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Is Monkeypox the New Covid? Here’s all you need to know

Is Monkeypox the New Covid? Here's all you need to know

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Source: Reuters

Last week, on the 23rd of July 2022, Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general declared the rising monkeypox cases as a global health emergency. 

If you are wondering what exactly this new virus is, what are its symptoms and how to protect yourself against it, keep reading to uncover the answers to your questions!

What is Monkeypox

What is Monkeypox?

Monkeypox is the disease caused by the monkeypox virus, which belongs to the variola family of viruses (same family as the virus that causes smallpox).

The first traces of human cases of monkeypox dates back to 1970 to a 9-month-old boy in the Republic of Congo. Ever since then, monkeypox cases have been confined to the Central and Western African regions. It was only in 2003 that monkeypox cases began to emerge outside of Africa: the first instance of which was in the USA, where there were cases amongst pets. Fast forward to 2022, more than 15,000 cases have since been discovered in several countries within the year, including the UK, India, Spain, Australia and Singapore.

What are the symptoms of monkeypox?

  • Rash that looks similar to pimples and blisters, appearing on the face, inside the mouth and on body parts such as hands, feet, chest, genitals or anus.
  • காய்ச்சல்
  • தலைவலி
  • Muscle aches and backaches
  • Swollen lymph nodes
  • Chills
  • Exhaustion
Monkeypox symptoms

How does monkeypox spread?

The virus is transmitted via respiratory secretions, droplets and skin to skin contact. You are at high risk especially if you come into contact with broken skin, eyes, nose or mouth of a person infected with monkeypox. Furthermore, monkeypox can also be spread when in contact with virus contaminated objects like bedding and clothing. In addition, although there hasn’t been any scientific evidence that monkeypox is transmitted via sexual fluids, patients with the virus are advised to use condoms during sexual intercourse for eight weeks as a precaution after being infected.

Is there a treatment for monkeypox? Is there a vaccine?

Vaccination against smallpox has proved to be 85% effective in monkeypox prevention. 

Monkeypox is a disease where the presenting rash goes through  multiple stages of healing – typically, symptoms last between 2-4 weeks. Although there have been more severe cases (some leading to death) that were reported in Africa, most cases are mild, sometimes similar to chickenpox. 

How many monkeypox related deaths are there?

As of June 2022, there have been 1595 cases which resulted in 72 deaths in the African Region as a result of monkeypox. 

Should Sri Lankans be worried?

There have been 4 monkeypox cases identified in India so far. If the spread in India tends to rise, Sri Lanka is also at a potentially high risk of a monkeypox outbreak. It is also possible that foreign travellers from other countries could import the virus to the country.

As seen visibly we have forgotten the basic safety rules that we strictly abided by in early 2020, so it’s best to start our healthy habits once again. Safety first, it’s important for us to protect ourselves and carefully identify symptoms to prevent its spread in our country. 

How to prevent catching monkeypox

  • Avoid skin-to-skin or close contact with people who have a rash that looks similar to monkeypox
  • Do not touch the rash or scabs of an infected person 
  • Do not share eating utensils with an infected person 
  • Do not touch bedding, towels or clothing of an infected person
  • Practice hand washing with soap and water or use an alcohol-based hand sanitizer
Preventing monkeypox

Please stay alert if you or anyone you know experiences these symptoms. By doing so, you can take necessary precautions to prevent a serious spread in our country. Stay safe and alert!

You can consult a GP via the oDoc app if you think you have the above symptoms or need further information from a medical professional.

References

  1. About Monkeypox, CDC (2022)
  2. Multi-country monkeypox outbreak in non-endemic countries, WHO (2022)
  3. Multi-country monkeypox outbreak: Situation update, WHO (2022)
  4. India’s 4th Monkeypox Case: Symptoms, Jabs and Global Outbreak Explained, NDTV (2022)
  5. What is monkeypox and how do you catch it? BBC, (2022)
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Is Indigestion Preventable?

Is Indigestion Preventable?

