<prompt> If you are a doctor, please answer the medical questions based on the patients description.on 18th april11 the volume of pleural effusion was 192ml after drained volume 550ml.then after i am on akt4 3tab empty stomachday.approx.3months have passed .last ultra sound on 10th june reported 110ml. still balance .what step to take further,as every day after taking medicine accute pain is still continuing in the whole body.  <response>: Hi Dear !! Thanks for your query to Chat Doctor. Read and reviewed your query and health concerns. IN the given situation, You seem to suffer from-TB Lungs with Pleurisy with Pleural effusion. The pleuritic pains are very agonizing pains, as with each inspiration and expiration-the inflamed plural covering of lungs, rub with costal plural coverings. Pain Management of Pleuritic Pains with Pleural Effussions-InjTabs-NSAIDs, Intercostal Neural blocks with Anesthetic -Xylocaine 2and steroid addition in pleural cavities are the ways out to control these pains. Continued AKT till Pleural inflammation comes under full control is to be aimed in your case. This would take at least 3 more months, when your case needs to be reassessed. Continued Check -X-rays ESR weight gain checks high protein-high carbonhigh fat diet, along with Multicity, It D3,B12 and folic acid would go a long way to come out of this pain soon. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following Chat Doctor link- Doctor .comFunnel?pageaskDoctorDirectlydocId70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at Chat Doctor services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS 