps people change ways of processing their beliefs and their experiences when they are overly negative,” she says.

Alternative treatment therapies have also shown to help with chronic pain… one of which Reiki healing being presently used in hundreds of American hospitals as well as thousands of hospitals throughout the world.

In the brain, emotional pain and physical pain interact. Just as people sometimes turn to opioids to mask their emotional problems, psychological therapy and other healing techniques can help physical pain. “It’s time to recognize that there is so much overlap that we almost can’t treat one without addressing the other,” Darnall, the Stanford professor of anesthesiology, says.

Psychological therapies can get better — and so can access to them

On the bright side, psychological therapies for pain are low-risk. The same cannot be said of medical treatments for chronic pain. Back surgery for lower back pain often backfires. Doctors literally call this “failed back surgery syndrome” — around 20 percent of back surgery patients will still have chronic pain despite successful procedures, which can cost $50,000 or more.

So the best advice to chronic pain sufferers is to explore ALL avenues even those that seem out of the ordinary.

Dr. D. Zluf

Answer by: Dr. D Zluf, Consultant Physician

4 Medical Cannabis – Marijuana Questions To Ask Your Doctor

Medical marijuana is increasingly being introduced as an additional treatment for some conditions but unfortunately your Doctor may not yet be familiar nor perhaps sympathetic to the idea, so before you head out to see your doctor make sure you have done your research.

If you can find documentation that medical cannabis may have helped other people with your condition or is actually being used as a potential treatment, make a copy of the study, article or video and bring it to your appointment.

A reputable source, scholarly journal or academic study is the best way to inform your Doctor and will be your best evidence, but you may also bring along patient testimonials, blog posts or general articles.

Since medical cannabis – marijuana is being used as an additional or alternative treatment, you need to feel confident that your symptoms can be better managed through the use of medical cannabis – marijuana and you need to be able to convey this to your Doctor in terms that she/he can understand.

Here are a few points:

  • Draw up an exhaustive list of all of your symptoms.
  • Indicate which ones can be managed through the use of medical cannabis.
  • Provide a list of all medication and treatments or therapies you have used.
  • Indicate how you responded to each medication, treatment or therapy.
  • Here are 4 questions that you should ask your Doctor:

    1. Given my condition, could medical cannabis be a valid treatment for me?

    2. Is medical cannabis safe for me to use?

    3. Will taking medical cannabis affect my other medications?

    4. What are the side effects?

    As new studies roll out and more jurisdictions legalize the use of medical marijuana, the medical professional will
    be more and more inclined to integrate medical cannabis – marijuana as a treatment option.

    Medical Marijuana and Cancer Treatments: The New Miracle?

    Many people believe that marijuana can help control or relieve some of the symptoms of cancer or the side effects of cancer treatments. But research shows that taking marijuana is not a clear cut solution to minimizing the effects of cancer treatment side effects or pain. However there are studies that show that taking cannabinoids may help.

    Marijuana is not all the same:

    Strains are developed to intensify specific characteristics of the plant, or to differentiate the strain for the purposes of marketing or to make it more effective as a drug or treatment.

    Marijuana contains THC which is a type of cannabinoid but there are many different types of cannaboids. There are at least 113 different cannabinoids isolated from cannabis. Phytocannabinoid tetrahydrocannabinol (THC) and Cannabidiol (CBD) being the two major cannabinoids constituents of the cannabis plant.

    According to cannabis experts, there are at least 779 known cannabis strains in the world. Some strains have been around for a long time. New strains are developed on a regular basis. Many come and go every day. Most strains can be found at a dispensary somewhere in the world. But the sheer volume of strains also increases the difficulty for researchers to properly study the effects of marijuana. With new strains being developed and new claims being made constantly yet never quite actually confirmed through clinical studies.

    Research studies are few and far between. And many are still ongoing.

    What we know about Medical Marijuana so far:

    1. Using medical marijuana, drugs containing cannabinoids or both may help you relax and give you a sense of well-being.

    2. Several studies have shown that some cannabinoids can relieve nausea, vomiting or both. These are side effects of some cancer treatments, including chemotherapy and radiation therapy.