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Ever felt full or bloated after a meal? Ever felt a burning sensation in your stomach right before a delicious meal? Or ever been on a first date where your stomach started making weird, AUDIBLE noises? (Shut up, stomach. Please). If you answered yes to any of these questions, there’s a high chance that indigestion is making your stomach a battlefield! It’s not a great feeling, we know! Read on to discover why this uncomfortable indigestion issue occurs and what you can do to treat it.

painful indigestion

What is indigestion?

Indigestion, dyspepsia or an upset stomach is a persistent pain in your upper abdomen.

Symptoms of indigestion

  • Burning in the stomach or upper abdomen
  • Abdominal pain
  • Feeling bloated
  • Belching and gas
  • Growling stomach
  • Nausea and vomiting
  • An acidic taste in the mouth

How does indigestion occur?

Indigestion occurs when your stomach acid comes into contact with mucosa, the lining of your digestive system. This causes the stomach acid to break down the lining, resulting in irritation and inflammation, which is the painful, burning sensation related with indigestion.

Causes of indigestion

The popular saying, “Too much of anything is good for nothing” applies to indigestion as well.

  • Lifestyle decisions like overeating, eating too quickly, eating fatty or spicy foods are directly linked to indigestion. 
  • Overconsumption of caffeine, alcohol, chocolate and carbonated drinks.
  • Smoking, certain antibiotics and overconsumption of pain relievers 

 

causes of indigestion

Here are some other conditions that cause indigestion

  • Gastritis
  • Peptic ulcers – These are open sores that develop on the inner lining of your stomach and upper portion of your small intestine
  • Celiac disease – It is a condition where your immune system attacks your tissues when you consume gluten
  • Gallstones
  • Stomach cancer
  • Intestinal blockage
  • நீரிழிவு
  • கற்பம் தரித்தல்

This is not an exhaustive list of the underlying causes that could cause indigestion. Please consult a gastroenterologist (via the oDoc app) to diagnose the causes for your indigestion for early detection of any other serious underlying conditions.

Is indigestion and gastritis the same thing?

The symptoms of indigestion and gastritis are similar and you may often get confused between the two. However, while indigestion occurs as a result of stomach acid, the main cause for gastritis is a bacteria called Helicobacter pylori.

How do you diagnose indigestion?

A gastroenterologist will first go through your medical history and discuss with you your presenting signs & symptoms. To ascertain  the causes of your indigestion, they  may  prescribe several blood tests and/or X rays of your stomach and small intestine. There are times when your doctor may recommend you to conduct an upper endoscopy to look closely at the inside of your stomach.

What can you do to prevent it?

Foods to avoid

  • Acidic foods like oranges and tomatoes
  • Foods and beverages that contain caffeine

Here are some tips that you can follow:

  • Eat meals in small portions so that your stomach doesn’t have to work too hard to digest it.
  • Practise eating your food slowly.
  • If stress and anxiety bring about your indigestion, take a look at our blog on ways to manage your anxiety.
  • Try quitting smoking and cutting back on consuming alcohol as these irritate your stomach lining.
  • Avoid lying down as soon as you eat
  • Do not exercise with a full stomach.
  • Wait a minimum of three hours after your last meal for the day before going to sleep.
how to prevent indigestion

Indigestion treatment options

If your indigestion does not go away, certain over-the-counter medicines and antacids may help. Please consult a gastroenterologist to know what medicines can help you. You can do so via oDoc from the safety and comfort of your home.

Things to watch out for

If you experience these symptoms, immediately consult a gastroenterologist as it may indicate serious health complications.

  • Vomiting or blood in vomit
  • Black, tarry stools or visible blood in stools
  • Severe abdominal pain
  • Discomfort which is not related to eating
  • Weight loss 
  • Loss of appetite

You can download the oDoc app today for comfortable and convenient consultations with gastroenterologists in the comfort of your home.

References

  1. Indigestion – Symptoms and Causes, Mayo Clinic (2021)
  2. Indigestion – Illnesses and conditions, NHS Inform (2021)
  3. Indigestion – Diagnosis and Treatment, Mayo Clinic (2021)
  4. Indigestion (Dyspepsia): Symptoms, Causes, Diet, and Treatment, Web MD (2022)
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The New Diet in Town – Intermittent Fasting

The New Diet in Town – Intermittent Fasting

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Intermittent Fasting

You: Why aren’t you eating lunch?

Co-worker: Oh I’m skipping lunch,  it’s just this new diet I started. It worked so well for my cousin. She lost 10 kilos! It’s called intermittent fasting.

Sounds familiar? In recent years, we’ve heard chatter about intermittent fasting on social media, our social media circles and health blogs. 

What is intermittent fasting? Is it healthy? Will it lead to other health problems? Whether it’s intermittent fasting for weight loss, overall health or lowering your blood sugar, keep reading to find out all the details about intermittent fasting. 

What is Intermittent Fasting?

Intermittent fasting is an eating pattern that cycles  between periods of fasting and eating. It doesn’t necessarily involve omitting certain food types to achieve your weight loss goals but focuses more on when you should eat vs what you should eat (that means you don’t have to say goodbye to cake forever, yay!)  AKA, in a typical intermittent fast, you will eat for a certain period of time and you will fast for a certain period of time. During fasting, you eat very little or nothing at all. 

Let’s look at some popular intermittent fasting methods: 

  1. The 16/8 method (popular with beginners)

With this, people generally skip breakfast but maintain their regular eating period for  8 hours. For example, you could only eat between 12 pm – 8 pm. After 8pm, you will be fasting for 16 hours until you can eat next.

         2. The 5:2 diet 

This dietary plan involves only consuming 500-600 calories during two non-consecutive days of the week. You can eat as you usually do on the other five days. 

         3. Eat-Stop-Eat (best for advanced/experienced fasters)

Eat-Stop-Eat requires fasting for 24 hours, usually once or twice every week. For instance, you would not eat anything between lunch on one day and lunch the next day. 

Please consult with a nutritionist before you begin the above diets.

 

Intermittent Fasting Balanced Diet

So, does it really work? 

40 studies found that subjects lost 3-5 kilos over ten weeks after an intermittent fasting period. Another study with 30 participants, including obese individuals, who practised intermittent fasting over 12 weeks achieved a 6.5% reduction in weight. That’s a sweet deal, isn’t it?

How often should you practise intermittent fasting?

Usually, the intermittent fasting period is for 16 or 24 hours daily, twice a week. It is recommended that you start slow if you are a beginner. For example, you can start with the 16/8 method (scroll up for more details). Refer to the FAQs below to find out if intermittent fasting is right for you.

How does it impact your body?

During this fasting process, your body adapts your hormone levels to make stored body fat more usable. In a nutshell, this is what happens:

  • Your growth hormone increases significantly. This helps in fat loss and even muscle gain.
  • Insulin sensitivity improves, decreasing your insulin levels (so, this is beneficial for diabetic patients) . Again, this causes your stored body fat to be more accessible. 
  • Hence, a fat-burning hormone, norepinephrine, is released, resulting in weight loss.
  • Whenever you fast, your cells begin a repairing process called autophagy where your cells digests and removes old and dysfunctional proteins building up in cells.
  • Your metabolic rate will also rise by 3.6-14%! 
How intermittent fasting works

Is it unhealthy for women?

Intermittent fasting involves hormonal changes to occur. Since hormones play a huge role in fertility and reproduction it is important to be cautious.  The hormonal changes that occur during the fast may impact your oestrogen, thyroid and cortisol hormones, resulting in low energy, reduced skin and hair health, etc. 

However, intermittent fasting can be practised by women in a healthy manner to avoid hormonal imbalances from happening. As per Flo Living, here are some tips you can follow.

  • Avoid fasting on consecutive days
  • Do not fast for over 12-13 hours at a time
  • Hold off intense workouts on fasting days
  • Do not fast when you’re menstruating 
  • Choose the best diet for your hormonal health

Now, onto some of the most common question everyone has about intermittent fasting

The most important one of the lot: Is intermittent fasting healthy?

As mentioned above, intermittent fasting has a range of health benefits. However, here are some common questions people have related to intermittent fasting plans;

Does intermittent fasting cause digestive issues?

The reduction in food intake may cause constipation, bloating and diarrhoea in some cases. However, a sufficient fibre intake will alleviate this.

What are the side effects?

Hunger, mood changes and dehydration are some side effects of intermittent fasting. However, carefully sticking to the necessary fasting periods, not exceeding them and ensuring water intake throughout the day will help you successfully practise intermittent fasting.