    3. Some people find that medical marijuana can increase their appetite.

    4. Some people claim that medical marijuana can help relieve long-term (chronic) or severe pain.

    Drugs derived from marijuana:

    There are a number of cannabis derived medications available today through prescriptions by your doctor. Some are still in the legal approval process. Others are still in development and clinical tests.

    1. Sativex

    Mouth spray whose chemical compound is derived from natural extracts of the cannabis plant. Sativex contains two cannabinoids: THC (delta-9-tetrahydrocannabinol) and CBD (cannabidiol).

    Used for the treatment of neuropathic pain and spasticity in patients with Multiple Sclerosis (MS); Analgesic treatment in adult patients with advanced cancer who experience moderate to severe pain.

    2. Dronabinol / Marinol

    Synthetic Delta-9 THC.

    Used for the treatment of nausea and vomiting for patients in cancer treatment; appetite stimulant for AIDS patients; analgesic to ease neuropathic pain in multiple sclerosis patients.

    3. Nabilone / Cesamet

    Synthetic cannabinoid similar to THC.

    Used for the treatment of nausea and vomiting in patients undergoing cancer treatment.

    4. Dexanabinol

    Synthetic non-psychotropic cannabinoid that blocks NMDA receptors and COX-2 cytokines and chemokines.

    Is a neuroprotective (protects brain from damage) for use after cardiac surgery; regain memory and other high-level function following Traumatic Brain Injury (TBI); possible future use as an anti-cancer drug.

    5. CT-3 (ajulemic acid)

    Synthetic, more potent analog of THC metabolite THC-11-oic acid.

    Used for the treatment of spasticity and neuropathic pain in MS patients; anti-inflammatory properties may help relieve pain from arthritis.

    6. Cannabinor (formerly PRS-211,375)

    Synthetic chemical that specifically binds to the brain’s secondary cannabinoid receptor (CB2).

    Used as an anti-inflammatory; treatment of chronic pain with an emphasis on neuropathic (nerve) pain; bladder control.

    7. HU 308

    Synthetic chemical that specifically binds to the brain’s secondary cannabinoid receptor (CB2).

    Used for the treatment of hypertension; anti-inflammatory.

    8. HU 331

    Synthetic chemical compound composed of central cannabinoid (CB1), peripheral cannabinoid (CB2), and non-CB receptor-mediated pharmacology.

    Used for the treatment of memory, weight loss, appetite, neurodegeneration, tumor surveillance, analgesia, and inflammation.

    9. Rimonabant / Acomplia

    Synthetic chemical that blocks endocannabinoids from being received in the brain, and, as a result, suppresses appetite.

    Used for anti-obesity (appetite reducer).

    10. Taranabant / MK-0364

    Targets receptors in the brain linked to appetite; acts as a Cannabinoid receptor type 1 (CB1R) inverse agonist, blocking cannabinoid receptors in the brain, which suppresses appetite.

    Used for anti-obesity.

    So is Marijuana the new miracle drug?

    The answer is not simple. With the bulk of research still ongoing and new strains and products in development, we still need to wait to know for sure. But what we know so far is that, yes, marijuana can help in some way. We also know that – like all new products being promoted- it is hard today to differentiate fact from hype.

    Buyer beware!

    How important is your sleeping posture?

    dr jean claude

    How important is your sleeping posture?

    Sleeping postures can have an important effect on your health:

    For such a simple thing, sleeping is not an easy thing to master. From obesity to heart-related issues, multiple things can be associated if your sleeping is disturbed. It turns out that it is not just the quantity of speed but also what posture you sleep in that matters. Your sleeping posture matters a lot so it needs a definite check!


    Some of the sleeping postures and their pros, as well as cons, are described below:

    Back sleepers:

    The good:
    You may be surprised but this is not the most popular sleeping position. Only eight out of every hundred people prefer sleeping on the back. This is although the best position to sleep in. Sleeping on the back allows the neck spine and head to be in a relaxed position. This will lead to minimal pressure on these vital areas. It is also good for patients suffering from gastric acid reflux. Make sure you also add a pillow so that your esophagus always lies higher (superior) than the stomach.

    The bad:
    But this sleeping posture has its cons as well, especially for people who suffer from sleep apnea and snoring. This can lead to an increased incidence of apneic episodes and worsen snoring as well.