Please do consult a doctor before practising intermittent fasting if you are 

  • Underweight
  • Having a history of eating disorders
  • Having diabetes
  • Having low blood pressure
  • Taking medications
  • A woman who is trying to conceive
  • A woman having a history of amenorrhea
  • Pregnant / Breastfeeding

Finally, after prolonged intermittent fasting, if you are experiencing extreme hunger, headaches, fatigue, and faintness, it is recommended to stop this eating pattern.

If you have a particular weight loss goal or any doubts about your diet for your intermittent fasting plan, you can consult dieticians from the comfort of your home via oDoc

References

  1. Intermittent Fasting 101 – The Ultimate Beginner’s Guide, Healthline (2022)
  2. Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials, RV Seimon, JA Roekenes, Jessica Zibellin, Benjamin Zhu, AA Gibson, AP Hills, RE Wood, NA King, NM Byrne, Amanda Sainsbury (2015)
  3. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial, KA Varady, Surabhi Bhutani, MC Klempel, CM Kroeger, JF Trepanowski, JM Haus, KK Hoddy and Yolian Calvo (2013)
  4. 9 Potential Intermittent Fasting Side Effects, Healthline (2021)
  5. Intermittent Fasting and Hormonal Health: What You Need to Know, Flo Living (2021)
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Pedal Power: Health Benefits of Cycling

Pedal Power: Health Benefits of Cycling

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Fuel shortage in Sri Lanka leads to more cycling

In a state where public transport has also been limited, and bus ticket prices have risen exponentially, the lack of transport options has made daily commuting and travelling during emergency situations increasingly difficult. As a result, walking and cycling have become almost the only choice for many Sri Lankans.

Cycling is a low-impact aerobic exercise that offers a wealth of benefits. It is a great exercise that keeps you moving and helps establish a physically and mentally healthy lifestyle.

1. Cycling can help you lose weight

Cycling is a great aerobic workout that burns calories and helps people lose weight and belly fat. To lose weight, you must burn more calories than you take in. Depending on your intensity and weight, cycling can burn between 400 and 1000 calories each hour.

Body parts that are exercised, targeted, toned, and used while cycling

  • Foot: Ankle dorsiflexion and plantar flexors
  • Arms: Triceps and biceps 
  • Shoulders: Deltoids
  • Calf: Gastrocnemius and soleus
  • Buttocks or Gluts: Gluteus minimus, gluteus maximus, and gluteus medius
  • Thigh: Quadriceps and hamstrings

2. Cycling boosts mental health and brain power

Cycling can ease feelings of stress, depression, or anxiety as it may help take your focus away from the mental chatter of your day.  When cycling, concentrating on the road or your cadence might help you improve your attention span and awareness of the present moment. Here are a few ways cycling could boost your positive mental health.

  • It improves your mood. Cycling increases blood flow throughout your body, allowing endorphins and other feel-good chemicals like dopamine, norepinephrine, and serotonin to spread quickly.
  • It promotes positive mental health. Exercise is known to have significant effects on self-esteem, sadness, anxiety, and stress. Still, cycling has been identified as one of the most beneficial exercises for the head and heart.
  • It helps you sleep better. Regular riding helps synchronise your circadian rhythm and can help to reduce levels of stress hormones that can make proper regenerative, deep sleep difficult.
  • Improves your memory. Riding a bike helps build new brain cells responsible for memory. 
  • Improves creative thinking. The regular, uniform movement of cycling relaxes the brain, stabilising both physical and mental functions.
  • Cycling promotes new thought patterns that promote feelings of calm and well-being. You can use it as a type of meditation and a great way to “zone out.”
benefits of cycling

3. Cycling improves balance, posture, and coordination

As you stabilise your body and keep your bike upright, you’ll improve your overall balance, coordination, and gait.

Maintaining balance is important because it tends to deteriorate with age and inactivity. Therefore, enhancing your balance can help lower your risk of injury and keep you off the sidelines by preventing falls and fractures.

correct posture of cycling

4. Cycling can reduce the risk of heart diseases

Regular cycling stimulates and improves your heart, lungs and circulation, reducing your risk of cardiovascular diseases such as strokes, high blood pressure and heart attacks.

Cycling also helps your cardiac muscles become more robust and lowers your resting pulse and blood fat levels.Additionally, research shows that people who cycle to work have a lung function that is two to three times better than those who commute by car.

Drawbacks of cycling and safety

Cycling has a few disadvantages to consider, and these primarily relate to cycling outside, which involves factors beyond your control.

There could always be a risk of an accident, whether in an urban or rural area. Hence, 

  • Obey the law at all times. Even if you have the right of way, exercise caution when passing through crossroads and crowded locations. Invest in a good helmet and any other necessary safety equipment.
  • Avoid wearing any loose clothing that could get caught in your bike chains.
  • Unfavourable weather might also be a barrier. So, invest in rain and cold weather gear and have a backup transportation plan for when conditions are unsafe for riding.
  • For extended daytime rides, use sunscreen on all exposed skin.
  • Take a break if you experience pain, fatigue, or muscle soreness.
  • If you have any cycling-related injuries, staying off the bike is best until you fully recover.
tips for cycling safely

The bottom line

Given the current situation in Sri Lanka, cycling to your destination may seem like the only option. However, just play it safe and use caution when necessary, especially on busy roads or during unfavourable weather.

If you have any injuries or need clarification regarding conditions that cycling may affect, speak to a general practitioner or a physician via the oDoc app.

Sources

  1. 15 benefits of cycling: why cycling is great for fitness, legs and mind, Cycling Weekly (2022).
  2. 12 Benefits of Cycling, Plus Safety Tips, Healthline (2021).
  3. Cycling – health benefits, Better Health (2021).
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Management Of Common Headache Disorders In Adults

Management Of Common Headache Disorders In Adults

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    Written by Dr. Namal Lasantha Ulluvisheva

Headache is a common medical condition worldwide. Physicians need to evaluate adult patients with acute headaches to determine whether the condition is benign (harmless) or if it indicates the features of life-threatening neurological or other systemic illness.

Approximately half of the adult population is affected by a headache disorder. Physicians are faced with many challenges in differentiating primary headaches (tension-type, migraine, cluster headache) from secondary headaches (those caused by infection or vascular disease). Hence, a thorough history, physical examination, and understanding of the typical features of primary headaches can reduce the patient’s cost of unnecessary investigation and intervention like neuroimaging, lumbar puncture, or other laboratory studies.

But if you experience frequent headaches, you might have a chronic headache. Unlike a specific headache type, chronic headaches include subtypes. The constant nature of this headache makes it one of the most disabling headache conditions. However, aggressive initial treatment and steady long-term management could help alleviate the pain.

Causes of chronic headaches

The causes of many chronic headaches are not well-understood. Primary chronic daily headaches don’t have an identifiable cause.

Conditions that might cause non-primary chronic daily headaches include:

  • Inflammation or vascular disorders in the brain, including stroke
  • Infections, such as meningitis
  • High Intracranial pressure
  • Brain tumour
  • Traumatic brain injury

Common Chronic Headache types are,

  • Migraine
  • Tension-type headache
  • Cluster Headache
  • New daily persistent headache
  • Medication overuse headache
  • Sinusitis associated headache
headache types

Cluster Headache – relatively rare

Severe or very severe unilateral orbital, supraorbital  or temporal pain may last 15 to 180 minutes (if untreated).

Headache is accompanied by at least one of the following

  • Conjunctival  injection, lacrimation, nasal congestion or rhinorrhea, eyelid edema,
  • Forehead and facial sweating, miosis or ptosis, restlessness or agitation

Tension-type headache – These headaches tend to:

  • Affect both sides of your head
  • Pain – Mild to moderate intensity
  • Pain that feels pressing or tightening but not pulsating

Migraine – This type typically occurs in people with a history of episodic migraines. 

Chronic migraines tend to:

  • Affect one side or both sides of your head
  • Have a pulsating, throbbing sensation
  • Cause moderate to severe pain

And they might have at least one of the following:

  • Nausea, vomiting or both
  • Sensitivity to light and sound(Photophobia & Phonophobia)

New daily persistent headacheThese headaches come on suddenly, usually in people without a headache history. They become constant within three days of the onset of the first symptoms. 