    Sleeping on the side:

    The good:
    In this position, the torso and legs are relatively straight but sideways. This is also a good position to sleep as the body is relatively stretched and spine is supported. It helps decrease any acid reflux, neck pain, and back pain. The benefit of this position oversleeping on the back is that it does not cause or worsen snoring. It is the posture of choice for patients with sleep apnea and loud snoring.

    The bad:
    Sleeping on your side can lead to nerve compression and joint pain. This is worse if you are suffering from nerve impingement or rotator cuff injury.

    Fetal position:

    The good:
    Fetal position is one of the most popular sleeping postures. Around 40 percent of all adults prefer sleeping in fetal posture. This includes a person being on side with knees in a bent position. This position is especially good for sleep if the person is pregnant. In pregnancy left lateral fetal position is recommended to increase blood flow to the maternal heart as well as fetal tissues.

    The bad:
    This position is however not good if you have joint problems as it can lead to joint soreness. It also restricts bleeding by not allowing a person’s diaphragm to move properly.


    Stomach position:

    Seven out of every one hundred people sleep on their stomachs. This posture unsurprisingly is one of the worse sleeping postures for your health. It leads to back pain and neck pain. It also leads to unnecessary pressure on your joints, muscles tingling and aches. It is especially recommended to change your habit of sleeping on your stomach if you have spine problems.

    So how exactly should you sleep?
    People mostly try to sleep whatever posture they feel comfortable in. You can experiment with whatever position you feel comfortable with. Each position has its benefits and flaws. It could be difficult to switch from one posture to another suddenly. Always try to consult your doctor first if you feel any changes in your body after you wake up so they may guide you more about your sleeping posture.

    Written by: Dr. Jean Claude, Consultant Physician

    How to have safe sex without protection?

    Hi Doctors, I am a 21 year woman and asking what is the best way to have sex without protections.

    Age: 21
    Medications: None


    STDs are sexually transmitted diseases that are very commonly seen in both the sexes
    especially in sexually active candidates. They are also called as Venereal diseases (VD).
    They spread most commonly by vaginal discharge, semen, blood, body fluids etc. STDs can
    be caused by both virus and bacteria.

    Most common bacteria- associated STDs.

    -Chlamydia : Chlamydia trachomatis is very commonly involved in risk of STDs among the
    -Gonorrhea : affects male and female genitourinary tract.
    -Syphilis / lues : The second stage of syphilis is highly infective followed by the first stage
    which is associated with the chancre on the penis.

    Most common virus – associated STDs.

    -Herpes virus II (HSV II) : Usually involves lower parts and genitals.
    -Human Immunodeficiency Virus (HIV) : AIDS.
    -HPV (Human Papilloma virus)
    -Hepatitis : Most commonly Hepatitis type B

    Signs and symptoms :

    Irritation and rashes in the genitals
    Genital sores
    Discharge from the penis and vagina associated with color change and strong odor
    Severe itching with painful urination
    Genital warts
    Painful intercourse



    DO’s to prevent STDs :

    The best way to prevent STDs is to use protection for every sexual intercourse.
    Although they are not 100% guaranteed to prevent STDs. Earlier it was thought that
    condoms with nonoxynol- 9 are effective in preventing STDs as they are bactericial
    (kills the bacterial organisms) but it was associated with irritation in vagina which
    caused secondary infections.

    Talk freely and honestly with your partner about your health and sexual history and
    get to know theirs as well before any sexual activity. But remember that it is not
    completely reliable as the symptoms may take some time to appear clinically . Also your
    partner may not share and may miss few informations.

    You and your partner can get the tests for HIV done before any activity.

    Timely blood investigations potentially reduces the risk of STDs and also if present it
    can be cured without any complications at an early stage.

    In case of active course of a disease, choosing sexual activities which are less risky is
    wise. It includes masturbation, dry humping, cuddling etc.

    Practicing safer intercourse with the use of female condoms and also gloves for manual
    exploration and penetration. Proper use of new sealed packaged condoms including its
    proper placement without tearing . Read the instructions and manual provided along
    with it for proper use.

    Use of dental dams during oral sex is also helpful.

    If the condoms accidentally breaks during the intercourse due to friction, it is advised
    to take oral contraceptives. And also prophylaxis may be needed if there is a previous
    history of STD. For such incidence, consult your doctors as soon as possible.

    Store condoms at room temperature.

    Keep condoms away from sharp objects.

    Using sterile biocompatible lubricant which does not cause allergy or irritation. Prefer
    water based lubricant as oil based may weaken the latex resulting in tearing during the

    Sex toys and prostheses may serve as a vehicle for STI transmission and should be used
    with a condom or properly cleansed between each use.

    Urination after the activity for females is beneficial as it removes the infectious
    materials reducing the risk of urinary tract infections (UTI).

    Pre-exposure prophylaxis (Pr-EP) and post-exposure prophylaxis (PEP) are effective in
    preventing the transmission of infections such as HIV in patients who are at risk for
    exposure or who have been exposed.

    General hygiene maintenance : This includes proper use of sterile razors, use of clean
    underclothing for intimate hygiene , use of clean sterile towel for cleaning the private
    parts and washing it before and after the intercourse. Other measures includes- daily
    clean bath with use of intimate hygiene wash which helps in maintaining the pH of the
    genital area which maintains normal immunity functions to kill the bacteria and

    Vaccination : They are most commonly recommended for Hepatitis B and human
    papilloma virus. This increases the resistance power against HBV and HPV. Also
    vaccinations for hepatitis A and Herpes are available.

    DONT’s to prevent STDs :

    It is better to avoid love making if any of the symptoms (mentioned above ) are
    encountered . They should be examined by a doctor and investigated. Once cured or
    subsides, it becomes comparatively safer to proceed for intercourse.

    If the disease is already under progress, it is always better to completely avoid until
    the treatment is completed and your doctor gives you an approval.

    Avoid multiple sex partners and avoid contact with sex workers.

    Having any type of unprotected sexual contact with an infected person posses a very
    high risk and chances of getting STD.

    Intercourse must be avoided under the influence of alcohol or drug abuse. Alcohol,
    and some prescription and illegal drugs can interfere with your ability to have a
    conversation and make decisions to have safer sex.

    Anal sex poses a high risk because tissues in the rectum tear easily. Fluids from the body can
    also carry the viruses and bacteria.

    During menstruation, intercourse should be delayed until the cycle gets over. As
    there are higher risks due to direct contact with the blood.

    Avoid sharing same razors , towels and under clothing.

    Female and male condoms should not be used at the same time. Using 2 condoms
    together may result in a condom breaking and tearing.

    Avoid using old expired and broken packaging protections.

    While unpackaging the condoms avoid using scissor or teeth to prevent damage or
    accidental tearing or micro- cuts.

    Do not reuse condoms.

    Avoid oil based lubricants like petroleum jelly.


    Overall to sum up

    Measures can be taken to prevent STDs without the use of protection. But this does not
    significantly reduce the risk .

    Use of protection along with other measures greatly reduces the risk but it is not 100%
    effective especially during the active course of the disease.

    Over-all immunity markedly varies from person to person. It plays a primary role in
    prevention and cause of any disease.

    If the partner feels unsafe for love making. It is necessary to respect them and accept it. After
    all proper healthcare and healthy practices plays a huge role in healthy and happy life.!!!

    Dr. D. Zluf

    Answer by: Dr. D Zluf, Consultant Physician

    My wife had a cervical stitch procedure done. What to do now?

    Question: My wife had a cervical stitch procedure done in the 19th week of pregnancy. She is now almost 37 weeks old and doctors oppose the removal of the suture. The last time the cervical length measured in week 23 was 36 mm. We suspect that he did this to encourage the delivery of a caesarean section. Do we have to get a second opinion in this case? My wife does not like going to cesarean section unless absolutely necessary. What to do now?

    Age: 37
    Medications: NA

    Answer: After inserting the cervical suture( to prevent pregnancy or premature birth), the goal is to remove it after the woman enters the latency phase or works actively in the workspace. There is no reason to have it withdrawn earlier so she can return home because this renews possibility of labour.. Once again, it is not related to cervical suture. If the baby is in proper position delivery must be performed. But if there is asynclitic (first shoulder) or non-progressive labor or fetal burden at birth or a tight neck strap, as determined by ultrasound and based on NST (non-stress test), then only cesarean section is planned and not due to the cervical suture. So she is right not to get rid of it now and continue with intent to deliver. You can actually wait until finished 40 weeks plus 3 days to start natural labor.