  • Often affect both sides of your head.
  • Cause pain that feels like pressing or tightening, but not pulsating
  • Cause mild to moderate pain
  • It might have features of chronic migraine or chronic tension-type headache.

Medication overuse headacheThis type of headache usually develops in people who have an episodic type headache disorder, usually migraine or tension-type, and are taking too much medication for their pain. If you’re frequently taking pain medications, even over-the-counter (generally more than two days a week), you will be at risk of developing rebound headaches.

Risk factors

Factors associated with developing frequent headaches include:

  • Female sex
  • பதற்றம்
  • மனச்சோர்வு
  • Sleep disturbances
  • அதீத உடல் பருமன்
  • Snoring
  • Overuse of caffeine
  • Overuse of analgesic medication
  • Other chronic pain conditions

Diagnosis

Your doctor will evaluate the symptoms and examine you for signs of underlying medical conditions such as infection, neurological problems, etc. If the cause of your headaches remains uncertain, your doctor might order imaging tests, such as a CT or MRI scan of the brain, to look for an underlying medical condition.

Prevention

Taking care of yourself might help ease chronic daily headaches.

Avoid headache triggers.

  •  Keeping a headache diary can help you determine what triggers your headaches to avoid the triggers.
  • Include details about every headache, such as when it started, what you were doing at the time and how long it lasted.

Avoid medication overuse. 

  • Taking over-the-counter medications more than twice a week can increase the severity and frequency of your headaches.
  • Consult your doctor about how to wean off the medication because there can be severe side effects if taken improperly.

Get adequate sleep. 

  • The average adult needs 7-8 hours of sleep a night, and it’s best to go to bed and wake up simultaneously every day. 
  • Talk to your doctor if you have sleep disturbances, such as snoring.

Don’t skip meals. 

  • Eat healthy meals at the same time daily. Avoid food or drinks, such as those containing caffeine that triggers headaches. 
  • Try to lose weight if you are obese or overweight.

Do regular exercise.

  • Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. 

Reduce stress.

  • Stress is a common trigger of chronic headaches, so get organised, simplify your schedule, plan ahead and stay positive.
  • Try stress-reduction techniques, such as yoga, tai chi or meditation.
preventing headache

When to see a doctor

Occasional headaches are common and usually require no medical attention. However, consult your doctor if:

  • You  have two or more headaches a week
  • You are required to take a pain reliever frequently
  • You need more than the recommended dose of over-the-counter pain remedies to relieve your headaches
  • The pattern of pain and headaches intensity has worsened
  • Headaches interrupt your daily routines

Seek prompt medical care if your headache:

  • Is sudden and causes severe pain
  • Accompanies a fever, neck stiffness, confusion, seizure, double vision, any limb weakness/numbness or difficulty speaking
  • Follows a head injury
  • Gets worse despite rest and pain medication

Treatment

Treatment for an underlying condition is the definitive management of chronic headaches. If the doctor cannot find such an etiological condition, treatment will be focused on symptom relief and prevention of pain.

Prevention strategies may vary depending on your headache type and whether medication overuse contributes to your headaches. If you take pain relievers more than three days a week, the first step might be to wean off these drugs with your doctor’s instructions.

After a detailed evaluation of the symptoms and signs, your doctor may recommend various medications depending on your clinical profile.

Coping and support

Chronic headaches can interfere with your day-to-day activities, relationships and quality of life. 

  • Have self-control – Commit yourself to living a full, satisfying life and discuss with your doctor to develop a treatment plan for you while doing things that lift your spirits.
  • Reach out to support groups. You might find it helpful to talk to other people who have chronic headaches.
  • Consider counselling. A counsellor/psychologist will support you, and they help to manage your stress. Additionally, there is evidence that cognitive-behavioural therapy can reduce headache frequency and severity.

In these difficult times, it is vital we look after ourselves and our loved ones. If you or anyone you know is suffering from any of the above-mentioned symptoms you can speak to an on-demand doctor on oDoc from the comfort of your home. 

Dr Namal Lasantha Ulluvisheva

General Physician

SLMC 19165

Sri Lanka Navy – Ministry of Defence 

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